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Öğe Comparison of the effects of tibolone and hormone replacement therapy on echocardiographic basic cardiac functions in postmenopausal women: A randomized placebo controlled study.(Elsevier Science Inc, 1997) Taskin, O; Buhur, A; Burak, F; Birincioglu, M; Burak, F; Atmaca, R; Ozdemir, R[Abstract Not Available]Öğe Comparison of TIMI frame counts of patients with and without coronary artery ectasia(W B Saunders Co Ltd, 2002) Yetkin, E; Atak, R; Turhan, H; Sivri, N; Ileri, M; Kosar, F; Ozdemir, R[Abstract Not Available]Öğe Detection of Chlamydia pneumoniae deoxyribonucleic acid in blood samples taken from coronary sinus after coronary angioplasty(Excerpta Medica Inc-Elsevier Science Inc, 2002) Yetkin, E; Yetkin, G; Tandogan, I; Kocabas, NA; Ileri, M; Ozdemir, R; Kosar, FChlamydia pneumoniae deoxyribonucleic acid was not found in blood samples (0%) taken from the coronary sinus immediately before coronary angioplasty, but C. pneumoniae deoxyribonucleic acid was detected in 4 of 14 patients' blood samples (29%) taken after coronary angioplasty. This finding suggests that coronary angioplasty can cause C. pneumoniae bacteremia.Öğe Determination of risk factors in obese and non-obese patients with coronary artery disease(Acta Cardiologica, 2005) Yologlu, S; Sezgin, AT; Sezgin, N; Ozdemir, R; Yesilada, E; Topal, EObjective - Obesity is a complex multifactorial chronic disorder recently classified by the American Heart Association (AHA) as a modifiable risk factor for coronary artery disease (CAD). This study was designed to assess conventional and novel risk factors in obese and non-obese patients with CAD. Methods and results - This study evaluates the association between conventional and novel coronary risk factors and CAD in obese and non-obese patients by using multivariate stepwise logistic regression analysis. The obese CAD group was identified by the following predictors of CAD: age, sex, hypertension, diabetes mellitus, smoking, family history of CAD, low level of HDL cholesterol, high LDL cholesterol, high C-reactive protein, high homocysteine. In a non-obese CAD group, the identified predictors of CAD were age, sex, hypertension, smoking, family history of CAD, levels of high C-reactive protein, and high homocysteine. Hypertension was found to be the strongest predictor for both obese (OR: 39.91, 95% confidence intervals (Cl): 5.51-280.3, p < 0.001) and non-obese (OR: 14.39, 95% CI: 4.4-25.8, p < 0.001) patients with CAD. Conclusions - From our data, we conclude that hypertension appears to be the strongest independent predictor of CAD regardless of body mass index (BMI).Öğe Effects of mobile telephones on the function of implantable cardioverter defibrillators(Blackwell Publishing, 2005) Tandogan, I; Ozin, B; Bozbas, H; Turhan, S; Ozdemir, R; Yetkin, E; Topal, EObjective: We investigated whether mobile telephones affect the function of implantable cardioverter defibrillators (ICDs). Background: It is well known that electromagnetic fields can affect medical devices. Methods: The study included 43 patients with ventricular tachycardia and/or fibrillation treated with transvenous pectoral ICDs. Testing was done under continuous electrocardiograph monitoring under supervision of an ICD programmer. Initially, each patient was tested during spontaneous rhythm. Then the ICD was programmed to a pace rhythm higher than the patient's heart rate, and the tests were repeated at paced rhythm. In 7 patients, tests were performed during the implantation procedure as well. In 3 of the patients, only a single defibrillation zone was active. The other 40 patients had one or more active ventricular tachycardia zones. Two mobile phones (both GSM 900 MHz) were positioned 50 cm away from the implanted device in opposite directions and switched on. Communication was established between these phones, two investigators had a 20-second conversation, and then the phones were switched off. The same procedure was repeated at 30, 20, and 10 cm away from the implantation site, respectively. Finally, the procedure was performed-with the antennae of both phones touching the device pocket. In the above-mentioned 7 cases where testing was done during implantation of the ICD, a call was made from one phone to the other, ringing occurred for 5 seconds, and then two investigators conversed while the device was implanted. Results: There was no change in the function of the ICDs during any of the phone testing procedures. In 5 cases, artifacts were noted on the surface lectrocardiographic (ECG) screen of the programmer during the tests, but no such changes were observed on the simultaneous intracardiac ECGs. Conclusion: The results of the study suggest that mobile phones have no effects on ICD function.