23 results on '"Kaya CT"'
Search Results
2. Prediction of subclinical left ventricular dysfunction with longitudinal two-dimensional strain and strain rate imaging in patients with mitral stenosis.
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Ozdemir AO, Kaya CT, Ozcan OU, Ozdol C, Candemir B, Turhan S, Dincer I, Erol C, Ozdemir, Aydan Ongun, Kaya, Cansin Tulunay, Ozcan, Ozgur Ulas, Ozdol, Cagdas, Candemir, Basar, Turhan, Sibel, Dincer, Irem, and Erol, Cetin
- Abstract
Longitudinal two-dimensional strain deformation is a novel technique which evaluates global and regional left ventricular (LV) function with high reproducibility. The aim of the study was to investigate the global and regional systolic function using this method in patients with pure mitral stenosis (MS). Conventional echocardiography and longitudinal two-dimensional strain analysis were performed in 60 patients (41 +/- 5 years, 48 women) with mild to moderate MS (mitral valve area: 1.9 +/- 0.5 cm(2)), and 52 healthy controls (40 +/- 7 years, 37 women). For strain analysis standard apical views were obtained, and by using a software system peak systolic strain and strain rate were calculated off-line in each segment. In all, 88% of the segments could be optimally tracked by the software system. Despite normal LV systolic function as assessed by ejection fraction (66 +/- 8%), mean global longitudinal strain (GLS) and global longitudinal strain rate (GLSR) were significantly reduced in patients with isolated MS (GLS -17 +/- 3.3 vs. -19 +/- 2.5%, P = 0.006 and GLSR -1.3 +/- 0.3 vs. -1.5 +/- 0.3 s(-1), P < 0.0001). Regional analysis demonstrated that patients with MS had a significantly reduced longitudinal peak strain and strain rate in all basal, and some mid (inferior, anteroseptal, interventricular septum) segments of the left ventricle. For other segments longitudinal peak strain and strain rate values were similar among the groups. Evaluation of LV systolic function by longitudinal two-dimensional strain deformation identified early abnormalities in MS patients who had apparently normal standard systolic function. [ABSTRACT FROM AUTHOR]
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- 2010
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3. Case-based session: unusual cases in clinical practice: Wednesday 3 December 2014, 09:00-10:30 * Location: Agora
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Dostalova, G, Hlubocka, Z, Ravlykova, K, Rohn, V, Zeman, J, Palecek, T, Linhart, A, Bochard Villanueva, B, Fabregat-Andres, O, De La Espriella-Juan, R, Cubillos-Arango, A, Ferrando-Beltran, M, Chacon-Hernandez, N, Estornell-Erill, J, Perez-Bosca, JL, Morell-Cabedo, S, Paya-Serrano, R, Mediratta, A, Retzer, E, Decara, J, Weinert, L, Shah, AP, Lang, R M, Gerede, DM, Acibuca, A, Uzun, C, Goksuluk, H, Kaya, CT, Ongun, A, Kilickap, M, Dincer, I, Erol, C, Altun, IA, Guz, GG, Akin, FA, Kose, NK, Ilknur Altun, IA, Felice, T, Mercieca Balbi, M, Yamagata, K, and Felice, H
- Abstract
Mucopolysaccharidosis type IV B (MPS IV B), also known as Morquio syndrome, is a rare inherited disease from a group of lysosomal storage disorders. Estimates of birth prevalence range from less than 1/40,000 to 1/200,000 births. MPS IV B occurs because of a deficiency of the enzyme beta-galactosidase. A deficiency of this enzyme leads to the accumulation of mucopolysaccharides in the whole body with e.g. growth retardation, a prominent lower face, an abnormally short neck, kyphoscoliosis, abnormal and/or a prominent breast bone (pectus carinatum). Also cardiomegaly may also occur. The accumulation in cardiomyocytes causes progressive damage to cells, tissues, and failure of their function. Cardiac manifestation could cause a premature death of the patient. Our clinical case report shows a 60-year old women with symptomatic aortic valve stenosis and severe hypertrophy of the left ventricle. From the childhood there raised suspicion of lysosomal storage disorder because of her clinical features. She had signs of enzymatic storage disorders (as growth retardation with height 140 cm in adulthood, abnormally short neck, kyphoscoliosis, abnormalities of foot and legs, pectus carinatum). The diagnosis of MPS IV, type B in our patient was confirmed by enzyme and genetic screening. The patient suffered from mild dyspnea (NYHA class II), patient's sister, also with MPS IV, died from sudden cardiac death at her 60. By echocardiographic examination there was significant aortic valve stenosis, with progression during 2 years follow up (AVA 0,67cm2, AVAi 0,45 cm2/m2,PG mean 75 mmHg) and asymetric septal hypertrophy with mild left ventricle outflow tract obstruction at rest. There was no coronary artery disease. MRI of cervical spine showed severe C2/C3 spinal stenosis with special need of perioperative anaesthesiologic care. Aortic valve replacement and septal myectomy were performed without any complications, also postoperative period is so far without any complications. The patient is free of symptoms. Histological examination of the aortic valve tissue and myocytes confirmed also lysosomal storage. Conclusions: Mucopolysaccharidosis type IV B with this combination of cardiac manifestation (severe valve disease and septal hypertrophy with LVOT obstruction) has not been published yet. Cardiologic and echocardiographic assessment should be completed at the time of diagnosis and according to the clinical course at least every 1–2 years thereafter by patients with MPS IV. Cardiac surgery with very careful perioperative monitoring seems to be safe and effective.
