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Biomedical subjects

Yuksel Aksoy

Publications and source records attributed to Yuksel Aksoy.

At least 19 recordsLinked to original sources
PubMed2006

Evaluation of cardiovascular risk factors and bone mineral density in patients undergoing coronary angiography and relation of findings to mitral annular calcium.

Prevalences of mitral annular calcium (MAC), osteoporosis, and coronary artery disease (CAD) increase with aging and often usually coexist. Correlates of MAC including cardiovascular risk factors and bone mineral density (BMD) have never been evaluated in men and women undergoing coronary angiography. Accordingly, we assessed the association between cardiovascular risk factors, BMD, and MAC in patients undergoing coronary angiography. The study population consisted of 484 consecutive patients (180 women, mean 60 +/- 10 years of age; 304 men, mean 60 +/- 10 years of age) who underwent coronary angiography. Complete transthoracic echocardiographic studies were performed in all patients. Diagnosis of MAC was made by M-mode and cross-sectional transthoracic echocardiography. All patients were referred to the nuclear medicine department to measure BMD (T score) using dual-energy x-ray absorptiometry. The following clinical and demographic parameters were recorded: age, gender, body mass index, hypertension, diabetes mellitus, CAD, hypercholesterolemia, and smoking status. Prevalence of MAC in our study population was 20%. There were no statistically significant differences between groups with respect to body mass index, diabetes mellitus, hypercholesterolemia, and presence of CAD (p >0.05 for all comparisons). Prevalence of hypertension and mean age were significantly higher in patients with MAC than in those without MAC (hypertension 74% vs 52%, p <0.001; age 68 +/- 9 vs 58 +/- 10 years, p <0.001, respectively). Age and hypertension were found to be independent positive risk factors for MAC, whereas T score and age-gender adjusted T score were found to be negatively and independently associated with MAC. In conclusion, we found that MAC in patients undergoing coronary angiography is independently and positively associated with age and hypertension and negatively associated with T-score measurement of BMD.

Absorptiometry, Photon↗
PubMed2006

The relationship of heart rate variability with severity and prognosis of cirrhosis.

Many studies have demonstrated that cirrhosis is frequently associated with autonomic dysfunction. The aim of this study was to test autonomic dysfunction in cirrhotic patients by analyzing heart rate variability (HRV), to determine whether or not the degree of autonomic dysfunction is correlated with the severity of disease, and, also, to compare the changes of HRV between survivor and nonsurvivor groups after 2-year follow-up periods. HRV was analyzed using 24-hr ECG recording in 30 cirrhotic patients and 28 normal controls. The changes in HRV parameters including mean normal-to-normal (N-N) interbeat intervals (mean NN), standard deviation of all N-N intervals (SDNN), standard deviation of the average of N-N intervals for each 5-min period over 24 hr (SDANN), root mean square succesive differences (r-MSSD; msec), and percentage of adjacent N-N intervals that are >50 msec apart (pNN50), all as time domain parameters, were evaluated. The cirrhotic patients were also evaluated according to Child-Pugh classification scores as markers of the disease severity. The time-domain measures of HRV in cirrhotic patients were significantly reduced compared with those in the control group (for all parameters; P < 0.001). The severity of disease was associated with reduced HRV measures (for all parameters; P < 0.001). After the 2-year follow-up periods, HRV measurements in cirrhotic patients were significantly much lower in nonsurvivors than in survivors (P < 0.001 for all). We conclude that increasing severity of cirrhosis is associated with a reduction in HRV. This finding may be an indicator of poor prognosis and mortality for cirrhosis.

Analysis of Variance↗
PubMed2006

Brain natriuretic peptide and its relationship to left ventricular hypertrophy in patients on peritoneal dialysis or hemodialysis less than 3 years.

An increase of brain natriuretic peptide (BNP) levels is commonly observed in patients on dialysis. Increased circulating levels of BNP are related to future cardiac events and associated with shorter survival in patients on chronic hemodialysis (HD). During the first 1 or 2 years on dialysis, patients on peritoneal dialysis (PD) have been shown to have an improvement in left ventricular hypertrophy, blood pressure, and volume status. This study compares BNP levels and cardiac status of PD and HD patients without cardiovascular disease and on dialysis for less than 36 months. The correlation between plasma BNP concentration and findings of echocardiography before HD scans were examined and compared with findings of PD. Twenty-two HD patients (15 men, 7 women; mean age, 52.5 +/- 13.9 years) and 19 PD patients (10 men, 9 women; mean age, 47.6 +/- 11.3 years) were studied. There were no significant differences between HD and PD patients with regard to age, gender, duration of dialysis, left ventricular mass, left ventricular mass index (p > 0.05). Plasma BNP levels were markedly greater in HD patients (467.8 +/- 466.5 pg/ mL) than those of PD patients (143.1 +/- 165.2 pg/mL). Urine output was significantly higher in PD patients compared with HD patients (p < 0.05). A positive correlation between systolic blood pressure, diastolic blood pressure, and plasma BNP in HD patients (r: 0.653, p: 0.001; r: 0.493, p: 0.023, respectively) was detected. Additional studies are needed to investigate whether lower BNP level in PD patients is an advantage.

