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Öğe A-V tam blok bulunan hipertrofik obstrüktif kardiyomiyopatili bir olguda DDD-R pacemaker uygulaması(2005) Karabağ, Turgut; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Koç, FatihHipertrofik obstrüktif kardiyomiyopatide (HOKM), iki odacıklı pacemaker (DDD) uygulaması, seçilmiş hastalarda sol ventrikül çıkış yolu (SVÇY) gradiyentini azaltan ve semptomları düzelten etkili bir yöntemdir. Kliniğimize atriyoventriküler tam blok, HOKM ve üçüncü derece mitral kapak yetersizliği tanılarıyla yatırılan 78 yaşındaki bir erkek hastaya DDD-R pacemaker takıldı. Uygulama sonrasında hastanın SVÇY gradiyentinde anlamlı azalma, fonksiyonel kapasitesinde ve semptomlarda ciddi düzelme görüldü.Öğe ACUTE ANTERIOR MYOCARDIAL INFARCTION DUE TO CORONARY ARTERY SPASM TRIGGERED BY PSYCHOSOCIAL TRAUMA IN A YOUNG ADULT PATIENT(ELSEVIER IRELAND LTD, 2011) Arıbaş, Alpay; Tekinalp, M.; Akıllı, Hakan; Alihanoğlu, Yusuf İzzettin; Özdemir, Kurtuluş[Abstract not Available]Öğe Akut kalp yetersizliği nedeni ile kardiyoloji yoğun bakım ünitesine yatırılan hastaların klinik ve demografik özelliklerinin ve bu özelliklerin hastanede kalış süresi ile ilişkisinin incelenmesi(2012) Şahin, Sami; Doğan, Umuttan; Özdemir, Kurtuluş; Gök, HasanAmaç: Görülme sıklığındaki artışa rağmen, akut kalp yetersizliği (KY) nedeniyle kardiyoloji yoğun bakım ünitesine (YBÜ) kabul edilen hastaların klinik ve demografik özellikleri ile ilgili veriler yetersizdir. Çalışmamızın amacı, bu hasta grubundaki başvuru özelliklerinin ve hastanede kalış süresini etkileyen faktörlerin incelenmesidir. Yöntemler: Birincil akut KY tanısıyla kardiyoloji YBÜ’ne yatırılan 150 hastanın dahil edildiği tek-merkezli, ileriye dönük bir çalışma düzenlendi. Kategorik ve sürekli değişkenlerin analizi için sırasıyla Ki-kare ve Student-t testleri kullanıldı. Hastanede kalış süresini etkileyen bağımsız faktörleri belirlemek için lineer regresyon analizi kullanıldı. Bulgular: Hastaların %49’unda yeni başlangıçlı KY ve %25’inde korunmuş sol ventrikül ejeksiyon fraksiyonu (EF) tespit edildi. Hastaların %25.3’ünde, yeni başlangıçlı KY hastalarının ise %46.6’sında tetikleyici faktör akut koroner sendromdu. Korunmuş EF’li hastalarda tetikleyici faktör olarak atriyal fibrilasyon ve kalp kapak hastalıklarına düşük EF’li hastalara göre daha fazla oranda rastlandı. Lineer regresyon analizi, anemi (?1.62; %95 GA 0.08-3.15; p0.039) ve ciddi mitral yetersizliği (?2.55; %95 GA 0.06-5.05; p0.045) ile sistolik kan basıncı (?-0.03; %95 GA -0.06 -0.002; p0.039) ve kan üre azotunun (?0.034; %95 GA 0.006-0.06; p0.016) hastanede kalış süresinin bağımsız belirleyicileri olduğunu gösterdi. Sonuç: Altta yatan kardiyovasküler risk faktörlerinin, eşlik eden hastalıkların ve tetikleyici patolojilerin çeşitliliği AKY sendromlarının heterojen yapısını ortaya koymaktadır. Bununla birlikte, hastane içi ölüm oranları yüksektir ve başvuru sırasındaki klinik özellikler hastane içi seyir ile önemli bir ilişki gösterir.Öğe Akut Miyokard Infarktüsünde Troponin-I, Miyoglobin ve Ck-Mb' nin Tanısal Değerleri(2001) Özeren, Ali; Telli, Hasan Hüseyin; Temizhan, Ahmet; Tokaç, Mehmet; Özdemir, Kurtuluş; Bük, SalihAMAÇ: Akut miyokard infarktüsünde miyokard hasarının göstergelerinden olan troponin-I, miyoglobin ve CK-MB enzimlerinin duyarlılık, özgüllük ve kinetiği ile bu parametrelerin koroner arter hastalığının şiddeti, risk faktörleri ve komplikasyonlarla olan bağıntılarını araştırmayı amaçladık. GEREÇ VE YÖNTEM: Akut miyokard infarktüsü tanısıyla yatırılan 46 (38 erkek, 8 kadın, yaş ortalaması 59,39,2 