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Öğe Acute Myocardial Infarction - Diabetics Versus Non Diabetics [Das Klinische Spektrum Von Diabetes-Patienten Mit Akutem Herzinfarkt Im Vergleich Zu Nichtdiabetikern](1995) Cin, V. G.; Gok, H.; Tavli, T.We have studied 40 patients with diabetes mellitus (mean age 62 + 8) and 45 patients without (mean age 53 + 9). All the patients were consecutively admitted to our coronary care unit with myocardial infarction. We have observed a higher incidence of heart failure (20% vs 13%), atrial fibrillation (17% vs 11%), postinfarction angina (23% vs 13%), and conduction abnormalities among diabetics. In our patients the higher mortality among diabetics is associated with cardiogenic shock and left ventricular failure. We concluded that the poorer outcome among diabetic patients with acute myocardial infarction could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery disease.Öğe Acute Myocardial-Infarction - Diabetics Versus Non Diabetics(F K SCHATTAUER VERLAG GMBH, 1995) Cin, V. G.; Gök, H.; Tavlı, T.We have studied 40 patients with diabetes mellitus (mean age 62 + 8) and 45 patients without (mean age 53 + 9). All the patients were consecutively admitted to our coronary care unit with myocardial infarction. We have observed a higher incidence of heart failure (20% vs 13%), atrial fibrillation (17% vs 11%), postinfarction angina (23% vs 13%), and conduction abnormalities among diabetics. In our patients the higher mortality among diabetics is associated with cardiogenic shock and left ventricular failure. We concluded that the poorer outcome among diabetic patients with acute myocardial infarction could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery disease.Öğe Examination of Coronary Heart Disease and Risk Factors in Asymptomatic Adults in Central Anatolia [eine Untersuchung Der Koronaren Herzerkrankung und Der Risikofaktoren Bei Asymptomatischen Erwachsenen in Zentralanatolien](1995) Gönen, M. S.; Cin, V. G.; Gök, H.; Bayram, A.; Telli, H. H.The coronary heart disease and its risk factors were investigated in Konya district which is situated in central Anatolia, Turkey. In this study 280 asymptomatic persons, who were middle aged and over (?40), were selected at random from Bozkir, a small town of Konya, which shows a homogenous structure of population. Cardiovascular system of all the cases were examined. ECG and teleradiography were taken. In 54 cases (19.3% ) hypertension, in 11 cases (3.9%) hyperglycemia and in 58 male cases (59.8%) smoking were found. Obesity was seen in 17% of male and 27% of female cases. Hypercholesterolemia in 12% of cases and hypertriglyceridemia in 7.4% of cases were also seen. In 40 cases, coronary heart disease was determined. Incidence of hypertension was increasing with age, but the rate of cigarette-smoking was not changed. Under the light of positive results of the struggle with the reversible major risk factors, periodic examinations in cases with high risk, medical and preventive treatment procedures were pointed out clearly as important issues for the physician.Öğe QT Dispersion Ratio in Patients With Unstable Angina Pectoris (A New Risk Factor?)(CLINICAL CARDIOLOGY PUBL CO, 1997) Cin, V. G.; Çelik, M.; Ulucan, S.Background: QT dispersion has been shown to be associated with fatal arrhythmias and sudden death in coronary artery disease. A recent study indicated that marked QT dispersion in electrocardiograms (ECGs) obtained during acute ischemia demonstrated a significant correlation with ventricular fibrillation. Hypothesis: This study investigated the ECG parameters for repolarization (QT dispersion, corrected QT, corrected QT dispersion, and QT dispersion ratio) and their interrelation with acute ischemia. Methods: QT parameters as well as a newly developed repolarization index, QT dispersion ratio [(QT dispersion/RR interval)x100] were calculated digitally during rest and ischemia in 32 patients with coronary artery disease (rest angina, Braunwald class III). Results were correlated with clinical consequences, mainly arrhythmias, within a follow-up period of 5 +/- 2 days. Results: While most patients had an increase in all four parameters, only the QT dispersion ratio showed a significant difference when correlated with ventricular arrhythmias (p < 0.001,F ratio = 38). Conclusion: QT dispersion ratio appears to be a new and promising parameter in predicting ventricular arrhythmias in patients with acute ischemia.