Angiotensinogen M235T polymorphism and left ventricular indices in treated hypertensive patients with normal coronary arteries
Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Oct 1, 2007
Hypertension and left ventricular hypertrophy (LVH) are important causes of morbidity and mortali... more Hypertension and left ventricular hypertrophy (LVH) are important causes of morbidity and mortality in the population. Angiotensinogen (AGT) M235T polymorphism has been associated with LVH, left ventricular dimensions, coronary artery disease and antihypertensive drug response in previous studies. We examined relationship between AGT M235T polymorphism and echocardiographic left ventricular indices in a Turkish population of treated hypertensive patients with normal coronary arteries. In this cross-sectional study a Turkish population of 92 hypertensive patients treated in our outpatient clinic were enrolled. All patients had normal coronary angiographic examinations. Genotypes for AGT M235T were determined from peripheral leukocytes. Left ventricular dimensions, mass and function indices, after adjustment for clinical covariates were analyzed by multiple regression analysis according to genotypes. Genotype frequencies for AGT M235T were MM-24.7%, MT-52.8% and TT-22.5%. Left ventricular end-systolic (LVES) dimensions for AGT M235T MM, MT, TT genotypes were 17.9+/-4.2 mm, 19.4+/-6.2 mm, and 16.4+/-2.9 mm, respectively (p=0.08). Angiotensinogen M235T TT genotype showed a trend towards a lower LVES dimension but results were not statistically significant. Left ventricular ejection fractions for AGT M235T MM, MT, TT subgroups were 61.3+/-15.0%, 59.4+/-14.0%, and 67.8+/-8.5%, respectively (p=0.07). Angiotensinogen M235T TT genotype showed a tendency towards lower left ventricular mass index but results were not statistically significant. None of the AGT M235T genotypes predicted left ventricular dilatation, mass or function in treated hypertensive patients with normal coronary arteries. Angiotensinogen M235T polymorphism was not useful to predict left ventricular mass, function, hypertrophy or dilatation in a small population of treated Turkish hypertensive patients with normal coronary arteries.
[Reduced coronary collateral vessel recruitment capacity in diabetes mellitus: an evidence for defective ischaemic tolerance]
Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Mar 1, 2004
Collateral channel opening is one of the components of the ischemic tolerance developing during s... more Collateral channel opening is one of the components of the ischemic tolerance developing during subsequent coronary balloon occlusions. The effect of diabetes mellitus (DM) on coronary collateral recruitment (CR) is still not known. We therefore sought the effect of DM on CR in patients with stable angina pectoris (SAP) by using intracoronary pressure measurement technique. Study material consisted of 44 patients (21 diabetic) with SAP. All of the patients had single vessel disease with more than 70% vessel narrowing and all of them underwent stent implantation to this vessel. After angiography, fiber-optic pressure monitoring guidewire was advanced distal to the stenosis to be dilated. Myocardial fractional flow reserve (FFRmyo) was determined under adenosine hyperemia by the ratio of simultaneously measured mean distal pressure to mean aortic pressure. During subsequent two 1 minute balloon occlusions, distal pressures were recorded as coronary wedge pressure (CWP). Collateral flow index was determined by the ratio of simultaneously measured CWP to mean aortic pressure. Percentage of the improvement in the coronary flow index (CFI) (first to second occlusion) between two occlusions was determined for each patient. There was no difference between two groups in terms of pre-intervention FFRmyo (0.54 +/- 0.12 in DM group and 0.50 +/- 0.11 in non-DM group). The baseline CFI was significantly higher in non-DM group (0.26 +/- 0.09 versus 0.17 +/- 0.08, p<0.03). Beyond this finding, mean CFI increased by 17% (from 0.17 +/- 0.08 to 0.20 +/- 0.09) in DM group and by 30% (from 0.26 +/- 0.09 to 0.34 +/- 0.10) in non- DM group. There was statistically significant difference between these two groups in terms of improvement in CFI during subsequent balloon occlusions (p<0.01). In addition to poor collateral vessels seen in patients with DM, CR is also impaired. This finding suggests that DM abolishes ischemic tolerance in terms of CR as well.
