Browsing by Author "Yildirim, Mustafa"

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A Novel Echocardiographic Method for the Prediction of Coronary Artery Disease
(int Scientific information, inc, 2008) Gunes, Yilmaz; Tuncer, Mustafa; Yildirim, Mustafa; Guentekin, Uenal; Gumrukcuoglu, Hasan Ali; Sahin, Musa
Background: Coronary artery disease (CAD) is a leading cause of death and prevention and early detection of CAD are major goals of healthcare. Although ultrasound methods allow valid and repeatable detection of structure and function of cardiovascular system, a rapid ultrasonographic method for the prediction of CAD has not yet been defined. Material/Methods: Ninety-one patients with newly diagnosed significant CAD on coronary angiography and 36 patients with normal coronary arteries were included in the study. Aortic strain, aortic distensibility, aortofemoral pulse-wave propagation velocity (PWPV), and color M-mode propagation velocity of the descending aorta (ANT) were measured. Results: Male sex and smoking were significantly more frequent in the CAD group. Mean values of the left ventricular ejection fraction and AVP were significantly lower with higher PWPV in patients with CAD than controls. Multivariate regression analysis including age, hypertension, LDL cholesterol, diabetes, smoking habit, body mass index, left ventricular ejection fraction, ANT, aortic strain, aortic distensibility, and PWPV revealed that AVP (beta=0.850, p<0.001) and PWPV (beta=0.166, p=0.008) were the only significant predictors of CAD. However, when ANT was extracted from the regression model, the adjusted R-2 decreased from 0.652 to 0.099. An AVP value of <41 cm/s, determined by receiver operating curve analysis, predicted CAD with 82.4% sensitivity and 97.2% specificity (positive predictive value: 98.7% and negative predictive value: 68.2%). Conclusions: Bedside risk stratification for CAD is feasible by echocardiographic determination of AVP. This novel parameter may be particularly useful in identifying patients who will benefit from further diagnostic strategies for
The Relation Between the Color M-Mode Propagation Velocity of the Descending Aorta and Coronary and Carotid Atherosclerosis and Flow-Mediated Dilatation
(Wiley, 2010) Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Ceylan, Yemlihan; Simsek, Hakki; Sahin, Musa; Yildirim, Mustafa
Background: To improve clinical outcomes, noninvasive imaging modalities have been proposed to measure and monitor atherosclerosis. Common carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilatation (FMD) have correlated with coronary atherosclerosis. Recently, the color M-mode-derived propagation velocity of descending thoracic aorta (AVP) was shown to be associated with coronary artery disease (CAD). Methods: CIMT, FMD, and AVP were measured in 92 patients with CAD and 70 patients having normal coronary arteries (NCA) detected by coronary angiography. Patients with acute myocardial infarction, renal failure or hepatic failure, aneurysm of aorta, severe valvular heart disease, left ventricular ejection fraction < 40%, atrial fibrillation, frequent premature beats, left bundle branch block, and inadequate echocardiographic image quality were excluded. Results: Compared to patients with normal coronary arteries, patients having CAD had significantly lower AVP (29.9 +/- 8.1 vs. 47.5 +/- 16.8 cm/sec, P < 0.001) and FMD (5.3 +/- 1.9 vs. 11.4 +/- 5.8%, P < 0.001) and higher CIMT (0.94 +/- 0.05 vs. 0.83 +/- 0.14 mm, P < 0.001) measurements. There were significant correlations between AVP and CIMT (r = -0.691, P < 0.001), AVP and FMD (r = 0.514, P < 0.001) and FMD and CIMT (r = -0.530, P < 0.001). Conclusions: The transthoracic echocardiographic determination of the color M-mode propagation velocity of the descending aorta is a simple practical method and correlates well with the presence of carotid and coronary atherosclerosis and brachial endothelial function. (Echocardiography 2010;27:300-305).