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Öğe Acute pericarditis as a complication of percutaneous mitral balloon valvulotomy(I C R Publishers, 2006) Turhan, H; Basar, N; Yasar, AS; Erbay, AR; Atak, RDuring the past two decades, percutaneous mitral balloon valvulotomy (PMBV) has been frequently used, with high success and low complication rates, in the treatment of patients with moderate to severe rheumatic mitral stenosis. The case is reported of a patient with severe rheumatic mitral stenosis who developed acute pericarditis two days after successful PMBV. To the best of the authors' knowledge, this is the first such case to be reported.Öğe Correlation between infarct-related coronary artery patency and predischarge electrocardiographic patterns in patients with first anterior myocardial infarction who received thrombolytic therapy(Springer-Verlag, 2004) Atak, R; Ileri, M; Senen, K; Turhan, H; Erbay, AR; Basar, N; Yetkin, EThe aim of this study was to investigate the correlation between the ST-segment and T-wave patterns in pre-discharge electrocardiogram and patency of left anterior descending coronary artery in patients with a first anterior myocardial infarction (AMI). One hundred and fifty-six of 175 consecutive patients who were admitted to our clinic between January 2000 and September 2002 due to a first episode of transmural AMI and who received thrombolytic therapy were enrolled. Coronary angiography was performed by the Judkins method on the 6th-10th day after the acute infarction. The corrected TIMI frame count (CTFC) was estimated according to the previously described method. According to the combination of the ST-segment and T-wave morphology on the day (6-10) of cardiac catheterization, patients were classified into four groups: group A, ST elevation <0.1 mV and negative T waves; group B, ST elevation ?0.1 mV and negative T waves; group C, ST elevation <0.1 mV and positive T waves; and group D, ST elevation greater than or equal to0.1 mV and positive T waves. Of the 99 patients with negative T waves, 47 (48%) had CTFCless than or equal to27,32 (32%) CTFC between 27 and 40,15 (15%) CTFCgreater than or equal to40-100, and 5 (5%) CTFC>100. Of the 57 patients with positive T waves, CTFC was less than or equal to27 in 14 (25%), between 27 and 40 in 17 (30%), greater than or equal to40-100 in 11 (19%), and >100 in 15 (26%) (P<0.001). From the 76 patients with an isoelectric ST segment, 38 (50%) had CTFC?27, 29 (38%) CTFC between 27 and 40, 8 (11%) CTFC?40-100, and 1 (1%) CTFC >100. Of the 80 patients with an elevated ST segment, 23 (29%) had CTFCless than or equal to27, 20 (25%) CTFC between 27 and 40,18 (23%) CTFCgreater than or equal to40-100, and 19 (23%) CTFC>100(P<0.001). Use of the combination of two electrocardiographic parameters (ST segment and T waves) also indicated that there were significant differences between groups A and D, and groups B and D (P<0.001 and P<0.05, respectively). Development of an isoelectric ST segment with negative T waves may indicate a better degree of reperfusion after AML In contrast, patients in whom ST-segment elevation and positive T waves remain at discharge from the coronary care unit have a higher probability of a nonpatent left anterior descending artery.Öğe High prevalence of metabolic syndrome among young women with premature coronary artery disease(Lippincott Williams & Wilkins, 2005) Turhan, H; Yasar, AS; Basar, N; Bicer, A; Erbay, AR; Yetkin, EBackground The metabolic syndrome is more prevalent with the use of the recently defined National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria and is associated with a greater risk of atherosclerotic cardiovascular disease than any of its individual components. This study evaluated the prevalence of metabolic syndrome in female and male patients with newly diagnosed premature coronary artery disease. Method The study population included 582 consecutive patients (496 men, 86 women) with newly diagnosed premature coronary artery disease (aged less than or equal to 45 years). Besides classic major coronary risk factors, all patients were evaluated for the presence of metabolic syndrome based on the NCEP ATP III criteria. Results The majority of patients were male (85% versus 15%). The overall prevalence of metabolic syndrome was 37%. Women with premature coronary artery disease were found to have a higher prevalence of metabolic syndrome than men (73% versus 31% respectively, p < 0.001). Furthermore, the mean number of components of metabolic syndrome was significantly higher in women compared to men (2.81 +/- 1.09 versus 1.85 +/- 1.08 respectively, p < 0.001). In addition, metabolic syndrome was detected to be the most frequent coronary risk factor in women (73%). Besides, cigarette smoking was found to be significantly higher in males compared to females (70% versus 36% respectively, p < 0.001) and it was the most prevalent coronary risk factor in men with premature coronary artery disease. Conclusion We have shown for the first time a higher prevalence of metabolic syndrome in young females compared with young males with premature coronary artery disease. This data may be useful in directing primary and secondary preventive measures. (C) 2005 Lippincott Williams Wilkins.