Öğe Effects of the sibutramine therapy on pulmonary artery pressure in obese patients(Blackwell Publishing Ltd, 2004) Guven, A; Koksal, N; Cetinkaya, A; Sokmen, G; Ozdemir, RAim: Obesity is a major global public health problem. Previous drugs (dexfenfluramine and fenfluramine) used for the treatment of obesity have been withdrawn due to various cardiac side effects. Sibutramine is an anti-obesity agent. The purpose of this study was to assess cardiac valve disease and pulmonary artery pressure (PAP) of the patients who used once daily doses of sibutramine. Methods: One hundred and six obese patients (51 men and 55 women) determined to have minimal tricuspid regurgitation (TR) on echocardiographic examination were included in the study. All patients had a complete physical examination, complete blood count and measurement of lipid parameters, and echocardiography was performed by which cardiac valves and PAP were evaluated. After the mean duration of 24-week of follow up, all examinations were repeated for each patient. Results: The drug was well tolerated by all patients for the follow-up period. A significant weight loss was recorded in all patients compared to the baseline values (93.1 +/- 9.6 kg vs. 85.8 +/- 7.7 kg, p < 0.001). Blood pressures and heart rate of the patients increased compared to the baseline measurements (systolic 122.3 +/- 8.5 vs. 124 +/- 10.2 mmHg, p = 0.128, diastolic 79.3 +/- 4.7 vs. 80 +/- 5.7 mmHg, p = 0.42 and heart rate 79.5 +/- 6.5 vs. 85 +/- 5.7 beats/min, p < 0.001). Echocardiographically determined aortic or mitral valve dysfunction appeared in none of the patients. PAP lightly increased after the treatment but the difference between pre and post-treatment values was not found statistically significant (14.7 +/- 1.8 vs. 16.3 +/- 1.6 mmHg, p = 0.06). Conclusions: A 24-week treatment with sibutramine does not affect heart valves and pulmonary artery pressure.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 Examination of the skin perforators of the posterior tibial artery on the leg and the ankle region and their clinical use(Lippincott Williams & Wilkins, 2006) Ozdemir, R; Kocer, U; Sahin, B; Oruc, M; Kilinc, H; Tekdemir, IBackground: There are many treatment alternatives for reconstruction of leg and foot defects. One of these treatment alternatives includes local flaps. A detailed understanding of the blood flow of the leg region is essential for producing new alternatives for the reconstruction of defects of this region. Methods: The leg and foot region blood flow was examined oil 11 fresh cadavers, and perforators of this region were examined in three zones. Perforator numbers and their diameters were defined at this region. It was determined in cadaver studies that especially zones I and II were more suitable for the planned flaps based oil perforators of the posterior tibial artery. In a clinical study that accompanies this anatomical study, eight patients underwent reconstruction by flaps based on the perforators of the posterior tibial artery. Results: Patients were followed for 3 to 14 months. In three patients, venous drainage problems had developed, and in one of them, partial flap loss had developed. This partially necrosed region was left to heal by secondary intention. Venous drainage problems resolved in 5 to 7 days in the two remaining patients. No other complications were seen. Conclusion: Regarding the results of the clinical study, the authors observed that this flap call provide the desired soft-tissue support for defects that expose the bones, tell dons, and neural and vascular bull dies.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 Impact of hemodialysis on comprehensive ventricular repolarization(Acta Cardiologica, 1997) Tuncer, C; Kulan, K; Komsuoglu, B; Ozdemir, R; Guven, A; Pekdemir, H; Sezgin, ATImpact of hemodialysis on comprehensive ventricular repolarization - Cardiac arrhythmia are one of the most important problems in haemodialysis patients. An important cause of the arrhythmias is inhomogenous myocardial repolarization. In this study, the ventricular repolarization parameters (QT, QTc, JT and JTc) and dispersions (d) of the parameters (QT-d, QTc-d, JT-d and JTc-d) were evaluated. Also, were recorded the right-sided lends (RV3-6) and posterior leads (V7-9) in addition to the standard 12 lead ECG to assess comprehensive ventricular repolarization. The leads were divided in three groups: Group A (Standard ECG leads), Group B (Right-sided leads) and Group C (All of the leads). Among the above mentioned parameters, only JT and JTc intervals decreased significantly in all groups. There was no significant difference between the groups in evaluation of the parameters. It was concluded that in assessment of ventricular repolarization, the most important ECG intervals may be JT and JTc intervals, and the standard 12 lead ECG record is sufficient in evaluation of ventricular repolarization in hemodialysis patients.