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Öğe Appropriateness of the Current Guidelines on Reperfusion Treatment for Patients Applying to Our Hospital With St-Segment Elevation Acute Myocardial Infarction(2012) Karaarslan, Şükrü; Alihanoğlu, Yusuf İzzettin; Yıldız, Bekir Serhat; Sönmez, Osman; Soylu, Ahmet; Bacaksız, Ahmet; Alur, İhsan; Özdemir, Kurtuluş; Düzenli, AkifObjectives: This study investigated the appropriateness of treatment for patients admitted with ST-segment elevation myocardial infarction (STEMI) according to the current guidelines. We also aimed to determine in-patient and out-patient factors affecting optimal re perfusion therapy. Study design: The reperfusion therapy of 176 patients with STEMI was determined. The time period from first contact with a healthcare provider to the time of balloon inflation (door to balloon time), and from the time period of first contact with a healthcare provider to the time of initiation of a thrombolytic (door to needle time) were calculated. Similarly, the time from admission at the emergency service (ES) of our hospital after referral to the moment of balloon inflation (ES to balloon time) and the period from admission to ES at our hospital to the moment of initiation of a thrombolytic (ES to needle time) were calculated. In order to determine the amount of in-hospital delay, the time from ES admission to the call to the cardiology department and the time for the cardiologist to evaluate the patient and transfer time were recorded. Whether the referring physician was a cardiologist and the effect of work hours on the reperfusion period was also recorded. Results: The door to balloon time in the referred patient group was calculated as an average of 228 minutes, while the time for patients directly admitted to ES was calculated as an average of 98 minutes. Patients referred for the mechanical reperfusion period compared to American Heart Association (AHA) guidelines consisted of only 6% of the eligible patients, while according to the European Society of Cardiology (ESC) guidelines 13% of patients were appropriate. Patients who were directly admitted to ES, experienced rates according to AHA guidelines and 73% experienced these rates according to ESC guidelines. We also found no significant effect of working hours or referring physician's specialty (cardiologist or other) on reperfusion time. Conclusion: Compliance rates of reperfusion therapy for patients presenting with STEMI was very low. We realized, when taking into consideration the reasons for delay in terms of both health community and the policy of the country, it is obvious that we have to take strict measures. © 2012 Turkish Society of Cardiology.Öğe Assessment of myocardial velocities and global function of the left ventricle in asymptomatic patients with moderate-to-severe chronic aortic regurgitation: A tissue doppler echocardiographic study(WILEY, 2007) Sokmen, Gulizar; Sokmen, Abdullah; Duzenli, Akif; Soylu, Ahmet; Ozdemir, KurtulusObjective: Asymptomatic patients with chronic aortic regurgitation (AR) have an excellent prognosis in the presence of preserved systolic function. It is a challenge to recognize patients with subclinical myocardial dysfunction in AR. Conventional parameters still have many drawbacks in predicting early left ventricular (LV) dysfunction. Pulsed-wave tissue Doppler imaging (PW-TDI) is a useful noninvasive technique for evaluating global and regional LV systolic function. In this study, we aimed to assess clinical usefulness of TDI in predicting early disturbance of myocardial contractility in asymptomatic patients with significant AR and preserved left ventricular systolic function. Methods and the Results: Echocardiograms were obtained in 32 AR patients and 33 healthy subjects. In addition to conventional parameters, regional myocardial velocities, isovolumetric