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  • Küçük Resim
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    Ankilozan spondilit hastalarında serum ADMA düzeyleri ve aortun elastik özelliklerinin değerlendirilmesi
    (Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, 2013) Kaya, Hasan; Tekbaş, Ebru Öntürk; Ertaş, Faruk; İnci, Ümit; Oylumlu, Mustafa; Yüksel, Murat; Aydın, Mesut; Batmaz, İbrahim; Yüksel, Hatice; Ülgen, Mehmet Sıddık
    Öz: Giriş: Ankilozan spondilit kronik infl amatuvar bir hastalık olup, kardiyovasküler komplikasyonlarla ilişkili olabilmektedir. Bu çalışmada amacımız, kardiyak tutulum olmayan ankilozan spondilit hastalarında aortun elastik özellikleri ile serum asimetrik dimetilarjinin (ADMA) düzeylerinin araştırılmasıdır.Hastalar ve Yöntem: Elli beş ankilozan spondilit hastasıyla benzer yaş ve cinsiyette 30 sağlıklı birey çalışmaya alındı. Açlık glukoz, serum lipidleri, C-reaktif protein (CRP), eritrosit sedimentasyon hızı (ESH) ve ADMA düzeyleri çalışıldı. Aortik strain, distensibilite ve sertlik indeksi transtorasik ekokardiyografi de aort çapı ölçümleri ve eş zamanlı kan basıncı ölçümleriyle hesaplandı. Bulgular: Ankilozan spondilit grubunda ESH ve CRP düzeyleri yüksekti. Serum ADMA düzeyleri ankilozan spondilit grubunda kontrol grubuna göre anlamlı olarak yüksekti (0.76 ± 0.19 ve 0.55 ± 0.12, p< 0.001). Alt grup analizinde, anti-TNF-alfa tedavisi alan grupta konvansiyonel tedavi grubuna göre daha düşük ADMA düzeyi ölçüldü (0.68 ± 0.15 ve 0.87 ± 0.18, p< 0.001). Ortalama aortik strain ve distensibilite değerleri ankilozan spondilit grubunda daha düşük iken, sertlik indeksi daha yüksek saptandı. Korelasyon analizinde ADMA düzeyleri ile aortun elastik özellikleri arasında ilişki izlenmezken, ankilozan spondilit grubunda hastalık süresi ile aortik strain ve distensibilite arasında ters yönde anlamlı korelasyon izlendi.Sonuç: Çalışmamızda elde ettiğimiz sonuçlar kardiyak tutulumun olmadığı ankilozan spondilit hastalarında aortik elastisitenin bozulduğunu ve ADMA düzeylerinin arttığını göstermektedir. Ayrıca, aortun elastik özellikleri ile ADMA düzeyleri arasında anlamlı ilişki saptanamamıştır.
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    Anticoagulant-induced hemopericardium with tamponade: A case report and review of the literature
    (2013) Oylumlu, Mustafa; Ülgen, Mehmet Sıddık; Ertaş, Faruk; Yıldız, Abdulkadir; Polat, Nihat
    Akut kardiyak tamponad acil tanı ve tedavi gerektirir. Biz 43 yaşında, erkek ve mitral valv replasmanı sonrası sekiz aydır warfarin tedavisi alan bir olguyu aldık. Hastanın bir-kaç gündir başlayan nefes darlığı ve halsizlik şikayetikleri mevcuttu. Kardiyak tamponad tanısı konuldu ve 1400 ml mai perikardiyosentezle acil olarak drene edildi. Tanı sı-rasında İNR değeri çok yüksek olan hastaya Vitamin Kantagonistleri ve taze donmuş plazma verilerek yuksekkoagülasyon durumu geriye döndürüldü. Patolojik incele-me sonucunda enfeksiyon ve malingnensi saptanmadı.Hastada kronik inflamasyon düşünüldü. Sonuç olarakwarfarin overdoz acil bir durum olup hemoperikardiyumlatamponada yol açabilmektedir. Bunun için warfarin teda-visi başlanılan hastalarda warfarin dozu ve hedef İNR de- ğerleri sıkı kontrol edilmelidir.
