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Öğe Effect of Immunoglobulin E on Myocardial Infarct Size(Elsevier Sci Ireland Ltd, 2003) Yazycy, M.; Tokaç, Mehmet; Yeter, E.; Özdemir, K.; Tokgözoğlu, L.Objective: Elevated Immunoglobulin E (Ig E) levels have been suggested to prevent patient with acute myocardial infarction (AMI) from its complications. The purpose of the present study was to investigate the effect of Ig E on biochemically and echocardiographycally determined myocardial infarct size. Methods: Patients suffered from AMI and having above 200IU/ml Ig E level were included in the study as a group 1. Patients suffered from AMI and having below 200IU/ml IgE level were included in the study as a group 2. Biochemical markers were obtained from two times every day and theirs peak levels were used. Echocardiographic evaluation was performed between 3-5 days. Obtained results are presented in table.Öğe The Effects of Halothane and Sevoflurane on Qtc Interval(2000) Reisli, Ruhiye; Çelik, J.; Özdemir, K.; Tavlan, A.; Apillioğlu, S.; Ökeşli, S.Prolongation of the QT interval may cause hazardous arrhythmias. The effects of halothane and sevoflurane on the Q T interval (QTc) have been investigated during induction of anaesthesia in 30 ASA I-II class patients. No premedication was used to avoid the effects of other anaesthetic agents. Anaesthesia was induced with either halothane (n=15) or sevoflurane (n=15), and inspired concentration was increased gradually to achieve a constant initial end-tidal concentration of 2 MAC. After pupils came to midline 0.05 mg/kg atracurium was administered and end-tidal concentration was reduced to 1 MAC. Recordings of ECG, heart rate, systolic and diastolic arterial blood pressure were obtained at the following times: prior to induction of anaesthesia, after the lost of eye slash reflex, 3 min following atracurium administration, 1 and 3 min after tracheal intubation. QT interval was corrected for the heart rate (QTc). Both halothane and sevoflurane prolonged QTc one minute after the tracheal intubation, but it was statistically significant only in sevoflurane group (p<0.05). The heart rate increased 1 and 3 rain after tracheal intubation with sevoflurane (p<0.05). In both groups, systolic and diastolic arterial blood pressures decreased after induction of anaesthesia (p<0.05). In conclusion the prolongation of the QTc interval by halothane and sevoflurane suggests that caution should be used during administration of these agents to patients with long QTc syndrome.Öğe Evaluation of "Admission Index of Insulin Resistance (Airi)" as an Early Stage Risk Predictor in Nondiabetic Acute Coronary Syndromes(2002) İçli, Abdullah; Gök, H.; Altunkeser, Bülent Behlül; Özdemir, K.; Gürbilek, Mehmet; Gederet, Y. T.; Sökmen, GülizarObjective: Insulin resistance is a risk predictor for many cardiovascular diseases, but its effect on etiology and prognosis of diseases has not been clearly identified. In this study, we aimed to investigate whether admission index of insulin resistance (aIRI), recently and practically presented for determination of insulin resistance, could be a new risk predictor of early prognosis in nondiabetic acute coronary syndromes. Methods: One hundred and sixty nondiabetic patients admitted to the intensive coronary care unit and underwent coronary angiography with the diagnosis of acute myocardial infarction (AMI) (Group I; 72 patients; mean age - 58 ± 12 years) or unstable angina pectoris (UAP) (Group II; 88 patients; mean age 58 ± 10 years) were included in the study. In all patients blood glucose and insulin levels were measured on admission and AIRI was calculated by the formula of "admission glucose level X insulin level / normal blood glucose level (5mmol/L) X normal insulin level (5 mU/L)" for each patient. After determining the left ventricular ejection fraction (LVEF) and wall motion score index (LVWMSI) echocardiographically and calculating the Gensini score index from coronary angiography, the patients were followed up for major cardiac events (heart failure, atrial fibrillation, reinfarction, life-threatening ventricular arrhythmias, atrio-ventricular block, need for revascularisation and mortality) for 30 days. Results: AIRI was found higher in Group I (7.2 ± 5.3 versus 5.2 ± 4.4, p< 0.01) than in Group II. AIRI was positively correlated with Gensini score and LVWMSI (r=0.41, p<0.01 and r=0.48, p<0.48, p<0.001, respectively) and negatively correlated with LVEF (r=-0.37, p=0.001) in Group I. In addition, it was seen that positive correlation of AIRI with Gensini score (r=0.23, p=0.01) and LVWMSI (r=0.43, p=0.0001) in Group I persisted on multivariate regression analysis. Again, AIRI was significantly correlated with heart failure (r=0.42, p<0.0001) atrial fibrillation (r=0.35, p=0.002) and reinfarction (r=0.23, p=0.04) in Group I. Along with this, in multivariate regression analysis, it was correlated with heart failure (r=0.21, p<0.007), atrial fibrillation (r=0.18, p=0.01) and reinfarction (r=0.18, p=0.01). On the other hand, there was no significant correlation between AIRI and these parameters in Group II. Conclusion: AIRI can be used in early stage as a risk predictor to determine high-risk subgroups of nondiabetic patients presenting with AMI. Also AIRI, a parameter, which is practically calculated and easily used, is an independent risk factor detecting the extent of coronary artery disease and left ventricular dysfunction in patients with AMI.Öğe Importance of Left Anterior Hemiblock Development in Inferior Wall Acute Myocardial Infarction(Westminster Publ Inc, 2001) Özdemir, K.; Uluca, Y.; Danış, G.; Tokac, M.; Altunkeser, Bülent Behlül; Telli, H. H.; Gök, H.The aim of this study was to investigate the clinical and angiographic importance of left anterior hemiblock (LAHB) during acute inferior myocardial infarction (AIMI) by comparing patient groups with and without LAHB after AIMI. One hundred seventy-two patients (141 men and 31 women) between 28 and 84 years of age (mean 55 +/- 10 years) with AIMI were included in the study, Patients were divided into 2 groups according to electrocardiogram (ECG) criteria: group I comprised 25 patients in whom ECG pattern characteristic of LAHB developed, group II comprised 147 patients without this pattern. According to the electrocardiogram, patients were placed in group I if the mean QRS axis was deviated to the left < 30 degrees in the frontal plane with the following pattern: increased S-wave voltage and decreased R-wave voltage in leads II, the appearance of a deep S-wave in lead II, and a terminal positive R-wave in lead aVR. Coronary angiography was performed within 2 weeks. A coronary stenosis was considered if the vessel diameter was narrowed by > 50%. The dominant coronary artery was classified as right or left or balanced. The left ventricular ejection fraction (LVEF) was calculated from left ventriculography. The mean age of the patients in group I was significantly higher (58 vs 54 years, p=0.007), while the risk factors were similar in both groups. Left anterior descending (LAD) and multivessel coronary artery disease (CAD) were found to be significantly higher in group I compared with group II (80% vs 38%, p=0.0001; 84% Vs 52%, p=0.001, respectively). The mean LVEF was found to be lower in group I (51% vs 56%, p=0.04). Peak creatine phosphokinase MB (CKMB) values were not different (216 vs 162 IU/L, p=0.09). The frequency of left dominant or balanced coronary artery was determined to be higher in group I (44% vs 17%, p=0.018). LAHB development during AIMI can be an indicator of LAD lesions, multivessel coronary artery disease, and impaired left ventricular systolic function.Öğe
