Yazar "Ulgen, MS" seçeneğine göre listele

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    Cardiac hydatid cysts located in both the left ventricular apex and the intraventricular septum: Case report
    (Springer, 2000) Ulgen, MS; Alan, S; Karadede, A; Aydinalp, O; Toprak, N
    Cardiac hydatid cyst is rarely encountered and constitutes 0.5%-2% of all hydatid cases. Although left ventricular (LV) location for hydatid cysts has been frequently reported, the involvement of both the left ventricle and the interventricular septum (IVS) has not been previously reported in the literature. We present a case of cardiac hydatid cyst with fatal recurrent cerebral embolism and the unusual involvement of both LV and IVS demonstrated by transthoracic echocardiography.
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    The effect of glucose-insulin-potassium solution on ventricular late potentials and heart rate variability in acute myocardial infarction
    (Lippincott Williams & Wilkins, 2001) Ulgen, MS; Alan, S; Akdemir, O; Toprak, N
    Background Blunted heart rate variability (HRV) and presence of ventricular late potentials (VLPs) are known to correlate with an increased risk of ventricular tachycardia and sudden cardiac death in acute myocardial infarction (AMI), In the present study, we investigated the effect of glucose-insulin-potassium (GIK) solution on the VLPs and HRV in AMI. Methods Seventy-two consecutive patients with first Q wave AMI were randomized to GIK solution and placebo. HRV analysis and ambulatory electrocardiographic recordings were taken in all patients between 24 and 48 h. Sub-maximal exercise testing and echocardiography were performed and signal-averaged electrocardiography (SAECG) was recorded before discharge. Results Total filtered QRS duration (FORS: 102 +/- 7 versus 108 +/- 11 ms; P < 0.05), low-amplitude signal (LAS: 25 +/- 8 versus 32 +/- 11 ms; P < 0.01) and frequency of VLPs (21 versus 45%; P < 0.05) were found to be significantly lower while root-mean-square voltage of the terminal 40 ms. of QRS (RMS-40: 45 +/- 18 versus 36 +/- 20 V; P < 0.05), and left ventricular ejection fraction (EF: 55 +/- 6 versus 48 +/- 7; P < 0.05) were significantly higher in the GIK group when compared to placebo. During the hospital period, the presence and frequency of post-myocardial infarction angina were significantly lower in the GIK group (15 versus 29%, P < 0.05), whereas an insignificant decrease in frequency of ventricular arrhythmias was observed in these patients. On HRV analysis, there was no significant difference between two groups in either time domain (SID, SDNN, RMS-SD) or frequency domain (HF, LF, LF/HF ratio) parameters. Conclusion GIK solution may be beneficial to VLPs, ischaemic events, and left ventricular systolic performance in the early period of AMI. This therapy has no significant effect on HRV in AM] patients. Coron Artery Dis 12:507-512 (C) 2001 Lippincott Williams &Lippincott Wilkins.
