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Öğe A 10-year-old child who underwent coronary artery bypass graft with the indication of familial hypercholesterolemia(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2018) Demircan, Tulay; Kizilca, Ozgur; Yilmaz, Nuh; Zihni, Cuneyt; Oncu, Bahattin; Kir, Mustafa; Unal, NurettinHomozygous familial hypercholesterolemia (HoFH) is a result of a defect in low-density lipoprotein (LDL) receptor gene located on the short arm of chromosome 19 which leads to inadequate clearance of lipoproteins from blood circulation. Homozygous and heterozygous types are available. In homozygous types coronary lesions emerge due to early atherosclerosis in the first decade of life, and untreated patients are lost generally when they are 20 years of age. Our patient was admitted to our outpatient clinic with the complaint of exertional chest pain six months after diagnosis of familial hypercholesterolemia. Coronary angiography was performed because of the patological exercise stress test. Significant coronary artery stenosis was detected. Then the patient successfully underwent coronary bypass grafting. This case is presented to highlight that coronary lesions may develop at an early disease stage of the patients with hyperlipidemia.Öğe Changes of oxidative stress in 3D film to be prepared for echocardiography A randomized controlled study(Lippincott Williams and Wilkins, 2024) Demir, Emel; Duzguner, Vesile; Yilmaz, Nuh; Yengil, ErhanBackground: Echocardiography (ECHO) is a nonprocedure that causes acute stress in children. Fear, anxiety, and fluctuations in children’s blood pressure and heart rate can potentially lead to alterations in echocardiographic measurements. The insufficient research on virtual reality pediatric preparation applications, particularly in the context of echocardiographic procedures, underscores the necessity for additional studies focusing on pediatric patients. This study sought to assess the impact of virtual reality applications tailored explicitly for ECHO on children’s oxidative stress levels. Methods: This was a prospective, randomized, controlled experimental study. Forty-eight children (experimental/24, control/24) aged 7 to 12 years who had an ECHO appointment in the pediatric cardiology outpatient clinic in the 3 months from June to August 2019 participated in the study. Participants whose blood analyses showed hemolysis were eliminated, and the study was completed with 37 children in total: 16 children in the experiment and 21 children in the control. Post hoc power analysis was performed for sample adequacy, and the power of the study was found to be 0.99. A 3D film was prepared for the research and applied to the experimental group before the procedure. All children’s oxidative stress levels (cortisol, malondialdehyde, nitric oxide) and glutathione levels were checked after ECHO. Results: The stress hormone cortisol and malondialdehyde levels were lower in the 3D-applied experimental group than in the control group. As another crucial anti-stress antioxidant factor, glutathione level increased in the experimental group compared to the control group (P < .05). Conclusion: The research revealed that the 3D film used to prepare ECHO reduces the stress parameters associated with heart risk and may affect the ECHO measurements. At the same time, the study also proved the positive effect of 3D film preparation by increasing the anti-stress factor. Copyright © 2024 the Author(s).Öğe Evaluation of left ventricular functions by speckle-tracking echocardiography in coarctation patients(Wiley, 2021) Demircan, Tulay; Kizilca, Ozgur; Yilmaz, Nuh; Zihni, Cuneyt; Kir, Mustafa; Unal, NurettinBackground/Aim Two-dimensional speckle-tracking echocardiography (2D-STE) is a novel method that allows the assessment of regional myocardial function. The aim of our study was to use 2D-STE to assess left ventricular deformation in patients with coarctation of the aorta (CoA). Methods In this prospective study, patients with CoA (n = 42) and healthy controls (n = 39) were recruited. Children with CoA who visited the outpatient clinic between 2013 and 2014 were included. The data were compared with those obtained from the sex- and age-matched controls. Results The mean age of the patients was 5.8 +/- 4.5 years. Global longitudinal strain based on all three apical views and total global strain values did not appear to be different between the patient and the control groups (P = .59, P = .51, P = .15, P = .38). Hypertension was detected in 14 (33.3%) patients with CoA. There were significant differences between the global longitudinal strain values of the normotensive CoA subgroup and the hypertensive CoA subgroup (P < .05). Conclusions In our study, we found that 2D-STE total strain analysis of patients with CoA was not different from comparative healthy controls. However, we determined that 2D-STE parameters were lower in the hypertensive CoA subgroup compared to the normotensive CoA subgroup.