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Öğe Dispersion Durations of P-wave and QT Interval in Children With Congenital Heart Disease and Pulmonary Arterial Hypertension(SPRINGER, 2013) Sap, Fatih; Karataş, Zehra; Altın, Hakan; Alp, Hayrullah; Oran, Bülent; Baysal, Tamer; Karaarslan, SevimThis study aimed to investigate homogeneity disorders of ventricular repolarization and atrial conduction via QT dispersion and P-wave dispersion in children with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH). Three groups of 20 each were generated and involved in this study. The first group included 20 children with both CHD and PAH. The second group consisted of 20 children with CHD but no PAH, and the third group was composed of 20 age- and sex-matched healthy children. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. The pulmonary hypertension group compared with the group having no pulmonary hypertension and the control group showed a significantly longer P-wave dispersion duration (39.10 +/- A 9.54 vs. 26.30 +/- A 4.99 ms, p < 0.001; and 24.80 +/- A 6.94 ms, p < 0.001, respectively) and QT dispersion duration (52.80 +/- A 15.11 vs. 37.60 +/- A 6.00 ms, p < 0.001; and 35.00 +/- A 7.77 ms, p < 0.001, respectively). In addition, the durations of maximum QTc and QTc dispersion were significantly longer in pulmonary hypertension group than in the other two groups. The risk of atrial and ventricular arrhythmia was found to be increased in the patients with both CHD and PAH. Physicians should pay close attention to possible atrial and ventricular arrhythmias during the treatment and follow-up evaluation of these patients.Öğe Is Myocardial Performance Index Useful in Differential Diagnosis of Moderate and Severe Hypoxic-İschaemic Encephalopathy? A Serial Doppler Echocardiographic Evaluation(Cambridge Univ Press, 2012) Karaarslan, Sevim; Alp, Hayrullah; Baysal, Tamer; Çimen, Derya; Örs, Rahmi; Oran, BulentIntroduction: The aim of this study was to investigate the importance of myocardial performance index as an additive criterion to Sarnat criteria in differential diagnosis of newborn babies with moderate and severe hypoxic-ischaemic encephalopathy. Methods: Our study group included 50 healthy term newborn babies and 20 newborn babies with hypoxic ischaemic encephalopathy. The 20 newborn babies with hypoxic-ischaemic encephalopathy were scored using Sarnat grades. Left and right ventricular functions were determined on the first day and thereafter in the 1, 3-4, 6-7, and 11-12 months of life by M-Mode and pulsed Doppler. Results: Myocardial performance indexes of the left ventricle were significantly higher in the severe hypoxic ischaemic encephalopathy group than in the control group during the first, second, and third analyses (p = 0.01, p = 0.02, p = 0.02, respectively) and only during the first analysis (p = 0.01) in the moderate hypoxic-ischaemic encephalopathy group. In addition, the myocardial performance indexes of the right ventricle were significantly higher during the first, second, and third analyses in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group (p = 0.01, all). Hypoxia-induced alterations last longer in the right ventricle than in the left ventricle in the moderate group, as during the second and third analyses myocardial performance index continues to be higher than the control group. Conclusion: Myocardial performance indexes for the left and right ventricles were significantly higher in both severe and moderate hypoxic-ischaemic encephalopathy groups than in the control group during the first analysis, and myocardial performance index greater than or equal to 0.5 can be used in order to distinguish moderate and severe hypoxic-ischaemic encephalopathy babies according to Sarnat grades as a discriminative additive criterion.Öğe Persistent fifth aortic arch with systemic-to- pulmonary arterial connection and pulmonary atresia in a neonate(2012) Şap, Fatih; Altın, Hakan; Karataş, Zehra; Alp, Hayrullah; Baysal, Tamer; Karaarslan, SevimPersistan beşinci aortikark (PBAA) çıkan aortanın distal bölümünden ayrılan gerçek arkus aortanın altından seyrederek sol subklaviyan arter ve duktus arteriyosus seviyesine uzanan bir arterdir. Persistan beşinci aortik ark ilk defa 1969 yılında tanımlandı. Bu çift lümenli aortik ark ya sistemik-sistemik ya da sistemik-pulmoner bağlantılıdır. Ekokardiyografi ile PBAA’dan şüphelenildiğinde tanıyı doğrulamak için kardiyovasküler anjiyografi ve/veya manyetik rezonans anjiyografi çekilmelidir. Semptomatik vakaların nadir olması ve vakanın karmaş ıklığı nedeni ile sistemik-pulmoner bağlantılı tip PBAA’sı olan bir günlük erkek yenidoğan bebek sunulmuştur.