Browsing by Author "Gumrukcuoglu, Hasan Ali"

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Acute Rupture of a Congenital Sinus of Valsalva Aneurysm After Severe Exercise
(Turkish Soc Cardiology, 2009) Tuncer, Mustafa; Eryonucu, Beyhan; Guntekin, Unal; Gumrukcuoglu, Hasan Ali
Ruptured aneurysms of the sinus of Valsalva may cause manifestations of prompt onset. A 22-year-old man with no previous cardiac complaints presented with dyspnea, palpitation, fatigue, and shortness of breath, all of which occurred after a football match. Transthoracic echocardiography showed an aneurysmal dilatation of the right sinus of Valsalva to the direction of the right ventricle. Color Doppler imaging showed a marked left-to-right turbulent flow from the aortic root to the right ventricle. Continuous Doppler imaging also revealed a continuous left-to-right systolodiastolic shunting. The patient was submitted to cardiovascular surgery for surgical repair.
Alterations in P Wave Duration and Dispersion in Depressive Patients Following Electroconvulsive Therapy
(Elsevier Science inc, 2012) Aydin, Adem; Gumrukcuoglu, Hasan Ali; Selvi, Yavuz; Besiroglu, Lutfullah; Ozdemir, Pinar G.; Ozdemir, Osman; Cegin, Bilal
Objective: Electroconvulsive therapy (ECT) consists of controlled convulsive seizure by electric stimulation of the brain. Although various electrocardiographic (ECG) changes have been reported during ECT, atrial conduction has not been studied extensively. The aim of the present study was to assess the effects of ECT on systemic arterial blood pressure and ECG parameters (P wave duration, P wave dispersion and heart rate). Methods: Thirty depressive patients undergoing ECT were included. Echocardiographic examination was performed on all patients before ECT sessions to exclude systolic heart failure and diastolic dysfunction which may affect P wave duration and dispersion. Twelve-lead ECG records were obtained before the first ECT and after the third session of ECT. Blood pressure was measured before and after convulsive therapy session. Results: Compared to baseline values, maximum P wave duration (99.3 +/- 14.6 to 111.3 +/- 8.2 ms, P=.001), P wave dispersion (50 +/- 14.8 to 63.3 +/- 10.3 ms, P=.001), and systolic (110.7 +/- 12 to 116 +/- 12.2 mmHg, P=.043) and diastolic blood pressures (70.7 +/- 9.4 to 75.3 +/- 8.2 mmHg, P=.028) were significantly increased after convulsive therapy session. Conclusions: We proposed that ECT alone or in combination with atypical antipsychotics or antidepressants may influence atrial conduction as evidenced by the significantly prolonged maximum P wave duration and P wave dispersion. Longer-term follow-up of patients undergoing ECT may be appropriate to evaluate the possible long-term outcomes of our short-term results. (C) 2012 Elsevier Inc. All rights reserved.
Association of Increased Qtc Dispersion and Right Ventricular Hypertrophy
(int Scientific information, inc, 2008) Tuncer, Mustafa; Gunes, Yilmaz; Guntekin, Unal; Aslan, Sukru; Gumrukcuoglu, Hasan Ali; Eryonucu, Beyhan; Ermis, Cengiz
Background: There have been reports demonstrating an association between increased QT dispersion and ventricular arrhythmia in a variety of pathological cardiac conditions, including left ventricular hypertrophy. However, there are limited data about an association of right ventricular hypertrophy (RVH) and corrected QT (QTc) dispersion. Material/Methods: Eighty-five persons who emigrated from a high-altitude region (2800-4200 in) of Afghanistan to Van, Turkey, (altitude: 1700-1800 in) 25 years ago were referred to our hospital for transthoracic examination between April 2003 and May 2007. RVH was detected in 37 of the persons, 12 of whom were not included in the study due to coexisting systemic hypertension, COPD, or pulmonary hypertension. Twenty-five individuals of the same population with normal echocardiographic findings were enrolled as the control group. Symptoms that may be consequent to arrhythmia (such as palpitation, dizziness, and syncope) were not reported by the study population. Twelve-lead electrography was performed to measure the heart rate, QTc intervals, and QTc dispersion values. Results: The age and gender of both the patient and control groups were similar. There was no significant difference between patients and controls with respect to QTinax, QTinin, and heart rate. However, mean QTc dispersion values were significantly increased in patients with RVH compared with the control group (59.0 +/- 14.7 vs. 35.9 +/- 11.4 ms, p < 0.001). Conclusions: Right ventricular hypertrophy is associated with an increase in QTc dispersion.
