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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 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 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 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 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 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 KOAH'lı istirahat koşullarında ekspiratuar akım hızları ve arter kan gazı değerlerinin egzersiz performansına etkisi(2002) Yazıcı, Mehmet; Arbak, Peri Meram; Balbay, Öner Abidin; Maden, Emin; Erbaş, Mete; Erbilen, Enver; Uyan, CihangirBu çalışmada KOAH'lılarda istirahat koşullarında ekspiratuar akım hızları ve kan gazı değerlerinin yürüme bandında efor testi parametreleri (treadmill exercise testing parametres: TETP) ile ilişkisi ve bunun hastalığın şiddetini öngörmedeki değeri araştırılmıştır. Bu çalışmaya 45 KOAH'lı hasta (kadın/erkek: 9/36, yaş ortalaması: 6111yıl) ve 21 sağlıklı birey (kadın/erkek: 4/17, yaş ortalaması: 6010 yıl) alındı. Tüm KOAH'lı hastalar (I. grup, FEV1 %51.37.2) FEV1 değerlerine göre 3 altgruba (II. grup/hafif KOAH, FEV1 %60-79, III. grup/orta düzeyde KOAH, FEV1 %40-59, IV. grup/ileri derecede KOAH, FEV1 %40 ) ayrıldı. Kontrol grubunda FEV1 %80 idi. Tüm gruplara istirahat koşullarında spirometri ile SFT ve sonrasında semptomla sınırlı maksimum efor testi uygulandı. Toplam koşu süresi (TKS), toplam metabolik eşdeğerleri (TMET), maksimum VO2 ( mVO2) düzeyleri ve maksimum kalp hızı (mKH), III. grup (mV02: 17.64.9; p0.0001, TKS: 3.81.1; p0.0001, TMET: 4.81.3, p0.001, mKH: 127.917.3 p0.01) ve IV. grupta (mVO2: 15.25.3, p0.0001, TKS: 3.31.2, p0.0001, TMET: 3.91.5, p0.0001, mKH: 114.915.6, p0.001) kontrollere (mVO2: 27.35.9, TKS: 7.11.3, TMET: 8.32.2, mKH: 137.313.4) göre anlamlı farklılık göstermekteydi. Ek olarak IV. grupta ventriküler erken atım sayısı (VEAS) kontrol grubuna göre anlamlı olarak artmıştı (2.91.4'e 1.71.1, p0.01). Hafif KOAH grubunun tüm değerleri kontrol grubuna benzerdi. FEV1 ile TETP arasında III. grupta (mVO2: r0.35/p0.005, TKS: r0.31/p0.01, TMET: r0.29/p0.01) ve IV. grupta (mVO2: r0.49/p0.001, TKS: r0.45/p0.005, TMET: r0.31/p0.01, mKH: r0.29/p0.01, VEAS: r0.27/p0.05) anlamlı korelasyonlar saptandı. Ayrıca IV. grupta PaO22 değerleri ile TETP arasında da benzer bir ilişki (mVO2: r0.43/p0.005, TKS: r0.35/p0.01, TMET: r0.32/p0.02, mKH: r0.31/p0.03, VEAS: r-0.29/p0.05) bulundu. Bu çalışmada orta-ileri derecede KOAH'lılarda istirahat ekspiratuar akım hızları ve PaO2 değerleri ile efor testi parametreleri arasında yakın bir ilişki olduğu ve bu ilişkinin hastalığın ciddiyetini öngörmede önemli bir rolü olabileceği sonucuna vardık.Öğe May primary empty sella turcica be a cause of isolated ACTH deficiency? A case report and the review of related literature(Maghira & Maas Publications, 2007) Gülcan, Erim; Gülcan, Aynur; Taşer, Figen; Korkmaz, Uğur; Erbilen, EnverIsolated ACTH deficiency is an uncommon cause of secondary adrenocortical insufficiency and accompaniment with primary empty sella has been reported in several cases. We present a case of isolated ACTH deficiency associated with empty sella. A sixty-two year old woman was admitted to our endocrine clinic with complaints of weakness, fatigue, weight loss, nausea, vomiting, and lack of appetite for about one month. Physical examination indicated orthostatic hypotension and epigastric tenderness. Laboratory investigations revealed hypoglycemia, hyponatremia and anemia, in addition low plasma cortisole and ACTH levels. Serum cortisole responses to short and prolonged ACTH stimulation were tested and partial and accurate responses were obtained, respectively. Plasma ACTH and serum cortisole levels failed to respond after intravenous injection of human corticotropin releasing hormone. Other hypophysial hormone levels were within the normal reference ranges. Although cranial and abdominal computerized tomography images were evaluated as normal, cranial magnetic resonance imaging of the pituitary gland revealed 'primary empty sella turcica' Replacement therapy with methylprednisolon resulted in the improvement of hypoglycemia, hyponatremia and clinical symptoms. Based on these results, the patient was diagnosed as isolated ACTH deficiency and was scheduled for follow up by our outpatient clinic. Our report is consistent with other reports pointing out that primary empty sella may be responsible for pathogenesis of isolated ACTH deficiency.