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Öğe Abnormal ECG Findings In Turkish Adults: An Epidemiologic Observational Study(Elsevier Science Inc, 2013) Karabacak, Ahmet; Türker, Yasin; Tibilli, Hakan; Türker, Yasemin; Albayrak, Sinan; Ekinözü, İsmail; Özhan, Hakan…Öğe Acute coronary stenosis in a young man with Behcet's syndrome(Karger, 2008) Erbilen, Enver; Albayrak, Sinan; Gülcan, Erim; Taşer, Figen; Bulur, Serkan; Özhan, Hakan; Yazıcı, MehmetObjective: To present a case of myocardial infarction due to Behcet's syndrome. Clinical Presentation and Intervention: A 27-year-old man who was known to have Behcet's syndrome for 1 year presented with retrosternal fluctuating chest pain, which radiated to the epigastrium 5 h prior to admission. Coronary angiography showed total occlusion of the left anterior descending coronary artery, which was successfully treated with coronary stent implantation. Conclusion: This case shows that patients with Behcet's syndrome who had acute chest pain should be thoroughly examined for any signs of acute myocardial infarction. Copyright (C) 2008 S. Karger AG, Basel.Öğe Acute myocardial infarction due to a bee sting manifested with ST wave elevation after hospital admission(Lippincott Williams & Wilkins, 2008) Erbilen, Enver; Gülcan, Erim; Albayrak, Sinan; Özveren, Olcay…Öğe Associations of TSH levels with blood lipids, metabolic syndrome, coronary risk factors, coronary heart disease in Turkish adult(Blackwell Publishing, 2006) Hergenç, Gülay; Onat, Altan; Albayrak, Sinan; Karabulut, Ahmet; Türkmen, Şule; Sari, Ita Puspita; Can, Günay…Öğe Clustering of risk factors for abdominal obesity in Turkish adults and its demographic distribution [Halkimizda abdominal obezitede risk faktörü kümelenmeleri ve demografik da?ilimi](2005) Onat, Altan; Uyarel, Hüseyin; Karabulut, Ahmet; Albayrak, Sinan; Doğan, Yüksel; Can, Günay; Sansoy, VedatObjectives: We investigated the distribution of abdominal obesity among Turkish adults, according to age groups and geographic regions, and the prevalence and type of its clustering with traditional risk factors including high total and low HDL cholesterol levels, smoking, hypertension, and diabetes. Study design: The study included a cohort of 3267 individuals (1607 men, 1660 women; mean age 52±12 years) whose waist circumferences were measured at least one time in the past three surveys of the Turkish Adult Risk Factor Study from 2000 to 2004. Cardiovascular disease was diagnosed on the basis of the presence of angina history, the Minnesota coding of resting electrocardiograms, and a history of stroke. Criteria of the NCEP ATP III guidelines proposed for metabolic syndrome were adopted for defining abdominal obesity and hypertension. Results: Out of every four adults aged 50 years or above, one man and three women had abdominal obesity. The prevalence of abdominal obesity did not exhibit marked changes among geographic regions. Coexistence of 3-5 risk factors in subjects with abdominal obesity showed a significantly higher proportion than other clusters of risk factors (p<0.001). All of the six risk factors studied exhibited significant and independent associations with abdominal obesity in women, whereas in men, only smoking, low HDL-C levels, and hypertension were independent factors. In contradistinction to men, there was an over three-fold adjusted likelihood of diabetes to accompany abdominal obesity in women, with hypercholesterolemia significantly clustering with both. While abdominal obesity conferred an increased likelihood of coronary heart disease through mediation of five risk factors in women, it was found as a residual independent component in men. Conclusion: According to the NCEP ATP III criteria, abdominal obesity is three times more prevalent among Turkish women than in men. The female-specific combination of abdominal obesity, diabetes, and hypercholesterolemia may partly contribute to the comparatively high risk for cardiovascular disease in Turkish women. This study needs a re-evaluation of the role of abdominal obesity in Turkish men with a threshold of ?96 cm, which was previously proposed by the authors.