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- 2014
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4. The diastolic function abnormalities in hemodialysis session: a two-dimensional speckle tracking echocardiographic (2DSTE) study.
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Kosku H, Kaya CT, Sengul S, Akbulut M, Aktar M, and Kutlay S
- Abstract
Hemodialysis (HD) decreases preload and its acute effect on the diastolic function is still controversial even with the introduction of new non-volume-dependent tissue Doppler echocardiographic indices. This study is designed to evaluate these acute changes following HD sessions. We enrolled 39 patients receiving standard thrice weekly HD for more than 6 months and performed two dimensional speckle tracking echocardiography (2DSTE) and tissue Doppler studies with a standard cardiac ultrasound device shortly before and after HD. We observed significant changes in most of the transmitral flow and tissue Doppler echocardiographic parameters after HD. The left atrial volume index, left ventricular mass index, mitral E, mitral E/A, and lateral annular E/é levels decreased after HD (p: < 0.001, p: 0.026, p: < 0.001, p: 0.011, p: < 0.001, respectively). Medial á, medial myocardial performance index (MPI), medial ś, lateral ś, and lateral MPI values increased significantly after HD (p: 0.049, p: 0.007, p: 0.001, p: < 0.001, p: 0.01, respectively). Diastolic parameters like diastolic strain ratio early diastole (DSRE), diastolic strain ratio late diastole (DSRA), E/DSRE, and E/DSRA did not change significantly after HD (p: 0.716, p: 0.117, p: 0.114, and p: 0.211, respectively). The global longitudinal strain value obtained with 2DSTE worsened after HD (- 18.4 ± 4.0 before vs - 15.9 ± 5.4 after HD, p: 0.011). Transmitral flow and tissue Doppler parameters changed significantly after HD while the change in 2DSTE findings was not significant. The diastolic measurements made with 2DSTE may be less volume and cardiac preload dependent compared to conventional echocardiography and this may explain the difference., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2022
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5. Lipoprotein apheresis efficacy and challenges: single center experience.
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Özdemir ZN, Şahin U, Yıldırım Y, Kaya CT, and İlhan O
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Introduction: Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center., Methods: We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019., Results: A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171-604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194-393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75-749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109-519 mg/dl) (64.2%), 232 mg/dl (207-291 mg/dl) (64.5%) and 325 mg/dl (22-735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p < .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (-300 to 771) vs 184 mg/dl (64-415), p < .001 and 196 mg/dl (11-712) vs 157 mg/dl (54-340), p < .001, respectively., Conclusions: Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event., (Copyright © 2022 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2022
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6. Acute effects of consumption of low-caffeine energy drinks on endothelial functions in healthy volunteers.
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Akhundova J, Kaya CT, and Gerede Uludağ DM
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- Adolescent, Blood Pressure, Caffeine adverse effects, Female, Healthy Volunteers, Heart Rate, Humans, Male, Young Adult, Energy Drinks adverse effects
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Objective: Energy drink consumption is increasing among the population, especially adolescents and young adults. The health effects of energy drinks are unknown. In this study, we investigate the effects of low caffeine energy drinks on endothelial functions assessed by flow-mediated dilation (FMD) of the brachial artery., Methods: Thirty healthy volunteers (15 men, 15 women) aged 19 to 46 years participated in the study. Flow-mediated dilation measurements of the brachial artery were performed and recorded per protocol. The volunteers were asked to drink 355 mL of energy drink containing 53.25 mg of caffeine after baseline measurements, and all measurements were repeated 60 minutes later. Baseline and post-energy drink values were compared., Results: Systolic blood pressure (p=0.592), diastolic blood pressure (p=0.714), and heart rate values (p=0.056) were similar before and after the consumption of energy drinks. Preocclusion arterial diameters (p=0.236) and blood velocities (p=0.447) did not change after energy drink consumption. FMD levels were 9.2%±4.6% and 8.1%±4.7%, respectively, before and after energy drink consumption (p=0.176). Women had a 3% increase in preocclusion arterial diameters after energy drink consumption, whereas men had a 2.6% decrease (p=0.026) Conclusion: Low caffeine energy drinks containing 53.25 mg of caffeine/355 mL can did not have any influence on blood pressure, heart rate, or endothelial functions in healthy volunteers.
