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Öğe Angiotensin-converting enzyme, angiotensin II receptor, apolipoprotein E and endothelial constitutive nitric oxide synthase gene polymorphisms in dilated cardiomyopathy(2004) Özhan, Hakan; Zungur, Mustafa; Yazıcı, Mehmet; Akdemir, Ramazan; Gündüz, Hüseyin; Erbilen, Enver; Kaya, G.Genetic factors are hypothesized to contribute to the dilated cardiomyopathy (DCM) susceptibility, even in sporadic cases. Abundant reports have investigated the association between various gene polymorphisms and the phenotypic expression of DCM. The aim of the present study is to assess the effect of four candidate gene polymorphisms (1166 A/C polymorphism of the angiotensin II type 1 receptor (AGTR1) gene, I/D polymorphism of angiotensin converting enzyme (ACE) gene, endothelial nitric oxide synthase (ec-NOS) and apolipoprotein E (APOE genes) on the pathogenesis of dilated cardiomyopathy. We studied 76 consecutive patients (mean age 58±12) with DCM and 88 healthy age- and sex-matched control subjects (mean age 59±12). All patients were assessed by 2-dimensional echocardiography and all had left ventricular dilatation (end diastolic diameter >55 mm) and impaired systolic function (ejection fraction <40%). All patients were catheterized. Patients having normal coronary arteries were classified as 'idiopathic' and the remaining group as 'ischemic' DCM. Patients with specific heart muscle disease, isolated right ventricular dilatation and valvular or pericardial disease were excluded. Deoxyribonucleic acid (DNA) was isolated from blood samples, and genotypes were determined by specific polymerase chain reaction (PCR) and separation of amplified fragments by agarose gel electrophoresis. We compared genotypes and allele frequencies, echocardiographic measurements, biochemical variables in our patients and control group. Age, sex, body mass index differences were statistically non-significant. APO E genotypes and allele frequencies were significantly different in patients with DCM. Multiple regression analyses demonstrated lack of independent association. Subgroup analysis revealed that the four candidate gene polymorphisms were not associated with ischemic or idiopathic DCM. Conclusions: No significant association exists between dilated cardiomyopathy and polymorphism of the AGTR1, ACE, ecNOS and APOE gene polymorphisms.Öğe A case of hypothyroidism mimicking acute coronary syndrome(Springer, 2006) Gündüz , Hüseyin; Arınç, Hüseyin; Yolcu, Mustafa; Akdemir, Ramazan; Kanat, Mustafa; Uyan, CihangirHypothyroid patients have increased concentrations of creatinine kinase that is mostly due to increased CK-MM. However, CK-MB has also been reported to increase above reference values in hypothyroid patients without apparent myocardial damage. This may create confusion during the evaluation of myocardial injury in a hypothyroid patient presenting with chest pain. Troponin I is considered as a superior marker for the diagnosis of myocardial infarction in hypothyroid patients. However, there are some reports showing an increase in the level of troponin I without any myocardial damage in hypothyroid patients as in our case. In this report, we present a 47 years old male hypothyroid patient who had chest pain, abnormal electrocardiographic findings and increased cardiac enzymes suggesting acute coronary syndrome although he had normal coronary arteriogram.Öğe A closed interatrial septal aneurysm mimicking a tumor in the left atrium(Texas Heart Inst, 2006) Akdemir, Ramazan; Duran, Sadık; Bulur, Serkan; Kaya, Ahmet; Sözen, Serhat Bahadır; Bilir, Cemil; Uyan, Cihangir…Öğe Color M-mode regurgitant flow propagation velocity: A new echocardiographic method for grading of mitral regurgitation(Blackwell Publishing, 2005) Akdemir, Ramazan; Özhan, Hakan; Bulur, Serkan; Ünlü, Hakan; Gündüz, Hüseyin; Arınç, Hüseyin; Uyan, CihangirPurpose: The aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). Methods: We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients, and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA), and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these three methods was determined. Results: The mean RFPV for mild, moderate, and severe MR were 26.4 +/- 7 cm/sec, 43.3 +/- 7 cm/sec, and 60.3 +/- 7.3 respectively (P < 0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1%-64.3% for mild and 100%-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC, and RJA (P < 0.0001, r = 0.87; P < 0.0001, r = -0.84, P < 0.0001, r = 0.76, respectively). Conclusion: This results show that RFPV is a reliable and simple semiquantitative new method that can be used for determining severity of MR.