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Öğe Akut Koroner Sendromlu Hastalarda Çok Damar Hastalığı İle Kardiyovasküler Risk Faktörleri Arasındaki İlişki(2019) Alp, Çağlar; Karadeniz, Muhammed; Sarak, Taner; Demir, VahitAmaç: Akut koroner sendrom olgularında ciddi darlık olan koroner arter sayısı ile kardiyovasküler risk faktörleri arasındaki ilişki değerlendirildi. Yöntemler: Bu çalışma retrospektif olarak dizayn edildi. 2016–2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiografi yapılan 904 hasta çalışmaya dahil edildi. Ciddi koroner arter darlığı olmayan ve koroner operasyon geçiren hastalar çalışma dışı bırakıldı. Hastalar kritik koroner arter darlıklarına göre tek damar hastalığı (TDH) ve çok damar hastalığı (ÇDH) olacak şekilde iki gruba ayrıldı. ÇDH ile TDH olanlar klasik kardiyovasküler risk faktörleri açısından karşılaştırıldı. Bulgular: Hastaların 544’ünde (%60) ÇDH 365’inde (%40) TDH saptandı. ÇDH olan grupta yaş, hipertansiyon ve diyabet mellitus istatistiksel olarak daha fazla saptandı (sırasıyla p<0.001, p=0.003, p=0.005). TDH olan grupta ise erkek cinsiyet, aile öyküsü ve sigara içiciliği istatistiksel olarak daha fazla saptandı (sırasıyla p=0.006, p<0.001, p<0.001). Sonuç: Diyabet ve hipertansiyon ÇDH grubunda yüksek saptanırken aile öyküsü ve sigara içiciliği TDH grubunda yüksek saptandı. Akut koroner sendrom hastalarında bu risk faktörlerin göz önünde bulundurulması önemlidir.Öğe Atrial electromechanical delay and p wave dispersion associated with severity of chronic obstructive pulmonary disease(Makerere Univ, Fac Med, 2021) Çelik, Yunus; Yıldırım, Nesligül; Demir, Vahit; Alp, Çağlar; Şahin, Ömer; Doğru, Mehmet TolgaBackground: The aim of this study was to evaluate atrial electromechanical delay (AEMD) with both electrocardiography (ECG) and echocardiography in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Total of 110 patients were included in this cross-sectional case-control study. P-wave dispersion (PWD) was measured on a 12-lead ECG. Atrial electromechanical intervals (PA) were measured as the time interval between the onset of the P wave on the ECG and the beginning of the late diastolic A wave. Results: PWD was found to be 40.9 +/- 9.2 ms in the healthy control group, 45.6 +/- 8.2 ms in the mild COPD and 44.8 +/- 8.7 ms in the severe COPD group (p<0.05). Intra-right atrial EMD was found to be 10.7 +/- 5.8 ms in mild COPD, 11.0 +/- 7 ms in severe COPD, and it was 16.4 +/- 7.3 ms in healthy control group (p<0.001). Interatrial EMD was detected to be 29.5 +/- 9.1 ms in the control group, 24.1 +/- 9 ms in mild COPD group, and 23.9 +/- 11.1 ms in the severe COPD group (p<0.001). Conclusion: Both mild and severe COPD groups decreased PWD, increased tricuspid PA and significantly decreased inter and right intra-AEMD times in comparison to the control group.Öğe The comparison of the relationships about the presence of branch retinal vein occlusion and endothelial functions between diabetic and non-diabetic patients(Lippincott Williams & Wilkins, 2019) Demir, Vahit; Dogru, Mehmet Tolga; Onaran, Zafer; Kandemir, Huseyin; Alp, CaglarObjectives The aim of this study was to investigate the endothelial functions in both patients with diabetics and non-diabetics with branch retinal vein occlusion by using pulse wave analysis and flow-mediated dilatation methods. Patients and methods This cross-sectional study included a total of 136 participants (47 diabetic patients with branch retinal vein occlusion, 43 non-diabetic patients with branch retinal vein occlusion, and 46 otherwise healthy subjects). Evaluation of endothelial functions was performed by flow-mediated dilatation and pulse wave analysis methods. Stiffness index, reflection index (RI), and pulse propagation time were calculated. Results The mean stiffness index and RI were significantly higher in the diabetic branch retinal vein occlusion group compared with the non-diabetic branch retinal vein occlusion and the healthy controls (for stiffness index: 11.5 +/- 2.8 vs. 10.1 +/- 2.5 and 8.3 +/- 2.0, P < 0.001; and for RI: 75.1 +/- 11.7 vs. 65.4 +/- 8.4 and 60.2 +/- 18.8, P < 0.001, respectively), whereas the pulse propagation time was significantly lower in the diabetic group (156.4 +/- 32.3 vs. 174.4 +/- 46.5 and 205.0 +/- 58.5, P < 0.001, respectively). There was a significant negative correlation between visual acuity and stiffness index (r = -0.512, P < 0.001). Besides, there was also a significant positive correlation between visual acuity and pulse propagation time (r = 0.398, P < 0.001). Conclusion This study demonstrated that the stiffness index and RI values were higher in patients with branch retinal vein occlusion compared to the healthy subjects. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.Öğe The Effects of Atorvastatin and Rosuvastatin Treatment on Endothelial Dysfunction Among Patients with Hyperlipidemia.(Excerpta Medica Inc-Elsevier Science Inc, 2017) Demir, Vahit; Ede, Huseyin; Yilmaz, Samet; Dogru, Mehmet Tolga…Öğe The effects of treatment with atorvastatin versus rosuvastatin on endothelial dysfunction in patients with hyperlipidaemia(Clinics Cardive Publ Pty Ltd, 2018) Demir, Vahit; Dogru, Mehmet Tolga; Ede, Huseyin; Yilmaz, Samet; Alp, Caglar; Celik, Yunus; Yidirim, NesligulIntroduction: Statins can reduce cardiovascular events and improve endothelial function, However. differences in the effect of statins on endothelial dysfunction have not been researched sufficiently. Here. we aimed to compare the effects of atorvastatin Versus rosuvastatin on endothelial function via flow-mediated ',aid endothelial-independent dilation. Methods: Hyperlipidaemic subjects on treatment with statins for one year (either 20 mg/day atorvastatin or 10 mg/day rosuvastatin) were enrolled in the study. In accordance with the literature, flow-mediated dilation (FMD) and nitrate-mediated endothelium-independent dilation (EID) were measured by ultrasonography on the right brachial artery of each subject. Baseline and final measurements were compa red to each group and between the groups. Results: One hundred and four subjects (50 atorvastatin and 54 rosuvastatin users) were enrolled in the study. Fifty-eight subjects were female. The groups were statistically similar in terms of age and body mass index, and haemoglobin, creatinine, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein cholesterol levels. In each group, the mean final FMD and LID values were higher compared to their respective baseline values. but the mean changes in FMD and EID were statistically similar in both groups (p = 0.958 for FMD and 0.827 for EID). There was no statistically significant difference between the atorvastatin and rosuvastatin groups in terms of final FMD and EID values (p = 0.122 and 0.115. respectively). Conclusion: This study demonstrated that both one-year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and FAD and measured by ultrasonography. However, the amount of improvement in endothelial dysfunction was similar in the two treatments.Öğe Heart rate turbulence measurements in patients with dipper and non-dipper hypertension: the effects of autonomic functions(Tubitak Scientific & Technological Research Council Turkey, 2021) Alp, Caglar; Dogru, Mehmet Tolga; Demir, VahitBackground/aim: Hypertensive patients have shown autonomic dysfunction that is closely associated with the measurements of heart rate variability (HRV) and heart rate turbulence (HRT). We aimed to show the alterations of HRV and HRT measurements in patients with both dipper and non-dipper hypertension. Materials and methods: This was a retrospective study consisting of one hundred and twenty-three participants (mean age +/- SD, 55.7 +/- 14.8 years; range, 18-90 years). The participants were divided into two groups: Group1: The patients with dipper hypertension, Group2: The patients with non-dipper hypertension. Two cardiologists performed HRV and HRT using 24-h electrocardiography (ECG) Holter and ambulatory blood pressure monitoring (ABPM) of patients. Results: The results indicated that patients in group 2 had higher low frequency power/high frequency power ratio (LF/HF), lower high frequency power (HF) , root mean square of standard deviation (RMSSD) values than group 1 (p = 0.007, p = 0.008, and p = 0.002, respectively). Group 2 also showed higher heart rate turbulence onset (HRTTO) and lower heart rate turbulence slope (HRTTS) values than Group 1 (p = 0.004, p = 0.001, respectively). We performed multivariate analysis and observed that HRTTS and HRTTO have statistically significant associations with the presence of dipper or non-dipper hypertension [F = 7.755, p = 0.001], LF/HF [F = 7.868, p = 0.001], and HF [F = 4.081, p = 0.020]. Conclusion: This study shows a statistically significant difference in HRT measurements between dipper and non-dipper hypertensive patients. Deteriorated autonomic circadian rhythm and autonomic functions may contribute to these results.