Browsing by Author "Tikiz, H"
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Item Diabetes mellitus adversely affects the outcomes of thrombolytic therapy in patients with acute myocardial infarctionTikiz, H; Tezcan, U; Ileri, M; Balbay, Y; Atak, R; Kütük, EThis study was performed to evaluate whether coexistent diabetes mellitus has any adverse effect on the outcomes of thrombolytic therapy in patients with acute myocardial infarction. Although the early reperfusion rates were similar between the two groups of patients who had acute myocardial infarction with and without diabetes mellitus (42% vs 45.4%, p > 0.05), the results of late angiographic examination showed a significantly lower rate of patency in infarct-related coronary artery (defined as TIMI 3 flow) in diabetics compared to nondiabetics (28.9% vs 41.3%, p < 0.001). The global left ventricular function was also poorer in diabetics (left ventricular wall motion score was 18.6 +/- 73 in diabetics and 14.1 +/- 4.6 in nondiabetics, p < 0.01).Item Endothelial dysfunction in patients with primary Sjogren's syndromePirildar, 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.Item Increased serum leptin concentrations in patients with chronic stable angina pectoris and ST-elevated myocardial infarctionTaneli, F; Yegane, S; Ulman, C; Tikiz, H; Bilge, AR; Ari, Z; Uyanik, BSLeptin is an adipocytokine that is produced mainly by adipose tissue; it is also identified in atherosclerotic lesions in human coronary atherosclerosis. However, the relation of serum leptin concentrations to ischemic heart disease (IHD) is still obscure. The aims of the present study were to investigate serum leptin concentrations in patients with ST-elevated myocardial infarction (STEMI) and with chronic stable angina pectoris (CSAP) and to evaluate the possible correlations of leptin to other atherosclerotic risk factors; including serum high sensitive C-reactive protein (Hs-CRP), serum homocysteine, and fibrinogen concentrations. For this purpose, 35 patients with CSAP, 40 with acute STEMI, and 30 control subjects with normal findings from coronary angiography were taken into the study prospectively. Serum leptin concentrations were significantly higher in patients with CSAP and STEMI compared to the control group (7.74 +/- 1.34 vs 6.37 +/- 1.85 ng/mL, p=0.021 and 8.22 +/- 3.13 vs 6.37 1.85 ng/mL, p=0.023, respectively). In addition, serum homocysteine concentrations were significantly increased in patients with CSAP (15.23 +/- 5.96 vs 11.40 +/- 2.11 mu mol/L, p=0.025) and patients with STEMI (15.90 +/- 5.02 vs 11.40 +/- 2.11 mu mol/L, p=0.012) compared to the control group. Serum fibrinogen concentrations were significantly increased only in the CSAP group as compared to controls (4.15 +/- 1.39 vs 3.45 +/- 1.19 g/L, p = 0.025). No significant correlation was found between leptin levels and selected risk factors. In conclusion, serum leptin concentrations were significantly higher in both the CSAP and STEMI groups. However, owing to the lack of correlation between the leptin levels and selected classical coronary risk factors, it may be considered that leptin can be evaluated as one of the independent risk factors for IHD. Further randomized and controlled studies will be required to determine the pathophysiological meaning of the increased leptin levels and the central role between adipocyte function and atherosclerosis.Item THE EFFECTS OF THE RESISTANCE TRAINING ON SERUM CORTISOL, IL-6, IL-8, AND TNF- αÖztürk, Y; Bereket-Yücel, S; Dinç, N; Taneli, F; Ulman, C; Tikiz, HObjective: The purpose of this study is to investigate effects of resistance training on IL-6, IL-8, TNF-alpha, blood hematocrit and cortisol levels. Materials and Methods: Thirteen players from Manisa Celal Bayar University soccer team and 14 sedentary male students were used as the study subjects. The subjects, whose average age was 18-24 years old, were healthy and free of any cardiovascular diseases. Anthropometrics measurements and blood samples were obtained from all the subjects. Blood samples were obtained basal sample (before the exercise), immediately after the training program (post-exercise), and 2 hours