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Hydration tests were performed on geosynthetic clay liners (GCL) to examine the influence of subsoil water content (w(subsoil)) and mass per unit area (MPUA) on the cation exchange occurred during hydration. Increase in the W-su(bso)il increased the final water content of GCL (w(final)). At MPUA of 4.0 kg/m(2), w(final) increased from 70 to 109%. Such increase was less pronounced when MPUA was considered. Also, an inverse relation between MPUA and w(final) existed where w(final) increased as the MPUA decreased. The greatest w(final) was determined when W-subsoil was similar to 17% and MPUA of GCL was similar to 3.0 kg/m(2) (112%). The exchange reaction was the most favorable when W-subsoil was similar to 8% and MPUA of GCL was similar to 3.0 kg/m(2) (mole fractions of monovalent cations, X-M, decreased from 0.81 to 0.65) and the least favorable when w(subsoil) was similar to 17% and MPUA of GCL was similar to 3.0 kg/m(2) (X-M decreased from 0.81 to 0.80). Combined influence of MPUA and W-subsoil showed that although cation exchange depends on both factors, w(subsoil) had significant role in this reaction more than MPUA. The findings of cation exchange analyses were supported with swell index tests. The hydrated GCLs had lower swell indices than the virgin GCL (17.5-19.0 mL/2g vs. 21.5 mL/2g), indicating cation exchange.

Resumo Fundamentos Os efeitos protetores da fase de leitura aberta mitocondrial do 12S rRNA-c (MOTS-C) em doenças cardiovasculares foram demonstrados em vários estudos. Entretanto, há pouca documentação da relação entre MOTS-C e fluxo sanguíneo coronariano no infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Objetivo Nosso objetivo foi investigar o papel do MOTS-C, que é conhecido por ter propriedades citoprotetoras na patogênese do fenômeno de no-reflow, comparando a taxa de fluxo coronariano e os níveis de MOTS-C em pacientes com IAMCSST submetidos à ICP primária. Métodos 52 pacientes com IAMCSST e 42 pacientes sem estenose >50% nas artérias coronárias foram incluídos no estudo. O grupo IAMCSST foi dividido em dois grupos de acordo com o grau de fluxo TIMI (do inglês Thrombolysis In Myocardial Infarction) pós-ICP: (i) No-reflow: graus 0, 1 e 2 e (ii) grau 3 (sucesso angiográfico). Um valor de p 50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of

İnsanoğlu Allah’tan her türlü isteğini onun “Bana dua edin, kabul edeyim.” emri üzerine dua yoluyla dile getirir. Bu istek dünyevi ve uhrevi birçok sebebe dayanmaktadır. Bu isteği dile getirirken de tüm samimiyeti ve acziyeti ile yüce Yaratan’ı çeşitli sıfatlarla metheder. Bu dile getirişlerin sanatsal bir ifade şekli de münâcât dediğimiz türlerdir. Bir sanat eseri olan ancak sanatçının sanat endişesini bir kenara koyarak tüm samimiyetiyle kaleme aldığı münâcâtlar, klasik edebiyatımızda pek çok sanatçı tarafından ya bir eserin içinde ya da müstakil olarak manzum ve mensur şekillerde yazılmıştır. Az sayıda örneğine rastladığımız mensur münâcâtlardan biri de Abdullah Bosnevî’nin Arapça kaleme aldığı müstakil münâcâttır. Abdullah Bosnevî, 17. yüzyıl Osmanlı âlimlerinden olup “Şârih-i Füsûs” olarak meşhur olmuş ve doğduğu yere nispetle “Bosnevî” diye tanınmıştır. Çalışmamızda klasik edebiyatımızdaki münâcât türü, Abdullah Bosnevî ve eserleri hakkında kısaca bilgi verilecek, Abdullah Bosnevî’ye ait olan Arapça münâcâtın tercümesi ve tahlili yapılacaktır.

