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Öğe Asymmetric septal hypertrophy with perimembranous septal defect and obstructive right ventricular outflow tract in a patient with hypertrophic cardiomyopathy(2007) Seyfeli, Ergun; Akgül, Ferit; Seydaliyeva, Tunzale; Duru, Mehmet; Yalçın, FatihThe previous echocardiographic studies have estimated the prevalence of hypertrophic cardiomyopathy (HCM) in the general population to be 0.2% (1). Asymmetric hypertrophy of the left ventricle, predominantly of the septum and anterior wall of the left ventricle, is present in 70 % of patients with HCM. However, right ventricular outflow obstruction with the left ventricular outflow tract intact is a very rare pathology (2). In addition, certain congenital cardiac malformations have been reported in patients with asymmetric septal hypertrophy (ASH) (3). To our knowledge, there are no studies and case reports, which show association between obstructive right ventricular hypertrophy and ASH with perimembranous ventricular septal defect (VSD). We present an ASH case with perimembranous septal defect and obstructive right ventricular hypertrophy.Öğe Decreased heart rate variability in scikle cell disease: Effect of pulmonary hypertension(2011) Akgül, Ferit; Batyraliev, Talantbek; Seyfeli, Ergün; Seydaliyeva, Tunzale; Gali, Edip; Yalçın, FatihKalp hızı değişkenliğinin (KHD) kompüturize analizi, kardiyak anatomik fonksiyonu tayin etmede non-invaziv bir yöntemdir. Azalmış KHD çeşitli hastalıklarda ve normal populasyonda, artmış mortalite hızı ile birliktedir. Bu çalışmanın amacı, orak hücreli hastalığa (OHH) sahip olan hastalarda KHD yi ve pulmoner hipertansiyonun KHD üzerine etkisini araştırmaktır. Biz doppler ekokardiyografiyi kullanarak OHH ya sahip 61 hastada (yaş ortalaması, 18.3±8.0 yıl) ile sağlıklı 22 bireyde (yaş ortalaması, 19.3+7.1 yıl) pulmoner arter sistolik basıncını ölçtük. Düşük frekanslı power (DFP) ile yüksek frekanslı power (YFP) orak hücreli hastalıklı hastalarda kontrol grubuna göre düşüktü. Buna karşın düşük frekanslı power ile, yüksek frekanslı po-werin oranı (DFP/YFP) orak hücreli hastalığı bulu-nanlarda artmış idi (p<0.0001). Orak hücreli hastalıklı hastalar arasında pulmoner hipertansiy-onlu hastalar, pulmoner hipertansiyonu bulunmayan hastalardan daha düşük YFP çok daha yüksek DFP/YFP oranına sahipti (her biri için p<0.001, p<0.05 ). Buna rağmen, Pulmoner hipertansiyonu ve pulmoner hipertansiyonsuz OHH lı hastalar arasında DFP yönünden fark yoktu. Kalp hastalığı preklinik devresinde olan, özellikle pulmoner hipertansi-yonu bulunan OHH hastalarda, KHD önemli ölçüde azalmıştır. Kalp hızı değişkenliği, pulmoner hipertansiyon-lu hastaların erken tanısı için bilhassa faydalı olabilir. Zira, bu hastanın kötü prognoz ve yüksek mortalite riski altında olduğuna işaret edebilir.Öğe Elastic properties of the aorta in patients with erectile dysfunction: assessment by conventional and color tissue Doppler echocardiography(Turkish Soc Cardiology, 2006) Seyfeli, Ergun; Gorur, Sadik; Akgul, Ferit; Gur, Mustafa; Seydaliyeva, Tunzale; Yalcin, Fatih; Kiper, Ahmet NamikObjectives: It has been suggested that erectile dysfunction (ED) may be the first clinical reflection of vascular disease. We investigated the stiffness and elastic properties of the aorta by conventional and color tissue Doppler echocardiography (TDE) in patients with ED of vascular origin. Study design: Thirty male patients with ED (mean age 52 +/- 8 years; range 41 to 73 years) were studied. Systolic and diastolic aortic diameters were measured by M-mode echocardiography to asses elastic properties of the aorta. Tissue Doppler velocities (S, E, and A cm/sec) of the upper and inferior aortic wall were measured by color TDE. Aortic strain and elasticity, and aortic stiffness index (ASI) were calculated. The results were compared with those of 30 healthy male controls (mean age 49 years). Results: Systolic and diastolic pressures and aortic systolic and diastolic diameters differed significantly between the two groups (p=0.001, p=0.034, p=0.045, p=0.004, respectively). Compared to controls, ASI was significantly higher (p=0.007), and aortic strain (p=0.002) and S wave velocity of the upper wall (p=0.001) were significantly lower in patients with ED. Significant correlations were found between S wave velocity of the upper wall with ASI (r=0.389, p=0.004), aortic strain (r=0.444, p=0.001) and elasticity (r=0.504, p<0.001), and between S wave velocity of the mitral lateral annulus and ASI (r=-0. 472, p<0.001) and aortic elasticity (r=0.533, p<0.001). Conclusion: Erectile dysfunction of vascular origin is associated with increased aortic stiffness and decreased aortic elasticity, this may foreshadow other vascular system diseases having a silent course.Öğe Erratum: Giant left atrium mimicking a right thoracic mass: Case report (Journal of the American Geriatrics Society (2006) 54, (183-184))(2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[No abstract available]Öğe Giant left atrium mimicking a right thoracic mass: Case report (vol 54, pg 183, 2006)(Blackwell Publishing, 2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[Abstract Not Available]Öğe Increased QT dispersion in sickle cell disease(Karger, 2007) Akgul, Ferit; Seyfeli, Ergun; Melek, Ismet; Duman, Taskin; Seydaliyeva, Tunzale; Gali, Edip; Yalcin, FatihBackground: QT dispersion has been proposed to be a predictor of adverse outcomes in a variety of cardiac disease states. The objective of this study was to examine QT dispersion in patients with sickle cell disease (SCD) and to assess the effect of pulmonary hypertension (PHT) on QT dispersion. Methods: We