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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 Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing(Springer, 2013) Dogan, Umuttan; Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Gok, HasanIncreased sympathetic activity and endothelial dysfunction are the proposed mechanisms underlying exaggerated blood pressure response to exercise (EBPR). However, data regarding heart rate behavior in patients with EBPR are lacking. We hypothesized that heart rate recovery (HRR) could be impaired in patients with EBPR. A total of 75 normotensive subjects who were referred for exercise treadmill test examination and experienced EBPR were included to this cross-sectional case-control study. The control group consisted of 75 age- and gender-matched normotensive subjects without EBPR. EBPR was defined as a peak exercise systolic blood pressure (BP) a parts per thousand yen210 mmHg in men and a parts per thousand yen190 mmHg in women. HRR was defined as the difference in HR from peak exercise to 1 min in recovery; abnormal HRR was defined as a parts per thousand currency sign12 beats/min. These parameters were compared with respect to occurrence of EBPR. Mean values of systolic and diastolic BP at baseline, peak exercise, and the first minute of the recovery were significantly higher in the subjects with EBPR. Mean HRR values were significantly lower (P < 0.001) in subjects with EBPR when compared with those without. Pearson's correlation analysis revealed a significant positive correlation between the decrease in systolic BP during the recovery and degree of HRR in individuals without EBPR (r = 0.42, P < 0.001). Such a correlation was not observed in subjects with EBPR (r = 0.11, P = 0.34). The percentage of abnormal HRR indicating impaired parasympathetic reactivation was higher in subjects with EBPR (29 % vs 13 %, P = 0.02). In logistic regression analyses, HRR and resting systolic BP were the only determinants associated with the occurrence of EBPR (P = 0.001 and P < 0.001, respectively). Decreased HRR was observed in normotensive individuals with EBPR. In subjects with normal BP response to exercise, a linear correlation existed between the degree of HRR and decrease in systolic BP during the recovery period. However, such a correlation was not found in subjects with EBPR. Our data suggest that mechanisms underlying the blunting of the HRR might be associated with the genesis of EBPR. The association between the extent of HRR and adverse cardiovascular outcomes in patients with EBPR needs to be investigated in detail in future research.Öğe Frequency of anxiety and depression, and affecting factors in inpatients in cardiology intensive care unit(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Kutlu, Ruhusen; Isiklar-Ozberk, Derya; Gok, Hasan; Demirbas, NurBackground: This study aims to evaluate the frequency of anxiety and depression, as well as affecting factors, in inpatients at the Cardiology Intensive Care Unit. Methods: This cross-sectional, analytical study included 245 inpatients (148 males, 97 females; mean age 63.5 +/- 13.8 years; range 20 to 98 years). All patients were administered a socio-demographical data form and hospital anxiety and depression scale. Smoking dependence was evaluated with the Fagerstrom test for nicotine dependence. Results: Of current smoker patients, the mean Fagerstrom dependence score was 5.6 +/- 1.9 (range 1 to 10) and 40% was in the middle level of dependency. Of male patients, 45.9% and 17.6% were followed-up with diagnoses of myocardial infarction and unstable angina pectoris, respectively. Of female patients; 30.9%, 26.8%, and 22.7% were followed-up with diagnoses of arrhythmia, myocardial infarction, and heart failure, respectively. Of the patients, 53.9% (n=132) and 86.1% (n=211) were found to have anxiety and depression, respectively. No significant relationship was detected between age, economic status, and smoking status and anxiety and depression scores (p>0.05). Anxiety scores in married patients (11.6 +/- 4.3) were significantly higher than those of not married patients (9.8 +/- 3.7) (p=0.008). Anxiety and depression scores were significantly higher in employed individuals (11.6 +/- 4.2 vs 10.0 +/- 4.0; p=0.013) (12.0 +/- 3.8 vs 9.7 +/- 3.9; p<0.001), primary school and lower educated individuals (11.7 +/- 4.3 vs 10.1 +/- 3.9; p=0.009) (12.2 +/- 3.9 vs 9.8 +/- 3.7; p<0.001), and female gender (12.1 +/- 4.6 vs 10.6 +/- 3.8; p=0.005) (12.3 +/- 4.2 vs 11.0 +/- 3.8; p=0.009), respectively. Conclusion: Anxiety and depression are common problems seen in inpatients in cardiology intensive care unit. Patients should be assessed by clinicians holistically in terms of biopsychosocial aspects. Detection of depression levels and related factors may facilitate adherence to treatment, reduce anxiety, and improve quality of life.