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Öğe ACUTE CARBON MONOXIDE POISINING RELATED MYOCARDIAL INFARCTION(Elsevier Ireland Ltd, 2010) Barutcu, Ahmet; Aktoz, Meryem; Tatli, Ersan; Donmez, Emrah; Ersoy, Nedret[Abstract Not Available]Öğe Assessment of the relationship between asymmetric dimethylarginine and severity of erectile dysfunction and coronary artery disease(Springer, 2010) Aktoz, Tevfik; Aktoz, Meryem; Tatli, Ersan; Kaplan, Mustafa; Turan, Fatma N.; Barutcu, Ahmet; Atakan, Irfan H.The plasma concentration of asymmetrical dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, has been linked to endothelial dysfunction. We investigated the relation between plasma ADMA concentration and severity of erectile dysfunction (ED) and coronary artery disease (CAD). We measured plasma levels of ADMA in 92 male patients. Patients were divided into three groups: group 1 (n = 41), patients with ED and without CAD; group 2 (n = 29), patients with stable CAD; group 3 (n = 22), control group (patients without CAD or ED). Erectile function was evaluated by the erectile function domain of the international index of erectile function (IIEF-EFD) a validated 15-item self-administered questionnaire. Erectile function is specifically addressed by six questions that form the so-called erectile function domain of the questionnaire. Each question is scored 0-5. ED is defined as any value < 26. Patients with CAD who have stable angina pectoris were selected after coronary angiography. ADMA was analyzed by ELISA method. Group 1 had significantly higher concentrations of plasma ADMA than groups 2 and 3 (respectively, 0.75 +/- A 0.40 vs. 0.50 +/- A 0.30, P = 0.013; 0.75 +/- A 0.40 vs. 0.50 +/- A 0.25, P = 0.021). There was negative correlation between ADMA and IIEF-EFD score in all groups (n = 92) (r = -0.322, P = 0.002). In a multiple logistic regression analysis adjusting for age, hyperlipidemia, ADMA remained independent predictor for severe ED. Odds ratio for plasma ADMA was 14.151 (1.101-181.940; P = 0.042). First of all, this study provides that ADMA concentrations are significantly higher in patients who have ED when compared to patients with CAD and controls. Second, there was a negative correlation between ADMA and severity of ED. Elevating levels of circulating ADMA is an independent risk factor for severe of ED, and ADMA may be a link between CAD and ED.Öğe Asymmetrical dimethylarginine and severity of erectile dysfunction and their impact on cardiovascular events in patients with acute coronary syndrome(Termedia Publishing House Ltd, 2010) Aktoz, Meryem; Aktoz, Tevfik; Tatli, Ersan; Kaplan, Mustafa; Turan, Fatma Nesrin; Barutcu, Ahmet; Atakan, Irfan HueseyinIntroduction: Coronary artery disease (CAD) and vascular erectile dysfunction (ED) are related to endothelial dysfunction. Elevated asymmetrical dimethylarginine (ADMA) levels and ED are common in patients with increased cardiovascular risk. Our aim was to investigate whether ADMA has a predictive role for major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS). The secondary aim of this study was to investigate whether severity of ED predicts MACE in these patients. Material and methods: Follow-up data were available for severity of ED in 71 patients with ACS. Plasma ADMA levels were determined by ELISA in 57 patients. Erectile dysfunction was assessed by the International Index of Erectile Function-6 (IIEF-6) score. Major adverse cardiovascular events (reinfarction, all-cause hospitalisation, stroke and all-cause death) was evaluated after a median of 10 months. Results: Severe ED had no significantly increased hazard ratio for cardiovascular events compared with mild, mild to moderate, and moderate ED (0.259 [95% CI 0.041-1.6], p = 0.147; 0.605 [95% CI 0.095-3.8], p = 0.594; 0.980 [95% CI 0.233-4.1], p = 0.978; and 0.473 [95% CI 0.052-1.3], p = 0.508). The patients who had ADMA levels 0.32 mu mol/l had no significantly increased hazard ratio for cardiovascular events compared with patients who had ADMA levels < 0.32 mu mol/l (2.018 [95% CI 0.615-6.6], p = 0.247). Conclusions: Severity of ED and ADMA did not increase the risk of cardiovascular events in follow-up patients with ACS in our study. Larger prospective studies are necessary to evaluate whether ADMA predicts cardiovascular events in patients with ACS.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 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 Prevalence of Raynaud's phenomenon in healthy Turkish medical students and hospital personnel(Springer Heidelberg, 2008) Cakir, Necati; Pamuk, Omer Nuri; Donmez, Salim; Barutcu, Ahmet; Diril, Hidayet; Odabas, Esin; Kiliccigil, VolkanIn this study, we investigated the frequency of Raynaud's phenomenon (RP) in medical students and hospital personnel and determined associated factors. Students and hospital personnel of our medical faculty (1,414 subjects; 838 females, 576 males, mean age, 27.2 +/- 6.6) were questioned for symptoms associated with RP, and the presence of smoking and headache. 530 subjects (37.5%) defined color changes on cold exposure. 51 subjects (3.6%) had biphasic or triphasic color changes (definite RP). The prevalence of definite RP in females (4.8%) was significantly higher than in males (1.9%) (P = 0.005). The frequency of smoking subjects (45.1 vs. 28.8%) was significantly higher in patients with RP (P = 0.009). There was numbness and/or paresthesia in 174 subjects (12.3%) who defined uniphasic color change on cold exposure (possible RP). Female sex and being a smoker were factors associated with RP in our study.Öğe The relation between the levels of osteoprotegerin and the degree of coronary artery disease in patients with acute coronary syndrome and stable angina pectoris(Via Medica, 2014) Aksu, Feyza; Ozcelik, Fatih; Kunduracilar, Hakan; Barutcu, Ahmet; Yel, Mesih; Umit, Elif Gulsum; Altun, ArmaganBackground: Osteoprotegerin (OPG), an inhibitor of osteoclastogenesis, has recently been under the spotlight in studies regarding the pathophysiology of atherosclerosis. Aim: To evaluate the value of serum OPG in the diagnosis and severity in patients with stable angina pectoris (SA) and unstable angina pectoris/non ST elevation myocardial infarction. Methods: This study involved 160 patients, SA (n = 65), acute coronary syndrome (NSTE-ACS; n = 65), and a control group (n = 30). Blood samples were collected in the first hour, after 24 hours and on the fifth day. The prevalence of coronary artery atherosclerotic lesions was determined using the Gensini scoring system. Results: A statistically significant difference was observed in the first hour OPG levels between the control group and both the SA and NSTE-ACS group (p < 0.001). When the cut-off value was determined as 247.71 pg/mL, the sensitivity and specificity of the first hour OPG levels indicating coronary artery disease were 91.54% and 46.67%, respectively, while the positive predictive value was 88.1% and the negative predictive value was 56%. No correlations were observed between the first, 24th hour and the fifth day OPG levels and the Gensini scores. No relation was denoted between the OPG levels and number of diseased coronary arteries. Conclusions: In our study, serum OPG level seemed to be unrelated to the severity or the degree of coronary artery disease in patients with SA and unstable angina pectoris/non ST elevation myocardial infarction. OPG may only be accepted as an indicator of coronary artherosclerosis.
