Browsing by Author "Sekuri C."
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Item Effects of Low-Dose Combination Therapy with an Angiotensin-Converting Enzyme Inhibitor and a Diuretic on Flow-Mediated Vasodilation in Hypertensive Patients: A 6-Month, Single-Center Study(Excerpta Medica Inc., 2003) Sekuri C.; Bayturan O.; Gocer H.; Tavli T.; Tezcan U.K.Background: Combination therapy with an angiotensin-converting enzyme (ACE) inhibitor and a diuretic has been shown to be highly effective in hypertension. Clinical trials have demonstrated that ACE inhibitors may improve endothelial cell dysfunction in hypertension. However, the effectiveness of the combination treatment in endothelial cell dysfunction is unknown. Objective: This study investigated the effects of a new low-dose combination, perindopril 2 mg plus indapamide 0.625 mg, on brachial artery flow-mediated vasodilation (FMD) and left ventricular diastolic function in hypertension. Methods: Patients aged 18 to 75 with newly diagnosed stage 1 or 11 hypertension were eligible. Endothelium-dependent brachial artery FMD and endothelium-independent vasodilation were assessed at baseline. Patients were treated with oral perindopril 2 mg plus indapamide 0.625-mg tablets once daily for 6 months. FMD measurements were then repeated. Percentage changes in FMD from baseline to 6 months, as well as left ventricular diastolic function parameters (isovolumic relaxation time [IVRT] and mitral diastolic E-wave deceleration time [EDT]), indicated the effectiveness of the intervention. Results: Twenty-nine Turkish patients were enrolled (17 women, 12 men; mean [SD] age, 54.5 [9.5] years [range, 38-75 years]). The mean (SD) baseline FMD was 7.00% (2.39%) (endothelial cell dysfunction) and increased significantly to 8.68% (2.78%) at 6 months (P = 0.02); FMD improved in 15 patients (51.7%). At baseline and 6 months of therapy, mean (SD) IVRT was 101.7 (12.4) ms and 95.5 (7.7) ms, respectively (P < 0.001), and EDT was 234.7 (33.9) ms and 217.9 (25.6) ms, respectively (P < 0.001). Conclusions: In this small sample of hypertensive patients, a low-dose combination ACE inhibitor and diuretic significantly improved brachial artery FMD and left ventricular diastolic function. The improvement in FMD values was independent of the stage of hypertension. These findings suggest a relationship between improvement in endothelial cell function and diastolic function. Copyright © 2003 Excerpta Medica, Inc.Item Diagnosis of asymptomatic atrial septal aneurysms using two-dimensional color Doppler and contrast transthoracic echocardiography(2003) Coşkun S.; Sekuri C.; Bayturan Ö.; Yüksel H.; Saribülbül O.; Bilge A.Objective. To evaluate the dimensions of atrial septal aneurysm (ASA), the presence and characteristics of interatrial shunt, the movement of the wall of the aneurysm, and correlation between these findings and sign and/or symptoms suggesting embolism in Manisa, a district of a western Anatolian city of Turkey. Methods. Two thousand five hundred cases were examined by routine transthoracic echocardiography (TTE) in both pediatric and adult cardiology outpatient clinics. ASA was detected in 20 cases and evaluated by two-dimensional color Doppler echocardiography (CDE). The length of the base, the maximum radius and the maximum displacement of ASA were measured. The shunt between the atria was examined by CDE. In cases where a shunt could not be found, galactose and palmitic acid was injected. Standard 12-lead electrocardiogram (ECG) and exercise stress test were also performed. Results. No clinical signs or symptoms were found, suggesting a systemic or cerebral embolism. The maximum displacement of ASA was between 2 and 5 mm. All of the aneurysms were localized in the right atrium, and the walls of the aneurysm did not move beyond the base of the left atrium during the maximum displacement. Interatrial shunt was detected in 14 of 20 patients (70%) by CDE and in the remaining six cases by contrast TTE. Frequent ventricular ectopic beats were observed in one patient. Conclusion. During routine TTE we observed 0.8% asymptomatic ASA in our population. The use of a contrast agent was found to be a valuable additional