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    Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Children With Turner Syndrome
    (Springer, 2014) Akyurek, Nesibe; Atabek, Mehmet Emre; Eklioglu, Beray Selver; Alp, Hayrullah
    Patients with Turner syndrome (TS) have an increased risk of cardiovascular morbidity. 29 TS and 25 healthy control subjects (CS) were included in the study. We investigated body mass index, waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test, 24-h ambulatory blood pressure (BP) monitoring, and carotid intima-media thickness (CIMT) and compared them with CS. 28 % (N = 7) of TS had insulin resistance (IR), and 36 % (N = 9) had IGT. Mean systolic BP and diastolic BP (DBP) dip were 7.24 +/- A 3.97 % and 11.84 +/- A 6.2 %, respectively. CIMT was greater in TS than in CS (p = 0.00). CIMT was correlated positively with fasting insulin, HOMA index, and insulin-sensitivity check index (r = 0.563, p = 0.015; r = 0.603, p = 0.008; and r = 0.623, p = 0.006, respectively) and negatively with fasting glucose-to-insulin ratio and DBP dipping (r = -0.534, p = 0.022; r = -0.534, p = 0.00, respectively) in the two groups combined. These results provide additional evidence for the presence of subclinical cardiovascular disease and its relation to hypertension in TS. They also indicate a significant relation between DBP dipping and increased arterial stiffness. It is also important to note that our findings show significant relationships between insulin sensitivity and cardiovascular changes and underline the importance of insulin resistance for predicting cardiovascular disease.
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    Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Patients with Congenital Adrenal Hyperplasia: A Preliminary Report
    (2015) Akyürek, Nesibe; Atabek, Mehmet Emre; Eklioğlu, Beray Selver; Alp, Hayrullah
    Objective: There is an increased risk of cardiovascular morbidity in children and adolescents with classical congenital adrenal hyperplasia (CAH), presumably associated with obesity, hypertension, impaired glucose tolerance and dyslipidemia. This study was designed to evaluate the metabolic and cardiovascular profile of a group of children with classical CAH from the perspective of cardiovascular risk.Methods: Twenty-five CAH patients and 25 healthy controls were included in the study. Metabolic and anthropometric parameters were investigated and compared in these two groups. Results: Subjects in the CAH group were shorter than the controls (p0.001) and had higher body mass index values (p0.033). Diastolic blood pressure (DBP) (p0.027) and carotid intima-media thickness (CIMT) values (p0.006) were also higher in the patient group. In 24% (n6) of CAH patients, 24-h ambulatory BP monitoring showed arterial hypertension. CIMT was significantly higher in the hypertensive patients than in those with no hypertension (p0.013). Twenty percent (n5) of CAH patients had nocturnal hypertension. CIMT was significantly greater in the nocturnal hypertensive group (p0.02). Mean systolic BP (SBP) and DBP dipping were significantly different in the CAH patients (p>0.001). CIMT correlated negatively with DBP dipping (r-0632, p0.037) in these patients.Conclusion: These results provide additional evidence for the presence of subclinical cardiovascular disease in classical CAH patients and its relationship with hypertension
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    Assessment of Cardiovascular Parameters in Obese Children and Adolescents with Non-Alcoholic Fatty Liver Disease
    (2015) Eklioğlu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, Hayrullah
    Objective: The aim of this study was to evaluate the periaortic fat thickness (PAFT) using conventional echocardiography in obese children and adolescents with non-alcoholic fatty liver disease (NAFLD).Methods: Two hundred and ninety-seven obese children and adolescents were included in the study. Anthropometric measurements were made in all subjects, and fasting venous blood samples were taken for determination of glucose, insulin, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Ultrasonography of the liver was used for assessment of NAFLD and the subjects were grouped as NAFLD and non-NAFLD. Echocardiography was performed in all subjects.Results: PAFT was higher in patients with NAFLD compared with the nonNAFLD group. In patients with NAFLD, PAFT was positively correlated with waist circumference and with total cholesterol levels. In multiple regression analysis, waist circumference (?0.28, p>0.001) was found to be the best predictor of PAFT.Conclusion: Conventional echocardiography may be used to determine increased PAFT at an early stage in obese children and adolescents with NAFLD for careful monitoring of cardiovascular risk