yıl) hastadan kabulde, trombolitik tedaviden 90 dk sonra, 12., 24. ve 48. saatlerde venöz kan örnekleri alınarak total CK-MB, troponin I ve miyoglobin ölçümleri yapıldı. Tüm hastalara koroner angiografi yapıldı. BULGULAR: Kabulde, 12., 24. ve 48. saatlerde duyarlılık ve özgüllük değerleri sırasıyla total CK-MB için %59.6-100, % 91.5-100, % 83-100, % 53.3-100, troponin-I için %94.9-58.3, % 100-94.1, % 100-100, % 100-69.6 ve miyoglobin için %97.3-57.7, % 100-69.6, % 100-45.7, % 100-32 olarak hesaplandı. troponin-I piki ile sol ventr i kül ejeksiyon fraksiyonu arasında negatif korelasyon mevcuttu (r0,42, p0,005). SONUÇ: Akut miyokard infarktüsünün ilk 48 saatinde özgüllüğü en yüksek olan göstergenin total CK-MB, duyarlılığı en yüksek olanın ise miyoglobin ile troponin-I olduğu saptanmıştır. Sol ventrikül ejeksiyon fraksiyonuyla olan negatif korelasyonu ve miyoglobinden daha özgül olması nedeniyle troponin-I'nın ilk 48 saatte gelen hastaların prognostik değerlendiriminde tercih edilebileceğini düşünmekteyiz.Öğe Analysis of the Myocardial Velocities in Patients With Mitral Stenosis(MOSBY, Inc, 2002) Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Gök, Hasan; İçli, Abdullah; Temizhan, AhmetBackground: Pure mitral stenosis (MS) affects left-ventricular performance as a result of myocardial and functional factors. We planned this study to evaluate the effect of MS on right- and left-ventricular functions using Doppler tissue imaging (DTI). Methods. A total of 46 patients with an established diagnosis of MS (mean age: 41 +/- 11 years), and 40 age-matched healthy individuals (mean age: 40 +/- 9 years) were included in this study. Echocardiography equipped with DTI function was performed on each participant. The mitral valve area was measured. Myocardial velocities were recorded at 4 different sites (septum, lateral, anterior, and inferior) of the left ventricle, and the right-ventricular free wall annulus by DTI The positive systolic velocity when the mitral and tricuspid ring moved toward the cardiac apex, and 2 negative diastolic velocities when the mitral annulus moved toward the base away from the apex (I during the early phase of diastole and another in the late phase of diastole [A(m)]) were measured. The early diastolic velocity/A(m) ratio was calculated for each wall. The mean of systolic and diastolic myocardial velocities of the left ventricle was calculated. Patients with pure MS were compared with healthy participants, and the relationship of DTI variables with mitral valve area was evaluated. Results. The myocardial velocities of the left ventricle indicating left-ventricular function were found to be significantly lower in patients with pure MS. Right-ventricular annulus velocities, on the other hand, were similar in both groups. A significant positive correlation could be established between mitral valve area and mean positive systolic velocity, A(m) of the left ventricle, and right-ventricular A(m) (r = 0.50, P <.001; r = 0.48, P =.001; r = 0.45, P =.002, respectively), whereas a significant negative correlation (r = -0.42, P =.004) was established for right-ventricular early diastolic velocity/A(m) ratio. Conclusion This first study where pure MS was evaluated by DTI shows that MS affects left-ventricular performance on long axis. The results indicate that the decrease in left-ventricular performance is caused by both functional and myocardial factors.