Öğe Foetal cardiac function in third trimester pregnancies with reduced fetal movements(Taylor & Francis Inc, 2022) Saglam, Aylin; Derwig, Iris; Gul, Murat; Kasap, Burcu; Yilmaz, Nuh; Sezik, Mekin; Celik, OnderThe objective of our study was to investigate the possible relationship between poor perinatal outcome and foetal cardiac functions in pregnant women with reduced foetal movements (RFM). This cross-sectional study included 126 pregnant women with normal foetal movements (Group 1, Controls) and 42 pregnant women over 32 weeks gestation with RFM (Group 2). Group 2 was further divided into two subgroups according to their perinatal outcome: normal perinatal outcome (Group 2a) and poor perinatal outcome (Group 2b). Cardiotocography, the E/A ratio in both atrioventricular valves, myocardial performance index (MPI) and foetal tricuspid annular plane systolic excursion (f-TAPSE) were evaluated. Foetuses with poor perinatal outcome had a higher MPI (p = .003), higher tricuspid and mitral E/A (p < .001), and lower f-TAPSE values (p < .001). In regression analysis, f-TAPSE was the only parameter (p = .04) independently associated with poor perinatal outcome. In conclusion, examining f-TAPSE may predict adverse perinatal outcome in pregnancies with RFM.IMPACT STATEMENT What is already known on this subject? Reduced foetal movement (RFM) is associated with adverse pregnancy outcome. Cardiotocography, amniotic fluid assessment, estimated birthweight, foetal Doppler and formal foetal movement count (kick chart) are generally used in the clinical assessment of pregnancies with reduced foetal movements. These tests, we currently use to assess foetal wellbeing in women with reduced foetal movements, have limited sensitivity in predicting foetal compromise. What do the results of this study add? Foetal cardiac Doppler may potentially be used as an important adjunct to the conventional management of women with a perception of reduced foetal movements. What are the implications of these findings for clinical practice and/or further research? Foetal echocardiographic evaluation, such as f-TAPSE, may influence clinical practice by enabling improved risk stratification for poor perinatal outcome, thus allowing more timely definitive intervention. This could help to decrease the rate of stillbirth related to reduced foetal movements. The few established echocardiographically derived parameters, which can asses global right ventricle function, are not always easy to obtain, however, f-TAPSE is easily obtainable using ultrasound and it appears to be a clinically useful echocardiographic measurement of right ventricular function.Öğe Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission(Hindawi Ltd, 2017) Bornaun, Helen Aghdasi; Yilmaz, Nuh; Kutluk, Gunsel; Dedeoglu, Reyhan; Oztarhan, Kazim; Keskindemirci, Gonca; Tulunoglu, ArasObjectives. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with unclear underlying aetiologies. Severe cardiac arrhythmias have been emphasised in a few studies on adult IBD patients. This study aimed to investigate the alteration of the P-wave and QT interval dispersion parameters to assess the risk of atrial conduction and ventricular repolarisation abnormalities in pediatric IBD patients. Patients and Methods. Thirty-six IBD patients in remission (UC: 20, CD: 16) aged 3-18 years and 36 age- and sex-matched control patients were enrolled in the study. Twelve-lead electrocardiograms were used to determine durations of P-wave, QT, and corrected QT (QTc) interval dispersion. Transthoracic echocardiograms and 24-hour rhythm Holter recordings were obtained for both groups. Results. The P-wave dispersion, QT dispersion, and QTc interval dispersion (Pdisp, QTdisp, and QTcdisp) were significantly longer in the patient group. The mean values of Pminimum, Pmaximum, and QTcminimum were significantly different between the two groups. The echocardiography and Holter monitoring results were not significantly different between the groups. Furthermore, no differences in these parameters were detected between the CD and UC groups. Conclusion. Results suggest that paediatric IBD patients may carry potential risks for serious atrial and ventricular arrhythmias over time even during remission.
