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    Assessment of Atrial and Ventricular Mechanics in Patients with Sickle Cell Disease without Overt Pulmonary Hypertension: A Two-Dimensional Deformation Imaging Study
    (Wiley-Blackwell, 2012) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Celik, Murat; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak
    [Abstract Not Available]
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    Assessment of left ventricular dyssynchrony in dipper and non-dipper hypertension
    (Taylor & Francis Ltd, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak; Sen, Nihat
    Background. Ventricular dyssynchrony is an co-determinant of progression and exacerbation of heart failure (HF). The co-existence of ventricular dyssynchrony with hypertension (HT) and HF were shown, however there is no data regarding the effect of circadian rhythm of blood pressure (BP) on ventricular synchrony. Therefore, we aimed to study the left ventricular synchrony in dipper and non-dipper normotensive and hypertensive participants. Methods. Participants (n = 142) were categorized into four groups as Normotensive-Dipper (NT-D) (n = 40), Normotensive-Non-dipper (NT-ND) (n = 30), Hypertensive-Dipper (HT-D) (n = 38) and Hypertensive-Non-dipper (HT-ND) (n = 34). Left ventricular dyssynchrony was investigated by color-coded tissue Doppler imaging. Results. Non-dippers had higher 24-h and night-time BP both in normotensives and hypertensives. The incidence of ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) was higher in the hypertensive group (47.2% vs 24.3%, p = 0.005). The frequency of ventricular dyssynchrony was higher in the HT-ND group than the HT-D group (58.8% vs 36.8%, p = 0.05); however, the frequency of ventricular dyssynchrony was similar among the normotensives (26.7% vs 22.5%, p = 0.45). Ts-SD-12 and Ts-12 were higher in NT-ND group than the NT-D group. Conclusions. Non-dipping BP pattern was associated with impaired left ventricular contraction synchrony in both normotensive and hypertensive participants, which may be related with short-and long-term effects of HT on myocardium.
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    Assessment of left ventricular dyssynchrony in patients with psoriasis
    (Wiley-Blackwell, 2014) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Mehmet Fatih; Buyukkaya, Sule
    Background Psoriasis is an inflammatory disorder, which has been reported to be associated with cardiovascular (CV) risks. Although increased CV risks in psoriasis are well established, there are no data about changes of contraction synchrony in psoriasis. Therefore, we aimed to study the left ventricular (LV) contraction synchrony in patients with psoriasis with narrow QRS and normal ejection fraction. Methods Fifty patients with psoriasis and 50 age- and sex-matched control subjects were included in the study. LV dyssynchrony was investigated by color-coded tissue Doppler imaging. Results In the psoriasis group, the mean high-sensitive C-reactive protein values were significantly higher compared with the controls. Peak A velocity, deceleration time, isovolumetric relaxation time, and E/E' values were higher in the psoriasis group; however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters [including standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments, standard deviation of Ts of the six basal LV segments, and maximal difference in Ts between any two of the six basal LV segments] were found to be higher in the psoriasis group. The patients with ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) were higher in the psoriasis group than the control group (34% vs. 6%, P < 0.01). Conclusion In patients with psoriasis with normal ejection fractions and narrow QRS, LV systolic dyssynchrony is an early manifestation of heart involvement and may coexist with diastolic dysfunction.
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    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, Perihan
    BackgroundPsoriasis 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.
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    Higher Pentraxin-3 Level in Patients with Metabolic Syndrome Reply
    (Karger, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Esra; Buyukkaya, Sule
    [Abstract Not Available]
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    Left Ventricular Dyssynchrony is an Early Manifestation of Heart involvement in Sickle Cell Anemia
    (Wiley-Blackwell, 2012) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Celik, Murat; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak
    [Abstract Not Available]
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    Relation of red cell distribution width with dipper and non-dipper hypertension
    (Medical Association of Zenica-Doboj Canton, 2016) Buyukkaya, Eyup; Erayman, Ali; Karakas, Esra; Nacar, Alper Bugra; Kurt, Mustafa; Buyukkaya, Sule; Akcay, Adnan Burak
    Aim Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure (BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated. Methods A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper (HT-ND). RDW and hs-CRP levels were measured. Results Hypertensive patients had higher RDW and hs-CRP levels (14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52 vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D) Conclusion RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with increased inflammatory state. © 2016, Medical Association of Zenica-Doboj Canton. All rights reserved.
