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ABSTRACT: Objectives: Carbohydrate antigen 125 (CA 125), known as a tumor marker for ovarian cancer, has been reported to increase in relation to disease severity in heart failure patients with systolic dysfunction. Aortic stenosis (AS) has a wide clinical spectrum that often includes heart failure symptoms. The purpose of the present study is to evaluate the serum levels of CA 125 in patients with AS and its relation to clinical severity and echocardiographic parameters. Study design: The study group consisted of 42 patients (20 males, 22 females, mean age 62.5±14.9 years) with AS and 35 healthy controls (17 men, 18 women; mean age 59.0±9.1 years). All patients and control subjects underwent chest X-ray and echocardiographic evaluation. We measured serum CA 125 values in patients with AS and control subjects. Results: The median (interquartile range) CA 125 level was significantly higher among AS patients than in the control group in covariate analysis (9.4 [2.5-38.1] vs. 6.8 [4.4-13.9] U/ml respectively; p=0.001). Spearman correlation analysis in the whole group indicated that CA 125 was positively correlated with aortic mean gradient (p=0.007, r=0.30) and creatinine levels (p=0.02, r=0.26). Conclusion: We found that CA 125 levels were elevated in patients with AS and were correlated with mean gradient and creatinine levels.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 06/2012; 40(4):309-15.
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Abdullah Doğan
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 03/2012; 40(2):192-5.
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ABSTRACT: No definite markers have been established to identify patients in whom anthracycline-containing chemotherapy may represent a high risk for the development of cardiotoxicity. We aimed to evaluate the predictive value of comprehensive echocardiography in anthracycline-induced cardiomyopathy.
In a prospective design, the study included 39 patients (9 males, 30 females; mean age 53.7±11.5 years) who received antineoplastic therapy including anthracycline. Comprehensive echocardiographic examination including tissue Doppler imaging and coronary flow reserve was performed before treatment with anthracycline and at the end of a six-month follow-up.
Eight patients (20.5%) developed cardiomyopathy during the follow-up period. Compared to patients with unaffected left ventricular ejection fraction at 6 months, patients with cardiomyopathy exhibited significant differences in baseline left ventricular systolic diameter, mitral E/A, E-wave deceleration time, Sm, Em, Em/Am ratio, Sm-Em duration, and the Tei index. In univariate logistic regression analysis, only Sm (OR 0.40, p=0.002) and the Tei index (OR 3.24, p=0.02) were significant variables for the development of cardiotoxicity. These two were also the only independent predictors of anthracycline cardiotoxicity in multivariate linear regression analysis. Receiver operating characteristic curve analysis yielded a cut-off value of 8 cm/sec for Sm and 0.38 for the Tei index to predict cardiomyopathy.
Our findings suggest that Sm and myocardial performance index (the Tei index) are significant independent markers to identify patients at high risk for the development of anthracycline-induced cardiomyopathy.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 12/2011; 39(8):646-53.
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ABSTRACT: Although various inflammatory markers have been studied in patients with slow coronary flow (SCF), serum neopterin levels have not been studied previously. We investigated the serum neopterin and high sensitivity C-reactive protein (hs-CRP) levels and the relationship between neopterin and hs-CRP levels and TIMI flow in patients with SCF.
The study group consisted of 51 patients with SCF. An age and gender matched control group was composed of 40 subjects. Coronary flow rates of all patients and control subjects were documented by Thrombolysis in Myocardial Infarction (TIMI) frame count. We measured serum neopterin and hs-CRP levels at the same time in patients with SCF and control subjects in this cross-sectional observational study. Chi-square, Mann-Whitney U and unpaired t tests, Pearson correlation and linear regression analyses were used for statistical analysis.
The TIMI frame counts for all coronary arteries and the mean TIMI frame count were significantly higher in the SCF group than controls. Serum neopterin levels were significantly higher among patients with SCF when compared with control group (2.13±1.03 vs. 1.60±0.50 ng/ml; p=0.004). Serum hs-CRP levels were significantly higher among patients with SCF when compared with control group (2.06±1.32 vs. 0.74±0.40 mg/L respectively; p<0.001). There was a significant association of serum neopterin levels (β=0.60, 95% CI: 4.93-9.06, p<0.001) and serum hs-CRP levels (β=0.29, 95%CI: 0.84-4.33, p=0.004) with mean TIMI frame count independent of potential confounders such as age, gender, body mass index, smoking, glucose and cholesterol levels.
