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Namik Kemal Eryol

Publications and source records attributed to Namik Kemal Eryol.

At least 19 recordsLinked to original sources
PubMed2006

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis.

B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are both secreted primarily from the ventricle myocardium in response to the increase in volume and pressure. We aimed to investigate the relationship between the severity of mitral stenosis (MS) and the level of plasma BNP. A total of 56 patients (50 female, 6 male) were included in the study. Mitral stenosis and its related parameters were evaluated by echocardiographic methods. Patients were divided into three groups as with mild, moderate and severe MS according to their planimetric valvular area. Plasma BNP levels were measured using "Triage-B-type natriuretic peptide test" method (Biosite Diagnostics, San Diego). The relationship of BNP with mitral stenosis and other echocardiographic parameters were studied. The comparison of the 3 groups with one another revealed that the BNP level in the group with moderate MS was higher than that in the group with mild MS, however it was statistically insignificant (74.9 +/- 49.7 versus 49.9 +/- 40.5 pg/ml, p > 0.05). BNP level in the group with severe MS was significantly higher than that in the mild MS (144.3 +/- 83.9 versus 49.9 +/- 40.5 pg/ml, p < 0.001) and that in the moderate MS group (144.3 +/- 83.9 versus. 74.9 +/- 49.7 pg/ml, p < 0.05). When patients were taken together, as the area of the mitral valve decreased, the level of BNP underwent a corresponding increase (r:-0.48, p < 0.001). We have ascertained that the level of plasma BNP and the degree of MS are significantly correlated, and as MS becomes more serious, the plasma BNP level rises.

Adult↗
PubMed2006

Protective effects of carvedilol against anthracycline-induced cardiomyopathy.

OBJECTIVES: The aim of this study was to determine the protective effect of carvedilol in anthracycline (ANT)-induced cardiomyopathy (CMP). BACKGROUND: Despite its broad effectiveness, ANT therapy is associated with ANT-induced CMP. Recent animal studies and experimental observations showed that carvedilol prevented development of CMP due to chemotherapeutics. However, there is no placebo-controlled clinical trial concerning prophylactic carvedilol use in preventing ANT-induced CMP. METHODS: Patients in whom ANT therapy was planned were randomized to administration of carvedilol or placebo. We enrolled 25 patients in carvedilol and control groups. In the carvedilol group, 12.5 mg once-daily oral carvedilol was given during 6 months. The patients were evaluated with echocardiography before and after chemotherapy. Left ventricular ejection fraction (EF) and systolic and diastolic diameters were calculated. RESULTS: At the end of 6 months of follow-up, 1 patient in the carvedilol group and 4 in the control group had died. Control EF was below 50% in 1 patient in the carvedilol group and in 5 in the control group. The mean EF of the carvedilol group was similar at baseline and control echocardiography (70.5 vs. 69.7, respectively; p = 0.3), but in the control group the mean EF at control echocardiography was significantly lower (68.9 vs. 52.3; p < 0.001). Both systolic and diastolic diameters were significantly increased compared with basal measures in the control group. In Doppler study, whereas E velocities in the carvedilol group decreased, E velocities and E/A ratios were significantly reduced in the control group. CONCLUSIONS: Prophylactic use of carvedilol in patients receiving ANT may protect both systolic and diastolic functions of the left ventricle.

Adrenergic alpha-Antagonists↗
PubMed2005

Preload dependence of Doppler tissue imaging derived indexes of left ventricular diastolic function.

