Mehmet Bilge

Yuzuncu Yil University, Thospia, Van, Turkey

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Publications (42)109.58 Total impact

  • Ali Ozeren · Mustafa Aydin · Mehmet Bilge · Aydin Dursun · Tolga Onuk

    No preview · Article · Aug 2005 · International Journal of Cardiology
  • Ali Ozeren · Mustafa Aydin · Mehmet Bilge · Fatih Cam
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    ABSTRACT: We report a case of 56-year-old man whose coronary angiography showed a single coronary artery arising from a single ostium in the right sinus of Valsalva.
    No preview · Article · Jul 2005 · International Journal of Cardiology
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    ABSTRACT: Spontaneous coronary artery dissection (SCAD) is relatively uncommon. It often occurs in healthy, middle-aged women without overt risk factors for atherosclerosis and is associated with the peripartum period. The pattern and severity of presentation are variable. There are only 5 reports in the literature about multivessel involvement. The etiopathogenesis of SCAD is unclear. Treatment strategy is not standard but is usually tailored to clinical features. Long-term survival of patients with SCAD who have had no problem at the initial event is good. The authors report the first case of unhealed chronic multivessel SCAD in the literature.
    No preview · Article · May 2005 · Angiology
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    ABSTRACT: The purpose of this prospective study was to determine the relationship between circadian blood pressure and left ventricular diastolic function in essential hypertension. The study population included 25 patients aged 56 +/- 18 years with non-dipper hypertension and 25 age- and sex-matched patients with dipper hypertension. They underwent conventional Doppler echocardiography and color tissue Doppler from apical 4- and 2-chamber views. In non-dipper patients, diastolic left ventricular function was reduced significantly. The transmitral E wave decreased (0.55 +/- 0.2 vs 0.62 +/- 0.2 m/s, P < 0.05), the transmitral A wave increased (0.77 +/- 0.1 vs 0.70 +/- 0.1 m/s, P < 0.01), the transmitral E/A ratio decreased (0.78 +/- 0.1 vs 0.86 +/- 0.2, P < 0.05), and the transmitral E-wave deceleration time increased in non-dipper patients (211 +/- 44 vs 196 +/- 42 ms, P < 0.05). The isovolumic relaxation time increased (112 +/- 15 vs 105 +/- 14 m/s, P < 0.05). The mean left ventricular myocardial velocities also differed significantly; the early diastolic velocity decreased (5.9 +/- 2. 1 vs 77 +/- 3.1 cm/s, P < 0.01), the late diastolic velocity increased (9.5 +/- 2.7 vs 8.7 +/- 1.6 cm/s, P < 0.05), and the E/A ratio decreased (0.68 +/- 0.55 vs 0.94 +/- 0.39, P < 0.01). These findings suggest that non-dipper hypertensive patients who have impaired left ventricular diastolic function should be identified early for careful follow-up and possible referral to a specialized center.
