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Cengiz Elçioglu B, Kılıç A, Baydar O, Şahin ŞT, Çelik HG, Aytekin V, Aytekin S. Evaluation of Aortic Elasticity Parameters Measured by Transthoracic Echocardiography in a Normotensive Population: A Single-Center Study. Turk Kardiyol Dern Ars 2023; 51:369-377. [PMID: 37671520 DOI: 10.5543/tkda.2023.88717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE Impaired arterial elastic features is one of the earliest manifestations of atherosclerosis in the vessel wall and is associated with the development of cardiovascular disease and increased mortality and morbidity. In this study, we aimed to investigate the mean values of aortic elasticity parameters in a normotensive population with transthoracic echocardiography and to evaluate these values in different age groups and their relationship with other risk factors. METHODS This retrospective study included 405 subjects who met the inclusion criteria among 2880 individuals screened between 2020 and 2022. The study population was divided into 5 groups according to their age. Aortic elasticity parameters (aortic strain, aortic stiffness index, and aortic distensibility) were calculated from the associated formulas by measurements made from the ascending aorta in the parasternal long axis. RESULTS In 405 subjects (mean age 42.18 ± 10.39, 54.3% female), the mean aortic strain value was 15.14 ± 3.56%, the mean aortic stiffness index was 3.24 ± 1.05, and the mean aortic distensibility was 7.48 ± 2.36 cm2/dyn1/103. It was observed that aortic strain and distensibility values significantly decreased with increasing age groups, while aortic stiffness significantly increased. All 3 aortic elasticity parameters were strongly correlated to age. In the multivariate linear regression analysis, age was found to be an independent factor for all aortic elasticity parameters. CONCLUSION Aortic elasticity parameters can be evaluated with transthoracic echocardiography in daily practice. Comparing these measurements with normal values in similar age groups may help to detect patients with increased cardiovascular risk in the early period, regardless of the other risk factors.
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Affiliation(s)
| | - Alparslan Kılıç
- Department of Cardiology, Koç University Hospital, İstanbul, Türkiye
| | - Onur Baydar
- Department of Cardiology, Koç University Hospital, İstanbul, Türkiye
| | | | | | - Vedat Aytekin
- Department of Cardiology, Koç University Hospital, İstanbul, Türkiye
| | - Saide Aytekin
- Department of Cardiology, Koç University Hospital, İstanbul, Türkiye
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Cengiz ElçioĞlu B, Kamat S, Yurdakul S, Şahin ŞT, Sarper A, Yıldız P, Aytekin S. Assessment of Subclinical Left Ventricular Systolic Dysfunction and Structural Changes in Patients with Chronic Obstructive Pulmonary Disease. Intern Med J 2021; 52:1791-1798. [PMID: 34139104 DOI: 10.1111/imj.15424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/22/2021] [Accepted: 05/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) can develop left ventricular (LV) systolic dysfunction and geometric changes due to several reasons. We investigated subclinical LV systolic dysfunction and structural features in patients with COPD, and its correlation with the severity of airway obstruction, identified by GOLD classification. METHODS We studied 52 patients with COPD and 29 age and sex-matched controls, without any cardiac disease. In addition to conventional echocardiographic evaluation speckle tracking echocardiography (STE) based strain imaging were performed to analyze sub-clinical LV systolic dysfunction. Also LV volumes were measured by using three dimensional real time echocardiography (3DRTE). All patients underwent spirometry. RESULTS Conventional echocardiographic parameters (LV wall thickness and diameters, LV EF) and LV volume measurements were similar between the groups. LV global longitudinal peak systolic strain (-14.76 ± 2.69% to -20.27 ± 1.41%, p < 0.001) and strain rate (0.75 ± 0.25 1/s to 1.31 ± 0.41 1/s, p < 0.001) were significantly impaired in patients, compared to controls demonstrating sub-clinical ventricular systolic dysfunction. Significant positive correlation was obtained between LV strain/strain rate and spirometry parameters (FEV 1, FEV%, FEV 1/ FVC, PEF %) (r = 0.78/0,68, p < 0.001; r = 0,83/0.70, p < 0.001); r = 0.74/0.55, p < 0.001; r = 0.72/0.65, p < 0.001, respectively). In addition, there was significant negative correlation between LV strain/strain rate and GOLD classification (r = -0.80/ -0.69, p < 0.001, respectively). CONCLUSION Subclinical LV systolic dysfunction can occur in COPD patients despite normal EF. STE is a technique that provides additional information for detailed evaluation of subtle changes in LV myocardial contractility, significantly associated with the severity of the disease in COPD patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Sadettin Kamat
