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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 Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention(Korean Soc Cardiology, 2016) Borekci, Abdurrezzak; Gur, Mustafa; Turkoglu, Caner; Baykan, Ahmet Oytun; Seker, Taner; Sahin, Durmus Yildiray; Harbalioglu, HazarBackground and Objectives: It has been demonstrated that the neutrophil/lymphocyte ratio (NLR) might be a useful marker to predict cardiovascular risk and events. We aimed to investigate the role of the NLR to predict ventricular remodeling (VR) in patients with anterior ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention. Subjects and Methods: We prospectively included 274 consecutive anterior STEMI patients. Echocardiography was performed during admission and at six months after myocardial infarction. VR was defined as at least 200/0 increase from baseline in left ventricular end diastolic volume. Patients were divided into two groups according to their VR status: VR (n=67) and non-VR (n=207). Total and differential leukocyte count, N -terminal pro -brain natriuretic peptide (NT-proBNP) and other biochemical markers were measured at admission and 24 hours later. Results: Compared with the non-VR group, peak creatine kinase MB (CK-MB), NT-proBNP (24 h), neutrophil/lymphocyte ratio, presence of diabetes, no-reflow frequency and wall motion score index were significantly higher in patients with VR (p<0.05 for all). On multivariate logistic regression analysis, NLR (beta=2.000, 950/o confidence interval=1.577-2.537, p<0.001) as well as peak CK-MB, NT-proBNP (24 h), WMSI and diabetes incidence were associated with VR. The cutoff value of the neutrophil/lymphocyte ratio obtained by receiver operator characteristic curve analysis was 4.25 for the prediction of VR (sensitivity: 79%, specificity: 74%). Conclusion: In patients with anterior STEMI, initial NLR and NT-proBNP measured 24 hours after admission may be useful for predicting adverse cardiovascular events including left VR.