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    Assessment of the left atrial volume index and plasma NT-proANP level in patients with acute ST-elevation myocardial infarction
    (Hospital Clinicas, Univ Sao Paulo, 2013) Bacaksız, Ahmet; Vatankulu, Mehmet Akif; Kayrak, Mehmet; Telli, Hasan Hüseyin; Ayhan, Selim Suzi
    OBJECTIVES: Acute ST-elevation myocardial infarction is associated with ventricular dysfunction due to ischemia-induced progressive myocardial damage. The decrease in ventricular compliance causes left atrial dilatation and stretching of the atrial myocardium, which are the main stimuli for the secretion of atrial natriuretic peptide. The aim of this study was to evaluate left atrial dimensions and atrial natriuretic peptide levels in patients early after their first acute ST-elevation myocardial infarction and assess the probable interaction between coronary lesions and these measurements. METHODS: A total of 110 patients with acute myocardial infarction and 50 controls were studied. Plasma atrial natriuretic peptide was measured at admission. Left ventricular function, diameter, and volume index were evaluated using transthoracic echocardiography. Gensini and vessel scores of the patients who underwent coronary angiography were calculated. RESULTS: Plasma atrial natriuretic peptide in the patients with myocardial infarction was increased compared with that in controls (3.90 +/- 3.75 vs. 1.35 +/- 0.72 nmol/L, p<0.001). Although the left atrial diameter was comparable in patients and controls, the left atrial volume index was increased in patients with acute myocardial infarction (26.5 +/- 7.1 vs. 21.3 +/- 4.9 mL/m(2), p<0.01). Multivariate regression analysis showed a strong independent correlation between the left atrial volume index and the plasma atrial natriuretic peptide level (beta = 0.23, p = 0.03). CONCLUSIONS: The left atrial volume index and plasma atrial natriuretic peptide level were correlated in patients with acute myocardial infarction.
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    The effect of smoking on myocardial performance index in middle-aged males after first acute myocardial infarction
    (Wiley, 2013) Bacaksız, Ahmet; Kayrak, Mehmet; Vatankulu, Mehmet Akif; Ayhan, Selim Suzi; Sönmez, Osman
    Background: Cigarette smoking is associated with increased rates of coronary artery disease and acute myocardial infarction (MI). Paradoxically, smokers had lower mortality after MI. The purpose of this study was to evaluate the effect of chronic smoking on myocardial performance index (MPI) in middle-aged men after an acute MI. Material and methods: A total of 429 patients (325 smokers vs. 104 nonsmokers) presenting with acute ST elevation MI were enrolled in this study. Thrombolysis in myocardial infarction (TIMI) flow of the infarct related artery was measured before and after the primary percutaneous coronary intervention (PCI), and Gensini score was also calculated. Conventional echocardiography and tissue Doppler echocardiography (TDI) were performed within 4872hours after onset of chest pain. Peak early (Em) and late (Am) diastolic velocities, peak systolic (Sm) mitral annular velocities and time intervals were recorded with TDI. The MPI, ratio of Em/Am, and E/Em were calculated. Results: Baseline demographic and angiographic characteristics such as Gensini score, pre and, post PCI TIMI flow were similar in 2 groups. In contrast, LV MPI was preserved among smokers (0.59 +/- 0.15 vs. 0.66 +/- 0.14, P=0.01), and Em/Am values were also higher in smokers (0.84 +/- 0.28 vs. 0.75 +/- 0.31, P=0.01). Independent predictors of impaired MPI (0.60) were determined as nonsmoking status (odds ratio 2.940, 95% CI 0.985.83, P=0.05), left anterior descending artery stenosis (odds ratio 3.196, 95% CI 1.735.91 P=0.001), and, age (odds ratio 1.12, 95% CI 1.031.22, P=0.01). Conclusions: Despite similar demographic and angiographic characteristics, smoker males had a paradoxically better MPI after acute MI.