method in patients with ASA when the shunt could not be detected by CDE. The risk for embolism is not high when the maximum displacement of the wall of ASA was 5 mm or less and no bulge into the left atrium was observed. Based on our experience with this method, TTE is easy to perform, well-tolerated and acceptable.Item The acute effect of orlistat on endothelial function in young obese women(2003) Sekuri C.; Tavli T.; Avsar A.; Sozcuer H.; Uyanik B.S.; Ari Z.Recent studies indicate that abdominal fat accumulation is related to impaired endothelial function in young healthy volunteers. The aim of this study was to determine the acute effect of gastrointestinal lipase inhibitor on brachial flow-mediated vasodilatation and hemodynamic parameters in young obese women. The study population was composed of 42 female obese patients (mean age 29 ± 4 years, age range between 18 and 34 years). Flow-mediated endothelial-dependent vasodilatation was assessed in the brachial artery in response to reactive hyperemia using high-resolution ultrasound. Brachial artery diameter (3.46 ± 0.72 mm to 3.82 ± 0.84 mm) and flow-mediated vasodilation (7.6 ± 0.8% to 9.8 ± 1.6%) changed significantly after 12 weeks of therapy (p < 0.001). Brachial artery flow was not changed (124 ± 92 ml/min to 148 ± 14 ml/min, p > 0.05). The results of this study demonstrate that orlistat improved endothelial function, weight, body mass index and systolic and diastolic blood pressure in young women.Item The acute effects of cilazapril on pulmonary function tests and arterial blood gas changes in patients with pulmonary hypertension(2003) Tavli T.; Sekuri C.; Goktalay T.; Uyanik B.S.; Ari Z.The aim of the present study was to evaluate pulmonary function tests and arterial oxygen transport in patients with pulmonary hypertension due to congestive heart failure before and after cilazapril treatment. Thirty patients (16 men and 14 women, mean age, 65 ± 18 years) with congestive heart failure and 30 healthy volunteers (20 men and 10 women, mean age 59 ± 12 years, p > 0.05) were included in the study. All patients underwent evaluation of pulmonary function by spirometry and arterial blood gas analysis. Arterial oxygen saturation and arterial oxygen transport changed significantly after treatment (81 ± 7 to 87 ± 8 and 317 ± 74 to 392 ± 8, respectively). Forced expiration volume in 1 second, vital capacity and total lung capacity were increased after cilazapril treatment (2.55 ± 0.7 to 2.61 ± 0.8, 3.2 ± 0.9 to 3.3 ± 1.0 and 3.6 ± 0.9 to 4.1 ± 1.1, respectively, p < 0.05). In conclusion, short-term cilazapril administration improved pulmonary function and arterial oxygen transport because it increased cardiac output, produced pulmonary vasodilatation, improved the pulmonary hemodynamics and removed interstitial fluid.Item Atorvastatin treatment decreases inflammatory and proteolytic activity in patients with hypercholesterolemia(Klinika Kardiologii CMKP, 2004) Ercan E.; Tengiz I.; Altuglu I.; Sekuri C.; Aliyev E.; Ercan H.E.; Akin M.Background. Statins have anti-inflammatory and anti-platelet effects, which are known as non-lipid effects. Statin treatment can decrease endogenous inflammatory response. Aim. To study the effects of atorvastatin on matrix metalloproteinase-9 (MMP-9) and high sensitive C-reactive protein (hs-CRP) - markers of the proteinolytic and inflammatory activity. Methods. In this prospective study 44 patients with hypercholesterolemia were randomly assigned into 2 groups; Group 1 (n=22) treated with atorvastatin and diet for 2 months, and Group 2 (n=22) - diet alone. MMP-9 and hs-CRP were measured at baseline and two months later. Results. Groups were matched for age, sex and baseline characteristics. Lipid levels decreased by 32% (LDL from 153.9±26.6 to 94.5±20.8 mg/dl, p<0.005) in the atorvastatin group and by 9% in the diet alone group. Atorvastatin lowered plasma CRP from 5.16±1.9 to 2.88±1.06 mg/L (p<0.001) and MMP-9 activity from 64.3±28.1 to 35.4±20.0 ng/ml (p<0.0001). Atorvastatin-induced reductions in CRP and MMP-9 were greater than in the diet alone group. MMP-9 levels did not show significant changes in Group 2 after two months of diet. Conclusions. Atorvastatin