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Biomedical subjects

Mesut Demir

Publications and source records attributed to Mesut Demir.

16 recordsLinked to original sources
PubMed2006

The effect of early statin treatment on inflammation and cardiac events in acute coronary syndrome patients with low-density lipoprotein cholesterol.

We investigated the effects of atorvastatin on inflammation and cardiac events during the inpatient period and initial 6-month follow-up in acute coronary syndrome (ACS) patients with low low-density lipoprotein (LDL) cholesterol level. One hundred and twelve consecutive ACS patients with LDL cholesterol less than 100 mg/dl were included in the study (mean 78.2+/-12.3 mg/dl). While 70 randomly selected patients received a dose of 40 mg atorvastatin within the first 24 h on top of their standard treatment as the atorvastatin group, the remaining 42 patients considered as the control group were given the standard treatment only, i.e., without any lipid-lowering drug therapy. Lipid profile, high-sensitivity C-reactive protein (hsCRP), and plasma amyloid A (SAA) levels were measured in all patients within the first 24 h of chest pain, on the 5th day, and in the 6th month. During the inpatient period and subsequent 6-month follow-up, all episodes of angina, reinfarction, revascularization, heart failure, rehospitalization, cardiac mortality, and total number of cardiac events were recorded. In the atorvastatin group, hsCRP and SAA values on the 5th day and in the 6th month compared to the first 24 h were significantly lower than those of the control group (P<0.0001). Mean LDL cholesterol level was significantly decreased in the atorvastatin group (55.7+/-17.7 mg/dl), but there was no significant change in the control group at the 6th month. The frequency of heart failure during the inpatient period and angina, unstable angina pectoris, heart failure, and revascularization in the first 6 months were also significantly reduced in the atorvastatin group. Atorvastatin started in the first 24 h reduces inflammation and improves the prognosis during both the inpatient period and the first 6 months of clinical follow-up in ACS patients with low LDL cholesterol levels.

Acute Disease↗
PubMed2006

Mitral annular systolic velocity reflects the left atrial appendage function in mitral stenosis.

BACKGROUND: Left atrial appendage (LAA) dysfunction is an independent predictor of thromboembolism in mitral stenosis (MS). OBJECTIVES: To investigate whether there is a relation between annular velocities obtained by tissue Doppler imaging and LAA function and to determine if the annular velocities can predict the presence of the inactive LAA in MS. METHODS: Eighty-five MS patients and 80 healthy controls were evaluated by transthoracic echocardiography and all patients underwent transesophageal echocardiography. The annular systolic (S-wave) and diastolic (E- and A-waves) velocities were recorded. Inactive LAA was defined as LAA emptying velocity <25 cm/sec. Patients were divided into three groups; group I (n = 43): sinus rhythm (SR) and LAA emptying velocity > or =25 cm/sec, group II (n = 15): SR and LAA emptying velocity <25 cm/sec and group III (n = 27): atrial fibrillation. RESULTS: Thrombus was detected in 12 patients and spontaneous echo contrast (SEC) was detected in 48 patients. Both S-wave and peak LAA emptying velocities were decreasing, while SEC frequency and density were increasing from group I to group III. There was a positive correlation between LAA emptying and S-wave velocities (P < 0.001, r = 0.682). Multivariate regression analysis showed that only S-wave is the independent predictor of inactive LAA (P = 0.001, odds ratio = 0.143, 95% CI = 0.047-0.434). In patients with SR, the cutoff value of S-wave was 13.5 cm/sec for the prediction of the presence of inactive LAA (sensitivity: 95.3%, specificity: 93.3%). CONCLUSIONS: S-wave is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS with SR.

Adult↗
PubMed2005

Tissue Doppler is a more reliable method in early detection of cardiac dysfunction in patients with AA amyloidosis.