contraction time (mICT), isovolumetric relaxation time (mIRT), and ejection time (mET) of left ventricle were obtained by TDI and modified LV myocardial performance index (MPI) was calculated. In AR, peak systolic velocity (Sm) of septal and anterior mitral annulus, and mean Sm was significantly lower, and LVMPI was significantly higher compared to control group. Conclusion: The data obtained by TDI show that LV MPI is lengthened, and systolic myocardial velocities are shortened in patients having chronic AR with normal LV systolic function according to conventional echocardiographic parameters. This suggests that LV long-axis contraction and global LV performance are preciously and noticeably decreased in patients with moderate-to-severe chronic AR despite normal LV ejection fraction.Öğe Bir delme dinamometresi tasarım ve imalatı ile HSS-1040 malzeme çiftinde ilerleme kuvveti ve döndürme momentinin analizi(Selçuk Üniversitesi Fen Bilimleri Enstitüsü, 2007-07-02) Soylu, Ahmet; Sağlam, HacıKesme kuvvetlerinin ölçülmesi, takım tasarımını optimize etmede faydalı olup, kesmenin bilimsel analizi için de gereklidir. Son yıllarda takıma etki eden kesme kuvvetlerinin yeterli hassaslıkta ölçülmesi için pek çok farklı dinamometre tasarımı ve imalatı gerçeklestirilmistir. Bu çalısmada, helisel matkaplarla delme islemi esnasında meydana gelen itme kuvveti ve döndürme momenti, takım geometrisi, uzama ölçer teknolojisi ve dinamometre imalatı için gereken kriterlerle ilgili literatür arastırması yapılmıstır. Delme islemi esnasında meydana gelen itme kuvveti ve döndürme momentini ölçebilecek, uzama ölçer esaslı bir dinamometre tasarımı ve imalatı gerçeklestirilmistir. Bu dinamometre ET?AL 44 Alasımlı Alüminyum malzemeden yapılmıs olup, 4000 N'luk itme kuvvetini ve 30 Nm'lik döndürme ii momentini ölçebilecek kapasitededir. Dinamometre statik olarak kalibre edilmistir. Dinamometreden alınan kuvvet ve moment sinyalleri sinyal yükselticiler ve veri toplama kartı arcılığı ile bilgisayara transfer edilmistir. Tam faktöriyel tasarım kullanılarak hazırlanan deney planına göre numuneler farklı matkap geometrisi [uç açısı (y=100°,118°,130°) ve helis açısı (g=20°,25°,30°)] ve kesme parametrelerinde [kesme hızı(v=18,22,28m/dak) ve ilerleme (f=0,1;0,2;0,3mm/dev)] delinmistir. Deneylerde çapı 10 mm TS 95/1, HSSE %10 Co alasımlı yüksek hız çeliğinden özel olarak imal edilmis matkaplar kullanılmıs, deney malzemesi olarak makine parçalarının imalatında yaygın olarak kullanılan gerilim giderme islemi yapılmıs Ç1040 çeliği kullanılmıstır. Deneyler sonunda matkap geometrisi ve kesme parametrelerinin kuvvet ve tork değerleri üzerindeki etkileri analiz edilmistir. Bu analiz sonucunda Ç1040 imalat çeliğinin delinmesinde optimum takım ve kesme parametreleri helis açısı 300, uç açısı 1180, kesme hızı 28 m/dak ve ilerleme 0,2 mm/dev olarak tespit edilmistir.Öğe A Case of Peripartum Cardiomyopathy Presenting With Complete Heart Block(2007) Can, İlknur; Düzenli, Akif; Altunkeser, Bülent Behlül; Soylu, AhmetA 33-year-old woman presented with unconsciousness and complete heart block 20 days postpartum. On admission, her blood pressure was 70/50 mmHg and heart rate was 30/min. Immediately, a temporary transvenous pacemaker was inserted via the right femoral vein and her blood pressure increased to 100/70 mmHg with restoration of consciousness. Echocardiographic examination showed reduced left ventricular systolic function. The following day, complete heart block resolved spontaneously to sinus rhythm with right bundle branch block. Ten days later, right bundle branch block resolved together with improvement in left ventricular ejection fraction. To our knowledge, a case of peripartum cardiomyopathy presenting with complete heart block has not been reported.