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Öğe Aberrant right ventricular branch of right coronary artery with mitral valve prolapse(2004) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer Ali; Özhan, Hakan; Akdemir, Ramazan; Özkökeli, Mehmet; Uyan, CihangirA 37-year-old man presented with a three-week history of chest pain. Transthoracic echocardiography demonstrated a mitral valve prolapse and mild mitral insufficiency. Coronary angiography showed normal left main, circumflex, left anterior descending and right coronary arteries; however, the right ventricular branch of the right coronary artery had a separate ostium. Concomitant congenital heart abnormaliries have been observed with coronary artery anomalies. Primary congenital coronary and valvular anomalies may have genetic heredity. In the present case, mitral valve prolapse was accompanied by a right ventricular coronary artery origin anomaly which, to the best of our knowledge, is the first report in the literature in which both anomalies presented together. © 2004 Pulsus Group Inc. All rights reserved.Öğe Acute myocarditis mimicking acute myocardial infarction associated with pandemic 2009 (H1N1) influenza A virus(2011) Erden, Ismail; Erden, Emine Çakcak; Özhan, Hakan; Basar, CengizThe prevalence of myocardial involvement in influenza infection ranges from 0% to 11% depending on the diagnostic criteria used to define myocarditis. Whether such an association holds for the novel influenza A strain, pandemic-2009-H1N1, remains unknown. The clinical presentation of myocarditis varies and often mimics myocardial infarction. Although history, physical examination, laboratory data points, and electrocardiogram are helpful in distinguishing myocarditis from myocardial infarction, differential diagnosis can sometimes be difficult. Here, we present the first known report of acute myocarditis mimicking acute myocardial infarction associated with the pandemic influenza A virus (H1N1) infection. © 2011 Via Medica.Öğe Akut miyokard enfarktüsü sonrası gelişen geniş ventriküler septal rüptürün başarılı tedavisi(Aves, 2007) Kaya, Ahmet; Kaya, Yasemin; Ordu, Serkan; Özkökeli, Mehmet; Özhan, Hakan; Dağlar, Bahadır; Yazıcı, MehmetPostinfarct ventricular septal rupture (VSR) is a rare but mortal complication of acute myocardial infarction (MI). VSR must be diagnosed earlier and the correct treatment must be applied immediately. Abrupt surgical repair is the choice of treatment, which decreases early mortality and improves long term survival. Septal rupture occurs more frequently with anterior than with other types of acute myocardial infarction. VSR occurs usually within 2 weeks after infraction. We describe here a 76-year-old woman with a giant VSR with little hemodynamic disturbance that developed twenty days after anterior myocardial infarction. She was successfully treated with abrupt surgical closure.Öğe Angiotensin-converting enzyme, angiotensin II receptor, apolipoprotein E and endothelial constitutive nitric oxide synthase gene polymorphisms in dilated cardiomyopathy(2004) Özhan, Hakan; Zungur, Mustafa; Yazıcı, Mehmet; Akdemir, Ramazan; Gündüz, Hüseyin; Erbilen, Enver; Albayrak, Sinan; Uyan, CihangirAmaç: Dilate kardiyomiyopati (DCM) sol yada her iki ventrikülün sistolik fonksiyonlarının bozulması ve genişlemesi ile karakterize bir hastalıktır. Ailesel kökenli DCM'nin tanımlanmasından sonra ailesel olmayan DCM olguları için de genetik faktörlerin rol oynayabileceği düşünülmüş ve konuyla ilgili araştırmalar yapılmıştır. Makalemizde ülkemizde yaşayan DCM'li olgularda, hastalığın patofizyolojisinde rol oynaması muhtemel dört aday genin polimorfizmleri araştırılmıştır (Angiotensin dönüştürücü enzim (ACE) I/D polimorfizmi, angiotensin II reseptör (AGTR1) 1166 A/C polimorfizmi, apolipoprotein E (APOE) ve endotelyal konstitütif nitrik oksit sentaz (ecNOS) geni polimorfizmi). Ortalama yaşı 58±12 olan ardışık 76 hasta ve yaş ortalaması 59±12 olan 88 kontrol