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Öğe 3D STRESS ECHOCARDIOGRAPHY EASIER TO USE COMPARED TO CONVENTIONAL METHOD PROVIDES HIGH PREDICTION RATE OF CORONARY ARTERY DISEASE(Elsevier Ireland Ltd, 2010) Kirilmaz, Bahadir; Turk, Ugur Onsel; Saygi, Serkan; Dogan, Huseyin; Tengiz, Istemihan; Ercan, Ertugrul[Anstract Not Available]Öğe Choosing cohort for epidemiologic studies Reply(Aves Yayincilik, 2009) Ercan, Ertugrul[Anstract Not Available]Öğe Decreased circulatory erythropoietin in hyperacute phase of myocardial ischemia(Elsevier Ireland Ltd, 2011) Alioglu, Emin; Ercan, Ertugrul; Tamer, Gulden Sonmez; Duman, Can; Turk, Ugur; Tengiz, Istemihan; Tuzun, NurullahPurpose: Erythropoietin provides cellular protection by inhibiting apoptosis. Myocardial damage related to the cardiac ischemia is more prominent especially in the first 6 h. In the present study, circulatory erythropoietin levels in response to cardiac ischemia were evaluated. Materials and methods: Patients with stable angina who underwent balloon angioplasty (study group, n = 55) and hospitalized for coronary angiography (as control group, n = 23) were enrolled into the study. Serum erythropoietin levels were measured in both groups in baseline, 6 and 18 h after the procedure. Results: Coronary balloon inflation time was accepted as duration of myocardial ischemia. Study group showed significant erythropoietin reduction at sixth hour compared to control group. Erythropoietin reduction at sixth hour was significantly correlated with duration of myocardial ischemia. Conclusion: Decreased circulatory erythropoietin levels in the early phase of acute cardiac ischemia may accelerate the apoptotic activity. Recombinant erythropoietin replacement to prevent erythropoietin decrease following cardiac ischemia may have negative effect on myocyte loss. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Öğe Experimental acute myocardial infarction in rats: HIF-1?, caspase-3, erythropoietin and erythropoietin receptor expression and the cardioprotective effects of two different erythropoietin doses(Elsevier Gmbh, Urban & Fischer Verlag, 2013) Bagla, Aysel Guven; Ercan, Ertugrul; Asgun, Halil Fatih; Ickin, Meltem; Ercan, Feriha; Yavuz, Ozlem; Bagla, SuatThe cardioprotective effects of two different doses of erythropoietin administration were analyzed in rats with experimental myocardial infarction. None, saline, standard-dose (5000 U kg(-1)) and high-dose (10,000 U kg(-1)) of human recombinant erythropoietin alpha were administered intraperitoneally in Wistar rats with myocardial infarction induced by coronary artery ligation. Infarct sizes measured after triphenyltetrazolium chloride staining, levels of biochemical markers, histopathology examined by light and electron microscopy, and immunohistochemical expressions of erythropoietin, erythropoietin receptor, hypoxia inducible factor-1 alpha and caspase-3, were analyzed. Lower scores of infarction and hemorrhage, lower number of macrophages and higher score of vascularization surrounding the infarct area were observed in the erythropoietin administered groups (p < 0.05). Erythropoietin administration after myocardial infarction reduced the area of infarction and hemorrhage. There were hypoxia inducible factor-1 alpha and caspase-3 expressions in the marginal area, and erythropoietin and erythropoietin receptor expression in both marginal and normal areas (p < 0.001). Vascularization, erythropoietin expression in the normal area and vascular erythropoietin expression were positively correlated with human erythropoietin levels. The cardioprotective effects of erythropoietin treatment were independent of endogenous erythropoietin/erythropoietin receptor activity. Moreover exogenous erythropoietin treatment did not suppress endogenous erythropoietin. Erythropoietin administration after myocardial infarction reduced caspase 3 expression (apoptotic activity) and induced neovascularization around the infarct area. Higher erythropoietin administration did not provide an additional benefit over the standard-dose in myocardial protection. (C) 2013 Elsevier GmbH. All rights reserved.