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Öğe Antidiabetic treatment in diabetic patients with coronary artery disease(2007) Soylu A.; Ülgen M.S.; Düzenli M.A.The prevalence of diabetes mellitus (DM) that is about 150 million today is estimated to exceed 300 million by the year 2025 (1). When considered that about half of the patients remain undiagnosed, it can be seen how serious the dimensions of the disease are (2). In the patients with DM more than 90% of whom are consisted by non-insulin dependent diabetes mellitus (NIDDM, Type 2 DM), the disease is a significant risk factor for the development of coronary artery disease (CAD) responsible for 75% of all deaths (3,4). In this group of the patients who generally require antidiabetic treatment inevitably, it is highly important to decide on an appropriate treatment due to the various cardiovascular (CV) effects of the anti-diabetics medications and drugs. In order to help establish this decision, in this review it was tried to investigate antidiabetic drugs after a general approach to CAD pathophysology in diabetic patients, especially in terms of their cardiovascular effects.Öğe A lethal but treatable complication: Free wall rupture after acute myocardial infarction(2006) Ülgen M.S.; Öztürk Ö.; Kayrak M.; Soylu A.; Düzenli M.A.; Koç F.A 43-year-old male patient was admitted to coronary intensive care unit with the diagnosis of acute inferolateral myocardial infarction and with a picture of cardiogenic shock. In physical examination, systolic blood pressure was 50 mmHg and diastolic blood pressure could not be taken. The patient was diagnosed with cardiogenic shock and was started on saline, dopamine and dobutamine infusion. His blood pressure did not increase although the dosage of positive inotropic agents was increased. A cardiac tamponade revealed with urgent echocardiographic evaluation and pericardiocentesis was carried out. Blood pressure returned to normal range within hours after pericardiosentesis. Echocardiographic examination performed on the second day of AMI on the asymptomatic patient revealed thrombosed myocardial rupture. The patient was referred to emergency surgery with the diagnosis of three-vessel disease and myocardial rupture according to urgent angiography. In the operation, the ruptured region in the ventricle free wall was primarily repaired. By-pass surgery was performed with saphenous vein graft to the LAD and CV-OM1 coronary arteries.Öğe The role of tissue Doppler echocardiography in the evaluation of functional capacity of patients with heart failure [Kalp yetersizli?i olan hastalarda fonksiyonel kapasitenin de?erlendirilmesinde doku Doppler ekokardiyografinin rolü](2008) Düzenli M.A.; Özdemir K.; Aygül N.; Zengin K.; Gök H.Objectives: We investigated correlations between the New York Heart Association (NYHA) functional classification system, which is commonly used to asses functional capacity, and conventional echocardiographic and tissue Doppler echocardiographic (TDE) parameters in patients with heart failure (HF). Study design: The study included 122 patients (31 females, 91 males; mean age 59±11 years) with HF, whose left ventricular (LV) ejection fraction (EF) was less than 50%. The patients were evaluated in two groups based on the NYHA class I-II (n=79; mean age 58 years) and class III-IV (n=43; mean age 61 years). Correlations were sought between the functional status and standard two-dimensional echocardiographic and TDE parameters. Results: The NYHA class showed significant inverse correlations with LV EF, LV stroke volume, mitral deceleration time of early filling, and flow propagation velocity (Vp), and significant positive correlations with end-systolic and enddiastolic diameters and volumes, pulmonary artery pressure (PAP), and the E/Vp ratio. Mitral early (E) and late (A) diastolic peak velocities and the E/A ratio were not correlated. Concerning TDE parameters, the NYHA class was in significant inverse correlation with systolic (Sm), early (Em) and late (Am) diastolic myocardial velocities, and in positive correlation with the E/Em ratio, whereas no correlation was found with the Em/Am ratio. Linear regression analysis showed that Sm, EF, and PAP were independent variables of functional capacity (?=-0.33, p<0.005; ?=-0.26, p<0.05; ?=0.23, p<0.05, respectively). Conclusion: There is significant relationship between myocardial velocities and functional capacity, and Sm, in particular, has the strongest association compared to conventional echocardiographic and other TDE parameters.Öğe Three-year follow up of recurrent cardiac echinococcosis simulating myxoma: Report of a rare case [Nadir görhülen bir olgu: Miksomayi taklit eden tekrarlayici kardiyak ekinokokozis ve 3 yillik takip](2007) Ülgen M.S.; Yazici M.; Kayrak M.; Düzenli M.A.; Koç F.[Abstract not Available]