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    Increased Epicardial Fat Thickness Is Associated with Cardiac Functional Changes in Healthy Women
    (Tohoku Univ Medical Press, 2012) Kilicaslan, Baris; Ozdogan, Oner; Aydin, Mehmet; Dursun, Huseyin; Susam, Ibrahim; Ertas, Faruk
    Epicardial fat tissue is a visceral fat depot with anatomical and functional contiguity to the myocardium and coronary arteries. The objective of this study was to evaluate the association between epicardial fat thickness (EFT) and cardiac changes in healthy female subjects. The study population consisted of ninety-six consecutive healthy female (mean age 31.1 +/- 6.7 years) who underwent transthoracic echocardiography. EFT was measured by echocardiography. Subjects were divided into two groups according to the EFT; EFT < 6 mm and EFT >= 6 mm. The cardiac structural changes, increased left atrial volume indices (LAVI) (41.2 +/- 9.9 vs. 52.6 +/- 12.5, p = 0.001) and left ventricular mass indices (LVMI) (129.6 +/- 32.1 vs. 155.6 +/- 31.6 p < 0.05), were observed in patients with increased EFT. Myocardial tei index (MTI), which was used to evaluate both systolic and diastolic functions, was higher with increased EFT (0.44 +/- 0.07 vs. 0.48 +/- 0.08, p = 0.02). The correlation analysis revealed significant correlation between EFT and each of LAVI (r = 0.312, p = 0.002), LVMI (r = 0.301, p = 0.003), body mass index (BMI) (r = 0.8, p < 0.001), and MTI (r = 0.27, p = 0.005). Multivariate regression analysis demonstrated that EFT was associated with BMI (t = 5.28, p = 0.001), MTI (r = 2.39, p = 0.019), LVMI (r = 2.16, p = 0.01), and LAVI (r = 3.21, p = 0.002). In conclusion, EFT is an important predictor of cardiac alterations in women who are prone to obesity.
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    Öğe
    Post transcatheter aortic valve replacement ejection fraction response is predictor of survival among patients with whole range of systolic dysfunction
    (Taylor & Francis Ltd, 2021) Kilicaslan, Baris; Unal, Baris; Coskun, Mehmet Sait; Zeren, Gonul; Ekin, Tuba; Ozcan, Sevgi; Erdogan, Siddik
    Aims The objective of this study is to assess the prognostic effects of T ranscatheter aortic valve replacement (TAVR) on the patients with different degrees of left ventricular systolic (LVS) function and severe symptomatic aortic stenosis. Also examines the prognostic association of LV remodelling after TAVR. Methods and results Patients stratified into four subgroups with respect to baseline LV ejection fraction (LVEF) (LVEF > 25%, LVEF 25%-40%, LVEF 41%-49% and LVEF >= 50%). We compared the baseline characteristics and temporal changes in echocardiographic parameters of the patients after TAVR, and determined all-cause mortality (ACM) in a follow-up period of mean 20.7 +/- 15.8 months (up to 84). There were 495 patients at 8 centres. ACM was similar in all groups (28.1%, 29.5%, 22.5% and 24.1% respectively; p = .44). Immediately after TAVR, there was an improvement in LVEF (from 38.7 +/- 9.4 to 44.9% +/- 10.9%, p .001). The percent change in LVEF (pDelta-EF) immediately after TAVR was more prominent in the patients with LVEF < 25% (48.1 +/- 49.6, 21.9 +/- 29.6), (8.4% +/- 15.2%) and (2.1 +/- 7)) (p .01). Importantly, a 12% increase in absolute Delta-EF was observed in patients with LVEF< 25% with 100% sensitivity and 42.5% specificity for the prediction of ACM. Conclusion This study shows that TAVR is beneficial in the whole range of LVS function, irrespective of the baseline EF. Early recovery in LVEF after TAVR is critical for survival, however, it seems to be more eye catching in the patients with advanced heart failure with reduced EF.