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Akgul F, Celik SB, Atabey P, Bucaktepe PG. Healthcare professionals' beliefs regarding influenza vaccination: What has COVID-19 changed? Niger J Clin Pract 2023; 26:515-523. [PMID: 37203119 DOI: 10.4103/njcp.njcp_433_22] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Influenza poses a potential public health threat among healthcare professionals since an infected healthcare professional can spread the virus to patients at higher risk as well as his/her own family members and colleagues. Annual influenza vaccination is the most effective way to protect HCPs. Aim This study was conducted to determine whether demand for and beliefs about influenza vaccination have changed among healthcare professionals in the COVID-19 era and the factors that might have influenced them in the early phase of the pandemic when COVID-19 vaccines were eagerly awaited. Patients and Methods This observational descriptive study was conducted between November 16, and December 15, 2020. A total of 317 healthcare professionals completed an online survey. Bivariate analysis and binary logistic regression analysis were performed. Results Nineteen (6.0%) healthcare professionals were regularly vaccinated against influenza every year, and 199 (62.8%) had never been vaccinated. During the 2019-2020 season, 30 (9.5%) participants had been vaccinated and the proportion desiring to be vaccinated against influenza during the 2020-2021 season was 49.8% (n = 158). The results revealed that those with chronic diseases, those who believed they had adequate information about influenza vaccination and those who believed healthcare professionals should be vaccinated against influenza regularly every year, respectively, had 3.5 times, 4.7 times, and 11 times higher vaccination rates. Conclusion Although the proportion of healthcare professionals with the intention to be vaccinated for influenza increased with the COVID-19 pandemic, it is still not high enough. Influenza vaccination rates should be promoted by in-service training programs.
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Affiliation(s)
- F Akgul
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - S B Celik
- Batman GAP Family Health Center, Batman, Turkey
| | - P Atabey
- Department of Otorhinolaryngology and Head and Neck Surgery, Ankara Medical Park Batikent Hospital, Ankara, Turkey
| | - P G Bucaktepe
- Department of Family Medicine, Dicle University Medical School, Diyarbakır, Turkey
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Kemec Z, Akgul F. Are patients with Covid-19 at risk of long-term chronic kidney disease? Niger J Clin Pract 2023; 26:341-346. [PMID: 37056110 DOI: 10.4103/njcp.njcp_382_22] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Background The relationship between Coronavirus Disease 2019 (COVID-19) and acute kidney injury (AKI) is well-established. However, a comprehensive evaluation of kidney outcomes in the long-term course of COVID-19 is not yet been performed. The aim of this study is to investigate whether chronic kidney disease (CKD) develops within six months after hospital discharge in COVID-19 patients who did not have kidney damage at the time of admission to the hospital. Patients and Methods This single-center retrospective study investigated a total of 1008 participants selected from 7500 COVID-19 patients with real-time reverse transcription-polymerase chain reaction (RT-PCR) positivity. All patients had mild/moderate or severe COVID-19. Patients were randomly selected from inpatient and outpatient settings. Critical COVID-19 patients were not included. Results The mean age of the patients was 56.57 ± 16.30 years, and 69.9% of them were male. The comorbidity percentages of the participants were as follows; 19.5% coronary artery disease (CAD), 28.6% diabetes mellitus (DM), 36.2% hypertension (HT), 3.1% cerebrovascular obstruction (CVO), 1.7% malignancy, 2.6% chronic obstructive pulmonary disease (COPD), 9.4% asthma, % 1.7 dementia, 9.9% hyperlipidaemia, and 1.7% hepatitis B virus (HBV). Kidney function tests of these patients at first admission and 6 months later were compared to reveal the relationship between COVID-19 and CKD. Serum glucose, sodium estimated glomerular filtration rate (eGFR), and uric acid levels were found to be high in the post-COVID-19 period (P = 0.001). However, there were a decrease in serum albumin, potassium, alanine aminotransferase (ALT), C-reactive protein (CRP), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and gamma-glutamyl transferase (GGT) levels (P = 0.001). The difference between the first measurement of serum urea and creatinine (Cr) levels and the measurement 6 months later was not statistically significant (P = 0.102 and P = 0.300, respectively). Conclusions Those who survived the mild/moderate and severe clinical manifestations of COVID-19 did not exhibit any risk of kidney outcomes after the acute phase of the disease, suggesting that the kidney can protect itself over a long period of time.
