Myocardial ischemia caused by a coronary anomaly: Left circumflex coronary artery arising from right sinus of valsalva

Aydin M. | Ozeren A. | Peksoy I. | Cabuk M. | Bilge M. | Dursun A. | Elbey M.A.

Article | 2004 | Texas Heart Institute Journal31 ( 3 ) , pp.273 - 275

We present the case of a patient in whom a previously undetected anomalous origin of the circumflex coronary artery caused myocardial ischemia and led to positive myocardial scintigraphic results. Subsequent coronary angiography showed that the left circumflex coronary artery arose from the right coronary ostium-an anomaly that has been associated with chest discomfort-without atherosclerotic lesions. The peripheral distribution, of the left circumflex artery was normal. We describe the clinical and angiographic findings in our patient and discuss the relationship between coronary artery anomalies and ischemia.

Left ventricular diastolic function and circadian variation of blood pressure in essential hypertension

Aydin M. | Ozeren A. | Bilge M. | Atmaca H. | Unalacak M. | Dursun A. | Elbey M.A.

Article | 2005 | Texas Heart Institute Journal32 ( 1 ) , pp.28 - 34

The purpose of this prospective study was to determine the relationship between circadian blood pressure and left ventricular diastolic function in essential hypertension. The study population included 25 patients aged 56 ± 18 years with non-dipper hypertension and 25 age- and sex-matched patients with dipper hypertension. They underwent conventional Doppler echocardiography and color tissue Doppler from apical 4-and 2-chamber views. In non-dipper patients, diastolic left ventricular function was reduced significantly. The transmitral E wave decreased (0.55 ± 0.2 vs 0.62 ± 0.2 m/s, P

Effect of metoprolol treatment on pulmonary venous flow pattern studied by transesophageal pulsed Doppler echocardiography in mild to moderate mitral stenosis in sinus rhythm

Aydin M. | Özeren A. | Bilge M. | Demirkiran M. | Cam F. | Dursun A. | Elbey M.A.

Article | 2004 | Turk Kardiyoloji Dernegi Arsivi32 ( 4 ) , pp.239 - 245

This study was conducted to evaluate the effect of metoprolol therapy on pulmonary venous flow pattern in patients with mild to modarete mitral stenosis in sinus rhythm. We studied 23 patients with isolated mild to moderate mitral stenosis (mitral valve area 1.6±0.3 cm2). All patients received metoprolol 100 mg once daily orallyfor 1 month. Pulsed wave Doppler transesophageal echocardiograpic examination of the pulmonary venous flow was performed at the beginning of the study and after 1 month of treatment. Peak systolic pulmonary venous fiow (PVs) velocity, PVs velocity time integral (VTI), peak diastolic pulmonary venous flow (PM) . . . velocity, PVd-VT, peak pulmonary venous atrial reversal flow (PVd) velocity, PVa-VTI, and PVa duration time were measured. Peak and mean transmitral gradient, pulmonary artery pressure, systolic and diastolic blood pressure, and heart rate, reduced significantly after metoprolol treatment. The pulmonary venous peak systolic velocity, and pulmonary venous atrial reversal flow velocity duration time increased significantly from 0.55 ± 0.19 m/s to 0.66 ± 0.12 m/s, p<0.05, and from 84 ± 27 to 11 2± 31 msec, p<0.01, respectively). Regarding VTI, PVs-VTI increased from 10.8±3.2 cm to 11.9±4.3 cm (p<0.01), PVd-VTI increased from 5.1±2.4 cm to 5.4±2.5 cm (p<0.05), and PVa-VTI increased from 2.8±1.1 cm to 3.1±1.3 cm, p<0.05. Conclusion: Metoprolol treatment increased pulmonary venous flow as an indicator of improved left atrial function in patients with mitral stenosis and sinus rhythm. These results may contribute to disclosing the underlying mechanisms of the favourable effects of beta blockade in mitral stenosis Daha fazlası Daha az

Effects of dipper and non-dipper status of essential hypertension on left atrial mechanical functions

Aydin M. | Ozeren A. | Bilge M. | Dursun A. | Cam F. | Elbey M.A.

Article | 2004 | International Journal of Cardiology96 ( 3 ) , pp.419 - 424

Aim: This study was designed in order to investigate the effects of dipper and non-dipper status of hypertension on left atrial mechanical (reservoir, conduit and booster pump) functions with left atrial volume measurements by means of two-dimensional echocardiography in untreated systemic hypertensive patients. Method: A total of 27 untreated dipper hypertensive patients, group I (15 female, 12 male, mean age 57±12 years); 23 untreated non-dipper hypertensive patients, group II (12 female, 11 male, mean age: 53±18 years); and 25 voluntary healthy individuals, group III (13 female, 12 male, mean age 53±10 years) were included into t . . .he study. Twenty-four hour blood pressure (BP) measurement was performed by the cuff-oscillometric method to evaluate the nocturnal decrease of BP. The patients whose night time mean blood pressure measurements were found 10% or more lower compared to mean day time measurements were classified as dipper hypertensive patients and the ones with a decrease of less than 10% were classified as non-dipper hypertensive patients. Left atrial (LA) volumes were measured echocardiographically according to biplane area-length method in apical four-chamber and two-chamber views. LA maximal volume (Vmax) was recorded at the onset of mitral opening, LA minimal volume (Vmin) was recorded at the onset of mitral closure and LA presystolic volume (Vp) was recorded at the beginning of the atrial systole (p wave on ECG). All volume measurements were corrected to body surface area, and following LA emptying functions parameters were calculated: LA passive emptying volume (LAPEV)=Vmax-Vp, LA passive emptying fraction (LAPEF)=LAPEV/Vmax, Conduit volume (CV)=left ventricular output volume-(Vmax-Vmin), LA active emptying volume (LAAEV)=Vp-Vmin, LA active emptying fraction (LAAEF)=LAAEV/Vp, LA total emptying volume (LATEV)=V max-Vmin, LA total emptying fraction (LATEF)=LATEV/V max. Results: LA volume indexes, Vmax, Vmin, and Vp, were significantly increased in the hypertensive subgroups (groups I and II) than in controls (p<0.001, p<0.001, p<0.001, respectively), but no significant difference was found in the Vp values between group I and group II. Vmax and Vmin were larger in non-dipper hypertensive group than in dipper hypertensive group (p<0.05 and p<0.05, respectively). LAPEV and LAPEF were observed to be significantly reduced in both dipper and non-dipper hypertensives than in control (p<0.001 and p<0.05, respectively), and this difference was more obvious in non-dipper than dipper cases (p<0.001). Conduit volume was significantly lower in hypertensive groups than controls (p<0.05). LA active emptying volume (p<0.001) and LAA active emptying fraction (p<0.001) were significantly greater in hypertensive cases than in controls. Furthermore, LA active emptying volume in non-dipper hypertensive subjects was significantly greater than dipper hypertensive cases (p<0.05). Left atrial total emptying volume and left atrial total emptying fraction in both hypertensive groups were similar to control (p>0.05). Conclusions: Atrial reservoir and booster pump functions increase in hypertensive patients, but this result is more prominent in non-dipper hypertensives than in dipper hypertensive patients. © 2003 Elsevier Ireland Ltd. All rights reserved Daha fazlası Daha az

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