Öğe Complete atrioventricular block in Becker Muscular Dystrophy: A case report(2003) Akdemir, Ramazan; Uyan, Cihangir; İmirzalıoğlu, Necat; Yazıcı, MehmetCardiac involvement in Becker Muscular Dystrophy, including dilated cardiomyopathy, mild to moderate degree mitral regurgitation, cardiac conduction system abnormalities and various arrhythymias, is one of the leading problems during the progression of the disease (1,2). But, complete atrioventricular block associated with Becker Muscular Dystrophy which necessitates permanent pacemaker implantation is a rare condition. We reported a patient with Becker Muscular Dystrophy which complicated complete atrioventricular block and dilated cardiomyopathy.Öğe Coronary-subclavian steal syndrome presenting with chest pain and syncope(Acta Cardiologica, 2004) Akdemir, Ramazan; Özhan, Hakan; Tataroğlu, CenkThe present case is a 68-year-old patient with complaints of chest pain and syncopal attacks during physical activity of the left arm, for the last six months. He had a coronary artery bypass graft operation 10 years ago. Angiographic examination demonstrated total occlusion of the subdavian artery. The subdavian artery was stealing blood from the left anterior descending artery via the left internal mammary artery and from the brain via the left vertebral artery, leading to the diagnosis of subdavian artery steal syndrome; a rare cause of coronary and cerebral ischaemia.Öğe Ebstein's anomaly in siblings: an original observation(Kluwer Academic Publ, 2002) Uyan, Cihangir; Yazıcı, Mehmet; Uyan, Ayten Pamukçu; Akdemir, Ramazan; İmirzalıoğlu, Nejat; Dokumacı, BarbarosSiblings, a 26-year old male and a 31-year old female, were found do have Ebstein's anomaly. Ebstein's anomaly is characterized by a downward displacement of the tricuspid valve into the right ventricle due to anomalous attachment of the tricuspid leaflets. Echocardiography is the method of choice to diagnose Ebstein's anomaly on its own or in association with other heart defects. Complications such as right ventricular failure, infective endocarditis, and paradoxical embolism can occur. Ebstein's anomaly diagnosed in adult life is a benign and stable disease, particularly if the patient is asymptomatic. These cases may represent a familial form of Ebstein's anomaly.Öğe The effect of decreasing preload on valvular regurgitation in patients undergoing dialysis [Diyalize giren hastalarda önyük azalmasinin kapak yetersizliklerine etkisi](Turkiye Klinikleri, 2005) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Akdemir, Ramazan; Oğuzhan, Abdurrahman; Uyan, CihangirObjective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis. Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated. Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted. Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure. Copyright © 2005 by Türkiye Klinikleri.Öğe Effect of reperfusion on P-wave duration and P-wave dispersion in acute myocardial infarction: Primary angioplasty versus thrombolytic therapy(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Tamer, Ali; Yazıcı, Mehmet; Erbilen, Enver; Uyan, CihangirAtrial fibrillation is a common arrhythmia occurring in about 10-20% of patients with acute myocardial infarction. P-wave dispersion and P-wave duration have been used to evaluate the discontinuous propagation of sinus impulse and the prolongation of atrial conduction time respectively. This study was conducted to compare the effects of reperfusion either by thrombolytic therapy or primary angioplasty on P wave duration and dispersion in patients