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Öğe Assessment of Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Obese Subjects(Wiley, 2011) Yagmur, Julide; Cansel, Mehmet; Acikgoz, Nusret; Ermis, Necip; Yagmur, Murat; Atas, Halil; Tasolar, HakanOur aim was to evaluate whether atrial electromechanical delay measured by tissue Doppler imaging (TDI), which is an early predictor of atrial fibrillation (AF) development, is prolonged in obese subjects. A total of 40 obese and 40 normal-weight subjects with normal coronary angiograms were included in this study. P-wave dispersion (PWD) was calculated on the 12-lead electrocardiogram (ECG). Systolic and diastolic left ventricular (LV) functions, inter-and intra-atrial electromechanical delay were measured by TDI and conventional echocardiography. Inter-and intra-atrial electromechanical delay were significantly longer in the obese subjects compared with the controls (44.08 +/- 10.06 vs. 19.35 +/- 5.94 ms and 23.63 +/- 6.41 vs. 5.13 +/- 2.67 ms, P < 0.0001 for both, respectively). PWD was higher in obese subjects (53.40 +/- 5.49 vs. 35.95 +/- 5.93 ms, P < 0.0001). Left atrial (LA) diameter, LA volume index and LV diastolic parameters were significantly different between the groups. Interatrial electromechanical delay was correlated with PWD (r = 0.409, P = 0.009), high-sensitivity C-reactive protein (hsCRP) levels (r = 0.588, P < 0.0001). Interatrial electromechanical delay was positively correlated with LA diameter, LA volume index, and LV diastolic function parameters consisting of mitral early wave (E) deceleration time (DT) and isovolumetric relaxation time (IVRT; r = 0.323, P = 0.042; r = 0.387, P = 0.014; r = 0.339, P = 0.033; r = 0.325, P = 0.041; respectively) and, negatively correlated with mitral early (E) to late (A) wave ratio (E/A) (r = -0.380, P = 0.016) and myocardial early-to-late diastolic wave ratio (E-m/A(m)) (r = -0.326, P = 0.040). This study showed that atrial electromechanical delay is prolonged in obese subjects. Prolonged atrial electromechanical delay is due to provoked low-grade inflammation as well as LA enlargement and early LV diastolic dysfunction in obese subjects.Öğe Elevated Oxidative Stress Markers and its Relationship With Endothelial Dysfunction in Behcet Disease(Sage Publications Inc, 2011) Acikgoz, Nusret; Ermis, Necip; Yagmur, Julide; Cansel, Mehmet; Karincaoglu, Yelda; Atas, Halil; Cuglan, BilalBehcet's disease (BD) is a multisystemic disorder characterized by endothelial dysfunction. However, the relationship between oxidative stress and endothelial function has not been clearly shown. We investigated the relationship between oxidative stress markers and endothelial function in patients with BD. Patients with BD (n = 40) having active disease and sex-and age-matched 40 controls were included. Endothelial function was assessed by flow-mediated dilatation (FMD) technique. Serum gammaglutamyltransferase (GGT) and high-sensitive C-reactive protein levels (hsCRP) were measured in all participants. Brachial artery FMD was significantly lower in patients with BD than in controls. Gamma-glutamyltransferase and hsCRP levels were higher in patients with BD than in controls. Also, GGT and hsCRP levels were inversely correlated with endothelial function. Oxidative stress markers are elevated in patients with BD having active disease. This may be one of the reasons behind the vasculitis in active BD.Öğe Elevated serum gamma-glutamyl transferase activity in patients with cardiac syndrome X and its relationship with carotid intima media thickness(Taylor & Francis Ltd, 2010) Yagmur, Julide; Ermis, Necip; Acikgoz, Nusret; Cansel, Mehmet; Atas, Halil; Karakus, Yasin; Pekdemir, HasanObjectives - We aimed to evaluate serum gamma-glutamyl transferase (GGT) activity and its relationship with carotid intima media thickness (CIMT) in patients with cardiac syndrome X (CSX). Methods - The study population consisted of 40 patients with CSX, 35 controls and 40 patients with coronary artery disease (CAD). All patients underwent a noninvasive stress test and conventional coronary angiography. Serum GGT and C-reactive protein (CRP) levels were measured and CIMT was assessed in all subjects. Results - Serum GGT activity was higher in the CSX and the CAD groups than in the control group (32.6 +/- 16.0 and 30.4 +/- 15.3 U/L, respectively, vs. 17.9 +/- 4.2 U/L; P < 0.001). There was no statistically significant difference in serum GGT activity between the CSX and the CAD groups. When compared to the control group, serum CRP levels were significantly increased in both the CSX and the CAD groups (4.1 +/- 2.0 and 4.7 +/- 2.6 mg/L, respectively, vs. 2.2 +/- 1.8 mg/L; P < 0.001). Patients with CSX and CAD had significantly higher CIMT values than the controls (0.74 +/- 0.17 and 0.94 +/- 0.12 mm, respectively, vs. 0.62 +/- 0.08 mm; P < 0.001). A significant correlation was found between GGT activity and CIMT measurements (r = 0.640, P < 0.001), but serum GGT activity did not correlate with serum CRP levels in patients with CSX (r = 0.277, P > 0.05). Conclusions - The present study showed that serum GGT activity in patients with CSX was as high as those in patients with CAD. Increased GGT levels may play a role in the pathogenesis of the microvascular atherosclerotic process of CSX.