Öğe G protein ?3 subunit gene polymorphism in Turkish hypertensives(Turkish Soc Cardiology, 2008) Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Yildiz, Ahmet; Tuerk, Ugur Oensel; Saygi, Serkan; Cam, F. SirriObjective: G protein is one of the most important regulators of intracellular signaling pathways. C825T polymorphism of G protein (33 subunit is associated with increased intracellular signal transduction. The 825T allele has been found associated with a variety of cardiovascular risk factors, including hypertension. The aim of the present study was to investigate the association between the C825T polymorphism of the G protein beta 3 subunit and essential hypertension in Turkish population. Methods: This cross-sectional, case-controlled study included 209 patients with essential hypertension (Patient group) and 82 subjects with normal blood pressure (Control group). The G protein 133 subunit C825T gene polymorphism was determined by polymerase chain reaction. Hypertension was defined according to JNC VII criteria. Statistical analysis was performed using Chi square and unpaired t tests. Logistic regression analysis was used to study association between hypertension and genotypes. Results: We found that the frequencies of the G protein 133 subunit C825T polymorphism in hypertensive and control groups were 17.7%, 59.3%, 23.0% and 32.9%, 48.8%, 18.3%, (CC, CT, TT) respectively (chi(2)=7.963, p=0.019). In the multivariate logistic regression analysis CT genotype had 2.2 (OR=2.262, 95% CI 1.228-4.167, p=0.009), and TT genotype had 2.3 times (OR=2.335, 95% CI 1.089-5.008, p=0.029) greater risk of hypertension compared to CC genotype. Conclusion: It seems that the G protein (33 subunit C825T gene polymorphism is associated with systolic and diastolic blood pressure. Furthermore, the study indicates that the G protein 133 subunit may be a susceptible gene to essential hypertension. (Anadolu Kardiyol Derg 2008; 8: 337-5)Öğe Helicobacter pylori Seropositivity in Patients with Acute Coronary Syndromes(Springer, 2009) Tamer, Gulden S.; Tengiz, Istemihan; Ercan, Ertugrul; Duman, Can; Alioglu, Emin; Turk, Ugur O.The aim of this study was to investigate the seroprevalence of Helicobacter pylori (HP) in patients with coronary atherosclerosis and acute coronary syndromes. We enrolled 152 patients (group I, 73 patients with acute coronary syndrome; group II, 79 patients with chronic stable angina) and 22 control subjects. An enzyme-linked immunosorbent assay for immunoglobulin (Ig) G test for HP diagnosis was used on all enrolled subjects. C-reactive protein (CRP) was also measured in all patients as an inflammatory marker. Seropositivity rates for HP were significantly higher in patients with coronary artery disease than in controls (80.2% versus 54.5%; P < 0.05). Although CRP level was significantly higher in group I than in group II (1.72 +/- A 2.89 mg/dl versus 0.53 +/- A 0.63 mg/dl, P < 0.0001), HP infection rates were similar between groups (86.3% versus 74.6%, P > 0.05). Infection with HP may influence atherogenesis through low-grade, persistent inflammatory stimulation. However, our data show evidence of increased systemic inflammation in patients with acute coronary syndrome, which was unrelated to an increased HP seropositivity.Öğe High Inflammatory Activity Related to the Number of Metabolic Syndrome Components(Wiley, 2010) Kirilmaz, Bahadir; Asgun, Fatih; Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Turk, Ugur; Saygi, SerkanIt has been known that each component of the metabolic syndrome (MS) has an atherogenic potential and increases the risk of cardiovascular events. Therefore, patients who have MS are candidates for the development of atherosclerosis and accompanying complications. In this study, the authors assessed the levels of acute phase reactants as an indicator of inflammation in patients with MS. Twenty-five patients with recently diagnosed MS and not treated before who had at least 3 of 5 diagnostic criteria of MS listed in the Third Report of the Adult Treatment Panel National Cholesterol Education Program (NCEP-ATP III) guidelines were included in the study. Twenty healthy patients constituted the control group. Inflammatory parameters were compared between the groups. There was no significant difference between the MS and control group with regard to age and sex. White blood cell count (/mm(3)), high-sensitivity C-reactive protein (hs-CRP), uric acid, interleukin (IL) 6, and fibrinogen levels were found to be significantly higher in the MS group. Number of MS components was strongly correlated with serum levels of hs-CRP (r=0.688, P=.0001), IL-6 (r=0.546, P=.0001), fibrinogen (r=0.551, P=.0001), uric acid (r=0.517, P=.0001), and leucocyte count (/mmr3) (r=0.456, P=.002). Inflammation plays an important role in atherosclerotic complications, which is activated in MS. Increased number of MS components are strongly associated with elevated inflammatory and metabolic markers. Measurement of serum inflammatory parameters in patients with MS may be beneficial in detection and management of cardiovascular events and in the assessment of efficacy of treatment. J Clin Hypertens (Greenwich). 