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    Abnormal Left Ventricular Mechanics in isolated Bicuspid Aortic Valve Disease may be independent of aortic distensibility: 2D Strain Imaging Study
    (I C R Publishers, 2012) Kurt, Mustafa; Tanboga, Ibrahim Halil; Bilen, Emine; Isik, Turgay; Kaya, Ahmet; Karakas, Mehmet Fatih; Buyukkaya, Eyup
    Background aim of the study: In this study, we hypothesized that subclinical impairment of left ventricular (LV) mechanical function in bicuspid aortic valve (BAV) patients is independent of valvular hemodynamics represented by valvuloarterial impedance and aortic elastic characteristics. Therefore, we aimed to test left ventricular mechanics in cases of isolated non-stenotic BAV with non-dilated aorta. Methods: Thirty-three patients with isolated BAV exhibiting non-dilated aorta, and 25 age-and gender-matched healthy subjects were included in the study. Patients with aortic valve velocity > 1.5 m/s and mild-to-moderate aortic regurgitation or ascending aorta diameter >3.5 cm were excluded from the study. Aortic elasticity parameters and valvulo-arterial impedance were calculated. Strain measurements were reported as the peak longitudinal strain (LS) for four chamber (4C), long axis (LAX) and two chamber (2C) views. Strain rate (Sr) measurements were reported as the peak systolic strain rate (Sr-sm), early diastolic strain rate (Sr-ern) and late diastolic strain rate (Sr-am) for 4C, LAX and 2C views. Results: Systolic and diastolic diameters of the ascending aorta, aortic elastic properties (aortic strain, aortic distensibility, aortic stiffness and aortic elastic modulus), and valvulo-arterial impedances were found to be comparable between the BAV and control groups. BAV group was observed to have statistically significantly lower 4C (18.9 +/- 1.7 vs 17.8 +/- 1.5, p=0.02), LAX (19.7 +/- 1.7 vs 17.7 +/- 1.3, p=0.001) and 2C (20.1 +/- 1.8 vs 17.7 +/- 1.2, p<0.001) peak longitudinal strain values compared with the control group. Moreover, LV-GS values were found to be significantly lower in the BAV group than in the control group (19.6 +/- 1.1 vs 17.7 +/- 0.9, p<0.001). However, there was no statistically significant difference between the groups in terms of Sr-sm, Sr-em ye Sr-am values in the 4C, LAX, and 2C views. Conclusion: BAV might affect LV systolic functions, assessed by 2D strain imaging, in a fashion independent from the valvular dynamics and aortic elasticity. This might show that BAV is not only a valvular disease, but possibly a ventricular disease as well. The Journal of Heart Valve Disease 2012;21:608-614
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    Assessment of aortic elasticity and its relation with left ventricular filling and diastolic parameters by transthoracic and transesophageal echocardiography
    (2013) Kurt, Mustafa; Tanboğa, İbrahim Halil; Karakaş, Mehmet Fatih; Büyükkaya, Eyüp; Akçay, Adnan Burak; Şen, Nihat
    Amaç: Aort boyutlar ve elastik özelliklerini transtorasik ekokardiyografi (TTE) ve transözofageal ekokardiyografi (TEE) ile karşılaştıran sınırlı veri vardır. Bu nedenle, TTE ve TEE elde edilen aort boyutlar ve aortik elastik indekslerinin karşılaştırmanın yanı sıra bunların sol ventrikül (LV) dolum ve diyastolik parametreleri ile ilişkisini araştırmayı amaçladık. Yöntem: Çalışmaya kırk iki hasta dahil edildi. Tüm hastaların TTE ve TEE kayıtlarından aort boyutları ve ilgili elastikiyet parametreleri, sol ventrikül dolum ve diyastolik parametreleri, sol atriyal volüm indeksi (LAVİ), sol ventrikül kütle i n- deksi hesaplandı. TTE ve TEE elde edilen aort elastikiyeti indeksleri ve sol ventrikül dolum ve diyastolik parametreleri için korelasyon analizi yapıldı. Bulgular: TTE ve TEE ile elde edilen aort boyutları ve elastikiyeti indeksleri arasında anlamlı bir fark yoktu. Korelasyon analizinde yaş, E / A, E / E`ve LAVİ hem TTE hem de TEE ile edilen aort elastikiyeti indeksleri ile anlamlı derecede ilişkili iken, sol ventrikül kitle indeksi sadece TEE ile elde edilen aort elastikiyeti indeksleri ile ilişkili saptandı. Sonuç: TTE ile karşılaştırıldığında, TEE elde edilen aortik elastik özellikleri sol ventrikül dolum ve diyastolik parame treleri ile daha yakından ilişkili bulunmuştur. Buna ek olarak, TEE ve TTE ile elde edilen aort fonksiyon indeksleri iyi gözlemci içi ve gözlemciler arası değişkenliği ile benzerdir.
