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Öğe Acute effect of DDD versus VVI pacing on arterial distensibility(Karger, 2004) Altun, A; Erdogan, O; Yildiz, MPulse wave velocity (PWV) is a new technique and frequently used today to determine the elastic distensibility of great arteries. Increased arterial stiffness and PWV have been proposed as possible mechanisms in the initiation and/or progression and/or complications of atherosclerosis and cardiovascular disease. We evaluated the acute effect of two frequently used pacing modes (DDD vs. VVI) on arterial distensibility using PWV. Methods: Seventeen patients ( age, 56 +/- 14 years) implanted with DDD pacemakers were included in the study. All patients were pacemaker dependent and continuously paced at the programmed rate. PWV was measured first in DDD mode, and then the mode was switched to VVI, and PWV was measured again at the same programmed heart rate as in the DDD mode. Results: Although systolic blood pressure significantly decreased from 129 +/- 18 to 119 +/- 16 mm Hg (p = 0.001) after switching the mode from DDD to VVI, diastolic blood pressure (81 +/- 12 vs. 80 +/- 13 mm Hg; p = 0.38) did not change. In addition, PWV significantly increased from 11 +/- 2.46 m/s in DDD mode to 11.29 +/- 2.43 m/s (p = 0.01) after having been programmed to VVI mode. Conclusions: Our results suggest that VVI pacing increases PWV, and therefore decreases arterial distensibility, and thus may contribute to the development and progression of atherosclerosis. Copyright (C) 2004 S. Karger AG, Basel.Öğe Arterial distensibility as determined by carotid-femoral pulse wave velocity in patients with Behcet's disease(Springer, 2005) Kürüm, T; Yildiz, M; Soy, M; Özbay, G; Alimgil, L; Tüzün, BBehcet's disease (BD) is a chronic, multisystem disorder characterized by genital and oral aphthae, skin lesions, uveitis, and tendency to thrombosis. Pulse wave velocity (PWV) is an important factor in determining cardiovascular mortality and morbidity. It is an index of arterial wall stiffness and inversely related to the arterial distensibility. In this study we investigated the arterial distensibility in BD by PWV. We studied 14 patients with BD ( 18 - 44 years old, 10 men) and 28 healthy subjects ( 18 - 39 years old, 21 men) without known cardiovascular disease. Arterial distensibility was assessed by automatic carotid-femoral PWV measurement using the Complior Colson device. PWV is calculated from measurements of pulse transit time and the distance traveled by the pulse between two recording sites, according to the following formula: pulse wave velocity (m/s)= distance (m)/transit time(s). The mean ages, systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, and PWV of Behcet's disease and control subjects were 32.1 +/- 7.4 vs 27.9 +/- 6.1 years, 112.9 +/- 12.0 vs 108.7 +/- 10.0 mmHg, 72.1 +/- 10.7 vs 67.7 +/- 7.5 mmHg, 40.7 +/- 12.2 vs 41.0 +/- 10.7 mmHg, 74.1 +/- 10.2 vs 77.2 +/- 10.1 bpm, and 8.4 +/- 1.4 vs 8.5 +/- 1.1 m/s, respectively. Differences between all parameters studied were not found to be statistically significant ( p> 0.05). The carotid-femoral PWV, an index of arterial stiffness and a marker of atherosclerosis, is not increased in patients with BD compared with control subjects.Öğe Effect of obesity on coronary collateral vessel development in patients with coronary artery disease(Sage Publications Inc, 2005) Tath, E; Yildiz, M; Gül, E; Birsin, A; Karahasanoglu, E; Özçelik, F; Özbay, GThe purpose of this study was to compare coronary collateral circulation and with other risk factors in patients with coronary artery disease and different body mass index. Between January 1999 and December 2001, of 867 patients who underwent angiography for the first time, 90 patients (24 women and 66 men), with occlusion in only I coronary artery participated in the study. Information regarding age, body mass index, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, preinfarction angina, and use of oral beta blockers and nitrates were recorded for all patients. The patients were separated into 2 groups in accordance with development of their coronary collateral circulation; those with insufficient (Rentrop 0, 1, and 2) and those with sufficient coronary collateral circulation. They were also divided into 3 groups on the basis of body mass index as follows: (1) 18.0-24.9 kg/m(2), (11) 25.0-29.9 kg/m(2), and (111) more than 30 kg/ml. In the obesity and overweight groups, hyperlipidemia, diabetes mellitus, and nitrate use were identified more frequently than in the other groups (p < 0.05). Use of oral nitrates more than 6 months before the myocardial infarction and existence of preinfarction angina affected collateral coronary vessel development in the positive direction (p=0.01, p = 0.03, respectively). There was no correlation between coronary artery disease and coronary collateral vessel development in the obese patients (p = 0.6). Although it has been shown that coronary collateral vessel development was affected negatively in obese patients with coronary artery disease, no statistical significance was identified.