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OP-146 The Relationship Between Parathyroid Hormone Level and Pulmonary Artery Stiffness in Patients with Chronic Kidney Disease
MARCH 26e29, 2015
O R A L A B S T R A C T S
systolic pressure measured through tricuspid regurgitant flow was 32 mmHg. In multislice CT angiography, main pulmonary artery was enlarged and measured to be 55 mm at the level of the aorticopulmonary window (Figure 1). Left pulmonary artery was 32 mm and right pulmonary artery was 42 mm. The patient underwent endoscopic examination of the larynx and the left vocal cord was found to be fixed in the paramedian position. Surgery was not considered due to existence of Behçet ’s disease, advanced age of the patient and extent of the aneurysm involving both pulmonary artery and its branches. Clinical remission and radiographic resolution were achieved with cyclophosphamide and corticosteroid therapy and the patient was discharged with follow up recommendations. The most common cause of Ortner’s syndrome is left atrial enlargement due to mitral stenosis. Mitral valve prolapse, thoracic aortic aneurysm, aortic dissection, cor pulmonale and pulmonary artery dilatation secondary to increased pulmonary artery pressure with any reason have also been described in etiology of Ortner’s syndrome. Ortner’s syndrome may arise from various intrathoracic pathologies of heart and great vessels but to the best of our knowledge this is the first report in the literature presenting a case of Ortner’s syndrome due to primary pulmonary artery aneurysm as a feature of Behçet’s disease. Consequently, it should be taken into consideration that hoarseness in a patient with Behcet’s disease may develop due to a pulmonary artery aneurysm and further evaluation should be performed.
- OP-146 The Relationship Between Parathyroid Hormone Level and Pulmonary Artery Stiffness in Patients with Chronic Kidney Disease. Murat Celik1, Hilmi Umut Ünal2, Yalçın Göko glan1, Serdar Fırtına3, Emre Yalçınkaya4, Suat Görmel1, Salim Yas¸ar1, Uygar Çagdas¸ Yüksel1, Hasan Kutsi Kabul1, Cem Barçın1, Barıs¸ Bugan5. 1 Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 2Department of Nephrology, Gulhane Military Medical Academy, Ankara, Turkey; 3Service of Cardiology, Maresal Cakmak Military Hospital, Erzurum, Turkey; 4Service of Cardiology, Aksaz Military Hospital, Mu gla, Turkey; 5Service of Cardiology, Girne Military Hospital, Girne, Cyprus. Background: Pulmonary arterial stiffness (PAS) is a new echocardiographic parameter, which can be used to estimate the elastic properties of pulmonary arterial vasculature noninvasively. We aimed to assess the elastic properties of pulmonary artery with echocardiography in chronic kidney disease patients without prominent pulmonary hypertension. Material-Method: Fifty-five patients diagnosed as CKD were retrospectively evaluated. Cardiovascular surgery, pulmonary hypertension and chronic obstructive disease were defined as exclusion criteria. PAS was calculated according to the following formula as the ratio of maximal flow velocity shift of pulmonary flow (MFV) to pulmonary acceleration time (AcT): PAS (kHz/sec) ¼ MFV/AcT. Results: Mean GFR value was 46.05 23.48 ml/min; mean age was 40.42 15.10 years; mean PTH level was 129.65 125.19. Also, we found that PAS was 9.14 2.40 kHz/sec and there was a moderate correlation between PTH and PAS (r¼ 0.466, p <0.001). In multivariate regression analysis, PTH (OR: 0.301, p¼0.015), tricuspide E/A ratio (OR:0.346, p¼0.002) and hemoglobin level (OR¼-0.330, p¼0.008) were found as independent variables of PAS in patients with CKD. Conclusion: We found that pulmonary arterial vasculature is affected in CKD patients without prominent pulmonary hypertension and PTH seems to play a role in this interaction. However, a further study is needed.