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- 2021
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7. Relation of Acute Decompensated Heart Failure to Silent Cerebral Infarcts in Patients With Reduced Left Ventricular Ejection Fraction.
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Ozyuncu N, Gulec S, Kaya CT, Goksuluk H, Tan TS, Vurgun VK, Us E, and Erol C
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Cerebral Infarction etiology, Heart Failure etiology, Stroke Volume, Ventricular Dysfunction, Left complications, Ventricular Dysfunction, Left physiopathology
- Abstract
Heart failure (HF) is a prothrombotic state with increased rate of thromboembolic events. Magnetic resonance imaging studies demonstrated increased rate of silent cerebral infarcts (SCI) in this patient group and SCIs were shown lead to dementia, cognitive decline, and depression. We aimed to show acute decompensated phase is associated with increased rate of recent SCI in reduced ejection fraction HF patients. HF patients with sinus rhythm hospitalized for acute decompensation were studied. Neuron specific enolase (NSE), a sensitive neuronal ischemia marker, was used to detect recent SCI. Decompensated and compensated phase blood samples for NSE were collected on the day of admission and on the third day of compensation, respectively. One hundred and forty seven patients with mean age of 72 were studied. There were significantly more patients with positive NSE levels at decompensated state (29% vs 4%, p <0.001). Multivariate predictors for recent SCI were smoking, new onset atrial fibrillation, spontaneous echo contrast of left ventricle, and aneurysmatic apex. Statin use was found to be protective against NSE elevation. In conclusion, our data reveal that decompensated HF is significantly associated with increased levels of NSE suggestive for silent neuronal injury., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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8. Prevention of minor myocardial injury after elective percutaneous coronary intervention: comparison of ticagrelor versus clopidogrel.
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Göksülük H, Atmaca Y, Uludağ MG, Kaya CT, Yıldırım O, Akbulut M, Özyüncü N, and Erol C
- Abstract
Background: Elective percutaneous coronary intervention (ePCI) may cause minor elevation of cardiac enzymes, so-called minor myocardial injury (MMI) which can be due to different pathophysiological mechanism (e.g. distal embolisation, side branch occlusion, increased platelet activation triggered by the intracoronary metallic stents). We aimed to compare the effectiveness of ticagrelor versus clopidogrel for the prevention of MMI and major adverse clinical events (MACEs) after ePCI., Methods: Study population consisted of two groups of patients based on the treatment: Group I, receiving clopidogrel (n = 104), Group II, receiving ticagrelor (n = 96). Cardiac troponin I (cTnI), CK-MB were studied before and 12 hours after the procedure. Elevation of cTnI greater than 0.06 ng/ml was considered as MMI. All patients were also evaluated for the MACEs (death, myocardial infarction, stroke and transient ischaemic attack)., Results: Fifty-two of 200 patients (26%) had MMI after the procedure. The minor myocardial injury was significantly more prevalent in clopidogrel group than that of ticagrelor group (33% vs. 19%, p = .03). Myocardial infarction (MI) and MACEs were significantly higher in the clopidogrel group (15% vs. 6%, for MI, p = .04; 16% vs. 6%, for MACEs, p = .03, respectively). Multivariate analysis demonstrated antiplatelet treatment, saphenous graft intervention, type-C lesion as independent predictors of MMI., Conclusions: Present study showed that the combination of ticagrelor and aspirin was more effective than combination of clopidogrel and aspirin in decreasing MMI and MACEs after elective stenting.
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- 2018
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9. Effects of Hemodialysis on Tei Index: Comparison between Flow Doppler and Tissue Doppler Imaging.