2010;12:136-144. (C)2009 Wiley Periodicals, Inc.Öğe In vitro protection of adipose tissue-derived mesenchymal stem cells by erythropoietin(Elsevier Gmbh, Urban & Fischer Verlag, 2014) Ercan, Ertugrul; Bagla, Aysel Guven; Aksoy, Ayca; Gacar, Gulcin; Unal, Z. Seda; Asgun, H. Fatih; Karaoz, ErdalMobilization of stem cells and their differentiation into cardiomyocytes are known to have protective effects after myocardial infarction. The integrity of transplanted mesenchymal stem cells for cardiac regeneration is dependent on cell-cell or cell-matrix interaction, which is adversely affected by reactive oxygen species in an ischemic environment. Treatment with erythropoietin was shown to protect human adipose tissue derived mesenchymal stem cells in an ischemic injury in vitro model. The analyses indicated that expression of erythropoietin receptors played a pivotal role in erythropoietin mediated cell survival. In this study, the anti-apoptotic effect of erythropoietin on stem cells was analyzed in apoptosis-induced human mesenchymal stem cells. Apoptosis was induced in cultured adult human adipose tissue derived mesenchymal stem cells by hydrogen peroxide. A group of cultured cells was also treated with recombinant human erythropoietin in a concentration of 50 ng mL(-1). The degree of apoptosis was analyzed by flow-cytometry and immunohistochemical staining for Caspase 3. The average percentages of apoptotic cells were significantly higher in H2O2-induced stem cells than in cells co-cultured with erythropoietin (63.03 +/- 4.96% vs 29 +/- 3.41%, p<0.01). We conclude that preconditioning with erythropoietin suppresses apoptosis of mesenchymal stem cells and enhances their survival. (C) 2013 Elsevier GmbH. All rights reserved.Öğe Left atrial appendage function in mitral stenosis: Is it determined by cardiac rhythm?(2011) Saygi, Serkan; Turk, Ugur Onsel; Alioglu, Emin; Kirilmaz, Bahadir; Tengiz, Istemihan; Tuzun, Nurullah; Ercan, ErtugrulBackground and aim of the study: The left atrial appendage (LAA) is a common source of cardiac thrombus formation associated with systemic embolism in patients with mitral stenosis (MS). Low flow velocities in the LAA are important factors in the development of thrombosis. Whilst oral anticoagulant therapy is used routinely in MS with atrial fibrillation (AF), the characteristics of LAA contractile functions and the protective role of oral anticoagulant treatment in patients with MS in sinus rhythm (SR) are unclear. The study aim was to compare LAA contractile functions in patients with MS who were either in SR or had AF. Methods: The study population comprised 51 patients with MS, who had undergone both standard transthoracic and transesophageal echocardiography. The patients were allocated to two groups, according to the presence of AF or SR. Ten healthy, gendermatched subjects were included in the study as a control group. Results: Except for age, the characteristics of the groups were similar. In patients with SR and AF, the LAA contractile functions were significantly lower than in controls. While the LAA contractile functions of the SR group were significantly lower than the AF group (LAA emptying/filling velocity: 26 ± 7/24 ± 8 versus 19 ± 5/17 ± 5 cm/s; p = 0.002 and p = 0.001, respectively, LAA maximum/minimum area: 5.4 ± 1.2/3.2 ± 0.9 versus 6.2 ± 1.1/3.7 ± 0.8 cm2, p = 0.02 and p =0.02, respectively), no statistically significant differences were observed between patients in SR with mitral valve area (MVA) ?1.5 cm 2 and patients in AF. Four SR patients (13%) and six AF patients (27%) had LAA thrombus. A strong correlation was observed between the MVA and LAA peak emptying/filling velocity in patients with MS in SR (r = 0.739, p = 0.0001 and r = 0.728, p = 0.0001, respectively). Conclusion: The study results showed that LAA contractile function is diminished in patients with mod-erate- severe MS in SR, and to a similar degree as patients in AF. It was concluded that patients with moderate-severe MS in SR have a higher risk for thromboembolic events than MS patients in AF. © Copyright by ICR Publishers 2011.