Öğe Effect of olmesartan medoxomil on cystatin C level, left ventricular hypertrophy and diastolic function(Taylor & Francis Ltd, 2009) Albayrak, Sinan; Ordu, Serkan; Özhan, Hakan; Yazıcı, Mehmet; Aydın, Mesut; Alemdar, Recai; Kaya, AhmetSerum cystatin C concentration is an alternative measure of kidney function that is less affected by age, sex or muscle mass, and is a more sensitive indicator of early renal dysfunction than creatinine-based estimations of glomerular filtration rate. Cardiovascular sequela increases progressively with the increase in left ventricular mass. Our goal was to evaluate the effect of olmesartan medoxomil on cystatin C levels and left ventricular hypertrophy (LVH) in patients with hypertension. Forty-four newly diagnosed hypertensive patients (27 women and 17 men) were recruited in the study. Olmesartan medoxomil (20 mg/day) was started and the patients were followed up for 6 months. Baseline echocardiographic findings (i.e. left ventricular mass index), serum creatinine, urine albumin/creatinine ratio (ACR) and serum cystatin C levels were compared with the levels of these variables measured at the end of 6-month follow-up period. After 6 months of treatment with olmesartan medoxomil, there was a significant reduction in systolic and diastolic blood pressure (p < 0.001) and in urine ACR (p = 0.04). Mean serum cystatin C levels decreased from 1.61 +/- 0.24 mg/l to 1.31 +/- 0.29 mg/l (p < 0.001). Olmesartan medoxomil treatment also reduced left ventricular mass index (p < 0.001) and LVH (p < 0.001). Our findings indicate that olmesartan medoxomil decreases serum cystatin C levels, urine ACR and reduces LVH in patients with hypertension. To our knowledge, this study is the first to show that olmesartan medoxomil decreases serum cystatin C levels, indicating that in patients with essential hypertension it may counteract end organ damage.Öğe Efficacy of Nebivolol on Flow-Mediated Dilation in Patients With Slow Coronary Flow(Int Heart Journal Assoc, 2009) Albayrak, Sinan; Ordu, Serkan; Yüksel, Hatice; Özhan, Hakan; Yazgan, Ömer; Yazıcı, MehmetSlow coronary flow (SCF) is the phenomenon of slow progression of angiographic contrast in the coronary arteries in the absence of stenosis in the epicardial vessels in some patients presenting with chest pain. There are no definite treatment modalities for patients with SCF. Our aim was to investigate the efficacy of nebivolol in patients with slow coronary flow by monitoring its effects on endothelial function and different markets of inflammation. Forty-two patients (16 females, 26 males mean age, 55 10) with slow coronary flow (SCF) were included in the study. After baseline assessment, the patients were administered nebivolol 5 mg once daily. After 12 weeks of nebivolol therapy, the biochemical and ultrasonographic examinations were repeated. Chest pain relief wits detected in 38 patients after treatment (90%). Systolic and diastolic blood pressure and high sensitive CRP were significantly decreased after nebivolol therapy. Among brachial artery dilation variables that reflect endothelial function, basal resistive index (RI), post-flow mediated dilation RI, and post-nitrate mediated dilation RI were significantly decreased after therapy. Nebivolol is effective at improving endothelial function in patients with SCF. It controls chest pain, decreases CRP, and has favorable effects on brachial artery dilation