We have shown that serum neopterin and hs-CRP levels were significantly elevated in patients with SCF when compared with control subjects. Serum neopterin and hs-CRP levels were correlated with mean TIMI frame count in patients with SCF.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 11/2011; 11(8):692-7. · 0.44 Impact Factor
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ABSTRACT: The purpose of the present prospective randomized study was to evaluate the effects of n-3 polyunsaturated fatty acids on recurrence rates of atrial fibrillation (AF) and inflammation after electrical cardioversion.
Calculation of the number of patients needed was based on the assumption of 20% and 65% chance of maintaining sinus rhythm with amiodarone and with polyunsaturated fatty acids, respectively. To observe a significant difference with an alpha level of 0.05 and a power of 0.80 it was necessary to include 22 patients in each group. A total of 47 patients were randomized to amiodarone (n=24) and amiodarone plus n-3 polyunsaturated fatty acids (n=23) groups before scheduled electrical cardioversion. The end-point was the recurrence of AF during 12-month follow-up. Effect of n-3 polyunsaturated fatty acids on inflammation was evaluated with high sensitivity C-reactive protein level measurements. Statistical analysis was performed using unpaired Student' t, Mann Whitney U and Chi-square tests. We analyzed the recurrence of AF using the Cox proportional hazards regression model to control for potentially confounding factors.
Nine patients in the amiodarone group (37.5%), and 9 patients in the amiodarone plus n-3 polyunsaturated fatty acids group (39.1%) had recurrence of AF during follow-up (p=1). With the Cox proportional model, risk factors for the recurrence of AF were previous electrical cardioversion (HR 10.33, 95% CI 1.74 to 61.10, p=0.01) and high sensitivity C-reactive protein levels (HR 1.07, 95% CI 1.02 to 1.38, p=0.007). High sensitivity C-reactive protein levels at baseline, at day 15 and during AF recurrence were similar between two groups (p > 0.05 for all).
N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2011; 11(4):305-9. · 0.44 Impact Factor
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ABSTRACT: Recent studies suggest that statins have anti-arrhythmic effects. The aim of this study was to evaluate the effects of statins on sustained ventricular tachycardia or ventricular fibrillation (S-VT or VF) in patients presenting with acute coronary syndrome (ACS).
The population of this study consisted of consecutive patients admitted to coronary care unit. It was an observational case-controlled retrospective analysis performed on prospective cohort. From a total of 1000 patients presenting with ACS, 241 were on and 759 were not on statin. Patient demographics, clinical characteristics and previous medical treatment including statins were recorded. A S-VT or VF episode during hospitalization was accepted as endpoint. Multiple logistic regression model was performed which considered the occurrence of S-VT or VF as the response variable.
Sustained VT or VF occurred in 3.3% of patients in statin group and in 9% of patients in non-statin group. Univariate positive predictors of S-VT or VF were ST elevation myocardial infarction as clinical presentation, smoking and thrombolysis; univariate negative predictors of S-VT or VF were ejection fraction, use of acetylsalicylic acid before hospitalization, use of statin before hospitalization, initiation of clopidogrel at the hospital and normal coronary arteries. In the multiple logistic regression analysis, the only independent predictor of S-VT or VF was ejection fraction (OR 0.96; 95% CI 0.93 to 0.99; p=0.005).
Our results indicate that, although the incidence of S-VT/VF was significantly lower in patients with ACS and previous statin use; statin use is not an independent predictor of the occurrence of S-VT or VF in patients presenting with ACS.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 02/2011; 11(1):22-8. · 0.44 Impact Factor
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ABSTRACT: Strong evidence has suggested that there is a circadian periodicity of acute coronary event. Beta-blockers, aspirin and angiotensin-converting enzyme inhibitors decrease the rate of acute myocardial infarction (AMI) and blunt the peak incidence in the morning. However, such effect has not been evaluated for statins. Accordingly, the present study aimed to evaluate the influence of statin therapy on circadian variation of AMI.
This retrospective study consisted of 451 consecutive patients with acute ST segment elevation AMI. The patients were divided into two group based on prior statin usage. In statistical analysis t test, Chi-square test and Mann Whitney U test were used for comparison of groups. We used harmonic regression models to evaluate the circadian variation of onset of MI symptoms in patients receiving statin and patients not receiving statin.
In all study participants, the highest incidence of AMI was between 6.00 and 12.00; the odds ratio was 1.34 (95% CI 1.20 to 1.46, p=0.001). In the non-statin group, the highest incidence of AMI occurred between 0:00 A.M. and 06.00. There was still a peak incidence between 6.00 A.M. and noon in the statin therapy receiving group; the odds ratio was 1.61 (95% CI 1.34 to 1.80, p=0.001). Accordingly, there was no statistical difference between the statin and non-statin groups regarding circadian variation of AMI. Prior usage of statin did not blunt the peak incidence of AMI in the morning.