Öğe Left Atrial Appendage Function in Mitral Stenosis: Is It Determined by Cardiac Rhythm?(I C R Publishers, 2011) Saygi, Serkan; Turk, Ugur Onsel; Alioglu, Emin; Kirilmaz, Bahadir; Tengiz, Istemihan; Tuzun, Nurullah; Ercan, ErtugrulBackground and aim of the study: The left atrial appendage (LAA) is a common source of cardiac thrombus formation associated with systemic embolism in patients with mitral stenosis (MS). Low flow velocities in the LAA are important factors in the development of thrombosis. Whilst oral anticoagulant therapy is used routinely in MS with atrial fibrillation (AF), the characteristics of LAA contractile functions and the protective role of oral anticoagulant treatment in patients with MS in sinus rhythm (SR) are unclear. The study aim was to compare LAA contractile functions in patients with MS who were either in SR or had AF. Methods: The study population comprised 51 patients with MS, who had undergone both standard transthoracic and transesophageal echocardiography. The patients were allocated to two groups, according to the presence of AF or SR. Ten healthy, gender-matched subjects were included in the study as a control group. Results: Except for age, the characteristics of the groups were similar. In patients with SR and AF, the LAA contractile functions were significantly lower than in controls. While the LAA contractile functions of the SR group were significantly lower than the AF group (LAA emptying/filling velocity: 26 +/- 7/24 +/- 8 versus 19 +/- 5/17 +/- 5 cm/s; p = 0.002 and p = 0.001, respectively, LAA maximum/minimum area: 5.4 +/- 1.2/3.2 +/- 0.9 versus 6.2 +/- 1.1/3.7 +/- 0.8 cm(2), p = 0.02 and p =0.02, respectively), no statistically significant differences were observed between patients in SR with mitral valve area (MVA) <= 1.5 cm(2) and patients in AF. Four SR patients (13%) and six AF patients (27%) had LAA thrombus. A strong correlation was observed between the MVA and LAA peak emptying/filling velocity in patients with MS in SR (r = 0.739, p = 0.0001 and r = 0.728, p = 0.0001, respectively). Conclusion: The study results showed that LAA contractile function is diminished in patients with moderate-severe MS in SR, and to a similar degree as patients in AF. It was concluded that patients with moderate-severe MS in SR have a higher risk for thromboembolic events than MS patients in AF.Öğe Long-term Prognostic Significance of Pentraxin-3 in Patients with Non-ST Elevation Myocardial Infarction and Coronary Stenting(Galenos Publ House, 2022) Kucuk, Ugur; Kirilmaz, Bahadir; Ercan, ErtugrulAim: We aimed to investigate the relationship of serially measured pentraxin-3 (PTX3) levels with Gensini risk score and cardiovascular mortality in long-term follow-up in patients who underwent percutaneous coronary intervention (PCI) with the diagnosis of non -ST elevation myocardial infarction (NSTEMI) and stable angina pectoris (SAP). Materials and Methods: Our study was planned retrospectively, and the long-term cardiovascular mortality results of patients with NSTEMI and SAP, who underwent PCI, were evaluated. Our study consisted of two groups, including the study and the control groups. Eighteen patients with NSTEMI who underwent PCI were included in the study group, and 37 patients with a diagnosis of SAP were included in the control group. Blood samples were taken from all patients for PTX3 measurements at the time of admission, at the 8th and 24th hours. Gensini scores were calculated before PCI. Results: PTX3 levels measured at the eighth hour were found to be numerically and statistically significant in NSTEMI patients compared to SAP patients [13.37 (5.47-27.75) and 5 (3.83-12.42), p=0.006]. PTX3 values measured at the time of admission were found to be associated with Gensini score (r=0.299, p=0.026). PTX3 values measured at the eighth hour were found to be independent predictors of long-term cardiovascular mortality (Hazard ratio: 1.294, 95% confidence interval: 1024-1.653, p=0.039). Conclusion: PTX3 may be helpful in identifying individuals at high risk for cardiovascular mortality in the long term in NSTEMI patients.