Öğe Hyperosmolar hyperglycaemic nonketotic coma associated with acute myocardial infarction(Taylor & Francis Ltd, 2002) Yildiz, M; Gül, Ç; Özbay, GDiabetes mellitus is one of the most commonly associated diseases of patients suffering an acute myocardial infarction. Although the coexistence of acute myocardial infarction with other clinical manifestations of diabetes have been well described, extremely few data exists about the concomitant occurrence of hyperosmolar hyperglycaemic nonketotic coma and myocardial infarctions. This article presents three patients with this association and aimed to discuss the clinical course and treatment strategies of this rare condition.Öğe Increased pulse wave velocity and shortened pulse wave propagation time in young patients with rheumatoid arthritis(Elsevier Science Inc, 2004) Yildiz, M; Soy, M; Kurum, T; Ozbay, GBACKGROUND: Rheumatoid arthritis (RA) is a systemic immune and inflammatory disease associated with excess cardiovascular morbidity and mortality. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. OBJECTIVE: To investigate arterial stiffness using carotid-femoral (aortic) PWV measurements in young patients with RA. PATIENTS AND METHODS: Eight patients (aged 21 to 34 years, seven women, mean RA duration 13.8+/-12.6 months) with RA according to the criteria of the American College of Rheumatology, and eight age- and sex-matched control subjects (aged 22 to 34 years, seven women) were recruited. Aortic PWV was determined using an automatic device, the Complior (Complior Colson, France), which allowed on-tine pulse wave recording and automatic calculation of PWV RESULTS: The carotid-femoral PWV, systolic blood pressure and heart rate were higher in young patients with RA than in sex- and age-matched control subjects (P=0.03, P=0.02 and P=0.002, respectively). In the young patients with RA, pulse wave propagation time between measurement sites was significantly shorter than in the control group (P=0.02). There were no significant differences in the sex, age, body mass index, waist to hip ratio, diastolic blood pressure, mean blood pressure or pulse pressure between the two groups (P=1.00, P=0.71, P=0.20, P=0.66, P=0.55, P=0.07 and P=0.11, respectively). CONCLUSION: The carotid-femoral PWV is increased and Pulse wave propagation time is decreased in young patients with RA. Measurements of carotid-femoral PWV may provide a simple and noninvasive technique for identifying patients at increased risk of vascular disease.Öğe Irbesartan has a masking effect on dipyridamole stress induced myocardial perfusion defects(Lippincott Williams & Wilkins, 2004) Altun, GD; Altun, A; Yildiz, M; Firat, MF; Hacimahmutoglu, S; Berkarda, SBackground and aim The angiotensin 11 type 1 (AT(1)) receptor antagonist irbesartan is used for the treatment of hypertension, but its anti-ischaemic effect is not yet known. Our aim was to assess the effect of irbesartan administration on the diagnostic yield of Tc-99m sestamibi single photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) after dipyridamole stress. Methods Our study group consisted of 13 patients (11 men and two women; mean age, 53.3 +/- 10.6 years; body mass index, 26.9 +/- 3.3 kg.m(-2)) with angiographically documented CAD. All patients underwent Tc-9m sestamibi SPECT studies at rest, before (STRESS-1) and 2 weeks after irbesartan (150 mg daily) administration (STRESS-2) at dipyridamole stress. The extent and severity of defects were analysed by using visual and quantitative Tc-99m sestamibi SPECT. Results The mean summed stress score was significantly higher during the STRESS-1 study than the STRESS-2 study (13.2 +/- 7.4 vs. 11 +/- 74, P=0.003). The mean size of perfusion defects at stress was significantly larger for the STRESS-1 group than the STRESS-2 group (17.8% +/- 2.85% vs. 15.3% +/- 2.95%, P=0.01). Conclusion Our study showed that the AT(1) receptor blocker irbesartan reduces the extent and severity of Tc-99m sestamibi perfusion defects after dipyridamole stress in patients with CAD. Irbesartan may alter coronary blood flow reserve. The continued use of irbesartan before stress myocardial perfusion SPECT has a masking effect on stress induced myocardial perfusion defects. For this reason AT(1) receptor blockers must be stopped before stress myocardial perfusion scintigraphic examinations. (C) 2004 Lippincott Williams Wilkins.