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Gerede DM, Turhan S, Kaya CT, Ozcan OU, Goksuluk H, Vurgun VK, Dincer I, Kutlay S, Erturk S, and Erol C
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- Female, Humans, Kidney Failure, Chronic therapy, Male, Middle Aged, Weight Loss, Echocardiography, Doppler methods, Renal Dialysis, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Objective: Myocardial performance index (MPI, Tei index) has been described as a noninvasive measurement of left ventricle (LV) function. Our aim was to investigate the influence of preload on the LV MPI obtained by pulsed-wave tissue Doppler imaging (PWTDI) and determined by flow Doppler waveforms in patients with end-stage chronic renal failure (CRF). The second aim of this study was to investigate the relationship between the Tei indices obtained by both methods., Methods: Eighty-four patients on regular hemodialysis (HD) treatment were included (mean age of 45.3 ± 14.5 years). Standard echocardiographic measurements, the Tei indices obtained by conventional flow Doppler and PWTDI methods, mitral inflow velocities, and mitral lateral annulus tissue Doppler velocities were measured immediately before and after hemodialysis., Results: After HD, weight loss in patients was significantly revealed (predialysis 63.6 ± 13.3 kg; postdialysis 60.9 ± 13.0 kg; P < 0.001). Left ventricle and left atrium diameters were significantly decreased after HD. Transmitral E and A velocities decreased after HD. Although Tei index measuring by conventional flow Doppler method significantly increased, Tei index measuring by PWTDI did not change after HD., Conclusions: The conventional flow Doppler-derived LV Tei index is influenced by hemodialysis. However, PWTDI-derived LV Tei index is not influenced by hemodialysis. The loading status of a patient should be taken into account during the application of the Tei index to the evaluation of myocardial performance., (© 2015, Wiley Periodicals, Inc.)
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- 2015
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10. Red cell distribution width as a predictor of left atrial spontaneous echo contrast in echocardiography.
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Gerede DM, Kaya CT, Vurgun VK, Acbuca A, Tak BT, Ongun A, Klckap M, and Erol C
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- Adult, Aged, Cardiovascular Diseases diagnostic imaging, Erythrocyte Count, Female, Heart Atria diagnostic imaging, Humans, Male, Middle Aged, Cardiovascular Diseases blood, Echocardiography
- Abstract
Red cell distribution width (RDW) represents the heterogeneity of red blood cells (anisocytosis). Spontaneous echo contrast (SEC) is thought to be a manifestation of red cell aggregation and it has been linked to the development of thromboemboli. The aim of this study was to evaluate the association between RDW levels and the presence of left atrial SEC (LASEC). One-hundred and 72 patients who underwent transesophageal echocardiography for various indications were enrolled in the study. All patients were categorized into 2 groups according to the presence of LASEC and into 4 groups according to the severity of LASEC. The baseline clinical characteristics, echocardiographic measurements, and laboratory findings, including RDW, were compared between the groups. The RDW (%) level was higher in the LASEC group (14.95 ± 1.32) compared with the non-LASEC group (12.20 ± 1.45; P = 0.0001). When the relationship between RDW and SEC was evaluated according to the increasing grade of SEC, a significant positive correlation was found (r = 0.645, P < 0.0001). In the ROC analysis, an RDW level >13.8% had 70% sensitivity and 89.2% specificity in predicting LASEC (area under the curve = 0.834, P < 0.0001, 95% CI 0.656-0.773). In multivariate analysis, RDW levels >13.8% and the presence of atrial fibrillation were independently associated with LASEC (odds ratio [OR] 1.697; 95% confidence interval [CI] 1.198-2.085; P = 0.001 and OR 1.586; 95% CI 1.195-2.098; P = 0.003, respectively]. Elevated RDW value is associated with the presence and the severity of SEC. RDW may be a useful marker and independent predictor for the presence of SEC.
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- 2015
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11. Effect of angiotensin converting enzyme inhibitors on periprocedural myocardial infarction in patients with metabolic syndrome.
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Ozcan OU, Ustun EE, Gulec S, Gerede DM, Goksuluk H, Vurgun VK, Kaya CT, and Erol C
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- Aged, Biomarkers blood, Chi-Square Distribution, Coronary Artery Disease diagnosis, Coronary Artery Disease epidemiology, Creatine Kinase, MB Form blood, Female, Humans, Incidence, Logistic Models, Male, Metabolic Syndrome diagnosis, Metabolic Syndrome epidemiology, Middle Aged, Multivariate Analysis, Myocardial Infarction blood, Myocardial Infarction diagnosis, Myocardial Infarction epidemiology, Odds Ratio, Percutaneous Coronary Intervention instrumentation, Prospective Studies, Risk Assessment, Risk Factors, Stents, Time Factors, Treatment Outcome, Troponin I blood, Turkey epidemiology, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Coronary Artery Disease therapy, Metabolic Syndrome drug therapy, Myocardial Infarction prevention & control, Percutaneous Coronary Intervention adverse effects
- Abstract
Background: Metabolic syndrome (MetS) has been reported as a risk factor for cardiovascular events. The aim of the present study is to investigate the association between chronic angiotensin-converting enzyme inhibitors (ACE-I) therapy and the rate of periprocedural myocardial infarction (PMI) after elective coronary stenting among patients with MetS., Methods: The inclusion criteria were MetS and plan for elective percutaneous coronary intervention. To assess the effect of ACE-I treatment on the incidence of PMI, measurements of cardiac biomarkers (CK-MB mass and troponin I) were performed at baseline and 24 h after the procedure., Results: A total of 459 patients fulfilling the inclusion criteria were recruited to chronic ACE-I treatment and ACE-I naive groups in a 2/1 ratio. Baseline troponin I and CK-MB levels were similar in both treatment groups, whereas they were significantly lower in ACE-I group 24 h after the procedure. Univariate analysis identified body mass index (BMI), LDL cholesterol, nitrate and ACE-I use as significant factors for the development of PMI. Multivariate regression model revealed that body mass index increased and use of nitrate and ACE-I decreased the probability of PMI independent from confounding factors (OR 1.14, 95% CI 1.05-1.23, p = 0.002 for BMI; OR 0.26, 95% CI 0.14-0.48, p = 0.01 for nitrate use, OR 0.51, 95% CI 0.27-0.93, p = 0.03 for ACE-I use)., Conclusions: This prospective observational cohort trial demonstrated that chronic ACE-I therapy was an independent predictor for reduced PMI among patients with MetS who underwent elective coronary intervention.
