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    Assessment of Left Atrial Volumes and Functions in Patients with Coronary Slow Flow
    (2021) Aslan, Burhan; Peker, Tezcan; Tenekecioğlu, Erhan; Aktan, Adem; Özbek, Mehmet; Karadeniz, Muhammed; Çil, Habib
    Objectives: Coronary slow flow phenomenon (CSFP) is the slow or late progression of the opaque material to the distal vascular structures during angiography in patients with normal or near-normal coronary arteries. This study aims to evaluate left atrial volumes and functions using conventional transthoracic and tissue Doppler echocardiographic parameters in patients with CSFP. Materials and Methods: According to criteria determined by Gibson, 50 patients with slow flow in at least one coronary artery were included as cases, and 40 subjects with normal coronary flow were included as controls. Results: In the transmitral and tissue Doppler analysis, mitral early velocity (E), mitral late velocity/mitral early velocity (E/A), and Em were significantly lower in the coronary slow flow (CSF) group. LA, Am, mitral early velocity/earlydiastolic velocity (E/Em), LAVmax, LAVmin, LAVpreA, index volumes, LAAEV, LATEV, and LAAEF were found to be higher in the CSF group. A significant positive correlation was observed between Frame LAD and LAAEF (r=0.66, p<0.001) and between Frame LAD and E/Em (r=0.34, p<0.001). A significant negative correlation was found between LAAEF and E/A ratio (r=-0.4, p=0.003). There was also a significant positive correlation between LAPEF and E/A (r=0.44, p<0.001) and between the mean frame and LAAEF (r=0.4, p=0.002). Conclusion: Impaired LV diastolic functions and significant changes in LA volumes were found in patients with CSFP.
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    The effect of body mass index on complications in cardiac implantable electronic device surgery
    (Wiley, 2024) Guzel, Tuncay; Demir, Muhammed; Aktan, Adem; Kilic, Raif; Arslan, Bayram; Gunlu, Serhat; Altintas, Bernas
    Background Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications.Methods1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m(2)), overweight (25 <= BMI < 30 kg/m(2)), and obese (BMI >= 30 kg/m(2)). The primary endpoint was accepted as cumulative events, including the composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of cumulative events.Results The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156-3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470-9.204, p < .001), BMI (OR:1.069, 95%CI:1.012-1.129, p = .01) were independent predictors of cumulative events rates.Conclusions Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.