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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 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 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 Atorvastatin Given prior to Electrical Cardioversion Does Not Affect the Recurrence of Atrial Fibrillation in Patients with Persistent Atrial Fibrillation Who Are on Antiarrhythmic Therapy(KARGER, 2011) Demir, Kenan; Can, İlknur; Koç, Fatih; Vatankulu, Mehmet Akif; Ayhan, Selim; Akıllı, Hakan; Arıbaş, AlpayObjective: In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation (AF) after electrical cardioversion (EC) in addition to antiarrhythmic therapy. Subjects and Methods: 48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters (high-sensitivity C-reactive protein, white blood cell count and fibrinogen level) were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of >10 min. Results: There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values (174 +/- 31 vs. 129 +/- 25 mg/dl, p = 0.001, and 112 +/- 23 vs. 62 +/- 20 mg/dl, p = 0.001, respectively), while no significant change occurred in control patients (168 +/- 26 vs. 182 +/- 29 mg/dl, p = 0.07, and 99 +/- 18 vs. 108 +/- 26 mg/dl, p = 0.1, respectively). At the end of the 2-month follow-up period, 9 patients (20.5%) experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups (26 vs. 13%; p = 0.2). Conclusion: Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy. Copyright (C) 2011 S. Karger AG, BaselÖğe 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 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 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, BaselÖğe DDD-R pacemaker implantation in a patient with A-V complete block and hypertrophic obstructive cardiomyopathy [A-V tam blok bulunan hipertrofik obstrüktif kardiyomiyopatili bir olguda DDD-R pacemaker uygulamasi](2005) Karabağ, Turgut; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Koç, FatihDual chamber permanent pacemaker (DDD) implantation is an effective method which reduces the severity of left ventricular outflow tract (LVOT) gradient and relieves the symptoms in selected patients with hypertrophic obstructive cardiomyopathy (HOCM). A 78-year-old male patient underwent DDD-R pacemaker implantation following admission with complete atrioventricular block, HOCM, and mitral regurgitation of grade III. Following the procedure, a significant decrease in LVOT gradient and serious improvement in functional capacity and symptoms were seen.Öğe A detailed investigation of electronic and optical properties of the exciton, the biexciton and charged excitons in a multi-shell quantum dot nanocrystal(IOP PUBLISHING LTD, 2014) Aktürk, Abdurrahman; Şahin, Mehmet; Koç, Fatih; Erdinç, AhmetIn the present study, the electronic and optical properties of the exciton (X), the biexciton (XX) and charged excitons (X- and X+) in a multi-shell quantum dot nanocrystal have been systematically explored in detail. The electronic properties have been determined in the framework of the single-band effective mass approximation. For this purpose, the Poisson-Schrodinger equations have been solved self-consistently in the Hartree approximation. In the electronic structure calculations for XX, X- and X+, the quantum mechanical exchange-correlation potentials between particles of the same type have been taken into account in the local density approximation. Some optical parameters, such as the overlap integrals, recombination oscillator strengths, radiative lifetimes, etc, have been determined by using the single-particle energy levels and wavefunctions obtained. A different approximation, reported in Sahin and Koc 2013 Appl. Phys. Lett. 102 183103, has been used in the recombination oscillator strength calculations. The results have been presented comparatively as a function of the shell thicknesses, and the well widths and probable physical reasons underlying them have been discussed in detail.