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Öğe 1923-1938 döneminde Konya(Selçuk Üniversitesi Sosyal Bilimler Enstitüsü, 1987) Sönmez, Osman; Erol, MineÖğe Anterior lokalizasyonlu miyokard infarktüsünde sağ ventrikül fonksiyonlarının doppler strain eko ile değerlendirilmesi(Selçuk Üniversitesi Tıp Fakültesi, 2009) Sönmez, Osman; Gök, HasanAnterior STYMİ de RV bölgesel miyokardiyal fonksiyonlarının güncel ve kapsamlı ekokardiografik görüntüleme yöntemleri kullanılarak değerlendirilmesi (Doku Doppler temelli Strain/Strain Rate Görüntüleme) amaçlanmıştır. Anterior STYMİ de infarktüs sorumlu lezyon ve EF ile RV bölgesel fonksiyonlarının ilişkisi de ayrıntılı şekilde değerlendirilecektir. Gereç ve yöntem: Hastalara ortalama ilk 24 saatinde eko yapıldı. Anterior STYMİ gurubunda 50 hasta, kontrol gurubunda 20 hasta değerlendirildi. Hasta ve kontrol gurupların konvansiyonel eko değerleri birlikte DD temelli RV S/SR değerleri ölçüldü. RV bazal, orta ve apikal bölgelere ayrılarak bu bölgelere ait değerler kaydedildi. LAD; lezyon lokalizasyonuna göre proksimal(N=23) ve orta segment (N=22), seyrine göre Apikali Dönmeyen (Non-wrapped) LAD (N=30), Apikali Dönen (Wrapped) LAD (N=17) şeklinde sınıflandırıldı. Değerler student t testi kullanılarak istatistiksel olarak karşılaştırıldı. Grupların değerlendirilmesinde Anova ve Kruskal Willis H test kullanıldı. DD temelli RV S/SR değerleri ile EF arasındaki kolerasyon spearman ve pearson kolerasyon testleri ile değerlendirildi. Bulgular: Hastaların demografik verileri arasında fark yoktu. Konvansiyonel parametrelerden LV MPİ, RV MPİ değerleri anlamlı idi.Bu değerlerden LV MPİ LAD orta segment lezyonlarında belirgin olarak yüksekti.Bu ilişki RV MPİ için geçerli değildi. Budeğerler EF ile kolore değildi. DD temelli RV S/SR değerlerinden RV orta (p:0,003, p:0,001 sırasıyla) ve apikal (p:0,0001, p:0,0001 sırasıyla) segmentine ait değerler ile ortalama S/SR (p:0,0001,p:0,0001 sırasıyla) hasta gurubunda kontrol gurubuna göre anlamlı olarak düşüktü. RV bazal segment S/SR değerleri ile RV ait velositelerde kontrol gurubuna göre değişiklik izlenmedi. Sonuç: Anterior STYMİ sonrası erken dönemde RV orta ve apikal segmentlerde subklinik tutulum Strain/Strain Doppler görüntüleme ile gösterimiştir. Bununla birlikte RV MPİ artmakta, RV miyokardiyal performansı bozulmaktadır. LAD orta segment lezyonlarında LV miyokardiyal performansı LAD proksimal lezyonlarına göre daha fazla bozulmaktadır.Öğe Appropriateness of the Current Guidelines on Reperfusion Treatment for Patients Applying to Our Hospital With St-Segment Elevation Acute Myocardial Infarction(2012) Karaarslan, Şükrü; Alihanoğlu, Yusuf İzzettin; Yıldız, Bekir Serhat; Sönmez, Osman; Soylu, Ahmet; Bacaksız, Ahmet; Alur, İhsan; Özdemir, Kurtuluş; Düzenli, AkifObjectives: This study investigated the appropriateness of treatment for patients admitted with ST-segment elevation myocardial infarction (STEMI) according to the current guidelines. We also aimed to determine in-patient and out-patient factors affecting optimal re perfusion therapy. Study design: The reperfusion therapy of 176 patients with STEMI was determined. The time period from first contact with a healthcare provider to the time of balloon inflation (door to balloon time), and from the time period of first contact with a healthcare provider to the time of initiation of a thrombolytic (door to needle time) were calculated. Similarly, the time from admission at the emergency service (ES) of our hospital after referral to the moment of balloon inflation (ES to balloon time) and the period from admission to ES at our hospital to the moment of initiation of a thrombolytic (ES to needle time) were calculated. In order