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    Assessment of myocardial performance index and its association with aortic elasticity in patients with ascending aortic aneurysm
    (Turkish Soc Cardiology, 2016) Baykan, Ahmet Oytun; Gur, Mustafa; Kalkan, Gulhan Yuksel; Acele, Armagan; Seker, Taner; Sen, Omer; Borekci, Abdurrezzak
    Objective: Ascending aortic aneurysms (AAA) are a leading cause of morbidity and mortality. Nevertheless, their effects on global cardiac functions are yet to be fully understood. Myocardial performance index (MPI) has been widely used to quantitatively assess myocardial functions. The aim of this study was to evaluate left ventricular (LV) functions in patients with AAA using tissue Doppler (TD) echocardiography and MPI in addition to conventional echocardiographic methods. Methods: Fifty patients with AAA (33 men, 17 woman; mean age 55.5+/-7.90 years) were included, and 106 patients without aortic dilatation (mean age 54.1+/-8.18 years) were included as the control group. LV systolic and diastolic functions were analyzed using 2-dimensional, M-mode, and TD echocardiography. Results: Patients with AAA had significantly higher MPI (0.5+/-0.04 vs 0.4+/-0.05, p<0.001), TD-MPI (0.5+/-0.02 vs 0.4+/-0.03, p<0.001), and reduced aortic elasticity, as indicated by reduced aortic distensibility (AD) (1.7+/-1.27 vs 3.1+/-1.25, p<0.001). Multivariate linear regression analysis showed that TD-MPI was independently correlated with reduced aortic distensibility (B=-0.006, p=0.019, 95% confidence interval,-0.011 to -0.001). Conclusion: MPI and TD-MPI indicated impairment of global cardiac functions in patients with AAA, which may be attributed to reduced aortic elasticity.
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    Coronary Flow Velocity Reserve in Patients with Ascending Aorta Aneurysm
    (Wiley-Blackwell, 2015) Baykan, Ahmet Oytun; Kalkan, Gulhan Yuksel; Gur, Mustafa; Ucar, Hakan; Acele, Armagan; Seker, Taner; Sen, Omer
    BackgroundAscending aorta aneurysms (AAA) are one of the leading causes of morbidity and mortality. Impairment in coronary flow may contribute to cardiovascular consequences in AAA patients. Coronary flow velocity reserve (CFVR) has been considered an important diagnostic index of the functional capacity of coronary arteries noninvasively. The aim of this study was to evaluate, by noninvasive CVFR, whether patients with AAA demonstrate significant coronary microvascular dysfunction in the absence of coronary artery disease (CAD). MethodsWe prospectively included 44 patients with thoracic AAA in the absence of concomitant CAD (30 men, 14 women; mean age 57.58.4years). A total of 36 patients without aortic dilatation (mean age 55.29.9years) were selected as the control group. Coronary flow velocities in the distal left anterior descending (LAD) artery were measured using transthoracic echocardiography. CFVR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio. ResultsCompared with controls, patients with AAA had higher baseline LAD peak diastolic coronary flow velocities (28.3 +/- 5.8 vs. 25.2 +/- 4.5cm/sec, P=0.01), lower hyperemic LAD flow velocities (54.0 +/- 10.3 vs. 57.2 +/- 12.7cm/sec, P=0.220), and consequently lower CFVR (1.9 +/- 0.3 vs. 2.3 +/- 0.5, P<0.001). Multivariate linear regression analysis showed that CFVR was independently associated only with aortic systolic diameter (AoSD) (=-0.679, P=<0.001). ConclusionsOur study demonstrates that noninvasive CFVR is significantly reduced in patients with AAA and AoSD is the most important determinant of impaired CFVR.