Öğe Aort Yetmezliğinin Derecelendirmesinde Kullanılan Ekokardiyoğrafik Yöntemlerin Birbirleriyle Korelasyonu ve Sol Ventrikül Relakasyon Bozukluğunun Bu Yöntemler Üzerindeki Etkisi(2001) Sökmen, Gülizar; Korkut, Bayram; Özdemir, Kurtuluş; Tokaç, Mehmet; Sökmen, Abdullah; Gök, HasanAMAÇ: Kronik AY'nde yetmezliğin derecesinin doğru tayin edilmesi klinik takip ve tedavi için oldukça önemlidir. PHT, JY/LVOT çapı ve . ölçümü bu amaçla pratikte sık kullanılan kantitatif yöntemlerdendir. LVRB kronik AY'de sıkça karşılaşılan bir durum olup yetmezliğin derecelendirmesinde kullanılan eko parametrelerini etkileyebilir. Bu çalışmada AY şiddetini değerlendiren farklı eko yöntemlerinin birbirleri korelasyonunu ve L VRB 'nün bu yöntemler üzerindeki etkisini araştırmayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya ekokardiyografık inceleme için başvurup çeşitli derecelerde A Y tesbit edilen toplam 38 hasta alındı. Hasta transmitral E / A, EDZ, IVRT ve TDIE /A parametreleri kullanılarak LVRB olan (n-19) ve olmayanlar (n19) olmak üzere iki gruba aynldı. Tüm hastalarda PHT, RF ve JY / LVOT çapı hesaplandı. Parasternal uzun aks ve apikalbeş boşluk pencerelerinden renkli akımla jet uzunluğu ölçüldü. BULGULAR: AY derecelendirmesinde kullanılan kantitatif eko yöntemleri birbirleriyle anlamlı düzeyde korele bulundu. Daha önceki çalışmalar anjiyografik AY derecelendirmesi ile korele olmadığı gösterilen jet uzunluklarının bu çalışmada kantitatif yöntemlerle anlamlı derecede korele olduğu görüldü. LVRB, kullanılan tüm parametreleri az çok etkilemekte idi ancak en belirgin etki PHT ve apikal jet uzunluğu üzerinde gözlen LVRB'nun etkilemediği RF ile bu iki parametre arasında LVRB (-) olan grupta anlamlı bir korelasyon gözlenirken, LVRB () olan grupta anim bir korelasyon tesbit edilemedi. SONUÇ: PHT, LVRB olan AY hastalarında yetmezliği doğru derecelendirmek için uygun bir metod değildir. LVRB diğer parametreleri istatistiksel olarak anlamlı olmasa da değişen derecelerde etkilediği için bu tip olgularda yetmezlik değerlendirilirken mümkün olduğu kadar fazla metodun kombinasyonunu kullanmak uygundur.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 Assessment of Left Ventricular Systolic and Diastolic Function With Conventional and Tissue Doppler Echocardiography Imaging Techniques in Patients Administered Tyrosine Kinase Inhibitor(2012) Alihanoğlu, Yusuf İzzettin; Kaya, Zeynettin; Arı, Hatem; Karaarslan, Şükrü; Yıldız, Bekir Serhat; Karanfil, Mustafa; Yazıcı, Mehmet; Börüban, Melih Cem; Özdemir, Kurtuluş; Ülgen, Mustafa SıddıkObjectives: The aim of this study was to use echocardiographic techniques to determine the possible cardiotoxic effects of low molecular weight tyrosine-kinase inhibitors (TKI) in patients receiving the therapy for the first time. Study design: Thirty patients (17 females; 13 males; mean age 49±16; range 22 to 76 years) who met the exclusion criteria and were diagnosed as having malignancy were enrolled. All patients underwent conventional echocardiography and tissue Doppler imaging (TDI) prior to the treatment. The conventional echocardiogram was repeated 2 months later as the patients were concurrently receiving therapy. Myocardial Performance Index was obtained by conventional echocardiography and by TDI techniques to evaluate left ventricular systolic and diastolic function. Results: Statistically significant increase occurred in mean left ventricle (LV) end-systolic volume. However, there was significant decrease in both mean LV ejection fraction and LV stroke volume values (64±3, 62±4, p=0.000 and 67±13, 61±13, p=0.000, respectively). Anterior wall Em/Am ratio measured by using the TDI technique was significantly decreased at the end of two months (0.99±0.49, 0.90±0.41, p=0.03). In