    Full-text · Article · Jan 2005 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
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    ABSTRACT: This study was designed in order to investigate the effects of dipper and non-dipper status of hypertension on left atrial mechanical (reservoir, conduit and booster pump) functions with left atrial volume measurements by means of two-dimensional echocardiography in untreated systemic hypertensive patients. A total of 27 untreated dipper hypertensive patients, group I (15 female, 12 male, mean age 57+/-12 years); 23 untreated non-dipper hypertensive patients, group II (12 female, 11 male, mean age: 53+/-18 years); and 25 voluntary healthy individuals, group III (13 female, 12 male, mean age 53+/-10 years) were included into the study. Twenty-four hour blood pressure (BP) measurement was performed by the cuff-oscillometric method to evaluate the nocturnal decrease of BP. The patients whose night time mean blood pressure measurements were found 10% or more lower compared to mean day time measurements were classified as dipper hypertensive patients and the ones with a decrease of less than 10% were classified as non-dipper hypertensive patients. Left atrial (LA) volumes were measured echocardiographically according to biplane area-length method in apical four-chamber and two-chamber views. LA maximal volume (V(max)) was recorded at the onset of mitral opening, LA minimal volume (V(min)) was recorded at the onset of mitral closure and LA presystolic volume (V(p)) was recorded at the beginning of the atrial systole (p wave on ECG). All volume measurements were corrected to body surface area, and following LA emptying functions parameters were calculated: LA passive emptying volume (LAPEV)=V(max)-V(p), LA passive emptying fraction (LAPEF)=LAPEV/V(max), Conduit volume (CV)=left ventricular output volume-(V(max)-V(min)), LA active emptying volume (LAAEV)=V(p)-V(min), LA active emptying fraction (LAAEF)=LAAEV/V(p), LA total emptying volume (LATEV)=V(max)-V(min), LA total emptying fraction (LATEF)=LATEV/V(max). LA volume indexes, V(max), V(min), and V(p), were significantly increased in the hypertensive subgroups (groups I and II) than in controls (p<0.001, p<0.001, p<0.001, respectively), but no significant difference was found in the V(p) values between group I and group II. V(max) and V(min) were larger in non-dipper hypertensive group than in dipper hypertensive group (p<0.05 and p<0.05, respectively). LAPEV and LAPEF were observed to be significantly reduced in both dipper and non-dipper hypertensives than in control (p<0.001 and p<0.05, respectively), and this difference was more obvious in non-dipper than dipper cases (p<0.001). Conduit volume was significantly lower in hypertensive groups than controls (p<0.05). LA active emptying volume (p<0.001) and LAA active emptying fraction (p<0.001) were significantly greater in hypertensive cases than in controls. Furthermore, LA active emptying volume in non-dipper hypertensive subjects was significantly greater than dipper hypertensive cases (p<0.05). Left atrial total emptying volume and left atrial total emptying fraction in both hypertensive groups were similar to control (p>0.05). Atrial reservoir and booster pump functions increase in hypertensive patients, but this result is more prominent in non-dipper hypertensives than in dipper hypertensive patients.
    No preview · Article · Sep 2004 · International Journal of Cardiology
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    ABSTRACT: This study was conducted to evaluate the effect of metoprolol therapy on pulmonary venous flow pattern in patients with mild to modarete mitral stenosis in sinus rhythm. We studied 23 patients with isolated mild to moderate mitral stenosis (mitral valve area 1.6±0.3 cm 2). All patients received metoprolol 100 mg once daily orallyfor 1 month. Pulsed wave Doppler transesophageal echocardiograpic examination of the pulmonary venous flow was performed at the beginning of the study and after 1 month of treatment. Peak systolic pulmonary venous fiow (PVs) velocity, PVs velocity time integral (VTI), peak diastolic pulmonary venous flow (PM) velocity, PVd-VT, peak pulmonary venous atrial reversal flow (PVd) velocity, PVa-VTI, and PVa duration time were measured. Peak and mean transmitral gradient, pulmonary artery pressure, systolic and diastolic blood pressure, and heart rate, reduced significantly after metoprolol treatment. The pulmonary venous peak systolic velocity, and pulmonary venous atrial reversal flow velocity duration time increased significantly from 0.55 ± 0.19 m/s to 0.66 ± 0.12 m/s, p<0.05, and from 84 ± 27 to 11 2± 31 msec, p<0.01, respectively). Regarding VTI, PVs-VTI increased from 10.8±3.2 cm to 11.9±4.3 cm (p<0.01), PVd-VTI increased from 5.1±2.4 cm to 5.4±2.5 cm (p<0.05), and PVa-VTI increased from 2.8±1.1 cm to 3.1±1.3 cm, p<0.05. Conclusion: Metoprolol treatment increased pulmonary venous flow as an indicator of improved left atrial function in patients with mitral stenosis and sinus rhythm. These results may contribute to disclosing the underlying mechanisms of the favourable effects of beta blockade in mitral stenosis.
