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    Investigating of the heart rate variability according to prolapse degree in patients possessing mitral valve prolapse
    (2011) Karakaya, Ilknur; Gürbüz, Süleyman; Tümer, Cemil; Akgül, Ferit; Yalçin, Fatih
    Objective: The serious arrhythmia which results in sudden death is related with increased sympathetic activity and diminished parasympathetic activity in mitral valve prolapse (MVP). Heart rate variability (HRV) is a simple method to assess both sympathetic and parasympathetic activities. The aim of this study was to investigate if there is a difference in HRV according to the severity of MVP. Material and Methods: The research was conducted in 88 person (58 woman and 30 man, mean age 35 ± 11 years) between 2008-2009. Twelve derivated electrocardiography machine and HRV analysis programme were used for HRV. The low frequency (LF) value which reflecting a HRV parameter, i.e; sympathovagal activity, high frequency (HF) value which reflecting parasympathetic activity and LF/HF ratio reflecting sympathovagal balance were measured. Results: It was found that mean LF value of control group was lower than that in moderate and severe MVP groups (p< 0.05, p< 0.001 respectively), when they were compared according to their HRV parameters. Moreover, when the patient groups were compared with each other it was determined that LF level of heavy MVP group was lower than mild MVP (p< 0.01). HF and LF/HF values was lower in severe MVP group compared to control group (p< 0.01, p< 0.05 respectively). Conclusion: As a result, while prolapse level rises, heart rate variability decreases in MVP patients in this research. So, early detection of decreased heart rate variability in patients with mitral valve prolapse is significant in terms of risk definition and prevent the possible arrhythmia-induced complications. Copyright © 2011 by Türkiye Klinikleri.
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    Öğe
    Prothrombin time, activated thromboplastin time, fibrinogen and D-dimer levels and von-Willebrand activity of patients with sheehan’s syndrome and the effect of hormone replacement therapy on these factors
    (2010) Paşa, Semir; Altıntaş, Abdullah; Tümer, Cemil; Demircin, Mustafa; Çil, Timuçin; Bayan, Kadim; Danış, Ramazan; Tüzün, Yekta; Atayan, Yahya; Ayyıldız, Orhan; Bahçeci, Mithat
    Increased mortality due to atherosclerotic cardiovascular disease has been described in adult patients with hypopituitarism, although the precise underlying mechanisms remain undetermined. Various abnormalities of coagulation and fibrinolysis occur in patients with thyroid diseases. Conversely, there are conflicting reports concerning the effects of growth hormone replacement on coagulation and fibrinolytic pathways in hypopituitary adults, and there is no existing data on the effects of hypocortisolism on thrombotic and fibrinolytic systems. The same controversial data were also obtained in studies which evaluate the effects of estrogen replacement therapy on cardiovascular events in post-menopausal women. The aim of this study was to investigate the effects of Sheehan&#8217;s syndrome (SS), which is a common cause of hypopituitarism, on haemostatic factors and to assess the effects of L-thyroxin, prednisolone and conjugated estrogen / medroxyprogesterone acetate replacement on these factors. Prothrombin time (PT), activated thromboplastin time (aPTT), fibrinogen and D-dimer levels, and von-Willebrand factor (vWF) activity were compared among 32 patients with SS and 35 control subjects (CS) with similar age. A shorter PT and aPTT, higher fibrinogen and d-dimer levels, and similar vWF activity were determined in patients with SS as compared with CS. In addition, it was determined that hormone replacement treatment did not have a significant effect on coagulation parameters except the fibrinogen and d-dimer levels.