after the training program (2h post-exercise). All subjects participated in the training program in which intensity prescribed individually in 10 different exercises; seated leg press, knee extension, knee flexion, chest press, chest flys, lat pull down, shoulder press, triceps extension, biceps curl and sit-ups. The exercise protocol was 8-10-12 repetitions of each exercise at 70 to 80 % of one-repetition maximum in accordance with the pyramid training system and three sets for each station. The volume of resistance training was 50-60 minutes. Results: Post exercise IL-6 (p=0.05) and IL-8 (p=0.04) concentration of athletes were statistically lower compared to that of sedentary group. Two hours after the exercise, the TNF-alpha values of the sedentary individuals were also statistically higher than those of the trained individuals. Furthermore, serum cortisol concentrations were found to be decreased in both study groups in post exercise and 2h post exercise samples compared to basal values (p<0.05). Post exercise IL-8 (p=0.04) and TNF-alpha (p=0.04) values of sedentary group increased significantly compared to values at 2h post exercise. There was no statistically significant change in IL 6 values of the trained and sedentary subjects immediately after the exercise. Conclusion: IL-6, IL-8, and TNF-alpha responses to resistance training vary depending on the recruitment of different muscle fiber types by the trained individuals during the resistance training and the recovery of glycogen storage, which is found to be different from that of sedentary individuals. The decrease in the serum IL-6 and IL-8 concentrations at post exercise and 2h post-exercise samples in the training group when compared to the sedantary group revealed us that, training lowers the proinflammatory marker IL-6 and IL-8 which reflects a positive effect of the training on the overall body inflammation status.Item The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritisTikiz, H; Arslan, Ö; Pirildar, T; Tikiz, C; Bayindir, PObjective: To investigate the effects of tumor necrosis factor (INF)-alpha antagonism with etanercept (ENC) on endothelial functions in patients with active rheumatoid arthritis (RA). Methods: A total of 21 patients with RA were enrolled in this prospective study. Eleven of them (8 women, 3 men mean age 47.0 +/- 10.1 years) with high disease activity despite the conventional treatment were assigned to Group 1 and were given ENC treatment twice a week (25 mg SC injection) for 12 weeks. Ten patients with RA (8 women, 2 men mean age 55.0 +/- 6.4 years) under conventional methotrexate and prednisone therapy were assigned as Control group (Group 2). Endothelium-dependent and -independent vasodilator responses of the brachial artery were assessed by high-resolution ultrasound. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured at baseline and at the post treatment period. Mann-Whitney U and Wilcoxon tests were used to compare the data and correlation analysis was performed using Pearson correlation test. Results: Endothelium-dependent vasodilatation improved from 5.2 +/- 0.8% to 7.9 +/- 1.3% (p=0.04) in ENC group, while no significant change was observed in the control group (from 6.6 +/- 1.1% to 7.0 +/- 1.8% p=0.67). No significant changes were found in endothelium-independent vasodilatation and baseline brachial artery diameters in both groups. A significant reduction in ESR and CRP were observed in patients receiving ENC (from 16.2 +/- 6.8 to 9.2 +/- 5.1 mm/h, p=0.003 and from 14.68 +/- 3.4 to 9.25 +/- 3.7 mg/L, p=0.003, respectively). Conclusion: Treatment with ENC for 12 weeks significantly improved endothelial function in patients with active RA compared to those under conventional therapy. The findings of the present study support the hypothesis that the use of TNF-alpha blockers in patients with active RA may reduce the high incidence of cardiovascular complications. (Anadolu Kardiyol Derg 2010; 10: 98-103)Item Peripheral polyneuropathy in patients receiving long-term statin therapyÖzdemir, IH; Copkiran, Ö; Tikiz, H; Tikiz, CObjective: Peripheral neuropathy is an important potential side effect of statin use. This