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Yılmaz AS, Kahraman F, Ersoy İ, Taylan G, Kaya EE, Aydın E, Karakayalı M, Öğütveren MM, Taşdelen AG, Kümet Ö, Gül M, Nurkoç SG, Atan Ş, Özgeyik M, Kılıç O, Toprak AM, Özbek M, Kertmen Ö, Şafak Ö, Mert GÖ, Demir M, Yavuz YE, Keleşoğlu Ş, Uçar M, Işık İB, Öncel CR, Cengil ME, Küçük U, Dindaş F, Altınsoy M, Akkaya F. Baseline Characteristics of a Patient Cohort and Predictors of In-hospital MORtality in CORonary Care Units (MORCOR-TURK) Trial in Türkiye. Turk Kardiyol Dern Ars 2024; 52:175-181. [PMID: 38573092 DOI: 10.5543/tkda.2023.67505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions.
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Affiliation(s)
- Ahmet Seyda Yılmaz
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Cardiology, Rize, Turkiye
| | - Fatih Kahraman
- Kütahya Evliya Çelebi Training and Research Hospital, Department of Cardiology, Kütahya, Turkiye
| | - İbrahim Ersoy
- Afyonkarahisar Science of Health University, Department of Cardiology, Afyon, Turkiye
| | - Gökay Taylan
- Trakya University, Department of Cardiology, Tekirdağ, Turkiye
| | - Emin Erdem Kaya
- Ersin Arslan Training and Research Hospital, Department of Cardiology, Gaziantep, Turkiye
| | - Ertan Aydın
- Giresun University, Department of Cardiology, Giresun, Turkiye
| | - Muammer Karakayalı
- Kafkas University Training and Research Hospital, Department of Cardiology, Kars, Turkiye
| | | | | | - Ömer Kümet
- Van Training and Research Hospital, Department of Cardiology, Van, Turkiye
| | - Murat Gül
- Aksaray University, Department of Cardiology, Aksaray, Turkiye
| | | | - Şeyhmus Atan
- Ankara University, Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Mehmet Özgeyik
- Eskişehir City Hospital, Department of Cardiology, Eskişehir, Turkiye
| | - Oğuz Kılıç
- Karaman Training and Research Hospital, Department of Cardiology, Karaman, Turkiye
| | - Aslıhan Merve Toprak
- Selçuk University, Faculty of Medicine, Department of Cardiology, Konya, Turkiye
| | - Mehmet Özbek
- Dicle University, Faculty of Medicine, Department of Cardiology, Diyarbakır, Turkiye
| | - Ömer Kertmen
- Amasya Training and Research Hospital, Department of Cardiology, Amasya, Turkiye
| | - Özgen Şafak
- Balıkesir University, Faculty of Medicine, Department of Cardiology, Balıkesir, Turkiye
| | - Gurbet Özge Mert
- Osmangazi University, Faculty of Medicine, Department of Cardiology, Eskişehir, Turkiye
| | - Mevlüt Demir
- Kütahya Evliya Çelebi Training and Research Hospital, Department of Cardiology, Kütahya, Turkiye
| | - Yunus Emre Yavuz
- Siirt Training and Research Hospital, Department of Cardiology, Siirt, Turkiye
| | - Şaban Keleşoğlu
- Erciyes University, Faculty of Medicine, Department of Cardiology, Kayseri, Turkiye
| | - Melisa Uçar
- Samsun Training and Research Hospital, Department of Cardiology, Samsun, Turkiye
| | | | - Can Ramazan Öncel
- Alanya Alaaddin Keykubat University, Department of Cardiology, Antalya, Turkiye