Azigos Vein: Is It a Malposition or an Alternative
(Turk Nefroloji Diyaliz Transplantasyon dergisi, 2011) Emre, Habib; Soyoral, Yasemin Usul; Begenik, Huseyin; Demirkiran, Davut; Erdur, Fatih Mehmet; Gumrukcuoglu, Hasan Ali; Erkoc, Reha
Use of a temporary central venous catheter is common practice in hemodialysis therapy. One of the most common complications of central venous catheterization is catheter malposition. Cannulation of the azygos vein (particularly the azygos arch) is a rare but hazardous catheter malposition that carries a substantial risk of perforation, thrombosis and vascular stenosis. On the other hand, the azygos vein can be used for vascular access in patients whose superior vena cava and inferior vena cava are thrombosed. We present a case where the required blood flow for hemodialysis was provided by a dilated azygos vein due to superior vena cava obstruction.
Bicuspit Aorta, Aneurysm of Ascendan Aorta, Significant Aort and Mitral Insufficiency in Patient With Marfan Syndrome
(Elsevier Ireland Ltd, 2010) Tuncer, Mustafa; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Gunes, Yilmaz
A Case of Complete Heart Block Induced by Octreotide
(Aves, 2010) Tuncer, Mustafa; Gumrukcuoglu, Hasan Ali; Mete, Rafet; Gunes, Yilmaz; Guntekin, Unal
A Case of Idiopathic Ventricular Tachycardia Developed in a 14-Year Obese Patient Who Used Golden Berry Fruit Extract Pills for Weight Loss
(Turkish Soc Cardiology, 2013) Simsek, Hakki; Dogan, Adnan; Sahin, Musa; Gumrukcuoglu, Hasan Ali
Several studies have determined an association between obesity and increased risk of cardiac arrhythmia. Currently, due to the increased frequency of obesity, food-, plant-, and drug-based therapies for weight loss have gained great attention. A 14-year-old female patient presented with complaints of palpitation of one-hour onset. Blood pressure was 110/ 70 mmHg and peripheral pulses were present. She had been using golden berry extract pills three times a day for 10 days. Electrocardiograms showed nonsustained monomorphic ventricular tachycardia (VT). Echocardiographic examination and cardiac magnetic resonance imaging (MRI) were normal. She returned to sinus rhythm following amiodarone infusion. She refused electrophysiologic study, which plays a vital role in the diagnosis and establishment of the appropriate therapy. Although there was no decrease in body mass index (BMI) of the patient during the two-year follow-up, and she had no complaint or evidence of VT on intermittent rhythm, we have thought that VT might be stem from golden berry extract use, rather than obesity.
A Case Report of Surgical Septal Myectomy of Hypertrophic Cardiomyopathy With Concomitant Left Ventricular Outflow Tract and Mid-Ventricular Obstructions
(Blackwell Publishing, 2006) Guler, Niyazi; Ozkara, Cenap; Gumrukcuoglu, Hasan Ali; Simsek, Hakki
A 27-year-old female presented with dyspnea, fatigue, and exertional angina is found to have hypertrophic cardiomyopathy with marked hypertrophy of the papillary muscles, apex, septum, and lateral wall of the left ventricle. Also, small left ventricular cavity and systolic anterior movement of anterior mitral leaflet were observed at the echocardiography. The Doppler echocardiography revealed severe peak gradients at the left ventricle outflow tract (105 mmHg) and mid-ventricle (80 mmHg). At the operation, septal myectomy and anterior papillary muscle resection in addition to mitral valve replacement was performed. Surgical treatment gave an excellent clinical result. Control Doppler echocardiograms revealed no left ventricular outflow tract gradient, although mid-ventricular gradient was persistent. The good results were still present 18 months after the operation.
Clinical and Echocardiographic Follow-Up in Pregnant Patients With Valvular Heart Disease
(Turkish Soc Cardiology, 2013) Gumrukcuoglu, Hasan Ali; Guler, Ayse; Odabasi, Dolunay; Simsek, Hakki; Sahin, Musa; Akdag, Serkan; Tuncer, Mustafa
Objectives: Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD). Study design: The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S. Results: We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively). Conclusion: Valvular heart disease is associated with fetal/maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.
