Biomedical subjects

Ramazan Topsakal

Publications and source records attributed to Ramazan Topsakal.

20 records · Page 2Linked to original sources

PubMed2002

[Is intermittent dobutamine treatment beneficial in patients with dilated cardiomyopathy?].

OBJECTIVE: Dobutamine is a sympathomimetic drug, which can be used in patients with dilated cardiomyopathy (DCM). We investigated the effects of intermittent dobutamine use on cardiac parameters and quality of life in patients with DCM. METHODS: Twelve patients with ischemic and idiopathic DCM, refractory to conventional therapy, have been included in the study. In addition to traditional treatment, dobutamine (1-2 micro g/kg/min infusion increasing up to 10 micro g/kg/min for 3 days) was administered, and repeated at the 1st, 2nd and 3rd months. The patients were evaluated 3 times, before and immediately after the first treatment and after the treatment on the third month, using echocardiography, exercise stress testing, ambulatory ECG, right ventricular catheterization, cardiac enzymes (creatine kinase MB isoenzyme - CK-MB, troponin-T) and the Minnesota Living with Heart Failure Questionnaire for quality of life. RESULTS: After the first treatment, left ventricular ejection fraction (LVEF), cardiac output, cardiac index (CI), pulmonary wedge pressure and life quality improved significantly (p<0.05); but, after the treatment on the third month, these parameters except PCWP returned to nearly baseline values. Additionally, a significant increase in the number of patients with ventricular premature beats and with troponin-T positivity was detected after the third month of treatment. CONCLUSION: The use of dobutamine in addition to conventional therapy in patients with DCM provided improvements in some systolic parameters and quality of life particularly after the first treatment. In the late period of the treatment, however, it was determined that these beneficial effects tended to disappear and harmful effects became more evident.

Cardiac Output↗

PubMedDate not supplied

The relation between chronic obstructive pulmonary disease and coronary collateral vessels.

Coronary collateral vessels can provide a perfusion reserve in case of increased myocardial oxygen demand. Development of coronary collateral vessels (CCV) is triggered by the pressure gradient between the coronary bed of arteries caused by an obstruction and myocardial ischemia. Myocardial hypoxia can facilitate development of CCVs. There is a chronic hypoxemia in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the effect of COPD on CCVs. The study included 98 patients with COPD who underwent coronary angiography. Those patients in whom coronary angiography is normal or severity of coronary artery stenosis in thought not to be sufficient for the development of CCVs (<80%) were excluded from the study. A total of 98 patients (mean age, 62 +/-9 years) met the criteria for the COPD group. For case-control matching, 98 consecutive without COPD patients (mean age 62 +/-10) who had one or more diseased vessels with 80% or greater stenosis were included in the control group. The CCVs were graded according to the Rentrop scoring system, and the collateral score was calculated by summing the Rentrop numbers of every patient. The mean number of diseased vessels in patients with COPD and without COPD were 1.61 +/-0.69 and 1.77 +/-0.89 (p=0.155), respectively. The mean collateral score was 2.15 +/-2.03 in the COPD group and 1.32 +/-1.54 in the control group. After confounding variables were controlled for, the collateral score in patients with COPD group was significantly different from that in patients without COPD group (p=0.002). These findings suggest that CCV development is better in patients with COPD than in those patients without COPD. Thus, COPD may be an important factor affecting CCV development, which may be related to the presence of chronic hypoxemia in patients with COPD.

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