treatment decreases inflammatory and proteolytic activity in patients with hypercholesterolemia.Item Retinal artery macroaneurysm as initial presentation of hypertension(Elsevier Ireland Ltd, 2004) Sekuri C.; Kayikcioglu M.; Kayikcioglu O.A case of uncontrolled hypertension with a vitreoretinal hemorrhage due to a retinal artery macroaneurysm of the right eye and chorio-retinal scars of the left eye as initial symptom of hypertension is presented. End organ damage was undiagnosed until an intraocular hemorrhage appeared in the right eye. The hemorrhage and retinal macroaneursym disappeared spontaneously with proper medical therapy for hypertension. © 2003 Elsevier Ireland Ltd. All rights reserved.Item Cardiovascular disease risk factors in post-menopausal women in West Anatolia: A rural region prevalence study(2004) Sekuri C.; Eser E.; Akpinar G.; Cakir H.; Sitti I.; Gulomur O.; Ozcan C.Cardiovascular risk factors are important causes of morbidity and mortality in post-menopausal women. The aim of this cross-sectional study was to evaluate the cardiovascular risk factors in 207 postmenopausal Turkish women over 45 years old in a rural district of West Anatolia, Manisa Muradiye district. A questionnaire on socioeconomic and sociodemographic characteristics was conducted in the women followed by the measurement of blood pressure, fasting blood glucose, cholesterol levels, and waist-hip ratio along with an electrocardiogram (ECG). The European Cardiology Society risk index was used for cardiovascular risk evaluation. The results showed that 86% percent of the women will be carrying more than a 5% probability of developing a cardiovascular risk in the next 10 years. Moreover, the results proved 7% of the women are at high risk for a cardiovascular condition. Hypertension, hypercholesterolemia, and impaired glucose tolerance, were observed in 62%, 35.3%, and 13.5% of the women, respectively. Seven percent had smoked for at least six months. Fourteen cases had complained of exercise angina and pathologic ECG signs were diagnosed in one-third of these 14 cases. The waist-hip ratio measured 0.8 or more in 66.2% of the cases, with a range of 68-147 cm (mean; 95.6 ± 11.55). The results indicate that the risk of a cardiovascular condition developing is extremely high in postmenopausal West Anatolian women and increases with age. Morever, the prevalance of hypertension increased with age and was very closely related with low socioeconomic levels. These hazardous cardiovascular disease risk factors should be considered as high priority health problems in rural and low socioeconomic areas of developing communities. Intervention to modify the cardiovascular risk factors should be included in routine primary health care programs. Copyright © 2004 by the Japanese Heart Journal.Item Association between the ACE I/D gene polymorphism and physical performance in a homogeneous non-elite cohort(Human Kinetics Publishers Inc., 2005) Cam F.S.; Colakoglu M.; Sekuri C.; Colakoglu S.; Sahan Ç.; Berdeli A.Background: I/D polymorphism of the ACE gene may be associated with better endurance performance and a stronger response to exercise training. The aim of this study was to investigate the association between ACE gene polymorphism and athletic performance in a homogeneous cohort. Methods: Eighty-eight male non-elite Caucasian Turkish athletes with similar training backgrounds for at least for 6 months were studied for ACE gene polymorphisms by PCR analysis. Performance on the 60-meter sprint and middle-distance running tests were evaluated. Results: The distributions of the ACE I/D genotypes were 20.5%, 40.9%, and 38.6% for II, ID, and DD polymorphisms in the whole group (N = 88), respectively. The ACE DD genotype frequency was significantly higher in the superior group (56.7%) than in the poor (37.9%) and mediocre (20.7%) group in middle-distance running performance (χ2 = 11.778; p = 0.019). Conclusion: The ACE DD genotype may be related to better short-duration aerobic endurance performance. Larger homogeneous cohorts may help clarify the association between ACE I/D polymorphism and physical performance. © 2005 Canadian Society for Exercise Physiology.Item Renin-angiotensin