Clinical and Laboratory Aspects of Our Patients Have Pericardial Effusion
(Elsevier Ireland Ltd, 2010) Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Tuncer, Mustafa; Gunes, Yilmaz; Akdag, Serkan; Begenik, Huseyin; Simsek, Hakki
Clinical Characteristics and Outcome of Brucella Endocarditis
(Royal Soc Medicine Press Ltd, 2009) Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Karahocagil, Mustafa; Ekim, Hasan
Brucella endocarditis, a rare complication of brucellosis, is the main cause of death attributable to this disease. There are difficulties in the diagnosis and uncertainty regarding many aspects of the treatment of Brucella endocarditis. We retrospectively examined the clinical characteristics and outcome of patients diagnosed with Brucella endocarditis. Of the six patients diagnosed as having Brucella endocarditis, four had valvular disease, one had aortic and mitral mechanic valve prosthesis (AVR + MVR) and one had secundum type atrial septal defect. Transesophageal echocardiography showed vegetations in four patients. Blood culture grew Brucella mellitensis only in two patients. Standard agglutination tests were elevated in all patients (range 1/320-1/10240). Four patients were managed with combined antibiotherapy and surgery. One refused further treatment and one refused an operation and follow-up was lost for that patient. Two patients died during follow-up; one having had a previous AVR + MVR operation refused further treatment and the other suffering renal failure. Due to the fulminant course of the disease, treatment should be initiated when there is a clinical suspicion, even if the culture results are unknown or negative. Agglutination titres aid in the diagnosis. A combination of antibiotherapy and surgery seems to be preferable treatment modality.
The Comparison of the Treatment Strategies Preferred in Patients With St Segment Elevated Myocardial Infarction (Thrombolytic Therapy for Life)
(Elsevier Science inc, 2013) Ozdemir, Mahmut; Yurtdas, Mustafa; Sahin, Musa; Aladag, Nesim; Karadas, Sevdegul; Babat, Naci; Gumrukcuoglu, Hasan Ali
Comparison of Two Patients With Mitral Stenosis Which Do Not Have Diagnosis Up To Advanged Age
(Elsevier Ireland Ltd, 2010) Sahin, Musa; Tuncer, Mustafa; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Simsek, Hakki
Compliance With Dyslipidemia Guidelines in Daily Practice: How Effective Is Cardiovascular Risk Prevention
(Elsevier, 2018) Guntekin, Unal; Gumrukcuoglu, Hasan Ali; Yaman, Mehmet; Ozturk, Fatih; Akyol, Aytac; Gumrukcuoglu, Fatma Nur; Kandemir, Yasemin Behram
Purpose: Cardiovascular disease (CVD) due to atherosclerosis is the leading cause of early mortality and morbidity. The current European guidelines on CVD prevention in clinical practice recommend the use of the Systematic Coronary Risk Estimation (SCORE) system. The current American Heart Association guidelines recommend the use of the new pooled cohort risk assessment equations to estimate the 10-year atherosclerotic CVD risk. The purpose of this article was to investigate the compliance of dyslipidemia guidelines in daily practice in patients with dyslipidemia or who have risk factors for CVD. Methods: The study group consisted of 500 outpatients who had dyslipidemia or risk factors for CVD. The risk level was computed according to the European and American Heart Association guidelines. Therapeutic LDL-C targets were identified based on the calculated risk level. Therapeutic target levels were compared based on the dosage of statins used and achievement of the LDL-C goal in daily practice according to the risk levels. Findings: According to the European dyslipidemia guidelines, 231 patients were in the very-high/high-risk group, and 106 patients (45.9%) achieved the LDL-C target (<100 mg/dL); 210 patients were in the moderate-risk group, and 156 (74.3%) patients achieved the LDL-C target (<115 mg/dL); and 59 patients were in the low-risk group, and 55 (93.2%) patients achieved the LDL-C target (<155 mg/dL). Univariate and multivariate logistic regression analyses revealed that the LDL-C level and presence of coronary artery disease were significantly reverse associated with achievement of the LDL-C goal (both, P < 0.001). (C) 2018 Elsevier Inc. All rights reserved.
Differential Effects of Nebivolol and Atenolol on Transmitral Diastolic Filling Parameters in Patients With Essential Hypertension
(Springer, 2008) Tuncer, Mustafa; Guntekin, Unal; Gunes, Yilmaz; Gumrukcuoglu, Hasan Ali; Eryonucu, Beyhan
Introduction: Impaired left ventricular (LV) diastolic relaxation, detected by pulsed Doppler echocardiography, is predictive of a higher incidence of major cardiovascular events in hypertensive patients. An improvement in LV diastolic function is an important goal of treatment. However, treatment of LV diastolic dysfunction remains empirical. The objective of our study was to compare the short-term effects of nebivolol and atenolol on Doppler diastolic filling parameters in hypertensive patients. Methods: A total of 32 patients with mild-to-moderate hypertension were enrolled in the study. The patients were randomly assigned to receive treatment with either nebivolol (5 mg/day) or atenolol (50 mg/day) for 1 month. Diastolic filling parameters, with pulsed-wave Doppler transmitral flow velocities, were measured 1 day before and 1 month after treatment. Results: Compared with baseline, both agents significantly decreased heart rate and blood pressure. However, there was no significant difference in pre-and post-treatment values between the nebivolol and atenolol groups. Both drugs significantly improved LV transmitral flow measured by early diastolic flow/atrial contraction signal (E/A) ratio, decreased deceleration time (DT) and isovolumetric contraction time (IVRT), but post-treatment improvement in E/A, DT and IVRT values was more significant with nebivolol compared with atenolol (P=0.05, P=0.05 and P=0.003, respectively). Conclusion: Although treatment with nebivolol or atenolol results in improved LV transmitral diastolic function filling parameters (E/A ratio, IVRT and DT), nebivolol has a greater effect compared with atenolol in patients with mild-to-moderate hypertension.
