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Öğe Acute coronary embolism without valve thrombosis in a patient with a prosthetic mitral valve - Successful percutaneous coronary intervention: A case report(FORUM MULTIMEDIA PUBLISHING, LLC, 2007) Yazici, Mehmet; Kayrak, Mehmet; Turan, Yasar; Koc, Fatih; Ulgen, Mehmet S.We present a 44-year-old female patient with anterior myocardial infarction caused by embolization from mitral valve prosthesis due to inadequate anticoagulation. The patient underwent a cardiac catheterization within the 1st hour of arrival. The angiography showed total occlusion of the left anterior descending coronary artery after the second diagonal branch. Percutaneous transluminal coronary angioplasty and stenting were performed, and coronary artery perfusion was restored. The pain disappeared completely immediately after this intervention. Transthoracic echocardiography shortly after this intervention showed normal prosthetic valve function and no thrombus. Transesophageal echocardiography performed 2 days later revealed no thrombus at the prosthetic valve. In conclusion, this case demonstrated that coronary embolism may occur even without prosthetic valve thrombus or dysfunction with suboptimal International Normalized Ratio levels, and can be successfully treated with percutaneous transluminal coronary angioplasty and stenting.Öğe The acute effect of bi-level positive airway pressure on heart rate variability in chronic obstructive pulmonary disease patients with hypercapnic respiratory failure(TURKISH SOC CARDIOLOGY, 2008) Yazici, Mehmet; Uzun, Kuersat; Ulgen, Mehmet Siddik; Teke, Turgut; Maden, Emin; Kayrak, Mehmet; Turan, YasarObjective: Non-invasive mechanical ventilation (NIMV) has the potential to improve sympathovagal control of heart rate. The aim of this study was to investigate the acute effects of NIMV on heart rate variability (HRV) in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure (HRF). Methods: In this prospective study 28 COPD patients (64 +/- 10 years) with HRF underwent electrocardiographic Holter monitorization. Both time domain (TD) and frequency domain (FD) means of HRV analysis were measured for two hours before and during NIMV application. For the TD, mean-RR, SDNN, SDANN, SDNN index, RMSSD, pNN50 and HRV triangular index were measured. For FD, high frequency (HF) and low frequency (LF) were detected. To compare HRV parameters before and during bi-level positive airway pressure (BiPAP) application; paired sample t test was used for normally distributed variables and Wilcoxon signed rank test was used for the variables that were not normally distributed. Pearson correlation test was used to analyze the correlation between HRV and blood gas parameters during BiPAP application. Results: High frequency power of HRV (39 (18-65) ms(2) vs. 28 (12-50) ms(2), p < 0.05), HRV triangular index (9 (3-17) units vs. 6 (2-13) units, p < 0.05) and pNN50 (59% (13-110) vs. 42% (5-84), p < 0.05), were higher during NIMV than before noninvasive mechanical ventilation. Conclusions: We think that NIMV may improve heart rate variability indices of parasympathetic modulation of heart rate in COPD cases with HRF and decrease arrhythmic potential. (Anadolu Kardiyol Derg 2008; 8: 426-30)Öğe Adult cyanotic congenital heart disease: an unusual cause of stroke(PAKISTAN MEDICAL ASSOC, 2013) Bacaksiz, Ahmet; Sonmez, Osman; Akif, Mehmet; Kayrak, MehmetA 33-year-old male patient with uncorrected tetralogy of Fallot was hospitalised for multiple peripheral arterial emboli. Bilateral above-knee amputation had been done after unsuccessful femoral embolectomy. A large thrombus was detected in the apical portion of the left ventricle which was the source of the embolus. The patient complained of mild frontal headache and progressive right-sided weakness shortly after an echocardiographic examination. A computed tomography (CT) scan revealed a left middle cerebral artery territory infarct. Patients with grown-up cyanotic congenital heart disease are at increased risk of thromboembolic cerebrovascular events. This report highlights the necessity for physicians to be alert for uncommon causes of acute stroke.