Biomedical subjects

Halil Tanriverdi

Publications and source records attributed to Halil Tanriverdi.

24 records · Page 2Linked to original sources

PubMed2005

Do female patients with metabolic syndrome have masked left ventricular dysfunction?

OBJECTIVE: Metabolic syndrome (MS) is a condition, which is recognized as raising the risk of cardiovascular disease. The aim of our study is to estimate the left ventricular functions by atrioventricular plane displacement (AVPD), myocardial performance index (MPI) and conventional methods in patients with MS who were diagnosed according to NCEP (ATP III) criteria. METHODS: Fifty-three female patients with MS (mean age 53.1+/-6.9 years) and 30 healthy female subjects (mean age 52.8+/-6.3 years, p>0.05) underwent complete echocardiographic assessment. All of the subjects had no heart and pulmonary diseases. The systolic mitral AVPD was recorded at 4 sites (septal, lateral, anterior, and posterior) by M-mode echocardiography and left ventricle ejection fraction (LVEF) was calculated from the AVPD-mean (EF-AVPD). The LVEF was also established by biplane Simpson's (EF-2D) and Teichholz's methods (EF-T). Left ventricular MPI was calculated as (isovolumic contraction time + isovolumic relaxation time) / aortic ejection time by Doppler echocardiography. RESULTS: Patients with MS showed mild left ventricular diastolic dysfunction (DD) in comparison to healthy subjects. The EF-2D and EF-T in patients with MS and healthy subjects were not different significantly and were within normal limits. Patients with MS showed LV global dysfunctions compared to healthy subjects (MPI: 0.56+/-0.12 and 0.46+/-0.11 respectively, p<0.01). Both the septal, anterior, lateral and posterior part of the atrioventricular plane values and also AVPD-mean during systole were statistically lower in patients with MS (12.85+/-1.76 mm) as compared with controls (14.65+/-2.19 mm, p<0.05). The EF-AVPD in patients with MS was statistically lower (65.58+/-11.95%) as compared with healthy subjects (74.45+/-11.07%, p<0.01). CONCLUSION: Female patients with MS had both left ventricular DD and a global dysfunction with an increased MPI. The EF-2D and EF-T were not different significantly between patients and controls, but patients with MS had a relatively reduced EF-AVPD. The AVPD method may indicate a systolic dysfunction with a relatively lower AVPD-mean and relatively lower EF-AVPD. The presence of global dysfunction in patients with MS may lead to heart failure.

Case-Control Studies↗

PubMed2004

Lp(a) lipoprotein and lipids in patients with rheumatoid arthritis: serum levels and relationship to inflammation.

OBJECTIVES: Changes in lipid profiles, Lp(a) lipoprotein, and acute phase reactants are associated with early atherosclerosis in rheumatoid arthritis (RA). The associations of Lp(a) levels with atherosclerotic disorders, diabetes, RA, and renal diseases suggest that Lp(a) might be involved in autoimmune reactions. METHODS: Eighty-seven women with RA diagnosed according to American Rheumatism Association criteria (mean age 45.4+/-9.4 years) were recruited and 50 healthy women (mean age 44+/-10.7 years) included as a control group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and C-reactive protein levels were analyzed. RESULTS: In the RA and C groups, serum Lp(a) levels were 39.2+/-20.6 mg/dl and 14.8+/-9.7 mg/dl, respectively (P<0.001). The TC levels were 188.4+/-41.8 mg/dl and 185.3+/-19.3 mg/dl (P>0.05), TG levels were 124.5+/-50.1 mg/dl and 94.6+/-24.9 mg/dl (P<0.01), HDL-C levels were 40.0+/-7.4 mg/dl and 52.8+/-4.8 mg/dl (P<0.01), and LDL-C levels were 123.4+/-24.6 mg/dl and 113.3+/-21.1 mg/dl (P>0.05). While serum CRP levels showed a positive correlation with Lp(a), they correlated negatively with HDL-C levels (r=0.83 and P<0.0001, r=-0.49 and P<0.0001, respectively). It was meaningful that Lp(a) correlated negatively with serum HDL-C level (r=-0.36, P<0.001). CONCLUSIONS: It is suggested that higher serum Lp(a), lower HDL-C, higher TG level, and a high ratio of TC/HDL-C might show high risk of atherosclerosis. Inflammation in RA may cause changes in HDL-C and Lp(a) metabolisms.

Acute-Phase Proteins↗

PubMed2004

Bilateral diagonal earlobe crease and coronary artery disease: a significant association.

BACKGROUND: The association between the presence of diagonal earlobe crease (ELC) and coronary artery disease (CAD) still remains controversial. OBJECTIVE: The aim of this study was to evaluate the association between bilateral ELC and CAD. METHODS: 415 patients were examined for the presence or absence of bilateral ELC, angiographic evidence of CAD and coronary risk factors. The patients were divided into 2 groups according to angiographic evidence of CAD. RESULTS: Bilateral ELC was significantly and positively correlated with CAD, hypertension, age, male gender, cigarette smoking and family history of CAD. The ELC was an independent variable for CAD. The observed sensitivity, specificity, positive predictive value and negative predictive value of the bilateral ELC for the diagnosis of CAD were in the following order: 51.3, 84.8, 89.4 and 41.2%. CONCLUSION: The presence of bilateral ELC was significantly associated with CAD and coronary risk factors. The bilateral ELC was an important dermatological indicator of CAD, and it might be a useful diagnostic tool in the clinical examination of patients.