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 The predictive value of CRP levels on future severe renal disease in overweight and obese subjects without diabetes mellitus and hypertension(Elsevier Science Inc, 2007) Gülcan, Erim; Gülcan, Aynur; Erbilen, Enver; Taşer, Figen; Şahin, Levent; Özbek, Orhan; Bahçebaşı, Zerrin BicikBackground: Obesity and related disorders have a high prevalence all over the world. Increased C-reactive protein (CRP) value in obese individuals and its potential adverse effects have been reported. Here we have investigated the relationship between CRP levels and renal functions in nondiabetic, nonhypertensive, overweight, and obese individuals. The aim of this study was to evaluate the predictive value of CRP levels on future severe renal disease. Methods: One hundred sixty individuals were included in the study. They were grouped as normal weight, overweight, and obese. Anthropometric measurements, renal function tests, and serum hsCRP values were obtained. Mean values were compared and correlation analysis was performed. Results: Significant differences were detected between the groups according to body mass index, waist circumference (WC), and body fat percentage. There was a significant difference with respect to creatinine clearance (CC). Difference in the mean urinary albumin excretion (UAE) was significant between normal-weight and overweight subjects. There was a linear increase in serum CRP values in parallel to the increase in body weight; mean values were significant between groups. A positive correlation was detected between CC and body mass index and WC, and there were significant correlations between CRP and anthropometric measurements, CC and UAE. Conclusions: This study showed that increased CRP levels in nondiabetic, nonhypertensive, overweight, and obese individuals could possibly associated with impaired renal functions that might be originating from endothelial dysfunction. Determination of cutoff levels of CRP, as in cardiovascular diseases, may be useful for early estimation and prevention of renal diseases.Öğe Predictors of hypertension control in Turkey: the MELEN study(Verduci Publisher, 2013) Baltacı, Davut; Erbilen, Enver; Türker, Yasemin; Alemdar, Recai; Aydın, Mesut; Kaya, Ahmet; Özhan, HakanBACKGROUND: Hypertension is one of the most common causes of atherosclerosis, morbidity and mortality in adults. A total of 11 million hypertensive patients were estimated in Turkey. AIM: The aim of this study was to investigate the prevalence, awareness and control of hypertension in Duzce and compare the current data with the literature. PATIENTS AND METHODS: The visits were carried out in May and June, 2010 in Yigilca town health centre on 2298 participants (1471 female, 827 male with a mean age of 50). Data were obtained by a simple form, physical examination and sampling of blood. Hypertension was defined as a blood pressure 140 mmHg and/or 90 mmHg, and/or use of antihypertensive medication. The data of patients under control were compared with the patients who were not under control. RESULTS: Hypertension was detected in 964 participants. General prevalence was 42%. Hypertension awareness ratio was 70%, use of antihypertensive medication was 39% and the ratio of patients under control was 28%. Antihypertensive drug use, age and awareness were lower in the uncontrolled group. Logistic regression analysis revealed that only antihypertensive drug use and BMI < 30 were the independent predictors of hypertension under control [Odd's ratio (OR) = 3.43; 95% confidence interval (CI) = 2.54-4.64, p < 0.001 and OR = 1.69; 95% CI = 1.23-2.32, p = 0.01; respectively]. CONCLUSIONS: Hypertension is one of the most important public health problems in Turkey. According to the literature data the awareness of hypertension was increased significantly in the last five years. On the other hand, control ratio was increased very little compared with the previous studies.