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    Relationship between the infarct localization and left ventricular rotation parameters following acute ST-segment elevation myocardial infarction
    (Turkish Soc Cardiology, 2020) Demirkiran, Aykut; Zorkun, Cafer; Demir, Hasan Deniz; Topcu, Birol; Emre, Ender; Ozdemir, Nihal
    Ojective: This study was an investigation of the role of left ventricular (LV) apical rotation seen in the early period after myocardial infarction (MI) in predicting infarct localization. Methods: A total of 124 patients with a ST-Segment elevation myocardial infarction (STEMI) diagnosis who underwent primary percutaneous coronary intervention (PCI) and 50 healthy volunteers with similar demographic characteristics were included in the study. The relationship between 2-dimenstional speckle tracking echocardiography (STE)-guided LV apical rotation angle measurements and technetium-99m sestamibi-single-photon emission computed tomography (SPECT)-guided infarct localization was evaluated. Conventional echocardiography and STE were performed on average 2 days after PCI, and gated SPECT myocardial perfusion imaging (MPI) was performed within an average of 60 days. Results: The apical rotation angle was lower in patients with an anterior MI compared with those who had an inferior MI and the control group (AntMl-InfMl: 6.51 +/- 2.4 degrees, AntMI-Control: 13.20 +/- 2.5 degrees, InfMI-Control: 14.3 +/- 2.1 degrees, p value: 0.00, 0.00, 0.15, respectively). SPECT MPI analysis revealed the presence of an LV apical scar in all patients with acute anterior MI, but only 14 of those with inferior MI group (usually the inferoapical wall). The apical rotation angle recorded in patients with apical scar was lower than that of the patients without apical scar (7.6 +/- 2.8 degrees and 14.5 +/- 2 degrees, respectively; p=0.00). Receiver operating characteristic curve analysis yielded an area under the curve for apical rotation of 0.799 (p<0.01). The optimal cutoff value of 12.1 degrees had a sensitivity of 78.3% and a specificity of 68.2% for predicting LV apical scar following STEMI. Conclusion: Detection of apical rotation angle decrease in the early period after STEMI may be useful in predicting extension of infarct scarring to the LV apex.
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    Speckle-tracking strain assessment of left ventricular dysfunction in synthetic cannabinoid and heroin users
    (Turkish Soc Cardiology, 2018) Demirkiran, Aykut; Albayrak, Neslihan; Albayrak, Yakup; Zorkun, Cafer Sadik
    Objective: There is growing evidence regarding the numerous adverse effects of synthetic cannabinoids (SCBs) on the cardiovascular system; however, no studies have shown the cardiovascular effects of opioids using strain echocardiography. This study examines the cardiac structure and function using echocardiographic strain imaging in heroin and synthetic cannabinoid users. Methods: This double-blind study included patients who were admitted or referred to a rehabilitation center for heroin (n=31) and synthetic cannabinoid users (n=30). Heroin users and synthetic cannabinoid users were compared with healthy volunteers (n=32) using two-dimensional (2D) speckle-tracking (ST) echocardiography. Results: No differences were found in the baseline characteristics and 2D echocardiography values. The mean global longitudinal strain value was -20.5%+/- 2.4% for SCB users, -22.3%+/- 2.4% for opioid users, and -22.5%+/- 2.2% for healthy volunteers (p=0.024). The mean apical 2-chamber (AP2C) L-strain values were -20.1%+/- 3.1%, -22.4%+/- 3.0%, and -22.3%+/- 2.8% for SCB users, opioid users, and healthy volunteers, respectively (p=0.032). The mean apical 4-chamber (AP4C) L-strain values were -20.7%+/- 2.5% for SCB users, -23.2%+/- 3.2% for opioid users, and -23.8%+/- 3.1% for healthy volunteers (p<0.001). Conclusion: SCBs are potential causes of subclinical left ventricular dysfunction.
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    Strain can hide some states Reply
    (Turkish Soc Cardiology, 2018) Demirkiran, Aykut; Albayrak, Neslihan; Albayrak, Yakup; Zorkun, Cafer Sadik
    [Abstract Not Available]