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1. Prediction of subclinical left ventricular dysfunction with longitudinal two-dimensional strain and strain rate imaging in patients with mitral stenosis

Author

Sibel Turhan, Cagdas Ozdol, Irem Dincer, Özgür Ulaş Özcan, Çetin Erol, Aydan Ongun Ozdemir, Basar Candemir, and Cansın Tulunay Kaya

Subjects
Adult, Male, medicine.medical_specialty, Severity of Illness Index, Ventricular Function, Left, Ventricular Dysfunction, Left, Predictive Value of Tests, Internal medicine, Image Interpretation, Computer-Assisted, medicine, Humans, Mitral Valve Stenosis, Radiology, Nuclear Medicine and imaging, Interventricular septum, Cardiac imaging, Retrospective Studies, Ejection fraction, Strain (chemistry), business.industry, Middle Aged, Strain rate, medicine.disease, Echocardiography, Doppler, Stenosis, medicine.anatomical_structure, Ventricle, Case-Control Studies, Strain rate imaging, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Longitudinal two-dimensional strain deformation is a novel technique which evaluates global and regional left ventricular (LV) function with high reproducibility. The aim of the study was to investigate the global and regional systolic function using this method in patients with pure mitral stenosis (MS). Conventional echocardiography and longitudinal two-dimensional strain analysis were performed in 60 patients (41 +/- 5 years, 48 women) with mild to moderate MS (mitral valve area: 1.9 +/- 0.5 cm(2)), and 52 healthy controls (40 +/- 7 years, 37 women). For strain analysis standard apical views were obtained, and by using a software system peak systolic strain and strain rate were calculated off-line in each segment. In all, 88% of the segments could be optimally tracked by the software system. Despite normal LV systolic function as assessed by ejection fraction (66 +/- 8%), mean global longitudinal strain (GLS) and global longitudinal strain rate (GLSR) were significantly reduced in patients with isolated MS (GLS -17 +/- 3.3 vs. -19 +/- 2.5%, P = 0.006 and GLSR -1.3 +/- 0.3 vs. -1.5 +/- 0.3 s(-1), P0.0001). Regional analysis demonstrated that patients with MS had a significantly reduced longitudinal peak strain and strain rate in all basal, and some mid (inferior, anteroseptal, interventricular septum) segments of the left ventricle. For other segments longitudinal peak strain and strain rate values were similar among the groups. Evaluation of LV systolic function by longitudinal two-dimensional strain deformation identified early abnormalities in MS patients who had apparently normal standard systolic function.

Published
2009
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2. Changing patterns of patient characteristics in the cath lab from 1998 to 2006: a single-centre retrospective analysis

Author

Aydan Ongun Ozdemir, Basar Candemir, Ömer Akyürek, Tamer Sayin, Özgür Ulaş Özcan, Çetin Erol, Mustafa Kılıçkap, Selcuk Ozturk, and Timucin Altin

Subjects
Male, Cardiac Catheterization, Pediatrics, medicine.medical_specialty, Time Factors, Percutaneous, Turkey, Cath lab, Patient characteristics, Coronary Artery Disease, Coronary Angiography, Risk Factors, Statistical significance, Diabetes mellitus, Prevalence, medicine, Retrospective analysis, Humans, Angioplasty, Balloon, Coronary, Retrospective Studies, business.industry, General Medicine, Middle Aged, medicine.disease, Case-Control Studies, Cohort, Conventional PCI, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background -There are few data on the change in the profile of cath lab patients over long time intervals. Methods - We retrospectively analysed our cath lab records, patient charts, in terms of demographic variables, clinical and laboratory characteristics in a thousand patients (499 patients in 1998 January-March, 501 patients in 2006 January-March). Results - Mean age was significantly higher in the 2006 cohort (57.5 ± II vs. 62.2 ± 10.8, P < 0.00I). Gender was similar in both cohorts (men 68.5% vs. women 69.9%, P = 0.65). Both hypertension and diabetes mellitus were more prevalent in the 2006 cohort (613% vs. 49.3 and 30.3 vs. I7.6 respectively, P< 0.001 for both). Smoking rates (past or active) did not differ between the cohorts. Rates of normal or near normal coronary angiograms were somewhat elevated in both cohorts (36.7% in 1998 and 39.1 % in 2006). Rates of multivessel disease (2-3 vessel disease) tended to increase and rates of single-vessel disease tended to decrease from the 1998 cohort to the 2006 cohort (27.7% to 34.4% and 35.7% to 26.7%, P = 0.006).The number of percutaneous coronary interventions (PCI) performed increased with a borderline statistical significance in the 2006 cohort (32% vs. 38.5%, P= 0.053). Conclusions - Our data indicates that today interventional cardiologists face an older and more severely diseased cath lab patient population compared with a decade earlier. In comparison with 1998, more PCls were performed.

Published
2009
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3. The effect of high-dose aspirin pre-treatment on the incidence of myonecrosis following elective coronary stenting

Author

Sadi Gulec, Timur Selçuk, Veysel Duzen, Aydan Ongun Ozdemir, Çetin Erol, Sibel Turhan, Selcuk Ozturk, Cagdas Ozdol, Kutay Vurgun, and Ahmet Temizhan

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Disease, Coronary artery disease, Necrosis, Risk Factors, Angioplasty, Internal medicine, medicine, Creatine Kinase, MB Form, Humans, Antipyretic, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, Aspirin, Dose-Response Relationship, Drug, Vascular disease, business.industry, Incidence, Myocardium, Incidence (epidemiology), Stent, Middle Aged, medicine.disease, Combined Modality Therapy, Anesthesia, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Background Inadequate platelet response to aspirin is associated with increased incidence of peri-procedural myonecrosis. Antiplatelet activity of aspirin can be improved by increasing the dose. High-dose aspirin pre-treatment, therefore, may reduce the incidence of myonecrosis post stenting. Methods and results Two-hundred patients taking 75–325mg daily doses of aspirin for at least 2 weeks were randomized for addition or no addition of 500mg aspirin before elective coronary stenting (aspirin 500 group, n =100 and control group, n =100). Primary endpoint was the occurrence of peri-procedural myonecrosis defined as creatine kinase-myocardial band (CK-MB) elevation of >1× upper limits of normal (ULN). Aspirin 500 patients were significantly younger and more likely to have family history of coronary artery disease, but less likely to have received statins than controls. Elevation of CK-MB was observed in 29% of aspirin 500 patients and 15% of controls ( p =0.017). The incidence of non-Q wave myocardial infarction (CK-MB elevation of >3×ULN) tended to be higher in the aspirin 500 group than in the control group (5% versus 0%, p =0.059). Multivariate analysis identified baseline aspirin dose (OR: 1.006; 95% CI: 1.002–1.010; p =0.004), aspirin 500mg treatment (OR: 2.5; 95% CI: 1.2–5.5; p =0.021) and baseline CK-MB level (OR: 1.4; 95% CI: 1.1–1.7; p =0.012) as independent predictors of CK-MB elevation after coronary stenting. Conclusion For patients taking daily low-dose aspirin therapy, supplementation with high-dose aspirin before elective coronary stenting does not reduce, but may increase the incidence of peri-procedural myonecrosis.