Doppler tissue imaging (DTI) has been proposed as a tool for the evaluation of diastolic function. Controversy exists regarding whether DTI measurements are influenced by preload. Changes in the circulating volume associated with hemodialysis result in preload reduction. To determine the influence of preload reduction on DTI and standard pulsed-Doppler transmitral diastolic velocities, 30 patients (mean age 41 +/- 14) with chronic renal insufficiency without overt heart disease were studied by DTI and standard pulsed Doppler before and after hemodialysis. From the apical window, DTI sample volume was placed at the lateral and septal mitral annulus and at the midsegment of lateral and septal myocardial wall of the left ventricle. Peak early diastolic annular and myocardial, and peak late diastolic annular and myocardial velocities were measured. Transmitral peak early and late diastolic velocities were also recorded by standard pulsed Doppler. The peak velocity of early diastolic mitral flow decreased from 100 +/- 30 to 85 +/- 34 cm/s (P < 0.001) after hemodialysis. Hemodialysis elicited marked reduction in early diastolic lateral mitral annular and midlateral myocardial velocities (6.9 +/- 3.2 to 6.3 +/- 2.9 cm/s, P < 0.04 and 6.7 +/- 0.3 to 5.5 +/- 2 cm/s, P < 0.001, respectively). Early diastolic, septal mitral annular, and midseptal myocardial velocities were also significantly decreased (5.8 +/- 2.8 to 4.6 +/- 2 cm/s, P < 0.006 and 6.2 +/- 2 to 5.1 +/- 1 cm/s, P < 0.008, respectively). Late diastolic mitral annular and myocardial velocities did not change. It is concluded that early diastolic mitral annular and myocardial velocities are affected by acute preload reduction. It is necessary to consider preload when diastolic function is assessed by DTI.

Adult↗
PubMed2005

Massive cardiac thrombosis in a patient with Sheehan's syndrome.

Growth hormone deficiency (GHD) is a risk factor for increased cardiovascular disease, and it has been recently demonstrated that abnormalities in coagulation system might contribute to the increased cardiovascular morbidity and mortality. However, there is not enough data related to the major thrombotic events in GH-deficient patients. We describe the case of a 62-year-old woman with Sheehan's syndrome who developed massive cardiac thrombosis. She was hospitalized with acute pulmonary edema. ECG revealed high ventricular responsive atrial fibrillation (AF) and T-wave inversion on precordial leads. The ejection fraction of left ventricle (LVEF) was measured as 60% by transthoracic echocardiography (TTE) and there was 2nd degree mitral regurgitation with concentric hypertrophic LV walls. Transesophagial echocardiography (TEE) established thrombi both at right atrium and left atrial appendix. Before anticoagulant therapy several hemostatic and fibrinolytic markers were measured. Except increased D-dimer concentration (763.14 mug/L (0-325)) we did not observe any pathological finding in these parameters. After 14 days of discharge, the patient was admitted to the intensive care unit with upper gastrointestinal bleeding. The warfarin and salicylate were stopped for two months. At the end of two months, the patient was again hospitalized with congestive heart failure and there was a high ventricular responsive AF on ECG. TEE was performed and three thrombi were demonstrated at right atrium (RA), left atrium (LA) and left ventricle (LV). There was no active bleeding on upper GIS endoscopy and anticoagulant therapy was restarted. In this particular case massive cardiac thrombi involving three chambers (LA, RA, LV) were more extensive than expected in AF. Moreover, there was a 2nd degree mitral regurgitation in the patient, and based on previous studies mitral regurgitation has been associated with less prevalent LA spontaneous echo contrast and fewer thromboembolic events. Therefore we hypothesized that severe GHD in the present case might be the major contributing factor in massive cardiac thrombosis. In summary, based on previous data there is increased risk of thromboembolic events in GHD although the mechanism is unclear yet. Our case is the first case showing massive cardiac thrombosis in a severe GH-deficient patient with Sheehan's syndrome. Therefore, patients with GHD should be screened carefully for thrombus in clinical practice, and further studies need to be done to understand the relation between GHD and coagulation system.

Atrial Function↗
PubMed2005

Are the high levels of cytomegalovirus antibodies a determinant in the development of coronary artery disease?