addition, decreases were determined in Sm values obtained from all of four LV walls and also in mean Sm value, but this decrease was significant only for the lateral wall Sm measurement (12.8±2.9, 11.6±2.3, p=0.004). Conclusion: Tyrosine-kinase inhibitors therapy can be administered safely to patients without predisposing factors for cardiotoxicity in short treatment intervals, and low molecular TKIs may cause subtle or clinically significant cardiotoxicity following the treatment period even in patients without predisposing factors for cardiotoxicity, so clinicians should consider this possibility.Öğe An asymptomatic left ventricular diverticulum(2007) Yazıcı, Mehmet; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Kayrak, Mehmet; Ülgen, SıddıkCongenital ventricular diverticulum is defined as a protrusion of the free wall of the ventricle, including endocardium, myocardium and pericardium. They have been classified in fibrous and muscular types. Congenital ventricular diverticulum may be asymptomatic or may be present with various clinical symptoms. Diverticulum is commonly seen in childhood, and fibrous type being the most common type. Muscular type is very rare seen in adults. We report here, a case with muscular type asymptomatic congenital left ventricular diverticulum in a 65 year-old female.Öğe Atorvastatin did not prevent recurrence of atrial fibrillation in addition to antiarrhythmic therapy after electrical cardioversion(OXFORD UNIV PRESS, 2007) Can, İlknur; Demir, Kenan; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Tokaç, M.; Gök, Hasan[Abstract not Available]Öğe Brugada sendromu: İki olgu sunumu ve ailenin gözden geçirilmesi(2004) Altunkeser, Bülent Behlül; Atar, İlyas; Özdemir, Kurtuluş; Aygül, Nazif; Yazıcı, Mehmet; Düzenli, Mehmet Akif; Ertan, ÇağatayBrugada sendromu, EKG'de sağ dal bloğu paterni ve sağ prekordiyal derivasyonlarda ST yükselmesi ile karakterize, ani ölüm riskinin yüksek olduğu bir genetik durumdur. Tüm dünyada yapılan epidemiyolojik çalışmalarda, özellikle gençlerde gözlenen, ani, beklenmedik kalp ölümlerinin önemli bir kısmından sorumludur. Tipik EKG değişiklikleri, hastalarda zaman zaman ortaya çıkıp zaman zaman kaybolabilmektedir. Sodyum kanallarını bloke eden bazı antiaritmik ajanların bu EKG değişikliklerini ortaya çıkarmada etkili oldukları bilinmektedir. Bu yazıda Brugada sendromlu bir ailenin klinik ve elektrokardiyografik özellikleri incelenmektedir.Öğe Calcific constrictive pericarditis in a patient presenting with right heart failure(2008) Can, İlknur; Kerimoğlu, Ülkü; Özdemir, KurtuluşKırk beş yaşında erkek hasta, altı aydır var olan nefes darlığı, karında şişkinlik ve ayak ödemi yakınmaları ile başvurdu. Yandan çekilen akciğer filminde yoğun perikardiyal kalsifikasyon izlendi. İkiboyutlu ve nabız dalgalı Doppler incelemesinde konstriktif perikardit bulguları vardı. Göğüs tomografisinde, diffüz, perikardı tamamen sarmayan kalsifikasyon ve genişlemiş superior vena kava izlendi. Hasta perikardiyektomi ameliyatını kabul etmediği için ilaç tedavisine başlandı.Öğe Can P Wave Parameters Obtained From 12-Lead Surface Electrocardiogram be a Predictor for Atrial Fibrillation in Patients Who Have Structural Heart Disease?