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Biomedical subjects

Cem Barcin

Publications and source records attributed to Cem Barcin.

16 recordsLinked to original sources
PubMed2006

Negative association of endothelial nitric oxide gene polymorphism with hypertension in Turkish patients: effect of ecNOS polymorphism on left ventricular hypertrophy.

BACKGROUND: Endothelial nitric oxide synthase produces nitric oxide which is involved in many physiologic regulatory functions. Variable number of tandem repeats in intron 4 of endothelial nitric oxide synthase gene are reported to be associated with blood pressure regulation. Nitric oxide is involved in regulation of cardiomyocyte genes but it is not known If endothelial nitric oxide synthase 4 gene polymorphisms are related with left ventricular hypertrophy. We studied endothelial nitric oxide synthase 4a/b allele status in hypertensive and normotensive patients and echocardiographic parameters in a subgroup of hypertensive group. METHODS: We performed a case-control study involving 110 Turkish hypertensive patients and 87 controls. All subjects were genotyped for endothelial nitric oxide synthase 4a/b polymorphism. Echocardiographic measurements were obtained in 94 of the hypertensive patients. RESULTS: Endothelial nitric oxide synthase 4a/b genotype frequencies were 6.4%, 23.6%, 70% in hypertensives and 1.1%, 18.4%, 80.5% in controls for a/a, a/b, b/b, respectively. Left ventricular dimensions, mass and diastolic indices were not different across endothelial nitric oxide synthase 4 genotypes. Patients with 4a/a genotype had higher interventricular septal thickness than the other group; 14.83(1.6), 11.91(1.51), 12.21(1.56) for a/a, a/b, b/b, respectively and p = 0.0001. CONCLUSION: Endothelial nitric oxide synthase 4a/b gene polymorphism is not associated with hypertension in Turkish patients. 4a/a genotype was associated with higher interventricular septal thickness in hypertensive patients.

Case-Control Studies↗
PubMed2006

Safety of gadodiamide mixed with a small quantity of iohexol in patients with impaired renal function undergoing coronary angiography.

Gadolinium-based contrast agents can be used in diagnostic and interventional angiography, and are safe in recommended doses in patients with impaired renal function, but the image quality is usually unsatisfactory. The objective of the present study is to evaluate the safety of gadolinium mixed with a small quantity of iodine-based contrast agent and the image quality of this mixture in patients with renal insufficiency undergoing diagnostic coronary angiography. Forty-two patients with baseline creatinine level>1.5 mg/dl were randomized into gadolinium or iodine groups. In the gadolinium group gadodiamide was mixed with 1:3 iohexole and in the iodine group only this agent was used as contrast material. Peak creatinine levels 48-72 h after the procedure were measured. The primary end point was the development of contrast-induced nephropathy (CIN), defined as >25% increase of baseline creatinine levels, and the secondary end points were absolute and relative changes in baseline creatinine levels. Total contrast volumes used were not different between groups (57+/-11 ml in gadolinium and 55+/-10 ml in iodine; P=0.68). Mean creatinine level did not increase significantly in the gadolinium group (from 1.9+/-0.3 to 1.9+/-0.4 mg/dl; P=0.06), but did in the iodine group (from 2.0+/-0.4 to 2.3+/-0.5 mg/dl; P=0.001). No patient had CIN in the gadolinium group whereas 5 (23%) patients had this phenomenon in the iodine group (P=0.048). Contrast regimen was very well tolerated in the gadolinium group, with only transient headache in two patients. Gadodiamide mixed with a small quantity of iohexol is safe in patients with azotemia undergoing diagnostic coronary angiography. The image qualities obtained with this combination are also satisfactory in all of the cases. Further evaluation of the safety of this technique is warranted, especially in other types of diagnostic and interventional procedures in which a higher amount of contrast dye is needed.

Aged↗
PubMed2006

Effects of non-heavy smoking on high-density lipoprotein cholesterol in healthy Turkish young men.