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    The assessment of arterial stiffness in pre-eclamptic patients RESPONSE
    (Informa Healthcare, 2014) Oylumlu, Mustafa; Yildiz, Abdulkadir; Yuksel, Murat
    [Abstract Not Available]
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    Assessment of atrial electromechanical delay and P-Wave dispersion in patients with Psoriasis
    (Echocardiography- A Journal Cardiovascular Ultrasound and Allied Techniques, 2014) Yildiz, Abdulkadir; Ucmak, Derya; Oylumlu, Mustafa; Akkurt, Meltem Z.; Yuksel, Murat; Akil, Mehmet Ata; Polat, Nihat; Aydin, Mesut; Bilik, M. Zihni; Acet, Halit
    Background: In this study, we sought to evaluate atrial electromechanical properties and conduction homogeneity by tissue Doppler imaging and electrocardiography in patients with psoriasis. Methods: Thirty-four patients with psoriasis and 30 age-and gender-matched healthy controls were included in the study. Atrial electromechanical coupling intervals were assessed by means of tissue Doppler echocardiography and P-wave dispersion (Pd) was calculated from electrocardiogram. Results: A total of 64 subjects (33 male) with a mean age of 36.8 +/- 11.9 years were included in the study. Basal characteristics were similar between 2 groups. Intra-atrial (15 +/- 7 ms vs. 12 +/- 5 ms, P = 0.009) and inter-atrial (28 +/- 7 ms vs. 23 +/- 7 ms, P = 0.002) electromechanical delays were significantly higher in patients with psoriasis compared with control groups. P-maximum (112 +/- 16 ms vs. 103 +/- 8 ms, P = 0.006) and Pd (35 +/- 9 ms vs. 20 +/- 6 ms, P < 0.001) were also prolonged in patients with psoriasis. Conclusion: This study demonstrated that atrial electromechanical coupling intervals and P-wave dispersion were prolonged in patients with psoriasis, which may cause an increased risk of atrial fibrillation in this patient group.
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    Assessment of neutrophil / lymphocyte ratio in patients with myocardial bridge
    (2014) Yüksel, Murat; Yıldız, Abdulkadir; Oylumlu, Mustafa; Polat, Nihat; Kayan, Fethullah; Alan, Sait; Aydın, Mesut
    Amaç: Miyokardiyal kas bandı miyokart içinde seyreden epikardiyal koroner arterlerin sistolde daralması ile seyreden konjenital bir anomalidir. İyi huylu olmasına rağmen önceki çalışmalarda proksimal kesimlerin artmış ateroskleroza eğilimli olduğu gösterilmiştir. Nötrofil/lenfosit oranı (NLO) aterosklerotik kalp hastalıklarında kötü prognozu öngören sistemik enflamasyonun duyarlı bir belirtecidir. Biz bu çalışmada NLO ile miyokardiyal kas bandı arasında bir ilişki var olup olmadığını araştırmayı amaçladık. Yöntemler: Anjiyografik olarak tespit edilmiş miyokardiyal kas bandı veya normal koroner arterleri olan 172 hasta (ortalama yaş: 50.8 ± 11.5 yıl, %77.3 erkek) çalışmaya dahil edildi. Otomatik kan sayacı kullanılarak tüm hastaların hematolojik parametreleri ölçüldü. Bulgular: Çalışma 71 miyokardiyal kas bandı (ortalama yaş: 51,4 ± 11,9 yıl, %80,3 erkek) ve 101 normal koroner arterleri (ortalama yaş: 50,5 ± 11,3 yıl, %75.2 erkek) olan hastadan oluşmaktaydı. Hemoglobin, trombosit sayısı, glukoz ve kreatinin açısından gruplar arasında fark saptanmadı. Kontrol grubuna göre miyokardiyal kas bandı grubunda NLO anlamlı olarak daha yüksekti (2,45 ± 1,19 vs. 1,72 ± 0,48; p< 0,001). ROC analizinde, NLO > 1,82 miyokardiyal kas bandı varlığını %70 duyarlılık ve %71 özgüllükle öngörmüştür (ROC eğri altında kalan alan: 0.733, 95% güvenlik aralığı: 0.654-0.811, p < 0.001).Sonuç: Çalışmamız miyokardiyal kas bandının vücutta enflamatuar düzeyi gösteren yüksek NLO seviyeleri ile ilişkili olduğunu göstermiştir.