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    Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Risk in Obese Children and Adolescents
    (Elsevier Science Inc, 2013) Alp, Hayrullah; Karaarslan, Sevim; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Altin, Hakan; Baysal, Tamer
    Background: The recent rise in the prevalence of obesity likely explains nonalcoholic fatty liver disease (NAFLD) epidemic worldwide. We evaluated cardiac functions, cardiovascular risk, and associated parameters with grades of NAFLD in obese children. Methods: Four hundred obese children were enrolled in the study. Obese children with NAFLD were classified in 2 subgroups according to ultrasonographic visualizing. Ninety-three obese children with NAFLD (mean age 11.73 +/- 2.72 years in group 2 and 12.69 +/- 2.61 years in group 3) were compared with 307 age- and sex-matched non-NAFLD obese children and 150 control subjects. Laboratory parameters were measured during the fasting state. Pulsed and tissue Doppler echocardiography were performed. Intima-media (IMT) and epicardial adipose tissue (EAT) thicknesses were measured. Results: NAFLD groups had a significantly higher body mass index (29.15 +/- 3.42 and 30.46 +/- 4.60; P < 0.001), total adipose tissue mass (37.95 +/- 4.46% and 46.57 +/- 6.45%; P < 0.001), higher insulin, alanine aminotransferase, and aspartate aminotransferase levels. Increased end-systolic thickness of the interventricular septum (P < 0.001), larger left ventricular mass (P < 0.003) and index (P < 0.003) were found in NAFLD groups. Children with NAFLD had higher Tei index values. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Waist and hip circumference, total cholesterol level, total adipose tissue mass, and interventricular septum were statistically different in NAFLD groups. Conclusions: Children with NAFLD had mildly altered left and right ventricular functions and all obese children had increased IMT and EAT thickness. Also, grade of liver steatosis was positively correlated with total adipose tissue mass and interventricular septum systolic thickness.
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    Association between vitamin D level and cardiovascular risk in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Atabek, M. E.; Eklioglu, Beray Selver; Akyurek, Nesibe; Alp, Hayrullah
    Background: The aim of our study was to evaluate the associations between vitamin D deficiency, the atherosclerosis and metabolic syndrome. Methods: Two hundred and forty-seven obese children and adolescents, 8-16 years of age (body mass index>95 p) were included in the study. Anthropometric measurements, blood pressure measurements, lipid profile, vitamin D level and carotid intima media thickness (c-IMT) were measured. MS was diagnosed according to IDF criteria. Results: The prevalance of vitamin D deficieny in obese children and adolescent was 46.6%. Low levels of vitamin D were associated with increased carotis intima media thickness and metabolic syndrome (p=0.03, p=0.04, respectively). For clinical cardiovascular risk factors, mutivariable regression analyses showed that low vitamin D level was best predictor of c-IMT. Conclusions: In this study we showed an association between low vitamin D status and atherosclerosis independent of traditional risk factors in obese children and adolescents.
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    Association between vitamin D level and cardiovascular risk in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Atabek, M. E.; Eklioglu, Beray Selver; Akyurek, Nesibe; Alp, Hayrullah
    Background: The aim of our study was to evaluate the associations between vitamin D deficiency, the atherosclerosis and metabolic syndrome. Methods: Two hundred and forty-seven obese children and adolescents, 8-16 years of age (body mass index>95 p) were included in the study. Anthropometric measurements, blood pressure measurements, lipid profile, vitamin D level and carotid intima media thickness (c-IMT) were measured. MS was diagnosed according to IDF criteria. Results: The prevalance of vitamin D deficieny in obese children and adolescent was 46.6%. Low levels of vitamin D were associated with increased carotis intima media thickness and metabolic syndrome (p=0.03, p=0.04, respectively). For clinical cardiovascular risk factors, mutivariable regression analyses showed that low vitamin D level was best predictor of c-IMT. Conclusions: In this study we showed an association between low vitamin D status and atherosclerosis independent of traditional risk factors in obese children and adolescents.
