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Öğe Acute myocardial infarction due to disulfiram (antabus)-alcohol interaction(Springer, 2006) Altun, Gurcan; Altun, Armagan; Erdogan, Okan[Abstract Not Available]Öğe Assessment of arterial distensibility in patients with cardiac syndrome x(Sage Publications Inc, 2007) Yildiz, Mustafa; Altun, Armagan; Ozbay, GultacThis study aims to investigate arterial distensibility by using carotid-femoral (aortic) pulse wave velocity measurements in Patients with cardiac syndrome X. The authors studied 10 patients with cardiac syndrome X (mean age 49.4 +/- 7.5, 39 to 67 years old, 3 men) and 10 healthy subjects (mean age 50.0 +/- 10.5, 38 to 70 years old, 3 men). Carotid-femoral pulse wave velocity measured by a Complior Colson device was calculated for each patient. The carotid-femoral pulse wave velocity was increased in patients with cardiac syndrome X as compared with age-matched control subjects (10.25 +/- 1.28 vs 8.95 +/- 0.89 m/s, p=0.01). In contrast, there were no significant differences in the age, weight, height, body mass index, waist/hip ratio, systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and heart rate (P=0.76, p=0.17, p=0.36, p=0.08, p=0.21, p=0.14, p=0.89, p=0.30, P=0.10, p = 0.36, respectively). No significant correlation was found between pulse wave velocity and age, sex, height, weight, heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, and pulse pressure in the studied groups (p > 0.05). The arterial distensibility was decreased in patients with cardiac syndrome X. The deterioration in these patients showed that this disease might be a more generalized disturbance of the vasculature. Measurements of carotid-femoral pulse wave velocity may provide a simple and noninvasive technique to identify patients at increased risk of vascular disease.Öğe Assessment of ventricular and left atrial mechanical functions, atrial electromechanical delay and P wave dispersion in patients with scleroderma(Via Medica, 2011) Aktoz, Meryem; Yilmaztepe, Mustafa; Tatli, Ersan; Turan, Fatma Nesrin; Umit, Elif G.; Altun, ArmaganBackground: The aim of this study was to investigate ventricular functions and left atrial (LA) mechanical functions, atrial electromechanical coupling, and P wave dispersion in scleroderma patients. Methods: Twenty-six patients with scleroderma and twenty-four controls were included. Left and right ventricular (LV and RV) functions were evaluated using conventional echocardiography and tissue Doppler imaging (TDI). LA volumes were measured using the biplane area-length method and LA mechanical function parameters were calculated. Inter-intraatrial electromechanical delays were measured by TDI. P wave dispersion was calculated by 12-lead electrocardiograms. Results: LV myocardial performance indices (MPI) and RV MPI were higher in patients with scleroderma (p = 0.000, p = 0.000, respectively) while LA passive emptying fraction was decreased and LA active emptying fraction was increased (p = 0.051, p = 0.000, respectively). P wave dispersion and inter-intraatrial electromechanical delay were significantly higher in patients with scleroderma (25 [10-60] vs 20[0-30], p = 0.000, 16.50 [7.28-26.38] vs 9.44 [3.79-15.78] and 11.33 [4.88-16.06] vs 4.00 [0-12.90], p < 0.05, respectively). Interatrial electromechanical delay was negatively correlated with LV E wave, (p = 0.018). LV E wave was demonstrated to be a factor independent of the interatrial electromechanical delay (R(2) = 0.270, beta = -0.52, p = 0.013). Conclusions: This study showed that in scleroderma patients, global functions of LV, RV and mechanical functions of LA were impaired, intra-interatrial electromechanical delays were prolonged and P wave dispersion was higher. LV E wave was demonstrated to be a factor that is independent of the interatrial electromechanical delay. Reduced LV E wave may also give additional information on the process of risk stratification of atrial fibrillation. (Cardiol J 2011; 18, 3: 261-269)Öğe Bidirectional tachycardia in a patient with pulmonary embolism(Via Medica, 2010) Tatli, Ersan; Aktoz, Meryem; Barutcu, Ahmet; Altun, ArmaganWe report a 55 year-old man with sudden cardiac arrest. Electrocardiography revealed runs of bidirectional ventricular tachycardia, and transthoracic echocardiography showed indirect findings of pulmonary