PubMed İndeksli Yayınlar Koleksiyonu
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Item Cardiovascular Magnetic Resonance In Autoimmune Rheumatic Diseases: A Clinical Consensus Document By The European Association Of Cardiovascular Imaging(2022) Mavrogeni, S.; Pepe, A.; Nijveldt, R.; Ntusi, N.; Sierra-Galan, L. M.; Bratis, K.; Wei, J.; Mukherjee, M.; Markousis-Mavrogenis, G.; Gargani, L.; Sade, L. E.; Ajmone-Marsan, N.; Seferovic, P.; Donal, E.; Nurmohamed, M.; Cerinic, M. Matucci; Sfikakis, P.; Kitas, G.; Schwitter, J.; Lima, J. A. C.; 35808990Autoimmune rheumatic diseases (ARDs) involve multiple organs including the heart and vasculature. Despite novel treatments, patients with ARDs still experience a reduced life expectancy, partly caused by the higher prevalence of cardiovascular disease (CVD). This includes CV inflammation, rhythm disturbances, perfusion abnormalities (ischaemia/infarction), dysregulation of vasoreactivity, myocardial fibrosis, coagulation abnormalities, pulmonary hypertension, valvular disease, and side-effects of immunomodulatory therapy. Currently, the evaluation of CV involvement in patients with ARDs is based on the assessment of cardiac symptoms, coupled with electrocardiography, blood testing, and echocardiography. However, CVD may not become overt until late in the course of the disease, thus potentially limiting the therapeutic window for intervention. More recently, cardiovascular magnetic resonance (CMR) has allowed for the early identification of pathophysiologic structural/functional alterations that take place before the onset of clinically overt CVD. CMR allows for detailed evaluation of biventricular function together with tissue characterization of vessels/myocardium in the same examination, yielding a reliable assessment of disease activity that might not be mirrored by blood biomarkers and other imaging modalities. Therefore, CMR provides diagnostic information that enables timely clinical decision-making and facilitates the tailoring of treatment to individual patients. Here we review the role of CMR in the early and accurate diagnosis of CVD in patients with ARDs compared with other non-invasive imaging modalities. Furthermore, we present a consensus-based decision algorithm for when a CMR study could be considered in patients with ARDs, together with a standardized study protocol. Lastly, we discuss the clinical implications of findings from a CMR examination.Item Left Atrial Mechanics For Secondary Prevention From Embolic Stroke Of Undetermined Source(2022) Sade, Leyla Elif; Keskin, Suzan; Can, Ufuk; Colak, Ayse; Yuce, Deniz; Ciftci, Orcun; Ozin, Bulent; Muderrisoglu, Haldun; https://orcid.org/0000-0003-3737-8595; 33206942; AAQ-7583-2021Aims Anticoagulation is not justified unless atrial fibrillation (AF) is detected in cryptogenic stroke (CS) patients. We sought to explore whether left atrial (LA) remodelling is associated with embolic stroke of undetermined source (ESUS). Methods and results In this prospective study, we evaluated consecutively 186 patients in sinus rhythm who presented with an acute ischaemic stroke (embolic and non-embolic) and sex- and age-matched controls. We performed continuous electrocardiogram (ECG) monitoring to capture paroxysmal AF episodes as recommended by the guidelines. After 12 months of follow-up, continuous ECG monitoring was repeated in patients with undetected AF episodes. We quantified LA reservoir and contraction strain (LASr and LASct) by speckle-tracking, LA volumes by 3D echocardiography. Out of 186 patients, 149 were enrolled after comprehensive investigation for the source of ischaemic stroke and divided into other cause (OC) (n = 52) and CS (n = 97) groups. CS patients were also subdivided into AF (n = 39) and ESUS (n = 58) groups. Among CS patients, LA strain predicted AF independently from CHARGE-AF score and LA volume indices. ESUS group, despite no captured AF, had significantly worse LA metrics than OC and control groups. AF group had the worst LA metrics. Moreover, LASr predicted both CS (embolic stroke with and without AF) and ESUS (embolic stroke with no detected AF) independently from LAVImax and CHA(2)DS(2)-VASc score. LASr >26% yielded 86% sensitivity, 92% specificity, 92% positive, and 86% negative predictive values for the identification of ESUS (areas under curve: 0.915, P < 0.0001, 