to determine the amount of in-hospital delay, the time from ES admission to the call to the cardiology department and the time for the cardiologist to evaluate the patient and transfer time were recorded. Whether the referring physician was a cardiologist and the effect of work hours on the reperfusion period was also recorded. Results: The door to balloon time in the referred patient group was calculated as an average of 228 minutes, while the time for patients directly admitted to ES was calculated as an average of 98 minutes. Patients referred for the mechanical reperfusion period compared to American Heart Association (AHA) guidelines consisted of only 6% of the eligible patients, while according to the European Society of Cardiology (ESC) guidelines 13% of patients were appropriate. Patients who were directly admitted to ES, experienced rates according to AHA guidelines and 73% experienced these rates according to ESC guidelines. We also found no significant effect of working hours or referring physician's specialty (cardiologist or other) on reperfusion time. Conclusion: Compliance rates of reperfusion therapy for patients presenting with STEMI was very low. We realized, when taking into consideration the reasons for delay in terms of both health community and the policy of the country, it is obvious that we have to take strict measures. © 2012 Turkish Society of Cardiology.Öğe The association between myocardial iron load and ventricular repolarization parameters in asymptomatic beta-thalassemia patients(2012) Kayrak, Mehmet; Acar, Kadir; Gül, Enes Elvin; Özbek, Orhan; Abdulhalikov, Turyan; Sönmez, Osman; Alibaşiç, HayruddinPrevious studies have demonstrated impaired ventricular repolarization in patients with ?-TM. However, the effect of iron overload with cardiac T 2 * magnetic resonance imaging (MRI) on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T 2 * MRI in asymptomatic ?-TM patients. Twenty-two ?-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T 2 * evaluation. Cardiac T 2 * score <20msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the ?-TM group compared to the healthy controls. T p - T e and T p - T e dispersions were also significantly prolonged in ?-TM group compared to healthy controls. (T p - T e) / QT was similar between groups. There was no correlation between repolarization parameters and cardiac T 2 * MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic ?-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load. Copyright © 2012 Mehmet Kayrak et al.Öğe A Bizarre Electrocardiographic Pattern Due to Chronic Lithium Therapy(Wiley, 2010) Kayrak, Mehmet; Duman, Çetin; Gül, Enes Elvin; Sönmez, Osman; Kaya, Zeynettin; Arı, HatemCardiotoxicity that results from lithium overdose is uncommon and electrocardiographic (ECG) changes are rarely reported. However, some authors have specifically reported the occurrence of ischemic ECG changes due to a lithium overdose. This article describes a case that is demonstrating ECG changes that mimic inferior myocardial infarction during the course of chronic lithium treatment and showing QTc prolongation in this patient. The patients’ ECG changes were partially recovered after hemodialysi.Öğe A case of exercise-induced sinus node deceleration without evident coronary artery disease(AVES YAYINCILIK, 2009) Kayrak, Mehmet; Alihanoğlu, Yusuf İzzettin; Arı, Hatem; Sönmez, Osman; Keser, Ahmet; Gök, Hasan[Abstract not Available]Öğe A Case of Late-Term Lead Endocarditis Causing Pacemaker Dysfunction(Churchill Livingstone Inc Medical Publishers, 2010) Kayrak, Mehmet; Sönmez, Osman; Gül, Enes Elvin; Gündüz, MehmetWith regard to pacemakers, lead endocarditis is a rare condition noted for causing difficulties in patient management. It has been reported in the literature that lead endocarditis may occur even after 10 years. In general, the incidence of pacemaker infections has not been carefully documented.1,2 The prevalence and incidence of pacemaker lead dysfunctions due to lead endocarditis have not been researched previously. We present a case of pacemaker dysfunction related to infective endocarditis.