Akpinar I. | Karabag T. | Sayin M.R. | Yildirim N. | Dogan S.M. | Aydin M.

Article | 2012 | Texas Heart Institute Journal39 ( 6 ) , pp.910 - 912

[No abstract available]

Sayin M.R. | Cetiner M.A. | Karabag T. | Akpinar I. | Sayin E. | Kurcer M.A. | Dogan S.M.

Article | 2014 | Herz39 ( 5 ) , pp.638 - 643

Objectives. Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Easy-to-perform and reliable parameters are needed to predict the presence and severity of CAD and to implement efficient diagnostic and therapeutic modalities. We aimed to examine whether the Framingham risk scoring system can be used for this purpose. Methods. A total of 222 patients (96 women, 126 men; mean age, 59.1±11.9 years) who underwent coronary angiography were enrolled in the study. Presence of >%50 stenosis in a coronary artery was assessed as critical CAD. The Framingham risk score (FRS) was calculated for each patient. CA . . .D severity was assessed by the Gensini score. The relationship between the FRS and the Gensini score was analyzed by correlation and regression analyses. Results. The mean Gensini score was 18.9±25.8, the median Gensini score was 7.5 (0-172), the mean FRS was 7.7±4.2, and the median FRS was 7 (0-21). Correlation analysis revealed a significant relationship between FRS and Gensini score (r=0.432, Daha fazlası Daha az

Karabag T. | Aydin M. | Barut F. | Buyukates M. | Dogan S.M. | Celik O. | Sayin M.R.

Article | 2012 | Texas Heart Institute Journal39 ( 1 ) , pp.116 - 118

Lymphomatoid granulomatosis is a rare, diffuse, large B-cell lymphoma that is positive for Epstein-Barr virus. A multiorgan process, it manifests itself chiefly in the lungs but can also affect the skin, nervous system, and kidneys. Cardiac involvement and pericardial effusion are very unusual. We report the case of a 62-year-old man with lymphomatoid granulomatosis involving the heart and lungs. Diagnosis was confirmed with wedge biopsy at pericardiotomy, and the patient was treated with cyclophosphamide, prednisolone, and vincristine. Although the patient was still symptomatic at 6-month follow-up, he was in partial remission with . . . improved functional capacity. © 2012 by the Texas Heart ® Institute, Houston 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

Sayin M.R. | Dogan S.M. | Aydin M. | Karabag T.

Article | 2011 | Canadian Journal of Cardiology27 ( 6 ) , pp.8.70E+19 - 8.70E+21

An unusual type of food poisoning, mad honey poisoning, is a well-known phenomenon in the Black Sea region of Turkey. Mad honey poisoning can result in severe cardiac complications including sinus bradycardia, nodal rhythm, various degrees of atrioventricular blocks, and even asystole. However, no cases of long QT interval have been reported so far. This paper reports the first case of extremely long QT interval to be associated with mad honey consumption. © 2011 Canadian Cardiovascular Society.

Karabag T. | Dogan S.M. | Aydin M. | Sayin M.R. | Buyukuysal C. | Gudul N.E. | Demirtas A.O.

Article | 2012 | Clinical and Investigative Medicine35 ( 1 ) , pp.8.70E+19 - 8.70E+21

Purpose: the aim of this study is to investigate whether P wave dispersion (PWD), measured before, during and after fibrinolytic therapy (FT,) is able to predict successful reperfusion and infarct related artery (IRA) patency in patients with acute anterior MI who received FT. Methods: Sixty-eight patients who presented with acute anterior MI were enrolled in the study. An electrocardiogram was performed before and at 30, 60, 90 and 120 minutes after the start of FT. PWD was defined as the difference between maximum and minimum P wave duration on standard 12-lead surface electrocardiogram. A multivariate logistic regression model wa . . .s used to assess whether PWD was predictor of IRA patency and STsegment resolution (STR) on electrocardiogram. Results: PWD 120 was significantly lower in patients with STR on electrocardiogram (38 patients) compared with those without STR (30 patients) (44.8±11.5 vs. 52.9±10.3 ms; p<0.001). PWD 120 was found to be significantly lower in patients with patent IRA (31 patients) compared to those with occluded IRA (37 patients) (42.3±9.7 vs. 53.5±10.6 ms; p<0.001). Logistic regression analysis revealed that PWD120 significantly predicted STR and IRA patency. A ?51.6 ms PWD 120 can predict an occluded IRA with a 87% sensitivity, ?51 ms PWD 120 can predict no reperfusion with a 74% sensitivity. Conclusion: PWD values, which were higher than 51 ms and 51.6 ms in patients who received fibrinolytic therapy, can serve as a marker of failed reperfusion and occluded IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates. © 2012 CIM Daha fazlası Daha az

Yildirim N. | Dogan S.M. | Aydin M. | Hekimoglu K. | Gungorduk A.

