Yazar "Iltümür K." seçeneğine göre listele
Listeleniyor 1 - 5 / 5
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Heart failure and anemia(2006) Karahan Z.; Iltümür K.; Toprak N.Anemia is commonly observed in patients with heart failure and is associated with aggravating symptoms. The cause of anemia in heart failure is not completely understood, but it is likely to be the result of a combination of factors including hemodilution, inflammatory activation, renal dysfunction, malnutrition due to right-sided heart failure, and drug therapy. Correcting anemia results in beneficial effects on cardiac function and morbidity in patients with heart failure. However, it should be recalled that aggressive treatment of anemia may also lead to adverse effects such as hypertension, thrombosis, and endothelial activation.Öğe The relation between infarction localization and late potentials(2001) Iltümür K.; Karabulut A.; Temamogullari A.V.; Karadede A.; Alan S.; Siddik Ulgen M.; Toprak N.OBJECTIVE: There are controversies about the relation between infarction localization and late potentials (LP) following acute myocardial infarction (AMI). To evaluate this issue 124 consecutive patients with first Q-wave AMI fulfilling the inclusion criteria were enrolled in this signal--averaged ECG (SAECG) study. METHODS: The patients were divided into three groups according to infarction localization: anterior (Group I n = 62; 50%), inferior (Group II: n = 42; 34%) and both inferior and right ventricular (RV) involvement (Group III n = 20; 16%). SAECG records were performed during the second week. LP results were evaluated as positive when at least two of the major criteria (QRS > 114 ms, LAS 40 > 38 ms, RMS < 20 V) were obtained. Tukey--Cramer multivariate analysis was performed. RESULTS: Positive LP results were obtained in 29% of group I, 35.7% of group II and 55% of group III patients. Patients with both inferior and RV involvement had a significantly higher positive LP results independent from left ventricular ejection fraction. CONCLUSION: Therefore, increased risk of arrhythmia in those patients with both inferior MI localization and RV involvement should be taken into consideration.Öğe The relation between ST segment elevation shape and low dose dobutamine stress echocardiography and clinical course in early period of anterior myocardial infarction(2001) Karadede A.A.; Temamo?ullari A.V.; Aydinalp Ö.; Ülgen M.S.; Alan S.; Iltümür K.; Toprak N.Although a relation between magnitude of ST segment elevation and myocardial damage was shown in early period of acute myocardial infarction, such a relation among shape of the ST segment elevation, myocardial damage and clinical course remains obscure. Sixty-two patients with acute anterior MI, in the first six hours of their first heart attack were enrolled for the study. Based on the precordial V3 derivation prior to thrombolytic treatment, the shape of the ST elevation was separated into three groups as concave (n=26), straight (n=24) or convex types (n= 12). The relation between the shape of the elevation recorded on admission and both results of low dose (5 and 10 ?g/kg/min) dobutamine stress echocardiography (LDSE) performed (n=53) in early period (the sixth day) of infarction and clinical course were investigated. Wall Motion Score Index (WMSI) was evaluated based on a 16-segmented scoring system of which nine segments were supplied by left anterior descending artery (LAD) and points were given for each segment from one (normal) to four (dyskinetic). Basal WMSI and response to LDSE were better in LAD region. Additionally both average akinetic segment number in infarct zone was higher and improvement in these segments were less in convex and straight groups (Concave 3,78±2 vs. 2,17±2.1 p<0.01; straight 5,15±2.7vs. 4,45±2,8, NS; convex 5,4±2,3 vs. 4,8±2,1 NS; basal vs. LDSE). Although only 13% (3/23) of the patients had no improvement in LDSE in Group A (p<0.05 v.s. group B and p<0.01 v.s. group C), 35% (7/20) of group B and 60% (6/10) of Group C patients were without improvement in LDSE. Although no relation was found between better left ventricular function (WMSI <2) and shape of the ST elevation in basal evaluation in multiple logistic regression analysis (p=0.06), an independent relation was found following LDSE (p=0.01, OR 4.5, %95CI 1.3-14.7). There was no in-hospital death in concave group whereas five patients died in either straight or convex group. Arrhythmia occurrence was lower in concave group during this period (p<0.05), and exercise capacities were lower. Conclusively, we suggested that there was an increased viability in infarct zone and decreased in-hospital mortality in patients with concave ST elevation on admission. This simple classification would be beneficial to estimate left ventricular functions at discharge.Öğe The value of late potential anaysis as a reperfusion criterion in acute myocardial infarction(2000) Iltümür K.; Kaymak H.; Ülgen M.S.; Temamoğullari A.V.; Karabulut A.; Karadede A.; Alan S.Various methods are available to evaluate reperfusion following thrombolytic treatment (TT) in Acute Myocardial Infarction (AMI). A few authors reported an inverse correlation between late potential (LP) positiveness and reperfusion in signal averaged ECG studies. Current prospective study was planned to investigate the value of LP analysis as a criterion of reperfusion following TT in AMI. METHODS:Ninety-two AMI patients (76 males and 16 females, with an average age of ± years) who were admitted to our clinics in the first twelve hours of pain initiation and were exposed AMI first time were enrolled. All patients had TT (TPA, n=31 or Streptokinase, n=61). Their clinical and labaratory parameters were recorded. RESULTS:Infarct related vessel was demonstrated angiographically in 69 patients (75%). Twenty-three (25%) had an occluded infarct related vessel. The LP incidence was quite low in cases with a patent infarct related vessel (7%) whereas it was higher in those with an occluded vessel (80%)(p<0.0001).Sensivity, specificity, positive and negative predictive values of LP analysis to put forward infarct related vessel patency were 95%, 80%, 92% and 87%, respectively. CONCLUSION: LP analysis with signal-averaged ECG might be used as a reperfusion criterion in AMI cases following TT.Öğe Ventricular septal defectas a consequence of stab wound: Two-year follow-up without repair: Case report(2010) Ender Topal A.; Eren M.N.; Iltümür K.; Gümüş H.Many cases with penetrating cardiac injury are later diagnosed to have suffered injury also to one of the intracardiac structures, mostly interventricular septum. Even ventricular septal defect (VSD) was diagnosed preoperatively, immediate repair is not recommended unless intractable heart failure develops as VSD can shrink or even spontaneously close with time. We present a case of traumatic VSD whose VSD was diagnosed on the postoperative fifth day. He was followed up along two years without repair. Although defect size has enlarged, pulmonary-to-systemic blood flow ratio decreased to 0.94 from 1.4. It may be recommended that if a patient is asymptomatic there is no point in insisting on immediate VSD repair. Copyright © 2010 by Türkiye Klinikleri.