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- 2015
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12. Quilty effect after extracorporeal photopheresis in a patient with severe refractory cardiac allograft rejection.
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Özcan ÖU, Sayın T, Soğut G, Heper A, Göksülük H, Vurgun VK, Kaya CT, Üstün EE, İlhan O, and Erol Ç
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- 2014
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13. The relationship between coronary collateral artery development and inflammatory markers.
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Oğuz D, Atmaca Y, Ozdöl C, Ozdemir AO, Kaya CT, and Erol C
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- Coronary Artery Disease blood, Coronary Artery Disease pathology, Cross-Sectional Studies, Female, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Biomarkers blood, Collateral Circulation, Coronary Artery Disease physiopathology, Peroxidase blood
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Objective: This study aims to show the effect of myeloperoxidase (MPO), hsCRP, TNF-alpha values and leukocyte count on the development of coronary collateral arteries in patients with severely diseased coronary arteries., Methods: Current study is an observational cross-sectional study. In the study, 295 patients who had functional obstruction or total coronary occlusion at least 1 month on their angiograms were included. We divided the study population into two groups according to their collateral grade as good collateral (Group 1) (169 patients) and poor collateral (Group 2) (126 patients). Multiple logistic regression analysis was used for independent variables associated with the coronary collateral grade., Results: History of stable angina pectoris was statistically more prevalent in good collateral group (61.5% and 48.4%, p=0.025). Furthermore, MPO activation was higher in good collateral group and the difference was statistically significant (3.7 U/mL and 3.0 U/mL p=0.001). In multiple logistic regression analysis, stable angina pectoris [OR 1.7, 95% CI (1.05-2.8), p=0.03] and high MPO levels [OR 2.7, 95% CI (1.7-4.3), p<0.001] were found to be independent predictors of good collateral development., Conclusion: We think that proinflammatory enzymes and cytokines released from these cells rather than inflammatory cells themselves may play an important role on the collateral development.
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- 2014
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14. An unusual case of vancomycin-related systemic reaction accompanied with severe thrombocytopenia mimicking pacemaker-related infective endocarditis: a case report and review of literature.
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Candemir B, Aribuca A, Koca C, Ozcan OU, Gerede M, and Kaya CT
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- Anti-Bacterial Agents adverse effects, Autoimmune Diseases prevention & control, Device Removal, Diagnosis, Differential, Endocarditis prevention & control, Female, Humans, Middle Aged, Pacemaker, Artificial adverse effects, Prosthesis-Related Infections diagnosis, Prosthesis-Related Infections etiology, Prosthesis-Related Infections prevention & control, Thrombocytopenia prevention & control, Treatment Outcome, Autoimmune Diseases chemically induced, Autoimmune Diseases diagnosis, Endocarditis diagnosis, Endocarditis etiology, Thrombocytopenia chemically induced, Thrombocytopenia diagnosis, Vancomycin adverse effects
- Abstract
Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive resistant bacteria. In recent years, several cases of vancomycin-associated immune thrombocytopenia have been presented as case reports, but the real incidence of this side effect is still unknown. In this report, we would like to present a case during which we confronted with a great dilemma: urgent removal of whole defibrillator system due to highly suspected infective endocarditis or leaving the defibrillator in place and simply switching vancomycin to another antibiotic agent and wait.
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- 2013
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15. Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction.