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    Cardiovascular Disease Risk in Children and Adolescents with Attention Deficit/Hyperactivity Disorder
    (Korean Coll Neuropsychopharmacology, 2023) Uzun, Necati; Ak, Mehmet Akif; Alp, Hayrullah
    Objective: The aim of this case-controlled study is to evaluate chronic inflammation, subclinical atherosclerosis and cardiovascular disease risk in children and adolescents with ADHD.Methods: A total of 51 medication-free children and adolescents with ADHD and 51 healthy controls were included in this study. K-SADS-PL was used to determine the diagnosis of ADHD and other psychiatric disorders. Conners' Parent Rating Scale-Revised Short Form and the Conners' Teacher Rating Scale-Revised Short Form severity of ADHD was used to evaluate severity of ADHD. In order to evaluate subclinical atherosclerosis, common carotid intima media thickness (IMT), epicardial adipose tissue thickness (EAT), and periaortic adipose tissue thickness (PAT) were assessed as well as clinical parameters.Results: The IMT (0.037 +/- 0.005 cm vs. 0.026 +/- 0.003 cm), EAT (0.472 +/- 0.076 cm vs. 0.355 +/- 0.051 cm), and PAT (0.135 +/- 0.016 cm vs. 0.118 +/- 0.009 cm) measurements were significantly higher in the ADHD group than in the control group. Additionally, partial correlation analyses revealed that a positive correlation was observed between IMT and EAT, and PAT measurements separately. Multivariate linear regression analysis revealed that, body mass index (BMI) positively predicted IMT. Also, age and BMI positively predicted the EAT levels of the subjects with ADHD.Conclusion: Our results suggest that children and adolescents with ADHD have a risk for cardiovascular disease. For this reason, subclinical atherosclerosis should be taken into consideration in the follow-up and treatment of ADHD for cardiovascular disease risk.
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    Comparison of left and right ventricular pulsed and tissue Doppler myocardial performance index values using Z-score in newborns with hypoxic-ischemic encephalopathy
    (Turkish Soc Cardiology, 2011) Alp, Hayrullah; Karaaslan, Sevim; Baysal, Tamer; Oran, Bulent; Ors, Rahmi
    Objective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MP's (Tei indexes) were calculated with PD and TO echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41 +/- 0.04, 0.51 +/- 0.02) and TD (0.59 +/- 0.04, 0.51 +/- 0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TO method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)
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    Cutis Tricolor Parvimaculata: A Distinct Neurocutaneous Syndrome with Brain Involvement: Case Report
    (Ortadogu Ad Pres & Publ Co, 2012) Alp, Hayrullah; Keser, Melike; Paksoy, Yahya
    Cutis tricolor is a skin disorder characterized by the coexistence of congenital hypo-and hyperpigmented maculer lesions, in close proximity to each other on a background of normal skin. Cutis tricolor parvimaculata describes the form consisting of smaller spots. These skin macules are called twin spotting and represent a part of a neurocutaneous malformation syndrome. Cut is tricolor may accompany various multisystem birth defects including craniofacial and brain abnormalities. It must be distinguished from other neurocutaneous syndromes such as tuberous sclerosis and neurofibromatosis. We described cutis tricolor parvimaculata in a 3-year-old girl, the reported youngest patient in the literature, with diffuse pigmentary spotting on the skin, facial anomalies, developmental delay and brain involvement.
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    Dispersion Durations of P-wave and QT Interval in Children With Congenital Heart Disease and Pulmonary Arterial Hypertension
    (Springer, 2013) Sap, Fatih; Karatas, Zehra; Altin, Hakan; Alp, Hayrullah; Oran, Bulent; Baysal, Tamer; Karaarslan, Sevim
    This study aimed to investigate homogeneity disorders of ventricular repolarization and atrial conduction via QT dispersion and P-wave dispersion in children with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH). Three groups of 20 each were generated and involved in this study. The first group included 20 children with both CHD and PAH. The second group consisted of 20 children with CHD but no PAH, and the third group was composed of 20 age- and sex-matched healthy children. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. The pulmonary hypertension group compared with the group having no pulmonary hypertension and the control group showed a significantly longer P-wave dispersion duration (39.10 +/- A 9.54 vs. 26.30 +/- A 4.99 ms, p < 0.001; and 24.80 +/- A 6.94 ms, p < 0.001, respectively) and QT dispersion duration (52.80 +/- A 15.11 vs. 37.60 +/- A 6.00 ms, p < 0.001; and 35.00 +/- A 7.77 ms, p < 0.001, respectively). In addition, the durations of maximum QTc and QTc dispersion were significantly longer in pulmonary hypertension group than in the other two groups. The risk of atrial and ventricular arrhythmia was found to be increased in the patients with both CHD and PAH. Physicians should pay close attention to possible atrial and ventricular arrhythmias during the treatment and follow-up evaluation of these patients.