Aldoisterone synthase -344c/t and angiotensin-converting enzyme I/D polymorphisms in Turkish hypertensive patients with normal coronary arteries
Acta Cardiol, 2006
ABSTRACT The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressur... more ABSTRACT The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressure regulation, left ventricular and vascular structure. Some hypertensive patients develop left ventricular dilatation and heart failure symptoms while others are relatively less affected. The purpose of our study was to determine whether two major polymorphisms of RAAS are associated with echocardiographic left ventricular mass, function and dilatation in hypertensive patients with normal coronary arteries. A Turkish population of 88 patients with hypertension and normal coronary arteries were studied by echocardiography for left ventricular dimension, mass and function. Genotyping was performed for aldosterone synthase (CYP11B2) -344C/T polymorphism in 85, angiotensin-converting enzyme (ACE) I/D polymorphism in 88 patients. Left ventricular dimensions, mass and function indices, after adjustment for clinical covariates, were analysed by multiple regression according to genotypes. None of the two genotypes studied predicted left ventricular dilatation, mass or function in hypertensive patients with normal coronary arteries. Neither ACE I/D nor CYP11B2 -344C/T polymorphisms were useful to predict left ventricular mass, function or dilatation in our hypertensive patients with normal coronary arteries.
Percutaneous antegrade transarterial treatment of traumatic radial arteriovenous fistula
Turk Kardiyoloji Dernegi Arsivi Turk Kardiyoloji Derneginin Yayin Organidir, May 1, 2013
Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma an... more Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma and there is usually a history of hemorrhage. Typically, the patient demonstrates a thrill and bruit over the site of injury. We report a woman who presented with longstanding pain and swelling of the right hand due to radial AVF that possibly occurred following an injury to the right hand that happened 10 years prior to the date of admission. Since surgery was considered high risk due to multiple fistulas and previous surgery, percutaneous coil embolization was performed via the ipsilateral antegrade radial approach.
[Isolated right ventricular myocardial infarction and saccular focal aortic root dissection leading to right coronary artery ostial obstruction in a patient receiving chemotherapy for small cell lung cancer]
Turk Kardiyoloji Dernegi Arsivi Turk Kardiyoloji Derneginin Yayin Organidir, Apr 1, 2010
To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis ... more To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis and the pressure derived collateral flow index (CFIp), determined using an intracoronary pressure measurement technique in patients with recent myocardial infarction. 33 patients were studied. TIMI grade III flow was achieved in the infarct related artery by thrombolysis. A surface ECG was obtained on admission and 90 minutes later. The sum of ST segment elevations was measured by summing all leads with ST elevation on the baseline ECG and on the 90 minute ECG (after thrombolysis) and calculating the percentage recovery. The study population was divided into two groups, with good STR (> or = 50%; group 1) or poor STR (< 50%; group 2). After angiography, a fibreoptic pressure monitoring guidewire was advanced to the stenosis to be dilated. The CFIp was determined as the ratio [coronary wedge pressure - central venous pressure]/[mean aortic pressure - central venous pressure]. The me...
Background: In the era of coronary stenting, ad hoc percutaneous coronary intervention (PCI) can ... more Background: In the era of coronary stenting, ad hoc percutaneous coronary intervention (PCI) can reduce both the length and the cost of hospital stay in patients with stable or unstable coronary artery disease. However, it raises some concerns regarding ethical issues, informed decision making, thrombocyte inhibition, reduced or increased cost, patient anxiety and safety issues in some elective cases. PCI, which is performed on the same day as diagnostic angiography were considered as "ad hoc"; but all the others were designated "staged". Objective: In our study, in order to overcome all these concerns due to ad-hoc PCI, we investigated the effects of following protocol termed as the “slow ad-hoc PCI strategy” on coronary vessels diameters and flow in patient with stable coronary artery disease who underwent elective PCI procedure. Methods: We retrospectively analyzed in-hospital clinical, pre-procedural, peri-procedural and postprocedural angiographic results of...
Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved ... more Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques. We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision. Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 ± 53542.71 mGy•cm² vs 11349.2 ± 8796.46 mGy•cm²; P<.001). Mean fluoroscopy times were higher in the cine group vs the LFH group (3.87 ± 5.08 minutes vs 1.66 ± 1.51 minutes; P<.01). Mean contrast use was higher...
Percutaneous antegrade transarterial treatment of traumatic radial arteriovenous fistula
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2013
Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma an... more Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma and there is usually a history of hemorrhage. Typically, the patient demonstrates a thrill and bruit over the site of injury. We report a woman who presented with longstanding pain and swelling of the right hand due to radial AVF that possibly occurred following an injury to the right hand that happened 10 years prior to the date of admission. Since surgery was considered high risk due to multiple fistulas and previous surgery, percutaneous coil embolization was performed via the ipsilateral antegrade radial approach.
[Reduced coronary collateral vessel recruitment capacity in diabetes mellitus: an evidence for defective ischaemic tolerance]
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2004
Collateral channel opening is one of the components of the ischemic tolerance developing during s... more Collateral channel opening is one of the components of the ischemic tolerance developing during subsequent coronary balloon occlusions. The effect of diabetes mellitus (DM) on coronary collateral recruitment (CR) is still not known. We therefore sought the effect of DM on CR in patients with stable angina pectoris (SAP) by using intracoronary pressure measurement technique. Study material consisted of 44 patients (21 diabetic) with SAP. All of the patients had single vessel disease with more than 70% vessel narrowing and all of them underwent stent implantation to this vessel. After angiography, fiber-optic pressure monitoring guidewire was advanced distal to the stenosis to be dilated. Myocardial fractional flow reserve (FFRmyo) was determined under adenosine hyperemia by the ratio of simultaneously measured mean distal pressure to mean aortic pressure. During subsequent two 1 minute balloon occlusions, distal pressures were recorded as coronary wedge pressure (CWP). Collateral flo...
Angiotensinogen M235T polymorphism and left ventricular indices in treated hypertensive patients with normal coronary arteries
Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Oct 1, 2007
Hypertension and left ventricular hypertrophy (LVH) are important causes of morbidity and mortali... more Hypertension and left ventricular hypertrophy (LVH) are important causes of morbidity and mortality in the population. Angiotensinogen (AGT) M235T polymorphism has been associated with LVH, left ventricular dimensions, coronary artery disease and antihypertensive drug response in previous studies. We examined relationship between AGT M235T polymorphism and echocardiographic left ventricular indices in a Turkish population of treated hypertensive patients with normal coronary arteries. In this cross-sectional study a Turkish population of 92 hypertensive patients treated in our outpatient clinic were enrolled. All patients had normal coronary angiographic examinations. Genotypes for AGT M235T were determined from peripheral leukocytes. Left ventricular dimensions, mass and function indices, after adjustment for clinical covariates were analyzed by multiple regression analysis according to genotypes. Genotype frequencies for AGT M235T were MM-24.7%, MT-52.8% and TT-22.5%. Left ventricular end-systolic (LVES) dimensions for AGT M235T MM, MT, TT genotypes were 17.9+/-4.2 mm, 19.4+/-6.2 mm, and 16.4+/-2.9 mm, respectively (p=0.08). Angiotensinogen M235T TT genotype showed a trend towards a lower LVES dimension but results were not statistically significant. Left ventricular ejection fractions for AGT M235T MM, MT, TT subgroups were 61.3+/-15.0%, 59.4+/-14.0%, and 67.8+/-8.5%, respectively (p=0.07). Angiotensinogen M235T TT genotype showed a tendency towards lower left ventricular mass index but results were not statistically significant. None of the AGT M235T genotypes predicted left ventricular dilatation, mass or function in treated hypertensive patients with normal coronary arteries. Angiotensinogen M235T polymorphism was not useful to predict left ventricular mass, function, hypertrophy or dilatation in a small population of treated Turkish hypertensive patients with normal coronary arteries.
