Adenotonsillektomi uygulanan çocuklarda sağ ventrikül fonksiyonlarının preoperatif ve postoperatif doku doppler ekokardiyografi ile değerlendirilmesi

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.[Abstarct Not Available

Relationship of Epicardial Adipose Tissue Thickness with Early Indicators of Atherosclerosis and Cardiac Functional Changes in Obese Adolescents with Metabolic Syndrome

Objective: Epicardial adipose tissue thickness (EATT) is suggested as a new cardiometabolic risk factor. Carotid intima-media thickness (IMT) is a potential indicator of subclinical atherosclerosis in patients with metabolic syndrome (MS). We investigated the association of EATT with carotid IMT and cardiac functional changes in obese adolescents with MS. Methods: One hundred thirty-eight obese adolescents and 63 lean subjects were enrolled in the study. The obese subjects were divided into two subgroups based on the presence or absence of MS (MS group and non-MS group). All subjects underwent transthoracic echocardiographic examination for determination of left ventricular (LV) function, LV mass index (LVMI), and myocardial performance index (MPI). EATT and carotid IMT were also measured during echocardiography. Results: The average LVMI measurements were higher in both MS and non-MS obese patients in comparison with the lean children. The MS group had significantly higher LVMI measurements than the non-MS and lean groups (88.5 +/- 23.0, 67.5 +/- 24.8 g/m(2), and 62.4 +/- 18.2 g/m(2), respectively; p<0.01). Carotid IMT was higher in both the MS and non-MS obese patients in comparison with the lean group. The MS group had significantly higher carotid IMT measurements than the non-MS and lean groups (0.91 +/- 0.23, 0.78 +/- 0.18, and 0.52 +/- 0.08 mm, respectively; p<0.01). The EATT was also increased significantly in patients with MS compared to lean adolescents (7.42 +/- 1.55 vs. 4.28 +/- 0.79 mm; p=0.001). EATT was positively correlated with body mass index-SDS, waist circumference, fasting glucose, insulin, homeostasis model assessment-insulin resistance, triglyceride levels, LV thickness, LVMI, and MPI in the MS obese group. EATT was the only independent predictor of carotid IMT in the multivariate analysis (beta= 0.69, p<0.001). Conclusion: The findings of the present study demonstrate a close relationship of EATT with carotid IMT and early cardiac dysfunction in obese adolescents with MS. Assessment of EATT and carotid IMT in routine echocardiographic examinations is suggested as a feasible and reliable method for the evaluation of obesity with MS and its related cardiovascular risks in children and adolescents.Publisher's Versio

Relationship of Epicardial Adipose Tissue Thickness with Early Indicators of Atherosclerosis and Cardiac Functional Changes in Obese Adolescents with Metabolic Syndrome

Objective: Epicardial adipose tissue thickness (EATT) is suggested as a new cardiometabolic risk factor. Carotid intima-media thickness (IMT) is a potential indicator of subclinical atherosclerosis in patients with metabolic syndrome (MS). We investigated the association of EATT with carotid IMT and cardiac functional changes in obese adolescents with MS. Methods: One hundred thirty-eight obese adolescents and 63 lean subjects were enrolled in the study. The obese subjects were divided into two subgroups based on the presence or absence of MS (MS group and non-MS group). All subjects underwent transthoracic echocardiographic examination for determination of left ventricular (LV) function, LV mass index (LVMI), and myocardial performance index (MPI). EATT and carotid IMT were also measured during echocardiography. Results: The average LVMI measurements were higher in both MS and non-MS obese patients in comparison with the lean children. The MS group had significantly higher LVMI measurements than the non-MS and lean groups (88.5±23.0, 67.5±24.8 g/m2, and 62.4±18.2 g/m2, respectively; p<0.01). Carotid IMT was higher in both the MS and non-MS obese patients in comparison with the lean group. The MS group had significantly higher carotid IMT measurements than the non-MS and lean groups (0.91±0.23, 0.78±0.18, and 0.52±0.08 mm, respectively; p<0.01). The EATT was also increased significantly in patients with MS compared to lean adolescents (7.42±1.55 vs. 4.28±0.79mm; p=0.001). EATT was positively correlated with body mass index-SDS, waist circumference, fasting glucose, insulin, homeostasis model assessment-insulin resistance, triglyceride levels, LV thickness, LVMI, and MPI in the MS obese group. EATT was the only independent predictor of carotid IMT in the multivariate analysis (β= 0.69, p<0.001). Conclusion: The findings of the present study demonstrate a close relationship of EATT with carotid IMT and early cardiac dysfunction in obese adolescents with MS. Assessment of EATT and carotid IMT in routine echocardiographic examinations is suggested as a feasible and reliable method for the evaluation of obesity with MS and its related cardiovascular risks in children and adolescents. Conflict of interest:None declared

A novel frameshift mutation of malonyl-CoA decarboxylase deficiency: clinical signs and therapy response of a late-diagnosed case

Biçer Çakır, Nihan (Arel Author)Key Clinical Message We evaluate the clinical findings and the treatment response of a late-diagnosed case with a novel homozygous insertion c.13_14insG (p.P6Afs*202) result in a frameshift mutation in MLYCD gene. Both cardiac and neurologic involvements were mild when compared to previously reported cases, and see low-fat/high-carbohydrate diet treatment is highly effective

İlk bulgusu ikinci derece atriyoventriküler blok olan akut romatizmal ateş tanılı bir vaka

Acute rheumatic fever caused by Group A b hemolytic streptococci is an autoimmune systemic disease affecting heart, joints, central nervous system, skin and subcutaneous tissue. A variety of conduction deficits are reported in acute rheumatic fever. The most common one is first-degree atrioventricular block. Second-degree atrioventricular block, nodal tachycardia, complete atrioventricular block and ventricular tachycardia are reported less frequently. Arrhythmia as a first sign of acute rheumatic fever is very rarely seen. In this case report we presented a 10-year-old girl admitted with second degree atrioventricular block and diagnosed as acute rheumatic fever during hospitalization.Akut romatizmal ateş A grubu b hemolitik streptokokların neden olduğu kalbi, eklemleri, merkezi sinir sistemi ve deri-deri altı dokuları tutabilen sistemik, otoimmun kökenli olduğu düşünülen bir hastalıktır. Akut romatizmal ateşte birçok çeşit ileti kusurunun gözlenebileceği bildirilmiştir. En sık birinci derece atrioventriküler blok saptanırken, az sayıda vakada ikinci derece atriyoventriküler blok, nodal taşikardi, atriyoventriküler tam blok ve ventriküler taşikardi saptanmaktadır. İlk başvuru bulgusu aritmi olan vakalar literatürde oldukça ender olarak bildirilmektedir. Bu vaka sunumunda göğüs ağrısı yakınmasıyla başvuran, ikinci derece atrioventriküler blok saptanan ve yatışı sırasında akut romatizmal ateş tanısı alan on yaşında bir vaka sunulmaktadır