25 research outputs found
Serbest dalış öncesi ve sonrası elektrokardiyografik değişikliklerin incelenmesi
Aim: To evaluate the electrocardiographic (ECG) parameters and hemodynamic parameters in predicting the development of arrhythmias after free diving static apnea performance and maximum breath hold. Material and Methods: Twenty-four volunteer athletes participating in the free diving competition in 2015 (19 males (79.2%) and 5 females (20.8%)) were included in the study. Peripheral O2 saturation (SpO2), heart rate (HR), ECG parameters (PR interval, QRS time, T wave amplitude, corrected QT time, presence of bandle branch block and new bandle branch block development, atrial premature beats, ventricular premature beats) were analyzed. Results: There was no statistically significant difference between before static apnea measurements (systolic blood pressure (SBP) 124.7 ± 10.8 mmHg, diastolic blood pressure (DBP) 76.5 ± 6.7 mmHg, heart rate (HR) 80.2 ± 13.4 beats / min, SpO2 97.1 ± 0.9%) and after performance (SBP 128.8 ± 13.6 mmHg DBP 78.0 ± 5.9 mmHg, HR 85.8, ± 16.5 beats / min and SpO2 96.7 ± 2.3%)(p = 0.175; p = 0.334; p = 0.104; p = 0.336, respectively). Conclusion: No significant changes were observed in ECG parameters, heart rate, saturation and blood pressure values evaluated after static apnea performance. These findings can be used to support that the risk of arrhythmia during static apnea does not persist after apnea has ended.Amaç: Serbest dalış statik apne performansı ile maksimum nefes tutma sonrası aritmi gelişimini öngörmede elektrokardiyografik (EKG) parametreleri ve hemodinamik göstergeleri değerlendirmek. Gereç ve Yöntemler: Çalışmaya 2015 yılında düzenlenen serbest dalış yarışmasına katılan 24 gönüllü sporcu dahil edilmiştir (19 erkek (%79,2) and 5 kadın (%20,8)). Performans öncesi ve sonrası ( 5. dakikada) periferik O2 satürasyonu ( pO2), kalp hızı (KH), EKG parametreleri ( PR aralığı, QRS süresi, T dalga amplitüdü, düzeltilmiş QT süresi, dal bloğu varlığı ve yeni dal bloğu gelişimi, atriyal erken atım, ventriküler erken atım varlığı) analiz edildi. Bulgular: Sporcuların statik apne öncesi sistolik kan basınçları (SKB) 124,7±10,8 mmHg, diyastolik kan basınçları (DKB) 76,5±6,7 mmHg, kalp hızı 80,2 ±13,4 atım/dk, pO2 %97,1±0,9 ve performans sonrası SKB 128,8±13,6 mmHg, DKB 78,0 ±5,9 mmHg, KH 85,8±16,5 atım/dk, pO2 %96,7±2,3 arasında istatistiksel olarak anlamlı fark saptanmadı ( sırasıyla p=0,175; p=0,334; p=0,104; p=0,336). Sonuç: Statik apne performansı sonrası değerlendirilen EKG parametrelerinde, kalp hızında, satürasyon ve tansiyon değerlerinde herhangi bir anlamlı değişiklik izlenmedi. Bu bulgular statik apne esnasında gelişebilecek aritmi riskinin apne sonlandıktan sonra devam etmediğini desteklemede kullanılabilir
Serbest daliş öncesi ve sonrasi elektrokardiyografik değişikliklerin incelenmesi
Aim: To evaluate the electrocardiographic (ECG) parameters and hemodynamic parameters in predicting the development of arrhythmias after free diving static apnea performance and maximum breath hold. Material and Methods: Twenty-four volunteer athletes participating in the free diving competition in 2015 (19 males (79.2%) and 5 females (20.8%)) were included in the study. Peripheral O2 saturation (SpO2), heart rate (HR), ECG parameters (PR interval, QRS time, T wave amplitude, corrected QT time, presence of bandle branch block and new bandle branch block development, atrial premature beats, ventricular premature beats) were analyzed. Results: There was no statistically significant difference between before static apnea measurements (systolic blood pressure (SBP) 124.7 ± 10.8 mmHg, diastolic blood pressure (DBP) 76.5 ± 6.7 mmHg, heart rate (HR) 80.2 ± 13.4 beats / min, SpO2 97.1 ± 0.9%) and after performance (SBP 128.8 ± 13.6 mmHg DBP 78.0 ± 5.9 mmHg, HR 85.8, ± 16.5 beats / min and SpO2 96.7 ± 2.3%)(p = 0.175; p = 0.334; p = 0.104; p = 0.336, respectively). Conclusion: No significant changes were observed in ECG parameters, heart rate, saturation and blood pressure values evaluated after static apnea performance. These findings can be used to support that the risk of arrhythmia during static apnea does not