embolism. (Cardiol J 2010; 17, 2: 194-195)Öğe Cannabis-induced coronary artery thrombosis and acute anterior myocardial infarction in a young man(Elsevier Ireland Ltd, 2007) Tatli, Ersan; Yilmaztepe, Mustafa; Altun, Gurcan; Altun, ArmaganInformation concerning acute myocardial infarction after cannabis usage is limited and the actual mechanism of cannabis-induced myocardial infarction is not well known. In the report, we described a young man with art acute myocardial infarction and cannabis-induced coronary thrombosis. (c) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe Circulating leptin and osteoprotegerin levels affect insulin resistance in healthy premenopausal obese women(Elsevier Science Inc, 2007) Ugur-Altun, Betul; Altun, ArmaganWe investigated the relationship between circulating leptin and osteoprotegerin (OPG) levels and insulin resistance assessed by HOMA-IR in premenopausal obese and normal weight women. Thirty four obese women (age 31 +/- 8 years) (BMI 35 +/- 4 kg/ m(2)) with 19 healthy controls (age 31 +/- 7 years) (BMI < 25 kg/m(2)) (BMI 21 +/- 2 kg/ m(2)) were included in the study. Women were healthy and had no osteoporosis. Circulating leptin levels were significantly higher in obese women (17.11 +/- 2.05 ng/ mL vs. 8.38 +/- 4.71 ng/mL, p < 0.0001) and decreased OPG levels were found (14.7 +/- 7.15 pg/mL vs. 19.17 +/- 6.37 pg/mL, p = 0.03). Leptin showed a positive correlation with BMI (r = 0.851, p < 0.0001), waist-to-hip ratio (r = 0.692, p < 0.0001), fasting insulin (r = 0.441, p < 0.001), HOMA-IR (r = 0.412, p = 0.002), fibrinogen (r = 0.387, p = 0.004), uric acid (r = 0.293, p = 0.033), hematocrit (r = 0.394, p = 0.003), systolic (r = 0.504, p < 0.0001), and diastolic blood pressure (r = 0.363, p = 0.008). OPG showed a negative correlation with insulin (r = -0.341, p = 0.013) and HOMA-IR (r = -0.324, p = 0.018). In obese women group, the regression equation of HOMA-IR was (HOMA-IR = [0.095 x leptin]-[0.051 x OPG] + 1.71). However, there was no relation between leptin and OPG levels. In conclusion, circulating leptin and OPG levels were related to insulin resistance in premenopausal obese women. However, leptin had no interference in OPG in premenopausal women. (c) 2007 IMSS. Published by Elsevier Inc.Öğe Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomized trial(Aves Yayincilik, 2011) Erdogan, Okan; Ertem, Bulent; Altun, ArmaganObjective: The aim of the present study is to compare the antihypertensive effects of carvedilol and nebivolol in mild to moderate hypertensive patients. Methods: It is a prospective; placebo-controlled, cross-over, double-blind, randomized, single-center clinical trial. Patients (n=20) who were first diagnosed with mild to moderate systemic hypertension according to mean ambulatory blood pressure measurements > 130/85 mmHg and no previous antihypertensive therapy were prospectively enrolled into the study. After 10 days of placebo run-in period, they were randomized within the same group as cross-over design to one month carvedilol 25 mg and one month nebivolol 5 mg regimen given once daily in the morning. The primary outcome variables were systolic and diastolic blood pressures determined by 24-hour ambulatory blood pressure measurements. Mutlivariate analysis of variance for repeated measurements with 3x2 factorial design was used for statistical analysis of results. Results: The study group consisted of 6 women and 14 men whose mean age was 42.9 +/- 12.8 years (range 19-63 years). Mean heart rate was significantly decreased after commencing both carvedilol (70.2 +/- 5.2 bpm) and nebivolol (64.9 +/- 3.9 bpm) treatments compared to placebo (78.8 +/- 5.2 bpm) (p<0.05). Both carvedilol (133.8 +/- 9/86.6 +/- 8.6 mmHg) and nebivolol (134 +/- 8.7/85.6 +/- 7.4 mmHg) significantly decreased mean systolic and diastolic blood pressures compared to placebo (143.9 +/- 8.9/94.4 +/- 9.2 mmHg), respectively (p<0.05). However, there was no significant difference in decreasing either systolic or diastolic blood pressure between nebivolol and carvedilol therapies (p>0.05). No side effects were recorded during both carvedilol and nebivolol treatments. Conclusion: Although both carvedilol and nebivolol effectively decreased blood pressure compared to placebo, they showed similar efficacy for lowering blood pressure. (Anadolu Kardiyol Derg 2011; 11: 