grubu çalışmaya alındı. Bütün hastalara ve kontrol grubuna ekokardiyografik çalışma yapıldı. DCM tanısı için ekokardiyografik olarak end-diastolik çapın >55mm ve ejeksiyon fraksiyonunun <%40 altında olması kriter alındı. Yine hasta grubuna koroner anjiografi yapılarak hastalar iskemik ve idyopatik DCM gruplarına ayrıldı. Spesifik kalp kası hastalığı, izole sağ ventrikül genişlemesi, kapak ve perikard hastalığı olanlar çalışma dışında tutuldu. Hasta ve kontrol grubunun kan hücrelerinden deoxiribonükleik asit (DNA) spesifik polimeraz zincir reaksiyonu (PCR) yöntemi ile genetik analiz yapıldı. Gen distribüsyonu ki kare testi ile değerlendirildi. Bağımsız risk için multivariate regresyon analizi uygulandı. 0,05 altındaki p değerleri istatistiksel olarak anlamlı kabul edildi. Sonuçlar: Hasta ve kontrol grubunun allel sıklıkları, ekokardiyografi, biyokimya analizi sonuçları ve demografik verileri karşılaştırıldı. APO E gen allel sıklığına ait dağılım her iki grupta farklılık gösterse de regresyon analizi sonuçlarına göre bu farklılığın bağımsız bir risk oluşturmadığı gözlendi.Öğe Asymetric dimethyl arginine level as a cardiovascular risk factor in patiens with hyperthyroidism(Editura Acad Romane, 2012) Alçelik, Aytekin; Özhan, Hakan; Alçelik, Ayşegül Gürses; Yalçın, Sübhan; Aydın, YusufIntroduction. Thyroid diseases may cause endothelial dysfunction. Asymmetric dimethylarginine (ADMA) levels in patients with thyroid dysfunction were analyzed by few studies. Aim. We aimed to compare ADMA levels in patients with hyperthyroidism in a cohort free of cardiovascular risk associates such as diabetes or chronic renal failure with further comparison with healthy control subjects. Materials and methods. The study took place in Duzce University Medical Faculty, Cardiology and Internal Medicine Department during the year 2010. The study group consisted of patients with hyperthyroidism (overt and subclinical). The patients with renal failure, diabetes and severe hypertension were excluded. Results. Mean ADMA level was 1.04 +/- 0.43 mu mol/L in the hyperthyroid group and 0.68 +/- 0.21 mu mol/L in the control group (p <= 0.001). The comparison of patients with hyperthyroidism according to the etiology (three groups as Graves', multinodular goiter and thyroiditis) did not show any significant difference. Conclusion. Asymmetric dimethylarginine increases in patients with hyperthyroidism regardless of the etiology. The increase of ADMA levels is independent of known major cardiovascular risk factors. It may reflect the possible counteraction of endothelial dysfunction in the pathogenesis of atherosclerosis in hyperthyroidism beyond the known cardiovascular risk factors.Öğe Cardiac emergencies caused by honey ingestion: a single centre experience(B M J Publishing Group, 2004) Özhan, Hakan; Akdemir, Ramazan; Yazıcı, Mehmet; Gündüz, Hüseyin; Duran, Sadık; Uyan, CihangirAn unusual type of food poisoning is commonly seen in the Black Sea coast of Turkey attributable to andromedotoxin containing toxic honey ingestion. This study is a retrospective case series of 19 patients admitted to an emergency department in 2002, poisoned by "mad'' honey. All of the patients had the complaints of nausea, vomiting, sweating, dizziness, and weakness, several hours after ingesting "mad'' honey. Physical examination showed hypotension in 15 patients, sinus bradycardia in 15, and complete atrioventricular block (AVB) in four patients on admission. Two patients with bradycardia and two with AVB fell and injured their heads. Three of them presented with local haematoma. One patient had a 6 cm cut on his head without any neurological deficit and his cranial computed tomography imaging was normal. Hypotension and conduction disorders resolved with atropine treatment, resulting in complete recovery within 24 hours.