Öğe Circadian Rhythm of Infarct Size and Left Ventricular Function Evaluated with Tissue Doppler Echocardiography in ST Elevation Myocardial Infarction(ELSEVIER SCIENCE INC, 2016) Arı, Hatem; Sönmez, Osman; Koç, Fatih; Demir, Kenan; Alihanoğlu, Yusuf İzzettin; Özdemir, Kurtuluş; Vatankulu, Mehmet AkifBackground We aimed to investigate the circadian rhythm on left ventricular (LV) function and infarct size, according to the onset of ST elevation myocardial infarction (STEMI), with echocardiography in patients with first STEMI successfully revascularised with primary percutaneous coronary intervention (PCI). Methods We conducted a retrospective analysis of 252 STEMI patients. Patients were divided into the four, six-hour periods of the day. Conventional and tissue Doppler imaging (TDI) echocardiography were performed within 48 hours after onset of chest pain. The average of peak systolic myocardial velocities (Sm) in each of the four myocardial segments and LV ejection fraction (LVEF) were calculated. Results A negative linear correlation was shown between CK-MB levels and Sm (r= -0.209, p = 0.001). There was an oscillation between time of day and average of Sm. The lowest Sm and largest infarct size were in the period of 06: 00-noon compared with period of noon-18: 00 and 18: 00-midnight (p = 0.029 and p = 0.031, respectively). A secondary analysis showed that both LVEF and Sm were lower in the midnight-noon group compared with the noon-midnight group (44.9 +/- 7.3% versus 47.3 +/- 7.9%, p = 0.018, and 7.6 +/- 1.4 cm/s versus 8.2 +/- 1.6 cm/s, p= 0.003, respectively). Conclusions This study has shown that there was a circadian rhythm of infarct size and LV function evaluated by echocardiography according to time of STEMI onset. The largest infarct size and poor LV function occurred in the midnight-noon period, in particular in the 06: 00-noon period.Öğe Distal sol sirkumfleks arterden köken alan sağ koroner arter(2011) Sönmez, Osman; Gül, Enes Elvin; Altunbaş, Gökhan; Özdemir, Kurtuluş- Sağ koroner arterin distal sol sirkumfleks koroner arterden köken alması nadir bir anomalidir. Altmış üç yaşında kadın hasta subakut anteroseptal miyokart enfarktüsü tanısıyla yatırıldı. Elektrokardiyografide, prekordiyal V1-V3 derivasyonlarda QS formasÖğe Does Spironolactone Have a Dose-Dependent Effect on Left Ventricular Remodeling in Patients with Preserved Left Ventricular Function After an Acute Myocardial Infarction?(WILEY-HINDAWI, 2013) Vatankulu, Mehmet Akif; Bacaksız, Ahmet; Sönmez, Osman; Alihanoğlu, Yusuf İzzettin; Koç, Fatih; Demir, Kenan; Gül, Enes ElvinAims The aim of this study was to investigate the effects of spironolactone on left ventricular (LV) remodeling in patients with preserved LV function following acute myocardial infarction (AMI). Methods and Results Successfully revascularized patients (n=186) with acute ST elevation MI (STEMI) were included in the study. Patients were randomly divided into three groups, each of which was administered a different dose of spironolactone (12.5, 25mg, or none). Echocardiography was performed within the first 3days and at 6months after MI. Echocardiography control was performed on 160 patients at a 6-month follow-up. The median left ventricular ejection fraction (LVEF) increased significantly