Gudul N.E. | Karabag T. | Sayin M.R. | Bayraktaroglu T. | Aydin M.

Article | 2017 | Korean Journal of Internal Medicine32 ( 2 ) , pp.286 - 294

Background/Aims: The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods: Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of t . . .he P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. Results: The mitral E/A and E’/A’ ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E’/A’. Conclusions: In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients. © 2017 The Korean Association of Internal Medicine Daha fazlası Daha az

Bilir C. | Akdemir N. | Çolak D. | Cinemre H.

Article | 2012 | American Journal of the Medical Sciences343 ( 1 ) , pp.27 - 29

INTRODUCTION: Primary dysmenorrhea (PD), which is characterized by painful menstrual cycles, is one of the common clinical problems in young adult women. The aim of this study was to investigate the risk of cardiac arrhythmias in PD patients by using the electrocardiographic (ECG) parameters. METHODS: Forty patients diagnosed with PD and 30 age-matched normal controls were included in this study. ECGs were performed by using 12-leads with 10 mV amplitude and 25 mm/sec velocity. P and QT waves were manually marked along the isoelectric line. P maximum, P minimum, QT maximum and QT minimum were measured on the surface 12-leads ECG, an . . .d the P wave and QT dispersions were calculated. RESULTS: There was not any significant correlation of P wave dispersion and QT dispersion between the age, sex, body mass index, hemoglobin, fasting blood glucose or any other laboratory parameters. P wave dispersion was significantly longer in the PD group than the control group (61.4 ± 19 msec versus 57 ± 14 msec, P = 0.01). The P minimum duration was significantly shorter in the PD group compared with the control group (36 ± 16 msec versus 41 ± 9 msec, P = 0.03). QT dispersion was significantly higher in the PD group compared with normal controls (76 ± 23 msec versus 58 ± 16 msec, P = 0.02). CONCLUSION: These results show that PD can be associated with cardiac arrhythmias, especially atrial fibrillation, by increasing P wave dispersion and ventricular arrhythmia risk because of an increased QT interval. © Copyright 2012 Southern Society for Clinical Investigation Daha fazlası Daha az

Buyukates, Mustafa | Acikgoz, Serefden | Aktunc, Erol | Kandemir, Ozer | Dogan, Sait Mesut | Aydin, Mustafa

Article | 2012 | WIENER KLINISCHE WOCHENSCHRIFT124 ( 17-18 ) , pp.618 - 623

An important reason for production of ischemia and reperfusion injury and oxidative stress is the sudden and rapid changes in body temperature during the institution of cardiopulmonary bypass. The aim of this study was to investigate the effects of warm priming solution on oxidative stress and atrial fibrillation. This is a preliminary prospective study on a group of 40 patients who underwent elective coronary artery bypass grafting operation using cardiopulmonary bypass. Patients were randomized into two groups, each consisting of 20 patients; one group was primed with a solution at 20 A degrees C and the other at 36 A degrees C in . . .itially for cardiopulmonary bypass. Blood samples from both of the groups were drawn preoperatively and at the 15th and 60th min of aortic cross clamping and 24th h following the surgery. Serum malondialdehyde levels, protein carbonyl content and total antioxidant status were detected. Patients were followed for postoperative atrial fibrillation. Malondialdehyde and protein carbonyl content were found to be significantly higher and total antioxidant status was concordantly lower in the cold priming group at the 15th and 60th min, recovering to the normal range postoperatively at the 24th h. Patients in the cold priming group had developed a significantly higher rate of atrial fibrillation when compared with the patients in the warm priming group during the postoperative period. In conclusion, although this study has its limitation about the sample size it may provide an insight about the probable preventive effects of 36 A degrees C warm priming solution in oxidative stress and postoperative atrial fibrillation Daha fazlası Daha az

Karabag T. | Hanci V. | Aydin M. | Dogan S.M. | Turan I.O. | Yildirim N. | Gudul N.E.