Öğe Increased plasma soluble adhesion molecules; ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow(Elsevier Ireland Ltd, 2006) Turhan, H; Saydam, GS; Erbay, AR; Ayaz, S; Yasar, AS; Aksoy, Y; Basar, NBackground: Inflammation has been reported to be a major contributing factor to many cardiovascular events. In the present study, we aimed to evaluate plasma soluble adhesion molecules; intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin as possible indicators of endothelial activation or inflammation in patients with slow coronary flow. Method: Study population included 17 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels (group I, 11 male, 6 female, mean age=48 +/- 9 years), and 20 subjects with angiographically proven normal coronary arteries without associated slow coronary flow (group II, 11 male, 9 female, mean age=50 +/- 8 years). Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction frame count (TIMI frame count). All patients in group I had TIMI frame counts greater than two standard deviation above those of control subjects (group 11) and, therefore, were accepted as exhibiting slow coronary flow. Serum levels of ICAM-1, VCAM-1, and E-selectin were measured in all patients and control subjects using commercially available ELISA kits. Results: Serum ICAM-1, VCAM-1, and E-selectin levels of patients with slow coronary flow were found to be significantly higher than those of control subjects with normal coronary flow (ICAM-1: 545 +/- 198 ng/ml vs. 242 +/- 113 ng/ml respectively, p < 0.001, VCAM-1: 2040 +/- 634 ng/ml vs. 918 +/- 336 ng/ml respectively, p < 0.001, E-selectin: 67 +/- 9 ng/ml vs. 52 +/- 8 ng/ml respectively, p < 0.001). Average TIMI frame count was detected to be significantly correlated with plasma soluble ICAM-1 (r=0.550, p < 0.001), VCAM-1 (r=0.569, p < 0.001) and E-selectin (r = 0.443, p = 0.006). Conclusion: Increased levels of soluble adhesion molecules in patients with slow coronary flow may be an indicator of endothelial activation and inflammation and are likely to be in the causal pathway leading to slow coronary flow. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe P-wave duration and P-wave dispersion in patients with dilated cardiomyopathy(Wiley, 2004) Kubilay, SA; Turhan, H; Erbay, AR; Basar, N; Yasar, AS; Sahin, O; Yetkin, EBackground: P-wave dispersion (PWD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. In the present study, we aimed to investigate PWD in patients with dilated cardiomyopathy. Method: The study population consisted of 72 patients with dilated cardiomyopathy and 72 healthy control subjects. Left atrial diameter, left ventricular end-diastolic and end-systolic diameters and left ventricular ejection fraction of all patients and control subjects were measured by means of transthoracic echocardiography. Maximum P-wave duration (Pmaximum) and minimum P-wave duration (Pminimum) were measured from the 12-lead surface electrocardiogram. PWD was calculated as the difference between Pmaximum and Pminimum. Results: Pmaximum and PWD of patients with dilated cardiomyopathy were significantly higher than those of control subjects (Pmaximum: 126 +/- 12 ms vs. 116 10 ms, PWD: 47 +/- 6 ms vs. 38 +/- 7 ms, respectively, P < 0.001 for all). However, there was no statistically significant difference between patient group and control group regarding Pminimum (79 7 ms vs. 78 6 ms, respectively, P = 0.27). Left atrial diameter was significantly higher in patients with dilated cardiomyopathy compared to control subjects (4.51 +/- 0.62 cm vs. 3.60 +/- 0.43 cm, respectively, P < 0.001). Left ventricular ejection fraction was found to be significantly lower in patients with dilated cardiomyopathy compared to control subjects (33 +/- 5% vs. 63 +/- 7%, respectively, P < 0.001). Conclusion: PWD was found to be significantly higher in patients with dilated cardiomyopathy than in healthy control subjects. (C) 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