In several epidemiological studies, it was suggested that a high titer of cytomegalo-virus (CMV) antibody meant CMV reactivation, and that this condition was a determinant of coronary artery disease (CAD). The purpose of this study was to investigate both the prevalence of the CMV infections in our study population and whether high CMV sero-positivity is a determinant of CAD. Blood samples from 179 (58 female, 121 male) individuals being evaluated for CAD suspicion by coronary angiography were tested for CMV seropositivity and CRP levels. Fifty-six patients had normal coronary arteries and 123 patients had CAD. Six patients did not have anti-CMV antibodies and 87 of the 173 seropositive patients had high levels of anti-CMV antibodies (> or = 8 U/mL). High CMV seropositivity (> or = 8 U/mL) was a significant CAD determinant even after adjustment for traditional CAD risk factors (odds ratio [OR] = 2.1 P = 0.04, respectively). The results indicate that the prevalence of high CMV seropositivity is an independent predictor of CAD in our study population and that our study population with CAD had a high rate of CMV infection.

Aged↗
PubMed2004

Color Doppler tissue imaging to evaluate left atrial appendage function in patients with mitral stenosis in sinus rhythm.

Two-dimensional color Doppler tissue imaging (CDTI) has so far been used, in general, to evaluate ventricular function. In this study, the left atrial appendage (LAA) tissue velocity was measured by CDTI. LAA function in 38 patients with mitral stenosis in sinus rhythm (SR) and 19 healthy subjects undergoing transesophageal echocardiography were examined by CDTI. Systolic tissue appendage velocity (SaV, m/s) was measured at the tip of the LAA in the basal short-axis view. LAA emptying (LAAEV) and filling (LAAFV) velocities (m/s) were also recorded 1 cm below the orifice of the appendage. LAA ejection fraction was also measured. In addition, two-dimensional imaging was used to determine the presence of thrombus and/or spontaneous echo contrast (SEC). Patients with mitral stenosis in SR had significantly decreased LAAEV, LAAFV, SaV, and LAA ejection fraction compared to controls (0.34 +/- 0.15 vs 0.72 +/- 0.17, 0.37 +/- 0.13 vs 0.63 +/- 0.19, 0.050 +/- 0.015 vs 0.071 +/- 0.093, and 39 +/- 14% vs 69 +/- 13%, respectively, P < 0.001, P < 0.001, P < 0.001, and P < 0.001). Among the patients with mitral stenosis in SR, 10 patients had SEC and one had LAA thrombus. Compared with patients without SEC, patients with SEC had decreased LAAEV, LAAFV, SaV, and LAA ejection fraction (0.24 +/- 0.05 vs 0.37 +/- 0.16, 0.29 +/- 0.05 vs 0.39 +/- 0.14, 0.039 +/- 0.087 vs 0.055 +/- 0.015, and 28 +/- 14% vs 43 +/- 12%, respectively, P = 0.01, P = 0.02, P = 0.01, and P = 0.006). In conclusion, these results suggest that the LAA dysfunction may occur in patients with mitral stenosis in SR and CDTI can successfully be used for the quantification of contraction at the tip of the LAA.

Adult↗
PubMed2004

Evaluation of left atrial appendage functions in patients with thrombus and spontaneous echo contrast in left atrial appendage by using color Doppler tissue imaging.

OBJECTIVE: Thrombus and spontaneous echo contrast (SEC) develops in the left atrial appendage (LAA) when LAA function is disturbed. Decrease of left atrial appendage emptying velocity shows LAA dysfunction. The purpose of this study is to examine the incidence of SEC and/or thrombus in LAA in patients with acute myocardial infarction and to assess the LAA function using color Doppler tissue imaging (CDTI) of the patients with detected SEC and/or thrombus. METHOD AND RESULTS: Eighty-four patients with acute myocardial infarction were included in the study. Spontaneous echo contrast and/or thrombus were observed in 24 (29%) of the 84 patients who were categorized as group 1 (mean age 59 +/- 12 years). Sixty patients (71%) without thrombus and/or SEC in LAA were categorized as group 2 (mean age 58 +/- 8 years). Left atrial diameters and left ventricular ejection fraction were measured by using transthoracic echocardiography. Left atrial appendage emptying and LAA filling velocity were measured by transesophageal Doppler echocardiography. Systolic appendage tissue velocities (SaV cm/s) were measured at the basal, mid, and tip of medial wall of LAA by transesophageal CDTI. Group 1 had significantly decreased LAA emptying velocities, mid SaVs, and left ventricular ejection fractions compared to group 2 (37 +/- 9 cm/s vs 55 +/- 22 cm/s, 3.1 +/- 1.6 cm/s vs 3.7 +/- 1.2 cm/s, and 47 +/- 13% vs 58 +/- 10%, respectively, P = 0.002, P = 0.04, P = 0.03). Group 1 had significantly increased left atrial diameters compared to group 2 (40 +/- 5 mm vs 36 +/- 6 mm P = 0.001). Left atrial appendage-filling velocities, basal SaVs and tip SaVs in group 1 were lower than those in group 2 but not significantly. CONCLUSIONS: Mid-SaV of LAA medial wall and LAA emptying velocity decrease in patients with thrombus and/or SEC were an indication of functional disorder of LAA. Color Doppler tissue imaging appears to be a clinically applicable and reliable imaging technique that allows quantitative assessment of regional LAA systolic function.

