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Öğe Acute myocardial infarction with normal coronary arteries in a young man with the Behcet's disease(Elsevier Ireland Ltd, 2005) Kosar, F; Sahin, I; Gullu, H; Cehreli, SBehcet's disease (BD) is an inflammatory disorder of unknown origin, which usually presents with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. Although cardiac involvement is not infrequent as a manifestation of Behcet's disease, coronary arteritis is very rarely reported. We suggest that the diagnosis of coronary arteritis should be considered in patients presenting acute myocardial infarction especially in young patients as underlying cause. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe A case of left atrial myxoma associated with atrial septal defect(Wiley, 2005) Kosar, F; Erdil, N; Gullu, H; Sahin, I; Nisanoglu, V; Battaloglu, BCardiac myxoma is the most frequent primary tumor of the heart. However, it is rarely associated with congenital cardiac anomalies such as atrial septal defect in the literature. We present a 72-year-old woman referred to the emergency department with loss of consciousness and finally diagnosed as a pedinculated mobile left atrial myxoma and concomitant occurrence of an ostiurn secundum type atrial septal defect. The mass was successfully excised, and atrial septal defect was safely repaired by primary suture, The patient is currently well after surgery. Atrial myxoma should be considered in the differential diagnosis when patients present with neurological consequences of systemic embolization.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 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 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 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 large true contractile left ventricular diverticulum mimicking ischemia in an adult patient: a case report(Springer, 2005) Kosar, F; Sahin, I; Gullu, HCongenital diverticulum of the ventricle is a rare cardiac abnormality that is characterized by local embryo-logic development failure of the ventricular muscle. It can be found as an isolated form or associated with other cardiac abnormalities. Clinically, it has been reported that it can lead to heart failure, arrhythmia, or chest pain, although frequently the course is asymptomatic. We present a patient who was referred to our clinic with chest pain due to isolated left ventricular diverticulum mimicking myocardial ischemia.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 Left main coronary artery compression by dilated pulmonary trunk in a patient with atrial septal defect(Acta Cardiologica, 2003) Gullu, H; Kosar, F; Battaloglu, BA 52-year-old man, presenting with exertional chest pain was investigated to explain his chest pain. Echocardiographic examination revealed he had the ostium secundum type of atrial septal defect, dilated right heart chambers, dilated pulmonary artery, and pulmonary artery systolic pressure of 65 mm Hg calculated from tricuspid regurgitation, but his chest pain could not be explained with these findings. Therefore, cardiac catheterization and coronary angiograph were performed Coronary angiography revealed severe stenosis of the left main coronary artery and otherwise normal vessels. Angiographic images made us think that there might be an external compressing structure on the left main coronary artery. For further evaluation, contrast-enhanced magnetic resonance images of the heart were taken. These images showed that the markedly dilated pulmonary artery was compressing the left main coronary artery.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]