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    Assessment of Platelet to Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Acet, Halit; Akil, Mehmet Ata; Polat, Nihat
    [Abstract Not Available]
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    Assessment of Right Ventricular Systolic Functions in Patients with Chronic Renal Failure before and after Hemodialysis
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Akyuz, Abdurrahman; Yuksel, Murat; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Polat, Nihat; Akil, Mehmet Ata
    [Abstract Not Available]
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    Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients With Ankylosing Spondilitis
    (Elsevier Science Inc, 2013) Kaya, Hasan; Tekbas, Ebru Onturk; Ertas, Faruk; Inci, Umit; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut
    [Abstract Not Available]
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    The Association between Neutrophil to Lymphocyte Ratio and Presence of Ventricular Premature Contractions
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Polat, Nihat; Acet, Halit; Bilik, Mehmet Zihni; Aydin, Mesut
    [Abstract Not Available]
  • Küçük Resim
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    Association between neutrophil to lymphocyte ratio and pulmonary arterial hypertension
    (Türk Kardiyoloji Derneği, 2013) Yıldız, Abdulkadir; Kaya, Hasan; Ertaş, Faruk; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Yüksel, Murat; Polat, Nihat; Akıl, Mehmet Ata; Atılgan, Zuhal; Ülgen, Mehmet Sıddık
    Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked by increased pulmonary artery resistance leading to right heart failure, with high mortality. Evidence is increasing to propose that inflammation plays a significant role in the pathophysiological mechanism. Increased prevalence of PH in patients with systemic inflammatory diseases is already known. Herein, we sought to evaluate the association between neutrophil to lymphocyte ratio (N/L ratio) and pulmonary arterial hypertension (PAH). Study design: Twenty-five patients with PAH and 25 controls were evaluated. Baseline clinical and echocardiographic variables were obtained. Complete blood counts in all patients and controls were reviewed retrospectively. Results: The N/L ratio was higher in patients with PAH compared to healthy volunteers (p=0.05). A cut-off value of 1.65 for N/L ratio predicted the presence of PAH with 72% sensitivity and 69% specificity. After multivariate analysis, only N/L ratio remained a significant predictor of PAH. Conclusion: We showed for the first time that N/L ratio was significantly increased in patients with PAH compared to controls.
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    The Association between Neutrophil/Lymphocyte Ratio and Functional Capacity in Patients with Idiopathic Dilated Cardiomyopathy
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Tuncez, Abdullah; Grbovic, Enis; Polat, Nihat; Yuksel, Murat; Aydin, Mesut; Oylumlu, Mustafa
    [Abstract Not Available]
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    The association between platelet/lymphocyte ratio and coronary artery disease severity
    (Turkish Society of Cardiology, 2015) Yüksel, Murat; Yıldız, Abdulkadir; Oylumlu, Mustafa; Akyüz, Abdurrahman; Aydın, Mesut; Kaya, Hasan; Acet, Halit; Polat, Nihat; Bilik, Mehmet Zihni; Alan, Sait
    Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). Methods: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. Results: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cut-off value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. Conclusion: Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis. (Anatol J Cardiol 2015; 15: 640-7).
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    The Association Between the Neutrophil-to-Lymphocyte Ratio and the Presence of Ventricular Premature Contractions in Young Adults
    (Sage Publications Inc, 2015) Yildiz, Abdulkadir; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut; Polat, Nihat; Acet, Halit; Akil, Mehmet Ata
    Inflammation has recently emerged in the pathogenesis of several cardiovascular disorders, including arrhythmias. The neutrophil-lymphocyte ratio (NLR) is a simple marker for the assessment of inflammatory status. Therefore, we aimed to investigate the relationship between the NLR and the ventricular premature contraction (VPC) existence. Patients aged between 18 and 40 years who were referred to the cardiology clinic were enrolled in the study. All patients' complete blood counts and 24-hour Holter recordings were analyzed. The NLR was higher within the VPC group compared to the control group (P < .001). According to the NLR tertiles, VPCs were more common in the higher NLR tertile (P < .001). A cutoff point of 1.80 for the NLR had 71% sensitivity and 60% specificity in predicting VPC in apparently healthy individuals. After multivariate analysis, only the NLR remained significant predictor of presence of VPC. In conclusion, the NLR is independently and significantly associated with VPC existence.