- OP-147 The Comparison of Long Axis and Short Axis Approaches in Ultrasound-Guided Internal Jugular Vein Catheterization. Ozkan Parlak1, Gokhan Ozkan2, Vedat Yıldırım2, Ahmet Cosar2. 1Department of Anesthesiology, Eskisehir Military Hospital, Eskisehir, Turkey; 2Department of Anesthesiology and Reanimation, Gulhane School of Medicine, Ankara, Turkey. Aims: The aim of this study was to compare long axis and short axis approaches in ultrasound-guided internal jugular vein (IJV) catheterization. After obtaining of Institutional Ethics Committee, the randomized controlled study which countain 64 surgical patients was designed. All participitants were informed about the study and written informed consents were obtained. Methods: The participitants were randomly assigned to 2 groups: group K (n¼32) and group U (n¼32). Patient demographics, comorbidities, number of attempts, visualization time, completion time of the attempt, total duration, catheter side, vein diameter were measured by ultrasound (US) and complications recorded. Results: In terms of demographics, no statistically difference were found between the groups. In terms of complications, there was no difference between short and long axis groups. The number of attempts in short axis approach was significantly lower compared to the long axis approach (p¼0.013). The first attempt success rate in the short axis approach was statistically significantly higher (p¼0.03) compared to the long axis approach. IJV was cannulated succesfully at the first attempt in 30 patients (93,8%) in short axis group and in 22 patients (68,8%) in long axis group. Long axis group visualization times were significantly longer compared with short axis group (p¼0.015). In terms of completion time of the attempt, total duration and vein diameters, there was no significant difference between groups. There was no significant difference between right or left side catheterization. Conclusion: In conclusion, we realized that the short axis approach has a higher the first attempt success rate and lower number of attempts compared with the long axis approach and that there is no significant difference between two approaches in terms of process time and complications.
- OP-148 Augmentation Index and Carotid Hemodynamic Parameters Before and After Carotid Stenting. Yusuf Can1, Harun Kılıç2, Ramazan Akdemir2, Hüseyin Gündüz2, Murat Aksoy2, Nimet Can3, Ibrahim Kocayigit4. 1Department of Cardiology, Sakarya Education and Research Hospital; 2Department of Cardiology, University of Sakarya, Sakarya, Turkey; 3 Department of Neurology, Sakarya Education and Research Hospital; 4Department of Cardiology, Sakarya Yenikent State Hospital. Objective: Augmentation index is an important parameter which is used for evaluating arterial stiffness. Arterial stifness is an significant predictor of cardiovascular events. In this study we aimed to evaluate the acute effects of carotis stenting on arterial stifness invasively which calculated by augmentation index and carotid hemodynamic parameters before and after stenting. Methods: Fifty-one patient who were diagnosed as serebrovascular accident and had stenosis above %70 in internal carotid artery which was shown in non invasive tests were included to our study. During carotis angiography systolic blood pressure, pulse pressure, augmentation pressure before and after stenting were investigated.
S64 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L A B S T R A C T S
systolic pressure measured through tricuspid regurgitant flow was 32 mmHg. In multislice CT angiography, main pulmonary artery was enlarged and measured to be 55 mm at the level of the aorticopulmonary window (Figure 1). Left pulmonary artery was 32 mm and right pulmonary artery was 42 mm. The patient underwent endoscopic examination of the larynx and the left vocal cord was found to be fixed in the paramedian position. Surgery was not considered due to existence of Behçet ’s disease, advanced age of the patient and extent of the aneurysm involving both pulmonary artery and its branches. Clinical remission and radiographic resolution were achieved with cyclophosphamide and corticosteroid therapy and the patient was discharged with follow up recommendations. The most common cause of Ortner’s syndrome is left atrial enlargement due to mitral stenosis. Mitral valve prolapse, thoracic aortic aneurysm, aortic dissection, cor pulmonale and pulmonary artery dilatation secondary to increased pulmonary artery pressure with any reason have also been described in etiology of Ortner’s syndrome. Ortner’s syndrome may arise from various intrathoracic pathologies of heart and great vessels but to the best of our knowledge this is the first report in the literature presenting a case of Ortner’s syndrome due to primary pulmonary artery aneurysm as a feature of Behçet’s disease. Consequently, it should be taken into consideration that hoarseness in a patient with Behcet’s disease may develop due to a pulmonary artery aneurysm and further evaluation should be performed.
