Eyüp Aslan

Correlation of P-wave dispersion with insulin sensitivity in obese adolescents

BACKGROUND P-wave dispersion is a new and simple electrocardiographic marker that has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. In the present study, we evaluated P-wave dispersion in obese adolescents and investigated the relationship between P-wave dispersion, cardiovascular risk factors, and echocardiographic parameters. METHODS We carried out a case-control study comparing 150 obese adolescents and 50 healthy controls. Maximum and minimum P-wave durations were measured using a 12-lead surface electrocardiogram, and P-wave dispersion was calculated as the difference between these two measures. Echocardiographic examination was also performed for each subject. Multivariate linear regression analysis with stepwise variable selection was used to evaluate parameters associated with increased P-wave dispersion in obese subjects. RESULTS Maximum P-wave duration and P-wave dispersion were significantly higher in obese adolescents than control subjects (143±19 ms versus 117±20 ms and 49±15 ms versus 29±9 ms, p<0.0001 for both). P-wave dispersion was positively correlated with body mass index, waist and hip circumferences, systolic and diastolic blood pressures, total cholesterol, serum levels of low-density lipoprotein cholesterol, triglycerides, glucose, and insulin, homoeostasis model assessment for insulin resistance score, left ventricular mass, and left atrial dimension. P-wave dispersion was negatively correlated with high-density lipoprotein cholesterol levels. By multiple stepwise regression analysis, left atrial dimension (β: 0.252, p=0.008) and homoeostasis model assessment for insulin resistance (β: 0.205; p=0.009) were independently associated with increased P-wave dispersion in obese adolescents. CONCLUSIONS Insulin resistance is a significant, independent predictor of P-wave dispersion in obese adolescents.

Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine growth restriction

BACKGROUND Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates. METHODS In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography. RESULTS The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (p<0.05). Both symmetric and asymmetric intrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2 versus 54.5±24.4 g/m2 versus 109±28.8 g/m2) when compared with the control group. CONCLUSIONS Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative posterior wall thickness, left ventricular mass, and mass index when compared with appropriate for gestational age neonates, left ventricular systolic functions were found to be preserved. In our study, low socio-economic level, short maternal stature, and low maternal weight were found to be risk factors to develop intrauterine growth restriction. To our knowledge, our study is the first to evaluate left ventricular dimensions, wall thicknesses, mass, and systolic functions in neonates with intrauterine growth restriction and compare results with respect to asymmetric or symmetric subgroups.

Different Spectrum of Arrhythmia in Myocarditis: QT Interval Prolongation Followed to Supraventricular Tachycardia

DOI: 10.4328/JCAM.1494 Received: 25.12.2012 Accepted: 10.01.2013 Printed: 01.05.2016 J Clin Anal Med 2016;7(3): 408-10 Corresponding Author: Eyup Aslan, Department of Pediatric Cardiology, Konya Training and Research Hospital, 42080, Konya, Turkey. T.: +90 3323236709 F.: +90 3323236723 E-Mail: doktor_eyup@mynet.com Özet Akut miyokardit, bebeklerde kardiyak disfonksiyon ve aritmiler ile komplike olabilen bir enfeksiyondur. Bu hastaların elektrokardiyografilerinde düşük voltaj QRS kompleksli sinus taşikardisi, T dalgası ve ST segment değişiklikleri, atriyal ve ventriküler taşikardi, atriyoventriküler blok ve QT süresinde uzama görülebilmektedir. Miyokarditte atriyal ve ventriküler aritmiler bildirilmiş olmasına rağmen bu aritmilerin birbirlerine geçiş göstermesi ile ilgili kısıtlı sayıda bildirim vardır. Viral miyokarditte supraventriküler taşikardi ile başvuran ve QT uzaması gelişen ve yeniden sinüs ritmine dönen bir bebek olgu sunuyoruz.

A New Association or Coincidence: Supraventricular Tachycardia in a Child Receiving Hyoscine N-Butylbromide

DOI: 10.4328/JCAM.1394 Received: 12.11.2012 Accepted: 31.12.2012 Publihed Online: 02.01.2013 Corresponding Author: Eyup Aslan, Department of Paediatric Cardiology, Konya Training and Research Hospital, 42080, Konya, Turkey. T.: +90 3323236709 F.: +90 3323236723 E-Mail: doktor_eyup@mynet.com Özet Hiyoskin N-Butilbromid, periferal etkili antikolinerjik, antimuskarinik bir ilaçtır. Gastrointestinal ve genitoüriner sistemin spazmlarının tedavisinde kullanılmaktadır. Antikolinerjik etkisi sebebiyle, atropine benzer şekilde pozitif kronotropik özelliğinden dolayı sinüs taşikardisine yol açabilmektedir. Bununla birlikte, literatürde hiyoskin n-butilbromid ile supraventriküler taşikardi birlikteliği bildirilmemiştir. Bu yazıda karın ağrısı için hiyoskin n-butilbromid tedavisi esnasında supraventriküler taşikardi gelişen bir olguyu sunuyoruz.