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    The association between the neutrophil/lymphocyte ratio and functional capacity in patients with idiopathic dilated cardiomyopathy
    (Turkish Soc Cardiology, 2015) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Polat, Nihat; Akil, Mehmet Ata; Acet, Halit
    Objective: The neutrophil/lymphocyte ratio (NLR) is an inexpensive, readily available and reliable inflammatory marker, which has a predictor value in different cardiovascular disorders. Functional capacity is one of the most important prognostic factors in patients with heart failure, which is usually stated as metabolic equivalents (MET). The goal of the study was to investigate the relationship between the NLR and functional capacity (FC) in patients with idiopathic dilated cardiomyopathy (IDC). Methods: Treadmill test according to modified-Bruce protocol was performed in 37 patients with IDC (mean age 46.7 +/- 11.7 years, 81.1% male) to assess their functional capacity. Baseline clinical and echocardiographic variables were obtained. Hematological and biochemical parameters were measured using standard techniques. Results: The patients were divided into low (<5 MET, n=18) and high (>5 MET, n=19) FC groups according to their functional status in the exercise test. The 2 groups were similar regarding age, gender and the presence of hypertension and diabetes mellitus. There was no significant difference between groups regarding echocardiographic parameters such as left ventricular ejection fraction and diameters. However, the NLR was significantly higher in low FC group compared to high FC group (3.62 +/- 2.24 vs. 2.24 +/- 0.67, p=0.002; respectively). There were significant negative correlations between the NLR, MET and left ventricular ejection fraction (r=-0.405, p=0.013 and r=-0.028, p=0.028; respectively). Diastolic dysfunction was present in all the patients with low functional capacity. A cut-off point of 2.26 for the NLR had 83% sensitivity and 69% specificity in predicting poor FC. After multivariate analysis, only the NLR remained significant predictor of poor functional status. Conclusion: We detected a significant association between the NLR and low FC, both of which has predictive and prognostic value in patients with heart failure. Functional capacity may depend on diastolic function rather than left ventricular ejection fraction in patients with IDC.
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    BLOOD PRESSURE DIURNAL RHYTHM IS RELATED WITH HEMATOLOGICAL INDICES IN GESTATIONAL DIABETES MELLITUS PATIENTS
    (Carbone Editore, 2013) Soydinc, Serdar; Oylumlu, Mustafa; Yuksel, Murat; Turgut, Abdulkadir; Soydinc, Hatice Ender
    Objective: Gestational diabetes mellitus (GDM) is related with cardiovascular risk factors. Non-dipping blood pressure pattern and high mean platelet volume, which is an indicator of increased platelet activation, are associated with cardiovascular morbidity and inortality. The aim of our study is to determine circadian variation of blood pressure and to study the impact of hematological indices on blood pressure dipping and non-dipping patterns in patient with GDM. Material and methods: A total of 42 patients who were diagnosed with GDM and 33 patients with healthy pregnancies were included into the study. Patients' blood pressures were monitored and were grouped due to their blood pressure circadian pattern. If the blood pressure while sleeping decreased more than 10% from the blood pressure while awake, the patient was classified as a dipper. If the decrease was less than 10%. the patient was classified as a non-dipper. Biochemical and hematological parameters were measured and clinical features were recorded for all study groups. Results: Ambulatory blood pressures monitoring of two groups revealed that average systolic and diastolic blood pressures as well as the day-phase diastolic and night-phase systolic and diastolic blood pressures of GDM patients were significantly increased than those of the control group. Besides, control patients had a more significant decrease in night-phase systolic and diastolic blood pressures than GDM patients (p<0.001). There was no significant difference between hematological indices and dipping status, except for mean platelet volume (MPV). MPV in non-dippers was significantly higher than dippers one (p<0.001). Step-wise multivariate linear regression demonstrated that MPV and GDM can be used as independent predictors of non-dipping status. Conclusion: According to our results the circadian variation of blood pressure is impaired and MPV is increased in GDM patients. Increasing in MPV is associated with non-dipping status of blood pressure. It is possible that non-dipping status and increased MPV levels may be additional risk factors for increased cardiovascular disease events in gestational diabetes patients.
