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Öğe Bone mineral density: A potential determinant of atherosclerotic plaque morphology in established coronary artery disease?(Elsevier Ireland Ltd, 2011) Sivri, Nasir; Yalta, Tülin; Yalta, Kenan; Yetkin, Ertan; Aksoy, YükselThe potential association between low bone mineral density (BMD) and coronary artery disease (CAD) has drawn particular attention in the recent years, but has yet remained to be thoroughly established. In their recently published article, Beer S. et al. investigated the association between low BMD and angiographically determined CAD in male patients [1]. The authors concluded that neither osteoporosis nor osteopenia is independently associated with the presence of CAD [1]. Likewise, in a previous study comprising postmenopausal women, neither CAD nor cardiovascular risk factors were found to be associated with low BMD [2]. However, as described below, low BMD may be closely associated with ectopic calcification in various tissues including heart valves, coronary arteries and atherosclerotic plaques etc. Extensive calcification of plaques associated with low BMD may particularly elicit propensity to a more stable plaque morphology possibly along with a reduced incidence of acute coronary syndromes (ACSs) in patients with established CAD and osteal pathologies.Öğe Chronotropic incompetence: An obscure cause of heart failure symptoms in survivors of critical diseases?(Elsevier Ireland Ltd, 2011) Yalta, Kenan; Yalta, Tülin; Sivri, Nasir; Aksoy, Yüksel; Yetkin, ErtanIn their recently published article, Ruiz-Bailén M et al. prospectively investigated the course of myocardial dysfunction that had developed in a group of critically ill patients, and comment on different aspects of reversible myocardial dysfunction in a critically ill patient (RMDCIP) [1]. They concluded from their study findings that myocardial segmental contractile dysfunction in response to stress may persist in some patients surviving RMDCIP indicating that myocardial dysfunction may not be totally reversible in these patients [1]. We agree with the authors on the concept of residual myocardial dysfunction in the survivors of RMDCIP. Residual myocardial contractile dysfunction may be totally asymptomatic or may elicit a variety of heart failure symptoms and signs in these patients. However, as described later, chronotropic incompetence associated with a related critical disease may also occur during the disease course, and may indefinitely persist to some degree potentially contributing to heart failure symptoms and signs in a portion of survivors of critical diseases.Öğe Copeptin (C-terminal provasopressin): A promising marker of arrhythmogenesis in arrhythmia prone subjects?(Elsevier Ireland Ltd, 2011) Yalta, Kenan; Sivri, Nasir; Yalta, Tülin; Geyik, Bilal; Aksoy, Yüksel; Yetkin, ErtanNeurohormones have drawn particular attention in the recent years possibly due to their potential diagnostic and prognostic values in a variety of clinical conditions including congestive heart failure (CHF), acute myocardial infarction (AMI), etc. Among neurohormones, arginine vasopressin (AVP) has been known to be secreted by hypothalamus in response to hypovolemia and increased plasma osmolality [1], and was also demonstrated to be a marker of the presence and severity of CHF [2]. However as described below, the potential association between AVP system and arrhythmogenesis may also confer some important therapeutic and prognostic implications in arrhthmia-prone patients. In the recent years, due to the instability and rapid clerance [1], the clinical utility of AVP has been gradually abandoned to some degree, and copeptin (CP), another novel neurohormone of the AVP system, has come into use in the clinical practice.Öğe Incremental effects of restless legs syndrome on nocturnal blood pressure in hypertensive patients and normotensive individuals(2012) Erden, Emine C.; Erden, Ismail; Türker, Yasin; Sivri, Nasir; Dikici, Süber; Ozşahin, MustafaBackground: Few studies have evaluated the role of restless legs syndrome (RLS) in the development of nondipping 24 h blood pressure (BP) patterning/sleep-time hypertension, which has been shown to be an independent predictor of cardiovascular risk. These were indirect studies that had reported the relation between BP and RLS attacks during polysomnographic investigations in the lab. The aim of the present study was to assess the relationship between RLS, which was diagnosed clinically, and night-time BP patterns in a relatively large young cohort who had not been treated before. Patients and methods: After applying the exclusion criteria, this cross-sectional study included 230 consecutive patients with never-treated hypertension who presented to our institution for initial evaluation of hypertension. RLS was assessed using a self-administered questionnaire based on the International Restless Legs Study Group criteria. The questions on RLS were completed by 214 patients and ambulatory BP monitoring was carried out for all patients. Results: In the study group, 133 patients were diagnosed as hypertensive (53.4% nondippings) and 81 patients as normotensives (54.3% nondippings). RLS was present in 61 patients (28.5%) in the total sample. The prevalence of RLS, overall, was significantly higher in nondippings compared with dippings (34.7 vs. 21.2%, respectively; P=0.028). Logistic regression analysis showed that the RLS is an independent determinant for both hypertension (odds ratio=0.43, 95% confidence interval=0.21-0.83; P=0.013) and the nondipping BP patterns (odds ratio=1.96, 95% confidence interval=1.05-3.67; P=0.035). Conclusion: We have shown that clinically diagnosed RLS was associated with the nondipping pattern, which has been shown to be an independent predictor of cardiovascular risk. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