Öğe A Case of Sinus Venosus Type Atrial Septal Defect (Superior Vena Cava Type) Accompanied by Partial Anomalous Pulmonary Vein Connection Displayed by Multislice Computed Tomography(2010) Soylu, Ahmet; Altunkeser, Bülent BehlülKonjenital kalp hastalığı olan hastaların tedavisi kalp ve büyük damarların detaylı bilgisini gerektirir. Fakat geleneksel metotlarla bazı malfor-masyonların (pulmoner ven malformasyonu gibi) teşhis edilmesi hem zor hem de zaman alıcı olabilir. Biz bu yazıda, sinüs venosus tip atriyal septal defekte (superior vena cava tip) eşlik eden anormal pulmoner venöz dönüşün bulunduğu kompleks bir konjenital kardiyak malformasyonun tespitinde çok kesitli bilgisayarlı tomografinin kullanışlılığını göstermeyi amaçladık.Öğe Comparison of increased aspirin dose versus combined aspirin plus clopidogrel therapy in patients with diabetes mellitus and coronary heart disease and impaired antiplatelet response to low-dose aspirin(EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2008) Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Aygul, Nazif; Soylu, Ahmet; Tokae, MehmetThe effects of therapy with aspirin 300 mg/day and with combined aspirin 100 mg/day plus clopidogrel 75 mg/day on platelet function were compared in patients with diabetes mellitus and coronary artery disease and impaired antiplatelet responses to aspirin 100 mg/day. The study population consisted of 151 outpatients with type 11 diabetes mellitus and coronary artery disease who were taking aspirin 100 mg/day. Of the 151 patients, a subgroup of subjects with impaired aspirin response were selected on the basis of the results of platelet aggregometry. Nonresponsiveness to aspirin was defined as mean aggregation >= 69% with 3 mu mol/L adenosine diphosphate and mean aggregation >= 70% with 2 mu mol/L collagen. Aspirin semiresponders were defined as meeting I but not both of these criteria. Nonresponders and semiresponders were randomized equally to aspirin 300 mg/day and aspirin 100 mg/day plus clopidogrel 75 mg/day, and aggregation tests were repeated after 2 weeks. Sixty of the 151 patients with diabetes (40%) were found to respond to aspirin inadequately. Platelet aggregation induced by adenosine diphosphate and collagen decreased significantly after aspirin 300 mg/day or combined therapy. Combined treatment was found to have a stronger inhibitory effect on platelet aggregation induced by adenosine diphosphate than aspirin 300 mg/day (p = 0.002). Impaired aspirin response was resolved by increasing the aspirin dose or adding clopidogrel to aspirin (p < 0.0001 for each). However, desired platelet inhibition was achieved in significantly more patients by combined treatment than by aspirin 300 mg/day (p < 0.05). In conclusion, aspirin 100 mg/day does not inhibit platelet function adequately in a significant number of patients with diabetes mellitus and coronary artery disease. Increasing the aspirin dose to 300 mg/day or adding clopidogrel to aspirin can provide adequate platelet inhibition in a significant number of those patients with impaired responses to low-dose aspirin. (C) 2008 Elsevier Inc. All rights reserved.Öğe Comparison of myocardial performance index obtained either by conventional echocardiography or tissue Doppler echocardiography in healthy subjects and patients with heart failure(SPRINGER, 2009) Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Aygul, Nazif; Soylu, Ahmet; Aygul, Meryem Ulku; Goek, HasanThis study was planned to investigate the normal reference values of myocardial performance index (MPI) obtained by tissue Doppler echocardiography (TDE) and the agreement between MPI measured by TDE and conventional MPI measured by pulsed-wave Doppler (PWD) in healthy subjects and patients with heart failure (HF). Two hundred and three patients with HF and 190 healthy subjects were enrolled in this study. Isovolumic contraction and relaxation time (ICT and IRT) and ejection time (ET) were measured