PubMed Health⌕ Search

Biomedical subjects

A Altun

Publications and source records attributed to A Altun.

At least 19 recordsLinked to original sources

Relationship between insulin resistance assessed by HOMA-IR and exercise test variables in asymptomatic middle-aged patients with type 2 diabetes.

UNLABELLED: We investigated the relationship between index of insulin resistance (IR) and exercise test variables in middle-aged asymptomatic patients with Type 2 diabetes. METHODS: 90 patients (48 men, 42 women; age: 49 +/- 6 yr) were included in the study. We used homeostasis model assessment for IR (HOMA-IR) index as index of IR. All patients were subjected to treadmill exercise test. Four subjects were tested positive (4.4%). Study patients were separated into three groups: group I (no.=26) HOMA-IR index <2.24; group II (no.=26) index 2.24-3.59; group III (no.=38) index >3.59. RESULTS: group I had less frequency of cardiovascular risk factors than group II and III (p=0.001). Systolic blood pressure baseline as well as peak exercise values, were higher in group III than in group I and II (p=0.048 vs p=0.01, respectively). Higher total exercise time and peak workload were found in group I than group II and III (p=0.04). The recovery of heart rate (delta HR(pr)) was similar among the study groups. We found significant negative correlations between HOMA-IR and total exercise time and peak workload. In addition we found significant negative correlations between age vs chronotrophic index (CI), delta HR(pr), and peak workload. There were also similar negative correlations between duration of diabetes vs CI and delta HR(pr). CONCLUSIONS: IR is associated with a variety of cardiovascular risk factors. Some exercise test variables point out changes of autonomic tone during exercise in elevated IR group. Negative correlation between HOMA-IR and peak exercise capacity (METs) may well confirm increased mortality in hyperinsulinemia.

Adult↗

Decreased serum osteoprotegerin levels in patients with cardiac syndrome X.

UNLABELLED: Receptor activator of nuclear factor KB (RANK) and osteoprotegerin (OPG) represent the ligand and decoy receptor, respectively, of a pleiotropic cytokine system that regulates bone metabolism and vascular biology. Several studies supported systemic microvascular abnormalities in patients with cardiac syndrome X (CSX). This study investigates serum OPG levels in healthy obese subjects and healthy lean controls affected by cardiac syndrome X. METHODS: We compared the OPG levels in 8 patients with cardiac syndrome X [2 males, 6 females; age: 46+/-6 yr; body mass index (BMI): 30+/-5 kg/m2] with 24 obese subjects (8 males, 16 females; age: 38+/-5 yr; BMI: 35+/-5 kg/m2) and 15 healthy lean controls (6 males, 9 females; age: 36+/-5 yr; BMI: 23+/-2 kg/m2; BMI<25kg/m2). RESULTS: Serum OPG levels in patients with cardiac syndrome X were lower than those in obese subjects and lean controls (11.45+/-8.36 pg/ml, 14.78+/-8.22 pg/ml, 19.24+/-6.96 pg/ml, respectively, cardiac syndrome X vs lean controls, p=0.039). CONCLUSIONS: Serum OPG levels are lower in patients with CSX. Further studies on the mechanisms of OPG in microangiopathy may help to evaluate the OPG system role as a marker for disease activity, prognosis and response to therapy in cardiovascular diseases.

Adult↗

Thermal, vibrational and EPR studies of Cu(II) bromide bis(p-methylaniline) and bis(m-methylaniline) complexes.

[CuBr(2)(pMA)(2)] and [CuBr(2)(mMA)(2)] complexes (pMA: p-methylaniline, mMA: m-methylaniline) have been prepared and characterized by elemental analyses, thermogravimetric analyses, magnetic moment measurements, and IR, Raman and EPR spectroscopic studies. Coordination effects on the vibrational spectra of the ligands have been investigated. The room temperature EPR spectra of the complexes and their simulated spectra are also discussed in detail. The vibrational and EPR spectral studies suggest that the coordination sphere around Cu(II) consist of a distorted tetragonal structure.

Aniline Compounds↗

Thermal studies and vibrational analyses of m-methylaniline complexes of Zn(II), Cd(II) and Hg(II) bromides.

