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Öğe A case of vasospastic angina resulting from coronary emboli in a patient with prosthetic valves(Int Heart Journal Assoc, 2004) Kosar, F; Gullu, H; Sahin, I; Acikgoz, N; Topal, E; Erdil, NIn addition to coronary atherosclerotic disease, coronary thromboembolisin can also lead to acute coronary syndromes. However, coronary thromboembolism due to prosthetic heart valves is very rare and not very well-known. It has Only a few cases have been reported. In this paper, we present a rare case with vasospastic angina pectoris secondary to coronary thromboembolism in a patient with prosthetic heart valves.Öğe Effect of ectasia size or the ectasia ratio on the thrombosis in myocardial infarction frame count in patients with isolated coronary artery ectasia(Springer, 2005) Kosar, F; Acikgoz, N; Sahin, I; Topal, E; Aksoy, Y; Cehreli, SCoronary blood flow was quantified using the thrombosis in myocardial infarction (TIMI) frame-count method. This measurement has been significantly correlated with flow velocity measured invasively by use of a Doppler flow wire. Coronary artery ectasia or aneurysm (CEA) is thought to be present in patients with a slow blood flow. In this study, we aimed to assess the relationship between the ectasia size or ectasia ratio and TIMI frame count in patients with CEA. The study population included 58 patients with isolated CEA of the right coronary artery. In patients with CEA, an ectasia ratio was calculated as diameter of the ectatic segment/diameter of the adjacent normal segment. According to the ectasia ratio, ectatic vessels were divided into two groups: ectasias with a 1.5- to 2.0-fold increase (group A) and more than 2.0-fold increase (group B) in normal vessel diameter. Patients with a significant stenotic lesion (> 50%) in the ectatic vessel were excluded. The control group was formed from a matched population of 35 patients with angiographically proven normal coronary arteries. Characteristics of the ectasia and control groups are similar. The TIMI frame counts for the right coronary artery (RCA) were significantly higher in the ectasia group as compared with the control group (43 +/- 12 vs 23 +/- 8, P < 0.001). The ectasia group had 38 patients in group A and 20 patients in group B. The TIMI frame counts were significantly higher in group B than in group A (43 +/- 10 vs 51 +/- 15, P < 0.05). The TIMI frame count of the RCA showed a significant correlation with the ectasia ratio and the maximum diameter of the ectatic segment (r = 0.578, P < 0.001 and r = 0.435, P < 0.001, respectively). Our data suggest that TIMI frame count measurement depends on the ectasia size or ectasia ratio, and an increased ectasia ratio is markedly associated with decreased TIMI frame counts in patients with CEA.Öğe Effects of co-existence of coronary stenosis and the extent of coronary ectasia on the TIMI frame count in patients with coronary artery ectasia(Int Heart Journal Assoc, 2005) Kosar, F; Acikgoz, N; Sahin, I; Topal, EU; Gunen, H; Ermis, N; Cehreli, SThe measurement of the thrombosis in myocardial infarction (TIMI) frame count is a simple method for evaluating coronary blood flow. Although it is well known that slow coronary flow is present in patients with coronary artery ectasia (CAE), the effects of coexisting stenosis and the severity of ectatic involvement on coronory flow have not been adequately studied. Thus, we examined (1) the effect of coexistence of obstructive coronary artery disease on TIMI frame count (TFC) and (2) the relation between the severity of ectatic involvement and TFC in patients with CAE. Ninety-seven study patients with CAE were examined in two steps to determine if they were appropriate in terms of the aim of this study. In the first step, ectasias were divided into three groups: an isolated CAE group, a CAE group with coexisting nonsignificant stenosis, and CAE with coexisting significant stenosis. In the second step, ectasias were subdivided into three groups: CAE with one segment, two segments, and three segments (or diffuse) involvement. The TIMI frame counts for the right coronary artery (RCA), the left circumflex coronary artery (LCx), and the left anterior descending artery (LAD) in the ectasia,roup were significantly higher than that of the control group (P < 0.001 P < 0.05, P < 0.05, respectively). The presence of coexisting nonsignificant stenosis or coexisting significant stenosis in patients with CAE did not influence TFC (P > 0.05, For all). In addition, the severity of ectasia involvement, regardless of the localization of ectatic segments and the type of the affected vessel. did not change the TFC (P > 0.05, for all). These results suggest that neither the coexisting stenosis nor the extent of involvement significantly affect TFC in patients with coronary ectasia.