with acute anterior wall myocardial infarction. We have retrospectively evaluated 72 consecutive patients (24 women, 48 men; aged 58 ±12 years) experiencing a first acute anterior wall myocardial infarction (AMI). Patients were grouped according to the reperfusion therapy received (primary angioplasty (PTCA) versus thrombolytic therapy). Left atrial diameter and left ventricular ejection fraction (LVEF) were determined by echocardiography in all patients. Electrocardiography was recorded from all patients on admission and on pach day of hospitalization. Maximum (P max) and minimum (P min) P wave durations and P wave dispersions (PWd) were calculated before and after treatment. There were no significant differences between the groups regarding age, gender, left ventricular ejection fraction (LVEF), left atrial diameter and volume, cardiovascular risk factors and duration from symptom onset to treatment. PWd and P wave durations were significantly reduced after PTCA (mean P max was 113±11 ms before and 95±17ms after the treatment [p=0.007]. Mean PWd was 46±12 ms before and 29±10 ms after the treatment (p=0.001). Also, P max and PWd were significantly lower in PTCA group (for P max 97±22 ms versus 114±16 ms and for PWd 31±13 ms versus 55±5 ms, respectively). Primary angioplasty reduces P max and P wave dispersion.Öğe Elastic properties of the ascending aorta and left ventricular function in patients with hypothyroidism(Blackwell Publishing, 2005) Özhan, Hakan; Yazıcı, Mehmet; Albayrak, Sinan; Erbilen, Enver; Bulur, Serkan; Akdemir, Ramazan; Uyan, CihangirBackground: We sought to clarify the possible role of elastic properties of the ascending aorta in the development of cardiac disease associated with hypothyroidism (HT). Methods: A total of 37 patients with HT (age: 39.3 +/- 8.9years) and 29 control subjects were studied. AscendingAortic (Ao) diameter, Ao elastic indexes, strain (AoST), distensibility (AoD), stiffness index (AoSI), and pressure strain modulus were calculated from the echocardiographically derived Ao diameters. Myocardial performance index (MPI), E/A ratio, isovolumetric relaxation time (IVRT), deceleration time (DT) were measured by Doppler echocardiography to assess diastolic LV function. Patients were treated with levothyroxine and followed-up for 6 months. Thyroid function tests and echocardiographic measurement's were repeated at the end of the study. Results: AoD (cm(2) dyn(-1) 10(-3)) and AoST (%) were significantly lower (3.8 vs. 6.1; P < 0.001, 7.4 vs. 12.6, P < 0.001; respectively), whereas AoSI was higher in HT patients (6.2 vs. 3.3; P < 0.001). After treatment, AoD and AoST were increased (5.7; P < 0.001 and 11.8; P < 0. 001; respectively), whereas AoSI was decreased significantly (3.7; P < 0. 001). Also, early / late mitral peak velocity ratio (Emax/Amax) was significantly lower in HT patients (1.19 vs 1.34; P < 0.001), whereas MPI was higher (0.52 vs. 0.42; P < 0.001). MPI showed a strong correlation with aortic root indexes [AoST (r = -0.61/P < 0.001); AoD, (r = -0.57/P < 0.002); AoSI, (r = 0.531P < 0.005)] in the HT group. After 6 months of therapy, MPI significantly decreased P < 0.001) and EIA ratios were normalized (P < 0.001). Conclusions: Ao root functions have an important role on diastolic LV function. Levothyroxine replacement therapy can reverse all of these adverse effects of HT.Öğe Embolised stent into the circumflex coronary artery during percutaneous coronary intervention(International Heart Journal Association, 2006) Uyan, Cihangir; Gündüz, Hüseyin; Arınç, Hüseyin; Akdemir, RamazanDislodgement and embolisation of the new generation of coronary stents before deployment are rare. If it is impossible to withdraw the embolised stent from the coronary artery, the stent may be crushed into the side wall of the coronary artery with a balloon over a wire passed alongside the embolised stent.