162 results on '"Kalçık M"'
Search Results
2. Role of anticardiolipin antibodies in the pathogenesis of prosthetic valve thrombosis: An observational study
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Aykan, A.Ç., Gökdeniz, T., Kalçık, M., Astarcıoğlu, M.A., Gündüz, S., Karakoyun, S., Gürsoy, M.O., Oğuz, A.E., Ertürk, E., Çakal, B., Bayram, Z., and Özkan, M.
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- 2015
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3. Relationship between neutrophil–lymphocyte ratio and in-hospital mortality
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Karakoyun, S., Kalçık, M., and Yesin, M.
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- 2016
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4. Lipid Lowering Therapy Use In Secondary Prevention: An Analysis Of Ephesus Study
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Basaran, O., primary, Doğan, V., additional, Mert, G.O., additional, Mert, K.U., additional, Ozlek, B., additional, Çelik, O., additional, Ozlek, E., additional, Çil, C., additional, Bekar, L., additional, Aktaş, M., additional, Resulzade, M., additional, Kalçık, M., additional, Aksan, G., additional, Cinier, G., additional, Akay, K., additional, Senol, U., additional, Demir, V., additional, Inci, S., additional, Biteker, M., additional, and Kayıkçıoğlu, M., additional
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- 2019
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5. Lipid management and LDL-C goal attainment in primary prevention: An analysis of EPHESUS study
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Basaran, O., Dogan, V., Mert, G.O., Mert, K.U., Ozlek, B., Celik, O., Ozlek, E., Cil, C., Bekar, L., Aktas, M., Resulzade, M., Kalcik, M., Aksan, G., Cinier, G., Akay, K., Senol, U., Demir, V., Inci, S., Biteker, M., and Kaykcioglu, M.
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- 2020
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6. Real-life use of digoxin in patients with non-valvular atrial fibrillation: data from the RAMSES study
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Biteker, M., primary, Başaran, Ö., additional, Dogan, V., additional, Beton, O., additional, Tekinalp, M., additional, Çağrı Aykan, A., additional, Kalaycıoğlu, E., additional, Bolat, I., additional, TaŞar, O., additional, Şafak, Ö., additional, Kalçık, M., additional, Yaman, M., additional, and Kırma, C., additional
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- 2016
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7. Relationship between neutrophil–lymphocyte ratio and in-hospital mortality
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Karakoyun, S., primary, Kalçık, M., additional, and Yesin, M., additional
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- 2015
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8. Thrombolytic therapy regimens for prosthetic valve thrombosis
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Kalçık, M., primary, Gürsoy, M. O., additional, and Özkan, M., additional
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- 2015
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9. Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection
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Karakoyun, S., primary, Gürsoy, M.O., additional, Akgün, T., additional, Öcal, L., additional, Kalçık, M., additional, Yesin, M., additional, Erdoğan, E., additional, Külahçıoğlu, S., additional, Bakal, R.B., additional, Köksal, C., additional, Yıldız, M., additional, and Özkan, M., additional
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- 2014
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10. Role of anticardiolipin antibodies in the pathogenesis of prosthetic valve thrombosis
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Aykan, A.Ç., primary, Gökdeniz, T., additional, Kalçık, M., additional, Astarcıoğlu, M.A., additional, Gündüz, S., additional, Karakoyun, S., additional, Gürsoy, M.O., additional, Oğuz, A.E., additional, Ertürk, E., additional, Çakal, B., additional, Bayram, Z., additional, and Özkan, M., additional
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- 2014
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11. The Role of Protein Z and Protein Z-Dependent Protease Inhibitor Polymorphisms in the Development of Prosthetic Heart Valve Thrombosis
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Karakoyun, S., Ozan Gürsoy, M., Kalçık, M., Yesin, M., Gündüz, S., Ali Astarcıoğlu, M., Bayram, Z., Beytullah Çakal, Bayam, E., Özkan, M., and Ardahan Üniversitesi
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Prosthetic Heart Valve Thrombosis ,Protein Z ,Dependent Protease Inhibitor Polymorphisms - Abstract
BACKGROUND AND AIM OF THE STUDY: Protein Z (PZ) is a vitamin K-dependent factor that is synthesized mainly by the liver. It acts as an activator of serpin, the protein Z-dependent inhibitor (ZPI), which inhibits factor Xa. The potential role of alterations in protein Z and/or ZPI levels in the pathogenesis of thrombotic and/or hemorrhagic diseases has been previously investigated, but results have been conflicting. The study aim was to evaluate the role of PZ/ZPI polymorphisms in the development of prosthetic valve thrombosis (PVT).METHODS: This prospective, observational cross-sectional study included 50 consecutive patients with PVT [non-obstructive thrombosis (NOT) in 35 patients; obstructive thrombosis (OT) in 15] and 50 consecutive healthy subjects with normally functioning prostheses. gDNA was extracted from ca. 5 × 106 leukocytes, using the QIAamp DNA Mini Kit (Qiagen), according to the manufacturer's recommendations. For mutational analysis, a minisequencing method was employed. Results of the analyses were compared between the PVT and control groups, and also between the OT and NOT subgroups.RESULTS: The frequency of A allele (mutant type) of PZG79A was equal in all PVT patients and in controls. With regards to PZ-A13G polymorphisms, frequency of the mutant G allele was 22% in PVT patients and 19% in controls. Serpina-R67X polymorphism was observed in 8% of PVT patients and 6% of controls. Normal variant CC was present in 47 controls (94%), whereas a heterozygotic mutation (CT) was detected in four PVT patients (8%). Frequency of the ZPI-R67X mutation was significantly higher in patients with OT than in those with NOT (p = 0.041).CONCLUSIONS: The present study was the first to evaluate the potential impact of PZ (PZ-A13G, PZG79A) and ZPI (R-67X, W303X) polymorphisms in the development of PVT. Based on the results of this small observational case-control study, PZ/ZPI polymorphisms do not appear to play an active role in the development of PVT. Hence, further extensive studies are necessary.
12. Combination anticoagulation strategy in pregnancy with mechanical valves: The KYBELE study.
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Özkan M, Güner A, Gündüz S, Yıldız G, Yıldırım Aİ, Kalçık M, Yesin M, Bayam E, Kalkan S, Gürsoy MO, Kılıçgedik A, Bayram Z, Sarı M, Aytürk M, Karakoyun S, Astarcıoğlu MA, Gündoğdu EC, Biçer A, Gürcü E, Koçak T, and Demirbağ R
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- Humans, Female, Pregnancy, Adult, Prospective Studies, Drug Therapy, Combination, Pregnancy Outcome, Pregnancy Trimester, First, Thromboembolism prevention & control, Thromboembolism etiology, Thromboembolism epidemiology, Thrombosis prevention & control, Thrombosis etiology, Anticoagulants administration & dosage, Warfarin administration & dosage, Warfarin adverse effects, Pregnancy Complications, Cardiovascular drug therapy, Heparin, Low-Molecular-Weight administration & dosage, Heparin, Low-Molecular-Weight therapeutic use, Heparin, Low-Molecular-Weight adverse effects, Heart Valve Prosthesis adverse effects
- Abstract
Background: Optimal first-trimester anticoagulation is still challenging in pregnant women with mechanical heart valves (MHVs) requiring high-dose warfarin. This multicenter prospective study aims to determine the optimal anticoagulation regimens for pregnant patients with MHVs., Methods: All women were allocated to one of three treatment options during first trimester including lone low-molecular-weight heparin (LMWH), combination of LMWH + 2.5 mg warfarin, and LMWH+4 mg warfarin. Primary maternal outcome included a combination of death, thromboembolism, severe bleeding, and need for treatment of mechanical valve thrombosis (MVT). Any fetal loss was determined as primary fetal outcome., Results: The study included 78 pregnancies in 65 women with MHVs. Primary maternal outcome rate was 44%, 12.5%, 3.5%, respectively. The rates of primary maternal outcome (44 vs 3.5%, P < .001), obstructive MVT (16 vs 0%, P = .04), MVT requiring treatment (28 vs 0%, P = .003), and cerebral embolism (24 vs 3.4%, P = .041) were found to be significantly higher in lone LMWH group compared to LMWH + 4 mg warfarin group. Moreover, the rates of primary maternal outcome (12.5 vs 44%, P = .015) and treatment for MHV thrombus (4.2 vs 28%, P = .049) were significantly lower in LMWH + 2.5 mg warfarin group compared to lone LMWH group. The incidences of fetal loss were 8 (32%) in the lone LMWH group, 8 (33.3%) in LMWH + 2.5 mg warfarin group, and 11 (37.9%) in LMWH + 4 mg warfarin group (P = .890 for 3-group).Warfarin related-embryopathy was not observed in any case., Conclusions: The combined anticoagulation strategy of LMWH plus low-dose warfarin during the first trimester of pregnancy may result in less maternal complications with comparable fetal outcomes in patients with MHVs., Condensed Abstract: Low-molecular-weight heparin (LMWH) is thought to be safer for the fetus, however it is suspected to be less protective for the mother. To solve this dilemma, the authors suggested a novel anticoagulation strategy in pregnant women with prosthetic valves. Seventy-eight pregnancies of 65 women (median age 32 [27-35] years) were included in the study. A combination of LMWH and a reduced dose warfarin were associated with low rates of thrombus-related complications in pregnant patients with mechanical heart valves., Competing Interests: Conflict of interest All of the authors have no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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13. Management of prosthetic valve thrombosis with unfractionated heparin.