persist after apnea has ended.Amaç: Serbest dalış statik apne performansı ile maksimum nefes tutma sonrası aritmi gelişimini öngörmede elektrokardiyografik (EKG) parametreleri ve hemodinamik göstergeleri değerlendirmek. Gereç ve Yöntemler: Çalışmaya 2015 yılında düzenlenen serbest dalış yarışmasına katılan 24 gönüllü sporcu dahil edilmiştir (19 erkek (%79,2) and 5 kadın (%20,8)). Performans öncesi ve sonrası ( 5. dakikada) periferik O2 satürasyonu ( pO2), kalp hızı (KH), EKG parametreleri ( PR aralığı, QRS süresi, T dalga amplitüdü, düzeltilmiş QT süresi, dal bloğu varlığı ve yeni dal bloğu gelişimi, atriyal erken atım, ventriküler erken atım varlığı) analiz edildi. Bulgular: Sporcuların statik apne öncesi sistolik kan basınçları (SKB) 124,7±10,8 mmHg, diyastolik kan basınçları (DKB) 76,5±6,7 mmHg, kalp hızı 80,2 ±13,4 atım/dk, pO2 %97,1±0,9 ve performans sonrası SKB 128,8±13,6 mmHg, DKB 78,0 ±5,9 mmHg, KH 85,8±16,5 atım/dk, pO2 %96,7±2,3 arasında istatistiksel olarak anlamlı fark saptanmadı ( sırasıyla p=0,175; p=0,334; p=0,104; p=0,336). Sonuç: Statik apne performansı sonrası değerlendirilen EKG parametrelerinde, kalp hızında, satürasyon ve tansiyon değerlerinde herhangi bir anlamlı değişiklik izlenmedi. Bu bulgular statik apne esnasında gelişebilecek aritmi riskinin apne sonlandıktan sonra devam etmediğini desteklemede kullanılabilir
An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER-2 study design
WOS: 000421963600007PubMed: 25782122Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials. gov number, NCT02354456.)
Double Left Main Coronary Artery Appearance : Saccular Ascending Aorta Aneurysm Mimicking Complete Proximal Occlusion of the Left Main Coronary Artery
Which is the best for the warfarin monitoring: Following up by fixed or variable physician?
OBJECTIVE: Warfarin therapy has some difficulties in terms of close monitoring and dosage. This study aims to evaluate the effect of same-fixed versus different-variable physician-based monitoring of warfarin therapy on treatment quality and clinical end-points. METHODS: A total of 625 consecutive patients requiring warfarin treatment were enrolled at seven centers. INR values of the patients measured at each visit and registered to hospital database were recorded. Time in therapeutic range (TTR) was calculated using linear interpolation method (Rosendaal’s method). A TTR value of ≥65% was considered as effective warfarin treatment. If a patient was evaluated by the same-fixed physician at each INR visit, was categorized into the same-physician (SP) group. In contrast, if a patient was evaluated by different-variable physicians at each INR visit, was categorized into variable physician (VP) group. Enrolled patients were followed up for bleeding and embolic events. RESULTS: One hundred and fifty-six patients (24.9%) were followed by SP group, 469 (75.1%) patients were followed by VP group. Median TTR value of the VP group was lower than that of SP group (56.2% vs. 65.1%, respectively, p=0.009). During median 25.5 months (9–36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p<0.001, p=0.023, p<0.001, respectively). In multivariate analysis, INR monitoring by VP group was found to be an independent predictor of increased risk of bleeding events (OR 2.55, 95% CI 1.64–3.96, p<0.001) and embolism (OR 3.42, 95% CI 1.66–7.04, p=0.001). CONCLUSION: INR monitoring by same physician was associated with better TTR and lower rates of adverse events during follow-up. Hence, it is worth encouraging an SP-based outpatient follow-up system at least for where warfarin therapy is the only choice
P-wave Dispersion and Evaluation of Atrial Conduction Times using Tissue Doppler Echocardiography in Inflammatory Bowel Disease
Time in Therapeutic Range TTR Value of Patients who use Warfarin and Factors which Influence TTR
Varfarin kullanan hastalarda terapötik aralıkta geçen zaman ve terapötik aralıkta geçen zamanı etkileyen faktörler
Objective: The time in therapeutic range (TTR) of international normalized ratio (INR) is essential for the safety and efficacy of warfarin treatment. In this study, we aimed to determine TTR and the factors that affect TTR in patients using warfarin.