Öğe Heart rate turbulence and heart rate variability in patients with mitral valve prolapse(Oxford Univ Press, 2006) Gündüz , Hüseyin; Arınç, Hüseyin; Kayardı, Mahmut; Akdemir, Ramazan; Özyıldırım, Serhan; Uyan, CihangirAims Heart rate turbulence (HRT) and heart rate variability (HRV) have been shown to be independent and powerful predictors of mortality in a specific group of cardiac patients. However, the predictive valsue of HRV alone is modest and information on HRV in patients with mitral valve protapse (MVP) has so far been conflicting. In addition, no studies have previously evaluated HRT in patients with MVP. To define better the effects of MVP on cardiac autonomic function, we assessed HRT and time-domain parameters of HRV in patients with MVP. Methods and results Fifty patients with MVP and 70 controls without MVP were investigated. The diagnosis of MVP was confirmed by cross-sectional echocardiography in the parasternal long-axis view and apicat 4-chamber view. The HRV and turbulence analysis were assessed from a 24-hour Hotter recording. When HRT parameters were compared, the values of the HRT onset and slope were significantly lower in MVP patients than in the controls group (-0.109 +/- 0.207 vs. -0.289 +/- 0.170%, P = 0.001 and 8.6 +/- 7.2 vs. 11.5 +/- 7.4 ms/RRI, P = 0.043, respectively) and the number of patients who had abnormal HRT onset was significantly higher in the MVP group than in controls (15 vs. 8, P = 0.011). In addition, HRV parameters were not statistically different between the two groups. Conclusion Although we found that the decrease in HRV parameters was not significantly different between MVP patients and controls, HRT variables (especially HRT onset) were significantly lower in MVP patients. Therefore, in our opinion, HRT is an attractive, easily applicable, and better way of non-invasive risk prediction compared with another non-invasive risk predictor, HRV.Öğe HLA-DR B1 and DQ B1 polymorphisms in patients with coronary artery ectasia(Acta Cardiologica, 2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Erbilen, Enver; Yazıcı, Mehmet; Duran, Sadık; Uyan, CihangirObjectives - The purpose of our study was to evaluate the significance of polymorphisms in HLA class II genes in coronary artery ectasia (CAE) patients. Methods and results - Twenty-six patients with CAE without associated cardiac defects were enrolled in the study. CAE was defined as luminal dilation of 1.5- to 2.0-fold of normal limits. Ninety-five healthy subjects who were donors for different organ transplantations, were chosen as control group. Physical examination, electrocardiography and chest X-ray were completely normal in these cases. Both the patients and the control group were screened and compared for their HLA class II genotypes. HLA-DR BI * 13, DR 16, DQ2 and DQ5 genotypes were significantly more frequent in the patient group. When the known risk factors of coronary heart disease were compared in the patients carrying these genotypes with the non-carrying group, no significant differences were encountered. Conclusions - HLA-DR BI * 13, DR 16, DQ2 and DQ5 may be associated with the pathogenesis and increase the risk of CAE.Öğe Images in Emergency Medicine: Acute severe coronary spasm associated with 5-fluorouracil chemotherapy(Bmj Publishing Group, 2006) Duran, Sadık; Bulur, Serkan; Sözen, Serhat Bahadır; Bilir, Cemil; Uyan, Cihangir; Akdemir, Ramazan…Öğe Immediate and six months clinical and angiographic results of intracoronary Ephesos stent implantation: the "Ephesos-1" study(Taylor & Francis Ltd, 2005) Uyan, Cihangir; Akdemir, Ramazan; Gündüz , Hüseyin; Özhan, Hakan; Arınç, HüseyinBackground - This study was conducted to evaluate the clinical and angiographic results of the Ephesos stent implantation in patients with symptomatic coronary artery disease. The Ephesos stent is a new balloon-expandable, stainless steel, tubular stent with multicellular design. Methods - One hundred ten patients with native coronary artery disease were included in the study. The Ephesos stents were implanted in 163 de novo lesions detected in these patients. Immediate and long-term clinical and angiographic follow-up results were evaluated. Results - Most of the patients had unstable angina 63.6%, and 36.7 % of the lesions were type B and C. Mean lesion length was 12.7 +/- 4.7. In 62% of the patients the reference lumen diameter