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    Assessment of left ventricular systolic and diastolic function with conventional and tissue Doppler echocardiography imaging techniques in patients administered tyrosine kinase inhibitor
    (Turkish Soc Cardiology, 2012) Alihanoglu, Yusuf Izzettin; Kaya, Zeynettin; Ari, Hatem; Karaarslan, Sukru; Yildiz, Bekir Serhat; Karanfil, Mustafa; Yazici, Mehmet
    Objectives: The aim of this study was to use echocardiographic techniques to determine the possible cardiotoxic effects of low molecular weight tyrosine-kinase inhibitors (TKI) in patients receiving the therapy for the first time. Study design: Thirty patients (17 females; 13 males; mean age 49 +/- 16; range 22 to 76 years) who met the exclusion criteria and were diagnosed as having malignancy were enrolled. All patients underwent conventional echocardiography and tissue Doppler imaging (TDI) prior to the treatment. The conventional echocardiogram was repeated 2 months later as the patients were concurrently receiving therapy. Myocardial Performance Index was obtained by conventional echocardiography and by TDI techniques to evaluate left ventricular systolic and diastolic function. Results: Statistically significant increase occurred in mean left ventricle (LV) end-systolic volume. However, there was significant decrease in both mean LV ejection fraction and LV stroke volume values (64 +/- 3, 62 +/- 4, p=0.000 and 67 +/- 13, 61 +/- 13, p=0.000, respectively). Anterior wall Em/Am ratio measured by using the TDI technique was significantly decreased at the end of two months (0.99 +/- 0.49, 0.90 +/- 0.41, p=0.03). In addition, decreases were determined in Sm values obtained from all of four LV walls and also in mean Sm value, but this decrease was significant only for the lateral wall Sm measurement (12.8 +/- 2.9, 11.6 +/- 2.3, p=0.004). Conclusion: Tyrosine-kinase inhibitors therapy can be administered safely to patients without predisposing factors for cardiotoxicity in short treatment intervals, and low molecular TKIs may cause subtle or clinically significant cardiotoxicity following the treatment period even in patients without predisposing factors for cardiotoxicity, so clinicians should consider this possibility.
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    Association between A/C1166 gene polymorphism of the angiotensin II type 1 receptor and biventricular functions in patients with acute myocardial infarction
    (Japanese Circulation Society, 2006) Ulgen, Mehmet S.; Ozturk, Onder; Yazici, Mehmet; Kayrak, Mehmet; Alan, Sait; Koc, Fatih; Tekes, Selahattin
    Background Although there have been several association studies of angiotensin II type 1 receptor (AT1R, A/C1166) gene polymorphism in clinical endpoints such as myocardial infarction (MI), hypertension, aortic stiffness, and left ventricular mass, the relationship between AT1R polymorphism and biventricular function in acute anterior MI has not been studied before. Methods and Results The study group comprised 132 consecutive patients who were admitted to the coronary care unit with their first acute anterior MI. Systolic and diastolic diameters, volumes, inflow properties, ejection fraction and myocardial performance index of both ventricles were measured. AT1R polymorphism was determined using polymerase chain reaction amplification. Based on A/C1166 polymorphism of ATIR, the patients were classified into 3 groups: group 1, A/A (n=91) genotype, group 2 A/C (n=28), and group 3 C/C (n=13) genotype. When the left ventricular and right ventricular echocardiographic functions were compared, all parameters of the 3 groups were found to be similar. No difference was detected in either the genotype distribution or allele frequencies between the patients and the controls for AT1R. Conclusions The results suggest that A/C1166 polymorphism of AT1R did not influence the risk of either acute MI or biventricular function after anterior MI.
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    Comparison of left ventricular functional parameters obtained from three different commercial automated software cardiac quantification program packages and their intraobserver reproducibility
    (Springer, 2011) Dostbil, Zeki; Ariturk, Zuhal; Cil, Habib; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, Mehmet; Yildiz, Ismail
    Objective ECG-gated myocardial perfusion scintigraphy (MPS) can be used to determine several cardiac functional parameters (e. g., left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV)). In this study, we aimed to compare these cardiac functional parameters calculated by the following cardiac quantification programs: Emory Cardiac Toolbox (ECTb), Quantitative Gated SPECT (QGS), and Myometrix. We also evaluated reproducibility of the cardiac programs. Methods Fifty-seven patients (27 male, 30 female) at Elazig Research and Training Hospital from 2008 to 2009 were included in this study. In all patients, (99m)Tc-MIBI ECG-Gated (8-bin frame mode) myocardial perfusion scintigraphies were performed. By using 3 different cardiac quantification programs (ECTb, QGS, and Myometrix); LVEF, EDV, and ESV were calculated. The same raw data of MPS images were reprocessed at different time periods, and these 3 parameters were recalculated. LVEF, EDV, and ESV yielded by 3 different programs were compared for interprogram variability assessment, and parameters calculated at two different time periods were compared to evaluate intraprogram reproducibility. Results There were statistically significant differences between ECTb, QGS, and Myometrix programs for LVEF, EDV, and ESV (p < 0.001). There was also a statistically significant correlation between LVEF and EDV (p < 0.001, r = 0.546; p < 0.001, r = 0.45, respectively), but no statistically significant correlation was present between the ESV values (p > 0.05, r = 0.09). Statistically significant differences were not found between the values of LVEF, EDV, and ESV obtained from the first and second reconstruction analysis of 3 cardiac quantification programs. Discussion Different MPS cardiac software programs give variable (but correlated) LVEF and left ventricular volumetric measures. Those obtained from different cardiac softwares cannot be used interchangeably. Our findings have shown that ECTb, QGS, and Myometrix programs are reproducible, with respect to LVEF, EDV, and ESV.