OBJECTIVE: Cardiac deposition of AA amyloidosis may result in increasing left ventricular mass and systolic and diastolic dysfunction (DD). The aim of this study was to investigate the left ventricular systolic and diastolic functions by both tissue Doppler imaging (TDI) and pulsed wave Doppler echocardiography (PWD) in patients with AA amyloidosis without congestive heart failure symptoms or arrthymia. METHODS AND RESULTS: Twenty-four patients with AA amyloidosis without congestive heart failure symptoms or arrthymia (15 men and nine women; mean age 44.3 +/- 16.7 years) and 25 healthy subjects (19 men and six women; mean age 43.1 +/- 9.2 years) as controls were included in the study. M-mode, two-dimensional, PWD, and TDI were performed. Peak transmitral filling velocity (E wave), peak transmitral atrial filling velocity (A wave), deceleration time, and isovolumic relaxation time were measured by PWD recordings. Peak myocardial systolic velocity (Sm), peak myocardial early (Em), and late diastolic velocities (Am) were also recorded by TDI. E/A ratio less than one was accepted as DD for both methods. Ejection fraction (EF) was calculated by Teicholtz method. The subjects were divided into three groups as follows: healthy controls (group 1), patients without DD (group 2), and patients with DD (group 3) according to the PWD findings. PWD echocardiography showed that DD was present in 50% of the patients, whereas TDI showed DD in 66% of such cases. In subgroup analysis, Sm wave as a systolic function index was lower in group 3 than in groups 1 and 2, whereas mean EF values were similar in all groups. CONCLUSION: Although AA amyloidosis uncommonly causes cardiac symptoms and findings, according to our results, patients with AA amyloidosis may have systolic and diastolic dysfunction eventhough they are asymptomatic. Also, tissue Doppler imaging is a more reliable method in the early detection of cardiac dysfunction in such patients.

Adult↗
PubMed2005

The evaluation of left ventricular systolic and diastolic functions in patients with Friedreich ataxia. A pulse tissue Doppler study.

Friedreich's ataxia (FRDA), the most common subtype of early onset hereditary ataxia, is an autosomal recessive neurodegenerative disorder caused by unstable GAA expansions. Two-dimensional, pulse, and pulse tissue Doppler echocardiographic examinations were performed on 21 patients with GAA expansion. There was no association between left ventricle ejection fraction, tissue Doppler systolic s wave, and left ventricle diastolic functions examined by pulse and tissue Doppler. The septum thickness of patients with Friedreich's ataxia was significantly increased when compared with that of the control group and wall thickness was found to be associated with GAA repeats. In patients with FRDA, despite a correlation between genetic abnormality with left ventricular early and late diastolic parameters, global diastolic functions were preserved when examined by tissue Doppler.

Adolescent↗
PubMed2005

Biochemical indicators and cardiac function tests in chronic alcohol abusers.

AIM: To determine the effect of chronic alcohol abuse on cardiac function, antioxidant system, trace elements, and liver function tests. METHODS: Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), superoxide dismutase (SOD), malondialdehyde (MDA), as well as zinc, magnesium, and copper were assayed in 25 chronic alcoholic patients and their 25 healthy relatives matched in age and gender. Echocardiographic parameters were evaluated for subjects. RESULTS: Mean corpuscular volume (96.7 fL vs 92.4 fL) and mean corpuscular hemoglobin levels (31.4 pg vs 30.5 pg) were found to be significantly increased in the patient group (P=0.002 and P=0.048, respectively). The results of the SOD and MDA assays showed no significant differences between the two groups. AST (38.7 U/L vs 22.1 U/L) and GGT (104.2 U/L vs 34.2 U/L) levels were found to be significantly increased in the patient group compared with controls (P=0.005 and P<0.001, respectively). Magnesium (1.6 mmol/L vs 1.8 mmol/L) and zinc levels (14.9 micromol/L vs 19.2 micromol/L) were significantly decreased, whereas copper levels (19.3 micromol/L vs 17.9 micromol/L) were increased in alcoholics (P=0.042, P<0.001 and P=0.003, respectively). Echocardiographic examination showed a significant decrease in mitral and tricuspid ratio of peak early and atrial flow velocity (E/A ratio) in alcoholics. CONCLUSION: Decrease in mitral and tricuspid E/A ratios accompanied with low levels of magnesium and zinc, and increased levels of copper indicate that alcoholics already have heart muscle disease even chronic alcohol exposure.

