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    Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation
    (Türk Kardiyoloji Derneği, 2019) Demirtaş, Abdullah Orhan; İçen, Yahya Kemal; Dönmez, Yurdaer; Koca, Hasan; Kaypaklı, Onur; Şahin, Durmuş Yıldıray; Koç, Mevlüt
    Objective: The aim of this research was to investigate the relationship between atrial fibrillation (AF) recurrence and second generation cryoballoon ablation (CBA) procedural parameters in patients with non-valvular paroxysmal AF (PAF). Methods: A total of 131 patients with a PAF diagnosis who underwent second-generation CBA (59 male; mean age: 55.2±10.6 years) were enrolled. Recurrence was defined as the detection of AF on a 12-lead electrocardiography (ECG) recording, or an attack lasting at least 30 seconds observed on Holter ECG records. CBA procedural data and echocardiographic findings were recorded and compared. Results: After 1 year of follow-up, AF recurrence was detected in 27 patients. Patients with recurrence were older and had higher rates of hypertension and diabetes (p<0.05 for both). Left atrial diameter, left atrial volume (LaV), left atrial volume index, and the averaged warming angle (calculated by combining lowest temperature point and balloon temperature at 20°C point) were significantly higher in the recurrence group. Balloon warming time was significantly longer in the non-recurrence group (p<0.001). In binary logistic regression analysis, the averaged warming angle (odds ratio [OR]: 1.559, 95% confidence interval [CI]: 1.342– 1.811; p<0.001) and LaV (OR: 1.063, 95% CI: 1.028–1.100; p<0.001) were found to be independent parameters for predicting recurrence. The cutoff value of the warming angle obtained with ROC curve analysis was 50° for the prediction of recurrence (sensitivity: 94.3%, specificity: 88.5%, area under the curve: 0.909; p<0.001). The cutoff value of LaV obtained by ROC curve analysis was 53.5 for prediction of recurrence (sensitivity: 77.8%, specificity: 74.5%; p<0.001). Conclusion: Measurement of balloon warming angle during CBA and increased LaV may predict the AF recurrence.
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    Epicardial fat thickness is associated with oxidative stress index in cardiac syndrome X
    (İnönü Üniversitesi, 2020) Özbiçer, Süleyman; Kalkan, Gülhan; Gür, Mustafa; Topuz, Mustafa; Kaypaklı, Onur; Koç, Mevlüt; Erel, Özcan
    AbstractAim: We aimed to investigate the relationship between oxidative parameters- total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI)- and EFT in patients with CSX. Without clinically significant coronary artery disease, cardiac syndrome X (CSX) is characterized by cardiac ischemia, and chest pain. However, there is some evidence about increased oxidative stress in CSX patients; the relationship between oxidative stress parameters and epicardial fat thickness (EFT) is not well established in this population.Material and Methods: : One hundred and twenty-two patients with normal coronary arteries (73 female, 49 males, mean age 56.71 ± 10.69 years) were enrolled in the study. The study population was divided into two groups according to their OSI. Oxidative stress index below the median was defined as the OSI low group and equal or higher than the median was defined as the OSI high group.Results: EFT was higher in the high OSI group than the low OSI group (6 (3.9 – 8.9) vs. 5.4 (0.56 – 7.2), p= 0.032). In bivariate correlation analysis EFT was positively correlated with OSI and TOS (r=0.242, p=0.036 and r=0.234, p=0.025 respectively). In binary logistic regression analysis, EFT was found to be an independent predictor of OSI.Conclusion: : In our study, EFT was independently associated with OSI in CSX patients. This finding suggests that EFT may be a marker of increased oxidative stress in CSX.
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    Tp-e interval and Tp-e/QTc ratio are significantly Increased in patients with brain death
    (Hacettepe Üniversitesi, 2019) Demirtaş, Abdullah Orhan; Urgun, Örsan Deniz; Koca, Hasan; Kaypaklı, Onur; İçen, Yahya Kemal; Koç, Mevlüt
    Objective: We aimed to investigate whether there is a change in Tp-e interval, Tp-e/ QT and Tp-e/QTc ratios in patients with brain death. Materials and Methods: Fifty brain death patients and 50 age and sex matched healthy controls were included in the study. In addition to routine evaluation, Tp-e interval, Tp-e / QT and Tp-e / QTc ratios were measured in 12-lead electrocardiography. Tp-e was measured in the precordial leads using the Tail method; the time from the peak of the T wave to the point where the wave reached the isoelectric line. Results: White blood cell, aspartate aminotransferase, alanine aminotransferase and high sensitive c reactive protein levels were significantly higher in patients with brain death. The frequency of patients with QTc prolongation, Tp-e interval, Tp-e/QT and Tp-e/QTc values were significantly higher in patients with brain death (p <0.05). Tp-e interval, Tp-e/QT and Tp-e/QTc values were found to be positively correlated with HsCRP (p<0.001 for all). Conclusion: Tp-e interval, Tp-e / QT and Tp-e / QTc ratios are increased in patients with brain death compared to healthy controls. The mechanisms of this association and possible relationship with neuroendocrine changes should be investigated in future studies.
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    Tp-e Interval and Tp-e/QTc Ratio Are Significantly Increased in Patients with Brain Death
    (2019) Demirtaş, Abdullah Orhan; Urgun, Örsan Deniz; Koca, Hasan; Kaypaklı, Onur; İçen, Yahya Kemal; Koç, Mevlüt
    Objective: We aimed to investigate whether there is a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with brain death.Materials and Methods: Fifty brain death patients and 50 age and sex matched healthy controls were included in the study. In addition to routine evaluation, Tp-e interval, Tp-e / QT and Tp-e / QTc ratios were measured in 12-lead electrocardiography. Tp-e was measured in the precordial leads using the Tail method; the time from the peak of the T wave to the point where the wave reached the isoelectric line.Results: White blood cell, aspartate aminotransferase, alanine aminotransferase and high sensitive c reactive protein levels were significantly higher in patients with brain death. The frequency of patients with QTc prolongation, Tp-e interval, Tp-e/QT and Tp-e/QTc values were significantly higher in patients with brain death (p <0.05). Tp-e interval, Tp-e/QT and Tp-e/QTc values were found to be positively correlated with HsCRP (p<0.001 for all). Conclusion: Tp-e interval, Tp-e / QT and Tp-e / QTc ratios are increased in patients with brain death compared to healthy controls. The mechanisms of this association and possible relationship with neuroendocrine changes should be investigated in fu-ture studies.