Browsing by Subject "Doppler echocardiography"
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Item Non-invasive evaluation of the adaptations of cardiac function in the neonatal period: A comparison of healthy infants delivered by vaginal route and caesarean section(2001) Coskun S.; Yüksel H.; Bilgi Y.; Lacin S.; Tansug N.; Onag A.Postnatal adaptations of cardiac hemodynamics in infants born vaginally or by caesarean section may be different. These cardiac functions were evaluated by Doppler echocardiography to assess adaptation differences. Cardiac output, heart rate, stroke volume, mean arterial pressure, total systemic vascular resistance, ejection fraction, and ductus arteriosus diameter were determined and compared at 1, 24 and 72 h of life in 22 infants born vaginally (group 1) and 23 born by caesarean section (group 2). One hour after delivery, heart rate, mean blood pressure, and total systemic resistance were found to be higher in group 1 infants (P < 0.01, P < 0.05, P < 0.05 respectively). Stroke-volume measurements were significantly higher in group 2 (P < 0.05). The ejection fraction and cardiac output values were similar in both groups. At 24 and 72 h, no significant differences were observed in measurements of infants born vaginally or by caesarean section. We did not find a parameter negatively affecting healthy newborns in either mode of delivery. However, under pathological conditions affecting the cardiovascular system at 1 h of life, including perinatal infections and hypoxemia, a lower stroke volume, higher heart rate, higher mean blood pressure, and higher peripheral resistance may cause additional work load to the cardiovascular system in infants born vaginally.Item QT dispersion in rheumatoid arthritis patients with and without Sjögren's syndrome(2003) Pirildar T.; Şekuri C.; Ütuk O.; Kemal Tezcan U.The aim of this study was to assess the effect of secondary Sjögren's syndrome (SjS) on QT dispersion and corrected QT dispersion in patients with rheumatoid arthritis (RA). We performed electrocardiography and Doppler echocardiography on 58 patients with RA whom we divided into two groups according to the presence of secondary SjS, and on 29 healthy controls. All patients revealed significantly longer QT dispersion and corrected QT dispersion values (P < 0.05). Diastolic function variables were significantly different in all patients compared to controls. QT dispersion and corrected QT dispersion values were significantly longer in RA patients with secondary SjS than in those without. We concluded that secondary SjS could be a cardiovascular risk factor contributing to the well documented cardivascular disease in RA patients.Item The effects of handgrip stress test on hemodynamic parameters before and after cilazapril treatment in patients with heart failure(2003) Tavli T.; Göçer H.Objective: To assess the effect of cilazapril treatment on several hemodynamic parameters during handgrip manuevers in patients with congestive heart failure. Cilazapril, an ACE inhibitor with high affinity, has been shown to be highly effective against a variety of vascular disorders. The effectiveness of isometric handgrip exercise on changes of cardiovascular hemodynamic parameters before and after cilazapril treatment in patients with congestive heart failure is unknown. Methods: The study population included 30 patients (16 male, 14 female) with mean age of 65±18 years. The effects of handgrip maneuver on hemodynamic parameters were studied by right heart catheterization and Doppler echocardiography. Results: Heart rate (HR) and mean arterial pressures (MAP) increased significantly after handgrip maneuver (from 95±6 beats/min to 101±12 beast/min; from 109±15 mm Hg to 118±19mm Hg, p<0.05 respectively). Pulmonary capillary wedge pressure (PCWP), pulmonary artery systolic (s) and diastolic (d) pressures (PAP), cardiac index (CI), right ventricular systolic and diastolic pressures (RVPs and RVPd), left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF) did not change after handgrip maneuvers (p<0.05). On the other hand, PAPs and PAPd, RVPs and RVPd, MAP and HR (p<0.05) decreased significantly during handgrip maneuvers after cilazapril treatment. However PCWP and CI, LVEF, RVEF did not change after treatment (p<0.05). Conclusion: Cardiovascular response to handgrip maneuver may be a marker of failure to respond to compensatory mechanisms. Cilazapril treatment was associated with significant improvement in hemodynamic parameters during handgrip stress test, the mechanisms of which are increased sympathetic and renin-angiotensin system activation, and altered vascular tonus.Item Evaluation of diastolic function by transmitral color M-mode flow propagation velocity in hypertensive patients; [Hipertansif olgularda transmitral renkli M-mod akim yayilma hizi ile diyastolik fonksiyonlarin deǧerlendirilmesi](2004) Şekuri C.; Tavli T.; Danahaliloǧlu S.; Göçer H.