Öğe Microalbuminuria: a Cardiovascular Risk Factor(Aves Yayincilik, Ibrahim Kara, 2010) Ercan, ErtugrulAlbumin is a protein which is charged negatively. By correcting for the daily excretion of creatinine, the albumin creatinin ratio implicates the daily excretion of albumin in spot urine. Albuminuria is a cardiovascular risk factor in patients with diabetes, hypertension, and the general population. Urinary albumin excretion is independently associated with an increased risk of cardiovascular events, even after adjustment for risk factors. Risk has been shown to increase continuously with increasing urinary albumin levels. Urinary albumin excretion rate should be monitorized routinely in a group of patients with high cardiovascular risk.Öğe New fully automated software for assessment of brachial artery flow-mediated dilation with advantages of continuous measurement(Turkish Soc Cardiology, 2012) Ercan, Ertugrul; Kırılmaz, Bahadır; Kahraman, İsmail; Bayram, Vildan; Doğan, HüseyinObjective: Flow-mediated dilation (FMD) is used to evaluate endothelial functions. Computer-assisted analysis utilizing edge detection permits continuous measurements along the vessel wall. We have developed a new fully automated software program to allow accurate and reproducible measurement. Methods: FMD has been measured and analyzed in 18 coronary artery disease (CAD) patients and 17 controls both by manually and by the software developed (computer supported) methods. The agreement between methods was assessed by Bland-Altman analysis. Results: The mean age, body mass index and cardiovascular risk factors were higher in CAD group. Automated FMD% measurement for the control subjects was 18.3+/-8.5 and 6.8+/-6.5 for the CAD group (p=0.0001). The intraobserver and interobserver correlation for automated measurement was high (r=0.974, r=0.981, r=0.937, r=0.918, respectively). Manual FMD% at 60th second was correlated with automated FMD % (r=0.471, p=0.004). Conclusions: The new fully automated software (c) can be used to precise measurement of FMD with low intra-and interobserver variability than manual assessment. (Anadolu Kardiyol Derg 2012; 12: 553-9)Öğe Reel syndrome: dislodgement of an active fixation lead(Turkish Soc Cardiology, 2013) Saygi, Serkan; Kirilmaz, Bahadir; Yildiz, Hicran; Ercan, Ertugrul[Anstract Not Available]Öğe The influence of ?-adducin gene polymorpism on response of blood pressure to exercise in patients with hypertension(Aves Yayincilik, 2010) Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Turk, Ugur Onsel; Ergun, Metin; Akgoz, Semra; Islegen, CetinObjective: Clinical studies have indicated that an excessive response of blood pressure (BP) to exercise predicts risk of cardiovascular mortality. Although the mechanism responsible for the excessive BP response to exercise has not been revealed, there are some plausible mechanisms linking with underlying structural abnormalities in the cardiovascular system. Carriers of the Trp460 allele of the alpha-adducin Gly460Trp polymorphism have an increased risk of hypertension. The aim of the present study was to examine the influence of alpha-adducin gene polymorphism on response of BP to exercise in patients with hypertension. Methods: The cross-sectional observational study consisted of 49 hypertensive patients (29 women and 20 men; mean age, 53.1 +/- 8.8 years). All participants underwent a multistage exercise treadmill test according to the Bruce protocol. Arterial BPs were compared at rest, peak exercise and end of the recovery phase. Patients were classified according to their alpha-adducin gene polymorphisms; Gly460Gly homozygotes - Group 1 (n=28) and Trp460Trp homozygotes and Gly460Trp heterozygotes - Group 2 (n=21). Statistical analysis was performed using Chi-square, unpaired t, Mann-Whitney U and ANCOVA tests. Results: Mean exercise duration and mean exercise capacity in metabolic equivalents were not different between Group 1 and 2. The major finding of the study was that systolic BP responses at peak exercise and recovery period (3. min) were significantly higher (p=0.036) in hypertensive patients carrying at least one Trp460 allele of the alpha-adducin gene. Conclusion: Our results suggest that genetic variants that alter renal function and/or vasoreactivity are logical candidates to explain some of the individual variability in the BP response to