Öğe A case of myocardial infarction with sumatriptan use(Springer, 2005) Erbilen, Enver; Özhan, Hakan; Akdemir, Ramazan; Yazıcı, MehmetSumatriptan is widely used in the treatment of acute attacks of cluster headache. It is a serotonin-1 (5HT-1) agonist. Several studies have reported an association between sumatriptan use and myocardial infarction, possibly due to the generalized vasoconstrictive nature of this agent. We report a 16-year-old male patient presenting with acute inferior myocardial infarction after sumatriptan use without any known risk factors of coronary artery disease.Öğe A case successfully treated giant ventricular septal rupture after acute myocardial infarction(Springer, 2007) Kaya, Ahmet; Kaya, Yasemin; Ordu, Serkan; Özkökeli, Mehmet; Özhan, Hakan; Dağlar, Bahadır; Yazıcı, MehmetVSR occurs in 1-3 % of all MI cases, usually within 2 weeks after infraction. 50-80% of partients die within the first week after the rupture unless they are surgically treated.Öğe Color M-mode regurgitant flow propagation velocity: A new echocardiographic method for grading of mitral regurgitation(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazıcı, Mehmet; Erbilen, Enver; Albayrak, Sinan; Ünlü, Hakan; Bulur, Serkan; Uyan, Cihangir; Arınç, HüseyinThe aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). This new transthoracic Doppler echocardiographic technique is easier and equally or more practical than qualitative and quantitative methods used to grade MR in patients both with normal and low left ventricular ejection fraction (LVEF). Color M-mode echocardiography allows resolution of regurgitant flow propagation along the echocardiography beam inside the left atrium. The characteristics of the velocity of this jet have not been studied in detail before. The present study compares the different qualitative and quantitative methods of MR grading with the RFPV. We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA) and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these 3 methods was determined. The mean RFPV for mild, moderate and severe MR were 26.4±7 cm/s, 43.3±7 cm/s and 60.3±7.3, respectively (p<0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1-64.3% for mild and 100-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC and RJA (p<0.0001, r=.87; p<0.0001, r=-.84; p<0.0001, r=.76, respectively). This results show that RFPV is a reliable and simple semi-quantitative new method that can be used for determining severity of MR.Öğe Color m-mode regurgitant flow propagation velocity: a new echocardiographic method for grading of mitral regurgitation(Blackwell Publishing, 2005) Akdemir, Ramazan; Özhan, Hakan; Bulur, Serkan; Ünlü, Hakan; Gündüz, Hüseyin; Arınç, Hüseyin; Uyan, CihangirPurpose: The aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). Methods: We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients, and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA), and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these three methods was determined. Results: The mean RFPV for mild, moderate, and severe MR were 26.4 +/- 7 cm/sec, 43.3 +/- 7 cm/sec, and 60.3 +/- 7.3 respectively (P < 0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1%-64.3% for mild and 100%-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC, and RJA (P < 0.0001, r = 0.87; P < 0.0001, r = -0.84, P < 0.0001, r = 0.76, respectively). Conclusion: This results show that RFPV is a reliable and simple semiquantitative new method that can be used for determining severity of MR.