The complexes having the MBr(2)L(2) (M: Zn, Cd and Hg; L: m-methylaniline) formulae have been prepared and characterized by their elemental analyses, thermogravimetric analyses, IR and Raman spectral studies. IR and Raman bands of the complexes have been assigned as compared with the free ligand. Coordination effects on the internal modes of m-methylaniline have been discussed. Vibrational spectra propose that the [ZnBr(2)(mMA)(2)] complex is in a tetrahedral environment around Zn(II) ion with C(2v) symmetry whereas Cd(II) and Hg(II) complexes have 5-coordinate polymeric bromide bridged structures.

Aniline Compounds↗

Intermittent mode reversion to VOO of a dual chamber pacemaker model.

This report describes an asymptomatic patient with a DDDR pacemaker system (Inos Cls, Biotronik) that showed intermittent mode reversion to VOO and sometimes to VVI without a detectable source of electromagnetic interference and oversensing. Patients with this Biotronik model should be carefully assessed along with a surface ECG before placing the programming head.

Cardiac Pacing, Artificial↗

[Melatonin and the cardiovascular system].

In recent years, melatonin, the most prominent product of the pineal gland, has evoked considerable interest. In this report we reviewed the effects of melatonin on cardiovascular system.

Antioxidants↗

[Quantitative ultrasonic myocardial texture analysis of the diabetic heart].

OBJECTIVE: Contraction and relaxation of the heart cause decrease and increase in myocardial video intensity (MVI) recorded from echocardiographic images, respectively. The present study was planned to compare this physiological cyclic variations of MVI in patients with type 1 diabetes mellitus and healthy subjects. METHODS: For this purpose, standard echocardiographic examination was performed to 18 young patients (age 23.2+6.4; range: 15-37 years) with insulin dependent type 1 diabetes mellitus (diabetes duration: 7.8+5.6; range: 1-17 years) and 14 age and sex matched controls. In all subjects, end-diastolic and end-systolic 2D echocardiographic images of 3 consecutive beats that had been recorded on videotapes were digitized. The quantitative analysis of digitized imaging was performed with the help of a calibrated digitization system in order to calculate the septum and the posterior wall textural parameters. The cyclic variation index (CVI) of the mean gray level (MGL) was calculated according the formula: (MGL dias- MGL diast x 100. RESULTS: Among the groups, left ventricular diastolic dimension-index, fractional shortening, E/A ratio, and isovolumic relaxation time showed no statistically significant differences, while septum and (8.3+1.1 vs. 7.3+0.9 mm; p=0.016) and posterior wall thickness (8+0.6 vs. 6.8+1.1mm; p=0.004) and E-deceleration time (167+23 vs. 140=19 msec.; p=0.003) were significantly higher in diabetics. The diabetic patients showed significantly lower CVI both for septum (18.2+11.5% vs. 39.3+11.5%; p=0.0001) and posterior wall (16.4+16% vs. 40.5+9.2%; p=0.0001), respectively. CONCLUSIONS: Altered videoensitometric parameters possibly represent a preclinical alteration, conceivably related to the myocardial collagen content increase, which does not necessarily indicate an actual disease but may be considered an early marker of the histopathologic findings of diabetic cardiomyopathy.

Adolescent↗

The effect of aminophylline administration on 99mTc-MIBI lung and liver uptake in patients with or without myocardial ischemia.

This work aims to analyze the influence of aminophylline in the pulmonary and hepatic uptake of 99mTc-methoxyisobutil isonitrile (99mTc-MIBI). 72 patients were studied and a myocardial perfusion (MPS) single photon emission computed tomography (SPECT) with 99mTc-MIBI was carried out after the administration of dipyridamole. According to the MPS, the patients were classified into 2 groups: Group A: 45 patients without myocardial ischemia and Group B: 27 with ischemia. Each group was divided into 2 subgroups according to whether they had (I) or had not (II) received intravenous aminophylline. The dipyridamole was administered for 4 minutes at a dose of 0.56 mg/kg. If the patients presented any complication, intravenous aminophylline was administered. At 30 minutes p.i., planar images were obtained during a scintigraphy in the interior projection after the injection of 99mTc-MIBI. The regions of interest in the heart, hepatic cupula, and most active area of the left lung were outlines and the activity rates were calculated: lung/heart (LHR) and liver/heart (LivHR). No statistically significant differences were observed in the uptake of 99mTc-MIBI between subgroups I and II. However, the LHR rates in both subgroups were significantly lower in the patients with normal myocardial perfusion than in the patients with ischemia: LHR group A1 vs B1: 0. 32 +/- 0.08 vs 0.36 +/- 0.06, p = 0.03; group AII vs BII 0.31 +/- 0. 07 vs 0.35 +/- 0.07, p = 0.01 respectively. In conclusion, the administration of aminophylline, after the infusion of dipyridamole for MPS, does not modify the pulmonary or hepatic uptake of 99mTc-MIBI.