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Kalkan S, Gürsoy MO, Güner A, Kalçık M, Bayam E, Gündüz S, and Özkan M
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- Humans, Male, Adult, Middle Aged, Heparin, Retrospective Studies, Anticoagulants, Heparin, Low-Molecular-Weight, Heart Valve Prosthesis adverse effects, Heart Valve Diseases diagnosis, Thrombosis diagnostic imaging, Thrombosis drug therapy, Thrombosis etiology
- Abstract
Background: Prosthetic valve thrombosis (PVT) is a severe and life-threatening complication. Surgery and thrombolytic therapy (TT) carry a high risk, and in several circumstances, optimal anticoagulation with unfractionated heparin (UFH) infusion may be an alternative treatment. This study aimed to assess the results of UFH in patients diagnosed with both obstructive and non-obstructive PVT., Methods: This observational retrospective study enrolled patients who had contraindications for TT and surgery underwent UFH therapy., Results: A total of 136 patients were enrolled [male: 55 (40.4%), mean age: 50.3 ± 14.6 years] in the study. In the successful group, 66 patients (48,5%) showed >75% regression in the thrombus burden without facing death or major non-fatal complications.In the unsuccessful group, 56 had less than a 50% reduction in thrombus load and 14 (10.3%) suffered major complications. The presence of obstruction (27.1% vs. 12.1%; p = 0.028), thrombus area 1.1 cm
2 vs. 0.8 cm2 ; p = 0.005] and the duration of UFH treatment (15.1 vs. 11.8 (days); p = 0.005) were significantly higher in the unsuccessful UFH group.In multivariate regression analyses the presence of obstruction (RR: 3.088, p = 0.020), increased thrombus area (RR: 2.400; p = 0.015), and increased duration of UFH therapy (RR: 1.073 95%, p = 0.012) were identified as independent predictive parameters for a failed UFH therapy., Conclusions: This study suggests that UFH therapy may be considered a relatively beneficial treatment strategy for some patients with PVT. The most significant factors affecting success are the obstructive nature and area of the thrombus., Competing Interests: Declaration of competing interest All of the authors have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)- Published
- 2024
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14. Misperceptions and management of LDL-cholesterol in secondary prevention of patients with familial hypercholesterolemia in cardiology practice: Real-life evidence from the EPHESUS registry.
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Kayıkcioglu M, Başaran Ö, Doğan V, Mert KU, Mert GÖ, Özdemir İH, Rencüzoğulları İ, Karadeniz FÖ, Tekinalp M, Aşkın L, Demirelli S, Gencer E, Bekar L, Aktaş M, Resulzade MM, Kalçık M, Aksan G, Cinier G, Akay KH, Pekel N, Utku Şenol, Demir V, İnci S, Derviş E, Özlek B, Özlek E, Çelik O, Çil C, and Biteker M
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- Humans, Cholesterol, LDL, Secondary Prevention, Registries, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hyperlipoproteinemia Type II complications, Hyperlipoproteinemia Type II drug therapy, Cardiology, Atherosclerosis complications, Atherosclerosis drug therapy, Atherosclerosis prevention & control, Anticholesteremic Agents therapeutic use
- Abstract
Background and Aims: Familial hypercholesterolemia (FH) is a common inherited disease, leading to premature atherosclerotic cardiovascular disease (ASCVD) due to elevated low-density lipoprotein cholesterol (LDL-C) levels. Achieving LDL-C goals is extremely important for preventing the complications of this fatal disease. We evaluated the management of FH patients with ASCVD in cardiology practice., Methods: We analyzed patients with ASCVD from the nationwide EPHESUS registry, which was conducted in 40 cardiology outpatient clinics, and compared those with and without FH., Results: Of the 1482 consecutively enrolled patients with ASCVD, 618 (41.7%) had FH, among which 455 were categorized as 'Possible FH' and 163 as 'Probable or Definite FH'. Proposed LDL-C goals were not attained in more than 90% of the patients with FH. The proportion of those on statin therapy was 77% for possible and 91% for probable or definite FH, whereas 34.2 % and 59.4% were in use of high-intensity statins, respectively. None of the patients were on PCSK-9 inhibitors, and only 2 used ezetimibe. Adverse media coverage was the most common cause of statin discontinuation (32.5% in 'possible FH' and 45.7% in 'probable/definite FH'). The negative impact of media in the decision to stop lipid lowering therapy (LLT) was increasing with education level., Conclusions: In real life most of the FH patients with ASCVD are undertreated in cardiology practice regarding statin dosing and combined LLT. Drug discontinuation rates are notably high and are mostly media-related, and side effects very rarely cause cessation of LLT. Urgent measures are needed to increase the awareness of FH among healthcare providers and patients and to develop improved treatment strategies aimed at preventing the complications of FH., (Copyright © 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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15. A Comprehensive Evaluation of National Cardiology Congresses Abstracts on the Basis of the 2016 Academic Criteria.
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Güner A, Güner EG, Kalçık M, Akman C, Kahraman S, Bayam E, Kalkan S, Yesin M, Çiloğlu K, Gökçe K, Uzun F, Doğan A, Gürsoy MO, Ertürk M, Gündüz S, and Özkan M
- Abstract
Objective: This study aimed to describe the effects of new academic criteria established in 2016 on the abstracts of the National Congress of the Turkish Society of Cardiology., Methods: The abstracts presented at 13 consecutive annual congresses were obtained. A literature search was conducted with PubMed, Google Scholar, and Web of Science databases to analyze whether the abstract was published in a scientific journal. The study was divided into 2 time groups according to the new academic criteria published in 2016. Group 1 included 4828 abstracts accepted at National Congress of the Turkish Society of Cardiology between 2009 and 2016, while Group 2 included 2284 abstracts accepted at National Congress of the Turkish Society of Cardiology between 2017 and 2021., Results: A total of 7112 abstracts were accepted for the 2009-2021 National Congress of the Turkish Society of Cardiology meetings scientific program. The publication rate (43.2% vs. 23.9%, P < 0.001), number of authors [7(5-9) vs. 4(3-6), P < 0.001], and rate of original investigation (72.3 vs. 56.5%, P < 0.001) were significantly lower in group 2 than in group 1. Among the quality parameters of the journals in which the abstracts were published, the impact factor (0.59 ± 1.71 vs. 0.26 ± 1.09, P < 0.001), the rate of journals in science citation index or science citation index-expanded indexes (70.4 vs. 57.9%, P < 0.001), and the rate of the second or third-quartile class (24.2 vs. 16.1%, P < 0.001) were significantly lower in group 2 as compared to group 1. Being in group 1 oral presentation, original investigation, and cardiac imaging were identified as independent predictors for publication in scientific journals., Conclusion: This study showed that the 2016 new academic criteria negatively affected the publication processes of accepted abstracts in National Congress of the Turkish Society of Cardiology.