Öğe Aneroid sfigmomanometreyle ölçülen brakiyal arter basıncının santral aortik basınçla karşılaştırılması ve farka etki eden faktörler(2008) Kayrak, Mehmet; Ülgen, Mehmet S.; Yazıcı, Mehmet; Demir, Kenan; Doğan, Yıldız; Koç, Fatih; Zengin, KadriyeAmaç: Aneroid sfigmomanometreyle alınan brakiyal arter kan basıncı (KB) ölçümleri ile çıkan aorttan alınan KB ölçümleri karşılaştırılarak iki ölçüm yöntemi arasındaki sapmaya etki eden temel faktörler araştırıldı. Ça lış ma pla nı: Çalışmaya, rutin koroner anjiyografi işlemine alınan 463 hasta (177 kadın, 286 erkek, ort. yaş 6011) alındı. Tüm hastalarda çıkan aorttan pigtail kateter aracılığıyla yapılan invaziv KB ölçümleriyle eşzamanlı olarak, sağ koldan aneroid sfigmomanometre ile brakiyal arter KB ölçümleri yapıldı. Sistolik ve diyastolik KB değerlerinden, nabız basıncı (NB), fraksiyone NB ve pulsatilite indeksleri hesaplandı. Bul gu lar: Brakiyal sistolik ve diyastolik KB değerleri, çıkan aorttan alınan ölçümlerden sırasıyla -3.110 mmHg ve 3.07.1 mmHg farklılık gösterdi (p0.001). İki yöntemle ölçülen sistolik KB değerleri kadınlar ve erkekler arasında anlamlı farklılık göstermedi; ancak, brakiyal diyastolik KB kadınlarda anlamlı sapma gösterdi (4.8 mmHg, p0.0001). Sfigmomanometre ile yapılan ölçümde diyastolik KB düzeyindeki sapma 60 yaş ve üzerindeki hastalarda daha fazlaydı (sırasıyla 4.5 mmHg ve 1.1 mmHg, p0.0001). Hipertansiflerde sistolik KB için belirlenen sapma, normotansiflerdekinden fazlaydı (-4 mmHg ve -2.0 mmHg, p0.04). Sistolik KB düzeylerindeki sapma, çıkan aorttan ölçülen sistolik KB düzeyiyle birlikte artmaktaydı (p0.0001). Diyabet ve hipertansiyonun birlikte görüldüğü hastalarda, iki yöntem arasındaki sapma sistolik KB için -5.8 mmHg (p0.01), diyastolik KB için 4.2 mmHg (p0.03) bulundu. Beden kütle indeksi ve kol çevresi ile iki yöntem arasındaki sapma ilişkili değildi. So nuç: İki yöntemle elde edilen KB değerleri arasındaki anlamlı farkları etkilediği bulunan temel faktörler (cinsiyet, yaş, KB yüksekliği ve diyabet varlığı) klinik pratikte dikkate alınmalıdır.Öğe Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera(WILEY-BLACKWELL, 2011) Kayrak, Mehmet; Acar, Kadir; Gul, Enes Elvin; Baglicaklioglu, Murat; Kaya, Zeynettin; Sonmez, Osman; Aydogdu, IsmetAims: The aim of this study was to evaluate myocardial performance index (MPI) which reflects the combined systolic and diastolic performance of the ventricles by tissue Doppler imaging (TDI) in patients with polycythemia vera (PV). Method and Materials: Twenty-eight patients with PV (17 men; mean age 60 +/- 9 years) and 30 age-matched healthy subjects were prospectively evaluated. The diagnosis of PV was performed according to the World Health Organization (WHO) criteria. Left ventricular (LV) systolic and diastolic functions were assessed by conventional echocardiography and TDI. MPI of both the LV and right ventricles (RV) were measured by TDI method. Results: The LV MPI was significantly higher in PV group than in the controls (0.61 +/- 0.16 vs. 0.49 +/- 0.05; P = 0.001). Also, the RV MPI was impaired in patients with PV compared to the control subjects (0.51 +/- 0.11 vs. 0.43 +/- 0.09; P = 0.005). RV late A filling velocity (Am) and RV isovolumetric relaxation time were significantly higher in the PV group compared to healthy subjects (P = 0.03 and 0.05, respectively). In logistic regression models, PV was determined as an independent predictor of impaired MPI (odds ratio: 3.7; CI 95%, 1.2-7.5). In addition, pulmonary arterial pressure was significantly elevated in patients with PV compared to the controls (P = 0.02). Conclusion: This study demonstrated that biventricular MPI is impaired in patients with