Aydin Karanfil

Fatih University, İstanbul, Istanbul, Turkey

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Publications (9)12.64 Total impact

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    ABSTRACT: Objective: Mitral valve prolapse (MVP) is a commonly recognized syndrome with an apparent prevalence of approximately 4-6%. The incidence of ventricular arrhythmias and sudden death appears to be high in this patient group. It was also claimed that the prolonged QT or QT dispersion intervals in MVP cases could be related to arrhythmia and sudden death. The aim of the present study was to determine the electrocardiographic features (including QT dispersion) in MVP cases. Material and Methods: We studied 37 patients with MVP and 30 healthy control subjects. In all subjects, transthoracic 2-dimensional and Doppler echocardiographic examinations were performed. Classic MVP was defined as superior displacement of mitral leaflets of more 2 mm during systole and as a maximal leaflet thickness of at least 5 mm during diastole and non-classic prolapse was defined as displacement of more than 2 mm, with a maximal leaflet of 5 mm. Electrocardiographic (ECG) parameters including QT dispersion of patients with mitral valve prolapse (MVP) were statistically compared with the parameters of healthy control subjects. Correlations of ECG parameters between themselves and their correlations with age were observed. Results: PR interval, QRS complex duration and QTc duration of MVP cases were shorter than those control cases but these findings were statistically insignificant. QT and QTc dispersions of MVP cases were significantly longer than of control cases (42.9±15 and 47.5±17 ms). QT interval and QT dispersion were correlated with age among MVP cases. Compared with control group, nonspecific ST segment changes and dysrhythmia were found to be more frequent within MVP cases. Among MVP cases, QT dispersions of cases with ST segment changes were also significantly longer than MVP subjects with normal ECG findings (58.6±14.3 vs 38.6±12.6 ms). Conclusion: QT dispersion prolongation, ST segment changes and dysrhythmias are commonly observed among subjects with MVP, which may explain increased incidence of sudden death in this population. QT interval and QT dispersion should be followed clinically as a routine procedure in the management of MVP. Furthermore, It is advisable to consider whether there is MVP or not in a patient with ischemic like changes such as ST segment changes or dysrhythmia.
    No preview · Article · Jan 2010 · Turkiye Klinikleri Cardiovascular Sciences
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    ABSTRACT: Acute pancreatitis has frequently been reported to be associated with transient electrocardiography changes mimicking myocardial infarction despite normal epicardial coronary arteries. Although the origin of these findings is poorly understood, suggested mechanisms have included electrolyte abnormalities, a vagally mediated reflex, coronary vasospasm, and myonecrosis because of the release of pancreatic proteolytic enzymes. We report a case of acute pancreatitis with new-onset electrocardiography changes and bradycardia despite no evidence of coronary artery disease. After resolution of inflammation in the pancreas, T-wave depletions in V1-V6 derivations in electrocardiography disappeared and the rhythm was sinus with 70/min. 201-Tl myocardial perfusion scintigraphy revealed no evidence of significant coronary artery disease.
    Full-text · Article · Dec 2009 · The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology
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    ABSTRACT: Acute myocardial infarction may occur in young people with angiographically normal coronary arteries but the pathophysiol-ogy of this condition remains unknown. The possible mechanisms underlying myocardial infarction with normal coronary arteries are coronary vasospasm, thrombosis, embolization or minimal ath-erosclerosis. Smoking is an important predisposing risk factor for myocardial infarction in the presence of normal coronary arteries. We describe a case of acute myocardial infarction in a adolescent female who had normal coronary arteries according to multislice computed tomography coronary angiography results.
    No preview · Article · Jan 2009 · European Journal of General Medicine
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    ABSTRACT: N-terminal probrain natriuretic peptide (NT-proBNP) is elevated in patients with heart failure. Numerous clinical trials have evaluated the efficacy of spironolactone in heart failure; however, no studies have directly examined the effects of spironolactone treatment on NT-proBNP level. This study investigated whether NT-proBNP levels decrease with daily spironolactone treatment. The study consisted of 117 adult patients with heart failure. All participants were divided into 3 groups, class I, class II, and class III, according to the New York Heart Association classification system. Patients were randomly assigned to receive spironolactone or were treated with another drug, other than spironolactone, as placebo. NT-proBNP plasma samples were taken at baseline and after 6 mo of treatment. A total of 62 patients were treated with daily spironolactone; 55 patients were followed with available treatment without spironolactone. The baseline demographic and laboratory parameters were similar for patients in all groups. At the end of 6 mo, spironolactone-treated patients had significantly lower NT-proBNP levels and significantly better ejection fractions than did patients in all New York Heart Association classes who were not treated with spironolactone. Results suggest that spironolactone decreases plasma NT-proBNP concentrations, and that the measurement of plasma NT-proBNP levels may be helpful in assessing therapeutic efficacy in patients who are treated for heart failure.
    No preview · Article · Nov 2007 · Advances in Therapy
