201 results on '"Mert İlker Hayıroğlu"'
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2. Catheter Ablation Approaches for the Treatment of Arrhythmia Recurrence in Patients with a Durable Pulmonary Vein Isolation
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Vinitha Nesapiragasan, Mert İlker Hayıroğlu, Vanessa Sciacca, Philipp Sommer, Christian Sohns, and Thomas Fink
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Medicine - Abstract
Catheter ablation has emerged as an effective treatment for atrial arrhythmias, and pulmonary vein isolation (PVI) is the cornerstone of ablation strategies. Significant technological evolution and widespread increase in operator experience have facilitated the effectiveness of catheter ablation to achieve durable PVIs in single or multiple ablation procedures. Nevertheless, arrhythmia recurrence is a common problem even after establishing PVI. Data on catheter ablation in these patients are sparse and repeat ablation in this population is highly challenging. In this review we have summarized the available data as well as potential strategies of catheter ablation following the initial PVI.
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- 2023
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3. Effect of the Obesity Paradox on Mortality in Patients with Acute Coronary Syndrome: A Comprehensive Meta-analysis of the Literature
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Faysal Şaylık, Tufan Çınar, and Mert İlker Hayıroğlu
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Medicine - Abstract
Background: The protective effect of obesity in patients with acute coronary syndrome undergoing percutaneous coronary intervention or bypass surgery has been described as the obesity paradox in the literature. Aims: In this comprehensive meta-analysis, we aimed to investigate the pooled effect of the obesity paradox on mortality in acute coronary syndrome patients. Study Design: Systemic meta-analysis and metaregression. Methods: We searched PubMed, Google Scholar, and the Cochrane Library for eligible studies that compared the mortality rates between body mass index cut-off points in acute coronary syndrome patients. This meta-analysis comprised 54 studies with 534,903 patients. Random- and fixed-effect models were used to calculate pooled effects sizes in the presence of moderately high and low heterogeneity between studies, respectively. A metaregression analysis was used to detect possible causes of heterogeneity. A dose-response meta-analysis was also conducted to detect the association between mortality risk and body mass index. Results: Overweight patients had lower mortality risk for 30-day (RR =0.69; 0.62-0.76, p < 0.01) and long-term (RR =0.73; 0.70-0.77, p < 0.01) mortality than normal-weight patients. The 30-day mortality risk was higher in low-weight patients than in normal-weight patients (RR =1.74; 1.39-2.18, p < 0.01). Meta-regression could not explain the possible causes of between-study heterogeneity. Patients with body mass index 40 kg/m2 had a higher risk of mortality, which was lowest at approximately 30 kg/m2. Conclusion: Low-weight and overweight acute coronary syndrome patients had higher mortality risk than normal-weight patients. A U-shaped nonlinear association was detected between body mass index and mortality risk.
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- 2023
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4. Digital Health Interventions in Patient Management Following Acute Coronary Syndrome: A Meta-Analysis of the Literature
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Faysal Şaylık, Tufan Çınar, Mert İlker Hayıroğlu, and Ahmet İlker Tekkeşin
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acute coronary syndrome ,digital health intervention ,meta-analysis ,standard care ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Acute coronary syndrome patients should be closely followed-up to maintain optimal adherence to medical treatments and to reduce adverse events. Digital health interventions might provide improved outcomes for patient care by providing closer follow- up, compared to standard care. Thus, in this meta-analysis, we aimed to evaluate the effect of digital health interventions on follow-up in acute coronary syndrome patients. Methods: We searched medical databases to obtain all relevant studies comparing digital health interventions with standard care in acute coronary syndrome patients. After reviewing all eligible studies, a meta-analysis was conducted with the remaining 11 randomized controlled studies and 2 non-randomized controlled studies. A modified Jadad scale and Newcastle-Ottawa scale were used to assess the quality of the publications for randomized controlled studies and non-randomized controlled studies, respectively. Results: This meta-analysis consisted of 7657 patients. The all-cause mortality rate was 49% lower in the digital health intervention cases, compared to those who received standard care [relative risk (RR) = 0.51 (0.37; 0.70), P
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- 2023
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5. Predictors for early mortality in patients with implantable cardiac defibrillator for heart failure with reduced ejection fraction
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Göksel Çinier, Mert İlker Hayıroğlu, Tufan Çınar, Levent Pay, Ahmet Çağdaş Yumurtaş, Ozan Tezen, Semih Eren, Zeynep Kolak, Tuğba Çetin, Serhan Özcan, Ceyhan Türkkan, Nazmiye Özbilgin, Ahmet İlker Tekkeşin, Ahmet Taha Alper, and Kadir Gürkan
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Heart failure with reduced ejection fraction ,Implantable cardiac defibrillator ,Early mortality ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Implantable cardioverter defibrillators (ICD) are recommended in heart failure with reduced ejection fraction (HFrEF) patients to reduce arrhythmic deaths. This study aimed to identify risk factors associated with mortality within one-year following the ICD. The data from our hospital's electronic database system was extracted for patients who were implanted ICD secondary to HFrEF between 2009 and 2019. Overall, 1107 patients were included in the present analysis. Mortality rate at one-year following the device implantation was 4.7%. In multivariate analysis; age, atrial fibrillation, New York Heart Association classification >2, blood urea nitrogen, pro-brain natriuretic peptide and albumin independently predicted one year mortality.