Öğe Does Spironolactone Have a Dose-Dependent Effect on Left Ventricular Remodeling in Patients with Preserved Left Ventricular Function After an Acute Myocardial Infarction?(WILEY-HINDAWI, 2013) Vatankulu, Mehmet Akif; Bacaksız, Ahmet; Sönmez, Osman; Alihanoğlu, Yusuf İzzettin; Koç, Fatih; Demir, Kenan; Gül, Enes ElvinAims The aim of this study was to investigate the effects of spironolactone on left ventricular (LV) remodeling in patients with preserved LV function following acute myocardial infarction (AMI). Methods and Results Successfully revascularized patients (n=186) with acute ST elevation MI (STEMI) were included in the study. Patients were randomly divided into three groups, each of which was administered a different dose of spironolactone (12.5, 25mg, or none). Echocardiography was performed within the first 3days and at 6months after MI. Echocardiography control was performed on 160 patients at a 6-month follow-up. The median left ventricular ejection fraction (LVEF) increased significantly in all groups, but no significant difference was observed between groups (P=0.13). At the end of the sixth month, the myocardial performance index (MPI) had improved in each of the three groups, but no significant difference was found between groups (F=2.00, P=0.15). The mean LV peak systolic velocities (S-m) increased only in the control group during the follow-up period, but there is no significant difference between groups (F=1.79, P=0.18). The left ventricular end-systolic volume index (LVESVI) and the left ventricular end-diastolic volume index (LVEDVI) did not change significantly compared with the basal values between groups (F=0.05, P=0.81 and F=1.03, P=0.31, respectively). Conclusion In conclusion, spironolactone dosages of up to 25mg do not augment optimal medical treatment for LV remodeling in patients with preserved cardiac functions after AMI.Öğe Ghrelin, resistin and leptin levels in patients with metabolic syndrome(2011) Koç, Fatih; Tokaç, Mehmet; Kocabaş, Volkan; Kaya, Coşkun; Büyükbaş, Sadık; Erdem, Sami; Karabağ, TurgutAmaç: Bu çalışmada metabolik sendromlu (MS) hastalar ile sağlıklı kontroller arasında açlık ghrelin, leptin ve resistin düzeylerinin karşılaştırılması amaçlanmıştır. Metod: Çalışmaya 21 MS hastası (7 erkek; ortalama yaş, 444) ve 17 sağlıklı kontrol (8 erkek; ortalama yaş 433) alınmıştır. MS tanısı Ulusal Kolesterol Eğitim Programı (NCEP) Erişkin Tedavi Paneli (ATP) III kriterlerine göre tanımlandı. MS karşılama kriterlerinden en az 3’üne sahip olan ve beden kitle indeksi (BKI) 30 kg/m² olan hastalar MS grubuna seçildi. Sağlıklı gönüllüler arasında BKI 30 kg/m² olanlar kontrol grubu olarak seçildi. Plazma ghrelin, leptin ve resistin düzeyleri ELISA yöntemi ile ölçüldü. Bulgular:Ghrelin düzeyleri MS ve kontrol grupları arasında benzerdi. Ghrelin ve Leptin seviyeleri ile BKİ arasında negatif bir ilişki tespit edildi (r-.54, P.01 ve r-.56, p 0.009, sırasıyla). Resistin düzeyleri kontrol grubu ile MS arasında benzer bulundu. Leptin düzeyleri kontrol grubuna göre MS grubunda (3517 ng/ml ve 148 ng/ml, p 0.001) anlamlı derecede daha yüksek bulundu. Leptin düzeyleri ile BKİ arasında pozitif korelasyon vardı (r 0.56; p 0.008). Biz MS grubunda leptin düzeylerinin kontrol grubuna göre daha yüksek olduğunu gösterdik. Ancak, ghrelin ve resistin düzeyleri kontrol grubuna benzerdi. Sonuç: Sonuç olarak biz leptin düzeyleri ile BKİ arasında pozitif bir ilişki olduğunu ve ghrelin seviyeleri ile negatif ilişkili olduğunu gösterdik.