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Öğe Atrial Functions in Prediabetic Patients(Elsevier Science Inc, 2013) Abdulhalikov, Turyan; Gul, Enes Elvin; Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Yazici, Mehmet; Gok, Hasan[Abstract Not Availabe]Öğe Our Experiences of Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Aribas, Alpay; Dogan, Umuttan; Yazici, Mehmet; Gok, Hasan[Abstract Not Availabe]Öğe The relationship between exercise capacity and masked hypertension in sedentary patients with diabetes mellitus(Taylor & Francis Inc, 2014) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Tekinalp, Mehmet; Ayhan, Selim Suzi; Gunduz, Mehmet; Alibasic, HajrudinAim: Although exaggerated blood pressure responses (EBPR) to exercise have been related to future hypertension and masked hypertension (MHT), the relationship between exercise capacity and MHT remains unclear. A sedentary life style has been related to increased cardiovascular mortality, diabetes mellitus (DM), and hypertension. In this study, we aimed to examine the relationship between exercise capacity and MHT in sedentary patients with DM. Methods: This study included 85 sedentary and normotensive patients with DM. Each patient's daily physical activity level was assessed according to the INTERHEART study. All patients underwent an exercise treadmill test, and exercise duration and capacity were recorded. Blood pressure (BP) was recorded during all exercise stages and BP values >= 200/110 mmHg were accepted as EBPR. MHT was diagnosed in patients having an office BP < 140/90 mmHg and a daytime ambulatory BP > 135/85 mmHg. Patients were divided into two groups according to their ambulatory BP monitoring (MHT and normotensive group). Results: The prevalence of MHT was 28.2%. Exercise duration and capacity were lower in the MHT group than in the normotensive group (p < 0.05) and were negatively correlated with age, HbA1c, mean daytime BP, and mean 24 hour BP. Peak exercise systolic BP and the frequency of EBPR were both increased in the MHT group (25.0% and 8.1%, respectively, p = 0.03). According to a multivariate regression, exercise capacity (OR: 0.61, CI95%: 0.39-0.95, p = 0.03), EBPR (OR: 9.45, CI95%: 1.72-16.90, p = 0.01), and the duration of DM (OR: 0.84, CI95%: 0.71-0.96, p = 0.03) were predictors of MHT. Conclusion: Exercise capacity, EBPR, and the duration of DM were predictors of MHT in sedentary subjects with DM.Öğe The Relationship Between Neutrophil / Lymphocyte Ratio and Myocardial Ischemia Detected in Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Aribas, Alpay; Yildirim, Oguzhan; Karanfil, Mustafa; Sertdemir, Ahmet Lutfi[Abstract Not Availabe]Öğe The relationship between red blood cell distribution width and myocardial ischemia in dobutamine stress echocardiography(Lippincott Williams & Wilkins, 2014) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Alibasic, Hajrudin; Yildirim, Oguzhan; Sertdemir, Ahmet Lutfi; Ozdemir, KurtulusObjectivesAlthough elevated red blood cell distribution width (RDW) is associated with adverse outcomes in patients with cardiovascular disease, its role in demonstrating the presence and extent of myocardial ischemia for coronary artery disease is not known. The purpose of this study is to investigate the relationship between RDW and myocardial ischemia by using dobutamine stress echocardiography (DSE).MethodsA total of 917 patients were included in this prospective study. A complete blood analysis was performed for RDW before DSE. According to DSE results, patients were divided into two groups: DSE negative and DSE positive. According to the number of ischemic segments in DSE, patients were divided into three groups: no-ischemic segment, 1-3 ischemic segments, and 4 ischemic segments. In addition, coronary angiography results of DSE-positive groups were assessed in respect of RDW.ResultsThe RDW of the DSE-positive group (n=277) was higher than for the DSE-negative group (n=640) (13.51.5 vs. 12.7 +/- 1.3%, P<0.001, respectively). Elevated RDW values were also related to higher