Search

Amaç: Stent içi restenoz (SR), perkütan koroner girişimin (PKG) önemli komplikasyonlarından biridir. Eozinofil ile SR arasındaki ilişkiyi ortaya çıkaran çok sayıda çalışma olmasına rağmen, literatürde eozinofil-lenfosit oranı (ELO)’nın SR gelişimi ile ilişkisi hakkında veri bulunmamaktadır. Bu çalışmada, hastaların başvuru ELO değerlerinin SR ile ilişkisini araştırmayı amaçladık. Yöntemler: Çalışmaya, daha önce koroner stent takılmış olup hastanemize stabil angina nedeniyle başvuran ve tekrar koroner anjiyografisi yapılan 314 hasta dahil edildi. Hastaların verileri retrospektif olarak incelendi. Anjiyografik olarak SR tespit edilen 197 kişi hasta grubuna alındı, stentleri açık olan 117 hasta ise kontrol grubuna dahil edildi. Bulgular: Yaş, cinsiyet, hipertansiyon, diabetes mellitus, LDL-kolesterol, HDL-kolesterol, platelet sayısı, platelet-lenfosit oranı (PLO), hemoglobin düzeyleri ve sol ventrikül ejeksiyon fraksiyonu (LVEF) ölçümleri bakımından gruplar arasında anlamlı bir fark yoktu. Başvuruda bakılmış olan kan beyaz küre sayısı (WBC), nötrofil, eozinofil, C-reaktif protein (CRP), ELO ve nötrofil-lenfosit oranı (NLO) değerleri SR grubunda kontrol grubuna göre istatistiksel olarak anlamlı şekilde daha yüksek lenfosit değerleri daha düşüktü. Tüm hastalar ELO düzeylerine göre iki gruba ayrıldığında, yüksek-ELO grubunda düşük-ELO grubuna kıyasla daha sık SR görüldü. Başvuru ELO değerinin ≥0,745 olması durumunda, SR’u %64 sensitivite ve %61 spesifite ile öngördürebildiği saptandı. Sonuç: Bu çalışmada ELO değerleri kontrol grubuna kıyasla SR grubunda anlamlı olarak daha yüksek bulundu. Çalışmadan elde ettiğimiz bulgular ışığında kolay ve ucuz bir yöntem olan ELO, SR açısından yüksek riskli hastaların belirlenmesine yardımcı olabilir ve yüksek ELO, SR için bir öngördürücü olarak kullanılabilir., Objective: Stent restenosis (SR) is an important compli­cation of percutaneous coronary intervention. There are many studies explored the relation of eosinophils with SR, however, there is no data about relationship between eo­sinophil-lymphocyte ratio (ELR) and SR. In this study we aimed to investigate the relationship between the value of ELR on admission and SR. Methods: The study was included 314 patients who had been applied a coronary stent implantation and they were admitted to cardiology clinic with stabile angina and un­derwent repeat coronary angiography. The data obtained from patients were analyzed retrospectively. The patient group was consisted of 197 patients who were diagnosed as SR, and the control group was consisted of 117 pa­tients whose stents were patent angiographically. Results: The groups were similar in terms of age, gender, hypertension, diabetes mellitus, LDL-C, HDL-C, platelet count, platelet-lymphocyte ratio (PLR), hemoglobin and left ventricle ejection fraction (LVEF). White blood cell (WBC), neutrophil, eosinophil, C-reactive protein (CRP), ELR and neutrophil-lymphocyte ratio (NLR) on admission were higher in the SR group compared to the controls. All patients were categorized into two groups according to ELR values and SR was more frequent in the high ELR group compared to low ELR group. An ELR value of ≥0.745 predicted SR with 64% sensitivity and 61% specif­ity. Conclusion: In this study ELR was found statistically higher in SR patients compared to the controls. Accord­ing to our data ELR as an inexpensive and easy method, may contribute to determination of high risk patients and increased ELR can be used as a predictor of SR.