Adult↗

The prevalence of hereditary thrombophilia in the Trakya region of Turkey.

The prevalences of deficiencies in antithrombin III (AT III), protein C (PC), protein S (PS) and in the activated protein C (APC) resistance in the thrombotic population of the Trakya region, Turkey were investigated. 37 patients with venous thrombosis (VT) and 17 patients with arterial thrombosis (ArT) were included in this study. The mean ages of the patients with VT and ArT were 46 years (range 20-70) and 38 years (range 32-40), respectively. The activity of AT III was measured by commercially available immuno-turbidimetric assay. The activities of PC and PS were determined by coagulometric assay. The APC resistance was measured using a modified APTT-based clotting assay. Among the VT patients, there were 2 cases (5.4%) with AT III, 5 (13.51%) with PC deficiency, 5 (13.51%) with PS deficiency and 2 (5.4%) with APC resistance. In the ArT patient group, there was 1 patient (5.88%) with AT III, 3 (17.64%) with PC deficiency, 1 (5.88%) with PS deficiency and no APC resistant patients, while there was one (2.08%) with PC deficiency and one (2.08%) with APC resistance in the control group (49 persons, mean age 41 years). The relative risk of thrombosis (odds ratio) was 1.7 in the deficiency of PC and 5.6 in the deficiency of PS. The data presented suggests that the prevalences of AT III, PC and PS deficiencies causing thrombophilia in the Trakya region of Turkey are higher than in other reported studies while the APC resistance is lower than in others. Further studies including more patients would be required to clarify these discrepancies.

Activated Protein C Resistance↗

Antianginal and anti-ischemic effects of nisoldipine and ramipril in patients with syndrome X.

BACKGROUND: Syndrome X is defined as typical angina pectoris, positive treadmill exercise test, negative intravenous ergonovine test, and angiographically normal coronary arteries. HYPOTHESIS: In the present study, we investigated the anti-ischemic and antianginal effects of nisoldipine and ramipril in patients with syndrome X. METHODS: After 2 weeks of the first wash-out period, 18 patients (7 men, 11 women, age 46 +/- 10 years) were given nisoldipine (NIS) 5 mg twice daily for 4 weeks, and after 2 weeks of the second wash-out period, the same patients were given ramipril (RAM) 2.5 mg once daily for 4 weeks. A treadmill exercise test with modified Bruce protocol was performed at the end of each period. RESULTS: The time to angina in exercise (607 +/- 115 s-650 +/- 117 s, p = 0.006, vs. 630 +/- 114 s-660 +/- 123 s, p = 0.02), total exercise time (612 +/- 110 s-656 +/- 114 s, p = 0.0008, vs. 630 +/- 114 s-660 +/- 123 s, p = 0.02), and maximum MET value (11.09 +/- 2.08-11.86 +/- 2.04, p = 0.0016, vs. 11.42 +/- 2.09-12.2 +/- 2.26, p = 0.01) were increased significantly with both therapy modalities. The time to 1 mm ST-segment depression (123 +/- 93 s-220 +/- 172 s, p = 0.002) was increased significantly with NIS therapy. The time to ST-segment recovery (434 +/- 268 s-330 +/- 233 s, p = 0.016 vs. 443 +/- 289 s-370 +/- 278 s, p = 0.012), the frequency of anginal attacks per week (1.27 +/- 1.4-0 +/- 0.38, p = 0.005, vs. 1 +/- 1.32-0.33 +/- 0.59, p = 0.028), and the need for sublingual nitroglycerin (1.16 +/- 1.29-0.11 +/- 0.32, p = 0.005, vs. 0.94 +/- 1.16-0.27 +/- 0.57, p = 0.012) were decreased significantly with both drugs. CONCLUSION: We observed that 10 mg daily NIS and 2.5 mg daily RAM have similar anti-ischemic and antianginal effects in patients with syndrome X.