95% confidence interval: 0.86-0.97). Conclusion Echocardiographic quantification of LA remodelling has great potential for secondary prevention from ESUS.Item Assessment of atrial functional remodeling in patients with atrioventricular nodal reentrant tachycardia with and without drug-induced type 1 Brugada pattern: A case-control study(2021) Kocabas, Umut; Payzin, Serdar; Hasdemir, Can; 33599988Purpose The time interval between the onset of the P-wave on electrocardiogram (ECG) and peak A ' velocity of the lateral left atrial wall assessed by tissue Doppler imaging (PA-TDI interval) determine total atrial conduction time (TACT) which reflects atrial remodeling and arrhythmic substrate. In this retrospective study, we aimed to assess TACT in patients with atrioventricular nodal reentrant tachycardia (AVNRT) with and without drug-induced type 1 Brugada electrocardiogram ECG pattern (DI-Type 1 BrP) and control subjects. Methods Study population consisted of 62 consecutive patients (46 women; mean age 44 +/- 12 years) undergoing electrophysiological study and ablation for symptomatic, drug-resistant AVNRT, and 42 age-matched and sex-matched control subjects. All patients and control subjects underwent ajmaline challenge test and tissue Doppler imaging. Results A DI-Type 1 BrP was uncovered in 24 of 62 patients with AVNRT (38.7%). PA-TDI interval was similar among AVNRT patients with and without DI-Type 1 BrP (124 +/- 12 ms vs 119 +/- 14 ms, respectively, P = .32), but significantly longer in patients with AVNRT with as well as without DI-Type 1 BrP than in control subjects (124 +/- 12 ms and 119 +/- 14 ms vs 105 +/- 11 ms, respectively, P < .001). Conclusion The TACT assessed by PA-TDI interval is longer in patients with AVNRT with and without DI-Type 1 BrP than in age-matched and sex-matched healthy control subjects.Item The year 2020 in the European Heart Journal-Cardiovascular Imaging: part II(2021) Cosyns, Bernard; Sade, Leyla Elif; Gerber, Bernhard L.; Gimelli, Alessia; Muraru, Denisa; Maurer, Gerald; Edvardsen, Thor; 34718480The European Heart Journal-Cardiovascular Imaging was launched in 2012 and has during these years become one of the leading multimodality cardiovascular imaging journal. The journal is now established as one of the top cardiovascular journals and is the most important cardiovascular imaging journal in Europe. The most important studies published in our Journal from 2020 will be highlighted in two reports. Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease. While Part I of the review has focused on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging.Item New perspectives by imaging modalities for an old illness: Rheumatic mitral stenosis(2020) Oz, Tugba Kemaloglu; Tok, Ozge Ozden; Sade, Leyla Elif; 0000-0003-3737-8595; 32120357; AAQ-7583-2021Mitral stenosis (MS) is a progressive and devastating disease and most often occurs among young women. Given its considerable prevalence in Mediterranean and Eastern European countries according to the Euro Heart Survey, new imaging modalities are warranted to improve the management of patients with this condition. A wide spectrum of abnormalities occurs involving all parts of this complex structure and causing different grades of MS and/or regurgitation as a consequence of rheumatic affection. Novel imaging modalities significantly improved the assessment of several aspects of this rheumatic destructive process including the morphological alterations of the mitral valve (MV) apparatus, left atrial (LA) function, LA appendage, right and left ventricular (LV) functions, and complications, namely, atrial fibrillation and thromboembolic events. Furthermore, new imaging modalities improved the prediction of outcome of patients who underwent percutaneous balloon mitral comissurotomy and changed the paradigm of patient selection for intervention and risk stratification. The present review aimed to summarize the role of new multimodality, multiparametric imaging approaches to assess the morphological characteristics of the rheumatic MS and its associated complications, and to guide patient management.Item Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry(2020) Anwer, Shehab; Oguz, Didem; Galian-Gay, Laura; Mitevska, Irena Peovska; Baghdassarian, Lilit; Dulgheru, Raluca; Lapinskas, Tomas; Santoro, Ciro; Loizos, Savvas; Cameli, Matteo; Srbinovska, Elizabeta; Grapsa, Julia; Magne, Julien; Donal, Erwan; 