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Candemir B, Kilickap M, Ozcan OU, Kaya CT, Gerede M, Ozdemir AO, Ozdol C, Kumbasar D, and Erol C
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- Aged, Blood Flow Velocity drug effects, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Myocardial Infarction pathology, Necrosis, Pilot Projects, Platelet Aggregation Inhibitors adverse effects, Time Factors, Tirofiban, Tyrosine administration & dosage, Tyrosine adverse effects, Angioplasty, Balloon, Coronary, Myocardial Infarction therapy, Platelet Aggregation Inhibitors administration & dosage, Tyrosine analogs & derivatives
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We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.
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- 2012
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16. Effect of hypertension on coronary remodeling patterns in angiographically normal or minimally atherosclerotic coronary arteries: an intravascular ultrasound study.
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Candemir B, Ertas FS, Ozdol C, Kaya CT, Kilickap M, Akyurek O, Atmaca Y, Kumbasar D, and Erol C
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- Adult, Aged, Blood Pressure, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Female, Humans, Hypertension diagnostic imaging, Male, Middle Aged, Risk Factors, Ultrasonography, Interventional methods, Coronary Artery Disease pathology, Coronary Vessels pathology, Hypertension physiopathology
- Abstract
Whether there is any particular role of hypertension in remodeling process has not been completely understood yet. The aim of this study was to assess the association between hypertension and remodeling patterns in normal or minimally atherosclerotic coronary arteries. Seventy-nine patients who were free of significant coronary atherosclerosis were divided into two groups according to the absence (n = 39) or presence (n = 40) of hypertension; and standard intravascular ultrasound examination was performed in 145 segments. To determine the remodeling pattern in early atherosclerotic process, patients were also analyzed according to the level of plaque burden at the lesion site after the analysis of remodeling patterns. Positive remodeling was more prevalent in the hypertensive group (52.5% vs. 12.8%; P < .001) whereas negative remodeling was more common in diabetic patients (53.6% vs. 27.4%; P = .03). Mean remodeling index was 1.04 for hypertensives and 0.96 for normotensives (P = .03). There were no correlations between remodeling patterns and other risk factors such as age, family history, and hypercholesterolemia. Early atherosclerotic lesions (< 30%) exhibited more negative remodeling characteristics while intermediate pattern was observed more frequently in patients with high plaque burden (P = .006 and .02, respectively). Positive remodeling showed no association in this context (P = .07). This study demonstrated that minimal atherosclerotic lesions in hypertensives had a tendency for compensatory arterial enlargement. Positive remodeling may result from local adaptive processes within vessel wall or hemodynamic effects of blood pressure itself.
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- 2012
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17. Cardiomyopathy with alopecia and palmoplantar keratoderma (CAPK) is caused by a JUP mutation.
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Erken H, Yariz KO, Duman D, Kaya CT, Sayin T, Heper AO, and Tekin M
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- Adult, Heterozygote, Humans, Male, Middle Aged, gamma Catenin, Alopecia genetics, Cardiomyopathies genetics, Desmoplakins genetics, Keratoderma, Palmoplantar genetics, Mutation, Missense genetics
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Inherited desmosomal cardiocutaneous syndromes are characterized by the quartet of woolly hair, palmoplantar keratoderma (PPK), skin fragility and cardiac abnormalities, which are caused by mutations in genes coding for desmosomal proteins. We describe a previously unrecognized autosomal recessive syndrome in a family with arrhythmogenic right ventricular cardiomyopathy associated with alopecia and PPK (named CAPK). Genetic investigation of the family led us to find a homozygous disease-causing mutation, p.R265H, in JUP which encodes plakoglobin, a well-described member of the desmosome complex. This study expands the clinical spectrum of disorders associated with germline mutations affecting desmosomal proteins by describing a novel phenotype., (© 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011.)
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- 2011
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18. Evaluation of acute infection-induced endothelial dysfunction and its potential mediators.
