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    Incidental detection of a quadricuspid aortic valve by transesophageal echocardiography in a patient with ruptured mitral valve chorda
    (I C R Publishers, 2002) Akdemir, O; Sürücü, H; Özbay, G
    Quadricuspid aortic valve is a rare congenital cardiac abnormality which is frequently detected at necropsy or surgery. Here, a young, asymptomatic patient with mild aortic. and mitral regurgitations is described in whom a quadricuspid aortic valve was detected incidentally on transesophageal echocardiography performed initially to diagnose ruptured mitral chordae tendineae.
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    Right ventricular function in patients with acute anterior myocardial infarction
    (Acta Cardiologica, 2002) Akdemir, O; Yildiz, M; Sürücü, H; Dagdeviren, B; Erdogan, O; Ozbay, G
    Objective - Our purpose was to investigate the right ventricular (RV) performance of patients with a first acute anterior myocardial infarction (AAMI) by using pulsed wave Doppler tissue (PWDT) samplings of tricuspid annulus and RV free wall. Methods and results - The study group included 31 patients with AAMI and 20 age-matched controls. Conventional indexes of RV functions were the magnitude of tricuspid annular plane systolic excursion (TAPSE), and the transpulmonary and transtricuspid Doppler parameters. PWDT velocities were obtained by placing the sample volume at the lateral tricuspid annulus and the mid-segment of RV free wall; the peak systolic (S), early (E) and late (A) diastolic PWDT velocities and time intervals from ECG-Q wave to their peaks were analysed. Standard indexes were comparable except TAPSE that was significantly lower in AAMI-patients (p < 0.001). S velocities were similar; A of both regions (p = 0.0 18 and 0.0 12) and E of RV free wall (p = 0.0 11) were significantly increased in AAMI-group. Q-Sa intervals in both regions (p = 0.007 and 0.0 IS) and Q-Ea of tricuspid annulus (p = 0.045) were significantly shorter in patients with AAMI. TAPSE and E of RV free wall had significant negative correlations with left ventricular systolic volume index and right atrial filling fraction (AFF), respectively (r -0.46, p = 0.0 1 for both). A of tricuspid annulus had a positive correlation with left AFF (r = 0.42, p 0.02). Conclusion - PWDT imaging of tricuspid annulus and RV free wall is capable to sensitively detect the adaptive mechanisms and unfavourable diastolic properties of RV dynamics in patients with AAMI.
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    Specific tissue Doppler predictors of preserved systolic and diastolic left ventricular function after an acute anterior myocardial infarction
    (Japan Heart Journal, Second Dept Of Internal Med, 2003) Akdemir, O; Dagdeviren, B; Yildiz, M; Gül, Ç; Sürücü, H; Özbay, G
    The degree of left ventricular (LV) dysfunction determines the outcome of patients suffering an acute anterior myocardial infarction (AAMI). Many recent studies have utilized tissue Doppler echocardiography (TDE) parameters in the assessment of LV function. We sought to investigate whether some variables easily obtained from TDE profiles of mitral annulus corners would predict a relatively preserved LV global function traditionally assessed with ejection fraction (EF) and deceleration time (DT), within the acute phase of AAMI Included were 50 consecutive patients with a first AAMI. Standard echocardiography and TDE of mitral annulus were performed within 36 hours of admission Pulsed wave sample volumes were set at the septal, lateral, anterior, and inferior corners of the mitral annulus. Preserved LV function was defined as an EF > 40% together with a DT greater than or equal to 140 ms and < 220 ms. An inferior annular systolic velocity of > 7.5 cm/s predicts preserved global left ventricular function with a sensitivity of 81% and specificity of 71%. An anterior mitral annular early diastolic velocity of > 8cm/s had a sensitivity of 69% and specificity of 85%. When these two velocities both exceed the limits above, such a combined index yielded a sensitivity of 69%, specificity of 94%, and an overall diagnostic accuracy of 86% for the estimation of preserved LV global function. The parameters derived from TDE profiles of inferior and anterior mitral annulus corners provide valuable information to predict preserved global left ventricular function during the early period of AAMI.