Giriş:Bu çalışmada, hematolojik parametrelerin ölçümleriile preeklamptik kadınlarda hipertansiyon şiddetini tahmin etmenin mümkün olupolmadığını araştırdık.Hastalarve Yöntem: İki yüz altmış birpreeklamptik ve 51 normal gebe kadın çalışmaya alındı. Preeklampsi olgularıhafif ve ağır preeklampsi olarak sınıflandırıldı.Bulgular:Doğum sonrası sonuçlar karşılaştırıldığında,preeklamptik kadınların trombosit sayıları düşük, ortalama trombosit hacimlerive nötrofil lenfosit oranları yüksekti (sırasıyla; p< 0.001, p< 0.001 vep< 0.001). Çoklu lineer regresyon analizinde, ortalama trombosit hacmi venötrofil lenfosit oranı hipertansiyon şiddeti ile bağımsız bir şekildekorelasyon gösterdi (sırasıyla; β= 0.25, p< 0.001 ve β= 0.31, p< 0.001).Sonuç: Hemortalama trombosit hacmi hemde nötrofil lenfosit oranı preeklamptikgebelerde hipertansiyonun şiddetini öngörmede bağımsız birer belirleyici olarakkullanılabilir., Introduction:This study was undertaken to examine the role ofhematological parameters in predicting the severity of hypertension inpre-eclamptic women.Patientsand Methods: Two hundred sixty-one pre-eclamptic women andfifty-one women with normal pregnancy were included in the study. The severityof preeclampsia was classified as mild or severe. Results:Compared to post-delivery period, pre-eclampticfemales had lower platelet count, raised mean platelet volume and raisedneutrophil lymphocyte ratio (p< 0.001, p< 0.001, p< 0.001,respectively). Multiple linear regression analysis showed an independentcorrelation between the severity of hypertension and mean platelet volume aswell as the neutrophil lymphocyte ratio (β= 0.25, p< 0.001; β= 0.31, p

Objectives: Our aim was to evaluate whether more than one observer or fractional flow reserve has the same re­sults in assessing coronary lesion severity in intermediate lesions. Methods: Our hospital\'s database was searched for frac­tional flow reserve procedures and then these patient\'s lesions were assessed visually by three experienced in­terventional cardiologist. Results: 8 of 46 patients were (17.4%) female and 38 of 46 were (82,6%) male. Average age was 61±11 years (Male: 60±11 / Female: 70±7 years). One observer could only detect 66.7% of severe lesions and 76.2% of non-severe lesions. When two observers agreed about lesion sever­ity, true detection of severe lesions was (max) 76.7%, and true detection of non-severe lesions was (max) 66.7%, so a decrease in true detection of non-severe lesions was observed. When one of the observers called a lesion “se­vere” and the lesion was assumed as “severe”, detection of a severe lesion was 83.3% (p=0.017); if all of the ob­servers agreed that the lesion was “non-severe” then true detection of a non-severe lesion was 90.5% (p, Amaç: Koroner arter hastalığında orta dereceli lezyonla­rın ciddiyetinin değerlendirilmesinde, çok gözlemci ile ya­pılan değerlendirmenin fraksiyonel akım rezervi ile benzer sonuçlar elde edip edemeyeceği belirlenmek istenmiştir. Yöntemler: Hastanemizin veritabanı fraksiyonel akım re­zervi işlemleri açısından tarandı ve hastalara ait lezyonlar üç deneyimli girişimsel kardiyolog tarafından görsel ola­rak değerlendirildi. Bulgular: 46 olgunun 8\'i (%17,4) kadın ve 38\'i (%82,6) erkekti. Yaş ortalaması 61±11 yıl idi. (Erkek: 60±11 / Ka­dın: 70±7 yıl). Tek gözlemcinin ciddi lezyonların ancak %66,7\'sini saptayabildiği, ciddi olmayan lezyonların ise en fazla %76,2\'sini saptayabildiği gözlendi. İki gözlemci­nin ortak kararına bakıldığında ise ciddi lezyonları sap­tama olasılığının maksimum %76,7, ciddi olmayan lez­yonları saptama olasılığının ise maksimum %66,7 olduğu saptandı, yani iki gözlemcinin ortak kararı ile ciddi olma­yan lezyonların değerlendirilmesinde yanlışlık olasılığının arttığı görüldü. Üç gözlemciden biri lezyona ciddi dediğin­de ciddi çıkma ihtimalinin %83,3 e yükseldiği (p=0,017), üç gözlemcinin de ciddi değil olarak değerlendirdiği lez­yonların ciddi çıkmama olasılığının %90,5\'e yükseldiği (p