Öğe Hiperlipidemik hastalarda atorvastatin ve rosuvastatin tedavisinin endotel fonksiyonlarına etkisinin noninvaziv yöntemler ile değerlendirilmesi(Kırıkkale Üniversitesi, 2011) Demir, Vahit; Doğru, Mehmet TolgaHiperlipidemi, ateroskleroz gelişiminde önemli bir risk faktörüdür. Kolesterol düşürücü ajanlar içinde en etkili grup statinlerdir. Statinlerin endotel fonksiyon bozukluğunu düzeltmedeki etkisi, endotelyal nitrik oksid sentez enziminin aktivasyonu ile gerçekleşmektedir. Endotel fonksiyon bozukluğu aterosklerozun erken bulgusu olup kardiyovasküler olay riskini artırmaktadır. Noninvaziv ultrasonografik yöntemler; farklı bölgelerdeki arteriyel yapılardan fikir edinilmesini sağlamaktadır. Brakiyal arter akıma bağlı vazodilatasyon veya akıma bağlı genişleme (ABG, FMD= flow mediated dilatation) ve karotis intima-media kalınlık (KİMK) ölçümü, endotel disfonksiyonu ve ateroskleroz yaygınlığını öngörmede kullanılmaktadır.Biz çalışmamızda; hiperlipidemisi olan hastalarda atorvastatin ve rosuvastatin tedavisinin endotel fonksiyonlarına etkisini noninvaziv yöntemlerle değerlendirdik ve statinlerin endotel üzerine etkilerini araştırdık.Çalışmamıza 18-80 yaş aralığında hiperlipidemisi olan toplam 104 hasta dahil edildi. Atorvastatin 20 mg/gün tedavisi alan 50 olgu ve rosuvastatin 10 mg tedavisi alan 54 olgu şeklinde iki gruba randomize edildi. Hastalar bir yıl süreyle takip edildi. Tüm bireylerde çalışma başında ve bir yıl sonra brakiyal arterden FMD, KİMK ve kan lipid değerleri ölçüldü.İki grup arasında demografik özellikler, başlangıç biyokimyasal parametreler, transtorasik ekokardiyografik ölçümler ve başlangıç brakiyal arter FMD ve KİMK ölçüm değerleri arasında istatistiksel olarak fark saptanmadı.Atorvastatin 20 mg/gün doz alan hasta grubunda total-kolesterol, düşük dansiteli kolesterol (LDL-K) ve trigliserid değerlerinde bazale göre istatistiksel anlamlı azalmalar tespit edildi. LDL-K'de tedavi öncesi değere göre 12. ayın sonunda % 52.5'lik azalma gözlenirken, yüksek dansiteli kolesterol (HDL-K) değerinde değişme gözlenmedi. FMD % 22. 3 artışla bazale göre istatistiksel anlamlı artış tespit edildi. Atorvastatin 20 mg/gün alan grupta KİMK'da azalma izlendi. (p<0.001)Rosuvastatin 10 mg/gün doz alan hasta grubunda LDL-K'de tedavi öncesi değere göre 12. ayın sonunda % 58.5'lik azalma gözlenirken, HDL-K değerinde değişme izlenmedi. Brakiyal arter bazal çap ve hiperemik çapta bazale göre istatistiksel artış gözlendi. (sırasıyla p=0.003, p<0.001)FMD % 30.9 artışla bazale göre istatistiksel anlamlı artış tespit edildi. Rosuvastatin 20 mg/gün alan grupta KİMK'da azalma izlendi. (p<0.001)İki grup arasında 12 aylık statin tedavisi sonunda rosuvastatin grubunda brakiyal arter nitrat sonrası çap değişim yüzdesinde istatistiksel olarak anlamlı farklılık tespit edildi. (p=0.045)Bazal çap değişimi ve hiperemi hız değişimi değerlerinde de rosuvastatin grubu lehine istatistiksel olarak anlamlı olmasa da değişim izlenmiştir. (sırasıyla p=0.089, p=0.088)Hiperlipidemik hastalara verilen ve bir yıl süreyle uygulanan atorvastatin 20 mg/gün ve rosuvastatin 10 mg/gün tedavilerinin her ikiside endotel fonksiyonları üzerinde önemli fayda sağlamıştır. Ancak rosuvastatinin endotel üzerindeki olumlu etkilerinin, noninvaziv değerlendirme verilerine göre atorvastatine göre daha belirgin olabileceğini göstermiştir.Anahtar Kelimeler: Hiperlipidemi, atorvastatin, rosuvastatin, akıma bağlı dilatasyon, karotis intima media kalınlığı, endotel fonksiyonuÖğe Influence of circadian blood pressure alterations on serum SCUBE-1 and soluble CD40 ligand levels in patients with essential