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    The effects of glucose-insulin-potassium therapy on signal-averaged electro-cardiography and heart rate variability in acute myocardial infarction
    (W B Saunders Co Ltd, 2000) Ulgen, MS; Alan, S; Karadede, A; Iltimür, K; Toprak, N
    [Abstract Not Available]
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    The effects of trimetazidine on heart rate variability and signal-averaged electrocardiography in early period of acute myocardial infarction
    (Elsevier Ireland Ltd, 2001) Ulgen, MS; Akdemir, O; Toprak, N
    Background: Acute myocardial infarction (AMI) is accompanied by electrophysiological changes in cardiovascular system as well as those in autonomic cardiac control. Heart rate variability (HRV) is depressed due to increased sympathetic activity and/or decreased parasympathetic activity following AMI. Moreover, the frequency of ventricular late potentials (VLP) is increased due to the electrophysiological changes. Based on the hypothesis that the treatments increasing HRV and decreasing the frequency of VLP can improve the prognosis of AMI, we investigated the short-term effects of trimetazidine (TMZ) on HRV and VLP in patients with AMI. Methods: The study group consisted of 64 patients (men 49, mean age 55 +/- 12 years, range 26-70) suffering from first Q-wave AMI. Thirty-one of them were treated with conventional therapy (thrombolytic therapy, aspirin, beta-blocker, heparin and intravenous nitroglycerin) plus TMZ 20 mg tid. The remaining 33 patients served as controls. Holter monitorization between 24 and 48 h, echocardiography at average day 6 (range 4-7 days) and SAECG and sub-maximal exercise at average day 7 (range 6-9 days) were performed to all patients. Results: While HRV parameters reflecting parasympathetic activity (SDSD: 43 +/- 16 ms-35 +/- 13 ms, RMSSD: 34 +/- 14 ms-27 +/- 8 ms, HF: 7.8 +/- 5 ms(2) -4.3 +/- 4 ms(2), P < 0.05) were of significantly higher levels in TMZ group, the low frequency component mainly reflecting sympathetic activity (LF: 10 6 ms(2)-10 +/- 5 ms(2), P > 0.05) was similar in both groups. In addition, LF/HF ratio showing sympatho-vagal balance was significantly decreased in TMZ group (1.5-3.0, P = 0.005). About VLP, the mean FQRS (105 +/- 8 ms-107 +/- 10 ms), LAS (28 +/- 10 ms-30 +/- 11 ms:) and RMS-40 (34 +/- 15 muV-41 +/- 12 muV) were not different in both two groups (P > 0.05). Conclusion: Our results suggest that TMZ treatment causes changes in sympatho-vagal balance in favor of vagal activity by increasing parasympathetic activity in AMI at early period; however, no effect on VLP was observed. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    Electrocardiologic and echocardiographic features of patients exposed to scorpion bite
    (Sage Publications Inc, 2004) Alan, S; Ulgen, MS; Soker, M; Geyik, F; Karabulut, A; Toprak, N
    The purpose of this study is to examine clinical progress and hemodynamic and electrocardiologic features (QT depression and heart rate variability [HRV]) of patients exposed to a scorpion bite. Seventeen patients bitten by scorpions, and, as a control group, 15 healthy subjects were included in the study. Standard electrocardiograph (ECG) records, 24-hour Holter-ECG, and Doppler echocardiographic examinations were performed. Holter ECG indicated sinus tachycardia, sinus bradycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, first-degree and second-degree atrioventricular block not requiring treatment, early atrial beats, and early ventricular beats in the patients at frequencies of 82%, 12%, 35%, 12%, 8%, 70%, and 47%, respectively. HRV parameters that reflected parasympathetic activity (SD 35 +/-13-43 +/-16, RMS-SD: 20 +/-9-30 +/-12, high frequency: 7.8 +/-2-4.3 +/-3, p<0.05) were significantly lower (p<0.05). Low frequency, which especially showed sympathetic activity (LF: 11 +/-13 - 11 +/-23, p > 0.05), was similar in both groups. In addition, the LF/HF ratio, which reflected sympathovagal balance, was significantly increased in the patient group (1.5 +/-1-3.0 +/-2, p = 0.005). Corrected QT and QT dispersion values were not significantly different with respect to the control (p > 0.05). In the patient group compared to the control, a significant decrease was determined in the proportion of mitral E velocity to mitral A velocity (mEv/mAv), diastolic filling period (DFP), and left ventricular ejection fraction (LVEF), while a significant increase was noticed in pulmonary artery pressure (PAP) (mEv/mAv: 0.9 +/-0.4-1.7 +/-0.6, DFP: 362 +/-8.5-425 +/-89, LVEF: 53.1 +/-6.7-68.6 +/-5.8, PAP: 38.1 +/-13-27.2 +/-6, p<0.05). Scorpion bite leads to serious cardiovascular disorders, associated with decreased HRV, decreased systolic and diastolic functions, increased arrhythmic events, and hemodynamic disturbance with sympathetic and parasympathetic balance disturbance.