from mitral inflow and left ventricular (LV) outflow. Tissue Doppler echocardiography recordings were obtained at the septal, lateral, inferior, and anterior of the mitral annulus and same time intervals were measured. Myocardial performance index was calculated. The functional capacity of the patients with HF was determined according to New York Heart Association classification. TDE-MPI values were higher than conventional PWD-MPI values in both groups (53% +/- 8% vs 48% +/- 11%, P < 0.0001 in the healthy subjects; 84% +/- 21% vs 72% +/- 19%, P < 0.0001 in the patients with HF). Moderate agreement was found between PWD-MPI and LV mean TDE-MPI in both groups. In identifying patients with moderately or severely decreased LV ejection fraction, TDE-MPI had higher cutoff values than conventional PWD-MPI, and TDE-MPI had higher specificity, sensitivity, negative predictive value, and diagnostic accuracy. In patients with HF, TDE-MPI had a stronger correlation with LV ejection fraction and functional capacity than did PWD-MPI. TDE-MPI is an alternative to conventional PWD-MPI in assessment of cardiac function. However, the higher MPI cutoff points should be considered when this method is used for the evaluation of cardiac function.Öğe Diyabetik hastalarda kalp hızı değişkenliği ile metabolik parametreler ve inflamasyon arasındaki ilişki(2005) Yazıcı, Mehmet; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Gönen, M. Sait; Yazıcı, Raziye; Soylu, Ahmet; Vatankulu, M. AkifAmaç: Kalp hızı değişkenliği (KHD) diyabetik hastalarda (DM) otonomik disfonksiyonu göstermede güvenilir parametrelerden biridir. Bu çalışmada DM'ta metabolik ve inflamatuvar parametreler ile KHD arasındaki ilişki gösterilmeye çalışıldı. Metod ve bulgular: Çalışmaya benzer yaş grubundan koroner arter hastalığı ve hipertansiyonu olmayan 40 sağlıklı birey (Grup 1, Ortalama yaş 46 13) ve 80 diyabetik hasta (Grup 2, Ortalama yaş 489) alındı. Tüm olguların 24 saatlik Holter monitörizasyonu ile KHD 'time-domain' parametreleri belirlendi. Grup 2'de açlık kan şekeri (AKŞ), tokluk kan şekeri (TKŞ), hemoglobin A1C (HbAlC), serum insülin düzeyi, idrar mikro-albumin düzeyi, fibrinojen ve C-reaktif protein (CRP) düzeyleri çalışıldı. DM'un süresi belirlendi. KHD'nin 'time domain' parametrelerinin tümü grup 2'de düşüktü (p0.05). Grup 2'de KHD ile AKŞ, TKŞ, HbAIC, insülin, idrar mikroalbumini, diyabetin süresi ve fibrinojen arasında korelasyon yoktu (p0.05). CRP ile KHD (pNN50) arasında negatif korelasyon mevcuttu (r-0.37, p0.05). Sonuç: Bu çalışmada KHD ile DM'un süresi ve metabolik parametreler arasında ilişki belirlenmemiştir. DM'ta KHD'ndeki azalmada inflamatuvar reaksiyonların rolü olabileceği sonucuna varılmıştır.Öğe The Effect of Coronary Revascularization on New-Onset Complete Atrioventricular Block Due to Acute Coronary Syndrome(FORUM MULTIMEDIA PUBLISHING, LLC, 2009) Narin, Cueneyt; Ozkara, Ahmet; Soylu, Ahmet; Ege, Erdal; Duzenli, Akif; Sarigul, Ali; Yeniterzi, MehmetBackground: Coronary artery disease is one of the most common causes of complete atrioventricular block (AVB) in adults. In this study, we evaluated whether prompt revascularization of the coronary artery occlusion can ameliorate newonset complete AVB due to acute coronary syndrome (ACS). Methods: Five patients (4 men and 1 woman) with a mean age of 69.8 +/- 7.1 years with diagnosed new-onset complete AVB and proven coronary artery disease were enrolled in the study. At the time of AVB diagnosis, 3 of the patients had acute myocardial infarction, and the other 2 patients had unstable angina pectoris. All patients underwent complete coronary bypass surgery after the diagnosis of complete AVB. A patient who underwent 2 coronary bypasses also underwent aortic valve replacement. Results: No mortality was observed in the study group. All but one of the patients converted back to sinus rhythm