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    Evaluation of collateral circulation with clinical, electrocardiographic, and angiographic parameters in patients with acute myocardial infarction
    (2006) Seyfeli, Ergün; Arinç, Hüseyin; Çiçek, Yüksel; Özdo?ru, Ibrahim; Sa?lam, Hayrettin; Abaci, Adnan; Yalçin, Fatih
    Objectives: We investigated the presence of collateral circulation (CC) during early period of acute myocardial infarction (AMI) and evaluated its relationship with clinical, electrocardiographic, and angiographic parameters. Study design: In 79 patients (63 men, 16 women; mean age 57 years) who presented within the first six hours of AMI, coronary angiography was performed before primary angioplasty to determine the infarct-related artery (IRA), the number of arteries with significant stenosis (?50%), localization of stenosis (proximal, middle, or distal), and the presence of CC. The presence of Q waves and reciprocal ST-segment changes were evaluated on initial electrocardiograms. Collateral circulation to the IRA was graded according to the Rentrop scoring system. Results: Collateral circulation to the IRA was detected in 31 patients (39.2%). Infarct-related artery was the left anterior descending (LAD) coronary artery in 43 patients (54.4%), circumflex (Cx) artery in 11 patients (13.9%), and the right coronary artery (RCA) in 25 patients (31.7%). On initial electrocardiograms, Q wave was absent in 34 patients (43%) and reciprocal ST-segment depression was present in 53 patients (67.1%). Collateral circulation was more common in RCA occlusions than those involving the LAD and Cx arteries (60%, 32.6%, and 18.2%, respectively; p=0.012). The presence of CC was significantly correlated with hypertension (r=0.226, p=0.045) and RCA occlusion (r=0.309, p=0.006). In multiple regression analysis, only RCA occlusion was found to be an independent predictor for CC (r=0.377, p<0.001). Conclusion: In the early period of AMI, collateral circulation becomes functional in a considerable number of patients who have hypertension and RCA occlusion. This may be helpful in choosing between conservative and invasive treatments.
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    Exercise-induced T wave normalization in a patient with stable angina pectoris
    (2008) Yalçin, Hülya; Küçukler, Nagehan; Gürbüz, Süleyman; Reyhan, Mehmet; Erol, Tansel; Atalay, Hakan; Yalçin, Fatih
    [No abstract available]
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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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    The Science Behind Stress: From Theory to Clinic, Is Basal Septal Hypertrophy the Missing Link between Hypertension and Takotsubo Cardiomyopathy?
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024) Çağatay, Boran; Yalçin, Fatih; Kıraç, Adnan; Küçükler, Nagehan; Abraham, Maria Roselle
    The modern theory of stress, initially proposed by Hans Selye in 1956, signifies an important development in our understanding of this phenomenon. Selye’s The Stress of Life serves as a foundational book for subsequent scientific questions. In this article, we focus on a comprehensive look at stress and use a literature review to explain its theoretical foundations as well as its clinical equivalent. Our research focuses on the complex mechanisms of stress, with a particular emphasis on the consequences of cardiac remodeling and adaptation processes. Myocardial remodeling might be seen as a response to increased stress in acute or chronic situations. Stressed heart morphology (SHM) is a very interesting description representing basal septal hypertrophy (BSH), which is detectable in both acute emotional stress and chronic stress due to increased afterload in hypertension. Acute stress cardiomyopathy (ASC) and hypertension in the same individuals could be clinically linked. Also, in this report, we mention the geometric and functional similarity of the left ventricle (LV) septal base in both acute and chronic clinical situations. Therefore, cardiac imaging methods are crucial to assessing LV segmental aspects in ASC patients. We propose a new paradigm that ASC may develop in hypertensive patients with SHM. We document the segmental progression of microscopic LV remodeling using a third-generation microscopic ultrasound and note that BSH takes a longer time to occur morphologically than an acutely developed syndrome. However, the majority of ASC events have a predominant base, and the absence of segmental remodeling details, including BSH and cardiac decompensation with apical ballooning, on echocardiographic reports may mask the possible underlying hypertensive disease. In fact, beyond ASC cases, previously undiagnosed hypertension is very common, even in developed countries, and is associated with masked target organ damage. © 2024 by the authors.