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Öğe Acute coronary embolism without valve thrombosis in a patient with a prosthetic mitral valve - Successful percutaneous coronary intervention: A case report(FORUM MULTIMEDIA PUBLISHING, LLC, 2007) Yazici, Mehmet; Kayrak, Mehmet; Turan, Yasar; Koc, Fatih; Ulgen, Mehmet S.We present a 44-year-old female patient with anterior myocardial infarction caused by embolization from mitral valve prosthesis due to inadequate anticoagulation. The patient underwent a cardiac catheterization within the 1st hour of arrival. The angiography showed total occlusion of the left anterior descending coronary artery after the second diagonal branch. Percutaneous transluminal coronary angioplasty and stenting were performed, and coronary artery perfusion was restored. The pain disappeared completely immediately after this intervention. Transthoracic echocardiography shortly after this intervention showed normal prosthetic valve function and no thrombus. Transesophageal echocardiography performed 2 days later revealed no thrombus at the prosthetic valve. In conclusion, this case demonstrated that coronary embolism may occur even without prosthetic valve thrombus or dysfunction with suboptimal International Normalized Ratio levels, and can be successfully treated with percutaneous transluminal coronary angioplasty and stenting.Öğe 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, YasarObjective: 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)Öğe The acute effect of trastuzumab infusion on ECG parameters in metastatic breast cancer patients(E M H SWISS MEDICAL PUBLISHERS LTD, 2007) Yavas, Ozlem; Yazici, Mehmet; Eren, Onder; Oyan, BasakObjectives: Although trastuzumab therapy is known to be associated with congestive heart failure, its arrhythmogenic potential has not been studied in detail. The purpose of this study was to determine the acute influence of trastuzumab infusion on electrocardiogram (ECG) parameters in patients with metastatic breast cancer. Patients and methods: Twenty patients with HER2 overexpressing metastatic breast cancer and normal cardiac function were enrolled in this single-centre prospective study. Standard 12-lead ECG recordings were performed at baseline and after trastuzumab infusion (2 mg/kg given over 30 min). P-wave durations, QT and RR intervals were measured and QT dispersion (QTd) and P-wave dispersion (Pd) were calculated. Results: In comparison with baseline, no statistically significant change in any ECG parameters, including QT and RR intervals, P wave durations, Pd and QTd, was observed after infusion of trastuzumab. Conclusion: In this study, no abnormality of atrial and ventricular depolarisation and repolarisation, indicated by Pd and QTd, was detected after infusion of trastuzumab. As Pd and QTd are both known to be associated with increased risk of serious arrhythmias and sudden death, it would appear that trastuzumab has no acute arrhythmogenic potential related to cardiac depolarisation and repolarisation.Öğe The acute effect of tropisetron on ECG parameters in cancer patients(SPRINGER, 2008) Yavas, Ozlem; Yazici, Mehmet; Eren, Onder; Boruban, Cem; Artac, Mehmet; Genc, MineObjectives The 5-hydroxytryptamine 3 receptor antagonists, including tropisetron, ondansetron, granisetron, and dolasetron are agents used effectively for supportive care. They are used for the prevention and treatment of chemotherapy and radiotherapy-induced emesis. Despite their overall excellent safety profile, some electrocardiographic changes related to heart rate and repolarization were reported. Ondansetron, granisetron, and dolasetron were studied on this manner. But to our knowledge, there is no information about the cardiac side effects of tropisetron. In this study, we aimed to determine the acute effects of tropisetron on ECG parameters related to repolarization, heart rate, and systemic blood pressure. Materials and methods Fifty-five cancer patients who received tropisetron for the prevention of acute chemotherapy-induced nausea and vomiting were enrolled into this single center, prospective study. Standard 12-lead ECG recordings were performed at baseline and 30 min after tropisetron (5 mg given over 1 min IV bolus) administration. P wave durations and corrected QT intervals were measured; P wave dispersion and QTc dispersion were calculated. Results In comparison with baseline, mean heart rate significantly decreased 30 min after administration of tropisetron. Tropisetron did not result in a significant change in P wave duration, corrected QT interval, P dispersion, and QTc dispersion. Conclusion In this study, tropisetron did not show any ventricular and atrial arrhythmogenic effect because of repolarization abnormalities. Only it may cause a slight decrease in heart rate.Öğe Complete atrioventricular block associated with rivastigmine therapy(AMER SOC HEALTH-SYSTEM PHARMACISTS, 2008) Kayrak, Mehmet; Yazici, Mehmet; Ayhan, Selim S.; Koc, Fatih; Ulgen, Mehmet S.Purpose. A case of complete atrioventricular block associated with rivastigmine use is presented. Summary. A 67-year-old Turkish woman with Alzheimer's disease was admitted to the hospital because of dizziness and syncope. Her medical history included diagnoses of hypertension (treated with amlodipine 5 mg daily) and diabetes mellitus (treated with nateglinide 120 mg daily). She had been taking both drugs for over five years. She had also been taking rivastigmine 6 mg p.o. daily for five months for the treatment of Alzheimer's disease. She had experienced dizziness since the onset of rivastigmine therapy but had not reported it to any health care provider. On admission, she had a blood pressure measurement of 90/60 mm Hg and a pulse rate of 34 beats/min. A 12-lead electrocardiogram revealed complete atrioventricular block. Echocardiography results, blood electrolyte levels, and