Biomedical subjects

S Ozme

Publications and source records attributed to S Ozme.

At least 55 records · Page 3Linked to original sources

PubMedDate not supplied

Left ventricular structure and function by echocardiography in congenital muscular dystrophy.

Cardiac involvement in congenital muscular dystrophy (CMD) has not previously been reported in the literature excepting Japanese ones. The purpose of this study was to investigate the probability of cardiac muscle involvement in 25 patients with CMD. Left ventricular dimensions, wall thicknesses and function were investigated by M-mode and Doppler echocardiography in patients and healthy control subjects. The M-mode echocardiographic data were similar in the two groups. However, the left ventricular mass index in the study group was significantly lower than that of the control group. Left ventricular diastolic function also differed significantly when compared with that of the control group. Mild diastolic dysfunction of the left ventricle might precede manifestations of probable cardiac muscle involvement or subclinical cardiac involvement.

Child↗

PubMedDate not supplied

The angiocardiographic analysis of 73 patients with double-outlet right ventricle.

The purpose of this study was to determine the cardiac anatomy of patients with double-outlet right ventricle by angiocardiography. A total of 73 patients between the ages of one day and 11 years were examined. The aorta was on the right side of the pulmonary artery in 23 cases (32%), right anterior in 20 (27%) and right posterior in 17 cases (23%). Pulmonary stenosis was found in 53 patients (73%) and subaortic stenosis in six cases. Ventricular septal defect (VSD) was subaortic in 39 cases (52%), remote type in 17 (23%), doubly committed in 10 (13%), and subpulmonic in 9 (12%). Double VSD was noted in two patients. Pulmonary hypertension was more frequent in subpulmonic ventricular septal defect (78%). The most common associated anomalies were atrial septal defect (34%), anomalous coronary arteries (12%) and endocardial cushion defect (10%). Aortic root angiography was not satisfactory in half of the cases with coronary arterial anomaly. In conclusion, double-outlet right ventricle is a complex anomaly, all of whose cardiac features can be successfully demonstrated in detail by echocardiography and angiocardiography. However, in order to determine the anatomy of the coronary arteries, selective coronary angiography may be necessary in some patients.

Angiocardiography↗

PubMedDate not supplied

Transtelephonic ECG versus electrophysiologic study in children with recurrent palpitation attacks.

Palpitation may be a terrifying event for children and pose diagnostic problems for pediatric cardiologists. Routine methods often fail to document episodic arrhythmia because the episodes may be brief or infrequent or both. The purpose of this study was to evaluate and compare values of non-invasive and invasive techniques. Twenty-three children (mean age 11.7 +/- 2 years, range 7-16 years) with recurrent palpitation attacks (> 2 times), who had normal physical examinations, ECG, echocardiography, 24 hour ambulatory ECG monitoring and treadmill exercise tests, were included in the study. Redline Model CG 4000 TTE recorders were given to patients for 10 or 20 days. We performed an intracardiac electrophysiologic study (EPS) on 14 patients. The mean number of palpitation attacks was 11.3 +/- 7.4 (median: 5), lasting 9.6 +/- 7 (median 3) minutes. The number of transmitting records was 2 +/- 1.4 (1-20). Of the 23 patients, only 15 (65%) transmitted during the palpitation attacks. Twenty-four-hour ambulatory ECG monitoring findings were normal in all patients. One patient had a wide QRS tachycardia attack in the TTE records. We stimulated ventricular tachycardia in the same patient in the EPS. Among the other patients who transmitted TTE records during palpitation attacks, we diagnosed two cases of concealed accessory pathway and eight cases of dual AV nodal pathway in the EPS. In conclusion, TTE is a sensitive and accurate method for diagnosis and follow-up of patients with cardiac arrhythmia. It can be used before invasive studies in children with recurrent palpitation attacks.

Adolescent↗

PubMedDate not supplied

Adenosine-sensitive right ventricular tachycardia in children.

Right ventricular outflow tachycardia is a distinct subgroup of idiopathic ventricular tachycardia (VT) with characteristic clinical and electrophysiologic properties. This study was planned to evaluate the effects of adenosine on idiopathic right ventricular tachycardia in children, and to assess the long-term efficacy of verapamil treatment. Diagnostic tests including electrocardiogram, chest roentgenogram, echocardiogram, exercise stress test and 24-hour ambulatory electrocardiographic monitoring were performed in each patient. Adenosine was administered in increasing amounts until an effective dose or a maximal dose of 300 micrograms/kg was reached. In adenosine-sensitive patients verapamil was given orally (3-10 mg/kg/day) for long-term suppression of arrhythmia. Seven patients with a mean age of 10.2 +/- 4.7 years were enrolled in the study. There were five male and two female patients. Six patients had VT, and one patient had frequent ventricular ectopic bests. Arrhythmia originated from the right ventricle in all patients. Adenosine was effective in terminating the arrhythmia in all patients, with a mean effective dose of 183 +/- 75 micrograms/kg. Favorable long-term results (mean follow-up period 17 +/- 8 months) were obtained with verapamil treatment at an average dose of 6.3 +/- 2.2 mg/kg. In conclusion, adenosine can be used effectively for termination of VT originating from the right ventricular outflow tract in children. In these patients verapamil may be considered as the drug of choice for long-term therapy.