Öğe Intravenous N-acetylcysteine Plus High-dose Hydration Versus High-dose Hydration and Standard Hydration for the Prevention of Contrast-induced Nephropathy: CASİS-A Multicenter Prospective Controlled Trial(Elsevier Ireland Ltd, 2012) Koç, Fatih; Özdemir, Kurtuluş; Kaya, Mehmet Güngör; Doğdu, Orhan; Vatankulu, Mehmet Akif; Ayhan, Selim; Erkorkmaz, Ünal; Sönmez, Osman; Aygül, Meryem Ülkü; Kalay, Nihat; Kayrak, Mehmet; Karabağ, Turgut; Alihanoğlu, Yusuf İzzettin; Günebakmaz, ÖzgürBackground: Contrast-induced nephropathy (CIN) is a leading cause of acute renal failure and affects mortality and morbidity. We investigated the efficacy of prophylactic intravenous (IV) N-acetylcysteine (NAC) and hydration for the prevention of CIN in patients with mild to moderate renal dysfunction who are undergoing coronary angiography and/or percutaneous coronary intervention (PCI). Methods: A total of 220 patients who had mild to moderate renal dysfunction with serum creatinine (SCr) >= 1.1 mg/dL or creatinine clearance <= 60 mL/min were randomized in 3 groups: 80 patients were assigned to IV NAC plus high-dose hydration with normal saline, 80 patients to only high-dose hydration with normal saline and 60 patients to standard hydration with normal saline (control group). The primary end point was the alteration of SCr level. The secondary end point was the development of CIN after the procedure. Results: SCr levels changed the least in the NAC plus high-hydration group (P=0.004). The rate of the CIN in the NAC plus high-dose hydration group was also lower than the high-dose hydration group (P=0.006). No significant differences in the primary and secondary end points were found between high-dose hydration and control group. Conclusion: The results of this study suggest that NAC plus high-dose hydration was superior to high-dose hydration alone as well as standard hydration for the protection of renal functions in patients with mild to moderate renal dysfunction who are undergoing coronary angiography and/or PCI. High-dose hydration without NAC was not better than standard hydration alone.Öğe Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study(TURKISH SOC CARDIOLOGY, 2011) Koç, Fatih; Erdem, Sami; Altunkaş, Fatih; Özbek, Kerem; Gül, Enes Elvin; Kurban, Sevil; Taşyürek, ErkanObjective: Slow coronary flow (SCF) is defined as late opacification in the epicardial coronary arteries without significant stenosis. The underlying mechanism of SCF is similar to coronary atherosclerosis. Free radical damage may be responsible for the pathology. In this study, we aimed to investigate ischemia-modified albumin (IMA) levels and differences with regard to total antioxidant status (TAS) between patients with normal coronary arteries and patients with SCF without significant stenosis. Methods: Thirty patients who were diagnosed with SCF using coronary angiography were included in this cross-sectional observational study 113 male; mean age, 56 10 years). The control group consisted of 30 patients who had normal coronary arteries as shown by coronary angiography (13 male; mean age, 53 11 years). In this study, we assessed serum IMA levels, albumin-adjusted IMA and TAS. The Student t-test was used to compare serum IMA levels and TAS between the two groups. Pearson's correlation test was used to explore the relationship between TAS and serum IMA levels. Results: Serum IMA levels and albumin-adjusted IMA were similar in both groups (p=0.432, p=0.349). The mean value of TAS was significantly lower in the SCF group compared to control group (p=0.011). The TAS was negatively correlated with the levels of IMA and albumin-adjusted IMA in the SCF group (r=-0.457, p=0.011; r=-0.509, p=0.004). Conclusion: This study shows that serum IMA levels and albumin-adjusted IMA were similar between the groups, however the mean value of TAS was significantly lower in the SCF group compared to control group and negatively correlated with IMA. These results are important in terms of understanding the pathophysiological basis of SCE (Anadolu Kardiyol Derg 2011; 11:582-7)Öğe Koroner arterleri normal olan bir hastada sigara ve ksilometazolin kullanımının tetiklediği akut miyokard infarktüsü(2006) Kayrak, Mehmet; Ülgen, M. Sıddık; Koç, Fatih; Soylu, AhmetAkut koroner sendrom nedenlerinden biri de koroner vazospazmdır. Sigara başta olmak üzere pek çok etken vazospazma neden olabilmektedir. Ksilometazolin, topikal etkisinden dolayı dekonjestan amaçlı yaygın olarak kullanılan bir sempatomimetiktir. Yoğun sigara içme sonrasında akut koroner sendrom tanısıyla yatırılan ve koroner anjiyografisi normal bulunan 50 yaşındaki erkek hasta, bir ay sonra, yüksek doz ksilometazolin kullanımı sonrasında ST yükselmeli miyokard infarktüsü ile tekrar başvurdu. Hastada vazospazmı provoke edebilecek başka bir neden yoktu. Göğüs ağrısı ile başvuran genç ve risk faktörleri açısından düşük riskli hastalarda ilaç kullanımı mutlaka sorgulanmalıdır.