study was an investigation of the incidence of peripheral neuropathy in patients taking atorvastatin or rosuvastatin for hypercholesterolemia and the relationship to the dose and duration of the treatment. Methods: In all, 50 patients using a statin treatment and 50 healthy controls matched for age and gender who had never taken a statin were included in the study. Polyneuropathy was assessed with a neurological examination and electroneuromyography (ENMG). Results: While no polyneuropathy was detected in the control group, polyneuropathy was seen in 33 (66%) of the patients in the statin group (p<0.01). There was no significant difference between the 2 statin groups in the results of the neurological examination or the ENMG findings regarding the incidence of polyneuropathy (p=0.288 and p=0.720, respectively). Neuropathy was observed in a neurological examination performed within the first year in 50% of the rosuvastatin users and 18% of those taking atorvastatin. The severity of the polyneuropathy increased with the duration of the treatment in the atorvastatin group (p=0.030). Conclusion: This study revealed an increased risk of peripheral neuropathy with long-term statin use (>1 year). Electrodiagnostic changes have been detected in motor and sensory nerves in nerve conduction studies of patients on long-term statin treatment. The assessment of neurological symptoms, like tingling, numbness, pain and tremor in the hands and feet, and unsteadiness during walking associated with peripheral neuropathy may be useful in the follow-up of the patients on long-term statin treatment. Early detection of peripheral neuropathy and changing hypercholesterolemia treatment may prevent permanent nerve damage.Item Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending arteryÇetin, N; Özlek, B; Özdemir, IH; Yildiz, BS; Yavuz, V; Tikiz, HBackground Myocardial bridge (MB) is generally considered as a benign condition, but it may trigger atherosclerosis, especially in the adjacent proximal coronary artery segment. In this study, we aimed to investigate whether the Framingham risk score (FRS) or atherogenic indices are risk factors for coronary atherosclerosis in patients with MB in the left anterior descending coronary artery (LAD). Methods We performed a retrospective study evaluating 155 patients who have MB in LAD. The patients were evaluated in two groups according to the presence of atherosclerosis (74 patients in atherosclerotic group vs. 81 patients in non-atherosclerotic group). Baseline characteristics, FRS and atherogenic indices were reviewed between groups. Significant independent risk factors for coronary atherosclerosis were investigated by logistic regression analysis. Results Patients in atherosclerotic group were significantly older (58.15 +/- 10.04 vs. 50.22 +/- 9.27 years, p < .001) and 74.3% of the patients were male. While the mean FRS in the atherosclerotic group was 21.20 +/- 8.81, it was 12.79 +/- 8.61 in the non-atherosclerotic group (p < .001). Among the atherogenic indices, only LDL-c/HDL-c ratio was significantly higher in the atherosclerotic group (3.49 +/- 1.2 vs. 3.11 +/- 0.98, p:.033). Multivariable analysis showed that age (OR: 1.08, 95% CI 1.03-1.13, p < .001) and FRS (OR: 1.06, 95% CI 1.01-1.11, p:.012) were independently associated with the presence of atherosclerotic lesion. Conclusions FRS is an easily applicable predictor in clinical practice that indicates the presence of coronary atherosclerosis in patients with MB in LAD.Item Left ventricular aneurysm formation after anterior myocardial infarctionTikiz, H; Atak, R; Balbay, Y; Genç, Y; Kütük, EBackground: Previous studies have reported controversial results regarding the clinical and angiographic factors involved in the left ventricular aneurysm (LVA) formation after myocardial infarction (MI). Objective: This study was performed to determine the clinical and angiographic factors that are priori predictors of LVA following anterior myocardial infarction and so to provide a paradigm which may identify patients who were candidates for aneurysm formation. Methods: Of the patients who underwent coronary angiography during the interval