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Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Resting Heart Rate and Real-Life Treatment Modalities in Outpatients with Left Ventricular Systolic Dysfunction Study: A Multicenter, Prospective, Observational, and National Registry(2021) Cavusoglu, Yuksel; Kozan, Omer; Temizhan, Ahmet; Kucukoglu, Mehmet Serdar; 33960305; ABC-9349-2021Objective: Heart rate (HR) reduction is associated with improved outcomes in heart failure (HF). This multicenter, prospective, observational, and national registry aimed to evaluate resting HR and the impacts of HR-related medications in real-life clinical practice in patients with HF. Methods: The Resting HR and Real-Life Treatment Modalities in Outpatients with Left Ventricular Systolic Dysfunction (REALITY HF) study enrolled 1054 patients with HF and left ventricular ejection fraction (LVEF) of <40% from 16 centers. Clinical characteristics, HR, and medications were noted (enrollment phase). A total of 487 patients with sinus rhythm and HR of >= 70 bpm were included in a further 4-month follow-up (FU) program (V0). Changes in HR and medications were reevaluated at 1-month (V1) and 4-month (V2) FU visits. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess the quality of life (QoL) of 320 patients in a 4-month FU program. Results: During enrollment, 794 patients (75.3%) were in sinus rhythm, in whom resting HR was 76.7 +/- 14 bpm, 69.1% had a resting HR of >= 70 bpm, 79.1% were receiving beta blocker (BB), and 6.1% were receiving ivabradine. Resting HR was lower in patients receiving BB (75.8 +/- 13 vs. 80.4 +/- 16 bpm; p=0.001); however, 65.8% of those still had a resting HR of >= 70 bpm. A significant association was found between elevated HR and worse New York Heart Association (NYHA) class, worse QoL, or lower LVEF. During the 4-month FU, adjustment of HR-lowering therapy was left to the physician's discretion. Resting HR significantly reduced from 83.6 +/- 12 (80) bpm at V0 to 78.6 +/- 13 (77) bpm at V1 (p=0.001) and further decreased to 73.0 +/- 11 (73) bpm at V2 (p=0.001). Patients achieving a resting HR of >= 70 bpm were 21.7% at V1 (p=0.001) and 39.9% at V2 (p=0.001). KCCQ significantly increased from 59.7 +/- 23 (62.7) at V0 to 73.1 +/- 18 (78.5) at V2 (p=0.001). In addition, patients with NYHA I increased from 22.2% at V0 to 29.2% at V1 and 39.4% at V2 (p=0.01). Conclusion: In real-life clinical practice, elevated HR is highly prevalent in HF despite widely used BB therapy and is associated with worse clinical picture. Therapeutic interventions targeting HR significantly reduce HR, and HR lowering is associated with improved clinical outcomes.Item Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease(2019) Akinci Ozyurek, Berna; Savas Bozbas, Serife; Aydinalp, Alp; Bozbas, Huseyin; Ulubay, Gaye; 31414640Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), maximum work rate (WR), Delta VO2/Delta WR and O-2 pulse (VO2/HR) values were calculated. Significant CAD was defined as >= 50% narrowing in at least one of the coronary arteries. Results: The mean age was 60.4 +/- 8.9 years ve 21 (65.6%) of subjects were male. On CAG, CAD was detected in 19 (59.4%) patients. Maximum heart rate, heart rate reserve (HRR), VE/VCO2 measured at anaerobic threshold AT) and VO2 (mL/kg/min) were significantly differed in patients with CAD than those without (p= 0.031; p= 0.041; p= 0.028; p= 0.03 respectively). Peak VO2, VO2/WR and O-2 pulse values were higher in patients with normal angiographic results than those with CAD but the difference did not reach to statistical significance. Conclusion: The findings of our study indicate that among CPET parameters AT VE/VCO2, ATVO(2) (mL/kg/dk) and HRR can have predictive value in the diagnosis of CAD. We think that these parameters might be used in the evaluation of patients with angina and dyspnea suspected of CAD. In conclusion parameters obtained during the test that are not influenced by patient's effort might increase the value of CPET in the diagnosis CAD.Item The role of mitochondrial ATP-sensitive potassium channels on cardiovascular effects of thiopental and ketamine in rats(2015) Altunkaynak, H.O.; Tecder-Unal, M.; 26435022OBJECTIVE: We aimed to investigate whether mitochondrial ATP-sensitive potassium (mitoK(ATP)) channels play any role on cardiovascular effects of thiopental (TP) or ketamine (K) anesthesia in rats. BACKGROUND: mitoK(ATP) channels are the end-effectors of cardioprotection induced by some anesthetics. TP and K are the most frequently used anesthetics with their own cardiovascular effects in experimental studies. To the best of our knowledge, there is no study investigating the cardiovascular effects of TP and K associated with mitoK(ATP) channels. MATERIALS AND METHODS: The experimental groups: TP control, K/Xylazine (X) control, TP+5-hydroxydecanoate (5-HD; mitoK(ATP), channel blocker) and K1X+5-HD. Mean arterial blood pressure (MABP), heart rate (HR) and standard limb lead II ECG were recorded and arrhythmia parameters were evaluated. RESULTS: Blockage of mitoKA(ATP) channels by 5-HD increased MABP and decreased HR in the TP+5-HD and K/X+5-HD groups, respectively. 5-HD caused an increase in ventricular ectopic beat (VEB) incidence. Moreover, VEB incidence was significantly different in TP+5-HD (100 %) than K/X+5-HDgroup (66.6 %) and ventricular tachycardia was only seen in TP+5-HD (incidence was 88.3 %). CONCLUSION: mitoK(ATP) channels play different roles in influencing cardiovascular effects of K/X and TP anesthesia in rats. The differences in hemodynamic parameters and arrhythmia scores of these anesthetics should be considered when they are used in an experimental study associated with mitoK(ATP) channels (Fig. 3, Ref. 35). Text in PDF www.elis.sk.