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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 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 Completely asymptomatic proximal aortic dissection and massive bullous lung disease: coincidence or is there any etiologic link?(OXFORD UNIV PRESS INC, 2009) Kayrak, Mehmet; Sonmez, Osman; Vatankulu, Mehmet A.; Ulgen, Mehmet S.This case report focuses on a completely asymptomatic proximal aortic dissection in a middle-aged mate smoker with bullous lung disease. The possibility of a relationship between A1-antitrypsin (A1AT) deficiency and aortic dissection is discussed in light of the recent data. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.Öğe Dilemma in predicting the infarct-related artery in acute inferior myocardial infarction: A case report and review of the literature(VIA MEDICA, 2011) Gul, Enes E.; Nikus, Kjell C.; Sonmez, Osman; Kayrak, MehmetThe electrocardiogram (ECG) has being used for decades as a reliable and inexpensive tool to diagnose acute myocardial infarction (AMI). ECG diagnosis of an occluded coronary artery is of the utmost importance. We present the case of a 46 year-old man admitted to our hospital for inferior AMI. The ECG findings suggested right coronary artery occlusion. Coronary angiography showed left circumflex artery occlusion. We also briefly review the literature. (Cardiol J 2011; 18, 2: 204-206)Öğe Does Estimated Glomerular Filtration Rate Have an Effect on Left Ventricular Function after ST-Elevation Myocardial Infarction?(WILEY, 2014) Sonmez, Osman; Vatankulu, Mehmet A.; Tasal, Abdurrahman; Bacaksiz, Ahmet; Ayhan, Selim; Yazici, Huseyin U.; Karakaya, EkremObjectivesLittle is known about whether estimated glomerular filtration rates (eGFR) affect left ventricular (LV) function and gain benefit with antiremodeling treatment in patients with ST-elevation myocardial infarction (STEMI). We investigated the effect of eGFR on LV function using tissue Doppler imaging (TDI) parameters. In addition, we sought to evaluate the antiremodeling effect of standard treatment at follow-up in patients with renal insufficiency (RI) after STEMI. Methods and ResultsA retrospective analysis of 579 patients with STEMI was performed. Patients were divided into 3 groups according to eGFR (Group 1: eGFR>90mL/min per 1.73m(2); Group 2: eGFR=60-89mL/min per 1.73m(2); Group 3: eGFR<60mL/min per 1.73m(2)). Conventional echocardiography and TDI were performed within 48-72hours after STEMI and at 6-month follow-up. The mean left ventricular ejection fraction (LVEF) was significantly lower in Group 3 than in Group 1 (P=0.021). The mean peak systolic velocity (Sm) was significantly lower in Group 3 than in Group 1 and Group 2 (P=0.002 and 0.006, respectively). The estimated GFR had a linear association with Sm and LVEF (P=0.001, r=0.161; P=0.005, r=0.132, respectively). Multivariate analysis showed that an eGFR<60mL/min per 1.73m(2) was an independent predictor of lower Sm and in-hospital mortality. In addition, an antiremodeling effect of standard treatment was seen in all groups at 6-month follow-up. ConclusionsEstimated glomerular filtration rate of <60mL/min per 1.73m(2) was associated with lower LV function after STEMI, and may gain an antiremodeling effect with standard treatment at follow-up.Öğe Electrocardiographic Findings in Patients with Polycythemia Vera(IVYSPRING INT PUBL, 2012) Kayrak, Mehmet; Acar, Kadir; Gul, Enes Elvin; Abdulhalikov, Turyan; Baglicaklioglu, Murat; Sonmez, Osman; Kaya, ZeynettinBackground: The 12-lead surface electrocardiogram (ECG) is a useful tool to predict both atrial and ventricular arrhythmias via P-wave and QT measurements and its derivatives. Polycythemia vera (PV) is a chronic myeloproliferative disorder associated with cardiovascular events. The aim of this study was to assess ECG findings of patients with PV. Method and materials: Sixty patients with PV (34 male, mean age 58 +/- 11 years) and 60 age and gender-matched healthy volunteers were enrolled into the study. From the 12-lead surface ECG, P-wave and both conventional QT measurements and transmyocardial repolarization parameters (T-peak-T-end interval (T-p-T-e) and derivatives) were evaluated digitally by two experienced cardiologists. In addition, a novel parameter, Pi was calculated digitally as the standard deviation of the P-wave duration across the 12 ECG leads. Results: QT duration and corrected QT interval were significantly longer in the PV group compared to healthy controls (p<0.01 and p<0.01, respectively). The T-p-T-e was longer and the T-p-T-e/QT ratio was significantly higher in the PV group compared to the controls. P-wave analyses showed that all P-wave parameters including Pmax, Pmin, P dispersion, and Pi were significantly prolonged in PV patients compared to the controls. The increase of both T-p-T-e and P max in the PV group was independent of age, BMI, diabetes and hypertension, gender, systolic blood pressure, hemoglobin, hematocrit, left atrial dimension, left ventricular end-diastolic diameter and early deceleration time in a univariate analysis of co-variance model (F= 11.097, p= 0.001 and F= 31.537, p= 0.0001, respectively). Conclusion: The present study demonstrated that PV may be associated with electrocardiographic abnormalities of both atrium and ventricle.Öğe Long-Term Immunesuppressive Treatment of Pemphigus Vulgaris as a Predisposing Factor for Native Valve Endocarditis: Report of Two Cases(I C R PUBLISHERS, 2011) Kayrak, Mehmet; Bacaksiz, Ahmet; Gul, Enes E.; Sonmez, Osman[Abstract not Available]Öğe Severe hypokalemia-associated rhabdomyolise and unusual poliuria in patient with primary aldosteronism(2012) Demir, Kenan; Sonmez, Osman; Kayrak, Mehmet; Ozdemir, KurtulusPrimer aldosteronizm hipertansiyon, hipopotasemi, yüksek plazma aldosteron seviyesi ve düşük plazma renin aktivitesiyle kara- kterize bir sendromdur. Bizim takdim ettiğimiz hasta proksimal kas güçsüzlüğü ve yorgunluk şikayetleriyle nöroloji kliniğine başvuran 56 yaşında bir erkek hastaydı. Kontrolsüz kan basıncı nedeniyle anti-hipertansif tedavi planlanması amacıyla kardiyoloji konsultasyonu istenmiş. Ciddi hipokalemiye bağlı (K:1.04) uzamış QT intervali ve dev U dalgaları olması nedeniyle hasta kardiy- oloji kliniğine aritmi riskleri açısından devralındı. Primer hiperaldosteronizm teşhisi konulduktan sonra tedavi başlandı ve tedavi boyunca hastada ciddi poliüri gelişti(19 L/gün).Öğe SPECIAL ATTENTION FOR ELDERLY WOMEN: ATYPICAL LEFT VENTRICULAR APICAL BALLOONING SYNDROME INDUCED BY DOBUTAMINE STRESS TEST: A CASE REPORT(WILEY-BLACKWELL PUBLISHING, INC, 2009) Sonmez, Osman; Duman, Cetin; Duzenli, Mehmet Akif; Tokac, Mehmet[Abstract not Available]