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Kilickap M, Goksuluk H, Candemir B, Kaya CT, Ozcan OU, Turhan S, Vurgun K, Ozdemir AO, and Erol C
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- Acute Disease, Algorithms, Apolipoprotein A-I blood, Apolipoproteins B blood, Biomarkers blood, Blood Flow Velocity, C-Reactive Protein metabolism, Cholesterol, LDL blood, Coronary Artery Disease blood, Coronary Artery Disease diagnosis, Female, Humans, Interleukin-6 blood, Lipoproteins, HDL blood, Male, Middle Aged, Respiratory Tract Infections blood, Risk Factors, Tumor Necrosis Factor-alpha blood, Vasodilation, Brachial Artery physiopathology, Coronary Artery Disease physiopathology, Endothelium, Vascular physiopathology, Inflammation blood, Respiratory Tract Infections physiopathology
- Abstract
Objectives: Inflammation plays an important role in the pathophysiology of atherosclerosis. Some studies suggest a link between chronic infections, an inflammatory state, and endothelial dysfunction. However, data related to acute infections are scant. We have investigated: (i) the effect of acute infection on endothelial function; (ii) the role of potential mediators of endothelial dysfunction., Methods: Forty patients 40 years old with acute infection (mean age 53.9 +/- 8.8 years), without coronary artery disease or its equivalents were enrolled. Endothelial function and blood levels of high sensitive C-reactive protein, interleukin-6, tumour necrosis factor-a, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), apolipoprotein-A1 (Apo-A1) and apolipoprotein-B100 (Apo-B100) were assessed in the acute infection phase and 1 month after recovery. Endothelial function was evaluated by brachial artery flow-mediated vasodilation (FMD)., Results: The intraclass correlation coefficients for intra- and interobserver agreement for FMD measurements were 0.98 (95% CI: 0.95-0.99) and 0.93 (95% CI: 0.83-0.97), respectively. FMD improved significantly 1 month after recovery (P < 0.001). Compared to the levels at 1 month, inflammatory markers, LDL cholesterol, LDL/HDL ratio, Apo-B100 and Apo-B100/Apo-A1 ratio were significantly higher. However, HDL and apo-A1 were significantly lower in the phase of acute infection. Change in FMD from baseline to 1 month after recovery correlated significantly only with the change in Apo-A1 (r = 0.35, P = 0.027)., Conclusions: Acute infection causes transient endothelial dysfunction. It increases inflammatory markers and generates an atherogenic lipid profile. Among the parameters evaluated, only the change in Apo-A1 level was associated with acute infection-induced endothelial dysfunction.
- Published
- 2011
- Full Text
- View/download PDF
19. [Case Images: pseudoaneurysm of the subclavian artery].
- Author
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Vurgun K, Kaya CT, Kılıçkap M, and Bilgiç S
- Subjects
- Female, Humans, Middle Aged, Radiography, Subclavian Artery diagnostic imaging, Aneurysm, False diagnosis, Subclavian Artery pathology
- Published
- 2010
20. Association between antibodies against calcifying nanoparticles and mitral annular calcification.
- Author
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Candemir B, Ertas FS, Kaya CT, Ozdol C, Hasan T, Akan OA, Sahin M, and Erol C
- Subjects
- Adult, Aged, Biomarkers blood, Calcinosis diagnostic imaging, Case-Control Studies, Chi-Square Distribution, Echocardiography, Doppler, Enzyme-Linked Immunosorbent Assay, Female, Heart Valve Diseases diagnostic imaging, Humans, Logistic Models, Male, Middle Aged, Mitral Valve diagnostic imaging, Odds Ratio, Risk Assessment, Risk Factors, Turkey, Antibodies blood, Calcinosis immunology, Heart Valve Diseases immunology, Mitral Valve immunology, Nanoparticles
- Abstract
Background and Aim of the Study: Mechanisms leading to vascular and tissue calcification are not yet fully understood. Previously, an association has been demonstrated between a controversial calcifying nanoparticle (CNP; also known as 'nanobacteria') and vascular calcification and kidney stone formation. The study aim was to evaluate a possible association between mitral annular calcification (MAC) and CNP infection., Methods: A total of 93 patients with MAC, detected using echocardiography, and 94 asymptomatic subjects without valvular and coronary artery calcification, were enrolled in the study. The serum levels of anti-CNP-antibodies were monitored in all subjects., Results: Patients with MAC were generally older and had a higher prevalence of systemic hypertension, diabetes mellitus, and dyslipidemia. The anti-CNP-antibody titers, which were significantly associated with MAC (p < 0.0001), were increased with older age and MAC thickness, but decreased in line with serum levels of HDL-cholesterol (p < 0.0001). In order to provide a cut-off point for anti-CNP-antibodies when detecting MAC, a receiver operating characteristic curve was created. Serum CNP-antibody levels above 0.19 units/ml showed a sensitivity of 73%, a specificity of 72%, and positive and negative predictive values of 72% and 73%, respectively. Multivariate logistic regression analysis revealed that increasing age, systemic hypertension, diabetes, HDL-cholesterol levels and high anti-CNP titers were risk factors that were independently associated with calcification in the mitral annuli., Conclusion: The study results suggested that CNP might play an important role in the pathogenesis of MAC.
- Published
- 2010
21. The relationship between angiotensin converting enzyme gene I/D polymorphism and QT dispersion in patients with hypertrophic cardiomyopathy.