    No preview · Article · Jun 2004
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    ABSTRACT: We report a 64-year-old Turkish man who presented with unstable angina pectoris. Coronary angiography revealed massive intracoronary thrombus, which completely occluded the distal part of the left circumflex coronary artery. The thrombotic segment and the rest of the coronary tree were free of atherosclerosis. The patient was treated with intravenous tirofiban, a glycoprotein IIb/IIIa inhibitor. A control angiography was performed one week later and showed total dissolution of the thrombus with tirofiban therapy.
    No preview · Article · Apr 2004 · Japanese Heart Journal
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    M Aydin · A Ozeren · M Bilge
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    ABSTRACT: A 76 year old man presented with chest pain; he had a personal history of hypertension, diabetes mellitus, and pneumoconiosis. He was hospitalised because of an inferior myocardial infarction. On the fifth day of his clinical follow up in the coronary intensive care unit, the patient experienced chest discomfort and palpitation, and an ECG revealed atrial fibrillation and ST segment depression. Afterwards, coronary angiographic examination revealed a thrombus that was narrowing the lumen to 80% at the bifurcation of the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (LCx) distal to the left main coronary artery (panel A). TIMI II flow was present at the distal LAD and LCx. The patient was treated with tissue plasminogen activator (tPA) because of intracoronary thrombus. One hour after the onset of treatment, the angina pectoris ceased and a normal sinus rhythm returned. ST segment depressions and T wave inversions on anterior derivatives returned to normal. Cardiac troponin I concentration increased to 2 ng/dl (normal limits 0.01–0.1 ng/dl). The patient was diagnosed with non-ST elevation myocardial infarction. Coronary angiography was repeated two days later. The large thrombus in the distal left mean coronary artery was found to have resolved (panel B).Several pathogenic processes, besides atherosclerosis, are known to involve the coronary arteries and to be responsible for severe acute coronary syndromes. Coronary embolism is included among non-atherosclerotic entities causing acute myocardial infarction and should be suspected in the presence of atrial fibrillation, and left atrial or ventricular thrombus. We report a case of distal left main coronary artery thrombus which was detected by coronary angiography and treated by tissue plasminogen activator.
    Full-text · Article · Apr 2004 · Heart (British Cardiac Society)
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    ABSTRACT: We present the case of a patient in whom a previously undetected anomalous origin of the circumflex coronary artery caused myocardial ischemia and led to positive myocardial scintigraphic results. Subsequent coronary angiography showed that the left circumflex coronary artery arose from the right coronary ostium-an anomaly that has been associated with chest discomfort-without atherosclerotic lesions. The peripheral distribution of the left circumflex artery was normal. We describe the clinical and angiographic findings in our patient and discuss the relationship between coronary artery anomalies and ischemia.
    Full-text · Article · Feb 2004 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
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    ABSTRACT: The authors describe a case of pulmonary endarteritis and subsequent embolization to the lungs as a complication of a patent ductus arteriosus (PDA). Although 2-dimensional echocardiography has been shown to be of great value in the diagnosis of patients with infective endocarditis, echocardiographic detection of vegetation within the pulmonary artery and subsequent embolization to the lung is extremely rare and, to our knowledge, has been previously reported only in a few cases. In brief, our case not only shows the importance of echocardiography in making this rare diagnosis but also emphasizes the role of echocardiography as an effective means of following up such a case.
