Yazar "Ülgen, MS" seçeneğine göre listele

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    A complicated case of pericardial hydatid cyst manifesting as constrictive pericarditis
    (Pulsus Group Inc, 2000) Karadede, A; Ülgen, MS; Temamogullari, AV; Toprak, N
    Although cardiac involvement with hydatid cyst is quite rare as a major complication, constrictive pericarditis is even less common. A 55-year-old man is presented in whom a hydatid cyst located in the right cardiophrenic angle anterior to the right ventricle ruptured into the pericardial sac, resulting in constrictive pericarditis.
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    Contribution of the peak exercise QT dispersion to the accuracy of an exercise test during the evaluation of coronary artery disease
    (Acta Cardiologica, 2000) Ülgen, MS; Karadede, A; Alan, S; Temamogulari, AV; Karabulut, A; Toprak, N
    Objective - Regional defects in ventricle repolarization are extremely sensitive to ischaemia which can be measured as QT dispersion (QTd). We investigated the role of QTd calculated at the time of peak exercise during treadmill studies. Methods and results - Thirty-three women and eighty men, whose treadmill test results and coronary angiography studies had been examined, were divided into four groups according to the test results: 1)subjects with a negative treadmill test and without significant stenosis results in the angiography, were considered normal (N; n = 35); 2) subjects with both a positive exercise test and a significant presence of stenotic coronary arteries, were considered true positive (TP; n = 52); 3) subjects with a positive exercise test, but without significant stenosis results in the angiography, were considered false positive (FP; n = 14); 4) subjects with a negative treadmill study, despite significantly stenotic arteries, were considered false negative (FN; n = 12), All subjects were evaluated on the basis of age, significant ST-segment depression, peak heart rate, rest and peak exercise QT, and QpT (measured from the beginning of the QRS complex to the highest point of the T wave) dispersion, and corrected (QTcd, QpTcd) values for heart rate. The most significant differences were observed between the N and the TP groups in terms of QTd and QTcd (p < 0.01), with a higher correlation (r = 0.48). A significant relationship was also observed in terms of QpT and QpTcd values during peak exercise (p < 0.01). The sensitivity of the peak exercise QTcd and QTcd greater than or equal to 70 ms in determining coronary artery disease was found to be 74%. In cases of QTcd greater than or equal to 70 ms, in addition to ST-segment depression, the test was found to be less sensitive, but more specific at 96%. Conclusion - It suggests that when peak exercise QTd and QpTd values are taken into account, with the exception of the ST-segment depression, the accuracy of the exercise test will increase and false positive results will decrease.
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    The effects of right ventricular involvement on heart rate variability and ventricular late potentials in acute inferior myocardial infarction
    (Sage Publications Inc, 2001) Ülgen, MS; Toprak, N
    Depressed heart rate variability and presence of ventricular late potentials in acute myocardial infarction are associated with a poor prognosis. Although it is known that the abnormalities vary according to anterior or inferior location of acute myocardial infarction, the relationship with right ventricular acute myocardial infarction is not clear. The effects of right ventricular myocardial infarction on heart rate variability and ventricular late potentials are studied. The study was performed with a total of 46 patients (38 males; aged 56 +/- 13 yr, range, 33 to 70 yr). Twenty-six patients had isolated inferior myocardial infarction while 20 patients had accompanying right ventricular involvement. For all patients, ambulatory Holter recordings between 24 and 48 hours following myocardial infarction, echocardiography in first 48 hours, and signal-averaged electrocardiography with submaximal exercise at average day 6 (range, 5 to 8 days) were performed. Heart rate variability and signal-averaged electrocardiography recordings were repeated after discharge (average, 39 days). During the first 24 to 48 hr, time domain parameters (SDNN1 and SD1) were significantly lower (SDNN1: 62 +/- 17 vs 100 +/- 20 ms, p = 0.001; SD: 37 +/- 10 vs 50 +/- 16 ms, p = 0.03) in patients with isolated inferior MI than in those with right ventricular involvement, whereas root-mean-square voltage (RMS-SD1) showed no significant difference in both groups (28 +/- 7 vs 35 +/- 8 ms). In post-discharge heart rate variability recordings, there were no significant differences (SDNN2: 86 +/- 13 vs 95 +/- 15 ms; SD2: 48 +/- 11 vs 57 +/- 13 ms; RMS-SD2: 32 +/- 14 vs 35 +/- 9 ms). In pre-discharge tests, the mean value of low-amplitude signals (LAS(1)) was higher (26 +/- 9 vs 33 +/- 11 ms, p = 0.03) in patients with isolated inferior myocardial infarction than in those with right ventricular involvement, while other signal-averaged electrocardiography parameters were not significantly different (filtered QRS(1) 102 +/- 5 vs 105 +/- 10 ms, RMS-40(1): 44 +/- 13 vs 26 +/- 10 muV; incidence of ventricular late potentials: 23% vs 30%, p = NS, respectively). In post-discharge tests, all of signal-averaged electrocardiography parameters were similar in both groups (filtered QRS(2): 112 +/- 12 vs 114 +/- 8 ms, LAS(2): 28 +/- 9 vs 32 +/- 13 ms, RMS-40(2): 36 +/- 10 vs 34 +/- 11 muV, and frequency of ventricular late potentials(2): 23% vs 30%, p = NS). These data suggest that right ventricular involvement in an acute inferior myocardial infarction is associated with improved heart rate variability parameters but not ventricular late potentials in pre-discharge period. However, the influence of right ventricular involvement on heart rate variability parameters fades away in the post-discharge period.
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    Relation between QT dispersion and ventricular arrhythmias in uncomplicated isolated mitral valve prolapse
    (Blackwell Science Asia, 1999) Ülgen, MS; Biyik, I; Karadede, A; Temamogullari, AV; Alan, S; Toprak, N
    Complications of mitral valve prolapse (MVP), among which serious ventricular arrhythmia and sudden death are of major importance, affect many individuals due to the high incidence of MVP itself in the community despite the actual low incidence of these complications. The present study investigated the incidence and distribution of ventricular arrhythmias according to their severity and relationship with the QT interval and dispersion of repolarization in uncomplicated isolated MVP (IMVP) cases. Fifty-eight uncomplicated IMVP patients, 33 patients with accompanying tricuspid valve prolapse (TVP), to compare its relationship with ventricular arrhythmia, and 60 age- and sex-matched control subjects were enrolled in the study. Individuals with accompanying cardiac or systemic disease, or who were on drug therapy that could potentially affect QT characteristics, were excluded. The incidence of ventricular arrhythmia was 48% in the IMVP group and 64% in the TVP group; the difference was statistically insignificant. In addition, the differences of the QT and Q peak T values were insignificant, whereas QT dispersion (QTd) and Q peak T dispersion (QpeakTd) values were significantly higher in the patient group (60+/-14, 54+/-14 ms, respectively) compared with the control group (42+/-10, 38+/-10 ms, respectively, p<0.001). Complex ventricular arrhythmias (Lown Grade greater than or equal to III) in the IMVP group had a significant relationship with QTd and QpeakTd (p<0.001), but not with QT or QpeakT. As a result of the study, it is concluded that TVP accompanying MVP does not increase the incidence of ventricular arrhythmia, that ventricular arrhythmia is related to QT dispersion rather than QT interval in IMVP, that the QT dispersion is a fairly good marker for identifying the high-risk group for serious ventricular arrhythmia and sudden death, and that QpeakT dispersion measurement is an additional indicator that could be an alternative when QT is difficult to determine in conditions such as high heart rate or the presence of U wave.