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    The effect of hypertension and obesity on left ventricular geometry and cardiac functions in children and adolescents
    (Lippincott Williams & Wilkins, 2014) Alp, Hayrullah; Karaarslan, Sevim; Eklioglu, Beray S.; Atabek, Mehmet E.; Baysal, Tamer
    Objectives:Obesity and hypertension are associated with structural and functional cardiac change in children and adults. The aim of the study is to evaluate the effect of hypertension and obesity on left ventricular geometric patterns and cardiac functions assessed by conventional and Doppler echocardiography.Methods:Four hundred and thirty obese children, aged 6-17 years and 150 age and sex-matched healthy controls, were included in the study. Left ventricular geometry was classified as concentric hypertrophy, eccentric hypertrophy, concentric remodeling and normal geometry.Results:Concentric hypertrophy group had the worst subclinical systolic and diastolic cardiac functions among all left ventricular geometric patterns. BMI and total adipose tissue mass are the predictors of abnormal ventricular geometry. Apart from the increase in carotid intima-media and epicardial adipose tissue thicknesses in different left ventricular geometry patterns, they are not predictable for abnormal geometry.Conclusion:The variety of alterations in cardiac function and morphology that has been observed in obese adults, appears to start earlier in life. Obesity and hypertension were clearly associated with the left ventricular geometry. Also, subclinical systolic and load-depended diastolic dysfunctions can be detected in obese hypertensive children with concentric hypertrophy.
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    Electrocardiographic ST elevation (mosque sign) without myocardial ischemia in an infant with tuberous sclerosis
    (Georg Thieme Verlag Kg, 2014) Alp, Hayrullah; Baysal, Tamer; Karaarslan, Sevim; Alpmar, Abdullah; Caksen, Huseyin
    Rhabdomyomas, the most common primary cardiac tumors seen in infants and children, are often associated with tuberous sclerosis. However, these cardiac rhabdomyomas may cause hemodynamic disturbances and arrhythmias. In the present case, we demonstrated an infant with electrocardiographic ST elevation suggesting myocardial ischemia associated with multiple cardiac rhabdomyomas.
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    Ellis-van creveld sendromu (Kondroektodermal displazi) bir olgunun sunumu: Tek atrium ve persistan sol süperior vena kava birlikteliği
    (2013) Alp, Hayrullah; Şap, Fatih; Altın, Hakan; Karataş, Zehra; Baysal, Tamer; Karaaslan, Sevim
    Ellis-van Creveld (EvC) sendromu, otosomal resesif olarak kalıtılan nadir bir kondral ve ektodermal hastalıktır. Kondro ve ektodermal displazi, polidaktili ve konjenital kalp defektleri bu sendromun karakteristik bulgularıdır. Tek atrium ve endokardiyal yastık defektlerinin bu sendromda en sık rastlanan konjenital kalp defektleri olduğu bildirilmektedir. EvC sendromunun nadir görülmesi nedeni ile ekokardiyografik ve anjiyokardiyografik incelemede, tek atrium ve persistan sol süperior vena kava gibi doğumsal kalp anomalilerinin yanı sıra EvC sendromunun diğer klasik bulguları saptanan dört yaşındaki kız hasta sunulmuştur.
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    Evaluation of cardiac functions in term small for gestational age newborns with mild growth retardation: A serial conventional and tissue Doppler imaging echocardiographic study
    (Elsevier Ireland Ltd, 2012) Altin, Hakan; Karaarslan, Sevim; Karatas, Zehra; Alp, Hayrullah; Sap, Fatih; Baysal, Tamer
    Background: The aim of this study is to evaluate the cardiac functions of term small for gestational age (SGA) babies with mild growth retardation by echocardiography during the postnatal period. Methods and results: Thirty term SGA (2271 +/- 207 g/38-41 weeks (mean 39.5 weeks)) and 30 term AGA (3298 +/- 338 g/38-41 weeks (mean 39 weeks)) newborns as the control group, with normal general health status and with no nutritional problems were evaluated at three time points, on the 3rd postnatal day, at the 3rd and the 6th months. In the initial analysis, heart rate, left ventricular end diastolic diameter index (LVEdDI), cardiac index (CI), all E/A, Em/Am and E/Em ratios, pulsed wave Doppler myocardial performance index (MPI), and tissue Doppler imaging MPI values were higher in SGA babies than the control group. In the last analysis, only heart rate, LVEdDI and CI values were different between SGA and control groups. Conclusions: Systolic and diastolic cardiac dysfunctions were determined in SGA babies with mild growth retardation during the first 6 months of postnatal period. Any disease that affects the hemodynamic stability of these patients during postnatal period may lead to early progressive deterioration in cardiac functions. Furthermore, many of the cardiac functions of these babies have been improved about the 6th month period, and high levels of heart rate and LVEdDI may be suggested as an indicator of cardiac remodeling. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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    Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, Zehra
    Background: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.