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Affiliation(s)
- Z Kemec
- Batman Training and Research Hospital, Department of Nephrology Clinic, Batman, Turkey
| | - F Akgul
- Batman Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Batman, Batman, Turkey
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Kemec Z, Akgul F. Relationship between acute kidney injury requiring renal replacement treatment and mortality in patients with COVID-19. Niger J Clin Pract 2022; 25:1348-1356. [DOI: 10.4103/njcp.njcp_290_22] [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: 01/08/2023]
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Somuncu MU, Avci A, Kalayci B, Gudul NE, Tatar FP, Demir AR, Can M, Akgul F. Predicting long-term cardiovascular outcomes in myocardial infarction survivors using multiple biomarkers. Biomark Med 2021; 15:899-910. [PMID: 34241548 DOI: 10.2217/bmm-2020-0875] [Citation(s) in RCA: 2] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: Although there are short- and long-term prognostic studies in patients with myocardial infarction (MI), the data that can be used to predict the clinical outcome following discharge is limited. Materials & methods: We analyzed creatinine kinase-MB and troponin related to myonecrosis, suppression of tumorigenicity 2 and NT-pro B-type natriuretic peptide related to myocardial stress, C-reactive protein and procalcitonin related to inflammation in 259 MI patients. Results: Being in the high group for myocardial stress (odds ratio [OR]: 3.45, 95% CI: 1.398-8.547, p = 0.004) and inflammation markers (OR: 4.30, 95% CI: 1.690-10.899, p = 0.001) predicted major cardiovascular adverse events while myonecrosis markers could not (OR: 1.70, 95% CI: 0.671-4.306, p = 0.263). Conclusion: Using multimarker risk stratification composed of inflammation and myocardial stress biomarkers improves the prediction of major cardiovascular adverse events in MI survivors.
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Affiliation(s)
- Mustafa U Somuncu
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Ahmet Avci
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Belma Kalayci
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Naile E Gudul
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Fatih P Tatar
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Ali R Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic & Cardiovascular Surgery Center, Training & Research Hospital, Istanbul, Turkey
| | - Murat Can
- Department of Biochemistry, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
| | - Ferit Akgul
- Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak, Turkey
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Avcı A, Somuncu MU, Can M, Akgul F. Could sST2 Predict Contrast-Induced Nephropathy in ST-Segment Elevation Myocardial Infarction? Int J Gen Med 2020; 13:1297-1304. [PMID: 33273849 PMCID: PMC7708263 DOI: 10.2147/ijgm.s287834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/21/2020] [Accepted: 11/12/2020] [Indexed: 01/09/2023] Open
Abstract
Background and Aim One of the most worrying complications of primary percutaneous coronary interventions is contrast-induced nephropathy (CIN) that is associated with increased mortality and morbidity in myocardial infarction. In this study, we questioned whether soluble suppression of tumorigenesis-2 (sST2), which has thought to play a role in inflammatory processes, cardiac remodeling, and fibrosis could give an idea about the development of CIN in ST-elevation myocardial infarction (STEMI) patients. Patients and Methods This study is a cross-sectional observational study and includes 357 consecutive STEMI patients. Demographic features, medical history, laboratory parameters, and procedural characteristics were compared according to CIN's development. The multivariate logistic regression analysis was selected to detect independent risk factors of CIN. Results In the study, 81 patients (22.7%) who developed CIN were identified. The concentration of sST2 in CIN (+) group was higher than that of CIN (-) group (40.6±21.0 ng/mL vs 31.5±13.0 ng/L, p<0.001). Independent predictors of CIN development were diabetes mellitus (OR, 2.059; 95% CI, 1.093-3.879; p=0.025), eGFR (OR, 0.983; 95% CI, 0.972-0.995; p=0.006), lower systolic blood pressure (OR, 0.976; 95% CI, 0.960-0.993; p=0.006), total procedure time (OR, 1.030; 95% CI, 1.011-1.049; p=0.002), and sST2 (OR, 1.101; 95% CI; 1.046-1.160; p<0.001). Besides, the risk of developing CIN in the high sST2 group is 3.06 times higher than the low group sST2 group regardless of other risk factors. Conclusion sST2 levels on admission in STEMI patients are useful in predicting CIN development.