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    The Relationship between Coronary Collateral Circulation and Neutrophil/Lymphocyte Ratio in Patients with Coronary Chronic Total Occlusion
    (Karger, 2015) Nacar, Alper Bugra; Erayman, Ali; Kurt, Mustafa; Buyukkaya, Eyup; Karakas, Mehmet Fatih; Akcay, Adnan Burak; Buyukkaya, Sule
    Objectives: To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion. Subjects and Methods: Our study population consisted of 275 consecutive patients with chronic total occlusion. One hundred and thirty-eight patients with chronic total occlusion were included in the study. They were classified into 2 groups as follows: impaired CCC (group 1: Rentrop grades 0-1) and good CCC (group 2: Rentrop grades 2-3). The NLR was calculated from the complete blood count. Results: The NLR values of the patients with impaired CCC (4.5 +/- 0.7) were significantly higher than of those with good CCC (2.7 +/- 0.6, p < 0.001). In the multivariate logistic regression test, NLR (OR 33.36, 95% CI 8.189-135.7, p < 0.001), high-sensitivity C-reactive protein (hs-CRP; OR 2.152, 95% CI 1.226-3.777, p = 0.008), estimated glomerular filtration rate (OR 1.167, 95% CI 1.049-1.298, p = 0.004) and systolic blood pressure (OR 1.068, 95% CI 1.009-1.1310, p = 0.025) were independent predictors of impaired CCC. The NLR value > 3.55 yielded an area under the curve value of 0.957 (95% CI 0.921-0.992, p < 0.001) and demonstrated a sensitivity of 95% and a specificity of 90% for the prediction of CCC. A moderate correlation between NLR and hs-CRP was observed (r = 0.443; p < 0.001). Conclusion: Our findings reveal that NLR correlates with the impaired development of coronary collaterals. (C) 2014 S. Karger AG, Basel
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    Serum Pentraxin 3 Levels Are Associated With the Complexity and Severity of Coronary Artery Disease in Patients With Stable Angina Pectoris
    (Bmj Publishing Group, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Motor, Sedat; Akcay, Adnan Burak; Buyukkaya, Sule; Karakas, Esra
    Background: Atherosclerosis is a complex inflammatory process in which inflammatory markers are involved. Although pentraxin 3 (PTX-3), a newly identified inflammatory marker, was associated with adverse outcomes in stable angina pectoris, no association between PTX-3 and the complexity of coronary artery disease (CAD) has been reported. Thus, the aim of the present study was to assess the association between the level of PTX-3 and the complexity and severity of CAD assessed with SYNTAX and Gensini scores in patients with stable angina pectoris. Methods: The study population consisted of 2 groups: 161 patients with anginal symptoms and evidence of ischemia who underwent coronary angiography and 50 age-and sex-matched control subjects without evidence of ischemia were included. Patients were grouped into 3 groups according to the complexity and severity of coronary lesions assessed by the SYNTAX score (30 patients with a SYNTAX score of 0 were excluded). Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Results: The PTX-3 levels demonstrated an increase from low to high SYNTAX groups (r = 0.72, P < 0.001). Whereas the low SYNTAX group had statistically significantly higher PTX-3 levels when compared with the control group (0.50 +/- 0.01 vs 0.24 +/- 0.01 ng/mL, P < 0.001), the hs-CRP levels were not different (0.81 +/- 0.42 vs 0.86 +/- 0.53 mg/dL, P = 0.96). However, the intermediate SYNTAX group had higher hs-CRP levels compared with the low SYNTAX group (1.3 +/- 0.66 vs 0.86 +/- 0.53 mg/dL, P = 0.002). Serum PTX-3 levels and hs-CRP levels were correlated with the SYNTAX scores and Gensini scores (for SYNTAX: r = 0.87 [P < 0.001] and r = 0.36 [P = 0.01]; for Gensini: r = 0.75 [P G 0.001] and r = 0.27 [P = 0.002], respectively), and according to the results of univariate and multivariate analyses, for intermediate and high SYNTAX scores, age, diabetes mellitus, low-density lipoprotein cholesterol, hs-CRP, and PTX-3 were found to be independent predictors, whereas for the presence of high SYNTAX score only PTX-3 was found to be an independent predictor. The receiver operating characteristic curve analysis further revealed that the PTX-3 level was a strong indicator of high SYNTAX score with an area under the curve of 0.91 (95% confidence interval, 0.86Y0.96). Conclusions: Pentraxin 3, a novel inflammatory marker, was more tightly associated with the complexity and severity of CAD than hs-CRP and was found to be an independent predictor for high SYNTAX score.
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    Serum Pentraxin-3 Levels Are Associated with the Severity of Metabolic Syndrome
    (Karger, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Motor, Sedat; Akcay, Adnan Burak; Karakas, Esra; Buyukkaya, Sule
    Objectives: The aim of the present study was to assess the association between the level of pentraxin-3 (PTX-3) and the severity of metabolic syndrome (MS). Subjects and Method: One hundred and two patients with MS and 101 consecutive age-and sex-matched control subjects were included in the study. The MS patients were classified into three groups based on the number of MS criteria, i.e. group 1: patients with 3 MS criteria, group 2: patients with 4 MS criteria, and group 3: patients with 5 MS criteria. Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Results: Group 1 had higher PTX-3 levels compared to the control group (0.58 +/- 0.11 ng/ml vs. 0.36 +/- 0.15 ng/ml, p < 0.001). PTX-3 levels were higher in group 3 than in both group 1 (0.90 +/- 0.06 ng/ml vs. 0.58 +/- 0.11 ng/ml, p < 0.001) and group 2 (0.90 +/- 0.06 ng/ml vs. 0.63 +/- 0.12 ng/ml, p < 0.001). Group 3, however, had higher hs-CRP levels than both group 1 (1.89 +/- 0.45 mg/dl vs. 1.40 +/- 0.44 mg/dl, p = 0.007) and group 2 (1.89 +/- 0.45 mg/dl vs. 1.47 +/- 0.58 mg/dl, p = 0.01). The control group had lower hs-CRP levels than group 1 (0.81 +/- 0.47 mg/dl vs. 1.40 +/- 0.44 mg/dl, p < 0.001) and group 2 (0.81 +/- 0.47 mg/dl vs. 1.47 +/- 0.58 mg/dl, p < 0.001). Serum PTX-3 levels correlated with serum hs-CRP levels (r = 0.49, p < 0.001). Conclusions: PTX-3, a novel inflammatory marker, was found to be associated with the severity of MS. Copyright (C) 2012 S. Karger AG, Basel