Published
2008
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4. Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction

Author

Aydan Ongun Ozdemir, Deniz Kumbasar, Cagdas Ozdol, Basar Candemir, Cansın Tulunay Kaya, Menekşe Gerede, Çetin Erol, Mustafa Kılıçkap, and Özgür Ulaş Özcan

Subjects
Male, Acute coronary syndrome, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Myocardial Infarction, Pilot Projects, Coronary artery disease, Necrosis, Bolus (medicine), Internal medicine, medicine, Humans, Angioplasty, Balloon, Coronary, Infusions, Intravenous, Aged, biology, business.industry, Percutaneous coronary intervention, Hematology, Tirofiban, Middle Aged, medicine.disease, Troponin, Conventional PCI, biology.protein, Cardiology, Tyrosine, Female, Cardiology and Cardiovascular Medicine, business, TIMI, Blood Flow Velocity, Platelet Aggregation Inhibitors, medicine.drug
Abstract

We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.

Published
2012

5. Evaluation of acute infection-induced endothelial dysfunction and its potential mediators

Author

Özgür Ulaş Özcan, Hüseyin Göksülük, Aydan Ongun Ozdemir, Mustafa Kılıçkap, Kutay Vurgun, Basar Candemir, Çetin Erol, Cansın Tulunay Kaya, and Sibel Turhan

Subjects
Male, medicine.medical_specialty, Necrosis, Brachial Artery, Inflammation, Vasodilation, Coronary Artery Disease, Gastroenterology, Coronary artery disease, Risk Factors, Internal medicine, medicine.artery, medicine, Humans, Endothelial dysfunction, Brachial artery, Respiratory Tract Infections, Apolipoproteins B, medicine.diagnostic_test, Apolipoprotein A-I, business.industry, Interleukin-6, Tumor Necrosis Factor-alpha, General Medicine, Cholesterol, LDL, Middle Aged, medicine.disease, Pathophysiology, C-Reactive Protein, Acute Disease, lipids (amino acids, peptides, and proteins), Female, Endothelium, Vascular, medicine.symptom, Cardiology and Cardiovascular Medicine, Lipid profile, business, Lipoproteins, HDL, Algorithms, Biomarkers, Blood Flow Velocity
Abstract

OBJECTIVES Inflammation plays an important role in the pathophysiology of atherosclerosis. Some studies suggest a link between chronic infections, an inflammatory state, and endothelial dysfunction. However, data related to acute infections are scant. We have investigated: (i) the effect of acute infection on endothelial function; (ii) the role of potential mediators of endothelial dysfunction. METHODS Forty patients 40 years old with acute infection (mean age 53.9 +/- 8.8 years), without coronary artery disease or its equivalents were enrolled. Endothelial function and blood levels of high sensitive C-reactive protein, interleukin-6, tumour necrosis factor-a, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), apolipoprotein-A1 (Apo-A1) and apolipoprotein-B100 (Apo-B100) were assessed in the acute infection phase and 1 month after recovery. Endothelial function was evaluated by brachial artery flow-mediated vasodilation (FMD). RESULTS The intraclass correlation coefficients for intra- and interobserver agreement for FMD measurements were 0.98 (95% CI: 0.95-0.99) and 0.93 (95% CI: 0.83-0.97), respectively. FMD improved significantly 1 month after recovery (P < 0.001). Compared to the levels at 1 month, inflammatory markers, LDL cholesterol, LDL/HDL ratio, Apo-B100 and Apo-B100/Apo-A1 ratio were significantly higher. However, HDL and apo-A1 were significantly lower in the phase of acute infection. Change in FMD from baseline to 1 month after recovery correlated significantly only with the change in Apo-A1 (r = 0.35, P = 0.027). CONCLUSIONS Acute infection causes transient endothelial dysfunction. It increases inflammatory markers and generates an atherogenic lipid profile. Among the parameters evaluated, only the change in Apo-A1 level was associated with acute infection-induced endothelial dysfunction.