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Affiliation(s)
- Ahmet Avcı
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Mustafa Umut Somuncu
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Murat Can
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Ferit Akgul
- Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Somuncu MU, Akgun T, Cakır MO, Akgul F, Serbest NG, Karakurt H, Can M, Demir AR. The Elevated Soluble ST2 Predicts No-Reflow Phenomenon in ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. J Atheroscler Thromb 2019; 26:970-978. [PMID: 30996145 PMCID: PMC6845696 DOI: 10.5551/jat.48413] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 12/11/2022] Open
Abstract
Aim: The primary percutaneous procedure resulted in a significant improvement in the prognosis of myocardial infarction. However, no-reflow phenomenon restrains this benefit of the process. There are studies suggesting that soluble suppression of tumorigenicity (sST2) can be valuable in the diagnosis and progression of heart failure and myocardial infarction. In this study, we aimed to investigate the effect of sST2 on no-reflow phenomenon in ST-elevated myocardial infarction (STEMI). Method: This study included 379 patients (258 men; mean age, 60 ± 11 years) who underwent primary percutaneous treatment for STEMI. sST2 levels were measured from blood samples taken at admission. Patients were divided into two groups according to Thrombolysis in Myocardial Infarction(TIMI) flow grade: group 1 consists of TIMI 0,1,2, accepted as no-reflow, and group 2 consists of TIMI 3, accepted as reflow. Results: No-reflow phenomenon occurred in 60 patients (15.8%). The sST2 level was higher in the no-reflow group (14.2 ± 4.6 vs. 11.3 ± 5.0, p = 0.003). Moreover, regression analysis indicated that diabetes mellitus, lower systolic blood pressure, multivessel vascular disease, high plaque burden, and grade 0 initial TIMI flow rate were other independent predictors of the no-reflow phenomenon in our study. Besides, when the patients were divided into high and low sST2 groups according to the cut-off value from the Receiver operating characteristics analysis, being in the high sST2 group was associated with 2.7 times increased odds for no-reflow than being in the low sST2 group. Conclusion: sST2 is one of the independent predictors of the no-reflow phenomenon in STEMI patients undergoing primary percutaneous coronary intervention.
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Affiliation(s)
| | - Tunahan Akgun
- Department of Cardiology, Bulent Ecevit University Faculty of Medicine
| | | | - Ferit Akgul
- Department of Cardiology, Bulent Ecevit University Faculty of Medicine
| | | | - Huseyin Karakurt
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital
| | - Murat Can
- Department of Biochemistry, Bulent Ecevit University Faculty of Medicine
| | - Ali Riza Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital
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Akgul F, Batyraliev TA, Fettser DV, Seyfeli E, Arystan AG, Seydaliyeva T, Gali E, Yalcin F, Sidorenko BA. [Decreased Heart Rate Variability in Sickle Cell Anemia as Effect of Pulmonary Arterial Hypertension]. ACTA ACUST UNITED AC 2019; 59:39-44. [PMID: 31002038 DOI: 10.18087/cardio.2019.4.10237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 11/18/2022]
Abstract
Decreased heart rate variability (HRV) is associated with increased mortality risk in various diseases. The objective of this investigation:to study HRV in patients with sickle cell anemia (SCA) and to assess the effect of pulmonary arterial hypertension (PAH) on HRV in these patients. Materials and methods. HRV registration and Doppler echocardiographic assessment of systolic pulmonary arterial pressure (PAP) was carried out in 61 stable patients with SCA and 24 healthy subjects. Results. Low frequency power (LFP) and high frequency power (HFP) were decreased in SCA patients compared to healthy subjects. Among SCA patients, PAH patients had lower LFP and HFP than patients without PAH. In SCA patients, systolic PAP showed significant negative correlation with LFP and HFP. Conclusion. HRV is significantly decreased in SCA patients, especially in those with PAH. HRV may be particularly useful in early detection of PAH patients who may have worse prognosis and higher mortality risk.