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- 2023
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16. Relationship Between Systemic Inflammation Index and No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction.
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Çelik MC, Karayiğit O, Ozkan C, Dolu AK, and Kalçık M
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- Humans, Blood Platelets, Inflammation, ST Elevation Myocardial Infarction therapy, No-Reflow Phenomenon etiology, No-Reflow Phenomenon epidemiology, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Percutaneous Coronary Intervention
- Abstract
This study aimed to evaluate the relationship between no-reflow phenomenon and systemic inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI). A total of 785 patients were included. The thrombolysis in myocardial infarction (TIMI) flow degree has been used to describe the no-reflow phenomenon. The study population was divided into two groups regarding the presence of no-reflow phenomenon including 110 patients with no-reflow (TIMI frame count 0-2) and 675 patients without no-reflow (TIMI frame count 3). The NLR [6.6 (4.6-11.6) vs 3.2 (2.0-5.3); P < .001], PLR [175 (121.3-220) vs 102.6 (76.1-150.1); P < .001] and SII [1921(1225-2906) vs 738.5 (450.5-1293); P < .001] were significantly higher in the no-reflow group. High NLR (OR: 1.078, 95%CI: 1.027-1.397; P = .021), PLR (OR: 1.009, 95%CI: 1.003-1.021; P = .041) and SII (OR: 1.216, 95%CI: 1.106-1.942; P = .004) were found to be independently associated with no-reflow phenomenon. The comparison of the receiver-operating characteristic curves showed that area under the curve of SII was greater than that of NLR (.789 vs .766, P = .007) and PLR (.789 vs .759, P = .048). SII levels may predict no-reflow phenomenon better than NLR and PLR.
- Published
- 2023
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17. Cardiovascular evaluation of pregnant women with hypertrophic cardiomyopathy.
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Güner A, Candan Ö, Kahraman S, Güner EG, Özcan S, Gürsoy MO, Kalçık M, Uslu A, Dönmez E, Zehir R, Ertürk M, Yıldız M, and Özkan M
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- Humans, Female, Pregnancy, Pregnant Women, Retrospective Studies, Arrhythmias, Cardiac diagnosis, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac prevention & control, Death, Sudden, Cardiac etiology, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic therapy, Tachycardia, Ventricular, Heart Failure complications
- Abstract
Background: The effect of physiological circulatory changes during pregnancy on hypertrophic cardiomyopathy (HCM) has been reported with limited data. This study aimed to provide information regarding outcomes of pregnant women with HCM and to identify predictors of major adverse cardiac event (MACE)., Methods: A total of 45 pregnancies with HCM were retrospectively reviewed. The primary endpoint was a MACE that occurred within an 8‑week period after delivery, including maternal death, heart failure (HF), syncope, and malignant ventricular arrhythmias (VAs). Baseline and outcome data were analyzed for all patients. Patients with and without MACE were compared, and patients with obstructive HCM were compared with those who had non-obstructive HCM. The study population was divided into two subgroups of patients having or not having an implantable cardioverter defibrillator implantation (ICD)., Results: At least one MACE occurred in 11 patients (24.4%); six patients developed HF (13.3%), six had a ventricular tachyarrhythmia (13.3%), and two had syncope (4.4%). New York Heart Association functional class of ≥ II, presence of HF signs before pregnancy, increased left ventricular outflow tract (LVOT) gradient were significantly associated with MACE. Fatal VAs were seen during pregnancy in one of five HCM patients with ICD. In the ROC curve analysis, an LVOT gradient higher than 53.5 mm Hg predicted the presence of MACE with a sensitivity of 90.9% and a specificity of 73.5%. This study is the largest series in the literature representing pregnant women who had HCM and ICD., Conclusion: The current data suggest that HF and high LVOT gradients are important risk factors for the development of cardiac complications., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
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- 2023
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18. How Did the Updated 2019 European Society of Cardiology/European Atherosclerosis Society Risk Categorization for Patients with Diabetes Affect the Risk Perception and Lipid Goals? A Simulated Analysis of Real-life Data from EPHESUS Study.
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Başaran Ö, Doğan V, Mert KU, Özlek B, Özlek E, Çelik O, Çil C, Özdemir İH, Rencüzoğulları İ, Özpamuk Karadeniz F, Tekinalp M, Aşkın L, Demirelli S, Gencer E, Bekar L, Aktaş M, Resulzade MM, Kalçık M, Aksan G, Çinier G, Halil Akay K, Pekel N, Mert GÖ, Şenol U, Demir V, İnci S, Derviş E, Biteker M, and Kayıkçıoğlu M
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- Adult, Humans, Goals, Cross-Sectional Studies, Cholesterol, LDL, Perception, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Cardiology, Atherosclerosis complications, Diabetes Mellitus drug therapy, Dyslipidemias drug therapy, Dyslipidemias complications
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Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting., Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines., Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on high-intensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target <55 mg/dL could only be achieved in 2.2% and 8.1% of very high-risk primary prevention and secondary prevention patients, respectively., Conclusion: The control of dyslipidemia was extremely poor among patients with diabetes. The use of lipid-lowering treatment was not at the desired level, and high-intensity lipid-lowering treatment use was even lower. Our simulation model showed that the high-dose statin plus ezetimibe therapy would improve goal attainment; however, it would not be possible to get goals with this treatment in more than one-third of the patients.
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- 2023
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19. The relationship between CHA2DS2VASc score and left ventricular apical thrombus formation in patients with acute anterior ST segment elevation myocardial infarction.
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Bayam E, Çakmak EÖ, Yıldırım E, Kalçık M, Bilen Y, Güner A, Küp A, Kahyaoğlu M, Çelik M, Öcal L, Avcı A, and Zehir R
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- Humans, Male, Adult, Middle Aged, Aged, Stroke Volume, Ventricular Function, Left, ST Elevation Myocardial Infarction complications, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction surgery, Anterior Wall Myocardial Infarction complications, Anterior Wall Myocardial Infarction diagnosis, Thrombosis diagnosis, Thrombosis etiology, Percutaneous Coronary Intervention adverse effects
- Abstract
Background: Left ventricular apical thrombus ( LVAT) formation is a well-known complication of acute anterior myocardial infarction (AMI). The CHA2DS2VASc is a scoring system that has been used to estimate the risk of thromboembolism in patients with nonvalvular atrial fibrillation. This score has also been used for other clinical conditions. The aim of this study was to investigate the relationship between CHA2DS2VASc score and development of LVAT in patients with AMI., Method: The study population included 378 patients (mean age: 56.5 ± 12.3 years, male: 318) presenting with AMI between January 2016 and January 2020. Primary percutaneous coronary intervention procedure was performed in all patients. Initial echocardiogram was performed within 7 days of admission. All patients were evaluated with echocardiography at 3rd, 6th and 12th months. Patients were divided into two groups according to the presence of LVAT on echocardiography., Results: The incidence of the LVAT was 8.5% ( n = 32) during a mean follow-up time of 233.1 ± 66.7 days. The mean CHA2DS2VASc score was notably higher in patients with LVAT compared to patients in the control group (3.1 ± 1.9 vs. 1.9 ± 1.2, p < 0.001). In Cox regression analysis, high CHA2DS2VASc score, low left ventricular ejection fraction (LVEF) and the presence of LV apical akinesis/aneurysm were the independent predictors for LVAT formation. All of these parameters were associated with higher cumulative incidence of LVAT formation in Kaplan-Meier analyses ( p < 0.001 for all)., Conclusion: High CHA2DS2VASc score, low LVEF and the presence of LV apical akinesis/aneurysm may be used for LVAT risk prediction among patients presenting with AMI.
