Browsing by Author "Tavli, V"

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    TAKOTSUBO SYNDROME DUE TO ENERGY DRINK: A CASE REPORT
    Tavli, T; Mergen, H; Madak, N; Acar, M; Sozcuer, H; Tavli, V
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    Diffuse left anterior descending coronary artery dissection with aortic coarctation
    Mergen, H; Nazli, Y; Acar, M; Tavli, V; Tavli, T
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    Cardiovascular risk factors and noninvasive assessment of arterial structure and function in obese Turkish children
    Yilmazer, MM; Tavli, V; Carti, OU; Mese, T; Güven, B; Aydin, B; Devrim, I; Tavli, T
    Obesity is associated with a number of risk factors, such as hyperlipidemia, hyperinsulinemia, hypertension, and early atherosclerosis. Evidence indicates that atherosclerosis begins in childhood and progresses over decades. In this work, we examined the relationship between cardiovascular risk factors and ultrasonographic signs of subclinical atherosclerosis in 77 obese children and adolescents compared to 40 non-obese healthy peers. Carotis intima media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and established cardiovascular risk factors were studied. In the obese patients, cIMT was significantly increased (0.57 mm vs 0.45 mm, p < 0.001) whereas CAC (1.84% vs 3.29%, p < 0.001) and FMD (9.67 % vs 14.81%, p < 0.001) were significantly decreased. In multiple linear regression analysis, a relation was observed between cIMT, CAC, brachial FMD on one hand, and body mass index (BMI) on the other. Among the lipid anomalies, only hypertriglyceridemia was found to be positively correlated with cIMT. Additionally, we found a significant association between waist circumference (WC) and FMD. These findings indicate that obesity in children is associated with arterial wall alterations and endothelial dysfunction. In hyperlipidemic situations, only hypertriglyceridemia was found to be positively correlated with cIMT. This finding has consistently indicated TG to be a risk factor for the development of atherosclerosis. To our knowledge this is the first study to determine the relation between FMD and WC, which is used as a parameter of obesity in childhood.
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    Spectral and time-domain analyses of heart-rate variability during head-upright tilt-table testing in children with neurally mediated syncope
    Evrengul, H; Tavli, V; Evrengul, H; Tavli, T; Dursunoglu, D
    Neurocardiac syncope (NS) is a common cause of syncope in children. The mechanism, though related to abnormalities in autonomic function, has not been fully elucidated, particularly in pediatric patients. This study assessed the heart-rate variability (HRV) response to head-upright tilt-table test (HUT) in children with NS and normal volunteers. Spectral and time-domain analysis of HRV was used to assess changes in autonomic function in 27 children (9 male, mean age 12.3 +/- 1.6 years) with a history of at least one episode of syncope and positive passive HUT and 27 age-matched normal volunteers with negative passive HUT before and during postural tilt and to attempt to relate such changes to specific types of hemodynamic response to tilt. Frequency-domain measurements of the high-(HF) and low-(LF) frequency bands and the ratio LF/HF were derived from Holter recordings and computed by fast Fourier analysis for 5-min intervals. Time-domain measurements of the SDNN, SDNNI, SDANN, RMSSD, and triangular index were derived from 24-h Holter recordings. There were no significant differences between clinical characteristics, time-domain, and basal frequency domain parameters of the groups. Mean values of LF and LF/HF ratio was increased and HF was decreased significantly in response to tilt in both patient and control groups. Mean values of LF and LF/HF ratio were higher and HF was lower compared to controls immediately after tilt. LF and LF/HF ratio showed a statistically significant decrease and a significant increase in HF during syncope in patients. The three subgroups of patients had similar patterns of changes in autonomic activity. The results of this study show that although the basal autonomic function was similar to that of the control group, patients with NS have a different pattern of response to the HUT. In our study, patients with NS demonstrated an exaggerated response to the HUT. This exaggerated response may be the factor that activates the pathological reflexes of NS. The pathological mechanism leading to NS appears to be independent of the specific type of hemodynamic response to HUT.