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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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    Clinical and morphological evaluation of coronary bifurcation lesions
    (2013) Kurt, Mustafa; Tanboğa, İbrahim Halil; Karakaş, Mehmet Fatih; Büyükkaya, Eyüp; Akçay, Adnan Burak; Şen, Nihat; Aksakal, Enbiya
    Amaç: Koroner bifurkasyon lezyonlarının anatomik ve morfolojik özelliklerini araştırmayı amaçladık. Çalışma planı: Çalışmaya koroner anjiyografi yapılan 542 stabil hasta alındı. Bifurkasyon lezyonları en az 2.5 mm çaplı ve en az %50 darlık olan ana dal ve yan dal lezyonları olarak tanımlandı. Bu ölçütler kullanılarak, bifurkasyon lezyonlarının varlığı ve sayısı, bu lezyonların bulunduğu damarlar, Medina sınıflandırmasına göre lezyonun tipi ve bifurkasyon lezyonunun açısı belirlendi. Bulgular: Bifurkasyon tanımına göre hastaların %19.3’ünde (n=105) bifurkasyon lezyonu vardı. Bunların %77’sinde, bifurkasyon açısı 70°’nin altında idi. Tüm lezyonların yaklaşık %37’si Medina 1.1.1 sınıflandırması ile uyumlu idi. Tüm bifurkasyon lezyonlarının yaklaşık %56’sı sol ön inen arter (LAD), %25.4’ü sirkumfleks arter (Cx) ve %12.5’i sağ koro- ner arter (RCA) bölgesinde idi. Medina 1.1.1 tip lezyonlar en sık LAD ve RCA’da gözlenirken en az Cx ve sol ana koro- ner bölgesinde saptandı. Diyabet bifurkasyon lezyonu olan hastalarda olmayanlara göre anlamlı olarak yüksek sıklıkta saptandı. Sonuç: Bifurkasyon lezyonları koroner anjiyografi pratiğinde sıkça gözlenmektedir. Bunların anjiyografik özellikleri ve bu lezyonların klinik durumla ile ilişkisi uygun girişimsel tedavinin seçiminde çok önemli olabilir.
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    Comparison of clinical outcomes in patients who underwent bare metal coronary stenting versus coronary by-pass surgery
    (2013) Tanboğa, İbrahim Halil; Kurt, Mustafa; Aksakal, Enbiya; Kaygın, Mehmet Ali; Kaya, Ahmet; Işık, Turgay; Çolak, Abdürrahim; Sevimli, Serdar
    Giriş: Biz bu çalışmamızda, koroner baypas greftleme cerrahisi ile çıplak metal stent uygulanmış hastalarda SYNTAX (Sx) skoru ile değerlendirilen koroner lezyon kompleksitelerinin klinik sonlanımlar üzerine etkisini incelemeyi amaçladık.Hastalar ve Yöntem: Çalışma grubumuz çıplak metal stent uygulanmış (n= 265) ve koroner baypas cerrahisine giden (n= 294) 459 hastadan oluşmaktadır. Koroner arter hastalığı kompleksitesi Sx skoru ile değerlendirilmiştir. Sx skoru, hafi f Sx skoru (<= 22), orta Sx skoru ve yüksek Sx skoru (>= 33) olmak üzere üç gruba ayrılmıştır.Bulgular: Çalışma süresince orta dönem takipte herhangi bir nedenle revaskülarizasyon sıklığı hem tüm grupta hem de Sx alt gruplarında perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Orta dönem takipte herhangi bir nedenden ölüm sıklığı düşük ve orta Sx gruplarında tedavi grupları arasında benzer bulunmuştur. Ancak yüksek Sx skoru grubunda orta dönem takipte herhangi bir nedenden ölüm sıklığı perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Tüm popülasyonda herhangi bir nedenden dolayı ölüm için düzeltilmiş risk perkütan koroner girişim ve koroner baypas cerrahisi arasında benzerken [hazard ratio, %95 GA: 0.88 (0.38-2.05), p= 0.780], herhangi bir nedenle revaskülarizasyon için düzeltilmiş risk koroner baypas cerrahisi grubuna göre perkütan koroner girişim grubunda belirgin olarak daha fazlaydı [hazard ratio, %95 GA: 0.12 (0.05-0.30), p< 0.001].Sonuç: Sx skoru ile değerlendirilen koroner lezyon kompleksitesi herhangi bir nedenle revaskülarizasyon sıklığı ile daha yakın ilişkilidir. Yüksek Sx skoru gubunda herhangi bir nedenden ölüm çıplak metal stent uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazlaydı
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    The correlation between infarct size and the QRS axis change after thrombolytic therapy in ST elevation acute myocardial infarction
    (2012) Karakaş, Mehmet Fatih; Bilen, Emine; Kurt, Mustafa; Arslantaş, Uğur; İpek, Göktürk; Karakaş, Esra; Yüksel, İsa Öner; Saatçi Yaşar, Ayşe
    Amaç: Elektrokardiyografi (EKG) ST yükselmeli akut miyokard infarktüsü (STYAMİ) ile gelen hastalarda prognostik infarkt genişliğini belirlemede pratik ve yönlendirici bir araç olabilir. Bu çalışma ile infarkt genişliği ile trombolitik tedavi sonrası QRS aks değişim miktarı arasında bir ilişki olup olmadığını bulmaya çalıştık. Gereç ve Yöntem: Bu çalışmada trombolitik tedavi alan STYAMİ hastaları retrospektif olarak seçildi. İki EKG’de (trombolitik tedavi öncesindeki ve tedavi sonrası 90. dakikadaki) ortalama QRS aksı bir formül yardımıyla hesaplandı. İnfarkt genişliğini belirlemede belirteç olarak kreatinin kinaz MB (CKMB) kullanıldı. Bulgular: Tüm Mİ altgrupları gözönüne alındığında infarkt genişliği ile QRS aksı değişimi arasında korelasyon saptamadık (p=0.80). Sadece izole inferior Mİ grubunda CKMB ile QRS aksı değişimi arasında iyi derece korelasyon saptadık (r=-0.52 p=0.049). Sonuç: QRS aksı değişimi, trombolitik tedavinin etkinliğinin değerlendirilmesinde ve prognostik infarkt genişliğinin belirlenmesinde çok vurgulanmamış, pratik ve gelecek vadeden bir araç gibi gözükmektedir.
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    The Correlation between Infarct Size and the QRS Axis Change after Thrombolytic Therapy in ST Elevation Acute Myocardial Infarction
    (Aves, 2012) Karakas, M. Fatih; Bilen, Emine; Kurt, Mustafa; Arslantas, Ugur; Ipek, Gokturk; Karakas, Esra; Yuksel, Isa Oner
    Objective: Electrocardiography (ECG) may be a practical guiding tool for prognostic infarct sizing in ST elevation acute myocardial infarction (STEAMI). In this study, we sought to find a relation between the infarct size and the change in the QRS axis after thrombolytic therapy. Materials and Methods: Patients with STEAMI who received thrombolytic therapy were selected retrospectively. The mean QRS axes of two ECGs (before and 90 minutes after thrombolytic therapy) were calculated. Creatinine kinase MB (CKMB) was used as the marker of infarct size. Results: We did not detect any correlation between infarct size and change in the QRS axis with respect to any myocardial infarction MI localizations (p=0.80). However, in the isolated inferior MI group, there was a good correlation between CKMB and change in the QRS axis (r=-0.52 p=0.049). Conclusion: The change in the QRS axis is rarely emphasized, providing a practical and promising tool for evaluating both the efficiency of the thrombolytic therapy and prognostic infarct sizing.