Atrial Function, Left↗
PubMed2004

Epidemiological and pharmacological profile of congestive heart failure at Turkish academic hospitals.

OBJECTIVE: We aimed to investigate the status of the treatment of congestive heart failure (CHF) in academic hospitals in Turkey. METHODS: Overall 661 successive patients from 16 academic hospitals were included in this retrospective study. In addition to treatments given to the patients before admission to hospital, during their hospital stay, and at hospital discharge, data regarding their functional classifications, causes of CHF, and laboratory findings were also recorded. RESULTS: In our study the mean age of patients was 61+/-12 years and the mean hospital stay 10+/-6 days. Ischemic CHF was observed more frequently in men (72% vs. 46%, p<0.001), while hypertension and rheumatic CHF were more frequent in women (27% vs. 19%, p<0.001 and 24% vs. 9%, p<0.001 respectively). While 90% of patients were in NYHA III-IV class at admission to hospital, only 2% of patients were in class IV at hospital discharge. The proportion of smokers was greater in men than in women (68% vs. 12%). Atrial fibrillation was present in 35% of patients. During hospitalization, angiotensin converting enzyme (ACE) inhibitors were used by 77%, diuretics by 95%, digitalis by 76%, nitrate by 85%, beta-blockers by 3%, aspirin by 86%, anticoagulants by 44%, Ca antagonist by 10%, positive inotropic agents by 42%; and antiarrhythmic agents by 15% of patients. CONCLUSION: The use of ACE inhibitors, the major milestone of CHF treatment, is not on an adequate level yet. The use of beta-blockers should also be encouraged.

Adrenergic beta-Antagonists↗
PubMed2003

Intracoronary electrocardiogram and angina pectoris during percutaneous coronary interventions as an assessment of myocardial viability: comparison with low-dose dobutamine echocardiography.

The aims of this study were to evaluate the diagnostic value of intracoronary electrocardiogram (ECG) and presence of angina pectoris during percutaneous coronary interventions in the prediction of myocardial viability assessed by low-dose dobutamine echocardiography (LDDE). Seventy-one patients (60 men; mean age, 54 +/- 11 years) with recent Q-wave MI and angiographically documented regional wall motion abnormality in the presence of a significant (>/= 70%) nonocclusive stenosis of the infarct-related vessel who were referred for angioplasty were prospectively included in the study. The intracoronary ECG was recorded using coronary angioplasty guidewire. Significant ST segment elevation was defined as a new or worsening ST segment elevation of >/= 0.1 mV at 80 msec after the J-point. Angina pectoris was noted as present or absent during balloon inflation. All patients underwent LDDE for viability assessment. Significant ST segment elevation in the intracoronary ECG and chest pain were observed in 56 (78.9%) and 49 (69%) of the 71 patients. Viability was present on LDDE in 52 (92.9%) of 56 patients with and 3 (20%) of 15 without ST segment elevation. Viability was detected in 45 (91.8%) of 49 patients with and 10 (45.4%) of 22 without angina pectoris during balloon occlusion. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ST segment elevation for viability were 94.5%, 75%, 92.9%, 80%, and 90.1%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of angina pectoris for viability were 81.8%, 75%, 91.8%, 54.5%, and 80.3%, respectively. The present study demonstrated that a simple assessment of ST segment elevation in the intracoronary ECG or angina pectoris during coronary angioplasty can be used to assess myocardial viability identified by LDDE in patients with previous MI.