310-3)Öğe Comparison of Five QT Correction Methods in Patients with Hypoxic Brain Injury(Elsevier Science Inc, 2013) Samsa, Murat; Aksit, Ercan; Aydin, Fatih; Yilmaztepe, Mustafa Adem; Altun, Armagan[Abstract Not Available]Öğe Contrast-induced nephropathy: preventive and protective effects of melatonin(Wiley, 2006) Gazi, Sabri; Altun, Armagan; Erdogan, OkanInfusion of contrast agents increases osmotic load, viscosity, hypoxemia of the renal medulla and renal free radical production through post-ischemic oxidative stress. The present experimental study sought to determine whether melatonin, because of its anti-oxidant properties might have a preventive and protective role against the development of contrast-induced nephropathy (CIN). Twenty-four adult male rats were divided into four experimental groups: healthy control rats (CR), rats with CIN (CINR), rats with CIN pretreated with melatonin (CINR1M), and rats with CIN pre- and post-treated with melatonin (CINR2M). In CINR, both serum creatinine (Cr) level and fractional excretion of sodium (FE-Na) significantly increased, whereas Cr clearance decreased at post-CIN compared with pre-CIN period. Rats in CINR1M did not show any improvement in renal function. Cr clearance decreased, whereas both serum Cr level and FE-Na increased in rats pretreated with melatonin. In contrast, significant improvements were observed in CINR2M. Serum Cr and Cr clearance did not change, whereas FE-Na significantly reduced in rats pre- and post-treated with melatonin. In conclusion, the present experimental study clearly demonstrated the preventive and protective role of melatonin against the development of CIN.Öğe Coronary Artery Disease Management in Polyclinic(Aves Yayincilik, Ibrahim Kara, 2010) Durusoy, Elcim; Yildirim, Tarik; Altun, ArmaganCoronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the world in both men and women. Coronary artery disease happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the build up of cholesterol and other material, called plaque on their inner walls. As the build up grows, less blood can flow through the arteries. As a result heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Treatment of CAD is aimed at controlling symptoms and slowing or stopping the progression of disease. The method of treatment is based on many factors determined by symptoms, a physical exam, and diagnostic testing.Öğe Coronary Artery Ectasia is Associated with the Elevation of Mean Platelet Volume Regardless of an Existing Acute Coronary Syndrome(Aves, 2013) Sivri, Nasir; Yalta, Tulin; Yalta, Kenan; Altun, Armagan; Sut, Necdet; Yetkin, ErtanObjective: Elevated mean platelet volume (MPV) has been considered as an indicator of enhanced platelet reactivity. In several studies, MPV has been shown to be elevated in the setting of acute coronary syndromes (ACS) and coronary artery ectasia (CAE). In this study we aimed to investigate the potential effects of CAE on MPV regardless of an existing acute coronary syndrome (ACS). Methods: Two independent operator retrospectively reviewed the records of 12,724 patients who had previously (between the years 2000 and 2011) undergone coronary angiography in the catheterization laboratory. The present study comprised an overall 337 patients including 112 patients with stable coronary artery disease (CAD) (group 1), 112 patients with ACS (group 2) and 113 patients with isolated CAE (without ACS) (group 3). Results: The values of mean ages were 52.3 +/- 5.6; 52.5 +/- 5.7 and 49.7 +/- 3.8 in groups 1, 2 and 3, respectively (p< 0.001). Cardiovascular risk factors and hemoglobin levels did not significantly differ among groups. Mean platelet levels in groups 2 and 3 (244.8 +/- 28.3, 239.1 +/- 28.8, respectively) were found to be significantly lower than that of group 1 (276.4 +/- 0.69) (p< 0.001) whereas mean levels of MPV in groups 2 and 3 (9,09 +/- 1.07fL, 9.06 +/- 1.07fL, respectively) were found to be significantly higher than that of group 1 (8,56 +/- 1.28fL) (p< 0.001). Conclusion: Nothwithstanding the similar cardiovascular risk factors and admission patterns suggestive of a common etiopathological background among these 3 entities, MPV levels may be more likely to be elevated in the setting of ACSs and isolated CAE (regardless of an existing ACS) compared to stable CAD.