Diverging Sex-Specific Long-Term Effects of Cigarette Smoking on Fasting Insulin and Glucose Levels in Non-Diabetic People
(Pergamon-elsevier Science Ltd, 2012) Onat, Altan; Can, Gunay; Cicek, Gokhan; Dogan, Yuksel; Kaya, Hasan; Gumrukcuoglu, Hasan Ali; Yuksel, Husniye
Objectives: We determined in non-diabetic persons the associations of current smoking with future glucose and insulin concentrations. Design and methods: Middle-aged non-diabetic adults (n = 1071) were studied in whom these values were measured at baseline and 5.2-years later. Results: Age-adjusted fasting insulin concentrations in 137 smoking men remained lower than never smokers at both surveys. While age-adjusted fasting glucose values in male never smokers declined at follow-up (p = 0.037), they rose in male smokers. In 94 female smokers, age-adjusted fasting insulin values marginally declined, and fasting glucose was reduced (by 0.09 mmol/L., p = 0.055) during follow-up. In contrast in never-smoking women, insulin and glucose concentrations rose (p < 0.001 in both). Age-adjusted insulin levels in former smokers exhibited similar trends as never smokers. Trends were essentially unchanged when adjustment included body mass index. Current male smokers demonstrated evidence of reduced insulin sensitivity, female smokers of improved one, as assessed by QUICKI. Conclusion: Smoking among Turks induces at long-term lower fasting insulin levels which represent improved insulin sensitivity in women, yet a reduced one in men. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Do Cardiac Neuropeptides Play a Role in the Occurrence of Atrial Fibrillation After Coronary Bypass Surgery
(Elsevier Science inc, 2007) Guler, Niyazi; Ozkara, Cenap; Dulger, Haluk; Kutay, Veysel; Sahin, Musa; Erbilen, Enver; Gumrukcuoglu, Hasan Ali
Background. One of the potential mechanisms to explain the occurrence of postoperative atrial fibrillation (AF) is imbalance of autonomic nervous system tone. The myocardium is innervated not only by cholinergic and adrenergic nerves but also by peptidergic nerves that synthesize and secrete neuropeptides. To investigate the possible role of cardiac neuropeptides in the development of AF after coronary artery bypass grafting (CABG), we analyzed the plasma levels of substance P (SubP), neuropeptide Y (NPY), and angiotensin II (Ang II) in patients who underwent elective on-pump CABG. Methods. This prospective study group included 83 consecutive patients scheduled for elective, on-pump CABG. Depressed left ventricular (LV)function ( ejection fraction [EF]less than 0.30), concomitant cardiac procedures, history of atrial fibrillation, second or third degree atrioventricular block, implanted pacemaker, postoperative myocardial infarction, use of class I or III antiarrhythmic drug, and hemodynamic deterioration were exclusion criteria. Preoperative and postoperative serum levels of SubP, NPY, and AngII were measured by radioimmunoassay technique. Results. Postoperative AF occurred in 27 patients (32.5%). Using multivariate logistic regression analyses, only a decrease in SubP level ( odds ratio [ OR] = 1.87, 95% confidence interval [CI] = 0.767 to 0.99, p = 0.031) and an increase in AngII level ( OR = 2.61, 95% CI = 1.002 to 1.021, p = 0.023) after CABG were found to be independently associated with AF. Increased age ( p = 0.02), diabetes mellitus ( p = 0.023), preoperative use of beta blocker ( p = 0.024), proximal right coronary artery involvement ( p = 0.024), low preoperative sodium levels ( p = 0.023), low LVEF ( p = 0.013), and increased mitral E wave deceleration time ( p = 0.044) were also associated with AF. Conclusions. These results indicate that the increase in AngII and the decrease in SubP after CABG may play a role in the occurrence of postoperative AF. Further studies are needed to define the physiologic and pathologic relevance of these substances at the occurrence of AF in patients who undergo CABG. (c) 2007 by The Society of Thoracic Surgeons.
