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    Increased epicardial fat tissue is a marker of metabolic syndrome in adult patients
    (Elsevier Ireland Ltd, 2013) Yorgun, Hikmet; Canpolat, Ugur; Hazirolan, Tuncay; Ates, Ahmet Hakan; Sunman, Hamza; Dural, Muhammet; Sahiner, Levent
    Background: Human epicardial adipose tissue (EAT) is a type of visceral adipose tissue functioning as a metabolically active endocrine organ by secreting several hormones and adipocytokines. In this study, we aimed to assess the relationship between EAT measured by dual source multidetector computed tomography (MDCT) and the presence and components of metabolic syndrome (MS). Methods: A total of 83 patients (43.4% male, mean age 56.1 +/- 11.9) who underwent MDCT for suspected coronary artery disease were enrolled in this study. Thickness of the EAT was measured on contrast enhanced multiplanar reformat images with parasternal short axis view at basal, mid-ventricular and apical levels and horizontal long axis view. Results: The mean EAT thickness was significantly increased in patients with MS compared to those without MS (8.49 +/- 1.43 mm vs 7.39 +/- 2.10 mm, p<0.001). Additionally there was a graded relationship between increasing number of MS components and mean total EAT and pericoronary fat thickness (p<0.05). Simple regression analysis revealed that the presence of MS, age and body mass index (BMI) were correlated with mean EAT thickness (r=0.398, r=0.376 and r=0.371 respectively, p<0.001). Multiple regression analysis revealed that the presence of MS, age and BMI were the strongest independent variables related to EAT. Conclusion: In this study we demonstrated that EAT and pericoronary fat thickness were associated with the presence of MS. Those findings may implicate that, EAT and pericoronary fat may be a novel and useful indicator for MS. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Transcatheter Interatrial Septal Defect Closure in a Large Cohort: Midterm Follow-up Results
    (Tech Science Press, 2013) Aytemir, Kudret; Oto, Ali; Ozkutlu, Suheyla; Canpolat, Ugur; Kaya, Ergun Baris; Yorgun, Hikmet; Sahiner, Levent
    ObjectivesWe evaluated immediate and midterm results of transcatheter closure of atrial septal defects (ASDs) and patent foramen ovale (PFO) using various closure devices. Materials and MethodsThe study included four hundred fourteen patients (one hundred eighty-two men, two hundred thirty-two women; mean age 39 12.3 years; range 17-67 years) who underwent transcatheter closure of secundum ASD (n = 193) or PFO (n = 221). All the patients were evaluated by transthoracic echocardiography and transesophageal echocardiography before the procedure. Transcatheter closure was performed by using Amplatzer (n = 184), Occlutech Figulla (n = 209), or BioSTAR (n = 21) devices. Closure of ASDs was performed under general anesthesia with transesophageal echocardiography guidance, and closure of PFOs was performed under local anesthesia with transthoracic echocardiography guidance. Follow-up controls were at 1, 6, and 12 months and annually thereafter. The median follow-up periods of ASD and PFO patients were 43 and 30 months. ResultsThe mean device size was 19.3 +/- 6.2mm for ASD patients and 24.6 +/- 2.6mm for PFO patients. The mean procedural and fluoroscopy times were 22.3 +/- 4.7 and 4.1 +/- 1.9 minutes for ASD closure and 12.4 +/- 3.2 and 3.1 +/- 1.2 minutes for PFO closure, respectively. Procedural device embolization occurred in only two patients (0.48%). During follow-up, recurrent embolic events occurred in four patients (1.8%) after PFO closure, and no residual shunts were seen after ASD closure. Device thrombosis developed in two ASD patients during the procedure and in one PFO patient at 12th month of the follow-up (0.72%). ConclusionTranscatheter closure of PFOs and secundum-type ASDs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an efficacious and safe therapeutic option.