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Öğe 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 EnderObjective: 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.Öğe 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, VedatAtrial 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.Öğe Mean platelet volume in functional and thrombotic prosthetic mitral valve(Lippincott Williams & Wilkins, 2012) Tekbas, Ebru; Akdemir, Ilyas; Soydinc, Serdar; Alici, Hayri; Yavuz, Fethi; Yuce, Murat; Cakici, MusaThe mean platelet volume (MPV) values reflect platelet size and are accepted as marker of platelet activation. We sought to test the hypothesis that platelet activation occurs independently from presence or absence of thrombus in prosthetic mitral valve. A total of 168 patients were included in the study. Study participants were divided in three groups: group 1 (n=62) - patients with normal prosthetic mitral valve; group 2 (n=37) - patients with prosthetic mitral valve thrombosis; and group 3 (n=69) - healthy individuals. MPV values were significantly higher in normal and thrombotic prosthetic mitral valve patients than in healthy individuals (P=0.008 and P=0.01, respectively). MPV values were not different between normal prosthetic mitral valve and thrombotic prosthetic mitral valve. This is the first study indicating that increased MPV is present in normal and thrombotic prosthetic mitral valve, implying that platelet reactivity occurs in prosthetic mitral valve irrespective of development of thrombus formation. Blood Coagul Fibrinolysis 23:91-93 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction(Informa Healthcare, 2011) Tekbas, Ebru; Kara, Ali F.; Ariturk, Zuhal; Cil, Habib; Islamoglu, Yahya; Elbey, Mehmet A.; Soydinc, SerdarMean platelet volume (MPV) is a marker of platelet activation. An increased MPV is associated with acute myocardial infarction (AMI) and long-term mortality. The aim of this study was to compare MPV in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Also, we investigated the value of MPV on in-hospital mortality and long-term prognosis of patients with STEMI and NSTEMI. We studied 429 patients with AMI (70.4% male, 61.9 +/- 12.4 years; 279 patients with STEMI, 150 patients with NSTEMI). MPV and platelet count were similar in both groups. Elevated MPV increased the risk of death by 3.1-fold (p < 0.001) in STEMI group during the hospitalization. However, increased MPV was not associated with in-hospital mortality in NSTEMI group. The area under the receiver operating characteristic curve of MPV was 0.868 (95% CI, 0.830-0.907) for predicting two-year mortality. A cut-off point of 11.1 fL showed a sensitivity of 81% and a specifity of 77% for prediction of two-year mortality. Kaplan-Meier survival curve showed two-year mortality rate of 12.5% in patients with MPV > 11.1 fL versus 9.9% in patients with MPV < 11.1 fL (p < 0.001). Cox regression analysis showed MPV to be an independent predictor of two-year mortality (Hazard ratio 1.7; 95% CI 1.5-1.9; p < 0.001). An increased MPV is an independent predictor of in-hospital mortality in patients with STEMI. However, elevated levels of MPV did not predict in hospital mortality in NSTEMI group. The increase in MPV values was independently correlated with two-year mortality in all study patients.