Angina Pectoris↗
PubMed2003

Color Doppler tissue imaging to evaluate left atrial appendage function in mitral stenosis.

Two-dimensional color Doppler tissue imaging (CDTI) has so far been used, in general, to evaluate ventricular function. This study examined if the left atrial appendage tissue velocity could reproducibly be measured with CDTI and if they have any predictive value for left atrial appendage (LAA) function and former thromboembolism. Thirty-six patients (24 women, 12 men; mean age 45 +/- 12 years; 18 AF; 11 former thromboembolic stroke) with mitral stenosis undergoing transesophageal echocardiography were examined with CDTI. Peak systolic tissue velocity (m/sec, peak systolic velocity [PSV]) was measured at the tip of the LAA in the basal short-axis view. LAA flow emptying (LAAEV) and filling (LAAFV) velocities (m/sec) were also recorded 1 cm immediately below the orifice of the appendage. Interobserver and intraobserver variabilities were determined for the PSV. LAA ejection fraction was measured by Simpson's method. Mitral regurgitation, AF, transmitral mean gradient, left ventricular ejection fraction, mitral valve area, and left atrial diameter were used as a covariant for adjustment. The intraobserver and interobserver correlation coefficients for the PSV using CDTI was 0.64 and 0.60, respectively (bothP = 0.01). LAAEV(0.29 +/- 0.09 vs 0.19 +/- 0.04, P = 0.001)and LAA ejection fraction(44 +/- 12 vs 29 +/- 14, P = 0.004)were found to be significantly decreased in the patients with decreased PSV (<0.05 m/sec), even after adjustment. The decreased PSV was positively correlated with the low LAAEV (<0.25 m/sec) and history of thromboembolism (r = 0.59, r = 0.38, respectively), and remained a significant determinant of the low LAAEV (OR 50.03, CI 1.46-1738.11,P = 0.02), but not of history of thromboembolism (OR 4.29, CI 0.52-35.01,P = 0.08) after adjustment. In conclusion, these results suggest that CDTI provides a reproducible method for quantification of contraction at the tip of the LAA. Decreased PSV may be predictive of poor LAA function.

Adult↗
PubMed2003

Colour tissue Doppler echocardiographic evaluation of right ventricular function in patients with right ventricular infarction.

OBJECTIVE: This study was undertaken to determine right ventricular (RV) function as assessed by colour Doppler tissue imaging (DTI) in patients with RV infarction. METHODS: During the study period, 35 patients were evaluated: 14 patients had an inferior myocardial infarction (MI) with RV infarction and 21 patients had an inferior MI without RV involvement. Twenty age-matched healthy subjects served as controls. The diagnosis of RV infarction was defined by ST segment elevation >0.1 mV in lead V4R. Systolic and early and late diastolic velocities were acquired from the apical four-chamber view at the lateral tricuspid annulus, the septal side of the tricuspid annulus and the RV free mid-wall using colour DTI. RESULTS: Systolic and early diastolic velocities at the lateral tricuspid annulus were significantly reduced in patients with inferior MI with RV infarction compared with those in healthy individuals (7.8 +/- 1 vs. 11 +/- 2 cm/s, p < 0.002) and patients with inferior MI without RV infarction (7.8 +/- 1 vs. 10 +/- 1 cm/s, p < 0.002). The late diastolic lateral annular velocity did not differ between the groups. Systolic and early diastolic RV free wall velocities were also significantly decreased in patients with RV infarction compared with those in healthy individuals (7 +/- 1 vs. 8.7 +/- 1 cm/s, p < 0.01; 6.3 +/- 2 vs. 8.7 +/- 2 cm/s, p < 0.05, respectively) and patients with inferior MI without RV infarction (7 +/- 1 vs. 9 +/- 2 cm/s, p < 0.01; 6.3 +/- 2 vs. 8.3 +/- 2 cm/s, p < 0.05, respectively). CONCLUSION: The evaluation of tricuspid annular and RV free wall velocities using colour DTI provides a rapid and noninvasive tool for assessing RV function in patients with RV infarction.