Prior usage of statin does not seem to play a role in the circadian periodicity of AMI.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2010; 10(5):429-33. · 0.44 Impact Factor
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ABSTRACT: Renin-angiotensin system may be activated during atrial fibrillation (AF). Our aim was to evaluate plasma renin activity (PRA) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients with different AF types who had normal left ventricular (LV) systolic function.
This cross-sectional study included 97 patients with recent (<or=7 days), persistent (7 days to 12 months) and permanent AF (<or=12 months), and age- and sex-matched 30 controls with sinus rhythm. Plasma levels of PRA and NT-pro-BNP were measured and presented as median (25th-75th percentiles). Echocardiographic examination was performed in all population. Variance and logistic regression analyses were also used for multiple comparisons and independent predictors, respectively.
Median NT-proBNP levels were higher in overall patients with AF than in controls [114 (63-165) vs 50 (38-58) pg/ml, p=0.001), but PRA level was comparable in both groups. Similarly, NT-proBNP levels were also higher in all subtypes of AF compared with controls (p=0.05). In addition, there was a significant difference in NT-proBNP level among recent, persistent and permanent AF subtypes (p=0.001). This difference mainly derived from the recent AF subtypes. Whereas PRA level was similar in all AF subtypes and controls. Age was an independent predictor of PRA level >or=1.9 ng/ml/hour (OR=1.1, 95% CI 1.01-1.23, p=0.03). With NT-proBNP level >or=52 pg/ml, independent predictors were age (OR=1.1, 95% CI 1.01-1.19, p=0.02), presence of persistent and/or permanent AF (OR=6.8, 95% CI 1.03-45.7, p=0.04) and left atrial dimension (OR=1.2, 95% CI 1.03-1.36, p=0.02).
Plasma NT-proBNP levels can be associated with AF and its subtypes in patients with normal LV systolic function, whereas there was no association between PRA levels and AF.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 08/2010; 10(4):317-22. · 0.44 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the association between renin - angiotensin - aldosterone system blockers and risk of postoperative atrial fibrillation (AF) development in patients with mild and moderate left ventricular systolic dysfunction.
The population of this prospective and observational study consisted of 269 patients with an ejection fraction of < or = 50% undergoing coronary artery bypass and/or valve surgery. Use of renin -angiotensin-aldosterone system blockers (angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB) and spironolactone) and their association with postoperative AF (AF episode lasting < or = 5 min) were evaluated. In statistical analysis t test for independent samples, Chi-square test and Mann Whitney U test were used for comparison of variables between groups. Predictors of postoperative AF were determined by multiple logistic regression analysis.
During follow-up, 50 patients (13%) developed postoperative AF. With multiple logistic regression analysis, risk factors for postoperative AF were determined: left atrial diameter (OR- 1.09; 95%CI 1.01-1.16, p=0.02), age (OR-1.04; 95%CI 1.002- 1.08, p=0.04), aortic cross-clamp duration (OR- 1.03, 95%CI -1.00-1.05, p=0.01), use of left internal mammarian artery (OR-0.33; 95%CI 0.13-0.88, p=0.03), ACEIs treatment (OR-0.27; 95%CI 0.12-0.62, p=0.002), and ARBs treatment (OR - 0.21, 95%CI 0.07-0.62, p=0.005).
Our results indicate that although treatments with ACEIs and ARBs are associated with low incidence of postoperative AF in patients with mild and moderate left ventricular systolic dysfunction, treatment with spironolactone is not.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2010; 10(2):137-42. · 0.44 Impact Factor
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ABSTRACT: The renin-angiotensin system (RAS) can play an important role as the underlying mechanism for the development and recurrence of atrial fibrillation (AF). In addition, AF itself can lead to atrial structural and/or electrophysiologic remodeling by activating the RAS. This remodeling serves as an arrhythmogenic substrate for AF. Thus, the inhibition of RAS with angiotensin converting-enzyme inhibitor or angiotensin receptor blockers may be a strategy to prevent occurrence and recurrence of AF in certain patients such as those with heart failure and hypertension in associated with left ventricular hypertrophy. In addition, it may facilitate the cardioversion of AF. In this review, we overview the effect of RAS blockers on cardioversion success and recurrence of AF.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 12/2009; 9(6):505-11. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 03/2009; 9(1):69-70. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 05/2008; 8(2):166-8. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 01/2008; 7(4):453-4. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2007; 7(3):322-3. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 07/2007; 7(2):237-8. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2004; 4(3):277-8. · 0.44 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2004; 4(3):274. · 0.44 Impact Factor
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ABSTRACT: The aim of this study was to compare the electrocardiographic (ECG) abnormalities in patients with acute ischemic and hemorrhagic stroke who had no history of heart disease.