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- 2023
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20. Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction.
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Dolu AK, Karayiğit O, Ozkan C, Çelik MC, and Kalçık M
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- Humans, Blood Platelets, Inflammation diagnosis, Retrospective Studies, ST Elevation Myocardial Infarction diagnosis, Myocardial Infarction, Thrombosis, Percutaneous Coronary Intervention
- Abstract
Aim: This study aimed to evaluate the relationship between intracoronary thrombus burden and systemic immune-inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI)., Patient & Methods: A total of 425 patients were included in the study. The clinical, laboratory, and demographic characteristics of the patients were recorded. The thrombus classification "Thrombolysis in myocardial infarction (TIMI)" was used to assess the intracoronary thrombus burden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombus burden (grade 0-3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) were compared. SII was calculated as platelet × neutrophil/lymphocyte counts., Results: High NLR (OR: 1.068, 95% CI:1.023-1.404; p = 0.031), PLR(OR: 1.012, 95% CI:1.002-1.018; p = 0.043), SII(OR: 1.325, 95% CI: 1.156-1.879; p = 0.015) and low left ventricle ejection fraction (LVEF) (OR: 0.957, 95% CI:0.924-0.990; p = 0.012) were found to be independent predictors of high thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitivity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795-0.877; p < 0.001). This predictiveness of SII was stronger as compared to NLR (0.836 vs. 0.818, p = 0.043) and PLR (0.836 vs. 0.780, p < 0.001)., Conclusion: SII is an independent predictor of high thrombus burden in patients with STEMI. In addition, SII is superior to NLR and PLR in this regard.
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- 2023
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21. Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve.
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Kalkan S, Güner A, Kalçık M, Gürsoy MO, Gündüz S, Bayam E, Yesin M, Karakoyun S, Keten MF, and Özkan M
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- Aortic Valve surgery, Humans, Prosthesis Failure, Aortic Valve Insufficiency complications, Calcinosis complications, Heart Valve Prosthesis adverse effects, Thrombosis etiology
- Abstract
Background: Intermittent malfunction is a rare but potentially serious complication of prosthetic heart valve replacement. This study aimed to describe the clinical features and etiologic causes of patients with intermittent mechanical prosthetic heart valve dysfunction., Methods: Between 2010 and 2021, 16 patients who were evaluated in the echocardiography laboratory of Koşuyolu Training and Research Hospital with the diagnosis of intermittent malfunction of prosthetic valves were included in the study., Results: The evaluated patients consisted of 12 bi-leaflet mitral valve replacements and 2 mono-leaflet mitral valve replacements. The underlying causes of intermittent malfunction were classified as follows: residual chord (n=4), obstructive thrombus (n=2), non-obstructive thrombus (n=2), vegetation (n=2), pannus and obstructive thrombus coexistence (n=1), and solely pannus (n=1). One of the patients with mono-leaflet mitral valve replacements had pannus and obstructive thrombus. In the other patient with mono-leaflet mitral valve replacement, a stuck valve was observed in 1 of 12 beats secondary to arrhythmia. There were also 2 patients with aortic valve replacements. One patient had moderate aortic regurgitation due to prominent calcification and the other had moderate obstruction due to pannus. In the patient with pannus, a stuck leaflet was observed in 1 of 6 beats and moderate aortic regurgitation arose in 1 of 2 beats in the patient with calcification., Conclusions: The intermittent stuck valve may have catastrophic outcomes. When making a treatment decision in these patients, assessing the degree of regurgitation or stenosis is essential. In particular, the frequency of entrapment should be taken into consideration when deciding the optimal therapy for intermittent prosthetic heart valve dysfunction.
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- 2022
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22. Serum Levels of Cholesterol and Lipoproteins in Patients With Symptomatic Paravalvular Leaks.
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Güner A, Özkan M, Kalçık M, Gürsoy MO, Gündüz S, Kılıçgedik A, Bayam E, Kalkan S, Kırma C, Türkmen M, Adademir T, Aksüt M, Fedakar A, and Kırali K
- Subjects
- Adult, Aged, Cardiac Catheterization methods, Cholesterol, Female, Humans, Lipids, Lipoproteins, Male, Middle Aged, Prosthesis Failure, Retrospective Studies, Treatment Outcome, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods
- Abstract
Paravalvular leak (PVL) is a complication of valve replacement surgery which may lead to serious clinical consequences including hemolytic anemia. This study aimed to retrospectively evaluate the effect of successful intervention on serum lipid parameters in patients with PVL. A total of 106 patients (mean age: 57.2 ± 13.6 years, male: 67) who underwent surgical or transcatheter closure for symptomatic PVL were enrolled in this study. During the follow-up period, hemolysis and lipid parameters were evaluated at each clinical visit. This is the first study describing the effects of PVL on lipid metabolism after surgical or transcatheter closure. In the study, 18 patients (17%) had aortic PVL, 84 patients (79%) had mitral PVL, and 4 patients (3.8%) had both aortic and mitral PVL. A total of 59 patients underwent transcatheter closure and 47 patients were treated surgically. Technical success of the procedures was 83%. After successful PVL closure, hemoglobin and haptoglobin levels increased significantly (9.5 ± 1.3 vs 11.9 ± 2.1 g/dl, p <0.001 and 16.6 ± 7.9 vs 34.1 ± 19.9 mg, p <0.001, respectively). A significant increase in total cholesterol (158.9 ± 42.7 vs 209.3 ± 58.7 mg/dl, p <0.001), low-density lipoprotein cholesterol (99.1 ± 33.8 vs 133.9 ± 45.7 mg/dl, p <0.001), and high-density lipoprotein cholesterol (39.8 ± 12.4 vs 44.8 ± 11.7 mg/dl, p <0.001) levels was observed after successful PVL closure. In conclusion, symptomatic patients with PVL had hypocholesterolemia, reflected by low serum lipoprotein levels. After successful PVL closure, an increase in serum lipoprotein levels was observed. The recovery in levels of lipoproteins could be used as a marker of successful PVL closure, and absence of recovery of lipoprotein levels may indicate incomplete closure., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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23. The role of thrombolytic therapy in pregnant patients with prosthetic valve thrombosis.
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Güner A, Akman C, Gökçe K, Güner EG, Kalçık M, and Ertürk M
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- Female, Fibrinolytic Agents therapeutic use, Humans, Pregnancy, Thrombolytic Therapy adverse effects, Heart Valve Diseases etiology, Heart Valve Prosthesis adverse effects, Thrombosis chemically induced, Thrombosis etiology
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- 2022
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24. Current evidence and future perspective for the management of left-sided prosthetic valve thrombosis.
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Güner A, Kalçık M, and Gündüz S
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- Humans, Heart Valve Diseases diagnosis, Heart Valve Diseases surgery, Thrombosis diagnosis, Thrombosis drug therapy, Thrombosis etiology
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- 2022
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25. The effect of complex vascular anatomy on silent new ischemic cerebral lesions in carotid artery stenting procedures (from the COMPLEX-CAS Trial).