Objective: Myocardial bridge (MB) is a congenital anomaly characterized by systolic narrowing of the epicardial coronary arterial segment while traveling in the myocardium. It is a benign entity but previous studies showed that the proximal portion is prone to an enhanced atherosclerosis. Neutrophil/lymphocyte ratio (NLR) is a sensitive marker of systemic inflammation used as a predictor for adverse cardiovascular outcomes in atherosclerotic heart disease. So in this study, we sought to evaluate the association between NLR and myocardial bridging. Methods: A total of 172 patients (mean age: 50.8 ± 11.5 years, 77.3% men) with either angiographically proven MB or normal coronary arteries were included in the study. For the entire study population, hematologic parameters were measured using an automatic blood counter. Results: The study population consisted of 71 patients with MB (mean age: 51.4 ± 11.9 years, 80.3% male) and 101 patients with normal coronary arteries (mean age: 50.5 ± 11.3 years, 75.2% male). There were no significant differences between groups regarding hemoglobin level, platelet count, glucose and creatinine. Compared to the control group, NLR was significantly higher in patients with MB (2.45 ± 1.19 vs. 1.72 ± 0.48; p< 0.001). In ROC analysis, NLR > 1.82 predicted myocardial bridge presence with 70% sensitivity and 71% specificity (ROC area under curve: 0.733, 95% CI: 0.654-0.811, p < 0.001). Conclusion: Our study findings demonstrated that MB is associated with elevated NLR, which is used to assess inflammatory status of the body. J Clin Exp Invest 2014; 5 (1): 24-28, Amaç: Miyokardiyal kas bandı miyokart içinde seyreden epikardiyal koroner arterlerin sistolde daralması ile seyreden konjenital bir anomalidir. İyi huylu olmasına rağmen önceki çalışmalarda proksimal kesimlerin artmış ateroskleroza eğilimli olduğu gösterilmiştir. Nötrofil/lenfosit oranı (NLO) aterosklerotik kalp hastalıklarında kötü prognozu öngören sistemik enflamasyonun duyarlı bir belirtecidir. Biz bu çalışmada NLO ile miyokardiyal kas bandı arasında bir ilişki var olup olmadığını araştırmayı amaçladık. Metodlar: Anjiyografik olarak tespit edilmiş miyokardiyal kas bandı veya normal koroner arterleri olan 172 hasta (ortalama yaş: 50.8 ± 11.5 yıl, %77.3 erkek) çalışmaya dahil edildi. Otomatik kan sayacı kullanılarak tüm hastaların hematolojik parametreleri ölçüldü. Bulgular: Çalışma 71 miyokardiyal kas bandı (ortalama yaş: 51,4 ± 11,9 yıl, %80,3 erkek) ve 101 normal koroner arterleri (ortalama yaş: 50,5 ± 11,3 yıl, %75.2 erkek) olan hastadan oluşmaktaydı. Hemoglobin, trombosit sayısı, glukoz ve kreatinin açısından gruplar arasında fark saptanmadı. Kontrol grubuna göre miyokardiyal kas bandı grubunda NLO anlamlı olarak daha yüksekti (2,45 ± 1,19 vs. 1,72 ± 0,48; p< 0,001). ROC analizinde, NLO > 1,82 miyokardiyal kas bandı varlığını %70 duyarlılık ve %71 özgüllükle öngörmüştür (ROC eğri altında kalan alan: 0.733, 95% güvenlik aralığı: 0.654-0.811, p < 0.001). Sonuç: Çalışmamız miyokardiyal kas bandının vücutta enflamatuar düzeyi gösteren yüksek NLO seviyeleri ile ilişkili olduğunu göstermiştir.

