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Öğe Coronary Flow Velocity Reserve in Donor Artery and Myocardial Performance Index After Successful Recanalization of Chronic Total Coronary Occlusions(H M P Communications, 2015) Baykan, Ahmet Oytun; Kalkan, Gulhan Yuksel; Sahin, Durmus Yildiray; Elbasan, Zafer; Gur, Mustafa; Seker, Taner; Turkoglu, CanerBackground. Percutaneous recanalization of chronic total coronary occlusion (CTO) tends to show a positive effect on left ventricular remodeling and ejection fraction (LVEF). Coronary flow velocity reserve (CFVR) is an important diagnostic index of the functional capacity of coronary arteries. The aim of this study was to evaluate, by non-invasive CFVR, whether the blood flow of donor artery reverts to normal after CTO percutaneous coronary intervention (PCI). Also, we assessed the effects of CTO recanalization on global cardiac functions by using myocardial performance index (MPI). Methods. We evaluated 25 patients (mean age, 57.5 +/- 14.1 years) who underwent CTO-PCI of the right coronary artery, whose collaterals were provided by the left anterior descending (LAD) artery. The coronary flow velocities in the distal LAD were measured using transthoracic echocardiography (TTE) before, 24 hours after, and within 3 months of PCI. Both two-dimensional and tissue Doppler (tD) echocardiography were used to calculate MPI. Results. CFVR at month 3 was significantly increased compared to the basal and early CFVR (1.8 +/- 0.3 vs 2.3 +/- 0.3 [P<.001] and 1.8 +/- 0.2 vs 2.3 +/- 0.3 [P<.001], respectively). MPI at month 3 was significantly decreased compared to the basal and early MPI (0.61 +/- 0.09 vs 0.53 +/- 0.07 [P<.001] and 0.60 +/- 0.08 vs 0.53 +/- 0.07 [P<.001], respectively). Also, tD-MPI within 3 months was significantly decreased (0.58 +/- 0.9 vs 0.53 +/- 0.8 [P=.01] and 0.57 +/- 0.07 vs 0.53 +/- 0.8 [P<.001], respectively, for tD-MPI septal and 0.59 +/- 0.08 vs 0.51 +/- 0.07 [P<.001] and 0.58 +/- 0.08 vs 0.51 +/- 0.07 [P<.001], respectively, for tD-MPI lateral). Conclusion. Successful recanalization of CTO results in increased CFVR-indicated blood flow in the donor artery and MPI-indicated global cardiac functions.Öğe Epicardial fat thickness as associated with left ventricular myocardial performance in patients with newly diagnosed hypertension(Turkish Soc Cardiology, 2015) Borekci, Abdurrezzak; Gur, Mustafa; Seker, Taner; Ucar, Ayse Kalyoncu; Baykan, Ahmet Oytun; Elbasan, Zafer; Harbalioglu, HazarObjective: Epicardial fat thickness (EFth) is associated with both left ventricular hypertrophy (LVH) and diastolic dysfunction. However, the effect of EFth on myocardial performance is not known. The aim of this study was to investigate the relationship between EFth and tissue Doppler myocardial performance index (TD-MPI), which incorporates both systolic and diastolic left ventricular (LV) function, in newly diagnosed hypertension (HT) patients. Methods: A total of 314 consecutive, newly diagnosed HT patients were prospectively included (mean age: 51.9 +/- 1.7 years). EFth was measured perpendicularly on the free wall of the right ventricle at the end of the systole in 2 echocardiographic views (parasternal short and long axis). Myocardial performance index (MPI) was calculated using tissue Doppler (TD) echocar-diography. Patients were divided into 2 groups according to median TD-MPI levels (TD-MPIlow and TD-MPIhigh). Results: EFth values of the TD-MPIhigh group were higher than those of the TD-MPIlow group (p<0.05). Patients in the TD-MPIhigh group also had higher age, body mass index, systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular mass index (LVMI), E/A ratio, and aortic distensibility, compared with the TD-MPIlow group (p<0.05 for all). Multivariate linear regression analysis showed that TD-MPI was independently associated with age (beta= 0.089, p= 0.012), LVMI (beta= 0.090, p= 0.05), E/A (beta=-0.118, p=0.005), and EFth (beta= 0.432, p<0.001). Conclusion: TD-MPI was independently associated with EFth in patients with newly diagnosed HT. EFth may be used as a predictor of impaired LV global functions in patients with normal left ventricular ejection fraction (LVEF) and newly diagnosed HT.Öğe A Novel Modified Provisional Bifurcation Stenting Technique: Jailed Semi-inflated Balloon Technique(Elsevier Science Inc, 2015) Cayli, Murat; Seker, Taner; Gur, Mustafa; Elbasan, Zafer; Sahin, Durmus Y.; Elbey, Mehmet A.; Cil, Habib[Abstract Not Available]Öğe A Novel-Modified Provisional Bifurcation Stenting Technique: Jailed Semi-Inflated Balloon Technique(Wiley-Blackwell, 2015) Cayli, Murat; Seker, Taner; Guer, Mustafa; Elbasan, Zafer; Sahin, Durmus Yildiray; Elbey, Mehmet Ali; Cil, HabibObjectiveWe proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi-inflated balloon technique (JSBT). BackgroundCurrently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri-procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach. MethodsBetween September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.611.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month. ResultsThe majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in-hospital stay and 1 month follow-up. ConclusionsThe JSBT technique can be successfully performed in both LM and non-LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. (J Interven Cardiol 2015;28:420-429)