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Güner A, Çelik Ö, Topel Ç, Arif Yalçın A, Kalçık M, Uzun F, Altunova M, Örten M, Akman C, Güner EG, and Ertürk M
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- Aged, Carotid Arteries surgery, Diffusion Magnetic Resonance Imaging, Humans, Male, Middle Aged, Risk Factors, Stents, Treatment Outcome, Brain Ischemia diagnostic imaging, Brain Ischemia epidemiology, Brain Ischemia etiology, Carotid Stenosis surgery, Carotid Stenosis therapy
- Abstract
Background: Carotid artery stenting is a minimally invasive, durable alternative treatment option, which is an alternative to the reference method, carotid endarterectomy, for patients with carotid artery stenosis; however, silent new ischemic cerebral lesions (SNICLs) after carotid artery stenting remain as a matter of concern. Hence, we aimed to assess the effect of complex vascular anatomy on silent new ischemic cerebral lesions in carotid artery stenting procedures., Methods: We prospectively evaluated 122 patients (mean age: 69.5 ± 7.1 years, male:83) who underwent carotid artery stenting for carotid artery revascularization. The patients having symptomatic transient ischemic attack or stroke after carotid artery stenting were excluded. The presence of a new hyperintense lesions on diffusion-weighted imaging without any neurological findings was considered as the SNICL. Patients were classified into two groups as DWI-positive and DWI-negative patients., Results: Among the study population, 32 patients (26.2%) had SNICLs. The DWI-positive group had a significantly higher common carotid artery (CCA)-internal carotid artery (ICA) angle, older age, more frequent history of stroke, a higher proportion of type III aortic arch, and longer fluoroscopy time than the DWI-negative group. High CCA-ICA angle was identified as one of the independent predictors of SNICL (OR (odds ratio) = 1.103 95%CI (confidence interval): (1.023-1.596); p = 0.034), and CCA-ICA angle higher than 34.5 degrees predicted SNICL with a sensitivity of 62.5% and a specificity of 62.2% (area under the curve: 0.680; 95% CI: 0.570 to 0.789; p = 0.003)., Conclusions: The higher CCA-ICA angle may predict pre-procedure SNICL risk in carotid artery stenting and may have clinical value in the management of patients with carotid artery stenosis.
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- 2022
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26. Thrombolysis or Surgery in Patients With Obstructive Mechanical Valve Thrombosis: The Multicenter HATTUSHA Study.
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Özkan M, Gündüz S, Güner A, Kalçık M, Gürsoy MO, Uygur B, Keleş N, Kaya H, Kılıçgedik A, Bayam E, Kalkan S, Astarcıoğlu MA, Karakoyun S, Yesin M, İnan D, Fedakar A, Sarıkaya S, Aksüt M, Onan B, and Koçoğulları CU
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- Adult, Female, Fibrinolytic Agents adverse effects, Fibrinolytic Agents therapeutic use, Humans, Male, Middle Aged, Thrombolytic Therapy adverse effects, Thrombolytic Therapy methods, Tissue Plasminogen Activator adverse effects, Tissue Plasminogen Activator therapeutic use, Treatment Outcome, Heart Valve Diseases complications, Heart Valve Prosthesis adverse effects, Thrombosis complications, Thrombosis etiology
- Abstract
Background: Prosthetic valve thrombosis (PVT) is one of the life-threatening complications of prosthetic heart valve replacement. Due to the lack of randomized controlled trials, the optimal treatment of PVT remains controversial between thrombolytic therapy (TT) and surgery., Objectives: This study aimed to prospectively evaluate the outcomes of TT and surgery as the first-line treatment strategy in patients with obstructive PVT., Methods: A total of 158 obstructive PVT patients (women: 103 [65.2%]; median age 49 years [IQR: 39-60 years]) were enrolled in this multicenter observational prospective study. TT was performed using slow (6 hours) and/or ultraslow (25 hours) infusion of low-dose tissue plasminogen activator (t-PA) (25 mg) mostly in repeated sessions. The primary endpoint of the study was 3-month mortality following TT or surgery., Results: The initial management strategy was TT in 83 (52.5%) patients and surgery in 75 (47.5%) cases. The success rate of TT was 90.4% with a median t-PA dose of 59 mg (IQR: 37.5-100 mg). The incidences of outcomes in surgery and TT groups were as follows: minor complications (29 [38.7%] and 7 [8.4%], respectively), major complications (31 [41.3%] and 5 [6%], respectively), and the 3-month mortality rate (14 [18.7%] and 2 [2.4%], respectively)., Conclusions: Low-dose and slow/ultraslow infusion of t-PA were associated with low complications and mortality and high success rates and should be considered as a viable treatment in patients with obstructive PVT., Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2022
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27. Management of antithrombotic therapy after prosthetic valve implantation.
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Kalçık M, Güner A, Gündüz S, and Özkan M
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- Fibrinolytic Agents therapeutic use, Humans, Prosthesis Failure, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation
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- 2022
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28. Incomplete surgical LAA closure is associated with increased thromboembolic complications.
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Güner A, Güner EG, Kalçık M, and Özkan M
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- Humans, Atrial Appendage diagnostic imaging, Atrial Appendage surgery, Thromboembolism etiology
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- 2022
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29. Revascularization strategies in patients with infective endocarditis-related ST-elevation myocardial infarction: The STEMI-ENDO Registry.
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Güner A, Uygun Kızmaz Y, Gündüz S, Arslan Ç, Özkan Öztürk S, Alizade E, Kalçık M, Kahraman S, Akman C, Kalkan AK, and Özkan M
- Subjects
- Angioplasty, Balloon statistics & numerical data, Chest Pain etiology, Coronary Angiography, Dyspnea etiology, Echocardiography, Transesophageal, Endocarditis diagnostic imaging, Endocarditis microbiology, Female, Fever etiology, Heart Valve Prosthesis Implantation statistics & numerical data, Hospital Mortality, Humans, Male, Mechanical Thrombolysis statistics & numerical data, Middle Aged, Myocardial Revascularization mortality, Registries, Retrospective Studies, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction mortality, Stents, Endocarditis complications, Myocardial Revascularization methods, ST Elevation Myocardial Infarction surgery
- Abstract
Objective: Infective endocarditis (IE)-related ST elevation myocardial infarction (STEMI) is extremely rare. A clear clinical consensus is lacking regarding the management of this emergency. In this study, we aimed to describe the clinical outcomes of treatment strategies in this patient population., Methods: The study population comprised 19 retrospectively evaluated patients (nine women; mean age 52±11.8 years) with a diagnosis of IE-related STEMI. Transesophageal echocardiography detected vegetation in all the patients. The study population was divided into two groups on the basis of in-hospital mortality., Results: Major clinical manifestations included dyspnea (89.5%), fever (78.9%), and chest pain (63.2%). Catheter-based coronary angiography was performed in all the patients. The causative agent was isolated in all the cases, and Staphylococcus aureus was identified in seven (36.8%). The most common infarction was in the left anterior descending artery (n=12 [63.2%]). The treatment strategy consisted of mechanical thrombectomy (n=1), valve replacement following stent implantation (n=5), direct balloon angioplasty (n=4), valve replacement along with coronary artery bypass grafting (CABG; n=6), and medical follow-up (n=3). Moreover, thrombolysis in myocardial infarction III flow was significantly higher in the survival group (100% vs. 0%, p<0.001). All these patients preferred CABG or stent implantation for revascularization., Conclusion: The current data suggest that a revascularization strategy with stent implantation or revascularization with CABG has a lower mortality rate in patients with IE-related STEMI.
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- 2021
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30. The relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction.
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Bayam E, Kalçık M, Öztürkeri B, Yıldırım E, Karaduman A, Kalkan S, Küp A, Günay N, Güner A, Kahyaoğlu M, and Uyan C
- Subjects
- Coronary Angiography, Humans, Risk Factors, Stroke Volume, Ventricular Function, Left, Coronary Artery Disease complications, Coronary Artery Disease diagnosis, Heart Failure, Non-ST Elevated Myocardial Infarction diagnosis, Percutaneous Coronary Intervention
- Abstract
Background: The Synergy between Percutaneous Coronary Intervention (SYNTAX) score, has been used to estimate the extent and complexity of coronary artery disease (CAD). The H2FPEF score enables robust discrimination of heart failure with preserved ejection fraction (HFpEF) from non-cardiac aetiologies of dyspnea. In the present study, we aimed to investigate the relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction (NSTEMI)., Method: Two hundred eighty two consecutive patients with NSTEMI who underwent coronary angiographic examination were enrolled in this study. The H2FPEF score was calculated for each patient on admission. All patients underwent coronary angiography within 2 days following their admission. The SYNTAX scoring system was used to evaluate the severity and extent of CAD., Results: The mean H2FPEF Score [3(2-4) vs 1(0.5-1.5), p < .001] and the frequencies of diabetes mellitus, hypertension and, atrial fibrillation were significantly higher and LVEF was significantly lower in patients with high SYNTAX score. High H2FPEF Score (OR: 3.61, 95%CI: 2.64-4.93; p = .001) and low left ventricular ejection fraction (OR: 0.94, 95%CI: 0.89-0.98; p = .013) were found to be independent associates for high SYNTAX score. H2FPEF Score above a cut-off level of 2.5 predicted high SYNTAX score with a sensitivity of 80% and a specificity of 82.5% (AUC: 0.890; 95%CI: 0.848-0.931; p < .001). There was a significant and moderate positive correlation between H2FPEF and SYNTAX Scores ( r = 0.694, p < .001)., Conclusion: High H2FPEF score may be associated with high SYNTAX score and may be used to estimate the extent and complexity of CAD in NSTEMI patients.
