Browsing by Author "Simsek, Hakki"

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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.
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
Comparison of the Effects of Quinapril and Irbesartan on P-Wave Dispersion in Hypertensive Patients
(Springer, 2008) Guntekin, Unal; Gunes, Yilmaz; Tuncer, Mustafa; Simsek, Hakki; Gunes, Ahmet
Introduction: P-wave dispersion (PWD) has been shown to be a non-invasive electrocardiographic predictor for development of atrial fibrillation (AF). Thus, it may be possible to attenuate AF risk through improvement of PWD. In this study, we compared the effects of an angiotensin-converting enzyme (ACE) inhibitor, quinapril, and an angiotensin receptor blocker (ARB), irbesartan, on PWD. Methods: A total of 38 newly diagnosed hypertensive patients were enrolled in the study. The patients were randomly assigned to receive treatment with either irbesartan (150-300 mg) or quinapril (20-40 mg). P-wave durations and PWD were measured at baseline and after 6 and 12 months of treatment. Echocardiographic examinations were performed at baseline and after 12 months of treatment. Results: Both drugs significantly reduced blood pressure to a similar degree (P < 0.001). Deceleration time (both P < 0.001) and isovolumetric relaxation time (both P=0.007) were also significantly reduced, whereas there was no significant change in the early diastolic flow/atrial contraction signal ratio. Both irbesartan and quinapril significantly decreased maximum P-wave duration (Pmax) (P < 0.001 and P=0.002, respectively) and PWD (from 68.0 +/- 22.1 to 41.0 +/- 25.1 msec for irbesartan, and from 70.5 +/- 20.4 to 46.6 +/- 13.3 msec for quinapril; both P < 0.001). Baseline and follow-up blood pressure, heart rate, echocardiographic findings, and P-wave values were not significantly different between the irbesartan and quinapril groups. No patient developed AF during follow-up. There was no significant correlation between PWD and blood pressure or diastolic function parameters. Conclusion: Antihypertensive treatment with either irbesartan or quinapril is associated with significant reductions in Pmax and PWD.
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
Decreased Risk of Ventricular Arrhythmias With Treatment of Nebivolol in Patients With Coronary Slow Flow
(Via Medica, 2016) Simsek, Hakki; Yaman, Mehmet; Babat, Naci; Akdag, Serkan; Akyol, Aytac; Demirel, Koray Celal; Gunes, Yilmaz
Background: Coronary slow-flow (CSF) is an angiographic phenomenon characterised by delayed opacification of vessels in the absence of any evidence of obstructive epicardial coronary disease. QT interval dispersion (QTD) reflects regional variations in ventricular repolarisation and cardiac electrical instability and has been reported to be longer in patients with CSF. Aim: To examine QT duration and dispersion in patients with CSF and the effects of nebivolol on these parameters. Methods: The study population included 67 patients with angiographically proven normal coronary arteries and CSF, and 38 patients with angiographically proven normal coronary arteries without associated CSF. The patients were evaluated with 12-lead electrocardiography, and echocardiography before and three months after treatment with nebivolol. Results: Compared to the control group QTcmax and QTcD were significantly longer in patients with CSF (p = 0.036, p = 0.019, respectively). QTcD significantly correlated with the presence of CSF (r = 0.496, p < 0.001). QTcmax (p = 0.027), QTcD (p = 0.002), blood pressure (p = 0.001), and heart rate (p < 0.001) values significantly decreased after treatment with nebivolol. Conclusions: Coronary slow flow is associated with increased QTD. Nebivolol reduced increased QTD in patients with CSF after three months.
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.
Effects of Illness Activity on Electrocardiographic Parameters in Patient With Multiple Sclerosis
(Drunpp-sarajevo, 2012) Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Akdag, Serkan; Simsek, Hakki; Tombul, Temel
Background: Multiple sclerosis (MS) has been reported to be associated with autonomic dysfunction. QT and P wave duration are clearly related to autonomic nervous system. We compared P wave dispersion (PWD) and corrected QT dispersion (QTcD) in stable phase and active phase MS patients to healthy control subjects. Method: 76 MS patients and44 healthy control subjects were included. Twelve-lead surface ECG recording was performed all participants. The P and QT wave parameters were measured manually Results: Maximum P wave and QTc duration were higher in MS patients than control groups. The average PWD and QTcD value of MS patients was also found to be higher than control groups. According to illness activity, statistically differences weren't observed at ECG parameters in patients with MS. Conclusion: P wave and QTc duration were found to be statistically different in patients with MS and control subjects. But illness activity didn't affect these electrocardiographic parameters as significantly.
