Browsing by Author "Sahin, Musa"

Now showing 1 - 20 of 31

Acute Toxic Fulminant Myocarditis After a Black Widow Spider Envenomation: Case Report and Literature Review
(Taylor & Francis Ltd, 2013) Golcuk, Yalcin; Velibey, Yalcin; Gonullu, Hayriye; Sahin, Musa; Kocabas, Engin
Association of Epicardial Adipose Tissue Thickness and Inflammation Parameters With Cha2ds2-Vasasc Score in Patients With Nonvalvular Atrial Fibrillation
(Dove Medical Press Ltd, 2015) Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Akyol, Aytac; Duz, Ramazan; Babat, Naci
Background: Epicardial adipose tissue (EAT), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) have been shown to be helpful in predicting adverse cardiovascular events. However, to date, in the literature, there have been no studies demonstrating the relationship between EAT, MPV, PLR, NLR, and thromboembolism risk in atrial fibrillation (AF). Therefore, we examined the relationship between EAT, MPV, PLR, NLR, and CHA(2)DS(2)-VASc score used for the evaluation of thromboembolism risk in patients with AF. Methods: The study included 96 consecutive patients with AF and 52 age-and sex-matched control subjects. We calculated CHA2DS2-VASc risk score for each patient and measured baseline EAT thickness, MPV, PLR, NLR, left atrial volume index, and left ventricular ejection fraction. Results: The group with high CHA2DS2-VASc score had higher EAT (7.2 +/- 1.5 vs 5.9 +/- 1.2 mm, P<0.001), MPV (9.1 +/- 1.1 vs 8.4 +/- 1.0 fL, P=0.004), PLR (152.3 +/- 28.4 vs 126.7 +/- 25.4, P=0.001), and NLR (4.0 +/- 1.6 vs 3.2 +/- 1.3, P<0.001) compared to group with low-intermediate CHA2DS2-VASc score. Moreover, CHA2DS2-VASc score was found to be positively correlated with EAT (r=0.623, P<0.001), MPV (r=0.350, P=0.004), PLR (r=0.398, P=0.001), and NLR (r=0.518, P<0.001). Conclusion: Our study results demonstrated that EAT thickness, MPV, PLR, and NLR were associated with the thromboembolic risk exhibited by CHA2DS2-VASc score in patients with nonvalvular AF.
Autonomic Symptoms in Migraineurs: Are They of Clinical Importance
(Galenos Yayincilik, 2011) Milanlioglu, Aysel; Tombul, Temel; Sayin, Refah; Odabas, Omer Faruk; Sahin, Musa
Aim: The aim of this study was to evaluate the presence of autonomic symptoms in migraine patients with and without aura and to investigate whether there is an association between expression of autonomic symptoms and disease duration, headache side, attack duration and frequency. Methods: The study sample comprised 82 subjects in headachefree phase including 20 migraine with aura patients and 62 - without aura; 61 were females (74.39%) and 21 were males (25.61%). The mean headache frequency was 2.63 +/- 1.29 per month and the mean duration of headache occurrence was 10.04 +/- 7.26 years from the first episode. The subjects were asked whether or not they had autonomic symptoms like diaphoresis, diarrhea, eyelid oedema, pallor, flushing, syncope or syncope-like episode, constipation, palpitation, diuresis, blurred vision, sensation of chills and coldness during each migraine headache. Results: Of all 82 migraine patients, 50 (60.98%) experienced at least one of the autonomic symptoms during the attack periods. The most common symptom was flushing (39.2%). Among the autonomic symptoms, syncope or syncope-like episode was significantly more in patients without aura compared to those with aura (p< 0.05). In this study, patients who experienced autonomic symptoms during their headache attack had statistically significantly higher attack frequency (p= 0.019). Conclusion: This result indicate that migraine patients with autonomic nervous system involvement have more frequent headaches, therefore these patients should be particularly and cautiously investigated.
