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  • Küçük Resim
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    Normal echocardiographic measurements in a Turkish population: The healthy Heart Echo-Tr trial
    (Turkish Society of Cardiology, 2019) Şafak, Özgen; Gürsoy, Ozan Mustafa; Karakoyun, Süleyman; Çaǧdaş, Metin; Asarcıklı, Lale Dinç; Demir, Fulya Avcı; Ersoy, İbrahim; Akyüz, Abdurrahman; Özlük, Özlem Arıcan; Er, Fahri; Baktır, Ahmet Oǧuz; Yesin, Mahmut; Eren, Hayati; Sungur, Aylin; Kurmuş, Özge; Emren, Volkan; Tülüce, Selcen Yakar; Akçay, Filiz Akyıldız; Akıl, Mehmet Ata; Makca, Tuba; Ergene, Oktay; Özkan, Mehmet
    Objective: Normal reference values for the cardiac chambers are widely based on cohorts from European or American populations. In this study, we aimed to obtain normal echocardiographic measurements of healthy Turkish volunteers to reveal the age, gender, and geographical region dependent differences between Turkish populations and other populations. Methods: Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination. Blood biochemical parameters were also obtained for all patients on admission. The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used to assess the echocardiographic cardiac chamber quantification. Results: The study included 1154 volunteers (men: 609; women: 545), with a mean age of 33.5±11 years. Compared to men, women had a smaller body surface area, lower blood pressure and heart rate, lower hemoglobin, total cholesterol, lower low-density lipoprotein (LDL) levels, and higher high density lipoprotein (HDL) levels. Cardiac chambers were also smaller in women and their size varied with age. When we compared the regions in Turkey, the lowest values of left cardiac chamber indices were seen in the Marmara region and the highest values were observed in the Mediterranean region. Regarding the right cardiac indices, the Mediterranean region reported the lowest values, while the Black Sea region and the Eastern Anatolia region reported the highest values. Conclusion: This is the first study that evaluates the normal echocardiographic reference values for a healthy Turkish population. These results may provide important reference values that could be useful in routine clinical practice as well as in further clinical trials.
  • Küçük Resim
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    Thrombolysis or surgery in patients with obstructive mechanical valve thrombosis the multicenter HATTUSHA study
    (Elsevier Science INC., 2022) Özkan, Mehmet; Gündüz, Sabahattin; Güner, Ahmet; Kalçık, Macit; Gürsoy, Mustafa Ozan; Uygur, Begüm; Kılıçgedik, Alev
    BACKGROUND Prosthetic valve thrombosis (PVT) is one of the life-threatening complications of prosthetic heart valve replacement. Due to the lack of randomized controlled trials, the optimal treatment of PVT remains controversial between thrombolytic therapy (TT) and surgery. OBJECTIVES This study aimed to prospectively evaluate the outcomes of TT and surgery as the first-line treatment strategy in patients with obstructive PVT. METHODS A total of 158 obstructive PVT patients (women: 103 [65.2%]; median age 49 years [IQR: 39-60 years]) were enrolled in this multicenter observational prospective study. TT was performed using slow (6 hours) and/or ultraslow (25 hours) infusion of low-dose tissue plasminogen activator (t-PA) (25 mg) mostly in repeated sessions. The primary endpoint of the study was 3-month mortality following TT or surgery. RESULTS The initial management strategy was TT in 83 (52.5%) patients and surgery in 75 (47.5%) cases. The success rate of TT was 90.4% with a median t-PA dose of 59 mg (IQR: 37.5-100 mg). The incidences of outcomes in surgery and TT groups were as follows: minor complications (29 [38.7%] and 7 [8.4%], respectively), major complications (31 [41.3%] and 5 [6%], respectively), and the 3-month mortality rate (14 [18.7%] and 2 [2.4%], respectively). CONCLUSIONS Low-dose and slow/ultraslow infusion of t-PA were associated with low complications and mortality and high success rates and should be considered as a viable treatment in patients with obstructive PVT. (J Am Coll Cardiol 2022;79:977-989) (c) 2022 by the American College of Cardiology Foundation.