Objective: We aimed to investigate short term effects of oral and infusion dosages of amiodarone on thyroid function. Methods: A hundred and fifty-five prospectively consecutive patients with a diagnosis of atrial or ventricular arrhythmias admitted to our clinic whom amiodarone were applied enrolled to our study. 134 patients received 16 mg/kg amiodarone iv infusion for 24 hours and oral 500±100 mg/day amiodarone as the maintenance dose for one month. 21 patients received only oral 500±100 mg/day amiodarone dose for one month. Follow up visit was performed in the first month of amiodarone therapy. Results: In this study 68% of patients were male and the average age of the patients was 62.8±13.5. The indications for amiodarone treatment were atrial fibrillation (41%), ventricular tachycardia (41%), and preoperative (5%), supraventricular tachycardia (5%), atrial flutter (5%), and ventricular fibrillation (3%). At the first month of follow up 83% of patients were in euthyroid state, 17% of the patients had amiodarone induced thyroid dysfunction (TD), 5% of patients had subclinical hyperthyroidism, 5% of patients had manifest hypothyroidism, 7% of patients had subclinical hyperthyroidism, and 1% of the patients developed overt hyperthyroidism. Conclusion: In this study we showed that amiodarone can cause adverse effects on thyroid function in a short time of period. For this reason patients should be followed in the first, third, sixth and twelfth months of amiodarone therapy and thyroid function should be evaluated. J Clin Exp Invest 2014; 5 (2): 280-285, Amaç: Bu yazıda amiodaronun tiroid fonksiyonları üzerindeki kısa dönem etkilerini, oral ve infüzyon dozlarınının tiroid fonksiyonları üzerindeki etkisini araştırmak amaçlanmıştır. Yöntemler: Kliniğimize atrial ve ventriküler aritmilerle başvurup amiodaron başlama endikasyonu olan ardışık 155 ötroid hasta çalışmaya alındı. Hastaların 134\'üne 16 mg/kg dozunda 24 saat IV amiodaron infüzyonu takiben bir ay boyunca oral 500±100 mg/gün, geriye kalan 21 hastaya ise sadece oral 500±100 mg/gün amiodaron başlandı. Hastalar tedavinin birinci ayında kontrole çağrıldı. Bulgular: Çalışmaya alınan hastaların %68\'i erkek olup hastaların ortalama yaşı. 62,8±13,5 idi. Amiodaron başlama endikayonu olan hastaların %41\'i atrial fibrilasyon, % 41\'i ventriküler taşikardi, %5\'i preoperatif, %5\'i supraventriküler taşikardi, %5\'i atriyal flutter, %3\'ü ventriküler fibrilasyondu. Birinci ay kontrolünde %83 hastada ötiroid durum, % 17 hastada ise amiodarona bağlı tiroid disfonksiyonu (TD) saptandı. TD saptanan hastaların %5\'i subklinik hipotiroidi, %5\'i aşikar hipotiroidi, %7\'si subklinik hipertiroidi, %1\'inde de aşikar hipertiroidi gelişmişti. Sonuçlar: Bu çalışmada amiodaronun kısa dönemde de tiroid fonksiyonları üzerinde olumsuz etki yapabileceğini gösterdik. Bu nedenle amiodaron tedavisi başlanan hastalar birinci ay, üçüncü ay, altıncı ay ve onikinci ay kontrole çağrılmalıdır. Böylece amiodaron tedavisi alması zorunlu hastalarda gelişecek olan TD erkenden tespit edilebilecek ve uygun tedavi başlanabilecektir.

A 40 years old male with history of unexplained recurrent presyncope and palpitation episodes referred to cardiology department. Patient had no past medical history. Subsequently, electrophysiology study was performed to detect any underlying atrioventricular nodal disease or inducible tachyarrhythmias. During this period, 1.0 mg of atropine was injected intravenously to performed stimulation and patient suddenly developed polymorphic ventricular tachycardia that could not be terminated with overdrive pacing. Ventricular tachycardia was terminated spontaneously, two minutes later. J Clin Exp Invest 2014; 5 (3): 449-451, Tekrarlayan çarpıntı ve presenkop şikayetleri ile 40 yaşında erkek hasta kardiyoloji kliniğine başvurdu. Hastanın öz geçmişinde herhangi bir özellik yoktu. Atriyoventriküler nod hastalığı veya taşiaritmi indüklemek için elektrofizyolojik çalışma yapıldı. Atropin 1.0 mg yapıldıktan sonra testin tekrarlanması planlandı. Bu esnada polimorfik ventriküler taşikardi gelişti. Overdrive pacing ile taşikardi sonlanmadı yaklaşık 2 dakika sonra spontan olarak sonlandı.

BSTRACT Objective: the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: the study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. the χ2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. the sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI. (

Yuksel, Murat/0000-0003-2636-5211 WOS: 000364114800011 Aim: To investigate the predisposing factors, demographic and clinical characteristics, echocardiographic and prognostic features, and Outcomes of patients with native valve infective endocarditis (IE) in Turkey in a multicenter based study. Materials and methods: The study population consisted Of 15,8 consecutive patients with native valve IE (NVE). Data on demographics, medical history, medications, clinical procedures, predisposing factors, clinical examination, microbiology, antibiotic therapy, echocardiography, surgery, complications, and outcome were collected and compared. Results: The mean age of the patients was 47 19 (range 13-87). Seventy seven patients (49%) Were female. Of the 158. NVE patients, 49 died during hospitalization. Mortality rate was 31%. Twenty eight patients experienced a stroke. The patients who died during hospitalization were significantly older than the survivors and had higher mean heart rate, white blood cell, C reactive protein, creatinine, poor NYHA functional etas's, multiple vegetations and large vegetations. Culture negative endocarditis was seen in 54 eases (34%). Staphylococci were the most common causative organisms (28%). Eighty patients had undergone surgical treatment (51%). Hemoglobin, presence of multiple vegetation, vegetation size. (>10 mm), septic shock and poor NYHA Class on admission were independent risks for in hospital mortality and stroke Beside these variables C. reactive Protein was also an independent risk for in hospital mortality Conclusion: Native valve IE in Turkey was associated with high in hospital mortality. Rheumatic heart disease continues to be the most common underlying heart condition and echocardiographie findings on admission were the most important independent predictors of mortality or stroke.