Angiotensin-Converting Enzyme Inhibitors↗

Heart failure during first inferior acute myocardial infarction.

BACKGROUND: Inferior acute myocardial infarctions (AMI) have better in-hospital prognosis than do anterior AMI. Authors of several studies reported that patients with inferior AMI complicated by atrioventricular block, concomitant precordial ST-segment depression and involvement of right ventricle have larger infarctions and a worse prognoses than do patients without these features. OBJECTIVE: To analyse the incidence, clinical course and in-hospital prognosis of patients with heart failure and first inferior AMI. METHODS: We analysed in 257 consecutive patients with first inferior AMI who had been admitted to the coronary care unit during January 1991 and March 1995. The clinical and electrocardiographic characteristics, as well as the morbidities and in-hospital mortalities, of groups of patients with and without heart failure during inferior AMI were compared. RESULTS: Symptoms and signs of heart failure were noted for 49 patients (19%). We found that patients who had suffered heart failure during inferior AMI were older (62.1 +/- 9.86 versus 58.78 +/- 10.58 years, P < 0.05) than those who had not suffered heart failure. There was no significant difference between patients' sex, history of diabetes mellitus, hypertension, smoking status, thrombolytic therapy, involvement of right ventricle and QRS score for these two groups. We found a greater prevalence of ST-segment depression (ST-segment depression > or = 1 mV in more than one precordial lead with maximal ST-segment depression in leads V4-V6) of V4-V6 precordial leads (57 versus 26%, P = 0.00002) and a lesser prevalence of no ST-segment depression (ST-segment depression < 0.1 mV in each precordial lead; 14 versus 38%, P = 0.001) among patients who had suffered heart failure. We found greater incidences of serious ventricular arrhythmias (53 versus 26, P = 0.0002) and ventricular tachycardiafibrillation (16 versus 7%, P = 0.03) among patients who had suffered heart failure than we did among those who had not. Third-degree atrioventricular block was more often found in patients who had suffered heart failure (23 versus 12%, P = 0.07) but this difference was not statistically significant. We found that the in-hospital mortality among patients who had suffered heart failure was much higher than that among those who had not (24.5 versus 3.8%, P = 0.000001). CONCLUSION: We found that heart failure occurs primarily in old patients, and in those with precordial ST-segment depression, especially in leads V4-V6. The patients who suffer heart failure have worse in-hospital prognosis due to serious ventricular arrhythmias and cardiogenic shock.

Acute Disease↗

Effect of aminophylline in patients with atropine-resistant late advanced atrioventricular block during acute inferior myocardial infarction.

BACKGROUND: Advanced atrioventricular (AV) block is a frequent complication in patients with acute inferior myocardial infarction (AIMI). This conduction abnormality is associated with narrow QRS complex in conducted or junctional escape beats, suggesting that the site of block is the AV node; however, its pathophysiology has not been properly established. HYPOTHESIS: This study investigated the effect of aminophylline in eight patients (5 men, 3 women, age range 51 to 78 years, mean 67.5 +/- 8.8 years) with atropine-resistant late advanced AV block during AIMI. METHODS: Advanced AV block was late in appearance in all patients, starting 2 to 5 days after AIMI, and consisted of second-degree Mobitz II type in two patients and of complete AV block in six patients; all patients had narrow QRS complexes. Before aminophylline administration, all patients had a temporary pacemaker installed which was switched off throughout the study. They were given intravenous atropine (1 mg) that was found to be ineffective. One-half h after atropine, the first aminophylline injection (240 mg) was given intravenously over 10 min. One h following the first injection, a second aminophylline dose (240 mg) was administered. Electrocardiographic rhythm strips were obtained before and after drug administration, and the type of AV block and atrial and ventricular rate were noted. RESULTS: Aminophylline restored 1:1 conduction with first-degree AV block in six patients, Mobitz I AV block in one patient, and normal sinus rhythm in one patient. Mean atrial and ventricular rates before aminophylline were 104 +/- 16 beats/min and 57 +/- 9 beats/min, respectively, and after drug administration 95 +/- 25 beats/min and 89 +/- 17 beats/min, respectively, (p = 0.012). CONCLUSION: These results indicate that aminophylline improves AV conduction in atropine-resistant late advanced AV block complicating AIMI.

Aged↗