| | | | - Uğur Küçük
- Çanakkale 18 Mart University, Department of Cardiology, Çanakkale, Turkiye
| | - Ferhat Dindaş
- Uşak Training and Research Hospital, Department of Cardiology, Uşak, Turkiye
| | - Meltem Altınsoy
- Ankara Etlik City Hospital, Department of Cardiology, Ankara, Turkiye
| | - Fatih Akkaya
- Ordu University, Faculty of Medicine, Department of Cardiology, Ordu, Turkiye
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Oktay V, Tüfekçioğlu O, Çicek Yılmaz D, Onrat E, Karabulut D, Çelik M, Serhat Balcıoğlu A, Murat Sucu M, Özdemir G, Kaya H, Kış M, Güven B, Bağdatoğlu O, Nihan Turhan Çağlar F, Çağdaş Yüksel U, Veysel Düzen İ, Barutçu A, Semih Şimşir Ö, Başarıcı İ, Parspur A, Dalgıç O, Özlem Arıcan Özlük F, Evlice M, Sağ S, Furkan Deniz M, Öcal A, Gazi E, Şen T, Özdabakoğlu O, Bayar Çakıcı N, Ozan Bakır E, Ülgen Kunak A, Çaylı G, Gül Taşdelen A, Akşit E, Uslu Çil Ş, Onay H. The Definition of Sarcomeric and Non-Sarcomeric Gene Mutations in Hypertrophic Cardiomyopathy Patients: A Multicenter Diagnostic Study Across Türkiye. Anatol J Cardiol 2023; 27:628-638. [PMID: 37466024 PMCID: PMC10621609 DOI: 10.14744/anatoljcardiol.2023.2805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/29/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a common genetic heart disease and up to 40%-60% of patients have mutations in cardiac sarcomere protein genes. This genetic diagnosis study aimed to detect pathogenic or likely pathogenic sarcomeric and non-sarcomeric gene mutations and to confirm a final molecular diagnosis in patients diagnosed with hypertrophic cardiomyopathy. METHODS A total of 392 patients with hypertrophic cardiomyopathy were included in this nationwide multicenter study conducted at 23 centers across Türkiye. All samples were analyzed with a 17-gene hypertrophic cardiomyopathy panel using next-generation sequencing technology. The gene panel includes ACTC1, DES, FLNC, GLA, LAMP2, MYBPC3, MYH7, MYL2, MYL3, PLN, PRKAG2, PTPN11, TNNC1, TNNI3, TNNT2, TPM1, and TTR genes. RESULTS The next-generation sequencing panel identified positive genetic variants (variants of unknown significance, likely pathogenic or pathogenic) in 12 genes for 121 of 392 samples, including sarcomeric gene mutations in 30.4% (119/392) of samples tested, galactosidase alpha variants in 0.5% (2/392) of samples and TTR variant in 0.025% (1/392). The likely pathogenic or pathogenic variants identified in 69 (57.0%) of 121 positive samples yielded a confirmed molecular diagnosis. The diagnostic yield was 17.1% (15.8% for hypertrophic cardiomyopathy variants) for hypertrophic cardiomyopathy and hypertrophic cardiomyopathy phenocopies and 0.5% for Fabry disease. CONCLUSIONS Our study showed that the distribution of genetic mutations, the prevalence of Fabry disease, and TTR amyloidosis in the Turkish population diagnosed with hypertrophic cardiomyopathy were similar to the other populations, but the percentage of sarcomeric gene mutations was slightly lower.