after a mean interval of 30 +/- 13.6 hours following revascularization procedures. Complete AVB persisted in 1 patient, and a permanent pacemaker was implanted. All patients were discharged uneventfully. The mean hospital stay was 11.4 +/- 4.5 days. All patients are still being followed up after surgery; at a mean follow-up of 27.4 +/- 0.9 months, there have been no further problems. Conclusion: Coronary revascularization may ameliorate ACS-related new-onset complete AVB with an acceptable rate of successful reversion to sinus rhythm. An especially appropriate time for surgery, complete coronary revascularization, and management of myocardial protection during surgery might improve the results of coronary bypass procedures in these patients.Öğe The effect of diabetes mellitus on the P-wave dispersion(JAPANESE CIRCULATION SOC, 2007) Yazıcı, Mehmet; Özdemir, Kurtuluş; Altunkeser, Bülent Behlül; Kayrak, Mehmet; Düzenli, M. Akif; Vatankulu, M. Akif; Soylu, AhmetBackground P-wave dispersion (PD), a measure of heterogeneity of atrial refractoriness, is defined as the difference between the minimum (P min) and maximum P-wave (P max) durations on standard 12-lead electrocardiography (ECG). Increase in PD shows the intra-atrial and inter-atrial non-uniform conduction. In the present study the evaluation of the effect of diabetes mellitus (DM) on PD in patients without coronary artery disease and hypertension was carried out. Methods and Results Seventy-six diabetic patients who had no coronary artery disease or hypertension (group 1; mean age 48 +/- 9) and 40 healthy volunteer individuals (group2; mean age 46 +/- 13) were enrolled in the study. After obtaining 12-lead surface ECG of all cases, P max and P min P-wave durations were measured and the differences between them were taken as PD (PD=P max-P min). Left atrium diameter, left ventricular end systolic and end diastolic diameters were measured and left ventricular ejection fraction was determined by echocardiography. Pulse wave mitral flow velocities were measured from the apical 4-chamber view. Mitral early diastolic velocity (E), late diastolic velocity (A), E/A, E deceleration time and isovolumetric relaxation time were determined. In comparison of the 2 groups there was no statistically significant difference among age, sex, systolic and diastolic blood pressure, resting heart rate and body mass index of the cases. Although PD and P max were significantly higher in diabetic patients, there was no difference between P min values (33 12 vs 28 +/- 10, p=0.02; 99 +/- 12 vs 93 +/- 10, p=0.011; 66 +/- 9 vs 65 +/- 10, p=NS; respectively). Conclusions DM might increase PD, even without ischemia, hypertension and left ventricular hypertrophy.Öğe Effect of insufficient decrease in nocturnal blood pressure in essential hypertension on right ventriculair functions(SPRINGER, 2007) Soylu, Ahmet; Düzenli, Mehmet Akif; Kadriye, Zengin[Abstract not Available]Öğe The effect of isolated left bundle branch block on the myocardial velocities and myocardial performance index(WILEY, 2008) Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Soylu, Ahmet; Aygul, Nazif; Yazici, Mehmet; Tokac, MehmetObjectives: This study was planned in order to investigate the effect of left bundle branch block (LBBB) on myocardial velocities obtained by tissue Doppler echocardiography (TDE) and myocardial performance index (MPI). Methods: Subjects with LBBB (n = 61) and age-matched healthy subjects (n = 60) were enrolled in the study. Left ventricular (LV) ejection fraction (EF), mitral inflow velocities (E-wave and A-wave), isovolumetric contraction and relaxation time (ICT and IRT), ejection time (ET), and flow propagation velocity (Vp) were measured by conventional echocardiography. Systolic velocity (Sm), early and late diastolic velocities (Em and Am) and time intervals were measured by TDE. MPI