Öcal Berkan

Vasorelaxing properties of some phenylacridine type potassium channel openers in isolated rabbit thoracic arteries.

In this study, 12 new 2,2,7,7-tetramethyl-9-aryl-2,3,4,5,6,7,9,10-octahydro-1,8-acridindione derivatives were synthesised and their effects on vascular potassium channels and mechanism of induced relaxations on phenylephrine-induced contractile responses in isolated rabbit thoracic arteries was investigated. Pinacidil was used as standard potassium channel openers in this study. Compounds 1-12 and pinacidil exerted concentration-dependent relaxation responses precontracted phenylephrine in the aortic rings with the efficacy order: 11>pinacidil>7>2>8>3>1>4>10>6>9>5>12.

Vasorelaxant effect of opioid analgesics on the isolated human radial artery

Background and objective: Arterial grafts are prone to vasospasm. Opioid analgesics are commonly used in the perioperative course of cardiac surgical procedures. Therefore, we investigated the direct effects of morphine, meperidine, fentanyl and remifentanil on the human radial artery. Methods: Radial artery segments, obtained from 20 patients, were precontracted with phenylephrine. Using the organ bath technique, the endothelium‐independent vasodilatation was tested in vitro by addition of cumulative concentrations of morphine, meperidine, fentanyl and remifentanil in separate organ baths, in the presence or absence of naloxone. Indomethacin and NG‐nitro‐l‐arginine methyl ester was added to all organ bath in order to determine the effects of prostaglandins and nitric oxide, respectively. Results: Morphine (10−8–10−4mol L−1), meperidine (10−10–10−6mol L−1), fentanyl (10−10–10−6mol L−1) and remifentanil (10−8–10−4mol L−1) caused a concentration‐dependent vasorelaxation in the human being artery rings. The relaxations in the presence of naloxane did not change. The maximal relaxant effects of meperidine and fentanyl were significantly greater than those of morphine and remifentanil (P < 0.05). Conclusions: These findings indicate that morphine, meperidine, fentanyl and remifentanil produce concentration‐dependent and endothelium‐independent relaxations in human being radial artery rings. Meperidine and fentanyl are more potent relaxant agents than morphine and remifentanil in the human being radial artery in vitro.

The Role of the CCR2 Gene Polymorphism in Abdominal Aortic Aneurysms

Objective: Chronic inflammation play an important role on abdominal aortic aneurysms (AAA) formation. Chemokine receptor-2 (CCR2) is involved in regulation of the inflammatory response. However, relation between CCR2 polymorphism and AAA formation in human has not yet been investigated. In this study, we aimed to investigate the relationship between AAA and CCR2-V64I gene polymorphism. Methods: In this study, 100 consecutive patients with AAA and 138 individuals with normal aortic diameter were included. CCR2-V64I gene polymorphism were analyzed by PCR-RFLP technique. Genotype distribution and allele frequencies of CCR2-V64I gene polymorphism in patients with AAA and healthy subjects were compared. Results: CCR2 heterozygote V64I polymorphism and allele frequency were more frequently observed in the AAA group (p = 0.01, p = 0.004). Significant relationship was observed between CCR2 V64I polymorphism (OR:2.31, 95% CI:1.19-4.46, p = 0.01) and presence of AAA in multivariate regression analysis. Conclusion: The present study, showed us a relationship between CCR2-V64I polymorphism and AAA.

Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials

AIMS Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF). However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine anti-arrhythmic benefits of these agents in this setting. We therefore aimed to quantify precisely the association between statin pretreatment and postoperative AF among patients undergoing cardiac surgery. METHODS AND RESULTS A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012) was conducted, followed by a review of the reference lists of published studies and correspondence with trial investigators to obtain individual-participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting ≥5 min. Overall, 1105 participants from 11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval 0.31-0.54, P < 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatment was consistent across different subgroups. CONCLUSION Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery.

Long non-coding RNAs in the atherosclerotic plaque

BACKGROUND AND AIMS Genetic and environmental factors are important components of the development of atherosclerosis. Long non-coding RNA (lncRNAs) have emerged as regulators of multiple pathophysiological pathways in the cardiovascular system. Here, we investigated potential associations between lncRNAs and atherosclerosis. METHODS Tissue samples from atherosclerotic coronary artery plaques and non-atherosclerotic internal mammary artery were obtained from 20 patients during coronary artery bypass surgery. Expression levels of five lncRNAs known to be associated with coronary artery disease were measured using quantitative PCR. RESULTS Cyclin-dependent kinase inhibitor 2B antisense RNA 1 (ANRIL) and myocardial infarction-associated transcript (MIAT) were more expressed in the atherosclerotic arteries compared to the non-atherosclerotic arteries. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) was less expressed in the atherosclerotic plaques. Expression levels of potassium voltage-gated channel, KQT-like subfamily, member 1 opposite strand/antisense transcript 1 (KCNQ1OT1) and hypoxia inducible factor 1A antisense RNA 2 (aHIF) were comparable between atherosclerotic and non-atherosclerotic arteries. In the atherosclerotic plaque, expression levels of MALAT1, MIAT, KCNQ1OT1 and aHIF were inversely correlated with age. CONCLUSIONS We report significant associations between lncRNAs and atherosclerosis. These findings support a role for lncRNAs in coronary artery disease development.

eNOS G894T Polymorphism and Abdominal Aortic Aneurysms

Background: The genetic risk factors that contribute to the risk of developing abdominal aortic aneurysm (AAA) are poorly understood. We assessed the association of endothelial nitric oxide synthase (eNOS) gene polymorphism with AAA. Methods: eNOS gene polymorphism of 61 patients with AAA and 62 control participants were analyzed by polymerase chain reaction (PCR)-restriction technique. Results: eNOS G894 homozygote T/T genotype polymorphism and 894T allele frequency in patients with AAA were significantly higher than those of the control participants (P = .01, P = .03). Among patients with AAA, the eNOS G894 T/T polymorphism and 894T allele frequency were associated with larger AAAs. Conclusion: The current study, in a small group of participants, showed a relationship between eNOS G894T polymorphism and AAA.