Öğe Relation between QT characteristics and transthoracic echocardiographic parameters in patients with uncomplicated isolated mitral valve prolapse(W B Saunders Co Ltd, 2002) Yazıcı, M.; Akdemir, Ramazan; Uyan, Cihangir; Erbilen, Enver; Albayrak, Sinan…Öğe Relationship between angiographically documented coronary artery disease and low bone mass in men(Japanese Circulation Society, 2007) Erbilen, Enver; Yazıcı, Selma; Özhan, Hakan; Bulur, Serkan; Ordu, Serkan; Yazıcı, MehmetBackground The present study aimed to investigate the association between low bone mass (LBM) and coronary artery disease (CAD) in male patients. Method and Results The data for 47 men who were screened for osteopenia and osteoporosis with dual energy X-ray absorptiometry and then underwent coronary angiography between February 2005 and May 2006 were retrospectively analyzed. Bone mineral density of the femur neck was stratified as normal (T score >-1.0 SD) or low (T score <-1.0 SD) and CAD was defined as >= 50% occlusion in at least 1 major coronary artery. Thirty-two patients were found to have angiographically significant CAD. Patients in the LBM group had a significantly higher incidence of CAD. Low bone mass was significantly and positively correlated with the Gensini scores of the patients (r=0.6037, p < 0.0001) and was found to be an independent predictor of CAD in multivariate logistic regression analysis (odds ratio: 5.4 [95% confidence interval 1.66 and 17.49]; p=0.0049). Repeated statistical analyses with the acceptance of CAD as coronary artery stenosis > 75% confirmed the same results. Conclusion Low bone mass was significantly associated with angiographically documented CAD in males.Öğe Relationship between arterial blood gas values, pulmonary function tests and treadmill exercise testing parameters in patients with COPD(Wiley, 2004) Yazıcı, Mehmet; Arbak, Peri Meram; Balbay, Öner Abidin; Maden, Emin; Erbaş, Mete; Erbilen, Enver; Uyan, CihangirObjective: There have been controversial reports regarding the relationship between exercise tolerance and resting pulmonary function in patients with COPD. The aim of this study was to examine the relationship between resting pulmonary function tests (rPFT) and cardiopulmonary exercise testing parameters (CETP) and their value in estimating exercise tolerance of patients. Methodology: In total, 45 patients with COPD (nine females, 36 males; mean age 61.2 +/- 11.2) and 21 healthy subjects (four females, 17 males; mean age 60.3 +/- 9.7) as a control group were studied. COPD patients (group I) were divided into three subgroups according to their FEV1 (mild/group II: FEV1 60-79% of predicted; moderate/group III: FEV1 40-59%; severe/group IV. FEV1 < 40%). In controls FEV1 was greater than or equal to 80%. Results: There were significant correlations between FEV1 and CETP in group III (maximal O-2 consumption (mVO(2)), r = 0.35, P < 0.005; total treadmill time (TTT), r = 0.31, P < 0.01; total metabolic equivalent values (TMET), r = 0.29, P < 0. 01)) and in group IV (mVO(2), r = 0.49, P < 0.001; TTT, r = 0.45, P < 0.005; TMET, r = 0.31, P < 0.01; peak heart rate (pHR), r = 0.29, P < 0.02; frequency of ventricular extrasystole (fVES), r = -0.27, P < 0.05). Additionally, in group IV there were significant correlations between PaO2 and CETP (mVO(2), r = 0.41, P < 0.02; TTT, r = 0.38, P < 0.03; TMET, r = 0.31, P < 0.05; pHR, r = 0.29, P < 0.05; fVES, r = -0.28, P < 0.05). Conclusion: There are significant correlations of resting FEV1% predicted and PaO2 Values with CETP in patients with moderate and severe COPD and these parameters may also have a role as indicators of exercise tolerance in these COPD patients.