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    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, Yasar
    Objective: 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)
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    Epicardial Fat Tissue Predicts Increased Long-Term Major Adverse Cardiac Event in Patients With Moderate Cardiovascular Risk
    (SAGE PUBLICATIONS INC, 2015) Ulucan, Seref; Kaya, Zeynettin; Efe, Duran; Keser, Ahmet; Katlandur, Huseyin; Aygun, Fatih; Ulgen, Mehmet Siddik
    We investigated the relationship between epicardial fat volume (EFV) measured by multislice computed tomography (MDCT) and long-term major adverse cardiac events (MACEs). Consecutive patients (n = 564) were enrolled in this retrospective study. Patients were divided into tertiles according to EFV. Patients were followed up for an average of 18 months. Patients in each tertile were similar in terms of gender and risk factors. Patients with greater EFV in the third group were more likely to be overweight (P = .001) and older (P = .001). High-density lipoprotein cholesterol levels were relatively lower in the third tertile (45 +/- 9, 45 +/- 11, and 43 +/- 9 mg/dL, respectively; P = .018). The third group had a significantly higher rate of myocardial infarction (0.6%, 1.1%, and 3.7%, respectively; P = .043). The incidence of MACEs during the follow-up period was highest in the third group 15.9% (4.1%, 7.7%, and 15.9%, respectively; P = .001). Epicardial fat volume measured by MDCT was associated with increased long-term cardiovascular risk.
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    Is there any relationship between metabolic parameters and left ventricular functions in type 2 diabetic patients without evident heart disease?
    (BLACKWELL PUBLISHING, 2008) Yazici, Mehmet; Ozdemir, Kurtulus; Gonen, Mustafa Sait; Kayrak, Mehmet; Ulgen, Mehmet Siddik; Duzenli, Mehmet Akif; Yazici, Raziye
    Background: The aim of the present study was to evaluate left ventricle (LV) systolic and diastolic function, using tissue Doppler echocardiography (TDE) and color M-mode flow propagation velocity, in relation to blood glucose status in normotensive patients with type 2 diabetes mellitus (T2DM) who had no clinical evidence of heart disease. Methods: Seventy-two patients with T2DM (mean age 49.1 +/- 9.8 years) without symptoms, signs or history of heart disease and hypertension, and 50 ages matched healthy controls (mean age 46.1 +/- 9.8 years) had echocardiography. Systolic and diastolic LV functions were detected by using conventional echocardiography, TDE and mitral color M-mode flow propagation velocity (V-E). Fasting blood glucose level (FBG) after 8 hours since eating a meal, postprandial blood glucose level (PPG), and HbA(1C) level were determined. The association of FBG, PPG and HbA(1C) with the echocardiographic parameters was investigated. Results: It was detected that although systolic functions of two groups were similar, diastolic functions were significantly impaired in diabetics. No relation of FBG and PPG with systolic and diastolic functions was determined. However, HbA(1C) was found to be related to diastolic parameters such as E/A, Em/Am, V-E and E/V-E (beta = -0.314, P = < 0.05; beta = -0.230, P < 0.05; beta = -0.602, P < 0.001, beta = 0.387, P < 0.005, respectively). In addition to HbA(1C), LV, diastolic functions were also correlated with age and diabetes duration. Conclusion: Diastolic LV dysfunction may develop even in absence of ischemia, hypertension, and LVH in T2DM. FBG and PPG have no effect on LV functions, but HbA(1C) levels may affect diastolic parameters.