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- 2021
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31. Does low molecular weight heparin really protect against prosthetic valve thrombosis during pregnancy with strict anti-Xa monitoring?
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Kalçık M, Güner A, Kalkan S, and Özkan M
- Subjects
- Enoxaparin administration & dosage, Female, Heart Valve Diseases, Heart Valve Prosthesis, Humans, Mitral Valve Insufficiency surgery, Pregnancy, Thrombosis drug therapy, Thrombosis etiology, Anticoagulants therapeutic use, Heparin, Low-Molecular-Weight administration & dosage, Pregnancy Complications, Cardiovascular, Thrombosis prevention & control
- Abstract
Competing Interests: Declaration of competing interest All of the authors have no conflict of interest.
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- 2021
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32. The relationship between dual antiplatelet treatment (DAPT) score and saphenous venous grafts patency after coronary artery bypass grafting surgery.
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Bayam E, Öztürkeri B, Yıldırım E, Kalçık M, Küp A, Çakmak EÖ, Günay N, Güner A, Kalkan S, Karaduman A, Kahyaoğlu M, and Zehir R
- Subjects
- Aged, Dinucleoside Phosphates, Female, Humans, Middle Aged, Retrospective Studies, Vascular Patency, Coronary Artery Bypass, Saphenous Vein diagnostic imaging
- Abstract
Background: Coronary artery bypass grafting (CABG) remains the gold standard treatment for mutivessel and left main coronary artery disease (CAD). Saphenous vein graft (SVG) patency is still a problem in CAD patients after CABG surgery. The Dual Antiplatelet Treatment (DAPT) score is a clinical prediction tool that predicts ischaemic and bleeding risk in CAD patients. The aim of this study is to investigate the relationship between DAPT score and SVG patency in CABG patients., Method: This retrospective study enrolled a total of 398 patients (68 female; mean age 65.8 ± 9.1 years) with a history of CABG surgery. The study population was divided into two subgroups according to SVG patency. The DAPT score was calculated for each patients and compared between the two groups., Results: Coronary angiography revealed SVG disease in 212 patients and SVG patency in 186 patients. The rates of diabetes mellitus and hypertension, red cell distribution width values, DAPT Score, time interval after CABG and number of SVGs were significantly higher while LVEF was significantly lower in patients with SVG disease. The presence of diabetes mellitus, high DAPT score, long time interval after CABG and high number of SVGs were found to be independent predictors of SVG patency. DAPT score above 2.5 predicted SVG disease with a sensitivity of 77.1% and a specificity of 87.1% (AUC: 0.873; 95%CI: 0.823-0.924; p < 0.001)., Conclusion: The DAPT score may provide useful information for SVG patency in CABG patients. Patients with high DAPT score should be followed up closely for SGV occlusion. DAPT score may be useful prior to CABG in determining the duration of dual anti-platelet therapy and in encouraging the use of arterial grafts with better patency.
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- 2021
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33. A well validated risk stratification index predicts weak material and fetal outcomes in pregnant women with cardiovascular disease.
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Güner A, Kalçık M, and Özkan M
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- Anticoagulants, Female, Heparin, Low-Molecular-Weight, Humans, Pregnancy, Pregnant Women, Risk Assessment, Warfarin, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Heart Valve Prosthesis, Pregnancy Complications, Cardiovascular diagnosis, Pregnancy Complications, Cardiovascular epidemiology
- Abstract
Competing Interests: Declaration of competing interest All of the authors have no conflict of interest.
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- 2021
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34. Management of LDL-cholesterol levels in patients with Diabetes Mellitus in Cardiology Practice: Real-life evidence of Under-treatment from the EPHESUS registry.
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Mert KU, Başaran Ö, Mert GÖ, Doğan V, Rencüzoğulları İ, Özlek B, Cinier G, Şenol U, Çelik O, Özlek E, Özdemir İH, Karadeniz FÖ, Bekar L, Aktaş M, Resulzade MM, Kalçık M, Aksan G, Akay K, Pekel N, Biteker M, and Kayıkçıoğlu M
- Subjects
- Aged, Atherosclerosis complications, Atherosclerosis drug therapy, Attitude of Health Personnel, Attitude to Health, Cardiovascular Diseases complications, Cardiovascular Diseases drug therapy, Cerebrovascular Disorders complications, Cholesterol, LDL blood, Coronary Disease complications, Diabetes Complications, Female, Humans, Hypercholesterolemia blood, Hypercholesterolemia complications, Male, Medication Adherence, Middle Aged, Patient Care Planning, Peripheral Arterial Disease complications, Practice Guidelines as Topic, Registries, Secondary Prevention, Turkey, Cardiologists, Cerebrovascular Disorders drug therapy, Coronary Disease drug therapy, Diabetes Mellitus, Guideline Adherence, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypercholesterolemia drug therapy, Peripheral Arterial Disease drug therapy
- Abstract
Background and Aims: Effective treatment of high low-density lipoprotein cholesterol (LDL-C) levels has been shown to improve cardiovascular outcomes of patients with diabetes mellitus (DM). Herein, we aimed to provide insight to the real-life management of patients with DM in terms of LDL-C goal attainment and adherence to lipid management recommendations. Our objective was also to reveal the reasons of poor LDL-C goal attainment by assessing the perceptions of both physicians and patients., Methods: We compared the diabetic and non-diabetic patients from the database of a nationwide registry conducted in cardiology outpatient clinics with regard to the demographic characteristics, educational status, comorbidities, medications, laboratory parameters and LDL-C goal attainment. Also, both the patients and attending physicians were surveyed to analyse perceptions and awareness of hypercholesterolemia., Results: Of the 1868 consecutively enrolled patients, 873 (47%) had DM. Proportion of patients on statins was significantly lower in patients with DM (67.8% vs 55.3%; P < .001). The proportion of patients who attained LDL-C targets were lower among the diabetic patients (17.8% vs 15%; P = .06). The most common causes of the discontinuation of statin therapy were negative media coverage about statins (32.1%), and recommendations of physicians to stop the lipid lowering therapy (29.6%). Analysis of the physician survey revealed that the physicians could determine the off-target patients accurately (negative predictive value 98.4%) while the positive predictive value (48.8%) was low. The reasons for not attaining the LDL-C goals in diabetic patients were not prescription of statins (38%) and inadequate (eg low-dose, non-adherent) statin (28.3%) dosages., Conclusions: In real-life clinical cardiology practice, diabetic patients are far below the recommended LDL-C treatment goals. High-intensity statin treatment in diabetic population is still avoided because of the concerns about polypharmacy and drug interactions. Also, the inertia of physicians and even cardiologists is probably a major cause of refraining of prescription of optimal statin dosages., (© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
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- 2021
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35. Management of Obstructive Prosthetic Heart Valve Thrombosis: Thrombolytic Therapy or Anticoagulation?
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Güner A, Kalçık M, Kalkan S, and Özkan M
- Subjects
- Anticoagulants therapeutic use, Heart Valves, Humans, Thrombolytic Therapy, Heart Valve Prosthesis adverse effects, Thrombosis diagnosis, Thrombosis drug therapy, Thrombosis etiology
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- 2021
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36. The relationship between incomplete surgical obliteration of the left atrial appendage and thromboembolic events after mitral valve surgery (from the ISOLATE Registry).
