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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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    Congenitally Corrected Transposition of Great Arteries with Severe Rhythm Disturbances
    (2010) Kayrak M.; Kaya Z.; Gul E.E.; Ulgen M.S.; Yazici M.; Gumus S.; Paksoy Y.
    Within recent years, much scientific attention has been devoted to adults with congenital heart disease (CHD) and probable complications. Congenitally corrected transposition of the great arteries (CCTGA) is a rare, complex form of congenital heart defects. CCTGA is characterized by atrioventricular (AV) and ventriculoarterial (VA) discordance and, hence, by a physiologically normal direction of blood flow. The development of complete AV block and global ventricular dysfunction has been identified as the cause of cardiac death. Although the development of arrhythmias represents a major cause of morbidity and mortality in patients with CHD, the account of all implantations of pacemakers and implantable cardioverter defibrillators (ICD) is less than one percent. This paper presents a case of CCTGA with severe rhythm disorders, discusses probable treatment options, and offers indications of ICD implantation in patients with CHD.
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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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    Investigation of serum homocysteine and coenzyme Q10 (CoQ10) levels in patients with essential hypertension [Esansiyel hipertansiyon hastalarinda serum koenzim Q10 (CoQ 10) ve homosistein düzeylerinin araştirilmasi]
    (2010) Şanlitürk Ş.; Mehmeto?lu I.; Kurban S.; Yazici M.
    Objective: Coenzyme Q10 (CoQ10, ubikinon) the only lipid soluble antioxidant synthesized endogenously, prevents the generation of free radicals as well as oxidative modifications of proteins, lipids, and DNA. Also, CoQ10 is as an electron carrier in the mitochondrial respiratory chain. Decreased levels of CoQ10 in humans are observed in many pathologies such as cardiac disorders, neurodegenerative diseases. Homocysteine is a naturally occuring, sulfur containing amino acid and elevated serum homocysteine levels is an independent risk factor for cardiovascular disease. In this study we have aimed to investigate the roles of homocysteine and CoQ10 levels in essential hypertension. Material and Methods: The study was performed on 30 patients (10 M, 20 F) with essential hypertension aged 38-79 years (57.23 ± 10.68) and 30 healty controls (12 M, 18 F) aged 38-83 years (56.50 ± 11.36). Fasting serum homocysteine and CoQ 10 levels of the subjects were measured by HPLC (high performance liquid chromatography) method. Results: Homocysteine levels of the patients with essential hypertension (17.35 ± 4.81 ?mol/L) were found significantly higher (p< 0.01) than that of the controls (11.16 ± 3.18 ?mol/L), while CoQ10 levels of the patients were (801.22 ± 285.91 ?g/L) slightly but not significantly lower than those of the controls (810.07 ± 278.63 ?g/L). Conclusion: It was concluded that high serum homocysteine levels may plays a role in the pathogenesis of essential hypertension whereas there was no contribution of CoQ10 levels to the pathogenesis of this disease. Copyright © 2010 by Türkiye Klinikleri.
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    Isolated mitral valve prolapsus does not affect left ventricular function [İzole mitral kapak prolapsusu sol ventrikül fonksiyonunu etkilemez]
    (2011) Demir K.; Koc F.; Can I.; Vatankulu M.A.; Yazici M.; Ülgen M.S.
    Aim: Idiopathic mitral valve prolapsus (MVP) is characterized by myxomatous degeneration of mitral valve. The most common determinant of cardiovascular mortality in patients with MVP is left ventricular (LV) dysfunction. Therefore we aimed to evaluate LV functions of cases with isolated MVP by tissue Doppler echocardiography (TDE). Method: Twenty five patients with MVP (mean age, 31±12 years) were enrolled the study as MVP group. Control group was consisted 20 age and sex matched patients (mean age, 34±9 years) were enrolled to this study. LV functions were detected by using conventional echocardiography and TDE. Myocardial peak systolic (Sm), early (Em) and late (Am) diastolic filling velocities, Em/Am, isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT) and ejection time (ET) were obtained in the basal segments of the inferior-septal and lateral wall. Myocardial performance index (MPI) was calculated. Result: Mild degree mitral regurgitation was present in 10 (40%) of patients with MVP, and moderate degree mitral regurgitation was present in 2 (8%) of patients. No difference was found between the two groups with regard to diastolic parameters. TDE-derivated MPI values were similar in all segments in two groups. There was significant difference between the two groups with regard to LV mean Sm and lateral wall Sm (11.6±2.8 vs. 9.4±1.0, p=0.001; 13.0±3.9 vs. 9.2±2.3, p=0.001 respectively). Conclusion: Isolated MVP without significant mitral regurgitation does not affect LV diastolic functions and MPI. However, Sm of late ral wall and LV mean was higher in patients with MVP than patients without MVP.
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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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    Thrombus entrapped in a patent foramen ovale presenting with acute pulmonary embolism [Akut pulmoner emboli ile ortaya çkan patent foramen ovale içine tuzaklanmış trombüs]
    (AVES, 2010) Kayrak M.; Kaya Z.; Ülgen M.S.; Yazici M.; Karaaslan Ş.; Ayhan S.S.
    [Abstract not Available]
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    Uvula haematoma: a rare complication after thrombolysis and intensive anti-platelet treatment.
    (2007) Kayrak M.; Ulgen M.S.; Yazici M.; Kiliç D.; Gok H.
    [Abstract not Available]