between 1995 and 2000 in our clinic, 809 were found to have anterior MI and LVA (aneurysm group) (677 men, 132 women, mean age 53.3 +/- 11.4 years). The clinical and the angiographic data of these patients were compared with those of 446 patients (399 men, 47 women, mean age 55.2 +/- 10.5 years) with previous anterior MI and without LVA (control group). Results: LVA was found to occur more frequently in females (16.3% in women and 10.4%, in men, P = 0.03) and in patients without previous angina (23.5 vs. 8.2%. P < 0.0001). Major cardiovascular risk factors, previous anti-anginal medication and thrombolytic therapy did not show a significant difference between the two groups. Angiographic examination revealed that single-vessel disease, proximal left anterior descending artery (LAD) stenosis, total LAD occlusion, mean stenosis in LAD artery, end-diastolic pressure and left ventricular score were all higher in the aneurysm group compared to control group. After adjustment for other clinical and angiographic variables, single-vessel disease [odds ratio (OR) 5.89, 95% confidence interval (CI) = 3.68-9.28, P < 0.0001), absence of previous angina (OR) = 4.21. 95% CI = 2.1-7.48, P = 0.0003), total LAD occlusion (OR = 2.63, 95% CI = 1.97-3.53, P < 0.0017) and female gender (OR = 1.60, 95% CI = 1.20-2.28, P = 0.043) remained the independent determinants of LVA formation after anterior MI. Conclusion: In patients with LVA, logistic regression analysis revealed that (1) single-vessel disease, (2) absence of previous angina, (3) total LAD occlusion and (4) female gender were independent determinants in the formation of LVA after anterior MI. Coronary collateral status and risk factors, such as hypertension, diabetes mellitus, hypercholesterolemia, smoking and family history of CAD were not found to be important determinants in the aneurysm formation. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Item THE EFFECT OF SMOKING AND DISEASE SEVERITY ON QT DISPERSION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASEHepcivici, U; Acar, M; Tikiz, H; Tezcan, UK; Tavli, T; Bilge, AR; Bayturan, O; Utuk, OItem The effects of different intensity walking programs on serum blood lipids, high-sensitive C-reactive protein, and lipoprotein-associated phospholipase A2 in premenopausal womenBuyukyazi, G; Ulman, C; Taneli, F; Esen, H; Gozlukaya, F; Ozcan, I; Tikiz, HAim. - This study examined the effects of 12 weeks of walking programs on serum lipids, high-sensitive C-reactive protein, and lipoprotein-associated phospholipase A2. Methods. - Twenty-six pre-menopausal women (30-49 years) completed 12 weeks of walking programs either at moderate or high intensity (50-55%, 70-75% maximum heart rate reserve, respectively). Estimated maximal oxygen consumption was assessed with a 2-km walking test; body composition, blood lipids, high-sensitive C-reactive protein, and lipoprotein-associated phospholipase A2 were measured before and after the study. Results. - Maximal oxygen consumption increased, favoring high-intensity group; body weights, percent body fat (p<0.01) and body mass index (p<0.05) decreased in both exercise groups. There were no significant changes in the measured blood lipids in any of the groups, except for a significant reduction in low-density lipoprotein-cholesterol in high-intensity group (p<0.05). High-sensitive C-reactive protein and lipoprotein-associated phospholipase A2 levels reduced significantly in high-intensity (p<0.01) and moderate-intensity (p<0.05) groups, which were also different from the changes in the control group. Conclusion. - Walking programs with different intensity result in favorable changes; however, for protective effects against cardiovascular diseases, high-intensity walking may be advised due to greater reductions in low-density lipoprotein-cholesterol, and high-sensitive C-reactive protein and lipoprotein-associated phospholipase A2. (C) 2010 Elsevier Masson SAS. All rights reserved.Item Effects of simvastatin on bone mineral density and remodeling parameters in postmenopausal osteopenic subjectsTikiz, C; Tikiz, H; Taneli, F; Gümüser, G; Tüzün, ÇObservational studies suggest that statin use may