performed Doppler echocardiographic assessments of pulmonary artery systolic pressure in 73 (mean age 18.5 +/- 8.0 years) steady-state SCD patients and 25 (mean age 19.6 +/- 7.2 years) healthy subjects. Resting 12-lead electrocardiogram was recorded and QT dispersion was calculated as the difference between maximum and minimum QT intervals. Bazett's formula was used to obtain a rate-corrected value of the QT interval (QTc). Results: Maximum QTc, minimum QTc and QTc dispersion were significantly increased in SCD patients compared to the control subjects (p < 0.0001, p < 0.05, p < 0.0001, respectively). Among SCD patients, patients with PHT had higher maximum QTc and QTc dispersion than patients without PHT (p < 0.0001). However, minimum QTc showed no significant differences between the two patient groups. Conclusion: QTc dispersion is significantly increased in SCD patients, especially those with PHT indicating regional inhomogeneity of ventricular repolarization. Copyright (c) 2007 S. Karger AG, Basel.Öğe Right ventricular and pulmonary function in sickle cell disease patients with pulmonary hypertension(Springer, 2006) Akgul, Ferit; Yalcin, Fatih; Babayigit, Cenk; Seyfeli, Ergun; Seydaliyeva, Tunzale; Gali, EdipThe effects of sickle cell disease (SCD) on right ventricular (RV) and pulmonary function in SCD patients with pulmonary hypertension is not well-known. The aim of this study was to investigate RV and pulmonary functions in patients suffering from SCD with or without pulmonary hypertension using color tissue Doppler imaging and spirometry. We evaluated 48 asymptomatic patients with SCD. All patients underwent echocardiography with tissue Doppler imaging and pulmonary function test. Patients were divided into two groups: Group 1 consisted of 27 patients (age, 18.1 +/- 7.1 years) with normal pulmonary artery pressure, and group 2 consisted of 21 patients (age, 21.4 +/- 7.4 years) with pulmonary hypertension. Both groups were compared with a sex- and age-matched control group including 24 normal healthy subjects (age, 19.8 +/- 9.2 years). Tricuspid lateral annular systolic (S-m) and early diastolic velocity (E-m) were higher in group 1 than group 2 and the control group (p < 0.05). Tricuspid lateral annular late diastolic velocities (A(m)), isovolumetric contraction time, and myocardial performance index (MPI) were higher and the E-m/A(m) ratio was lower in group 2 than group 1 and the control group (p < 0.05). However, no differences were found in the tricuspid lateral annular E-m deceleration time, ejection time, and isovolumetric relaxation time between group 1, group 2, and the control group. Tricuspid lateral annular S-m and E-m were similar in group 2 and the control group. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the diffusion capacity of the lung for carbon monoxide were decreased in both groups of patients compared to the control group (p < 0.05). However, there was no difference in respiratory rate, FEV1/FVC ratio, peak expiratory flow, and total lung capacity between group 1, group 2, and the control group. There were no differences in any indices of lung function between the two groups of patients. MPI is useful index to evaluate RV function in patients with SCD. RV diastolic function was disturbed in only SCD patients with pulmonary hypertension. On the other hand, the restrictive pattern of pulmonary function abnormalities had developed in both groups of patients.Öğe Right ventricular diastolic abnormalities in rheumatoid arthritis and its relationship with left ventricular and pulmonary involvement. A tissue Doppler echocardiographic study(Springer, 2006) Seyfeli, Ergun; Guler, Hayal; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Saglam, Hayrettin; Seydaliyeva, TunzaleObjectives To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement. Methods Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients. Results An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P < 0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio < 1 (in 31 (89%) of 35 patients) (P=0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36 +/- 5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19 +/- 5 mmHg), (P=0.014, P=0.006, P=0.015, P=0.049, respectively). Conclusions This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA.Öğe Subclinical left ventricular dysfunction in multiple sclerosis(Blackwell Publishing, 2006) Akgul, Ferit; Mclek, Ismet; Duman, Taskin; Seyfeli, Ergun; Seydaliyeva, Tunzale; Yalcin, FatihObjectives: To investigate the left (LV) and right ventricular (RV) function in multiple sclerosis (MS) using standard echocardiography and Doppler tissue imaging (DTI). Materials and methods: A total of 41 patients with definite MS and 32 healthy controls were included in the study. Results: LV end-systolic dimension was increased and LV ejection fraction was decreased in MS patients compared with controls (P < 0.05). LV end-diastolic dimension was increased in MS patients, however, did not reach significance. Among DTI parameters, mitral annular peak early diastolic velocity to peak late diastolic velocity ratio (Em/Am) was decreased in MS patients, but not reach statistical significance. No significant differences in tricuspid annular Em/Am ratio was found between MS patients and controls. A statistically significant increase of DTI derived LV myocardial performance index was found in MS patients as compared with controls. RV myocardial performance index showed a tendency to be increased in MS patients, however, did not reach significance. Conclusions: These findings suggest subclinical LV dysfunction and preserved RV function in patients with MS.
