Browsing by Author "Tezcan, UK"

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    Coarctation of the aorta evaluated with 64-row multislice computed tomography
    Utuk, O; Karaca, M; Bayturan, O; Oncel, G; Tezcan, UK; Bilge, AR
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    Endothelial dysfunction in patients with primary Sjogren's syndrome
    Pirildar, T; Tikiz, C; Özkaya, S; Tarhan, S; Ütük, O; Tikiz, H; Tezcan, UK
    \The aim of this study was to determine the endothelial function in patients with primary Sjogren's syndrome ( SS). We also aimed to determine whether endothelial ( dys) function correlates with extraglandular manifestations, specific autoantibodies and the severity of salivary gland involvement of SS. Endothelium dependent vasodilation and endothelium- independent vasodilation of the brachial artery were assessed by a high- resolution ultrasound on 25 patients with primary SS and on 29 healthy controls. Patients with primary SS had significantly less mean endothelium- dependent vasodilation than did controls ( 3.0 +/- 0.4% vs 4.2 +/- 0.3%; p= 0.012). Endothelium- independent vasodilation induced by sublingual glycerol trinitrate was not different between the two groups ( 12.9 +/- 1.4% vs 14.1 +/- 1.2%; p= 0.86;). We concluded that endothelium- dependent vasodilation was impaired in primary SS patients, in particular those presenting with Raynaud's phenomenon, when compared with the healthy controls and this impairment was not associated with the presence of RF, ANA, anti- Ro/ SS- A, anti- La/ SS- B and with the other extraglandular manifestations of the disease.
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    Androphenotypic features in patients with coronary artery disease
    Gençoglan, G; Gülbasaran, F; Inanir, I; Tezcan, UK; Gündüz, K
    Objective: It has been a debate whether phenotypic features are associated with increased risk of coronary heart disease. Proposed explanations for this relation include biological aging, individual susceptibilities, and androgens which contribute to both the atherosclerotic process and dermatological signs. The results of the studies are inconsistent and most are not based on cardiovascular imaging techniques. Here, association between androphenotypic features and the risk and severity of coronary artery disease (CAD) in men is evaluated. Methods: This case-control study consists of 166 male patients with angiography-proven CAD and 160 age-gender-matched controls. Gensini score of angiograms (for severity of CAD) and phenotypic characteristics including androgenetic alopecia (AGA), thoracic hairiness (TH), hair graying a diagonal earlobe crease (DEC), and hairy ear (HE) were recorded. Men with well-established cardiovascular risk factors were excluded. Results: AGA, DEC, and HE were significantly more frequent in patients with CAD than controls (98.2% and 83.1% [P < 0.001], 61.4% and 23.8% [P < 0.001], 69.3% and 50.6% [P = 0.001], respectively). As the severity of AGA increased, the incidence of heart disease was increasing in patients. The presence of TH and AGA was found to be related to higher Gensini scores. Conclusion: The exact mechanism between these phenotypic features and CAD still remains to be elucidated. However, observation of visible aging signs is easy and inexpensive. AGA, HE, and DEC may be used as early screening tools for CAD.
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    Evaluation of coronary sinus strain in patients with dipper and nondipper hypertension
    Akcay, S; Turker, Y; Kobat, MA; Cetin, N; Bilge, AR; Tezcan, UK
    Objective Hypertension has been reported to affect both the left and the right ventricular functions, but its effect on the coronary sinus has not been investigated. The aim of this study was to investigate the effect of systemic hypertension on the cardiac venous system by evaluating the coronary sinus strain (CSS). Methods One-hundred and twelve hypertensive patients without diabetes and 44 healthy individuals (the control group) were evaluated consecutively at the outpatient clinic and enrolled in the study. CSS was evaluated by echocardiography in all the participants before blood pressure evaluations. Twenty-four-hour ambulatory blood pressure monitoring enabled the study population to be divided into two groups: 52 patients with dipper pattern hypertension and 60 with nondipper pattern hypertension. Results Nondipper pattern patients had significantly lower values of CSS compared with the participants in the control group (140.8 +/- 54.2 and 193.9 +/- 48.1, P < 0.001). Similarly, dipper pattern patients had significantly lower values of CSS values compared with the controls (164 +/- 68.4 and 193.9 +/- 48.1, P = 0.036). On comparing the three groups, the CSS values showed a progressive decrease from normal individuals to dipper and nondipper hypertension patients. Correlation analysis indicated a positive correlation between the aortic strain and the CSS (r = 0.247, P = 0.002). There was a weak correlation between left ventricular mass and CSS (r = -164, P = 0.041). Conclusion Our study suggests that systemic hypertension may affect the cardiac venous system as well as the arterial system, which has been reported in many papers. The effect on the venous system may be more pronounced in nondipper pattern hypertension. Blood Press Monit 19: 320-326 (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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    Evaluation of Coronary Sinus Strain in Patients with Dipper and Non-Dipper Hypertension
    Akçay, S; Turker, Y; Kobat, MA; Çetin, N; Bilge, AR; Tezcan, UK
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    THE EFFECT OF SMOKING AND DISEASE SEVERITY ON QT DISPERSION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
    Hepcivici, U; Acar, M; Tikiz, H; Tezcan, UK; Tavli, T; Bilge, AR; Bayturan, O; Utuk, O
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    Endovascular coil treatment of a coronary artery aneurysm related to polyarteritis nodosa
    Bayturan, Ö; Tarhan, S; Cöpkiran, Ö; Düzgün, F; Tezcan, UK
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    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
    Sekuri, C; Bayturan, O; Gocer, H; Tavli, T; Tezcan, UK
    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 I or II 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 (C) 2003 Excerpta Medica, Inc.