“Çehâr Yâr-ı Güzîn” olarak adlandırılan ve Hz. Peygamber'in hem dostu hem de ondan sonra halifesi olan Hz. Ebû Bekir, Hz. Ömer, Hz. Osmân ve Hz. Ali hakkında klasik edebiyatta manzum ve mensur pek çok eser yazılmıştır. Bu eserlerden bazıları müstakil bazıları da eserler içinde bölüm halinde olmuştur. Çalışmanın konusu olan “Çehâr Yâr-ı Güzîn” Yenâbî‘ü’l-Yakîn fî İhyâ’i ‘Ulûmi’d-Dîn adında XVII. yüzyılın başlarında Osmanlı Türkçesi ile yazılan ve İmam Gazzalî’nin en önemli eserlerinden biri olan İhyâ’u ‘Ulûmi’d-Dîn’in bir tercümesi olan eserde yer almaktadır. Müellif tercümesini İhyâ’nın aslına uygun olarak bölümler halinde yapmış, ikinci bölümden sonra müstakil olarak mensur-manzum karışık bir “Çehâr Yâr-ı Güzîn” kaleme almıştır. Burada her birini ayrı başlıklar altında ele alan müellif, onlar hakkında hem tarihi bilgilere yer vermiş hem de hayatlarından kesitler sunmuştur. Ayrıca kendince uygun gördüğü yerlerde anlatımını şiirlerle de süslemiştir. Çalışmada Yenâbî‘ü’l-Yakîn fî İhyâ’i ‘Ulûmi’d-Dîn kısaca tanıtılmış, dört halife ile ilgili eserdeki bilgiler tahlil edilmiş ve bölümün transkripsiyonu verilmiştir. Bu çalışma ile bir İhyâ tercümesi olan Yenâbî‘ü’l-Yakîn fî İhyâ’i ‘Ulûmi’d-Dîn içinde müstakil bölüm olan “Çehâr Yâr-ı Güzîn”in ilim âlemine tanıtımı amaçlanmıştır.

Objective: Atrial fibrillation (AF) is frequently an electrical sign of underlying structural heart disease. Structural remodeling may begin not only in ventricles but also in atrium secondary to AF. In this study, we sought to investigate the effect of paroxysmal atrial fibrillation (PAF) on right ventricle function. Method: We prospectively analyzed 30 patients diagnosed with PAF and 25 control individuals. Cardiac risk factors and medical treatment of patients were obtained and recorded in both groups. Right ventricle tricuspid annular plane systolic excursion (TAPSE) and Tei indexes were measured as an indicator of right ventricular function. Results: There was no statistical difference between groups in terms of demographic and clinical characteristics. Tei index was higher and TAPSE was lower in PAF group compared to control individuals (p > 0.05). There was no statistically significant difference between PAF and control groups in terms of right ventricular diastolic functions neither. Although isovolumic relaxation time (IVRT) was higher in PAF group, it did not give statistical significance. Conclusion: In this study, even not being statistically significant Tei index, which assess right ventricular function was over upper limit in PAF patients. This may have been as the result of prolonged IVRT. This result may indicate that right ventricular diastolic functions may be effected in patients with PAF

OBJECTIVES Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention. MATERIALS AND METHODS A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated. RESULTS CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p

Yenâbiü'l-Yakîn fî İhyâi Ulûmi’d-Dîn tek nüshası Süleymaniye Kütüphanesi Fatih Kitaplığında 2574 numara ile kayıtlı olan, Osmanlı Türkçesi ile yazılmış bir eserdir. Eser, muhtelif kaynaklarda Bostanzâde Mehmet Efendi’ye ait bir İhya’u Ulûmi’d-Dîn tercümesi olarak geçmektedir.Eserle ilgili yapılan çalışmalarda öncelikle eserin kaynaklardaki bilgilerinin doğru olup olmadığı araştırılmıştır. Nitekim yaptığımız ön araştırmalarda eserin içeriği ile kayıtlardaki bilgileri arasında bazı tutarsızlıklar olduğu görülmüştür. Özellikle eserin Osmanlı padişahı Sultan I. Ahmet’e sunulduğu ifade edilmesine rağmen Bostanzâde Mehmet Efendi’nin, Sultan I. Ahmet tahta çıkmadan önce vefat etmiş olması bu tutarsızlıklardan biri olarak görülmüştür. Bu tutarsızlıkların giderilmesi amacıyla esere ait farklı nüshalar araştırılmış, eserin kime ait olduğu tespit edilmeye çalışılmış ve bunun bir İhya’u Ulûmi’d-Dîn’in tercümesi olup olmadığı araştırılmıştır. Eserin müellifi ile ilgili yapılan çalışmalarda, eserde yer alan şiirlerden üçünde “Mehmet/Muhammet” ismi tespit edilmiştir. Bu ismin eserin müellifi olduğu kanaatindeyiz. Eserin Sultan I. Ahmet’e sunulduğu bilgisinden yola çıkarak o dönemde yaşamış bu isimdeki şairler araştırılmış ve özellikle iki isim ön plana çıkmıştır. Bunlar Hocazâde Mehmet Efendi ve Hocazâde Mehmet Esad Efendi. Bu isimlere ait kayıtlardaki bilgiler ve eserleri incelenecek, çalıştığımız eserle olan benzerlik ve farklılıklar ortaya konularak müellif tespiti yapılmaya çalışılacaktır.

Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P

İslamiyet, Türklerin hayatlarının her alanında olduğu gibi edebî hayatlarının şekillenmesinde de kendini göstermiş ve dinî konuların ele alındığı çok çeşitli edebî türün ortaya çıkmasında etkili olmuştur. Bu edebî türlerden biri de Hz. Muhammed’in sûret ve sîretini konu edinen hilye türüdür. Klâsik edebiyatımızda, Hz. Muhammed’in fizîkî ve ruhî portresini ele alan hilye türünün manzum şekilleri on altıncı yüzyılda görülmeye başlanmış ve bu alanda pek çok örnek ortaya konmuştur. Türk kültüründe hilyeye büyük önem verilmiş, hilyeyi ezberleyenin hem dünyada hem ahirette büyük mükâfatlara nâil olacağı ve huzura erişeceği ifade edilmiştir. Hilye, evde veya işyerinde bulundurulursa o mekânın çeşitli kötülüklerden korunacağına, yanında taşıyanların kaza ve musibetlere uğramayacağına inanılmıştır. Bu çalışmada, XIX. asırda yaşamış, dinî-tasavvufî eserler vermiş bir şâir olan İsmâil Sâdık Kemâl b. Muhammed Vecîhî Paşa’ya ait olan Âsâr-ı Kemâl’deki manzum hilye incelenmiştir. Müellifin hayatı, edebî kişiliği ve eserlerine kısaca değinilmiş, özellikle çalışmamızın konusu olan hilyenin yer aldığı Âsâr-ı Kemâl hakkında da bilgi verilmiştir. Hilye türü ve bu türün edebiyatımızdaki yeri hakkında kısaca bilgi verildikten sonra eserin, şekil ve muhteva yönünden incelenmesi yapılmış ve eserin transkribe edilmiş metni çalışmanın sonunda verilmiştir. Ayrıca bu çalışma ile önceki çalışmalarda sehven mensur eserler listesinde adı geçen eserin manzum olduğu bilim dünyasına duyurulmuştur.

Summary Background Endothelial dysfunction plays a key role in the aetiopathogenesis of slow coronary flow (SCF) even if there is no obstructive epicardial lesion. Reduced plasma levels of endothelial nitric oxide synthase (eNOS) are an important indicator of endothelial dysfunction. We aimed to determine plasma levels of eNOS and their relationship with exercise in patients with SCF. Methods Twenty-two patients with SCF in at least one coronary artery and 17 healthy individuals were included in this study. The TIMI frame count method was used to determine SCF. Plasma levels of eNOS before and after effort were determined in the patient and control groups. Results Basal eNOS levels in the patient group were lower than in the control group (p = 0.040), and plasma eNOS levels after exercise decreased more significantly in the patient group compared to the control group (p = 0.002). Median decreases of eNOS in response to exercise were higher in the SCF group than in the control group (p < 0.001), and the decrease observed in the control group was not statistically significant (p = 0.35). There were significantly negative correlations between TIMI frame count and plasma levels of eNOS at baseline and after exercise (r = –0.51, p = 0.015, r = –0.58, p = 0.005, respectively). Moreover, there was also a positive correlation between the rate–pressure product and plasma levels of eNOS after exercise in patients with SCF (r = 0.494, p = 0.019). Conclusion Our findings indicate an important pathophysiological relationship between the severity of SCF in which endothelial dysfunction plays a role in its pathogenesis and the level of circulating plasma levels of eNOS.