Published
2011

6. Türk hipertansiyon hastalarında mikroalbuminüri sıklığı ve ilişkili kardiyovasküler risk faktörleri

Author

V Çam, M Etemoglu, Sebahattin Ateşal, E Koçak, Bulent Polat, Meral Kayıkçıoğlu, Yekta Gürlertop, Cem Köz, Ö Özbek, H Yegin, Ceyhun Ceyhan, K Dönmez, B Tosun, H Atmaca, G Dönmez, B. ilerigelen, H Bozdemir, I Biyik, A Sökmen, F Koca, Kenan Övünç, Ramazan Topsakal, Sadi Gulec, O Tartanoglu, Kurtulus Ozdemir, A Fiskeci, E Akarca, Ahmet Sakalli, A Yavuz, M Bilaloglu, Giray Kabakci, T Keleş, F K Inceer, H Tunar, Ş Coşkun, M Şan, S C Turan, Serkan Topaloglu, Irem Dincer, S Yorganci, R Yoldaş, Ömer Kozan, I T Kurt, Mehmet İlker Gökçe, Hakan Kültürsay, A Yilmaz, C Genç, M Ö Sunay, K Tigen, A Sinci, T Ulusoy, Şükrü Ünal, Filiz Özerkan, Sinan Aydoğdu, H Bozkurt, N S Aran, Ercan Varol, O Sancaktar, A Delice, H Tikiz, Emin Evren Özcan, Fatih Sinan Ertaş, H Kaymak, E Semiz, C Rezzagil, I Susal, N Çam, F Özmen, Vedat Aytekin, S Çolak, A Keskin, E Acartürk, N Ata, Oben Döven, H Boga, H Vural, E Şensoy, A Lazoglu, I Özdogru, Y Balbay, Dursun Aras, J Jordan, Dilek Yeşilbursa, H Akgöz, E Onrat, Y Selçoki, Dilek Ural, R Uçar, Sinan Kahraman, H Gök, M T Sirkeci, T Peker, M Bilge, Mehmet Metin Seker, C Agçal, D Aytekin, S Toktaş, A Birdane, Y Yakar, A H Sözcüer, U Sümerkan, S Sakalli, Mehmet Oc, N Sönmez, M Bostan, A Akyüz, Adnan Abaci, V Koca, K Şahna, K Aytemir, Yuksel Cavusoglu, M Tahtasiz, Adalet Gürlek, O Ergene, V Gökçe, I Dogru, M Dagalp, Cuneyt Turkoglu, Ramazan Akdemir, C Uyan, Ahmet Vural, R Kargin, Enver Atalar, A Ünsal, A Bitigen, T T Gündogdu, Kaan Kulan, B Erol, A U Gülmez, Merih Kutlu, K Öztaş, I Tandogan, A Karanfil, Mustafa Polat, S Cinsoy, A Sert, M Çakmak, Ali Ergin, T Durmaz, A Aydinlar, P Pinar, A Kerpeten, Serdar Sevimli, Saide Aytekin, C Nazli, T Kirat, Zeynep Tartan, H Atasever, A Çamsari, A Aribaş, N Keser, Aydan Ongun Ozdemir, N Coşkun, Mehmet Yazici, Y Erzurum, Nevrez Koylan, Mustafa Yilmaz, M Ş Güçel, A E Kiliçoglu, O H Elönü, A Köşüş, G Topkara, G Daş, L Saraç, M Melek, D Gaffari, A Bayram, Z Tosun, K Kaya, Mahmut Şahin, Z Işilak, A Içli, Necla Ozer, Mustafa Kılıçkap, E Aygün, H Gündüz, H Öney, A Daver, Z Kaplan, M Gürsürer, Huseyin Arinc, A Irmak, Osman Alper Onbasili, F V Ulusoy, Mehmet Ridvan Yalcin, M Şerifi, Ahmet Temizhan, Ahmet Çelik, C Kirdar, S Mecit, Cihan Örem, A Güven, Kozan, Ö., Dokuz Eylül University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Özcan, E.E., Izmir Hospital, Izmir, Turkey -- Sancaktar, O., Istanbul Şafak Hospital, Istanbul, Turkey, Akdeniz University Medical Faculty, Department of Cardiology, Antalya, Turkey -- Kabakci, G., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Sözcüer, A.H., Merkez Efendi State Hospital, Cardiology Clinic, Manisa, Turkey -- Kerpeten, A., Kütahya State Hospital, Cardiology Clinic, Kütahya, Turkey -- Delice, A., Kizilay Health Center, Cardiology Polyclinic, Kayseri, Turkey -- Içli, A., Konya Municipality Hospital, Cardiology Clinic, Konya, Turkey -- Sökmen, A., Sütçü Imam University Medical Faculty, Department of Cardiology, Kahramanmaraş, Turkey -- Gürlek, A., Ankara University Medical Faculty, Department of Cardiology, Ibn-i Sina Hospital, Ankara, Turkey -- Abaci, A., Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Bayram, A., Erzurum Numune State Hospital, Cardiology Clinic, Erzurum, Turkey -- Köşüş, A., Ordu Medical Center, 19 Eylül Internal Diseases Polyclinic, Ordu, Turkey -- Çamsari, A., Mersin University Medical Faculty, Department of Cardiology, Mersin, Turkey -- Sakalli, A., Afyon State Hospital, Cardiology Clinic, Afyon, Turkey -- Sert, A., Beypazari State Hospital, Cardiology Clinic, Ankara, Turkey -- Temizhan, A., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Yilmaz, A., Cumhuriyet University Medical Faculty, Department of Cardiology, Sivas, Turkey -- Daver, A., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Aydinlar, A., Uludag University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Ergin, A., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Kiliçoglu, A.E., Elazig State Hospital, Cardiology Clinic, Elazig, Turkey -- Birdane, A., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Aribaş, A., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Lazoglu, A., Intermed Medical Center, Cardiology Clinic, Alanya, Antalya, Turkey -- Özdemir, A., 1 Eylül State Hospital, Cardiology Clinic, Uşak, Turkey -- Fiskeci, A., Balikesir State Hospital, Cardiology Clinic, Balikesir, Turkey -- Çelik, A., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Bitigen, A., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Keskin, A., Akhisar State Hospital, Cardiology Clinic, Manisa, Turkey -- Yavuz, A., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Akyüz, A., Sultan 1. Izzettin Keykavuş State Hospital, Cardiology Clinic, Sivas, Turkey -- Karanfil, A., Fatih University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Ünsal, A., Gölcük State Hospital, Cardiology Clinic, Kocaeli, Turkey -- Sinci, A., Bilecik State Hospital, Cardiology Clinic, Bilecik, Turkey -- Gülmez, A.U., Pamukkale State Hospital, Cardiology Clinic, Denizli, Turkey -- Irmak, A., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Vural, A., Toros State Hospital, Cardiology Clinic, Mersin, Turkey -- Güven, A., Sütçü Imam University Medical Faculty, Department of Cardiology, Kahramanmaraş, Turkey -- Ilerigelen, B., Istanbul University Cerrahpaşa Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Erol, B., Giresun State Hospital, Cardiology Clinic, Giresun, Turkey -- Polat, B., Polatli Duatepe State Hospital, Cardiology Clinic, Ankara, Turkey -- Tosun, B., Aydin 82. Yil State Hospital, Cardiology Clinic, Aydin, Turkey -- Agçal, C., Isparta State Hospital, Cardiology Clinic, Isparta, Turkey -- Genç, C., Gülhane Military Medical Academy, Department of Cardiology, Ankara, Turkey -- Kirdar, C., Eskişehir State Hospital, Cardiology Clinic, Eskişehir, Turkey -- Rezzagil, C., Şevket Yilmaz State Hospital, Cardiology Clinic, Bursa, Turkey -- Köz, C., Gülhane Military Medical Academy, Department of Cardiology, Ankara, Turkey -- Nazli, C., Atatürk Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Ceyhan, C., Adnan Menderes University Medical Faculty, Department of Cardiology, Aydin, Turkey -- Örem, C., Karadeniz Technical University Medical Faculty, Department of Cardiology, Trabzon, Turkey -- Uyan, C., Abant Izzet Baysal University Medical Faculty, Department of Cardiology, Bolu, Turkey -- Türkoglu, C., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Gaffari, D., Kizilay Health Center, Cardiology Polyclinic, Üsküdar, Istanbul, Turkey -- Aytekin, D., Salihli Public Hospital, Cardiology Clinic, Manisa, Turkey -- Ural, D., Kocaeli University Medical Faculty, Department of Cardiology, Kocaeli, Turkey -- Yeşilbursa, D., Uludag University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Aras, D., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Semiz, E., Pamukkale University Medical Faculty, Department of Cardiology, Denizli, Turkey -- Koçak, E., Evliya Çelebi State Hospital, Cardiology Clinic, Kütahya, Turkey -- Atalar, E., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Varol, E., Süleyman Demirel University Medical Faculty, Department of Cardiology, Isparta, Turkey -- Onrat, E., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Şensoy, E., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Acartürk, E., Çukurova University Medical Faculty, Department of Cardiology, Adana, Turkey -- Akarca, E., Nazilli State Hospital, Cardiology Clinic, Aydin, Turkey -- Aygün, E., Bafra State Hospital, Cardiology Clinic, Samsun, Turkey -- Ertaş, F.S., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Koca, F., Alsancak State Hospital, Cardiology Clinic, Izmir, Turkey -- Özmen, F., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Ulusoy, F.V., Ankara Numune Hospital, 2nd Cardiology Clinic, Ankara, Turkey -- Özerkan, F., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Inceer, F.K., Çorum State Hospital, Cardiology Clinic, Çorum, Turkey -- Dönmez, G., Bakirköy Dr. Sadi Konuk Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Topkara, G., Bandirma State Hospital, Cardiology Clinic, Balikesir, Turkey -- Daş, G., 82. Yil State Hospital, Cardiology Clinic, Adiyaman, Turkey -- Bozkurt, H., Antakya State Hospital, Cardiology Clinic, Antakya, Turkey -- Kültürsay, H., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Tikiz, H., Celal Bayar University Medical Faculty, Department of Cardiology, Manisa, Turkey -- Akgöz, H., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Kaymak, H., Tarsus State Hospital, Cardiology Clinic, Mersin, Turkey -- Öney, H., Artvin State Hospital, Cardiology Clinic, Artvin, Turkey -- Yegin, H., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Boga, H., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Gök, H., Selçuk State Hospital, Cardiology Clinic, Izmir, Turkey -- Vural, H., Vedat Ali Özkan State Hospital, Cardiology Clinic, Kayseri, Turkey -- Atasever, H., Adapazari State Hospital, Cardiology Clinic, Adapazari, Turkey -- Arinç, H., Izzet Baysal University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Bozdemir, H., Buca Seyfi Demirsoy State Hospital, Cardiology Clinic, Izmir, Turkey -- Gündüz, H., Izzet Baysal University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Tunar, H., Salihli State Hospital, Cardiology Clinic, Manisa, Turkey -- Atmaca, H., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Dogru, I., Çukurova State Hospital, Cardiology Clinic, Adana, Turkey -- Özdogru, I., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Susal, I., Karşiyaka State Hospital, Cardiology Clinic, Izmir, Turkey -- Kurt, I.T., Atakalp Heart Hospital, Cardiology Clinic, Izmir, Turkey -- Dinçer, I., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Biyik, I., Uşak State Hospital, Cardiology Clinic, Uşak, Turkey -- Tandogan, I., Cumhuriyet University Medical Faculty, Department of Cardiology, Sivas, Turkey -- Jordan, J., Uludag University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Kulan, K., Trabzon Numune State Hospital, Cardiology Clinic, Trabzon, Turkey -- Şahna, K., Ordu State Hospital, Cardiology Clinic, Ordu, Turkey -- Öztaş, K., Samsun State Hospital, Cardiology Clinic, Samsun, Turkey -- Dönmez, K., Manavgat State Hospital, Cardiology Clinic, Antalya, Turkey -- Övünç, K., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Kaya, K., Bursa State Hospital, Cardiology Clinic, Bursa, Turkey -- Aytemir, K., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Özdemir, K., Selçuk University Medical Faculty, Department of Cardiology, Konya, Turkey -- Tigen, K., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Saraç, L., Istinye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Sirkeci, M.T., Kizilay Health Center, Cardiology Polyclinic, Erzincan, Turkey -- Çakmak, M., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Şahin, M., Ondokuz Mayis University Medical Faculty, Department of Cardiology, Samsun, Turkey -- Kutlu, M., Harput State Hospital, Cardiology Clinic, Elazig, Turkey -- Bilge, M., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Bostan, M., Rize State Hospital, Cardiology Clinic, Rize, Turkey -- Melek, M., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Sunay, M.