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Affiliation(s)
- Veysel Oktay
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | | | - Dilek Çicek Yılmaz
- Department of Cardiology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ersel Onrat
- Department of Cardiology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Türkiye
| | - Dilay Karabulut
- Clinic of Cardiology, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Murat Çelik
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Akif Serhat Balcıoğlu
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye
| | - Mehmet Murat Sucu
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Güllü Özdemir
- Clinic of Cardiology, Private Çekirge Heart and Arrhythmia Hospital, Bursa, Türkiye
| | - Hakkı Kaya
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Mehmet Kış
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
| | - Barış Güven
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | | | | | - Uygar Çağdaş Yüksel
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - İrfan Veysel Düzen
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Ahmet Barutçu
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | | | - İbrahim Başarıcı
- Department of Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Afşin Parspur
- Clinic of Cardiology, Kütahya University of Health Sciences, Evliya Çelebi Training and Research Hospital, Kütahya, Türkiye
| | - Onur Dalgıç
- Clinic of Cardiology, Private Kardiya Cardiology Center, İzmir, Türkiye
| | | | - Mert Evlice
- Clinics of Cardiology, Adana City Hospital, Adana, Türkiye
| | - Saim Sağ
- Clinic of Cardiology, Acıbadem Bursa Hospital, Bursa, Türkiye
| | - Muhammed Furkan Deniz
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | - Arslan Öcal
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Emine Gazi
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Taner Şen
- Clinic of Cardiology, Kütahya University of Health Sciences, Evliya Çelebi Training and Research Hospital, Kütahya, Türkiye
| | | | - Nermin Bayar Çakıcı
- Department of Cardiology, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Eren Ozan Bakır
- Department of Cardiology, Faculty of Medicine, Celal Bayar University, Manisa, Türkiye
| | | | - Gizem Çaylı
- Medical Affairs Rare Diseases, Sanofi, İstanbul, Türkiye
| | - Aybike Gül Taşdelen
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | - Ercan Akşit
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | | | - Hüseyin Onay
- Gene2Info Health Informatics, İstanbul, Türkiye
- Multigen Genetic Diseases Diagnosis Center, İzmir, Türkiye
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Arabacı HO, Taşdelen AG, Buğday İ, Ülkücü A, Sinan ÜY, Yıldızeli B, Küçükoğlu MS. A Breathtaking Case of Pulmonary Hypertension with Frightening Complications and Intertwining Different Etiologies. Turk Kardiyol Dern Ars 2023; 51:488-492. [PMID: 37861255 DOI: 10.5543/tkda.2023.22477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Pulmonary hypertension (PH) is a major health problem with increasing awareness. Although most common cause of PH is left heart disease (Group 2 PH), life-threatening complications occur mostly in Group 1 (pulmonary arterial hypertension) and Group 4 (chronic thromboembolic PH) patients. Although external compression of the left main coronary artery (LMCA) due to pulmonary artery dilatation is rare, it is a life-threatening complication since it causes myocardial ischemia and sudden cardiac death. In addition, PH is more than a single clinical entity due to its complex mechanism in which more than one subgroup may develop over time in the same patient. This complex mechanism challenges us when diagnosing the patient and faces us with life-threatening complications. In this case; we report a pulmonary arterial hypertension patient applied to our clinic with progressive dyspnea and recent angina, after detection of LMCA ostial stenosis, the patient was treated with intravascular ultrasound-guided stent implantation. In the further follow-ups, the patient underwent the pulmonary endarterectomy operation due to the diagnosis of chronic thromboembolic pulmonary hypertension secondary to newly diagnosed primary antiphospholipid syndrome.
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Affiliation(s)
- Hidayet Ozan Arabacı
- Department of Cardiology, İstanbul University-Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
| | - Aybike Gül Taşdelen
- Department of Cardiology, İstanbul University-Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
| | - İdil Buğday
- Department of Cardiology, İstanbul University-Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
| | - Attila Ülkücü
- Department of Emergency, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Ümit Yaşar Sinan
- Department of Cardiology, İstanbul University-Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
| | - Bedrettin Yıldızeli
- Department of Thoracic Surgery, Marmara University, Faculty of Medicine, İstanbul, Türkiye
| | - Mehmet Serdar Küçükoğlu
- Department of Cardiology, İstanbul University-Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
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4