OBJECTIVE: Decreased effects of smoking on serum high-density lipoprotein cholesterol (HDL-c) were demonstrated in subjects smoking more than 20 cigarettes a day. We aimed to evaluate the effects of non-heavy smoking (< or =20 cigarettes a day) on HDL-c in young, healthy men who are similar in terms of age, physical activity and diet. METHODS: A total of 1012 male students between 19 and 25 years old (21.4 +/- 1.5) in a military college who do not smoke or smoking < or =20 cigarettes a day were enrolled. Subjects who were consuming alcohol were excluded. Smoking levels (0: nonsmoker, 1: 1-5 cigarettes, 2: 6-10 cigarettes, 3:11-20 cigarettes a day) and duration were obtained by a questionnaire. Blood samples were taken after an over-night fasting. Blood pressure and anthropometric measurements were reported. RESULTS: HDL-c showed a stepwise decrease as the level of smoking increased (49 +/- 9 mg/dL in level 0, 47 +/- 7 mg/dL in level 1, 46 +/- 8 mg/dL in level 2, 45 +/- 7 mg/dL in level 3, p < 0.001). Total cholesterol, triglycerides and low-density cholesterol were not different among the smoking levels. Body mass index (BMI) and waist/hip ratio were found to be slightly decreased in smokers. In a multivariate regression model including smoking level, duration, BMI, systolic and diastolic blood pressures, smoking level was the only predictor of HDL-c (B = -1.407, p < 0.001). CONCLUSION: Smoking, even in relatively low levels, has a negative stepwise relationship with HDL-c in a homogeneous population of healthy young men in whom other major non-genetic factors that are known to affect HDL-c levels are identical.

Adult↗
PubMed2004

Comparison of combination therapy of adenosine and nitroprusside with adenosine alone in the treatment of angiographic no-reflow phenomenon.

We sought to compare the combination therapy of adenosine and nitroprusside in no-reflow phenomenon during percutaneous coronary intervention. Improvement in coronary flow from no-reflow to postdrug state was evaluated. Patients who received adenosine (n = 21) were compared to ones who received the combination of adenosine and nitroprusside (n = 20) for treatment. Improvement of TIMI flow grades was higher in the group that received combined therapy (1.5 +/- 1.0 vs. 0.8 +/- 0.6; P < 0.05). Combination therapy of adenosine and nitroprusside is safe and provides better improvement in coronary flow compared to intracoronary adenosine alone in case of impaired flow during coronary interventions.

Adenosine↗
PubMed2004

Percutaneous transcatheter repositioning of displaced permanent pacemaker atrial lead with a simple system.

A 48-year-old man who was implanted with a DDD-R pacemaker because of sick sinus syndrome eight days ago presented to our institute with a syncopal attack. Fluoroscopy showed a dislodged active fixation atrial pacemaker lead. With a snare system simply improvised from a 0.014 inch guidewire and a NIH catheter, the lead was repositioned via percutaneous transfemoral approach. The procedure was easy and completed without any complication. Follow-up controls after two weeks and three months showed stability of the lead position with normal pacing and sensing functions.

Cardiac Catheterization↗
PubMed2004

Angiographic restenosis after myocardial bridge stenting.

Data on restenosis after stent implantation in myocardial bridges (MB) are very limited. Six-month angiographic results for 12 symptomatic patients who underwent stent implantation for myocardial bridges were compared retrospectively with those of 39 patients who underwent direct stent implantation for de novo atherosclerotic lesions in the left anterior descending artery. Diameter stenosis decreased from 69 +/- 8% to 4 +/- 5% in the MB group and from 79 +/- 8% to 7 +/- 6% in the control group after stent deployment. Systolic narrowing was abolished in all patients with MB. In follow-up, quantitative angiography revealed late loss of 1.8 +/- 1.3 mm in the MB group and 0.9 +/- 0.9 mm in the control group (P = 0.025). The in-stent restenosis rate was also higher in the MB group compared to the control group (67% versus 28%; P = 0.037). Despite favorable immediate results, stent implantation in MBs may not be promising because of the higher in-stent restenosis rate compared to stenting in de novo atherosclerotic lesions.

Angioplasty, Balloon, Coronary↗
PubMed2004

Intercoronary communication with unidirectional blood flow.

Intercoronary communication is a rare condition in which there is an open-ended circulation with bidirectional blood flow between two coronary arteries. This report highlights a case of an intercoronary connection between the right coronary and circumflex arteries with unidirectional flow. Selective injection of the right coronary artery showed retrograde filling only of the circumflex artery, but left coronary injection did not fill the right coronary artery.

Chest Pain↗
PubMed2003

Long-term effects of octreotide therapy on in-stent restenosis.

The purpose of this study was to assess the long-term effects of octreotide therapy on in-stent restenosis at 6-month follow-up coronary angiography and the clinical events after stenting. A randomized, double-blind, placebo-controlled trial was conducted to assess the effects of octreotide on restenosis after stenting. The patients ( n = 148) received either subcutaneous octreotide or placebo 1 h before the stenting procedure and then every 8 h for 3 weeks. Percent diameter stenosis was interpreted before and after stenting, and on a 6-month follow-up coronary angiogram by quantitative coronary angiography. The mean percent diameter stenosis of the octreotide group was significantly lower than that of the placebo group on the 6-month follow-up coronary angiograms (18.8% +/- 14.2% vs 35.0% +/- 19.2%, respectively; P = 0.001). The restenosis rate of the octreotide group was statistically lower than that of the placebo group (11.8% vs 26.4%, respectively; P << 0.05). With regard to major cardiovascular events, there was no significant difference between the octreotide and placebo groups. The administration of octreotide for treatment of in-stent restenosis results in a relatively low long-term angiographic restenosis rate and no significant acute effects on cardiovascular clinical events.

