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Yayın Effectiveness of glucose-insulin-potassium treatment in nondiabetic patients with acute myocardial infarction(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2008) Keskin, F. E.; Çelebi, Aslan; Keskin, Serkan; Sayali, Erhan; Gurol, Tayfun; Alicanoğlu, Riza; Koc, Deniz OgutmenObjective: Glucose-insulin-potassium (GIK) treatment given additional to standard therapy effectiveness was investigated in nondiabetic patients with acute myocardial infarction. Material and Method: 29 nondiabetic patients with acute myocardial infarction participated between January and June 2005 in Taksim Training and Research Hospital Coronary Care Unit. Besides standard therapy 14 patients received GIK solution while 15 patients did not. The cardiac enzyme increasing velocity differences were investigated. All patients investigated were nondiabetics. Myocardial infarction was diagnosed by chest pain, electrocardiography and cardiac enzyme assessments. Blood samples for creatin phosphokinase, CPK-MB, myoglobine, Troponin-I and C-reactive protein (CRP) were enrolled at index and further after 6th, 12th and 24th hours. Results: No difference was detected regarding age, body weight, height, application time and lipid profiles between two groups. Although index of 6th and 12th hour controls showed no difference, 24th hour values showed statistically significant difference with a p=0.0013. CRP level in GIK group was 22.56 +/- 12.95 mg/dL and 78.92 +/- 69.94 mg/dL in non-GIK group. In our assessment using DUNN's multiple comparison test, although in the group receiving GIK, there was a statistically significant difference accordingly Troponin-I initial and 6th, 12th hours; there was no difference in the given GIK and non GIK group. In comparison of the CRP levels at index and at 24th hour p values were found less than 0,05 (p<0,05) in both groups. Conclusion: In our study, we realized that in the group given GIK; some of the myocardial injury markers were decreasing and finally decided that GIK solution could be beneficial in diabetic and nondiabetic patients.Yayın Interaction between Cardioverter Defibrillator and Enhanced External Counterpulsation Device(WILEY-BLACKWELL, 2013) Celik, Omer; Aydin, Alper; Yilmazer, Mustafa S.; Sarigul, Nedim U.; Gurol, Tayfun; Dagdeviren, BahadirBackground Potential interference between implanted cardiac devices and other medical instruments is an important concern. Therefore, we aimed to investigate the possible device interaction between implantable cardioverter defibrillators (ICDs) and external enhanced counterpulsation (EECP) treatment. Methods Twenty-one patients with an implanted ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were enrolled into the study. EECP had applied as two sessions of 5 minutes. Data from device interrogations before and after the first EECP session and during second EECP session were recorded and analyzed for signs of possible device interaction. Results There was no sign of inappropriate sensing or noise during EECP session. There was no difference regarding electrode impedance, pacing, and sensing values before and after EECP. There was a statistically significant difference regarding heart rates during EECP therapy between rate response off and on modes (68.69 +/- 5.92 beats/min and 90.32 +/- 11.05 beats/min, respectively P = 0,001). In four patients with CRT-D and unipolar left ventricular pacing, counterpulsation could not be done because of QRS sensing problems. Conclusions EECP seems to be a safe treatment modality in patients with implanted ICD and CRT-D devices. It should be kept in mind that in those patients with CRT-D, rate responsive mode is on; inappropriate sinus tachycardia can be seen during EECP therapy. Also in patients with CRT-D using a unipolar sensing mode, problems of QRS complex sensing by the EECP may occur and, therefore, this effects synchronization and success of EECP therapy.Yayın The morphologic and functional features of LAD myocardial bridging at multi detector computed tomography coronary angiography: correlation with coronary artery disease(TURKISH SOC CARDIOLOGY, 2015) Aydin, Alper; Cubuk, Rahmi; Atasoy, Mehmet Mahir; Gurol, Tayfun; Soylu, Ozer; Dagdeviren, BahadirObjectives: The aim of this study was to retrospectively evaluate the morphologic and functional features of myocardial bridging (MB) and to investigate the