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Affiliation(s)
- F Akgul
- Bulent Ecevit University, Zonguldak
| | | | | | | | - A G Arystan
- Medical Centre Hospital of President's Affairs Administration of the RK, Astana
| | | | - E Gali
- Antakya State Hospital, Antakya
| | - F Yalcin
- Mustafa Kemal University, Antakya
| | - B A Sidorenko
- Central State Medical Academy, President Management Department RF
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8
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Çağlar A, Er A, Özden Ö, Karaarslan U, Akgul F, Koroğlu TF, Duman M. Efficacy of Early Noninvasive Ventilation in Three Cases of Nonfatal Drowning with Pulmonary Oedema in the Paediatric Emergency Department. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300206] [Citation(s) in RCA: 6] [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: 11/16/2022] Open
Abstract
Drowning is still one of the most important causes of the preventable mortality worldwide. Some patients should be treated with noninvasive ventilation immediately in the emergency department (ED). The practice of noninvasive ventilation has been increased recently in the paediatric ED. We present here three nonfatal drowning patients with pulmonary oedema and hypoxia who were successfully treated with noninvasive ventilation in the paediatric emergency department. All of the patients had aspirated sea water during swimming. In addition, two of the patients had aspirated water during snorkeling. Noninvasive ventilation was applied to the patients immediately in paediatric emergency service. All of the patient's clinical and radiological findings recovered rapidly. There are limited reports about use of noninvasive ventilation in nonfatal drowning cases in the paediatric emergency department. We emphasize that the early application of noninvasive ventilation should be a preventive method for reducing the morbidity of nonfatal drowning cases. (Hong Kong j.emerg.med. 2016;23:42-46)
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Affiliation(s)
| | | | - Ö Özden
- Dokuz Eylul University, Faculty of Medicine, Department of Paediatric Intensive Care Unit, Turkey
| | - U Karaarslan
- Dokuz Eylul University, Faculty of Medicine, Department of Paediatric Intensive Care Unit, Turkey
| | | | - TF Koroğlu
- Dokuz Eylul University, Faculty of Medicine, Department of Paediatric Intensive Care Unit, Turkey
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9
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Batyraliev TA, Pershukov IV, Niyazova-Karben ZA, Karaus A, Calenici O, Guler N, Eryonucu B, Temamogullari A, Ozgul S, Akgul F, Sengul H, Dogru O, Demirbas O, Timoshin IS, Gaigukov AV, Petrakova LN, Peresypko MK, Sidorenko BA. Current Role of Laser Angioplasty of Restenotic Coronary Stents. Angiology 2016; 57:21-32. [PMID: 16444453 DOI: 10.1177/000331970605700104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Treatment of in-stent restenosis (ISR) with conventional percutaneous transluminal coronary angioplasty (PTCA) causes significant recurrent neointimal tissue growth in 30-85%. Therefore, laser ablation of intrastent neointimal hyperplasia before balloon dilation can be an attractive alternative. However, the long-term outcomes of such treatment have not been studied thoroughly enough. This prospective case-control study evaluated angiographic and clinical outcomes of PTCA alone and a combination of excimer laser coronary angioplasty (ELCA) and adjunct PTCA in 125 patients with ISR. ELCA was performed before balloon dilation in 67 patients, PTCA alone was performed in 58 patients. Basic demographic and clinical data were comparable in both groups. Lesions included in ELCA group were longer (17.1 ±9.9 vs 13.6 ±9.1 mm; p=0.034), more complex (36.5% type C stenoses vs 14.3%; p=0.006), and more frequently had reduced distal blood flow (TIMI <3: 18.9% vs 4.8%; p=0.025) compared to lesions in the PTCA group. Immediate angiographic results of PTCA and ELCA + PTCA appeared to be comparable. PTCA alone was successful in 57 patients (98.3%), ELCA + PTCA, in 66 patients (98.5%). The rates of hospital complications were comparable (3.0% in ELCA group vs 8.6% in PTCA group). The 1-year follow-up showed that the rates of major adverse cardiac events (MACE) were comparable in the 2 groups (37.3% in ELCA group vs 46.6% in PTCA group). The rates of target vessel revascularization (TVR) within 1 year after the intervention were also similar in the 2 groups (32.8% vs 34.5%). The data mean that ELCA in patients with complex ISR is efficient and safe. Despite a higher complexity of lesions in the ELCA group, no increase in the rate of complications was registered.
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10
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Yalcin H, Balci DD, Ucar E, Ozcelik N, Tasci C, Seyfeli E, Akgul F, Yalcin F. Myocardial perfusion is preserved in patients with psoriasis without clinically evident cardiovascular disease. J Eur Acad Dermatol Venereol 2009; 23:798-802. [PMID: 19470047 DOI: 10.1111/j.1468-3083.2009.03178.x] [Citation(s) in RCA: 4] [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: 11/26/2022]
Abstract
BACKGROUND Psoriasis is associated with a premature atherosclerosis due to the chronic inflammatory process. To evaluate the effect of disease process on myocardial perfusion, we planned to perform 99mTc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) in patients with psoriasis. METHODS The study group consisted of 28 psoriasis patients (17 men, 11 women), aged 18-76 years, and mean age 41.2 +/- 14.1 years. The patients were selected among those who were older than 18 years and longer than 10 years of disease duration with more than two times of systemic treatment. All patients underwent 99mTc-MIBI myocardial perfusion SPECT with the same day protocol. RESULTS We detected various risk factors including smoking habits in 7, family history of cardiovascular disease in 4, hypertension in 1, hyperlipidemia in 9 patients. We completed myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. CONCLUSION We detected that myocardial perfusion is preserved in the patients with psoriasis. The majority of acute heart attacks are caused by noncritical coronary stenosis and this may be an explanation for increased cardiovascular risk in these patients despite normal coronary perfusion.
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Affiliation(s)
- H Yalcin
- Mustafa Kemal University School of Medicine, Department of Nuclear Medicine, Antakya, Turkey
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11
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Seyfeli E, Duru M, Saglam H, Akgul F, Kuvandik G, Kaya H, Yalcin F. Association of left ventricular diastolic function abnormalities with aortic elastic properties in asymptomatic patients with type 2 diabetes mellitus. A tissue doppler echocardiographic study. Int J Clin Pract 2008; 62:1358-65. [PMID: 17511794 DOI: 10.1111/j.1742-1241.2007.01381.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between the aortic elastic properties and the left ventricular diastolic function measured by tissue Doppler echocardiography (TDE) in asymptomatic type 2 diabetes mellitus. METHODS Fifty-seven asymptomatic patients with type 2 diabetes (33 women, mean age: 49 +/- 6 years) and 25 healthy control subjects (19 women, mean age: 46 +/- 7 years) were included in the present study. Diastolic filling indices were measured by conventional (CE) and tissue Doppler echocardiography. The aortic elastic properties [Aortic stiffness index (ASI), aortic distensibility and strain] were measured as previous definition. RESULTS Compared with control subjects, the ratio of LV diastolic abnormalities measured by CE and TDE were found higher in patients with type 2 diabetes (36% and 73.6%, p = 0.001, respectively, and 52% and 89.4%, p < 0.001, for septal annulus; 48% and 89.4%, p < 0.001 for septal basal respectively). The ASI was significantly higher (p < 0.001), aortic distensibility and aortic strain were also significantly lower in patients with type 2 diabetes than control subjects (p < 0.001 and p < 0.001 respectively). In the regression analysis, Ao distensibility was correlated to age (beta = -0.299, p = 0.004), septal basal Em/Am ratio (beta =0.543, p < 0.001) and HDL-cholesterol (beta = 0.192, p = 0.039). ASI was also correlated only to age (beta = 0.255, p = 0.044), the presence of diabetes mellitus (beta = 0.304, p = 0.009), mitral A wave (beta = 0.322, p = 0.013) and mitral annulus Em wave (beta = -0.505, p < 0.001). CONCLUSION The aortic elastic function is impaired in asymptomatic patients with type 2 diabetes. Increased ASI and decreased Ao distensibility are closely associated with diastolic filling indices measured by CE and TDE.
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Affiliation(s)
- E Seyfeli
- Department of Cardiology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.
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12
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Guler H, Seyfeli E, Sahin G, Duru M, Akgul F, Saglam H, Yalcin F. P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters. Rheumatol Int 2007; 27:813-8. [PMID: 17431630 DOI: 10.1007/s00296-007-0307-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 01/01/2007] [Indexed: 01/20/2023]
Abstract
P wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.
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Affiliation(s)
- Hayal Guler
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mustafa Kemal University, Tip Fak. Arastirma Hastanesi, Bağriyanik mah, Ormanci cad, P.K. 3100, Antakya/Hatay, Turkey.
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13
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Melek IM, Seyfeli E, Duru M, Duman T, Akgul F, Yalcin F. Autonomic dysfunction and cardiac repolarization abnormalities in patients with migraine attacks. Med Sci Monit 2007; 13:RA47-9. [PMID: 17325646] [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] [Received: 01/03/2006] [Accepted: 03/28/2006] [Indexed: 05/14/2023] Open
Abstract
The clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.
