Browsing by Author "Tezcan U.K."
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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 Images in cardiovascular medicine. Giant unruptured noncoronary sinus of Valsalva aneurysm.(2004) Utuk O.; Bayturan O.; Bilge A.R.; Tikiz H.; Tezcan U.K.[No abstract available]Item Doppler index of myocardial performance and its relationship with mitral E wave deceleration time in acute Q-wave myocardial infarction; [Akut Q-Dalgali Miyokard ̇ Infarktününde Miyokardiyal Performans ̇Indeksi ve Mitral E Dalga Deselerasyon Zamani Arasindaki ̇ Ilişki](2004) Şekuri C.; Kurhan Z.; Tavli T.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.Objective: The objectives of the study were to assess myocardial systolic and diastolic functions by myocardial performance index (MPI) and its relationship with E - wave deceleration time (DT) in early phase of acute Q-wave myocardial infarction (MI). Methods: We performed nongeometric Doppler-derived echocardiography to assess combined systolic and diastolic functions using myocardial performance index in 50 patients with acute Q-wave MI at early phase of events, (25 pts with anterior MI and 25 pts with inferior MI). The index is defined as the sum of the isovolumic contraction and isovolumic relaxation times divided by ventricular ejection time and was obtained by Doppler measurement from the diastolic mitral inflow and left ventricular outflow velocity-time intervals. Results: As a result, the index was 0.54±0.1 in all patients with MI. We also estimated the higher MPI and DT values in anterior than inferior MI (MPI: 0.61±0.07 vs., 0.46±0.06, p<0.001; DT: 244±64 msec vs. 204±31.2 msec, p=0.005, respectively). Myocardial performance index was positively correlated with DT in inferior MI (r=0.42, p<0.035) and negatively correlated with anterior MI (r=- 0.72, p=0.0001). Conclusion: These data suggest that Doppler-derived MPI reflects severity of global left ventricular dysfunction in early phase of acute MI and may be a useful parameter in these patients.Item Increased P Wave Dispersion and Maximum P Wave Duration after Hemodialysis(2004) Tezcan U.K.; Amasyali B.; Can I.; Aytemir K.; Köse S.; Yavuz I.; Kursaklioglu H.; Işik E.; Demirtaş 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 (Pmax), P wave minimum (Pmin), and P wave dispersion (Pd). Methods: We studied Pmax, Pmin, and Pd 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 = Pmax - Pmin). Results: There was a significant increase in Pmax 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). Pd 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 Pmax and P d respectively (P < 0.05). A weak positive correlation was found between serum calcium, bicarbonate at the end of dialysis and Pmax and Pd (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.Item Serum level of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in acute coronary syndromes and relationship with prognosis; [Akut Koroner Sendromlarda ̇ Insl̈in Benzeri Büyüme Faktörü-I ve ̇ Insülin Benzeri Büyüme Faktörü Baǧlayici Protein-3 Düzeyleri ve Prognozla ̇ Ilişkisi](2004) Şekuri C.; Arslan Ö.; Ütük O.; Bayturan Ö.; Onur E.; Tezcan U.K.; Tavli T.Objective: The aim of the present study was to examine the levels of insulin-like growth factor (IGF-I) and binding protein-3 (IGFBP-3) in acute coronary syndrome (ACS) and their relationship with prognosis. Methods: Thirty patients with ACS (22 male, 8 female) were included in our study. Patient's population included 20 patients with ST elevation myocardial infarction (STEMI) and 10 with non-ST-elevation ACS. Death, re-infarction, revascularization and malignant arrhythmia were monitored during 3 months. Study group was compared with 20 healthy subjects (Controls). Blood samples were collected in the first 24 hours and at the end of third month. Serum IGF-I and IGFBP-3 levels were determined by radioimmunoassay method. Results: We found decreased level of IGF-I only in the STEMI group (105±84 ng/ml vs. 715±150 ng/ml, p<0.0001). There were no significant differences in IGFBP-3 levels between two groups. Serum IGF-I levels were significantly increased after 3rd month in the STEMI group (356±72 ng/ml vs. 105±84 ng/ml, p=0.025). There was no relationship between IGF-I, IGFBP-3 levels and cardiovascular events occurred during 90 days of follow-up. Conclusion: These data allows to suggest that significantly decreased level of IGF-I in STEMI group of ACSs can be used as a marker of myocardial necrosis. There was no relationship between IGF-I level and cardiovascular events occurred in 90 days, so this parameter can not be used as a negative prognostic factor.Item The effects of clarithromycin treatment on cardiac events in acute coronary syndrome patients; [Akut Koroner Sendromlu Hastalarda Klaritromisin Tedavisinin Kardiyak Olaylar Üzerine Etkisi](2004) Ütük O.; Şekuri C.; Bayturan Ö.; Bilge A.R.; Tikiz H.; Tavli T.; Tezcan U.K.Objective: The assessment of short duration early clarithromycin treatment on major cardiac events in acute coronary syndrome patients. Methods: One hundred and thirteen patients with acute coronary syndrome had been enrolled in the study in a prospective manner. Fifty-seven of 113 patients received peroral clarithromycin 1 g/day for 14 days in addition to standard therapy. The remaining 56 patients were considered as control group. The treatment and control groups had similar major cardiac risk factors such as