Objective: The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX). Methods: We compared 34 patients with CSX (18 females, mean age 47.9±10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6±9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann–Whitney U test, and chi-square test were used to statistically analyze data. Results: LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7±2.5% vs. -19.8±1.8%; p

The aim of this study was to evaluate the relationship between cigarette smoking and atrial rhythm disorders with the use of noninvasive methods.The study population consisted of 50 healthy volunteer smokers and 40 healthy volunteer non-smokers who had normal echocardiographic parameters and similar sex and age profiles. P-wave dispersion (PWD) was calculated from the 12-lead surface ECG. Left ventricle (LV) end-systolic and end-diastolic diameters, LV ejection fraction, and interatrial and intraatrial electromechanical delay were measured by tissue Doppler imaging and conventional echocardiography.Isovolumetric relaxation time and deceleration time were significantly higher (91.5 ± 11 vs. 82.35 ± 8.6, p 0.0001; 215.7 ± 37.1 vs. 175.3 ± 17.7, p 0.0001, respectively), and HDL cholesterol was significantly lower in smokers (39.34 ± 7.5 vs.44.3 ± 8.07, p = 0.003). There were no significant differences between the groups with respect to Sm and Em values, Am value, and E/A and E/Em ratios. However, the Em/Am ratio was significantly lower in smokers (1.28 ± 0.21 vs. 1.44 ± 0.33, p 0.006). Inter- and intraatrial electromechanical delay were significantly higher in smokers when compared with non-smokers (51.11 ± 1.54 vs. 27.30 ± 3.36, p 0.0001, and 30.63 ± 3.2 vs. 12.24 ± 3.26, p 0.0001, respectively). The amount of smoking was strongly correlated with interatrial electromechanical delay (r = 0.567, p 0.0001), and a significant correlation was detected between PWD and interatrial electromechanical delay (r = 0.653, p = 0.001).We have demonstrated the relationship between inter- and intraatrial electromechanical delay and PWD. These parameters may be useful predictive markers for the development of AF in the asymptomatic period before cardiac rhythm disturbances occur. This finding may indicate that smokers have an increased risk of developing atrial rhythm disturbances.

The aim of the study was to evaluate congestive heart failure (HF) patients with real-time three-dimensional echocardiography (3DE) to investigate why some of them present with acute decompensation despite having two-dimensional echocardiographic (2DE) parameters with compensated HF patients.The study population consisted of 36 patients with decompensated HF (24 males, 12 females; mean age 65.8±10.4 years) and 30 patients with compensated HF (21 males, 9 females; mean age 63.2±11.5 years).The levels of pro-brain natriuretic peptide (pro-BNP), serum electrolytes, renal function tests and complete blood counts were determined. All patients underwent 2DE and 3DE evaluations.Heart rate and blood urea nitrogen levels were higher in patients with decompensated HF than those with compensated HF (95.8±21.4 vs. 81.2±14.9, p=0.002; 28.3±15.7 mg/dl vs. 18±6.8 mg/dl, p=0.001, respectively). Pro-BNP levels and NYHA class were significantly higher in patients with decompensated heart failure [4925 pg/ml (2199-8711) vs. 330 pg/ml (197-756), p0.0001 and 2.3±0.6 vs. 1.2±0.4, p0.0001, respectively]. Although 2DE parameters were similar between groups, left ventricular ejection fraction was lower in patients with decompensated HF while end-diastolic and end-systolic volumes by 3DE were significantly higher in the same group (26.3±3.8% vs. 30.3±4.0%; 205.6±55.5 ml vs. 145.0±33.7 ml; 178.4±55.6 ml vs. 115.7±32.5 ml, all p0.0001, respectively). However, systolic volume was higher in patients with compensated HF (52.0±15.5 ml vs. 62±12 ml, p=0.005).We think that 3DE provides more reliable information about left ventricular volume and functions in the evaluation of patients with HF.