    Full-text · Article · Jan 2004 · Angiology
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    ABSTRACT: To analyze the function of cardiac autonomic regulation in patients with obstructive sleep apnea syndrome (OSAS), we enrolled 36 patients with OSAS and divided them according to the apnea hypopnea index (AHI) into 2 groups: Group I (n=19) had mild OSAS (AHI < 20) and Group II (n=17) had severe OSAS (AHI > or = 20). The findings were compared with those of 24 healthy control subjects who were matched for age, sex, blood pressure, and body mass index. All participants underwent 24-hour Holter monitoring, with continuous time-dependent and spectral analysis of heart rate variability. In addition, we performed arrhythmia analysis. Frequent or repetitive ventricular arrhythmias (> or = 30 premature ventricular beats/hour) were detected in 15 (42%) patients with OSAS and in 6 (25%) members of the control group. In both mild and severe OSAS, SDNN was significantly lower than in controls, and SDANN findings were similar. In mild OSAS, RMSSD values were not significantly lower than in controls, but in severe OSAS they were. The ULF, VLF, LF and LF/HF values of both groups of OSAS patients were significantly higher than those of controls, but their HF values were lower. The mean LF/HF ratio during the same period was significantly higher in Group II than in Group I and the control group. Our results suggest that cardiac autonomic activity may be altered in patients with OSAS throughout a 24-hour period, that this alteration occurs even in the absence of hypertension, heart failure, or other disease states, and that it is linked to the severity of OSAS.
    Full-text · Article · Jan 2004 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital

  • No preview · Article · Feb 2003 · Thrombosis Research
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    ABSTRACT: The purpose of this study was to evaluate the chronic effect of rilmenidine on time domain indexes of heart rate variability in patients with mild hypertension. Twenty patients (12 males, eight females; mean age, 47 yr; age range, 38-55 yr), with untreated and newly diagnosed mild hypertension were studied. There was no evidence of diseases other than hypertension. All patients received 1 mg of rilmenidine once daily. If the diastolic blood pressure was still greater than 90 mm Hg after 4 weeks of active treatment, the dose was increased to 2 mg once daily. Twenty-four hour ambulatory electrocardiograms were recorded before, and 4 and 12 weeks after the start of therapy. Time domain parameters of heart rate variability were calculated. Rilmenidine therapy determined a marked decrease in blood pressure. At 4 weeks, rilmenidine induced a significant reduction in systolic and diastolic blood pressure and a further reduction was observed after 12 weeks. At 4 and 12 weeks, time domain parameters of heart rate variability and heart rate were not significantly different in the data obtained before therapy. In conclusion, this study demonstrated that the administration of rilmenidine to patients with mild essential hypertension induced significant reductions in blood pressure, without any significant changes in time domain parameters of heart rate variability.
    No preview · Article · Mar 2002 · Angiology
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    ABSTRACT: To investigate whether reduction in blood pressure has a beneficial effect on left atrial appendage (LAA) function, the authors evaluated 24 untreated systemic hypertensive patients with normal left ventricular systolic function in sinus rhythm at baseline and at 3 months after initiation of antihypertensive therapy. They performed transthoracic and transesophageal echocardiographic examinations in hypertensive patients before and after treatment of hypertension. Three of the 24 patients had blood pressure that failed to respond to the regimen of antihypertensive therapy and were removed from the analysis. Of the remaining 21 patients, mean systolic and diastolic blood pressures at baseline were 170 +/- 18 and 104 +/- 6 mm Hg, respectively, and fell significantly at 3 months to 141 +/- 10 and 90 +/- 5 mm Hg, respectively, (p<0.001) after initiation of antihypertensive therapy. There was no significant change in heart rate with treatment (baseline 81 +/- 8 and at 3 months 84 +/- 9 beats/min). There was no significant change in left ventricular end-diastolic diameter, left ventricular ejection fraction, left ventricular wall thickness, or left atrial diameter from baseline (49 +/- 4 mm, 58 +/- 5%, 12 +/- 1 mm, and 41 +/- 4 mm, respectively) at 3 months (48 +/- 5 mm, 59 +/- 4%, 12 +/- 1 mm, and 40 +/- 3 mm). The treatment caused a significant reduction in maximal LAA areas (6.3 +/- 1.3 cm2 at baseline, 4.6 +/- 0.7 cm2 at 3 months, p<0.001), with a concomitant increase in LAA emptying velocity (44 +/- 7 cm/sec at baseline, 60 +/- 9 cm/sec at 3 months, p<0.001). In conclusion, these findings suggest that reduction in blood pressure with antihypertensive therapy could improve LAA function in hypertensive patients with normal left ventricular systolic function in sinus rhythm.
