Diurnal variation of the P-wave dispersion in chronic ischemic heart diseases

Yíldírím N. | Topaloglu S. | Bozboga S. | Ocal A. | Saricam E.

Article | 2006 | Coronary Artery Disease17 ( 8 ) , pp.707 - 710

OBJECTIVE: Electrocardiographic indices like maximum P-wave duration (Pmax) and P-wave dispersion (PD) can be used to detect patients with atrial conduction disorders, myocardial ischemia and those at risk for atrial fibrillation. Considering the diurnal variation of ischemia in patients with significant coronary lesions, this study was designed to investigate the diurnal variation of eventual atrial conduction abnormalities. METHODS: Forty-eight patients (31 male) with typical angina were grouped according to coronary angiography results as group 1 - 70% or more luminal reduction in at least one of the coronary arteries (n=28), and . . . group 2 - normal coronary arteries (n=20). The difference between the Pmax and minimum P-wave durations (Pmin) is designated as PD. The diurnal Pmax, Pmin and PD values were compared between and within the groups. RESULTS: The morning Pmax value of group 1 was significantly higher than the value of group 2 (112±1 vs. 102±1 ms, Daha fazlası Daha az

The effect of radiotherapy on cardiac function

Dogan S.M. | Bilici H.M. | Bakkal, Bekir Hakan | Aydin M. | Karabag T. | Sayin M.R. | Aktop Z.

Article | 2012 | Coronary Artery Disease23 ( 3 ) , pp.146 - 154

BACKGROUND: Radiation-induced heart disease is a complication that may be encountered after radiotherapy (RT) of tumors in the vicinity of the heart. In this study, we aimed to evaluate the effect of RT on the heart, by comparing conventional and tissue Doppler echocardiography parameters obtained before and after RT. METHODS: Forty patients who had undergone RT for either lung or left breast cancer were included in the study. ECG, conventional, and tissue Doppler echocardiography were performed before and 4-6 weeks after RT. RESULTS: The mean value of the radiation dose applied to all regions of the heart was calculated as 13.1±2.2 . . . Gy (maximum 41.7 Gy). The value for the left ventricle was 10.2±2.0 Gy (maximum 43.6 Gy). A decrease in early transmitral diastolic velocity (E), E/A ratio, EF, Em, and Em/Am, and an increase in E-wave deceleration time, isovolumic relaxation time, isovolumic contraction time, ejection time, and QTc were found after RT. CONCLUSION: We found detrimental effects of RT on systolic and diastolic cardiac functions and the electrical conduction system of the heart. Maximal prevention should be provided for the patients during RT. © 2012 Lippincott Williams & Wilkins, Inc Daha fazlası Daha az

N-terminal probrain natriuretic peptide predicts altered circadian variation in essential hypertension

Dogan S.M. | Aydin M. | Gursurer M. | Dursun A. | Mungan G. | Onuk T.

Article | 2007 | Coronary Artery Disease18 ( 5 ) , pp.347 - 352

Diminished nocturnal blood pressure fall in nondipper hypertensive patients are closely associated with poor prognosis. N-terminal probrain natriuretic peptide can also identify poor prognosis in miscellaneous heart diseases. In this study, we aimed to clarify the association between probrain natriuretic peptide levels and diminished nocturnal blood pressure fall in patients with essential hypertension. Twenty-six consecutive nondipper (age: 53±8 years, 14 men) (group 1), and 26 dipper hypertensive patients (age: 52±9 years, 16 men) (group 2), based on ambulatory blood pressure monitoring, and age and sex-matched 28 normotensive par . . .ticipants (age: 50±11 years, 16 men) (group 3) were compared with each other. Although systolic and diastolic ambulatory blood pressure values were similar in hypertensives during the day, those at night were higher in group 1 ( Daha fazlası Daha az

?-3 fatty acid treatment in cardiac syndrome X: A double-blind, randomized, placebo-controlled clinical study

Bozcali E. | Babalik E. | Himmetoglu S. | Mihmanli I. | Toprak S.