in all groups, but no significant difference was observed between groups (P=0.13). At the end of the sixth month, the myocardial performance index (MPI) had improved in each of the three groups, but no significant difference was found between groups (F=2.00, P=0.15). The mean LV peak systolic velocities (S-m) increased only in the control group during the follow-up period, but there is no significant difference between groups (F=1.79, P=0.18). The left ventricular end-systolic volume index (LVESVI) and the left ventricular end-diastolic volume index (LVEDVI) did not change significantly compared with the basal values between groups (F=0.05, P=0.81 and F=1.03, P=0.31, respectively). Conclusion In conclusion, spironolactone dosages of up to 25mg do not augment optimal medical treatment for LV remodeling in patients with preserved cardiac functions after AMI.Öğe The Effect of Smoking on Myocardial Performance Index in Middle-Aged Males after First Acute Myocardial Infarction(WILEY, 2013) Bacaksız, Ahmet; Kayrak, Mehmet; Vatankulu, Mehmet Akif; Ayhan, Selim S.; Sönmez, Osman; Akıllı, Hakan; Arıbaş, AlpayBackground: Cigarette smoking is associated with increased rates of coronary artery disease and acute myocardial infarction (MI). Paradoxically, smokers had lower mortality after MI. The purpose of this study was to evaluate the effect of chronic smoking on myocardial performance index (MPI) in middle-aged men after an acute MI. Material and methods: A total of 429 patients (325 smokers vs. 104 nonsmokers) presenting with acute ST elevation MI were enrolled in this study. Thrombolysis in myocardial infarction (TIMI) flow of the infarct related artery was measured before and after the primary percutaneous coronary intervention (PCI), and Gensini score was also calculated. Conventional echocardiography and tissue Doppler echocardiography (TDI) were performed within 4872hours after onset of chest pain. Peak early (Em) and late (Am) diastolic velocities, peak systolic (Sm) mitral annular velocities and time intervals were recorded with TDI. The MPI, ratio of Em/Am, and E/Em were calculated. Results: Baseline demographic and angiographic characteristics such as Gensini score, pre and, post PCI TIMI flow were similar in 2 groups. In contrast, LV MPI was preserved among smokers (0.59 +/- 0.15 vs. 0.66 +/- 0.14, P=0.01), and Em/Am values were also higher in smokers (0.84 +/- 0.28 vs. 0.75 +/- 0.31, P=0.01). Independent predictors of impaired MPI (0.60) were determined as nonsmoking status (odds ratio 2.940, 95% CI 0.985.83, P=0.05), left anterior descending artery stenosis (odds ratio 3.196, 95% CI 1.735.91 P=0.001), and, age (odds ratio 1.12, 95% CI 1.031.22, P=0.01). Conclusions: Despite similar demographic and angiographic characteristics, smoker males had a paradoxically better MPI after acute MI.Öğe Effect of termination of the left anterior descending coronary artery (wrapped or non-wrapped property) on(2012) Sönmez, Osman; Vatankulu, Mehmet A.; Kayrak, Mehmet; Karaarslan, Şükrü; Altunbaş, Gökhan; Özdemir, Kurtuluş; Gök, HasanAmaç: Primer perkütan koroner girişim ile başarılı tedavi edilen anteriyor miyokart enfarktüs (AME) hastalarında sol ön inen koroner arter (LAD) sonlanımının doku Doppler ekokardiyografi(DDE) bulgularına etkisinin değerlendirilmesi amaçlandı. Yöntemler: Çalışma enine kesitli gözlemsel prospektif olarak planlandı. Seksen dört hasta çalışmaya dahil edildi. Hastalara ilk üç gün içinde ekokardiyografik değerlendirme yapıldı. Klasik DDE parametreleri sağ ventrikül (RV) lateral duvar ve sol ventriküle (LV) ait dört duvardan alındı. DDE parametreleri olarak; sistolik fonsiyonların değerlendirilmesinde - DDE mitral annüler sistolik hız değeri - Sm, diyastolik fonksiyonların - DDE mitral annüler erken ve E/A değerleri, kombine sistolik ve diyastolik fonksiyonların değerlendirilmesinde - miyokart performans indeksi (MPI) değeri kullanıldı. LAD sonlanım özelliğine göre iki gruba (sarılı olan ve olmayan LAD) ayrıldı. İstatistiksel analizde Student-t, Mann-Whitney U ve Ki-kare testleri, Pearson ve Spearman bivaryasyon korelasyon analizleri kullanıldı. Bulgular: Hastaların demografik verileri ve bazal ekokardiyografik ölçümleri benzerdi. RV ve LV için 4 duvardan alınan anüler DDE parametrelerinden sadece anteriyor Sm değerinde (Ant Sm) istatistikî anlamlılık ortaya çıkarken, Em, Am ve MPI değerlerinde anlamlı değişiklik tespit edilmemiştir. LAD koroner arterin LV apikalde sonlanan, diyafragmatik yüze (sarılı olmayan) geçiş göstermeyen olgularda anteriyor duvarın Sm değeri LAD koroner arterin LV apikalde sonlanmayan, diyafragmatik yüze geçiş gösterdiği (sarılı olan) olgulara göre daha fazla etkilendiği ortaya çıkmıştır (6.701.66 and 7.441.66 cm/sn; p0.036). Anteriyor Sm değeri ile LAD uzunluğu arasında korelasyon tespit edildi (r236, p0.036). Sonuç: LAD sonlanımı primer perkütan koroner girişim ile başarılı tedavi edilen AME hastalarında, erken dönemde anteriyor duvarın sistolik fonksiyonları için önemli bir parametredir.Öğe Effect of termination of the left anterior descending coronary artery (wrapped or non-wrapped property) on tissue Doppler echocardiography findings in patients with anterior myocardial infarction: an observational study(TURKISH SOC CARDIOLOGY, 2012) Sönmez, Osman; Vatankulu, Mehmet A.; Kayrak, Mehmet; Karaarslan, Şükrü; Altunbaş, Gökhan; Özdemir, Kurtuluş; Gök, HasanObjective: We aimed to evaluate effect of termination property of left anterior descending (LAD) on tissue Doppler echocardiography (TDE) parameters in patients experiencing their first anterior myocardial infarction (AMI) who had undergone successful primary percutaneous coronary intervention (PCI) Methods: A prospective, cross-sectional observational study was performed. Eighty-four patients were enrolled in the study. Echocardiography was performed during the first three days of AMI. Conventional TDE measurements were obtained from right ventricular (RV) and four left ventricular (LV) walls: for the systolic function - mitrel annular TDE systolic velocity - Sm, for diastolic function - mitral annular TDE early and late diastolic velocities - Em, Am, transmitral early and late diastolic velocities ratio - E/A, and combined systolic and diastolic function - myocardial performance index (MPI). Coronary arteries were evaluated and patients were divided into two groups (non-wrapped LAD and wrapped LAD) according to the termination properties. Student-t, Mann-Whitney U and Chi-square tests, bivariate Pearson and Spearman correlation analyses were used for statistical analysis. Results: Baseline characteristics and conventional echocardiographic parameters of the patients were similar. There was a statistically significant difference for the anterior wall Sm parameter, whereas there was no substantial difference for Em, Am and MPI values. The anterior wall Sm was more affected in patients with non wrapped LAD than in patients with wrapped LAD (6.70 +/- 1.66 and 7.44 +/- 1.66 cm/s; p=0.036,). The anterior Sm parameter was uniquely correlated with LAD termination status when compared with other independent parameters (r=0.236, p=0.036). Conclusion: We showed that termination of LAD is important for the anterior wall systolic functions in the early stage of AMI treated successfully. (Anadolu Kardiyol Derg 2012; 12: 465-71)Öğe Exaggerated Blood Pressure Response to Exercise - A New Portent of Masked Hypertension(Taylor & Francis Inc, 2010) Kayrak, Mehmet; Bacaksız, Ahmet; Vatankulu, Mehmet Akif; Ayhan, Selim S.; Kaya, Zeynettin; Ari, Hatem; Sönmez, Osman; Gök, HasanMasked hypertension (MHT) is a popular entity with increased risk of developing sustained hypertension, heart attack, stroke, and death. Subjects have normal blood pressure (BP) at office but elevated values at night so it is difficult to diagnose. Exaggerated blood pressure response to exercise (EBPR) is also a predictor of future hypertension. To investigate the relationship between these two entities, we evaluated 61 normotensive subjects with EBPR. The subjects underwent 24-h ambulatory blood pressure monitoring (ABPM). The prevalence of masked hypertension among subjects with EBPR was 41%. Body mass index (BMI), non-high density lipoprotein (HDL) cholesterol, diastolic blood pressure (DBP) at peak exercise and recovery, nondipping DBP pattern, and elevated early morning average BPs were associated with masked hypertension. In multivariate logistic regression analysis, the DBP measured at peak exercise was detected as an independent predictor of MHT in subjects with EBPR. Subjects with abnormally elevated BP during exercise are prone to MHT, necessitate medical assessment and close follow-up for hypertension.Öğe II. Dünya Savaşı sırasında Türkiye'nin iktisadi politikası(Selçuk Üniversitesi Sosyal Bilimler Enstitüsü, 1992) Sönmez, Osman; Hazır, HayatiÖğe Intravenous N-acetylcysteine Plus High-dose Hydration Versus High-dose Hydration and Standard Hydration for the Prevention of Contrast-induced Nephropathy: CASİS-A Multicenter Prospective Controlled Trial(Elsevier Ireland Ltd, 2012) Koç, Fatih; Özdemir, Kurtuluş; Kaya, Mehmet Güngör; Doğdu, Orhan; Vatankulu, Mehmet Akif; Ayhan, Selim; Erkorkmaz, Ünal; Sönmez, Osman; Aygül, Meryem Ülkü; Kalay, Nihat; Kayrak, Mehmet; Karabağ, Turgut; Alihanoğlu, Yusuf İzzettin; Günebakmaz, ÖzgürBackground: Contrast-induced nephropathy (CIN) is a leading cause of acute renal failure and affects mortality and morbidity. We investigated the efficacy of prophylactic intravenous (IV) N-acetylcysteine (NAC) and hydration for the prevention of CIN in patients with mild to moderate renal dysfunction who are undergoing coronary angiography and/or percutaneous coronary intervention (PCI). Methods: A total of 220 patients who had mild to moderate renal dysfunction with serum creatinine (SCr) >= 1.1 mg/dL or creatinine clearance <= 60 mL/min were randomized in 3 groups: 80 patients were assigned to IV NAC plus high-dose hydration with normal saline, 80 patients to only high-dose hydration with normal saline and 60 patients to standard hydration with normal saline (control group). The primary end point was the alteration of SCr level. The secondary end point was the development of CIN after the procedure. Results: SCr levels changed the least in the NAC plus high-hydration group (P=0.004). The rate of the CIN in the NAC plus high-dose hydration group was also lower than the high-dose hydration group (P=0.006). No significant differences in the primary and secondary end points were found between high-dose hydration and control group. Conclusion: The results of this study suggest that NAC plus high-dose hydration was superior to high-dose hydration alone as well as standard hydration for the protection of renal functions in patients with mild to moderate renal dysfunction who are undergoing coronary angiography and/or PCI. High-dose hydration without NAC was not better than standard hydration alone.