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- 2022
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6. The Role of Artificial Intelligence in Coronary Artery Disease and Atrial Fibrillation
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Mert İlker Hayıroğlu and Servet Altay
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Medicine - Published
- 2023
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7. Predictive value of uric acid/albumin ratio for the prediction of new-onset atrial fibrillation in patients with ST-Elevation myocardial infarction
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Murat Selçuk, Tufan Çınar, Faysal Şaylık, Tayyar Akbulut, Suha Asal, Vedat Çiçek, Mert İlker Hayıroğlu, and İbrahim Halil Tanboğa
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Uric acid/albumin ratio. New-onset atrial fibrillation. ST-elevation myocardial infarction. ,Internal medicine ,RC31-1245 - Abstract
Background: There is a lack of studies supporting the association between the uric acid/albumin ratio (UAR) and the development of new-onset atrial fibrillation (NOAF) in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI). Objective: The objective of the study was to assess the efficacy of the UAR for predicting the occurrence of NOAF in STEMI patients undergoing pPCI. Methods: We recruited 1484 consecutive STEMI patients in this retrospective and cross-sectional investigation. The population sample was classified based on the development of NOAF during hospitalization. NOAF was defined as an atrial fibrillation (AF) observed during hospitalization in patients without a history of AF or atrial flutter. The UAR was computed by dividing the serum uric acid (UA) level by serum albumin level. Results: After pPCI, 119 STEMI patients (8%) were diagnosed with NOAF. NOAF patients had higher serum UAR levels than individuals who did not have NOAF. According to the multivariable logistic regression model, the UAR was an independent predictor for NOAF in STEMI patients (OR: 6.951, 95% CI: 2.978-16.28, p < 0.001). The area under curve (AUC) value of the UAR in a receiver operating characteristics (ROC) evaluation was 0.758, which was greater than those of its components (albumin [AUC: 0.633] and UA [AUC: 0.647]) and C-reactive protein (AUC: 0.714). The optimal UAR value in predicting NOAF in STEMI patients was greater than 1.39, with a sensitivity of 69% and a specificity of 74.5%. Conclusion: To the best of our knowledge, this is the first study indicating that the UAR was an independent predictor of NOAF development in STEMI patients.
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- 2022
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8. Evaluation of websites reached using Google in the modern digital era related to approach to cholesterol
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Mert İlker Hayıroğlu, Göksel Çinier, Nurgül Keser, Mehmet Uzun, Ali Karagoz, Ali Serdar Fak, Ertugrul Okuyan, Can Altundaş, and Ilker Tekkesin
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cholesterol ,google ,internet ,medical information ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: The Google search engine is widely used as a source of medical information; however, legal and medical governance of the accuracy of the content retrieved is lacking. The aim of this study was to assess the most read Turkish-language texts related to cholesterol during a specific period according to the validity of the content. Methods: Google Trends was queried on January 5, 2019 for the search term 'cholesterol' and the 9 other most popular search phrases used in Turkey that included the word cholesterol. In all, 100 links were obtained for each phrase, generating a total of 1000 links. Once duplicates were eliminated, a total of 604 links was used for the study. Since there is currently no validation scoring system for this purpose in the literature, the authors created a checklist according to well-accepted recent guidelines focused on cholesterol. The content of the texts acquired was classified as misleading, insufficient but favorable, or sufficient and favorable. Results: The source of the online texts studied was universities (n=8, 1.3%), hospitals (n=6, 0.9%), personal blogs (n=200, 33.1%), health websites (n=183, 30.2%), and medical journals (n=207, 34.2%). In all, 235 texts (38.9%) were classified as sufficient and favorable and 35 (5.7%) were categorized as misleading. A medical practitioner was named in 378 texts (62.5%). All of the results from universities and hospitals were ranked in the favorable group. A statistical difference in the word count was seen in a comparison of the misleading and favorable texts. Conclusion: Google can connect users to a significant quantity of material related to cholesterol that includes a wide range from misleading information to sufficient and favorable texts. The variation in the quality of the content on websites accessible via Google necessitates that cholesterol resource material should be selected with great care.