Adenosine↗

PubMedDate not supplied

Microdeletion of 22q11 (CATCH 22) in children with conotruncal heart defect and extracardiac malformations.

CATCH 22 is a medical acronym for cardiac defects, abnormal facies, thymic hypoplasia, cleft palate, and hypocalcemia, and a variable deletion on chromosome 22q11. The deletion within the chromosome region of 22q11 may occur in patients with dysmorphologic and cardiological syndromes: DiGeorge syndrome (DGS), velocardiofacial syndrome (VCFS), and conotruncal anomaly face syndrome (CAFS). In this study, using N25 (D22S75) DiGeorge chromosome region probe. fluorescence in situ hybridization (FISH) analyses were performed on 32 patients with congenital heart diseases. Twenty-nine of 32 patients had conotruncal heart disease. A 22q11 deletion was detected in two patients (6.9%) of the 29 patients with conotruncal heart disease. One of our 22qdel (+) patients had unilateral facial nerve palsy. Although it is not a frequent finding, unilateral facial nerve palsy will be included among the symptoms of CATCH 22 syndrome. After careful clinical evaluation of patients with conotruncal cardiac anomalies, only syndromic cases should be screened for this deletion.

Abnormalities, Multiple↗

PubMedDate not supplied

Analysis of 2017 Holter records in pediatric patients.

Holter monitoring (HM) is widely used in arrhythmic disorders of adult patients; however, studies in the pediatric age group are limited. This study aims to determine the value of HM in diagnosis and treatment of disorders related to arrhythmias in pediatric patients. We examined 2,017 Holter records of 1,500 children who applied to our institution between November 1994 and October 1998. The age ranged from 0-24 years (52% male, 48% female). The indications for HM were screening for arrhythmic symptoms (palpitation, chest pain, syncope) in 67 percent, monitoring dysrhythmic therapy in 17 percent, postoperative control in five percent, and pacemaker control in four percent. Palpitation is the leading presenting symptom, with more frequent findings of supraventricular extrasystole (SVE), supraventricular tachycardia (SVT), ventricular extrasystole (VE) and complete heart block (CHB) when compared to other symptoms. Only 5.3 percent of the patients had arrhythmic symptoms during monitoring and asymptomatic patients had more frequent arrhythmias. SVT, VE, and CHB are more frequent findings in the abnormal heart with previous cardiac operations. The diagnostic yield is low with arrhythmic symptoms in the pediatric age group; however, HM enables cumulative evaluation of heart rhythm and rhythm variability, which is important in diagnosing silent arrhythmias in high risk groups (abnormal heart, postoperative heart).

Adolescent↗

PubMedDate not supplied

Congenital sick sinus syndrome with breath holding and severe syncope episodes during infancy. A case report.

Sick sinus syndrome is a rare cause of bradycardia in children without structural heart disease. A case of profound sinus bradycardia, sinus arrest with junctional escape, and pauses in a two-year-old infant with breath-holding and syncope episodes is presented. As a result of these clinical symptoms and electrocardiographic findings, the patient with sick sinus syndrome underwent implantation of transvenous ventricular pacemaker. He has been well and asymptomatic since the insertion of the pacemaker. In the differential diagnosis of an infant with breath-holding and syncope episodes, when these symptoms in particular cannot be explained by other common reasons, sick sinus syndrome should be kept in mind. This case also illustrates the importance of electrocardiographic studies for the diagnosis.

Apnea↗

PubMedDate not supplied

Two-dimensional and Doppler echocardiography in the diagnosis of absent pulmonary valve syndrome (surgery without catheterization).

The majority of severely affected infants with absent pulmonary valve syndrome develop varying degrees of respiratory distress. Cardiac catheterization and angiocardiography are still performed in the diagnosis of these infants prior to surgery. However, considering the high risks of these invasive investigations for severely symptomatic infants, diagnosis using only noninvasive methods becomes important. In this regard, we present three cases of absent pulmonary valve syndrome, diagnosed pre-operatively by both two-dimensional and Doppler echocardiography. The diagnosis was confirmed by cardiac catheterization and angiocardiography in two cases and by surgery in a symptomatic infant. Therefore, we are of the opinion that the two-dimensional and Doppler echocardiographic methods are most reliable in diagnosing absent pulmonary valve syndrome, and that severely symptomatic infants can be referred for surgery without catheterization.

Angiocardiography↗

PubMedDate not supplied

Idiopathic long Q-T syndrome.