be associated with lower incidence of fracture. However, there are conflicting data for their effects on bone remodeling parameters and bone mineral density (BMD). In the present study, we aimed to investigate the effects of simvastatin on bone metabolism and BMD in subjects with hypercholesterolemia (> 240 mg/dl). For this purpose, 32 postmenopausal osteopenic subjects who were given simvastatin treatment (20 mg/day) and not on osteoporosis treatment were included in the study. During the 1-year follow-up period, the total cholesterol level decreased from 262.1 +/- 30.9 to 202.2 +/- 30.1 mg/dl (p < 0.0001). At a period as early as the 3rd month, levels of the anabolic markers, e.g., bone-specific alkaline phosphatase (BSAP) and osteocalcin (OCL), were found to be significantly increased (from 120.8 +/- 56.6 to 149.5 +/- 57.6 IU/l, p = 0.008, and from 20.8 +/- 12.6 to 34.7 +/- 118.4 mu g/l, p = 0.015, respectively) while no significant change was observed in the resorptive marker of serum N-telopeptide of type I collagen (CTX). At the 6th and 12th month, BSAP and OCL were both found to be decreased below the pretreatment values. While a significant reduction was found in BSAP levels (from 120.8 +/- 56.6 to 55.9 +/- 18.8 IU/l, p < 0.001), no significant change was observed in CTX levels after the 6-month treatment period. Parathyroid hormone showed a gradual profound increase during the follow-up period (from 62.7 +/- 41.5 to 108.4 +/- 51.7 pg/ml, p < 0.001). No significant change was found in BMD levels at the spine, femoral neck, Ward's triangle, and trochanter at the end of the 1-year follow-up period. In conclusion, simvastatin treatment showed a short-lasting anabolic effect on bone metabolism. However, this effect was lost by prolongation of therapy. The decrease in both anabolic and resorptive markers at the 6th and 12th month suggests that simvastatin affects bone metabolism mostly in favor of inhibition of the bone turnover in a long-term observation period although this inhibitory effect was not reflected in BMD.Item Effects of angiotensin-converting enzyme inhibition and statin treatment on inflammatory markers and endothelial functions in patients with longterm rheumatoid arthritisTikiz, C; Utuk, O; Pirildar, T; Bayturan, O; Bayindir, P; Taneli, F; Tikiz, H; Tuzun, CObjective. To investigate the effects of angiotensin-converting enzyme (ACE) inhibitors and statins (hydroxy-methyl-glutaryl-CoA reductase inhibitors) on inflammatory markers and endothelial functions in patients with rheumatoid arthritis (RA). Methods. A total of 45 patients with longterm RA were randomized into 3 groups to receive 8 weeks of treatment with placebo (n = 15), simvastatin (20 mg/day, n = 15), or quinapril (10 mg/day, n = 15) as an adjunct to existing antirheumatic drug treatment. Factors with a role in the development of endothelial dysfunction, such as C-reactive protein (CRP), fibrinogen, nitric oxide (NO), and serum cytokine concentrations including interleukin 1 beta (IL-1 beta), IL-6, and tumor necrosis factor-alpha (TNF-alpha) were measured at baseline and in the posttreatment period. Brachial artery vasodilator responses were assessed by high resolution ultrasound to evaluate endothelial functions. Results. Simvastatin treatment significantly decreased serum CRP and TNF-alpha [from 14 6 to 7 3 mg/l (p = 0.025) and 30 +/- 5 to 16 +/- 4 pg/ml (p = 0.012), respectively], while quinapril had no significant changes in these 2 measures. IL-1 beta and IL-6 showed insignificant changes in patients in the 2 drug groups. Endothelium-dependent vasodilatation was improved significantly in the simvastatin group [from 5.3 +/- 1.1% to 8.9 +/- 1.4% (p = 0.025)], while there was no difference in endothelium-independent vasodilatation [9.0 +/- 1.8% to 11.2 +/- 2.5% (p = 0.17)]. The quinapril group showed no significant changes in both types of vasodilation although there was a tendency to an increase in endothelium-dependent vasodilatation [from 6.1 +/- 0.8% to 7.8 +/- 0.7% (p = 0.06)]. Treatment with the 2 drugs had no significant effects on resting arterial diameter. Conclusion. We show that simvastatin 20 mg daily improves endothelial