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Association of cardiovascular calcifications with coronary artery disease
(2004) Abacı, Adnan; Oğuzhan, Abdurrahman; Özdoğru, İbrahim; Sirkeci, Tarık; Elönü, Orhan; Seyfeli, Ergun; Kıranatlı, Burhanettin; Salur, Sibel; Ergin, Ali
Çalışmanın amacı koroner anjiyografi yapılan hastalarda, torasik aortadaki aterom plağı kalsifikasyonu veya aort kapak kalsifikasyonu ile koroner arter hastalığı arasındaki ilişkiyi incelemektir. Kardiyovasküler kalsifikasyonlar ile koroner arter hastalığı arasında ilişki olması durumunda, bu kalsifikasyonlar koroner aterosklerozun göstergesi olarak kullanılabilir. Çalışmaya koroner anjiyografi yapılan 1100 hasta alındı. Aort kapak kalsifikasyon varlığı ekokardiyografi ile değerlendirildi. Torasik aortadaki kalsifikasyonları saptamak için PA akciğer grafisi kullanıldı. Çalışmaya alınan 1100 hastanın 812'sinde (%73.8) koroner arter hastalığı saptanırken, 288'inde (%26.2) koronerler normal bulundu. Hastaların 420'sinde (38%) aort kapak kalsifikasyonu ve 180'inde (16%) torasik aorta plak kalsifikasyonu saptandı. Aort kapak kalsifikasyonu saptanan hastalarda, koroner arter hastalığı sıklığı (%88 karşı %65, p<0.0001) ve çok damar hastalığı oranı (%65% karşı %55, p=0.003) daha yüksek bulundu. Koroner arter hastalığı sıklığı ve çok damar hastalığı oranı, torasik aorta plak kalsifikasyonu saptanan hastalarda da yüksek bulundu (sırasıyla, %86 karşı %71, p<0.0001 ve %66 karşı %57, p=0.035). Logistik regresyon analizi ile koroner arter hastalığı risk faktörlerine göre düzeltme yapıldıktan sonra bile, aort kapak kalsifikasyonu (p=0.003) ve torasik aorta plak kalsifikasyonu (p=0.004), koroner arter hastalığı ile ilişkili bulundu. Aort kapak kalsifikasyonu olan hastalarda, torasik aorta plak kalsifikasyonu daha sık izlendi (%23% karşı. %12, p<0.0001). Sonuç olarak, çalşımamızda aort kapak kalsifikasyonu ve torasik aorta plak kalsifikasyonları ile koroner arter hastalığı arasında anlamlı ilişki saptadık. Ayrıca, aort kapak kalsifikasyonu ile torasik aorta plak kalsifikasyonu anlamlı olarak ilişkili idi. Kardiyovasküler kalsifikasyonların varlığı koroner arter hastalığı için bir gösterge olarak düşünülebilir.
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, Fatih
The 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.
Autonomic dysfunction and cardiac repolarization abnormalities in patients with migraine attacks
(Int Scientific Information, Inc, 2007) Melek, Ismet M.; Seyfeli, Ergun; Duru, Mehmet; Duman, Taskin; Akgul, Ferit; Yalcin, Fatih
The clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.
A Delayed Diagnosis of a Patient with Bronchiectasis: Swyer-James/MacLeod Syndrome
(Aves, 2007) Karazincir, Sinem; Babayigit, Cenk; Balcı, Ali; Akoglu, Sebahat; Seyfeli, Ergun; Sumbas, Haldun
Swyer-James/MacLeod Syndrome is a rare disease which is characterized by unilateal hyperlucent lung due to hypoplasia of its pulmonary artery. A non-smoker, 57 years old female patient admitted to our clinic with cough, sputum production and fever. Her medical history revealed that these symptoms has been recurrent since her childhood. Furthermore she had been followed up with as a patient of chronic bronchitis or bronchiectasis outside of our clinic so far. Physical examination revealed diminished respiratory sounds and coarse crackles onmiddle and lower zones of left hemithorax. Chest X Ray showed hyperluceny and volume loss of the left lung and bronchiectasis at the left lower zone. Computerized and High Resolution Computerized Tomography revelaed hypoplasia of left pulmonary artery with reduced diameters of its branches, hyperlucent left lung and cyctic bronchiectasis in left lower, and superior and lingular segments of the left upper lobes. Colored Doppler Echocardiography showed hypoplasia of the left pulmonary artery and enlargement of the main pulmonary artery. Swyer-James/MacLeod Syndrome is diagnosed in childhood or early adulthood of most of the cases. We present this case to emphasize the delayed diagnosis until the age of 57 although she had been investigated several times because of her recurrent symptoms since her childhood and to emphasize considering this syndrome especially when a hyperlucent lung was detected on chest X ray.