Article | 2011 | International Heart Journal52 ( 1 ) , pp.23 - 26

Female gender is an independent risk factor for some types of arrhythmias. We sought to determine whether the menstrual cycle affects P wave dispersion, which is a predictor of atrial fibrillation. The study population consisted of 59 women in follicular phase (mean age, 29.3 ± 7.7 years) (group F) and 53 women in luteal phase (mean age, 28.1 ± 6.8 years) (group L). The ECGs of 35 patients (mean age, 26.4 ± 4.5) were obtained in both follicular and luteal phase. Both groups underwent a standard 12-lead surface electrocardiogram recorded at 50 mm/s. Maximal (Pmax) and minimal P wave durations (Pmin) were measured. P wave dispersion ( . . .PD) was defined as the difference between Pmax and Pmin. PD was significantly higher in group L than group F (46.6 ± 18.5 versus 40.1 ± 12.7; P < 0.05). Pmin was significantly lower in group L than group F (51.6 ± 12.1 versus 59.1 ± 12.1; P = 0.002). When we compared ECGs in different phases of the 35 patients, PD was significantly higher in luteal phase than follicular phase (53.2 ± 12.3 versus 42.8 ± 10.2; P < 0.05). Pmin was significantly lower in luteal phase than follicular phase (47.6 ± 6.6 versus 56 ± 10.1; P = 0.05). We detected a significant correlation between the day of the menses and PD (r = 0.27; P < 0.05). PD was increased in luteal phase compared to follicular phase, and this difference was more prominent as the days of the cycle progressed Daha fazlası Daha az

Karabag T. | Aydin M. | Altin R. | Dogan S.M. | Cil C. | Buyukuysal C. | Sayin M.R.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 13-14 ) , pp.444 - 452

Objective The aim of this study was to evaluate atrial electromechanical delay measured by tissue Doppler imaging and left atrial mechanical function in patients with obstructive sleep apnea (OSA). Materials and methods Fourty-seven moderate-tosevere OSA patients who were newly diagnosed by poly-somnography (Apnea-hypopnea index ≥15 events/h, 32 males, mean age 49.4±11.5) and 30 patients who had no OSA in polysomnography (Apnea-hypopnea index<5 events/h, 21 males, mean age 45.4±9.1) were included in the study. Using tissue Doppler, diastolic functions, atrial electromechanical coupling were measured from the lateral mitral, se . . .ptal, and tricuspid annulus. Inter, intra, and left atrial electromechanical delay were calculated (lateral-tricuspid, septum-tricuspid, lateralseptal). Left atrial volumes (maximal, minimal, and presystolic) were measured by the method of discs in the apical four-chamber view and were indexed to body surface area. Mechanical function parameters of the left atrium were also calculated. Results Interatrial, intraatrial, and left atrial electromechanical delays were significantly higher in the OSA group compared to the control group. Passive emptying fraction was significantly decreased, volume at the beginning of atrial systole and active emptying volume were significantly increased in OSA patients compared to the controls. The apnea-hypopnea index was significantly associated with interatrial and intraatrial electromechanical delay, passive emptying fraction, and conduit volume. Conclusions Electromechanical delay was markedly prolonged and left atrial electromechanical function was impaired in untreated OSA patients. These impairments worsen with increasing severity of OSA. © Springer-Verlag Wien 2012 Daha fazlası Daha az

Tascilar N. | Ekem S. | Aciman E. | Ankarali H. | Mungan G. | Ozen B. | Unal A.

Article | 2009 | Tohoku Journal of Experimental Medicine218 ( 4 ) , pp.293 - 300

Homocysteine, a sulfur-containing amino acid, is an intermediate during the conversion of methionine to cysteine. Homocysteine can cause vascular injury and atherosclerotic plaque instability. In addition, homocysteine may be directly correlated with hyperlipidemia and lipoprotein(a) and inversely with high-density lipoprotein cholesterol. However, the results regarding the association of homocysteine level with subtypes of stroke and traditional risk factors for stroke have been inconsistent, perhaps due to ethnic differences. The aim of this study was to evaluate the role of serum homocysteine levels in Turkish patients diagnosed . . .with atherosclerotic stroke and those with cardioembolic stroke. We measured homocysteine levels, traditional risk factors for stroke (hypertension, diabetes mellitus, and smoking) and lipoprotein(a) levels in 103 patients with large-vessel atherosclerotic stroke, 37 patients with cardioembolic stroke, and 37 controls with normal cranial magnetic resonance imaging. Only hypertension was found to be a risk factor in all patient groups (p = 0.001). Hyperhomocysteinemia (homocysteine level ? 15.90 µmol/L) was more common in patients with large-vessel atherosclerotic stroke and cardioembolic stroke (p = 0.0435 and p = 0.007, respectively); nevertheless, it was found to be a risk factor only in patients with cardioembolic stroke (p = 0.023; odds ratio (OR): 5.745). Furthermore, in the patients with large-vessel atherosclerotic stroke, hyperhomocysteinemia was positively correlated with the lipoprotein(a) level (r = 0.227, p = 0.035). In conclusion, hyperhomocysteinemia is common in patients with large-vessel atherosclerotic stroke and cardioembolic stroke. More importantly, hyperhomocysteinemia is an independent risk factor only for cardioembolic stroke in the Turkish population. © 2009 Tohoku University Medical Press Daha fazlası Daha az

Karabag T. | Aydin M. | Dogan S.M. | Ali Cetiner M. | Sayin M.R. | Gudul N.E. | Kucuk E.