Ö., Balikesir State Hospital, Cardiology Clinic, Balikesir, Turkey -- Şeker, M., Meram State Hospital, Cardiology Clinic, Konya, Turkey -- Güçel, M.Ş., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Yazici, M., Düzce University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Kayikçioglu, M., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Öç, M., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Gürsürer, M., Karaelmas University Medical Faculty, Department of Cardiology, Zonguldak, Turkey -- Dagalp, M., Ziraat Bank Hospital, Cardiology Clinic, Ankara, Turkey -- Bilaloglu, M., Erzurum Numune State Hospital, Cardiology Clinic, Erzurum, Turkey -- Yalçin, M., GATA Haydarpaşa Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Şerifi, M., Izmit State Hospital, Cardiology Clinic, Kocaeli, Turkey -- Gökçe, M., Karadeniz Technical University Medical Faculty, Department of Cardiology, Trabzon, Turkey -- Kiliçkap, M., Ankara University Medical Faculty, Department of Cardiology, Heart Center, Ankara, Turkey -- Polat, M., Ceyhan State Hospital, Cardiology Clinic, Adana, Turkey -- Şan, M., Çukurova University Medical Faculty, Department of Cardiology, Adana, Turkey -- Tahtasiz, M., Eşrefpaşa Municipality Hospital, Cardiology Clinic, Izmir, Turkey -- Yilmaz, M., Kayseri State Hospital, Cardiology Clinic, Kayseri, Turkey -- Etemoglu, M., Izmir Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Coşkun, N., Harput State Hospital, Cardiology Clinic, Elazig, Turkey -- Aran, N.S., Istanbul University Cerrahpaşa Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Ata, N., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Sönmez, N., Bodrum State Hospital, Cardiology Clinic, Mugla, Turkey -- Çam, N., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Koylan, N., Istanbul University Istanbul Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Özer, N., Iskenderun State Hospital, Cardiology Clinic, Hatay, Turkey -- Keser, N., Maltepe University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Döven, O., Mersin University Medical Faculty, Department of Cardiology, Mersin, Turkey -- Tartanoglu, O., Karaman State Hospital, Cardiology Clinic, Karaman, Turkey -- Ergene, O., Atatürk Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Elönü, O.H., Melikgazi Hospital, Cardiology Clinic, Kayseri, Turkey -- Onbaşili, O.A., Adnan Menderes University Medical Faculty, Department of Cardiology, Aydin, Turkey -- Özbek, Ö., Marmara University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Pinar, P., Manisa State Hospital, Cardiology Clinic, Manisa, Turkey -- Akdemir, R., Düzce University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Kargin, R., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Topsakal, R., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Yoldaş, R., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Uçar, R., Giresun State Hospital, Cardiology Clinic, Giresun, Turkey -- Ateşal, S., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Toktaş, S., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Cinsoy, S., Sabuncuoglu Şerafeddin State Hospital, Cardiology Clinic, Amasya, Turkey -- Güleç, S., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Aytekin, S., Kadir Has University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Çolak, S., Kizilay Health Center, Cardiology Polyclinic, Sivas, Turkey -- Mecit, S., Çanakkale Şehitlik State Hospital, Cardiology Clinic, Çanakkale, Turkey -- Sakalli, S., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Sevimli, S., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Topaloglu, S., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Aydogdu, S., Ankara Numune Hospital, Cardiology Clinic, Ankara, Turkey -- Turan, S.C., Fatih Sultan Mehmet State Hospital, Cardiology Clinic, Istanbul, Turkey -- Kahraman, S., Nigde State Hospital, Cardiology Clinic, Nigde, Turkey -- Yorganci, S., Atatürk State Hospital, Cardiology Clinic, Antalya, Turkey -- Coşkun, Ş., Bursa State Hospital, Cardiology Clinic, Bursa, Turkey -- Ünal, Ş., Nevşehir State Hospital, Cardiology Clinic, Nevşehir, Turkey -- Durmaz, T., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Ulusoy, T., Aksaray State Hospital, Cardiology Clinic, Aksaray, Turkey -- Keleş, T., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Kirat, T., Mugla State Hospital, Cardiology Clinic, Mugla, Turkey -- Gündogdu, T.T., Gebze Fatih Hospital, Cardiology Clinic, Kocaeli, Turkey -- Peker, T., Gemlik State Hospital, Cardiology Clinic, Bursa, Turkey -- Sümerkan, U., Marmara University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Aytekin, V., Kadir Has University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Koca, V., Bursa Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Bursa, Turkey -- Çam, V., Fethiye State Hospital, Cardiology Clinic, Mugla, Turkey -- Gökçe, V., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Gürlertop, Y., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Balbay, Y., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Çavuşoglu, Y., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Erzurum, Y., Eskişehir Yunus Emre State Hospital, Cardiology Clinic, Eskişehir, Turkey -- Selçoki, Y., Fatih University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Yakar, Y., Tokat State Hospital, Cardiology Clinic, Tokat, Turkey -- Işilak, Z., GATA Haydarpaşa Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Tosun, Z., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Kaplan, Z., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Tartan, Z., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey, Zonguldak Bülent Ecevit Üniversitesi, 0-Belirlenecek, Ondokuz Mayıs Üniversitesi, BAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Uyan, Cihangir, Aytekin, Saide, Aytekin, Vedat, Kozan, Ö., Dokuz Eylül University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Özcan, E.E., Izmir Hospital, Izmir, Turkey -- Sancaktar, O., Istanbul Şafak Hospital, Istanbul, Turkey, Akdeniz University Medical Faculty, Department of Cardiology, Antalya, Turkey -- Kabakci, G., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Sözcüer, A.H., Merkez Efendi State Hospital, Cardiology Clinic, Manisa, Turkey -- Kerpeten, A., Kütahya State Hospital, Cardiology Clinic, Kütahya, Turkey -- Delice, A., Kizilay Health Center, Cardiology Polyclinic, Kayseri, Turkey -- Içli, A., Konya Municipality Hospital, Cardiology Clinic, Konya, Turkey -- Sökmen, A., Sütçü Imam University Medical Faculty, Department of Cardiology, Kahramanmaraş, Turkey -- Gürlek, A., Ankara University Medical Faculty, Department of Cardiology, Ibn-i Sina Hospital, Ankara, Turkey -- Abaci, A., Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Bayram, A., Erzurum Numune State Hospital, Cardiology Clinic, Erzurum, Turkey -- Köşüş, A., Ordu Medical Center, 19 Eylül Internal Diseases Polyclinic, Ordu, Turkey -- Çamsari, A., Mersin University Medical Faculty, Department of Cardiology, Mersin, Turkey -- Sakalli, A., Afyon State Hospital, Cardiology Clinic, Afyon, Turkey -- Sert, A., Beypazari State Hospital, Cardiology Clinic, Ankara, Turkey -- Temizhan, A., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Yilmaz, A., Cumhuriyet University Medical Faculty, Department of Cardiology, Sivas, Turkey -- Daver, A., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Aydinlar, A., Uluda? University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Ergin, A., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Kiliço?lu, A.E., Elazi? State Hospital, Cardiology Clinic, Elazi?, Turkey -- Birdane, A., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Aribaş, A., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Lazo?lu, A., Intermed Medical Center, Cardiology Clinic, Alanya, Antalya, Turkey -- Özdemir, A., 1 Eylül State Hospital, Cardiology Clinic, Uşak, Turkey -- Fiskeci, A., Balikesir State Hospital, Cardiology Clinic, Balikesir, Turkey -- Çelik, A., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Bitigen, A., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Keskin, A., Akhisar State Hospital, Cardiology Clinic, Manisa, Turkey -- Yavuz, A., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Akyüz, A., Sultan 1. Izzettin Keykavuş State Hospital, Cardiology Clinic, Sivas, Turkey -- Karanfil, A., Fatih University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Ünsal, A., Gölcük State Hospital, Cardiology Clinic, Kocaeli, Turkey -- Sinci, A., Bilecik State Hospital, Cardiology Clinic, Bilecik, Turkey -- Gülmez, A.U., Pamukkale State Hospital, Cardiology Clinic, Denizli, Turkey -- Irmak, A., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Vural, A., Toros State Hospital, Cardiology Clinic, Mersin, Turkey -- Güven, A., Sütçü Imam University Medical Faculty, Department of Cardiology, Kahramanmaraş, Turkey -- Ilerigelen, B., Istanbul University Cerrahpaşa Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Erol, B., Giresun State Hospital, Cardiology Clinic, Giresun, Turkey -- Polat, B., Polatli Duatepe State Hospital, Cardiology Clinic, Ankara, Turkey -- Tosun, B., Aydin 82. Yil State Hospital, Cardiology Clinic, Aydin, Turkey -- A?