Effect of weight loss on P wave dispersion in obese subjects
(Wiley, 2006) Duru, Mehmet; Seyfeli, Ergun; Kuvandik, Guven; Kaya, Hasan; Yalcin, Fatih
Objective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe PhotoShop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 +/- 10 and 7 +/- 12 ins, p < 0.002) was more prominent in Group II (>= 12% loss of their original weight) than Group I (<12% loss of their original weight) after the weight loss program. A statistically significant correlation between decrease in the level of P wave dispersion and percentage of weight loss was found (r = 0.624, p < 0.001). Discussion: Substantial weight loss in obese subjects is associated with a decrease of P wave duration and dispersion. Therefore, these observations suggest that substantial weight loss is associated with improvement in atrial repolarization abnormalities in obese subjects.
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 Namik
Objectives: 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.
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]
Fever of Unknown Origin Due to Left Atrial Myxoma
(Lippincott Williams & Wilkins, 2006) Savas, Lutfu; Onlen, Yusuf; Kiziltan, Tarik; Pourbagher, Ali; Seyfeli, Ergun; Turunc, Tuba; Yalcin, Fatih
Fever of unknown origin may present diagnostic and/or curative difficulties. Myxomas are one of the rare causes of fever of unknown origin. A 67-year-old man with a 4-month history of fever of unknown origin was admitted to our department. Physical examination revealed 38.4 degrees C axillary temperature and accentuated second heart sound in cardiac auscultation. Blood, urinary, and throat cultures were negative. Transesophageal echocardiography showed a left atrial mass partially prolapsing into the left ventricle during diastole. Left atrial mass was excised, and histological examination showed atrial myxoma. Fever resolved within 48 hours after the operation, and the patient was discharged from hospital with complete improvement.
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]
Hyperthyroidism as a rare cause of complete AV block
(2009) Karakaş, Can Yoldaş; Topaloğlu, Caner; Canbolat, Elif; Seyfeli, Ergun; Akgül, Ferit
(1). Multislice computed tomography (CT) may be useful for detecting myocardial fat infiltration and diagnosing ARVC (1-3). Because of its excellent spatial and temporal resolution, CT has received much attention in diagnosing of ARVC. It has been reported that CT findings of ARVC are (a) a dilated right ventricle, b) abundant epicardial adipose tissue, (c) conspicuous trabeculations with low attenuation, (d) a scalloped appearance of the right ventricular free wall, and (e) intramyocardial fat deposits (1, 2). Coronary artery fistula is an uncommon clinical entity with an incidence in selected series ranging from 0.26% to 0.40% of congenital cardiac anomalies. Many adults are asymptomatic if the fistulae are small. Symptoms of fatigue, dyspnea, angina (due to “steal” phenomenon), atrial arrhythmia, signs of congestive heart failure, pulmonary hypertension or infective endocarditis are seen. In one report, patients older than 20 years had dyspnea on exertion (35%), fatigue (8%) or angina (22%). Conversely, only 9% of those <20 years of age had had such symptoms (4, 5).
Increased QT dispersion in sickle cell disease
(Karger, 2007) Akgul, Ferit; Seyfeli, Ergun; Melek, Ismet; Duman, Taskin; Seydaliyeva, Tunzale; Gali, Edip; Yalcin, Fatih
Background: 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.