The association of Q-T interval prolongation, syncope and sudden death is known as the long Q-T syndrome. The syndrome may be familial, associated with congenital deafness, or idiopathic. The diagnosis is based on the electrocardiographic finding of a prolonged Q-T interval with or without T wave abnormalities. In this article, we present a nine-year-old boy admitted to the Hacettepe University Children's Hospital with complaints of syncopal episodes. The prolonged Q-T syndrome was diagnosed as the cause of the syncopal attacks. In addition, the same syndrome was detected in his father. The prolonged Q-T syndrome should be considered in the differential diagnosis of cases with recurrent, unexplained syncope in the pediatric age group.

Child↗

PubMedDate not supplied

Experience with propafenone for the treatment of cardiac arrhythmias in children.

The aim of this prospective study was to evaluate the efficacy of propafenone in suppressing various arrhythmias in a group of children who were patients in the Pediatric Cardiology Unit of Hacettepe University Children's Hospital. Seven of the 13 children (53.8%) with ventricular ectopics, all three children with paroxysmal re-entry atrioventricular tachycardia, and two of the three children with paroxysmal atrial tachycardia were treated successfully with propafenone. The drug did not cause any side effects or arrhythmogenesis. The median dosage of propafenone at discharge was 300 mg/m2/day (range 250-400 mg/m2/day) every eight hours. Our findings confirm the efficacy and safety of propafenone for the treatment of childhood arrhythmias.

Adolescent↗

PubMedDate not supplied

Detection of intracardiac left-to-right shunts in children by contrast echocardiography and the radionuclide technique.

This study was carried out in the Departments of Pediatrics and Nuclear Medicine at Hacettepe University Faculty of Medicine between April 1986 and March 1988 with the aim of detecting left-to-right shunts in 70 patients with isolated ventricular septal (VSD) defect, isolated atrial septal defect (ASD) and patent ductus arteriosus, by using the radionuclide technique together with contrast echocardiography. In some patients, the results were confirmed by both cardiac catheterization and angiocardiography. Most of the data were confirmed during surgery. A good correlation was found between the results of contrast echocardiography and radionuclide angiography. The difference between the QP/QS value and the grade of positive contrast effect was tested statistically and "p" was found to be less than 0.001. Therefore, we conclude that these methods could be applied together to determine the indication for surgery in cases with ASD or VSD.

Adolescent↗

PubMedDate not supplied

Exercise-induced ventricular tachycardia in children.

Two children with exercise-induced tachycardia, one with idiopathic long-QT syndrome, are presented. The patients were evaluated by exercise testing and electrophysiologic study. From the onset of treatment with the beta-blocking agent, pindolol, the patients have been symptom-free. These findings emphasize that children with syncope must be evaluated by ECG, exercise testing, 24-h Holter-monitoring, and finally, electrophysiological study.

Adolescent↗

PubMedDate not supplied

Percutaneous transluminal balloon pulmonary valvuloplasty: immediate and medium-term results.

Ten patients with pulmonary stenosis, (six males and four females) whose ages ranged between five and ten years (mean age 7 years) underwent cardiac catheterization and balloon valvuloplasty. Right ventricular systolic pressure before valvuloplasty ranged from 90 to 200 mm Hg (mean 133.5 +/- 33.3 mm Hg). It fell to 50-90 mm Hg (mean 64.5 +/- 13.8 mm Hg) immediately after the procedure. The peak systolic gradient across the pulmonary valve before valvuloplasty ranged from 70 to 180 mm Hg (mean 114.5 +/- 35.4 mm Hg) and decreased significantly to 30-70 mm Hg (mean 43.0 +/- 13.8 mm Hg) immediately after dilation. Doppler echo studies confirmed these results. At repeat cardiac catheterization in three patients, five to 15 months after valvuloplasty, restenosis was noted in one patient while there was no change in the others. All patients had been followed up by Doppler echocardiography. Patients with isolated valvular pulmonary stenosis can be adequately and safely treated with balloon valvuloplasty which results in excellent immediate and medium-term results.

Catheterization↗

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Peripheral vein contrast echocardiography in atrial septal defect.

This study was carried out on 233 children suspected clinically of having atrial septal defect with the aim of investigating the diagnostic capability of peripheral venous contrast echocardiography. The transfer of contrast material from the right atrium into the left atrium was evaluated as "positive contrast", while noncontrast blood, passing from the left atrium into the right atrium was termed "negative contrast". Positive contrasts were quantitated in four grades. A significant negative contrast effect was graded 3- or 4-. Three positive, 4+ and/or 3-, 4- contrast effects were considered definite evidence of an atrial septal defect. Among the cases with the above findings 92 underwent surgical closure of atrial septal defect. The procedure was successful in all patients operated; the size of the defect was large. This result demonstrates that the method applied is a safe and reliable one. However, in a group of cases without the above echocardiographic findings the presence of an atrial septal defect was detected by cardiac catheterization and angiocardiography. Therefore, we can conclude that the method applied is not a sensitive, but a specific one, for definite detection of atrial septal defect.

Adolescent↗

PubMedDate not supplied