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Öğe Absence of posterior mitral leaflet with secundum atrial septal defect(Elsevier Science Inc, 2010) Heper, Gülümser; Yetkin, Ertan; Şenen, KubilayA rare case of a 54-year-old woman with absence of congenital posterior mitral leaflet, moderate mitral insufficiency, and large secundum-type atrial septal defect is reported. Two-dimensional color Doppler and transesophageal echocardiography revealed complete absence of the posterior mitral leaflet, a thick muscular formation replacing the posterior leaflet, a 3.3-cm secundum type atrial septal defect, and severe pulmonary hypertension. This report describes the rare case of congenital absence of posterior mitral leaflet associated with secundum type large atrial septal defect in a middle-age woman. (Ann Thorac Surg 2010;90:2055-7) (C) 2010 by The Society of Thoracic SurgeonsÖğe Cardiac findings in Behcet's patients(Wiley, 2010) Heper, Gülümser; Polat, Mualla; Yetkin, Ertan; Şenen, KubilayBehcet's disease is a chronic multi-system inflammatory disorder and the severity and clinical manifestations of Behcet's patients may show geographic variation. We aimed to detect the cardiac findings in 30 Behcet's patients and compare them with the normal population (n = 29). We used color-doppler echocardiography and transesophageal echocardiography in combination. We calculated manually QT intervals and QT dispersion (QTd) from twelve-lead ECG recordings. There was no E/A inversion and coronary ischemia in all patients or control group. The E velocity difference between groups was not significant. The mean A velocity was significantly lower in Behcet's patients than normal group. The mean DT was 154.4 +/- 5.8 msec in Behcet's patients and 122.59 +/- 0.96 msec in control group (P < 0.0001). The mean IVRT was 75.66 +/- 1.36 msec in Behcet's patients and 69.1 +/- 0.55 msec in control group (P < 0.0001). There was no QTc time difference between the Behcet's patients and the control group. The mean QT dispersion (QTd) interval was 45.46 +/- 2.65 msec in Behcet's patients and 31.83 +/- 1.23 msec in control group (P < 0.0001). Atrial septal aneurysm, mitral valve prolapse and insufficiency, tricuspid valve insufficieny, and pulmonary hypertension frequencies in Behcet's patients were significantly higher than in the control group. We concluded that Behcet's cardiac involvement may effect cardiac structure and cause diastolic dysfunction, electrical instability and structural abnormalities. We also concluded that cardiac involvement in Behcet's disease may be specific for this geographic area.Öğe Mean platelet volume: Controversies in coronary artery disease and acute coronary syndrome(Elsevier Ireland Ltd, 2010) Yetkin, Ertan; Heper, Gülümser; Şenen, KubilayDear Editor, We have read the article published by De Luca et al. [1] with great interest. In their report, they have investigated the possible association of mean platelet volume (MPV) with coronary artery disease (CAD) in a very large consecutive cohort of patients undergoing coronary angiography. Briefly, they have used the number of diseased vessels as a measure of extent of CAD and carotid intima-media thickness to assess the relation between atherosclerosis and MPV. It has been concluded out that MPV is not related to the extent of CAD, carotid intima-media thickness and cannot be considered as a risk factor for CAD. Additionally no relationship has been observed between MPV and platelet aggregation in a subgroup of patients.Öğe Plasma viscosity and mean platelet volume in patients undergoing coronary angiography(Ios Press, 2010) Şenen, Kubilay; Topal, Ergün; Kılınç, Evren; ten Cate, Hugo; Tek, İbrahim; Yetkin, ErtanBackground: Markers of platelet activation and haemorrheological indices have been demonstrated to play a role in the pathophysiology of atherosclerosis and cardiovascular events. In this study, we aimed at investigate the association between plasma viscosity and platelet indices in patients undergoing coronary angiography. Materials and methods: Three hundred and eighty four consecutive patients scheduled to undergo coronary angiography were included in the study. Prior to coronary angiography, blood samples were withdrawn to determine routine biochemical markers, blood cell analyses and viscosity measurements. According to the results of coronary angiography, patients were classified either in a subgroup with coronary artery disease (CAD; 1 or more stenoses > 50%) or normal coronary arteries (NCA; no stenoses or < 50%). Results: There was a statistically significant correlation between plasma viscosity and mean platelet volume levels in all patients undergoing coronary angiography (r = 0.199, p < 0.001). Additionally, when correlation analysis was performed within each group, plasma viscosity significantly correlated with MPV both in patients with CAD (r = 0.18, p = 0.004) and in patients with NCAs (r = 0.272, p = 0.002). Linear regression analysis revealed that plasma viscosity was positively associated with MPV while platelet number was inversely but significantly associated with MPV. Conclusion: We have shown for the first time that MPV correlates with plasma viscosity in patients undergoing coronary angiography, suggesting a relation with plasma proteins and activation of circulating platelets or peripheral consumption of platelets. To evaluate this relation further controlled studies also in patients with acute coronary syndromes are warranted.Öğe Plasminogen activator inhibitor-1 levels in patients with primary varicose vein(Edizioni Minerva Medica, 2012) Ergüzel, Nuri; Yetkin, Ertan; Erdem, Gülnur; Erdil, Nevzat; Yetkin, Gülay İmadoğlu; Heper, Gülümser; Şenen, KubilayAim. Plasmin is involved in extracellular matrix remodeling by activating some matrix metallo-proteinases and degrading extracellular matrix; therefore component of fibrinolytic system such as tissue plasminogen activator and plasminogen activators inhibitors (PAI-1) might have a role in the pathogenesis of vascular remodeling. In our study we aimed to investigate the levels of PAI-1 levels in patients with primary varicose veins (VV) and in their age and gender matched control group. Methods. Forty-one consecutive patients with peripheral varicose veins and 37 healthy age and gender-matched control subjects were included in the study from the outpatient cardiology and cardiovascular surgery clinic. Study population consisted of 41 consecutive patients who met the inclusion criteria and diagnosed as having class II primary VV according to CEAP classification. Routine biochemical and hematological analysis were performed in all patients and control subjects. Results. Plasma levels of PAI-1 were found to be lower in patients than those in control subjects (5.19 +/- 2.2 ng/mL vs. 6.47 +/- 2.6 ng/mL, P=0.025). Logistic regression analysis revealed that only the plasma levels of PAI-1 were found to be independently but inversely associated with the presence of primary VVs (Odds ratio: 0.80 CI: 0.64-0.99, P=0.04). Conclusion. We have shown that PAI-1 levels are significantly decreased in patients with pVVs and it has an independent association with the presence of pVVs. However, its exact relation and role via matrix metlalloproteinases on the pathogenesis of the disease remains to be elucidated in further studies. [Int Angiol 2012;31:176-80]