Article | 2008 | International Journal of Cardiology127 ( 2 ) , pp.8.70E+19 - 8.70E+21

Interrupted aortic arch (IAA) is a rare and usually lethal congenital malformation. Patients with complete IAA very rarely do reach adult age without previous surgical intervention. The present report describes a 26-year-old asymptomatic isolated IAA case with hypertension that was incidentally diagnosed. IAA just distal to the left subclavian artery and a markedly developed collateral circulation was demonstrated by cardiac catheterization and thoracic 3D magnetic resonance angiography. This case report was also interesting that only mild arterial hypertension of the upper extremities was incidentally found in the patient. © 2007 E . . .lsevier Ireland Ltd. All rights reserved 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

Çelebi G. | Büyükateş M. | Dogan S.M. | Pişkin N. | Aydemir H. | Öztoprak N. | Aktaş E.

Article | 2009 | Mikrobiyoloji Bulteni43 ( 2 ) , pp.319 - 323

Staphylococcus lugdunensis is an infrequent cause of infective endocarditis (IE) and usually involves native valves of the heart. It causes life-threatening events such as rupture of cardiac valve or cerebral or pulmonary embolism due to necrosis on the endocardial tissue involved by the bacteria. Antibiotic therapy without cardiac surgery or delayed cardiac surgery usually follows a fatal course in S.lugdunensis endocarditis. In this report the first case of S.lugdunensis endocarditis from Turkey was presented. A 37 years-old man was admitted to the emergency department with a 2-weeks history of fever chills and accompanying interm . . .ittent pain on the left side of the thorax. Other than recurrent folliculitis continuing for 20 years, his history was unremarkable. Echocardiography revealed vegetation on the mitral valve of the patient and vancomycin plus gentamicin were initiated with the diagnosis of IE. All blood cultures (5 sets) taken on admission and within the initial 48 hours of the antibiotic therapy yielded S.lugdunensis. According to the susceptibility test results, the antibiotic therapy was switched to ampicillin-sulbac-tam plus rifampin. Blood cultures became negative after the third day of therapy, however, cardiac failure was emerged due to rupture of mitral valve and chorda tendiniea on the 12 th day of the therapy. Cardiac surgery revealed that mitral valve and surrounding tissue of the valve were evidently necrotic and fragile, anterior leaflet of the mitral valve was covered with vegetation, posterior leaflet and chorda tendiniea were ruptured. Vegetation was removed and the destructed mitral valve was replaced with a mechanical valve. Vegetation culture remained sterile, however, antibiotics were switched to vancomycin plus rifampin due to persistent fever on the 21 st day of the therapy (9 th day of operation). Fever resolved four days after the antibiotic switch. Antibiotics were stopped on the 9 th weeks of admission and the patient was discharged. He had no problem in follow-up controls for one year. In conclusion, proper antibiotic therapy combined with early cardiac surgery seems to be the optimal therapeutic approach in IE caused by S.lugdunensis Daha fazlası Daha az

Karabag T. | Aydin M. | Dogan S.M. | Sayin M.R. | Cetiner M.A.

Article | 2011 | Echocardiography28 ( 6 ) , pp.612 - 618

Background: Our aim was to investigate whether diastolic functions, myocardial velocities and pulmonary vein flow show diurnal variation within a 24-hour day. Method and Results: Fourty-four healthy subjects with no history of cardiovascular or systemic diseases (32 males, 12 females; mean age 34.7 ± 8.7 years, mean BMI: 25.5 ± 3.5 kg/m 2) were enrolled in this study. None of the subjects had a history, symptoms or signs of cardiovascular or systemic diseases or were taking drugs of any kind. All underwent echocardiographic examination at 7 a.m., 1 p.m., 7 p.m., and 1 a.m. M-mode systolic, diastolic velocities and pulmonary vein flo . . .w measurements were obtained. There were no differences in systolic and diastolic blood pressures and heart rate. The left atrial diameter was greater at 1 p.m. (3.80 ± 0.44; P = 0.031). The isovolumic contraction time (ICT) was found to be the shortest (41 ± 12 msn; P = 0.050), and ejection time (ET) the longest (290 ± 31 msn; P = 0.017) at the 1am measurements. The mitral myocardial performance index (MPI) was lowest during the 1 a.m. measurements (0.42 ± 0.11; P = 0.001). The systolic myocardial velocities (Sm) obtained from the septum and inferior region were significantly higher at 1 p.m. and lower at 7 a.m. (9.17 ± 1.79, 10.25 ± 2.29; 8.11 ± 1.06, 8.63 ± 1.49; P < 0.05). The late diastolic velocities obtained from the lateral, inferior and anterior regions were higher at 1 p.m. and 7 p.m. Conclusion: The left ventricular diameter and ejection fraction did not exhibit circadian variations. However, our data indicate that some parameters reflecting diastolic function, systolic myocardial velocities and MPI, as well as left atrial diameter change at different times of the day, independent of blood pressure and heart rate. © 2011, Wiley Periodicals, Inc Daha fazlası Daha az