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    Correlation of Neutrophil to Lymphocyte Ratio With the Presence and Severity of Metabolic Syndrome
    (Sage Publications Inc, 2014) Buyukkaya, Eyup; Karakas, Mehmet Fatih; Karakas, Esra; Akcay, Adnan Burak; Tanboga, Ibrahim Halil; Kurt, Mustafa; Sen, Nihat
    Purpose: The aim of this study is to investigate the relationship between the criteria comprising metabolic syndrome (MS) and neutrophil-lymphocyte ratio (NLR), a simple and reliable indicator of inflammation. Method: Seventy patients with MS and 71 age- and sex-matched control participants were included. Patients were classified into 3 groups based on the number of MS criteria: group 1 (with 3 criteria), group 2 (with 4 criteria), and group 3 (with 5 criteria). The NLR was calculated from complete blood count. Results: Patients with MS had significantly higher NLR compared to the control group. Moreover, the group 3 patients had higher NLR than those in groups 2 and 1 (P = .008 and P = .078, respectively), whereas there was no difference between the patients meeting 3 and 4 MS criteria (P = .320). Besides, NLR increased as the severity of MS increased (r = .586, P < .001). The cutoff level for NLR with optimal sensitivity and specificity was calculated as 1.84. Serum glucose and high-sensitive C-reactive protein level were found to be independent predictors of an NLR value greater than 1.84. Conclusion: The present study indicated a significant correlation between the criteria of MS and inflammation on the basis of NLR. Furthermore, there an increase in NLR as the severity of MS increases.
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    Effect of Remote Ischemic Postconditioning on Left Ventricular Mechanics
    (Wiley, 2015) Nacar, Alper Bugra; Topcu, Selim; Kurt, Mustafa; Tanboga, Ibrahim Halil; Karakas, Mehmet Fatih; Buyukkaya, Eyup; Aksakal, Enbiya
    BackgroundRemote ischemic postconditioning (RIPC) decreases infarct size and prevents left ventricular (LV) remodeling in patients with myocardial infarction. However, there is no study that evaluates the effect of RIPC on LV mechanics assessed by speckle tracking echocardiography. Therefore, we aimed to test the effects of RIPC on LV deformation parameters such as strain, strain rate, rotation, and twist in healthy subjects. MethodsThe study group consisted of 22 healthy subjects. To test the effects of RIPC, 3 cycles of reperfusion followed by ischemia (each lasting 10 or 30seconds) were applied immediately after 20minutes of nondominant arm ischemia. Transthoracic echocardiography (TTE) was obtained at baseline and repeated 30minutes after the completion of these cycles. In TTE images, apical 4-3-2 chamber longitudinal strain (LS)/strain rate, basal and apical circumferential strain/strain rate, and rotational parameters, such as basal rotation, apical rotation, and LV twist, were recorded. ResultsApical 4-3-2 chamber LS and apical circumferential strain/strain rate measurements were comparable before and after RIPC, whereas basal circumferential strain was significantly decreased after RIPC (-233.4 vs. -18.9 +/- 6.9, P=0.017). After RIPC, apical rotation was significantly increased (11.6 +/- 3.7 vs. 16.7 +/- 4.0, P<0.001) and basal rotation was significantly decreased (-6.1 +/- 2.1 vs. -4.7 +/- 2.4, P=0.03).Consequently, net LV twist was significantly increased (17.4 +/- 4.5 vs. 21.7 +/- 4.7). ConclusionsWe proposed that RIPC affects the rotational mechanics of the heart rather than longitudinal mechanics. These results might give new insights into understanding the favorable effects of the post- conditioning.
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    Effect of Serum Gamma-Glutamyl Transferase Levels on Myocardial Perfusion and Long-Term Prognosis After Primary Angioplasty in Patients With Acute ST-Elevation Myocardial Infarction
    (Bmj Publishing Group, 2012) Ozcan, Firat; Karakas, Mehmet Fatih; Ozlu, Mehmet Fatih; Akcay, Adnan Burak; Buyukkaya, Eyup; Kurt, Mustafa; Erden, Gonul
    Background: Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population. Methods and Results: One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow <= 2 or TIMI flow 3 with final myocardial bush grade <= 2 after PCI) and electrocardiographically (ST resolution <30%) detected no-reflow were increased in number across the GGT tertiles. In addition, 1-year mortality rates showed a significant increase across the tertile groups (4% vs 11% vs 23%, P<0.01). Multivariable logistic regression analysis revealed that GGT levels on admission were a significant predictor of long-term mortality of myocardial blush grade-detected no-reflow phenomenon. High GGT level on admission was a significant predictor for long-term mortality and major adverse cardiac events. Conclusions: In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.