variables in patients with coronary slow flow. (Int Heart J 2009; 50: 545-553)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 Evaluation of cardiovascular system in fibromyalgia syndrome: Tissue Doppler echocardiographic investigation(2010) Yazıcı, Selma; Yazıcı, Mehmet; Albayrak, Sinan; Makarç, Sevim; Kolbaş, Melek; Erbilen, Enver; Ataoğlu, SafinazAim: We aim to investigate besides the cardiac structures and functions by both conventional methods and Tissue Doppler Echocardiography (TDE) which is a new and useful method in patients with Fibromyalgia (FM). Additionally, we evaluated QT parameters (QT maximum, QT minimum and QT dispertion) with the use of electrocardiography in order to measure the autonomic dysfunction which is a possible mechanism in the pathogenesis of the disease. Methods: The study was performed on 42 patients (mean age 41 years, 38 female) and 38 completely healthy subjects (35 female, mean age of 42 years) who were admitted to the same clinic were collected as the control group. All the individuals were undergone a complete physical examination, electrocardiography (recordings were displayed at 50 mm/s speed) and echocardiography evaluation (both conventional methods and TDE). Results: Analysis of electrocardiographic recordings revealed mildly increased mean QT dispertion in the patient group, but this difference was statistically insignificant. Analysis of conventional echocardiographic parameters revealed similar results between the patient group and the control cases. However, an important finding of this study is that significant diastolic dysfunction was found in the patient group which was recorded with the TDE technique. Em wave velocity and Em/Am ratios were significantly lower in patients with FM compared with controls (p<0.005, p<0.01, respectively). Sm and Am waves velocities were similar in both groups. Conclusion: In this study, significant left ventricular diastolic dysfunction which was detected by TDE technique can partly explain several symptoms such as fatigue and dyspnea in FM. In addition, fully cardiac evaluation of patients with FM might be obtained supporting findings the autonomic dysfunction theory in fibromyalgia pathogenesis. © 2010 Düzce Medical Journal.Öğe Fibromiyalji sendromunda kardiyovasküler sistemin değerlendirilmesi: doku Doppler ekokardiyografik inceleme(2010) Yazıcı, Selma; Yazıcı, Mehmet; Albayrak, Sinan; Makarç, Sevim; Kolbaş, Melek; Erbilen, Enver; Ataoğlu, SafinazAmaç: Biz Fibromiyalji (FM) hastalarında kardiyak yapı ve fonksiyonların hem geleneksel hem de yeni ve faydalı bir metot olan doku Doppler ekokardiyografik (DDE) yöntemle incelemeyi amaçladık. Ayrıca, hastalığın patogenezinde olası mekanizmalardan biri olarak gösterilen otonom fonksiyon bozukluğunu elektrokardiyografik olarak QT parametrelerini (QT maksimum, QT minimum ve QT dispersiyonu) ölçerek değerlendirdik. Yöntem: Çalışma aynı kliniğe başvuran 42 hasta (ortalama yaş 41, 38 kadın ) ve kontrol grubu olarak alınan tamamen sağlıklı 38 kişi üzerinde yapıldı. Bireylerin her birine tam bir fizik muayene, elektrokardiyografik (50 mm/s hızla kaydedilen) ve ekokardiyografik (hem geleneksel, hem de DDE) ile değerlendirme yapıldı. Bulgular: Elektrokardiografik kayıtların analizinde QT dispersiyonunda hafif fakat istatistiksel olarak anlamlı olmayan bir artış saptandı. Geleneksel ekokardiyografik parametreler açısından hasta grubu ile kontrol grubu benzerdi. Bununla birlikte bu çalışmanın önemli bir bulgusu hasta grubunda DDE yöntemi ile saptanan gevşeme bozukluğu idi. Em dalga hızı ve Em/Am oranları FM hastalarında kontrollere kıyasla anlamlı düzeyde düşüktü (sırasıyla, p 0.005, p 0.01). Sm ve Am dalga hızları ise her iki grupta da benzerdi. Sonuç: Bu çalışmada hasta grubunda DDE yöntemi ile saptanan sol ventrikülün gevşeme bozukluğu FM’de görülen yorgunluk ve nefes darlığı gibi bazı semptomları kısmen açıklayabilir. Ayrıca tam bir kardiyak değerlendirme yapılması ile fibromiyaljinin patogenezindeki otonomik disfonksiyon teorisini destekleyecek bulgular elde edilebilir.