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Öğe Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study(Wiley, 2016) Bulbul Sen, Bilge; Ekiz, Ozlem; Rifaioglu, Emine Nur; Buyukkaya, Eyup; Karakas, Mehmet Fatih; Buyukkaya, Sule; Bilen, PerihanBackgroundPsoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. ObjectivesThis study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. MethodsThe study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. ResultsPatients with psoriasis had significantly lower meanstandard deviation (SD) 4C (17.1 +/- 1.7 vs. 19.2 +/- 2.3; P<0.01), LAX (16.6 +/- 1.5 vs. 19.5 +/- 2.3; P<0.01), and 2C (16.5 +/- 1.5 vs. 19.4 +/- 2.2; P<0.01) peak longitudinal strain values compared with the control group. Moreover, mean +/- SD LV global strain (16.6 +/- 1.5 vs. 19.9 +/- 2.1; P<0.01) and strain rate (1.39 +/- 0.30 vs. 1.51 +/- 0.20; P<0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (=0.29, P=0.04), duration of disease (=0.35, P<0.01), ejection fraction (EF) (=0.38, P=0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E ratio) (=0.34, P=0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (=0.36, P<0.01), EF (=0.32, P=0.01), and E/E ratio (=0.35, P<0.01). ConclusionsUsing 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.Öğe Hipertansif hastalarda insülin direnci ile stresle indüklenen miyokardiyal doku doppler parametreleri arasındaki ilişkinin incelenmesi(Hatay Mustafa Kemal Üniversitesi, 2012) Bilen, Perihan; Akçay, Adnan BurakGiriş ve Amaç: Hipertansiyon (HT) artan oranda tıbbi ve halk sağlığı sorunudur. İnsülin direnci (İD), belirli konsantrasyondaki insüline subnormal biyolojik yanıt alınması olarak tanımlanabilir. Tip 2 DM, HT ve obezite sıklıkla bir arada bulunan hastalıklardır. Bu önemli hastalıkları ilişkili kılan ise İD'dir. Çalışmamızda konvansiyonel ekokardiyografi (EKO) ve doku Doppler parametrelerini kullanarak nondiyabetik hipertansif hastalarda İD'nin stresle ilişkili sol ventrikül fonksiyonlarına etkisini araştırdık.Gereç ve Yöntem: Esansiyel HT'si olan; 27 İD olan ve 33 İD olmayan 60 hasta çalışmaya dahil edildi. İstirahatte ve egzersizde konvansiyonel EKO ve doku Doppler kullanılarak bölgesel miyokardiyal fonksiyonlar değerlendirildi.Bulgular: Çalışmamızda egzersiz stres EKO'da, doku Doppler yöntemini kullanarak, esansiyel HT'li İD olan ve olmayan hastaların verileri kıyaslandığında istirahatte İD olan grupta Em ve Ea değeri anlamlı olarak düşük bulundu. İD olan ve olmayan gruplar kıyaslandığında streste İD olan grupta E/A oranı ve Am değeri anlamlı olarak düşük bulundu. İki gruptaki hastalar yaş, cinsiyet, vücut kitle indeksi, sol ventrikül ejeksiyon fraksiyonu açısından benzerdi. Diyastolik fonksiyonlar kıyaslandığında istirahatte İD olan 11 hastada diyastolik disfonksiyon (DD) saptanırken İD olmayan 9 hastada DD saptandı ve iki grup arasında anlamlı fark yoktu (p:0.27). Egzersizde diyastolik fonksiyonlar İD olan ve olmayan gruplar arası kıyaslandığında İD olan 19 hastada ve İD olmayan 14 hastada DD tesbit edildi ve İD olanlarda DD anlamlı olarak daha yüksek bulundu (p:0.03).Sonuç: İD olanlarda egzersizin diyastolik fonksiyonları belirgin olarak kötüleştirdiğini düşünmekteyiz. Sonuçta henüz klinik diyabet gelişmeden tesbit edilebilen İD ileride gelişebilecek DD gelişimi için ön belirteç olabilir.Öğe Prognostic significance of neutrophil gelatinase-associated lipocalin in St-segment elevation myocardial infarction(BMJ Publishing Group, 2012) Akcay, Adnan Burak; Ozlu, Mehmet Fatih; Sen, Nihat; Cay, Serkan; Ozturk, Oktay Hasan; YalNcn, Fatih; Bilen, PerihanObjectives: This study investigated the prognostic value of neutrophil gelatinaseYassociated lipocalin (NGAL) in patients with ST-segment elevation myocardial infarction (STEMI). Background: Neutrophil gelatinaseYassociated lipocalin is a promising biomarker for acute kidney injury. Recently, it was concluded that NGAL may be used beyond the boundaries of renal physiopathology. It was found to be an important factor indirectly contributing to the inflammatory processes. Little is known regarding its predictive role in STEMI. Methods: One hundred six consecutive patients who underwent percutaneous coronary intervention (PCI) for STEMI and control group consisted of age- and sex-matched 60 consecutive patients with chest pain admitted to the hospital for elective PCI. According to median NGAL level, patients were classified into high- and low-NGAL groups. Results: Neutrophil gelatinaseYassociated lipocalin levels were higher in patients with STEMI compared to the elective PCI group subjects. Inhospital and 1-year mortality rates were found to be significantly greater in patients with high NGAL. In addition, inhospital and 1-year major adverse cardiovascular event rates were significantly greater in the high-NGAL group, compared to the low NGAL group. High NGAL level on admission was a significant predictor for long-term mortality and major adverse cardiovascular events. The receiver operating characteristics curve analysis further illustrated that NGAL level on admission is a strong indicator of mortality, with an area under the curve of 0.76 (95% confidence interval, 0.62-0.89). Conclusions: High NGAL levels may be associated with poor prognosis after PCI in patients with STEMI. However, further studies with larger numbers of patients and longer follow-up are required to evaluate the usefulness of plasma NGAL level for predicting prognosis of STEMI. © 2012 by The American Federation for Medical Research.