Female↗
PubMed2006

Platelet activity and serum homocysteine levels in patients with end-stage renal failure with regard to dialysis modality.

BACKGROUND: Recent evidence suggests that the activation of platelets and their interaction with circulating cells are important independent risk factors for atherosclerosis. In non-uremic patients with symptomatic peripheral vascular disease, a relationship between serum homocysteine (Hcy) levels and platelet activity had been reported. The purposes of this study were to evaluate of effects of dialysis modality on platelet activity in patients with end-stage renal failure and to investigate the relationship between platelet activity, Hcy, and left ventricular hypertrophy (LVH). MATERIAL AND METHODS: In age and sex matched 19 healthy subjects, 20 hemodialysis (HD) patients, and 18 continuous ambulatory peritoneal dialysis (CAPD) patients, the expression of platelet surface receptors CD41, CD61, CD42a, and CD62P were investigated. CD62P expression was statistically significantly increased in HD patients compared with CAPD patients and controls (34.4 +/- 22.5%; 17.3 +/- 19.6%, 12.0 +/- 15.6%, respectively, p < 0.05), but not in CAPD patients compared with controls. There was a positive correlation between CD62 expression and duration of dialysis in HD patients (r = 0.498, p = 0.026). Mean plasma Hcy levels in dialysis patients were higher than reference levels. However, we could not find any relationship between CD62 expression, Hcy, and LVH in both groups (p > 0.05). CONCLUSIONS: Hemodialysis and peritoneal dialysis (PD) have a different impact on the expression of CD62: peritoneal dialysis seems to have a more favorable effect. It may be possible that the differences in biocompatibility between PD and HD potentially contribute to differences in CD62 expression.

Aged↗
PubMed2006

Elevated plasma homocysteine levels in patients with isolated coronary artery ectasia.

OBJECTIVE: Coronary artery ectasia is a variant of coronary atherosclerosis. Hyperhomocysteinemia has emerged as a major, independent risk factor for cardiovascular diseases. The purposes of this study were to determine plasma hyperhomocysteine levels in patients with coronary artery ectasia, and to compare patients with coronary artery ectasia, coronary artery disease, and controls with normal coronary angiogram. METHOD: The study population included 37 patients with coronary artery ectasia and 36 patients with coronary artery disease. The control group consisted of 32 patients with angiographically proven normal coronary arteries. Plasma hyperhomocysteine levels were measured in all study patients with an enzyme-linked immunosorbent assay. RESULTS: Plasma homocysteine levels were significantly higher in patients with both coronary artery ectasia and coronary artery disease than in the controls (14.8+/-1.1 and 15.9+/-0.8 vs. 2.5+/-0.6 micromol/l; P<0.001 and P<0.001, respectively). No significant differences in plasma homocysteine levels were found among CAE and CAD groups (P>0.05). CONCLUSIONS: We have demonstrated that patients with coronary artery ectasia and coronary artery disease have increased plasma hyperhomocysteine levels compared with the controls. These findings suggest that hyperhomocysteinemia may play an important role in the pathogenesis of coronary artery ectasia as in coronary artery disease.

Biomarkers↗
PubMed2006

Decreased endothelium-dependent vasodilatation in patients with migraine: a new aspect to vascular pathophysiology of migraine.

BACKGROUND: Migraine is a common neurovascular disorder characterized by attacks of severe headache, autonomic and neurological symptoms. We hypothesized that patients with migraine had abnormal endothelial function. The vascular theory of migraine assumes that the major pathophysiological events that initiate the migraine attack occur in the perivascular nerves of the major cerebral vessels. Accordingly, we aimed to measure endothelium-dependent vasodilatation in migraineurs by means of flow-mediated dilatation, which reflects endothelium-dependent vasodilatation capacity. MATERIALS AND METHODS: Forty-five patients who fulfilled the diagnostic criteria for migraine and 45 age and sex-matched healthy participants were enrolled in the study. Flow-mediated dilatation of the brachial artery was determined using a high-resolution B-mode ultrasonographic system. Flow-mediated vasodilatation was expressed as the change in post-stimulus diameter as a percentage of the baseline diameter. RESULTS: Mean ages of the patients were 33+/-10 years in migraineurs (range: 18-52 years, 36 female, 9 male) and 33+/-9 years in non-migraineurs (range: 17-50 years, 36 female and 9 male). Flow-mediated dilatation of patients with migraine is significantly lower than that of the controls (8.02+/-4.095% vs. 10.72+/-3.52%, respectively, P=0.001). CONCLUSION: We have shown that migraineurs have decreased endothelium-dependent vasodilatation capacity compared with non-migraineurs. Migraine may be a local manifestation of systemic vascular vasomotion abnormalities.

Adolescent↗
PubMed2006

Decreased nitrate-mediated dilatation in patients with coronary artery ectasia: an ultrasonographic evaluation of brachial artery.