system gene polymorphisms and premature coronary heart disease(JRAAS Limited, 2005) Sekuri C.; Cam F.S.; Ercan E.; Tengiz I.; Sagcan A.; Eser E.; Berdeli A.; Akin M.Introduction: Experimental and clinical studies demonstrated that the renin-angiotensin system (RAS) affects the pathogenesis of atherosclerosis and prognosis of coronary heart disease (CHD). The aim of this study was to investigate the genotype distribution and the allele frequencies of three RAS genes polymorphisms and their effects on premature CHD in a Turkish population. Materials and methods: One-hundred and fifteen Turkish patients with premature CHD and 128 controls were included into the study. Angiotensin-converting enzyme (ACE), angiotensin II type 1 (AT1) receptor and angiotensinogen (AGT) gene polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Results: The patients group showed an increased frequency of the ACE D allele compared with controls (65% vs. 35%, p-0.0001). There was a significant association between the DD genotype and premature CHD (ACE DD vs. ID and II; odds ratio [OR]=2.82 [CI 95% 1.33-2.91, P=0.002]). Also, we observed increased premature CHD risk associated with higher frequencies of the AGT MM genotype in patients when compared with controls (AGT MM vs. TT and MT, OR=1.92 [CI 95% 1.11-3-33, p=0.018]). We found a significant association between AT1-receptor AA genotype and decreased risk of premature CHD (AT1R AA vs. AC and CC, OR=0.57[CI 95% 0.34-0.95, p=0.03]). Conclusions: We demonstrated that increased premature CHD risk is associated with higher frequencies of the ACE DD and AGT MM genotypes. These findings indicate a synergistic contribution of ACE DD and AGT MM polymorphisms to the development of premature CHD. Also, our results suggest that family history, smoking, diabetes, hypertension, obesity and ACE DD genotype were independent risk factors for premature CHD.Item Association between the eNOS (Glu298Asp) and the RAS genes polymorphisms and premature coronary artery disease in a Turkish population(2005) Berdeli A.; Sekuri C.; Sirri Cam F.; Ercan E.; Sagcan A.; Tengiz I.; Eser E.; Akin M.The renin-angiotensin system (RAS) and endothelial nitric oxide (NO) affect the pathogenesis of atherosclerosis and prognosis of coronary artery disease (CAD). Previous epidemiologic data suggested that genetic factors are more likely to affect young rather than old people. Our objective was to investigate the association between the polymorphisms of eNOS (Glu298Asp) and the RAS genes and premature CAD in a Turkish population. A total of 115 Turkish patients with premature CAD and 83 controls were included in the study. ACE I/D, AT1R A/C, AGT T/M and eNOS Glu298Asp gene polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). It was found that increased premature CAD risk is associated with higher frequencies of the ACE DD [OR: 2.600 (CI 95% 1.395-4.847, p=0.002)], AGT MM [OR=2.407 (CI 95% 1.267-4.573, p=0.007)] and eNOS 894TT [OR=17.000 (CI 95% 3.952-73.125, p<0.001)] genotypes. Carriers of ACE DD+eNOS 894TT (p=0.002), AGT MM+eNOS 894TT (p=0.001), AT1R AA+eNOS 894TT and AT1R non-AA+eNOS 894TT (p=0.002) genotypes were significantly associated with the risk of premature CAD. This study indicates a synergistic contribution of RAS genes (ACE I/D, AGT T/M, AT1R T/C) and eNOS Glu298Asp polymorphisms to the development of the premature CAD. © 2004 Elsevier B.V. All rights reserved.Item The G894T polymorphism on endothelial nitric oxide synthase gene is associated with premature coronary artery disease in a Turkish population(2005) Cam S.F.; Sekuri C.; Tengiz I.; Ercan E.; Sagcan A.; Akin M.; Berdeli A.Introduction: The aim of the present study was to investigate the association between premature coronary artery disease and Glu298Asp polymorphism of the endothelial nitric oxide synthase gene. Materials and methods: The eNOS gene polymorphism was analysed in 115 (mean age, 48.1±7.9 years) Turkish patients with a diagnosis of premature coronary artery disease and 83 (mean age, 44.6±1.4 years) control subjects. The Glu298Asp polymorphism of the endothelial nitric oxide synthase gene was determined by polymerase chain reaction and restriction fragment length