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Öğe Anti-ischaemic and anti-anginal effects of nisoldipine and ramipril in patients with cardiological syndrome X(1998) Ozcelik F.; Altun A.; Ozbay G.We investigated anti-ischaemic and anti-anginal effects of nisoldipine and ramipril in patients with the cardiological syndrome X. After a two-week wash-out period, 18 patients (7 men, 11 women; mean age: 46±10 years) with cardiological syndrome X (stable angina pectoris, positive exercise test, negative ergonovine test, and normal coronary angiography) were given nisoldipine 5 mg twice daily for four weeks. And after a second two-week wash-out period, the same patients were given ramipril 2.5 mg daily for four weeks. Treadmill exercise test with modified Bruce protocol was performed at the end of each period. The time until anginal attack occurred (p=0.006 vs p=0.02), total exercise time (p=0.0008 vs p=0.02), and mean metabolic equivalent (p=0.0016 vs p=0.01) were increased significantly after nisoldipine and ramipril therapy periods. The time until ST segment depression by 1mm occurred (p=0.002) was increased significantly after nisoldipine therapy. The time until ST segment depression recovery (p=0.016 vs p=0.012), the weekly number of angina pectoris (p=0.00 vs p=0.028), and the weekly number of sublingual nitroglycerin consumption (p=0.00 vs p=0.012) were decreased significantly after nisoldipine and ramipril therapy periods. We conclude that 10 mg/daily nisoldipine or 2.5 mg/daily has anti-ischaemic and anti-anginal effects in patients with cardiological syndrome X.Öğe Automatic backscatter analysis of regional right ventricular systolic function using color kinesis in patients with acute anterior myocardial infarction(1999) Kurum T.; Ozbay G.; Korucu C.; Ozcelik F.; Eker H.; Oztekin E.Color kinesis (CK) is a recently developed echocardiographic method based on acoustic quantification (AQ) that automatically tracks and displays endocardial motion in real time. We studied whether AQ and CK may provide quantitative assessment of global and regional right ventricular function in patients with acute anterior myocardial infarction since the evaluation of right ventricular function has important prognostic implications in these patients. Twenty consecutive patients with recent (within 1 week) acute anterior myocardial infarction and 15 age- and gender-matched controls were studied. Right ventricular AQ and CK images were acquired in the apical 4-chamber view. After image quality was optimized, AQ system for endocardial border detection was activated. Once the region of interest was drawn around the right ventricle, all gain compensations were adjusted to optimize tracking of the blood-endocardial interface. AQ waveforms of right ventricular fractional area change were displayed along with the electrocardiogram and concurrent cross sectional image. CK digitized right ventricular end-systolic images were evaluated by reviewing the stored loops obtained in all normal subjects and patients. To evaluate right ventricular systolic endocardial excursion, a further quantitative CK analysis was performed by measuring the systolic segmental endocardial motion and the time of systolic segmental endocardial motion. Compared to controls, acute anterior myocardial infarction patients had reduced right ventricular fractional area change (26 ± 7 vs 45 ± 6%, p < 0.05), reduced mean systolic segmental endocardial motion (14 ± 5 vs 21 ± 3 mm, p < 0.05), and reduced mean time of systolic segmental endocardial motion (210 ± 38 vs 290 ± 30 ms, p < 0.05). In conclusion, our data suggest that right ventricular systolic function is influenced in acute anterior myocardial infarction, and AQ and CK are feasible techniques for investigating right ventricular regional systolic function in these patients.Öğe Concentric left ventricular hypertrophy: Is electrocardiography important to follow left ventricular functions? [2](1999) Altun A.; Ozbay G.[No abstract available]Öğe Effect of left ventriculography on left and right ventricular repolarization parameters(2001) Altun A.; Erdogan O.; Ozbay G.Background: Contrast agents due to their osmolality, sodium content, and calcium-chelating properties produce a variety of adverse hemodynamic and electrophysiologic effects. To evaluate the effect of left ventriculography on left and right ventricular repolarization parameters. Methods: Our study group consisted of 22 consecutive male patients (mean age 55±10 years) with stable angina pectoris according to clinical, ECG, and stress test results. In all patients left ventriculography preceded the selective injections of coronary arteries. All ECGs were recorded from left (V1-V6) and right (RV3-RV6) precordial leads immediately before and after left ventriculography. Each of the ECG parameters obtained from left and right precordial leads was calculated as the mean value of three consecutive QRST complex obtained at the same time. Dispersion of all intervals and dispersion ratios were calculated and compared. Results: QTc dispersion, JTc dispersion, Tec dispersion, QT dispersion / RR ratio, JT dispersion / RR ratio, and Te dispersion / RR ratio calculated before and after left ventriculography from left precordial derivations were found to be significantly different (p < 0.05). However, only one parameter (Te dispersion) (p < 0.05) calculated from right precordial derivations before and after left ventriculography was changed significantly. Conclusions: Preventing potential ventricular arrthythmias is mandatory during cardiac catheterization procedures. One must be always cautious which type and how much of contrast agent used during the procedures of high risk patients. Both injection pressure and contrast volume should be lessened as much as possible in order to prevent potential arrhythmias.