Background: Ivabradine is a novel specific heart rate (HR)-lowering agent that improves event-free survival in patients with heart failure (HF). Objectives: We aimed to evaluate the effect of ivabradine on time domain indices of heart rate variability (HRV) in patients with HF. Methods: Forty-eight patients with compensated HF of nonischemic origin were included. Ivabradine treatment was initiated according to the latest HF guidelines. For HRV analysis, 24-h Holter recording was obtained from each patient before and after 8 weeks of treatment with ivabradine. Results: The mean RR interval, standard deviation of all normal to normal RR intervals (SDNN), the standard deviation of 5-min mean RR intervals (SDANN), the mean of the standard deviation of all normal-to-normal RR intervals for all 5-min segments (SDNN index), the percentage of successive normal RR intervals exceeding 50 ms (pNN50), and the square root of the mean of the squares of the differences between successive normal to normal RR intervals (RMSSD) were low at baseline before treatment with ivabradine. After 8 weeks of treatment with ivabradine, the mean HR (83.6 ± 8.0 and 64.6 ± 5.8, p < 0.0001), mean RR interval (713 ± 74 and 943 ± 101 ms, p < 0.0001), SDNN (56.2 ± 15.7 and 87.9 ± 19.4 ms, p < 0.0001), SDANN (49.5 ± 14.7 and 76.4 ± 19.5 ms, p < 0.0001), SDNN index (24.7 ± 8.8 and 38.3 ± 13.1 ms, p < 0.0001), pNN50 (2.4 ± 1.6 and 3.2 ± 2.2 %, p < 0.0001), and RMSSD (13.5 ± 4.6 and 17.8 ± 5.4 ms, p < 0.0001) substantially improved, which sustained during both when awake and while asleep. Conclusion: Our findings suggest that treatment with ivabradine improves HRV in nonischemic patients with HF.

Aims Behcet's disease (BD), a multisystemic inflammatory disorder, has been associated with a number of cardiovascular dysfunctions, including endomyocardial fibrosis of the right heart, atrial fibrillation, ventricular arrhythmias and sudden cardiac death. The incidence and nature of cardiac involvement in BD are not yet clearly documented. Our aim was to evaluate left atrial (LA) volume and functions using real-time three-dimensional echocardiography (RT3DE) in Behcet's patients without any cardiac symptom. Methods and results The study included 40 BD (16 females, 24 males and mean age of 33 ± 7 years) and 30 healthy (11 females, 19 males and mean age of 35 ± 6 years) subjects. All the patients' demographic parameters such as age, gender, and duration of BD were recorded. All the individuals underwent comprehensive 2D echocardiography examination, and RT3DE was performed to assess LA volumes and mechanical functions. LA maximum volume ( V max) and before atrial contraction volume ( V pre A), LA active stroke volume and total stroke volumes (TSV), total emptying and active emptying fractions and expansion index were significantly higher in Behcet's disease patients when compared with the controls ( P < 0.0001 for all). LA passive emptying fraction was significantly lower in the patients with BD than in the controls (41 ± 7 vs. 44 ± 5, P = 0.039). There were positive correlations between TSV and high-sensitive C-reactive protein level ( r = 0.413, P = 0.008), TSV, and disease duration ( r = 0.417, P < 0.007). Conclusion Our study has shown that LA mechanical functions and volumes are impaired in BD. These results may be an early form of subclinical cardiac involvement in patients with BD who have no clinical evidence for cardiovascular disease.

Objective: The aim of our study was to evaluate serum uric acid level and its relationship with carotid intima-media thickness (CIMT) in patients with cardiac syndrome X (CSX). Subjects and Methods: A total of 50 patients with CSX (28 females/22 males, 51.0 ± 10.9 years) and 40 controls (27 females/13 males, 53.0 ± 10.2 years) were included in the study. All subjects underwent a noninvasive stress test and conventional coronary angiography. Serum uric acid levels were measured and B mode ultrasonography was performed to assess CIMT in all subjects. Results: Serum uric acid levels were higher in patients with CSX than in the control subjects (5.1 ± 1.8 vs. 3.9 ± 1.3 mg/dl; p = 0.002). The CIMT was higher in patients with CSX than in the control subjects (0.75 ± 0.18 vs. 0.63 ± 0.09 mm; p < 0.001). A significant correlation was found between serum uric acid values and CIMT measurements in patients with CSX (r = 0.666, p < 0.001). Conclusions: Serum uric acid levels were higher in patients with CSX and elevated serum uric acid levels were associated with carotid atherosclerosis, thereby indicating that elevated serum uric acid levels might contribute to the development of subclinical atherosclerosis in CSX patients.

