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Öğe Comparison of low dose DSE and echocardiography during GIK infusion for the detection of myocardial viability after anterior myocardial infarction(W B Saunders Co Ltd, 2002) Yetkin, E; Kubilay, S; Atak, R; Ileri, M; Tandogan, I; Turhan, H; Kosar, F[Abstract Not Available]Öğe Comparison of low-dose dobutamine stress echocardiography and echocardiography during glucose-insulin-potassium infusion for detection of myocardial viability after anterior myocardial infarction(Lippincott Williams & Wilkins, 2002) Yetkin, E; Senen, K; Ileri, M; Atak, R; Tandogan, I; Yetkin, Ö; Kosar, FBackground Low-dose dobutamine stress echocardiography (LDDSE) is one of the methods most used to assess myocardial viability. Glucose-insulin-potassium (GIK) infusion has been shown to increase contraction of the ischemic zone. The aim of this study was to compare LDDSE and echocardiography during GIK infusion for detection of myocardial viability. Methods Thirty-two patients who had first anterior myocardial infarction (MI) without previous MI were included in the study. Echocardiographic evaluation was carried out on the 7th +/- 2 days after MI. During continuous electrocardiographic, blood pressure and echocardiographic monitoring, an intravenous infusion of dobutamine (3 mug/kg body weight/min) was started with an infusion pump, continued for 5 min and then increased to 5 mug/kg/min and 10 mug/kg/min for another 5 min. The GIK protocol consisted of a fixed dose of insulin (100 muU/kg/h intravenously) and a variable glucose/potassium infusion rate. GIK echocardiography was done at baseline and after 60 min of GIK. The detected viable myocardium was defined as one or two scores decreasing in at least two adjacent abnormal segments during LDDSE and GIK echocardiography. Results Under resting conditions 225 segments (44%) were normokinetic, 21 segments (4%) dyskinetic, 117 segments (23%) akinetic and 149 segments (29%) hypokinetic. Viability was detected in 20% (57 segments) of the asynergic segments at baseline with GIK echocardiography and in 22% (62 segments) of those segments with LDDSE (P < 0.05). Left ventricular wall motion score index at baseline was 1.87 and it decreased significantly indicating improvement in left ventricular systolic function during both LDDSE and GIK echocardiography (P < 0.001, versus 1.75 and 1.76 respectively). The agreement between LDDSE and GIK echocardiography for detection of myocardial viability was 96%. Conclusion We have shown that GIK echocardiography is similar to LDDSE for detection of myocardial viability. With the support of further clinical studies GIK echocardiography could be used to detect myocardial viability after acute MI.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 Detection of Chlamydia pneumoniae DNA in blood samples taken from coronary sinus after coronary angioplasty(W B Saunders Co Ltd, 2001) Yetkin, E; Yetkin, G; Tandogan, I; Aygun, N; Ileri, M; Cehreli, S; Mert, A[Abstract Not Available]Öğe Documentation of slow coronary flow by the TIMI frame count in habitual smokers with normal coronary arteries(W B Saunders Co Ltd, 2002) Yetkin, E; Turhan, H; Atak, R; Ileri, M; Senen, K; Yetkin, O; Tandogan, I[Abstract Not Available]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 Identification of viable myocardium after anterior myocardial infarction: Comparison of combined low dose dobutamine-nitrate echocardiography and low dose dobutamine stress echocardiography(Lippincott Williams & Wilkins, 2002) Senen, K; Yetkin, E; Ileri, M; Atak, R; Turhan, H; Tandogan, I; Cehreli, S[Abstract Not Available]Öğe Identification of viable myocardium in patients with chronic coronary artery disease and myocardial dysfunction: Comparison of low-dose dobutamine stress echocardiography and echocardiography during glucose-insulin-potassium infusion(Sage Publications Inc, 2002) Yetkin, E; Senen, K; Ileri, M; Atak, R; Battaoglu, B; Yetkin, O; Tandogan, ILow-dose dobutamine stress echocardiography (LDDSE) is one of the methods most used to assess myocardial viability. Glucose-insulin-potassium (GIK) has been shown to increase contraction of the ischernic zone. The aim of this study was to compare LDDSE and echocardiography during GIK infusion for detection of myocardial viability in patients with chronic coronary artery disease (CAD) and myocardial dysfunction. Twenty-one patients who had chronic CAD and myocardial dysfunction were included in the study. Glucose-insulin-potassium protocol consisted of a fixed dose of insulin (100 muU/kg/hour IV) and a variable glucose/potassium infusion rate. GIK echocardiography was made at baseline and after 60 minutes of GIK infusion. During continuous electrocardiographic, blood pressure, and echocardiographic monitoring, an intravenous infusion of dobutamine (3 mug/kg body weight/min) was started with an infusion pump and continued for 5 minutes and then increased to 5 mug/kg/min and 10 mug/kg/min for another 5 minutes. The detected viable myocardium was defined as I or 2 scores decreasing in at least 2 adjacent abnormal segments during LDDSE and GIK echocardiography. Viability was detected in 19% (52 segments) of the asynergic segments at baseline with GIK echocardiography and 16% (44 segments) of those segments with LDDSE (p > 0.05). Left ventricular wall motion score index at baseline was 2.24 +/- 0.35 and it decreased significantly during both LDDSE (p=0.004 vs 2.11 +/- 0.36) and GIK echocardiography (p=0.001 vs 2.09 +/- 0.32). The agreement between LDDSE and GIK echocardiography for detection of myocardial viability was 95%. This study shows that GIK echocardiography is similar to LDDSE for detection of myocardial viability. With the support of further clinical studies GIK echocardiography can be used to detect myocardial viability in patients with chronic CAD.