Öğe Independent prediction of metabolic syndrome by plasma fibrinogen in men, and predictors of elevated levels(Elsevier Ireland Ltd, 2009) Onat, Altan; Özhan, Hakan; Erbilen, Enver; Albayrak, Sinan; Küçükdurmaz, Zekeriya; Can, Günay; Hergenç, GülayThe role of plasma fibrinogen levels in predicting metabolic syndrome (MetS) and assessment of determinants of these levels were investigated. A total of 2234 men and women, aged 49 +/- 12 years, representative of Turkish adults who had plasma fibrinogen determinations, were prospectively evaluated and followed for a mean of 6.6 years. The modified Clauss method was used for assays. MetS was defined by ATPIII criteria modified for male abdominal obesity. MetS cases at baseline were excluded in prospective analyses. Median (interquartile range) fibrinogen values were 2.87 (2.29; 3.56) g/L. Fibrinogen levels predicted significantly newly developing MetS in men (RR 1.40 [95%CI 1.07; 1.83] for a 2-fold increment), after adjustment for age and smoking status, and (RR 1.32 [95%CI 0.95; 1.83] again for doubling), after additional adjustment for all 5 components of MetS. MetS was not significantly predicted by fibrinogen levels in women in either multivariable model. By regression analysis of eight covariates, not waist circumference, but systolic blood pressure, current smoking and C-reactive protein (CRP) in men, and age in women were predictors of elevated (>3.0 g/L) fibrinogen at follow-up (p<0.05 in all). Conclusions: Plasma fibrinogen predicts MetS independently of its components in men, in contradistinction to women, and, hence, is likely one of its components. Hyperfibrinogenemia representing an inflammatory state is postulated as the underlying mechanism. Central obesity is linked to elevation in fibrinogen mainly through the mediation of blood pressure, CRP, and via being affected by cigarette smoking. Crown Copyright (C) 2008 Published by Elsevier Ireland Ltd. All rights reserved.Öğe Koroner arter hastalığı için aile öyküsü pozitif olan bireylerde asimetrik dimetilarjinin düzeylerinin geleneksel risk puanlama yöntemleri ile ilişkisi(Turkish Soc Cardiology, 2011) Satılmışoğlu, Muhammet Hulusi; Özhan, Hakan; Albayrak, Sinan; Kaya, Ahmet; Erden, İsmail; Yazıcı, MehmetAmaç: Koroner arter hastalığı (KAH) Dünyada ve Türkiye’de en sık ölüm nedenidir. Asimetrik dimetilarjinin insanda nitrik oksit biyosentezinin majör inhibitörüdür. Yapılan çalışmalarda plazma asimetrik dimetilarjinin (ADMA) düzeylerindeki artışın endotel disfonksiyonu ve artmış aterogenez ile ilişkili olduğu gösterilmiştir. Bu çalışmada asimetrik dimetilarjinin düzeylerinin koroner arter hastalığı aile öyküsü olan sağlıklı bireylerde mevcut risk belirleme yöntemleri ile ilişkisi araştırılmıştır. Yöntemler: Enine-kesitli gözlemsel olarak tasarlanan bu çalışmaya birinci derece yakınları erken yaşta miyokart enfarktüsü geçiren, yaşları 20-40 arasında olan 52 birey ile kontrol grubu olarak benzer yaş grubunda 26 sağlıklı birey alınmıştır. Çalışmaya alınan deneklerin sigara, diyabet, hiperlipidemi gibi klasik, homosistein ve C-reaktif protein (CRP) gibi biyokimyasal risk faktörleri; Framingham ve TEKHARF risk skorları ve serum asimetrik dimetilarjinin seviyeleri arasındaki ilişki kategorik değişkenler için Ki-kare, sürekli değişkenler için Mann-Whitney U testi ile karşılaştırıldı. Bulgular: Yapılan değerlendirme sonunda KAH açısından riskli bireylerin ortalama açlık kan şekeri, trigliserit, yüksek-dansiteli lipoprotein, diyastolik kan basıncı, bel çevresi, TEKHARF risk skoru kontrol grubundan yüksekti. Total kolesterol, düşük-dansiteli lipoprotein, CRP, homosistein, kreatinin, Framingham risk skoru değerleri gruplar arasında benzer bulundu. Asimetrik dimetilarjinin değerleri risk grubunda ortalama 0.1 μmol/L daha yüksek bulunsa da, bu fark istatistiksel olarak anlamlılığa ulaşmadı (0.7±0.1 μmol/l’e karşılık 0.8±0.1 μmol/l; p=0.061). Sonuç: Asimetrik dimetilarjinin düzeyinin aile öyküsü pozitif olan bireylerde mevcut risk belirleme yöntemlerine ek fayda sağladığı gösterilememiştir. Bu konuda değişik risk gruplarına ait daha fazla sayıda olgu ile yapılacak çalışmalara ihtiyaç vardır. (Anadolu Kardiyol Derg 2011; 2: 114-8)Öğe Koroner arter hastalığı için aile öyküsü pozitif olan bireylerde asimetrik dimetilarjinin düzeylerinin geleneksel risk puanlama yöntemleri ile ilişkisi(2011) Satılmışoğlu, Muhammet Hulusi; Özhan, Hakan; Albayrak, Sinan; Kaya, Ahmet; Erden, İsmail; Yazıcı, MehmetAmaç: Koroner arter hastalığı (KAH) Dünyada ve Türkiye’de en sık ölüm nedenidir. Asimetrik dimetilarjinin insanda nitrik oksit biyosentezinin majör inhibitörüdür. Yapılan çalışmalarda plazma asimetrik dimetilarjinin (ADMA) düzeylerindeki artışın endotel disfonksiyonu ve artmış aterogenez ile ilişkili olduğu gösterilmiştir. Bu çalışmada asimetrik dimetilarjinin düzeylerinin koroner arter hastalığı aile öyküsü olan sağlıklı bireylerde mevcut risk belirleme yöntemleri ile ilişkisi araştırılmıştır. Yöntemler: Enine-kesitli gözlemsel olarak tasarlanan bu çalışmaya birinci derece yakınları erken yaşta miyokart enfarktüsü geçiren, yaşları 20-40 arasında olan 52 birey ile kontrol grubu olarak benzer yaş grubunda 26 sağlıklı birey alınmıştır. Çalışmaya alınan deneklerin sigara, diyabet, hiperlipidemi gibi klasik, homosistein ve C-reaktif protein (CRP) gibi biyokimyasal risk faktörleri; Framingham ve TEKHARF risk skorları ve serum asimetrik dimetilarjinin seviyeleri arasındaki ilişki kategorik değişkenler için Ki-kare, sürekli değişkenler için Mann-Whitney U testi ile karşılaştırıldı. Bulgular: Yapılan değerlendirme sonunda KAH açısından riskli bireylerin ortalama açlık kan şekeri, trigliserit, yüksek-dansiteli lipoprotein, diyastolik kan basıncı, bel çevresi, TEKHARF risk skoru kontrol grubundan yüksekti. Total kolesterol, düşük-dansiteli lipoprotein, CRP, homosistein, kreatinin, Framingham risk skoru değerleri gruplar arasında benzer bulundu. Asimetrik dimetilarjinin değerleri risk grubunda ortalama 0.1 µmol/L daha yüksek bulunsa da, bu fark istatistiksel olarak anlamlılığa ulaşmadı (0.70.1 µmol/l’e karşılık 0.80.1 µmol/l; p0.061). Sonuç: Asimetrik dimetilarjinin düzeyinin aile öyküsü pozitif olan bireylerde mevcut risk belirleme yöntemlerine ek fayda sağladığı gösterilememiştir. Bu konuda değişik risk gruplarına ait daha fazla sayıda olgu ile yapılacak çalışmalara ihtiyaç vardır.Öğe Lifestyle modification decreases the mean platelet volume in prehypertensive patients(Taylor & Francis Inc, 2009) Yazıcı, Mehmet; Kaya, Ahmet; Kaya, Yasemin; Albayrak, Sinan; Cinemre, Hakan; Özhan, HakanMean platelet volume (MPV) is an indicator of platelet activation. The present study was designed to investigate platelet function by measuring MPV, platelet count (PLC) and platelet mass (PLM) in prehypertensive (PHT) subjects. Additionally, we also evaluated the effects of lifestyle modification on platelet functions by measuring MPV, PLC and PLM. We selected 36 newly diagnosed PHT patients and 21 control subjects (BP 120/80 mmHg) matched for age and sex. Lifestyle modifications (weight loss, reduced sodium intake, increased physical activity, limited alcohol consumption and the Dietary Approaches to Stop Hypertension (DASH) diet) were recommended to PHT individuals for 20 weeks. At entry into the study, although PLM and PLC values were similar between