cardiac biochemical markers were normal. After initial evaluation, a temporary transvenous pacemaker was implanted via the right femoral vein. Amlodipine and rivastigmine were discontinued. On the first day of hospitalization, a coronary angiogram revealed normal coronary anatomy. Two days later, the complete atrioventricular block resolved spontaneously to sinus rhythm. Rivastigmine 6 mg p.o. daily was reinitiated, and complete atrioventricular block recurred on the fourth day of therapy. A VVI permanent pacemaker was implanted on the fifth day of hospitalization. Amlodipine and rivastigmine were reinitiated. The patient continued rivastigmine 6 mg p.o. daily after permanent pacemaker implantation. A three-month follow-up appointment revealed that no further syncope episodes or dizziness had occurred. Conclusion. A 67-year-old woman developed complete atrioventricular block after receiving rivastigmine for the treatment of Alzheimer's disease.Öğe Does Smoking Amplify the Risk of Acute Myocardial Infarction Related with Pregnancy in Factor V Leiden Carriers?(AKAD DOKTORLAR YAYINEVI, 2009) Yazici, Mehmet; Acar, Kadir; Kayrak, Mehmet; Ayhan, S. Selim; Dogan, Umuttan; Ulgen, Mehmet S.[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 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.Öğe Is enoxaparin injection from the abdominal wall safe in elderly people? A fatal case of rectus sheath hematoma(COLL FAMILY PHYSICIANS CANADA, 2008) Kayrak, Mehmet; Bacaksiz, Ahmet; Yazici, Mehmet[Abstract not Available]Öğe 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, RaziyeBackground: 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.Öğe Pericardial Hemorrhage Due to Acetylsalicylic Acid in a Patient With Essential Thrombocythemia(SAGE PUBLICATIONS INC, 2009) Kayrak, Mehmet; Acar, Kadir; Yazici, Mehmet; Kaya, Coskun; Ayhan, S. Selim; Gok, HasanEssential thrombocythemia is a clonal myeloproliferative disorder that Causes thrombocytosis. Essential thrombocythemia is characterized by increased incidence of thrombosis with arterial event more than venous events and hemorrhagic complications. Acetylsalicylic acid enhances both minor and major bleedings. The authors describe pericardial hemorrhage, which is related to the use of low-dose acetylsalicylic acid in a patient with essential thrombocythemia. The patient was Successfully managed with clopidogrel therapy during the 16 Months follow-up without recurrent thrombotic or hemorrhagic events.Öğe Relation Between Abnormalities in Circadian Blood Pressure Rhythm and Target Organ Damage in Normotensives(JAPANESE CIRCULATION SOC, 2009) Soylu, Ahmet; Yazici, Mehmet; Duzenli, Mehmet Akif; Tokac, Mehmet; Ozdemir, Kurtulus; Gok, HasanBackground: To determine the individual effect of abnormalities in blood pressure (BP) circadian rhythm (non-dipping status (NDS), increased morning BP (MBP) or increased MBP surge (MBPS)) on target organ damage (TOD) and which of these is more closely related to TOD in normotensives. Methods and Results: The 24-h ambulatory BP monitoring (ABPM) and echocardiography were performed and urinary albumin excretion (UAE) was measured in 47 dipper (28 women, mean age 45.8 +/- 9.3) and 32 non-dipper (25 women, mean age 49.1 +/- 8.3 years) normotensive subjects. The left ventricular mass index (LVMI) was higher in non-dipper group (103.8 +/- 24.1 vs 91.6 +/- 23.5 g/m(2), 12, P=0.03). UAE in non-dipper group was higher, but the difference between the two was not statistically significant (18.9 [10.3, 28.9] vs 14.1 [7.5, 23.8], P=0.11). In multivariate analysis, both LVMI and UAE were affected by NDS and MBP independent of other confounding variables (for LVMI; Coefficient=0.27, P=0.01 and Coeffcient=0.37, P=0.001, respectively, and for UAE; Coefficient=0.27, P=0.02 and Coefficient =0.28, P=0.01, respectively). Conclusions: It may be Postulated that increased night and MBP are the factors that cause TOD, and it seems reasonable to attempt to restore normal diurnal rhythm of the BP even in normotensive Subjects. (Circ J 2009; 73: 899-904)Öğe Should We Routinely Screen for Warfarin Gene Polymorphism in Patients with Coumadin Overdose?(AVES, 2016) Gul, Enes Elvin; Erdogan, Halil Ibrahim; Yazici, MehmetGenetic polymorphisms can affect an individual's response to the pharmacological agents. Warfarin has a narrow therapeutic range and dose arrangement may vary from individual to individual. An insufficient dose may fail to prevent thromboembolism and overdose may increase the risk of bleeding. Increasing evidence suggests that genetic variation of CYP2C9 and VKORC1 greatly influences effective warfarin dosing (1). In the present case report, frequently occurring warfarin toxicity was caused by a genetic mutation in the patient with mitral valve replacement.Öğe Surgery of left atrial myxoma as a second primary tumor in a patient previously treated for breast cancer(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012) Narin, Cuneyt; Ege, Erdal; Onoglu, Rasit; Yazici, Mehmet; Sarigul, AliA rising level of experience and advances in cardiac surgery are leading to more operations being performed on elderly patients with other complicated diseases. But cardiac surgery in patients with malignant diseases remains a problem. Although most malignant diseases are curable, surgeons are usually reluctant to perform open heart surgery in patients with advanced tumors and a short life expectancy. Among patients undergoing open heart surgery, the incidence of malignancy is 1.2%. In this article, we present a successful atrial myxoma excision in an elderly patient with treated breast cancer using cardiopulmonary bypass and cardiac arrest.Öğe Three-year follow up of recurrent cardiac echinococcosis simulating myxoma: report of a rare case(GALENOS YAYINCILIK, 2007) Ulgen, Mehmet S.; Yazici, Mehmet; Kayrak, Mehmet; Duzenli, M. Akif; Koc, Fatih[Abstract not Available]