[Reduced coronary collateral vessel recruitment capacity in diabetes mellitus: an evidence for defective ischaemic tolerance]
Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Mar 1, 2004
Collateral channel opening is one of the components of the ischemic tolerance developing during s... more Collateral channel opening is one of the components of the ischemic tolerance developing during subsequent coronary balloon occlusions. The effect of diabetes mellitus (DM) on coronary collateral recruitment (CR) is still not known. We therefore sought the effect of DM on CR in patients with stable angina pectoris (SAP) by using intracoronary pressure measurement technique. Study material consisted of 44 patients (21 diabetic) with SAP. All of the patients had single vessel disease with more than 70% vessel narrowing and all of them underwent stent implantation to this vessel. After angiography, fiber-optic pressure monitoring guidewire was advanced distal to the stenosis to be dilated. Myocardial fractional flow reserve (FFRmyo) was determined under adenosine hyperemia by the ratio of simultaneously measured mean distal pressure to mean aortic pressure. During subsequent two 1 minute balloon occlusions, distal pressures were recorded as coronary wedge pressure (CWP). Collateral flow index was determined by the ratio of simultaneously measured CWP to mean aortic pressure. Percentage of the improvement in the coronary flow index (CFI) (first to second occlusion) between two occlusions was determined for each patient. There was no difference between two groups in terms of pre-intervention FFRmyo (0.54 +/- 0.12 in DM group and 0.50 +/- 0.11 in non-DM group). The baseline CFI was significantly higher in non-DM group (0.26 +/- 0.09 versus 0.17 +/- 0.08, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03). Beyond this finding, mean CFI increased by 17% (from 0.17 +/- 0.08 to 0.20 +/- 0.09) in DM group and by 30% (from 0.26 +/- 0.09 to 0.34 +/- 0.10) in non- DM group. There was statistically significant difference between these two groups in terms of improvement in CFI during subsequent balloon occlusions (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). In addition to poor collateral vessels seen in patients with DM, CR is also impaired. This finding suggests that DM abolishes ischemic tolerance in terms of CR as well.
Aldoisterone synthase -344c/t and angiotensin-converting enzyme I/D polymorphisms in Turkish hypertensive patients with normal coronary arteries
Acta Cardiol, 2006
ABSTRACT The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressur... more ABSTRACT The renin-angiotensin-aldosterone system (RAAS) plays an important role in blood pressure regulation, left ventricular and vascular structure. Some hypertensive patients develop left ventricular dilatation and heart failure symptoms while others are relatively less affected. The purpose of our study was to determine whether two major polymorphisms of RAAS are associated with echocardiographic left ventricular mass, function and dilatation in hypertensive patients with normal coronary arteries. A Turkish population of 88 patients with hypertension and normal coronary arteries were studied by echocardiography for left ventricular dimension, mass and function. Genotyping was performed for aldosterone synthase (CYP11B2) -344C/T polymorphism in 85, angiotensin-converting enzyme (ACE) I/D polymorphism in 88 patients. Left ventricular dimensions, mass and function indices, after adjustment for clinical covariates, were analysed by multiple regression according to genotypes. None of the two genotypes studied predicted left ventricular dilatation, mass or function in hypertensive patients with normal coronary arteries. Neither ACE I/D nor CYP11B2 -344C/T polymorphisms were useful to predict left ventricular mass, function or dilatation in our hypertensive patients with normal coronary arteries.
Percutaneous antegrade transarterial treatment of traumatic radial arteriovenous fistula
Turk Kardiyoloji Dernegi Arsivi Turk Kardiyoloji Derneginin Yayin Organidir, May 1, 2013
Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma an... more Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma and there is usually a history of hemorrhage. Typically, the patient demonstrates a thrill and bruit over the site of injury. We report a woman who presented with longstanding pain and swelling of the right hand due to radial AVF that possibly occurred following an injury to the right hand that happened 10 years prior to the date of admission. Since surgery was considered high risk due to multiple fistulas and previous surgery, percutaneous coil embolization was performed via the ipsilateral antegrade radial approach.