polymorphism. Results: The patients group showed an increase in the frequency of the T allele compared to controls (0.456 versus 0.169, p=0.0001). There was a significant association between the TT genotype and premature coronary artery disease [eNOS TT vs. TG and GG; OR=17.000 (CI 95% 3.952-73.125, p=0.0001)]. The eNOS T/G genotypes were not associated with the number of affected vessels (p>0.05). In addition, the family history of premature coronary artery disease, smoking, diabetes, obesity, dyslipidemia and eNOS TT genotype were independent risk factors of coronary artery disease. The patients with eNOS TT genotype had 15 fold risk of coronary artery disease compared with the control group [OR=15.356(CI 95% 3.262-77.289, p=0.001)]. Conclusions: These results suggest that premature coronary artery disease is associated with the Glu298Asp polymorphism of the endothelial nitric oxide synthase gene in our population. © 2004 Elsevier Ltd. All rights reserved.Item Effects of the blockade of cardiac sarcolemmal ATP-sensitive potassium channels on arrhythmias and coronary flow in ischemia-reperfusion model in isolated rat hearts(2006) Gok S.; Vural K.; Sekuri C.; Onur R.; Tezcan A.; Izanli A.Activation of ATP-sensitive K+ channels (KATP) during ischemia leads to arrhythmias and blockade of these channels exert antiarrhythmic action. In this study, we investigated the effects of HMR1098, a sarcolemmal KATP channel blocker and 5-hydroxydeconoate (5-HD), a mitochondrial KATP channel blocker on cardiac function and arrhythmias in isolated rat hearts. The hearts were subjected to 30 min coronary occlusion, followed by 30 min reperfusion. In the preischemic period, both HMR 1098 and 5-HD slightly increased coronary perfusion pressure. Coronary occlusion increased the perfusion pressure and decreased the left ventricular developed pressure (LVDP) in both control and drug-treated hearts. However, inhibition of LVDP was greater and recovery of the perfusion pressure was lower in 30 μmol/l HMR1098 and 100 μmol/l 5-HD-treated hearts compared to control (P < 0.05). HMR1098, at 3 μmol/l, but not at 30 μmol/l, significantly reduced the ratio of bigeminis, couplets and salvos (P < 0.05). Ventricular tachycardia and ventricular fibrillation were not prevented by HMR1098, at both concentrations, and with 5-HD (100 μmol/l). These results suggest that blockade of sarcKATP and mitoKATP channels exert weak antiarrhythmic action, but reduce the recovery of coronary perfusion and contractile force, implying that both types of KATP channels have beneficial role in the recovery of ischemic rat myocardium. © 2005 Elsevier Inc. All rights reserved.Item The role of ATP sensitive K+ channels and of nitric oxide synthase on myocardial ischemia/reperfusion-induced apoptosis(Elsevier GmbH, 2006) Gok S.; Vatansever S.; Vural K.; Sekuri C.; Izanli A.; Tezcan A.; Cilaker S.During ischemia, ATP-sensitive K+ channels (KATP channels) open, and this triggers necrotic processes and apoptosis. In this study, we investigated whether selective sarcoplasmic and mitochondrial KATP channel blockers affected myocardial apoptosis and nitric oxide synthase (NOS) activity in a rat model of myocardial ischemia/reperfusion in vitro. Isolated rat hearts were subjected to 30 min of coronary artery occlusion followed by 30 min of reperfusion. A selective sarcKATP channel blocker, HMR1098 and a selective mitoKATP channel blocker, 5-hydroxydecanoate, were added to the perfusion fluid 10 min before occlusion. Myocardial apoptosis was detected immunohistochemically using the TUNEL method. Myocardial inducible NOS (iNOS) and endothelial NOS (eNOS) were determined immunohistochemically. In control hearts, apoptosis induction was associated with a greater immunoreactivity of iNOS than eNOS. Treatment with HMR1098, at a concentration of 3 μmol/l, significantly reduced the TUNEL-positive cardiomyocytes and this was associated with decreased iNOS and increased eNOS immunoreactivity. When this drug was administered at a higher concentration, at 30 μmol/l, a more marked reduction in apoptosis was observed but, in contrast to the effects observed at the lower drug concentration, eNOS immunoreactivity was almost completely