was calculated by the formula (ICT + IRT)/ET. Results: LVEF and mitral E/A ratio were similar in both groups. Vp was lower in the LBBB group than in the control group, whereas the E/Em and the E/Vp ratio was higher. LV Sm and Em/Am ratio were lower in LBBB group. Right ventricular Sm and Em/Am ratio were similar in both groups. LV mean and RV MPI were significantly increased in LBBB group. Conclusion: These findings obtained by TDE show that isolated LBBB impairs the ventricular functions. Both of the LV and RV dysfunctions shown by the new parameters may contribute to increased morbidity and mortality in cases with isolated LBBB.Öğe The Effect of Nondipping Blood Pressure Patterns on Cardiac Structural Changes and Left Ventricular Diastolic Functions in Normotensives(WILEY, 2009) Soylu, Ahmet; Duzenli, Mehmet Akif; Yazici, Mehmet; Ozdemir, Kurtulus; Tokac, Mehmet; Gok, HasanBackground: Cardiac structural changes have been reported to be more prominent in nondipper normotensives than the dipper ones. But the influence of nondipping status on cardiac diastolic functions of normotensives has not been studied yet. In this study, we investigated the effect of nondipping status on both cardiac structural changes and left ventricular (LV) diastolic functions in normotensives. Methods: We performed ambulatory blood pressure (BP) monitoring (ABPM) and echocardiography in 62 normotensive subjects with the following criteria: (1) office BP < 140/90 mmHg; (2) average 24-hour ambulatory BP < 130/80 mmHg. Results: In the evaluation by tissue Doppler imaging (TDI), the early diastolic myocardial peak velocity (Em) and Em/late diastolic myocardial peak velocity (Am) ratio (Em/Am ratio) were lower in nondippers than those in dippers (P = 0.009 and P < 0.001, respectively). Isovolumic relaxation time (IRT) and myocardial performance index (MPI) were higher in nondippers than those in dippers (P = 0.036 and P = 0.026, respectively). Nondipping status, independent of other factors, was observed to cause both a decrease in the Em and Em/Am ratio and an increase in IRT. However, its effect on IRT was not statistically significant (coefficient = -0.27, P = 0.027; coefficient = -0.37, P = 0.002; coefficient = 0.20, P = 0.082, respectively). Conclusions: Nondipping of nocturnal BP seems to be a determinant of cardiac remodeling and LV diastolic dysfunction (LVDD) and may result in a cardiovascular (CV) risk independent of the increase in LV mass (LVM) in normotensives. (ECHOCARDIOGRAPHY, Volume 26, April 2009).Öğe Effect of the use of drug eluting stents on the rate of coronary arterial flow(SPRINGER, 2007) Soylu, Ahmet; Düzenli, Mehmet Akif[Abstract not Available]Öğe Effects of menopause on the myocardial velocities and myocardial performance index(JAPANESE CIRCULATION SOC, 2007) Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Sokmen, Abdullah; Soylu, Ahmet; Aygul, Nazif; Gezginc, Kazim; Tokac, MehmetBackground Although menopause is known to increase cardiovascular risk and mortality, the effect of menopause on cardiac functions has not been investigated in detail. This study investigates the effect of menopause on cardiac functions by tissue Doppler echocardiography (TDE) and myocardial performance index (MPI). Methods and Results A total of 72 postmenopausal and 71 age-matched premenopausal women were enrolled in the study. After conventional echocardiographic parameters were measured, TDE recordings were obtained at the septal, lateral, anterior and inferior side of the mitral annulus, and tricuspid lateral annulus. Systolic velocity (Sm), early and late diastolic velocities (Em and Am) and time intervals were measured and MPI was calculated. A sequentially symptom-limited exercise stress test was performed. Although left ventricular (LV) ejection fraction and end-diastolic and end-systolic diameter were similar in both