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Güner A, Kalçık M, Gündüz S, Gürsoy MO, Güner EG, Ulutaş AE, Kalkan S, Onan B, Bayam E, Ertük M, Kalkan ME, and Özkan M
- Subjects
- Aged, Echocardiography, Transesophageal, Humans, Male, Middle Aged, Mitral Valve diagnostic imaging, Mitral Valve surgery, Registries, Retrospective Studies, Atrial Appendage diagnostic imaging, Atrial Appendage surgery, Atrial Fibrillation surgery, Thromboembolism epidemiology, Thromboembolism etiology
- Abstract
Left atrial appendage (LAA) is a common site of thrombus formation especially in patients with atrial fibrillation (AF). Complete surgical LAA closure (cSLC) is the surgical aim, however incomplete surgical LAA closure (iSLC) is not rare. In this study, we aimed to evaluate the risk of thromboembolic complications (TEC) in AF patients with iSLC after mitral valve surgery. A total of 101 AF patients (mean age: 61.8 ± 11.8 years; male:32), who underwent surgical suture ligation during mitral valve surgery were enrolled in this retrospective study. All patients underwent transthoracic and transesophageal echocardiography (TEE) at least 3 months after surgery. The primary outcome was the occurrence of TEC including any ischemic stroke, transient ischemic attack, coronary or peripheral embolism. TEE examination revealed cSLC in 66 (65.3%) and iSLC in 35 patients (34.6%). A total of 12 TECs (11.9%) occurred during a mean follow-up time of 41.1 ± 15.6 months. TECs were found to be significantly higher in the iSLC group (25.7% vs 4.5%, p = 0.002). The prevalence of iSLC was significantly higher in patients with TEC (75 vs. 29.2%, p = 0.002). High CHA
2 DS2 -VASc Score and iSLC were found to be independent predictors of TEC. Long term TEC free survival was found to be significantly decreased in patients with iSLC. The presence of iSLC was associated with a significantly increased risk of TEC in AF patients after mitral valve surgery. Routine intraoperative and postoperative screening for iSLC by TEE and long-term strict anticoagulation therapy are recommended in these patients.- Published
- 2021
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37. Efficacy and Safety of Low-Dose Systemic Fibrinolytic Therapy for Acute Submassive Pulmonary Embolism.
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Güner A, Güner EG, Karakurt S, and Kalçık M
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- Humans, Treatment Outcome, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism drug therapy, Thrombolytic Therapy adverse effects
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- 2021
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38. Challenges in the management of patients with mechanical prosthetic heart valves during pregnancy.
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Kalçık M, Güner A, Gürsoy MO, and Özkan M
- Subjects
- Anticoagulants therapeutic use, Female, Heart Valves, Humans, Pregnancy, Thromboembolism prevention & control, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Pregnancy Complications, Cardiovascular
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- 2021
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39. Relationship between P wave peak time and coronary artery disease severity in non-ST elevation acute coronary syndrome.
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Bayam E, Yıldırım E, Kalçık M, Karaduman A, Kalkan S, Güner A, Küp A, Kahyaoğlu M, Yılmaz Y, Selcuk M, and Uyan C
- Subjects
- Aged, Coronary Angiography, Electrocardiography, Female, Humans, Middle Aged, Retrospective Studies, Stroke Volume, Ventricular Function, Left, Acute Coronary Syndrome diagnostic imaging, Coronary Artery Disease diagnostic imaging
- Abstract
Background: Early diagnosis of non-ST elevation acute coronary syndrome (NSTE-ACS) and prediction of the severity of current coronary artery disease (CAD) play a major role in patient prognosis. Electrocardiography has a unique value in the diagnosis and provides prognostic information on patients with NSTE-ACS. In the present study, we aimed to examine the relationship between P wave peak time (PWPT) and the severity of CAD in patients with NSTE-ACS., Methods: A total of 132 consecutive patients (female: 35.6%; mean age: 60.1 ± 11.6 years) who were diagnosed with NSTE-ACS were evaluated retrospectively. Gensini scores (GSs) were used to define the angiographic characteristics of the coronary atherosclerotic lesions. The patients were divided into two groups according to the GS. The PWPT was defined as the duration between the beginning and the peak of the P wave, and R wave peak time (RWPT) was defined as the duration between the beginning of the QRS complex and the peak of the R wave., Results: There were 59 (44.6%) patients in the high-GS group (GS ≥25 ) and 73 (55.3%) patients in the low-GS group (GS <25 ). Presence of diabetes mellitus, low left ventricular ejection fraction, and high RWPT and PWPT were identified as predictors of a high GS in the study population. There was no significant difference between the area under the curves of PWPT and RWPT for predicting the severity of CAD (0.663 vs. 0.623, respectively; p = 0.573)., Conclusion: The present study found that both PWPT and RWPT on admission electrocardiography were associated with the severity and complexity of CAD in patients with NSTE-ACS.
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- 2021
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40. Systemic Fibrinolytic Therapy Versus Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute İntermediate-High Risk Pulmonary Embolism.
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Güner A, Güner EG, and Kalçık M
- Subjects
- Catheters, Hemodynamics, Humans, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism drug therapy, Thrombolytic Therapy
- Abstract
Competing Interests: Disclosures The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2021
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41. Normal reference values for mechanical mitral prosthetic valve inner diameters and areas assessed by two-dimensional and real-time three-dimensional transesophageal echocardiography.
- Author
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Kalçık M, Özkan M, Gündüz S, Gürsoy MO, Yesin M, Bayam E, Güner A, Kalkan S, Karakoyun S, and Tanboğa Hİ
- Subjects
- Adult, Female, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases physiopathology, Hemodynamics, Humans, Male, Middle Aged, Mitral Valve diagnostic imaging, Mitral Valve physiopathology, Predictive Value of Tests, Prosthesis Design, Reference Standards, Treatment Outcome, Echocardiography, Three-Dimensional standards, Echocardiography, Transesophageal standards, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Mitral Valve surgery
- Abstract
It was previously observed that two dimensional (2D) Doppler derived and real-time three-dimensional (RT-3D) directly measured valve areas were smaller than reported manufacturer sizes. It may be helpful to obtain the ranges of inner diameters (IDs) and the geometric orifice area (GOA) during evaluation of prosthetic mitral valves. In this study, we aimed to provide reference dimensional parameters of bileflet mitral mechanical prosthetic valves. Patients with recent mitral valve replacement were examined by 2D and RT-3D transesophageal echocardiography (TEE) in the early postoperative period when the presence of pannus overgrowth was unlikely. Measurements of 2D IDs, 3D hinge to hinge (HHD) and edge to edge diameters (EED) and 3D GOA were obtained and compared with reported manufacturer sizes and areas. This study enrolled 126 patients with mitral prosthetic valves (38 ATS, 42 Carbomedics, 46 St. Jude Medical, all bileaflet). The measured 2D and 3D IDs and GOA were significantly smaller than reported manufacturer sizes in the majority of the valve sizes. This RT-3D TEE-guided study provides ranges of reference values for directly measured IDs and GOA of the three most commonly used mechanical mitral prosthetic valve types for the first time in a relatively large series.
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- 2021
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42. The predictive value of CHADS2 score for subclinical cerebral ischemia after carotid artery stenting (from the PREVENT-CAS trial).
