Browsing by Author "Aysel, S"

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    Acute phase reactants in patients with coronary slow flow phenomenon
    Madak, N; Nazli, Y; Mergen, H; Aysel, S; Kandaz, M; Yanik, E; Çekdemir, D; Tavli, T
    Objective: In this study, we sought to investigate the serum levels of high sensitivity C-reactive protein (Hs-CRP), N-terminal pro-brain natriuretic peptide (NT proBNP), erythrocyte sedimentation rate, leukocyte, thyroid hormone and fibrinogen levels in patients with coronary slow flow phenomenon (CSFP). Methods: A total of 82 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels (45 males and 37 females, mean age 59 11 years) and 34 patients with normal coronary arteries and normal coronary flow (19 males and 15 females, mean age 56 10 years) with similar risk profiles were included in this cross-sectional observational study. Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count, serum level of Hs-CRP, NT proBNP, sedimentation, leukocyte, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and fibrinogen levels were measured. Statistical analysis was performed using t test for independent samples, Chi-square test and Pearson correlation analysis. Results: Hs-CRP (0.88 +/- 0.86 vs 0.36 +/- 0.35 mg/L, p<0.001) and NT proBNP (117.83 +/- 163.2 vs 47.33 +/- 30.6 ng/ml, p<0.01) were found to be significantly higher in patients with coronary slow flow compared with normal control group. There were no significant differences regarding thyroid hormones, fibrinogen, sedimentation rate and leukocyte count between two groups. The mean TIMI frame counts were positively correlated (r=0.454, p=0.001 and r=0.554, p=0.001, respectively) with plasma Hs-CRP levels and NT-proBNP levels. Conclusion: Hs-CRP and NT proBNP are significantly higher in patients with coronary slow flow compared with normal control group. Their increased levels are positively correlated with TIMI frame count. (Anadolu Kardiyol Derg 2010; 10:416-20)
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    Blood pressure and ejection fraction changes due to ultrafiltration in hemodialysis
    Kursat, S; Aysel, S; Alici, T; Tezcan, UK
    Background: Nocturnal hypertension (NH) is an unsolved problem in hemodialysis (HD) patients. The effect of ultrafiltration (UF) on NH and myocardial performance has not been systematically investigated in HD patients. Methods: Seventeen reverse-dipper (RD) HD patients were subjected to intensified UF. Before and after UF, echocardiographic and blood pressure (BP) measurements were taken. Results: Excluding daytime diastolic BP, all BP parameters (mmHg), namely daytime systolic BP (138.1 +/- 15.1; 131.1 +/- 12.5), night-time systolic BP (150.4 +/- 17.6; 125.3 +/- 16.5), night-time diastolic BP (87.3 +/- 10.3; 76.5 +/- 11.6), daytime pulse pressure (56.1 +/- 7.6; 50.5 +/- 5), night-time pulse pressure (63.3 +/- 9.4; 48.7 +/- 7), significantly decreased (p<0.001 for all comparisons). Thirteen patients converted to non-dipper and two patients converted to dippers, whereas two patients remained on RD. Unit for measurement of diameters was mm. Ejection fractions (EF) increased (51.23 +/- 9.01; 64.05 +/- 7.23, p<0.001), left atrial diameters (LAD) decreased (35 +/- 8.29; 32.05 +/- 7.12, p<0.001), the vena cava inferior collapse index increased (VCICI) [24.82 +/- 8.20 (%); 51.76 +/- 9.65 (%), p<0.001], left ventricular end-systolic (LVES) and diastolic diameters (LVED) decreased (3.19 +/- 0.60; 2.77 +/- 0.51, p<0.001; 4.39 +/- 0.65; 4.18 +/- 0.56, p=0.002, respectively). Percentage reduction in night-time diastolic BP correlated with the percentage reduction in LA-D (p=0.038). Percentage reduction in night-time pulse pressure correlated with the percentage increase in EF (p<0.013). Similarly, percentage reductions in night-time systolic BP, night-time diastolic BP and night-time mean BP correlated with the percentage reduction in LVESD (p=0.014, p<0.001 and p=0.001, respectively). Conclusions: NH in HD patients is a volume dependent phenomenon. Improved night-time BP parameters have a more profound effect on myocardial function than daytime BP parameters.