Öğe The effect of propaphenone on the premature ventricular beats(1990) Onal G.; Ozbay G.; Demir M.; Yuce M.[No abstract available]Öğe Electrocardiographic left axis deviation: Does it have a relationship with inferolateral perfusion defects?(2003) Erdogan O.; Altun A.; Gul C.; Durmus-Altun G.; Ozbay G.Isolated reversible inferolateral perfusion defect is usually considered as true defect and not associated with false positive results due to attenuation artifact or technical processing. In order to investigate the diagnostic value of inferolateral reversible perfusion defect in predicting significant coronary artery stenosis we undertook a clinical study. We retrospectively and prospectively collected records of patients who underwent coronary angiography and demonstrated inferolateral reversible perfusion defect (n=21). Patients were divided into two groups according to presence or absence of significant CAD. Both groups were also compared according to their clinical characteristics, electrocardiographic QRS axis deviation and risk factors. Only 7 (33 %) patients had significant coronary artery disease (CAD) involvement. Left circumflex artery stenosis was detected in 6 (86 %) of 7 patients with CAD. Patients with CAD complained of anginal chest pain (86%) more frequently than patients without CAD (64%) (p=0.314). Since all patients with CAD had at least two-coronary risk factors, it determined the association of CAD with inferolateral reversible perfusion defect (p=0.015). It showed 100% sensitivity and negative predictive value for predicting CAD. Abnormal leftward mean QRS axis deviation on surface ECG was detected in 19 out of 21 study subjects (90%). Predicting CAD involvement in a patient with inferolateral reversible perfusion defect is more accurately established when the patient has multiple coronary risk factors. Leftward mean QRS axis deviation causing a change in heart position may cause a shift of usually observed inferior diaphragmatic attenuation to the inferolateral region and be responsible for reversible perfusion defects.Öğe Quantitative ultrasonic myocardial texture analysis of the diabetic heart(2001) Akdemir O.; Dagdeviren B.; Altun A.; Ugur B.; Arikan E.; Tugrul A.; Ozbay G.OBJECTIVE: Contraction and relaxation of the heart cause decrease and increase in myocardial video intensity (MVI) recorded from echocardiographic images, respectively. The present study was planned to compare this physiological cyclic variations of MVI in patients with type 1 diabetes mellitus and healthy subjects. METHODS: For this purpose, standard echocardiographic examination was performed to 18 young patients (age 23.2+6.4; range: 15-37 years) with insulin dependent type 1 diabetes mellitus (diabetes duration: 7.8+5.6; range: 1-17 years) and 14 age and sex matched controls. In all subjects, end-diastolic and end-systolic 2D echocardiographic images of 3 consecutive beats that had been recorded on videotapes were digitized. The quantitative analysis of digitized imaging was performed with the help of a calibrated digitization system in order to calculate the septum and the posterior wall textural parameters. The cyclic variation index (CVI) of the mean gray level (MGL) was calculated according the formula: (MGL dias- MGL diast x 100. RESULTS: Among the groups, left ventricular diastolic dimension-index, fractional shortening, E/A ratio, and isovolumic relaxation time showed no statistically significant differences, while septum and (8.3+1.1 vs. 7.3+0.9 mm; p=0.016) and posterior wall thickness (8+0.6 vs. 6.8+1.1mm; p=0.004) and E-deceleration time (167+23 vs. 140=19 msec.; p=0.003) were significantly higher in diabetics. The diabetic patients showed significantly lower CVI both for septum (18.2+11.5% vs. 39.3+11.5%; p=0.0001) and posterior wall (16.4+16% vs. 40.5+9.2%; p=0.0001), respectively. CONCLUSIONS: Altered videoensitometric parameters possibly represent a preclinical alteration, conceivably related to the myocardial collagen content increase, which does not necessarily indicate an actual disease but may be considered an early marker of the histopathologic findings of diabetic cardiomyopathy.Öğe Single lead changed to double lead DDD pacemaker in a patient with diaphragmatic stimulation(2001) Altun A.; Akdemir O.; Erdogan O.; Birsin A.; Tatli E.; Ozbay G.The AA. report on patient who suffered diaphragmatic stimulation due to atrial impulse of a single lead DDD pacemaker system. Although the well-known advantages of single lead DDD systems there are some major drawbacks of this technique to consider before implantation. As it is described in this present case, diaphragmatic stimulation can not be avoided in some individuals. This problem was overcome by inserting a separate atrial lead and programming the pacemaker to DDD mode.