Öğe Metabolik Sendromlu Hastalarda Nondipper Kan Basıncı Seyrinin Hedef Organ Hasarı Üzerine Etkisi(2009) Soylu, Ahmet; Güleç, Hakan; Alihanoğlu, Yusuf İzzettin; Sönmez, Osman; Ayhan, Selim Suzi; Gök, HasanObjectives: Both metabolic syndrome (MetS) and non-dipping status (insufficient reduction in nocturnal blood pressure) have been linked with target organ damage. We evaluated the effect of nondipping status on target organ damage in subjects with MetS. Study design: Eighty-two patients diagnosed as having MetS were divided into two groups according to the findings of 24-hour ambulatory blood pressure monitoring as dipper (n=35, 19 women, 16 men; mean age 48.4±6.4 years) and nondipper (n=47, 35 women, 12 men; mean age 50.4±4.7 years). Cardiac damage was assessed by conventional and tissue Doppler echocardiography, and renal damage by 24-hour urinary albumin excretion. Results: The two groups were similar with regard to age, body mass index, presence of diabetes, smoking, clinical and 24-hour, daytime and nighttime blood pressures, plasma lipid profile, distribution of and the mean total number of MetS criteria. The ratio of early (Em) to late (Am) left ventricular peak diastolic myocardial velocities (Em/Am) was significantly lower in nondippers (p=0.016). Nondippers also had higher values of left ventricular mass index, myocardial performance index, and 24-hour urinary albumin excretion, but these differences did not reach a significant level (p=0.110, p=0.099, p=0.093, respectively). Multivariate regression analysis showed increasing age and nondipping status as independent factors associated with decreased Em/Am ratio (?=-0.25, p=0.020 and ?=-0.22, p=0.042, respectively). Conclusion: In subjects with MetS, nondipping status may be associated with both cardiac and renal damage independent of other components of MetS. Since the degree of diastolic dysfunction is more marked than that of albuminuria in nondippers, it may be extrapolated that the extent of cardiac damage surpasses renal damage in these subjects.Öğe Metabolik sendromlu hastalarda nondipper kan basıncı seyrinin hedef organ hasarı üzerine etkisi(2009) Soylu, Ahmet; Güleç, Hakan; Alihanoğlu, Yusuf İzzettin; Sönmez, Osman; Ayhan, Selim Suzi; Gök, HasanAmaç: Hem metabolik sendromun (MetS) hem de nondipper durumun (gece kan basıncı düşüşündeki yetersizlik) hedef organ hasarı ile ilişkili olduğu gösterilmiştir.Bu çalışmada MetS’li kişilerde nondipper durumun hedef organ hasarına etkisi araştırıldı. Ça lış ma pla nı: Metabolik sendrom tanısı konan 82 hasta, 24 saatlik ambulatuvar kan basıncı izleme sonuçlarına göre dipper (n35, 19 kadın, 16 erkek; ort. yaş 48.46.4) ve nondipper (n47, 35 kadın, 12 erkek; ort. yaş 50.44.7) olarak iki gruba ayrıldı. Tüm çalışma grubunda kardiyak hasar konvansiyonel ve doku Doppler ekokardiyografi ile, böbrek hasarı ise 24 saatlik idrarda albümin atılımı ile değerlendirildi. Bul gu lar: İki grup, yaş, beden kütle indeksi, diyabet varlığı, klinik ve 24 saatlik kan basıncı, gece ve gündüz kan basın- cı değerleri, plazma lipit düzeyleri, sigara kullanımı, MetS ölçütlerinin dağılımı ve toplam MetS ölçütü sayısı bakımından benzer özellikteydi. Sol ventrikül tepe diyastolik erken miyokardiyal hız (Em)/tepe diyastolik geç miyokardiyal hız (Am) oranı nondipper grupta anlamlı derecede daha düşük bulundu (p0.016). Sol ventrikül kütle indeksi, miyokart performans indeksi ve 24 saatlik idrar albümin atılımı nondipper grupta daha yüksek olmakla birlikte, fark anlamlı değildi (sırasıyla p0.110, p0.099 ve p0.093). Çokdeğişkenli regresyon analizi sonucunda yaş artışı ve nondipper durumun bağımsız olarak Em/Am oranında azalmaya neden olduğu görüldü (sırasıyla; ?-0.25, p0.020 ve ?-0.22, p0.042). So nuç: Metabolik sendromlu kişilerdeki nondipper durumu diğer MetS bileşenlerinden bağımsız olarak hem kardiyak hem de böbrek hasarı ile ilişkili olabilir. Nondipper gruptaki diyastolik disfonksiyonun albüminüri düzeyindeki artıştan daha belirgin olması, bu kişilerde kardiyak hasarın böbrek hasarından daha ön planda olabileceğini düşündürmektedir.