Öğe New echocardiographic parameters in reperfusion therapy [Reperfüzyon tedavisinde yeni ekokardiyografik göstergeler](2006) Karabağ, Turgut; Altunkeser, Bülent Behlül; Özdemir, Kurtuluş; Koç, FatihObjectives: We examined whether pulmonary venous flow parameters by Doppler echocardiography would throw light on the assessment of reperfusion therapy in acute myocardial infarction (AMI) with ST-segment elevation. Study design: The study included 88 patients who were admitted to intensive care unit with AMI. Data obtained from standard echocardiographic parameters and mitral and pulmonary vein Doppler parameters were evaluated in the following groups: Patients with or without ST-segment resolution on electrocardiograms (n=47, mean age 57±11 years and n=41, mean age 59±11 years, respectively) and patients with (n=53) or without (n=35) fibrinolytic therapy. ST resolution was defined as the disappearance of at least 70% of elevation detected on initial electrocardiograms. Results: Compared to those without ST resolution, patients with ST resolution had significantly higher mitral E-wave deceleration time (EDT), mitral E-wave pressure half time (E-PHT), pulmonary antegrade systolic flow (PS), and ejection fraction (EF) (p<0.05, p<0.05, p<0.05, p<0.001, respectively), and significantly lower end-systolic volume and left ventricle end-diastolic pressure (p<0.001, p<0.05 respectively). There was a significant correlation between PS and EF (r= 0.41, p<0.01) in patients without ST resolution, whereas PS was not correlated with EF in those with ST resolution (r= 0.21, p>0.05). In both groups with (r= -0.30) and without (r= -0.34) ST resolution, PS exhibited a negative correlation with pulmonary artery systolic pressure (p<0.05). With fibrinolytic therapy, the presence of ST resolution was significantly associated with higher values of EDT, E-PHT, and PS (p<0.05). However, in those who did not receive fibrinolytic therapy, patients with ST resolution had higher EDT, E-PHT, and PS compared to those without ST resolution, but only PS reached significance (p<0.05). Deceleration time of the pulmonary antegrade diastolic flow was significantly lower in patients who did not receive fibrinolytic therapy (p<0.01). Conclusion: In addition to electrocardiographic ST resolution, early echocardiographic variables such as PS, deceleration time of the pulmonary antegrade diastolic flow, and mitral EDT may contribute to noninvasive assessment of myocardial perfusion.Öğe Non-Hodgkin Lenfoma Tedavisinde Sisplatin Kullanımı Sonrası Gelişen Akut Miyokard İnfarktüsü-Koroner Trombüs Olgusu(2006) Karabağ, Turgut; Yeter, Ekrem; Özdemir, Kurtuluş; Koç, FatihAntineoplastik ajanların kullanımı sonrası miyokard infarktüsü (Mİ) gibi kardiyovasküler komplikasyonlar geliştiği bilinmektedir. Bu yazıda non-Hodgkin lenfoma nedeniyle daha önce 6 kez farklı antineoplastik ajanlar kullanılmasına rağmen rekürrensler gelişen ve son kürde MOPP protokolü (mekloretamin, vincristin, prokarbazin, prednizon) tedavisine ilave olarak sisplatin verildikten sonra koroner trombüs sonucu Mİ gelişen bir olgu sunulmuş ve tartışılmıştır.