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    Influence of angiotensin-converting enzyme I/D gene polymorphism on the right ventricular myocardial performance index in patients with a first acute anterior myocardial infarction
    (Japanese Circulation Soc, 2005) Ozturk, O; Ulgen, MS; Tekes, S; Ozturk, U; Toprak, N
    Background The genetic influence on the myocardial performance index is uncertain, so the aim of the present study was to determine the effects of polymorphism of the angiotensin-converting enzyme (ACE) gene on the right ventricular myocardial performance index (RVMPI) after a first acute anterior myocardial infarction (MI). Methods and Results The subjects were 116 patients with a first acute anterior MI. Based on the polymorphism of the ACE gene, they were classified into 3 groups: deletion/deletion (DD) genotype (group 1, n=45), insertion/deletion (ID) genotype (group 2, n=58), insertion/insertion (II) genotype (group 3, n=13). Echocardiograms were used to determine the RVMPI, left ventricular myocardial performance index (LVMPI), tricuspid E/A, tricuspid deceleration time and the left ventricular diameter diastolic and diameter systolic (LVDd and LVDs). RVMPl and LVMPI were significantly higher in the ACE DD group. Tricuspid E/A, DT, LVDd and LVDs showed no differences among the 3 groups. Conclusion The ID polymorphism of the ACE gene may affect RVMPI and LVMPI after a first acute anterior MI.
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    Intima-media thickness and arterial distensibility in Behcet's disease
    (Sage Publications Inc, 2004) Alan, S; Ulgen, MS; Akdeniz, S; Alan, B; Toprak, N
    The etiology of Behcet's disease, a systemic vasculitis, is unknown. Vascular involvement may be seen in 25% of patients with Behcet's disease. Vasculitis make the prognosis of Behcet's disease severe. The aim of this study is to examine the structural and functional changes and relations of these changes with progression and prognosis of Behcet's disease. For this purpose, 40 patients with Behcet's disease and 40 healthy volunteer control subjects were analyzed, additionally patients with Behcet's disease were divided into 2 subgroups as those with vascular complications and those without vascular complications. Intima-media thickness and arterial distensibility were measured in all subjects with carotid artery ultra sonography, Carotid artery distensibility was significantly lower in the patient group compared to the control group (0.67 +/- 0.2, 0.93 +/- 0.4, p < 0.05), and carotid artery IMT was significantly higher (0.59 +/- 12, 0.80 +/- 0.11, p < 0.05). A statistically significant increase in IMT has been detected (0.77 +/- 11, 0.86 +/- 11, p < 0.05) in patients with Behcet's disease with vascular involvement compared to patients with Behcet's disease without vascular involvement, arterial distensibility in patients with vascular disease was similar with those who has no vascular disease (0.69 +/- 0.25, 0.63 +/- 0.25, p > 0,05). There was a significant negative linear regression between arterial distensibility and systolic blood pressure (SBP) (B= -1 X 10(-2), p < 0.05), and a significant positive linear regression has also been found between IMT and SBP and diastolic blood pressure (DBP) and pulse pressure (PP) (B = 6.8 X 10(-3) for SBP, p < 0.05, B = 6.9 X 10(-3) for DBP, p < 0.05, B = 6 X 10(-3) for PP, p < 0.05). As a result, IMT increases and AD decreases in patients with Behcet's disease compared to results in the control group. Although more studies are required for this subject, use of noninvasive parameters such as IMT and AD, which reflect the structural and functional characteristics of vasculature, may be useful to define disease progression and subjects at high risk.
