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Öğe Assessment of cases with syncope due to primary pulmonary hypertension(2002) Tatli E.; Karahasano?lu E.; Kaldir H.M.; Aktaş Z.; Özçelik F.; Özbay G.Primary pulmonary hypertension is an uncommon disease. Its diagnosis is suspected after clinical examination however it can be made only after detailed evaluation of heart and lungs and exclusion of all etiologies for secondary pulmonary hypertension. Prognosis in general is poor but it ranges individually. In this article we aimed to examine this subject by interpreting a patient referred to our clinic for syncope and diagnosed as primary pulmonary hypertension.Öğe Assessment of the effect of left ventricular hypertrophy on right ventricular functions using pulsed wave tissue Doppler imaging in patients with essential hypertension(2003) Sürücü H.; Akdemir O.; Üstünda? S.; Tatli E.; Köker I.; Özbay G.There are limited number of studies evaluating right ventricular functions in patients with essential hypertension. Standard echocardiographic parameters have been used in all those studies, and data on effects of left ventricular hypertrophy (LVH) on right ventricular functions are lacking. This paper seeks the effect of LVH on the right ventricular functions with standard echocardiography (echo) and pulsed wave tissue Doppler imaging (TDI) in 114 patients with essential hypertension. Findings were compared to 34 healthy subjects who had no systemic disease and negative exercise test, according to the Bruce protocol (group 1). Patients were classified as no LVH in electrocardiography (ECG) and echo (group-2), LVH by echo but not by ECG (group-3) and those who had LVH both by ECG and echo (group-4). None of the standard echocardiographic parameters could detect an abnormality in right vetricular functions due to LVH. However; right ventricular TDI parameters of IVRa speed and Ea deceleration time were higher than in patients with LVH. IVRa speed data collected in right ventricular myocardium (group 4) were greater than in other groups (p 0.01, 0.02 and <0,001, respectively). The Ea deceleration time in group 4 was also prolonged compared to the healthy group and essential hypertensie group which had no LVH (P:0.020 and p:0.037). Assuming these changes reflect right ventricular diastolic dysfunction, following results can be concluded: right ventricular functions were influenced by left ventricular hypertrophy and these changes could not be detected by standard echo parameters and thus it is concluded that LVH in ECG indicates right ventricular diastolic dysfunction.Öğe Automatic backscatter analysis of regional right ventricular systolic function using colour kinesis in patients with inferior wall acute myocardial infarction with or without right ventricular involvement(Klinika Kardiologii CMKP, 2002) Kürüm T.; Özbay G.; Korucu C.; Eker H.; Öztekin E.Background. In patients with inferior acute myocardial infarction (AMI), right ventricular (RV) function is an important determinant of global cardiac performance, prognosis, and exercise capacity. Several echocardiographic methods for quantifying RV function have been developed over the years but the usefulness of colour kinesis (CK) and acoustic quantification (AQ) have not yet been investigated. Aim. To test whether AQ and CK may provide quantitative assessment of global and regional RV function in patients with inferior AMI. Methods. Thirty two consecutive patients with recent inferior AMI with or without RV involvement (n=17 and n=15, respectively), and 15 age- and gender-matched controls were studied. The graphs of RV fractional area change were displayed along with ECG and the concurrent cross sectional image. CK digitised end-systolic images of RV and were evaluated by reviewing the stored loops obtained from normal subjects and patients. To evaluate the entire RV systolic endocardial excursion, further quantitative CK analysis was performed by measuring the systolic segmental endocardial motion (SEM). Results. In comparison with the control group, patients with inferior AMI with or without RV involvement had reduced RV fractional area change (30±7%, 36±6%, 45±6%, p<0.05, p<0.01 respectively), reduced mean free wall SEM (3.9±1.1 mm, 5.2±1.3 nim, 6.3±1.4 mm, p<0.05, p<0.01 respectively) and mean septal wall SEM (4.9±1.2 mm, 6.4±1.5 mm, 7.2±1.4 mm, p<0.05, p<0.05, respectively). Conclusions. Our results confirmed that RV systolic functions are significantly more altered in patients with inferior AMI than in controls, and that RV abnormalities are more pronounced in patients with rather than without RV involvement. AQ and CK are able to detect wall motion disturbances in patients with inferior AMI with RV involvement.