Showing papers by "Okan Onur Turgut published in 2013"

Atrial fibrillation is associated with increased mean platelet volume in patients with type 2 diabetes mellitus.

Abstract: Platelet abnormalities in diabetes mellitus (DM) and atrial fibrillation (AF) may underline the etiology of a prothrombotic state in these conditions. Increased mean platelet volume (MPV) is a marker of abnormal platelet function and activation. We aimed to investigate the possible association of chronic AF with MPV in patients who have type 2 DM. Patients who had type 2 DM with either chronic (≥6 months) AF or normal sinus rhythm (NSR) were included in the study. A total of 162 patients (aged 38–89 years) were divided into 2 groups according to the presence of either AF or NSR. Group 1 consisted of 81 diabetic patients with AF, and group 2 consisted of 81 diabetic patients with NSR. The two groups were not significantly different in terms of age, and gender, as well as in hypertension, smoking, history of coronary artery disease, previous cerebrovascular accidents, microalbuminuria, retinopathy, duration of DM, body mass index, hemoglobin A1c, total cholesterol, low-density lipoprotein cholesterol, high-...

Elevated mean pulmonary artery pressure in patients with mild-to-moderate mitral stenosis: a useful predictor of worsening renal functions?

Abstract: Objective Renal dysfunction commonly accompanies the course of cardiac disorders and strongly associates with increased morbidity and mortality. Elevated central venous pressure is related to worsening renal function in patients with heart failure. However, predictors of worsening renal function in mitral stenosis-whose pathophysiologic process is similar to heart failure with regard to right heart dysfunction-are unknown. This study aimed to evaluate whether clinical and echocardiographic parameters might predict worsening renal function in patients with mild-to-moderate mitral stenosis. Methods The current study has a prospective cohort design. Sixty consecutive patients (9 male, 51 female, mean age 50±13 years) with mild-to-moderate mitral stenosis were followed up for 34±13 months (range 1-60) and their renal functions were monitored. Worsening renal function was defined as a decline in glomerular filtration rate of ≥ 20% on follow-up. In order to presence or absence of worsening renal functions, study patients divided into two groups. Statistical analysis was performed using the Chi-square, Independent samples t / Mann-Whitney U tests, univariate and multivariate Cox proportional hazards analyses, receiver operating characteristic (ROC) and Kaplan-Meier curve analyses. Results Worsening renal function was observed in 14 patients (23%). In univariate analysis, male gender, mean pulmonary artery pressure (mPAP), peak tricuspid regurgitation velocity, systolic pulmonary artery pressure, digitalis and antiplatelet usage, right atrial size, and TEI index were determined to be predictors of worsening renal function. In a multivariate Cox proportional hazards model, mPAP (HR=1.136, 95% CI: 1.058-1.220, p 21 mmHg, and those who did not have, in terms of worsening renal function (p=0.006), and the difference between the groups increased after 30 months of follow-up. Conclusion Elevated mean pulmonary artery pressure at the time of initial evaluation, in patients with mild-to-moderate mitral stenosis, might help to predict worsening renal function.

Assesment of Autonomic Function in Metabolic Syndrome using Combination Heart Rate Variability and Heart Rate Turbulence

Abstract: Background and objective: Metabolic syndrome (MetS) is described as a group of various abnormal metabolic risk factors such as obesity, dyslipidemia, increased blood pressure, increased plasma glucose levels, prothrombotic condition and proinflammatory state. These parameters are related to decreased parasympathetic and increased sympathetic activity. We aimed to evaluate autonomic function using a combination with heart rate variability (HRV) and heart rate turbulence (HRT) in metabolic syndrome to compare non-metabolic syndrome(non-MetS). Methods: We selected consecutive 50 patients with MetS and 50 patients with healthy non-MetS individuals. All patients underwent 24 hours holter monitoring to evaluate HRT and HRV parameters. Results: Age of patients was not different in two groups. Mean age of MetS patients was 57,50±12,13 and 54,6±10,25 in non- MetS individuals. Sex of patients was non different in MetS compared to non-MetS (37 female and 13 male vs. 22 female, 28 male p<0,05 respectively). SDNN and RMSSD was lower in MetS compared to those without MetS (131,96±49,12 vs 179,59±85,83 p=0,03 and 78,64±35,22 vs 112,73±81,24 p=0,08 respectively). SDANN, pNN50,Mean RR, mean heart rate, count of ventricular premature complex(VPC) were not different between two groups. Turbulence Slope(TS) was not different in two groups. Turbulence Onset(TO) was higher in MetS compared to non-MetS (2,01±15,29 and -6,21±13,5 p=0,005). Conclusion: We showed that autonomic function in MetS was impaired using a combination with HRT and HRV. These patients should be followed closely for adverse cardiovascular outcome especially including cardiac arrhythmia. Keywords: Metabolic syndrome, autonomic dysfunction, heart rate variability, heart rate turbulence

Prevalence of arrhythmias in heavy vehicle drivers

Abstract: Objective: In our study we aimed to determine the frequency of arrhythmias that we believe may affect driving safety. Methods and Results: Two hundred drivers were randomly selected from the heavy vehicle driver population (82 bus and 118 truck drivers, p = 0.08, q = 0.92, N = 1200, α = 0.01, d = 0.045). A questionnaire was completed via face to face interviews with the individuals including questions about their personal socio-demographic characteristics and symptoms for arrhythmias. An electrocardiography (ECG) was taken of the study participants using the Cardioline Delta 3 Plus Digital ECG machine. The cardiologist at the clinic evaluated the questionnaire and ECG for presence of arrhythmias. When indicated, ambulatory electrocardiography (Holter Monitoring) was performed for 24 hours in 133 individuals (71 driver and 62 control). In cases that had Holter examination; ventricular ectopy was identified in 25.4% and 22.6%, and supra-ventricular ectopy in 45.1% and 35.5% in the driver and the control groups; respectively. Ventricular tachycardia was detected in 2 patients. Arrhythmia frequencies were 59.1%, 54.8% and 57.1% in drivers, control and both groups respectively. Statistical differences between drivers and control group for rhythm disorders were not detected. Conclusions: Arrhythmias with lethal and devastating potential; need to be diagnosed and treated in professional drivers with extreme caution. The follow up and screening for heart diseases has a crucial role in preventing accidents and occupational diseases in drivers.