abolished while iNOS was strong. Moreover, ischemia-induced cardiac dysfunction (e.g. contractile force and recovery of coronary flow) was increased by the higher concentration of HMR 1098. In hearts treated with 5-hydroxydecanoate, myocyte apoptosis was slightly reduced, and this was associated with an almost equal increase in both iNOS and eNOS immunoreactivity. These findings suggest that iNOS appears to be more important than eNOS in the reduction of apoptosis. However, the further inhibition of apoptosis by the higher concentration of HMR 1098 was associated with poorer cardiac function. © 2006 Elsevier GmbH. All rights reserved.Item ACE I/D gene polymorphism and aerobic endurance development in response to training in a non-elite female cohort(2007) Cam S.; Colakoglu M.; Colakoglu S.; Sekuri C.; Berdeli A.Aim. The aim of this study was to investigate the association between ACE gene polymorphism and short- and medium-duration aerobic endurance performance improvements in response to the same training regimen in a non-elite female cohort. Methods. Fifty-five female non-elite Caucasian Turkish athletes trained to enhance running speeds corresponding to 70% and 90% of heart rate reserve (V-HRR70 and V-HRR90 respectively) 30 min running speed performance (V-30min) 3 times per week, for 6 weeks. ACE gene polymorphisms studied by PCR analysis. Results. The distribution of genotypes in the whole cohort was 21.8%, 41.8%, 36.4% for II (n=12), ID (n=23) and DD (n=20), respectively. Subjects with ACE II genotype had significantly higher improvements in V-30min and V-HRR70 than the ACE DD group (P<0.05). However, in HRR90 ACE DD genotype had a better performance enhancement in running speed than others (P<0.05). Endurance improvements in the V-HRR70 and in the V-30min showed a linear trend as II>ID>DD (P<0.05 and P<0.01, respectively) while a linear trend as DD>ID>II (P<0.01) observed in V-HRR90. Conclusion. ACE II genotype may related with better improvements in medium duration aerobic endurance performance whilst ACE DD genotype seems to be more advantageous in performance enhancement in shorter duration and higher intensity endurance activities.Item No association of interleukin-6 gene polymorphism (-174 G/C) with premature coronary artery disease in a Turkish cohort(2007) Sekuri C.; Cam F.S.; Sagcan A.; Ercan E.; Tengiz I.; Alioglu E.; Berdeli A.OBJECTIVES: Interleukin-6 (IL-6) may contribute to the inflammatory response by activating endothelial cells and stimulating the synthesis of fibrinogen. It might thus be important in the pathogenesis of inflammation associated with coronary artery disease (CAD). Several studies suggested that the -174 C allele was associated with an increased prevalence of coronary heart disease. The aim of this study was to investigate further the association of the IL-6 -174 G/C allele status with premature CAD. METHODS: A total of 120 patients and 105 controls were included in the study. The IL-6 -174 G/C polymorphism was genotyped using PCR-restriction fragment length polymorphism. RESULTS: The genotype distribution of the -174 G/C polymorphism was not different in premature CAD patients (GG: 53%; GC: 42.6%; CC: 4.3%) and controls (GG: 54.3%; GC: 39%; CC: 6.7%) (P=0.72). The prevalence of the C allele was 25.6% in patients and 26.1% in controls. By multiple regression analysis, family history, smoking, diabetes, and hypertension were independent risk factors of premature CAD, but not IL-6 genotype. CONCLUSIONS: We conclude that the IL-6 -174 G/C polymorphism is not associated with the risk of premature CAD, and does not contribute to cardiovascular risk stratification. © 2007 Lippincott Williams & Wilkins, Inc.Item Is pulmonary arterial pressure affected by allergic rhinitis with nasal obstruction?