Öğe The Relationship between Coronary Sinus and Impaired Right Ventricular Myocardial Performance Index in Mitral Stenosis(WILEY-BLACKWELL, 2013) Vatankulu, Mehmet Akif; Koç, Fatih; Gül, Enes Elvin; Bacaksız, Ahmet; Sönmez, Osman; Demir, Kenan; Alihanoğlu, Yusuf İzzettinObjectives: We aimed to investigate whether coronary sinus (CS) dilatation develops in patients with mitral stenosis (MS) and to demonstrate its relationship with the global myocardial performance of the right ventricle (RV). Methods: We enrolled 34 patients with MS who underwent echocardiography after exhibiting typical symptoms (31 female; mean age 41 +/- 12 years) and 20 age-and sex-matched controls without MS who underwent echocardiography (16 female; mean age 38 +/- 13 years). The RV myocardial performance index (MPI) was detected using tissue Doppler echocardiography (TDE), and maximum CS diameter was measured from the posterior atrioventricular groove in the apical fourchamber view during the ventricular systole. Results: The RV MPI was significantly higher in the MS group compared to the control group (0.60 +/- 0.11 vs. 0.41 +/- 0.08, P < 0.001). Moreover, the maximum CS dimension was higher in the MS group compared to the control group (8.5 +/- 1.1 mm vs. 6.5 +/- 1.4 mm, P < 0.001). The maximum CS dilatation was positively correlated with the RV MPI (r = 0.691; P < 0.001). Conclusion: The RV MPI, which represents both systolic and diastolic functions, is increased in patients with MS and correlates with CS dilatation.Öğe Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study(TURKISH SOC CARDIOLOGY, 2011) Arı, Hatem; Tokaç, Mehmet; Alihanoğlu, Yusuf İzzettin; Kıyıcı, Aysel; Kayrak, Mehmet; Arı, Mehtap; Sönmez, OsmanObjective: Although, there has been great improvement on the diagnosis and early treatment of acute coronary syndromes, especially in terms of myocardial damage biochemical markers, we do not have a specific marker yet, for using the diagnosis of stable coronary artery disease (CAD). This study aimed to evaluate the relationship between CAD and the changes of heart-type fatty acid binding protein (H-FABP) levels before and after exercise stress testing (EST). Methods: A total of 47 patients were enrolled in this observational study. Of 47 patients, 21 had normal coronary anatomy; the remaining 26 patients had coronary lesions over 70% in at least one major coronary artery. All patients performed EST. Along with this, H-FABP levels before EST and at peak exercise, 1(st) hour, 3(rd) hour (3h), were measured in all patients. Differences among the measurements were evaluated through the Friedman test and Wilcoxon test, and the Bonferroni correction was applied to determine which measurement caused the difference. Results: Contrary to expectations, the means of the H-FABP values measured at particular intervals for each group tended to decline from the basal level to the 3h level. When the difference between the 3h measurement and the basal level was compared in each group, the decreasing was statistically significant in both groups (p<0.05). A statistically significant decrease at the 3h measurement compared to the basal level in the CAD group was more apparent than in the control group (2.790 +/- 2.569ng/ml vs. 0.837 +/- 2.070ng/ml, p=0.009). Conclusion: We found that H-FABP levels did not increase during EST and contrary to expectation, were inclined to decrease. We thought that decreasing H-FABP levels likely resulted from exercise-induced proteinuria. (Anadolu Kardiyol Berg 2011; 11: 685-91)
