Browsing by Author "Bilge, M."

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Comparison of Heart Rate Variability and Treadmill Exercise Score in Patients With Stable Coronary Artery Disease
(2001) Eryonucu, B.; Bilge, M.; Güler, N.
Depressed heart rate variability (HRV) is associated with increased mortality and morbidity with various forms of heart disease, and the Duke treadmill score (DTS) provides diagnostic and prognostic information for the evaluation of patients with coronary artery disease (CAD). Our study was aimed at assessing any possible correlation between HRV and DTS in stable CAD. We evaluated the correlation between the HRV assessed by using 24 hour ambulatory ECG monitoring, and treadmill exercise score in 37 patients with angiographically proven and clinically stable CAD. In univariate analysis, DTS showed a significant negative correlation with age (r = -0.89, p < 0.01) and a significant positive correlation with the square root of the mean of the sum of the squares of differences between adjacent R-R intervals (RMSSD) (r = 0.67, P < 0.05), percent difference between adjacent normal R-R intervals >50 ms (PNN50) (r = 0.69, P < 0.05), and mean of the standard deviation of all R-R intervals in all the 5-minute intervals (HRVM) (r = 0.63, P < 0.05). There is no significant correlation between DTS and standard deviation of all R-R intervals (SDNN), standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recordings (SDANN) and standard deviation of the SDNN in all the 5-minute intervals (HRVSD). In multiple regression analysis, age was the only independent significant predictor of DTS (p < 0.01). DTS decreased with advancing age. SDNN, SDANN, RMSSD, HRVM and HRVSD were not appearent predictors for detecting of DTS. Age was an independent predictor of DTS. Although DTS was correlated with RMSSD, PNN50 and HRVM in patients with stable CAD, time domain parameters of HRV were not appearent predictor for DTS.
The Effect of Perindopril and Amlodipine on Brachial Artery Pulse Wave Velocities in Patients With Essential Hypertension
(1999) Guler, N.; Bilge, M.; Eryonucu, B.; Ipeksoy, U.
It is known that the brachial artery flow velocity as assessed by duplex Doppler ultrasound is changed in hypertension. The main purpose of this study was to assess the effects of perindopril and amlodipine on the brachial artery pulse wave velocity in essential hypertension. Blood flow profile and velocity of the brachial artery were determined noninvasively by pulsed Doppler ultrasound technique under the guidance of a B-mode ultrasound image. Thirty-two untreated hypertensive patients and 11 control subjects matched for age and sex were included in the study. Hypertensive patients were classified into two groups which were treated either with amlodipine 5 mg or perindopril 4 mg and re-evaluated after 15 days. Patients with essential hypertension had significantly larger peak systolic velocity than those without it (71(18 cm/sec vs. 45(16 cm/sec, P<0.001). After antihypertensive treatment, significant decrease was found in the mean blood pressures of both groups (P<0.001). After treatment with perindopril, peak systolic velocity decreased (73±19 vs 58±14 cm/sec, P<0.05) and duration of systolic flow prolonged (269±18ms vs 291±17ms, P<0.05). Also, after treatment with amlodipine, peak systolic wave decreased (68±15ms vs 55±13ms, P<0.05) and duration of systolic flow prolonged (266±17ms vs 288±18ms, P<0.01). In conclusion, as assessed by duplex Doppler ultrasound, peak systolic wave was increased and systolic flow duration not changed in essential hypertension. Both perindopril and amlodipine treatments decreased peak systolic velocity and prolonged systolic flow duration. Further study is needed to clarify the exact mechanisms of the flow velocity alterations with antihypertensive therapy.
The Effects of Volatile Anaesthetic Agents in Myocardial Repolarization During Induction of Anaesthesia
(1999) Guler, N.; Bilge, M.; Eryonucu, B.; Demirel, C.B.; Kati, I.; Sayarlioglu, M.
QT dispersion may serve as a measure of variability in ventricular repolarization time and may be a means of identifying patients at risk of arrhythmias and sudden death after different clinical settings. The acute responses of QTc dispersion were assessed in 47 American Society of Anesthesiology (ASA) class 1 or 2 patients receiving volatile anaesthetic agents. Anaesthesia was induced with sevoflurane (n=16), halothane (n=17), or isoflurane (n=14), and the inspired concentration increased to reach an end- tidal concentration of 1% to 6%. Recordings of ECG, heart rate, blood pressures were obtained at the following times: prior to induction of anaesthesia, 1 min and 3 min after stable end-tidal concentration, 1 min and 3 min later vecuronium administration, and 1 min and 3 min after tracheal intubation. All the patients studied had normal values of QTc interval and QTc dispersion at rest. All anaesthetic agents significantly increased QTc dispersion compared with baseline values. Both isoflurane and sevoflurane increased QTc interval compared with baseline in contrast to halothane which did not change it significantly. Thus, anaesthetic agents cause myocardial repolarization abnormalities in man in terms of increased QTc dispersion. This may be relevant in the aetiology of arrhythmias in patients receiving anaesthesia without cardiovascular disease.