Does Isotretinoin Therapy Have Any Effects on Electrocardiography, Heart Rate and Blood Pressure
(Taylor & Francis Ltd, 2012) Karadag, Ayse Serap; Gumrukcuoglu, Hasan Ali; Bilgili, Serap Gunes; Ozkol, Hatice Uce; Ertugrul, Derun Taner; Simsek, Hakki; Calka, Omer
Background: Isotretinoin therapy is associated with numerous adverse effects of various systems. Although some cases have been reported, cardiac side effects are rare following isotretinoin treatment. Objective: To investigate the effects of isotretinoin on the cardiovascular system. Methods: Seventy patients with acne vulgaris were enrolled in the study. The patients were treated with a dose of 0.5-1.0 mg/kg per day of isotretinoin. Screening for biochemical and hematologic parameters, heart rate, blood pressure and electrocardiographic parameters were done before treatment and after 3 months of isotretinoin treatment. Results: Heart rate, systolic/diastolic tension and electrocardiographic parameters (P-wave duration and QTc duration) were not statistically different before compared with after treatment. Conclusion: As far as we know, there is no study researching the effect of isotretinoin on P- and QT-wave measurements in the literature. We found that isotretinoin did not affect P- and QT-wave measurement. Further studies with longer periods of follow-up are needed to understand the effect of isotretinoin on the cardiovascular system.
The Effect of Altitude on P-Wave and Qt Duration and Dispersion
(Wiley, 2008) Guntekin, Unal; Gunes, Yilmaz; Tuncer, Mustafa; Gumrukcuoglu, Hasan Ali; Kaya, Yuksel
Background: Short-term and long-term exposure to high altitude has been reported to change the surface electrocardiogram. We aimed to compare P-wave and QT parameters between healthy people living at high altitude and sea level. Methods: Twelve-lead electrocardiographies of 38 healthy people living at sea level (Antalya,Turkey) and 38 healthy people living at high altitude (Van, Turkey; 1,700-1,800 m) were obtained. Minimum and maximum P-wave durations, P-wave dispersion, minimum and maximum corrected QT intervals, and corrected QT dispersion were calculated. Results: There was no significant difference between the two groups in respect to heart rate and QT variables. Mean Pminimum values were slightly but significantly lower in the high altitude group (P = 0.029). Mean Pmaximum values tended to be lower at high altitude but did not reach statistical significance (P = 0.085). However, there was no significant difference in respect to P-wave dispersion values. Conclusions: In a sample of men and women living at high altitude in Turkey, significant reduction of Pminimum and borderline reduction of Pmaximum duration, but no significant change of P-wave and QT dispersion, were observed.
The Effect of Low-Sodium Dialysate on Ambulatory Blood Pressure Measurement Parameters in Patients Undergoing Hemodialysis
(Dove Medical Press Ltd, 2015) Akdag, Serkan; Akyol, Aytac; Cakmak, Huseyin Altug; Tosu, Aydin Rodi; Asker, Muntecep; Yaman, Mehmet; Gumrukcuoglu, Hasan Ali
Background: End stage renal disease is related to increased cardiovascular mortality and morbidity. Hypertension is an important risk factor for cardiovascular disorder among hemodialysis (HD) patients. The aim of this study was to investigate the effect of low-sodium dialysate on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels detected by ambulatory BP monitoring (ABPM) and interdialytic weight gain (IDWG) in patients undergoing sustained HD treatment. Patients and methods: The study included 46 patients who had creatinine clearance levels less than 10 mL/min/1.73 m(2) and had been on chronic HD treatment for at least 1 year. After the enrollment stage, the patients were allocated low-sodium dialysate or standard sodium dialysate for 6 months via computer-generated randomization. Results: Twenty-four hour SBP, daytime SBP, nighttime SBP, and nighttime DBP were significantly decreased in the low-sodium dialysate group (P<0.05). No significant reduction was observed in both groups in terms of 24-hour DBP and daytime DBP (P=NS). No difference was found in the standard sodium dialysate group in terms of ABPM. Furthermore, IDWG was found to be significantly decreased in the low-sodium dialysate group after 6 months (P<0.001). Conclusion: The study revealed that low-sodium dialysate leads to a decrease in ABPM parameters including 24-hour SBP, daytime SBP, nighttime SBP, and nighttime DBP and it also reduces the number of antihypertensive drugs used and IDWG.