The Role of NF‐κB1A Promoter Polymorphisms on Coronary Artery Disease Risk

Coronary artery disease (CAD), which is now regarded as a chronic inflammatory disease, is the leading cause of death worldwide. Nuclear factor (NF)‐κB is a transcription factor that plays an important role in the regulation of the immune system. NF‐κBIA is the inhibitory version of NF‐κB. This study is the first investigation of the association between CAD and NF‐κBIA‐297 C/T, ‐826 C/T, ‐881 A/G polymorphisms in a Turkish population using PCR–RFLP method. The study population comprised 201 cases with CAD and 201 healthy controls. There was no significant difference in NF‐κB1A‐297 C/T and ‐881 A/G in allele and genotype frequencies between case and control populations. The genotype frequency of NF‐κBIA‐826TT in the patients with CAD was significantly higher than that of the controls (p = 0.015, adjusted OR = 7.09, 95% CI = 1.95–25.70). The patients with CAD also had significantly higher carriage rate of NF‐κBIA‐826T allele than the controls (p = 0.03, OR = 1.43, 95% CI = 1.03–1.99). Linkage analysis indicated a close linkage among these three variants of NF‐κBIA (for case, χ2 = 85.35 and p < 0.001; for control, χ2 = 21.58 p < 0.001) and TTG, TTA and TCG haplotypes were associated with CAD (adjusted OR = 2.54, 95% CI = 0.88–7.27; p = 0.001, adjusted OR = 1.61, 95% CI: 0.64–4.02; p = 0.04, adjusted OR = 0.08, 95% CI = 0.01–0.64; p < 0.001, respectively). NF‐κBIA‐826TT genotype may be a significant risk factor and a valuable marker for the development of CAD.

Association Between ApoE4 Allele and Deep Venous Thrombosis: A Pilot Study

Introduction: Deep vein thrombosis (DVT) is a multifactorial disease with genetic and acquired risk factors playing in concert in its pathogenesis. ApoE gene polymorphisms seem to have some impact among patients with cardiovascular disease; however, association between DVT and ApoE gene polymorphism has not been evaluated. Materials and Methods: We aimed to search the relative frequencies ApoE alleles among patients with DVT and healthy participants. We enrolled 59 consecutive patients with DVT and 59 age- and sex-matched healthy controls. Results: In the DVT group, E3/E4 gene polymorphism was detected in 20 patients (33.9%), in the control group E3/E4 polymorphism was detected in six patients (10.2%; P = .002). In the multivariable regression analysis, E3/E4 was independently associated with 1.31-fold increased risk of DVT (odds ratio [OR] 1.31; 95% confidence interval [CI], 1.30-10.48). Conclusion: It seems there is a relationship between ApoE3/E4 gene polymorphism and DVT in the Turkish population. However, this pilot study should be supported with large-scale studies.

Type I plasminogen activator inhibitor 4G allele frequency is associated with chronic venous insufficiency.

Chronic venous insufficiency (CVI) is a common disease associated with poor quality of life. Genetic polymorphisms causing coagulation abnormalities may account for some of the CVI pathogenesis. Type I plasminogen activator inhibitor (PAI-1) is responsible for fibrinolytic system regulation, and plasma levels of PAI-1 are strongly correlated with PAI-1 4G/5G gene polymorphism. The association between PAI-1 4G/5G gene polymorphism and CVI was investigated. In 34 consecutive patients with clinically overt CVI, the PAI-1 4G/4G polymorphism was detected in three cases (8.8%); the 4G/5G polymorphism was detected in 28 (82.4%). In 34 age- and sex-matched controls, the PAI-1 4G/4G polymorphism was detected in one case (2.9%) and the 4G/5G polymorphism was detected in 14 cases (41.2%). The PAI-1 4G allele was found significantly more frequently in CVI patients than in controls. The 4G allele was associated with a 3.25-fold increase in CVI risk. Thus, a relationship between CVI and the PAI-1 4G allele is apparent.

Pulmonary arterial aneurysm in Behçet's disease

To the Editor: Since its first description in 1937, Behqet’s disease (BD) has been characterized by the triad of uveitis with oral and genital ulcerations [l]. BD is a multisystemic disorder of unknown etiology. It may involve the vascular system, affecting both arteries and veins [2]. Pulmonary involvement and arterial aneurysm formation have a particularly poor prognosis in these cases [3,4]. Herein, we present a case with BD and a pulmonary aneurysm and we review the corresponding literature. A 30-year-old man had symptoms of BD for 5 years, consisting of recurrent oral and genital ulcerations, arthritis uveitis and positive pathergy test. He had a history of femoro-popliteal thrombophlebitis. In 1994, initially colchicine and azathioprine were given, but later on, because of the major venous occlusion, anticoagulant and antiaggregant therapy was included. In May 1994, he was admitted to a pneumontology clinic with symptoms of cough, chill, pleuritic pain and fever. Diagnosis of pneumonia was observed and therapy with antibiotics began. In February 1997, he was readmitted to our department with massive hemoptysis which occurred spontaneously, and showed a single sacculer aneurysm of 31 X 18 mm before the branching of the right pulmonary artery (Fig. 1). Surgery was suggested