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Öğe Autonomic dysfunction and cardiac repolarization abnormalities in patients with migraine attacks(Int Scientific Information, Inc, 2007) Melek, Ismet M.; Seyfeli, Ergun; Duru, Mehmet; Duman, Taskin; Akgul, Ferit; Yalcin, FatihThe clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.Öğe Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure(Mdpi, 2022) Yalcin, Fatih; Yalcin, Hulya; Kucukler, Nagehan; Arslan, Serbay; Akkus, Oguz; Kurtul, Alparslan; Abraham, Maria RoselleHypertension plays a dominant role in the development of left ventricular (LV) remodeling and heart failure, in addition to being the main risk factor for coronary artery disease. In this review, we focus on the focal geometric and functional tissue aspects of the LV septal base, since basal septal hypertrophy (BSH), as the early imaging biomarker of LV remodeling due to hypertensive heart disease, is detected in cross-sectional clinic studies. In addition, the validation of BSH by animal studies using third generation microimaging and relevant clinical observations are also discussed in the report. Finally, an evaluation of both human and animal quantitative imaging studies and the importance of combined cardiac imaging methods and stress-induction in the separation of adaptive and maladaptive phases of the LV remodeling are pointed out. As a result, BSH, as the early imaging biomarker and quantitative follow-up of functional analysis in hypertension, could possibly contribute to early treatment in a timely fashion in the prevention of hypertensive disease progression to heart failure. A variety of stress stimuli in etiopathogenesis and the difficulty of diagnosing pure hemodynamic overload mediated BSH lead to an absence of the certain prevalence of this particular finding in the population.Öğe BASAL SEPTAL HYPERTROPHY IN ADAPTIVE PHASE OF REMODELLING AND INTRACAVITARY GRADIENTS(Elsevier Science Inc, 2023) Yalcin, Fatih; Cagatay, Boran; Kucukler, Nagehan; Marangozoglu, Yusuf; Yalcin, Hulya[Abstract Not Available]Öğe Cardiac arrest and acute anterior STEMI induced by vancomycin infusion(Aves Yayincilik, 2012) Yeral, Nurettin; Akcay, A. Burak; Yalcin, Fatih[Abstract Not Available]Öğe The co-occurrence of Chiari type 1 malformation with syringomyelia and total situs inversus(Int Scientific Literature, Inc, 2007) Serarslan, Yurdal; Melek, Ismet M.; Duman, Taskin; Eraslan, Turali; Akdemir, Goekhan; Yalcin, FatihBackground: Total situs inversus (TSI) is a rare congenital anomaly that often occurs concomitantly with other disorders. TSI is the complete left-to-right inversion of the thoracic and abdominal organs. It develops due to an abnormal rotation of the cardiac tube during embryogenesis, the mechanism of which is of unknown mechanism. Syringomyelia (SM) is an uncommon disease of the spinal cord and is known as the occurrence of a cystic space in the middle of the spinal cord. SM occurs due to spinal cord injury, a primary tumor of the spinal cord, or an extramedullary lesion at the foramen magnum such as a Chiari type I malformation (CMI). In the literature there has been reported association of CMI and SM (CMI/SM) with known genetic syndromes. Case Report: We report a 33-year-old female with CMI/SM coexisting with TSI. Our patient presented with pain in the neck, arm, and upper back. She had no trsuma history. There was dysesthesia in the cervical-2 dermatomes. Radiological tools revealed that CMI/SM with TSI accompanied by no other abnormality. Conclusions: It can be suggested that the existence of this case indicates that genetic factors rnay influence the pathogenesis of some CMI/SM cases.Öğe Could early septal involvement in the remodeling process be related to the advance hypertensive heart disease?