(Westminster Publ Inc, 2003) Altunkeser, Bülent Behlül; Özdemir, Kurtuluş; Gök, Hasan; Temizhan, Ahmet; Tokaç, Mehmet; Karabağ, TurgutThis study was planned to investigate the parameters detecting risk of developing atrial fibrillation (AF) in patients with sinus rhythm with structural heart disease. Forty-five patients with AF and 37 patients without AF but with structural heart disease (Group I) were included in this study. Thirty-eight patients (Group II) had successfully undergone medically or electrically cardioversion after transesophageal echocardiography. The restoration of sinus rhythm could not be achieved in 7 patients who were excluded from this study. After providing sinus rhythm, amiodarone was given orally to the patients to prevent recurrences. Left ventricular ejection fraction (LVEF) was calculated and left atrial diameter (LAD) was measured by echocardiography in group I and in group II after cardioversion. A 12-lead electrocardiography (ECG) was simultaneously obtained from all the patients. In these ECG recordings, maximum P wave duration (P max), minimum P wave duration (P min), and P wave dispersion (P dispersion) were calculated. P dispersion was expressed as "P max-P min." Also, the highest P wave voltage is expressed as P amplitude maximum (P amp max), the lowest P wave as P amplitude minimum (P amp min), and P amplitude dispersion (P amp dispersion) was calculated as the difference of both. In univariate analysis, P max, P dispersion, P amp max, P amp dispersion, LAD, LVEF, and old age were significant predictors of chronic AF (p < 0.001, p < 0.01, p < 0.01, p < 0.01, p = 0.003, p = 0.02, and p = 0.01, respectively). However, in multivariate analysis, P max and LAD were independent predictors of chronic AF in patients with structural heart disease (r = 0.39, p < 0.05; r = 0.34; p < 0.05, respectively). In conclusion, in estimating the risk of developing chronic AF, P max and LAD are predictive parameters in patients with sinus rhythm with structural heart disease.Öğe A Case of Catecholamine Induced Heart Failure With Left Ventricular Hyphertrophy Accompanied by Mid-Ventricular Obstruction(Japan Heart Journal, Second Dept of Internal Med, 2002) Gök, Hasan; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Mil, Sibel; Kayrak, Mehmet; Yalın, SevgiA 36 year old Turkish female patient complaining of widespread redness of the skin, shortness of breath, palpitations, nausea, hum and reverberation in the head was examined. The patient was diagnosed with catecholamine induced hypertension, which was caused by paraganglionoma. In addition, left ventricular concentric hypertrophy accompanied by systolic gradient in mid-ventricle, which is rarely observed, was determined by echocardiography. Hypertensive attacks and mid-ventricular systolic gradient disappeared after surgery. This case shows that one of the causes of the heart failure due to catecholamine releasing tumors can be left ventricular obstruction.Öğe A Case Report of an Unusual Complication of Amanita Phalloides Poisoning: Development of Cardiogenic Shock and Its Successful Treatment with Intra-Aortic Balloon Counterpulsation(Pergamon-Elsevier Science Ltd, 2010) Aygül, Nazif; Düzenli, Mehmet Akif; Özdemir, Kurtuluş; Altunkeser, Bülent BehlülAmanita phalloides is responsible for the majority of the fatalities caused by mushroom poisoning. It causes damage in liver, kidneys and rarely pancreas, causing encephalopathic coma, disseminated intravascular coagulation, hemorrhage and hypovolemic shock. However, its effect on cardiac functions has not been established yet. In this case report, we aimed to present a female patient poisoned by A. phalloides mushroom complicated with multi-organ failure and cardiogenic shock due to advanced left ventricular systolic dysfunction. This case report was the first to show a successful treatment of cardiogenic shock due to mushroom poisoning with intra-aortic balloon counterpulsation, whereas she did not respond to other therapies.