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    Fragmented QRS is associated with cirrhotic cardiomyopathy in patients with decompensated cirrhosis
    (Univ Catholique Louvain-Ucl, 2016) Demir, Mehmet; Kurt, Mustafa; Akcay, Adnan Burak
    Background/Aim : It has been reported that the fragmented QRS (fQRS) is related to left ventricular systolic dysfunction and diastolic dysfunction. The aim of this study was to determine the frequency of fragmented QRS (fQRS) in patients with decompensated cirrhosis and to evaluate the relationship between the presence of fQRS and systolic and diastolic dysfunction. Methods : The study included consecutive 189 patients with decompensated cirrhosis. 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. Conventional echocardiography and tissue doppler echocardiography were performed in all patients. Results : The prevalence of fQRS was 31% (59/189) in patients with decompensated cirrhosis. The patients with fQRS had worse diastolic and systolic functions in comparison to the patients without fQRS. In addition, multivariate analysis revealed that the presence of an fQRS, Na levels < 125 mEq/L, the Child-Pugh score and the MELD score were independent predictive factors for mortality (respectively, p < 0.001, p < 0.001, p < 0.001 and p < 0.001). Conclusions : In conclusion, this study showed a relationship between the presence of an fQRS and cardiac dysfunction. In addition, the fQRS appeared to act as an independent predictor of mortality in patients with decompensated cirrhosis. These data suggest that the fQRS may represent a novel noninvasive marker for cardiac involvement and for predicting mortality in patients with decompensated cirrhosis.
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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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    The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study
    (Via Medica, 2016) Isik, Turgay; Kurt, Mustafa; Tanboga, Ibrahim Halil; Ayhan, Erkan; Gunaydin, Zeki Yuksel; Kaya, Ahmet; Uyarel, Huseyin
    Background: Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long-term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI). Methods: Ninety-six consecutive patients (mean age 60.6 +/- 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge. Results: There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level >= 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, < 95% CI 1.71-16.10; p = 0.004) was an independent predictor of long-term MACE. Conclusions: A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE.
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    Increased epicardial fat tissue is a marker of subclinic atherosclerosis in ankylosing spondylitis
    (2014) Üstün, Nilgün; Yağız, Erman; Güler, Hayal; Turhanoğlu, Ayşe; Kurt, Mustafa; Atcı, Nesrin
    Amaç: Çalışmada ankilozan spondilit (AS) hastalarında epikardiyal yağ kalınlığı, karotis intima media kalınlığı (CIMT) ve aortik sertlik indeksi (ASI) gibi subklinik ateroskleroz belirteçleri değerlendirildi ve ilaveten subklinik ateroskleroz belirteçleri ile hastalık aktivite/fonksiyon/mobilite indeksleri arasındaki ilişki araştırıldı. Hastalar ve yöntemler: Çalışmaya 26 AS hastası (22 erkek, 4 kadın; ort. yaş 43 yıl) ve yaş ve cinsiyet uyumlu 26 sağlıklı kontrol (21 erkek, 5 kadın; ort. yaş 42 yıl) alındı. Kardiyovasküler veya eşlik eden hastalıkları olan hastalar ve kontroller çalışmadan çıkarıldı. Hastalık aktivitesi Bath Ankilozan Spondilit Hastalık Aktivite İndeksi, fonksiyonel kapasite Bath Ankilozan Spondilit Fonksiyonel İndeksi ve mobilite durumu Bath Ankilozan Spondilit Metroloji İndeksi ile değerlendirildi. Tüm hastalar epikardiyal yağ kalınlığı ve ASI .l.ülmek üzere transtorasik ekokardiyografiye ve CIMT .l.ülmek üzere ultrason ile muayeneye tabi tutuldu. Bulgular: Ankilozan spondilitli hastalar ve kontroller arasında demografik ve kardiyovasküler özellikler açısından anlamlı fark yoktu (p>0.05). Epikardiyal yağ kalınlığı (5.15±1.13 ve 4.11±1.22; p=0.003), CIMT (0.70±0.16 ve 0.60±0.10; p=0.012) ve ASI (14.2±10.8 ve 8.6±3.1; p=0.018) değerleri kontrollere kıyasla hastalarda daha yüksek idi. Subklinik ateroskleroz belirteçleri ile hastalık aktivite/fonksiyon/mobilite indeksleri arasında anlamlı ilişki yoktu (p>0.05). Sonuç: Ankilozan spondilit hastalarında sağlıklı kontrollere kıyasla epikardiyal yağ kalınlığı, CIMT ve ASI anlamlı olarak daha yüksekti.