çal, C., Isparta State Hospital, Cardiology Clinic, Isparta, Turkey -- Genç, C., Gülhane Military Medical Academy, Department of Cardiology, Ankara, Turkey -- Kirdar, C., Eskişehir State Hospital, Cardiology Clinic, Eskişehir, Turkey -- Rezzagil, C., Şevket Yilmaz State Hospital, Cardiology Clinic, Bursa, Turkey -- Köz, C., Gülhane Military Medical Academy, Department of Cardiology, Ankara, Turkey -- Nazli, C., Atatürk Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Ceyhan, C., Adnan Menderes University Medical Faculty, Department of Cardiology, Aydin, Turkey -- Örem, C., Karadeniz Technical University Medical Faculty, Department of Cardiology, Trabzon, Turkey -- Uyan, C., Abant Izzet Baysal University Medical Faculty, Department of Cardiology, Bolu, Turkey -- Türko?lu, C., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Gaffari, D., Kizilay Health Center, Cardiology Polyclinic, Üsküdar, Istanbul, Turkey -- Aytekin, D., Salihli Public Hospital, Cardiology Clinic, Manisa, Turkey -- Ural, D., Kocaeli University Medical Faculty, Department of Cardiology, Kocaeli, Turkey -- Yeşilbursa, D., Uluda? University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Aras, D., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Semiz, E., Pamukkale University Medical Faculty, Department of Cardiology, Denizli, Turkey -- Koçak, E., Evliya Çelebi State Hospital, Cardiology Clinic, Kütahya, Turkey -- Atalar, E., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Varol, E., Süleyman Demirel University Medical Faculty, Department of Cardiology, Isparta, Turkey -- Onrat, E., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Şensoy, E., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Acartürk, E., Çukurova University Medical Faculty, Department of Cardiology, Adana, Turkey -- Akarca, E., Nazilli State Hospital, Cardiology Clinic, Aydin, Turkey -- Aygün, E., Bafra State Hospital, Cardiology Clinic, Samsun, Turkey -- Ertaş, F.S., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Koca, F., Alsancak State Hospital, Cardiology Clinic, Izmir, Turkey -- Özmen, F., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Ulusoy, F.V., Ankara Numune Hospital, 2nd Cardiology Clinic, Ankara, Turkey -- Özerkan, F., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Inceer, F.K., Çorum State Hospital, Cardiology Clinic, Çorum, Turkey -- Dönmez, G., Bakirköy Dr. Sadi Konuk Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Topkara, G., Bandirma State Hospital, Cardiology Clinic, Balikesir, Turkey -- Daş, G., 82. Yil State Hospital, Cardiology Clinic, Adiyaman, Turkey -- Bozkurt, H., Antakya State Hospital, Cardiology Clinic, Antakya, Turkey -- Kültürsay, H., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Tikiz, H., Celal Bayar University Medical Faculty, Department of Cardiology, Manisa, Turkey -- Akgöz, H., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Kaymak, H., Tarsus State Hospital, Cardiology Clinic, Mersin, Turkey -- Öney, H., Artvin State Hospital, Cardiology Clinic, Artvin, Turkey -- Ye?in, H., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Bo?a, H., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Gök, H., Selçuk State Hospital, Cardiology Clinic, Izmir, Turkey -- Vural, H., Vedat Ali Özkan State Hospital, Cardiology Clinic, Kayseri, Turkey -- Atasever, H., Adapazari State Hospital, Cardiology Clinic, Adapazari, Turkey -- Arinç, H., Izzet Baysal University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Bozdemir, H., Buca Seyfi Demirsoy State Hospital, Cardiology Clinic, Izmir, Turkey -- Gündüz, H., Izzet Baysal University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Tunar, H., Salihli State Hospital, Cardiology Clinic, Manisa, Turkey -- Atmaca, H., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Do?ru, I., Çukurova State Hospital, Cardiology Clinic, Adana, Turkey -- Özdo?ru, I., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Susal, I., Karşiyaka State Hospital, Cardiology Clinic, Izmir, Turkey -- Kurt, I.T., Atakalp Heart Hospital, Cardiology Clinic, Izmir, Turkey -- Dinçer, I., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Biyik, I., Uşak State Hospital, Cardiology Clinic, Uşak, Turkey -- Tando?an, I., Cumhuriyet University Medical Faculty, Department of Cardiology, Sivas, Turkey -- Jordan, J., Uluda? University Medical Faculty, Department of Cardiology, Bursa, Turkey -- Kulan, K., Trabzon Numune State Hospital, Cardiology Clinic, Trabzon, Turkey -- Şahna, K., Ordu State Hospital, Cardiology Clinic, Ordu, Turkey -- Öztaş, K., Samsun State Hospital, Cardiology Clinic, Samsun, Turkey -- Dönmez, K., Manavgat State Hospital, Cardiology Clinic, Antalya, Turkey -- Övünç, K., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Kaya, K., Bursa State Hospital, Cardiology Clinic, Bursa, Turkey -- Aytemir, K., Hacettepe University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Özdemir, K., Selçuk University Medical Faculty, Department of Cardiology, Konya, Turkey -- Tigen, K., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Saraç, L., Istinye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Sirkeci, M.T., Kizilay Health Center, Cardiology Polyclinic, Erzincan, Turkey -- Çakmak, M., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Şahin, M., Ondokuz Mayis University Medical Faculty, Department of Cardiology, Samsun, Turkey -- Kutlu, M., Harput State Hospital, Cardiology Clinic, Elazi?, Turkey -- Bilge, M., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Bostan, M., Rize State Hospital, Cardiology Clinic, Rize, Turkey -- Melek, M., Afyon Kocatepe University Medical Faculty, Department of Cardiology, Afyon, Turkey -- Sunay, M.Ö., Balikesir State Hospital, Cardiology Clinic, Balikesir, Turkey -- Şeker, M., Meram State Hospital, Cardiology Clinic, Konya, Turkey -- Güçel, M.Ş., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Yazici, M., Düzce University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Kayikçio?lu, M., Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey -- Öç, M., Ümraniye State Hospital, Cardiology Clinic, Istanbul, Turkey -- Gürsürer, M., Karaelmas University Medical Faculty, Department of Cardiology, Zonguldak, Turkey -- Da?alp, M., Ziraat Bank Hospital, Cardiology Clinic, Ankara, Turkey -- Bilalo?lu, M., Erzurum Numune State Hospital, Cardiology Clinic, Erzurum, Turkey -- Yalçin, M., GATA Haydarpaşa Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Şerifi, M., Izmit State Hospital, Cardiology Clinic, Kocaeli, Turkey -- Gökçe, M., Karadeniz Technical University Medical Faculty, Department of Cardiology, Trabzon, Turkey -- Kiliçkap, M., Ankara University Medical Faculty, Department of Cardiology, Heart Center, Ankara, Turkey -- Polat, M., Ceyhan State Hospital, Cardiology Clinic, Adana, Turkey -- Şan, M., Çukurova University Medical Faculty, Department of Cardiology, Adana, Turkey -- Tahtasiz, M., Eşrefpaşa Municipality Hospital, Cardiology Clinic, Izmir, Turkey -- Yilmaz, M., Kayseri State Hospital, Cardiology Clinic, Kayseri, Turkey -- Etemo?lu, M., Izmir Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Coşkun, N., Harput State Hospital, Cardiology Clinic, Elazi?, Turkey -- Aran, N.S., Istanbul University Cerrahpaşa Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Ata, N., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Sönmez, N., Bodrum State Hospital, Cardiology Clinic, Mu?la, Turkey -- Çam, N., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Koylan, N., Istanbul University Istanbul Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Özer, N., Iskenderun State Hospital, Cardiology Clinic, Hatay, Turkey -- Keser, N., Maltepe University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Döven, O., Mersin University Medical Faculty, Department of Cardiology, Mersin, Turkey -- Tartano?lu, O., Karaman State Hospital, Cardiology Clinic, Karaman, Turkey -- Ergene, O., Atatürk Training and Research Hospital, Cardiology Clinic, Izmir, Turkey -- Elönü, O.H., Melikgazi Hospital, Cardiology Clinic, Kayseri, Turkey -- Onbaşili, O.A., Adnan Menderes University Medical Faculty, Department of Cardiology, Aydin, Turkey -- Özbek, Ö., Marmara University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Pinar, P., Manisa State Hospital, Cardiology Clinic, Manisa, Turkey -- Akdemir, R., Düzce University Medical Faculty, Department of Cardiology, Düzce, Turkey -- Kargin, R., Kartal Koşuyolu Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey -- Topsakal, R., Erciyes University Medical Faculty, Department of Cardiology, Kayseri, Turkey -- Yoldaş, R., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Uçar, R., Giresun State Hospital, Cardiology Clinic, Giresun, Turkey -- Ateşal, S., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Toktaş, S., Adana Numune Training and Research Hospital, Fatma Timurçin Heart Center, Adana, Turkey -- Cinsoy, S., Sabuncuo?lu Şerafeddin State Hospital, Cardiology Clinic, Amasya, Turkey -- Güleç, S., Ankara University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Aytekin, S., Kadir Has University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Çolak, S., Kizilay Health Center, Cardiology Polyclinic, Sivas, Turkey -- Mecit, S., Çanakkale Şehitlik State Hospital, Cardiology Clinic, Çanakkale, Turkey -- Sakalli, S., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey -- Sevimli, S., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Topalo?lu, S., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Aydo?du, S., Ankara Numune Hospital, Cardiology Clinic, Ankara, Turkey -- Turan, S.C., Fatih Sultan Mehmet State Hospital, Cardiology Clinic, Istanbul, Turkey -- Kahraman, S., Ni?de State Hospital, Cardiology Clinic, Ni?de, Turkey -- Yorganci, S., Atatürk State Hospital, Cardiology Clinic, Antalya, Turkey -- Coşkun, Ş., Bursa State Hospital, Cardiology Clinic, Bursa, Turkey -- Ünal, Ş., Nevşehir State Hospital, Cardiology Clinic, Nevşehir, Turkey -- Durmaz, T., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Ulusoy, T., Aksaray State Hospital, Cardiology Clinic, Aksaray, Turkey -- Keleş, T., Ankara Atatürk Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Kirat, T., Mu?la State Hospital, Cardiology Clinic, Mu?la, Turkey -- Gündo?du, T.T., Gebze Fatih Hospital, Cardiology Clinic, Kocaeli, Turkey -- Peker, T., Gemlik State Hospital, Cardiology Clinic, Bursa, Turkey -- Sümerkan, U., Marmara University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Aytekin, V., Kadir Has University Medical Faculty, Department of Cardiology, Istanbul, Turkey -- Koca, V., Bursa Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Bursa, Turkey -- Çam, V., Fethiye State Hospital, Cardiology Clinic, Mu?la, Turkey -- Gökçe, V., Konya Numune State Hospital, Cardiology Clinic, Konya, Turkey -- Gürlertop, Y., Atatürk University Medical Faculty, Department of Cardiology, Erzurum, Turkey -- Balbay, Y., Ankara Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Çavuşo?lu, Y., Osmangazi University Medical Faculty, Department of Cardiology, Eskişehir, Turkey -- Erzurum, Y., Eskişehir Yunus Emre State Hospital, Cardiology Clinic, Eskişehir, Turkey -- Selçoki, Y., Fatih University Medical Faculty, Department of Cardiology, Ankara, Turkey -- Yakar, Y., Tokat State Hospital, Cardiology Clinic, Tokat, Turkey -- Işilak, Z., GATA Haydarpaşa Training and Research Hospital, Department of Cardiology, Istanbul, Turkey -- Tosun, Z., Antalya State Hospital, Cardiology Clinic, Antalya, Turkey -- Kaplan, Z., Ankara Training and Research Hospital, Cardiology Clinic, Ankara, Turkey -- Tartan, Z., Siyami Ersek Hospital, Cardiology Clinic, Istanbul, Turkey, Maltepe Üniversitesi, and Çukurova Üniversitesi

Subjects
Male, heart atrium fibrillation, Turkey, Cross-sectional study, urinalysis, anticoagulant agent, Coronary artery disease, Turkey (republic), hydroxymethylglutaryl coenzyme A reductase inhibitor, low density lipoprotein cholesterol, sedentary lifestyle, Risk Factors, high density lipoprotein cholesterol, cardiovascular disease, middle aged, dipeptidyl carboxypeptidase inhibitor, Albuminuria/complications/epidemiology, Cardiovascular diseases, Hypertension/complications, Prevalence, Risk factors, Turkey/epidemiology, Medicine, Family history, family history, education.field_of_study, C reactive protein, adult, creatinine, article, beta adrenergic receptor blocking agent, clinical trial, antithrombocytic agent, Middle Aged, urine, comorbidity, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, female, congestive heart failure, risk factor, laboratory test, diabetes mellitus, Hypertension, antihypertensive agent, Female, triacylglycerol, InformationSystems_MISCELLANEOUS, Cardiology and Cardiovascular Medicine, cardiovascular risk, Adult, disease control, medicine.medical_specialty, microalbuminuria, heart infarction, Population, Urinalysis, albuminuria, smoking, Young Adult, blood, Internal medicine, cross-sectional study, Albuminuria, Humans, human, Risk factor, Intensive care medicine, education, Triglycerides, concentration (parameters), business.industry, screening, dyslipidemia, Cholesterol, HDL, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, cholesterol, Cholesterol, LDL, medicine.disease, major clinical study, Comorbidity, brain ischemia, predictor variable, multicenter study, Cross-Sectional Studies, ComputingMethodologies_PATTERNRECOGNITION, transient ischemic attack, observational study, Microalbuminuria, disease duration, business, Dyslipidemia, peripheral occlusive artery disease
Abstract