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Affiliation(s)
- Ismet M Melek
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
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14
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Seyfeli E, Guler H, Akoglu S, Karazincir S, Akgul F, Saglam H, Seydaliyeva T, Yalcin F. Right ventricular diastolic abnormalities in rheumatoid arthritis and its relationship with left ventricular and pulmonary involvement. A tissue Doppler echocardiographic study. Int J Cardiovasc Imaging 2006; 22:745-54. [PMID: 16705477 DOI: 10.1007/s10554-006-9096-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 04/10/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement. METHODS Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients. RESULTS An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P<0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio <1 (in 31 (89%) of 35 patients) (P = 0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36+/-5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19+/-5 mmHg), (P = 0.014, P = 0.006, P = 0.015, P = 0.049, respectively). CONCLUSIONS This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA.
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Affiliation(s)
- Ergun Seyfeli
- Department of Cardiology, School of Medicine, Mustafa Kemal University, 31100, Hatay, Turkey.
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15
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Abstract
Sickle cell disease (SCD) is a common form of hemoglobinopathy and is highly prevalent worldwide. Silent cerebral infarction, which represents infarction without clinical signs, is a risk factor for clinical stroke in patients with SCD. It is well known that silent infarction predisposes patients with SCD to overt stroke. The aim of the present study is to investigate the effect of silent infarction on neurological soft signs (NSS), which demonstrate subtle impairments in sensory integration, motor coordination and the sequencing of complex motor acts and to evaluate whether NSS can be used in clinical practice to evaluate the patients at risk of stroke in SCD patients with silent infarction. Fifty-nine SCD patients without any documented history of cerebrovascular accident and 28 healthy controls were included in this study. All the patients with SCD were evaluated with cerebral magnetic resonance imaging. We found that the NSS scores were significantly higher in patients with silent cerebral infarction than those in patients without silent infarction and control subjects (p < 0.05). Importantly, there was no significant difference in the NSS scores between the patients without silent infarction and control subjects. These results indicate that high NSS scores represnt an important finding for diagnosis of silent infarction in SCD patients. As silent infarction increases the risk for stroke in patients with SCD, NSS can be used to provide additional information in diagnosis of the patients with possible stroke risk during the course of SCD.
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Affiliation(s)
- Ismet Melek
- Department of Neurology, Faculty of Medicine, Mustafa Kemal University, Nöroloji ABD. 31100, Antakya, Turkey.
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16
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Akgul F, Batyraliev T, Besnili F, Karben Z. Emergency stenting of unprotected left main coronary artery after acute catheter-induced occlusive dissection. Tex Heart Inst J 2006; 33:515-8. [PMID: 17215985 PMCID: PMC1764943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Left main coronary artery dissection occurs very rarely during selective coronary angiography, but it generally progresses to complete coronary occlusion. The traditional treatment of occlusive dissection of the unprotected left main coronary artery has been surgical. Percutaneous treatment has been sporadic and controversial. We report a case of iatrogenic occlusive dissection of the unprotected left main coronary artery during diagnostic coronary angiography, followed by successful stenting of the lesion.
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Affiliation(s)
- Ferit Akgul
- Faculty of Medicine, Mustafa Kemal University, 31100 Antakya, Turkey
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17
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Seyfeli E, Akoglu S, Karazincir S, Akgul F, Seydaliyeva T, Yalcin F, Duru M. GIANT LEFT ATRIUM MIMICKING A RIGHT THORACIC MASS: CASE REPORT. J Am Geriatr Soc 2006; 54:183-4. [PMID: 16420231 DOI: 10.1111/j.1532-5415.2005.00575_14.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Batyraliev TA, Pershukov IV, Niiazova-Karben ZA, Preobrazhenskiĭ DV, Sercelik A, Karaus A, Calenici O, Guler N, Eryonucu B, Kadayifci S, Ozgul S, Akgul F, Temamogullari A, Demirbas O, Sengul H, Dogru O, Petrakova LV, Sidorenko BA. [Rheolytic thrombectomy with AngioJet catheter during transluminal coronary revascularization in patients with acute myocardial infarction]. Kardiologiia 2003; 43:9-15. [PMID: 14593376] [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] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Although balloon angioplasty and stenting are effective in the treatment of acute myocardial infarction (M1), reduced coronary flow and distal embolization frequently complicate interventions when thrombus is present. Adjunctive treatment with mechanical thrombectomy devices was suggested to reduce these complications. METHODS We evaluated immediate angiographic, in-hospital and 30-day follow-up clinical outcomes of 185 patients with acute MI and angiographically evident thrombus who were treated with AngioJet rheolytic thrombectomy followed by immediate definitive treatment. RESULTS Procedural success (residual diameter stenosis <50% and thrombolysis in myocardial infarction [TIMI] flow >2 after final treatment) was 97%. Rheolytic thrombectomy success was achieved in 7% of patients. Subsequent definitive treatment included stenting in 67% and balloon angioplasty alone in 26% of patients. Final TIMI 3 flow was achieved in 89%. AngioJet treatment resulted in mean thrombus area reduction from 69.6 mm(2) at baseline to 17.3 mm(2) post-thrombectomy (p<0.001). Procedural complications included distal embolization (7.6%) and perforation (1.1%). Clinical success (procedure success without major in-hospital cardiac events) rate was 88%, in-hospital mortality - 7.0%. There were no further major adverse events during 30-day follow-up. CONCLUSION Rheolytic thrombectomy can be performed safely and effectively in patients with acute MI, allowing for immediate definitive treatment of thrombus-containing lesions.