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.
The Effects of Perindopril on Qt Duration and Dispersion in Patients With Coronary Slowflow
(Elsevier Ireland Ltd, 2010) Guntekin, Unal; Gunes, Yilmaz; Gunes, Ahmet; Gumrukcuoglu, Hasan Ali; Ceylan, Yemlihan; Simsek, Hakki; Tuncer, Mustafa
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.
The Evaluation of Paraoxonase 1 Activity in Patients With Gestational Diabetes
(Carbone Editore, 2013) Atay, Ahmet Engin; Sakar, Mehmet Nafi; Culcu, Nurdagul Serife Nurani; Simsek, Hakki; Akbas, Halit; Acar, Murat; Tuzcu, Alpaslan Kemal
Material and methods: Sixty five patients with GDM and 66 healthy pregnants were enrolled. Paraoxonase activity, insulin levels, HOMA-IR, demographic features and anthropometric measurements were evaluated. Results: The mean paraoxonase activity was significantly diminished in patients with GDM (p:0,004). Insulin level and HOMA-IR were significantly higher in GDM patients (p:0,004 and p:0,001; respectively). The mean interval between present and previous pregnancy was significantly shorter in patients group (p:0,004). There was a significant correlation between PON1 activity and serum LDL, HDL levels and weight gained during pregnancy (p:0,001,p<0,001 and p:0,002; respectively) but not with weight and parity. However HOMA-IR was significantly correlated with weight and parity (p:0,001 and p:0,002; respectively). Discussion: Diminished PON1 activity and enhanced oxidative stress accompany to insulin resistance in the pathogenesis of GDM. Oxidative stress is associated with weight gained during first 2 trimesters of pregnancy rather than obesity.
Increased Frequency of Pulmonary Hypertension in Psoriasis Patients
(Springer, 2008) Gunes, Yilmaz; Tuncer, Mustafa; Calka, Omer; Guntekin, Unal; Akdeniz, Necmettin; Simsek, Hakki; Ozdemir, Ilknur Yorgun
Several reports have demonstrated an association between psoriasis and cardiovascular diseases such as hypertension, valvular disease and arrhythmia. However, the data is scarce. Forty-seven psoriasis patients and 20 healthy people underwent transthoracic echocardiographic examination including pulse- and tissue Doppler analysis and 24-h ambulatory electrocardiographic monitoring including heart rate variability (HRV) analysis. Patients having systemic hypertension, diabetes mellitus, history of structural or ischemic heart disease, chronic obstructive pulmonary disease and any associated systemic disease were excluded. Psoriasis Area and Severity Index (PASI) was calculated and severe psoriasis was defined in the case of history of hospitalizations for psoriasis and/or getting systemic therapy. Mean age of the patients was 35.7 +/- 12.9 years and disease duration was 123.2 +/- 84.3 (3-360) months. PASI ranged from 0.4 to 34.0 (mean +/- SD: 7.1 +/- 6.6) and 20 (42.6%) patients had severe psoriasis. There were no significant differences between psoriasis patients and control group with respect to mean values of blood pressure, body mass index, lipid profile and cardiac dimensions. However, frequency of being overweight was significantly higher in psoriasis patients (42.6 vs. 10.0%, P = 0.011). No patient had valvular disease. Mild pulmonary hypertension (PH) (30-40 mmHg) was significantly more frequent in psoriasis patients (31.9 vs. 0%, P = 0.003). Pulse wave mitral Doppler deceleration and isovolumetric relaxation times were significantly longer in psoriasis patients (195.9 +/- 29.7 vs. 191.6 +/- 14.7 ms, P = 0.002 and 91.6 +/- 14.7 vs. 79.6 +/- 10.5 ms, P = 0.001, respectively). However, frequency of diastolic dysfunction was not significantly different than the control group (8.5 vs. 0%, P = 0.309). HRV parameters and frequency of supraventricular and ventricular premature beats were not significantly different between the groups. No patient had ventricular tachycardia. Echocardiographic follow-up of psoriasis patients may be important due to possible association of PH. However, incidences of structural heart disease and arrythmia are not increased in psoriasis according to our results.
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.