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    Cardiac device-related infective endocarditis; analysis of 15 cases
    (Turkish Soc Cardiology, 2013) Elbey, Mehmet Ali; Eren, Nihan Kahya; Kalkan, Mehmet Emin; Demirtas, Sinan; Kahraman, Fatih; Sayin, Rasit; Oylumlu, Mustafa
    Objectives: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemaker (PM), and implantable cardioverter-defibrillator (ICD) - related endocarditis in this study. Study design: The study population consisted of 15 patients with permanent PM and ICD-related endocarditis. Data on patients'demographic characteristics, medications used, clinical, and microbiological data, echocardiographic findings, types, and outcomes of surgical treatments were recorded. Results: The mean age of the patients was 57+/-16. Seven patients (47%) were female. Of the 15 patients with permanent PM and ICD-related endocarditis, 5 died during in-hospital follow-up (33%). In four patients (27%) pulmonary embolism developed. Culture-negative endocarditis was detected in 5 cases (33%). Staphylococci were the most common causative organisms in 60% of the patients. Three (20%). patients underwent surgical treatment Conclusion: Cardiac device-related endocarditis remains a rare complication of intracardiac device implantation still with higher mortality rates.
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    Cardiac Metastasis of a Low-Grade Myofibroblastic Sarcoma
    (Wiley, 2014) Oylumlu, Muhammed; Yildiz, Abdulkadir; Ercan, Suleyman; Oylumlu, Mustafa; Davutoglu, Vedat
    We aim to present a rare case of low-grade myofibroblastic sarcoma arising in the inguinal region accompanied by cardiac metastasis. A 36-year-old male patient suffering from recurrent inguinal swelling was operated on and the initial histopathological evaluation mistakenly diagnosed the condition as benign. During follow-up, a recurrence of mass was detected in the same region and a pathological examination revealed a low-grade myofibroblastic sarcoma. Cardiac metastasis was diagnosed shortly before rapid disease progression and death. The learning points relevant to this case are as follows: (1) Echocardiographic screening in patients with noncardiac myofibroblastic sarcomas may be helpful in the detection of silent metastasis. (2) Low-grade myofibroblastic sarcomas in the inguinal region may be misdiagnosed as benign after enucleation. Thus, rigorous histopathological examination of myofibroblastic sarcomas is crucial. (3) According to our knowledge, this is the first report of a low-grade myofibroblastic sarcoma to have a potential for cardiac metastasis with potentially fatal course. Mini-Abstract We present a case of low-grade myofibroblastic sarcoma arising from inguinal region accompanied by cardiac metastasis. A 36-year-old male patient suffering from recurrent inguinal swelling was operated. Initial evaluation mistakenly diagnosed the condition as benign. During follow-up, recurrence of mass revealed a low-grade myofibroblastic sarcoma. Echocardiographic screening in patients with noncardiac myofibroblastic sarcomas may be helpful in detecting silent metastases before development of cardiac symptoms in terms and may offer prognostic information. This is first report of a low-grade myofibroblastic sarcoma to metastasize to myocardium. Cardiac metastasis of a sarcoma might have rapid progression of the disease with fatal course.