Öğe Coronary Slow Flow and Acute Coronary Syndrome in a Patient with Spinal Cord Injury(Texas Heart Inst, 2011) Aktoz, Meryem; Tatli, Ersan; Barutcu, Ahmet; Ozkalayci, Flora; Umit, Elif; Altun, ArmaganWe report the case of a 55-year-old man who presented with acute coronary syndrome due to coronary slow flow after spinal cord injury. Data regarding the causes and clinical manifestations of coronary slow flow are inconclusive, but the autonomic nervous system is believed to be at least a contributing factor The predominant vagal activity causes vasodilation and hemostasis, which can lead to acute coronary syndrome. We hereby call attention to hyperactive parasympathetic tonicity, which can lead to coronary slow flow and acute coronary syndrome in acute spinal cord injury patients. (Tex Heart last J 2011;38(4):433-6)Öğe CORONARY SLOW FLOW AND ACUTE CORONARY SYNDROME IN PATIENT WITH SPINAL CORD INJURY: A CASE REPORT(Elsevier Ireland Ltd, 2010) Aktoz, Meryem; Tatli, Ersan; Barutcu, Ahmet; Ozkalayci, Flora; Umit, Elif; Altun, Armagan[Abstract Not Available]Öğe Dilemma in the strategy of treatment: revascularization or medical treatment? Reply(Aves Yayincilik, 2009) Tatli, Ersan; Aktoz, Meryem; Aydin, Goekhan; Yilmaztepe, Mustafa; Altun, Armagan[Abstract Not Available]Öğe Do plasma leptin levels predict diastolic dysfunction in patients with hypertension?(Termedia Publishing House Ltd, 2009) Tatli, Ersan; Aktoz, Meryem; Altun, ArmaganIntroduction: Increased plasma leptin levels were showed in a number of cardiac problems such as hypertension, left ventricular hypertrophy, coronary artery disease and acute myocardial infarction. The possibility that leptin plays a role in the cardiovascular system was strengthened by the evidence that chronic leptin infusion had been shown to increase heart rate and blood pressure through stimulation of sympathetic nervous system activity. However, the relationship between increased plasma leptin levels and diastolic dysfunction hasn't been exactly investigated so far. Thus, we investigated relation between plasma leptin levels and diastolic dysfunction in patients with hypertension. Material and methods: Sixty mate patients with newly diagnosed essential hypertension were, consecutively included in the study. Hypertensive patients were divided into two groups according to Doppler echocardiographic parameters as patients with diastolic dysfunction (group 1, n = 38) and without diastolic dysfunction (group 11, n = 22). Both groups were compared patients' characteristics, plasma leptin levels, glucose, insulin, insulin resistance and thyroid hormones. Results: There were no significant differences between patients' characteristics, fasting insulin, glucose, insulin resistance, thyroid hormones. Echocardiographic evaluation showed similar values of septal and posterior wall thickness, left ventricular end-systolic and end-diastolic diameters, fractional shortening and ejection fraction in both groups. Plasma leptin levels were also found similarly in both groups (group 1, 40.6 +/- 18.4 ng/ml vs. group 1, 36.7 +/- 20.7 ng/ml, p = 0.650). Conclusions: We suggested that leptin levels didn't predict diastolic dysfunction in patients with hypertension.Öğe EFFECT OF COLD STRES ON THE RIGHT VENTRICULAR FUNCTIONS IN PATIENTS WITH SCLERODERMA(Elsevier Ireland Ltd, 2010) Yilmaztepe, Mustafa Adem; Aktoz, Meryem; Tatli, Ersan; Altun, Armagan[Abstract Not Available]Öğe The effect of cold stress on right ventricular function in patients with systemic sclerosis(Marmara Univ, Fac Medicine, 2018) Yilmaztepe, Mustafa; Aktoz, Meryem; Tatli, Ersan; Altun, ArmaganObjective: Pulmonary hypertension and right heart failure are poor prognostic factors in systemic sclerosis (SSc). The effect of cold stress on pulmonary vasospasm was evaluated in some trials but the results were conflicting. The aim of our study was to determine the effect of cold stress on right ventricular (RV) function. Materials and Methods: Twenty-four patients with SSc and 24 age and sex-matched healthy controls were enrolled in the study. Transthoracic echocardiography (TIE) was performed to all patients at rest and after peripheral cold exposure. Baseline and after cold stress test TIE results were compared between the groups. Results: Cold exposure induced changes in particularly right venticular function. Pulmonary acceleration time was significantly shortened in the SSc group (118.8 +/- 11.7ms vs 111.3 +/- 13.7ms, P<0.001). Tricuspid annular plane systolic excurison and RV fractional area change were also decreased after cold exposure in the SSc group. (23.3 +/- 1.6mm vs 21.9 +/- 1.9 mm, P<0.001; 46.3 +/- 5.8 vs 44.4 +/- 5.8,P= 0.007, consecutively). Left ventricular (LV) function did not change after cold stress (LV myocardial performance index (0.42 +/- 0.04 vs 0.42 +/- 0.05), P=0.748). Conclusion: Peripheral cold exposure caused a reduction in right ventricular function indicating pulmonary Raynaud's phenomenon as a possible contributing factor.