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    Giant unruptured noncoronary sinus of valsalva aneurysm
    Utuk, O; Bayturan, O; Bilge, AR; Tikiz, H; Tezcan, UK
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    QT dispersion in rheumatoid arthritis patients with and without Sjogren's syndrome
    Pirildar, T; Sekuri, C; Ütük, O; Tezcan, UK
    The aim of this study was to assess the effect of secondary Sjogren's syndrome (SjS) on QT dispersion and corrected QT dispersion in patients with rheumatoid arthritis (RA). We performed electrocardiography and Doppler echocardiography on 58 patients with RA whom we divided into two groups according to the presence of secondary SjS, and on 29 healthy controls. All patients revealed significantly longer QT dispersion and corrected QT dispersion values (P < 0.05). Diastolic function variables were significantly different in all patients compared to controls. QT dispersion and corrected QT dispersion values were significantly longer in RA patients with secondary SjS than in those without. We concluded that secondary SjS could be a cardiovascular risk factor contributing to the well documented cardivascular disease in RA patients.
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    The effect of tirofiban on ST segment resolution in patients with non-ST elevated myocardial infarction
    Bayturan, Ö; Bilge, AR; Seküri, C; Ütük, O; Tikiz, H; Eser, E; Tezcan, UK
    ST segment resolution in ST elevated myocardial infarction has independent predictive value for congestive heart failure and death at 30 days.(1-2)) ST segment depression in unstable angina pectoris (UAP) and non-ST elevated myocardial infarction (NSTEMI) predicts high risk of MI and death and may discriminate patients likely to have greater benefit from aggressive antithrombotic and interventional therapy.(5-6)) This study assessed the effect of tirofiban added to conventional treatment on ST segment resolution in NSTEMI patients. Sixty-four patients were randomized to one of the two groups: 32 patients received conventional treatment while tirofiban was added in the second group of 32 patients. In the first group, 6 patients refused to participate further after giving initial informed consent while 1 patient in the tirofiban group dropped out. We had 26 patients (mean age, 59 years) in the conventional treatment group and 31 patients (mean age, 59 years) received also tirofiban. Tirofiban was administered by intravenous infusion over a 72 hour period. More than 50% regression of depression was considered to be ST segment resolution. The characteristics of the two groups were comparable (Table I). The ST segment resolution evolution did not differ at the 4(th) and 24(th) hours between the two groups. Significant differences occurred in the 72(nd) hour ECG (Table III). ST resolution was present in 67.9% of the tirofiban patients and in 32.1% of the conventional treatment group (P < 0.05). Tirofiban treatment was not associated with an increase in major bleeding even though there was a trend toward an increase in minor bleeding cases and did not influence the occurrence of refractory angina pectoris.
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    TAKOTSUBO CARDIOMYOPATHY IN A MALE PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
    Bayturan, Ö; Çetin, N; Yavuz, V; Yurdam, F; Uludag, Ö; Tezcan, UK
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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.
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    Increased P wave dispersion and maximum P wave duration after hemodialysis
    Tezcan, UK; Amasyali, B; Can, I; Aytemir, K; Köse, S; Yavuz, I; Kursaklioglu, H; Isek, E; Demirtas, E; Oto, A
    Background: Atrial fibrillation is a frequent arrhythmia in patients undergoing hemodialysis. The consequences of hemodialysis on P wave durations and P wave dispersion have not been fully understood. The objective of this study was to study the effect of dialysis on P wave maximum (P-max), P wave minimum (P-min), and P wave dispersion (P-d). Methods: We studied P-max, P-min, and P-d in 32 patients (17 men and 15 women, mean age 54 +/- 18 years) with chronic renal failure undergoing hemodialysis. The difference between maximum and minimum P wave duration was calculated and defined as P wave dispersion (P-d = P-max - P-min). Results: There was a significant increase in P-max at the end of dialysis compared to the beginning (98 +/- 13 ms vs. 125 +/- 12 ms, P < 0.001). P-min did not show any significant change (71 +/- 11 ms vs. 73 +/- 10 ms, P = 0.42). P-d was significantly increased at the end of dialysis (27 +/- 9 ms vs. 52 +/- 11 ms, P < 0.001). There was a negative correlation between serum potassium, magnesium, phosphate, blood urea nitrogen, and creatinin at the end of dialysis and P-max and P-d. respectively (P < 0.05). A weak positive correlation was found between serum calcium, bicarbonate at the end of dialysis and P-max and P-d (P < 0.05). Conclusion: Hemodialysis ends with significant increase in P wave maximum duration and P wave dispersion, which might be responsible for the increased occurrence of atrial fibrillation in these groups of patients.
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    Survey of cardiac pacing in Turkey: calendar years 2000, 2001 and 2002
    Karaoguz, R; Yazicioglu, N; Ozin, B; Mercanoglu, F; Tezcan, UK