32650695Background: The aim of this aortic stenosis registry was to investigate the changes of routine echocardiographic indices and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period. Methods: Our aortic stenosis registry is observational, prospective, multicenter registry of nine countries, with 197 patients with aortic valve area less than 1.5 cm(2). The enrolment took place from January to August 2017. We excluded patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require intervention and who had a complete follow-up study. Results: In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and follow-up studies (218 +/- 34 grams vs 253 +/- 29 grams, p = 0.02). However, when indexed to body surface area, there was no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 +/- -4.8 vs (-16.4 vs -3.8, p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and mid-cavity diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient aortic stenosis had significantly lower global longitudinal strain (-12.3% +/- -3.9% vs -19.7% +/- -4.8%, p = 0.01). Conclusion: Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of aortic stenosis.Item Training, competence, and quality improvement in echocardiography the European Association of Cardiovascular Imaging Recommendations: update 2020(2020) Popescu (Chair), Bogdan A.; Stefanidis, Alexandros; Fox, Kevin F.; Cosyns, Bernard; Delgado, Victoria; Di Salvo, Giovanni Di; Donal, Erwan; Flachskampf, Frank A.; Galderisi, Maurizio; Lancellotti, Patrizio; Muraru, Denisa; Sade, Leyla Elif; Edvardsen, Thor; 33245758The primary mission of the European Association of Cardiovascular Imaging (EACVI) is 'to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging'. Echocardiography is a key component in the evaluation of patients with known or suspected cardiovascular disease and is essential for the high quality and effective practice of clinical cardiology. The EACVI aims to update the previously published recommendations for training, competence, and quality improvement in echocardiography since these activities are increasingly recognized by patients, physicians, and payers. The purpose of this document is to provide the general requirements for training and competence in echocardiography, to outline the principles of quality evaluation, and to recommend a set of measures for improvement, with the ultimate goal of raising the standards of echocardiographic practice. Moreover, the document aims to provide specific guidance for advanced echo techniques, which have dramatically evolved since the previous publication in 2009.Item T1 Mapping by Cardiac Magnetic Resonance and Multidimensional Speckle-Tracking Strain by Echocardiography for the Detection of Acute Cellular Rejection in Cardiac Allograft Recipients(2019) Sade, Leyla Elif; Hazirolan, Tuncay; Kozan, Hatice; Ozdemir, Handan; Hayran, Mutlu; Eroglu, Serpil; Pirat, Bahar; Sezgin, Atilla; Muderrisoglu, Haldun; 29680337; X-8540-2019OBJECTIVES The aim of this study was to test the hypothesis that echocardiographic strain imaging, by tracking subtle alterations in myocardial function, and cardiac magnetic resonance T1 mapping, by quantifying tissue properties, are useful and complement each other to detect acute cellular rejection in heart transplant recipients. BACKGROUND Noninvasive alternatives to endomyocardial biopsy are highly desirable to monitor acute cellular rejection. METHODS Surveillance endomyocardial biopsies, catheterizations, and echocardiograms performed serially according to institutional protocol since transplantation were retrospectively reviewed. Sixteen-segment global longitudinal strain (GLS) and circumferential strain were measured before, during, and after the first rejection and at 2 time points for patients without rejection using Velocity Vector Imaging for the first part of the study. The second part, with cardiac magnetic resonance added to the protocol, served to validate previously derived strain cutoffs, examine the progression of strain over time, and to determine the accuracy of strain and T1 measurements to define acute cellular rejection. All tests were performed within 48 h. RESULTS Median time to first rejection (16 grade 1 rejection, 15 grade >= 2 rejection) was 3 months (interquartile range: 3 to 36 