Adult↗
PubMed2005

Atrial myxoma: an unusual cause of myocardial infarction.

A 55-year-old woman had an inferior myocardial infarction due to a coronary artery embolus from a large, polypoid, left atrial mass. The mass had an irregular surface and was prolapsing into the mitral valve orifice during diastole. Coronary angiography revealed tumor vascularization next to the right coronary artery. The other coronary arteries were normal. The tumor was removed surgically; pathologic examination confirmed the diagnosis of myxoma. The patient did well after the procedure and was discharged on postoperative day 10.

Cardiac Surgical Procedures↗
PubMed2004

Late infective endocarditis after cholecystectomy in a patient with repaired tetralogy of Fallot: a case report.

Late endocarditis after surgical repair of tetralogy of Fallot is rare. We describe a case of endocarditis following cholecystectomy in a 22-year old patient with repaired tetralogy of Fallot. After cholecystectomy, the patient was referred to a cardiology clinic with unexplained fever and suspicion of endocarditis. Echocardiography revealed a large mass at the basal level of interventricular septum. Endocarditis was diagnosed on the basis of clinical and echocardiographic findings and antibiotic treatment was initiated immediately. Nine days later, the clinical status of the patient deteriorated and urgent surgery was performed. Patch dehiscence which mimicked a large vegetation, and multiple vegetations on the patch were found during operation. The patch was removed and ventricular septum defect was repaired with a new dacron patch. Enterobacter agglomerans was isolated in the vegetation cultures.

Adult↗
PubMed2004

Relation between age and gender differences in plasma triglyceride concentrations and coronary artery disease in Southern Turkey.

BACKGROUND: Coronary artery disease (CAD) is still a leading cause of morbidity and mortality in both genders in Turkey as well as other countries. The role of plasma triglycerides (TG) as a CAD risk factor has been controversial. We investigated the relation between age and gender differences in plasma TG and CAD in patients with angiographically proven CAD. METHODS: The study population consisted of 937 patients (605 males and 332 females, aged between 32 and 82 years). The patients were divided into three age groups as < 45, 45-59 and > or = 60 years. Risk factors were considered as hypertension, hyperlipidemia, diabetes mellitus, cigarette smoking and family history. Hypertriglyceridemia was defined as TG concentration > 150 mg/dl (> 1.69 mmol/l). RESULTS: Of the total, 608 had CAD. TG was an independent risk factor for CAD only in women (p < 0.05). There was also a positive correlation between TG concentrations and number of the diseased vessels only in women (p = 0.001, r = 0.2). CONCLUSION: High TG concentrations increase CAD risk more in women than in men in Southern Turkey. Triglycerides should be taken into consideration as an important risk factor especially in women > 45 years of age.

Adult↗
PubMed2004

Prothrombin 20210GA and factor V Leiden mutations in patients less than 55 years old with myocardial infarction.

Several studies claim that prothrombin 20210GA and factor V Leiden mutations are related to arterial thrombosis. We investigated the frequencies of these mutations and their significance in the development of early atherosclerosis in acute myocardial infarction (AMI) patients younger than 55 years of age. We investigated 96 patients with AMI and 77 control subjects. The diagnosis of AMI was established by typical chest pain and ST elevations on the presentation electrocardiogram and characteristic cardiac enzyme elevations. None of the control subjects had evidence of cardiovascular disease. DNA samples were isolated from all subjects and prothrombin 20210GA and factor V Leiden mutations were determined by the RealTime PCR technique with the aid of a Light Cycler device. The prevalence of factor V Leiden mutation was 6.3% and 5.2% in the patient and control groups, respectively (OR 0.6 [95% CI 0.1- 3.9], P = 0.6), whereas the prevalence of prothrombin G20210A mutation was 4.2% and 2.6% in the patient and control groups, respectively (OR 2.8 [95% CI 0.2 - 32.2], P = 0.4). None of the patients had both mutations. Prothrombin 20210GA and factor V Leiden mutations are not significant risk factors for the development of myocardial infarction in patients less than 55 years old in Southern Turkey.