Öğe Obez ve metabolik sendromlu hastaların yeni ekokardiyografi parametreleri ile değerlendirilmesi(Selçuk Üniversitesi Tıp Fakültesi, 2006) Koç, Fatih; Tokaç, MehmetAmaç: Metabolik sendrom kriteri taşıyan obezler ile metabolik sendrom kriteri taşımayan obezlerde, sol ventrikül sistolik ve diyastolik fonksiyonlarını konvansiyonel metodlar ve yeni ekokardiyografik parametreleri kullanarak değerlendirmeyi amaçladık. Materyal-Metod: Hastalar metabolik sendrom tanısı alan obezler (grup 1), metabolik sendrom tanısı almamış obezler (grup 2) ve kontrol grubu olmak üzere 3 gruba ayrıldı. Metabolik sendrom tanısı almış 20 obez hasta, metabolik sendrom kriteri taşımayan 20 obez, kontrol grubu olarak 19 sağlıklı birey alındı. Beden kütle indeksi >30 kg/m² olanlar obez olarak kabul edildi. Metabolik sendrom tanısı için NCEP-2001 ATP III MS tanı kriterleri kullanıldı. Metabolik sendrom kriterlerinden en az 3 tanesine sahip, BK >30 kg/m² olan hastalar obez-metabolik sendrom grubuna dahil edildi. Kontrol gurubu için tamamen sağlıklı olan gönüllülerden BK <30 kg/m² olanlar seçildi. Hasta ve kontrol grubunun konvansiyonel ve doku Doppler yöntemleri ile SV çapları, kütlesi, diyastolik fonksiyonları ve miyokard performans indeksleri hesaplandı. statiksel değerlendirmede, gruplar arası değerlerin araştırılmasında One Way Annova testi, gruplar arası anlamlılık için bazal değerlerdeki farklılıkların sonuca etkisini engellemek için ?univariate covariance? analiz yapıldı. Tüm istatistikler için p<0.05 olması anlamlı olarak kabul edildi. Bulgular: Gruplar arsında yaş ve cinsiyet açısından istatistiksel olarak fark yoktu. Beden kütle indeksi ve bel çevresi; grup 1 ve grup 2 de benzer ancak kontrol grubundan anlamlı olarak daha yüksekti. Sistolik ve diyastolik kan basınçları, grup 1'de, grup 2 ve kontrol grubundan anlamlı olarak daha yüksek, grup 2 ve kontrol grubu arasında ise fark yoktu. Konvansiyonel ekokardiyografi parametreleri açısından gruplar karşılaştırıldığında; sol ventrikül çaplarında gruplar arasında anlamlı fark bulunamazken, septum kalınlığı, kontrol grubunda grup 1 ve grup 2 ye göre daha düşüktü. Sol ventrikül kütlesi beklenildiği üzere grup 1 ve grup 2 de kontrol grubuna göre yüksek bulundu. Grup 1 ve 2 ise benzerdi (137.09±32.61 gr, 142.73±29.85 gr ve 129.72±32.60 gr, p<0.05, sırasıyla). Gruplar arasında diyastolik fonksiyonlar karşılaştırıldığında; E/A oranı, grup 1 de, diğer 2 gruptan anlamlı olarak düşüktü, grup 2'de de kontrol grubundan anlamlı olarak daha düşük bulundu (0.78±0.15, 1.04±0.32 ve 1.38±0.44, p<0.05, sırasıyla). EDZ, grup 1 ve 2 arasında benzerken, kontrol grubundan anlamlı olarak daha yüksekti (195.5±47.5 msn, 194.8±42.1 msn ve 158.9±35.6 msn, p<0.05, sırasıyla). Doku Doppler parametrelerinden; ortalama Em/Am, grup 1'de diğer gruplara göre daha düşük bulundu. Grup 2 ise kontrol grubundan anlamlı olarak daha düşüktü (0.72±0.16, 0.98±0.40, 1.24±0.37, p=0.06, sırasıyla). E/Ortalama Em ve Ps/Pd açısısndan gruplar arasında 37 anlamlı fark gözlenmedi. Gruplar sol ventrikül MP 'leri açısından değerlendirildiğinde grup 1 ve grup 2'de kotrol grubuna göre MP 'ler anlamlı olarak yüksek bulundu. Doku Doppler ile hesaplanan ortalama MP , grup1 ve grup 2 arasında benzerken, her iki grup için de kontrol grubuna göre anlamlı olarak yüksek bulundu (0.58±0.07, 0.62±0.12 ve 0.49±0.06, p<0.05, sırasıyla). Konvansiyonel metodla hesaplanan MP grup 1 ve grup 2'de kontrol grubuna göre anlamlı olarak yüksekti, grup 1 ve grup 2 arasında fark yoktu (0.54±0.14, 0.55±0.18 ve 0.37±0.12, p<0.05, sırasıyla). Sonuç: Obezite MS'un diğer parametreleri olmasa da tek başına SV fonksiyonlarını bozabilir. Doppler EKO bu hastalarda kolay uygulanabilir, ucuz bir yöntemdir. Doku Doppler ise yine obezitede fizyolojik koşullardan daha az etkilenerek konvansiyonel Dopplere iyi bir alternatif olabilir.