[Isolated right ventricular myocardial infarction and saccular focal aortic root dissection leading to right coronary artery ostial obstruction in a patient receiving chemotherapy for small cell lung cancer]
Turk Kardiyoloji Dernegi Arsivi Turk Kardiyoloji Derneginin Yayin Organidir, Apr 1, 2010
To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis ... more To investigate the relation between the degree of ST segment resolution (STR) after thrombolysis and the pressure derived collateral flow index (CFIp), determined using an intracoronary pressure measurement technique in patients with recent myocardial infarction. 33 patients were studied. TIMI grade III flow was achieved in the infarct related artery by thrombolysis. A surface ECG was obtained on admission and 90 minutes later. The sum of ST segment elevations was measured by summing all leads with ST elevation on the baseline ECG and on the 90 minute ECG (after thrombolysis) and calculating the percentage recovery. The study population was divided into two groups, with good STR (> or = 50%; group 1) or poor STR (< 50%; group 2). After angiography, a fibreoptic pressure monitoring guidewire was advanced to the stenosis to be dilated. The CFIp was determined as the ratio [coronary wedge pressure - central venous pressure]/[mean aortic pressure - central venous pressure]. The me...
Background: In the era of coronary stenting, ad hoc percutaneous coronary intervention (PCI) can ... more Background: In the era of coronary stenting, ad hoc percutaneous coronary intervention (PCI) can reduce both the length and the cost of hospital stay in patients with stable or unstable coronary artery disease. However, it raises some concerns regarding ethical issues, informed decision making, thrombocyte inhibition, reduced or increased cost, patient anxiety and safety issues in some elective cases. PCI, which is performed on the same day as diagnostic angiography were considered as "ad hoc"; but all the others were designated "staged". Objective: In our study, in order to overcome all these concerns due to ad-hoc PCI, we investigated the effects of following protocol termed as the “slow ad-hoc PCI strategy” on coronary vessels diameters and flow in patient with stable coronary artery disease who underwent elective PCI procedure. Methods: We retrospectively analyzed in-hospital clinical, pre-procedural, peri-procedural and postprocedural angiographic results of...
Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved ... more Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques. We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision. Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 ± 53542.71 mGy•cm² vs 11349.2 ± 8796.46 mGy•cm²; P<.001). Mean fluoroscopy times were higher in the cine group vs the LFH group (3.87 ± 5.08 minutes vs 1.66 ± 1.51 minutes; P<.01). Mean contrast use was higher...
Percutaneous antegrade transarterial treatment of traumatic radial arteriovenous fistula
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2013
Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma an... more Traumatic arteriovenous fistulas (AVF) are almost exclusively the result of penetrating trauma and there is usually a history of hemorrhage. Typically, the patient demonstrates a thrill and bruit over the site of injury. We report a woman who presented with longstanding pain and swelling of the right hand due to radial AVF that possibly occurred following an injury to the right hand that happened 10 years prior to the date of admission. Since surgery was considered high risk due to multiple fistulas and previous surgery, percutaneous coil embolization was performed via the ipsilateral antegrade radial approach.
[Reduced coronary collateral vessel recruitment capacity in diabetes mellitus: an evidence for defective ischaemic tolerance]
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2004
Collateral channel opening is one of the components of the ischemic tolerance developing during s... more Collateral channel opening is one of the components of the ischemic tolerance developing during subsequent coronary balloon occlusions. The effect of diabetes mellitus (DM) on coronary collateral recruitment (CR) is still not known. We therefore sought the effect of DM on CR in patients with stable angina pectoris (SAP) by using intracoronary pressure measurement technique. Study material consisted of 44 patients (21 diabetic) with SAP. All of the patients had single vessel disease with more than 70% vessel narrowing and all of them underwent stent implantation to this vessel. After angiography, fiber-optic pressure monitoring guidewire was advanced distal to the stenosis to be dilated. Myocardial fractional flow reserve (FFRmyo) was determined under adenosine hyperemia by the ratio of simultaneously measured mean distal pressure to mean aortic pressure. During subsequent two 1 minute balloon occlusions, distal pressures were recorded as coronary wedge pressure (CWP). Collateral flo...
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