Methods: Patients taking warfarin for valvular and nonvalvular atrial fibrillation (AF) or prosthetic heart valves who were admitted to our cardiology outpatient clinic were enrolled. TTR was calculated using the linear interpolation method. The patients were analyzed according to warfarin indications and TTR efficiency (TTR >= 60%). Weekly warfarin dose, the duration of warfarin use, the frequency of INR visits per year, and the awareness of patients regarding target INR were noted.
Results: The TTR of 248 patients (aged 57.21 +/- 12.45 years, 33.1% male) was 55.92 +/- 27.84%, and 48.0% patients exhibited efficient TTR. Clinical and demographic characteristics (age, sex, socioeconomic status, and comorbidities) exerted no effect on TTR and TTR efficiency. The frequency of INR visits per year was 10.02 +/- 3.80. TTR was related to the frequency of annual INR visits (r=0.131, p=0.039). Only one-third (30.2%) of patients were aware of their target INR. The literacy of the patients and duration of warfarin use exerted a positive effect on awareness (p=0.011 and p=0.024, respectively).
Conclusion: The findings of our study demonstrated that TTR and TTR efficiency were low and not associated with the characteristics of patients or indications. Unfortunately, in patients with valvular AF and prosthetic valves, warfarin is the sole drug that can be used. Thus, awareness and knowledge regarding target INR are essential to overcome poor anticoagulation monitoring with frequent INR visits.Amaç: Uluslararası normalleştirilmiş oranın (INR) terapötik
aralıkta geçen zamanı (Time in therapeutic range - TTR)
varfarin tedavisinin etkinliği ve güvenliği için zorunludur. Bu
çalışmada, varfarin kullanan hastalarda TTR değerlerini ve
TTR’yi etkileyen faktörleri belirlemeyi amaçladık.
Yöntemler: Kardiyoloji polikliniklerine başvuran valvüler-valvüler olmayan AF veya prostetik kalp kapağı için varfarin kullanan hastalar çalışmaya alındı. Terapötik aralıkta
geçen süre doğrusal interpolasyon yöntemi ile hesaplandı.
Hastalar varfarin endikasyonlarına ve TTR etkinliğine (TTR
≥%60) göre analiz edildi. Haftalık varfarin dozu, varfarin kullanım süresi, yıllık INR kontrol sıklığı ve hastaların hedef
INR değeri konusunda farkındalıkları not edildi.
Bulgular: Katılan 248 hastanın (ortalama yaş: 57.21±12.45
yıl, %33.1’i erkek) TTR değeri %55.92±27.84 idi ve hastaların % 48.0’i etkin TTR’ye sahipti. Klinik ve demografik
özelliklerin (yaş, cinsiyet, sosyoekonomik durum, komorbiditeler) TTR ve TTR etkinliği üzerinde etkisi gösterilemedi.
Yıllık INR kontrolü sıklığı 10.02±3.80 idi. Yıllık INR kontrolü
sıklığıyla TTR ilişkili bulundu (r=0.131, p=0.039). Hastaların sadece 1/3’ü (%30.2) hedef INR değerinin farkındaydı.
Hastanın okur-yazarlık durumu ve ilaç kullanım süresi farkındalık üzerinde olumlu etki sağladığı görüldü (sırasıyla
p=0.011 ve p=0.024).
Sonuç: Çalışmamız TTR ve TTR etkinliğinin düşük olduğunu ve bu iki parametrenin hastaların karakteristikleri ve varfarin endikasyonunuyla ilişkili olmadığını gösterdi. Maalesef
valvüler AF ve protez kapak varlığında kullanılabilecek tek
ilaç varfarindir. Bu nedenle kötü antikoagulasyon izleminin
üstesinden gelmek için sık INR kontrolleri ile takip olmak,
varfarin hakkında bilgi sahibi olmak ve farkındalık gereklidir