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    Increased Epicardial Fat Tissue Is a Marker of Subclinic Atherosclerosis in Ankylosing Spondylitis
    (Turkish League Against Rheumatism, 2014) Ustun, Nilgun; Kurt, Mustafa; Atci, Nesrin; Yagiz, Erman; Guler, Hayal; Turhanoglu, Ayse
    Objectives: This study aims to assess subclinical atherosclerosis markers such as epicardial fat thickness, carotid intima media thickness (CIMT), and aortic stiffness index (ASI) in ankylosing spondylitis (AS) patients as well as to investigate the relationship between the subclinical atherosclerosis markers and disease activity/function/mobility indices. Patients and methods: Twenty-six AS patients (22 males, 4 females; mean age 43 years) and 26 age-and sex-matched healthy controls (21 males, 5 females; mean age 43 years) were included. Patients and controls with any reported cardiovascular disease or other comorbidities were excluded. Disease activity, functional capacity and spinal mobility were measured using the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index, respectively. All patients underwent complete transthoracic echocardiographic examination including epicardial fat thickness and ASI, and sonographic examination including CIMT. Results: There were no significant differences in demographical and cardiovascular characteristics between AS patients and healthy controls (p>0.05). Epicardial fat thickness (5.15 +/- 1.13 vs. 4.11 +/- 1.22; p=0.003), CIMT (0.70 +/- 0.16 vs. 0.60 +/- 0.10; p=0.012) and ASI (14.2 +/- 10.8 vs. 8.6 +/- 3.1; p=0.018) were significantly increased in patients with AS compared to the healthy controls. There was no significant correlation between the subclinical atherosclerosis markers and disease activity/function/mobility indices (p>0.05). Conclusion: A significantly increased epicardial fat thickness, CIMT, and ASI were observed in AS patients compared with healthy controls.
  • [ N/A ]
    Öğe
    Increased Epicardial Fat Tissue is a Marker of Subclinic Atherosclerosis in Patients with Psoriasis
    (Elsevier Science Inc, 2013) Sen, Bilge Buelbuel; Atci, Nesrin; Rifaioglu, Emine Nur; Ekiz, Oezlem; Kartal, Ismail; Buyukkaya, Eyup; Kurt, Mustafa
    [Abstract Not Available]
  • Küçük Resim
    Öğe
    Kardiyak sendrom X'de eritrosit dağılım genişliği (R DW) ile Hs-CRP seviyelerinin incelenmesi
    (2013) Karakaş, Mehmet Fatih; Büyükkaya, Eyüp; Kurt, Mustafa; Büyükkaya, Şule; Karakaş, Esra; Akçay, Adnan Burak; Şen, Nihat
    Amaç: Kardiyak Sendrom X(KSX), angina pektoris ve objektif iskemi bulgularına rağmen normal koroner arterlerin saptandığı bir tablodur. KSX’ in patogenezinde inflamasyonun rol oynadığı bulunmuştur. Eritrosit dağılım genişliği (RDW), dolaşımdaki eritrositlerin büyüklüğünü gösteren bir indeks olmasının yanında, son çalışmalarda inflamasyonu gösteren bir parametre olarak değerlendirilmeye başlanmıştır. Biz bu çalışmada KSX olan hastalarda inflamasyon ile RDW arasındaki ilişkiyi araştırdık. Yöntem: Bu çalışmaya iskemik bulguların saptandığı koroner anjiyografisi normal olan 35 KSX hastası (KSX grubu), ciddi koroner arter hastalığı bulunan 35 hasta (KAH grubu) ve 34 kontrol hastası alındı. Her üç gruptan RDW ve hs -CRP çalışıldı . Bulgular : KSX grubunda RDW değerleri kontrol grubuna göre artmış bulundu (13.9 ± 1.2 vs 12.9 ±0.7, p < 0.001). Ancak KSX grubu ile KAH grubu arasında fark bulunmadı (13.9 ± 1.2 vs. 14,1 ± 1,1, p: 0. 63). Aynı şekilde KSX ile KAH grubu arasında hs-CRP değerleri arasında fark yoktu(1.03 ± 0.5 vs. 1.05 ± 0.5, p: 0.92). Kontrol grubu nda hs-CRP düzeyi KSX ve KAH grubuna göre anlamlı bir şeki l de düşük bulundu. RDW ile hs- CRP arasında pozitif korelasyon olduğu bulu n du(r=0.24, p: 0.014). Sonuç : RDW, klinikte uzun süredir bilinen ancak inflamatuvar marker olarak yeni kullanılan bir parametre olup KSX olan hasta larda yükselmektedir.