Article | 2013 | Coronary Artery Disease24 ( 4 ) , pp.328 - 333

OBJECTIVE: We conducted a clinical trial to examine the effect of ?-3 fatty acids in patients with cardiac syndrome X (CSX). We aimed to evaluate the potential impact of ?-3 fatty acids on endothelial function, oxidative stress, and symptom relief in the CSX. METHODS AND RESULTS: Eighteen patients with CSX were enrolled according to a double-blind, randomized, placebo-controlled design. Patients were randomized to ?-3 fatty acids (1440 mg/day, n=8) or placebo (n=10) for 4 months. We assessed plasma levels of malondialdehyde (MDA), endothelium-dependent vasodilatation [flow-mediated dilatation (FMD)], endothelium-independent vasodila . . .tation [nitroglycerin- mediated dilatation (NMD)], and status of symptom [score with Seattle Angina Questionnaire (SAQ)] before and after the treatment. After 4 months, patients who were treated with ?-3 fatty acids showed significant increases in the FMD (from 47±48 to 104±23%, Daha fazlası Daha az

Differences in sex, angiographic frequency, and parameters in patients with coronary artery anomalies: Single-center screening of 25 368 patients by coronary angiography

Akpinar I. | Sayin M.R. | Karabag T. | Gursoy Y.C. | Kucuk E. | Kiran S. | Dogan S.M.

Article | 2013 | Coronary Artery Disease24 ( 4 ) , pp.266 - 271

BACKGROUND: Although the prevalence of coronary artery anomalies varies in different series, the precise population frequency is unknown. MATERIALS AND METHODS: The medical records of all patients who underwent coronary angiography between January 2002 and August 2012 were retrieved, and 238 cases with coronary anomalies were evaluated. Unlike other studies, we compared several angiographic parameters (fluoroscopy time, number of images, and catheters used) in addition to frequency and sex data. RESULTS: The angiographic frequency of coronary artery anomalies was 0.94%. The most common coronary anomaly was a left anterior descending . . .-circumflex artery originating from separate ostia (0.29%). The second most common anomaly was a right coronary artery (RCA) originating from the left sinus of Valsalva (sV) (0.23%). Overall, coronary artery anomalies (1.28 vs. 0.80%; Daha fazlası Daha az

Predictors of atrial fibrillation after coronary artery bypass surgery

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

Assessment of QRS duration and presence of fragmented QRS in patients with Behçet's disease

Sayin M.R. | Akpinar I. | Gursoy Y.C. | Kiran S. | Gudul N.E. | Karabag T. | Koca R.

Article | 2013 | Coronary Artery Disease24 ( 5 ) , pp.398 - 403

BACKGROUND: QRS prolongation and the presence of QRS fragmentation in 12-lead ECG are associated with increased mortality and sudden cardiac death in the long term. In this study we aimed to assess QRS duration and fragmentation in patients with Behçet's disease (BD). METHODS: A total of 50 patients (mean age 42.7±12.0 years) previously diagnosed with BD were recruited. In addition, a control group consisting of 50 healthy people (mean age 39.4±12.5 years) was formed. The longest QRS duration was measured in surface 12-lead ECG and QRS complexes were evaluated in terms of fragmentation. Serum C-reactive protein levels were also obta . . .ined. RESULTS: QRS duration and corrected QT duration were significantly longer in patients with BD compared with controls (102.75±11.91 vs. 96.99±10.91 ms, P=0.007; 438.55±30.80 vs. 420.23±28.06 ms, P=0.003, respectively). Fragmented QRS (fQRS) pattern was more common in patients with BD than controls [n=27 (54%) vs. n=16 (32%), P=0.026]. Disease duration was longer in patients with BD with fQRS compared with those without (12.67±8.68 vs. 7.09±7.06 years, P=0.010). Furthermore, C-reactive protein level was higher in patients with BD with fQRS compared with those without (6.53±4.11 vs. 4.97±6.32 mg/dl, P=0.043). Correlation analysis revealed no association between disease duration and QRS duration (r=0.219, P=0.126). CONCLUSION: QRS duration is greater and fQRS complexes are more frequent in patients with BD. These findings may indicate subclinical cardiac involvement in BD. Given the prognostic significance of ECG parameters, it is reasonable to evaluate patients with BD with prolonged and fQRS complexes more in detail such as late potentials in signal averaged ECG in terms of cardiac involvement. © 2013 Wolters Kluwer Health / Lippincott Williams & Wilkins Daha fazlası Daha az

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