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Oktay V, Tüfekçioğlu O, Yılmaz DÇ, Onrat E, Karabulut D, Çelik M, Balcıoğlu AS, Sucu MM, Özdemir G, Kaya H, Kış M, Güven B, Bağdatoğlu O, Turhan Çağlar FN, Yüksel UÇ, Düzen İV, Barutçu A, Şimşir ÖS, Başarıcı İ, Parspur A, Dalgıç O, Arıcan Özlük FÖ, Evlice M, Sağ S, Deniz MF, Öcal A, Gazi E, Şen T, Özdabakoğlu O, Bayar Çakıcı N, Bakır EO, Ülgen Kunak A, Çaylı G, Gül Taşdelen A, Akşit E, Uslu Çil Ş, Onay H. The Definition of Sarcomeric and Non-Sarcomeric Gene Mutations in Hypertrophic Cardiomyopathy Patients: A Multicenter Diagnostic Study Across Türkiye. Anatol J Cardiol 2023. [PMID: 37466024 DOI: oi10.14744/anatoljcardiol.2023.2805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a common genetic heart disease and up to 40%-60% of patients have mutations in cardiac sarcomere protein genes. This genetic diagnosis study aimed to detect pathogenic or likely pathogenic sarcomeric and non-sarcomeric gene mutations and to confirm a final molecular diagnosis in patients diagnosed with hypertrophic cardiomyopathy. METHODS A total of 392 patients with hypertrophic cardiomyopathy were included in this nationwide multicenter study conducted at 23 centers across Türkiye. All samples were analyzed with a 17-gene hypertrophic cardiomyopathy panel using next-generation sequencing technology. The gene panel includes ACTC1, DES, FLNC, GLA, LAMP2, MYBPC3, MYH7, MYL2, MYL3, PLN, PRKAG2, PTPN11, TNNC1, TNNI3, TNNT2, TPM1, and TTR genes. RESULTS The next-generation sequencing panel identified positive genetic variants (variants of unknown significance, likely pathogenic or pathogenic) in 12 genes for 121 of 392 samples, including sarcomeric gene mutations in 30.4% (119/392) of samples tested, galactosidase alpha variants in 0.5% (2/392) of samples and TTR variant in 0.025% (1/392). The likely pathogenic or pathogenic variants identified in 69 (57.0%) of 121 positive samples yielded a confirmed molecular diagnosis. The diagnostic yield was 17.1% (15.8% for hypertrophic cardiomyopathy variants) for hypertrophic cardiomyopathy and hypertrophic cardiomyopathy phenocopies and 0.5% for Fabry disease. CONCLUSIONS Our study showed that the distribution of genetic mutations, the prevalence of Fabry disease, and TTR amyloidosis in the Turkish population diagnosed with hypertrophic cardiomyopathy were similar to the other populations, but the percentage of sarcomeric gene mutations was slightly lower.
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Affiliation(s)
- Veysel Oktay
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | | | - Dilek Çicek Yılmaz
- Department of Cardiology, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ersel Onrat
- Department of Cardiology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Türkiye
| | - Dilay Karabulut
- Clinic of Cardiology, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Murat Çelik
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Akif Serhat Balcıoğlu
- Department of Cardiology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye
| | - Mehmet Murat Sucu
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Güllü Özdemir
- Clinic of Cardiology, Private Çekirge Heart and Arrhythmia Hospital, Bursa, Türkiye
| | - Hakkı Kaya
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Mehmet Kış
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
| | - Barış Güven
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | - Oktay Bağdatoğlu
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | | | - Uygar Çağdaş Yüksel
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - İrfan Veysel Düzen
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Ahmet Barutçu
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | | | - İbrahim Başarıcı
- Clinic of Cardiology, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Afşin Parspur
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Onur Dalgıç
- Department of Cardiology, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
| | - Fatma Özlem Arıcan Özlük
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Mert Evlice
- Medical Affairs Rare Diseases, Sanofi, İstanbul, Türkiye
| | - Saim Sağ
- Department of Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Muhammed Furkan Deniz
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | - Arslan Öcal
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Emine Gazi
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Taner Şen
- Department of Cardiology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| | - Osman Özdabakoğlu
- Department of Cardiology, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | - Nermin Bayar Çakıcı
- Clinic of Cardiology, Kütahya University of Health Sciences, Evliya Çelebi Training and Research Hospital, Kütahya, Türkiye
| | - Eren Ozan Bakır
- Clinic of Cardiology, Private Kardiya Cardiology Center, İzmir, Türkiye
| | | | - Gizem Çaylı
- Clinic of Nephrology, Ankara City Hospital, Ankara, Türkiye
| | - Aybike Gül Taşdelen
- Department of Cardiology, İstanbul University-Cerrahpaşa, Institute of Cardiology, İstanbul, Türkiye
| | - Ercan Akşit
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | | | - Hüseyin Onay
- Clinics of Cardiology, Adana City Hospital, Adana, Türkiye
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