Adult↗

PubMed2004

Effects of a beta-blocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving successful thrombolytic therapy.

Late potentials (LP) detected on the signal-averaged electrocardiogram (SAECG) predict arrhythmic events after acute myocardial infarction (AMI). It is also well established that successful thrombolytic therapy reduces the incidence of LP. Our aim was to evaluate the effects of a beta-blocker on LP in patients receiving thrombolytic therapy. We studied 40 patients presenting with anteroseptal AMI (< 6 hours). All patients received thrombolytic therapy and were evaluated with coronary angiography at predischarge. Eighteen patients received metoprolol (5 mg IV on admission followed by 50 mg BID). SAECG recordings were obtained serially using an ART system (40-250 Hz filter, noise < 0.5 mV) prior to thrombolytic therapy, after 48 hours and after 10 days. LP was defined as posi-tive if the SAECG met at least 2 of the Gomes criteria. Changes observed in SAECG recordings after thrombolytic therapy were correlated with angiographic and clinical data with regard to the usage of BB. The frequencies of LP before and after thrombolytic therapy were compared with the McNemar test. There were no significant differences between the clinical characteristics, risk factors, and angiographic findings (including infarct related artery patency and LV functions) of the groups. Baseline SAECG findings were also similar between the groups. The incidence of LP significantly decreased after TT in the BB group, however, this change was not observed in patients who did not receive BB (P = 0.012, McNemar test). Beta-blockers reduce the incidence of LPs following thrombolytic therapy in patients with anterior AMI. This might be explained by the possible beneficial effect of BB on the arrhythmogenic substrate.

Adrenergic beta-Antagonists↗

PubMed2004

Assessment of systolic function by atrioventricular plane displacement in patients with diastolic dysfunction.

OBJECTIVES: Early recognition and appropriate therapy of diastolic dysfunction (DD) is advisable to prevent further progression to diastolic or systolic heart failure and death. The mitral atrioventricular plane displacement (AVPD) method has been shown to be a reliable and simple technique to study left ventricular systolic function in patients, because the mitral annulus can be visualized in almost all patients even if the endocardial borders are difficult to trace. The aim of our study is to estimate the left ventricular ejection fraction by AVPD method (EFAVPD), in addition to Teicholz's short axis method (EF-T) and Simpson's biplane method (EF-2D) in patients with DD. MATERIAL AND METHODS: One hundred and two subjects were submitted to complete echocardiographic assessment, and DD was shown in 62 patients. The systolic mitral AVPD was recorded at 4 sites (septal, lateral, anterior, and posterior) using M-mode and left ventricular ejection fraction was calculated from the AVPD-mean in 62 patients with DD (mean age 55.67 +/- 5.65, 24 men and 38 women) and in 40 age-matched control subjects (mean age 54.07 +/- 6.96, 15 men and 25 women). There were no statistically significant group differences related to age, gender, heart rate or body mass index. However, in the patients with DD, presence of hypertension and/or diabetes mellitus was significantly higher than control subjects. RESULTS: The systolic functions, as assessed by conventional measures in patients with DD and healthy subjects were not stastically different, and were within normal limits. The septal, anterior, lateral and posterior part of the atrioventricular plane values and AVPD-mean during systole were statistically lower in the DD group (12.35 +/- 1.42 mm) compared with controls (15.32 +/- 1.38 mm) (p < 0.001). EFAVPD in patients with DD was statistically lower (62.97 +/- 7.85%) than healthy subjects (79.30 +/- 7.60%) (p < 0.001). Significant positive correlations between EFAVPD and EF-2D (r = 0.325, p < 0.01) and EF-T (r = 0.355, p < 0.01) and FS (r = 0.314, p < 0.01) were found. EFAVPD correlated only with velocity of mitral flow propagation (VPR) in diastolic function parameters (r = 0.374, p < 0.01). CONCLUSIONS: The AVPD method may indicate a systolic dysfunction with a relatively lower AVPD-mean and relatively lower EFAVPD in the DD group compared with controls. This indicated the presence of a statistically significant and mildly reduced left ventricular systolic function by the AVPD method in patients with DD. It might be suggested that DD might be combined with systolic dysfunction. However, isolated diastolic dysfunction is uncommon. The mitral AVPD is reproducible, widely applicable and a simple non-invasive method for the estimation of left ventricular systolic function in patients with DD.

Blood Flow Velocity↗

PubMedDate not supplied

Coronary arterial revascularization in an adult with congenitally corrected transposition of great arteries and dextrocardia.

OBJECTIVES: Congenitally corrected transposition of great arteries with dextrocardia is an extremely rare lesion in adulthood. This group of patients does not live long enough for atherosclerotic coronary artery disease processes, because of existing comorbid anomalies. METHODS: We report a 47-year-old man with isolated congenitally corrected transposition of great arteries, dextrocardia, and athersclerotic coronary artery disease. The patient underwent coronary artery revascularization with cardiopulmonary bypass. The free left internal mammary artery (LIMA) was grafted to the tiny left anterior descending artery (LAD), and the reversed saphenous vein Y graft was anastomosed to the posterior descending and posterolateral branches of the morphologic right coronary artery. RESULTS: The patient recovered uneventfully. He is alive and well 24 months after the surgery. CONCLUSIONS: To our knowledge, the present case is the first congenitally corrected transposition of great arteries with dextrocardia treated with grafted coronary artery bypass. Early and full revascularization is very important for the systemic right ventricle exposed to a systemic workload. The vessel pathologies and technical details of this unusual case are discussed in this paper.

Coronary Disease↗