Öğe Increased thrombolysis in myocardial infarction frame counts in patients with isolated coronary artery ectasia(Springer, 2004) Senen, K; Yetkin, E; Turhan, H; Atak, R; Sivri, N; Battaloglu, B; Tandogan, IThe Thrombolysis in myocardial infarction (TIMI) frame count is a simple clinical tool for assessing quantitative indexes of coronary blood flow. This measurement has been significantly correlated with flow velocity measured with a flow-wire by several investigators during baseline conditions or hyperemia. In this study we aimed to evaluate the coronary flow in patients with isolated coronary artery ectasia by means of the TIMI frame count and to compare the results with those of patients with angiographically normal coronary arteries. The study population consisted of 37 patients with coronary artery ectasia only in the right coronary artery (RCA). The control group consisted of 31 patients with angiographically proven normal coronary arteries. Coronary artery ectasia was defined as nonobstructive lesions of the coronary arteries with a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. The TIMI frame count was determined for each major coronary artery in each patient according to the methods first described by Gibson et al. The TIMI frame count of RCA in the study group was significantly higher than in that of the control group (51+/-17 vs 25+/-8, P<0.0001). The TIMI frame counts of the study group for the left anterior descending and left circumflex coronary artery were also significantly higher than those of the control group (corrected TIMI frame count for LAD=42+/-11 vs 24+/-7, P<0.001; TIMI frame count for LCx=44+/-15 vs 25+/-9, P<0.001). In patients with coronary artery ectasia, the TIMI frame count of the RCA was higher than that of the left anterior descending and left circumflex coronary artery (51+/-17 vs 42+/-11 and 44+/-15, respectively, P<0.05). We have shown increased TIMI frame counts in patients with isolated coronary artery ectasia and suggest that the pathophysiological mechanism of coronary artery ectasia is not a focal disease. TIMI frame counts can be regarded as an index of the severity of impaired coronary flow in patients with coronary artery ectasia.Öğe QTc dispersion measurement for risk of syncope in patients with aortic stenosis(Westminster Publ Inc, 2001) Kosar, F; Hisar, I; Durmaz, T; Ileri, M; Tandogan, IThe purposes of this study are to evaluate the clinical usefulness of maximum QTc and QTc dispersion determination in aortic stenosis, and to compare the effects of maximum QTc and QTc dispersion on the risk of syncope in aortic stenosis. The QT interval dispersion has long been known to be a marker of dispersion of ventricular repolarization and, hence, electrical instability. Additionally, it has been shown that these patients have a propensity to ventricular tachyarrhythmic syncope. The study included 86 patients with aortic stenosis who underwent left-heart catheterization and coronary angiography during investigation of syncope and 30 healthy subjects. The patients were characterized with regard to the presence or absence of a history of syncope and the severity of aortic stenosis (the degree of peak transvalvular gradient). In addition, QT max and QT dispersion measurements were corrected for heart rate according to Bazett's formula. The QTc max and QTc dispersion were greater in patients with aortic stenosis than in the healthy subjects (477 +/- 49 ms vs 370 +/- 22 ms, p<0.001; 60 +/- 13 ms vs 38 +/- 1 ms, p < 0.001). Similarly, the QTc max and QTc dispersion were greater in the patients with a history of syncope than in the patients with no history of syncope (493 +/- 48 ms vs 459 +/- 4 ms, p < 0.001; 68 +/- 12 ms vs 53 +/- 10 ms, p < 0.001). In addition, both parameters were greater in the patients with a high transvalvular gradient than in the patients with a low transvalvular gradient (489 +/- 49 ms vs 451 +/- 39 ms, p < 0.001; 65 +/- 12 ms vs 50 +/- 9 ms, p < 0.001). Multivariate logistic regression analysis showed that only a increased QTc dispersion had significant value for the risk of syncope in aortic stenosis. An increased QTc dispersion caused a 10.4% increase in the occurrence of syncope in aortic stenosis. These results suggest that high values of QTc dispersion are sensitive noninvasive markers to determine the risk for syncope in aortic stenosis.Öğe An unusual cause of hemoptysis: ventriculopulmonary fistula(Edizioni Minerva Medica, 2003) Kuzucu, A; Tandogan, I; Cihan, HB; Gulcan, O; Turkoz, RA 55-year-old man presented with massive hemoptysis following coronary artery bypass grafting and repair of a left ventricular aneurysm. Radiological and bronchoscopic examinations revealed no bronchial cause. The findings of computed tomography (CT) of the chest and echocardiography showed a pseudoaneurysm of the left ventricle. Surgical exploration confirmed that the pseudoaneurysm communicated with the lung parenchyma.