was < 3 mm. One Q-wave and one non-Q-wave myocardial infarction (MI) occurred due to acute thrombotic occlusion during hospital stay. The 6-month event-free survival rate was 77.3%. No patients died in the six-month follow-up period, but 2 patients had non-Q wave MI and I patient experienced Q-wave MI within this period. Control angiographic data was collected from I 10 patients (100% of patients and a total of 163 lesions). Angiographic restenosis rate was 18.1 %. Twenty-two patients with restenosis had repeated target lesion balloon dilatation. Conclusion -The results of the present study showed that the Ephesos stent is a safe and effective choice with a low incidence of major adverse cardiac events and restenosis rate within six months of follow-up.Öğe Increased P wave dispersion in hypothyroidism: a sign of risk of atrial fibrillation(Tubitak Scientific & Technical Research Council Turkey, 2009) Akdemir, Ramazan; Eryaşar, Neslihan Ebru; Çelik, Kudret; Güngüneş, Aşkın; Cinemre, Hakan; Bilir, Cemil; Kılıç, HarunAim: As in hyperthyroidism, cardiac arrhythmias can be seen in hypothyroidism. In this study, we measured P wave dispersion among hypothyroid patients to evaluate atrial fibrillation risk. Methods: 75 patients who received first time diagnosis of hypothyroidism and 40 normal control patients were included in this study. Each patient had echocardiographic and electrocardiographic studies were carried out. Groups were compared for statistically significant difference in P wave dispersion, minimum P wave duration and maximum P wave duration. Results: The groups were similar in echocardiographic and electrocardiograpic features. P wave dispersion was significantly higher in the hypothyroid group compared to normal controls (31.9 +/- 9.3 ms vs. 26.5 +/- 9.4 ms, p = 0.003). Minimum P wave duration was significantly shorter in the hypothyroid group compared to controls (63.8 +/- 9.2 ms vs 68 +/- 9.2ms, p = 0.026). Maximum P wave duration was not significantly different between groups (95.4 +/- 12.3 ms vs. 94.7 +/- 8.7 ms, p.0, 74). Conclusion: P wave dispersion was increased in the first time diagnosed clinical hypothyroid patients. This is the first study to evaluate P wave dispersion in clinical hypothyroid patients. We believe that our findings have clinically important implications and provide insight into possible mechanisms of this morbid condition.Öğe Increased Serum Asymmetric Dimethylarginine Levels in Primary Dysmenorrhea(Karger, 2010) Akdemir, Nermin; Cinemre, Hakan; Bilir, Cemil; Akın, Okhan; Akdemir, RamazanBackground: Primary dysmenorrhea is a common disorder among young women, and uterine ischemia plays an important role in pelvic pain. Asymmetric dimethylarginine (ADMA) is accepted as a strong marker of endothelial dysfunction. Objective: To investigate the role of ADMA in primary dysmenorrhea. Methods: Thirty-three patients with primary dysmenorrhea and 29 healthy controls were evaluated in a hospital outpatient clinic-based study. Secondary causes of dysmenorrhea had been ruled out in each patient. LDL cholesterol, triglycerides measured and body mass index were also calculated. Blood samples for determination of ADMA concentration were drawn on the 3rd day of menses in each woman. Groups were compared for statistically significant difference by Mann-Whitney U test. Results: Groups did not differ in age or hormone levels. ADMA level was higher in women with dysmenorrhea compared to healthy controls (Mann-Whitney U test, Z = -2.24, p = 0.025). ADMA levels showed positive correlation with age and erythrocyte sedimentation rate in the first group (Spearman's rho = 0.360, p = 0.040, and r = 0.379, p = 0.029, respectively). Although erythrocyte sedimentation rate and C-reactive protein (CRP) were positively correlated, no significant correlations were found between high-sensitivity CRP and ADMA level in the first group (Spearman's rho = 0.048, p = 0.749). Conclusion: ADMA concentrations are elevated in primary dysmenorrhea compared to healthy controls. This suggests that endothelial dysfunction plays a role in primary dysmenorrhea. Copyright (C) 2009 