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Çelik Ö, Güner A, Kalçık M, Güler A, Demir AR, Demir Y, Uygur B, Şahin AA, Topel Ç, and Ertürk M
- Subjects
- Aged, Carotid Arteries, Diffusion Magnetic Resonance Imaging, Humans, Male, Risk Factors, Stents, Treatment Outcome, Brain Ischemia etiology, Brain Ischemia prevention & control, Carotid Stenosis diagnostic imaging, Carotid Stenosis therapy, Endarterectomy, Carotid, Stroke etiology
- Abstract
Background: Carotid artery stenting (CAS) is being increasingly used as an alternative revascularization procedure to carotid endarterectomy; however, subclinical ischemic cerebral lesions after CAS remain as a matter of concern. Hence, we aimed to assess the clinical utility of the CHADS
2 score in predicting subclinical ischemic events after CAS., Methods: We prospectively evaluated 107 patients (mean age: 70.4 ± 6.6 years, male:77) who underwent CAS for carotid artery revascularization. The patients having symptomatic transient ischemic attack or stroke after CAS were excluded. The presence of new hyperintense lesion on diffusion-weighted imaging (DWI) without any neurological findings was considered as silent ischemia. Patients were classified into two groups as DWI-positive and DWI-negative patients., Results: Among study population, 28 patients (26.2%) had subclinical embolism. The DWI-positive group had a significantly higher CHADS2 scores, older age, more frequent history of stroke, higher proportion of type III aortic arch, and longer fluoroscopy time than the DWI-negative group. Increased CHADS2 score was identified as one of the independent predictors of silent embolism (OR = 5.584; 95%CI: 1.516-20.566; p = .010), and CHADS2 score higher than 2.5 predicted subclinical cerebral ischemia with a sensitivity of 72% and a specificity of 71% (AUC: 0.793; 95% CI: 0.696 - 0.890; p < .001)., Conclusions: CHADS2 score was able to predict the risk of periprocedural subclinical ischemic events in CAS and might be of clinical value in the management of patients with carotid artery stenosis., (© 2020 Wiley Periodicals LLC.)- Published
- 2021
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- View/download PDF
43. Is fibrinolytic therapy really safe in the treatment of prosthetic valve thrombosis in patients with high INR?
- Author
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Güner A, Kalçık M, Gündüz S, Gürsoy MO, and Özkan M
- Subjects
- Fibrinolytic Agents therapeutic use, Humans, International Normalized Ratio, Thrombolytic Therapy, Heart Valve Diseases drug therapy, Heart Valve Prosthesis adverse effects, Thrombosis drug therapy, Thrombosis etiology
- Published
- 2021
- Full Text
- View/download PDF
44. Intravascular ultrasound is essential for left main coronary artery bifurcation stenting.
- Author
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Güner A, Güner EG, Kalçık M, Uzun F, and Ertürk M
- Subjects
- Coronary Angiography, Dissection, Humans, Iatrogenic Disease, Ultrasonography, Interventional, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Stents
- Published
- 2021
- Full Text
- View/download PDF
45. Intraoperative transesophageal echocardiography is essential for left atrial appendage closure.
- Author
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Güner EG, Çörekçioğlu B, Ulutaş AE, Kalçık M, Güner A, and Ertürk M
- Subjects
- Echocardiography, Echocardiography, Transesophageal, Humans, Atrial Appendage diagnostic imaging, Atrial Appendage surgery, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Cardiac Surgical Procedures
- Published
- 2021
- Full Text
- View/download PDF
46. Utility of multimodality imaging for the diagnosis of prosthetic valve dysfunction.
- Author
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Güner A, Kalçık M, Ertürk M, Güner EG, and Özkan M
- Subjects
- Humans, Multimodal Imaging, Prosthesis Failure, Heart Valve Prosthesis
- Published
- 2020
- Full Text
- View/download PDF
47. Complex vascular anatomy is a predictor of silent cerebral ischemia after carotid artery stenting.
- Author
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Guner A, Kalçık M, Çelik Ö, and Ertürk M
- Subjects
- Carotid Arteries, Cerebral Infarction, Humans, Risk Factors, Stents, Brain Ischemia diagnostic imaging
- Published
- 2020
- Full Text
- View/download PDF
48. A comprehensive review of the diagnosis and management of mitral paravalvular leakage.
- Author
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Gürsoy MO, Güner A, Kalçık M, Bayam E, and Özkan M
- Subjects
- Cardiac Catheterization, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Humans, Mitral Valve diagnostic imaging, Prosthesis Failure, Mitral Valve surgery, Mitral Valve Insufficiency surgery
- Abstract
Mitral paravalvular leaks (PVLs) commonly occur in patients with prosthetic valves. Paravalvular defects may be clinically inconsequential and may aggravate hemolysis or cause heart failure through regurgitation. Accordingly, patients may eventually require intervention such as redo surgery or a transcatheter closure of the defects. The introduction of purpose-specific closure devices and new steerable catheters has opened a new frontier for the transcatheter PVL closure. This mode of treatment is an initial therapy in most centers with experienced structural heart team. However, head-to-head data comparing two treatment modalities (surgery and transcatheter closure) are limited, and the world-wide experience is based on nonrandomized studies. Multimodality imaging, including three-dimensional transesophageal echocardiography, facilitates the delineation of mitral PVLs and provides essential data that aids the communication between the members of the structural heart team. In the near future, the success of interventional therapies will most probably increase in patients with mitral PVLs with the introduction of hybrid imaging modalities (echocardiography, cardiac computed tomography, and fluoroscopy). In conclusion, this paper summarizes the etiopathogenesis, clinical characteristics, diagnosis, and treatment of mitral PVLs.
- Published
- 2020
- Full Text
- View/download PDF
49. Multimodality imaging is essential for the diagnosis of multisystem organ involvement of immunoglobulin G4-related disease.
- Author
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Güner A, Çelik Ö, Kalçık M, Ertürk M, Güner EG, and Özkan M
- Subjects
- Heart, Humans, Immunoglobulin G, Multimodal Imaging, Immunoglobulin G4-Related Disease diagnostic imaging
- Published
- 2020
- Full Text
- View/download PDF
50. Impaired repolarization parameters may predict fatal ventricular arrhythmias in patients with hypertrophic cardiomyopathy (from the CILICIA Registry).
- Author
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Güner A, Kalçık M, Çelik M, Uzun F, Çizgici AY, Ağuş HZ, Aslan S, Güner EG, Ulutaş AE, Bayam E, and Kalkan ME
- Subjects
- Adult, Arrhythmias, Cardiac, Death, Sudden, Cardiac, Humans, Male, Middle Aged, Predictive Value of Tests, Registries, Retrospective Studies, Risk Factors, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnosis, Electrocardiography
- Abstract
Background: Hypertrophic cardiomyopathy (HCM) is significantly associated with high risk of fatal ventricular arrhythmias (VAs). Increased frontal QRST angle (fQRSTa), Tpe interval, and Tp-e/QTc ratio are described as ventricular repolarization parameters which are related to arrhythmias. In this study, we aimed to investigate the predictive value of these repolarization parameters for fatal VAs in patients with HCM., Methods: A total of 127 HCM patients (mean age: 47.9 ± 12.6 years; male:79) were enrolled in this retrospective study. All patients underwent transthoracic echocardiography. Moreover, the last electrocardiograms within 3 months prior to the fatal VA documentation were assessed. The primary outcome was the occurrence of fatal VAs including sustained ventricular tachycardia and ventricular fibrillation which were documented from implantable cardioverter defibrillator records., Results: There were documented fatal VAs in 37 (29.1%) patients during a mean follow-up time of 70.1 ± 22.6 months. The prevalence of fatal VAs was significantly higher in patients with fQRSTa ≥140 degrees (67.4 vs. 7.4%; p < 0.001) and in patients with Tp-e/QTc ratio ≥ 0.19 (61.5 vs. 6.7%; p < 0.001) as compared to others. High Tp-e/QTc ratio (hazard ratio: 1.564; 95% confidence interval: 1.086-4.796; p = 0.032) and high fQRSTa (hazard ratio: 1.864; 95% confidence interval: 1.106-8.745; p = 0.002) were found to be independent predictors of fatal VAs in HCM patients., Conclusions: Wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio may be associated with fatal VAs in HCM patients. In addition to traditional risk factors, these simple ECG parameters may provide valuable information during evaluation of sudden cardiac death risk in HCM patients., Competing Interests: Declaration of Competing Interest All of the authors have no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
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