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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 Acute myocardial infarction in a 14-year-old male with normal coronary arteries(Lippincott Williams & Wilkins, 2007) Tatli, Ersan; Surucu, Huseyin; Fatih, Ozcelik[Abstract Not Available]Öğe Arrhythmias following Revascularization Procedures in the Course of Acute Myocardial Infarction: Are They Indicators of Reperfusion or Ongoing Ischemia?(Hindawi Ltd, 2013) Tatli, Ersan; Alicik, Guray; Buturak, Ali; Yilmaztepe, Mustafa; Aktoz, MeryemObjective. The most important step in the treatment of ST elevation myocardial infarction is to sustain myocardial blood supply as soon as possible. The two main treatment methods used today to provide myocardial reperfusion are thrombolytic therapy and percutaneous coronary intervention. In our study, reperfusion arrhythmias were investigated as if they are indicators of coronary artery patency or ongoing ischemia after revascularization. Methods. 151 patients with a diagnosis of acute ST elevation myocardial infarction were investigated. 54 patients underwent primary percutaneous coronary intervention and 97 patients were treated with thrombolytic therapy. The frequency of reperfusion arrythmias following revascularization procedures in the first 48 hours after admission was examined. The relation between reperfusion arrhythmias, ST segment regression, coronary artery patency, and infarct related artery documented by angiography were analyzed. Results. There was no statistically significant difference between the two groups in the frequency of reperfusion arrhythmias (P = 0.355). Although angiographic vessel patency was higher in patients undergoing percutaneous coronary intervention, there was no significant difference between the patency rates of each group with and without reperfusion arrythmias. Conclusion. Our study suggests that recorded arrhythmias following different revascularization procedures in acute ST elevation myocardial infarction may not always indicate vessel patency and reperfusion. Ongoing vascular occlusion and ischemia may lead to various arrhythmias which may not be distinguished from reperfusion arrhythmias.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 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 The Association between Left Ventricular Diastolic Dysfunction and Increased Aortic Stiffness Can Be Explained by Possible Neurohumoral Mechanisms(Wiley-Blackwell Publishing, Inc, 2010) Surucu, Huseyin; Tatli, Ersan; Boz, Hakki; Meric, MehmetObjective: In our study, we tried to find an answer to the question How could the association between left ventricular diastolic dysfunction (LVDDF) and increased aortic stiffness (IAS) be explained? Methods: Cases without coronary artery disease (CAD) were divided into three groups according to their left ventricular (LV) inflow patterns and their LV basal-lateral annulus pulsed-wave tissue Doppler imaging (pw-TDI). Group 1 (n = 38) represented the normal LV inflow pattern while Group 2 (n = 54) represented impaired LV relaxation and Group 3 (n = 18) represented pseudonormalization. Aortic diameters were measured by using M-mode at a level that is 3 cm above the aortic valve. Aortic strain (AS) and aortic distensibility (AD) were calculated by using aortic diameters and pulse pressure. Results: In Group 3, AS was lower compared to Groups 1 and 2 (respectively P < 0.001, P = 0.040). AS was also lower in Group 2 compared to Group 1 (P = 0.012). AD was higher in Group 1 compared to Groups 2 and 3 (respectively P = 0.01, P < 0.001). Early diastolic velocity of aortic pw-TDI was higher in normal LV inflow compared to Groups 2 and 3 (respectively P = 0.022, P = 0.050). Unfortunately, none of echocardiographic parameters that evaluate LV and aortic functions together (stroke volume, pulse pressure/stroke volume, pulse pressure/stroke volume index) were different among the groups. Conclusion: The results of our study clearly showed the association between LVDDF and IAS in cases without CAD. Additionally, it was concluded that this togetherness could be explained not by hemodynamic factors but by possible neurohumeral mechanisms. (Echocardiography 2010;27:275-281).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 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 Cardiac rhabdomyoma in an adult patient presenting with right ventricular outflow tract obstruction(Elsevier Ireland Ltd, 2008) Aktoz, Meryem; Tatli, Ersan; Ege, Turan; Yalcin, Omer; Buyuklu, Mutlu; Aksu, Feza; Gul, CetinWe present a 24 year old woman with cardiac rhabdomyoma. Cardiac rhabdomyoma is the most common benign cardiac tumor in infants, but in adults, cardiac rhabdomyoma is very rare. These tumors are often spontaneously reversible because they are associated to the right or left ventricular outflow tract obstruction, tachyarrhythmias and heart failure where surgery is necessary. (C) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe Clinical Significance of Positive Isovolumetric Relaxation Velocity of Pulsed-Wave Tissue Doppler Imaging(Wiley, 2009) Sueruecue, Hueseyin; Tatli, Ersan; Degirmenci, Ali; Okudan, Selnur; Aktoz, Meryem; Boz, HakkiObjective: Among the pulsed-wave tissue Doppler imaging (pw-TDI) parameters, there are two different pw-TDI velocities (IVRa and IVRb) after systolic velocity, but before Ea velocity. In our study, we investigated the clinical importance of these two velocities in left ventricular diastolic dysfunction (LVDDF) evaluation. Methods: One hundred and eighty cases without exclusion criteria were included in the study. Cases with a transmitral E to A flow (E/A) ratio below 1 were assigned to group 2. In cases with an E/A ratio between 1 and 2, the pw-TDI parameters were taken into consideration. Cases with an Ea/Aa ratio above 1 were assigned to group 1 and cases with an Ea/Aa ratio 1 or below than 1 