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Öğe The association of paraoxonase 1 gene L55M polymorphism with the extent and severity of coronary artery disease in the Turkish population and its dependence on gender(Turkish Soc Cardiology, 2016) Kocakap, Derya Beyza Sayin; Dogru, Mehmet Tolga; Simsek, Vedat; Cabuk, Feryal; Yildirim, Nesligul; Celik, Yunus; Erdem, SolmazObjective: Coronary artery disease (CAD) is a common, complex, and progressive disorder characterized by the accumulation of lipids and fibrous elements in the arteries. It is one of the leading causes of death in industrialized nations. Oxidative modification of low-density lipoprotein (LDL) in the arterial wall plays an important role in the initiation and progression of atherosclerosis. Paraoxonase1 (PON1) is involved in lipid metabolism and is believed to protect LDL oxidation. In our study, we aimed to clarify the relationship between PON1 gene L55M polymorphism and the extent and severity of CAD. Methods: In total, 114 patients (54 males, mean age: 56.7 +/- 12.0 years; 60 females, mean age: 55.7 +/- 13.2 years) with stable angina or angina equivalent symptoms were enrolled in this prospective study. Cardiological evaluation was performed with electrocardiogram and transthoracic echocardiogram. The presence of hypertension, dyslipidemia, diabetes, and smoking status were ascertained. The patients were grouped according to their Gensini scores and gender. Genetic analysis of the PON1 gene L55M polymorphism was performed by polymerase chain reaction-restriction fragment length polymorphism. Results: We determined that the LL genotype was more prevalent in patients with Gensini score higher than or equal to 20 (p=0.026) and that this correlated with severe atherosclerotic coronary artery lesions in both gender groups, reaching a statistical significance in the female subjects (p=0.038). Conclusion: It was thought that the PON1 gene L55M polymorphism plays a significant role in CAD progression, especially in females.Öğe Atrial electromechanical coupling interval and P-wave dispersion in healthy elderly(Springer, 2012) Yildirim, Nesligul; Tulmac, Murat; Simsek, Vedat; Dogru, Mehmet Tolga; Ebinc, Haksun; Guzel, Murat; Eser, OzerBackground and aims: The aim of our study was to investigate the potential effect of natural aging on atrial fibrillation (AF) by means of electrocardiographic P-wave analysis and measurement of the transthoracic echocardiographic electromechanical coupling interval (EMC). Methods: The study comprised 25 healthy individuals aged >= 65 years (group 1) and 25 control subjects <65 years (group 2). The difference between maximum (Pmax) and minimum (Pmin) P-wave durations on 12-lead electrocardiography were defined as P-wave dispersion (PD). Intra- and inter-atrial EMC were measured by tissue Doppler imaging. Results: Pmax (107.2 +/- 3.58 msec vs 100.0 +/- 3.56 msec, p<0.001) and PD (43.6 +/- 4.98 msec vs 36.5 +/- 3.56 msec, p<0.001) were significantly higher in group 1 than in group 2. Left atrial EMC [24.6 (15.20) vs 13.3 (4.50), p<0.001] and inter-atrial EMC [43.2 (16.05) vs 33.3 (4.75), p<0.001] were significantly delayed in group 1 compared with group 2. There was a significant correlation between left atrial diameter, PD, Pmax, left atrial EMC, and inter-atrial EMC. Conclusion: Aging is correlated with increased left atrial size and impaired diastolic relaxation, which may contribute to a greater risk of AF in terms of prolonged PD and atrial EMC. (C)2012, Editrice KurtisÖğe Atrial Electromechanical Coupling Interval and P-Wave Dispersion in Patients With White Coat Hypertension(Taylor & Francis Inc, 2012) Yildirim, Nesligul; Simsek, Vedat; Tulmac, Murat; Ebinc, Haksun; Dogru, Mehmet Tolga; Alp, Caglar; Simsek, FadimeBackground. The aim of our study was to investigate the effect of white coat hypertension (WCH) to atrial conduction abnormalities by electrocardiographic P-wave analysis and echocardiographic electromechanical coupling (EMC) interval measurement. Methods. The study consisted of sex-, age-, and body mass index-matched 24 patients with WCH, 24 patients with sustained hypertension (SH), and 24 subjects with normotension (NT). The difference between the maximum (Pmax) and minimum P-wave durations on 12-lead electrocardiography was defined as P-wave dispersion (PD). Intra- and inter-atrial EMC were measured by tissue Doppler imaging. Results. Pmax and PD of subjects with WCH were significantly higher than those of normotensives and lower than those of patients with SH. Inter-atrial EMC and left atrial EMC values of WCH group were intermediate between NT and SH groups. There was a significant correlation between left atrial diameter, PD, Pmax, left ventricle mass index, left atrial EMC, and inter-atrial EMC. Conclusion. White coat hypertension is an intermediate group between SH and NT in terms of atrial electromechanical abnormalities which may be associated with the risk of atrial fibrillation.Öğe Effect of overnight nasal continuous positive airway pressure treatment on the endothelial function in patients with obstructive sleep apnea(Aves Yayincilik, 2012) Tulmac, Murat; Tireli, Emine; Ebinc, Haksun; Simsek, Vedat; Dogru, Mehmet Tolga; Yildirim, Nesligul; Ekici, Mehmet SavasObjective: In this prospective study, we aimed to investigate acute effect of nasal continuous positive airway pressure (CPAP) therapy on the endothelial function of patients with obstructive sleep apnea syndrome (OSA) by using brachial artery flow mediated dilatation (FMD) method. Methods: Newly diagnosed thirty OSA patients with ages between 29 and 72 years were included in this study. FMD and high sensitivity C-reactive protein (hsCRP) values of patients obtained before and after CPAP dose titration test were compared with paired samples t test or Wilcoxon signed ranks test. Results: With CPAP therapy apnea hypopnea indices were reduced (60.6 +/- 24.9/h vs. 9.6 +/- 7.9/h; p<0.001) and oxygen desaturation indices recovered (50 +/- 27/h vs. 6 +/- 7/h; p<0.001). Heart rates of patients decreased after CPAP therapy (80 +/- 10/min vs. 73 +/- 8/min; p=0.003). FMD values significantly increased after CPAP (8.55 +/- 5.82 percent vs. 12.08 +/- 7.17 percent; p=0.003). HsCRP values after CPAP were not different from baseline values Conclusion: Acute improvement of the endothelial function with one night CPAP therapy suggests endothelial dysfunction in OSA patients to be result of acute pathophysiologic factors. In intermediate and severe OSA patients, CPAP therapy may be considered in acute treatment of diseases associated with endothelial dysfunction. (Anadolu Kardiyol Derg 2012; 12: 560-5)