    No preview · Article · Sep 2001 · Angiology
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    ABSTRACT: Duplex-Doppler study typically exhibits triphasic brachial artery blood flow velocity pattern in subjects classified as normal without clinically evident atherosclerotic complications, heart disease, hypertension, or diabetes mellitus. In this study, the authors described the late systolic wave on the brachial artery blood flow velocity pattern in patients with coronary artery disease and investigated the relation between late systolic wave and vascular stiffness. Blood flow profile and velocity of the brachial artery were determined noninvasively by ultrasound pulsed-Doppler technique under the guidance of a B-mode ultrasound image in 96 patients with coronary artery disease (CAD). The control group consisted of 23 healthy subjects with no or maximally 2 risk factors (only among age, cigarette smoking, obesity, and gender) for vascular disease. None of the patients and controls had clinical evidence of arterial disorders at upper extremities. In 32 patients (33%) with CAD, a late systolic wave was observed in the brachial artery Doppler study. On the other hand, no late systolic wave was observed in the healthy subjects. In addition, multivessel disease, hypertension, advanced age, diabetes, and smoking were significantly more frequent in patients with the late systolic wave. In conclusion, peripheral arterial abnormalities induced by vascular stiffness may produce alterations in regional wave reflections, and the normal triphasic pattern of the brachial artery blood flow may change by the appearance of the late systolic wave.
    No preview · Article · Sep 2001 · Angiology
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    B Eryonucu · K Uzun · N Güler · M Bilge
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    ABSTRACT: This study investigated the effects of beta2-adrenergic agonist therapy on heart rate variability (HRV) in adult asthmatic patients by using frequency domain measures of HRV. A randomized crossover design was used. Twenty adult patients with asthma were studied. All patients showed a mild-to-moderate decrease in baseline forced expiratory volume in one second. Any diseases that might have influenced the autonomic function were excluded. All patients had a complete physical examination and medical history that revealed no cardiovascular disease or medication. The study used 200 microg inhaled salbutamol and 500 microg inhaled terbutaline. HRV analysis was performed for each 5-min segment, 5 min before inhalation of the study drug and 5, 10, 15, 20, 25 and 30 min after inhalation. Total power (TP: <0.40 Hz), high-frequency power (HF: 0.15-0.40 Hz), low-frequency power (LF: 0.04-0.15 Hz) and LF/HF ratio were calculated. The LF and LF/HF ratio increased and TP decreased at 5, 10, 15 and 20 min after the salbutamol and the terbutaline inhalation, HF did not change significantly after the salbutamol and terbutaline inhalation. Acute salbutamol and terbutaline inhalation produce similar effects on heart rate variability and increase sympathetic modulation in the cardiac autonomic activity.
    Preview · Article · Jun 2001 · European Respiratory Journal
  • Beyhan Eryonucu · Mehmet Bilge · Niyazi Güler
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    ABSTRACT: Depressed heart rate variability (HRV) is associated with increased mortality and morbidity with various forms of heart disease, and the Duke treadmill score (DTS) provides diagnostic and prognostic information for the evaluation of patients with coronary artery disease (CAD). Our study was aimed at assessing any possible correlation between HRV and DTS in stable CAD. We evaluated the correlation between the HRV assessed by using 24 hour ambulatory ECG monitoring, and treadmill exercise score in 37 patients with angiographically proven and clinically stable CAD. In univariate analysis, DTS showed a significant negative correlation with age (r=–0.89, p50 ms (PNN50) (r=0.69, P
    No preview · Article · May 2001 · International Journal of Angiology
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    ABSTRACT: A young male with Wolff-Parkinson-White syndrome whose electrocardiographic pattern was suggestive of acute anterior myocardial infarction is described. A 21-year-old male with a history of ventricular fibrillation after being successfully resuscitated was admitted to the coronary care unit. His electrocardiogram showed ST elevation in the precordial leads (V1-V6). This condition was erroneously interpreted as an acute myocardial infarction. At the fourth day, while ST elevations returned to baseline, short PR interval and delta waves were observed on the ECG. Myocardial infarction was excluded by biochemical tests, echocardiography, and coronary angiography. Electrophysiologic study confirmed Wolff-Parkinson-White syndrome with two accessory pathways.