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.Objective: Diastolic dysfunction is considered as the most important cause of heart failure and morbidity in hypertensives. This study was designed to evaluate the relationship between the transmitral diastolic color M-mode flow propagation velocity (FPV) and left ventricular relaxation by using Doppler echocardiography. Methods: In the present study, thirty-nine patients (21 male, %58.3, age mean 52.7 ± 5.9 years) with hypertension stage-I and over, were included. Transmitral diastolic E and A velocities, E-deceleration time (DT) and isovolumic relaxation time (IVRT) were measured by pulse Doppler method. We performed color M-mode technique for measurement of FPV of transmitral diastolic flow in the apical four-chamber view. We measured slope of aliasing velocity (blue aliasing) determined by color M-mode images. Results: Flow propagation velocity values were not statistically related with age and gender, whereas differentiation of age groups were estimated as poor parabolic relationship, specially in patients over fifty years, FPV is estimated to be decreasing. Color M-mode FPV is correlated with DT, (r = -0.715, p<0.01), IVRT (r = -0.736, p<0.01 and interventricular septum thickness (r = -0.498, p<0.01), but not correlated with E/A ratio. Conclusion: Color M-mode FPV is correlated with DT and IVRT, which are important parameters for evaluation of diastolic function in hypertensive patients. This parameter is related with left ventricular relaxation and should be considered as a routine echocardiographic evaluation, because it is not affected by minimal changes in left ventricular filling pressure.Item Doppler index of myocardial performance and its relationship with mitral E wave deceleration time in acute Q-wave myocardial infarction; [Akut Q-Dalgali Miyokard ̇ Infarktününde Miyokardiyal Performans ̇Indeksi ve Mitral E Dalga Deselerasyon Zamani Arasindaki ̇ Ilişki](2004) Şekuri C.; Kurhan Z.; Tavli T.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.Objective: The objectives of the study were to assess myocardial systolic and diastolic functions by myocardial performance index (MPI) and its relationship with E - wave deceleration time (DT) in early phase of acute Q-wave myocardial infarction (MI). Methods: We performed nongeometric Doppler-derived echocardiography to assess combined systolic and diastolic functions using myocardial performance index in 50 patients with acute Q-wave MI at early phase of events, (25 pts with anterior MI and 25 pts with inferior MI). The index is defined as the sum of the isovolumic contraction and isovolumic relaxation times divided by ventricular ejection time and was obtained by Doppler measurement from the diastolic mitral inflow and left ventricular outflow velocity-time intervals. Results: As a result, the index was 0.54±0.1 in all patients with MI. We also estimated the higher MPI and DT values in anterior than inferior MI (MPI: 0.61±0.07 vs., 0.46±0.06, p<0.001; DT: 244±64 msec vs. 204±31.2 msec, p=0.005, respectively). Myocardial performance index was positively correlated with DT in inferior MI (r=0.42, p<0.035) and negatively correlated with anterior MI (r=- 0.72, p=0.0001). Conclusion: These data suggest that Doppler-derived MPI reflects severity of global left ventricular dysfunction in early phase of acute MI and may be a useful parameter in these patients.Item Huge pulsating cystic cardiac mass(2006) Utuk O.; Bilge A.R.; Bayturan O.; Sirin H.; Iskesen I.; Tezcan U.K.[No abstract available]Item Pulmonary hypertension in patients with chronic renal failure(2007) Havlucu Y.; Kursat S.; Ekmekci C.; Celik P.; Serter S.; Bayturan O.; Dinc G.Background: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. Objectives: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. Methods: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. Results: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 ± 1.01 months. Systolic PAP >35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 ± 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients (29.5 ± 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 ± 10.7 to 32.8 ± 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 ± 10.5 and 32.04 ± 10.5 mm Hg, respectively). Conclusions: This study demonstrates a high incidence of PH among patients with CRF. CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values. Copyright © 2007 S. Karger AG.Item Congenitally corrected transposition of the great arteries plus dextrocardia operated with an unusual operative technique(2008) Sirin B.H.; Kurdal A.T.; Iskesen I.We describe a case of congenitally corrected transposition of the great arteries plus dextrocardia and normal anatomical abdominal viscera. Systemic (tricuspid) valve replacement was performed due to moderately severe valve regurgitation. An unusual operative technique was used because of the patient's rare morphology. On cardiopulmonary bypass, the systemic valve was approached via a left atriotomy anterior to the left pulmonary veins, whereby the surgeon was positioned on the patient's left side. As the surgeon had excellent exposure from the opposite side of the table, he was able to perform a tricuspid valve replacement through the left atrium. Our aim is to share our limited experience of such cardiac morphology, which may oblige the surgeon to be positioned on the left side of the table to perform systemic valve surgery. © Georg Thieme Verlag KG Stuttgart.Item Effect of losartan on excercise tolerance and echocardiographic parameters in patients with mitral regurgitation(2008) Sekuri C.; Utuk O.; Bayturan O.; Bigle A.; Kurban Z.; Tavli T.Objectives. The aim of this study was to assess the effects of losartan treatment on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation (MR) secondary to mitral valve prolapse or rheumatic heart disease. Methods. Twenty-seven patients (14 males, 13 females, mean age 51±11, range 21-76) with moderate MR due to mitral valve prolapse or rheumatic heart disease were examined by means of Doppler echocardiography. The subjects were submitted to treadmill exercise tests using the modified Bruce protocol at baseline, after six hours and after the six-week treatment period to be evaluated based on their exercise tolerance. Mitral Regurgitant Volume (MRV), effective regurgitant orifice diameter, left atrial volume, left ventricle (LV) end-diastolic volume index, LV end-systolic volume index, LV ejection fraction (LVEF), left ventricle mass index were calculated at baseline and after six weeks of treatment with single dose of losartan (50 mg/ day). Results. Total treadmill exercise time increased from 477.7±147.9 to 535.7±149.0 seconds after six hours (p<0.01) and to 559.6±142.8 seconds after six weeks of treatment.Also, metabolic equivalent values increased following six hours of first dose and six weeks of losartan treatment (from 10.9±2.9 to 11.8±3.1,p=0.006 and 12.4±3.1, p=0.002; respectively). However, peak exercise systolic blood pressure (BP) was reduced after six hours and six weeks of treatment, and resting diastolic BP did not change after six hours but reduced at the end of the treatment period. MR volume decreased significantly from 29.3±14.1 ml to 25.1±14.8 ml, (p=0.025) without significant change in regurgitant orifice diameter (0.72±0.37 cm vs. 0.66±0.37 cm, p=NS), left atrium diameter and area while LVEF increased from 51.70±13.37 to 54.11-11.75 (p=0.015) with losartan. Conclusion. We conclude that the angiotensin II receptor antagonist losartan improves exercise tolerance and echocardiographic parameters in patients with moderate MR.Item Surgical treatment of aortic stenosis of subvalvular, valvular and supravalvular levels and patent ductus arteriosus in a single procedure(2010) Sirin B.H.; Iskesen I.; Kurdal A.T.; Kahraman N.The association between discrete subaortic stenosis and valvular-supravalvular aortic stenosis and other cardiac anomalies is a well known but rarely reported occurrence. The aim of our paper is to define the patient that has four cardiac problems and repaired all of them in a single procedure. 12 year old boy has 1- subvalvular discrete membrane, 2- bicuspid aortic valvular stenosis, 3- supravalvular aortic stenosis and 4- patent ductus arteriosus. All of the problems were repaired and the patient was discharged asymptomatically after successful relief of the obstruction.Item Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents(2010) Ozkol M.; Ersoy B.; Kasirga E.; Taneli F.; Bostanci I.E.; Ozhan B.The aims of our study were: (1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p∈<∈0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r∈=∈-0.285, p∈=∈0.004; r∈=∈-0.328, p∈=∈0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r∈=∈-0.263, p∈=∈0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p∈=∈0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p∈=∈0.027), while body mass index was the determinant of FL assessed by two methods (p∈<∈0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents. © 