Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Impaired Coronary Microvascular and Left Ventricular Diastolic Function in Patients with Inflammatory Bowel Disease(2015) Caliskan, Zuhal; Gokturk, Huseyin Savas; Caliskan, Mustafa; Gullu, Hakan; Ciftci, Ozgur; Ozgur, Gulsum Teke; Guven, Aytekin; Selcuk, Haldun; 0000-0003-2579-9755; 0000-0002-8445-6413; 0000-0002-6463-6070; 25128749; AAJ-8546-2021; JYO-9455-2024; IXD-5147-2023; AAJ-6976-2021; A-7318-2017Background and aim: Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Methods: Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Results: Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1 +/- 3.9 vs. 22.4 +/- 2.9, p < 0.05), and hyperemic DPFV (56.1 +/- 12.5 vs. 70.6 +/- 15.3, p < 0.05) and CFR (2.34 +/- 0.44 vs. 3.14 +/- 0.54, p < 0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. Conclusion: CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP. (C) 2014 Published by Elsevier Inc.Item Increased Morning Blood Pressure Surge and Coronary Microvascular Dysfunction in Patient with Early Stage Hypertension(2014) Caliskan, Mustafa; Caliskan, Zuhal; Gullu, Hakan; Keles, Nursen; Bulur, Serkan; Turan, Yasar; Kostek, Osman; Ciftci, Ozgur; Guven, Aytekin; Aung, Soe Moe; Muderrisoglu, Haldun; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0002-9635-6313; 25224866; IXD-5147-2023; A-7318-2017; AAJ-8546-2021; AAG-8233-2020Morning blood pressure surge (MBPS) is defined as an excessive increase in blood pressure (BP) in the morning from the lowest systolic BP during sleep, and it has been reported as a risk factor for cardiovascular events in current clinical studies. In this study, we evaluated the association between the rate of BP variation derived from ambulatory BP monitoring data analysis and coronary microvascular function in patients with early stage hypertension. One hundred seventy patients with prehypertension and Stage 1 hypertension who fulfilled the inclusion and exclusion criteria were included in the study. We divided our study population into two subgroups according to the median value of coronary flow reserve (CFR). Patients with CFR values <2.5 were defined as the impaired CFR group, and patients with CFR values >= 2.5 were defined as the preserved CFR group, and we compared the MBPS measurements of these two subgroups. CFR was measured using transthoracic Doppler echocardiography (TTDE). Ambulatory 24-hour systolic and diastolic BP, uric acid, systolic MBPS amplitude, diastolic MBPS amplitude, high-sensitivity C-reactive protein, and mitral flow E/A ratio were statistically significant. These predictors were included in age- and gender-adjusted multivariate analysis; ambulatory 24-hour systolic BP (beta = 0.077, P <.001; odds ratio [OR] = 1.080; 95% confidence interval [CI] [1.037-1.1241) and systolic MBPS amplitude (beta = 0.043, P =.022; OR = 1.044; 95% CI [1.006-1.0841) were determined to be independent predictors of impaired CFR (Hosmer-Lemeshow test, P=.165, Nagelkerke's R-2 = 0.320). We found that increased changes in MBPS values in patients with prehypertension and Stage 1 hypertension seemed to cause microvascular dysfunction in the absence of obstructive coronary artery disease. (C) 2014 American Society of Hypertension. All rights reserved.