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    Comparison of the differences in circadian autonomic function in hyperlipidemic men with and without erectile dysfunction
    (Springer, 2010) Doğru, M. Tolga; Basar, M. Murad
    Background We aimed to investigate differences in circadian autonomic changes in patients suffering from hyperlipidemia with and without erectile dysfunction and compared results to control cases. Materials and methods A total of 77 patients (age range: 24-74, mean age: 45.3 +/- 9.3) with uncontrolled hyperlipidemia (total cholesterol > 200 mg/dL and/or LDL > 160 mg/dL despite a regular diet) were enrolled into the study. These patients were divided into two groups according to their International Index of Erectile Function (IIEF-EF) scores as having erectile dysfunction (IIEF-EF < 26) (Group 1) or as having normal erectile function (IIEF-EF >= 26) (Group 2). In addition, the control group comprised 44 healthy men (age range: 20-57, mean age: 44.0 +/- 10.8) (Group 3). Heart rate variability parameters obtained by 24-h Holter monitoring were utilized for the indirect evaluation of autonomic function. Results There were statistically significant differences between the groups with respect to daytime and nocturnal autonomic activity (p < 0.005). Moreover, Group 1 had lower nocturnal parasympathetic and higher nocturnal sympathetic activity compared to the other groups (for nocturnal HFn p(1-2) < 0.001; p(1-3) < 0.001; p(2-3) > 0.05; for nocturnal LFn p(1-2) < 0.001; p(1-3) < 0.001; p(2-3) > 0.05). Conclusion We concluded that hyperlipidemia results in deterioration of autonomic circadian rhythm. Hyperlipidemic patients with erectile dysfunction had diminished nocturnal parasympathetic activities.
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    The Difference of Heart Rate Recovery between Males with and without Erectile Dysfunction
    (Wiley-Blackwell, 2010) Doğru, M. Tolga; Başar, M. Murad; Haciislamoglu, Ahmet
    Material and Methods: A total of 135 participants (mean age: 45.0 +/- 11.8 years) were enrolled into the study. Detailed biochemical and hormonal analyses, 12-lead electrocardiography and EST (Treadmill) were performed in all participants. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire form. Patients were categorized into two groups according to their IIEF scores as ED (+) (IIEF < 26) and ED (-) (IIEF >= 26). Afterward, statistical analyses were performed to evaluate the correlations between ED and HRR and CHIND. Results: A total of 65 patients were ED (+) (mean age 44.9 +/- 6.4 years), while 70 patients (mean age 43.7 +/- 7.7 years) had normal erectile status. There were statistically significant differences in CHIND (P = 0.015) and HRR time (P = 0.037) between ED (+) and ED (-) patients. In correlation analysis, IIEF score was found positively correlated with HRR and metabolic equivalent (MET) values (r(HRR) = 0.293, P = 0.037; r(METs) = 0.388, P = 0.011, respectively). Linear regression analysis revealed that METs value and total exercise time had a more linear relationship with IIEF score compared to the other EST parameters (p(METs) = 0.002 and p(TET) = 0.015, respectively). Conclusion: Chronotropic incompetence and dynamic postexercise autonomic dysfunction are present in ED patients. This condition may reflect decreased functional capacity and exercise intolerance in these patients. Ann Noninvasive Electrocardiol 2010;15(3):223-229.
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    Pentalogy of Fallot in a patient with Down syndrome
    (2006) Mısırlıoğlu, Dibek Emine; Aliefendioğlu, Didem; Doğru, M. Tolga; Şanlı, Cihat
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    The relationship between serum sex steroid levels and heart rate variability parameters in males and the effect of age
    (Aves, 2010) Doğru, M. Tolga; Başar, M. Murad; Yuvanç, Ercan; Şimşek, Vedat; Şahin, Ömer
    Objectives: We evaluated the relationships between sex steroid levels and heart rate variability (HRV) parameters. Study design: The study included 114 male subjects (mean age 46.6 +/- 11.3 years) presenting to our department for cardiologic evaluation. Hormonal analysis included serum levels of luteinizing hormone, prolactin, total testosterone (TT), free testosterone, estradiol (E2), and dehydroepiandrosterone sulfate (DHEA-S). Parameters of HRV were derived from 24-hour Holter monitoring. The associations between serum sex steroid levels and HRV parameters were investigated in three age groups (20-39 years; 40-59 years; >60 years). Results: All the participants had normal biochemical results. The three age groups were similar in terms of anthropometric measurements. Among sex steroids analyzed, only serum DHEA-S level was significantly different among the groups (p=0.026), showing a decreasing trend with age. In the evaluation of HRV, all parasympathetic activities decreased (for HFn, pNN50, and rMSDD: p=0.001, p=0.000, and p=0.000, respectively), while only LF/HF among sympathetic activities increased (p=0.000) with age. Partial correlation analysis with control of age and waist circumference showed that TT and DHEA-S were positively correlated with HFn (parasympathetic parameter), and were in negative correlation with LF/HF24 hours and global sympathetic index (GSI) (sympathetic parameters). Serum E2 level was negatively correlated with the parasympathetic parameter of rMSSD, and positively correlated with LF/HF24 hours and GSI. Among serum sex steroids, DHEA-S was the most correlated parameter with autonomic functions. Conclusion: Our results showed positive correlations between androgens and parasympathetic activity and between estradiol and sympathetic activity in men, independent from anthropometric factors.