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Öğe Blood pressure diurnal rhythm is related with hematological indices in gestational diabetes mellitus patients(Acta Medica Mediterranea, 2013) Soydinc S.; Oylumlu M.; Yuksel M.; Turgut A.; Soydinc H.E.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 mortality. 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 Effect of sleep quality on hemodynamic response to exercise and heart rate recovery in apparently healthy individuals(The Canadian Society for Clinical Investigation, 2014) Yuksel M.; Yildiz A.; Demir M.; Bilik M.Z.; Ozaydogdu N.; Aktan A.; Isik F.Purpose: Poor sleep quality has an unfavorable impact on autonomic nervous system activity, especially that of the cardiovascular (CV) system. The heart rate (HR) and blood pressure (BP) at rest and during exercise, along with the heart rate recovery (HRR), were examined in poor sleepers and compared with individuals with good sleep quality. Methods: A total of 113 healthy individuals were enrolled to the study. All participants performed treadmill stress testing. Sleep quality of participants was assessed by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire: 48 subjects were categorized as 'poor sleepers' (PSQI score > 6 points), and the rest were grouped as 'good sleepers'. Results: The poor sleepers showed higher resting HR (p<0.001), higher diastolic BP (p=0.006), similar systolic BP (p=0.095), more frequent hypertensive response to exercise (p=0.046) and less HR increase with exercise (chronotropic incompetence) (p=0.002) compared with individuals who reported good sleep quality. In addition, the poor sleepers demonstrated reduced heart rate recovery at the 1st and 3rd minute of recovery (p=0.005 and 0.037, respectively) compared with good sleepers. Multivariate logistic regression analysis revealed that only resting diastolic BP was the independent predictor of HRE. The PSQI score was positively correlated with resting HR; while it was negatively correlated with HR response to exercise, HRR1 and HRR index-1. Conclusion: This cross-sectional study emphasizes the effect of poor sleep quality on unfavorable cardiovascular outcome indicators of the treadmill stress test. © 2012 CIM.Öğe Prognostic factors and in-hospital outcome of native valve endocarditis in Turkey. A multicenter study(Acta Medica Mediterranea, 2014) Ata Akil M.; Acet H.; Elbey M.A.; Aydin M.; Bilik Z.; Yildiz A.; Yuksel M.Aim: To investigate the predisposing factors, demographic and clinical characteristics, echocardiographic and prognostic features, and outcomes of patients with native valve infective endocarditis (IE) in Turkey in a multicenter based study. Materials and methods: The study population consisted of 158 consecutive patients with native valve IE (NVE). Data on demographics, medical history, medications, clinical procedures, predisposing factors, clinical examination, microbiology, antibiotic therapy, echocardiography, surgery, complications, and outcome were collected and compared. Results: The mean age of the patients was 47±19 (range 13-87). Seventy seven patients (49%) were female. Of the 158 NVE patients, 49 died during hospitalization. Mortality rate was 31%. Twenty eight patients experienced a stroke. The patients who died during hospitalization were significantly older than the survivors and had higher mean heart rate, white blood cell, C reactive protein, creatinine, poor NYHA functional class, multiple vegetations and large vegetations. Culture-negative endocarditis was seen in 54 cases (34%). Staphylococci were the most common causative organisms (28%). Eighty patients had undergone surgical treatment (51%). Hemoglobin, presence of multiple vegetation, vegetation size (>10 mm), septic shock and poor NYHA class on admission were independent risks for in hospital mortality and stroke. Beside these variables C reactive protein was also an independent risk for in hospital mortality Conclusion: Native valve IE in Turkey was associated with high in-hospital mortality. Rheumatic heart disease continues to be the most common underlying heart condition and echocardiographic findings on admission were the most important independent predictors of mortality or stroke.Öğe The relationship between coagulation factor XI levels and cardiac syndrome X in patients with diabetes mellitus(Cardiology Academic Press, 2014) Yazicioglu M.V.; Yuksel M.; Batgerel U.; Acar G.; Avci A.; Simsek Z.; Tabakci M.M.Cardiac syndrome X (CSX) is a characterized with normal epicardial coronary arteries and exertional angina pectoris. The aim of this study was to measure the levels of coagulation factor XI (F XI) and XII (F XII) to compare the intrinsic coagulation pathway activities in DM patients with and without CSX. A total of 50 Type 2 DM patients with CSX diagnosed by non-invasive tests accompanied with coronary angiography, and control group of 51 Type 2 DM patients matching with the CSX group in terms of age and sex were included in the study. F XII levels were tended to be higher in patient group than controls [107 ± 26 vs 99 ± 21 IU/dL; p = 0.124, respectively]. Moreover F XI levels were found to be significantly higher in CSX patient group compared to the controls [130 ± 23 IU/dL vs 118 ± 17 IU/dL; p = 0.005, respectively]. This study demonstrates that intrinsic coagulation pathway of DM patients with CSX is more active than those without CSX. It is also suggested that hypercoagulability may play an important role in the pathogenesis of CSX.