During 12 months, 222 consecutive stroke patients were enrolled in this study. Of them 162 had ischemic stroke and 60 had hemorrhagic stroke. Frequency of arrhythmias and ECG changes were compared between two stroke groups. Electrocardiographic abnormalities included ischemia-like changes (ST-segment depression or elevation, abnormal T and U waves), QTc prolongation and arrhythmias.
Ischemic stroke patients were elder than hemorrhagic ones (64+/-14 years vs. 57+/-13 years, p=0.003). Other clinical characteristics were comparable in both groups. Ischemia-like ECG changes were found in 65% of ischemic stroke patients while they were observed in 57% of hemorrhagic stroke patients (p=0.33). Atrial fibrillation was more frequent in ischemic stroke than in hemorrhagic stroke (34% vs. 13%, p=0.01) patients. Individually, other ECG abnormalities were not different in both groups. With relation of ECG abnormalities to location of the brain lesion, there was a trend in favor of involvement of the temporal, frontal and parietal lobes.
Regardless stroke-related lesion, ECG abnormalities can be seen frequently in stroke patients without primary heart disease. They can lead to diagnostic and therapeutic difficulties for cardiologists and neurologists.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 07/2004; 4(2):135-40. · 0.44 Impact Factor
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ABSTRACT: SüleymanDemirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 1998 Aralık; 5(4) Kısa Süreli Losartan Tedavisinin Hafif ve Orta Derece Esansiyel Hipertansiyonla Olgulardaki Etkileri Ahmet Altınbaş, Abdullah Doğan, Fehmi Özgüner ÖZET Esansiyel hipertansiyon sebebi belirlenemeyen hipertansiyon olarak tanımlanır. Yapılan farmakolojik çalışmalar hipertansiyon patofizyolojisinde renin anjiyotensin sisteminin, dolayısıyla anjiyotensin H'nin rolünü onaya koymuş¬tur, Anjiyotensin II reseptör antagonistleri non-peptid yapıda imidazol der iv eleridir. Losartan anjiyotensin II ATI re¬septörünün kompetitifantagonistidir. Bu çalışmanın amacı losartaııın esansiyel hipertansiyonla olgularda antihiper-tansif etkinliğini ve kan biyokimyasına etkilerini incelemektir. Çalışma daha önce antihipertansif tedavi almamış 22 olguda (ortalama yaş 46J±10.6,12' si kadın 10'u erkek) yapıldı. Tedavi sonrası sistolik ve diyastolik kan basınçları anlamlı ölçüde düştü (p
SDÜ Tıp Fakültesi Dergisi; Vol 5, No 4 (1998).
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ABSTRACT: SüleymanDemirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 1998 Aralık; 5(4) Primer Hiperkolesterolemili Yakalarda Kısa Süreli Pravastatmm Etkinliği Abdullah Doğan, Ahmet Altınbaş, Fehmi Özgüner ÖZET Anjiyografik çalışmalarda, serum kolesterol düzeylerinin azaltılmasıyla, koroner atherosklerozun gerilediği gös¬terilmiştir. Çalışmamızda, primer hiperkolesterolemüi hastalarda, pravastatinin kısa süreli etkinliğini ve yan etki pro¬fili incelendi. Diyete rağmen, hiperkolesterolemisi devam eden 26'sı erkek, 19'u kadın 45 hasta çalışmaya alındı. Yaş ortala¬ması 5520±11.62 yıldı. Aktif karaciğer hastalığı olanlar, üç ay içinde miyokard infarktüsü geçirenler ve kolesterol düzeyini etkileyebilecek ilaç kullananlar çalışma dışı bırakıldı. Vakaların %54 'ünde kesin koroner arter hastalığı var¬dı. Hastalara üç ay boyunca 10 mg/gün pravastatin verildi. Total kolesterolde %19 (294.40*37.04-239.75±32.76 mg/dL), LDL kolesterolde %27 (213.90+36,30-156.31'±34.01 mg/dL) ve trigliseritte %30 (169.33±15.45-118.34+38.27 mg/dL) azalma gözlendi. HDL kolesterolde ise %17 (47.29±963-553±8.54 mg/dL) artış bulundu. Tüm sonuçlar anlamlıydı (p
SDÜ Tıp Fakültesi Dergisi; Vol 5, No 4 (1998).
