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    Assessment of relationship between contrast-induced nephropathy and left ventricular myocardial performance index in patients at risk for nephropath
    (2019) Ozturk, Mustafa; Turan, Oguzhan Ekrem; Sahin, Mursel; Kutlu, Merih
    Aim: Contrast induced nephropathy (CIN) is associated substantially with a risk of morbidity and mortality. The aim of this study was to assess the left ventricular myocardial performance assessed by ‘Tei index’ on the development of contrast induced nephropathy in patients underwent coronary angiography. Material and Methods: Study population consist of patients who underwent coronary angiography and/or percutaneous coronary intervention and baseline creatinine level 1 mg/dl above and/or having diabetes mellitus. 51 patient were included the study. Patients divided into two groups as CIN developed or not. CIN was defined as %25 and/or 0.5 mg/dl increase in basal serum creatinine levels after 48-72 hours exposure to contrast media. Conventional and tissue Doppler echocardiography was performed in all patients prior to angiography. Tei index was calculated from tissue Doppler echocardiography data. Results: Two groups were defined as CIN-developed group (n =13, 62.5 ± 6.8 ) and CIN-undeveloped (n=38, 62.4±9.6 )group. Except gender, there is no difference in demographic characteristics between the study groups. Left ventricular (LV) systolic function such as ejection fraction and tissue Doppler imaging Sm and basic LV diastolic function (E/A, Em/Am, DT) parameters were found to be similar in both groups. Tissue Doppler-derived Tei index values did not differ significantly between the two groups (0.42 ± 0.09 vs 0.46 ± 0.12, p = 0.25). Conclusion: The Tei index is inadequate for predicting the risk of developing nephropathy in patients at risk for contrast induced nephropathy with preserved ejection fraction.
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    What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?
    (Elsevier Ireland Ltd, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Dogan, Volkan; Ceyhan, Ceyhun; Tuncez, Abdullah; Kutlu, Merih; Onrat, Ersel
    Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.