Öğe Effects of Gender on Electrocardiography in Subjects with Shortened Ventricular Depolarization (QRS)(Wiley, 2016) Aydin, Fatih; Aktoz, Meryem; Altun, Armagan; Gursul, Erdal; Aksit, ErcanBackground: Distinctions between electrocardiograms of female and male subjects have been recognized for many years. Due to these differences, arrhythmias in each gender have a tendency to differ. In our study, we aimed to compare electrocardiography intervals between men and women with short QRS durations. Methods: Subjects with a QRS interval of <= 80 ms were included in the study. Patients were grouped by gender and the parameters were compared. Patients with diseases that might affect QRS interval and/or who were on medications were excluded. The electrocardiogram intervals of the subjects were measured, Holter monitors were placed, and parameters of time-based heart rate variation were analyzed. Results: A total of 100 patients (55% female) were included in the study. According to statistical analysis, no significant difference between the genders was observed in the heart rate or in the parameters, such as QT, JT, JTp, and TpTe intervals or heart rate-corrected QTc, JTc, JTpc, and TpTec intervals, which affect repolarization and are known to be arrhythmia precursors by shortening or elongation. No statistically significant difference was found between the two groups for the parameters of heart rate variability time measures (SDNN, SDANN, rMSSD, and pNN50). Conclusion: We observed that when the QRS interval gets shorter, repolarization differences between the genders disappear. New studies are required on this subject.Öğe Electrocardiographic prediction of left ventricular geometric patterns in patients with essential hypertension(Elsevier Ireland Ltd, 2007) Aktoz, Meryem; Erdogan, Okan; Altun, ArmaganBackground: The present study sought to determine the diagnostic value of electrocardiographic voltage criteria in predicting geometry patterns in patients with essential hypertension. Methods: Patients with essential hypertension (n=125) according to left ventricular mass index and relative wall thickness as determined by echocardiography were assigned in the following groups: normal geometry (N, n=50), concentric remodeling (CR, n=12), concentric hypertrophy (CH, n=28) and eccentric hypertrophy (EH, n=35). Each patient underwent 12-lead ECG followed by determination of conventional voltage criteria as well as peak to peak QRS lengths in each lead. Results: Voltage criteria such as Sokolow-Lyon, Cornell, Cornell product > 2440, DIR+D3S > 25 mm, and AVL R > 11 mm could not significantly predict and discriminate geometric patterns of LVH. However, they all were very specific (range 97-100%) and showed very high positive predictive values (range 94-100%) for detecting abnormal geometry. DI peak > 12 mm had a sensitivity 61%, specificity 67%, accuracy 63%, positive predictive value 81%, and negative predictive value 42% in predicting to differentiate CH from CR. Sum of the calculated values from the peak of the R to the nadir of the S wave in all limb leads > 60 mm had sensitivity 68%, specificity 75%, accuracy 70%, positive predictive value 86% and negative predictive value 50% in predicting to differentiate CH from CR. Conclusions: Conventional ECG voltage criteria could not significantly discriminate specific geometry patterns observed in patients with essential hypertension. (c) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe Impact of osteoprotegerin and leptin on amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in healthy young adults(Elsevier Ireland Ltd, 2007) Altun, Armagan; Ugur-Altun, Betul; Arkan, Ender; Kunduracilar, Hakan; Guldiken, Sibel; Kara, Mujdat; Tugrul, Armagan[Abstract Not Available]