Öğe Color M-mode regurgitant flow propagation velocity: A new echocardiographic method for grading of mitral regurgitation(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazici, Mehmet; Erbilen, Enver; Albayrak, Sinan; Ünlü, HakanThe aim of this study was to evaluate the reliability of mitral regurgitation color M-mode regurgitant flow propagation velocity (RFPV) in grading mitral regurgitation (MR). This new transthoracic Doppler echocardiographic technique is easier and equally or more practical than qualitative and quantitative methods used to grade MR in patients both with normal and low left ventricular ejection fraction (LVEF). Color M-mode echocardiography allows resolution of regurgitant flow propagation along the echocardiography beam inside the left atrium. The characteristics of the velocity of this jet have not been studied in detail before. The present study compares the different qualitative and quantitative methods of MR grading with the RFPV. We prospectively examined 52 consecutive patients with grades of MR mild in 10 patients, moderate in 19 patients and severe in 23 patients with quantitative pulse Doppler echocardiography. MR was evaluated by vena contracta diameter (VCD), regurgitant jet area (RJA) and RFPV. These qualitative and quantitative methods were compared with the pulsed Doppler quantitative flow measurements and concordance of these 3 methods was determined. The mean RFPV for mild, moderate and severe MR were 26.4±7 cm/s, 43.3±7 cm/s and 60.3±7.3, respectively (p<0.001). RFPV is highly sensitive and moderately specific in differentiating mild and severe MR from other subgroups. Sensitivity and specificity were 92.1-64.3% for mild and 100-68.5% for severe MR, respectively. Significant correlation was observed between pulse Doppler quantitative grades, RFPV, VC and RJA (p<0.0001, r=.87; p<0.0001, r=-.84; p<0.0001, r=.76, respectively). This results show that RFPV is a reliable and simple semi-quantitative new method that can be used for determining severity of MR.Öğe Complete atrioventricular block in Becker muscular dystrophy(2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Yazıcı, Mehmet; Erbilen, , Enver; Uyan, Cihangir; İmirzalıoğlu, NecatÖğe Complete dissection of left anterior descending artery in a young woman after myocardial infarction(2012) Özhan, Hakan; Bulur, Serkan; Kayapinar, Osman; Türker, YasinSpontaneous coronary artery dissection (SCAD) is a rare clinical condition that causes acute coronary syndrome and sudden cardiac death. Herein, we report a case of left anterior descending artery dissection after myocardial infarction. On the third day of myocardial infarction after successful thrombolysis, the patient had recurrent chest pain without any ST wave elevation. She was referred to our clinic for coronary angiography which showed completely dissected left anterior descending (LAD) artery. She was referred to a tertiary centre with intravascular ultrasonography (IVUS) capability. Her control angiogram showed restored flow with only minimal dissection (so IVUS was not performed) in the mid LAD. The lesions in the distal and mid LAD were stented. The final angiogram showed TIMI-III flow. Percutaneous coronary intervention is the first choice of treatment in patients with single-vessel spontaneous coronary artery dissection with ongoing signs of ischemia.Öğe Constrictive pericarditis associated with right atrial and major venous thrombosis(Acta Cardiologica, 2004) Özhan, Hakan; Ökçün, Barış; Akdemir, RamazanRight atrial thrombi are very rare. Existence of right atrial thrombus with constrictive pericarditis is even rarer. Only few cases have been reported in the English literature. Here, we report an unusual case of constrictive pericarditis complicated with right atrial and major venous thrombi. The patient underwent a successful pericardiectomy procedure. He had no thrombi during the follow-up period.Öğe Coronary-subclavian steal syndrome presenting with chest pain and syncope(Acta Cardiologica, 2004) Akdemir, Ramazan; Özhan, Hakan; Tataroğlu, CenkThe present case is a 68-year-old patient with complaints of chest pain and syncopal attacks during physical activity of the left arm, for the last six months. He had a coronary artery bypass graft operation 10 years ago. Angiographic examination demonstrated total occlusion of the subdavian artery. The subdavian artery was stealing blood from the left anterior descending artery via the left internal mammary artery and from the brain via the left vertebral artery, leading to the diagnosis of subdavian artery steal syndrome; a rare cause of coronary and cerebral ischaemia.