Öğe The relationship between echocardiographic features of mitral valve and elastic proporties of aortic wall and Beighton hypermobility score in patients with mitral valve(Japan Heart Journal, Second Dept Of Internal Med, 2004) Yazıcı, Mehmet; Ataoğlu, Safinaz; Makarç, Sevim; Sarı, İbrahim; Erbilen, Enver; Albayrak, Sinan; Uyan, CihangirThe present study was designed to investigate the incidence of benign joint hypermobility syndrome (BJHMS) in mitral valve prolapse (MVP) and the correlation between the echocardiographic features of the mitral valve and elastic properties of the aortic wall and Beighton hypermobility score (BHS) in patients with MVP and BJHMS. Fourty-six patients with nonrheumatic, uncomplicated, and isolated mitral anterior leaflet prolapse (7 men and 39 women, mean age; 26.1 +/- 5.9) and 25 healthy subjects (3 men and 22 women, mean age, 25.4 +/- 4.3) were Studied. Patients were divided into two groups according to their BHS (group I, MVP+BJHMS; group II, MVP-BJHMS). Individuals with accompanying cardiac or systemic disease were excluded. Echocardiographic examination was performed in all subjects. The presence of BJHMS was evaluated according to Beighton's criteria. The incidence of BJHMS in patients with MVP was found to be significantly higher than that of controls (45.6%, (21/46) vs 12% (3/25), P < 0.0001). Group I (MVP + BJHMS) had significantly increased anterior mitral leaflet thickness (AMLT, 3.4 +/- 0.4 vs 3.1 +/- 0.3; P < 0.005), maximal leaflet displacement (MLD, 2.4 +/- 0.4 vs 1.7 +/- 0.4; P < 0.005), and degree of mitral regurgitation (DMR, 17.1 +/- 7.2 vs 11.2 +/- 4.4; P < 0.01) compared to group II. However, the index of aortic stiffness (IAOS) was found to be lower (17.6 +/- 6.9 vs 23.9 +/- 7.6; P < 0.005) and aortic distensibility (AOD) to be higher (0.0035 +/- 0.007 vs 0.0024 +/- 0.005; P < 0.005) in group I. There was a significant correlation between AMLT, MLD and DMR, and BHS (r = 0.57/P = 0.007, r = 0.55/P < 0.009, r = 0.51/P < 0.01, respectively). In addition, AOD correlated positively with BHS (r = 0.53/ P < 0.005), but the index of aortic stiffness correlated inversely with BHS (r = -0.49/P < 0.007). The incidence of BJHMS in patients with MVP was more frequent than the normal population and there was a significant correlation between the severity of BJHMS (according to BHS) and echocardiographic features of the mitral leaflets and elastic properties of the aortic wall.Öğe Three years of experience with a mobile angiograph in a center without on-site surgical back-up(K Faisal Spec Hosp Res Centre, 2004) Akdemir, Ramazan; Özhan, Hakan; Yazıcı, Mehmet; Gündüz, Hüseyin; Erbilen, Enver; Albayrak, Sinan; Uyan, CihangirBackground: The safety of percutaneous coronary interventions (PCI) performed in centers without surgical back-up is controversial, but data from several western countries indicates that this approach can be extended to a larger number of hospitals. We assessed the safety and efficacy of performing angiography and PCI with a mobile C-arm angiograph in a center without on-site surgical back-up, and compared our data with that reported in the literature. Methods: We retrospectively analyzed 1485 coronary angiograms and 172 PCI procedures performed in our center from January 2001 to May 2003 using a mobile angiograph. Half of the patients that have undergone PCI had refractory unstable angina and one-third had acute myocardial infarction (AMI). The safety of PCI was assessed by the analysis of in-hospital complications (death, urgent need for repeated revascularization, AMI with or without ST elevation and stroke).The PCI procedures were considered effective when the post-PCI residual stenosis did not exceed 50% with distal Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow. Results: In patients who underwent diagnostic coronary angiography there were no deaths, anaphylatic shock, acute renal failure or major ischemic complications. In patients who underwent PCI, the mortality rate was 1.1% (2 deaths), two patients (1.1%)developed acute MI with ST segment elevation, one patient (0.5%) underwent repeated PCI and three patients (1.7%) were referred for urgent by-pass surgery. Conclusions: Diagnostic and PCI procedures can be safely performed using a mobile angiograph. The efficacy and safety requirements of PCI, performed in a center without an on-site surgical back-up facility using a mobile angiograph were similar to other data reported in the literature.