- OP-146 The Relationship Between Parathyroid Hormone Level and Pulmonary Artery Stiffness in Patients with Chronic Kidney Disease. Murat Celik1, Hilmi Umut Ünal2, Yalçın Göko glan1, Serdar Fırtına3, Emre Yalçınkaya4, Suat Görmel1, Salim Yas¸ar1, Uygar Çagdas¸ Yüksel1, Hasan Kutsi Kabul1, Cem Barçın1, Barıs¸ Bugan5. 1 Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; 2Department of Nephrology, Gulhane Military Medical Academy, Ankara, Turkey; 3Service of Cardiology, Maresal Cakmak Military Hospital, Erzurum, Turkey; 4Service of Cardiology, Aksaz Military Hospital, Mu gla, Turkey; 5Service of Cardiology, Girne Military Hospital, Girne, Cyprus. Background: Pulmonary arterial stiffness (PAS) is a new echocardiographic parameter, which can be used to estimate the elastic properties of pulmonary arterial vasculature noninvasively. We aimed to assess the elastic properties of pulmonary artery with echocardiography in chronic kidney disease patients without prominent pulmonary hypertension. Material-Method: Fifty-five patients diagnosed as CKD were retrospectively evaluated. Cardiovascular surgery, pulmonary hypertension and chronic obstructive disease were defined as exclusion criteria. PAS was calculated according to the following formula as the ratio of maximal flow velocity shift of pulmonary flow (MFV) to pulmonary acceleration time (AcT): PAS (kHz/sec) ¼ MFV/AcT. Results: Mean GFR value was 46.05 23.48 ml/min; mean age was 40.42 15.10 years; mean PTH level was 129.65 125.19. Also, we found that PAS was 9.14 2.40 kHz/sec and there was a moderate correlation between PTH and PAS (r¼ 0.466, p <0.001). In multivariate regression analysis, PTH (OR: 0.301, p¼0.015), tricuspide E/A ratio (OR:0.346, p¼0.002) and hemoglobin level (OR¼-0.330, p¼0.008) were found as independent variables of PAS in patients with CKD. Conclusion: We found that pulmonary arterial vasculature is affected in CKD patients without prominent pulmonary hypertension and PTH seems to play a role in this interaction. However, a further study is needed.
- OP-147 The Comparison of Long Axis and Short Axis Approaches in Ultrasound-Guided Internal Jugular Vein Catheterization. Ozkan Parlak1, Gokhan Ozkan2, Vedat Yıldırım2, Ahmet Cosar2. 1Department of Anesthesiology, Eskisehir Military Hospital, Eskisehir, Turkey; 2Department of Anesthesiology and Reanimation, Gulhane School of Medicine, Ankara, Turkey. Aims: The aim of this study was to compare long axis and short axis approaches in ultrasound-guided internal jugular vein (IJV) catheterization. After obtaining of Institutional Ethics Committee, the randomized controlled study which countain 64 surgical patients was designed. All participitants were informed about the study and written informed consents were obtained. Methods: The participitants were randomly assigned to 2 groups: group K (n¼32) and group U (n¼32). Patient demographics, comorbidities, number of attempts, visualization time, completion time of the attempt, total duration, catheter side, vein diameter were measured by ultrasound (US) and complications recorded. Results: In terms of demographics, no statistically difference were found between the groups. In terms of complications, there was no difference between short and long axis groups. The number of attempts in short axis approach was significantly lower compared to the long axis approach (p¼0.013). The first attempt success rate in the short axis approach was statistically significantly higher (p¼0.03) compared to the long axis approach. IJV was cannulated succesfully at the first attempt in 30 patients (93,8%) in short axis group and in 22 patients (68,8%) in long axis group. Long axis group visualization times were significantly longer compared with short axis group (p¼0.015). In terms of completion time of the attempt, total duration and vein diameters, there was no significant difference between groups. There was no significant difference between right or left side catheterization. Conclusion: In conclusion, we realized that the short axis approach has a higher the first attempt success rate and lower number of attempts compared with the long axis approach and that there is no significant difference between two approaches in terms of process time and complications.
- OP-148 Augmentation Index and Carotid Hemodynamic Parameters Before and After Carotid Stenting. Yusuf Can1, Harun Kılıç2, Ramazan Akdemir2, Hüseyin Gündüz2, Murat Aksoy2, Nimet Can3, Ibrahim Kocayigit4. 1Department of Cardiology, Sakarya Education and Research Hospital; 2Department of Cardiology, University of Sakarya, Sakarya, Turkey; 3 Department of Neurology, Sakarya Education and Research Hospital; 4Department of Cardiology, Sakarya Yenikent State Hospital. Objective: Augmentation index is an important parameter which is used for evaluating arterial stiffness. Arterial stifness is an significant predictor of cardiovascular events. In this study we aimed to evaluate the acute effects of carotis stenting on arterial stifness invasively which calculated by augmentation index and carotid hemodynamic parameters before and after stenting. Methods: Fifty-one patient who were diagnosed as serebrovascular accident and had stenosis above %70 in internal carotid artery which was shown in non invasive tests were included to our study. During carotis angiography systolic blood pressure, pulse pressure, augmentation pressure before and after stenting were investigated.
S64 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral