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Gultekin SS, Sadic M, Bilgin M, Koca G, Acikel S, Yeter E, Korkmaz M. The value of transient ischemic dilation for detecting restenosis after coronary artery revascularization. J Nucl Cardiol 2018; 25:586-592. [PMID: 27663249 DOI: 10.1007/s12350-016-0607-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/11/2016] [Accepted: 07/11/2016] [Indexed: 11/29/2022]
Abstract
AIM Transient ischemic dilation (TID) is a marker of severe coronary artery disease (CAD). We aimed to assess the incremental value of TID in a cohort of patients with known significant CAD who had recurrence of symptoms after revascularization. METHODS We identified in our databases 104 patients who had recent coronary revascularization and recurrence of symptoms. 62 patients had PCI (75 arteries) and 42 patients had CABG (104 arteries). All had follow-up stress SPECT MPI and repeat coronary angiography. Myocardial perfusion findings of ischemia and TID were correlated with presence of significant obstructive CAD (>70% stenosis). RESULTS Follow-up stress Tc-99m Sestamibi SPECT MPI revealed inducible ischemia in 38 patients (36.5%) and TID > 1.20 in 49 patients (47%). Subsequent coronary angiography showed significant obstructive CAD in 44 patients (42%). The sensitivity for detecting obstructive CAD was 61% for SPECT MPI alone, but increased significantly to 93% by the addition of TID as a diagnostic criterion (P < 0.0001). CONCLUSIONS In this selected patient cohort with prior coronary revascularization, TID is an important marker of obstructive CAD and has incremental value over SPECT MPI alone.
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Affiliation(s)
- Salih Sinan Gultekin
- Department of Nuclear Medicine, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Etlik, Ankara, Turkey.
| | - Murat Sadic
- Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey
| | - Gökhan Koca
- Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey
| | - Sadik Acikel
- Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey
| | - Meliha Korkmaz
- Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey
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2
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Cimen T, Algul E, Efe TH, Sunman H, Yeter E. Flash pulmonary edema: A rare cause and possible mechanisms. Turk J Emerg Med 2017; 17:65-67. [PMID: 28616618 PMCID: PMC5459517 DOI: 10.1016/j.tjem.2016.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 07/21/2016] [Accepted: 08/10/2016] [Indexed: 12/01/2022] Open
Abstract
Flash pulmonary edema frequently develop in case of bilateral renal artery stenosis and unilateral renal artery stenosis with functional solitary kidney. In some rare cases, unilateral renal artery stenosis with bilaterally functional kidneys may also lead to flash pulmonary edema. Here, we present a case of flash pulmonary edema caused by accessory renal artery stenosis. To our knowledge, it is the first case reported in the literature.
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Affiliation(s)
- Tolga Cimen
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Engin Algul
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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3
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Çimen T, Sunman H, Efe TH, Akyel A, Yayla K, Şahan HF, Bilgin M, Asarcıklı LD, Nallbani A, Doğan M, Açıkel S, Yeter E. Early changes in atrial conduction times in hypertensive patients with elevated pulse pressure. Rev Port Cardiol 2017; 36:453-459. [DOI: 10.1016/j.repc.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/09/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
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4
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Gok Oguz E, Akoglu H, Ulusal Okyay G, Karaveli Gursoy G, Yildirim T, Merhametsiz O, Cimen T, Canbakan B, Yeter E, Ayli MD. Increased serum renalase in peritoneal dialysis patients: Is it related to cardiovascular disease risk? Nefrologia 2017; 37:189-194. [PMID: 28160962 DOI: 10.1016/j.nefro.2016.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 10/12/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Renalase, with possible monoamine oxidase activity, is implicated in degradation of catecholamines; which suggests novel mechanisms of cardiovascular complications in patients with chronic kidney diseases. Epicardial adipose tissue (EAT) has been found to correlate with cardiovascular diseases (CVD) in dialysis patients. The present study aimed to evaluate the association of serum renalase levels with EAT thickness and other CVD risk factors in peritoneal dialysis (PD) patients. METHODS The study included 40 PD patients and 40 healthy controls. All subjects underwent blood pressure and anthropometric measurements. Serum renalase was assessed by using a commercially available assay. Transthoracic echocardiography was used to measure EAT thickness and left ventricular mass index (LVMI) in all subjects. RESULTS The median serum renalase level was significantly higher in the PD patients than in the control group [176.5 (100-278.3) vs 122 (53.3-170.0)ng/ml] (p=0.001). Renalase was positively correlated with C-reactive protein (r=0.705, p<0.001) and negatively correlated with RRF (r=-0.511, p=0.021). No correlation was observed between renalase and EAT thickness or LVMI. There was a strong correlation between EAT thickness and LVMI in both the PD patients and the controls (r=0.848, p<0.001 and r=0.640, p<0.001 respectively). CONCLUSIONS This study indicates that renalase is associated with CRP and residual renal function but not with EAT thickness as CVD risk factors in PD patients.
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Affiliation(s)
- Ebru Gok Oguz
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey.
| | - Hadim Akoglu
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Gulay Ulusal Okyay
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Guner Karaveli Gursoy
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Tolga Yildirim
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Ozgur Merhametsiz
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Tolga Cimen
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Basol Canbakan
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Ekrem Yeter
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - M Deniz Ayli
- Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
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5
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Çimen T, Sunman H, Efe TH, Erat M, Şahan HF, Algül E, Guliyev İ, Akyel A, Doğan M, Açıkel S, Yeter E. The relationship between 24-hour ambulatory blood pressure load and neutrophil-to-lymphocyte ratio. Rev Port Cardiol 2017; 36:97-105. [PMID: 28159426 DOI: 10.1016/j.repc.2016.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE The neutrophil-to-lymphocyte ratio (NLR) is established as a reliable marker of systemic inflammation. Low-grade inflammation has a key role in the pathogenesis and progression of hypertension (HTN). Blood pressure (BP) load, defined as the percentage of abnormally elevated BP readings, is a good marker of HTN severity. We aimed to evaluate the relationship between HTN severity and NLR using averaged ambulatory BP readings and BP load. METHODS A total of 300 patients with untreated essential HTN were included in this cross-sectional study. Patients were divided into quartiles according to NLR values (first: <1.55; second: 1.55-1.92; third: 1.92-2.48; and fourth: >2.48). Averaged ambulatory BP values and BP load were assessed for each quartile. RESULTS In the interquartile evaluation there were no differences between quartiles in terms of baseline demographic, clinical and echocardiographic characteristics (p>0.05). Daytime systolic BP (SBP), 24-hour diastolic BP (DBP), daytime DBP, daytime SBP load, 24-hour DBP load and daytime DBP load were found to be significantly higher in the upper two quartiles (p<0.05 for all). In correlation analysis, log NLR values were found to be positively correlated with 24-hour SBP, DBP, SBP load and DBP load (Pearson coefficients of 0.194, 0.197, 0.157 and 0.181, respectively; p<0.01 for all). In multivariate analysis, log NLR had an independent association with 24-hour SBP and DBP and 24-hour SBP and DBP load. CONCLUSION This study showed for the first time that increased NLR is independently associated with HTN severity in untreated essential HTN patients.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Mehmet Erat
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Haluk Furkan Şahan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Engin Algül
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - İlkin Guliyev
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sadık Açıkel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Sunman H, Erat M, Gayretli Yayla K, Algül E, Aytürk M, Dinç Asarcıklı L, Bilgin M, Çimen T, Akyel A, Açıkel S, Doğan M, Yeter E. Comparison of coronary artery dimensions in patients with chronic aortic regurgitation or stenosis. Turk Kardiyol Dern Ars 2017; 44:656-662. [PMID: 28045411 DOI: 10.5543/tkda.2016.25852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Effects of various conditions on coronary artery dimensions is an important research topic, and data regarding effect of aortic valvular diseases are limited. Aim of the present study was to investigate effects of aortic regurgitation (AR) and aortic stenosis (AS) on coronary artery dimensions. METHODS Coronary dimensions of 95 patients (35 with isolated AR, 30 with isolated AS, and 30 without any valvular disease) were calculated. Patients with severe coronary artery disease and concurrent moderate to severe additional valvular disease were excluded. Mean diameter of major coronary arteries was determined using quantitative coronary angiography. RESULTS The 3 study groups were similar in terms of baseline characteristics. Diameter of left main coronary artery was found to be greater in AR group than AS group (2.66±0.57 mm/m2 vs 2.36±0.49 mm/m2; p=0.015). Mean diameter of left anterior descending and left circumflex arteries were found to be similar in AR and AS groups, and greater than control group. Mean diameter of right coronary artery was found to be greater in AR group compared with controls; however, no significant difference was found in same measurement between AS group and controls. CONCLUSION Present study findings indicate that coronary dimensions in AR group tend to be greater than AS group. Further studies investigating factors that affect coronary dimensions would be beneficial in order to demonstrate mechanisms and differences in AR and AS groups.
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Affiliation(s)
- Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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7
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Efe TH, Arslan ED, Ertem AG, Yayla Ç, Felekoğlu MA, İnci S, Çimen T, Erken Pamukcu1 H, Aydın M, Bilgin M, Yeter E. The Prognostic Value of the Monocyte/HDL Ratio in Predicting Short-term Mortality in Patients with Acute Pulmonary Embolism. ACTA ACUST UNITED AC 2016. [DOI: 10.5578/khj.23104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Efe TH, Açar B, Ertem AG, Yayla KG, Algül E, Yayla Ç, Ünal S, Bilgin M, Çimen T, Kirbaş Ö, Yeter E. Serum Irisin Level Can Predict the Severity of Coronary Artery Disease in Patients with Stable Angina. Korean Circ J 2016; 47:44-49. [PMID: 28154590 PMCID: PMC5287186 DOI: 10.4070/kcj.2016.0079] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/01/2016] [Accepted: 07/07/2016] [Indexed: 01/07/2023] Open
Abstract
Background and Objectives The recently discovered myokine irisin has a proposed role in adipose tissue metabolism. The aim of this study was to evaluate the relationship between serum irisin level and the coronary artery severity in patients with stable coronary artery disease (CAD). Subjects and Methods Sixty-three patients who underwent coronary angiography (CA) diagnosed with stable CAD and twenty-six patients with normal coronary artery (NCA) were enrolled in the study. Stable CAD patients were divided into two groups as high synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score (≥23) and lower SYNTAX score (<23). Serum irisin level measurement was carried out using human irisin colorimetric enzyme-linked immunosorbent assay (ELISA) commercial kit (AG-45A-0046EK-KI01, Adipogen, San Diego, CA, USA) as recommended by the manufacturer's protocol. Results The patients with stable CAD with a higher SYNTAX score (score ≥23) had significantly lower serum irisin levels (127.91±55.38 ng/mL), as compared the patients with a low SYNTAX score (score <23) (224.69±92.99 ng/mL) and control group (299.54±123.20 ng/mL). Irisin levels showed significant differences between all groups (p<0.001). Conclusion Serum irisin level is an independent predictor of coronary artery severity in patients with stable CAD.
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Affiliation(s)
- Tolga Han Efe
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Burak Açar
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Göktuğ Ertem
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Engin Algül
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sefa Ünal
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Murat Bilgin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Tolga Çimen
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Özgür Kirbaş
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Vural MG, Çetin S, Gündüz H, Özcan Abacıoğlu Ö, Akdemir R, Fırat H, Yeter E. Assessment of left atrial appendage function during sinus rhythm in patients with obstructive sleep apnea. Anatol J Cardiol 2016; 16:34-41. [PMID: 26467361 PMCID: PMC5336703 DOI: 10.5152/akd.2015.5751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective: Obstructive sleep apnea (OSA) is associated with thromboembolic events. Compromised left atrial appendage (LAA) function due to left ventricular (LV) performance abnormality, often present in patients with OSA, may play an important role. The purpose of this study is to evaluate LV and LAA mechanical functions during sinus rhythm (SR) in patients with OSA. Methods: LV and LAA functions were assessed in 43 OSA patients and compared with that of 20 control patients in SR. Tissue Doppler velocities of the LAA apex and emptying velocities (EV) of LAA were obtained on parasternal short-axis view. Results: The baseline clinical characteristics were similar except for AHI (apnea-hypopnea index), minimal SaO2, mean SaO2, hypertension, and body-surface area. Most of the LV echocardiographic parameters significantly deteriorated in OSA patients in comparison with those in the control group. LAA EV, LAA systolic relaxation velocity (SM), LAA early-diastolic velocity (EM), LAA contraction velocity (AM), left atrial (LA) minimum volume index, LA ejection fraction, LA conduit volume index, and LA reservoir volume index were lower in OSA patients compared with those in the control group (p<0.05). LAA AM was negatively correlated with AHI and the ratio of peak early diastolic flow velocity (E) to early-diastolic (E’) and positively correlated with LA conduit volume (p<0.05). Multiple predictors for LAA AM were AHI, presence of diastolic dysfunction, and E/E’ values (p<0.05). Conclusion: LAA mechanical function is significantly depressed in patients with OSA and SR. LAA dysfunction may predispose these patients to thromboembolic events. The evaluation of LAA mechanical function by tissue Doppler study using transthoracic echocardiography (TTE) may become an alternative for routine work-up in OSA patients.
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Affiliation(s)
- Mustafa Gökhan Vural
- Department of Cardiology, Faculty of Cardiology, Sakarya University; Sakarya-Turkey.
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10
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Efe TH, Gayretli Yayla K, Yayla C, Ertem AG, Cimen T, Erken Pamukcu H, Bilgin M, Erat M, Dogan M, Yeter E. Calcific aortic stenosis and its correlation with a novel inflammatory marker, the lymphocyte/monocyte ratio. Rev Port Cardiol 2016; 35:573-578. [DOI: 10.1016/j.repc.2016.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 02/07/2023] Open
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11
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Efe TH, Gayretli Yayla K, Yayla C, Ertem AG, Cimen T, Erken Pamukcu H, Bilgin M, Erat M, Dogan M, Yeter E. Calcific aortic stenosis and its correlation with a novel inflammatory marker, the lymphocyte/monocyte ratio. Revista Portuguesa de Cardiologia (English Edition) 2016. [DOI: 10.1016/j.repce.2016.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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12
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Çimen T, Bilgin M, Akyel A, Felekoğlu MA, Nallbani A, Özdemir Ş, Erden G, Öztürk A, Doğan M, Yeter E. Endocan and Non-Dipping Circadian Pattern in Newly Diagnosed Essential Hypertension. Korean Circ J 2016; 46:827-833. [PMID: 27826342 PMCID: PMC5099339 DOI: 10.4070/kcj.2016.46.6.827] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/27/2016] [Accepted: 04/05/2016] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension. Subjects and Methods Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded. Results Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern. Conclusion Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Felekoğlu
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ali Nallbani
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Şeyda Özdemir
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gönül Erden
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Alpaslan Öztürk
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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13
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Efe TH, Cimen T, Ertem AG, Coskun Y, Bilgin M, Sahan HF, Pamukcu HE, Yayla C, Sunman H, Yuksel I, Yeter E. Atrial Electromechanical Properties in Inflammatory Bowel Disease. Echocardiography 2016; 33:1309-16. [PMID: 27158773 DOI: 10.1111/echo.13261] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There is much evidence linking inflammation to the initiation and continuation of atrial fibrillation (AF). Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic systemic inflammatory disorders. Atrial electromechanical delay (EMD) has been known as an early marker of AF. The objectives of this study were to evaluate the atrial electromechanical properties in patients with IBD. METHODS Fifty-two patients with IBD and 26 healthy controls were recruited in the study. Twenty-five of patients with IBD were on active period, and the remaining 27 were on remission period. Atrial electromechanical properties were measured by using transthoracic echocardiography and tissue Doppler imaging and simultaneous surface ECG recording. Interatrial EMD, left intraatrial EMD, and right intraatrial EMD were calculated. RESULTS Patients on activation with IBD had significantly prolonged left and right intraatrial EMDs and interatrial EMD compared to patients on remission (P = 0.048, P = 0.036, P < 0.001, respectively) and healthy controls (P < 0.001, for all comparisons). Left and right intraatrial EMDs and interatrial EMD were also found to be higher when patients on remission with IBD compared with healthy controls. No statistical difference was observed between UC and CD in terms of inter- and intraatrial EMDs. CONCLUSIONS Atrial electromechanical conduction is prolonged in IBD, and exposure to chronic inflammation may lead to structural and electrophysiological changes in the atrial tissue that causes slow conduction. Measurement of atrial EMD parameters might be used to predict the risk for the development of AF in patients with IBD.
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Affiliation(s)
- Tolga Han Efe
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey.
| | - Tolga Cimen
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
| | - Ahmet Goktug Ertem
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Training Hospital, Ankara, Turkey
| | - Yusuf Coskun
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
| | - Haluk Furkan Sahan
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
| | - Hilal Erken Pamukcu
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
| | - Cagri Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Training Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
| | - Ilhami Yuksel
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Training Hospital, Ankara, Turkey
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Oguz EG, Gursoy GK, Yayar O, Yildirim T, Cimen T, Bulut C, Eser B, Canbakan B, Yeter E, Ayli MD. Increased serum renalase in hemodialysis patients: is it related to left ventricular hypertrophy? Ren Fail 2016; 38:1180-6. [PMID: 27416751 DOI: 10.1080/0886022x.2016.1208516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end stage renal disease (ESRD). Hypertension, diabetes, increased body mass index, gender, age, anemia, and hyperparathyroidism have been described as risk factors for LVH in patients on dialysis. However, there may be other risk factors which have not been described yet. Recent studies show that renalase is associated with cardiovascular events. The aim of this study was to reveal the relation between renalase, LVH in patients under hemodialysis (HD) treatment. METHODS The study included 50 HD patients and 35 healthy controls. Serum renalase levels and left ventricle mass index (LVMI) were measured in all participants and the relation between these variables was examined. FINDINGS LVMI was positively correlated with dialysis vintage and C-reactive protein (CRP) (r = 0.387, p = 0.005 and r = 0.597, p < 0.001, respectively) and was negatively correlated with residual diuresis and hemoglobin levels (r = -0.324, p = 0.022 and r = -0.499, p < 0.001, respectively). There was no significant association of renalase with LVMI in the HD patients (r = 0.263, p = 0.065). Serum renalase levels were significantly higher in HD patients (212 ± 127 ng/mL) compared to controls (116 ± 67 ng/mL) (p < 0.001). Renalase was positively correlated with serum creatinine and dialysis vintage (r = 0.677, p < 0.001 and r = 0.625, p < 0.001, respectively). DISCUSSION In our study, LVMI was correlated with dialysis vintage, residual diuresis, CRP, and hemoglobin. LVMI tends to correlate with renalase and this correlation may be significant in studies with more patient numbers. The main parameters affecting renalase levels are dialysis vintage and serum creatinine.
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Affiliation(s)
- Ebru Gok Oguz
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Guner Karaveli Gursoy
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Ozlem Yayar
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Tolga Yildirim
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Tolga Cimen
- b Department of Cardiology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Cengiz Bulut
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Barıs Eser
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Basol Canbakan
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Ekrem Yeter
- b Department of Cardiology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - M Deniz Ayli
- a Department of Nephrology , Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
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Çimen T, Efe TH, Akyel A, Sunman H, Algül E, Şahan HF, Erden G, Özdemir Ş, Alay EF, Doğan M, Yeter E. Human Endothelial Cell-Specific Molecule-1 (Endocan) and Coronary Artery Disease and Microvascular Angina. Angiology 2016; 67:846-53. [DOI: 10.1177/0003319715625827] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endothelial cell-specific molecule-1 (endocan) is an immunoinflammatory marker linked to endothelial activation and dysfunction. We investigated the relationship between obstructive coronary artery disease (CAD), microvascular angina (MVA), and plasma levels of endocan. We included 53 healthy individuals as controls, 40 MVA patients, and 120 patients with obstructive CAD. The severity of CAD was assessed by the Gensini and SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery (SYNTAX) scores. Endocan levels were 382.7 (313.8-470.2) pg/mL in patients with obstructive CAD; 324.3 (277.1-460.7) pg/mL in MVA group, and 268.0 (226.4-336.5) pg/mL ( P < .001) in controls. Endocan levels in obstructive CAD and MVA groups were similar but both were significantly higher than for the control group ( P < .001 and P = .002, respectively). In subgroup analysis, similar to the hypertensive subgroup results, endocan was still an independent predictor of presence of obstructive CAD in normotensives (odds ratio = 1.005, 95% confidence interval = 1.001-1.010, P = .024). There was also an independent positive correlation between endocan levels and SYNTAX score both in the hypertensives (β = 0.414, t = 3.21, P = .002) and in the normotensives (β = .301, t = 2.23, P = .031). In conclusion, endocan could be a common predictor of the endothelium-dependent inflammatory processes, rather than related with specific risk factors.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Engin Algül
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Haluk Furkan Şahan
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gönül Erden
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Şeyda Özdemir
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Emine Figen Alay
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Efe TH, Arslan ED, Ertem AG, Yayla Ç, Şahan HF, Felekoğlu MA, Algül E, Genç S, Yeter E. PP-103 The Prognostic Value of the Monocyte / HDL ratio in Predicting Short-term Mortality in Patients with Acute Pulmonary Embolism. Am J Cardiol 2016. [DOI: 10.1016/j.amjcard.2016.04.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Efe TH, Felekoglu MA, Sabanoglu C, Yeter E, Doğan M. OP-099 Paroxysmal Atrial Fibrillation Following Synthetic Cannabinoid Abuse. Am J Cardiol 2016. [DOI: 10.1016/j.amjcard.2016.04.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Dinç Asarcikli L, Efe TH, Yucesoy C, Ertem AG, Acar B, Topaloglu N, Beton O, Yeter E. PP-180 Breast Arterial Calcifications on Mammogram Predicts Aortic Stiffness. Am J Cardiol 2016. [DOI: 10.1016/j.amjcard.2016.04.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gok Oguz E, Karaveli Gursoy G, Yayar O, Yildirim T, Cimen T, Bulut C, Eser B, Canbakan B, Yeter E, Ercan Z, Ayli MD. MP552THE RELATION BETWEEN RENALASE LEVELS ANDLEFT VENTRICULAR HYPERTROPHY IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw196.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Tokgözoğlu L, Özdemir R, Altındağ R, Ceyhan C, Yeter E, Öztürk C, Bayram F, Delibaşı T, Değertekin M, Dinçkal MH, Keleş İ, Fak AS, Aydoğdu S, Zorkun C, Tartan Z. Patient characteristics and statin discontinuation-related factors during treatment of hypercholesterolemia: an observational non-interventional study in patients with statin discontinuation (STAY study). Turk Kardiyol Dern Ars 2016; 44:53-64. [PMID: 26875131 DOI: 10.5543/tkda.2015.47041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The purpose of this study was to identify patient characteristics and statin discontinuation-related factors in patients with hypercholesterolemia. METHODS A total of 532 patients (age mean±SD: 57.4±11.5 years; 52.4% women, 47.6% men) with hypercholesterolemia and statin discontinuation were included in this national cross-sectional non-interventional observational study. Data on socio-demographic characteristics of patients, cardiovascular risk factors, past treatment with and discontinuation of statin treatment were collected in one visit. RESULTS Mean±SD duration of hypercholesterolemia was 4.9±4.2 years at time of discontinuation of statin treatment. Statin treatment was initiated by cardiologists in the majority of cases (55.8%), whereas discontinuation of statin treatment was decided by patients in the majority of cases (73.7%), with patients with higher (at least secondary education, 80.4%) more likely than those with lower (only primary education, 69.7%) to decide to discontinue treatment (p=0.022). Negative information about statin treatment disseminated by TV programs-mostly regarding coverage of hepatic (38.0%), renal (33.8%), and muscular (32.9%) side effects (32.9%)-was the most common reason for treatment discontinuation. CONCLUSION The decision to discontinue statin treatment was made at the patient's discretion in 74% of cases, with higher likelihood of patients with higher educational status deciding to discontinue treatment and switch to non-drug lipid-lowering alternatives. Cardiologists were the physicians most frequently responsible for the initiation of the statin treatment; coverage of several non-life-threatening statin side effects by TV programs and patients' lack of information regarding high cholesterol and related risks were the leading factors predisposing to treatment discontinuation.
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Affiliation(s)
- Lale Tokgözoğlu
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Ramazan Özdemir
- Department of Cardiology, İnonü University Faculty of Medicine, Malatya, Turkey
| | - Rojhat Altındağ
- Department of Cardiology, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
| | - Ceyhun Ceyhan
- Department of Cardiology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Cihan Öztürk
- Department of Cardiology, Kahramanmaraş Pazarcık Private Middle East Health Center, Kahramanmaraş, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Tuncay Delibaşı
- Department of Endocrinology and Metabolism, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Muzaffer Değertekin
- Department of Cardiology, Yeditepe University Faculty of Medicine, İstanbul, Turkey
| | | | - İbrahim Keleş
- Department of Cardiology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ali Serdar Fak
- Department of Cardiology, Akademi Hospital, İstanbul, Turkey
| | - Sinan Aydoğdu
- Department of Cardiology, Turkish High Specialty Training and Research Hospital, Ankara, Turkey
| | - Cafer Zorkun
- Department of Cardiology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Zeynep Tartan
- Department of Cardiology, Ataşehir Memorial Hospital, İstanbul, Turkey
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Efe TH, Ertem AG, Coskun Y, Bilgin M, Algul E, Beton O, Asarcikli LD, Erat M, Ayturk M, Yuksel I, Yeter E. Atrial Electromechanical Properties in Coeliac Disease. Heart Lung Circ 2016; 25:160-5. [PMID: 26412487 DOI: 10.1016/j.hlc.2015.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 05/06/2015] [Revised: 07/31/2015] [Accepted: 08/17/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coeliac disease (CD) is an autoimmune and inflammatory disorder of the small intestine. There is reasonable evidence linking inflammation to the initiation and continuation of atrial fibrillation (AF) in inflammatory conditions. Atrial electro-mechanic delay (EMD) was suggested as an early marker of AF in previous studies. The objectives of this study were to evaluate atrial electromechanical properties measured by tissue Doppler imaging and simultaneous electrocardiography (ECG) tracing in patients with CD. METHODS Thirty-nine patients with coeliac disease (CD), and 26 healthy volunteers, matched for age and sex, were enrolled in the study. Atrial electromechanical properties were measured by using transthoracic echocardiography and surface ECG. Interatrial electro-mechanic delay (EMD), left intraatrial EMD, right intratrial EMD were calculated. RESULTS There was no difference between CD patients and healthy volunteers in terms of basal characteristics. Patients with CD had significantly prolonged left and right intraatrial EMDs, and interatrial EMD compared to healthy controls (p= 0.03, p= 0.02, p<0.0001, respectively). Interatrial EMD was positively correlated with age, disease duration, anti-gliadin IgG, anti-endomysium and disease status. In multiple linear regression, interatrial EMD was independently associated with disease duration, anti-endomysium and disease status after adjusting for age and sex. CONCLUSIONS In the present study, atrial EMDs were found significantly higher in patients with CD compared with healthy individuals. Measurement of atrial EMD parameters might be used to predict the risk of development of AF in patients with CD.
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Affiliation(s)
- Tolga Han Efe
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey.
| | - Ahmet Goktug Ertem
- Department of Cardiology, Ankara Ataturk Education and Training Hospital, Ankara, Turkey
| | - Yusuf Coskun
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Engin Algul
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Osman Beton
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Lale Dinc Asarcikli
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Mehmet Erat
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Mehmet Ayturk
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Ilhami Yuksel
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
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Yayla Ç, Canpolat U, Akyel A, Yayla KG, Yilmaz S, Açikgöz SK, Özcan F, Turak O, Doğan M, Yeter E, Aydoğdu S. Association Between Platelet to Lymphocyte Ratio and Saphenous Vein Graft Disease. Angiology 2016; 67:133-138. [PMID: 25818104 DOI: 10.1177/0003319715578258] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Indexed: 09/12/2023]
Abstract
Atherosclerosis plays an important role in saphenous vein graft disease (SVGD). Previous trials showed that inflammatory blood cells play a role in this process. The platelet to lymphocyte ratio (PLR) has been proposed as a novel predictor for cardiovascular risk and indicator of atherosclerosis. The aim of this study was to assess the relationship between SVGD and PLR. A total of 220 patients with SVG were enrolled (n = 87 with SVGD and n = 133 with patent SVG). A ≥ 50% stenosis within the SVG was defined as clinically significant. Median PLR (P < .001) and mean platelet volume (MPV; P = .043) were significantly higher in patients with SVGD. Also, PLR showed significantly positive correlation with age of SVG (P < .05). Median age of SVGs was also higher in the SVGD group (P = .025). In multivariate logistic regression analyses, the PLR and MPV were independent predictors of SVGD. Using a cutoff level of 106.3, the PLR predicted SVGD with a sensitivity of 87.4% and a specificity of 80.3%. To the best of our knowledge, this study showed, for the first time, that PLR was independently associated with SVGD. Both PLR and MPV might predict SVGD.
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Affiliation(s)
- Çağrı Yayla
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Uğur Canpolat
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Samet Yilmaz
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sadık Kadri Açikgöz
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Fırat Özcan
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Osman Turak
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sinan Aydoğdu
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Çimen T, Doğan M, Kızıltepe U, Akyel A, Sunman H, Yeter E. Mitral-aortic intervalvular fibrosa pseudoaneurysm with rupture into the left atrium: a three-dimensional trans-esophageal echocardiographic approach. Anatol J Cardiol 2015; 15:1030-1. [PMID: 26663226 PMCID: PMC5368457 DOI: 10.5152/anatoljcardiol.2015.6663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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Abstract
Objective: Cigarette smoking increases the risk of cardiovascular events. The heart rate recovery index (HRRI) is an indicator of autonomous nervous system function and is an independent prognostic risk factor for cardiovascular diseases. In this study, we aimed to evaluate HRRI in heavy smokers. Methods: A total of 179 apparently healthy subjects (67 non-smokers as the control group and 112 heavy smokers) were enrolled into this prospective cross-sectional study. The presence of hypertension, diabetes mellitus, and known cardiac or non-cardiac diseases was specified as the exclusion criteria. Heavy cigarette smoking was defined as the consumption of more than one packet of cigarette per day. All subjects underwent the maximal Bruce treadmill test. HRRIs of the heavy cigarette smoker group at 1, 2, 3, and 5 min after maximal exercise were calculated and compared to those of the control group. Student t-test, chi-square test, and analysis of covariance were used for statistical analysis. Results: The baseline characteristics of the two groups were similar, except for body mass index and high-density lipoprotein level. HRRIs at 1, 2, 3, and 5 min after maximal exercise were found to be significantly lower in the heavy smoker group (HRRI1: 26.78±8.81 vs. 32.82±10.34, p<0.001; HRRI2: 44.37±12.11 vs. 51.72±12.87, p<0.001; HRRI3: 52.73±11.54 vs. 57.22±13.51, p=0.018; and HRRI5: 58.31±10.90 vs. 62.33±13.02, p=0.029). Conclusions: In the present study, we found that HRRI was impaired in heavy smokers. Our results suggest that beside previously known untoward effects on vascular biology, heavy smoking also has deleterious effects on the neuro–cardiovascular system.
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Affiliation(s)
- Mehmet Erat
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Mehmet Doğan
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Hamza Sunman
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey.
| | - Lale Dinç Asarcıklı
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Tolga Han Efe
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Murat Bilgin
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Tolga Çimen
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Ahmet Akyel
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Ekrem Yeter
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
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Saygısunar U, Kılıç H, Aytürk M, Karagöz A, Gökhan Vural M, Aksoy M, Yeter E. Volume depletion provided by blood donation alters twist mechanics of the heart: Preload dependency of left ventricular torsion. SCAND CARDIOVASC J 2015; 50:23-7. [DOI: 10.3109/14017431.2015.1112028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Uğur Saygısunar
- Department of Cardiology, Giresun State Hospital, Giresun, Turkey
| | - Harun Kılıç
- Department of Cardiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Aytürk
- Department of Cardiology, Keçiören Education and Research Hospital, Ankara, Turkey
| | - Ahmet Karagöz
- Department of Cardiology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Mustafa Gökhan Vural
- Department of Cardiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Murat Aksoy
- Department of Cardiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
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Doğan M, Erat M, Sunman H, Yeter E. Case images: Successful treatment with anticoagulant therapy of a thrombus trapped in a patent foramen ovale in a patient with acute pulmonary embolism. Turk Kardiyol Dern Ars 2015; 43:660. [PMID: 26536996 DOI: 10.5543/tkda.2015.43247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Erat
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Yayla Ç, Akboğa MK, Canpolat U, Akyel A, Yayla KG, Doğan M, Yeter E, Aydoğdu S. Platelet to Lymphocyte Ratio Can be a Predictor of Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2015; 66:831-836. [PMID: 25712290 DOI: 10.1177/0003319715573658] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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] [Indexed: 09/12/2023]
Abstract
Patency of infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI) before primary percutaneous coronary intervention (pPCI) is associated with lower mortality and better clinical outcome. However, there were little data regarding the predictors of IRA patency before pPCI in the setting of STEMI. We aimed to assess the association of platelet to lymphocyte ratio (PLR) with IRA patency in STEMI. A total of 452 patients were enrolled and categorized as occluded or patent IRA. Patency IRA was assessed by the thrombolysis in myocardial infarction (TIMI) flow grade. Blood samples were obtained on admission to calculate PLR. Of all patients, 92 (20.4%) patients revealed pre-pPCI TIMI 3 flow in IRA. The PLR was significantly higher in occluded IRA group (138.4 ± 51.4 vs 95.4 ± 43.5, P < .001). Glucose, troponin I, and neutrophil to lymphocyte ratio (NLR) levels were also higher in occluded IRA group (P < .05). Multivariate regression analysis demonstrated the PLR (odds ratio [OR]: 0.987; 95% confidence interval [CI]: 0.978-0.995, P = .002) and NLR (OR: 0.758; 95% CI: 0.584-0.985, P = .038) on admission as independent predictors of IRA patency. In conclusion, a higher PLR is a powerful and independent predictor of IRA patency in patients with STEMI before pPCI.
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Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Doğan
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Efe TH, Ertem AG, Coskun Y, Bilgin M, Algul E, Beton O, Asarcikli LD, Erat M, Ayturk M, Yuksel I, Yeter E. Atrial Electromechanical Properties in Coeliac Disease. Heart Lung Circ 2015. [PMID: 26412487 DOI: 10.1016/j.hlc.2015.08.003.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
BACKGROUND Coeliac disease (CD) is an autoimmune and inflammatory disorder of the small intestine. There is reasonable evidence linking inflammation to the initiation and continuation of atrial fibrillation (AF) in inflammatory conditions. Atrial electro-mechanic delay (EMD) was suggested as an early marker of AF in previous studies. The objectives of this study were to evaluate atrial electromechanical properties measured by tissue Doppler imaging and simultaneous electrocardiography (ECG) tracing in patients with CD. METHODS Thirty-nine patients with coeliac disease (CD), and 26 healthy volunteers, matched for age and sex, were enrolled in the study. Atrial electromechanical properties were measured by using transthoracic echocardiography and surface ECG. Interatrial electro-mechanic delay (EMD), left intraatrial EMD, right intratrial EMD were calculated. RESULTS There was no difference between CD patients and healthy volunteers in terms of basal characteristics. Patients with CD had significantly prolonged left and right intraatrial EMDs, and interatrial EMD compared to healthy controls (p= 0.03, p= 0.02, p<0.0001, respectively). Interatrial EMD was positively correlated with age, disease duration, anti-gliadin IgG, anti-endomysium and disease status. In multiple linear regression, interatrial EMD was independently associated with disease duration, anti-endomysium and disease status after adjusting for age and sex. CONCLUSIONS In the present study, atrial EMDs were found significantly higher in patients with CD compared with healthy individuals. Measurement of atrial EMD parameters might be used to predict the risk of development of AF in patients with CD.
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Affiliation(s)
- Tolga Han Efe
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey.
| | - Ahmet Goktug Ertem
- Department of Cardiology, Ankara Ataturk Education and Training Hospital, Ankara, Turkey
| | - Yusuf Coskun
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Engin Algul
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Osman Beton
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Lale Dinc Asarcikli
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Mehmet Erat
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Mehmet Ayturk
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Ilhami Yuksel
- Department of Gastroenterology, Diskapi Education and Training Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Education and Training Hospital, Ankara, Turkey
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Arslantaş U, Yıldırım S, Kaynakçı Bayram M, Yurtseven A, Çimen T, Dogan M, Yeter E. Terapötik serum seviyesinde Digoksin Toksisitesi. Mustafa Kemal Üniv Tıp Derg 2015. [DOI: 10.17944/mkutfd.10244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Balcı KG, Balcı MM, Aksoy MM, Yılmaz S, Aytürk M, Doğan M, Yeter E, Akdemir R. Remodeling process in right and left ventricle after percutaneous atrial septal defect closure in adult patients. Turk Kardiyol Dern Ars 2015; 43:250-8. [PMID: 25905996 DOI: 10.5543/tkda.2015.57106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate acute cardiac remodeling after transcatheter closure of atrial septal defect (ASD) in adult patients. METHODS This study included 19 patients (40.0 ± 13.51 mean age) with secundum ASD who underwent successful transcatheter closure. All patients received routine transthoracic echocardiography, including tissue Doppler left ventricle (LV) and right ventricle (RV) myocardial performance indices (MPI), mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) before ASD closure, on first day, and at first and third months after closure. RESULTS Left ventricle end-diastolic diameter (LVEDD) increased (37 ± 4 mm to 44 ± 5 mm, p<0.001); RVEDD decreased markedly after closure (40 ± 4 mm to 32 ± 5 mm, p<0.001); and differences existed in LV and RV adaptation. While MAPSE (1.87 ± 0.22 cm to 2.01 ± 0.23 cm, p<0.001) and LVMPI improved soon after procedure (0.44 ± 0.04 to 0.36 ± 0.03, p<0.001), RVMPI worsened until the first month post-procedure (0.25 ± 0.02 to 0.31 ± 0.03, p<0.001), but recovered by the third month follow-up visit (0.31 ± 0.03 to 0.27 ± 0.02, p<0.001). TAPSE remained unchanged (2.49 ± 0.46 cm to 2.51 ± 0.32 cm, p=0.078). CONCLUSION Closure of ASD using the Amplatzer Septal Occluder device led to a decrease in RV size and an increase in LV size. In the early period, while LV function improved, RV function deteriorated, probably due to RV functional and anatomical differences.
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Affiliation(s)
- Kevser Gülcihan Balcı
- Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Mustafa Mücahit Balcı
- Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Muhammed Murat Aksoy
- Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Samet Yılmaz
- Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Mehmet Aytürk
- Department of Cardiology, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
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Ayyildiz YO, Vural MG, Efe TH, Ertem AG, Koseoglu C, Ayturk M, Yeter E, Keskin G, Akdemir R. Effect of Long-Term TNF-α Inhibition with Infliximab on Left Ventricular Torsion in Patients with Rheumatoid Arthritis. Hellenic J Cardiol 2015; 56:406-413. [PMID: 26429369] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION We evaluated the impact of tumor necrosis factor alpha (TNF-α) inhibition on left ventricular torsion (LVtor) in patients with rheumatoid arthritis (RA) using speckle-tracking echocardiography (STE). METHODS Thirty-eight RA patients without cardiovascular disease and 30 healthy subjects were enrolled in the study. Twenty patients received infliximab, a monoclonal antibody against TNF-α, and 18 patients received increasing doses of prednisolone for 180 days. Global systolic longitudinal strain (G-LS), global systolic radial strain (G-RS) and global systolic circumferential strain (G-CS) were determined by STE. LV basal and apical rotations from the base and apex were obtained and used for calculation of LVtor. Pre-treatment LVtor levels were compared with LVtor levels after therapy in both treatment groups. RESULTS RA patients had lower G-LS (-16.5 ± 2.9; p<0.01), G-RS (37.6 ± 1.5; p<0.01) and higher GCS (-23.6 ± 3.5; p=0.04) compared with control subjects (-20.0 ± 2.8, 40.7 ± 4.8, -22.4 ± 2.5, respectively; p<0.01). LVtor levels were significantly higher in RA patients compared to controls (16.4 ± 2.7 vs. 15.1 ± 2.5; p=0.04), which might be attributed to higher values of apical rotation (9.7 ± 2.4 vs. 8.8 ± 2.3; p=0.01). Patients treated with infliximab experienced a significant decrease in LVtor (p=0.04), and a significant increase in G-LS (p<0.01) and G-RS (p<0.01). No significant changes were observed among patients treated with prednisolone. Percentage changes in LVtor were correlated with percent changes in C-reactive protein CRP (r=0.58; p<0.01), disease activity score (r=0.78; p<0.01), and G-LS (r=-0.40; p=0.04) in patients treated with infliximab. CONCLUSIONS RA is characterized by increased LVtor. Long term TNF-α inhibition improves LV longitudinal and radial systolic deformation and decreases LVtor.
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Affiliation(s)
- Yasemin Ozden Ayyildiz
- Department of Internal Medicine, Diskapi Education and Training Hospital, Ankara, Turkey
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Ay B, Vural MG, Ertem AG, Çağırcı G, Akdemir R, Efe TH, Keskin G, Yeter E. Chronic inhibition of tumor necrosis factor-α with infliximab improves myocardial deformation in parallel with aortic elasticity in rheumatoid arthritis. Turk Kardiyol Dern Ars 2015; 43:138-48. [PMID: 25782118 DOI: 10.5543/tkda.2015.07337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study investigated the effects of infliximab, a monoclonal antibody against TNFα, on myocardial deformation and aortic elasticity in patients with rheumatoid arthritis (RA), and the association of aortic elasticity with myocardial deformation. STUDY DESIGN 38 female rheumatoid arthritis (RA) patients and 30 healthy controls were included in the study. Twenty patients received infliximab and 18 patients received prednisolone. Left ventricular (LV) longitudinal, circumferential and radial strain, systolic strain rate and early diastolic strain rate using speckle-tracking echocardiography, and aortic elasticity using M-mode echocardiography were assessed at baseline and post-treatment. RESULTS LV systolic longitudinal basal-, mid-, and apical strain, systolic mid- and apical strain rate, basal-, mid- and apical early strain rate, circumferential systolic apical strain and systolic strain rate were reduced in RA patients compared to controls. Compared to baseline, infliximab treatment increased aortic strain, aortic distensibility and decreased aortic ß index. No significant aortic elastic changes were observed with prednisolone treatment. Longitudinal basal- and apical strain, basal-, mid- and apical systolic and diastolic strain rates, circumferential basal systolic strain, radial mid- and apical strain and apical strain rate were increased following infliximab treatment. Infliximab treatment improves aortic elasticity in parallel to myocardial deformation, but no significant association was observed following prednisolone treatment. CONCLUSION Myocardial deformation is impaired in RA patients and is related to aortic stiffness. Chronic inhibition of TNFα improves LV deformation in association with aortic elasticity.
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Affiliation(s)
- Birgül Ay
- Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | | | - Ahmet Göktuğ Ertem
- Department of Cardiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Göksel Çağırcı
- Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Göksal Keskin
- Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Ertaş F, Kaya H, Kaya Z, Bulur S, Köse N, Gül M, Kahya Eren N, Cağlıyan CE, Köroğlu B, Vatan B, Acar G, Yüksel M, Bilik MZ, Gedik S, Simşek Z, Akıl MA, Yılmaz R, Oylumlu M, Arıbaş A, Yıldız A, Aydın M, Yeter E, Kanadaşı M, Ergene O, Ozhan H, Ulgen MS. Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER study. Turk Kardiyol Dern Ars 2015; 41:99-104. [PMID: 23666295 DOI: 10.5543/tkda.2013.18488] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Although atrial fibrillation (AF) is one of the most common rhythm disorders observed in clinical practice, a multicenter epidemiological study has not been conducted in our country. This study aimed to assess our clinical approach to AF based upon the records of the first multicenter prospective Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. STUDY DESIGN Taking into consideration the distribution of the population in our country, 2242 consecutive patients with at least one AF attack determined by electrocardiographic examination in 17 different tertiary health care centers were included in the study. Inpatients and patients that were admitted to emergency departments were excluded from the study. Epidemiological data of the patients and the treatment administered were assessed. RESULTS The mean age of the patients was determined as 66.8 ± 12.3 years with female patients representing 60% of the study population. While the most common AF type in the Turkish population was non-valvular AF (78%), persistent/permanent AF was determined in 81% of all patients. Hypertension (%67) was the most common co-morbidity in patients with AF. While a stroke or transient ischemic attack or history of systemic thromboembolism was detected in 15.3% of the patients, bleeding history was recorded in 11.2%. Also, 50% of the patients were on warfarin treatment and 53% were on aspirin treatment at the time of the study. The effective INR level was detected in 41.3% of the patients. The most frequent cause of not receiving anticoagulant therapy was physician neglect. CONCLUSION These results demonstrate the necessity for improved quality of physician care of patients with AF, especially with regards to antithrombotic therapy.
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Affiliation(s)
- Faruk Ertaş
- Dept. of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
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Yayla Ç, Bilgin M, Akboğa MK, Gayretli Yayla K, Canpolat U, Dinç Asarcikli L, Doğan M, Turak O, Çay S, Özeke Ö, Akyel A, Yeter E, Aydoğdu S. Evaluation of Tp-E Interval and Tp-E/QT Ratio in Patients with Aortic Stenosis. Ann Noninvasive Electrocardiol 2015; 21:287-93. [PMID: 26246339 DOI: 10.1111/anec.12298] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The risk of syncope and sudden cardiac death due to ventricular arrhythmias increased in patients with aortic stenosis (AS). Recently, it was shown that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio can be novel indicators for prediction of ventricular arrhythmias and mortality. We aimed to investigate the association between AS and ventricular repolarization using Tp-e interval and Tp-e/QT ratio. METHODS Totally, 105 patients with AS and 60 control subjects were enrolled to this study. The severity of AS was defined by transthoracic echocardiographic examination. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured from the 12-lead electrocardiogram. RESULTS Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly increased in parallel to the severity of AS (P < 0.001, P = 0.001, and P = 0.001, respectively). Also, it was shown that Tp-e/QTc ratio had significant positive correlation with mean aortic gradient (r = 0.192, P = 0.049). In multivariate logistic regression analysis, Tp-e/QTc ratio and left ventricular mass were found to be independent predictors of severe AS (P = 0.03 and P = 0.04, respectively). CONCLUSIONS Our study showed that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with severe AS. Tp-e/QTc ratio and left ventricular mass were found as independent predictors of severe AS.
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Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Murat Bilgin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Lale Dinç Asarcikli
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Doğan
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Osman Turak
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Çay
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Özcan Özeke
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Bilgin M, Akyel A, Doğan M, Sunman H, Yeter E. Acute coronary syndrome secondary to clarithromycin: the first case and review of the literature. Turk Kardiyol Dern Ars 2015; 42:461-3. [PMID: 25080953 DOI: 10.5543/tkda.2014.92891] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Kounis syndrome (KS) is characterized by concurrent acute coronary syndrome and allergic reaction, in which acute inflammatory mediators cause spasm and/or erosion and rupture of coronary atheromatous plaque. In this report, we remind clinicians to consider KS in patients who are subjected to allergenic substances and demonstrate acute chest pain. A 36-year-old woman had chest pain, severe dyspnea, hypotension, and symmetrical negative T waves on the anterior leads during electrocardiography approximately two hours after the use of clarithromycin. KS was considered as a possible diagnosis based on the presentation. Laboratory tests revealed an elevated level of troponin I, suggesting myocardial infarction, and an elevated level of serum tryptase level, suggesting an allergic reaction. The patient promptly underwent coronary angiography, which revealed only plaques in all main coronary arteries without any obstructive lesion. To the best of our knowledge, we report herein the first case in the literature describing an association between clarithromycin and KS.
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Affiliation(s)
- Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Çimen T, Durmaz HA, Akyel A, Yeter E, Karapınar K, Felekoğlu MA. Hypotension, tachycardia, and tachypnea in a patient with coronary artery disease. Anatol J Cardiol 2015; 15:430, 440. [PMID: 25993720 PMCID: PMC5779186 DOI: 10.5152/akd.2015.6151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tolga Çimen
- Clinic of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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Çetin S, Süha Ç, Mustafa G, Gökhan VM, Keskin G, Göksal K, Yeter E, Ekrem Y, Doğan M, Mehmet D, Öztürk MA, Akif ÖM. Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results. Cardiovasc J Afr 2015; 25:168-75. [PMID: 25192300 PMCID: PMC4170177 DOI: 10.5830/cvja-2014-036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 06/13/2014] [Indexed: 11/25/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study, we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further, we tried to demonstrate the effects of infliximab, an anti-TNFalpha agent, on echocardiographical LA abnormality in RA patients with preserved left ventricular (LV) ejection fraction. Methods We compared 38 female RA patients without clinical evidence of heart disease and 30 female controls without RA and clinical evidence of heart disease. Further, we compared RA patients receiving infliximab and increasing doses of prednisolone over a three-month period. At baseline and post treatment, this study assessed (1) LA and LV parameters using conventional and speckle tracking echocardiography (STE), and (2) electrocardiographic P-wave changes. Results The values of C-reactive protein (CRP), isovolumic relaxation time (IVRT), A wave, and deceleration time (DT) were significantly higher in RA patients compared to the control group (p < 0.05), whereas E/E′ and E/A values were found to be lower (p < 0.05) in RA patients. E/E′ values were lower in prednisolone- compared to infliximab-treated patients (p < 0.05). After three months of infliximab and prednisolone treatment, CRP and disease activity score (DAS 28) values decreased in both groups (p < 0.05), and Duke activity status index (DASI) increased (p < 0.05). Maximal left atrial volume index (LAVImax), pre-contraction left atrial volume index (LAVIpreA) and maximum P wave (Pmax) of the RA patients were higher compared to the control group (p < 0.05), whereas LA global strain was found to be lower (p < 0.05). There was no difference in Pmax values between groups before and after the treatment period. E/E′, LAVImax and LAVIpreA values of infliximab-treated patients decreased and LA global strain increased after three months of therapy compared to baseline (p < 0.05). At baseline in both treatment groups, E/E′ and LA global late diastolic strain rate were lower in prednisolone-compared to infliximab-treated patients (p < 0.05). Conclusion There was echocardiographic LA abnormality in these RA patients. In this patient group there was also a meaningful increase in maximum P wave assessed by electrocardiography. Infliximab therapy for a period of three months improved LA abnormality.
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Affiliation(s)
| | - Çetin Süha
- Department of Cardiology, 29 Mayis Hospital, Ankara, Turkey.
| | | | - Vural Mustafa Gökhan
- Department of Cardiology, Dişkapi Research and Education Hospital, Ankara, Turkey
| | | | - Keskin Göksal
- Department of Internal Medicine, Dişkapi Research and Education Hospital, Ankara, Turkey
| | | | - Yeter Ekrem
- Department of Cardiology, Dişkapi Research and Education Hospital, Ankara, Turkey
| | | | - Doğan Mehmet
- Department of Cardiology, Dişkapi Research and Education Hospital, Ankara, Turkey
| | - Mehmet Akif Öztürk
- Department of Rheumatology, School of Medicine, Gazi University, Ankara, Turkey
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Ertem AG, Bağbancı H, Kılıç H, Yeter E, Akdemir R. Relationship between HbA1c levels and coronary artery severity in nondiabetic acute coronary syndrome patients. Turk Kardiyol Dern Ars 2015; 41:389-95. [PMID: 23917003 DOI: 10.5543/tkda.2013.95666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the relationship between HbA1c levels and the severity of coronary artery stenosis in patients with acute coronary syndrome (ACS) without diabetes mellitus. STUDY DESIGN In this study, we included 65 patients (11 females, mean age: 57±11.42 years; 54 males, mean age: 54.56±8.51 years) who were diagnosed as acute myocardial infarction without diabetes mellitus. During hospitalization, fasting blood glucose, postprandial blood glucose and HbA1C were measured in each patient. Gensini score was used to assess the severity of coronary artery disease. RESULTS Twenty patients (30.8%) had hypertension, 15 (23.1%) had impaired fasting glucose, 10 (15.3%) had combined impaired fasting and postprandial glucose, 28 had a low HDL cholesterol (45%), and 30 (46%) had abdominal obesity. Coronary angiography revealed one-vessel disease in 13 patients (20%), and two- and three-vessel disease in 52 patients (80%). There were no significant differences in terms of high-sensitive C-reactive protein (hs-CRP), total cholesterol, fasting glucose, and postprandial glucose (0.068, 0.974, 0.178, 0.677, respectively). There was no significant relation between the Gensini score and HbA1c levels (p=0.299), but there was a significant relation between the Gensini score and obesity (p=0.024). CONCLUSION In our study, no significant relationship could be determined between the Gensini score and HbA1C, fasting and postprandial blood glucose levels, lipid profile, and hs-CRP levels in patients with nondiabetic ACSs.
