Ahmet Birand

Effects of Trimetazidine on Heart Rate Variability and Left Ventricular Systolic Performance in Patients with Coronary Artery Disease After Percutaneous Transluminal Angioplasty

Fifty-one patients (mean age 51.6 ± 7.1 years) with angiographically proven coronary artery disease (CAD) entered the study. In 26 patients (Group I), trimetazidine treatment started twenty-four hours after percutaneous transluminal coronary angioplasty (PTCA). Another 25 patients (Group II) without trimetazidine treatment were kept as controls. The groups were comparable by age, gender, risk factors of CAD, coronary anatomy, left ventricular performance, and heart rate variability indices at baseline state. Power spectral analysis of heart rate variability and two-dimensional and Doppler echocardiographic examinations were performed before PTCA, and twenty-four hours, ten days, thirty days, and three months after PTCA. A statistically significant improvement of left ventricular systolic performance (P<0.001), augmentation of the parasympathetic band of heart rate variability (P<0.001), and decline of P1/P2 ratio (P<0.01) were evident in patients treated with trimetazidine, while no apparent changes were observed in controls. The intergroup analysis also showed marked difference between groups as recorded on the day 30 and month 3 of observation (P<0.001). During follow-up period recurrences of angina pectoris and ischemia were registered in Group II, while no evidence of ischemia was discerned in Group I patients. In conclusion, trimetazidine modulates the autonomic control of heart rate, ie, reduces sympathetic overactivity and augments vagal influences, improves left ventricular contractility, and diminishes the clinical manifestations of ischemia in patients with CAD after PTCA.

Left ventricular systolic and diastolic functions in patients with sickle cell anemia

The aim of this study was to evaluate the left ventricular systolic and diastolic functions in patients with sickle cell anemia. Fifty-four patients (34 male, 20 female, mean age 22.6±7.3 years) and 23 healthy persons (12 male, 11 female, mean age 26.7±6.8 years) were studied. After clinical examination and routine biochemical evaluation by a hematologist, patients with sickle cell anemia were admitted to the study. M-mode and 2-dimensional and Doppler echocardiographic measurements of patients and controls were performed according to criteria of the American Echocardiography Society. The values of the patient groups were compared with the values of normal healthy subjects (controls). Left ventricular systolic and diastolic diameters of sickle cell patients were greater than those of controls (p<0.001). All of the sickle cell anemia patients had reduced systolic cardiac function (EP: 0.57±0.1 vs 0.63±0.06 and FS: 0.30±0.06 vs 0.34±0.04,p<0.02) and abnormal diastolic left ventricular function parameters compared with the control group (IRT: 114±20 msec vs 65±7 msec,p<0.0001; E/A ratio: 1.2±0.5 vs 1.6±0.04,p<0.01). Left ventricular mass (LVM) was greater in patients than in controls (222±78 g vs 177±46 g,p<0.01). Left ventricular systolic and diastolic functions were abnormal in patients with sickle cell anemia, and the left ventricular mass was greater in the patients compared with controls.

Validity Test for a Set of Nonlinear Measures for Short Data Length with Reference to Short-Term Heart Rate Variability Signal

In this paper we investigate the requirementsfor the size of data set to be analyzed by a set of nonlinearmeasures. Time series from some standard nonlinear systems possessingchaotic behavior, as well as sinusoidal and random signals areconsidered. For Hénon, Kaplan-Yorke and logistic mapswe found the measures of correlation dimension (CD), approximateentropy (AE), Lyapunov exponents (LE), and deterministic ratio(DR) to be reliable for data length as short as 500 samples.On short-term heart rate variability (HRV) signal, AE and DRmeasures were able to distinguish between various experimentallymodified states of autonomic nervous system (ANS) controllingthe heart rate (HR). Thus, titling and parasympathetic blockademake the system more deterministic and reduce its entropy whilstsympathetic blockade makes it less deterministic.

Effect of the Final Coronary Arterial Diameter After Coronary Angioplasty on Heart Rate Variability Responses

Background: Autonomic nervous system dysfunction and reduced heart rate variability (HRV) after percutaneous transluminal coronary angioplasty (PICA) were reported in patients with coronary artery disease. However, factors related to reduced HRV are not clearly demonstrated. The aim of the present study was to assess the relationship between HRV indices and the final coronary arterial luminal diameter after PICA.

Comparative Assessment of the Effects of Vasodilators on Peripheral Vascular Reactivity in Patients with Systemic Scleroderma and Raynaud's Phenomenon: Color Doppler Flow Imaging Study

The aim of the present study was assessment of peripheral vascular reactivity during cold test and effects of different types of vasodilators on vascular resistance in patients with progressive systemic sclerosis and Raynauds phenomenon with use of color Doppler flow imaging of upper extremity.

Relationship between components of heart rate variability and Doppler echocardiographic indices of left ventricular systolic performance in patients with coronary artery disease

Decreased heart rate variability (HRV) has been reported as prognostic predictor in coronary artery disease population. The aim of the study was to assess the relationship between cardiac autonomic tone disturbances and the degree of left ventricular dysfunction, estimated by 2-dimensional and Doppler echocardiography, in patients with coronary artery disease. Forty patients with angiographically proven coronary artery disease and 15 age-and sexmatched healthy subjects were included into the study (Group I and II, respectively). Routine clinical examinations, electrocardiography, coronary angiography, and 2-dimensional and Doppler echocardiography with assessment of LV systolic performance were done in all the patients and control subjects. Cardiac autonomic function was assessed by means of frequency-domain analysis of heart rate variability. The powers of LF and HF bands (P1 and P2), their ratio (P1/P2), and the logarithmic expression of powers were measured. The patients (Group I) had lower values of parasympathetic band of HRV and higher sympathetic activity than the healthy population (Group II) (p<0.0002 for P2 andp<0.04 for P1/P2 ratio). A positive significant correlation was seen between parasympathetic band of HRV and ejection fraction (r=0.61,p<0.0001), and mean acceleration of aortal flow (r=0.56,p<0.0001), whereas P1/P2 ratio inversely and significantly correlated with the same parameters (r=−0.46,p<0.002 and r=−0.41,p<0.008).

Atrial natriuretic factor in high-altitude pulmonary hypertension: the influence of acute hypoxia on plasma atrial natriuretic factor, renin, and aldosterone concentrations in highlanders with initially normal or elevated pulmonary artery pressure and without evidence of right ventricular hypertrophy.

Since the renin-angiotensin-aldosterone system and atrial natriuretic factor are directly involved in the regulation of hemodynamics and structural alterations in the circulatory system, the interest of investigators in the observed changes in this system during exogenous hypoxia and the resultant development of high-altitude pulmonary hyperten sion is quite understandable. The authors measured the plasma levels of hormones from the major vasoconstrictor neurohumoral system and from one vasodilatory system and correlated them with hemodynamic variables in native highlanders of Tien-Shan.

Effects of the hypoxic test on left and right ventricular contractility in progressive systemic sclerosis with pulmonary arterial hypertension

AbstractThe purpose of this investigation was to assess hypoxic test effects on left and right ventricular contractility in patients with progressive systemic sclerosis (PSS) and pulmonary arterial hypertension (PAH). Ten patients (mean age 48.8±13.2 years) who were diagnosed with PSS and PAH were included in the study. All the patients underwent left and right heart catheterization. Right ventricular (RV) contractility was measured according to the method of Ferlinz [1] and left ventricular (LV) contractility according to the method of Kennedy et al. [2] using indirect digital substraction angiography. The mean pulmonary artery pressures (

Cardiac functions, autonomic nervous system and lipoprotein values in white coat hypertension patients

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