number of ischemic segments (no-ischemic segment group: 12.7 +/- 1.3, 1-3 ischemic segments group: 13.2 +/- 1.5, and 4 ischemic segments group: 14.2 +/- 1.3, P<0.001). A receiver operating curve analysis showed a cut-off value of RDW greater than 13.5% for predicting myocardial ischemia (sensitivity: 57.0%, specificity: 77.8%, positive predictive value: 52.7%, negative predictive value: 80.7%). In addition, positive predictive value of DSE was increased from 82.4 to 94.2% for detecting coronary artery disease by coronary angiography, when RDW (>13.5%) was used.ConclusionRDW is related to the presence and extent of myocardial ischemia in DSE. A high RDW increases the diagnostic accuracy of DSE.Öğe The Relationship Between Red Blood Cell Distribution Width and Myocardial Ischemia in Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Alibasic, Hajrudin; Yildirim, Oguzhan; Sertdemir, Ahmet Lutfi; Ozdemir, Kurtulus[Abstract Not Availabe]Öğe Self-Reported Sleep Quality of Patients with Atrial Fibrillation and the Effects of Cardioversion on Sleep Quality(Wiley, 2013) Kayrak, Mehmet; Gul, Enes Elvin; Aribas, Alpay; Akilli, Hakan; Alibasic, Hajrudin; Abdulhalikov, Turyan; Yildirim, OguzhanBackground Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance encountered in clinical practice and is associated with impaired quality of life. Data from the previous studies have shown that sleep quality (SQ), as a component of life quality, may also deteriorate in patients with AF. However, it remains unclear; we do not know whether SQ improves after sinus rhythm is maintained. Therefore, we aimed to examine the relationship between SQ and AF, as well as the effects of sinus rhythm restoration with direct current cardioversion (DCC) on SQ among patients with persistent AF. Methods One hundred fifty-three patients with a diagnosis of nonvalvular AF and 150 age-matched control subjects with sinus rhythm were recruited. SQ was assessed using the Pittsburgh Sleep Quality Index (PSQI). The study was designed with two stages. First, the difference in SQ between AF patients and age-matched controls was examined. Patients with global PSQI scores greater than 5 were defined as poor sleepers. Thus, a higher global PSQI score indicated worsened SQ. Predictors of poor SQ were also analyzed using a regression model. Second, the effect of rhythm control on SQ was studied in patients with AF who were eligible for DCC. Of the 65 patients with persistent AF, 54 patients with successful cardioversion were followed for 6 months. The remaining 11 patients, whose cardioversion was unsuccessful, were not followed. After 6 months of follow-up, the PSQI scores of patients with sinus rhythm maintenance (n = 39) and patients with AF recurrence (n = 15) were reassessed. Changes in global PSQI scores (baseline vs after 6 months) were analyzed. Results The PSQI scores were significantly higher in the AF group compared to the control group (9.4 +/- 4.6 vs 5.8 +/- 4.1, P = 0.001, respectively). The prevalence of poor sleepers was significantly higher in the AF group (76%) than in the control group (45%) (P < 0.001 by the (2) test). Multivariate logistic regression analysis showed that AF (odds ratio [OR]: 3.36, 95% confidence interval [CI]: 2.00-5.55), age (OR: 1.02, 95% CI: 1.00-1.04), and diabetes mellitus (OR:1.79, 95% CI: 1.03-3.14) were independent predictors of poor SQ. In the second stage, the effect of rhythm control on the SQ of the 54 patients with successful DCC was analyzed. PSQI scores improved significantly between baseline and the 6 months in sinus rhythm maintenance group (8.7 +/- 4.1 vs 7.2 +/- 3.8, P < 0.001, respectively). However, in the AF recurrence group, the change in global PSQI scores between baseline and the sixth month was not statistically significant (9.8 +/- 4.5 vs 9.2 +/- 4.2, P = 0.56, respectively). Conclusion Patients with AF have shorter sleep duration and poor SQ. Maintenance of sinus rhythm after DCC may have a favorable effect on the SQ of patients with AF. Nevertheless, AF is an independent predictor of poor SQ.