Sürdürülebilir Kalkınma Amaçları

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• MakaleAçık Erişim2025/r/gumushane/10326
  Athlete's Heart in Women's Contact Sports: Echocardiographic and Strain-Based Insights From Elite Rugby Players

  Tunca, Cagatay; Gök, Saner Bahadir; Günes, Ozan; Özkan, Mehmet Taha; Tas, Alperen; Ibis, Ayse Nur Ozkaya; Sahin, Yusuf Bozkurt; Akdogan, Murat; Kivrak, Ahmet; Akbuga, Kursat

  Background: Athlete's heart encompasses cardiac adaptations to long-term intensive training. Although male-dominated sports have been widely studied, limited data exist on structural and functional cardiac remodeling in female contact-sport athletes. This study aimed to evaluate cardiac changes in elite female rugby players using conventional and strain echocardiography. Methods: This cross-sectional study included 66 elite female rugby players and 50 sedentary controls. Anthropometric measurements and transthoracic echocardiographic assessments, including speckle tracking-derived global longitudinal strain (GLS), were performed. Linear, multivariable, and partial correlation analyses evaluated associations between GLS, active playing years (APY), and body mass index (BMI). Results: Compared to controls, athletes exhibited increased ventricular diameters, wall thicknesses, and left atrial size, with preserved left ventricular ejection fraction (LVEF). GLS values were significantly lower in rugby players (p < 0.001), though within normal limits. APY and BMI both showed significant inverse correlations with GLS (r = -0.456 and -0.370, respectively). In multivariable analysis, APY (beta = -0.392, p = 0.001) and BMI (beta = -0.225, p = 0.013) independently predicted GLS. Partial correlation confirmed the independent association of APY with GLS (r = -0.412, p = 0.001). GLS showed strong discriminative performance for >= 5 years of play (AUC = 0.816) and moderate performance for BMI >= 24.13 (AUC = 0.666). Conclusion: Elite female rugby athletes demonstrate physiological cardiac remodeling, including reduced GLS associated with training duration and BMI. These findings highlight the need for sex- and sport-specific echocardiographic reference values and further longitudinal research to clarify long-term clinical implications.

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• MakaleYalnız künye2020/r/gumushane/16407
  Right Ventricular Early Inflow-Outflow Index-A new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism

  Acar, Emrah; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet Fatih; Izgi, Ibrahim Akin; Kirma, Cevat

  Introduction Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life-threatening. Several risk graduation algorithms may be applied to delineate short-term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow-outflow (RVEIO) index, which is a Doppler-based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. Methods In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI >= 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured. Results There were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581-0.814; P < .001). RVEIO index was higher in the sPESI >= 1(n:72) than in the patients with sPESI < 1(14.27 +/- 2.13 vs 10.63 +/- 2.09; P < .001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P < .001). Conclusion As well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well-correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short-term mortality in APE patients.

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• MakaleYalnız künye2016/r/gumushane/16451
  Assessment of Left Atrial Mechanics in Patients with Preexcitation Syndrome Scheduled for Catheter Ablation

  Karakoyun, Suleyman; Tanboga, Ibrahim Halil; Gökdeniz, Tayyar; Lazoglu, Zakir; Topçu, Selim; Karal, Huseyin; Aksakal, Enbiya; Sevimli, Serdar

  ObjectivesWe aimed to test the left atrial (LA) mechanics and contraction synchrony by 2D strain imaging, in patients with Wolff-Parkinson-White (WPW) syndrome, before and after radiofrequency catheter ablation (RFCA). MethodsStudy population consisted of 25 patients with WPW scheduled for RFCA and 30 healthy controls. The peak LA strain at the end of the ventricular systole (LAs strain) and the LA strain with LA contraction (LAa Strain) were obtained. To assess LA dyssynchrony, septal versus lateral wall time-to-peak strain measurements were measured. ResultsThere was no difference between the patients with WPW and control subjects with regard to peak LAs and LAa strain. Patients with WPW demonstrated higher global time-to-peak LAs and LAa strain values compared with the control group. Peak LAs strain and LAa strain values, measured before and after the RF ablation of the accessory pathway, were comparable (34.33.92 vs. 34.6 +/- 3.2, P=0.816, 14.7 +/- 2.8 vs. 15.3 +/- 2.3, P=0.052, respectively). Global time-to-peak LAs and LAa strain measurements were significantly shorter after the RFCA compared with the values obtained before the RFCA. However, septo-lateral times to peak LA strain differences were found to be comparable in both WPW versus control and pre- versus postablation groups. ConclusionLA mechanical function assessed by 2D strain imaging was comparable between patients with WPW and control subjects. Patients with WPW had more prominent LA dyssynchrony during atrial pump phase as compared with the controls, a condition which could not improve after successful elimination of the accessory pathway by RFCA.

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• MakaleYalnız künye2013/r/gumushane/16079
  Coronary Flow Reserve and Myocardial Performance Index in Newly Diagnosed Diabetic Patients

  Kalkan, Gulhan Yuksel; Gür, Mustafa; Sahin, Durmus Yildiray; Baykan, Ahmet Oytun; Elbasan, Zafer; Kuloglu, Osman; Kivrak, Ali; Türkoglu, Caner; Arik, Osman Ziya; Çayli, Murat

  BackgroundPatients with diabetes mellitus (DM) are at high risk of left ventricular (LV) dysfunction. A reduction of coronary flow reserve (CFR) has been demonstrated in diabetic patients without coronary artery stenosis. In this study, we investigated the association between LV myocardial diastolic and systolic functions and the CFR in newly diagnosed diabetic patients in the absence of coronary artery disease. MethodWe studied 88 patients (mean age 4910years) with newly diagnosed DM and 40 healthy control subjects (mean age 509years). All subjects underwent transthoracic echocardiography. The myocardial performance index (MPI) was determined by using pulsed-wave Doppler. The CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio. ResultsPatients with diabetes had significantly longer mitral E-wave deceleration time and higher MPI value than control group (P=0.023 and P<0.001, respectively). The mean CFR was lower in diabetic patients compared with controls (P=0.001). The MPI was significantly correlated with CFR (r=-0.371, P<0.001), LV ejection fraction (r=-0.274, P=0.018) E/A ratio (r=-0.244, P=0.024), and glycosylated hemoglobin (HbA1c) (r=0.476, P<0.001). Multivariate regression analysis showed that MPI was independently associated with CFR (=-0.292, P<0.0001) and HbA1c level (=0.372, P<0.0001). ConclusionsThe MPI was independently associated with CFR in newly diagnosed diabetic patients. The decrease in CFR may cause LV systolic and diastolic dysfunction in asymptomatic diabetic patients.

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