2010 Springer-Verlag.Item Right ventricular outflow obstruction of the patient with biventricular non-compaction(2010) Sirin B.H.; Kurdal A.T.; Iskesen I.; Cerrahoglu M.We present a case of a 16-year-old girl who underwent infundibular myectomy for right ventricular outflow tract obstruction complicated by biventricular non-compaction. The pathogenesis of this condition remains unknown. In pediatric patients non-compaction cardiomyopathy is associated with other cardiac abnormalities and carries a high mortality as a result of heart failure. In view of her improved cardiac performance after operation, we believe that a cardiac repair procedure should be performed based on the usual indications if left ventricular function is preserved. © Georg Thieme Verlag KG Stuttgart - New York.Item The value of echocardiography versus cardiac troponin i levels in the early detection of anthracycline cardiotoxicity in childhood acute leukemia: Prospective evaluation of a 7-year-long clinical follow-up(2011) Oztarhan K.; Guler S.; Aktas B.; Arslan M.; Salcioglu Z.; Aydogan G.The present study was designed to evaluate the significance of echocardiography versus cardiac troponin I levels in early detection of anthracycline dependent cardiotoxicity in acute lymphoblastic leukemia (ALL) patients. A total of 276 pediatric ALL patients were included in the study prospectively along 3 phases of data collection lasted from 2002 to 2009; including phase I (March 2002 to February 2003; n = 25; 53.3% females), phase II (September 2003 to April 2004; n = 35; 57.1% females), and phase III (January 2005 to June 2009; n = 216; 52.7% females) with respect to cumulative anthracycline doses applied. Anthracycline was administered in accordance with berlin-Franfurt-Munich (BFM)-2000 protocol in doses of 30 to 350 mg/m (in the first phase) and 30 to 240 mg/m (in the following phases). Evaluation of cardiotoxicity was performed via echocardiography and measurement of cardiac troponin I levels. Patients in each phase were homogenous in terms of gender and age. Diastolic dysfunction determined via reduction E/A ratio below the cutoff value was demonstrated to deteriorate earlier than systolic functions and alteration in cardiac enzymes. Being similar between dose groups, cTnI levels were shown to rise in the presence of congestive heart failure. In conclusion, anthracycline cardiotoxicity appears to be detected in an earlier stage by using diastolic parameters compared to systolic parameters and cardiac enzymes. © 2011 Informa Healthcare USA, Inc.Item Relationship Between Epicardial Adipose Tissue, Inflammation and Volume Markers in Hemodialysis and Transplant Patients(2015) Çolak H.; Kilicarslan B.; Tekce H.; Tanrisev M.; Tugmen C.; Aktas G.; Kursat S.Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin-6 [IL-6] and high sensitive C-reactive protein [Hs-CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs-CRP, IL-6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein-cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs-CRP, IL-6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC-CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD. Therapeutic Apheresis and Dialysis. © 2015 International Society for Apheresis.Item Relation between vascular endothelial markers and right ventricular function in the children with asthma(Tehran University of Medical Sciences, 2017) Cetin M.; Karaboga B.; Yilmaz O.; Yilmaz M.; Yuksel H.; Coskun S.Objectives: The aim of the study was to evaluate the possible relationship of clinical severity during asthmatic exacerbation with the ventricular functions and the levels of vascular endothelial-related biomarkers endothelin-1 (ET-1) and platelet-derived growth factor-BB (PDGF-BB) in the condensed breathing air in the children with asthma. Methods: The study included a total of 80 children with acute asthmatic episode; of these, 28 had a mild, 26 had a moderate, and 26 had a severe attack. Samples of condensed breathing air were obtained for being analyzed for ET-1 and PDGF-BB levels during the study. All patients were evaluated by echocardiography at the beginning of the study and two weeks after the treatment of asthmatic episode. Results: Before treatment, mPAP in moderate and severe asthma groups was significantly higher than in mild asthma group (21.6 ± 7.3, 30.1 ± 9.8 and 32.7 ± 7.8; P < 0.01, P < 0.001, respectively). After treatment, no significant difference was detected between the asthma groups (P > 0.05). Am and Em waves, and IVRT, IVCT, ET and RV MPI during the asthmatic attack and after treatment did not change significantly between the groups; pre- and post-treatment values