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Öğe Biatrial thrombosis in dilated cardiomyopathy(2006) Iltimur K.; Karabulut A.; Karahan Z.; Toprak N.[No abstract available]Öğe Glucose-insulin-potassium therapy and its effects on signal-averaged electrocardiography in acute myocardial infarction(2000) Ulgen M.S.; Iltimur K.; Karadede A.; Alan S.; Toprak N.Low amplitude signals (LP) at the end of the QRS in patients with acute myocardial infarction (AMI) are related to fragmentation of the electrical impulse in ventricular myocardium and detected on signal-averaged electrocardiography. In this study, we investigated the use of glucose- insulin-potassium (GIK) solution and its effects on the SAECG in AMI. Methods: Seventy-two consecutive patients diagnosed with first Q-wave AMI were prospectively studied. Thrombolytic therapy was given to all patients unless contraindicated. The patients were randomly given glucose-insulin- potassium (GIK, n=34) solutions which consisted of 300 g of glucose, 50 units of insulin and 80 mEq of KCl in 1000 cc water placebo (saline, n.38). Ambulatory electrocardiographic examinations were performed in all patients between 24-48th hours. Sub-maximal exercise testing (if not contraindicated), signal-averaged electrocardiogram (SAECG) and echocardiographic records were obtained before discharge (6-9, mean 7 days). In postdischarge early period (in 30-40 days after index infarction) SAECG and echocardiography recordings were repeated. Results: There were no differences found between both groups in view of ages, number of risk factors, localization of infarction. In pre- discharge evaluations total filtered QRS duration (FQRS1: 103±7 msec vs 108±11 msec p<0.05), low-amplitude terminal signal duration (HFLA1: 25±8 msec vs 32±11 msec, p<0.01) and frequency of VLP1 (%20 vs %45 p<0.05) were found to be lower while root mean square voltage of the terminal 40 msec of the QRS (RMS-401: 45±18?V vs 36±20?V p<0.05), left ventricle ejection fraction (EF: 54±9 vs 48±8, p<0.05) to be higher in GIK when compared with the placebo group. In post discharge evaluations, FQRS2 (105±8 vs 110±10, p=0.05), HFLA2 (26±7 vs 34±10, p<0.01) and frequency of VLP2, (%25 vs %38, p>0.05) were found to be lower while RMS-402 (47±21 vs 33±19 p<0.05) and EF2 (59±10 vs 52±11, p<0.05) were higher in the GIK compared with the placebo group. The incidence of post-MI angina pectoris was significantly lower in the GIK-administered group (p<0.005) than in the placebo groups. The incidence of premature ventricular contraction was insignificantly lower in the GIK-administrated group (p>0.05). We concluded that using GIK solutions at the early stages of AMI may be beneficial on the SAECG, angina incidence, and left ventricular systolic performance in the pre-and postdischarge early period of AMI.Öğe Two mitral stenosis cases without anticoagulant therapy with signs of left atrial thrombus(2004) Karabulut A.; Iltimur K.; Toprak N.[No abstract available]