    No preview · Article · May 2001 · Angiology
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    ABSTRACT: Cardiac troponin levels are regarded as the most specific of currently available biochemical markers of myocardial damage. Elevated levels of troponin have been previously reported in patients with left heart failure, reflecting small areas of undetected myocardial cell death. The aim of this study was to compare the levels of the cardiac troponin I (cTnI) in patients with left- and right-sided heart failure. Cardiac troponin I levels were studied with immunochemical methods in patients with right heart failure (n = 17) resulting from chronic obstructive pulmonary disease, ischemic left heart failure (n = 23), and nonischemic left heart failure (n = 18) who were admitted to departments of cardiology and chest diseases. Also, cTnI levels were measured in 32 healthy subjects as control group. Protein markers of myocardial injury (cTnI and myoglobin) in patients with left and right heart failure were collected approximately 12 to 36 hours after onset of obvious symptoms. Serum creatine kinase MB band was determined on admission and thereafter twice a day during the first 3 days. Elevated levels of serum cTnI were found in patients with nonischemic (0.83 +/- 0.6 ng/mL, p<0.01) and ischemic left heart failure (0.9 +/- 0.5 ng/mL, p<0.01) when compared to healthy subjects, whereas serum cTnI levels in patients with right heart failure due to chronic obstructive pulmonary disease were not significantly different from those of control subjects (0.22 +/- 0.1 vs 0.16 +/- 0.1 ng/mL, p>0.05). In addition, creatine kinase MB band and myoglobin levels were not significantly different between patient and healthy groups. The mean of cTnI levels in ischemic and even nonischemic left heart failure were increased compared to the mean of values in healthy individuals but without significant creatine kinase MB band and myoglobin elevations. But cTnI levels were not increased in patients with right heart failure due to chronic obstructive pulmonary disease. These data indicate that the cTnI levels are abnormal in left heart failure but not in cor pulmonale.
    No preview · Article · May 2001 · Angiology
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    ABSTRACT: To examine the effects of halothane, isoflurane, and sevoflurane on Q-Tc interval (corrected for heart rate) during inhalation induction of anesthesia. Prospective, double-blind, randomized study. Departments of Cardiology and Anesthesiology in a university hospital. Patients undergoing noncardiac surgery. A total of 65 American Society of Anesthesiologists physical status I-II patients, aged 16 to 50 years, undergoing general anesthesia, were randomly allocated to receive halothane, isoflurane, or sevoflurane. The time to reach the predetermined end-tidal concentrations of 3 minimum alveolar concentration was 6 to 10 minutes. When compared with preinduction values, heart rate decreased after halothane (p < 0.01) and sevoflurane (p < 0.05) administration; in contrast, heart rate increased after induction of anesthesia with isoflurane (p < 0.05). The mean QRS intervals were not significantly changed after halothane, isoflurane, or sevoflurane. The Q-Tc interval was increased with isoflurane compared with baseline (465 +/- 23 v 441 +/- 18 msec, p < 0.01), not changed with sevoflurane (441 +/- 17 v 434 +/- 19 ms, p > 0.05), and shortened with halothane (426 +/- 23 v 445 +/- 21 msec, p < 0.01). Sevoflurane or halothane may be preferred to isoflurane in patients with conditions that are known to induce a prolonged Q-Tc interval. The effects of Q-Tc interval changes resulting from different anesthetic agents on morbidity and the incidence of arrhythmias during anesthesia warrant further investigation.
    No preview · Article · Apr 2001 · Journal of Cardiothoracic and Vascular Anesthesia