hypertension(E-Century Publishing Corp, 2019) Guzel, Murat; Dogru, Mehmet Tolga; Simsek, Vedat; Demir, Vahit; Alp, Caglar; Kandemir, Huseyin; Kisa, UclerBackground: Dipper and non-dipper hypertension are different clinical forms of essential hypertension. In this study, the effect of circadian blood pressure changes on serum SCUBE-1 and soluble CD40 ligand (sCD40L) levels was investigated in patients with hypertension. Methods: A total of 100 participants aged 23-89 years were included in the study. Patients with essential hypertension were followed up by ambulatory blood pressure measurement. Results: Serum SCUBE1 levels were significantly higher in the non-dipper group than in the normal group (P < 0.001). Dipper and non-dipper patients had significantly higher serum sCD40L levels when compared to the normal group (P = 0.048 and P = 0.035, respectively). We also found a positive correlation between SCUBE1, sCD40L levels and 24-hour mean systolic blood pressure levels (r: 0.232, p: 0.034 and r: 0.241, p: 0.027, respectively). Conclusion: Serum SCUBE1 and sCD40L levels were higher in hypertensive patients than normal participants. Serum SCUBE1 levels were higher in patients with non-dipper compared to other participants.Öğe Leukocyte telomere length and lipid parameters in patients with myocardial infarction with non-obstructive coronary arteries(C M B Assoc, 2021) Inandiklioglu, Nihal; Demir, Vahit; Celik, Yunus; Demirtas, MustafaMyocardial infarction with non-obstructive coronary arteries (MINOCA) is defined as stenosis of less than 50% or no stenosis on coronary angiography in a patient diagnosed with myocardial infarction. Telomere length is expressed by studies that it acts as a biomarker, especially for biological aging and cardiovascular diseases. In this study, we aimed to investigate whether there is a relationship between circulating leukocyte telomere length (LTL) and serum lipid values in MINOCA patients. Forty-five newly diagnosed patients with MINOCA were included in the study, along with 45 healthy controls who matched the patients in terms of age and gender. We determined the LTL value using the RT-PCR method. As a result of the study, we found LTL (p< 0.001) and serum lipid values (HDL-cholesterol (p< 0.001), LDL-cholesterol (p< 0.001), triglycerides (p< 0.05), and total cholesterol (p< 0.05)) to be significantly higher in the MINOCA group than in the control group. When the correlation relationship between LTL and lipid values in the MINOCA group was evaluated, a negative correlation was determined only between LTL and HDL (p=0.014, r=-0.362). This is the first study to evaluate telomere length in MINOCA patients in Turkey. Our results support the existence of short telomere length in MINOCA patients.Öğe Serum pentraxin-3 levels and flow-mediated dilation in dipper and non-dipper hypertension(Wiley, 2019) Alp, Caglar; Dogru, Mehmet Tolga; Karadeniz, Muhammed; Sarak, Taner; Demir, Vahit; Celik, Yunus; Kisa, UclerBackground Endothelial dysfunction is one of the main pathological processes of hypertension. The association of serum pentraxin-3 (PTX3) levels and endothelial dysfunction becomes a more interesting scientific research issue due to high potential of PTX3 as a diagnostic and prognostic biomarker. We aimed to investigate the relationship between serum PTX3 levels and flow-mediated dilation results in patients with dipper and non-dipper hypertension. Methods This study included 90 hypertensive patients were divided into two groups based on 24 hours ambulatory blood pressure monitoring (ABPM): 38 patients with a dipper pattern and 52 patients with non-dipper pattern. Noninvasive evaluation of the endothelial functions was performed using flow-mediated dilation (FMD) method. Results Serum pentraxin-3 levels were higher in patients with non-dipper HT compared to dipper hypertension (P = 0.028). In addition, we found negative correlation between serum PTX3 and FMD basal/FMD hyperemia ratio (r = -0.297, P = 0.05 for FMD basal/FMD hyperemia ratio, respectively). Conclusions Serum PTX3 levels are closely related with the measures of indirect noninvasive evaluation methods (FMD) in both DH and NDH patients.