function in patients with RA. Its beneficial effect may be attributed to lowering CRP and TNF-a concentrations. ACE inhibition with daily 10 mg quinapril was found to have no significant effects on inflammatory markers and endothelial vasodilator response.Item The effect of long-term continuous positive airway pressure treatment on systolic and diastolic function in patients with obstructive sleep apnoea syndrome: A five year observational studyBilge, AR; Yavuz, V; Çetin, N; Dalgiç, O; Kum, G; Yilmaz, H; Tikiz, HObjective: Evaluation of the long-term effects of continuous positive airway presure (CPAP) on mean heart rate and left ventricular systolic and diastolic parameters in obstructive sleep apnea syndrome (OSAS) using conventional and tissue Doppler techniques. Methods: This prospective cohort study is designed to evaluate the long-term effects of CPAP treatments in normotensive OSAS patients. Initially 40 patients aged from eighteen to fifty five with documented OSAS syndrome were evaluated within one month of CPAP treatment. All had high self-reported compliance with treatment. From the latter, 21 patients with uninterrupted CPAP therapy (for at least 5 years, 5 hours per day) were included in the study and further evaluated with treatment. The left ventricular systolic function was assessed on apical four-chamber view using modified Simpson method and diastolic function was evaluated with classic transmitral pulsed and tissue Doppler techniques. Paired t test and Wilcoxon signed rank test had been used to compare the clinical and echocardiography data before and after treatment period. Results: A comparison of values assessed after one month and after 5 years of CPAP therapy, revealed a significant increase in the acceleration time(AT) Em/Am ratio and ejection time (ET) (AT: p=0.04; Em/Am ratio p=0.03 ET: p=0.04) while a significant decrease was observed on deceleration time (DT), isovolumetric relaxation time (IRT), myocardial performance index (MPI), mitral regurgitation (MR) and 24 hour mean heart rate (HR) in all subjects (DT: p=0.02; IVRT: p=0,04; MPI: p=0,01; MR: p=0.001; HR: p=0.004). Conclusion: We observed a significant improvement in the left ventricular systolic and diastolic function and a significant decrease of 24-hour heart rate and mitral regurgitation with unchanged ejection fraction of the left ventricle with long-term CPAP treatment similar to short-term treatment studies. The long-term maintenance of the beneficial effect of CPAP throughout the 5 year long-term treatment can be one of the pathophysiologic mechanisms that may explain the decrease of cardiovascular mortality observed with long-term CPAP therapy in OSAS patients.Item Thrombosis of a Coronary Artery Related to the Myocardial BridgingUtuk, O; Bilge, A; Bayturan, O; Tikiz, H; Tavli, T; Tezcan, UItem The Factor V G1691A, Factor V H1299R, prothrombin G20210A polymorphisms in children with family history of premature coronary artery diseaseÇiftdogan, DY; Coskun, S; Ulman, C; Tikiz, HAtherosclerosis, the major cause of coronary artery disease (CAD), has a very long asymptomatic development phase, which begins in childhood. In this study, we describe the Factor V G1691A, Factor V H1299R and prothrombin G20210A gene polymorphisms in children with a family history of premature CAD. Evidence of these polymorphisms in these children may predict the probability of having atherosclerosis in the future. Our study included a total of 140 children, 72 males and 68 females between the ages of 4.9 and 15.7 years. Among these children, 73 had a parental history of premature CAD and the remaining 67 belonged to our control group. The participants were screened for the mutations Factor V G1691 A, Factor V H1299R and prothrombin G20210A by polymerase chain reaction amplified DNA products with specific oligonucleotide probes. Our results suggested that frequencies of the mutated allele of Factor V G1691A and prothrombin G20210A are higher in children with a parental history of premature CAD. In conclusion, Factor V G1691A and prothrombin G20210A polymorphisms which were detected in higher frequencies in children with a parental history of premature