study groups, MPV values were significantly higher in the PHT group than in the control group (respectively, 10.41 0.93 fl vs. 9.56 1.04 fl, p 0.01). Additionally, MPV was positively correlated with the systolic blood pressure (BP), body mass index (BMI) and insulin resistance (IR) in the PHT group (r: 0.41; p 0.02, r: 0.37; p 0.04, r: 0.35; p 0.05, respectively). Only age and PHT were found to be independent predictors of MPV after regression analysis. The program substantially lowered BP (net reductions in systolic and diastolic BPs of 16.2 and 8.7 mmHg, p 0.001, p 0.001, respectively). In addition, BMI, waist circumference (WC) and IR were significantly reduced in the PHT group (p 0.01, p 0.01, p 0.05, respectively). At the end of study, although PLM, PLC values were reduced in the PHT group, only the decrease in MPV reached statistical significance (respectively, 10.41 0.93 fl vs. 9.67 1.2 fl, p 0.01). In closing, to our best notice, our study is the first to display a significant increase in MPV in PHT subjects and to show a decrease in MPV by lifestyle modification after 20 weeks. As a result, we consider that decreased platelet activation with multi-aspect effects of lifestyle modification therapy might play an important role in reducing thrombotic risk in PHT patients.Öğe MELEN study: Rationale, methodology and basic results(2011) Aydın, Yusuf; Özhan, Hakan; Albayrak, Sinan; Türker, Yasin; Bulur, Serkan; Erden, İsmail; Erbilen, EnverAim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adults by utilizing newest techniques. Besides prevalence and types of endemic goiter will be established which was an important health problem in the Black sea region Method: The study was conducted on 2230 participants (1427 women, 803 men with a mean age of 49). The participants underwent a Doppler Ultrasound examination of carotid intima media thickness, echocardiographic examination, ECG recording, bioempedance meter analysis of body composition, pulmonary function test and various biochemical analysis. Result: Twenty nine percent of the population had hypertension, 12% had diabetes mellitus and 17% were smokers. Thyroid ultrasonography revealed that 29% of the cohort had goiter. Echocardiographic measurements showed that 39% of the participants had diastolic dysfunction. Comparison of males with females showed that men had significantly higher visceral fat, triglyceride, hemoglobin and CIMT whereas women had higher mean diastolic blood pressure, HDL and total cholesterol. Conclusion: According to the histories of patients, hypertension, diabetes mellitus and smoking were very frequent among Turkish adults. Among the objectively measured variables, diastolic dysfunction, visceral adiposity and goiter were strikingly high.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 Performance of Bioelectrical Impedance Analysis in the Diagnosis of Metabolic Syndrome(Lippincott Williams & Wilkins, 2012) Özhan, Hakan; Alemdar, Recai; Çağlar, Onur; Ordu, Serkan; Kaya, Ahmet; Albayrak, Sinan; Bulur, SerkanObjective: Central obesity is a prerequisite for the diagnosis of metabolic syndrome (MetS). Precise measurement of visceral fat by bioelectrical impedance analysis (BIA) has been validated. The aim of this study was to investigate the diagnostic performance of BIA in MetS and validate the best cutoff in a large adult cohort. Materials and Methods: The study was performed on the MELEN Study cohort-a prospectively designed survey on the prevalence of cardiometabolic risk factors in Turkish adults. The final cohort consisted of 2219 participants. Weight and visceral body composition were measured without shoes in light indoor clothes using a bioimpedance analyzer (Omron BF 510; Omron Corp, Kyoto, Japan). Plasma concentrations of cholesterol, insulin, fasting