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    Evaluation of ivabradine in left ventricular dyssynchrony and reverse remodeling in patients with chronic heart failure
    (Wiley, 2020) Soylu, Korhan; Cerik, Idris Bugra; Aksan, Gokhan; Nar, Gokay; Meric, Murat
    Objectives: Ivabradine is a pharmacological agent used in patients with heart failure and sinus rhythm. Its only known pharmacological effect is to slow the heart rate. In this study, we investigated the impact of ivabradine on dyssynchrony parameters in heart failure patients. Methods: In this study, we assigned 55 patients taking medication for heart failure to receive ivabradine in addition (Group I). Twenty healthy volunteers comprised Group II. Echocardiographic measurements (dyssynchrony, left ventricular volumes and left ventricular ejection fraction) were taken at baseline, 1 month, and 3 months. Results: A total of 32 heart failure patients in Group I completed the study. There was significant improvement in dyssynchrony parameters after ivabradine treatment in Group I. Interventricular dyssynchrony (IVD) decreased from 42.0 +/- 24.4 milliseconds at baseline to 33.6 +/- 20.7 milliseconds at 1 month (P = .001) and to 30.7 +/- 19.4 milliseconds at 3 months (P < .001). Septal to posterior wall motion delay decreased from 90.3 +/- 21.4 milliseconds to 83.9 +/- 26.9 milliseconds (P = .011) at 1 month and to 81.5 +/- 27.3 milliseconds at 3 months (P = .001). Septal to lateral Ts delay (TsSL) decreased from 42.7 +/- 24.5 milliseconds to 35.8 +/- 22.6 milliseconds at 1 month (P < .001) and to 34.8 +/- 22.4 milliseconds at 3 months (P = .002). Left ventricular end-systolic volume (LVESV) decreased from 139.4 +/- 42.2 mL to 135.3 +/- 39.6 mL at 1 month (P = .006) and to 123.3 +/- 39.5 mL at 3 months (P < .001). Conclusion: The addition of ivabradine to heart failure treatment improves cardiac dyssynchrony parameters in chronic systolic heart failure patients with sinus rhythm.
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    A multicentre, comparative study of Cera septal occluder versus AMPLATZER Septal Occluder in transcatheter closure of secundum atrial septal defects
    (EUROPA EDITION, 2014) Kaya, Mehmet Gungor; Akpek, Mahmut; Celebi, Ahmet; Saritas, Turkay; Meric, Murat; Soylu, Korhan; Karapinar, Hekim; Lam, Yat-Yin
    Aims: To evaluate the safety and efficacy of the new Cera septal occluder (CSO) for atrial septal defect (ASD) closure as compared to the AMPLATZER Septal Occluder (ASO). Methods and results: A total of 405 ASD patients receiving CSO or ASO were studied. The ASDs were classified into simple defects (isolated defects <26 mm) or complex defects (isolated defects >26 mm, large defects with a deficient rim, double or multi-fenestrated defects). Clinical and echocardiographic findings were collected before discharge, at one month, and every six months after implantation. Two hundred and five (133 females, aged 30 +/- 13 years) and 200 (135 females, aged 28 +/- 14 years) patients received CSO and ASO implants, respectively. The CSO group had similar ASD and device sizes, prevalence of complex lesions, procedural times and success rates as compared to the ASO group. Echocardiographic follow-up at one and six months showed similar residual shunts between devices. Both groups had similar rates for device embolisation and atrial arrhythmia. The average equipment cost per patient was lower in the CSO group than in the ASO group (US$3,500 vs. US$5,600, p<0.001). Conclusions: Transcatheter ASD closure with CSO is safe and effective. It appears to be an attractive alternative to ASO because of its relatively low cost.