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    Association between family history of premature coronary artery disease and coronary atherosclerotic plaques shown by multidetector computed tomography coronary angiography
    (Elsevier Ireland Ltd, 2013) Sunman, Hamza; Yorgun, Hikmet; Canpolat, Ugur; Hazirolan, Tuncay; Kaya, Ergun Baris; Ates, Ahmet Hakan; Dural, Muhammed
    Background: There is controversy regarding the role of family history (FH) of premature coronary artery disease (CAD) as an independent risk factor for CAD. Herein, we aimed to assess the role of FH of premature CAD in prediction of coronary atherosclerosis shown by multidetector computed tomography (MDCT) coronary angiography. Methods: We analyzed consecutive subset of 349 patients in whom MDCT coronary angiography was performed for suspected CAD. All patients underwent coronary MDCT imaging using dual-source MDCT scanner. Coronary arteries were evaluated on 16-segment basis, critical CAP was described as luminal narrowing >50%, whereas plaque morphology was assessed on per segment basis. Results: Study population consisted of 202 (57.9%) male and 147 (42.1%) female patients with mean age of 57.8 +/- 10.8 years. The presence of CAP was higher in patients with FH of premature CAD in LAD and Cx compared to patients without FH of premature CAD (70.8% vs 58.0%, p=0.013 for LAD; 42.3% vs 30.4%, p=0.021 for Cx; 34.5% vs 29.8%, p=0.348 for RCA). In multinominal logistic regression analysis age, male gender, dyslipidemia and FH of premature CAD seemed significant predictors of primarily noncalcified CAP(OR:1.17, 95% CI:1.07-1.15, p<0.001; OR:0.19, 95% CI:0.09-0.38, p<0.001; OR:2.26, 95% CI:1.21-4.24, p=0.01; OR:3.32, 95% CI:1.74-6.34, p<0.001 respectively) after adjustment for other risk factors. Conclusion: Our study results indicate that FH of premature CAD is associated with severity, extent and noncalcified CAP shown by MDCT. Further investigation is needed to clarify the exact diagnostic and prognostic role of MDCT coronary angiography in subjects with positive FH and suspected CAD. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Epicardial adipose tissue thickness predicts descending thoracic aorta atherosclerosis shown by multidetector computed tomography
    (Springer, 2012) Yorgun, Hikmet; Canpolat, Ugur; Hazirolan, Tuncay; Sunman, Hamza; Ates, Ahmet Hakan; Gurses, Kadri Murat; Ertugrul, Ozgur
    Human epicardial adipose tissue (EAT) is a type of visceral adipose tissue functioning as an endocrine organ by secreting hormones and adipocytokines which have an important role in the atherosclerotic process. In this study, we aimed to assess the relationship between EAT measured by dual source multidetector computed tomography (MDCT) and descending thoracic aorta (DTA) atherosclerosis. A total of 148 patients who underwent MDCT for the evaluation of 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. The atherosclerotic plaque was scored from 0 to 4 points by the percentage of the luminal surface at the cross sectional area of proximal, mid and distal segments of descending aorta. Among the study population, 84 (56.8%) were male and age was (mean +/- A standart deviation) 56.9 +/- A 11.7 years. In patients with critical coronary atherosclerosis, DTA atherosclerosis had a significant relationship with EAT (P = 0.012). Multivariate linear regression analysis revealed that in addition to critical coronary stenosis, age and total epicardial fat thickness were associated with aortic atherosclerosis (beta value, 0.058 and 0.035; t value, 4.74 and 2.28, respectively; P < 0.05) after adjustment for traditional cardiovascular risk factors. In this study we demonstrated that atherosclerotic plaque burden of DTA was associated with the amount of EAT thickness among patients with suspected CAD shown by MDCT. Further large scale prospective studies are needed to address the interaction of EAT as well as the mediators of inflammation and adipocytokines with the development of atherosclerotic plaques in aorta and effects on cardiovascular outcomes.
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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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    Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography
    (Via Medica, 2011) Ates, Ahmet Hakan; Canpolat, Ugur; Yorgun, Hikmet; Kaya, Ergun Baris; Sunman, Hamza; Demiri, Edis; Taher, Ali
    Background: Total white blood cell (WBC) count has been consistently shown to be an independent risk factor and predictor for future cardiovascular outcomes, regardless of disease status in coronary artery disease (CAD). The purpose of this study is to evaluate the relationship between total WBC count and the presence, severity and extent of coronary atherosclerosis detected in subjects undergoing multislice computed tomographic (MSCT) coronary angiography for suspected CAD. Methods: A total of 817 patients were enrolled in this cross-sectional study. Non-significant coronary plaque was defined as lesions causing <= 50% luminal narrowing, and significant coronary plaque was defined as lesions causing > 50% luminal narrowing. For each segment, coronary atherosclerotic lesions were categorized as none, calcified, non-calcified and mixed. All images were interpreted immediately after scanning by an experienced radiologist. Results: An association between hypertension, diabetes mellitus, age, gender, hyperlipidemia, smoking, total WBC counts and coronary atherosclerosis was found when patients were grouped into two categories according to the presence of coronary atherosclerosis (p < 0.05). Although plaque morphology was not associated with total WBC counts, the extent of coronary atherosclerosis was increased with higher total WBC quartiles (p = 0.006). Patients with critical luminal stenosis had higher levels of total WBC counts when compared to patients with non-critical luminal narrowing (7,982 +/- 2,287 vs 7,184 +/- 1,944, p < 0.05). Conclusions: Our study demonstrated that total WBC counts play an important role in inflammation and are associated with the presence, severity and extent of coronary atherosclerosis detected by MSCT. Further studies are needed to assess the true impact of WBC counts on coronary atherosclerosis, and to promote its use in predicting CAD. (Cardiol J 2011; 18,4: 371-377)