of these parameters also did not show significant differences. In exhaled air samples of the group with severe asthma exacerbation ET-1 and PDGF-BB were higher than those in the moderate and mild group (0.80 ± 0.42, 0.58 ± 0.30, 0.50 ± 0.15; P = 0.002 and 281.7 ± 253.2, 167.3 ± 148.1, 135.9 ± 74.9; P = 0.008 respectively). Conclusions: Ourstudy resultsshowedthatmPAPin direct proportion with the increasedinflammatory cytokineswassignificantly higher in asthma attacks and levels of ET-1 and PDGF-BB were significantly increased with severity of asthma, indicating a vascular response. © 2017, Iranian Journal of Pediatrics.Item Asymmetric dimethylarginine levels and diabetes duration: Relationship with measures of subclinical atherosclerosis and cardiac function in children and adolescents with Type 1 diabetes(SAGE Publications Ltd, 2018) Ersoy B.; Eroğlu N.; Çetin M.; Onur E.; Özkol M.; Coşkun Ş.Aims: We aimed to evaluate asymmetric dimethylarginine levels in young patients with Type 1 diabetes mellitus according to diabetes duration and to examine the relationship between these levels and measures of atherosclerosis and myocardial function. Materials and methods: In total, 83 patients (8.5–22 years) with Type 1 diabetes mellitus were stratified by diabetes duration: 12–60 months (Group 1, n = 27), >60–120 months (Group 2, n = 29) and >120 months (Group 3, n = 27). Asymmetric dimethylarginine levels were assessed. Carotid intima–media thickness was measured. Myocardial function was assessed by M-mode, conventional Doppler and tissue Doppler echocardiography. Results: Asymmetric dimethylarginine level was significantly higher in Group 1, while carotid intima–media thickness was significantly greater in Group 3 (p < 0.05). Tissue Doppler echocardiography showed the ratio of peak early to peak late diastolic myocardial annular velocity decreased significantly in Groups 2 and 3 with a negative correlation with duration (r: −0.310, p = 0.004) and HBA1c levels (r = −0.391, p < 0.001). Myocardial performance index in all groups and isovolumic relaxation time in Group 3 increased significantly. Asymmetric dimethylarginine levels were negatively correlated with carotid intima–media thickness and isovolumic relaxation time (p < 0.05). Conclusion: In contrast to adult diabetics, asymmetric dimethylarginine concentration decreases as diabetes duration increases in young Type 1 diabetic patients and is associated with worsening measures of cardiovascular risk and poorer diastolic function. © 2018, © The Author(s) 2018.Item Effect of heart rate-oriented therapy on diastolic functions in patients with heart failure with reduced ejection fraction(Republic of China Society of Cardiology, 2018) Taş S.; Taş Ü.; Özpelit E.; Edem E.; Akdeniz B.Background: Resting heart rate (HR) is a strong predictor of cardiovascular mortality and morbidity in patientswith heart failure with reduced ejection fraction (HFrEF). However, the effects of HR-lowering therapy on diastolic function in HFrEF patients are notwell described. In this study,we aimed to investigate the effect of lowering HR on diastolic function in HFrEF patients with sinus rhythm. Methods: Fifty patientswith HFrEF with coexisting diastolic dysfunction and sinus rhythm with resting HR > 70 bpm were prospectively included in the study. All patients were treated with intended HR-lowering therapy, which targeted a HR below70 bpm.We divided thewhole population according to the resting HR achieved with strict rate control (group 1) and to that achieved without strict rate control (group 2; HR > 70 bpm) at the end of the study. Left ventricular diastolic function and B-type natriuretic peptide (BNP) values at baseline and at the end of the study were compared in both groups. Results: No significant differences were found between the groups in terms of baseline parameters except for lower diastolic blood pressure in group 2. At the end of follow-up, E/Em ratio, E/A ratio and left atrial area significantly decreased with an increased deceleration time in group 1. The changes in HR (delta HR) were correlated with E/Em (r = 0.67, p < 0.001) and delta BNP level (r = 0.49, p < 0.001). Conclusions: This study showed that an effective HR lowering in patients with HFrEF can lead to improvements in diastolic function. © 2018, Republic of China Society of Cardiology. All rights reserved.Item Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy(Churchill Livingstone, 2021) Alkan F.; Ersoy B.; Kızılay D.O.; Coskun S.Introduction: Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this. Methods: M-mode, pulse-wave Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured. Results: Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (p < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (p > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened ejection time, and a significant increase in myocardial performance index compared to controls (p < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (p < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter. Conclusion: Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels. © 2021 Elsevier LtdItem Use of the modified myocardial performance index for evaluating fetal cardiac functions in pregestational diabetic pregnancy babies(Taylor and Francis Ltd., 2021) Oncel Alanyali M.; Alkan F.; Artunc Ulkumen B.; Coskun S.The aim of this study is assessment of importance of use of the modified myocardial performance index (Mod-MPI) for the evaluation of foetal cardiac function in foetuses of women with pregestational diabetes mellitus (PDM). In this study, data of 30 pregnant patients aged 18–45 years diagnosed with PDM and 30 pregnant women aged 18–45 years with normal pregnancy and their babies were evaluated. Foetal echocardiographic and doppler measurements, foetal biometric measurements, umbilical artery and ductus venosus pulsatility indexes were measured in both PDM and control groups. The Mod-MPI was significantly higher in foetuses of PDM women. Many influences especially cardiac and postpartum complications are observed in infants of PDM women. The Mod-MPI is a simple and useful method for assessing foetal ventricular function. Our study has shown that PDM is associated with foetal ventricular dysfunction.Impact statementWhat is already known on this subject? Although MPI is frequently used in routine clinical assessment of neonates, it is not used adequately in foetuses. Many influences especially cardiac and postpartum complications are observed in infants of PDM women. However, there are few studies focussed specifically on the assessment of foetal cardiac function in PDM. What do the results of this study add? MPI, which shows both diastolic and systolic functions is independent of ventricular anatomy and foetal heart rate, was found significantly higher in diabetic mother foetuses, can be said to be a valuable parameter in evaluating foetal cardiac functions globally. What are the implications of these findings for clinical practice and/or further research? Our study has shown that foetuses PDM are associated with foetal ventricular dysfunction. For this MPI measurement can be routinely performed at foetal cardiac measurements in foetuses of PDM mothers. © 2020 Informa UK Limited, trading as Taylor & Francis Group.Item Evaluation of cardiac structure, exercise capacity and electrocardiography parameters in children with partial and complete growth hormone deficiency and their changes with short term growth hormone replacement therapy(Springer, 2023) Alkan F.; Ersoy B.; Kızılay D.O.; Ozyurt B.C.; Coskun S.Purpose: To evaluate cardiac structure, exercise capacity and electrocardiography (ECG) parameters of children with complete and partial growth hormone (GH) deficiency (GHD) and the effect of 12 months GH treatment on these. Methods: M-mode echocardiography, ECG and exercise test expressed as metabolic equivalent (MET) were performed in children with GHD, aged 9–14 years, divided into those with a peak GH response < 7 µg/L (complete GHD; n = 30) and 7–10 µg/L (partial GHD; n = 17) after two GH stimulation tests, at baseline and 12 months after GH initiation. Forty-eight healthy peers underwent the same tests once. Results: Left ventricular mass (LVM) was significantly lower before treatment in both groups with GHD compared to healthy peers (p = 0.015 and p = 0.032) but LVM in the GHD groups was similar to controls after 12 months of treatment. The increase in LVM in the complete GHD group was significant (p = 0.044). LVM index was significantly reduced with treatment in children with partial GHD (p = 0.035). Max METs, VO2max and exercise duration were significantly increased in children with complete GHD after treatment (p = 0.022, p = 0.015 and p = 0.002, respectively). Significant changes in P wave and QTc dispersion on ECG between groups were within physiological limits. Conclusion: This study showed that children with both partial and complete GHD had smaller cardiac structures and less exercise capacity compared to their healthy peers prior to GH treatment but this improved with 12 months of treatment. The cardiac trophic effect of GH, as well as the effect of increasing exercise capacity, is greater in those with complete GHD than in those with partial GHD. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.