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

akil, mehmet ata/0000-0001-6004-1822; KAYA, HASAN/0000-0003-3923-4026 WOS: 000319517900003 PubMed: 23661513 OBJECTIVE: This study aimed at the assessment of the clinical approach to atrial fibrillation (AF) in the older population and the consistency with the guidelines based on the records of the multicenter, prospective AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) study. PATIENTS AND METHODS: 2242 consecutive patients admitted to the Cardiology Outpatient Clinics of 17 different tertiary Health Care Centers with at least one AF attack determined on electrocardiographic examination, were included in the study. Among the patients included in the study, 631 individuals aged 75 years and older were analyzed. RESULTS: The mean age of the patients was determined as 80.3 +/- 4.2 years. The most frequent type of AF in geriatric population was the persistent-permanent type with a percentage of 88%. 60% of the patients with AF were female. Hypertension was the most common co-morbidity in patients with AF (76%). While in 16% of patients a history of stroke, transient ischemic attack or systemic thromboembolism was present, a history of bleeding was present in 14% of the patients. 37% of the patients were on warfarin treatment and 60% of the patients were on aspirin treatment. In 38% of the patients who were on oral anticoagulant treatment, INR level was in the effective range. CONCLUSIONS: The rate of anticoagulant use in the elderly with AF was 37% and considering the reason of this situation was the medication not being prescribed by the physician, one should pay more attention particularly in the field of treatment.

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEY Kaya, Hasan/0000-0003-3923-4026; WOS: 000329858400146 … Turkish Soc Cardiol

Ayhan, Erkan (Balikesir Author), Amaç: Adiponektin, insülin duyarlılığını düzenleyen ve adipositden sekrete edilen bir proteindir ve dolaşımdaki seviyesinin azalması insülin direnci ile ilişkilidir. Biz, stabil anjina pektorisli hastalarda serum adiponektin ve kan gli- koz seviyeleri ile koroner arter hastalığı şiddeti arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: Bu çalışmaya stabil anjina pektorisli 160 hasta (82 erkek) dahil edildi. Hastalar başvuru es- nasındaki kan glikoz seviyerine göre 3 gruba ayrıldı; 24 hasta normal kan glikoz grubu,53 hasta bozulmuş glikoz tolerans grubu ve 53 hasta diabetes mellitus (DM) grubu. Koroner lezyonların şiddeti Gensini skoru kullanarak de- ğerlendirildi. Tüm gruplarda serum adiponektin seviyeleri de ölçüldü. Bulgular: Hipertansiyon, hiperlipidemi, obesite ve insü- lin direnci DM grupta anlamlı olarak daha yüksekdi. DM’li hastalarda serum adiponektin seviyeleri anlamlı olarak daha düşük saptandı (13.55±7.16, p=0.002). Ortalama Gensini skoru DM grupta 40.84 ±37.25 olarak saptandı (p=0.006). Sonuç: Stabil anjina pektorisi olan hastalarda serum adi- ponektin düzeyleri koroner arter hastalığı yaygınlığı için bir ipucu olabilir., Objectives: Adiponectin is an adipocyte-secreted protein that modulates insulin sensitivity and whose low circulat- ing concentration is associated with insulin resistance. We evaluated the association between serum adiponec- tin and blood glucose levels with coronary artery disease severity on the angiogram in patients with stable angina pectoris. Materials and methods: The study included 160 patients (82 males) with stable angina pectoris. The patients were divided into three groups according to the blood glucose levels on admission; thus, 24 had normal glucose group, 53 had impaired glucose tolerance group, and 53 had diabetes mellitus (DM) group. The severity of coronary lesions was assessed using the Gensini score. Serum adiponectin levels were measured in the all group. Results: The hypertension, hyperlipidemia, obesity, and insulin resistance were significantly higher in the DM group. Patients with DM significantly lower serum levels of adiponectin (13.55±7.16, p=0.002). The mean Gensini score was 40.84± 37.25 in the DM group (p=0.006). Conclusion: Serum adiponectin levels may be a clue for severity coronary artery disease in patients with stable angina pectoris.