S. Karger AG, BaselÖğe Koroner anjiyografi yapılan hastalarda iohexolün solunum fonksiyon testi parametrelerine etkisi(2004) Akdemir, Ramazan; Özhan, Hakan; Balbay, Öner Abidin; Erbaş, Mete; Gündüz, Hüseyin; Arbak, Peri Meram; Uyan, CihangirAmaç: Damar içine uygulanan anjiyografik kontrast ajanlara bağlı olumsuz yan ekilerin varlığı daha önceki çalışmalarda bildirilmiştir. Bu çalışmanın amacı günlük uygulamada “iohexolün”ün koroner anjiyografi sırasında kullanımına bağlı solunumsal etkilerini incelemektir. Materyal ve Metod: Koroner arter hastalığı ön tanısıyla koroner anjiyografi yapılan 30 hasta çalışmaya alındı. Kronik obstruktif akciğer, bronşiyal astım, miyokard infarktüsü ve ekokardiyografik olarak saptanmış sol ventrikül sistolik disfonksiyonu olan hastalar çalışmaya alınmadı. Koroner anjiyografiden hemen önce ve sonra solunum fonksiyon testi yapıldı ve kan gazı bakıldı. Hastalar anjiyografide koroner arter hastalığı olanlar (Grup1) ve olmayanlar (Grup2) şeklinde ikiye ayrıldı. Koroner anjiyografi işlemi tek deneyimli bir operatör tarafından yapıldı. Protokol gereği hastaların hiç birine sol ventrikülografi yapılmadı. Bulgular:Koroner anjiyografi öncesi ve sonrası sonuçlar karşılaştırıldı. İşlem sonrası bakılan birinci saniye sonu forse orta ekspiryum volüm (FEV1), maksimum mid-ekspiryum akım hızı (MMFR) 25-75, arteriyel oksijen basıncı (PaO2),bikarbonat (HCO3) değerleri tüm hastalarda anlamlı derecede düşük bulundu ( p 0.01). İşlem sonrası bakılan FEV1 ve PaO2 Grup1’de diğer gruplara göre anlamlı derecede daha düşük bulundu ( p 0.01) Sonuç: Bilinen bir akciğer hastalığı olmayan hastalarda iohexol kullanılarak yapılan tanısal koroner anjiyografi, solunum fonksiyon testi parametrelerinde küçük, ama önemli bir bozulmaya yol açmaktadır. Bundan dolayı bilinen akciğer hastalığı olanlarda opak madde kullanımında dikkatli olunması gerekli olduğu sonucuna varıldı.Öğe Myocardial bridging of obtuse marginal branch of the left circumflex artery associated with congenital corrected transposition of the great arteries(Elsevier Ireland Ltd, 2005) Gündüz , Hüseyin; Akdemir, Ramazan; Tataroğlu, Cenk; Albayrak, Sinan; Erbilen, Enver; Akdemir, Nermin; Uyan, CihangirA 54-year-old male was admitted to the emergency department with progressive dyspnea and chest paint during exercise. Congenital corrected transposition of the great arteries was detected on echocardiography. Coronary angiography revealed myocardial bridging on the obtuse marginal branch of the left circumflex coronary artery. Being a rare complex cardiac anomaly we discussed the congenitally corrected transposition of the great arteries (CCTGA) in association with myocardial bridging. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Regression of the Carotid Intima Media Thickness by Propylthiouracil Therapy in Graves' Hyperthyroidism(Elsevier Science Inc, 2012) Bilir, Cemil; Gökosmanoğlu, Feyzi; Çalışkan, Mustafa; Cinemre, Hakan; Akdemir, RamazanIntroduction: One of the cardiovascular effects of hyperthyroidism is increased carotid intima media thickness (CIMT). The aim of this study is to investigate the CIMT in patients with Graves' hyperthyroidism and the effect of propylthiouracil (PTU) therapy on CIMT. Method: Twenty-six patients with Graves' hyperthyroidism and 33 healthy controls were included in the study. CIMT was measured at the right and left external carotid arteries in every patient in both groups. CIMT was measured before and after the PTU therapy in patients with Graves' hyperthyroidism. Results: There was a significant difference in CIMT between the group of Graves' hyperthyroid patients and the control group (0.72 versus 0.55 mm, P < 0.0001) at baseline. Twenty-five of 26 patients with Graves' disease were followed up for 18 months prospectively. Euthyroidism has been achieved in 21 patients. After 18 months of treatment, CIMT decreased significantly compared with the baseline values [0.84 (0.54-1.3) to 0.72 (0.50-1.2), change 0.12 mm, P < 0.001]. Conclusion: Graves' hyperthyroidism is associated with atherosclerosis as assessed by CIMT. Treatment of Graves' hyperthyroidism with PTU decreases the CIMT.