groups, LV septum and posterior wall thickness were higher in postmenopausal women. Mitral early inflow velocity and mitral early inflow velocity:mitral late inflow velocity ratio were significantly lower in postmenopausal women compared to premenopausal women. LV Sm, and LV and right ventricular (RV) Em:Am ratios were lower in postmenopausal women. MPI calculated by TDE was significantly increased in postmenopausal women. In addition, exercise duration and metabolic equivalent values were significantly lower in postmenopausal women than in premenopausal women. Conclusions Menopause negatively affects MPI and myocardial velocities, both of which provide more quantitative data about myocardial functions. These findings indicate that the hormonal changes in menopause impair LV systolic and diastolic functions and RV diastolic function.Öğe Glutathione S-transferase M1 and T1 genotypes and myocardial infarction(SPRINGER, 2013) Cora, Tulin; Tokac, Mehmet; Acar, Hasan; Soylu, Ahmet; Inan, ZiyaMyocardial infarction (MI), which is the most important manifestation of coronary artery disease, is the leading cause of morbidity and mortality in the world. Glutathione S transferases (GSTs) are enzymes responsible for the metabolism of numerous xenobiotics and are known to be polymorphic in humans. We investigated the association between the GSTM1 and GSTT1 gene polymorphisms and MI. The study consists of 296 healthy controls and 324 consecutive patients who had undergone coronary angiography for suspicion of coronary artery disease and with a past history of myocardial infarction. DNA was extracted from whole blood of patient and control. GSTM1 and GSTT1 gene polymorphisms were examined using multiplex PCR. We found that the null GSTM1 was associated with protective effect on MI, although this increase was not significant for GSTM1 (p < 0.054). However, GSTT1 genotype was associated with an increase in the risk of developing MI. In addition to after adjusting other all coronary risk factors, the interactive effect of GSTT1 null genotype remained statistically significant (p < 0.001) for MI disease but GSTM1 null genotype was not statistically significant. Patients, who smoke having the null genotypes of GSTM1, were at a higher risk for developing MI (p < 0.001, OR = 0.41, 95 % CI = 0.240-0.207). There was an effect of interaction of GSTM1 null genotype and smoking on MI development between patient and control groups (p < 0.001). Our results showed that individuals with the null genotypes for GSTM1 had protective effect, while GSTT1 was at a higher risk for MI disease. In addition, there was additional effects of smoking when smoking and non-smoking groups were compared.Öğe Hipertansif Hastalarda Gece Kan Basıncındaki Azalmaya Obezitenin Etkisi(2005) Soylu, Ahmet; Düzenli, M. Akif; Yazıcı, MehmetAmaç: Gece kan basıncı düşüşü olmayan kişilerde kardiyovasküler riskin arttığı bilinmektedir. Bu çalışmada hipertansif kişilerde gece kan basıncındaki azalmaya obezitenin etkisi araştırıldı. Gereç ve Yöntem: Beden kitle indeksi (BMI) 30 ve üzerinde olanlar obez kabul edilerek, 35 obez (17 erkek, 18 kadın; yaş ort.: 49,26,3 yıl) ve 36 nonobez (18 erkek, 18 kadın; yaş ort.: 50.16,2 yıl) olmak üzere yeni teşhis edilen veya daha önce teşhis edilmiş fakat düzenli antihipertansif ilaç kullanmayan ve kan basıncı kontrol altında olmayan toplam 71 esansiyel hipertansiyonlu hasta çalışmaya alındı. Tüm hastalarda 24 saatlik ambulatuvar kan basıncı ölçümü yapıldı. Bulgular: Obez olan grupta gece ortalama sistolik kan basıncı yüksek bulundu. Gündüz kan basıncı değerleri ile kıyaslandığında gece kan basıncı düşüşünün obez grupta daha az olduğu tespit edildi. Sistolik kan basıncına göre her iki grubun "dipper" olduğu görülürken, diyastolik ve ortalama kan basınçlarına göre obez grubun "nondipper" olduğu görüldü. Sonuç: Hipertansif hastalar incelendiğinde obezite kardiyovasküler riskin artışına neden olan gece kan basıncındaki düşüşün azalmasına yani nondipping durumuna katkıda bulunmaktadır.