Index of myocardial performance in patients with type 2 diabetes without hypertension and its relationship with clinical and echocardiographic parameters
(Wiley, 2009) Saglam, Hayrettin; Seyfeli, Ergun; Gul, Ibrahim; Duru, Mehmet; Gokce, Cumali
Background: Diabetes mellitus affects the systolic and diastolic function of the left ventricle (LV). The aim of the present study was to evaluate the index of myocardial performance (IMP), a new Doppler index, in asymptomatic, normotensive patients with type 2 diabetes mellitus (T2DM). Methods: The study population consisted of 40 asymptomatic normotensive patients with T2DM (22 women, 18 men; mean [+/- SD] age 49 +/- 7 years) and 20 healthy controls (13 women, seven men; mean age 45 +/- 4 years). M-Mode and two-dimensional Doppler echocardiography was performed in all subjects to calculate IMP. Venous blood samples were collected for analysis and body mass index (BMI) was calculated. Results: In normotensive T2DM patients, the mitral E wave was decreased, whereas mitral A wave, mitral E/A ratio, and septal wall thickening were increased compared with values obtained for the control group. The IMP was higher in normotensive T2DM patients than in the control group (P = 0.004). There was a significant correlation between IMP and triglyceride (TG) levels (P < 0.001), mitral E wave (P < 0.001), mitral E/A ratio (P < 0.001), ejection fraction (P = 0.001), fasting blood glucose (P = 0.007), LV systolic dimension (P < 0.001), duration of diabetes (P = 0.017), and BMI (P = 0.029). Stepwise multiple regression analysis demonstrated that only TG levels (beta = 0.355, t = 2.487, P = 0.017) and the mitral E/A ratio (beta = -0.384, t = -2.690, P = 0.011) had an independent effect on IMP. Conclusion: The results of the present study indicate that IMP is increased in normotensive T2DM patients. The findings suggest that increased IMP may be an early sign of diabetic cardiomyopathy in normotensive diabetic patients with preserved LV function.
Myocardial blush grade: T evaluate myocardial viability in patients with cute myocardial lnfarction
(Sage Publications Inc, 2007) Seyfeli, Ergun; Abaci, Adrian; Kula, Mustafa; Topsakal, Ramazan; Eryol, Namik K.; Arinc, Huseyin; Ozdogru, Ibrahim
Myocardial blush grade (MBG) is used to assess myocardial perfusion in the infarcted myocardium. The purpose of this study was to determine whether the analysis of myocardial blush grade after resolution of the acute phase of myocardial infarction is useful for assessing myocardial viability. The present study is consisted of 64 patients (55 men, mean age 55 11 years) who had acute myocardial infarction and nonoccluded stenosis (>50%) in an infarct-related artery. All the patients had thrombolysis in myocardial infarction (TIMI)-3 flow in the infarct-related artery on coronary angiograms. Myocardial viability was determined by single-photon emission computed tomography (SPECT) within the same week after coronary angiograms. MBG 0 in 5 (8%) patients, grade 1 in 10 (16%) patients, grade 2 in 23 (36%) patients, and grade 3 in 26 (40%) patients were present. Fifty-four (84%) of 64 patients showed myocardial viability by SPECT. Myocardial viability was demonstrated in 1 1 of 15 patients (74%) with MBG 011 and 43 of 49 patients (88%) with MBG 2/3. There was a weak relation between MBG and myocardial viability by correlation analysis (r = 0.28, p = 0.025). If MBG 0 and 1 are regarded as a sign of nonviable myocardium, and if MBG 2 and 3 are regarded as a sign of viable myocardium, the sensitivity of MBG for the prediction of myocardial viability was 79%, specificity was 40%, positive predictive value was 88%, and negative predictive value was 27%. MBG has a weak correlation with myocardial viability. Although sensitivity is fairly good, specificity is very low. We concluded that the diagnostic value of MBG is limited to detect myocardial viability in the infarcted region.
P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters
(Springer, 2007) Guler, Hayal; Seyfeli, Ergun; Sahin, Gunsah; Duru, Mehmet; Akgul, Ferit; Saglam, Hayrettin; Yalcin, Fatih
P wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.