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    Does aspirin use prevent acute coronary syndrome in patients with pneumonia: multicenter prospective randomized trial
    (Lippincott Williams & Wilkins, 2013) Oz, Fahrettin; Gul, Sule; Kaya, Mehmet G.; Yazici, Mehmet; Bulut, Ismet; Elitok, Ali; Ersin, Gunay
    Objectives The aim of this study was to test the hypothesis that aspirin would reduce the risk for acute coronary syndromes (ACSs) in patients with pneumonia. Backgrounds Pooled data suggest that pneumonia may trigger an ACS as a result of inflammatory reactions and the prothrombotic changes in patients with pneumonia. Hypothetically considering its antiaggregating and anti-inflammatory effects, aspirin might also be beneficial for the primary prevention of ACS in patients with pneumonia. Methods One hundred and eighty-five patients with pneumonia who had more than one risk factor for cardiovascular disease were randomized to an aspirin group (n = 91) or a control group (n = 94). The patients in the aspirin group received 300 mg of aspirin daily for 1 month. ECGs were recorded on admission and 48 h and 30 days after admission to assess silent ischemia. The level of high-sensitivity cardiac troponin T was measured on admission and 48 h after admission. The primary endpoint was the development of ACS within 1 month. The secondary endpoints included cardiovascular death and death from any cause within 1 month. Results The chi(2)-test showed that the rates of ACS at 1 month were 1.1% (n = 1) in the aspirin group and 10.6% (n = 10) in the control group (relative risk, 0.103; 95% confidence interval 0.005-0.746; P = 0.015). Aspirin therapy was associated with a 9% absolute reduction in the risk for ACS. There was no significant decrease in the risk of death from any cause (P = 0.151), but the aspirin group had a decreased risk of cardiovascular death (risk reduction: 0.04, P = 0.044). Conclusion This randomized open-label study shows that acetyl salicylic acid is beneficial in the reduction of ACS and cardiovascular mortality among patients with pneumonia. Coron Artery Dis 24:231-237 (c) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Coronary Artery Disease 2013, 24:231-237
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    Left ventricle hydatid cyst mimicking acute coronary syndrome
    (J Infection Developing Countries, 2012) Tekbas, Ebru Onturk; Tekbas, Guven; Atilgan, Zuhal Ariturk; Islamoglu, Yahya; Cil, Habib; Yazici, Mehmet
    Cardiac echinococcosis rarely mimics acute coronary syndrome. The diagnosis of cardiac hydatid cyst might be difficult on account of varying clinical presentations and nonspesific symptoms. A 75-year-old female was admitted to our hospital with typical chest pain. The patient had no history of previous cardiac symptoms or any illness leading to heart disease. Her ECG revealed ischemic changes. However, her coronary angiography revealed noncritical plaques in the left anterior descending artery. The diagnosis of cardiac echinococcosis was identified using echocardiography, computed tomography and magnetic resonance imaging. The patient was referred to cardiac surgery for resection of the cyst; however, she refused surgery. Albendezol 800 mg/day was prescribed.
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    Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide
    (Via Medica, 2012) Islamoglu, Yahya; Cil, Habib; Atilgan, Zuhal; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, Mehmet
    Ingestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (ML) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol J 2012; 19, 1: 86-88)
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    Resolution of Intracoronary Thrombus with Tirofiban Infusion: A Case Report
    (Aves Press Ltd, 2010) Ariturk, Zuhal; Tekbas, Ebru; Cil, Habib; Islamoglu, Yahya; Elbey, M. Ali; Yazici, Mehmet
    A 27 year-old man presented with chest pain lasting for fourteen-hour duration. The patient had electrocardiographic evidence of subacute anterior wall myocardial infarction. Coronary angiography revealed total occlusion of the left anterior descending coronary artery. Tirofiban infusion was administered for 48 hours. Then, coronary angiography showed intraluminal filling defects due to a massive thrombus in the proximal segment of the left anterior descending coronary artery. Vie present a case of effective thrombolysis with tirofiban in young myocardial infarction case.