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    ABSTRACT: Cyclosporine A (CsA) is a frequently used immunosuppressive agent in transplant medicine to prevent rejection and in the treatment of autoimmune diseases. However, CsA generates reactive oxygen species, which causes nephrotoxicity, hepatotoxicity and cardiotoxicity. The use of antioxidants reduces the adverse effects of CsA. The aim of this study is to determine the protective effects of erdosteine on CsA-induced heart injury through tissue oxidant/antioxidant parameters and light microscopic evaluation in rats. CsA cardiotoxicity was induced by administrating an oral dose of 15mg/kg CsA daily for 21 days. The rats were divided into four groups: control group (n=4), CsA administrated group (15mg/kg, n=5), CsA+erdosteine administrated group (10mg/kg day orally erdosteine, n=4) and only erdosteine administrated group (10mg/kg day orally n=5). CsA treated rats showed increase in the number of infiltrated cells and disorganization of myocardial fibers with interstitial fibrosis. The number of infiltrated cells, disorganization of myocardial fibers and interstitial fibrosis was diminished in the hearts of CsA-treated rats given erdosteine. The malondialdehyde, the protein carbonyl content and nitric oxide levels were increased in the cyclosporine A group in comparison with the control and CsA plus erdosteine groups. The activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) were higher in CsA plus erdosteine group than CsA group. However, the CAT, GSH-Px and SOD activities were significantly lower in CsA group than in control group and erdosteine group. These results suggest that erdosteine has protective effect against CsA-induced cardiotoxicity.
    No preview · Article · Oct 2007 · Toxicology
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    ABSTRACT: We report a case of infective endocarditis developing after pedicure in a 36-y-old female. Methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis was diagnosed. Even aggressive therapy was ineffective. To our knowledge, we report the first case of infective endocarditis secondary to pedicure in the literature.
    No preview · Article · Feb 2007 · Infectious Diseases
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    Full-text · Article · Dec 2005 · European Journal of Internal Medicine
  • Mesut S Tezer · Aydin Karanfil · Davut Aktaş
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    ABSTRACT: Adenoid hypertrophy causing upper airway obstruction can cause cardiovascular complications, including pulmonary hypertension and right heart failure in children. Adenoidal-nasopharyngeal ratio (ANR) is a practical, non-invasive and reliable method to evaluate adenoid enlargement. Our aim was to evaluate a possible association between ANR and echocardiographic parameters of right ventricle. Twenty-one children who were affected by upper respiratory obstruction symptoms due to adenoid hypertrophy were included in this study (male/female: 12/9; mean age was 6.0 +/- 1.5 years). ANRs were calculated as the ratio of adenoidal depths to the nasopharyngeal depths on lateral cephalometric radiographs. Pulmonary arterial pressures, right ventricular diastolic filling parameters (peak E, peak A, E/A ratio), right ventricular end-diastolic diameters, and left ventricular ejection fractions were measured using echocardiography both preoperatively and also 3 months after the operation. Preoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 23.10 +/-3.43 mmHg, 1.01 +/- 0.20, 1.95 +/- 0.16 cm, and 69.43 +/- 3.68%, respectively. Postoperative pulmonary arterial pressure, E/A ratio, right ventricular end-diastolic diameter, and left ventricular ejection fraction values were 16.94 +/- 1.45 mmHg, 1.24 +/- 0.14, 1.72 +/- 0.15 cm, and 69.77 +/- 2.17%, respectively. There were significant differences between preoperative and postoperative pulmonary arterial pressures, E/A ratios, and right ventricular end-diastolic diameters (p < 0.01 for each), while left ventricular ejection fraction values did not significantly change after the operation (p > 0.05). There was a negative correlation between E/A ratio and ANR-Ba (p < 0.05, r = -0.44). ANR can give information about the right ventricular functions in children with enlarged adenoids causing obstructive symptoms.
    No preview · Article · Sep 2005 · International Journal of Pediatric Otorhinolaryngology
  • Ayşe Tunca · Aydin Karanfil · Asli Köktener · Ayşe Kargili · Oguz Tekin
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    ABSTRACT: It remains controversial as to whether mitral annular calcification (MAC) is an independent predictor of stroke. The aim of this study was to investigate whether there is an association between the presence of MAC and stroke or whether MAC is one of the predictive factors of carotid atheroma and therefore is a secondary risk for stroke. Fifty-six patients who had MAC demonstrated by echocardiography underwent carotid artery duplex sonography and computed brain tomography with various causes were enrolled in the study. They were compared with 58 control patients without MAC. MAC was defined as a dense, localized, highly reflective area larger than 5 mm at the junction of the atrioventricular groove and posterior mitral valve leaflet. Carotid artery stenosis was defined as lumen diameter narrowing exceeding 60%. Cerebral ischemia was detected by spiral tomography and was classified as infarction and lacunae. A significant association was found between the presence of MAC and carotid atheroma (P = 0.011), MAC and hyperechogen plaque (P = 0.034), and MAC and stenosis (P = 0.008). There was an association between the presence of carotid atheroma and cerebral infarction (P = 0.007). Logistic regression analysis revealed hypertension and diabetes mellitus were independent risk factors (P = 0.030, P = 0.034, respectively) for developing carotid atheroma. MAC was an independent factor for carotid stenosis (P = 0.029). MAC may not be a significant causative factor for stroke, but may be a secondary risk factor. A significant association between the presence of MAC and carotid artery atherosclerotic disease may explain the high prevalence of stroke in patients with MAC.
    No preview · Article · Dec 2004 · Japanese Heart Journal