Pulmonary hypertension in sickle-cell disease
(Karger, 2007) Akgul, Ferit; Yalcin, Fatih; Seyfeli, Ergun; Ucar, Edip; Karazincir, Sinem; Balcı, Ali; Gali, Edip
Background: Our aim is to determine comorbidities associated with pulmonary hypertension (PHT) in clinically stable sickle-cell disease (SCD) patients and to evaluate left ventricular (LV) and right ventricular (RV) function in those patients. Methods: Echocardiography was performed in 87 SCD patients that were divided into group I (without PHT) and group II (with PHT). Both groups were compared with healthy controls. Results: A history of retinopathy and leg ulcer was more frequent in group II than group I (p < 0.01). Haemoglobin levels were lower (p < 0.05), whereas blood urea nitrogen, lactate dehydrogenase and total bilirubin levels were higher in group II (p < 0.01). Although group II patients had larger LV end-diastolic, LV end-systolic and RV diastolic diameters compared with group I patients and controls (p < 0.05), LV ejection fraction was similar in the three groups. The mitral peak early diastolic inflow velocity to peak late diastolic inflow velocity (E/A) ratio was similar in group I, group II and the control group. The tricuspid E/A ratio was lower in group II than group I and controls (p < 0.05). Conclusion: End organ damage occurs more often and haemolysis is severer in SCD patients with PHT than SCD patients without PHT. Although LV systolic and diastolic function is well preserved, RV diastolic function is disturbed in those patients with PHT. Copyright (c) 2007 S. Karger AG, Basel.
The Relationship between Cardiac Troponins and Left Ventricular Mass Index in Patients with Chronic Renal Failure
(Taylor & Francis Ltd, 2008) Seyfeli, Ergun; Abaci, Adnan; Ekici, Eyup; Oguzhan, Abdurrahman; Tokgoz, Bulent; Yalcin, Fatih; Utas, Cengiz
The abstract of this study was accepted as an oral presentation in the 10th Annual Meeting of the ESC Working Group on Echocardiography, December 6-9, 2006, Prague, Czech Republic.
Relationship between elastic properties of the aorta and uric acid levels in newly diagnosed hypertensive patients
(Turkish Soc Cardiology, 2006) Gur, Mustafa; Yilmaz, Remzi; Demirbag, Recep; Seyfeli, Ergun; Ozdogru, Ibrahim; Altiparmak, Ibrahim Halil; Dogan, Ali
Objectives: The association between elastic properties of the aorta and uric acid levels was investigated in patients with newly diagnosed hypertension. Study design: The study included 109 patients (68 females, 41 males; mean age 51.6+/-6.9 years) with newly diagnosed hypertension. Echocardiographic examination was performed. Systolic and diastolic diameters were measured by M-mode echocardiography, and elastic indices (aortic strain and distensibility) were calculated. Pulse pressure was obtained by a sphygmomanometer. Blood samples were obtained to determine serum uric acid levels and other biochemical parameters. The results were compared with those of a control group consisting of 21 age-and sex-matched healthy volunteers. Results: Compared to the control group, aortic strain and distensibility were significantly lower (p<0.001) and uric acid levels were significantly higher (p=0.044) in hypertensive patients. In multivariate regression analysis, aortic strain and distensibility showed independent relationships with uric acid levels (p=0.010 and p=0.009, respectively), age (p=0.001 and p<0.001), and left ventricular mass index (p=0.002 and p<0.001) in the patient group. Multivariate analysis according to gender showed that aortic strain and distensibility were in independent relationship with uric acid levels, age, and left ventricular mass index only in female patients. Conclusion: These data support the view that increased uric acid levels may have a role in the pathogenesis of impaired elastic properties of the aorta especially in hypertensive women.
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, Edip
The 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.
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, Tunzale
Objectives 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.
Stress-induced hypercontractility in patients with hypertension: An interesting imaging finding
(Elsevier Ireland Ltd, 2010) Yalcin, Fatih; Yalcin, Hulya; Seyfeli, Ergun; Akgul, Ferit
Excessive sympathetic activity and stress-induced LV hypercontractility may be detected in hypertensives or hypertensive LV hypertrophy. Recent quantitative data support that hypertensive patients may be associated with stress-induced LV hypercontractility. Stress-induced hypercontractility may also be related to basal LV cavity obliteration and dynamic LV outflow tract obstruction in hypertensives. In contrast to LV cavity dilation, stress-induced LV cavity obliteration may be associated with favorable outcome, however it has not been completely elucidated. Hypertensives with dynamic LVOT obstruction may clinically present with acute heart failure and normal systolic function. LV contractility may change and evaluation of LV geometry, contractility and volume by imaging techniques may be important in disease progression. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

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