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    Long-term glucose insulin potassium infusion improves systolic and diastolic function in patients with chronic ischaemic cardiomyopathy
    (E M H Swiss Medical Publishers Ltd, 2003) Alan, S; Ulgen, MS; Dedeoglu, I; Kaya, H; Toprak, N
    We assessed the effects of glucose-insulin-potassium (GIK) using echocardiography, right ventricular catheterisation and myocardial scintigraphy with 99mTc sestamibi in stable patients with ischaemic cardiac dysfunction. Methods: Thirty male patients with stable coronary disease (SCD) and an ejection fraction (EF) <40% were studied for systolic and diastolic function. Glucose 30%, 300 insulin units and KCl 6 g/l were infused at 1 ml/kg per hour for 24 hours. Haemodynamic, echocardiographic and myocardial scintigraphy measurements were recorded at rest on completion of the GIK infusion. Results: A significant increase in EF was observed (32.1 +/- 7.8% and 43.3 +/- 11.6%, p <0.01). A significant prolongation was seen in the diastolic filling periods (365 +/- 52 msec and 428 +/- 70 msec, p <0.05). A significant decrease in pulmonary capillary wedge pressure was measured (22.2 +/- 5.3 and 17.1 +/- 4.3, p <0.01) and a significant decrease in stress score (S S) was observed (13 +/- 7 and 11 +/- 5, p >0.05). Conclusion: Our present work suggests that GIK infusion improves systolic and diastolic function in patients with SCD and an ejection fraction <40%. Further studies are needed to determine whether long-term GIK infusion could be useful for therapeutic strategies in patients with chronic ischaemic coronary diseases.
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    Relation between coronary artery disease, risk factors and intima-media thickness of carotid artery, arterial distensibility, and stiffness index
    (Westminster Publ Inc, 2003) Alan, S; Ulgen, MS; Ozturk, O; Alan, B; Ozdemir, L; Toprak, N
    Atherosclerosis is a diffuse process that involves vessel structures. In recent years, the relation of noninvasive parameters such as intima-media thickening (IMT), arterial distensibility (AD), and stiffness index (SI) to cardiovascular diseases has been researched. However, we have not found any study that has included all these parameters. The aim of this study is to examine the relation between the presence of coronary artery disease (CAD) and its risk factors to AD, SI, and IMT, which are the noninvasive predictors of atherosclerotic process in the carotid artery. Included in the study were 180 patients who were diagnosed as having CAD by coronary angiography (those with at least; greater than or equal to 30% stenosis in the coronary arteries) and, as a control group, 53 persons who had normal appearing coronary angiographies. IMT, AD, and SI values of all the patients in the study were measured by echo-Doppler imaging (AD formula = 2 x (AoS-AoD)/PP x AoD, SI formula = (SBP/DBP)/([AoS - AoD]/AoD). Significantly increased IMT (0.82 +/-0.1, 0.57 +/-0.1, p<0.05), decreased AD (0.25 +/-0.9, 0.37 +/-0.1, p<0.05), and increased SI (13 +/-4, 8 +/-3, p<0.05) values were detected in the CAD group compared to the control group. A significant correlation was found between IMT and presence of diabetes mellitus (DM), systolic blood pressure, total cholesterol, and presence of plaque in carotids, and age. In the coronary artery disease group there was a significant correlation between AD and age, systolic blood pressure, and HDL cholesterol levels, while there was no significant correlation with plaque development. A significant correlation was also found between stiffness index and systolic blood pressure and age; however, there was no relation between number of involved vessels and IMT, AD, and SI. We found sensitivity, specificity, and positive predictive and negative predictive values for CAD diagnosis to be 70%, 75%, 77%, and 66%, respectively. In CAD cases, according to data in this study, IMT and SI increased while AD decreased, and this was detected by carotid artery Doppler ultrasonography. Therefore, it was concluded that these cheaper, noninvasive, and easily available parameters could be used in early diagnosis of CAD.