The aim of this study was to evaluate the left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) in order to provide the early detection of myocardial dysfunction in patients with Behcet's disease (BD). We also aimed to examine the relationship between LV systolic strain and N-terminal pro-B type natriuretic peptide (NT-proBNP), which is a cardiac biomarker of ventricular dysfunction. Methods and results Longitudinal and circumferential systolic strain assessed by STE was obtained in 32 BD patients and 27 age-matched controls. NT-proBNP levels were also measured in all subjects. Regional and mean longitudinal strain (217.8+ 2.7 vs. 220.5+ 1.8%; P , 0.0001) was significantly lower in BD patients when compared with the healthy controls. Whereas regional and mean circumferential strain values (222.0+ 1.6 vs. 222.2+ 2.3%; P ¼ 0.62) did not reveal a significant difference between the patients and the controls. NT-proBNP was significantly higher in the patients than in the controls (65.18+ 84.51 vs. 30.84+ 14.75 pg/mL; P ¼ 0.003). Linear regression analyses revealed only NT-proBNP as the independent correlate of mean LV longitudinal strain (R ¼ 0.603, P ¼ 0.001). Conclusion Longitudinal myocardial systolic function assessed by STE, which is a sensitive marker of subclinical ventricular dys- function is impaired in BD. Increased NT-proBNP levels may be a sign of subclinical ventricular dysfunction in these patients.

We aimed to evaluate serum gamma-glutamyl transferase (GGT) activity and its relationship with carotid intima media thickness (CIMT) in patients with cardiac syndrome X (CSX).The study population consisted of 40 patients with CSX, 35 controls and 40 patients with coronary artery disease (CAD). All patients underwent a noninvasive stress test and conventional coronary angiography. Serum GGT and C-reactive protein (CRP) levels were measured and CIMT was assessed in all subjects.Serum GGT activity was higher in the CSX and the CAD groups than in the control group (32.6 +/- 16.0 and 30.4 +/- 15.3 U/L, respectively, vs. 17.9 +/- 4.2 U/L; P0.001). There was no statistically significant difference in serum GGT activity between the CSX and the CAD groups. When compared to the control group, serum CRP levels were significantly increased in both the CSX and the CAD groups (4.1 +/- 2.0 and 4.7 +/- 2.6 mg/L, respectively, vs. 2.2 +/- 1.8 mg/L; P0.001). Patients with CSX and CAD had significantly higher CIMT values than the controls (0.74 +/- 0.17 and 0.94 +/- 0.12 mm, respectively, vs. 0.62 +/- 0.08 mm; P0.001). A significant correlation was found between GGT activity and CIMT measurements (r = 0.640, P0.001), but serum GGT activity did not correlate with serum CRP levels in patients with CSX (r = 0.277, P0.05).The present study showed that serum GGT activity in patients with CSX was as high as those in patients with CAD. Increased GGT levels may play a role in the pathogenesis of the microvascular atherosclerotic process of CSX.

The interaction between moderate-to-severe obstructive sleep apnea (OSA) and cardiac arrhythmias, especially atrial fibrillation (AF), is well known. We aimed to determine whether atrial electromechanical parameters assessed by tissue Doppler imaging (TDI) would be affected in moderate-to-severe OSA, and detect the influential factors of atrial electromechanical parameters in these patients. Interatrial and intra-atrial electromechanical delay was measured by TDI in patients with moderate-to-severe OSA (n = 64) and control subjects (n = 39). P-wave dispersion (PWD) was calculated on the 12-lead ECG. Interatrial and intra-atrial electromechanical delay was significantly higher in the OSA group when compared with the controls (52.26 ± 12.9 vs 29.61 ± 11.26, P

To the Editor In their article, Vlahandonis et al. [1] investigated the long-term effects of pediatric sleep-disordered breathing (SDB) which either resolved or remained unresolved on spectral indices of heart rate variability (HRV). The authors found that control, resolved, and unresolved groups all exhibited a significant reduction in total power (TP), low-frequency (LF) power, and high-frequency (HF) power, as well as an increase in LF/HF ratio from baseline to the follow-up period of 4 years. They concluded that spectral HRV did not differ between controls, resolved, and unresolved SDB groups after the follow-up period [1]. HRV indices frequently are used in sleep research studies to quantify modulation of the sympathetic and parasympathetic branches of the autonomic nervous system [2,3]. Parameters of frequency domain HRV such as LF and HF power components usually are measured in absolute values of power (ms). LF and HF also can be measured in normalized units, which show the relative value of each power component in comparison to the TP. The appearance of LF and HF powers in normalized units highlights controlled and balanced behavior of the two branches of the autonomic nervous system. Furthermore, the normalization seems to decrease the effects of the changes in TP on the values of LF and HF power. Nonetheless, it will be appropriate and useful to display normalized units together with their unnormalized versions of the same variables to identify the complete distribution of power in spectral components [4].