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    Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
    (Walter De Gruyter Gmbh, 2014) Alp, Hayrullah; Eklioglu, Beray Selver; Atabek, Mehmet Emre; Karaarslan, Sevim; Baysal, Tamer; Altin, Hakan; Karatas, Zehra
    Background: Childhood obesity is a cardiovascular risk factor. Objective: Epicardial adipose tissue (EAT) thickness, carotid intima-media thickness (IMT) and cardiac functions of obese children and their correlations were evaluated. Subjects: Five hundred obese children and 150 age-and sex-matched healthy controls. Methods: Anthropometric, laboratory data and echocardiographic measurements of IMT, EAT and cardiac functions were determined. Results: Increased M-mode echocardiographic measurements, E/e' ratios, Tei index values and decreased E/A and e'/a' ratios (where E and A are early and late mitral/tricuspid diastolic velocities, respectively, and e' and a' are peak early diastolic and peak atrial systolic myocardial velocities, respectively), were determined in the obese group. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Carotid artery IMT, EAT thickness and left ventricular mass (LVM) were found to be strongly associated with Tei index values. Conclusion: Obesity is a major risk factor for cardiovascular diseases. In our study, we showed that obese children have early subclinical systolic and diastolic dysfunctions. Also, these cardiac impairments are correlated with the increase in IMT, EAT thickness and LVM.
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    Evaluation of Periaortic Adiposity and Metabolic Disorders in Obese Children
    (2016) Eklioğlu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, Hayrullah
    Objective: To evaluate the relationship between periaortic fat thickness (PAFT) and parameters involved in the development of metabolic complications of the cardiovascular system in obese children and to assess the usefulness of echocardiographic measurements of PAFT in correlation with cardiovascular risk factors.Methods: The study was conducted with 263 obese and 100 healthy children and adolescents. PAFT was measured with echocardiography method which was recently performed in obese children and adolescents.Results: PAFT was significantly higher in the obese group (0.258±0.031 mm) than in the control group (0.137±0.032 mm) (p>0.001). In multivariable regression analysis, body mass index-standard deviation score and total body fat were predictors of PAFT. The area under the receiver operating characteristic curve was 0.989 and was quite significant at p>0.001. PAFT above 0.179 mm was determined as the cut-off value in obese children and adolescents (sensitivity1, specificity0.97). Conclusion: The measurement of PAFT in obese children and adolescents may be a good method to reveal the presence of early cardiovascular risk.
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    Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery
    (2012) Alp, Hayrullah; Narin, Cüneyt; Tamer, Baysal; Sarıgül, Ali
    Amaç: Çalışmada doğuştan kalp cerrahisi yapılan çocuklarda ameliyat öncesi ve sonrası QTc dispersiyonu değişkenliği değerlendirildi. Ça­lış­ma pla­nı: Ekim 2006 - Mart 2011 tarihleri arasında doğuştan kalp cerrahisi yapılan ve ilk dahil edilme kriterlerini karşılayan ardışık 279 hasta (144 kadın, 135 erkek; ort. yaş 56.6±5.0 ay; dağılım 15 gün-17 yaş) çalışmaya alındı. QTc dispersiyon ölçümleri, hastalardan ameliyat öncesi (bir ay) ve ameliyat sonrası (bir hafta) dönemde elde edilen standart 12 derivasyonlu istirahat elektrokardiyogramlarından hesaplandı. Bulgular: Kardiyak cerrahi yapılan tüm hastaların %75.9’unda QTc dispersiyonu, ameliyat sonrası ameliyat öncesinden istatistiksel olarak yüksek bulundu. Çalışma grubunda en sık tespit edilen doğuştan kalp hastalıkları ventriküler septal defekt (VSD) ve sekundum atriyal septal defekt (ASD) idi. Ventriküler septal defekt, atriyoventriküler septal defekt, Fallot tetrolojisi (TOF) ve sekundum ASD onarımları QTc dispersiyonundaki artış için majör risk faktörleriydi. Ancak, VSD ile pulmoner stenoz onarımı, koarktasyonda aortun uç uca anostomozu, patent duktus arteriozus ligasyonu ve divizyonu, pulmoner bant ve Glenn prosedürü yapılan çocuklarda ameliyat öncesi ve sonrası QTc dispersiyonları arasında istatistiksel fark bulunmadı. Yapılan kardiyak ameliyatın tipine göre ortaya çıkan aritmiler, uzun QTc dispersiyonu olan grupta, olmayanlara kıyasla, istatistiksel olarak yüksekti. So­nuç: QTc dispersiyonu ölçümü aritmilerin araştırılmasında kullanışlı ve invaziv olmayan bir elektrokardiyografik testtir. Çalışma sonuçları, QTc dispersiyonunun ameliyat sonrası dönemde kullanımının ortaya çıkacak aritmilerin öngörüsünde yardımcı olabileceğini göstermektedir.