Cetiner M.A. | Sayin M.R. | Yildirim N. | Karabag T. | Dogan S.M. | Kucuk E. | Aydin M.

Article | 2014 | Echocardiography31 ( 10 ) , pp.1253 - 1258

Objective: In this study, we examined the role of isovolumic acceleration (IVA) measured with right ventricle (RV) tissue Doppler imaging (TDI) to predict the presence of acute pulmonary embolism (APE) in hemodynamically stable patients with clinical suspicion of APE. Materials and Method: This study included 25 hemodynamically stable (systolic blood pressure >90 mmHg) patients diagnosed with APE for the first time. Twenty-five subjects with similar demographic characteristics in whom APE was excluded due to preexisting clinical suspicion were also enrolled as the control group. All control group subjects were enrolled after prov . . .ed to have no evidence of APE on imaging. Both groups were compared with respect to RV-IVA measured with TDI in addition to conventional echocardiographic parameters. Results: Among the echocardiography parameters, only RV-IVA was impaired in patients with hemodynamically stable APE compared to controls (2.85 [1.37-6.42] m/sec2 vs. 3.32 [2.24-6.52] m/sec2, respectively; P = 0.02). A receiver operating characteristic (ROC) analysis was performed to determine the RV-IVA value to predict clinically suspected APE. A cutoff level of 3.22 m/sec2 had a sensitivity of 64% and a specificity of 60%; a cutoff level of 3.17 m/sec2 had a sensitivity of 64% and a specificity of 64%; and a cutoff level of 3.10 m/sec2 had a sensitivity of 60% and specificity of 64% (ROC area under curve: 0.691, 95% CI: 0.543-0.839, P = 0.02). Conclusion: Results of our study suggest that RV-IVA may be a useful parameter to detect subtle alterations in RV and may predict the presence of APE in hemodynamically stable patients. © 2014, Wiley Periodicals, Inc Daha fazlası Daha az

Dogan S.M. | Yildirim N. | Gursurer M. | Aydin M. | Kalaycioglu E. | Cam F.

Article | 2008 | Journal of Electrocardiology41 ( 1 ) , pp.55 - 59

Aim: P-wave dispersion (PD), and duration has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate the PD in patients with coronary slow flow (CSF) phenomenon. Methods: Study population included 48 patients with angiographically proven normal coronary arteries and slow coronary flow in all 3 coronary vessels (group I, 36 men; mean age, 54 ± 9 years) and 32 subjects with angiographically proven normal coronary arteries without associated slow coronary flow (group II, 24 men, mean age, 53 ± 10 years). Coronary flow rates of all patients and control . . .subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count. All patients in group I had TIMI frame counts greater than 2 SD above those of control subjects (group II). The mean TIMI frame count for each patient and control subject was calculated by adding the TIMI frame counts for each major epicardial coronary artery and then dividing the obtained value into 3. The maximum and minimum P-wave duration (Pmax and Pmin) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed. Results: There was no statistically significant difference between the 2 groups with respect to age, sex, hypertension, diabetes mellitus, hyperlipidemia, and cigarette smoking (P > .05). P-wave dispersion and Pmax of patients with CSF were found to be significantly higher than those of control subjects (39.4 ± 17 vs 21.2 ± 10 milliseconds and 121.6 ± 17.1 vs 104.3 ± 10.4 milliseconds, respectively; P < .0001). Moreover, we found a significant positive correlation between both Pmax and PD with mean TIMI frame count (r = 0.836 and r = 0.806, respectively; P < .0001). Conclusions: P-wave dispersion and P-wave duration both were found to be greater in patients with CSF than in controls. © 2008 Elsevier Inc. All rights reserved Daha fazlası Daha az