(2007) Bayrak P.; Kirmaz C.; Sekuri C.; Yuksel H.Obstructive pathologies of the pulmonary tract may cause various levels of hypoxia. To compensate for the hypoxia, pulmonary arterial pressure and pulmonary arterial flow may increase. We investigated 35 patients with seasonal allergic rhinitis (AR) whether hypoxia caused by AR with a high level of obstruction in the airways may lead to an increased pulmonary arterial pressure. An echocardiographical evaluation was made following the determination of the symptomatic and non-symptomatic symptom scores. We found a positive correlation between the symptom scores both in the symptomatic and non-symptomatic periods, nasal obstruction scores and the mean pulmonary arterial pressures during these periods. Further studies with more cases are needed in order to determine the cardiac effects of hypoxia in AR, mainly pulmonary arterial hypertension.Item Effect of monocyte chemoattractant protein-1 (MCP-1) gene polymorphism in Turkish patients with premature coronary artery disease(2008) Cam S.F.; Sekuri C.; Sagcan A.; Ercan E.; Tengiz I.; Alioglu E.; Berdeli A.Objectives. It has been suggested that monocyte chemoattractant protein-1 (MCP-1) is important in the initiation of atherosclerosis and crucial in monocyte recruitment into the subendothelial lesions. Recent studies have demonstrated that MCP-1 -2518 A>G polymorphism is associated with susceptibility to coronary artery disease (CAD). Since there are conflicting reports on the possible association of MCP-1 -2518 A>G polymorphism with CAD, we investigated the role of this polymorphism in Turkish patients with premature CAD. Material and methods. Genomic DNA was collected from 171 premature CAD patients and 151 healthy individuals. MCP-1 -2518 A>G polymorphism was genotyped using the PCR-RFLP method. Results. There were no differences between genotype distribution and allele frequencies in the premature CAD and control groups (AA: 49.7 %; AG: 40.3 %; GG: 10.0 % in premature CAD groups and AA: 53.7 %; AG: 34.4 %; GG: 11.9 % in controls; p = 0.53). The prevalence of the G allele was 0.302 in patients and 0.291 in controls. Conclusions. Our data demonstrate that MCP-1 -2518 A>G polymorphism is not associated with premature CAD in Turkish patients. Further studies are needed to elucidate the role of this polymorphism in the pathogenesis of CAD in various populations. © 2008 Informa UK Ltd (Informa Healthcare, Taylor & Francis AS).Item Effect of losartan on excercise tolerance and echocardiographic parameters in patients with mitral regurgitation(2008) Sekuri C.; Utuk O.; Bayturan O.; Bigle A.; Kurban Z.; Tavli T.Objectives. The aim of this study was to assess the effects of losartan treatment on exercise tolerance and echocardiographic parameters in patients with mitral regurgitation (MR) secondary to mitral valve prolapse or rheumatic heart disease. Methods. Twenty-seven patients (14 males, 13 females, mean age 51±11, range 21-76) with moderate MR due to mitral valve prolapse or rheumatic heart disease were examined by means of Doppler echocardiography. The subjects were submitted to treadmill exercise tests using the modified Bruce protocol at baseline, after six hours and after the six-week treatment period to be evaluated based on their exercise tolerance. Mitral Regurgitant Volume (MRV), effective regurgitant orifice diameter, left atrial volume, left ventricle (LV) end-diastolic volume index, LV end-systolic volume index, LV ejection fraction (LVEF), left ventricle mass index were calculated at baseline and after six weeks of treatment with single dose of losartan (50 mg/ day). Results. Total treadmill exercise time increased from 477.7±147.9 to 535.7±149.0 seconds after six hours (p<0.01) and to 559.6±142.8 seconds after six weeks of treatment.Also, metabolic equivalent values increased following six hours of first dose and six weeks of losartan treatment (from 10.9±2.9 to 11.8±3.1,p=0.006 and 12.4±3.1, p=0.002; respectively). However, peak exercise systolic blood pressure (BP) was reduced after six hours and six weeks of treatment, and resting diastolic BP did not change after six hours but reduced at the end of the treatment period. MR volume decreased significantly from 29.3±14.1 ml to 25.1±14.8 ml, (p=0.025) without significant change in regurgitant orifice diameter (0.72±0.37 cm vs. 0.66±0.37 cm, p=NS), left atrium diameter and area while LVEF increased from 51.70±13.37 to 54.11-11.75 (p=0.015) with losartan. Conclusion. We conclude that the angiotensin II receptor antagonist losartan improves exercise tolerance and echocardiographic parameters in patients with moderate MR.