- Author
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Kaya CT, Gurlek A, Altin T, Kilickap M, Karabulut HG, Turhan S, Ozcan O, Bokesoy I, Oral D, and Erol C
- Subjects
- Adult, Aged, Aged, 80 and over, Electrocardiography, Female, Gene Deletion, Genotype, Humans, Male, Middle Aged, Polymorphism, Genetic, Cardiomyopathy, Hypertrophic genetics, Cardiomyopathy, Hypertrophic physiopathology, Peptidyl-Dipeptidase A genetics
- Abstract
Introduction: Hypertrophic cardiomyopathy (HCM) is characterized by disorganized myocardial architecture, and may cause ventricular arrhythmias and sudden death. The angiotensin-converting enzyme (ACE) with two deletion alleles (DD genotype) has been proposed to be associated with increased myocardial collagen content. We evaluated QT dispersion (QTd), which reflects regional differences in ventricular repolarization, in HCM patient and controls among the three different ACE genotypes., Materials and Methods: Sixty-three patients with HCM and 20 healthy subjects were included in the study. QT parameters were measured from 12 lead electrocardiograms. ACE genotypes were determined from the DNA extracted from peripheral blood by a polymerase chain reaction (PCR) method. QT parameters were compared among the three ACE genotypes both in HCM patients and controls., Results: Median ages were similar in HCM and control groups. QTd and corrected QTd (QTcd) were significantly greater in the HCM group compared with the controls. The frequencies of each genotype were similar in both groups. Although QTd and QTcd did not differ among the three genotypes in the control subjects, they were significantly greater in patients with DD genotype compared with other genotypes in the HCM group., Conclusion: QTd and QTcd are increased in patients with HCM, especially in those with the DD genotype.
- Published
- 2010
- Full Text
- View/download PDF
22. Two-dimensional longitudinal strain and strain rate imaging for assessing the right ventricular function in patients with mitral stenosis.
- Author
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Ozdemir AO, Kaya CT, Ozdol C, Candemir B, Turhan S, Dincer I, and Erol C
- Subjects
- Adult, Case-Control Studies, Chi-Square Distribution, Elasticity Imaging Techniques, Female, Humans, Male, Software, Statistics, Nonparametric, Systole, Echocardiography methods, Mitral Valve Stenosis diagnostic imaging, Mitral Valve Stenosis physiopathology, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right physiopathology
- Abstract
Background: Longitudinal two-dimensional strain (L2DS) deformation is a novel technique that evaluates global and regional right ventricular (RV) function. The aim of the study was to investigate the systolic function of RV by using this method in patients with pure mitral stenosis (MS)., Methods: Conventional echocardiography and L2DS analysis were performed in 45 MS patients and 21 healthy controls. For strain analysis apical four-chamber views were obtained and by using a software system, peak systolic strain and strain rates were calculated off-line in each segment., Results: The mean global longitudinal strain (GLS) of the whole RV (-20 + or - 7 vs. -24 + or - 6%, P= 0.02) and mean GLS of the septum (-19 + or - 7 vs. -23 + or - 5%, P = 0.03) were significantly reduced in the MS patients. Compared with the control group no significant change was determined in the mean GLS of the RV free wall (RVFW). While the mean global longitudinal strain rates (GLSR) of the entire RV and RVFW were similar between the groups, a significant difference in the mean GLSR of the septum (-1.2 + or - 0.4 vs. -1.5 + or - 0.3 s(-1), P= 0.005) was determined in the patients with MS. A regional analysis demonstrated that MS patients had significantly reduced strain and strain rates in the basal and mid-segments of the septum, whereas only lower strain values in the basal RVFW., Conclusions: RV systolic function evaluated by L2DS analysis in patients with MS has shown decreased global and segmental systolic functions. (ECHOCARDIOGRAPHY 2010;27:525-533).
- Published
- 2010
- Full Text
- View/download PDF
23. The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral development - a cross sectional study.
- Author
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Ozdemir AO, Gulec S, Uslu N, Kaya CT, Ozdol C, Turhan S, Atmaca Y, Altin T, and Erol C
- Subjects
- Brachial Artery diagnostic imaging, Coronary Stenosis diagnostic imaging, Coronary Vessels diagnostic imaging, Endothelium, Vascular diagnostic imaging, Female, Humans, Male, Middle Aged, Ultrasonography, Vasodilation, Blood Flow Velocity, Brachial Artery physiopathology, Collateral Circulation, Coronary Angiography methods, Coronary Stenosis physiopathology, Coronary Vessels physiopathology, Endothelium, Vascular physiopathology
- Abstract
Background: Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals., Methods: We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms., Results: Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 +/- 5.6 vs. 10.4 +/- 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 +/- 5.9 vs. 12.8 +/- 6.5%, p = 0.521)., Conclusion: No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.
- Published
- 2009
- Full Text
- View/download PDF
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