BACKGROUND: Coronary artery ectasia has been defined as localized or diffuse nonobstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Although coronary artery disease is supposed to be responsible for more than 50% of coronary ectasia, the precise pathology of coronary artery ectasia is not clearly understood. The brachial artery ultrasound test for flow-mediated endothelial-dependent vasodilatory function includes administration of sublingual nitrates to examine the vasodilating effect of an exogenous source of nitric oxide. In the present study, we aimed to compare flow-mediated and nitrate-mediated responses of brachial artery in patients with coronary artery ectasia and patients with coronary artery disease. MATERIALS AND METHODS: Thirty-six consecutive patients with coronary artery ectasia in combination with coronary artery disease and 42 age-matched and sex-matched patients with coronary artery disease alone were included in the study. Flow-mediated and nitrate-mediated dilatations were measured in all patients using a high-resolution B-mode ultrasonographic system. RESULTS: Baseline brachial artery diameters in patients with coronary artery ectasia were not statistically different from those in patients with coronary artery disease (4.2+/-0.6 vs. 4.0+/-0.6 mm, respectively, P=0.16). Although the forearm flow-mediated dilatation of the patients with coronary artery ectasia did not differ from that of patients with coronary artery disease alone (5.5+/-3.8 vs. 4.8+/-3.6%, respectively, P=0.41), nitrate-mediated dilatation was significantly lower than that of patients with coronary artery disease alone (7.9+/-5.2 vs. 10.9+/-5.4%, respectively, P=0.02). CONCLUSION: We have shown that patients with coronary artery ectasia have decreased nitrate-mediated response of brachial artery compared with patients with coronary artery disease alone, suggesting more severe dysfunction or, possibly, destruction of the media layer in coronary artery ectasia than in coronary artery disease.

Aged↗
PubMed2006

Impact of coronary collateral circulation on QT dispersion in patients with coronary artery disease.

OBJECTIVE: The aim of this study was to assess the effect of coronary collateral circulation (CCC) on QT dispersion (QTD) in coronary artery disease. BACKGROUND: A prolonged QTD has been linked to increased heterogeneity of ventricular repolarization implicated in the genesis of ventricular arrhythmias and has been associated with an adverse prognosis in patients with coronary artery disease. METHOD: CCC and corrected QTD (QTcD) were established in patients who had at least 85% stenosis in the left anterior descending coronary artery or in proximal part or in the body of the right coronary artery. Furthermore, left ventricular function score was determined for all the patients. RESULTS: While CCC was not present (CCC grade 0) in 32 patients, 68 patients were observed with CCC (CCC grade > or =1). Mean QTcD was higher in patients who had CCC grade > or =1 than in patients with grade 0 (64.3+/-3.5 and 46.8+/-2.7, respectively, P=0.002). We detected a significant correlation between the collateral score and QTcD (r=0.354, P=0.001). CCC grade > or =1 patients had higher mean left ventricular function scores than grade 0 patients (P=0.048). Left ventricular function score and QTcD were observed to be correlated (r=0.200, P=0.046). CONCLUSION: CCC in chronic coronary artery disease was not established to have a positive decreasing effect on QTcD. On the contrary, QTcD values were observed to be even higher in patients with well developed CCC. Further research including larger series and long-term follow-up is required to investigate this issue.

Arrhythmias, Cardiac↗
PubMed2005

Beneficial effect of deep breathing on premature ventricular complexes: can it be related to the decrease in QT dispersion?

It has been reported that deep breathing at 6 breaths/min is associated with reduction of premature ventricular complexes. The beneficial effect of deep breathing is supposed to be due to vagal modulation of sinoatrial and atrioventricular node. Beside the modulating effects of deep breathing, we believe that deep breathing, which is also used in yoga training, might have additional effects via decreasing QT dispersion.

Breathing Exercises↗
PubMed2005

Relationship between cytokines and tumour markers in patients with chronic heart failure.

AIMS: Serum levels of some cytokines and tumour markers are elevated in patients with chronic heart failure (HF). We aimed to investigate the relationship between circulating levels of cytokines and tumour markers in patients with HF. METHODS: We included 35 HF patients and 33 normal controls. HF patients were divided into two groups: mild HF (NYHA class I/II) (n=10) and severe HF (NYHA class III/IV) (n=25). Serum cytokine levels (TNF-alpha, IL-1 beta, IL-6, and IL-10) were measured by ELISA and tumour markers (CA 125, CA 19-9, CA 15-3, CEA and AFP) by chemiluminescent enzyme immunoassay. RESULTS: Serum levels of TNF-alpha, IL-6, and IL-10 as cytokines, and CA 125 and CA 19-9 as tumour markers were significantly higher in HF patients than in normal controls (p<0.0001 for all). Serum levels of TNF-alpha, IL-6 and IL-10 and CA 125 in the severe HF patients were significantly higher than in the mild HF patients (p<0.001 for all). Correlation analysis showed that CA 125 was positively related to TNF-alpha (r=0.624, p<0.001), IL-6 (r=0.671, p<0.001), and IL-10 (r=0.545, p<0.001) in HF. CONCLUSION: These findings show that CA 125 is markedly elevated in patients with HF, and correlates with serum TNF-alpha, IL-6 and IL-10 levels. Therefore, we speculate that among the tumour markers studied, only CA 125 is closely related to the cytokine system.

Adult↗