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    Echocardiographic evaluation of aortic elasticity parameters in aortic stenosis patients with preserved ejection fractions undergoing transcatheter aortic valve implantation
    (2022) Bayramoğlu, Adil; Tasolar, Hakan; Ulutaş, Zeynep; Akaycan, Julide; Cansel, Mehmet; Ermiş, Necip; Yiğit, Yakup
    Abstract Aim: Aortic stiffness is an important risk factor that reflects the mechanical tension and elasticity of the aorta and predicts cardiovascular mortality and morbidity. However, it has been found that aortic stiffness contributes to both symptom burden and clinical outcomes in patients with aortic stenosis (AS). In our study, we aimed to evaluate the effect of transcatheter aortic valve implantation (TAVI) on aortic elasticity parameters by echocardiography in patients with severe aortic stenosis, especially with preserved ejection fraction. Materials and Methods: A total of 55 consecutive patients with symptomatic severe AS who underwent TAVI were included in the study. Demographic data, echocardiographic and aortic elasticity measurements of all patients were measured before and 6 months after the procedure. To evaluate the elastic properties of the aorta, aortic strain, distensibility and stiffness index were calculated. Results: Left ventricular mass index (LVMI) (p < 0.001) and aortic stiffness (p < 0.001) were decreased, while aortic strain (p < 0.001) and aortic distensibility (p < 0.001) were found to be increased in the measurements performed at 6 months after TAVI. In the regression analysis, age and LVMI were found to be independent predictors for predicting improvement in aortic stiffness; on the other hand, LVMI also independently predicted the increase in aortic distensibility. Conclusion: Improvement in aortic elastic properties and left ventricular functions were found in patients who underwent TAVI. Age and LVMI were observed to predict the improvement in stiffness and distensibility of the aorta in patients undergoing TAVI, especially in AS patients with preserved ejection fraction.
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    Evaluation of left atrial volume and functions by 3D echocardiography in patients with prediabetes and investigation of its correlation with NT-pro ANP levels
    (2022) Eyyüpkoca, Ferhat; Hidayet, Siho; Ozyalin, Fatma; Bayramoğlu, Adil; Altıntaş, Mehmet Sait; Akaycan, Julide
    Background: An increased burden of cardiovascular disease is observed in prediabetes compared to normoglycemic. In this study, we aimed to evaluate left atrium (LA) volume indices and mechanical functions in prediabetes patients by real-time three- dimensional echocardiography (3DE) and examine the relationship of these parameters with N-terminal pro-atrial natriuretic peptide (NT-pro-ANP) levels. Methods: 41 patients diagnosed with prediabetes by the oral glucose tolerance test in the endocrinology outpatient clinic and 43 healthy controls were included in this study. We evaluated the volume indices and mechanical functions of the LA using 3DE. Plasma NT-proANP was evaluated by the enzyme-linked immunosorbent assay method. Results: Median NT-pro-ANP level was higher in the prediabetes group than the control group (1.5 vs 0.7 nmol/L, p<0.001). Levels of LA volume index (LAVI), minimum and maximum of LA volume (Vmin, Vmax; respectively), pre- atrial contraction volume (VpreA), active emptying fraction, and total and active emptying volume, each reflects reservoir and pump functions of LA, were higher in the prediabetes group. In contrast, the LA passive emptying fraction (PEF) level was lower (p<0.05). There was a positive correlation between levels of NT-pro-ANP and Vmax (r= 0.352, p=0.024), Vmin (r= 0.563, p<0.001), VpreA (r= 0.504, p<0.001), and LAVI (r= 0.338, p=0.031), while negative correlation existed between levels of NT-pro-ANP and total emptying fraction (r = -0.522, p<0.001) and PEF (r= -0.349, p=0.025) was found. Conclusion: LA volume and mechanical functions are impaired in prediabetes patients, and this deterioration was positively correlated with NT pro-ANP levels. The current findings demonstrate that cardiac structural deterioration in prediabetes patients is just initiated before overt diabetes onset.
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    Evaluation of the Effect of Transcatheter Aortic Valve Implantation on Left Ventricular Function by 4-Dimensional Echocardiography
    (Kare Publ, 2023) Bayramoglu, Adil; Ulutas, Zeynep; Akaycan, Julide; Hidayet, Siho; Tasolar, Hakan; Cansel, Mehmet; Ermis, Necip
    Objective: Beneficial effects of transaortic valve implantation on left ventricular hemodyna-mics and prognosis of patients have been demonstrated. Although left ventricular systolic and diastolic function following transaortic valve implantation procedure have been examined in previous studies, 4-dimensional echocardiographic parameters have not been extensively studied, especially in patients with preserved ejection fraction aortic stenosis. In our study, we planned to evaluate the effect of transaortic valve implantation on myocardial deformation using 4-dimensional echocardiography. Methods: A total of 60 consecutive patients who underwent transaortic valve implantation for severe aortic stenosis with preserved ejection fraction were prospectively enrolled in the study. Standard 2-dimensional echocardiography and 4-dimensional echocardiography were per-formed in all patients before and 6 months after the transaortic valve implantation procedure. Results: Six months after valve implantation, significant improvement was observed in global longitudinal strain (P < 0.001), spherical circumferential strain (P = 0.022), global radial strain (P = 0.008), and global area strain (P < 0.001). In the regression analysis, global area strain and absence of diabetes mellitus were determined as independent predictors to show a 10% increase in the left ventricular ejection fraction. Conclusions: In patients with preserved ejection fraction who underwent transaortic valve implantation, left ventricle deformation parameters have improved after 6 months, especially by using 4-dimensional echocardiography. The use of 4-dimensional echocardiography should be more common in daily practice.
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    Important considerations in the echocardiographic assessment of tricuspid regurgitation and right ventricular function
    (2020) Akaycan, Julide; Hidayet, Siho; Ulutaş, Zeynep; Karaca, Yücel
    Abstract: Tricuspid regurgitation (TR) and right ventricular dysfunction, which have been traditionally underemphasized, are known to be associated with increased morbidity and mortality, particularly in patients undergoing left-sided cardiac valvular surgery. Echocardiographic assessments are of utmost importance in terms of timely management and proper patient selection. In this review, our aim was to assess tricuspid failure as well as right ventricular functions using echocardiography.
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    Subclinical left ventricular dysfunction in Sjogren's syndrome assessed by four-dimensional speckle tracking echocardiography
    (Wiley, 2020) Akaycan, Julide; Hidayet, Siho; Bayramoglu, Adil; Yolbas, Servet; Karaca, Yucel; Yigit, Yakup; Ulutas, Zeynep
    Objective The aim of this study was to evaluate the left ventricular (LV) systolic strain by four-dimensional speckle tracking echocardiography (4D-STE) in order to provide the early detection of myocardial dysfunction in patients with Sjogren's syndrome (SS). Methods Forty consecutive patients with primary SS diagnosed at the rheumatology outpatient clinic and 35 age- and sex-matched healthy volunteers were included in the study. 4DSTE was performed, and global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were measured. 4DSTE results were compared with the healthy volunteers. Results No significant differences were observed between the GRS and GCS values of the two groups. A significant difference was observed in the GLS and GAS measurements between the two groups (P = .005 for GLS,P < .001 for GAS). Positive correlation was detected between disease duration and LV-GLS and LV-GAS. Conclusion We demonstrated subclinical systolic dysfunction in SS patients by 4DSTE, which is a sensitive marker of ventricular dysfunction. Deterioration of the LV became more evident as duration of the disease increased. Therefore, we believe that a cardiac evaluation will be of benefit to patients with long-term SS.