impact of morphologic features on presence of atherosclerosis with multi-detector computed tomography (MDCT) coronary angiography. Study design: The study population consisted of 191 consecutive patients. Besides coronary lesions, morphologic features of the MB (depth, length and the distance of the tunneled artery from the left coronary ostium) were analyzed. Results: MDCT detected MB on left anterior descending artery in 41 patients (21.5%). The prevalence of atherosclerotic plaques proximal to the MB of LAD was 49% (20/41). There was a statistically significant correlation between percentage of systolic compression and depth of the tunneled segment (r=0.538, p<0.01). There was no relation between distance of the tunneled segment from the ostium and degree of systolic compression. No significant correlation was found between percentage of systolic compression and length of the tunneled segment (r=0.058, p=0.721). Morphologic features of MB were not related to the presence of CAD in proximal segments. Conclusion: MDCT coronary angiography depicts the morphologic and functional features of the MB in detail. The depth of MB segment was correlated with systolic compression of MB. There was no relationship between distance of the tunneled segment from the ostium and systolic compression.Yayın Ondansetron administration before transoesophageal echocardiography reduces the need for sedation and improves patient comfort during the procedure(OXFORD UNIV PRESS, 2010) Aydin, Alper; Yilmazer, Mustafa Serdar; Gurol, Tayfun; Celik, Omer; Dagdeviren, BahadirTransoesophageal echocardiography (TEE) is an uncomfortable procedure for the majority of patients. In the current double-blind randomized prospective study, we sought to assess whether ondansetron would improve patient comfort, reduce the need for sedation, and increase tolerance during TEE, and we compared ondansetron, metoclopramide, and placebo. One hundred and fifty-six patients who underwent TEE were randomized into three groups receiving ondansetron HCl, metoclopramide, or placebo. Data concerning additional doses of midazolam, procedural time, recovery time in the outpatient ward, blood pressure values, percutaneous arterial oxygen saturation values, side effects of the medications used, and patient discomfort via a visual analogue scale (VAS) were collected and analysed. The ondansetron group received less additional midazolam than the metoclopramide and placebo groups (ondansetron group: 0.6 +/- 0.7 mg; metoclopramide group: 1.9 +/- 0.9 mg; and placebo group: 2.1 +/- 0.8 mg; P < 0,001). VAS was significantly lower in the ondansetron group than in the metoclopramide and placebo groups (4.0 +/- 1.6, 6.1 +/- 1.8, and 6.6 +/- 1.6, respectively; P < 0.001). Recovery time in the outpatient ward was shorter in the ondansetron group than in the metoclopramide and placebo groups (22.5 +/- 4.8, 30.9 +/- 6.6, and 30.4 +/- 5.0 min, respectively; P < 0.001). No adverse reaction to ondansetron was observed, whereas one patient developed mild spontaneously resolving dystonia due to metoclopramide. Ondansetron administration reduces the need for sedation during TEE and improves patient comfort.Yayın Sudden death in a patient with Noonan syndrome(CAMBRIDGE UNIV PRESS, 2011) Aydin, Alper; Yilmazer, Mustafa S.; Gurol, TayfunWe report here the case of a 27-year-old woman with Noonan syndrome presenting with ventricular fibrillation. After successful defibrillation, echocardiography revealed hypertrophic cardiomyopathy associated with left ventricular outflow tract obstruction. Normal echocardiographic cardiac structure and function were reported 11 years ago. This case emphasises the importance of regular follow-up in patients with congenital disorders in which cardiac manifestations might develop in early adulthood or later.Yayın An Unusual Cause of Syncope in a Patient with Prosthetic Aortic Valve(Galenos Yayincilik, 2012) Aydın, A.; Gurol, Tayfun; Yılmazer, Mustafa Serdar; Dagdeviren, BahadirThe authors present the case of a patient with aortic valve surgery and unexplained syncopal attacks. With the use of an implantable loop recorder, sinus node dysfunction was diagnosed more than 4 months after implantation. This case highlights the importance of implantable loop recorders in patients with unexplained syncope and that atrioventricular block is not the only mechanism of syncope in patients with aortic valve surgery.