- University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Selen Yurdakul
- Department of Cardiology, Istanbul Bilim University, Istanbul, Turkey
| | | | | | - Pınar Yıldız
- University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Saide Aytekin
- Department of Cardiology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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Çelik HG, Keske Ş, Şener Ü, Tekbaş M, Kapmaz M, Şahin ŞT, Özyıldırım A, Aytekin S, Aytekin V, Ergönül Ö. Why we should be more careful using hydroxychloroquine in influenza season during COVID-19 pandemic? Int J Infect Dis 2021; 102:389-391. [PMID: 33130195 PMCID: PMC7834514 DOI: 10.1016/j.ijid.2020.10.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to describe the QTc prolongation and related adverse cardiac events during the administration of hydroxychloroquine (HCQ) and its combinations for the treatment of coronavirus disease 2019 (COVID-19). Hospitalized patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who received HCQ and had initial and follow-up electrocardiograms performed between March 10 and May 30, 2020 were included. Critical QTc prolongation was detected in 12% of the patients. On multivariate analysis, diabetes mellitus (odds ratio 5.8, 95% confidence interval 1.11-30.32, p = 0.037) and the use of oseltamivir (odds ratio 5.3, 95% confidence interval 1.02-28, p = 0.047) were found to be associated with critical QTc prolongation.
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Affiliation(s)
| | - Şiran Keske
- Department of Infectious Diseases, American Hospital, Istanbul, Turkey
| | - Ülker Şener
- Department of Pharmacy, American Hospital, Istanbul, Turkey
| | - Müge Tekbaş
- Department of Pharmacy, Koç University Hospital, Istanbul, Turkey
| | - Mahir Kapmaz
- Koç University İş Bank Research Center for Infectious Diseases, Istanbul, Turkey
| | | | | | - Saide Aytekin
- Department of Cardiology, Koç University School of Medicine, Istanbul, Turkey
| | - Vedat Aytekin
- Department of Cardiology, Koç University School of Medicine, Istanbul, Turkey
| | - Önder Ergönül
- Koç University İş Bank Research Center for Infectious Diseases, Istanbul, Turkey.
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Şahin ŞT, Yılmaz N, Cengiz B, Yurdakul S, Çağatay Y, Kaya E, Aytekin S, Yavuz Ş. Subclinical biventricular systolic dysfunction in patients with systemic sclerosis. Eur J Rheumatol 2019; 6:89-93. [PMID: 31365343 PMCID: PMC6467320 DOI: 10.5152/eurjrheum.2019.18155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/25/2018] [Indexed: 12/02/2022] Open
Abstract
Objective Silent myocardial involvement is associated with poor prognosis in patients with systemic sclerosis (SSc). Here we aimed to evaluate the subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in patients with SSc without any cardiovascular diseases, by using both strain imaging methods, speckle tracking echocardiography (STE) and real-time 3D echocardiography (RT3DE). Methods A total of 47 patients with SSc and 20 age- and gender-matched healthy controls (HC) were studied. Conventional echocardiography, STE-based strain imaging, and real-time 3D echocardiography (Bothell, WA, USA) were performed to assess the biventricular deformation. Clinical and serological findings were sought. Results Conventional echocardiographic LV measurements were similar between SSc and HC. Both the LV and RV longitudinal peak systolic strain/strain rates were significantly impaired in SSc, demonstrating subclinical LV and RV systolic dysfunction (p≤0.001). Systolic pulmonary artery pressure (SPAP) was negatively correlated with both the LV and RV longitudinal peak systolic strain/strain rates (LV, r=−0.554 and r=−0.642, respectively, p<0.001; and RV, r=−0.554 and r=−0.642, respectively, p=0.001). There was a trend for decreasing LV strain and increasing LEVSV in a 1-year analysis of patients with SSc. Conclusion SSc is associated with myocardial systolic dysfunction. A deformation scrutiny conducted by both the STE-based strain imaging and end-systolic LV volume analysis by real-time 3D echocardiography are promising modalities that allow us for non-invasive, comprehensive investigation of subtle deterioration in the biventricular systolic function of patients with SSc.