Öğe Hormon replasman tedavisinin kardiyak fonksiyonlar üzerine etkisinin yeni parametrelerle değerlendirilmesi(2004) Düzenli, M. Akif; Özdemir, Kurtuluş; Sökmen, Abdullah; Çelik, Çetin; Soylu, Ahmet; Gezginç, Kazım; Yazıcı, MehmetAmaç: Menopoz nedeniyle meydana gelen değişikliklerden en çok etkilenen sistemlerden biri de kardiyovasküler sistemdir. Bu çalışma, sağlıklı postmenopozal kadınlarda HRTnin kardiyak fonksiyonlar üzerine etkilerinin yeni parametreler kullanılarak değerlendirilmesi amacıyla planlanmıştır. Yöntem: Çalışmaya HRT uygulanacak 35 ve kontrol grubu olarak da aynı özelliklere sahip 32 sağlıklı postmenopozal kadın alındı. Tüm bireylere standart ekokardiyografi yapıldı. Ardından doku Doppler pulsed wave yöntemi uygulanarak miyokardiyal hızlar ile sistolik ve diyastolik zaman intervalleri ölçülerek miyokard performans indeksi (MPİ) hesaplandı. Üç ay sonra elde edilen parametreler, bazal değerlerle karşılaştırıldı. Bulgular: Sol ventrikül (SV) segmenter sistolik miyokardiyal hız (Sm), ortalama Sm ve triküspit Sm değerlerinde her iki grupta da 3 ay sonra değişiklik tespit edilemedi. HRT grubunda SV için ortalama erken miyokardiyal hızı (Em) artarken geç miyokardiyal hız (Am) azaldı. Em/Am oranı ve mitral erken diyastolik doluş hızı/mitral geç diyastolik hızı oranı arttı. MPİ değerlerinde HRT alan grupta üç ay sonra azalma eğilimi vardı. Fakat bu değişiklikler istatistiki anlamlılığa ulaşmadı. Sonuç: Anlamlı olmasa da, 3 ay süreli HRT özellikle SV diyastolik fonksiyonlarında düzelmeye neden olabilir. Bu düzelme eğiliminin anlamlı olup olmadığının ortaya çıkarılması için uzun süreli geniş katılımlı randomize çalışmalara ihtiyaç vardır.Öğe Hyperkalemia-Induced Accelerated Idioventricular Rhythm in a Patient with Acute Renal Failure(Informa Healthcare, 2012) Gül, Enes Elvin; Erdoğan, Halil ibrahim; Yıldırım, Oğuzhan; Soylu, Ahmet; Nikus, Kjell C.Electrolyte disorders can alter cardiac ionic currents and depending on the changes can promote proarrhythmic effects. Potassium (K+) is the most common intracellular cation related to arrhythmic disorders. Hyperkalemia is mainly seen in the setting of impaired renal function. Severe hyperkalemia may lead to rhythm disorders. Herein, we report a patient with accelerated idioventricular rhythm (AIVR) due to hyperkalemia, which was successfully treated with glucose-insulin (GI) infusion.Öğe Impact on Diabetes Mellitus on the Epicardial Coronary Flow Velocity Assessed by the Thrombolysis in Myocardial Infarction Frame Count(SAGE PUBLICATIONS INC, 2009) Soylu, Ahmet; Ozdemir, Kurtulus; Duzenli, Mehmet Akif; Yazici, Mehmet; Tokac, MehmetThe aim of this study is to evaluate the effect of type 2 diabetes mellitus on epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count. The thrombolysis in myocardial infarction Frame count was measured in 272 coronary arteries from 101 patients with type 2 diabetes mellitus and in 271 coronary arteries from 104 age- and gender-matched patients without type 2 diabetes mellitus referred for coronary angiography. The thrombolysis in myocardial infarction frame count was measured only in normal arteries or in arteries Without significant lesion. By both univariate and multivariate analysis, the thrombolysis in myocardial infarction frame count was not related with either type 2 diabetes mellitus or the duration and glycated hemoglobin levels in the patients with type 2 diabetes mellitus. The thrombolysis in myocardial infarction Frame Count Was significantly associated with body surface area, heart rate, and proximal coronary artery diameter. Type 2 diabetes mellitus did not affect epicardial coronary flow velocity assessed by the thrombolysis in myocardial infarction frame count.