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Affiliation(s)
- Ahmet Göktuğ Ertem
- Department of Cardiology, Ankara Penal Institution Campus State Hospital, Ankara, Turkey.
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Gok Oguz E, Yildirim T, Merhametsiz O, Ercan Z, Cimen T, Ulusal Okyay G, Akoglu H, Canbakan B, Yeter E, Ayli M. SP481ASSOCIATIONS OF RENALASE WITH EPICARDIAL FAT TISSUE THICKNESS AND LEFT VENTRICLE HYPERTROPHY IN PATIENTS UNDER PERITONEAL DIALYSIS TREATMENT. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv196.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Akyel A, Yayla Ç, Erat M, Çimen T, Doğan M, Açıkel S, Aydoğdu S, Yeter E. Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis. Anatol J Cardiol 2015; 15:1002-7. [PMID: 25880055 PMCID: PMC5368453 DOI: 10.5152/akd.2015.5909] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: Coronary artery disease is closely linked with inflammation, and the neutrophil-to-lymphocyte ratio (NLR) has emerged as a new inflammatory marker. Fractional flow reserve (FFR) is a well-established method for determining hemodynamic significance of coronary artery stenosis. In this study, we aimed to investigate the relationship between NLR and hemodynamic significance of coronary artery lesion as assessed by FFR. Methods: A total of 134 patients with FFR measurement between January 2012 and December 2013 were enrolled in this retrospective study. Patients with single intermediate-grade coronary artery stenosis were enrolled, and those with second intermediate or severe coronary artery stenosis were excluded from study. Patients’ NLR were calculated. An FFR value of <0.80 was accepted for hemodynamic significance. Statistical analysis was performed by the chi-square test, Student’s t-test, Mann–Whitney U test, logistic regression analysis, and ROC curve analysis. Results: Patients with hemodynamically significant lesions had higher NLR values (3.3±1.2 vs. 2.0±0.9, p<0.001). White blood cell count, male gender, high-density lipoprotein levels, platelet-to-lymphocyte ratio, and NLR were found to be possible confounding factors predicting hemodynamically significant coronary artery stenosis. In multiple logistic regression analysis, NLR remained as the only independent predictor for hemodynamically significant coronary artery stenosis. An NLR value of 2.4 had 87.5% sensitivity and 78.4% specificity for prediction of hemodynamically significant coronary artery stenosis. Conclusion: In present study, we showed that NLR was significantly higher in patients with hemodynamically significant coronary artery stenosis. We also found NLR to be an independent predictor of hemodynamically significant coronary artery stenosis as measured by FFR. Further studies are needed to find a causal relationship.
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Affiliation(s)
- Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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Akyel A, Yayla KG, Erat M, Sunman H, Doğan M, Çimen T, Aytürk M, Yeter E. Relationship between Epicardial Adipose Tissue Thickness and Atrial Electromechanical Delay in Hypertensive Patients. Echocardiography 2015; 32:1498-503. [DOI: 10.1111/echo.12917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ahmet Akyel
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Kadriye G. Yayla
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Erat
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Hamza Sunman
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Doğan
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Tolga Çimen
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Aytürk
- Department of Cardiology; Keçiören Education and Research Hospital; Ankara Turkey
| | - Ekrem Yeter
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
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Acikel S, Orcan S, Yalcindag A, Sari M, Sahan FH, Sunman H, Kilic H, Akdemir R, Yeter E. THE EFFECT OF MANUAL THROMBUS ASPIRATION OVER ENDOTHELIAL FUNCTION AND INFLAMMATORY MARKERS IN PATIENTS PRESENTING WITH ST-ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60072-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Acikel S, Asarcikli LD, Akyel A, Cimen T, Sunman H, Pamukcu HE, Efe T, Bilgin M, Dogan M, Yeter E. PP-030 Manual Thrombus Aspiration and High-dose Adenosine via Thrombus Aspiration Catheter in the Treatment of No-reflow for Saphenous Vein Graft Intervention in ST-elevation Myocardial Infarction. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yayla Ç, Canpolat U, Akyel A, Yayla KG, Yılmaz S, Açıkgöz SK, Özcan F, Turak O, Doğan M, Yeter E, Aydoğdu S. OP-066 Association Between Platelet to Lymphocyte Ratio and Saphenous Vein Graft Disease. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Acikel S, Asarcikli LD, Akyel A, Cimen T, Efe T, Pamukcu HE, Bilgin M, Dogan M, Yeter E. PP-134 The Successful Percutaneous Revascularization of Subclavian Artery Stenosis Causing Coronary Subclavian and Vertebral Artery Steal Syndrome. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Erat M, Doğan M, Sunman H, Algül E, Felekoğlu MA, Yayla KG, Asarcıklı LD, Efe TH, Bilgin M, Çimen T, Akyel A, Yeter E. OP-198 Evaluate the Heart Rate Recovery Index in Patients with Heavy Cigarette Smoking. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Asarcikli LD, Erat M, Acikel S, Dicle CB, Yuceege M, Efe TH, Bilgin M, Akyel A, Dogan M, Firat H, Yeter E. PP-156 Neutrophil to Lymphocyte Ratio is Associated with Severe Obstructive Sleep Apnea Syndrome and Increased Inflammation. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Acikel S, Akdemir R, Kilic H, Cagirci G, Dogan M, Yesilay AB, Yeter E. Diastolic dysfunction and contrast-induced nephropathy in patients undergoing coronary angiography. Herz 2014; 40 Suppl 3:254-9. [PMID: 25432103 DOI: 10.1007/s00059-014-4173-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 10/02/2014] [Accepted: 10/14/2014] [Indexed: 01/20/2023]
Abstract
OBJECTIVES It has been demonstrated that decreased left ventricular ejection fraction (LVEF) is associated with an increased risk of contrast-induced nephropathy (CIN). In this study, we aimed to assess whether there is a relationship between left ventricular (LV) diastolic dysfunction and renal function decline after coronary angiography (CAG). PATIENTS AND METHODS The study consisted of two groups: group I, patients with normal diastolic function; group II, patients with cardiac symptoms and abnormal diastolic function. Serum creatinine (Crea) and glomerular filtration rates (GFR) were measured before and after 48 h of CAG. RESULTS After the procedure, serum Crea values were higher in group II compared with group I (p = 0.051). Postprocedural 48-h GFR values determined by Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations were lower in group II compared with group I (p = 0.016 and p = 0.003, respectively). Delta (Δ) ΔCrea and ΔGFR determined by the Cockcroft-Gault and MDRD equations were statistically higher in group II than in group I (p = 0.005, p = 0.052, p = 0.030). The presence of higher age (p = 0.025), E/E' lateral ratio (p = 0.030), and left atrial volume index (p = 0.05) were independent predictors of worsening renal function. CONCLUSION The presence of diastolic dysfunction may play a role in determining the risk of CIN in patients with normal LVEF.
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Affiliation(s)
- S Acikel
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, 06110, Ankara, Turkey,
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Aytürk M, Sunman H, Yeter E. A persisting dilemma for triple antithrombotic therapy: are we close to finding the correct answer? J Am Coll Cardiol 2014; 64:231. [PMID: 24509279 DOI: 10.1016/j.jacc.2013.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 10/07/2013] [Indexed: 11/28/2022]
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Sunman H, Erat M, Doğan M, Yeter E. Case images: Cardiogenic shock caused by huge para-aortic hematoma and pseudoaneurysm after Bentall operation. Turk Kardiyol Dern Ars 2014; 42:414. [PMID: 24899493 DOI: 10.5543/tkda.2014.26925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Mehmet Erat
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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