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 A Comparison of Artificial Intelligence Methods on Determining Coronary Artery Disease(Springer-Verlag Berlin, 2010) Babaoğlu, İsmail; Baykan, Ömer Kaan; Aygül, Nazif; Özdemir, Kurtuluş; Bayrak, MehmetThe aim of this study is to show a comparison of multi-layered perceptron neural network (MLPNN) and support vector machine (SVM) on determination of coronary artery disease existence upon exercise stress testing (EST) data. EST and coronary angiography were performed on 480 patients with acquiring 23 verifying features from each. The robustness of the proposed methods is examined using classification accuracy, k-fold cross-validation method and Cohen's kappa coefficient. The obtained classification accuracies are approximately 78% and 79% for MLPNN and SVM respectively. Both MLPNN and SVM methods are rather satisfactory than human-based method looking to Cohen's kappa coefficients. Besides, SVM is slightly better than MLPNN when looking to the diagnostic accuracy, average of sensitivity and specificity, and also Cohen's kappa coefficient.Öğe Comparison of Pulmonary Venous Flow Velocities and Left Ventricular Diastolic and Ejection Time in Patients With Moderate Mitral and Aortic Stenosis - Pulmonary Venous Flow Velocities in Mitral and Aortic Stenosis(Kluwer Academic Publ, 2003) Altunkeser, Bülent Behlül; Özdemir, Kurtuluş; İçli, Abdullah; Gök, HasanBackground: Doppler pulmonary venous flow velocities (PVFV) pattern are useful parameters in assessing the left ventricular diastolic functions. Both mitral stenosis (MS) and aortic stenosis (AS) lead to diastolic dysfunction. We compared PVFV and left ventricular diastolic and ejection time (ET) in patients with moderate MS and AS. Methods: Forty-three patients with moderate MS (group 1), 65 patients with moderate AS (group 2), and 33 healthy subjects as controls (group 3) were included in this study. After obtaining standard measurements echocardiographically, diastolic period (DP), ET, the ratio of the DP to the ET (DP/ET) isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), peak systolic flow velocity (PS), peak antegrade diastolic flow velocity (PD) peak reversal flow velocity at atrial contraction (PRA), the ratio of the peak systolic to the diastolic flow velocity (PS/PD), deceleration time of the antegrade diastolic flow (PDDT), and pressure half time of the peak antegrade diastolic flow velocity (PDPHT) were measured. Mitral valve area (MVA), aortic valve area (AVA), systolic pulmonary artery pressure (PAP), peak and mean gradients were calculated with standard formulas. Results:In univariate analysis, MVA was correlated with PDPHT and PDDT (r = -0.41; p < 0.01, r = -0.36; p < 0.05, respectively), also it was correlated with DP/ET (r = -0.57; p < 0.001). Mitral peak and mean diastolic gradient were correlated with PS/PD (r = -0.43; p < 0.01, r = -0.36; p < 0.05, respectively) and DP/ET (r = 0.51; p < 0.01, r = 0.46; p < 0.01, respectively). AVA was only correlated with DP/ET (r = 0.38; p < 0.05). Aortic peak and mean systolic gradient were correlated with PS/PD (r = -0.29; p < 0.05, r = -0.27; p < 0.05, respectively) and DP/ET (r = -0.38; p < 0.01, r = -0.40; p < 0.01, respectively). In the same analysis, PAP in patients in group 1 and 2 was correlated with PS/PD (r = -0.42; p < 0.01 and r = -0.40; p < 0.01, respectively) and also it was correlated with PD (r = -0.37; p < 0.05 and r = -0.27; p < 0.05, respectively) in both groups. Conclusion : Moderate MS and AS similarly affect the PVFV and PS/PD correlates with hemodynamics similarly both in MS and AS. Nevertheless, PDDT and PDPHT correlate with solely MVA. IRT higher in AS than MS, though DP/ET and ICT higher in MS than AS, and DP/ET relates with the severity of both MS and AS.