months) in 49 patients. GLS and global circumferential strain worsened significantly during grade 1 rejection and >= 2 rejection and were independent predictors of any rejection. In the second part of the study, T1 time >= 1,090 ms, extracellutar volume GLS >= 32%, GLS >-14%, and global circumferential strain >=-24% had 100% sensitivity and 100% negative predictive value to define grade >= 2 rejection with 70%, 63%, 55%, and 35% positive predictive values, respectively. The combination of GLS > 16% and T1 time >= 1,060 ms defined grade 1 rejection with 91% sensitivity and 92% negative predictive value. After successful treatment, T1 times decreased significantly. CONCLUSIONS T1 mapping and echocardiographic GLS can serve to guide endomyocardial biopsy selectively. (C) 2019 by the American College of Cardiology Foundation.Item Diagnosis and treatment of abnormal left coronary artery originating from the pulmonary artery: A single-center experience(2019) Yakut, Kahraman; Tokel, Niyazi Kursad; Ozkan, Murat; Varan, Birgul; Erdogan, Ilkay; Aslamci, Mehmet Sait; 31789610Objective: We aimed to review symptoms, findings, surgical treatment options, short- and mid-term outcomes, and reoperation rate of patients diagnosed with of left coronary artery from the pulmonary artery (ALCAPA) of an anomalous origin in our institution. Methods: From May 2000 to March 2018, 33 patients who had left coronary artery originating from the pulmonary artery were retrospectively examined. The clinical features of patients, diagnostic tools and their efficacy, outcomes of surgical repair, and problems during follow-up were evaluated. Results: Thirty-three patients (22 females, 11 males) were included in the study. At the time of surgery, the median age and weight of patients were 6 months (minimum/maximum, 1-166 months) and 6.5 kg (minimum/maximum, 3-38.5 kg), respectively. The mean follow-up was 5 +/- 3.5 years (range, 1-16 years). Dyspnea, tachypnea, diaphoresis, prolonged feeding time, and developmental delay were common presenting signs and symptoms. It was determined that all the patients who were diagnosed at another center reached our center for surgical treatment within 1 month. Twenty-three (69.7%) patients had pathologic 1:1 wave with anterior and/or anterolateral myocardial infarction signs on an electrocardiogram (ECG), whereas 22 (66.6%) patients had ST-T segment changes. Twenty-one (63.6%) patients had cardiomegaly on the telecardiogram. A reimplantation surgery was performed to 22 patients and 10 patients underwent the Takeuchi procedure. In addition to ALCAPA repair, 5 patients needed mitral valve plasty. Atrial septal defect (ASD) and ventricular septal defect (VSD) were closed in one patient, and Tetralogy of Fallot was totally corrected in another. At discharge, there was a significant improvement in left ventricular (LV) systolic functions. At the last visit, all patients had normal LV systolic functions except four who had mild dysfunction. The mean follow-up of the four patients was 2.8 years. In the early postoperative period, complications were seen in 10 patients. Five patients died in the early postoperative period, while one patient died 9 months after the ALCAPA surgery because of low cardiac output syndrome that developed after mitral repair. Conclusion: Patients with ALCAPA commonly present with congestive heart failure symptoms. When the diagnosis is confirmed in these patients, surgical treatment should not be delayed. The availability of surgical center and surgery outcomes for ALCAPA diagnosed patients are comparable with other countries, but the delay in the diagnosis of disease is still a problem in our country.Item How do we measure epicardial adipose tissue thickness by transthoracic echocardiography?(2015) Eroglu, Serpil; 25993714Epicardial adipose tissue (EAT) is a component of the visceral adiposity located between the heart and pericardium. It is associated with certain diseases, such as metabolic syndrome, coronary artery disease, and hypertension. Therefore, measurement of EAT thickness has recently gained importance. Examination by transthoracic echocardiography for measuring EAT thickness is preferable because of easy availability and low cost. The present review focuses on the method of measuring EAT thickness by transthoracic echocardiography as well as the issues of concern.