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 Coronary Subclavian Steal Syndrome in a Young Woman
(Blackwell Publishing, 2007) Guler, Niyazi; Ozkara, Cenap; Akyuz, Aydin; Sahin, Musa
A 41-year-old woman presented with complaints of increasing angina pectoris and coldness of her left arm for 1 month. Six months ago, she had undergone triple coronary artery bypass grafting (CABG) including left internal mammary artery (LIMA) to left anterior descending artery (LAD) and two saphenous vein grafts to the diagonal branch of LAD and obtuse marginal branch of the circumflex artery. Coronary angiography revealed that contrast media injected into the saphenous vein graft coursing down the diagonal branch flowed up to LAD and drained into the LIMA opacifying the left subclavian artery. Arch angiography documented a total occlusion of the left subclavian artery. A polytetraflouraethylene graft was anastomosed between the left common carotid and axillary artery. After operation, the symptoms disappeared and blood pressure in her left arm recovered. This complication could be prevented by identification of subclavian artery stenosis during coronary angiogram or CABG. This study may suggest that subclavian artery angiography should be performed in patients who will undergo CABG even for a young woman such as our case.
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.
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
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.
Effects of Ankylosing Spondylitis on the Heart
(Taylor & Francis Ltd, 2009) Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Sahin, Musa; Yazmalar, Levent
Background - Various cardiac pathologies have been linked to ankylosing spondylitis (AS) in various conflicting reports. Objectives - A pilot exploration is done to search frequencies of structural heart involvement, arrhythmias and heart rate variability (HRV) in AS patients. Methods - Thirty-five AS patients and 25 healthy people were evaluated with 12-lead electrocardiography, echocardiography and 24-hour Holter monitoring. Results - No patient had significant valvular heart disease except one. Ventricular and supraventricular premature beat counts were significantly higher in AS patients compared to the control group (P = 0.002 and 0.01). Frequency of ventricular premature beats was significantly correlated with isovolumetric relaxation time (IVRT) (r = 0.291, P = 0.025). Abnormal ECG was defined in 4 AS patients; 2 incomplete right bundle-branch block (RBBB), one left axis deviation and one complete RBBB and left anterior hemiblock. QT and P wave dispersions were not significantly different between AS patients and the control group. Although mitral inflow deceleration time (DT) and IVRT were significantly longer in AS patients (P < 0.001, both), frequency of diastolic dysfunction was not significantly different. Among HRV parameters rMSSD (day time), PNN50 (day time) and SDSD (day and night time) were significantly lower than the control group. There were weak to moderate but significant negative correlations of IVRT and DT with these parameters. Conclusions - In this small sample there is no significant increase in structural heart disease in patients with AS. Diastolic functions may be affected in the course of disease and this may be associated with increased frequency of premature beats. Day time heart rate variability is decreased and associated with diastolic function parameters of IVRT and DT in AS patients.
The Effects of Iron Deficiency Anemia on P Wave Duration and Dispersion
(Hospital Clinicas, Univ Sao Paulo, 2010) Simsek, Hakki; Gunes, Yilmaz; Demir, Cengiz; Sahin, Musa; Gumrukcuoglu, Hasan Ali; Tuncer, Mustafa
OBJECTIVES: The association between P wave dispersion and iron deficiency anemia has not been documented in the literature. In this study, we evaluated P wave dispersion in patients with iron deficiency anemia and the possible relationships between P wave dispersion and other echocardiographic parameters. INTRODUCTION: The iron status of an individual may play an important role in cardiovascular health. Anemia is an independent risk factor for adverse cardiovascular outcomes. P wave dispersion is a simple electrocardiographic marker that has a predictive value for the development of atrial fibrillation. Apart from cardiovascular diseases, several conditions, such as seasonal variation, alcohol intake and caffeine ingestion, have been demonstrated to affect P wave dispersion. METHODS: The study included 97 patients who had iron deficiency anemia and 50 healthy subjects. The cases were evaluated with a clinical examination and diagnostic tests that included 12-lead electrocardiography and transthoracic echocardiography. RESULTS: Compared to the control group, patients with iron deficiency anemia showed significantly longer maximum P wave duration (Pmax) ( 91.1 +/- 18.0 vs. 85.8 +/- 6.7 msec, p = 0.054), P wave dispersion (PWD) (48.1 +/- 7.7 vs. 40.9 +/- 5.6 msec, p < 0.001), mitral inflow deceleration time (DT) (197.5 +/- 27.9 vs. 178.8 +/- 8.9 msec, p < 0.001) and isovolumetric relaxation time (IVRT) (93.3 +/- 9.2 vs. 77.4 +/- 8.2 msec, p < 0.001); they also showed increased heart rate (85.7 +/- 16.1 vs. 69.0 +/- 4.4, p < 0.001) and frequency of diastolic dysfunction (7 (7.2%) vs. 0). Correlation analysis revealed that PWD was significantly correlated with IVRT, DT, heart rate, the presence of anemia and hemoglobin level. CONCLUSIONS: Iron deficiency anemia may be associated with prolonged P wave duration and dispersion and impaired diastolic left ventricular filling.
