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    Acute myocardial infarction provoked by smoking and xylometazoline use in a patient with normal coronary arteries [Koroner arterleri normal olan bir hastada sigara ve ksilometazolin kullaniminin tetikledi?i akut miyokard infarktüsü]
    (2006) Kayrak M.; Ülgen M.S.; Koç F.; Soylu A.
    Coronary vasospasm is a cause of acute coronary syndrome. Many factors, in particular smoking may induce vasospasm. Xylometazoline is a commonly used sympathomimetic to provide decongestive action with topical effect. A 50-year-old male patient was admitted with typical angina pectoris that developed after heavy smoking. Coronary angiography showed normal coronary anatomy. One month later, he presented with myocardial infarction of ST elevation following high dose of xylometazoline application. There was no other cause to provoke coronary vasospasm. This case underlines the need for a thorough investigation into drug use in young and relatively low-risk patients presenting with chest pain.
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    Comparison between brachial blood pressures obtained by aneroid sphygmomanometer and central aortic pressures: Factors affecting the measurements [Aneroid sfigmomanometreyle ölçülen brakiyal arter basincinin santral aortik basinçla karşilaştirilmasi ve farka etki eden faktörler]
    (2008) Kayrak M.; Ülgen M.S.; Yazici M.; Demir K.; Do?an Y.; Koç F.; Zengin K.
    Objectives: We compared brachial artery blood pressures (BP) measured by aneroid sphygmomanometer with ascending aortic blood pressures and evaluated the factors affecting the differences between the two methods. Study design: The study included 463 patients (177 women, 286 men; mean age 60±11 years) undergoing routine coronary angiography. Simultaneously, ascending aortic pressures were measured using a pigtail catheter and brachial artery pressures were measured from the right arm with an aneroid sphygmomanometer. Pulse pressure, fractional pulse pressure, and pulsatility index were calculated from systolic and diastolic BP values. Results: Overall, systolic (-3.1±10 mmHg) and diastolic (+3.0±7.1 mmHg) brachial pressures showed significant deviations from aortic pressures (p=0.001). Although systolic BP did not differ significantly in both methods for men and women, brachial diastolic BP was significantly different in women (+4.8 mmHg, p=0.0001). Brachial diastolic BP showed a greater deviation from the aortic diastolic pressure in patients ?60 years of age (+4.5 mmHg and +1.1 mmHg, respectively; p=0.0001). Deviation of systolic BP in hypertensive patients (-4 mmHg) was greater than that in normotensives (-2.0 mmHg, p=0.04). Deviation of brachial systolic BP was highly correlated with increases in aortic systolic pressure (p=0.0001). Differences between the two methods in systolic (-5.8 mmHg, p=0.01) and diastolic (+4.2 mmHg, p=0.03) BP were significant in patients with coexisting diabetes and hypertension. Body mass index and arm circumference were not correlated with deviations between the two methods. Conclusion: The main factors (female gender, age, hypertension, diabetes) affecting BP differences between the two methods should be considered in clinical practice.
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    Diastolic functions and myocardial performance index in obese patients with or without metabolic syndrome: A tissue Doppler study
    (2010) Koç F.; Tokaç M.; Kaya C.; Kayrak M.; Yazici M.; Karaba? T.; Vatankulu M.A.
    Objectives: This study was designed to evaluate left ventricular (LV) diastolic functions and myocardial performance index (MPI) in obese individuals with or without metabolic syndrome (MetS). Study design: The study included 44 obese subjects with MetS (16 men; 28 women; mean age 46±7 years) and 32 obese subjects without MetS (16 men, 16 women; mean age 43±9 years). Diagnosis of MetS was based on the ATP III criteria. Obesity was defined with a body mass index (BMI) of ?30 kg/m2. All the subjects underwent echocardiography and tissue Doppler imaging to determine LV diastolic functions and MPI. Clinical and echocardiographic characteristics of obese subjects were compared with those of a control group consisting of 21 healthy, nonobese individuals (10 men, 11 women; mean age 42±4 years). Results: Waist circumference, weight, and BMI were similar in the two obese groups. Control subjects and obese subjects without MetS had similar systolic and diastolic blood pressures, fasting blood glucose, triglyceride, and HDL cholesterol levels, but all these significantly differed in patients with MetS. Left ventricular mass, mass index, and diastolic parameters were similar in the two obese groups, but differed significantly from the controls (p<0.05). Body mass index was correlated with the LV mass (r=0.42, p=0.001) and mass index (r=0.33, p=0.001). Left ventricular MPI was similar in the two obese groups with (0.59±0.10) and without (0.59±0.11) MetS, but was higher compared to the control group (0.48±0.06, p<0.05). Left ventricular MPI was correlated with BMI, waist circumference, LV mass, and mass index (r=0.24, p=0.02; r=0.30, p=0.005; r=0.31, p=0.002; r=0.21, p=0.04, respectively). Conclusion: Our findings demonstrate that obesity with or without MetS affects LV MPI. In addition, LV MPI showed significant correlations with BMI, waist circumference, and LV mass.
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    Ghrelin, resistin and leptin levels in patients with metabolic syndrome [Metabolik sendromlu hastalarda grelin, rezistin ve leptin düzeyleri]
    (2011) Koç F.; Tokaç M.; Kocabaş V.; Kaya C.; Büyükbaş S.; Erdem S.; Karaba? T.
    Aim: This study was designed to compare the fasting ghrelin, leptin and resistin levels between metabolic syndrome (MS) patients with healthy controls. Method: This trial was performed on 21 patients with MS (7 men; mean age, 44±4 years) and 17 healthy controls (8 men; mean age, 43±3 years). Diagnosis of MS was defined based on National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria. Patients meeting at least 3 of the MS criteria, with a body mass index (BMI) ?30 kg/m2 were included in the MS group. Among healthy volunteers, those with a BMI<30 kg/m2 were selected as the control group. Plasma ghrelin, serum leptin and resistin concentrations were measured by ELISA method. Result: Ghrelin levels were similar between MS and control groups. There was a negative correlation detected between ghrelin levels with BMI and leptin levels (r=-.54, P=.01 and r=-.56, P=.009, respectively). Resistin levels were found similar between MS with control groups. Leptin levels were significantly higher at the MS group than control group (35±17 ng/ml vs. 14±8 ng/ml, P=.001). Leptin levels had a positive correlation with BMI (r=.56; P=.008). Conclusion: We have demonstrated that leptin levels in MS group were higher than control group. However, ghrelin and resistin levels were similar to control group. In addition, we have showed leptin levels has a positive correlation with BMI and a negative correlation with ghrelin levels.
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    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.
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    Successful stent implantation to bilateral renal artery stenosis in a case with diffuse atherosclerotic involvement.
    (2008) Yazici M.; Ulgen M.S.; Kayrak M.; Koç F.; Zengin K.
    [Abstract not Available]
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