Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccessSubject: search.filters.subject.coronary flow reserve

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    Effects of Paclitaxel and Carboplatin Combination on Mechanical Myocardial and Microvascular Functions: A Transthoracic Doppler Echocardiography and Two-Dimensional Strain Imaging Study
    (2015) Altin, Cihan; Elif Sade, Leyla; Demirtas, Saadet; Karacaglar, Emir; Kanyilmaz, Suleyman; Simsek, Vahide; Ayhan, Ali; Muderrisoglu, Haldun; 24814007
    AimPaclitaxel and carboplatin are frequently used chemotherapy drugs in the treatment of gynecologic malignancies. Little is known about their effects on left ventricular mechanical and coronary microvascular functions. MethodsThirty consecutive patients were prospectively enrolled. Patients underwent transthoracic echocardiography (TTE) before and after chemotherapy, to evaluate left ventricular mechanical functions and coronary flow reserve (CFR). A comprehensive TTE, tissue Doppler and two-dimensional (2D) strain imaging were performed and coronary flow velocity was measured at baseline and after dipyridamole infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak flow velocities. Mitral annular velocities by tissue Doppler, peak strain, and systolic strain rate by velocity vector imaging (VVI) were measured. Baseline measurements were compared with healthy controls (n=26). ResultsNo patient developed heart failure (HF) symptoms, no significant change occurred in left ventricular ejection fraction or cardiac output and no significant difference was observed in CFR after chemotherapy. Baseline mean longitudinal peak strain and systolic stain rate were similar between patients and controls: -17.52.6% versus -17.6 +/- 2.2% (P=NS) and -1.04 +/- 0.14/sec versus -1.05 +/- 0.12/sec (P=NS). Peak strain and systolic strain rate decreased significantly after chemotherapy (from -17.5 +/- 2.6% to -16.2 +/- 2.5%, P<0.02; and from -1.05 +/- 0.12/sec to -0.96 +/- 0.11/sec, P=0.01, respectively). However, mean longitudinal velocity did not change significantly. ConclusionPaclitaxel and carboplatin combination did not impair CFR; however, this chemotherapy combination could induce subtle impairment in myocardial mechanical function which can be detected by advanced deformation imaging techniques rather than by tissue Doppler imaging or conventional 2D and Doppler echocardiography.
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    The Association between Aortic Distensibility and Coronary Flow Reserve in Newly Diagnosed Diabetic Patients
    (2015) Kalkan, Gulhan Yuksel; Gur, Mustafa; Haydardedeoglu, Filiz Eksi; Kirim, Sinan; Baykan, Ahmet Oytun; Kuloglu, Osman; Ucar, Hakan; Sahin, Durmus Yildiray; Elbasan, Zafer; Seker, Taner; Turkoglu, Caner; Yildirim, Arafat; Cayli, Murat; 0000-0002-0179-9673; 24815036; AAK-5003-2021
    IntroductionAortic distensibility (AD) is an important parameter affecting coronary hemodynamics. Coronary flow velocity reserve (CFVR) is a reliable marker of coronary endothelial function in diabetic patients. The aim of this study was to investigate the association between AD and CFVR in newly diagnosed diabetic patients. MethodWe studied 77 patients with newly diagnosed diabetes mellitus (DM) and 30 age- and sex-matched healthy control subjects. CFVR was calculated as the hyperemic to resting coronary diastolic velocities ratio by using transthoracic echocardiography. Pulse pressure (PP) and AD were calculated. ResultsFasting blood glucose, HbA1c and PP were significantly higher in patients with diabetes (P<0.001, P<0.001 and P=0.009, respectively). Other clinical and demographical characteristics, laboratory findings and echocardiographic findings were similar in both groups (P>0.05, for all). The measurement of CFVR and AD in patients with diabetes were significantly lower compared with the controls (P<0.001 and P=0.001, respectively). CFVR was significantly negatively correlated with age, body mass index, HbA1c, systolic blood pressure, and PP, while significantly positively correlated with AD (P<0.05, for all). Multivariate regression analysis showed that only AD (=0.485, P<0.0001) and HbA1c (=-0.362, P<0.0001) were independently associated with CFVR. The cutoff value of AD obtained by the receiver operator characteristic (ROC) curve analysis was 2.44 for the prediction of impaired CFVR. ConclusionAortic distensibility and HbA1c were independently associated with CFVR. The decrease in AD may be used as a marker of impaired coronary microcirculation in asymptomatic diabetic patients.