Effects of Lowering Dialysate Sodium on Carotid Artery Atherosclerosis and Endothelial Dysfunction in Maintenance Hemodialysis Patients
(Springer, 2012) Gumrukcuoglu, Hasan Ali; Ari, Elif; Akyol, Aytac; Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Tuncer, Mustafa
Purpose Our aim in this study was to examine the effects of low-sodium dialysate on carotid artery atherosclerosis, endothelial dysfunction, and blood pressure (BP) in maintenance hemodialysis (HD) patients. Methods After baseline measurements were obtained, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Carotid artery intima-media thickness (CIMT) and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low-sodium dialysate. Interdialytic weight gain (IDWG), pre- and post-dialysis BP, and dialysis-related symptoms were monitored during the study. Results Fifty-two patients were enrolled, and 41 patients completed the study. Twenty-one patients had hypertension and were receiving antihypertensive medications. The average number of antihypertensive drugs per patient was 1.9 +/- 0.8. There was no significant reduction in BP at the end of the study, but the average number of antihypertensive drugs was reduced to 1.2 +/- 0.4 (P < 0.001). There were significant improvements in CIMT (P = 0.003) and FMD (P < 0.001) with low-sodium HD. The IDWG decreased significantly during the low-sodium dialysate treatment (P < 0.001). However, hypotensive episodes and cramps were more frequent during the study period. Conclusions Our study demonstrated that the lowering of dialysate sodium concentration reduced CIMT, improved FMD, and provided better control of IDWG and BP, but increased the incidence of dialysis-related symptoms.
The Effects of Nebivolol on Qt Duration and Dispersion in Patients With Coronary Slow Flow
(Elsevier Science inc, 2013) Sahin, Musa; Simsek, Hakki; Akyol, Aytac; Akdag, Serkan; Akil, Mehmet Ata; Aksoy, Hakan; Gumrukcuoglu, Hasan Ali
The Effects of Perindopril on Qt Duration and Dispersion in Patients With Coronary Slow Flow
(Springer, 2011) Guntekin, Unal; Gumrukcuoglu, Hasan Ali; Gunes, Yilmaz; Gunes, Ahmet; Simsek, Hakki; Sahin, Musa; Tuncer, Mustafa
Coronary slow flow (CSF) is characterized by delayed opacification of coronary arteries in the absence epicardial occlusive disease. QT duration and dispersion have been reported to be longer in patients with CSF. ACE inhibitors may improve CSF through positive effects on endothelial function. The study included 32 patients having CSF and 25 subjects having normal coronary arteries in coronary angiography. The patients were evaluated with 12-leads electrocardiography and echocardiography before and 3 months after treatment with perindopril. Compared to the control group, maximum corrected QT duration (QTcmax) (432.0 +/- A 28.9 vs. 407.0 +/- A 39.1 ms, p = 0.008) and QT dispersion (QTcD) (64.0 +/- A 16.5 vs. 37.3 +/- A 12.1 ms, p < 0.001), mitral inflow deceleration time (DT) (251.3 +/- A 49.4 vs. 218.8 +/- A 44.5 ms, p = 0.013), and isovolumetric relaxation time (IVRT) (115.8 +/- A 18.4 vs. 107.2 +/- A 22.9 ms, p < 0.001) were significantly longer and E/A ratio 0.85 +/- A 0.2 vs. 1.1 +/- A 0.3, p = 0.004) was lower in patients with CSF. QTcmax (to 407.0 +/- A 28.0 ms, p = 0.001), QTcD (to 44.5 +/- A 11.4 ms, p < 0.001), DT (to 221.6 +/- A 37.7 ms, p < 0.001) and IVRT (to 103.8 +/- A 16.1 ms, p < 0.001) were significantly decreased and E/A ratio (to 0.98 +/- A 0.3, p < 0.001) was significantly increased after treatment with perindopril. Coronary slow may be associated with prolonged QT interval and increased QT dispersion and impaired diastolic filling. Perindopril may be helpful in restoration of these findings.
Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease
(Korean Soc Cardiology, 2016) Yaman, Mehmet; Arslan, Ugur; Gumrukcuoglu, Hasan Ali; Sahin, Musa; Simsek, Hakki; Akdag, Serkan
Background and Objectives: Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value for arrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects of trimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease. Subjects and Methods: One hundred patients (23 females, mean age 55.6 +/- 9.2 years) with stable ischemic heart disease were included in the study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patients were stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for a minimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWA values were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography. Results: After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63 +/- 8 mu V vs. 53 +/- 7 mu V, p<0.001). Abnormal MTWA was present in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001). Conclusion: Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parameters related with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmic complications and improve myocardial functions in patients with stable coronary artery disease.
Improved Left and Right Ventricular Functions With Trimetazidine in Patients With Heart Failure: a Tissue Doppler Study
(Springer, 2009) Gunes, Yilmaz; Guntekin, Unal; Tuncer, Mustafa; Sahin, Musa
Downregulation of glucose and fatty acid oxidation occurs in heart failure (HF). Trimetazidine reduces fatty acid oxidation and increases glucose oxidation. In this single-blind study, trimetazidine, 20 mg three times per day (n = 51) or placebo (n = 36) was added to treatment of 87 HF patients receiving optimal HF therapy. Etiology of heart failure was coronary artery disease in 35 patients (68.6%) in the trimetazidine group and 22 (62.9%) in the placebo group. Fourteen (27.5%) patients in the trimetazidine group and 11 (31.4%) patients in the placebo group had diabetes. Peak systolic velocity (Vs), and the peak early diastolic (Vd) and late diastolic (Va) velocities of various segments left and right ventricles (RV) were obtained with tissue Doppler imaging (TDI) and averaged. Patients were re-evaluated three months later. Significant increases in mean left ventricular ejection fraction (LVEF) (33.3% +/- 5.6% to 42.4% +/- 6.3%, P < 0.001 and 30.6% +/- 8.2% to 33.2% +/- 6.6%, P = 0.021) and LV and RV myocardial velocities and mitral and tricuspid annular TDI velocities were observed in both groups. However, compared to placebo, increments in LVEF (9.1% +/- 4.2% vs. 2.5% +/- 1.4%, P < 0.001) and myocardial velocities were significantly higher with trimetazidine (P < 0.001 for LV Vs, Vd, Va; P = 0.035 for RV Vd; and P < 0.001 for RV Va and Vs). Increase in LVEF with trimetazidine was significantly correlated with presence of diabetes (r = 0.524, P < 0.001). With trimetazidine LVEF increased significantly more in diabetic patients compared to nondiabetics (P < 0.001). Also, patients having both diabetes and ischemic HF tended to have greater improvement in LVEF compared to ischemic HF patients without diabetes (P = 0.063). Addition of trimetazidine to current treatment of HF, especially for those who are diabetic, may improve LV and RV functions.
Increased P-Wave Dispersion in Patients With New Diagnosed Lichen Planus
(Elsevier Science inc, 2013) Sahin, Musa; Bilgili, Serap Gunes; Simsek, Hakki; Akdag, Serkan; Akyol, Aytac; Gumrukcuoglu, Hasan Ali; Karadag, Ayse Serap
Increased P-Wave Dispersion in Patients With Newly Diagnosed Lichen Planus
(Hospital Clinicas, Univ Sao Paulo, 2013) Sahin, Musa; Bilgili, Serap Gunes; Simsek, Hakki; Akdag, Serkan; Akyol, Aytac; Gumrukcuoglu, Hasan Ali; Karadag, Ayse Serap
OBJECTIVE: Lichen planus is a chronic inflammatory autoimmune mucocutaneous disease. Recent research has emphasized the strong association between inflammation and both P-wave dispersion and dyslipidemia. The difference between the maximum and minimum P-wave durations on an electrocardiogram is defined as P-wave dispersion. The prolongation of P-wave dispersion has been demonstrated to be an independent risk factor for developing atrial fibrillation. The aim of this study was to investigate P-wave dispersion in patients with lichen planus. METHODS: Fifty-eight patients with lichen planus and 37 age-and gender-matched healthy controls were included in this study. We obtained electrocardiographic recordings from all participants and used them to calculate the P-wave variables. We also assessed the levels of highly sensitive C-reactive protein, which is an inflammatory marker, and the lipid levels for each group. The results were reported as the means +/- standard deviations and percentages. RESULTS: The P-wave dispersion was significantly higher in lichen planus patients than in the control group. Additionally, highly sensitive C-reactive protein, LDL cholesterol, and triglyceride levels were significantly higher in lichen planus patients compared to the controls. There was a significant positive correlation between highly sensitive C-reactive protein and P-wave dispersion (r = 0.549, p<0.001) in lichen planus patients. CONCLUSIONS: P-wave dispersion increased on the surface electrocardiographic measurements of lichen planus patients. This result may be important in the early detection of subclinical cardiac involvement. Increased P-wave dispersion, in terms of the tendency for atrial fibrillation, should be considered in these patients.