  • Küçük Resim
    Öğe
    Koroner arter ektazisinde serum pentraksin-3 seviyelerinin incelenmesi
    (2013) Kurt, Mustafa; Karakaş, Mehmet Fatih; Büyükkaya, Eyup; Büyükkaya, Şule; Karakaş, Esra; Motor, Sedat; Akçay, Adnan Burak; Şen, Nihat; Yalçın, Fatih
    Giriş: Koroner arter ektazisi, koroner arterlerin tamamının veya bir bölümünün arterin normal kısmındaki çapına göre 1.5 kat veya daha fazla olmasıyla karakterize durum olup patofi zyolojisinde infl amasyon, nörohormonal aktivite ve ateroskleroz sorumlu tutulmaktadır. Koroner arter ektazisiyle infl amatuvar belirteçlerin ilişkisini gösteren çalışmalar mevcuttur, ancak koroner arter ektazisinin yeni tanımlanan bir infl amatuvar belirteç olan pentraksin-3 (PTX-3) ile ilişkisi konusunda yeterli veri yoktur. Bu çalışmamızda koroner arter ektazisi hastalarında serum PTX-3 ve yüksek duyarlı (high sensitive) C-reaktif protein (hs-CRP) seviyeleri arasındaki ilişkiyi incelemeyi amaçladık.Hastalar ve Yöntem: Bu çalışmaya anjinal semptomları ve pozitif iskemi bulguları olduğu için koroner anjiyografi yapılan 66 hasta ve 32 kontrol hastası dahil edilmiştir. Hastalar koroner arter hastalığı grubu (n= 32) ve koroner arter ektazisi grubuna ayrılmıştır (n= 34). Serum PTX-3 ve hs-CRP seviyeleri ölçülmüştür.Bulgular: Koroner arter ektazisi ve koroner arter hastalığı grubunda kontrol grubuna göre hs-CRP seviyesi yüksekti (koroner arter hastalığı ve kontrol hastası grubu için, 1.4 ± 0.7 vs. 0.8 ± 0.5, p< 0.001; koroner arter ektazisi ve kontrol hastası grubu için, 1.2 ± 0.5 vs. 0.8 ± 0.5, p< 0.001). Koroner arter hastalığı ve koroner arter ektazisi grubunda PTX-3 seviyeleri arasında (0.67 ± 0.29 vs. 0.66 ± 0.34, p= 0.63) belirgin fark olmamasına karşın koroner arter hastalığı (0.67 ± 0.29 vs. 0.32 ± 0.24, p < 0.001) ve koroner arter ektazisi (0.66 ± 0.34 vs. 0.32 ± 0.24, p< 0.001) grubundaki hastaların PTX-3 seviyesi kontrol grubuna göre daha yüksekti. Korelasyon analizi sonucu serum PTX-3 ve hs-CRP seviyeleri birbirleriyle ilişkili bulundu (Rho= 0.24, p= 0.016). Sonuç: Koroner arter ektazisi olan hastalarda yeni bir infl amatuvar belirteç olan PTX-3 yüksek bulunmuştur. Bu durum infl amasyonun koroner arter ektazisi patofi zyolojisinde önemli bir role sahip olduğunu düşündürmektedir