Öğe The effect of right ventricular outflow tract and apical pacing sites on electrocardiographic parameters in patients with permanent pacemakers(2004) Erdo?an O.; Altun A.; Özbay G.Right ventricular outflow tract (RVOT) pacing is an alternative pacing site to apical pacing. RVOT pacing seems to be superior to apical pacing in terms of hemodynamic support while providing synchronous activation similar to native conduction pattern. In order to increase the cardiac output and synchronize ventricular activation pattern the paced QRS complex duration should be as narrow as possible according to previous biventricular pacing applications. However, it is not well established how much RVOT pacing will change the paced QRS time and other various electrocardiographic intervals in comparison to apical pacing. To investigate this, we undertook a prospective clinical study consisting of 16 patients in whom the ventricular leads were positioned and fixed in the RVOT. In 11 of these patients, time intervals of various electrocardiographic parameters including QRS, QTc, JTc, TTc, QTd, JTd, and TTd were measured from ECG recordings taken on RVOT and apical pacing sites during pacemaker implantation. Mean QRS time in RVOT position was significantly decreased in contrast to apical position (127 ± 26 vs 155 ± 21, p=0.004). Although QTc, JTc and TTc intervals increased in duration when paced from RVOT, only JTc reached statistical significance (p=0.01). We did not detect any significant change in other parameters. We did not observe any complication during and after the procedure in all 16 patients. In conclusion, RVOT pacing significantly diminishes the mean QRS duration as compared to apical pacing. It is a safe and easy applicable technique while providing synchronous activation pattern similar to native conduction and can be considered as an alternative site of permanent pacing.Öğe Excision of aortic vegetation in Brucella endocarditis(Asia Publishing Exchange Pte Ltd, 2001) Duran E.; Sunar H.; Ege T.; Canbaz S.; Akata F.; Özbay G.A 19-year-old man with brucella endocarditis was treated by antimicrobial therapy and surgical excision of vegetation with preservation of the native aortic valve.Öğe Proximal anastomotic marker use in coronary artery bypass operations(2002) Çikirikçio?lu M.; Özbay G.; Duran E.Detection and evaluation of aorto-to-saphenous vein anastomosis sites (proximal anastomoses) in patients who had undergone coronary artery bypass surgery are comparatively harder than native coronary orifices during follow-up re-angiography procedures. Placement of a radioopaque proximal anastomotic graft marker during coronary artery bypass procedure poses medical and economical advantages in case of postoperative reangiography during follow-up of these patients. Indication of whether or not to use a proximal anastomotic marker is in general decide on by the operating surgeon. However, coronary angiography is a task of interventional cardiologist. Difference of the teams performing cathaterization and the surgical procedure may rise some inconsistencies in terms of requirements for these markers. In order for these dilemmas to be prevented, surgical team should be informed of the complication re-angiography procedure. Proper strategy for the implantation of this technique, which is convenient not only for cardiologist and surgeon but also in economic terms, should be decided on with collaboration of cardiology and cardiovascular surgery teams. In this article, advantages of the proximal anastomotic markers during the postoperative follow-up and re-angiography have been presented with the related literature review.Öğe Significance of ST elevation in lead V1 in acute anterior myocardial infarction: A pulsed wave tissue Doppler echocardiography study(2003) Akdemir O.; Yildiz M.; Gül Ç.; Birsin A.; Altun A.; Özbay G.Recent studies have focused upon the significance of ST segment elevation (STE) in lead V1 in acute anterior myocardial infarctions (AAMI). Our study investigated whether STE in V1 is associated with alterations in regional and global left ventricular functions determined by tissue Doppler (TD) imaging mitral annulus corners. Standard echocardiography and TD imaging of four sites of mitral annulus were performed to 47 consecutive patients with AAMI within 36 hours of hospital admission. Correlations between the maximum STE amplitude in V1 and TD velocities were analyzed. The amplitude of STE in V1 significantly correlates with early diastolic TD velocities of septal (r= -0.49), anterior (r= -0.47) and inferior mitral annulus (r= -0.51), early to late diastolic TD velocity ratio of inferior mitral annulus (r= -0.48), and mean early diastolic TD velocity (r= -0.52). A subgroup analysis revealed that patients with STE of 2 mm in V1 (32%) had significantly lower peak systolic and late diastolic TD velocity at septal annulus (5.9 ±1.8 cm/s vs. 6.8 ±1.3 cm/s; p=0.03 and 9.1 ±2.5 cm/s vs. 10.6 ±1.8 cm/s; p=0.02, respectively), early diastolic velocity at lateral mitral annulus (6.1 ±1.7 cm/s vs. 8.1 ±2.6 cm/s; p=0.02), and mean systolic TD velocity (6.2 ±1.2 cm/s vs. 6.8 ±0.9 cm/s; p=0.04). In patients with AAMI, a pronounced STE in V1 is associated with high degree of functional impairment involving both infarct-related and apparently best functioning portions of the left ventricle as determined by TD analysis of different mitral annulus corners.