Adult↗
PubMed2003

C-reactive protein on admission and the success of thrombolytic therapy with streptokinase: is there any relation?

BACKGROUND: Recent evidence has demonstrated that inflammation plays a major role in the initiation and progression of atheroma plaques. C-reactive protein (CRP) is shown to have prognostic significance in acute coronary syndromes. We investigated the influence of CRP levels before thrombolytic therapy on infarct-related artery (IRA) patency and the degree of residual stenosis. METHODS: 45 consecutive patients with a first attack of acute myocardial infarction (MI) who underwent streptokinase therapy and subsequently coronary angiography were enrolled into the study. Patients were divided into 2 groups according to the level of CRP on admission. RESULTS: Serum CRP levels were > or =0.5 mg/dL in 26 patients (Group-I) and <0.5 mg/dL in 19 patients (Group-II). The patency of IRA (TIMI-2 and 3) evaluated at 90th minute after the initiation of thrombolytic therapy was similar between the two groups (62% vs. 68%, p>0.05). However, the presence of TIMI-3 flow was significantly lower and TIMI-2 flow was higher in Group-I as compared to Group-II (12% vs. 53%, p=0.003 and 50% vs. 16%, p=0.018 respectively). Additionally, among patients with patent IRA, the degree of residual stenosis was significantly higher in Group-I (80 +/- 14% vs. 68 +/- 15%, p=0.032). CONCLUSION: High serum CRP levels on admission in patients within 6 hours after the start of acute ST-segment elevation MI are associated with lower TIMI flow grades and higher residual stenosis of IRA after intravenous streptokinase. Our observations imply that patients with higher CRP levels on admission require closer follow-up during and after acute MI.

Aged↗
PubMed2002

Single coronary artery with anomalous origin of the right coronary artery as a branch from the left anterior descending artery: a very rare coronary anomaly.

Anomalous origin of the right coronary artery arising from the left anterior descending artery (LAD) is a very rare coronary anomaly. It has previously been reported in only six adult cases. In this report, we present a patient with an anomalous origin of the right coronary artery from the LAD. The patient had anginal symptoms with exercise. Myocardial perfusion imaging with thallium-201 revealed a reversible inferior perfusion defect. We suggest that this could cause myocardial ischemia.

Arteries↗
PubMed2002

Idiopathic ventricular fibrillation in a patient with Wolff-Parkinson-White syndrome.

Ventricular fibrillation in a patient with ventricular preexcitation is usually due to atrial fibrillation with an extremely rapid ventricular rate from which it degenerates. We present a case with Wolff-Parkinson-White syndrome and coexistent idiopathic ventricular fibrillation. The patient, a 23-year-old male, had had a cardiac arrest four years earlier. In electrophysiological study, the accessory pathway was located in the left posteroseptal region and successfully eliminated with radiofrequency catheter ablation. After the ablation procedure, ventricular fibrillation was induced with programmed ventricular stimulation. A dual chamber implantable cardioverter defibrillator was implanted in the patient.

Adult↗
PubMed2002

A permanent junctional reciprocating tachycardia with atypical location, treated with radiofrequency catheter ablation.

Permanent junctional reciprocating tachycardia (PJRT) is an incessant or almost incessant supraventricular tachycardia with a long RP interval, usually occurring in children and young adults. The differential diagnosis of PJRT includes an atrial tachycardia and atypical atrioventricular nodal reentrant tachycardia (AVNRT). The accessory pathways in PJRT are typically located in the posteroseptal region. We report a case of successful radiofrequency catheter ablation in a 28-year-old male patient with PJRT due to a left posterolateral accessory pathway.

Accessory Nerve↗
PubMedDate not supplied

Radiofrequency catheter ablation of a left lateral accessory pathway in a patient with persistent left superior vena cava.

Persistent left superior vena cava is an unusual congenital anomaly that can coexist with accessory atrioventricular pathways. This anomaly can cause difficulty in mapping because of the dilated coronary sinus. This study describes a successful catheter ablation in a young male with persistent left superior vena cava and Wolff-Parkinson-White Syndrome as a result of a left lateral accessory pathway.

Accessory Nerve↗