Öğe Pulmoner ven doppler akım hızları ve klinik kullanımı(2006) Karabağ, Turgut; Altunkeser, Bülent Behlül; Koç, FatihAmaç: Bu derlemenin amacı pulmoner ven Doppler akım hızlarının teknik esasları, normal paterni ve klinik kullanım alanları gözden geçirmektir. Ana bulgular: Pulmoner ven Doppler akım hızları yaşa ve cinse göre farklı paternler gösterebilmekte, gerek tek başına gerekse diğer Doppler parametreleri ile beraber kullanıldığında çeşitli kalp hastalıkları hakkında önemli bilgiler vermektedir. Başta diyastolik fonksiyonların değerlendirilmesi ile, sol ventrikül dolum basınçlarının belirlenmesi olmak üzere, kapak hastalıkları, perikardiyal hastalıklar, ritm bozuklukları ve invazif prosedürler sonrasında faydalanılabilmektedir. Sonuç: Pulmoner ven Doppler dalgalarının, geniş bir spektrumu içeren kullanım alanı vardır. Noninvazif olarak kolayca elde edilebilen, hastaların kliniği ile birlikte değerlendirildiğinde tedavisine yön verebilen önemli bilgiler içermektedir. Rutin ekokardiyografik değerlendirmeler içerisinde yer almalıdır.Öğe The Relationship between Coronary Sinus and Impaired Right Ventricular Myocardial Performance Index in Mitral Stenosis(WILEY-BLACKWELL, 2013) Vatankulu, Mehmet Akif; Koç, Fatih; Gül, Enes Elvin; Bacaksız, Ahmet; Sönmez, Osman; Demir, Kenan; Alihanoğlu, Yusuf İzzettinObjectives: We aimed to investigate whether coronary sinus (CS) dilatation develops in patients with mitral stenosis (MS) and to demonstrate its relationship with the global myocardial performance of the right ventricle (RV). Methods: We enrolled 34 patients with MS who underwent echocardiography after exhibiting typical symptoms (31 female; mean age 41 +/- 12 years) and 20 age-and sex-matched controls without MS who underwent echocardiography (16 female; mean age 38 +/- 13 years). The RV myocardial performance index (MPI) was detected using tissue Doppler echocardiography (TDE), and maximum CS diameter was measured from the posterior atrioventricular groove in the apical fourchamber view during the ventricular systole. Results: The RV MPI was significantly higher in the MS group compared to the control group (0.60 +/- 0.11 vs. 0.41 +/- 0.08, P < 0.001). Moreover, the maximum CS dimension was higher in the MS group compared to the control group (8.5 +/- 1.1 mm vs. 6.5 +/- 1.4 mm, P < 0.001). The maximum CS dilatation was positively correlated with the RV MPI (r = 0.691; P < 0.001). Conclusion: The RV MPI, which represents both systolic and diastolic functions, is increased in patients with MS and correlates with CS dilatation.Öğe Relationship Between L-arginine/asymmetric Dimethylarginine, Homocysteine, Folic Acid, Vitamin B Levels, and Coronary Artery Ectasia(Lippincott Williams & Wilkins, 2010) Koç, Fatih; Ardıç, İdris; Erdem, Sami; Kalay, Nihat; Özbek, Kerem; Yarlıoğlueş, Mikail; Ceyhan, Köksal; Çelik, Ataç; Kadi, Hasan; Taner, Alpaslan; Şahin, Şemsettin; Önalan, Orhan; Kaya, Mehmet GüngörBackground Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. The ratio of L-arginine/asymmetric dimethylarginine (ADMA) and homocysteine are important factors for endothelial function. In this study, we investigate the ratio of L-arginine/ADMA, homocysteine, and folic acid/vitamin B levels in patients with CAE. Methods Forty patients diagnosed with CAE using coronary angiography were included in the study (24 male; mean age, 56 +/- 11 years). The control group consisted of 30 patients who had normal coronary arteries as determined by coronary angiography (11 male; mean age, 54 +/- 8 years). The ratio of L-arginine/ADMA and plasma homocysteine was measured using high-performance liquid chromatography. Results The L-arginine/ADMA ratio and L-arginine levels were significantly lower in the CAE group compared with the control group (110 +/- 27 vs. 149 +/- 77, P = 0.02 and 157 +/- 32 mu mol/l vs. 187 +/- 59 mu mol/l, P = 0.02, respectively). Plasma ADMA levels were similar in the two groups. Patients with CAE had higher plasma homocysteine levels (P = 0.01). Plasma folic acid, vitamin B6, and vitamin B12 levels were similar between the two groups. Conclusion This study shows that patients with CAE have a lower L-arginine/ADMA ratio and higher plasma homocysteine levels. These results show a potential relationship between endothelial dysfunction and CAE.