Increased Risk of Atrial and Ventricular Arrhythmia in Long-Lasting Psoriasis Patients
(Hindawi Ltd, 2013) Simsek, Hakki; Sahin, Musa; Akyol, Aytac; Akdag, Serkan; Ozkol, Hatice Uce; Gumrukcuoglu, Hasan Ali; Gunes, Yilmaz
Background. Several reports have demonstrated an association between psoriasis and cardiovascular diseases. P wave dispersion (PWD) is the most important electrocardiographic (ECG) markers used to evaluate the risk of atrial arrhythmias. QT dispersion (QTD) can be used to assess homogeneity of cardiac repolarization and may be a risk for ventricular arrhythmias. Aim. To search PWD and QTD in patients with psoriasis. Methods. Ninety-four outpatient psoriasis patients and 51 healthy people were evaluated by physical examination, 12-lead ECG, and transthoracic echocardiography. Severity of the psoriasis was evaluated by psoriasis area and severity index (PASI). Results. Mean disease duration was 129.4 +/- 83.9 (range, 3-360) months and PASI ranged from 0 to 34.0 (mean +/- SD; 7.6 +/- 6.7). Compared to control group, psoriatic patients had significantly shorter Pmax and Pmin durations, longer QTcmax, and greater PWD and QTcD. Transmitral deceleration time (DT) and isovolumetric relaxation time (IVRT) were significantly longer among psoriasis patients. QTcD and PWD were significantly correlated with disease duration (r = 0.693, P < 0.001, and, P = 0.368, P = 0.003, resp.). Conclusions. In this study, we found that both PWD and QTcD are increased in psoriasis patients compared to healthy subjects. In addition, they had longer DT and IVRT.
Long-Term Follow-Up of P-Wave Duration and Dispersion in Patients With Mitral Stenosis
(Blackwell Publishing, 2008) Guntekin, Unal; Gunes, Yilmaz; Tuncer, Mustafa; Gunes, Ahmet; Sahin, Musa; Simsek, Hakki
Background: Patients with mitral stenosis have prolonged P-wave duration and increased P-wave dispersion (PWD) that have been associated with increased risk for atrial fibrillation. Methods: Thirty mild-to-moderate mitral stenosis patients were followed for 38.4 +/- 10.7 (23-48) months. Baseline and last 12-lead electrocardiographic and transthoracic echocardiographic measurements were evaluated. Maximum and minimum P-wave durations (P-max and P-min) and PWD were calculated. Results: P-max and PWD were significantly higher in patients compared to control group. Left atrial (LA) size, mitral gradient, and pulmonary artery systolic pressure (PASP) were significantly increased and mitral valve area (MVA) was decreased during follow-up. There were significant increases in P-max and PWD and significant decrease in P-min (P-max: 101.0 +/- 12.5 ms vs 105.0 +/- 16.5 ms, P = 0.005; P-min: 59.3 +/- 8.5 ms vs 55.0 +/- 12.3 ms P = 0.004; PWD: 41.7 +/- 5.5 ms vs 50.0 +/- 6.2 ms, P < 0.001). Baseline P-max, P-min, and PWD were significantly correlated with MVA (P-max: r = -0.605, P < 0.001, P-min: r = -0.632, P < 0.001, PWD: r = -0.402, P = 0.0028) and mean mitral gradient (P-max: r = 0.412, P = 0.024, P-min: r = 0.632, P = 0.049, PWD: r = 0.378, P = 0.039). In addition to MVA and mean mitral gradient follow-up P-wave variables were significantly correlated with LA size (P-max: r = 0.573, P = 0.001, P-min: r = 0.636, P = 0.001, PWD: r = 0.265, P = 0.046) and PASP (P-max: r = 0.462, P = 0.011, P-min: r = 0.472, P = 0.008 PWD: r = 0.295, P = 0.047). Conclusions: P-wave duration and PWD increase progressively in accordance with the progression of mitral stenosis. (PACE 2008; 31:1620-1624).