Öğe Correlation of plasma B-type natriuretic peptide with shunt severity in patients with atrial or ventricular septal defect(Springer, 2007) Özhan, Hakan; Albayrak, Sinan; Uzun, Hakan; Ordu, Serkan; Kaya, Ahmet; Yazıcı, MehmetThe goal of this study was to test the utility of bedside plasma concentration of B-type natriuretic peptide (BNP) assay as a screen for large shunts in pediatric patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs). Thirty-five children at a mean age of 70 +/- 129 weeks with ASD or VSD were included in the study. Nine patients had VSD and 26 had ASD. Plasma BNP values were compared with the Q(p)/Q(s) ratios derived from quantitative Doppler flow measurements. Mean BNP was 29 +/- 42 pg/ml, with a range between < 5 pg/ml and 208 pg/ml. Sixteen patients had Q(p)/Q(s) values > 1.5 and 19 had values < 1.5. The difference of mean BNP in these patient groups was statistically significant (45 +/- 56 vs 14 +/- 17, p = 0.03). BNP was positively correlated with shunt significance. Receiver operating characteristic curve analysis revealed a sensitivity of 69% and a specificity of 79% at a plasma BNP cut-off level of >= 20 pg/ml. Bedside measurement of BNP correlates with magnitude of ASD and VSD in children. BNP can provide information for the management of children with ASD or VSD. It can be used as part of the evaluation of a child with a preliminary diagnosis of a congenital defect.Öğe Diyabetik hastalarda egzersiz stres testinde hesaplanan Qt parametrelerine trimetazidinin etkisi(2005) Özhan, Hakan; Yazici, Mehmet; Albayrak, Sinan; Erbilen, Enver; Gülcan, Erim; Bulur, SerkanAmaç: Çalışmamızda normal epikardiyal koroner arterlere sahip tip II diyabetik hastalarda, egzersizle QT parametrelerindeki değişim ve buna trimetazidin tedavisinin etkisi araştırıldı.Gereç ve Yöntem: Çalışmaya koroner anjiografisi normal olan tip II diabetes mellitus (DM) tanısı almış 19 hasta (ortalama yaş; 52±15, erkek/kadın; 9/10) ve 20 sağlıklı birey (ortalama yaş; 51±11, erkek/kadın; 10/10) alındı. Tüm bireylere trimetazidinle 3 aylık tedavi öncesi ve sonrası Bruce protokolü ile semptom-sınırlı treadmill egzersiz testi (EST) uygulandı. Çalışmaya alınan bireylerin klinik, biyokimyasal, ekokardiyografik ve elektrokardiyografik değerleri kaydedildi. EST sırasında belli aralıklarla QT intervalleri, Bazzet formülüyle hıza göre düzeltililen QT dispersiyonu (QTcD) kaydedildi.Bulgular: EST öncesinde, hastaların QTcD değerleri kontrollerden yüksekti. Pik egzersizde ölçülen QTcD'de (pik QTcD) kontrol grubunda anlamlı değişiklik olmazken hasta grubunda belirgin bir artış (sırasıyla; 31.7±6.9 ms; p>0.05, 53.7±9.6 ms; p<0.001) saptandı. EST sonrası QTcD değerleri de azalmasına rağmen kontrollere göre yüksekti (43.4±8.1 ms; p<0.01) . Tedavi sonrasında yapılan EST öncesi, sonrası ve pik egzersizde hesaplanan QTcD değerleri azalmış ve kontrollerinkine benzer bulundu (sırasıyla; 34.7±6.9 ms, 35.9±8.9 ms, 33.9±7.3 ms, p>0.05). Bunlardan pik QTcD değerleri tedavi öncesine göre belirgin olarak azaldı (35.9±8.9 ms; p<0.005).Sonuç: Bu bulgular, tip II DM'li hastalarda QTcD'de özellikle egzersizle belirginleşen artışın ventriküler aritmiyi tetikleyebileceği ve dolayısıyla ani ölüm sıklığındaki artışla ilişkili olabileceğini düşündürmektedir. Trimetazidinle tedavi sonrası pik QTcD'deki belirgin azalma ilacın hücresel düzeydeki anti-iskemik etkisinden kaynaklanan dolaylı bir elektrofizyolojik sonuç olarak görülebilir.