PV. (Echocardiography 2011;28:948-954)Öğe The Association Among Lipoprotein-associated Phospholipase A2 Levels, Total Antioxidant Capacity and Arousal in Male Patients with OSA(IVYSPRING INT PUBL, 2011) Bekci, Taha T.; Kayrak, Mehmet; Kiyici, Aysel; Maden, Emin; Ari, Hatem; Kaya, Zeynettin; Teke, TurgutBackground: The mechanisms of the increased cardiac and vascular events in patients with OSA are not well understood. Arousal which is an important component of OSA was associated with increased sympathetic activation and electrocardiographic changes which prone to arrhythmias. We planned to examine the association among arousal, circulating Lp-PLA2 and total antioxidant capacity in male patients with OSA. Methods: Fifty male patients with newly diagnosed OSA were enrolled the study. A full-night polysomnography was performed and arousal index was obtained. Lp-PLA2 concentrations were measured in serum samples with the PLAC Test. Total antioxidant capacity in patients was determined with Antioxidant Assay Kit. Results: Arousal was positively correlated with LP-PLA2 levels (r=0.43, p=0.002) and was negatively correlated with total antioxidant capacity (r= -0.29, p=0.04). Elevated LP-PLA2 levels and decreased total antioxidant activities were found in the highest arousal quartile compared with the lowest and 2nd quartiles (p=0.02, p=0.05, respectively). LP-PLA2 was an independently predictor of arousal index in regression model (beta=0.357, p=0.002) Conclusions: This study demonstrated a moderate linear relationship between arousal and LP-PLA2 levels. Also, total antioxidant capacities were decreased in the higher arousal index. Based on the study result, the patients with higher arousal index may be prone to vascular events.Öğe Association Between A/C1166 Gene Polymorphism of the Angiotensin II Type 1 Receptor and Biventricular Functions in Patients With Acute Myocardial Infarction(Japanese Circulation Society, 2006) Ülgen, Mehmet S.; Öztürk, Önder; Yazıcı, Mehmet; Kayrak, Mehmet; Alan, Sait; Koç, Fatih; Tekes, SelahattinAlthough there have been several association studies of angiotensin II type 1 receptor (AT1R, A/C1166) gene polymorphism in clinical endpoints such as myocardial infarction (MI), hypertension, aortic stiffness, and left ventricular mass, the relationship between AT1R polymorphism and biventricular function in acute anterior MI has not been studied before. Methods and Results The study group comprised 132 consecutive patients who were admitted to the coronary care unit with their first acute anterior MI. Systolic and diastolic diameters, volumes, inflow properties, ejection fraction and myocardial performance index of both ventricles were measured. AT1R polymorphism was determined using polymerase chain reaction amplification. Based on A/C1166 polymorphism of ATIR, the patients were classified into 3 groups: group 1, A/A (n=91) genotype, group 2 A/C (n=28), and group 3 C/C (n=13) genotype. When the left ventricular and right ventricular echocardiographic functions were compared, all parameters of the 3 groups were found to be similar. No difference was detected in either the genotype distribution or allele frequencies between the patients and the controls for AT1R. Conclusions The results suggest that A/C1166 polymorphism of AT1R did not influence the risk of either acute MI or biventricular function after anterior MI.Öğe Association Between Exaggerated Blood Pressure Response to Exercise and Serum Asymmetric Dimethylarginine Levels(Japanese Circulation Soc, 2010) Kayrak, Mehmet; Bacaksız, Ahmet; Vatankulu, Mehmet Akif; Ayhan, Selim S.; Taner, Alparslan; Ünlü, Ali; Yazıcı, Mehmet; Ülgen, Mehmet S.Background: The exaggerated blood pressure response to exercise (EBPR) is an independent predictor of hypertension. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide inhibitor and higher plasma levels of ADMA are related to increased cardiovascular risk. The aim of this study is to identify the relationship between ADMA and EBPR. Methods and Results: A total of 66 patients (36 with EBPR and 30 as controls) were enrolled in the study. EBPR is defined as blood pressure (BP) measurements >= 200/100 mmHg during the treadmill test. All the subjects underwent 24-h ambulatory BP monitoring. L-arginine and ADMA levels were measured using a high performance lipid chromatography technique. The serum ADMA levels were increased in the EBPR group compared to the healthy controls (4.0 +/- 1.4 vs 2.6 +/- 1.1 mu mol/L respectively, P=0.001), but L-arginine levels were similar in the 2 groups (P=0.19). The serum ADMA levels were detected as an independent predictor of EBPR (odds ratio 2.28; 95% confidence interval 1.22-4.24; P=0.002). Conclusions: Serum ADMA levels might play a role in EBPR to exercise.Öğe The association between myocardial iron load and ventricular repolarization parameters in asymptomatic beta-thalassemia patients(2012) Kayrak, Mehmet; Acar, Kadir; Gül, Enes Elvin; Özbek, Orhan; Abdulhalikov, Turyan; Sönmez, Osman; Alibaşiç, HayruddinPrevious studies have demonstrated impaired ventricular repolarization in patients with ?-TM. However, the effect of iron overload with cardiac T 2 * magnetic resonance imaging (MRI) on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T 2 * MRI in asymptomatic ?-TM patients. Twenty-two ?-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T 2 * evaluation. Cardiac T 2 * score <20msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the ?-TM group compared to the healthy controls. T p - T e and T p - T e dispersions were also significantly prolonged in ?-TM group compared to healthy controls. (T p - T e) / QT was similar between groups. There was no correlation between repolarization parameters and cardiac T 2 * MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic ?-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load. Copyright © 2012 Mehmet Kayrak et al.Öğe The Association of Glomerular Filtration Rate and Erectile Dysfunction with Severity of Coronary Artery Disease in Patients Presenting with Chest Pain(SPRINGER, 2010) Solak, Yalçın; Akıllı, Hakan; Atalay, Hüseyin; Kayrak, Mehmet; Gök, Hasan; Türk, SüleymanBackground The most common cause of death in patients with chronic kidney disease is cardiovascular. Coexistence of reduced estimated glomerular filtration rate (eGFR) and erectile dysfunction (ED) may predate severe underlying coronary artery disease (CAD). The aim of this study was to evaluate the predictive value of presence and severity of ED and reduced estimated eGFR in the risk stratification of CAD in patients with chest pain. Methods Two hundred and sixty-five consecutive male patients with chest pain were included. All patients underwent exercise stress test (EST), of whom those with positive EST underwent coronary angiography. eGFR was calculated and sexual health inventory for men (SHIM) form was applied to evaluate ED. The relation between SHIM scores, eGFR and the number of arteries with significant lesions was evaluated. Results Of the 265 male patients, 105 had positive EST while the remaining 160 patients had negative EST. ED was present in 62 patients (38.8%) in the EST (-) group and in 64 patients (61%) in the EST (+) group (P = 0.000). In the EST (+) group, coronary angiography (CAG) revealed normal coronary anatomy or insignificant coronary lesions in 19 (18%), one-vessel disease in 45 (43%), two-vessel disease in 22 (21%) and three-vessel disease in 19 (18%) patients, respectively. The lowest ED prevalence (36.8%) was seen in patients who had normal coronary anatomy or insignificant coronary lesions while the highest prevalence was in those with three-vessel disease (89.5%). When eGFR were taken into account, there was a significant difference between the groups as well (107.2 +/- 19.2 ml/min in the EST (-) group versus 94.1 +/- 20.0 ml/min in the EST (+) group; P = 0.001). Conclusion The presence and severity of ED and reduced eGFR are associated with the severity of underlying CAD in patients presenting with chest pain, and they could be implemented in the risk stratification of these patients.