(Elsevier Ireland Ltd, 2015) Yalcin, Fatih; Topaloglu, Caner; Kucukler, Nagehan; Ofgeli, Mehmet; Abraham, Theodore P.Background: Quantitative imaging analyses showed an earlier septal wall involvement in hypertension. We planned to determine the effect of hypertension on regionalmyocardial performance index (MPI) in a hypertensive patient population. Methods: We evaluated 119 hypertensive patients who were divided into gr. I:57 patients without left ventricular hypertrophy (LVH), (53.1 +/- 10 years), and gr.II:62 patients with LVH (55.1 +/- 9 years) using conventional and tissue doppler imaging. They were compared with gr. III, a sex-age-matched normal control group (37 subjects, 53.0 +/- 10 years). Results: We detected basal septal and basal lateral contraction time (CT), isovolumetric CT and relaxation time (IVRT) and MPI. EF was 68 +/- 5 % in gr. I, 69 +/- 5 % in gr. II, 69 +/- 4 % in gr. III. LV mass index was 122 +/- 11 g/m2 in gr. I, 148 +/- 13 g/m2 in gr. II and 118 +/- 13 g/m2 in gr. III. Concentric LVH was detected in gr. II (relative wall thickness=0.49 +/- 0.8). LV septal and lateral MPI were abnormal in both hypertensive groups (p < 0.0001). Septal MPI was correlated moderately with septal wall thickness (r = 0.447, p < 0.001). Conclusions: LV diastolic dysfunction becomes more severe in septal wall than lateral wall in hypertensive LVH. Septal myocardial performance is more dominantly affected by hypertension possibly due to earlier septal involvement in disease course. Septal MPI is correlated moderately with septal wall thickness. (C) 2015 Published by Elsevier Ireland Ltd.Öğe CT assessment of main pulmonary artery diameter(Turkish Soc Radiology, 2008) Karazincir, Sinem; Balcı, Ali; Seyfeli, Erguen; Akoglu, Sebahat; Babayigit, Cenk; Akgul, Ferit; Yalcin, FatihPURPOSE The purpose of this study was to determine the normal range of the main pulmonary artery diameter (MPAD) by computed tomography (CT) in persons with normal pulmonary artery pressure, and then to evaluate the relationship of the diameter with age, gender, and body surface area (BSA). MATERIALS AND METHODS Between October 2005 and June 2007, among patients who had previously undergone a contrast-enhanced thorax CT scan, 112 persons (47 females, 65 males) without pulmonary pathology were selected for the study. A patients had normal mean pulmonary artery pressure. The widest diameter perpendicular to the long axis of the main pulmonary artery was measured at the pulmonary artery bifurcation level. The outer limits of the contrast were used to determine vessel diameter. RESULTS Pulmonary artery diameters showed a homogeneous distribution; the CT-determined mean pulmonary artery diameter was 26.6 +/- 2.9 mm. The mean MPAD in males was 27 2,8 mm, and 25.9 +/- 3.0 mm in females. This difference was considered to be statistically significant (P = 0.048). There was a significant relationship between the MAPD and age and BSA (P = 0.043, P < 0.001). CONCLUSION The present study demonstrated that in individuals with normal pulmonary artery pressure, the upper limit of the MPAD is 32.6 mm and that MPAD is well-correlated with BSA.Öğe The effect of valsartan on left ventricular myocardial functions in hypertensive patients with left ventricular hypertrophy(Lippincott Williams & Wilkins, 2012) Kucukler, Nagehan; Kurt, Ibrahim H.; Topaloglu, Caner; Gurbuz, Suleyman; Yalcin, FatihBackground It has been shown by various diagnostic methodologies that angiotensin receptor blockage reduces left ventricular mass, improves diastolic function and increases contractility in hypertensive left ventricular hypertrophy (LVH). We planned to detect the effect of angiotensin receptor blockage on midwall mechanics and myocardial dynamics in hypertensive patients with LVH. Methods Angiotensin 2 type 1 receptor blocker (valsartan 80-160 mg) was administered to 38 previously untreated hypertensive patients with LVH for 6 months. Left ventricular midwall mechanics and tissue Doppler velocities were measured at baseline and at the end of the study. Results: Mean blood pressure was reduced from 152 +/- 14/92 +/- 8 to 131 +/- 14/83 +/- 9 mmHg (P<0.05). Left ventricular mass index was decreased from 135 +/- 15 to 114 +/- 14 g/m(2) (P<0.001). Midwall fractional shortening was increased from 19.0 +/- 4 to 22.4 +/- 3% (P<0.05). Circumferential end-systolic wall stress was decreased from 131 +/- 44 to 119 +/- 37 X 10(3) dyn/cm(2) (P<0.05). Left ventricular interventricular septal myocardial tissue peak systolic velocity was increased from 6.7 +/- 1 to 8.1 +/- 0.9 cm/s (P<0.001) and lateral wall myocardial tissue peak systolic velocity was increased from 7.5 +/- 1 to 9.0 +/- 1 cm/s (P<0.001), and E/E-m ratio was significantly decreased (11.0 +/- 0.3 to 8.90 +/- 0.1, P<0.05) with 6-month valsartan therapy. Conclusion This study suggests that valsartan exhibits not only blood pressure-lowering qualities but also cardioprotective actions in patients with hypertension because it enhances regression of LVH and improves left ventricular myocardial contractility and relaxation.