Öğe Exercise-induced changes in QT interval duration and dispersion in patients with isolated myocardial bridging(Elsevier Ireland Ltd, 2004) Barutcu, I; Sezgin, AT; Gullu, H; Topal, E; Acikgoz, N; Ozdemir, RBackground: Isolated myocardial bridging (NIB) often is considered to be an unimportant angiographic finding; however, its association with cardiovascular event has been shown. In this study we aimed to assess exercise-induced electrocardiographic (ECG) changes and susceptibility to arrhythmia in patients with MB. Method: 21 consecutive patients who had angiographically proven MB (group 1) and 25 subjects (group 11) who had normal coronary arteries underwent exercise test using Bruce protocol. Before and after the exercise test the changes in QT interval duration and dispersion were compared. Results: Baseline characteristics of both groups were similar. Heart rate significantly increased after exercise test in both groups. In group 1, after exercise mean QT(max) and QT(min) durations did not change significantly compared to baseline values, respectively. (QT(max): 411 +/- 20 vs. 421 +/- 18 ms, p > 0.05 and QT(min) : 380 +/- 12 vs. 378 +/- 10 ms, p>0.05). However, following exercise test QT dispersion (QT(d)) and corrected QT dispersion (QT(cd)) significantly increased when compared to baseline values, respectively. (34 +/- 13 vs. 66 +/- 14 ms, p<0.05 and 37 +/- 14 vs. 69 +/- 17 ms, p<0.05) On the other hand, in control group QT(max) and QT(min) durations, QT(c) and QT(cd) did not change significantly compared to baseline values, respectively. (QT(max): 408 +/- 18 vs. 412 +/- 17 ms, p>0.05 and QT(min) : 390 +/- 11 vs. 387 +/- 10 ms, p>0.05; QT(d): 25 +/- 14 vs. 31 +/- 16 ms, p>0.05; QT(cd): 27 +/- 15 vs. 33 +/- 17 ms, p>0.05). Conclusion: Treadmill exercise test significantly increased QT dispersion in patients with MB. This increase may result from exercise-induced ischemia at the area perfused by bridged artery. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Increased prevalence of varicocele in patients with coronary artery ectasia(Lippincott Williams & Wilkins, 2005) Yetkin, E; Kilic, S; Acikgoz, N; Ergin, H; Aksoy, Y; Sincer, I; Aktürk, EBackground Coronary artery ectasia (CAE) is defined as localized or diffuse non-obstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Varicocele is the dilatation of the pampiniform plexus. Recently increased prevalence of peripheral varicose veins has been shown in patients with CAE. In this study we aimed to assess the prevalence of varicocele, which is dilatation of another venous system, in patients with CAE. Materials and methods Thirty-five male consecutive patients with coronary artery ectasia in combination with or without coronary artery disease (CAD) and 63 male, age-matched patients with coronary artery disease were included in the study. All patients were evaluated for the presence of varicocele. Results Twenty-one patients with CAE were found to have varicocele (62% of group I patients). In patients with CAD, 24 patients (38%) were found to have varicocele. The difference between the two groups in respect to presence of varicocele was statistically significant (P=0.02; odds ratio=1.57; 95% confidence interval 1.05-2.3). Conclusion We have shown that patients with coronary artery ectasia have an increased prevalence of varicocele compared to those with coronary artery disease. The mechanism underlying coronary artery ectasia might further increase the prevalence of varicocele in susceptible patients.Öğe Tissue Doppler velocities of the right and left ventricles and their association with C-reactive protein and homocysteine levels in Behcet's disease(Excerpta Medica Inc-Elsevier Science Inc, 2005) Topal, E; Ozdemir, R; Aksoy, Y; Acikgoz, N; Ermis, N; Sincer, I; Akturk, EIn the present study, we aimed to investigate whether tissue Doppler imaging could provide more information than standard echocardiography about left and right ventricular functions and their relations to homocysteine and C-reactive protein (CRP) levels in the course of Behcet's disease (BD). In the right ventricle, patients with BD had lower early diastolic tricuspid annular velocity and early diastolic/late diastolic tricuspid annular velocity ratios than the control group. Mitral and tricuspid annular systolic velocities did not significantly differ; however, diastolic velocities were correlated with duration of the disease. In addition, early/late diastolic mitral annular velocity,ratio and early/late diastolic tricuspid annular velocity ratios showed an inverse relation with ocular involvement, serum homocysteine, and CRP levels in patients with BD. (C) 2005 Elsevier Inc. All rights reserved.Öğe Vascular endothelial function and plasma homocysteine levels in Behcet's disease(Excerpta Medica Inc, 2004) Ozdemir, R; Barutcu, I; Sezgin, AT; Acikgoz, N; Ermis, N; Esen, AM; Topal, EThe purpose of the present study was to test endothelial function and to determine if plasma homocysteine levels are associated with endothelial injury in patients with Behcet's disease (BD). Flow-mediated dilation in patients with BD was smaller than. that of control subjects (p = 0.001), and mean plasma homocysteine levels in patients with BD were significantly higher (p = 0.0001). On regression analysis, only mean plasma homocysteine concentration was independently related to flow-mediated dilation (F = 5.7; p = 0.001). (C) 2004 by Excerpta Medica, Inc.
