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Yaziciolu M.V.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital
European review for medical and pharmacological sciences | Year: 2012

Recent findings suggest that there is a close relationship between chronic heart failure and uric acid. The aim of the study was to assess whether increased uric acid levels in patients with dilated cardiomyopathy might correlate with the degree of functional mitral regurgitation (MR). Sixty two consecutive patients diagnosed with dilated cardiomyopathy were included in the study. The patients were classified according to severity of functional MR into two groups: mild-moderate functional MR (ERO < 0.2 cm2) and severe functional MR. The patients with severe functional MR had significantly higher serum uric acid levels compared to patients without severe functional MR (6.34 ± 1.61 mg/dL vs 5.43 ± 1.17 mg/dL respectively, p = 0.012). Furthermore, tenting area, an important predictor of functional MR severity, was moderately correlated with the serum uric acid levels (r = 0.351, p = 0.005). It was also shown that the serum uric acid concentrations were inversely correlated with left ventricular (LV) ejection fraction, and positively correlated with LV volumes. There was also a significant relation between the serum uric acid and left atrial volumes and also brain natriuretic peptide (BNP) levels. In conclusion, this study demonstrates that elevated serum uric acid levels in patients with dilated cardiomyopathy are correlated with the severity of functional MR and echocardiographic volume indices. Source


Yildiz M.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Kocabay G.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital
Journal of Forensic and Legal Medicine | Year: 2013

Aluminium (Al) is the third most prevalent element, representing approximately 8% of total mineral components in the earth's crust (1). Chronic exposure to Al is mainly encountered at particular work places, for example, in foundries or in the Al powder industry, as an occupational exposure. In case of occupational Al exposure, inhalation is the main route of uptake. Chronic exposure to Al is associated with skeletal, neurological, hematological and lung changes. Studies regarding the Al powder industry showed that long-term inhalative exposure to Al can induce pulmonary fibrosis (2). Although there is only one report about ventricular tachycardia as a cardiac manifestation in occupationally exposed persons (3), in this report, we presented a case that had Mobitz type I second-degree atrioventricular block and nonsustained ventricular tachycardia. To our knowledge, this is the first report in chronic poisoning. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. Source


Akcakoyun M.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Emiroglu Y.,Van Yuksek Ihtisas Hospital | Pala S.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Kargin R.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | And 5 more authors.
PACE - Pacing and Clinical Electrophysiology | Year: 2010

Background: Heart rate recovery (HRR) and chronotropic incompetence (CI) in patients with subclinical hypothyroidism (SCH) has not been explored previously. The aim of the present study was to evaluate the HRR and CI in patients with SCH. Methods: Twenty-five patients (11 men, 14 women with a mean age of 36 ± 10 years) who were diagnosed SCH determined by an increased serum thyrothrophine (TSH) concentration (>4.0 ng/mL) and the normal free triiodothyronine (fT3) and free thyroxin (fT4) levels, were included in the study. The control group of healthy individuals with normal TSH (12 males, 15 females) with a mean age of 36 ± 3 years was also included. Two groups were well matched for age, sex, and body mass index. Medical history, physical examination, electrocardiogram, treadmill exercise testing, and chest radiogram were performed for all participants. Results: The characteristics of SCH patients and control cases were similar with regard to age, sex, and BMI except for TSH levels. Serum TSH levels were significantly higher in SCH patients than the controls (P < 0.001). No significant differences were observed in the changes of heart rate (HR), exercise tolerance (metabolic equivalents), or systolic and diastolic blood pressures at rest or during exercise between the groups, whereas HRR and CI were significantly lower during exercise testing in the SCH patients compared to controls (P < 0.003; P < 0.03, respectively). Conclusion: The results of the present study demonstrated that SCH can cause impaired cardiovascular autonomic function and attenuated HR response to exercise. (PACE 2010; 2-5) © 2009 Wiley Periodicals, Inc. Source


Acar G.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Akcakoyun M.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Sari I.,Marmara University | Bulut M.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | And 7 more authors.
Sleep and Breathing | Year: 2013

Background: Sleep deprivation (SD) is known to be associated with adverse cardiovascular events. Strain and strain rate measure the local deformation of the myocardium and have been used to evaluate atrial phasic function in various disease states. The aim of the study was to investigate whether strain rate imaging enables the identification of left atrial dysfunction in otherwise healthy young adults with acute SD which has not been studied previously. Method:s Adequate echocardiographic images of 27 healthy volunteers were obtained both after a night with regular sleep and after a night with SD. Tissue Doppler-derived strain and strain rate were measured from the apical fourand two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate (S-Sr), early diastolic (E-Sr) and late diastolic (A-Sr) strain rate. Phasic left atrial (LA) volumes and fractions were also calculated. Results: There was no significant difference in the traditional parameters of atrial function and LA volumes. Subjects had similar S-Sr, A-Sr and global atrial strain values after the night of sleep debt when compared after regular sleep, whereas they had significantly reduced E-Sr values (mean (SD) 3.2 (0.7) s-1 vs 3.7 (0.6) s-1, p<0.001). Moreover, global E-Sr showed a significant correlation with sleep time (r00.554, p<0.001). Conclusion: Acute SD in healthy adults is associated with a reduction in LA early diastolic strain rate in the absence of geometric alterations or functional impairment of the left atrium, raising the possibility that chronic SD may more profoundly affect LA function and thereby promote the occurrence of atrial fibrillation. © Springer-Verlag Berlin Heidelberg 2013. Source


Karabay C.Y.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Kocabay G.,University of Padua | Kalayci A.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Tasar O.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital | Kirma C.,Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital
Herz | Year: 2014

Stent thrombosis is an example of device-induced, platelet-mediated arterial thrombosis with a potentially fatal adverse event that often leads to myocardial infarction and/or death. The optimal treatment of patients with drug-eluting stent thrombosis in whom mechanical thrombectomy has failed is not established. This case demonstrates the usefulness of intracoronary thrombolysis after failed mechanical thrombectomy in patients with stent thrombosis. To our knowledge, this is the first report on using intracoronary thrombolysis in this specific situation. © 2014 Urban & Vogel. Source

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