Öğe Effect of weight loss on P wave dispersion in obese subjects(Wiley, 2006) Duru, Mehmet; Seyfeli, Ergun; Kuvandik, Guven; Kaya, Hasan; Yalcin, FatihObjective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe PhotoShop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 +/- 10 and 7 +/- 12 ins, p < 0.002) was more prominent in Group II (>= 12% loss of their original weight) than Group I (<12% loss of their original weight) after the weight loss program. A statistically significant correlation between decrease in the level of P wave dispersion and percentage of weight loss was found (r = 0.624, p < 0.001). Discussion: Substantial weight loss in obese subjects is associated with a decrease of P wave duration and dispersion. Therefore, these observations suggest that substantial weight loss is associated with improvement in atrial repolarization abnormalities in obese subjects.Öğe Effects of Different Inspiratory Muscle Training Protocols on Exercise Capacity, Respiratory Muscle Strength, and Health-Related Quality of Life in Patients with Hypertension(Wiley-Hindawi, 2024) Huzmeli, Irem; Katayifci, Nihan; Yalcin, Fatih; Huzmeli, Esra DogruAim. This study aimed to explore how varying inspiratory muscle training workloads affect exercise capacity, health-related quality of life (HrQoL), depression, peripheral and respiratory muscle strength, pulmonary function, dyspnea, fatigue, and physical activity levels in hypertension (HT) patients. Methods. A randomized, controlled three-arm study. Forty-five patients (58.37 +/- 8.53 y, 7F/38M) with HT received IMT (7 days/8 weeks) by POWERbreathe (R) Classic LR device and were randomized to control group (CG, 10% maximal inspiratory pressure (MIP), n: 15), low-load group (LLG, 30% MIP), and high-load group (HLG, %50 MIP). Exercise capacity, HrQoL, depression, peripheral and respiratory muscle strength, pulmonary function, fatigue, physical activity level, dyspnea, and sleep quality were evaluated before and after the training. Results. Exercise capacity, physical functioning, peripheral muscle strength, and resting dyspnea were statistically significantly improved in HLG and LLG after the training compared to CG . Similar improvements in perception of depression, fatigue, and sleep quality were seen within and between the groups . Statistically significant differences were found within all the groups in terms of MIP and PEF values of respiratory functions . The superior improvement in the physical activity level was found in the HLG . Discussion. High-load IMT was particularly effective in increasing physical activity level, peripheral muscle strength, exercise capacity, and improved HrQoL. Low-load IMT was effective in reducing dyspnea and improving respiratory function. Device-guided breathing exercises decreased blood pressure, improved sleep quality, and strengthened respiratory muscles. IMT, an efficient method, is suggested for inclusion in rehabilitation programs due to its capacity to increase physical activity, exercise capacity, and peripheral muscle strength, enhance HrQoL and respiratory function, and alleviate dyspnea. Also, the efficacy of IMT should be investigated with different training protocols such as endurance IMT or functional IMT in HT patients.