Adult↗
PubMed2003

[Echocardiographic evaluation of associated valve lesions in mitral stenosis].

OBJECTIVE: When mitral stenosis is associated with other valve lesions, diagnosis, prognosis and the treatment strategies are affected. Mitral valve prolapse may occur in some pathological settings that affect mitral apparatus. We investigated the incidence of valve lesions including mitral valve prolapse that accompany mitral stenosis and assessed the relation between echocardiographic measures. METHODS: Two hundred and one patients (31 male, 170 female) between 16 and 72 years of age (mean age 40.9+/-11.4 years) with mitral stenosis were included in the study. Patients were divided into three groups according to the mitral valve area obtained by echocardiography using planimetric method as Group I (MVA<1.1 cm(2)), Group II (MVA -1.1-1.5 cm(2)) and Group III (MVA >1.5 cm2). RESULTS: Mitral stenosis with mitral regurgitation, aortic regurgitation, aortic stenosis, combined aortic valve disease, tricuspid regurgitation and tricuspid stenosis were found in 117 (58.2%), 84 (41.8%), 18 (9%), 9 (4.5%), 62 (30.8%) and 6 (3%) patients, respectively. Twenty- three patients (11.4%) had mitral valve prolapse in only anterior leaflet. Nobody of patients had mitral valve prolapse of posterior mitral valve leaflet. Age, gender, rhythm, degree of stenosis, degree of mitral and aortic regurgitations, mean pressure gradient, left atrial diameter, ejection fraction and valve score did not differ in patients with and without mitral valve prolapse. CONCLUSION: Our study has shown that valve lesions including mitral valve prolapse frequently accompany mitral stenosis and the incidence of mitral valve prolapse in patients with mitral stenosis is high.

Adolescent↗
PubMedDate not supplied

Mitral annular calcification and aortic valve calcification may help in predicting significant coronary artery disease.

Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.

Adult↗
PubMedDate not supplied

The presence of a calcific plaque in the common carotid artery as a predictor of coronary atherosclerosis.

Many contradictory reports have been published investigating the relationship between coronary artery disease (CAD) and the increased intima-media thickness (IMT) in the common carotid artery (CCA). However, only a limited number of studies evaluate the relationship between CAD and CCA disease as reflected by both the plaque morphology (fibrous and calcific plaques) and IMT. We have studied the associations between CAD and the wall morphology of CCA by B-mode ultrasound (US). One hundred and forty-four subjects, whose angiography was planned on the basis of suspected CAD, were included into the study. The patients were divided into 4 groups on the basis of B-mode US findings; Group I: normal, Group II: increased IMT (IMT >/= 0.8 mm and plaque absent), Group III: fibrous plaque, Group IV: calcific plaque. Coronary artery disease was diagnosed in 63 patients. A statistically significant correlation was found between CAD and CCA wall morphology (r =0.42, CI (95%) = 0.30-0.51, p<0.001). Positive predictive values were 45.0%, 48.4%, and 75.0% in patients with increased IMT, fibrous plaque, and calcific plaque, respectively. None of the women with normal CCA wall morphology had significant coronary artery lesion. With respect to the normal group, the risk for CAD increased by 4.3 fold with the existence of fibrous plaque (p=0.02) and by 9.9 fold with the existence of calcific plaque (p<0.001). It has been shown that the CCA wall morphology determined by B-mode US is correlated with CAD in patients with chest pain, and the presence of calcific plaque is a better predictor for CAD than that of fibrous plaque and increased IMT. Women with chest pain and normal CCA wall morphology may not need coronary angiography.

Carotid Artery Diseases↗