Öğe Diyalize giren hastalarda önyük azalmasının kapak yetersizliklerine etkisi(2005) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Akdemir, Ramazan; Oğuzhan, Abdurrahman; Uyan, CihangirAmaç: Diyalize giren kronik böbrek yetersizlikli hastaların vücut sıvısındaki artışa bağlı olarak ekokardiyografi sırasında kalp büyüklüğü ve sol ventrikül kitlesine ait ölçümler olduğundan farklı, kapak yetersizliğiyse olduğundan fazla olarak değerlendirilebilmektedir. Çalışmamızda diyalizle birlikte yapılan ultrafiltrasyonun, sol ventrikül ve sol atriyum büyüklüklerine, vena kava inferior çapları ve kollapsibilitesine etkisi ayrıca diyaliz öncesi kapak yetersizliği saptanan hastaların yetersizlik varlığı ve ciddiyetine olan etkisi incelendi. Gereç ve Yöntemler: Bu çalışmaya son dönem böbrek yetmezliği tanısı konmuş, hipervolemisi olan ve hemodiyalizle birlikte ultrafiltrasyon yapılacak 16’sı erkek, 14’ü kadın toplam 30 hasta alındı. Diyalizle birlikte yapılan ultrafiltrasyon öncesi ve sonrası ekokardiyografi ile sol ventrikül diyastolik-sistolik genişlikleri, septum ve arka duvar diyastolik-sistolik kalınlıkları, sol atriyum genişliği, aort çapı ve varsa perikardiyal sıvı ölçümleri yapıldı. Mitral, aort, triküspid ve pulmoner kapak fonksiyonları, varsa kaçak akımları 4 üzerinden derecelendirildi. Vena kava inferior inspiratuar ve ekspiratuar çapları ölçülüp, vena kava inferior çökebilirlik indeksi hesaplandı. Bulgular: Hemodiyaliz sonrası sol atriyum büyüklüğünde, sol ventrikül diyastolik ve sistolik genişliklerinde anlamlı azalma oldu. Hastaların mitral ve triküspid yetersizliği ciddiyetinde belirgin azalma olurken, aort ve pulmoner yetersizlikleri ciddiyetindeyse belirgin azalma saptanmadı. Vena kava inferior inspiryum ve ekspiryumdaki çaplarında anlamlı küçülme, çökebilirliğinde anlamlı artış saptandı. Sonuç: Diyalizde sıvı azaltılmasına bağlı hemodinamik ve ekokardiyografik parametrelerde anlamlı değişiklikler olmaktadır. Özellikle kapak yetersizliklerinin varlığında ve ciddiyetinde azalma olmaktadır.Öğe The effect of decreasing preload on valvular regurgitation in patients undergoing dialysis(Turkiye Klinikleri, 2005) Arinç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Akdemir, Ramazan; O?uzhan, Abdurrahman; Uyan, CihangirObjective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis. Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated. Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted. Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure. Copyright © 2005 by Türkiye Klinikleri.Öğe Effect of dipping status on QRS morphology in patients with hypertension(2010) Erden, Ismail; Erden, Emine Cakcak; Özhan, Hakan; Yalçin, Subhan; Basar, Cengiz; Aydin, MesutBACKGROUND: Prolongation of the QRS complex on the surface electrocardiogram (ECG) has been shown to be predictive of cardiovascular outcomes in selected populations. A 'nondipper' blood pressure (BP) profile is currently regarded as a risk factor in its own right for cardiovascular events and target organ damage. The predictive value of ECG parameters in hypertensives with nondipper profile has not been established. MethodS: A total of 750 consecutive patients with hypertension who had been evaluated with ambulatory BP monitoring were screened for this study. One hundred and thirty-six patients who had fulfilled the inclusion and exclusion criteria were included in the final analysis. Dipper and nondipper patterns were detected and the maximum QRS duration (QRSd) measured on a 12-lead ECG was recorded. RESULTS: There were 70 nondipper and 66 dipper hypertensives. There was no significant difference between the two groups regarding the daytime systolic and diastolic mean BPs, number of medications taken, and the proportion of each class of antihypertensive medications. Other variables were similar between the two groups. QRSd was significantly higher in nondippers than dippers (P=0.006). Correlation analysis revealed that the systolic BP fall at night was inversely and significantly related with QRSd (r=-0.482, P<0.001). Regression analysis further showed that the systolic BP fall at night and age were independent correlates of QRSd. Conclusion: QRSd on the standard-surface 12-lead ECG was increased in patients with nondipper pattern and furthermore the systolic BP fall at night was independent correlate of QRSd in patients with hypertension. Copyright © 2010 Lippincott Williams & Wilkins.
