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Öğe Decreased serum lipoprotein levels as a guide for clinical severity in patients with idiopathic dilated cardiomyopathy(Tohoku Univ Medical Press, 2005) Sezgin, N; Sezgin, AT; Gullu, H; Karabulut, A; Barutcu, I; Topal, E; Yalcintas, DHyperlipidemia is a cardiovascular risk factor. In patients with idiopathic dilated cardiomyopathy (IDC), prognostic roles of endogenous lipoproteins are not fully clarified. It has been known that there is a direct relationship between the levels of cytokines (tumor necrosis factor-alpha [TNF-alpha] and interleukin-6 [IL-6]) and deteriorating functional classes of heart failure and mortality. The present study compared the levels of circulating TNF-alpha, IL-6, lipoproteins, and apolipoproteins in patients with stable IDC (n = 28) with those of patients with unstable IDC (n = 26) and controls (n = 24). Mean serum total. cholesterol (TC) was significantly lower in stable IDC patients than controls (p < 0.05). In unstable IDC patients, mean serum TC was also lower than controls but not statistically significant. The IDC patients had significantly higher concentrations of IL-6 and TNF-alpha than the controls (p < 0.01). Serum IL-6 and Apo AI levels were significantly different between stable and unstable IDC patients (p = 0.021 and p = 0.012, respectively). Increased levels of IL-6 were associated with decreased levels of TC (r = -0.266, p = 0.019), LDL-C (r = -0.376, p = 0.001) and apolipoprotein AI (apo AI) (r = -0.495, p < 0.001) in all IDC patients. TNF-a was also inversely related to apo AI (r = -0.455, p < 0.001) and LDL-C (r = -0.364, p = 0.001) in all patients. Thus, elevated serum levels of cytokines in patients with IDC are associated with decreased lipoprotein concentrations, which may indicate impaired prognosis. (c) 2005 Tohoku University Medical Press.Öğe The effects of trimetazidine on heart rate variability in patients with slow coronary artery flow(Churchill Livingstone Inc Medical Publishers, 2006) Topal, E; Ozdemir, R; Barutcu, I; Aksoy, Y; Sincer, I; Akturk, E; Çehreli, SObjective: We sought to examine the effect of trimetazidine (TMZ) on heart rate variability (HRV), endothelin-1 (ET-1), NO, and anginal symptoms in patients with slow coronary artery flow (SCAF). Methods: The 48 patients with SCAF (29 women and 19 men; mean age, 52 +/- 9 years) were included in the study. Twenty milligrams TMZ 3 times a day or matched placebo were given randomly in a double-blinded fashion for 4 weeks. Patients were divided into 4 groups as follows: exercise-positive, TMZ-given group (group A, n = 12); exercise-positive, placebo-given group (group B, n = 12); exercise-negative, TMZ-given group (group C, n = 12); and exercise-negative, placebo-given group (group D, n = 12). Results: After TMZ treatment, HRV parameters, including SD of the all R-R intervals, SD of the averages of R-R intervals in all 5-minute segments of the entire recording, percentage of R-R intervals with more than 50-millisecond variation, and the square root of the mean of the sum of the squares of differences between adjacent R-R intervals, significantly improved both in exercise-positive and exercise-negative groups when compared with baseline. After TMZ treatment, ET-1 and NO levels significantly altered both in exercise-positive and exercise-negative groups when compared with baseline (17.7 +/- 2.7 vs 13.9 +/- 2.8 pg/mL [P = .01] and 18.1 +/- 3.8 vs 14.2 +/- 2.6 pg/mL [P = .01], respectively). After TMZ treatment, NO levels significantly increased in both exercise-positive and exercise-negative groups when compared with baseline (36.4 +/- 5.4 vs 43.3 +/- 6.8 pmol/L [P = .01] and 36.8 +/- 7.8 vs 43.3 +/- 4.8 mu mol/L [P = .01], respectively). However, in placebo group, neither HRV parameters nor ET-1 and NO levels altered when compared with baseline. Also, after treatment, a significant correlation was detected between HRV parameters, including SID of the averages of R-R intervals in all 5-minute segments of the entire recording, SID of the all R-R intervals, percentage of R-R. intervals with more than 50-millisecond variation, and the square root of the mean of the sum of the squares of differences between adjacent R-R intervals, and NO and ET-1 levels in TMZ group but not placebo. Conclusion: Short-term TMZ therapy improved HRV parameters and endothelial products such as ETLI and NO as well as anginal symptom in patients with SCAR Improvement in HRV parameters was correlated with ET-1 and NO levels. (c) 2006 Elsevier Inc. All rights reserved.Öğe Elevated plasma homocysteine level in slow coronary flow(Elsevier Ireland Ltd, 2005) Barutcu, I; Sezgin, AT; Sezgin, N; Gullu, H; Esen, AM; Topal, E; Ozdemir, RBackground: Slow flow velocity of dye in coronary arteries is not an infrequent finding during routine coronary angiography and its precise mechanism is unknown. In this study, we measured the plasma homocysteine level in patients with slow coronary flow (SCF) in comparison with subjects having normal coronary flow (NCF). Method: The study consisted 39 patients (mean age, 47 +/- 8 years) with angiographically diagnosed SCF. SCF was defined according to TIMI frame count (TFC) method. Thirty subjects (mean age 46 8 years) with NCF served as control group. Plasma homocysteine levels were measured after 12 h fasting period in each subject. Results: Baseline demographic properties were similar in both groups. In patients with SCF, TFC was significantly higher than those with NCF. Similarly, in patients with SCF plasma homocysteine level was significantly higher than that of control group (14.1 +/- 2.2 vs. 5.5 +/- 1.3 mu mol/l, respectively p < 0.001). Conclusion: Elevated plasma homocysteine level supports the hypothesis that endothelial function is impaired in slow coronary flow. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Endothelial function and slow coronary flow(Elsevier Science Inc, 2003) Sezgin, A; Sigirci, A; Barutcu, I; Topal, E; Sezgin, N; Ozdemir, R; Gullu, H[Abstract Not Available]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 Findings of ambulatory blood pressure monitoring and heart rate variability in patients with Behcet's disease(Excerpta Medica Inc-Elsevier Science Inc, 2003) Ozdemir, R; Sezgin, AT; Topal, E; Kutlu, R; Barutcu, I; Gullu, HAlthough we found lack of a decrease in nocturnal blood pressure; impaired heart rate variability; and diastolic dysfunction inpatients with Behcet's disease, we could not demonstrate, whether or not this finding has a prognostic value in patients with this disease. (C) 2003 by Excerpta Medica, Inc.Öğe Identifying risk factors in a mostly overweight patient population with coronary artery disease(Westminster Publ Inc, 2003) Yologlu, S; Sezgin, AT; Ozdemir, R; Sezgin, N; Colak, C; Topal, E; Barutcu, IOverweight/obesity is a complex multifactorial chronic disorder, and the American Heart Association (ANA) has recently classified as a modifiable risk factor for coronary heart disease (CAD). This study (1) evaluates the association between CAD in a patient population mostly overweight (MOP) and conventional and novel coronary risk factors by using univariate and multivariate logistic regression analysis and (2) seeks to find the best model by comparing univariate and multivariate logistic regression analysis algorithms, which were systematically applied to risk factors by using Hosmer-Lemeshow statistic test. In univariate analysis, there were significant associations between CAD in MOP and conventional and novel risk factors. However, the model's sensitivity, specificity, and accuracy levels were weak. In multivariate analysis, although some risk factors were not found as predictors of coronary artery disease, the model showed good fit to data and had high sensitivity, specificity, and accuracy levels. This was also confirmed by using the Hosmer-Lemeshow goodness of fit test, more specifically.Öğe Impaired left ventricle filling in slow coronary flow phenomenon: An echo-Doppler study(Westminster Publ Inc, 2005) Sezgin, AT; Topal, E; Barutcu, I; Ozdemir, R; Gullu, H; Bariskaner, E; Ermis, NSlow coronary flow (SCF) in a normal-appearing coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. The aim of the study was to evaluate echocardiographic features in patients with SCF Thirty-four patients with angiographically proven SCF (group I) and 25 patients with normal coronary flow (group II) were enrolled in the study. The diagnosis of SCF was made with use of the TIMI frame count (TFC) method. All patients underwent complete transthoracic echocardiographic examination (M-mode, 2-dimensional [2-D], and Doppler parameters such as color, continuous, pulsed wave). There were no significant differences with respect to systolic parameters between the 2 groups; in spite of these, group I showed impaired left ventricular diastolic patterns compared to group II. Group I patients had higher peak late diastolic filling velocities due to enhanced atrial systole (A), lower peak (E/A) diastolic filling velocity ratios, and longer isovolumetric relaxation times compared with group II, and these were statistically significant (p < 0.001). In conclusion; the authors detected diastolic filling abnormalities and showed diastolic dysfunction in patients with SCF.Öğe Isolated true contractile left ventricular diverticulum in an adult patient(Elsevier Ireland Ltd, 2004) Barutcu, I; Gullu, H; Kosar, F[Abstract Not Available]Öğe Plasma homocysteine level in slow coronary flow(W B Saunders Co Ltd, 2003) Barutcu, I; Sezgin, A; Ozdemir, R; Gullu, H; Topal, E[Abstract Not Available]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.Öğe Vascular endothelial function in patients with slow coronary flow(Lippincott Williams & Wilkins, 2003) Sezgin, AT; Sigirci, A; Barutcu, I; Topal, E; Sezgin, N; Ozdemir, R; Yetkin, EBackground Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. Design The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery. Methods Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 476 8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 475 74 years). Results The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48 +/- 0.10% compared with 9.11 +/- 0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8 +/- 1.1% compared with 171 +/- 1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFCm) was strongly and inversely related to the percentage of FMD (r = -0.29, P < 0.01) in all participants. When the patients with SCIF were excluded, CTFC, was still inversely related to the percentage of FMD (r = -0.36, P < 0.05). CTFC, was also inversely related to NTG-induced dilatation in the 57 participants (r = -0.23, P < 0.05). Multiple regression analysis showed that CTFC, was inversely related to the percentage of FMD only (r = -0.37, P < 0.05). Conclusions These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.