PubMed ID: 22257801, Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology.

Published
2011

7. [Percutaneous treatment of Lutembacher syndrome: a case report]

Author

Aydan Ongun, Ozdemir, Deniz, Kumbasar, Irem, Dinçer, and Yusuf, Atmaca

Subjects
Treatment Outcome, Septal Occluder Device, Humans, Mitral Valve, Female, Middle Aged, Lutembacher Syndrome, Echocardiography, Transesophageal, Heart Septal Defects, Atrial
Abstract

Lutembacher syndrome is a rare combination of congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Although it is traditionally corrected by surgical treatment, both conditions are amenable to transcatheter treatment without the need for surgery. We present a 49-year-old woman with Lutembacher syndrome. On pretreatment transthoracic echocardiography, planimetric mitral valve area was 1.5 cm(2), maximum diastolic gradient was 17 mmHg, and mean diastolic gradient was 9 mmHg. Combined percutaneous treatment was performed including balloon valvuloplasty for MS and closure of the ASD with the Amplatzer septal occluder. The patient was discharged uneventfully. Transthoracic echocardiography performed a week later showed planimetric mitral valve area as 2.1 cm(2), maximum diastolic gradient as 9 mmHg, and mean diastolic gradient as 4 mmHg. Complete closure of the ASD was achieved. Transcatheter treatment may be an effective alternative to surgery in selected patients with Lutembacher syndrome.

Published
2010

8. Two-dimensional longitudinal strain and strain rate imaging for assessing the right ventricular function in patients with mitral stenosis

Author

Aydan Ongun, Ozdemir, Cansin Tulunay, Kaya, Cagdas, Ozdol, Basar, Candemir, Sibel, Turhan, Irem, Dincer, and Cetin, Erol

Subjects
Adult, Male, Chi-Square Distribution, Echocardiography, Systole, Case-Control Studies, Ventricular Dysfunction, Right, Elasticity Imaging Techniques, Humans, Mitral Valve Stenosis, Female, Software, Statistics, Nonparametric
Abstract

Longitudinal two-dimensional strain (L2DS) deformation is a novel technique that evaluates global and regional right ventricular (RV) function. The aim of the study was to investigate the systolic function of RV by using this method in patients with pure mitral stenosis (MS).Conventional echocardiography and L2DS analysis were performed in 45 MS patients and 21 healthy controls. For strain analysis apical four-chamber views were obtained and by using a software system, peak systolic strain and strain rates were calculated off-line in each segment.The mean global longitudinal strain (GLS) of the whole RV (-20 + or - 7 vs. -24 + or - 6%, P= 0.02) and mean GLS of the septum (-19 + or - 7 vs. -23 + or - 5%, P = 0.03) were significantly reduced in the MS patients. Compared with the control group no significant change was determined in the mean GLS of the RV free wall (RVFW). While the mean global longitudinal strain rates (GLSR) of the entire RV and RVFW were similar between the groups, a significant difference in the mean GLSR of the septum (-1.2 + or - 0.4 vs. -1.5 + or - 0.3 s(-1), P= 0.005) was determined in the patients with MS. A regional analysis demonstrated that MS patients had significantly reduced strain and strain rates in the basal and mid-segments of the septum, whereas only lower strain values in the basal RVFW.RV systolic function evaluated by L2DS analysis in patients with MS has shown decreased global and segmental systolic functions. (ECHOCARDIOGRAPHY 2010;27:525-533).

Published
2009

9. The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral development – a cross sectional study

Author

Yusuf Atmaca, Cagdas Ozdol, Nihal Uslu, Aydan Ongun Ozdemir, Cansın Tulunay Kaya, Çetin Erol, Sibel Turhan, Timucin Altin, and Sadi Gulec

Subjects
Male, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Brachial Artery, Collateral Circulation, Vasodilation, Fractional flow reserve, Coronary Angiography, Internal medicine, medicine.artery, Occlusion, medicine, Humans, Radiology, Nuclear Medicine and imaging, Brachial artery, Endothelial dysfunction, Reactive hyperemia, Ultrasonography, Angiology, business.industry, Research, Coronary Stenosis, General Medicine, Middle Aged, Collateral circulation, medicine.disease, Coronary Vessels, lcsh:RC666-701, Radiology Nuclear Medicine and imaging, Cardiology, Female, Endothelium, Vascular, Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity
Abstract

Background Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals. Methods We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms. Results Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 ± 5.6 vs. 10.4 ± 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 ± 5.9 vs. 12.8 ± 6.5%, p = 0.521). Conclusion No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.