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    The relation between ST-segment elevation shape and both of signal-averaged EKG and clinical course in early period of anterior myocardial infarction
    (W B Saunders Co Ltd, 2001) Karadede, A; Aydynalp, O; Temamogullary, A; Ulgen, MS; Sucu, M; Toprak, N
    [Abstract Not Available]
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    The relationship of coronary artery disease and carotid Doppler flow velocity and resistance index in patients with no significant carotid stenosis
    (Westminster Publ Inc, 2001) Ulgen, MS; Bilici, A; Acar, M; Toprak, N
    [Abstract Not Available]
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    Reliability and efficacy of metoprolol and diltiazem in patients having mild to moderate mitral stenosis with sinus rhythm
    (Westminster Publ Inc, 2002) Alan, S; Ulgen, MS; Ozdemir, K; Keles, T; Toprak, N
    The authors evaluated the effects of beta blockers (metoprolol) and calcium channel blockers (diltiazem) in patients having mild to moderate mitral stenosis (MS) with sinus rhythm. Eighty patients with a complaint of dyspnea with diagnosed MS were included in this study. Patients were randomized into metoprolol and diltiazem groups, The first group received oral diltiazem treatment for 3 months following an IV dose of 25 mg diltiazem, The second group received oral metoprolol for 3 months following an IV dose of 5 mg metoprolol. All patients performed a treadmill exercise test at the beginning of and after 3 months of treatment, Transthoracic echocardiographic studies were also performed following the IV drug administration and after 3 months of treatment, In addition, oxygen uptakes of patients were measured before and after the stress and after 3 months of treatment. Decreases in peak gradient (PG) and mean transmitral gradient (MG) were observed in the metoprolol group after IV and oral metoprolol treatment, A prolongation of exercise time in treadmill exercise test (TET) and a decrease in the maximum heart rate after oral metoprolol treatment were noted. Eighteen patients in the metoprolol group had benefited symptomatically from this treatment and complaints of dyspnea were alleviated, whereas no symptomatic relief was seen in the diltiazem group. No significant prolongation was observed in effort times (p > 0.05) of the diltiazem group, Transmitral gradients measured via echocardiographic examination did not change (p > 0.05). With respect to oxygen uptake rates, a statistically significant decrease was determined in the metoprolol group, whereas no difference was found in diltiazem group, The authors conclude that metoprolol may be useful in patients with MS and can provide symptomatic relief. They did not observe any beneficial effect of diltiazem in these patients.
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    The value of hemodynamic changes induced by carotid sinus massage on the diagnosis of coronary artery disease
    (Westminster Publ Inc, 2001) Ulgen, MS; Karadede, A; Alan, S; Toprak, N
    The aim of this study is to investigate the value of hemodynamic changes induced by Carotid sinus massage (CSM) on the diagnosis of coronary artery disease (CAD). A total 108 patients (mean age, 54 +/- 10 years, range 33-70) who had no significant stenosis in the carotid artery by duplex ultrasonography (USG) and no history of syncope were included in this study. Carotid sinus massage was performed before coronary angiography with monitoring of electrocardiography and blood pressure. The patients were divided into three groups according to response to CSM: group 1 patients had a decrease in blood pressure or < 10 beats/minute (bpm); group 2 patients had a decrease between 10 and 20 bpm; and group 3 patients had > 20 mm Hg decrease in blood pressure or > 20 bpm. Coronary angiography was performed after CSM in all patients. There was single-vessel disease (VD) in 23 cases, two-VD in 24 cases, and three-VD in 35 cases. Coronary angiography results were normal in 26 cases. The changes in systolic and diastolic blood pressures and heart rate before and after CSM correlated with number of VD. These changes were highest in patients with three-VD, but lowest in patients with normal coronary angiography. The number of diseased vessels and total coronary artery score were lowest in group 1, but highest in group B. The specificity and sensitivity of CSM-induced > 10 mm Hg in blood pressure (BP) or > 10 bpm changes in heart rate in the diagnosis of CAD were 85% and 71%, respectively. The positive and negative predictive values were 93% and 49%, respectively in the diagnosis of CAD. At the end of this study, we concluded that CSM induced the fall in blood pressure and heart rate and was correlated with number of diseased vessels and the score of coronary artery disease. As dichotomized values, the decrease of > 10 mm Hg in blood pressure and/or > 10 bpm has highest specificity, sensitivity, and positive predictive value in the diagnosis of CAD.