CAD may indicate a risk for developing atherosclerosis and might be useful in screening for CAD in children; however, large population-based research is necessary to investigate further genetic risk assessment for CAD. Coron Artery Dis 20:435-439 (C) 2009 Wolters Kluwar Health vertical bar Lippincott Williams & Wilkins.Item The association of apolipoprotein E polymorphism and Lipid levels in children with a family history of premature coronary artery diseaseÇiftdogan, DY; Coskun, S; Ulman, C; Tikiz, HBACKGROUND: Polymorphisms in the apolipoprotein E (apoE) gene may modulate lipoprotein metabolism and influence plasma lipid levels. Thus, they have been associated with relative risk of coronary artery disease (CAD). OBJECTIVE: To evaluate the association of apolipoprotein E polymorphism and lipid levels in children with family history of premature coronary artery disease. METHODS: The apoE genotypes, allele frequencie,s and plasma lipid levels were analyzed in 137 children. Among these children, 70 (study group) had and 67 (control group) did not have a parental history of premature CAD RESULTS: Total cholesterol (TO levels were greater in the study group (P = .04). The frequencies of epsilon 3 epsilon 4 genotype and epsilon 4 allele were significantly greater in the study group (P = 005 for both), The epsilon 2 allele correlated negatively with Tc and low-density lipoprotein cholesterol levels, and e4 had a positive correlation with Tc and low-density lipoprotein cholesterol levels. CONCLUSIONS: Tc levels are influenced by apoE genotypes in childhood. Also, the frequency of the epsilon 4 allele is greater in children with family history of premature CAD. The e4 allele may be associated with an increased risk for development of atherosclerosis by elevated levels of Tc in children with family history of CAD. The evaluation of apoE gene polymorhisms may contribute to the assessment of cardiovascular risk in children with a family history of CAD. (C) 2012 National Lipid Association. All rights reserved.Item Standard dose of inhaled albuterol significantly increases QT dispersion compared to low dose of albuterol plus ipratropium bromide therapy in moderate to severe acute asthma attacks in childrenCoskun, S; Yuksel, H; Tikiz, H; Danahaliloglu, SBackground: Beta-2 agonist therapy has previously shown to increase the QT dispersion (QTd) in asthmatic patients and increased QTd has been well documented in association with cardiac arrhythmias and sudden death. However. the data concerning the effect of low doses of beta-2 agonist therapy in combination with the anticholinergic agents to potentiate bronchodilatation on QTd in asthmatic children are limited. The objectives of this study was to investigate the changes on QTd during both the standard close of nebulized albuterol therapy and 10 dose nebulized albuterol plus inhaled ipratropium therapyn to assess the potential arrhytmogenic risk, of these two treatment strategies in children with acute asthmatic attacks. Methods: Forty-three children with the diagnosis of moderate to severe acute asthma were enrolled in the study. Standard dose of nebulized albuterol therapy (0.15 mg/kg) were administered to 20 patients (group 1) and low dose of nebulized albuterol (0.075 mg/kg) plus nebulized ipratropium bromide therapy (250 mug/dose) were given to the remaining 23 patients (group 2). Respiratory distress score, peak expiratory flow rate, arterial blood pressure. O-2 saturation. serum potassium and urea nitrogen levels were studied and QT interval parameters were measured from the standard 12-lead electrocardiograms at baseline and after treatment. Results: Significant improvement was achieved in respiratory distress score and peak expiratory flow rate after three dose inhalation. No significant difference was observed between the pre and post-treatment values of serum potassium, blood urea nitrogen. O-2 saturation and arterial blood pressure values. The evaluation of the corrected QTd (QTcd) showed that while there was no statistical difference in the pre and post-treatment values in group 2 (30.4 +/- 3.1 msn vs 32.1 +/- 3.9 msn). QTcd was found to be significantly increased