Öğe Comparison of traditional risk factors, angiographic findings, and in-hospital mortality between smoking and nonsmoking turkish men and women with acute myocardial infarction(2010) Aygül, Nazif; Özdemir, Kurtuluş; Abacı, Adnan; Aygül, Meryem Ülkü; Düzenli, Mehmet Akif; Yazıcı, Hüseyin Uğur; Özdoğru, İbrahim; Karakaya, EkremBackground: The prevalence of smoking is high in Turkey. However, there are no data available evaluating the differences between smokers and nonsmokers according to their sex in patients with acute myocardial infarction (AMI) in Turkey. Hypothesis: The aim of the study was to determine the prevalence of smoking and its relationship to age, localization, and extension of coronary heart disease (CHD), and other risk factors in Turkish men and women with first AMI. Methods: This study included, 1502 patients with first AMI from 3 different cities in Turkey. The baseline characteristics and traditional risk factors for CHD, Coronary angiographic results, and in-hospital outcome were recorded. Results: The proportion ofmale smokers was significantly higher than that ofwomen (68%vs 18%, P < 0.001). Smokers were younger by almost a decade than nonsmokers (P < 0.001). Male nonsmokers were younger than females; however, the mean age of first AMI was similar in male and female smokers. In both genders, prevalence of hypertension and diabetes mellitus was significantly lower in smokers than in nonsmokers (P < 0.001). Smokers had lessmultivessel disease andless comorbidity as compared to nonsmokers. Although the in-hospital mortality rate was lower in smokers, smoking status was not an independent predictor of mortality. Conclusions: Smoking, by decreasing the age of first AMI in women, offsets the age difference in first AMI betweenmen and women. The mean age of first AMI is lower in Turkey than most European countries due to a high percentage of smoking. © 2010 Wiley Periodicals, Inc.Öğe Coronary Ectasia Is Associated with Impaired Left Ventricular Myocardial Performance in Patients without Significant Coronary Artery Stenosis(KARGER, 2012) Ceyhan, Köksal; Koç, Fatih; Özdemir, Kurtuluş; Çelik, Ataç; Altunkaş, Fatih; Karayakalı, Metin; Kadı, HasanObjectives: To determine both ventricular functions and tissue Doppler echocardiography (TDE)-derived myocardial performance index (MPI) in patients with coronary artery ectasia (CAE). Subjects and Methods: Twenty-five patients with CAE (13 men; mean age 57 +/- 9 years) and 25 age- and sex-matched controls without CAE (8 men; mean age 54 +/- 10 years) were enrolled in the study. Left and right ventricular functions were detected using conventional echocardiography and TDE. Results: Left ventricle-lateral wall (0.61 +/- 0.17; 0.50 +/- 0.10, p = 0.02), interventricular septum (0.66 +/- 0.17; 0.52 +/- 0.10, p = 0.007) and mean MPI (0.63 +/- 0.15; 0.51 +/- 0.09, p = 0.004) were increased in the CAE group compared to the control group. Right ventricular MPI was similar in both the CAE and control groups (0.58 +/- 0.18; 0.52 +/- 0.19, p > 0.05). Conclusion: The findings show that left ventricular MPI is different in CAE patients without obstructive coronary artery disease compared to the normal control group. Also in these patients, right ventricular MPI was similar to the control group. Copyright (C) 2011 S. Karger AG, Basel