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    Evaluation of Serum Ischemia Modified Albumin Levels in Acute Rheumatic Fever Before and After Therapy
    (All India Inst Medical Sciences, 2014) Toker, Aysun; Karatas, Zehra; Altin, Hakan; Karaarslan, Sevim; Cicekler, Humeyra; Alp, Hayrullah
    To investigate ischemia modified albumin (IMA) levels in children with acute rheumatic fever (ARF) before and after therapy and compare them with those of controls. Twenty seven patients with ARF and 18 healthy, age and sex matched children were included in the study. The diagnosis of ARF was established according to the modified Jones criteria. Follow-up studies were made when acute phase reactants [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] levels returned normal. IMA levels were measured using the rapid and colorimetric method with the albumin cobalt binding test. IMA levels were significantly higher in ARF group (p < 0.001) compared with controls at the time on admission. IMA (absorbance units) was measured as 0.41 +/- 0.10 in the control group, 0.55 (0.44-1.13) in the study group before treatment and 0.48 +/- 0.12 in the study group after treatment. After treatment, statistically important decrements were determined in the levels of ESR (p < 0.001), CRP (p < 0.001) and IMA (p < 0.01). There was no significant difference for IMA levels between after treatment and control group. IMA levels at the time on admission correlated positively with ESR (r = 0.605, p < 0.01) and CRP (r = 0.543, p < 0.01). The present study shows that increased serum IMA levels in patients with ARF at the time of diagnosis is a sign of increased inflammation. Thus, serum IMA levels may be used as a follow-up marker like CRP and ESR for evaluating the efficacy of treatment in ARF.
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    Evaluation of subclinical cardiovascular risk in drug-naive pediatric patients with anxiety disorders
    (Sage Publications Inc, 2024) Akinci, Mehmet Akif; Uzun, Necati; Alp, Hayrullah
    Objective This study aims to evaluate subclinical atherosclerosis in drug-naive children with anxiety disorders using non-invasive measures and to investigate the clinical features associated with subclinical atherosclerosis. Method This study included 37 drug-naive children and adolescents with anxiety disorders and 37 healthy controls. The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI-T and STAI-S) were used to assess children's depression and anxiety levels. Carotid artery intima-media (cIMT), epicardial adipose tissue (EAT), and periaortic adipose tissue (PAT) thicknesses, which are indicators of subclinical atherosclerosis, were obtained by echocardiographic measurements. Results Multivariate analysis of covariance (MANCOVA) revealed a significant main effect for cIMT, EAT thickness, and PAT thickness in both groups, independent of confounding factors such as age, sex, body mass index, mean blood pressure, and family income (Pillai's Trace V = .76, F (1, 72) = 35.60, P < .001, & eta;p(2) = .76). Analysis of covariance (ANCOVA) showed that cIMT, EAT thickness, and PAT thickness values were significantly higher in the anxiety disorder group than in the control group (P < .001). In partial correlation analysis, a positive correlation was observed between STAI-T and cIMT, and EAT thickness. In linear regression analyses, age and STAI-T were identified as correlates of cIMT and EAT thickness levels. Conclusions These results suggest that subclinical cardiovascular risk is significantly increased in children and adolescents with anxiety disorders.