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Affiliation(s)
- T A Batyraliev
- Presidential Medical Center Clinical Hospital, Moscow, Russia
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Birand A, Kudaiberdieva GZ, Batyraliev TA, Akgul F, Usal A. Effects of trimetazidine on heart rate variability and left ventricular systolic performance in patients with coronary artery disease after percutaneous transluminal angioplasty. Angiology 1997; 48:413-22. [PMID: 9158385 DOI: 10.1177/000331979704800505] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fifty-one patients (mean age 51.6 +/- 7.1 years) with angiographically proven coronary artery disease (CAD) entered the study. In 26 patients (Group I), trimetazidine treatment started twenty-four hours after percutaneous transluminal coronary angioplasty (PTCA). Another 25 patients (Group II) without trimetazidine treatment were kept as controls. The groups were comparable by age, gender, risk factors of CAD, coronary anatomy, left ventricular performance, and heart rate variability indices at baseline state. Power spectral analysis of heart rate variability and two-dimensional and Doppler echocardiographic examinations were performed before PTCA, and twenty-four hours, ten days, thirty days, and three months after PTCA. A statistically significant improvement of left ventricular systolic performance (P < 0.001), augmentation of the parasympathetic band of heart rate variability (P < 0.001), and decline of P1/P2 ratio (P < 0.01) were evident in patients treated with trimetazidine, while no apparent changes were observed in controls. The intergroup analysis also showed marked difference between groups as recorded on the day 30 and month 3 of observation (P < 0.001). During follow-up period recurrences of angina pectoris and ischemia were registered in Group II, while no evidence of ischemia was discerned in Group I patients. In conclusion, trimetazidine modulates the autonomic control of heart rate, ie, reduces sympathetic overactivity and augments vagal influences, improves left ventricular contractility, and diminishes the clinical manifestations of ischemia in patients with CAD after PTCA.
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Affiliation(s)
- A Birand
- Cardiology Department, Cukurova University, Medical Faculty, Balcali Hospital, Adana, Turkey
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Niazova ZA, Batyraliev TA, Aikimbaev KS, Kudaiberdieva GZ, Akgul F, Soodanbekova YK, Birand A. High-altitude pulmonary hypertension: effects of captopril on pulmonary and systemic arterial pressures. J Hum Hypertens 1996; 10 Suppl 3:S141-2. [PMID: 8872846] [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: 02/02/2023]
Abstract
The purpose of investigation was the assessment of the effect of captopril on both systemic (Pa) and pulmonary arterial pressures (PPA) in patients with high-altitude pulmonary hypertension (HAPH). Seventeen patients (mean age 44 +/- 6.8 years) with HAPH and mild-to-moderate systemic arterial hypertension were included in the study. All the patients underwent right heart catheterization with measurements of systolic PPA (PPA,syst), mean PPA (PPA) and diastolic PPA (PPA,diast). After a 4 week placebo phase, patients with PPA,syst > 25 mm Hg, PPA > 15 mm Hg and systemic diastolic blood pressure (Pa,diast) > 100 mm Hg received captopril (50-75 mg at 08.00) for a period of 12 weeks. The statistical evaluation of the results were made using the Student's t-test. It was found that captopril significantly decreases PPA and Pa.
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Affiliation(s)
- Z A Niazova
- Cukurova University, Balcali Hospital, Department of Cardiology, Adana, Turkey
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