Öğe Evaluation of atrial conduction time by P wave dispersion and tissue Doppler echocardiography in prehypertensive patients(Aves, 2010) Ermis, Necip; Acikgoz, Nusret; Yasar, Erdogan; Tasolar, Hakan; Yagmur, Julide; Cansel, Mehmet; Atas, HalilObjectives: Prehypertension is a predictor for the future development of hypertension and represents an increased risk for cardiovascular morbidity and mortality. Prolonged intra/interatrial conduction times demonstrated by P wave dispersion (PD) and tissue Doppler echocardiography (TDE) are related to the development of atrial fibrillation. The aim of this study was to evaluate atrial conduction time by PD and TDE in patients with prehypertension. Study design: In 46 prehypertensive patients (22 males, 24 females; mean age 56.5 +/- 12.3 years) and 39 normotensive healthy controls (19 males, 20 females; mean age 55.8 +/- 11.7 years), we measured P wave duration and dispersion on 12-lead electrocardiography, and atrial electromechanical coupling intervals (PA) by TDE. Results: Maximum P wave duration (Pmax) and PD were prolonged in prehypertensives compared to controls (Pmax 110.1 +/- 13.8 vs. 91.4 +/- 7.7 msec, p<0.001; PD 55.7 +/- 11.1 vs. 36.8 +/- 5.7 msec, p<0.001). Atrial PAs measured at the lateral and septal mitral annuluses were significantly delayed in the prehypertensive group (lateral PA 76.5 +/- 10.1 vs. 65.4 +/- 10.4 msec, p<0.001; septal PA 59.0 +/- 6.4 vs. 53.5 +/- 7.5 msec, p=0.002). Both interatrial (lateral PA-tricuspid PA) and intraatrial (septal PA-tricuspid PA) conduction times were delayed in the prehypertensive group (25.8 +/- 9.3 vs. 17.0 +/- 9.5 msec, p<0.001; 9.2 +/- 3.7 vs. 6.7 +/- 3.0 msec, p=0.008, respectively). Correlation analysis showed that both Pmax and PD were correlated with interatrial (r=0.38, p<0.001 and r=0.40, p<0.001, respectively) and intra-atrial (r=0.31, p=0.01 and r=0.38, p<0.001, respectively) electromechanical delays. Conclusion: Our finding of significant prolongation of atrial electromechanical coupling and PD may indicate an increased risk for the development of atrial fibrillation in prehypertensive subjects.Öğe A free-floating left atrial thrombus visualized by real-time three-dimensional echocardiography(Oxford Univ Press, 2011) Yagmur, Julide; Atas, Halil; Cansel, Mehmet; Akturk, Erdal; Erdil, Nevzat[Abstract Not Available]Öğe Increased Mean Platelet Volume in Behcet's Disease with Thrombotic Tendency(Tohoku Univ Medical Press, 2010) Acikgoz, Nusret; Karincaoglu, Yelda; Ermis, Necip; Yagmur, Juelide; Atas, Halil; Kurtoglu, Ertugrul; Cansel, MehmetThe relationship between Behcet's disease (BD) and platelet aggregation has not sufficiently been investigated yet. Mean platelet volume (MPV) is a marker of platelet function, and the increase in MPV has been identified as an independent risk factor of recurrent vascular events. BD is characterized by a relapsing vasculitis of the venous as well as arterial thrombosis. However, the precise pathogenic mechanisms underlying thrombotic tendency in BD are not known. We hypothesized that there might be an association between thrombotic complication and MPV in these patients. Therefore, we investigated activation of platelets in patients with BD using a simple marker, MPV, the most accurate measure of platelet size. A total of 60 patients with BD and 40 age- and gender-matched controls were included. The BD patients were divided into subgroups based on the presence (n = 22) or absence of thrombosis (n = 38) and clinically active (n = 30) or inactive (n = 30) state. MPV was higher in patients with BD than controls (8.14 +/- 0.8 vs. 7.48 +/- 0.3 fl, p = 0.001). Among BD patients, MPV was larger in patients with thrombosis than those without thrombosis (8.45 +/- 1.0 vs. 7.96 +/- 0.7 fl, p = 0.038). However, there was no significant difference in MPV between BD patients with active and inactive states. The increase in MPV is independent of the disease activity, and the presence of thrombosis is associated with higher MPV in BD patients. Therefore, antiplatelet therapy may be useful to prevent thrombotic complications in BD patients.Öğe Mean platelet volume in patients with idiopathic and ischemic cardiomyopathy Reply(Aves Yayincilik, 2013) Acikgoz, Nusret; Ermis, Necip; Yagmur, Julide; Cansel, Mehmet; Atas, Halil; Pekdemir, Hasan; Ozdemir, Ramazan[Abstract Not Available]Öğe Response: Is Mean Platelet Volume Increased in Behcet's Disease with Thrombosis?(Tohoku Univ Medical Press, 2010) Acikgoz, Nusret; Karincaoglu, Yelda; Ermis, Necip; Yagmur, Julide; Atas, Halil; Kurtoglu, Ertugrul; Cansel, Mehmet[Abstract Not Available]Öğe Saddle Pulmonary Embolism Visualized by Real Time Three-Dimensional Echocardiography(Wiley, 2012) Yagmur, Julide; Atas, Halil; Cansel, Mehmet; Akturk, Erdal; Yetkin, OzkanSaddle pulmonary embolism is defined as a visible thromboembolus straddling the bifurcation of the main pulmonary artery. It is very unusual to visualize a pulmonary artery thrombus on transthoracic echocardiography. We describe a case of a saddle embolus of the main pulmonary artery visualized by real time three-dimensional echocardiography and successfully treated with intravenous unfractionated heparin, followed by oral anticoagulation achieving a complete dissolution of the thrombus. (Echocardiography 2012;29:E8-E9)