Öğe Association of paraoxonase-1 activity and major depressive disorder in patients with metabolic syndrome(SPRINGER INDIA, 2015) Ari, Hatem; Kayrak, Mehmet; Gunduz, Mehmet; Kayhan, Fatih; Kaya, Zeynettin; Kiyici, Aysel; Uguz, FarukAssociations between metabolic syndrome (MS) and major depressive disorder (MDD) are well documented although the underlying biological mechanisms for this relationship are less studied. Paraoxonase (PON1) is a high-density lipoprotein (HDL)-associated enzyme, with demonstrated evidence of strong antioxidant activity. Oxidative stress has been implicated in the pathophysiology of MS and MDD. PON1 activity has been studied to some extent in patients with MS and less in MDD. The aim of this study was to compare serum PON1 activity in patients with MS and MDD, MS without MDD, and normal control groups in the context of the biological mechanism of the association between MS and MDD. In this case-control study, 67 patients with MS and 25 healthy controls from the hospital-university staff were recruited. All patients and healthy controls were assessed by a semi-structured psychiatric interview. Patients with MDD were diagnosed according to the DSM-IV criteria for MDD. Serum PON1 activity was determined with a spectrophotometric method, and the activity was compared between patients with MS and MDD, with MS but without MDD, and control groups. Serum PON1 activity levels were lower in patients with MS and MDD group compared to those in the patients with MS and without MDD group and control group (69.5+/-24.2, 84.3+/-34.6, and 97.1+/-40.8 U/ml, p=0.03, respectively). Post hoc analysis showed that PON1 activity was statically significantly lower in the MS with MDD group than in the control group (p=0.02). Impaired PON1 activity, in the context of enhanced oxidative stress, could be one of the possible underlying biological mechanisms of the MS-MDD association.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 A Bizarre Electrocardiographic Pattern Due to Chronic Lithium Therapy(Wiley, 2010) Kayrak, Mehmet; Duman, Çetin; Gül, Enes Elvin; Sönmez, Osman; Kaya, Zeynettin; Arı, HatemCardiotoxicity that results from lithium overdose is uncommon and electrocardiographic (ECG) changes are rarely reported. However, some authors have specifically reported the occurrence of ischemic ECG changes due to a lithium overdose. This article describes a case that is demonstrating ECG changes that mimic inferior myocardial infarction during the course of chronic lithium treatment and showing QTc prolongation in this patient. The patients’ ECG changes were partially recovered after hemodialysi.Öğe Can neutrophil/lymphocyte ratio predict recurrence of non-valvular atrial fibrillation after cardioversion?(TURKISH SOC CARDIOLOGY, 2013) Arıbaş, Alpay; Akıllı, Hakan; Gül, Enes Elvin; Kayrak, Mehmet; Demir, Kenan; Duman, Çetin; Alibaşiç, HayruddinObjective: High neutrophil/lymphocyte ratio (NLR) has been associated with post-operative AF development in patients who underwent cardiac surgery. In this study, effectiveness of NLR for prediction of recurrence after electrical cardioversion (CV) in non-valvular AF was investigated. Methods: A total of 149 patients who underwent a successful CV were included in this prospective cohort study. Baseline complete blood cell count, routine biochemical tests, high sensitive C-reactive protein (hs-CRP), and echocardiographic measurements were examined. After CV, patients were monitored over six months for recurrence. Baseline characteristics of recurrence group were compared with sinus rhythm group by using Student's t -test. Logistic regression analysis was used to determine predictors of recurrence. Results: Recurrence occurred in a total of 46 patients (30.9%). Median AF duration [16 (IQR:14.25) vs. 12 (IQR: 11) months, p=0.01], baseline hs-CRP [9.80 (IQR:8.50) mg/dL vs. 4.28 (IQR:5.65) mg/dL, p=0.002] and left atrium (LA) diameter (4.5 +/- 0.4 cm, 4.3 +/- 0.5 cm, p=0.023) were significantly higher in the recurrence group than sinus rhythm group. Median NLR was comparable in recurrence and sinus groups [2.38 (IQR:2.09) vs. 2.23, (IQR: 1.23) p=0.96, respectively]. There was a weak correlation between NLR and hs-CRP (r=0.22, p=0.05) and age (r=0.24, p=0.02). In multiple logistic regression analysis, hs-CRP [OR: 1.34 (1.09-1.65 95% CI) p=0.006], LA diameter [OR: 11.92 (1.84-77.07 95% CI) p=0.01], spontaneous echo contrast positivity, [OR: 5.40 (1.04-12.02 95% CI) p=0.045] and systolic blood pressure [OR: 1.05 (1.01-1.10 95% CI) p=0.03] were independent predictors of AF recurrence. Conclusion: NLR failed to predict AF recurrence after a successful electrical CV, but hs-CRP remained an inflammatory marker of AF recurrence. (Anadolu Kardiyol Derg 2013; 13: 123-30)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 of exercise-induced sinus node deceleration without evident coronary artery disease(AVES YAYINCILIK, 2009) Kayrak, Mehmet; Alihanoğlu, Yusuf İzzettin; Arı, Hatem; Sönmez, Osman; Keser, Ahmet; Gök, Hasan[Abstract not Available]Öğe A Case of Late-Term Lead Endocarditis Causing Pacemaker Dysfunction(Churchill Livingstone Inc Medical Publishers, 2010) Kayrak, Mehmet; Sönmez, Osman; Gül, Enes Elvin; Gündüz, MehmetWith regard to pacemakers, lead endocarditis is a rare condition noted for causing difficulties in patient management. It has been reported in the literature that lead endocarditis may occur even after 10 years. In general, the incidence of pacemaker infections has not been carefully documented.1,2 The prevalence and incidence of pacemaker lead dysfunctions due to lead endocarditis have not been researched previously. We present a case of pacemaker dysfunction related to infective endocarditis.Öğe Coenzyme Q10 supplementation and diastolic heart functions in hemodialysis patients: A randomized double-blind placebo-controlled trial(WILEY, 2013) Turk, Suleyman; Baki, Aysegul; Solak, Yalcin; Kayrak, Mehmet; Atalay, Huseyin; Gaipov, Abduzhappar; Aribas, AlpayCoenzyme Q10 (CoQ10) supplementation has been shown to improve diastolic heart function in various patient cohorts. Systolic and diastolic dysfunctions are common in patients with end-stage renal disease. Favorable effects of CoQ10 on cardiac functions are yet to be seen in hemodialysis patients. We aimed to evaluate effect of CoQ10 supplementation on diastolic function in a cohort of maintenance hemodialysis patients. This was a prospective, double-blind, placebo-controlled, crossover study in which all patients received placebo and oral CoQ10 200mg/d during the 8 weeks in each phase, with a 4-week washout period. Participants underwent conventional and tissue Doppler echocardiography before and after each study phase. Parameters characterizing left ventricle diastolic function and other standard echocardiographic measurements were recorded. Twenty-eight patients were randomized, but 22 patients completed study protocol. Intraventricular septum (IVS) thickness and left ventricle mass were significantly decreased in CoQ10 group (P=0.03 and P=0.01, respectively). Myocardial peak systolic and early diastolic velocities derived from IVS were significantly increased (P=0.048 and P=0.04, respectively). Isovolumetric relaxation time and E/Em ratio calculated for IVS also significantly reduced in CoQ10 group (p=0.02 and p=0.04, respectively). There was no significant difference in any of the studied echocardiographic parameters in placebo group. The results of this study showed that CoQ10 supplementation did not significantly improved diastolic heart functions compared with placebo in maintenance hemodialysis patients.