Published
2009
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10. Torsade de pointes associated with moxifloxacin: A rare but potentially fatal adverse event

Author

Özgür Ulaş Özcan, Ömer Akyürek, Aydan Ongun Ozdemir, Muharrem Güldal, Remzi Karaoguz, Timucin Altin, and Sibel Turhan

Subjects
Bradycardia, medicine.medical_specialty, Long QT syndrome, Moxifloxacin, Torsades de pointes, Case Report, QT interval, Syncope, Anti-Infective Agents, Risk Factors, Torsades de Pointes, Permanent cardiac pacemaker, Internal medicine, medicine, Humans, Adverse effect, Aged, 80 and over, Aza Compounds, business.industry, Cardiac Pacing, Artificial, Female sex, Pneumonia, medicine.disease, Long QT Syndrome, Treatment Outcome, Anesthesia, Cardiology, Quinolines, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug, Fluoroquinolones
Abstract

Torsade de pointes occuring due to a long QT interval is a rare but potentially fatal arrhythmia. Acquired long QT develops most commonly because of drugs that prolong ventricular repolarization. It has been reported that fluoroquinolone antimicrobials prolong the corrected QT interval but rarely cause torsade de pointes. A patient with torsade de pointes risk factors (female sex, advanced age, extreme bradycardia and renal failure) who developed the condition on the fourth day of 400 mg/day of oral moxifloxacin treatment is presented. After the moxifloxacin was stopped, the corrected QT interval normalized and a permanent cardiac pacemaker was implanted. During 11 months of follow-up, arrhythmia did not recur.

Published
2007

11. Glu298Asp polymorphism of the eNOS gene is associated with coronary collateral development

Author

Halil Gürhan Karabulut, Çetin Erol, Timucin Altin, Eralp Tutar, Aydan Ongun Ozdemir, Cagdas Ozdol, Yasemin Genç, Sadi Gulec, and Sibel Turhan

Subjects
Male, medicine.medical_specialty, Nitric Oxide Synthase Type III, Glutamic Acid, Neovascularization, Physiologic, Diabetes Complications, Enos, Polymorphism (computer science), Internal medicine, Diabetes mellitus, Genotype, Occlusion, medicine, Humans, Allele, Alleles, Aged, Aspartic Acid, Polymorphism, Genetic, biology, Vascular disease, business.industry, Coronary Stenosis, Middle Aged, medicine.disease, biology.organism_classification, Coronary Vessels, Nitric oxide synthase, Endocrinology, Amino Acid Substitution, Coronary Occlusion, biology.protein, Cardiology, Regression Analysis, Female, Cardiology and Cardiovascular Medicine, business
Abstract

We examined the endothelial nitric oxide (eNOS) gene Glu298Asp polymorphism to assess its possible association with the extent of coronary collaterals.A total of 473 consecutive patients who had high grade coronary stenosis or occlusion were evaluated for the extent of coronary collaterals by using Rentrop classification. Patients with grade 0 or 1 collaterals were identified as having poor collaterals. The relation between collateral status and eNOS Glu298Asp polymorphism was studied by multivariate logistic regression analysis.Subjects with poor collaterals were more likely to have diabetes mellitus (p0.001) and unstable angina pectoris as clinical presentation (p=0.014) and more likely to carry Asp298 variant (p=0.02) but they were less likely to have received statins (p=0.031). Multivariate analysis demonstrated that Asp298 allele carriers were 1.7 times more likely to have poor collaterals than patients with GluGlu genotype (95% CI: 1.09-2.69, p=0.024). There was a significant interaction between diabetes mellitus and eNOS Glu298Asp polymorphism in the analysis of collateral development. Among 145 diabetic patients Asp298 allele was the only predictor of poor collateral development with OR of 5.38 (95% CI: 2.41-11.98, p0.001). Once diabetic patients were excluded from the analysis Asp298 allele was no longer a significant correlate of poor collateral formation.The present study suggests that the Asp298 allele of the eNOS gene is significantly associated with impaired collateral development, especially in patients with diabetes mellitus. Treatment strategies that modulate eNOS activity and/or NO production may improve coronary collateral development.

Published
2007

12. Elevated levels of C-reactive protein are associated with impaired coronary collateral development

Author

Çetin Erol, Aydan Ongun Ozdemir, H. Maradit-Kremers, Yusuf Atmaca, Sadi Gulec, and Irem Dincer

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Clinical Biochemistry, Collateral Circulation, Coronary Angiography, Biochemistry, Coronary artery disease, Cohort Studies, Coronary circulation, Risk Factors, Internal medicine, Diabetes mellitus, Coronary Circulation, medicine, Humans, Aged, biology, business.industry, C-reactive protein, Coronary Stenosis, General Medicine, Middle Aged, medicine.disease, Collateral circulation, Stenosis, medicine.anatomical_structure, C-Reactive Protein, Cohort, Cardiology, biology.protein, Female, business, Diabetic Angiopathies
Abstract

Background In vitro studies have shown that C-reactive protein (CRP) attenuates nitric oxide production and inhibits angiogenesis, which may result in impaired collateral development. The aim of this study was to investigate the association between high sensitivity CRP (hsCRP) levels and the extent of coronary collaterals. Materials and methods We investigated the association between hsCRP levels and the extent of coronary collaterals according to the Rentrop classification in a cohort of 185 patients who had high-grade coronary stenosis or occlusion on their angiograms. Results Mean age was 62 years and 80% were males. Subjects with a higher grade of collaterals were significantly less likely to have diabetes mellitus (OR; 0·48, 95% and CI; 0·28, 0·83) or acute coronary syndrome (OR; 0·58, 95% and CI; 0·33, 0·99), but they were more likely to have higher number of vessels with significant stenosis (OR; 1·41, 95% and CI; 1·03, 1·93) and to have received statins (OR; 1·84, 1.09, 3.13). The mean hsCRP values reduced significantly as the Rentrop grades increased (trend, P = 0·0006). After adjusting for age, gender, statin use, clinical presentation with acute coronary syndrome, diabetes mellitus and the number of vessels with significant stenosis, each 10-unit increase in hsCRP values corresponded to a 31% reduced odds of having a higher collateral score (OR; 0·69, 95% and CI; 0·53, 0·90). Conclusions Our findings indicate that elevated hsCRP levels are associated with a significant impairment in coronary collateralization. These data suggest a previously unrecognized mechanism through which inflammation may worsen cardiovascular outcomes.

Published
2006

13. Angiographic evaluation of myocardial perfusion in patients with syndrome X

Author

Çetin Erol, Cagdas Ozdol, Sadi Gulec, Didem Oguz, Deniz Kumbasar, Aydan Ongun Ozdemir, and Yusuf Atmaca

Subjects
Male, medicine.medical_specialty, Coronary Angiography, Sensitivity and Specificity, Text mining, Predictive Value of Tests, Internal medicine, Coronary Circulation, medicine, Humans, In patient, Prospective Studies, Aged, Microvascular Angina, medicine.diagnostic_test, business.industry, Tissue level, Middle Aged, Control subjects, Case-Control Studies, Angiography, Circulatory system, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Perfusion, Syndrome x
Abstract

We evaluated tissue level perfusion in patients who had syndrome X using the myocardial blush grade technique. Normal tissue perfusion in all coronary territories was observed in 23 patients (41.8%) who had syndrome X and in 44 control subjects (80%). Total myocardial blush score (sum of the myocardial blush grades of each coronary territory) was significantly lower in patients who had syndrome X than in control subjects (8.2 +/- 0.7 vs 8.7 +/- 0.5, p0.0001). We have demonstrated for the first time that a substantial number of patients who have syndrome X have impaired tissue level perfusion, and this might be assumed as a surrogate marker of a diseased microvascular network in the catheterization laboratory.

Published
2005

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