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    Comparative Validity and Reliability Study of The QIDS-SR16 in Turkish and American College Student Samples
    Mergen, H; Bernstein, IH; Tavli, V; Ongel, K; Tavli, T; Tan, S
    Comparative validity and reliability study of the QIDS-SR16 in Turkish and American college student samples Objective: To evaluate the validity and reliability of the Quick Inventory of Depressive Symptomatology, self-reported version, in a Turkish student sample (QIDS-SR16-T) by comparing it to (a) the American version (QIDS-SR16-US) and (b) the Turkish version of the Beck Depression Inventory (BDI-II-T). Materials and Methods: Slightly modified versions of the QIDS-SR16-T, and the BDI-II-T were administered to 626 outpatients at the Uludag University campus-based family health center. The QIDS-SR16-US was administered to 584 respondents at an American university. SAS and MPlus were used to provide descriptive statistics, classical exploratory factor analysis, and item response theory analyses (in the form of a multiple group confirmatory factor analysis). Results: The internal consistency (Cronbach a) of the QIDS-SR16-T was 0.77. Both QIDS-SR16 versions were unidimensional, but the BDI-II-T was not. The mean QIDS-SR16-T and QIDS-SR16-US item-total correlations were similar. The correlation between the QIDS-SR16-T and BDI-II-T was 0.72 (.90 when disattenuated). Multiple-group confirmatory factor analysis suggested that the QIDS-SR16-T and QIDS-SR16-US had the same factor loadings but different intercepts. This reflects group differences in level of depression, perhaps because the Turkish respondents, unlike their US counterparts, were seen in a medical context where illness-related depression is more prevalent. Scores on the QIDS-SR16-T and the BDI-II-T were also equated. Discussion: The QIDS-SR16-T has good psychometric properties and convergent validity with the BDI-II-T. Its use is recommended when a self-reported instrument is appropriate.
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    Myocardial performance after successful intervention for native aortic coarctation
    Tavli, V; Saritas, T; Guven, B; Okur, F; Saylan, BC; Tavli, T; Uyanik, BS; Ari, Z; Isbilen, B
    Coarctation of the aorta is associated with increased risk for hypertension in adulthood, despite successful repair. The intrinsic mechanisms underscoring hypertension and left ventricular performance in these patients, however, remains to be determined. Our objective was to evaluate left ventricular performance by means of echocardiographic and biochemical parameters at midterm follow-up in normotensive children who have had undergone successful surgical or catheter interventional treatment of coarctation with a residual gradient of less than 20 mmHg at rest. We studied prospectively 14 patients with native aortic coarctation who underwent surgery or balloon angioplasty, the cohort made up of equal numbers of boys and girls, and having a mean age of 8.5 plus or minus 4 years. We also studied 30 age-matched healthy subjects, measuring mitral inflow pulsed wave signals, isovolumic relaxation and contraction times, myocardial performance index parameters, and levels of B-type natriuretic peptide and endothelin-1 in both groups. We found no differences in systolic blood pressure at rest between the patients and their controls. The ventricular septal diastolic dimensions, left ventricular posterior wall dimensions, mitral valve E wave, deceleration time, isovolumic relaxation time, isovolumic contraction time and myocardial performance index were all significantly increased in the patients. Levels of plasma B-type natriuretic peptide and endothelin-1 were also significantly higher in the patients when compared to the control group. We conclude that aortic coarctation is a chronic disease characterized by persistency of myocardial and vascular alterations. The elevated levels of plasma b-type natriuretic peptide and endothelin-1 may be indicative of late onset hypertension after successful treatment of native coarctation in early childhood.
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    The role of marker chromosome in total abnormal pulmonary venous return to the coronary sinus
    Solak, M; Tavli, V; Bagci, G; Fistik, T; Demircan, K; Kayhan, B; Bagci, H