were assigned to group 3. Group 1 (n: 68) represented normal diastolic left ventricular (LV) inflow while group 2 (n = 87) represented impaired relaxation and group 3 (n = 25) represented pseudonormal LV inflow. Results: In our study, we found that IVRa velocity was lower in group 1 compared to group 2 and group 3 (P < 0.001 and P = 0.038, respectively). Similarly, this velocity was significantly different in group 3 and group 2 such as it was higher in group 2 compared to group 3 (P = 0.022). There was no difference in IVRb velocity and IVRa/IVRb ratio among the groups. A negative correlation was found between IVRa velocity and Ea velocity (r = 44%, P < 0.001). Positive correlation was found between IVRa velocity and isovolumetric relaxation time (r = 18%, P = 0.014) and also between IVRa velocity and Aa velocity (r = 19%; P = 0.010). Conclusion: Based on the results of our study, we concluded that IVRa velocity is an important pw-TDI parameter in the evaluation of LVDDF, especially in differentiating pseudonormal LVDDF type from normal LV inflow. (ECHOCARDIOGRAPHY, Volume 26, January 2009).Öğe Coronary artery ectasia in a patient with Behcet's disease(Saudi Med J, 2007) Tatli, Ersan; Surucu, Huseyin; Aktoz, Meryem; Buyuklu, MutluBehcet's disease is a multisysternic disease of unknown etiology. Disease manifestations consist of recurrent oral and genital ulceration, skin lesions, and relapsing ocular inflammation. Arterial involvement is an uncommon complication of Behcet's disease, and it most frequently affects the abdominal aorta followed by femoral artery, and the pulmonary artery. Coronary lesions in Behcet's disease have been little reported in the literature. A-36-year-old female with 6-year history of Behcet's disease was hospitalized with ectasia of the left main coronary artery. This unusual vascular complication Behcet's disease is presented.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 Cutaneous analgesia before transradial access for coronary intervention to prevent radial artery spasm(Sage Publications Ltd, 2018) Tatli, Ersan; Yilmaztepe, Mustafa Adem; Vural, Mustafa Gokhan; Tokatli, Alptug; Aksoy, Murat; Agac, Mustafa Tarik; Cakar, Mehmet AkifAim: Transradial access (TRA) for coronary intervention is increasingly used in current clinical practice. The aim of the present study was to evaluate the hypothesis that cutaneous analgesia before TRA for coronary intervention at a puncture site 30 minutes before puncture can reduce patient discomfort and the incidence of radial artery spasm (RAS). Methods: Patients (n=104) undergoing planned coronary interventions using TRA were prospectively randomized to receive either 1 mL of 1% lidocaine subcutaneously (n=52) (control group) or subcutaneous lidocaine plus 5% lidocaine cream (n=52) cutaneously 30 minutes before puncture (treatment group). The primary endpoint was angiographically or clinically confirmed RAS. Secondary endpoints were the occurrence of patient discomfort in the forearm during the procedure and access-site crossover to the femoral artery. Patient discomfort was quantified with a visual analogue scale (VAS) score. Results: Fifty-two patients in the treatment group (60.5 +/- 9.4 years of age and 16 female) and 52 patients in the control group (60.4 +/- 9.7 years of age and 16 female) were included in the final analysis. Radial artery spasm occurrence decreased in the treatment group compared to the control group (26.9% vs 9.6%; p=0.04) accompanied by a VAS score of 3.7 +/- 1.8 in the treatment group and 4.9 +/- 2.0 in the control group; p=0.02. The access site crossover rate did not differ between the groups (7.6% vs 21.1%; p=0.09). Conclusion: Cutaneous analgesia before TRA for coronary interventions is associated with a substantial reduction in the RAS and the procedure-related level of patient discomfort.Öğe Diagnostic Approach to a Case with Aortic Dissection(Aves, 2010) Aktoz, Meryem; Erdogan, Okan; Tatli, ErsanWithout a dear diagnosis, patients with aortic dissection often die before presentation to the hospital. Keeping a high clinical index of suspicion is mandatory for the accurate and rapid diagnosis of aortic dissection. The choice of the diagnostic modality mainly depends on the availability of the diagnostic tools and the experience of the physicians at the given institution.Öğe Diagnostic value of plasma fibronectin level in predicting the presence and severity of coronary artery disease(Springer, 2009) Ozcelik, Fatih; Erdogan, Okan; Aktoz, Meryem; Ekuklu, Galip; Tatli, Ersan; Demir, MuzafferThe relation between fibronectin and coronary artery disease (CAD) according to previous study results is controversial. The aim of the present study is to investigate the predictive value of fibronectin in determining the presence and severity of CAD. Patients with stable angina (n = 62) who had angiographically documented CAD, and control patients (n = 31) who had normal coronary angiograms, were included in the study. Plasma fibronectin levels were determined in all patients. Plasma fibronectin level (milligrams per liter) in patients with CAD was higher than normal controls (364.2 +/- 171 vs 265.1 +/- 135.5, p = 0.006). The severity of CAD determined according to Gensini score and fibronectin level did not show any correlation (r = 0.13, p = 0.311). If fibronectin level 240 mg/l was determined as cutoff, it showed 76% sensitivity, 46% specificity, 46% negative predictive value, and 72.3% positive predictive value for predicting CAD. The present study showed that plasma fibronectin level in CAD is significantly higher than normal control subjects. However, it has no role in predicting the severity of CAD.Öğe Dilemma in the strategy of treatment: revascularization or medical treatment?(Aves Yayincilik, 2008) Tatli, Ersan[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.
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