Öğe Prediction of the development of pulmonary arterial hypertension with Tei Index in congenital heart diseases with left-to-right shunt(Turkish Society of Cardiology, 2019) Yücel, Mehmet; Alp, Hayrullah; Yorulmaz, Alaaddin; Karaarslan, Sevim; Baysal, TamerObjective: The aim of this study was to determine the usefulness of the Tei Index, an echocardiographic parameter, in the early determination of pulmonary artery pressure (PAP) in congenital heart disease (CHD) with a left-to-right shunt. Methods: Right and left ventricular functions were evaluated using Tei Index values determined with tissue Doppler echocardiography. Cardiac catheterization was performed in all cases. The presence of pulmonary arterial hypertension (PAH) was defined as a mean PAP of ?25 mm Hg and a pulmonary vascular resistance index of >3 WU/m2. Patients with a pulmonary/systemic blood flow ratio of ?2 were considered candidates for surgery. Results: The Tei Index values measured from the left ventricular posterior wall and the right ventricular anterior wall were found to be significantly higher in the patients with PAH (0.68±0.18, 0.67±0.16, respectively) compared with the patients without PAH (0.56±0.16, p=0.027; 0.51±0.12 p=0.001). A significant correlation was detected between the Tei Index value measured from the left ventricular posterior wall and the mean PAP (correlation coefficient: 0.491). Conclusion: The right ventricular Tei Index values in children with CHD and a left-to-right shunt can be used as a parameter to follow up on the potential development of PAH, to make a diagnosis in the early period, and to make a timely decision about surgery. © 2019 Turkish Society of Cardiology.Öğe Pulmonary arterial pressure in infants with laryngomalacia(ELSEVIER IRELAND LTD, 2006) Unal, Ekrem; Oran, Bulent; Baysal, Tamer; Baspinar, Osman; Keser, Melike; Karaarslan, Sevim; Arbag, HamdiObjective: Persistent upper airway obstruction may lead to increased pulmonary arterial pressure in childhood. Laryngomalacia is one of the most common causes of transient upper airway obstruction by laryngeal blockage in infants. The aim of the study is to evaluate the pulmonary arterial pressures in infants with laryngomalacia during infancy period. Methods: Fifteen infants with laryngomalacia and 30 healthy controls were enrolled into this study. The pulmonary arterial pressures were measured by using Doppler echocardiography. Infants were also evaluated by clinical investigations, telecardiography and electrocardiography. Results: Our results showed that infants with laryngomalacia may have significantly higher pulmonary arterial pressure than healthy subjects. Pressures of patient group were significantly decreased at the end of infancy period. Conclusions:. Increased pulmonary arterial pressure levels due to laryngomalacia are reversible by during developmental process. Therefore, in symptomatic period, evaluation of infants with laryngomalacia by using Doppler echocardiography may be useful for monitoring pulmonary arterial pressure and following up the clinical outcome. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe Usability of QTc Dispersion for the Prediction of Orthostatic Intolerance Syndromes(ELSEVIER SCI LTD, 2012) Karataş, Zehra; Alp, Hayrullah; Şap, Fatih; Altın, Hakan; Baysal, Tamer; Karaarslan, SevimBackground: Syncope is defined as transient loss of consciousness and muscle tone, usually of short duration. Noncardiac causes of syncope are classified as orthostatic intolerance syndromes (OIS). QT and QTc (corrected QT) dispersions are the measurements of myocardial instability and show predisposition to arrhythmias. In this study; clinical findings, QT and QTc dispersions of the patients who were diagnosed as OIS were evaluated retrospectively. Also, the aim of the study is to clarify the association of clinical characteristics of unexplained syncope with the outcome of the QT and QTc dispersions in children. Methods: We designed a retrospective study including 152 children and adolescents who had repeated unexplained syncope or presyncope between June 2002 and August 2010. Head-up Tilt table test (HUTT) were performed for all patients. Control group consisted of 67 healthy children. The QT and QTc dispersions were measured from the 12 ECG leads. Results: Eighty-four (55.2%) patients had positive and 68 (44.8%) had negative response to HUTT. QT and QTc dispersions were significantly higher in HUTT-positive group than in negative (p < 0.01, p < 0.001 respectively). Also, QTc dispersion was significantly higher in both vasovagal syncope and postural orthostatic tachycardia syndrome groups than in HUTT-negative group (p < 0.001, p < 0.05 respectively). Specifity and sensitivity of QTc dispersion for predicting positive HUTT are 76.5% and 59.5% respectively. The positive predictive value of the test calculated as 75.8%. Conclusions: These results revealed that we can use QTc dispersion measurement as a noninvasive electrocardiographic test to evaluate OIS for predicting positive result before performing HUTT.Öğe Zellweger sendromu ve hipertrofik kardiyomiyopati birlikteliği(2012) Alp, Hayrullah; Gezgiç, Sevilay Kasay; Energin, Vesile Meltem; Baysal, Tamer; Karaarslan, SevimZellweger sendromu, peroksizom eksikliği veya yokluğuna bağlınörolojik sistem, iskelet sistemi, karaciğer, böbrek ve göze ait anomalilerin izlendiği nadir görülen bir sendromdur. Serebrohepatorenal sendrom olarak da adlandırılan hastalık otozomal resesif olarak kalıtılır. Hastalık, büyüme geriliği, hipotoni, erken dönem beyin gelişiminde ciddi problemler, yüksek alın, oküler hipertelorizm, deforme kulak gibi yüz anomalileri ve hepatomegali ile karakterizedir. Peroksizomlardaki eksiklik kanda çok uzun zincirli yağasitlerinde artışa ve eritrositlerde plazmolojenlerin azalmasına yol açar. Zellweger sendromunda çok çeşitli konjenital kalp hastalıkları da görülebilmektedir. Makalemizde daha önce literatürde bildirilmemişolan hipertrofik kardiyomiyopatinin tespit edildiği 3 aylık Zellweger sendromlu bir kız vaka sunulmuştur.