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- 2020
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9. Effect of acute kidney injury on long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention in a high-volume tertiary center
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Mert İlker Hayıroğlu, Emrah Bozbeyoglu, Özlem Yıldırımtürk, Ahmet İlker Tekkeşin, and Seçkin Pehlivanoğlu
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acute kidney injury ,cardiogenic shock ,myocardial infarction. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Acute kidney injury (AKI) is a reflection of both renal and cardiac reserve in patients with ST-segment elevation myocardial infarction (STEMI), but there is a lack of evidence related to the effect of AKI on long-term mortality in patients with STEMI. This study was an investigation of the prognostic value of AKI for long-term mortality in patients with STEMI complicated by cardiogenic shock (CS) and primary percutaneous coronary intervention (PPCI). Methods: This retrospective analysis evaluated the long-term prognostic impact of AKI on 492 patients with STEMI complicated by CS who were treated with PPCI. AKI was defined as ≥0.3mg/dL increase in serum creatinine within 48 hours or a ≥50% increase in serum creatinine in 7 days, or a reduction in urine output (documented oliguria of less than 0.5mL/kg per hour >6 hours. Patients were grouped according to the incidence of AKI and long-term mortality was compared. Cox regression analysis was used to determine independent prognostic factors of long-term mortality. Results: In Cox regression analysis, the age- and sex- adjusted hazard ratios (HRs) were higher for all-cause mortality in patients with AKI. [HR: 4.556; 95% confidence interval: (CI) 2.370–8.759]. After adjustment for confounding variables, the relative risk was greater for patients with AKI in comparison with patients without AKI (HR: 2.207; 95% CI: 1.150–4.739). Age (HR: 1.060, 95% CI: 1.027–1.094; p
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- 2020
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10. The Prognostic Value of the GRACE Score for Acute Kidney Injury in Patients with ST Elevation Myocardial Infarction Complicated with Cardiogenic Shock
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Mert İlker Hayıroğlu, Tufan Çınar, and Ahmet İlker Tekkeşin
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grace ,acute kidney injury ,prognostic value ,cardiogenic shock. ,Medicine (General) ,R5-920 - Abstract
Objective: The Global Registry of Acute Coronary Events (GRACE) risk score has been proposed in predicting short-term death in patients who are diagnosed with acute coronary syndrome. The aim of the present study was to investigate the significance of the GRACE score for acute kidney injury (AKI) in patients with cardiogenic shock (CS)–ST elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PPCI). Materials and Methods: We retrospectively examined a total of 492 consecutive patients with CS–STEMI who had undergone PPCI. The GRACE score was calculated for each patient. Patients were stratified by tertiles (T1, T2, and T3) according to the GRACE score, and the incidence of AKI was compared between the groups. Results: In univariate analysis, the incidence of AKI was significantly higher for patients allocated into the T3 group than for patients in the T1 group (odds ratio (OR) 2.8, 95% confidence interval (CI) 1.8–4.1, p
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- 2020
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11. Association of Uric Acid Albumin Ratio with Recurrence of Atrial Fibrillation after Cryoballoon Catheter Ablation
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Mehmet Baran Karataş, Gündüz Durmuş, Ahmet Zengin, Murat Gökalp, Mert İlker Hayıroğlu, Tufan Çınar, Kadir Gürkan, and Neşe Çam
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catheter ablation ,atrial fibrillation ,uric acid/albumin ratio ,recurrence ,Medicine (General) ,R5-920 - Abstract
Objective: Despite improvements in the technology of catheter ablation of atrial fibrillation (AF), recurrences are still a major problem, even after a successful procedure. The uric acid/albumin ratio (UAR), which is an inexpensive and simple laboratory parameter, has recently been introduced in the literature as a predictor of adverse cardiovascular events. Hence, we aimed to investigate the relationship between the UAR and AF recurrence after catheter ablation. Methods: A total of 170 patients who underwent successful catheter ablation for AF were included. The primary outcome was the late recurrence after treatment. The recurrence (+) and recurrence (−) groups were compared for clinical, laboratory and procedural characteristics as well as the predictors of recurrence assessed by regression analysis. Results: In our study population, 53 (26%) patients developed AF recurrence after catheter ablation. Mean UAR was higher in the recurrence (+) group compared to recurrence (−) group (2.4 ± 0.9 vs. 1.8 ± 0.7, p < 0.01). In multivariable regression analysis, left atrial diameter (HR: 1.08, 95% CI: 1.01–1.16, p = 0.01) and UAR (HR:1.36, 95% CI: 1.06–1.75, p = 0.01) were found to be independent predictors of recurrence. In ROC analysis, the UAR > 1.67 predicted recurrence with a sensitivity of 77% and a specificity of 57% (AUC 0.68, p < 0.01). Conclusion: For the first time in the literature, the UAR were found to be correlated independently with AF recurrence after catheter ablation.