Öğe Prognostic Significance of Neutrophil Gelatinase-Associated Lipocalin in ST-Segment Elevation Myocardial Infarction(Bmj Publishing Group, 2012) Akcay, Adnan Burak; Ozlu, Mehmet Fatih; Sen, Nihat; Cay, Serkan; Ozturk, Oktay Hasan; Yalicn, Fatih; Bilen, PerihanObjectives: This study investigated the prognostic value of neutrophil gelatinase-associated lipocalin (NGAL) in patients with ST-segment elevation myocardial infarction (STEMI). Background: Neutrophil gelatinase-associated lipocalin is a promising biomarker for acute kidney injury. Recently, it was concluded that NGAL may be used beyond the boundaries of renal physiopathology. It was found to be an important factor indirectly contributing to the inflammatory processes. Little is known regarding its predictive role in STEMI. Methods: One hundred six consecutive patients who underwent percutaneous coronary intervention (PCI) for STEMI and control group consisted of age- and sex-matched 60 consecutive patients with chest pain admitted to the hospital for elective PCI. According to median NGAL level, patients were classified into high-and low-NGAL groups. Results: Neutrophil gelatinase-associated lipocalin levels were higher in patients with STEMI compared to the elective PCI group subjects. Inhospital and 1-year mortality rates were found to be significantly greater in patients with high NGAL. In addition, inhospital and 1-year major adverse cardiovascular event rates were significantly greater in the high-NGAL group, compared to the low NGAL group. High NGAL level on admission was a significant predictor for long-term mortality and major adverse cardiovascular events. The receiver operating characteristics curve analysis further illustrated that NGAL level on admission is a strong indicator of mortality, with an area under the curve of 0.76 (95% confidence interval, 0.62-0.89). Conclusions: High NGAL levels may be associated with poor prognosis after PCI in patients with STEMI. However, further studies with larger numbers of patients and longer follow-up are required to evaluate the usefulness of plasma NGAL level for predicting prognosis of STEMI.Öğe Relation of Fragmented QRS to Tissue Doppler-Derived Parameters in Patients with Familial Mediterranean Fever(Elsevier Science Inc, 2013) Celik, Muhammet Murat; Buyukkaya, Eyup; Ustun, Nilgul; Nacar, Alper Bugra; Kurt, Mustafa; Karakas, Mehmet Fatih; Bilen, Perihan[Abstract Not Available]Öğe Relation of fragmented QRS to tissue Doppler-derived parametersin patients with familial Mediterranean fever(Springer Wien, 2015) Celik, Muhammet Murat; Buyukkaya, Eyup; Ustun, Nilgul; Nacar, Alper Bugra; Kurt, Mustafa; Karakas, Mehmet Fatih; Bilen, PerihanFamilial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR', evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. There was no significant difference between groups regarding age (29 +/- 12 vs 29 +/- 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p < 0.01). E/Em ratio showed a statistically significant increase in the FMF group with fQRS (p < 0.0001), while the mean Em value was markedly lower (p < 0.0001). FMF patients displayed a statistically significant increase in frequency of fQRS. Doppler-derived diastolic index was statistically significantly impaired in FMF patients with fQRS as compared with the patients without fQRS. In conclusion, fQRS might be a new noninvasive marker for cardiac involvement in FMF patients.Öğe The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major(Canadian Soc Clinical Investigation, 2012) Buyukkaya, Eyup; Karakas, Mehmet Fatih; Kurt, Mustafa; Bilen, Perihan; Yalcin, Fatih; Celik, Murat; Helvaci, RamiPurpose: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. Methods: The patients with b-thalassaemia major (n=66; mean age: 23 +/- 6 years) and healthy controls (n=30; mean age: 23 +/- 4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. Results: When compared to those in control group, fQRS was more frequent in b-thalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p < 0.05), the mean Em and Sm values were found to be significantly low (p < 0.05). Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.Öğe The relationship between coenzyme Q10 and severity of coronary artery disease(2013) Büyükkaya, Eyüp; Evliyao?lu, Osman; Islamo?lu, Yahya; Cil, Habib; Karakaş, Mehmet Fatih; Akçay, Adnan Burak; Bilen, PerihanAim To evaluate the relationship between the levels of plasma coenzyme Q10 (CoQ10), a known antioxidant, and severity of the coronary atherosclerosis (AS) measured by Gensini score. Methods Patients with coronary artery disease (CAD) were enrolled to the study between 2010 and 2011 in cardiology outpatient clinics. They were admitted for diagnostic coronary angiography or angioplasty for typical indications. The Gensini scoring system was used to calculate CAD severity. Serum CoQ10, total cholesterol (TC), HDL cholesterol, LDL cholesterol, and triglyceride levels were assessed. Results One hundred thirteen subjects (83 CAD, 30 controls) were included. The patients with CAD were separated into three groups according to Gensini score. The serum levels of CoQ10, CoQ10/ TC, CoQ10/LDL-C, CoQ10/TG rates in the subjects of mild and severe AS groups were significantly lower than the control group (p<0.016 for all control vs. AS group comparisons). There were no significant differences in serum levels of CoQ10 and CoQ10/ TC, CoQ10/LDL-C, CoQ10/TG rates between the mild and severe AS groups. Conclusion This study revealed that although the serum CoQ10 levels were lower in stable CAD, there was no relationship between the severity of CAD and serum CoQ10 levels in patients with stable angina pectoris.