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    Clopidogrel resistance in patients with type 2 Diabetes Mellitus: A comparison between oral antidiabetic agents and insulin
    (Drunpp-Sarajevo, 2012) Ariturk, Zuhal; Cil, Habib; Gunduz, Ercan; Yavuz, Celal; Kaya, Hasan; Ertas, Faruk; Oylumlu, Mustafa
    Background: Clopidogrel resistance has been found in certain patient populations, including patients with acute coronary syndrome, ischemic stroke, patients undergoing percutaneous coronary intervention with a drug-eluting stent, diabetes mellitus, ischemic stroke and stent restenosis. The aim of this study was to assess clopidogrel resistance in diabetic patients taking oral antidiabetic drugs and insulin. Methods and Results: Platelet aggregation was measured after clopidogrel treatment in 101 diabetic patients undergoing percutaneous coronary intervention. Two diabetic patient subpopulations were compared: patients who used insulin (group 1) and patients who used oral antidiabetic agents (group 2). Clopidogrel nonresponders and responders were defined by a relative inhibition of adenosine diphosphate (20 mol/L) induced platelet aggregation of < 10% and >= 30%, respectively. Among group 1 patients, 12.5% were clopidogrel nonresponders and Among group 2 patients, 9.4% were clopidogrel nonresponders. There were no statistical differences found between the two groups (P=0.618). Conclusions: This study demonstrates that there was no significant difference in the clopidogrel resistance between type 2 diabetes mellitus patients taking insulin or oral antidiabetes medication. The clinical implications of this finding are unknown and need to be evaluated in large-scale clinical trials.
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    Demographical data and outcomes of surgically treated patients with the diagnosis of infective endocarditis: a multi-center retrospective study
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Oylumlu, Mustafa; Elbey, Mehmet Ali; Kalkan, Emin; Akdag, Serkan; Ozbek, Kerem; Eren, Nihan Kahya; Topcu, Selim
    Background: This study aims to investigate the demographic and clinical characteristics and echocardiographic and microbiological findings of the patients as well as the outcomes of surgery undergoing surgical treatment with the diagnosis of infective endocarditis in Turkey. Methods: Between January 2005 and August 2012 116 patients (65 males, 51 females; mean age 43 +/- 16 years; range 14 to 80 years) with the diagnosis of infective endocarditis who underwent surgery in 13 tertiary university/research and education hospitals were included in this multi-center study. Demographic and clinical characteristics of the patients, and echocardiographic and microbiological findings, surgical indications and outcomes of surgery were retrospectively analyzed. Results: The most common symptom on admission and physical finding was fever. Blood cultures were negative in 35 patients (30%). Staphylococci were the most common microbiological pathogens (22%). Congestive heart failure was the most common indication for surgery in 56 patients (48%). Valve repair was performed in 12 patients (10%), valve replacement was the procedure of choice in 104 patients (90%). Thirty-three patients undergoing surgical treatment died in the postoperative period. The mortality rate was 28%. Independent predictors of surgical mortality were Class 3-4 functional capacity, elevated C-reactive protein, and renal dysfunction. Conclusion: Although complicated cases of infective endocarditis can be treated through surgery, surgical morbidity and mortality is still high.
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    The effect of the glucose-insulin-potassium solution on the p-wave dispersion of the heart failure patients
    (Aves Press Ltd, 2012) Ercan, Suleyman; Oylumlu, Muhammed; Oylumlu, Mustafa; Soydinc, Serdar; Davutoglu, Vedat
    Atrial fibrillation (AF) has adverse effects on the disease prognosis and the functional capacity during heart failure. P wave dispersion has been considered as one of the most important parameters predicting the development of AF. It is known that glucose-insulin-potassium (GIK) infusion has favorable metabolic and hemodynamic effects. The aim of our study is to investigate the effects of GIK infusion on P wave dispersion in patients with heart failure. In our study, 30 patients with the diagnosis of heart failure and a low left ventricular ejection fraction (EF<40%) were included. Fifteen patients randomized to GIK solution (20 U insulin and 60 mEq KCl in 20% 500 ml dextrose solution) in 8 hours for consecutive 3 days (Group I) and other 15 patients were randomized to isotonic NaCl solution in addition to the conventional therapy (Group II, control). Twelve-lead electrocardiography were recorded in all patients to detect the P wave dispersion. P wave dispersion was calculated between the Group I and Group II patients before the study respectively (19.4 +/- 7.5 and 19 +/- 6.3) (p>0.05). In Group I, P wave dispersion measured after GIK infusion was 13 +/- 6.5. In group II, P wave dispersion measured after 0.9% NaCl solution infusion were 20.4 +/- 6.4. P wave dispersion was found significantly lower in patients administrated GIK infusion (p=0.001). According to the present study, we showed that the P wave dispersion which predicts AF was significantly lower in the patients treated with GIK than in the control group.