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 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 Selective endothelin a (ETA) receptor antagonist (BQ-123) reduces both myocardial infarct size and oxidant injury(Elsevier Ireland Ltd, 2006) Ozdemir, R; Parlakpinar, H; Polat, A; Colak, C; Ermis, N; Acet, AObjective: Endothelins (ET) can be considered stress-responsive regulators working in paracrine and autocrine fashion. It has been suggested that elevated levels of ET may be responsible for the low coronary re-flow phenomena. Ischemia-reperfusion (I/R) was shown to stimulate ET release in rat heart; however, the mechanism(s) of this effect has not been clarified. Therefore, this study was focused to investigate the effect of BQ-123, selective ETA receptor antagonist, on three aspects of myocardial ischemia-reperfusion (MI/R) injury: hemodynamic parameters, infarct size and oxidant-antioxidant status in the absence and presence of ET-1 in an vivo rat model. Methods and results: To produce MI/R, a branch of the descending left coronary artery was occluded for 30 min followed by 2 h reperfusion. ECG changes, blood pressure (BP), and heart rate (HR) were measured before occlusion and continued both occlusion and reperfusion. Forty rats were randomly assigned to five groups equally: (1) sham-operated rats without coronary ligation, (2) I/R group, (3) I/R + BQ-123-treated group (10 mu g/kg/min i.v.), (4) I/R + ET-treated group (25 ng/kg/min i.v.), (5) I/R + ET + BQ-123-treated group. The results are expressed as mean +/- S.E.M. In the ET-1 plus I/R group, the ratio between the infarcted area and area at risk 56 +/- 1% was significantly higher than I/R group (49 +/- 1%). In the BQ-123 group with or without exogenous ET-1 treatment in I/R group, this ratio was significantly lower at 40 +/- 2 and 37 +/- 1%, respectively. As compared to sham group, I/R increased lipid peroxidation whereas decreased nitric oxide (NO), glutathione (GSH), catalase (CAT) and superoxide dismutase (SOD) contents. This decreased antioxidant enzymatic defense could result in aggravated oxidative damage in I/R group rat hearts. ET-1 administration group showed severe oxidative damage. BQ-123 administrations to I/R group with or without ET-1 caused significantly decrease in lipid peroxidation and increased in SOD, CAT activities and NO generation and GSH content when compared with I/R group alone. Conclusions: The most important finding of the present study is that the ET blockade reduced I/R-induced myocardial injury. The mechanism of this reduction was speculated to be a resistance to ischemic injury in the subcellular levels of the myocardium conferred by a reduction of vascular constriction and improvement of imbalance in the antioxidant status. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Serum and ascites fluid cytokine levels in patients with chronic heart failure(Acta Cardiologica, 2001) Sari, R; Yildirim, B; Sevinc, A; Bahceci, F; Ozdemir, R; Hilmioglu, FObjective - Cytokines that are capable of modulating cardiovascular function were reported to be elevated in patients with advanced heart failure. We evaluated the diagnostic importance of cytokines both in the serum and ascites. Material and methods - We determined serum and ascites fluid TNF-alpha, IL-1 beta, IL-6, IL-8, and soluble IL-2 receptor levels in 14 patients with congestive heart failure (group I) and in 15 patients with chronic liver disease (group 2). Results - Ascites fluid IL-8 and soluble IL-2 receptor levels were found to be significantly elevated in group I when compared with group 2 (p = 0.014 and p = 0.005). There were no statistical differences in serum TNF-alpha, IL-1 beta, IL-6, IL-8, and soluble IL-2 receptor levels and ascites fluid TNF-alpha, 1L- I (IL-1 beta, and IL-6 Ievels. Ascites fluid/serum IL- I (IL-1 beta and IL-8 ratio was lower in group 1 when compared with group 2 (p = 0.001 and p = 0.005). Ascites fluid/serum IL-2 and IL-6 ratio was higher in group I when compared with group 2 (p = 0.035 and p = 0.025). Conclusion - Cytokine levels in ascites fluid, but not in serum, are important in congestive heart failure. Ascites fluid/serum cytokine level ratios were detected to be more conclusive and valid in the diagnosis work-up of ascites aetiology.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.
