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    Analysis of 24-hour heart rate variations in patients with epilepsy receiving antiepileptic drugs
    (ACADEMIC PRESS INC ELSEVIER SCIENCE, 2011) Yildiz, Gulce Unal; Dogan, Ebru Apaydin; Dogan, Umuttan; Tokgoz, Osman Serhat; Ozdemir, Kurtulus; Genc, Bulent Oguz; Ilhan, Nurhan
    Objective: The goal of the study described here was to evaluate interictal heart rate variability (HRV) in young patients with epilepsy, a patient population in whom sudden unexpected death in epilepsy (SUDEP) is known to be more common. Methods: Twenty-four-hour ambulatory ECG Holter recordings of 37 patients (15-40 years old) and 32 healthy controls were compared. Results: All of the time domain indices (SDNN, SDANN, RMSSD, and HRV triangular index) were significantly suppressed (P < 0.001), and there was a marked reduction in parasympathetic tone (reduced HFnu, P < 0.001) and an increase in sympathetic tone (increased LFnu and LF/HF ratio, P < 0.001) in the patient group. Stepwise linear regression analysis revealed that polytherapy and epilepsy duration > 10 years were independent variables associated with a reduction in SDNN. Conclusion: Our data suggest that the major determinants of suppressed SDNN are polytherapy and epilepsy duration > 10 years. Analysis of spectral measures of frequency domain indices suggests that an increased sympathetic tone in association with a decreased parasympathetic tone may constitute the mechanism underlying SUDEP in young people with epilepsy. (C)2010 Elsevier Inc. All rights reserved.
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    Does Smoking Amplify the Risk of Acute Myocardial Infarction Related with Pregnancy in Factor V Leiden Carriers?
    (AKAD DOKTORLAR YAYINEVI, 2009) Yazici, Mehmet; Acar, Kadir; Kayrak, Mehmet; Ayhan, S. Selim; Dogan, Umuttan; Ulgen, Mehmet S.
    [Abstract not Available]
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    Evaluation of clinical and demographic characteristics and their association with length of hospital stay in patients admitted to cardiac intensive care unit with the diagnosis of acute heart failure
    (TURKISH SOC CARDIOLOGY, 2012) Sahin, Sami; Dogan, Umuttan; Ozdemir, Kurtulus; Gok, Hasan
    Objective: Despite increasing incidence, data regarding clinical and demographic characteristics of patients with acute heart failure (AHF) admitted to cardiac intensive care unit (ICU) are inconclusive. The aim of this study was to assess the presentation characteristics and factors determining the length of hospital stay in this particular patient population. Methods: We conducted a single-center, prospective study involving 150 patients hospitalized to cardiac ICU with the primary diagnosis of AHF. Chi-square and Student t tests were used for the analysis of categorical and continuous variables, respectively. Linear regression analysis (LRA) was used to determine the factors affecting the length of hospital stay. Results: Forty-nine percent of the patients had new-onset AHF and 25% had preserved left ventricular ejection fraction (LVEF). In 25.3% of all patients and 46.6% of the patients with new-onset HF the precipitating factor was acute coronary syndrome. Atrial fibrillation and valvular heart disease as precipitating factors were more common in patients with preserved EF, when compared to low EF group. LRA showed that presence of anemia [beta=1.62; 95% CI 0.08-3.15; p=0.039)] and severe mitral regurgitation (beta=2.55; 95% CI 0.06-5.05; p=0.045) and systolic blood pressure (beta=-0.03; 95% CI -0.06 - -0.002; p=0.039) and blood urea nitrogen (beta=0.034; 95% CI 0.006 - 0.06; p=0.016) were the independent predictors of length of stay. Conclusion: Underlying cardiovascular risk factors, comorbidities and precipitating pathologies were diverse and highlighted the inhomogeneous characteristics of AHF syndromes. However, in-hospital mortality was high and initial clinical presentation characteristics were significantly associated with in-hospital outcome. (Anadolu Kardiyol Derg 2012; 12: 123-31)
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    The First Case Report of a Metastatic Myxoid Liposarcoma Invading the Left Atrial Cavity and Pulmonary Vein
    (FORUM MULTIMEDIA PUBLISHING, LLC, 2011) Dogan, Umuttan; Zamani, Adil; Gormus, Niyazi; Paksoy, Yahya; Avunduk, Mustafa Cihat; Demirbas, Soner
    Myxoid liposarcoma (MLS) is the most commonly encountered liposarcoma subgroup, accounting for about 50% of all cases. Metastatic MLS of the heart is extremely rare. Herein we describe for the first time metastasis of MLS to the left atrium and left upper pulmonary vein in a 54-year-old woman who was admitted with shortness of breath and cough persisting for 2 weeks. The patient reported that a total surgical excision of MLS of the left thigh followed by radiotherapy was performed 4 years ago. An emergency operation was performed due to rapidly progressive worsening of clinical condition and echocardiographic determination of left atrial mass protruding into the left ventricle and obstructing the mitral inflow throughout the diastole. The mass could not be totally excised because it was tightly adhered to the surrounding tissue. Postoperative magnetic resonance imaging (MRI) showed a 5 x 3 cm residual tumor deforming the posterior wall of the left atrium entirely and extending into the left upper pulmonary vein. Histopathological examination was consistent with MLS. In conclusion, considering probable cardiac metastasis in patients presenting with respiratory symptoms with medical history of soft tissue sarcomas would be life saving. The case is discussed, and a review of the literature in relation to the metastatic involvement of the heart by MLS is presented.
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    P-wave parameters and cardiac repolarization indices: Does menopausal status matter?
    (ELSEVIER IRELAND LTD, 2012) Dogan, Umuttan; Dogan, Nasuh Utku; Basarir, Ahmet Ozgur; Yildirim, Serkan; Celik, Cetin; Incesu, Feyzanur; Ozdemir, Kurtulus
    Background and purpose: Data regarding electrocardiographic characteristics of postmenopausal women are lacking. In this prospective, cross-sectional study, electrocardiographic P-wave parameters and cardiac repolarization indices of age-matched pre- and postmenopausal healthy women were compared. We hypothesized that menopausal status would have a significant effect on cardiac electrical activity and hence electrocardiography (ECG) recordings. Materials and methods: Twelve-lead ECG recordings were obtained from 125 consecutively recruited postmenopausal healthy women aged between 44 and 54 years. The control group consisted of 125 age-matched premenopausal women. P-wave parameters and cardiac repolarization indices were measured and compared with respect to menopausal status. Results: Demographic features of premenopausal and postmenopausal women were comparable. There were no significant differences between two groups regarding mean values of heart rate, maximum and minimum P-wave duration, P-wave dispersion, maximum and minimum QT interval, and QT dispersion. Mean values of QT interval obtained from lead V5 were also similar. Corrected values which were calculated according to Bazett and Fridericia formulas also did not differ between the groups. Mean values of Tpeak to Tend (TpTe) (p < 0.001) and corrected TpTe (p = 0.001) intervals obtained from lead V5 were significantly shorter in postmenopausal women when compared to those without menopause. Conclusion: Tpeak to Tend interval decreased significantly while QT intervals and P-wave parameters did not change in postmenopausal women when compared to premenopausal women. Association of these findings with changes in levels of sex steroids and their prognostic implications need to be elucidated with further studies. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.