Öğe A Comparison of Blood Pressure and Pulse Pressure Values Obtained by Oscillometric and Central Measurements in Hypertensive Patients(Taylor & Francis Ltd, 2010) Kayrak, Mehmet; Ülgen, Mehmet Sıddık; Yazıcı, Mehmet; Yılmaz, Remzi; Demir, Kenan; Doğan, Yıldız; Özhan, Hakan; Alihanoğlu, Yusuf İzzettin; Koç, Fatih; Bodur, SaitObjective. Wide pulse pressure (PP) affects the accuracy of oscillometric blood pressure measurements (OBPM): however, the degree of this impact on different patient groups with wide PPs is unclear. This study will investigate the accuracy of OBPM in achieving target BP and PP in isolated systolic hypertension (ISH) group compared with mixed hypertension (MHT) group. Method. A total of 115 patients (70 with ISH and 45 with MHT) were enrolled in the study. Upper arm and wrist OBPM, obtained by OmronM3 and OmronR6 devices respectively, were compared with the simultaneously measured values from the ascending aorta. The ISH was defined as a systolic blood pressure (SBP) >= 140 mmHg and a diastolic blood pressure (DBP) < 90 mmHg. MHT was defined as a SBP >= 140 mmHg and a DBP >= 90 mmHg. Results. The mean central arterial blood pressure (BP) and central PP were higher in the ISH group than those in the MHT group. The upper arm OBPM underestimated the central SBP in two groups (-5 mmHg, -3 mmHg, p=0.5, respectively), but overestimated DBP in the ISH group compared with MHT patients (6.8 mmHg, 1 mmHg, p=0.04, respectively). Wrist OBPM similarly underestimated to the central SBP in each group (-16 mmHg, -19 mmHg, p=0.15), whereas the sum of overestimation of DBP was significantly higher in the ISH than in the MHT group (+6 mmHg, - 1 mmHg, p=0.001, respectively). Also, each of the devices underestimated the central PP in the ISH group (about 10 mmHg) as being higher than that of the MHT group. Conclusion. Oscillometric devices may be used for self-BP measurement in patients with ISH without clinically important disadvantages compared with the patients with MHT. For PP measurement in patients with ISH, there were substantial differences between intra-arterial and indirect arm BP measurements.Öğe A comparison of the effects of aggressive dose and conventional dose atorvastatin applications on IL-6 and NO levels in patients with acute myocardial infarction(ACADEMIC JOURNALS, 2011) Basarali, Mustafa Kemal; Buyukbas, Sadik; Yazar, Hayrullah; Kiyici, Aysel; Kayrak, Mehmet; Ulgen, SiddikHigh dose statin medication in acute coronary syndrome cases is a therapy which lowers mortality and morbidity rates. Interleukin-6 (IL-6) is produced in higher amounts in acute myocardial infarction (MI) and facilitates myocardial damage. However, secretion of nitric oxide (NO) is depleted. We aimed to compare the effects of conventional dose (10-40 mg/day) and aggressive dose (80 mg/day) atorvastatin medications on IL-6 and NO levels in patients with primary percutaneous transluminal coronary angioplasty (PTCA) intervention after acute MI. 50 patients (8 females, 42 males) with the diagnosis of acute MI with ST segment elevation enrolled to the study. Primary PTCA intervention was performed on these patients and consequently either conventional dose (10 to 40 mg/day) or aggressive dose (80 mg/day) atorvastatin medications were given to the patients. Three months later, plasma IL-6 and NO levels were determined and alterations in the groups were evaluated. IL-6 levels decreased from 24.34 +/- 12.04 to 11.40 +/- 5.79 pg/ml and from 29.62 +/- 17.38 to 12.51 +/- 8.95 pg/ml in conventional dose and aggressive dose regimens respectively (p<0.001). However, NO concentrations increased from 22.90 +/- 8.24 to 31.70 +/- 7.56 mu M in conventional dose and from 19.37 +/- 5.60 mu M to 34.15 +/- 9.60 mu M in aggressive dose groups (p < 0.001). The effects of aggressive dose atorvastatin medication on IL-6 and NO levels were similar to conventional dose application in cases with ST segment elevation acute MI.