in group 1 after treatment (29.0 +/- 3 msn vs 40.6 +/- 5.1 msn, P < 0.0001). Conclusion: The data of the present study suggest that the increase of the QTd is more prominent with the use of a standard dose of albuterol compared to low dose albuterol plus ipratropium therapy. Therefore. it may be Concluded that a low dose of albuterol plus ipratropium bromide therapy may be preferred to avoid rhythm disturbances in asthmatic children.Item Giant unruptured noncoronary sinus of valsalva aneurysmUtuk, O; Bayturan, O; Bilge, AR; Tikiz, H; Tezcan, UKItem Selective COX-2 inhibition with different doses of rofecoxib does not impair endothelial function in patients with coronary artery diseaseTikiz, C; Ütük, O; Bayturan, O; Bayindir, P; Ekmekçi, C; Tikiz, HIn this study, we investigated the effects of both 25 and 50 mg daily doses of rofecoxib on the endothelial functions of patients with coronary artery disease (CAD). For this purpose, 34 patients with documented severe CAD and who were under aspirin treatment (300 mg/day) were randomized to receive 4 weeks of treatment with a placebo (n = 10, group I), rofecoxib 25 mg/day (n = 12, group II), and rofecoxib 50 mg/day (n = 12, group III). Brachial artery vasodilator responses were measured in order to evaluate endothelial function. The percentage of change in endothelial-dependent vasodilation in groups I, II, and III were similar at the baseline level and showed no significant change after treatment (6.2 +/- 3.9% vs. 5.9 +/- 3.1% and 5.8 +/- 3.3% vs. 5.6 +/- 3.8% and 6.1 +/- 4.5% vs. 5.8 +/- 4.1%, respectively; P > 0.05). Compared with the baseline, endothelium-independent vasodilatation, as assessed by nitroglycerine (NTG), remained unchanged after the treatment period (11.2 +/- 6.9% vs. 10.3 +/- 7.1% and 11.2 +/- 6.3% vs. 9.9 +/- 5.1% and 9.5 +/- 4.9% and 8.8 +/- 4.6 %, respectively; P > 0.05). Treatment with both doses also showed no significant effects on high-sensitivity C-reactive protein (hs-CRP) levels and resting arterial diameters (P > 0.05). In conclusion, 4 weeks of treatment with standard and high doses of rofecoxib showed no significant effects on either endothelial-dependent or independent vasodilator response or plasma hs-CRP levels in patients with severe CAD taking concomitant aspirin.Item The Effects of an 8-week Walking Program on Serum Lipids, Circulation Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Post-menopausal WomenBüyükyazi, G; Ulman, C; Taneli, F; Aksoy, D; Tikiz, H; Ari, ZPurpose: To examine the effects of an 8-week walking program on serum lipids, circulation matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in post-menopausal women. Method: Body weight, percent body fat, body mass index, estimated maximal oxygen consumption, blood lipids, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 concentrations were assessed and their matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 molar ratios were calculated in exercise (n=12) and control (n=12) groups. Exercise group completed an eight-week walking program at moderate (similar to 6.29 +/- 0.15km/h; similar to 62% maximum heart rate reserve) intensity. Results: Significant changes in estimated maximal oxygen consumption, systolic and diastolic blood pressures, body weight, and body mass index (p<.05) were determined in exercise group. However, there were no significant changes in the measured blood lipids (triglyceride, cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol), matrix metalloproteinase-9, and tissue inhibitor of metalloproteinase-1 concentrations, and matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 molar ratio of exercise group, except for a nearly significant change in tissue inhibitor of metalloproteinase-1 level (p=.092). We determined no significant changes in any of the measured parameters in control group. Conclusion: Despite its protective effects against coronary heart disease risks, the duration and intensity of this program is not sufficient to cause significant changes in blood lipids, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinase-1 concentrations. A higher-intensity, longer-duration program accompanied with diet is proposed.