exercise. (Anadolu Kardiyol Derg 2010; 10: 400-4)Öğe The relationship between adiponectin, NT-pro-BNP and left ventricular ejection fraction in non-cachectic patients with systolic heart failure: an observational study(Aves, 2013) Tengiz, Istemihan; Turk, Ugur Onsel; Alioglu, Emin; Kirilmaz, Bahadir; Tamer, Gulden S.; Tuzun, Nurullah; Ercan, ErtugrulObjective: NT-pro-brain natriuretic peptide (NT-proBNP) has been shown to be an accurate diagnostic marker in patients with heart failure (HF). Adiponectin (Adp) levels are increased in HF but its diagnostic value is still uncertain in these patients. The study was designed to investigate the possible association of these markers in non-cachectic patients with newly diagnosed systolic heart failure. Methods: Fifty-seven systolic HF patients and 20 matched controls were enrolled in an observational cross-sectional study. Physical and echocardiographic examinations were performed and serum Adp, NT-proBNP, tumor necrosis factor-alpha (TNF-alpha) levels were measured. Study variables were compared between the groups. Correlation analyses were done and the diagnostic validity of the markers was compared with ROC analysis. Results: Adp and NT-proBNP levels were significantly higher in HF group (20.19 +/- 12.9 vs. 7.65 +/- 4.6 mu g/mL; p<0.001 and 1051.74 +/- 606.2 vs. 222.53 +/- 65.6 pg/mL; p=0.002; respectively). TNF-alpha levels were similar between the groups (2.83 +/- 1.8 vs. 2.08 +/- 1.2 pg/mL; p=0.582). Correlation analysis showed significant association among Adp and NT-proBNP levels, (r=0.448; p<0.001), and left ventricular ejection fraction (LVEF) values (r=-0.466; p<0.001). The Adp and NT-proBNP showed comparable diagnostic performances with mean [95% confidence interval] areas under the curves of 0.857 (0.771-0.944) and 0.888 (0.815-0.960), respectively. Conclusion: There were significant correlation between Adp levels with NT-proBNP levels and LVEF values but no any association between Adp levels with body mass index values and TNF-alpha levels in patients with newly diagnosed systolic heart failure. The result may arouse suspicion about the hypothesis, which proposes that Adp levels simply reflects disease severity or cardiac cachexia in patients with HF.Öğe Thrombotic occlusion of a left main coronary artery in a patient with prosthetic mitral valve(Turkish Soc Cardiology, 2010) Saygi, Serkan; Alioglu, Emin; Turk, Ugur; Tuzun, Nurullah; Kirilmaz, Bahadir; Tengiz, Istemihan; Ercan, Ertugrul[Anstract Not Available]Öğe Vascular endothelial functions, carotid intima-media thickness, and soluble CD40 ligand levels in dipper and nondipper essential hypertensive patients(Springer Heidelberg, 2008) Alioglu, Emin; Turk, Ugur O.; Bicak, Firat; Tengiz, Istemihan; Atila, Dincer; Barisik, Vatan; Ercan, ErtugrulObjective The lack of nocturnal decline in blood pressure (BP) is associated with an increase in cardiovascular events. Soluble CD40 ligand (sCD40L) is involved in the pathogenesis of risk factor-related vascular damage. The purpose of this study was to examine the relationship between vascular endothelial functions, carotid intimamedia thickness (cIMT), plasma sCD40L levels and circadian BP profile in patients with essential hypertension. Material and methods The study population consisted of 81 essential hypertensive out-patients. BP dipping was defined as a night-to-day systolic and diastolic decrease >= 10%. Forty-seven dipper and 34 nondipper patients were compared. High sensitivity C-reactive protein (hs-CRP), sCD40L and urinary albumin were measured. Brachial artery flow-mediated dilatation (FMD) and cIMT was compared between the groups. Results sCD40L level (3.28 +/- 2.08 and 2.30 +/- 1.99 ng/ml, respectively, P = 0.036) and urinary albumin concentration (36.7 +/- 20.1 and 23 +/- 29.7 mg/l, respectively, P < 0.0001) were higher in nondippers than in dippers. Serum hs-CRP levels were not significantly different. FMD was found higher in dippers than nondippers (11.8 +/- 3.9% and 6.6 +/- 2.2%, respectively, P < 0.0001). The average cIMT was significantly higher in nondippers than dippers (0.928 +/- 0.060 Vs. 0.734 +/- 0.134 mm; P < 0.0001). Conclusions Nondipper patern has an additional negative effect on endothelial functions in hypertensive patients. Nondippers have enhanced sCD40L levels, which may contribute to their increased susceptibility to develop vascular damage.