Öğe Elastic properties of the aorta in patients with erectile dysfunction: assessment by conventional and color tissue Doppler echocardiography(Turkish Soc Cardiology, 2006) Seyfeli, Ergun; Gorur, Sadik; Akgul, Ferit; Gur, Mustafa; Seydaliyeva, Tunzale; Yalcin, Fatih; Kiper, Ahmet NamikObjectives: It has been suggested that erectile dysfunction (ED) may be the first clinical reflection of vascular disease. We investigated the stiffness and elastic properties of the aorta by conventional and color tissue Doppler echocardiography (TDE) in patients with ED of vascular origin. Study design: Thirty male patients with ED (mean age 52 +/- 8 years; range 41 to 73 years) were studied. Systolic and diastolic aortic diameters were measured by M-mode echocardiography to asses elastic properties of the aorta. Tissue Doppler velocities (S, E, and A cm/sec) of the upper and inferior aortic wall were measured by color TDE. Aortic strain and elasticity, and aortic stiffness index (ASI) were calculated. The results were compared with those of 30 healthy male controls (mean age 49 years). Results: Systolic and diastolic pressures and aortic systolic and diastolic diameters differed significantly between the two groups (p=0.001, p=0.034, p=0.045, p=0.004, respectively). Compared to controls, ASI was significantly higher (p=0.007), and aortic strain (p=0.002) and S wave velocity of the upper wall (p=0.001) were significantly lower in patients with ED. Significant correlations were found between S wave velocity of the upper wall with ASI (r=0.389, p=0.004), aortic strain (r=0.444, p=0.001) and elasticity (r=0.504, p<0.001), and between S wave velocity of the mitral lateral annulus and ASI (r=-0. 472, p<0.001) and aortic elasticity (r=0.533, p<0.001). Conclusion: Erectile dysfunction of vascular origin is associated with increased aortic stiffness and decreased aortic elasticity, this may foreshadow other vascular system diseases having a silent course.Öğe Erratum: Giant left atrium mimicking a right thoracic mass: Case report (Journal of the American Geriatrics Society (2006) 54, (183-184))(2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[No abstract available]Öğe EVALUATION OF REGIONAL MYOCARDIAL DYNAMICS IN LEFT VENTRICULAR HYPERTROPHY SECONDARY TO ESSENTIAL HYPERTENSION(Elsevier Science Inc, 2011) Yalcin, Fatih; Kucukler, Nagehan; Haq, Nowreen; Abraham, Theodore P.[Abstract Not Available]Öğe Fever of Unknown Origin Due to Left Atrial Myxoma(Lippincott Williams & Wilkins, 2006) Savas, Lutfu; Onlen, Yusuf; Kiziltan, Tarik; Pourbagher, Ali; Seyfeli, Ergun; Turunc, Tuba; Yalcin, FatihFever of unknown origin may present diagnostic and/or curative difficulties. Myxomas are one of the rare causes of fever of unknown origin. A 67-year-old man with a 4-month history of fever of unknown origin was admitted to our department. Physical examination revealed 38.4 degrees C axillary temperature and accentuated second heart sound in cardiac auscultation. Blood, urinary, and throat cultures were negative. Transesophageal echocardiography showed a left atrial mass partially prolapsing into the left ventricle during diastole. Left atrial mass was excised, and histological examination showed atrial myxoma. Fever resolved within 48 hours after the operation, and the patient was discharged from hospital with complete improvement.Öğe Geomeric and functional aspects in hypertension and takotsubo: importance of basal septal hypertrophy(Oxford Univ Press, 2023) Yalcin, Fatih; Cagatay, Boran; Kucukler, Nagehan; Abraham, Theodore P.[Abstract Not Available]Öğe Giant left atrium mimicking a right thoracic mass: Case report (vol 54, pg 183, 2006)(Blackwell Publishing, 2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[Abstract Not Available]Öğe Increased QT dispersion in sickle cell disease(Karger, 2007) Akgul, Ferit; Seyfeli, Ergun; Melek, Ismet; Duman, Taskin; Seydaliyeva, Tunzale; Gali, Edip; Yalcin, FatihBackground: QT dispersion has been proposed to be a predictor of adverse outcomes in a variety of cardiac disease states. The objective of this study was to examine QT dispersion in patients with sickle cell disease (SCD) and to assess the effect of pulmonary hypertension (PHT) on QT dispersion. Methods: We performed Doppler echocardiographic assessments of pulmonary artery systolic pressure in 73 (mean age 18.5 +/- 8.0 years) steady-state SCD patients and 25 (mean age 19.6 +/- 7.2 years) healthy subjects. Resting 12-lead electrocardiogram was recorded and QT dispersion was calculated as the difference between maximum and minimum QT