Öğe The Use of Basic Clinical and Exercise Variables in Postmenopausal Women for the Diagnosis of Coronary Artery Disease(Springer New York, 2000) Cin, V. G.; Tartanoğlu, O.; Düzenli, A.; Sarıgüzel, A.; Şeker, M.The diagnostic utility of clinical and exercise parameters in women with possible coronary artery disease are underestimated and considered unreliable, in most cases. This seems to be mainly due to the lower likelihood of the disease in selected populations. In this study, postmenopausal women with variable clinical and exercise parameters were tried to be correlated with significant coronary artery disease. One hundred twenty patients with atherosclerotic risk factors, typical angina, or atypical chest pain with ischemic ECG changes were involved. All patients underwent exercise stress test, and 110 suitable patients had coronary angiography. Nonsignificant and significant coronary stenoses (50% narrowing, at least) were investigated due to the parameters involved. Single vessel disease was detected as the most extensive form of the disease, whereas significant lesions correlated only with diabetes, peripheral artery disease, multiple risk factors, typical angina at exercise, insufficient maximum workload, and early ST/T changes. A positive predictive value of 78.5% and a negative predictive value of 80% were determined. The diagnosis of significant coronary artery disease, using basic parameters, is similar to that of men, provided that factors leading to lower likelihood of the disease are excluded. This is a contrasting result with earlier studies which imply unreliable results attributable to female gender.Öğe The Use of the Handgrip Maneuver to Identify Left Ventricular Diastolic Function Abnormalities by Doppler Echocardiography in Patients with Coronary Artery Disease(1995) Tavlı, T.; Cin, V. G.; Tavli, V.; Wong, M.Doppler echocardiography accurately identifies diastolic dysfunction through the assessment of transmitral flow patterns during the application of the handgrip (HG) maneuver. In this study, 45 normal control patients (mean age 46 ± 9, group A) and 13 patients with coronary artery disease (CAD) (mean age 51±6, group B) were involved. The effects of handgrip maneuver on transmitral flow patterns were studied by Doppler echocardiography. Group B patients had higher peak late diastolic filling velocities (A), lower peak early (E) to late diastolic filling velocity ratios (E /A) and longer isovolumic relaxation times (IVRT) compared to group A. On die other hand, systolic blood pressure (SBP), heart rate (HR) and peak E velocity (E) did not change significantiy (p > 0.05) in either group, at rest. During the supine handgrip maneuver, NR (mean + standard error of mean, + 21 ± 13%, p < 0.05) and SBP (+ 21 ± 9%, p < 0.05) increased significantiy in both group A and group B (+ 20 ± 13%, p < 0.05, + 22 ± 15%, p < 0.05, respectively). In group B, E/A ratio (-28 ± 7%) decreased significantly (p < 0.05) compared to group A (-20 ± 6%), as a consequence of significantly increased peak A velocity in group B (+ 7 + 5%) compared to group A (+ 6 ± 3%, p < 0.05). Deceleration time decreased significantiy in both groups (-10 + 6% vs-9 ± 6%, p < 0.05). Isovolumic relaxation time (IVRT) significantly increased in both groups (+18+ 7% vs + 16 + 6%, p < 0.001). Peak E/A ratios were >1.0 in all patients of botli groups in the supine position. This parameter remained greater than 1.0 only in group A during the HG maneuver. Therefore HG was effective in identifying diastolic function abnormalities in patients with CAD. (Jpn Heart J 36: 23-28, 1995). © 1995, International Heart Journal Association. All rights reserved.