triglycerides, high-density lipoprotein cholesterol, glucose, and other biochemical variables were measured. The diagnostic performance of visceral fat measurement by BIA in patients with MetS was assessed. Results: Metabolic syndrome was detected in 751 participants (520 women and 231 men with a mean age of 55 [12] years; 34% of the whole study population). Total body fat and visceral fat levels were higher in subjects with MetS. Correlation analyses showed that there were significant correlations between anthropometric and BIA measurements. Receiver operating curve characteristics of visceral adiposity revealed the best cutoff values as greater than 12% for men and greater than 9% for women. The diagnostic performance was good in both sexes (the sensitivity/specificity and area-under-the-curve values were 76%/75% and 0.83 for men and 83%/67% and 0.81 for women, respectively). Conclusions: Visceral fat measured with BIA is an easily applicable and useful method for identifying people with MetS. The best cutoff values were higher than 12% for men and higher than 9% for women.Öğe Pityriasis rosea-like adverse reaction to atenolol(Sage Publications Ltd, 2016) Güleç, Ali İhsan; Albayrak, Hülya; Kayapınar, Osman; Albayrak, SinanA 56-year-old female patient was presented with diffuse, bright red to violet colour, scaly patches on trunk and extremities after using a hypertension drug, atenolol. The patient was diagnosed as pityriasis rosea-like adverse reaction to atenolol based on her history, dermatological examination and histopathological findings. To the best of our knowledge, this is the first reported case of pityriasis rosea-like adverse reaction to atenolol that is widely used in hypertension treatment.Öğe Predictors of Major Adverse Cardiovascular Events by Combining Clinical Data with Non-Invasive Screening Methods(Elsevier Science Inc, 2013) Özhan, Hakan; Albayrak, Sinan; Türker, Yasin; Aslantaş, Yusuf; Ekinözü, İsmail; Tibilli, Hakan…Öğe Predictors of major adverse cardiovascular events; results of population based MELEN study with prospective follow-up(Verduci Publisher, 2015) Albayrak, Sinan; Özhan, Hakan; Aslantaş, Yusuf; Ekinözü, İsmail; Tibilli, Hakan; Kayapınar, OsmanOBJECTIVE: In healthy persons, cardiovascular risk is the result of multiple interacting risk associates including demographic, clinical, genetic and environmental factors. Several non-invasive tools such as echocardiography, ultrasonography and electrocardiography as well as new biochemical markers were shown to be applicable to predict cardiovascular events. However, implementation of all of these tools has not been tested before. The aim of the study was to evaluate the independent predictors of major adverse cardiovascular events in a prospective population based study, with the use of bioempedance analysis, echocardiography, ultrasonography and ECG. PATIENTS AND METHODS: The baseline measurements were conducted on 2230 participants (1427 women, 803 men with a mean age of 49 +/- 15). The follow-up was done 36 months after the baseline admission via telephone call. Major adverse event was defined as mortality or myocardial infarction or stroke. RESULTS: Follow-up data was possible in 1495 participants (65%). During the follow-up of 36 months (4485 patient years), 42 major adverse events occurred (0.03%). Among them, 16 were death (1 stroke, 2 cancer, 13 cardiac related), 12 were stroke and 14 were myocardial infarction. Age, body mass index and atrial fibrillation were independent predictors of major adverse events; AF being the most powerful (Odds ratio 10.46; 95% confidence interval [1.73-63.14]; p = 0.010). CONCLUSIONS: Age, lower body mass index and atrial fibrillation were independent predictors of major cardiovascular events in our cohort.