intervals. Bazett's formula was used to obtain a rate-corrected value of the QT interval (QTc). Results: Maximum QTc, minimum QTc and QTc dispersion were significantly increased in SCD patients compared to the control subjects (p < 0.0001, p < 0.05, p < 0.0001, respectively). Among SCD patients, patients with PHT had higher maximum QTc and QTc dispersion than patients without PHT (p < 0.0001). However, minimum QTc showed no significant differences between the two patient groups. Conclusion: QTc dispersion is significantly increased in SCD patients, especially those with PHT indicating regional inhomogeneity of ventricular repolarization. Copyright (c) 2007 S. Karger AG, Basel.Öğe Neurological soft signs as the stroke risk in sickle cell disease(Tohoku Univ Medical Press, 2006) Melek, Ismet; Akgul, Ferit; Duman, Taskin; Yalcin, Fatih; Gali, EdipSickle cell disease (SCD) is a common form of hemoglobinopathy and is highly prevalent worldwide. Silent cerebral infarction, which represents infarction without clinical signs, is a risk factor for clinical stroke in patients with SCD. It is well known that silent infarction predisposes patients with SCD to overt stroke. The aim of the present study is to investigate the effect of silent infarction on neurological soft signs (NSS), which demonstrate subtle impairments in sensory integration, motor coordination and the sequencing of complex motor acts and to evaluate whether NSS can be used in clinical practice to evaluate the patients at risk of stroke in SCD patients with silent infarction. Fifty-nine SCD patients without any documented history of cerebrovascular accident and 28 healthy controls were included in this study. All the patients with SCD were evaluated with cerebral magnetic resonance imaging. We found that the NSS scores were significantly higher in patients with silent cerebral infarction than those in patients without silent infarction and control subjects (p < 0.05). Importantly, there was no significant difference in the NSS scores between the patients without silent infarction and control subjects. These results indicate that high NSS scores represnt an important finding for diagnosis of silent infarction in SCD patients. As silent infarction increases the risk for stroke in patients with SCD, NSS can be used to provide additional information in diagnosis of the patients with possible stroke risk during the course of SCD.Öğe P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters(Springer, 2007) Guler, Hayal; Seyfeli, Ergun; Sahin, Gunsah; Duru, Mehmet; Akgul, Ferit; Saglam, Hayrettin; Yalcin, FatihP wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.Öğe Predictive value of the SYNTAX score for diabetic retinopathy in stable coronary artery disease patients with a concomitant type 2 diabetes mellitus(Elsevier Ireland Ltd, 2021) Kurtul, Bengi Ece; Kurtul, Alparslan; Yalcin, FatihAims: Diabetic retinopathy (DR) is a serious complication of type 2 diabetes mellitus (T2DM) and is the most common cause of impaired vision for adults. DR is related to a number of risk factors. The aim of this study was to investigate the relationship between burden of coronary artery disease assessed by Syntax Score (SS) and DR in T2DM. Methods: A total of 96 T2DM patients undergoing coronary angiography were prospectively included in the study. Presence and severity of DR were assessed by ocular fundus examination. DR was graded as no apparent retinopathy (NDR), non-proliferative (NPDR), and proliferative DR (PDR). The SS for each patient was calculated. Results: The mean age was 58.0 +/- 8.2 years. SS gradually increased from NDR group to PDR group. The median (IQR) value of SS was 10 (5-16) in patients with NDR, 22.8 (17-35.8) in those with NPDR, and 35.5 (28-37) in those with PDR (p < 0.001). On multivariate analysis SS [odds ratio (OR) 1.145, p = 0.001] and duration of diabetes (OR 1.753, p = 0.031) were independent factors for DR. Conclusions: The SS is independently associated with the occurrence of DR in T2DM. Ophthalmologists and cardiologists must cooperate when evaluating patients with DM because of possible complications. (c) 2021 Elsevier B.V. All rights reserved.