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Affiliation(s)
- Şükrü Taylan Şahin
- Department of Cardiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Neslihan Yılmaz
- Department of Rheumatology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Betül Cengiz
- Department of Cardiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Selen Yurdakul
- Department of Cardiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Yonca Çağatay
- Department of Rheumatology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Esra Kaya
- Department of Cardiology, Ege University School of Medicine, İzmir, Turkey
| | - Saide Aytekin
- Department of Cardiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Şule Yavuz
- Department of Rheumatology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
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Cengiz B, Şahin ŞT, Yurdakul S, Kahraman S, Bozkurt A, Aytekin S. Subclinical left ventricular systolic dysfunction in patients with severe aortic stenosis: A speckle-tracking echocardiography study. Turk Kardiyol Dern Ars 2018; 46:18-24. [PMID: 29339687 DOI: 10.5543/tkda.2017.43037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE In patients with aortic stenosis (AS), the left ventricular (LV) geometry changes due to the increased LV afterload. However, subclinical myocardial dysfunction can develop despite a normal LV ejection fraction (EF). This study was an investigation of subclinical LV systolic dysfunction in patients with severe AS with a normal LV EF using a strain imaging method, speckle-tracking echocardiography (STE), and an evaluation of its correlation with novel indices to assess the severity of AS. METHODS A total of 45 asymptomatic patients with severe AS and 25 age- and sex-matched controls without any cardiac disease and with preserved LV EF (EF ≥60%) were studied. In addition to performing conventional echocardiography and STE-based strain imaging, novel indices (energy loss index [ELI], valvulo-arterial impedance, systemic arterial compliance) were also measured. RESULTS The LV EF, and the LV end-diastolic and end-systolic diameters were similar in the 2 groups. The LV longitudinal peak systolic strain (10.66±1.15% to 19.66±2.62%; p=0.0001) and strain rate (0.32±0.07 s-1 to 1.85±0.32 s-1; p=0.0001) were significantly impaired in the study patients compared to the controls, demonstrating subclinical ventricular systolic dysfunction. A significant positive correlation was observed between the ELI and the LV strain/strain rate (r=0.45, p=0.002; r=0.55, p=0.0001, respectively). CONCLUSION Patients with severe AS develop subclinical LV systolic dysfunction, despite a preserved EF. Novel strain imaging-based echocardiographic techniques may provide additional data that can detect early myocardial systolic deterioration in these patients.
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Affiliation(s)
| | | | | | | | | | - Saide Aytekin
- Department of Cardiology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey.
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Şahin ŞT, Cengiz B, Yurdakul S, Aytekin S. A huge multilocular hydatid cyst with an unusual localization. Acta Cardiol 2015; 70:746. [PMID: 26717232 DOI: 10.2143/ac.70.6.3120196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Şahin ŞT, Yurdakul S, Cengiz B, Bozkurt A, Özenç E, Aytekin V, Aytekin S. Subclinical Left Ventricular Systolic Dysfunction in Patients with Coronary Artery Anomaly: A Speckle Tracking and Velocity Vector Imaging-Based Study. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Şahin ŞT, Yavuz Ş, Yılmaz N, Cengiz B, Yurdakul S, Bozkurt A, Çağatay Y, Aytekin S. Subclinical Biventricular Systolic Function is Impaired in Patients with Systemic Sclerosis: A Speckle Tracking-Based Echocardiographic Study. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yurdakul S, Öner F, Şahin ŞT, Cengiz B, Bozkurt A, Ercan G, Direskeneli H, Aytekin S. Subclinical Left Ventricular Systolic Dysfunction in Patients with Systemic Lupus Erythematosus: A Speckle Tracking and Real Time Three Dimensional Echocardiographic Study. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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