Öğe Investigation of Oxidative Stress Markers in Essential Hypertension(Clin Lab Publ, 2013) Toker, Aysun; Mehmetoglu, Idris; Yerlikaya, F. Humeyra; Nergiz, Suleyman; Kurban, Sevil; Gok, HasanBackground: The main goal of this study was to evaluate ischemia modified albumin (IMA), total antioxidant status (TAS), and total oxidant status (TOS) levels in treated essential hypertensive patients and to compare them with levels of normotensive subjects. Methods: In 45 hypertensive and 30 control subjects, serum levels of IMA were determined manually using a spectrophotometric Co(II)-albumin binding assay. TAS and TOS levels were evaluated spectrophotometrically. Lipid profile was estimated by routine methods. Results: Hypertensive patients had significantly higher levels of TOS and IMA (p = 0.020 and p = 0.034, respectively) and lower levels of TAS (p = 0.016) in comparison with control subjects. Serum levels of TAS were negatively correlated with TOS and IMA levels in the patient group. Serum levels of TOS were also positively correlated with IMA levels. There was no significant correlation between blood pressure and TAS, TOS, and IMA levels. Conclusions: Our results showed higher levels of IMA in hypertensive patients. We suggest that higher levels of IMA may result from increased oxidative stress and decreased antioxidant status in hypertensive patients.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 Relationship Between Myocardial Bridges and Arrhythmic Complications(H M P Communications, 2012) Erdogan, Halil Ibrahim; Gul, Enes Elvin; Gok, HasanMyocardial bridge (MB) is defined as compression of coronary artery during systole while it is normal in diastole. In angiographic series, the prevalence of this anomaly was reported between 0.5% and 2.5%. It is occasionally seen in the middle segment of the left anterior descending coronary artery. Although MB is considered to be a benign anomaly, the association of MB with ischemia, systolic dysfunction, conduction abnormality, arrhythmias, and sudden cardiac death were reported. Herein, we report 3 cases of MB that were diagnosed with coronary angiography and were associated with arrhythmic complications. In 2 patients, complete atrioventricular block was present, and another patient was diagnosed with sick sinus syndrome with the help of an electrophysiological study. All patients underwent permanent cardiac pacemaker implantation.Öğe Secondary chordae rupture due to low-tension electricity trauma(W B Saunders Co-Elsevier Inc, 2013) Akilli, Hakan; Aribas, Alpay; Akilli, Nazire Belgin; Kayrak, Mehmet; Gok, HasanThe most frequent cardiac pathologies caused by electric shock are arrhythmias with a wide clinical picture ranging from sinus tachycardia to asystole. Cardiac mechanical complications secondary to electric shock have rarely been reported. Despite the use of electrocardiography and cardiac monitorization in evaluating dysrhythmias and in the patients' follow-up, there is still no consensus on how to assess patients against probable mechanical complications and how to follow up these patients. In this study, we have presented the rupture in the secondary chordae of the mitral anterior leaflet caused by low-voltage electrical trauma. To our knowledge, this is the first cardiac mechanical complication reported as a consequence of low-tension electrical trauma.Öğe Swallowing-induced atrioventricular block and syncope in a patient with achalasia(Aves, 2015) Erdogan, Halil Ibrahim; Gok, Hasan; Karanfil, Mustafa[Abstract Not Availabe]Öğe Transesophageal echocardiography in the evaluation of penetrating intrapericardial injuries(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Erdogan, Halil Ibrahim; Gul, Enes Elvin; Gok, Hasan[Abstract Not Availabe]