Article | 2011 | Kardiologia Polska69 ( 6 ) , pp.566 - 571

Background: It is known that overt diabetes as well as chronic hyperglycaemia can lead to atrial fibrillation. A P wave dispersion (PWD) represents heterogeneity in atrial refractoriness. Aim: To investigate PWDs in patients with pre-diabetes. Method: Based on the results of examinations, 84 pre-diabetic patients (the pre-DM group; 50 female, 34 male; mean age 54 ± 8.6 years) who had no overt diabetes, coronary artery disease or hypertension, whose fasting blood glucose was higher than 100 mg/dL and/or whose 2 h glucose concentrations on an oral glucose tolerance test was in the range of 140 to 199 mg/dL, and 48 healthy volunteers ( . . .the non-DM group, 30 female, 18 male; mean age 51.7 ± 7.3 years) with no illnesses, were enrolled in this study. Standard 12-lead electrocardiograms of all patients were taken at 50 mm/s and 20 mm/mV standardisation. Maximum (Pmax) and minimum (P min) P-wave durations were measured. The PWD was defined as the difference between Pmax and Pmin. Results: The P max and PWD values were significantly higher in pre-DM compared to non-DM (104 ± 13 ms vs 98 ± 12 ms; p < 0.05, 42 ± 13 ms vs 34 ± 11 ms; p < 0.01 respectively). A positive correlation was found between PWD and fasting blood glucose (r = 0.32; p < 0.01). There was no correlation between PWD and HbA1c levels (r = 19; p > 0.05). Multivariate regression analysis showed no relationship between PWD and age, left atrial diameter, E, A, E/A or HbA1c. However, there was a relationship between PWD and fasting blood glucose. Conclusions: The Pmax and PWD are increased in pre-diabetic patients who have no coronary artery disease, hypertension or left ventricular hypertrophy. Copyright © Polskie Towarzystwo Kardiologiczne Daha fazlası Daha az

Dogan S.M. | Buyukates M. | Kandemir O. | Aydin M. | Gursurer M. | Acikgoz S. | Yavuzer R.

Article | 2007 | Coronary Artery Disease18 ( 5 ) , pp.327 - 331

OBJECTIVE: Atrial fibrillation is one of the most common arrhythmias associated with not only increased morbidity after coronary artery bypass grafting but also increased healthcare costs. Many factors are associated with atrial fibrillation onset after coronary artery bypass grafting. We prospectively examined which factors could predict atrial fibrillation after coronary artery bypass grafting. METHODS: Fifty-seven consecutive patients (37 men, mean age=60.2±12 years) with sinus rhythm before coronary artery bypass grafting are included the study. Clinical, demographic, laboratory and echocardiographic characteristics are all eval . . .uated prospectively. The maximum and minimum P-wave duration (Pmax and Pmin) were measured from the 12-lead surface electrocardiogram. The difference between the Pmax and the Pmin was calculated and defined as P-wave dispersion. Preoperative venous blood samples were taken for N-terminal proBrain natriuretic peptide level analysis. RESULTS: Ten (17%) patients had postoperative atrial fibrillation. Patients with postoperative atrial fibrillation were older (69.4±6 versus 58.2±12 years, P=0.01), had lower ejection fraction (44.1±8.9% versus 54.3±9; P=0.002), higher proBrain natriuretic peptide levels (538±136 pg/ml versus 293±359 pg/ml; P=0.03), longer Pmax (142.2±13.7 ms versus 120.8±21.2 ms; P=0.006) and longer P-wave dispersion (55.0±8.2 ms versus 41.3±14.3 ms; P=0.008) compared with the patients without atrial fibrillation. Univariate analysis showed that increased age (P=0.01), lower ejection fraction (P=0.02), enlargement of left atrium (P=0.02), increased Pmax (P=0.006) and increased P-wave dispersion (P=0.008) and increased level of preoperative proBrain natriuretic peptide (P=0.03) were associated with postoperative atrial fibrillation. Positive correlation was seen between the age and level of proBrain natriuretic peptide (r=0.322 and P=0.015). In multivariate analysis, age (P=0.05), lower ejection fraction (P=0.03), left atrial enlargement (P=0.05), longer Pmax (P=0.01) and P-wave dispersion (P=0.01) were found to be independent predictors of postoperative atrial fibrillation. CONCLUSION: Age, poor left ventricular functions, Pmax and P-wave dispersion are found to be independent predictors of atrial fibrillation after coronary artery bypass grafting. © 2007 Lippincott Williams & Wilkins, Inc Daha fazlası Daha az