diabetes, hypertension, dyslipidemia and smoking habits. The occurrence of unstable angina pectoris, non-ST elevation myocardial infarction and ST elevation myocardial infarction was comparable in both groups. The use of thrombolytic therapy and glycoprotein IIb/IIIa receptor blockers administration was also similar in both groups. The patients were followed for major cardiac events for 6 months. Results: During the follow-up, no difference was observed between groups in the occurrence of unstable angina pectoris, myocardial infarction, the need for revascularization with percutaneous coronary intervention or cardiac surgery and cardiac death. We observed a reduction of myocardial infarction and cardiac death occurrence and an increase in the necessity of percutaneous interventions in the treatment group even though this difference did not reach statistical significance. Conclusion: No benefit of short duration early clarithromycin therapy was observed in the occurrence of major cardiac events in acute coronary syndromes. Studies with longer treatment and follow-up period using different antibiotics are necessary to elucidate the possible effect of antibiotics on major cardiac events in patients with acute coronary syndrome.Item Evaluation of diastolic function by transmitral color M-mode flow propagation velocity in hypertensive patients; [Hipertansif olgularda transmitral renkli M-mod akim yayilma hizi ile diyastolik fonksiyonlarin deǧerlendirilmesi](2004) Şekuri C.; Tavli T.; Danahaliloǧlu S.; Göçer H.; Bayturan O.; Ütük O.; Bilge A.R.; Tikiz H.; Tezcan U.K.Objective: Diastolic dysfunction is considered as the most important cause of heart failure and morbidity in hypertensives. This study was designed to evaluate the relationship between the transmitral diastolic color M-mode flow propagation velocity (FPV) and left ventricular relaxation by using Doppler echocardiography. Methods: In the present study, thirty-nine patients (21 male, %58.3, age mean 52.7 ± 5.9 years) with hypertension stage-I and over, were included. Transmitral diastolic E and A velocities, E-deceleration time (DT) and isovolumic relaxation time (IVRT) were measured by pulse Doppler method. We performed color M-mode technique for measurement of FPV of transmitral diastolic flow in the apical four-chamber view. We measured slope of aliasing velocity (blue aliasing) determined by color M-mode images. Results: Flow propagation velocity values were not statistically related with age and gender, whereas differentiation of age groups were estimated as poor parabolic relationship, specially in patients over fifty years, FPV is estimated to be decreasing. Color M-mode FPV is correlated with DT, (r = -0.715, p<0.01), IVRT (r = -0.736, p<0.01 and interventricular septum thickness (r = -0.498, p<0.01), but not correlated with E/A ratio. Conclusion: Color M-mode FPV is correlated with DT and IVRT, which are important parameters for evaluation of diastolic function in hypertensive patients. This parameter is related with left ventricular relaxation and should be considered as a routine echocardiographic evaluation, because it is not affected by minimal changes in left ventricular filling pressure.Item The effect of tirofiban on ST segment resolution in patients with non-ST elevated myocardial infarction(2004) Bayturan Ö.; Bilge A.R.; Seküri C.; Ütük O.; Tikiz H.; Eser E.; Tezcan U.K.ST segment resolution in ST elevated myocardial infarction has independent predictive value for congestive heart failure and death at 30 days. 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. 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 4th and 24th hours between the two groups. Significant differences occurred in the 72nd 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.Item Endothelial dysfunction in patients with primary Sjögren's syndrome(2005) Pirildar T.; Tikiz C.; Özkaya S.; Tarhan S.; Ütük O.; Tikiz H.; Tezcan U.K.The aim of this study was to determine the endothelial function in patients with primary Sjögren'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. © Springer-Verlag 2005.Item Blood pressure and ejection fraction changes due to ultrafiltration in hemodialysis(2006) Kursat S.; Aysel S.; Alici T.; Tezcan U.K.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 LAD (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. © Società Italiana di Nefrologia.Item Coarctation of the aorta evaluated with 64-row multislice computed tomography(2006) Utuk O.; Karaca M.; Bayturan O.; Oncel G.; Tezcan U.K.; Bilge A.R.[No abstract available]Item Huge pulsating cystic cardiac mass(2006) Utuk O.; Bilge A.R.; Bayturan O.; Sirin H.; Iskesen I.; Tezcan U.K.[No abstract available]Item Evaluation of coronary sinus strain in patients with dipper and nondipper hypertension(Lippincott Williams and Wilkins, 2015) Akcay S.; Turker Y.; Kobat M.A.; Cetin N.; Bilge A.R.; Tezcan U.K.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. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.Item Endovascular coil treatment of a coronary artery aneurysm related to polyarteritis nodosa(Turkish Society of Cardiology, 2017) Bayturan Ö.; Tarhan S.; Çöpkıran Ö.; Düzgün F.; Tezcan U.K.[No abstract available]Item Substrate-Based Ablation of Purkinje-Related Ventricular Fibrillation in an Elderly Patient with Ischemic Cardiomyopathy(Sociedade Brasileira de Cardiologia, 2023) Çetin N.; Soylu M.Ö.; Özbaş B.; Bayturan Ö.; Tezcan U.K.[No abstract available]