Öğe Management of a patient with active rheumatoid arthritis and suspected tuberculosis causing effusive-constrictive pericarditis(Elsevier Sci Ireland Ltd, 2003) Yildiz, M; Erdogan, O; Aktoz, M; Gul, C; Ozbay, GIn the following case report we present a patient who has been admitted for pericardial effusion causing cardiac compression with active rheumatoid arthritis and suspected tuberculosis. The patient was successfully treated with intravenous pulse steroid for active rheumatoid arthritis, with prophylactic anti-tuberculosis agents for suspected tuberculosis and with surgical pericardiectomy for the thickened pericardium as well as recurrent pericardial effusion. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Right ventricular function in patients with acute anterior myocardial infarction(Acta Cardiologica, 2002) Akdemir, O; Yildiz, M; Sürücü, H; Dagdeviren, B; Erdogan, O; Ozbay, GObjective - Our purpose was to investigate the right ventricular (RV) performance of patients with a first acute anterior myocardial infarction (AAMI) by using pulsed wave Doppler tissue (PWDT) samplings of tricuspid annulus and RV free wall. Methods and results - The study group included 31 patients with AAMI and 20 age-matched controls. Conventional indexes of RV functions were the magnitude of tricuspid annular plane systolic excursion (TAPSE), and the transpulmonary and transtricuspid Doppler parameters. PWDT velocities were obtained by placing the sample volume at the lateral tricuspid annulus and the mid-segment of RV free wall; the peak systolic (S), early (E) and late (A) diastolic PWDT velocities and time intervals from ECG-Q wave to their peaks were analysed. Standard indexes were comparable except TAPSE that was significantly lower in AAMI-patients (p < 0.001). S velocities were similar; A of both regions (p = 0.0 18 and 0.0 12) and E of RV free wall (p = 0.0 11) were significantly increased in AAMI-group. Q-Sa intervals in both regions (p = 0.007 and 0.0 IS) and Q-Ea of tricuspid annulus (p = 0.045) were significantly shorter in patients with AAMI. TAPSE and E of RV free wall had significant negative correlations with left ventricular systolic volume index and right atrial filling fraction (AFF), respectively (r -0.46, p = 0.0 1 for both). A of tricuspid annulus had a positive correlation with left AFF (r = 0.42, p 0.02). Conclusion - PWDT imaging of tricuspid annulus and RV free wall is capable to sensitively detect the adaptive mechanisms and unfavourable diastolic properties of RV dynamics in patients with AAMI.Öğe Specific tissue Doppler predictors of preserved systolic and diastolic left ventricular function after an acute anterior myocardial infarction(Japan Heart Journal, Second Dept Of Internal Med, 2003) Akdemir, O; Dagdeviren, B; Yildiz, M; Gül, Ç; Sürücü, H; Özbay, GThe degree of left ventricular (LV) dysfunction determines the outcome of patients suffering an acute anterior myocardial infarction (AAMI). Many recent studies have utilized tissue Doppler echocardiography (TDE) parameters in the assessment of LV function. We sought to investigate whether some variables easily obtained from TDE profiles of mitral annulus corners would predict a relatively preserved LV global function traditionally assessed with ejection fraction (EF) and deceleration time (DT), within the acute phase of AAMI Included were 50 consecutive patients with a first AAMI. Standard echocardiography and TDE of mitral annulus were performed within 36 hours of admission Pulsed wave sample volumes were set at the septal, lateral, anterior, and inferior corners of the mitral annulus. Preserved LV function was defined as an EF > 40% together with a DT greater than or equal to 140 ms and < 220 ms. An inferior annular systolic velocity of > 7.5 cm/s predicts preserved global left ventricular function with a sensitivity of 81% and specificity of 71%. An anterior mitral annular early diastolic velocity of > 8cm/s had a sensitivity of 69% and specificity of 85%. When these two velocities both exceed the limits above, such a combined index yielded a sensitivity of 69%, specificity of 94%, and an overall diagnostic accuracy of 86% for the estimation of preserved LV global function. The parameters derived from TDE profiles of inferior and anterior mitral annulus corners provide valuable information to predict preserved global left ventricular function during the early period of AAMI.Öğe Specific tissue Doppler predictors of preserved systolic and diastolic left ventricular function after an acute anterior myocardial infarction [Meeting Abstract](W B Saunders Co Ltd, 2002) Akdemir, O; Dagdeviren, B; Yildiz, M; Gul, C; Surucu, H; Ozbay, G[Abstract Not Available]