Aged↗
PubMed2003

Electrocardiographic J wave as a result of hypercalcemia aggravated by thiazide diuretics in a case of primary hyperparathyroidism.

Electrocardiographically, the QT interval is shortened, ST segment is depressed, and T wave becomes negative in hypercalcemia. The use of diuretics in cases with hyperparathyroidism decreases the excretion of calcium, causes changes in bone-calcium turnover and parathyroid hormone activity, and forms hypercalcemia. A 67 year-old Turkish female patient in whom we electrocardiographically observed a J wave is presented as a hypercalcemic case with primary, hyperparathyroidism aggravated by the use of a thiazide diuretic.

Aged↗
PubMed2002

Is the change of late potential over time related to enzyme levels? Ischemic burden in acute myocardial infarction.

BACKGROUND: The ventricular late potential (VLP) detected using the technique of signal average electrocardiography (SAECG) interacts with several factors, primarily time. METHOD: In this study, we examined the interaction, over time, of VLP with the initial ischemic burden and enzyme levels in acute myocardial infarction. Patients diagnosed as having acute myocardial infarction were included in the study. On the first day, the patients underwent enzyme analysis and electrocardiography (ECG) follow-up every 6 hours. A 24-hour ambulatory ECG was performed on the seventh day in order to determine the ischemic burden. SAECG findings (TQRS, RMS, LAS) were obtained on the seventh day, in the first and third months. The study was continued with the patients who did not require angioplasty as decided with angiographic evaluation in the first month. RESULTS: The study included 30 patients with acute myocardial infarction (mean age 51 +/- 12, 28 males and 2 females). The initial mean CK-MB levels and the mean ischemic burden were 98 +/- 31 U/L and 44 +/- 96 minutes. The TQRS (ms), LAS (ms), and RMS (microV) values (mean +/- SD ) obtained at day 7, month 1, and month 3 are 97 +/- 12, 96 +/- 9, 103 +/- 11, P = 0.01; 31 +/- 10, 31 +/- 11, 32 +/- 10, P = 0.46; 43 +/- 28, 41 +/- 26, 33 +/- 25, P = 0.01, respectively. We observed that the TQRS and RMS values changed significantly with time, but these levels of significance disappeared when adjusted for the initial ischemic burden and CK-MB levels (P = 0.06; P = 0.53). The VLP frequency was 33% at day 7 and 23% at month 3. Unlike the CK-MB level, the initial ischemic burden was significantly different between the patients with and without VLP at month 3 (150.85 +/- 149.28, 12.34 +/- 26.48, P = 0.001 ). When tested together with age and gender, it was found that the high initial ischemic burden increased the possibility of VLP (OR: 24, CI: 2.09-279.52, P = 0.01 ) at month 3. CONCLUSION: SAECG findings in patients with myocardial infarction changed with time; however, this change occurred depending on the initial ischemic burden and CK-MB levels. Of these, only the initial ischemic burden, especially in high levels, was a determinant for the presence of VLP in the late period of myocardial infarction.

Adult↗
PubMed2002

Application of the vena contracta method for the calculation of the mitral valve area in mitral stenosis.

OBJECTIVES: The vena contracta is the narrowest region of the regurgitant or stenotic jet just downstream the orifice and reflects the size of that orifice. This study was performed to assess the accuracy of the vena contracta width (VCW) in evaluating the severity of mitral stenosis (MS) and to compare the mitral valve area (MVA) determined by VCW with MVAs obtained by other more traditional echocardiographic methods. METHODS: We studied 59 patients (43 females, 42 +/- 14 years) with MS. VCW was measured in the apical four chamber view by Doppler color flow mapping. The largest diameter of the VCW during diastole was measured for at least three cardiac cycles and averaged. MVA was calculated from the following equation: pir(2), where r = VCW/2. MVA was also determined by planimetry, the pressure half-time method, and by the Gorlin formula. RESULTS: In this study, the width of the vena contracta ranged from 0.89 to 1.73 cm (mean 1.30 +/- 0.21). MVA, calculated based on the VCW, ranged from 0.63 to 2.35 cm(2) (mean 1.36 +/- 0.41). MVA by VCW (1.36 +/- 0.41 cm(2)) showed good correlations with three comparative techniques: (1) the cross-sectional area by planimetry (1.35 +/- 0.36 cm(2), mean difference = 0.21 +/- 0.16 cm(2), y = 0.91x + 0.14, r = 0.79, SEE = 0.26 cm(2), p < 0.001); (2) the area derived from the Doppler pressure half-time (1.27 +/- 0.32 cm(2), mean difference = 0.22 +/- 0.19 cm(2), y = 0.97x + 0.13, r = 0.76, SEE = 0.27 cm(2), p < 0.001), and (3) the area derived from the Gorlin equation in the 18 patients who underwent catheterization (1.27 +/- 0.35 cm(2), mean difference = 0.19 +/- 0.16, y = 0.98x + 0.05, r = 0.81, SEE = 0.26 cm(2), p < 0.001). CONCLUSIONS: These findings suggest that Doppler color flow imaging of the MS jet in the vena contracta can provide an accurate estimation of MVA and appears to be potentially applicable in the assessment of the severity of MS.

Adult↗
PubMed2002

Color Doppler tissue imaging in assessing the elastic properties of the aorta and in predicting coronary artery disease.

We hypothesized that the change in aortic elastic properties could directly be shown with color Doppler tissue imaging (CDTI), that these findings could be related to aortic stiffness and distensibility and that, through these, coronary artery disease (CAD) could be predicted. One hundred and twenty six patients (group I: 83 with CAD, mean age 54+/-10 years, 18 female, 65 male; group II: 43 without CAD, mean age 53+/-10 years, 27 female, 16 male) having been evaluated for coronary artery disease by angiography were examined by echocardiography. Arterial pressure was measured immediately before echocardiographic evaluation. Internal aortic systolic and diastolic diameters by M-mode echocardiography and aortic upper wall tissue velocities (Aortic S, E, A, m/sec) by CDTI were measured 3 cm above the aortic valve. Lateral mitral annulus tissue velocities (Annulus S, E, A, m/sec) were also recorded. Aortic distensibility (cm2 x dynes(-1)) and aortic stiffness index were calculated using formulas. In the statistical analyses, CAD risk factors and left ventricular ejection fraction were used for adjustment. Aortic stiffness (2.79+/-3.49 vs 1.62+/-1.31, P=0.03), distensibility (1.55+/-1.46 vs 2.37+/-3.08, P=0.04), and aortic S velocity (0.057+/-0.016 vs 0.064+/-0.015, P=0.02) differed significantly between groups I and II. After adjustment, while aortic stiffness and S velocity were still statistically different (P=0.04; P=0.03 respectively), the significance of the difference in aortic distensibility disappeared (P=0.051). Aortic stiffness and aortic S velocity (0.06 m/sec<) were important CAD determinants (Odds ratio=1.4 P=0.03; Odds ratio=3.6 P=0.01, respectively), but aortic distensibility was not. Aortic stiffness was correlated only with aortic S velocity (r=-0.28, P=0.01), and aortic distensibility had a significantly positive correlation with aortic S velocity (r=0.20, P=0.02). The interobserver and intraobserver correlation coefficients for aortic S velocities were 0.65 and 0.71, respectively (P<0.05). Elastic properties of the aorta can directly be assessed by reproducibly measuring the movements in the upper wall of the aorta by CDTI. Reduced aortic S velocity is associated with increased aortic stiffness. Increased aortic stiffness and reduced aortic S velocity are important predictors of CAD.

Adult↗
PubMed2002

A case of atrioventricular complete block due to Behçet's disease.

The cardiovascular system is involved in 5% of the cases of Behçet's disease. Thrombophlebitis. aneurysm in arteries, pericarditis, myocarditis, valvular disease, ventricular arrhythmia, and conduction system disorders may occur. A case of Behçet's disease with complete proximal atrioventricular block is presented.

Adult↗