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- 2022
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12. Successful treatment of pulmonary embolism in a patient with polycythemia vera by rheolytic thrombectomy
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Tufan Çinar, Mert İlker Hayıroğlu, and Ahmet Oz
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acute pulmonary embolism ,polycythemia vera ,rheolytic thrombectomy ,contraindication ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Acute pulmonary embolism (APE) may lead to life-threatening conditions such as cardiac death and congestive heart failure. Thus, a proper diagnosis and management play a crucial role to prevent such complications. Moreover, APE is a rare clinical onset of chronic myeloproliferative disease. We herein describe a 67-year-old patient with polycythemia vera presented to our cardiology clinic with pulmonary embolism despite the fact that an intense antiplatelet treatment started secondary to acute myocardial infarction prior. Because the patient had hypotension and head trauma, rheolytic thrombectomy was performed successfully to restore adequate pulmonary perfusion.
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- 2019
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13. Clinical characteristics and outcomes of acute coronary syndrome patients with intra-aortic balloon pump inserted in intensive cardiac care unit of a tertiary clinic
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Mert İlker Hayıroğlu, Yiğit Çanga, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Ayça Gümüşdağ, Ahmet Okan Uzun, Koray Kalenderoğlu, Muhammed Keskin, Göksel Çinier, Murat Acarel, and Seçkin Pehlivanoğlu
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cardiac care unit ,cardiogenic shock ,intra-aortic balloon pump ,myocardial infarction. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients. Methods: The data of patients who were admitted to the ICCU between September 2014 and March 2017 were analyzed retrospectively. The data were retrieved from the ICCU electronic database of the clinic. A total of 142 patients treated with IABP were evaluated in the study. All of the patients were in cardiogenic shock following percutaneous coronary intervention, at the time of IABP insertion. Results: The mean age of the patients was 63.0+-9.7 years and 66.2% were male. In-hospital mortality rate of the study population was 54.9%. The patients were divided into 2 groups, consisting of survivors and non-survivors of their hospitalization period. Multivariate analysis after adjustment for the parameters in univariate analysis revealed that ejection fraction, Thrombolysis in Myocardial Infarction flow score of ≤2 after the intervention, chronic renal failure, and serum lactate and glucose levels were independent predictors of in-hospital mortality. Conclusion: The mortality rate remains high despite IABP support in patients with acute coronary syndrome. Patients who are identified as having a greater risk of mortality according to admission parameters should be further treated with other mechanical circulatory support devices.
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- 2018
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14. Assessment of factors related to statin non-adherence in patients with established coronary artery disease: A single-center observational study
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Tuba Özdemir, İrfan Şahin, İlhan İlker Avcı, Barış Güngör, Eser Durmaz, Sevil Tuğrul, Mert İlker Hayıroğlu, Serdar Kahyaoğlu, Orkhan Karımov, and Ertuğrul Okuyan
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adherence ,coronary artery disease ,statin. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Lifelong statin treatment is recommended in patients with cardiovascular diseases, but drug adherence is a significant problem. The aim of this study was to investigate factors related to statin discontinuation in high-risk patients with coronary artery disease (CAD) diagnosed by coronary angiography. Methods: A total of 300 consecutive patients who were followed-up with a diagnosis of CAD were recruited. Patients were categorized as statin adherent or statin non-adherent (patients interrupting statin therapy >30 days). Study participants completed a questionnaire regarding demographic characteristics, medical history, knowledge of statin treatment, and factors related to statin discontinuation. Results: In all, 160 patients (53.3%) were found to be statin adherent. Of those, 122 patients had suffered myocardial infarction, and atorvastatin was the most prescribed statin on discharge. Among the study population, 26% were illiterate and 55% had graduated from primary school. Only 39 cases (13%) cases had a low-density lipoprotein-cholesterol level
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- 2017
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15. Exceptional cause of chest pain: idiopathic ascending aortitis
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Mert İlker Hayıroğlu, Muhammed Keskin, Hüseyin Kuplay, Tolga Sinan Güvenç, and Barış Güngör
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aortitis ,chest pain ,idiopathic ascending aortitis. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Idiopathic ascending aortitis is an insidious disease most often encountered during an evaluation for other cardiovascular and connective tissue diseases. To the best of our knowledge, admission to an emergency department with chest pain due to idiopathic ascending aortitis has not been reported before. Herein, the case of a 46-year-old man with chest and back pain symptoms that were discovered to be secondary solely to idiopathic ascending aortitis is described.
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- 2017
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16. The use of monocyte to HDL ratio to predict postoperative atrial fibrillation after aortocoronary bypass graft surgery
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Ahmet İlker Tekkeşin, Mert İlker Hayıroğlu, Regayip Zehir, Ceyhan Türkkan, Muhammed Keskin, Göksel Çinier, and Ahmet Taha Alper
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atrial fibrillation ,postoperative atrial fibrillation ,monocyte to high density lipoprotein ratio ,Medicine ,Medicine (General) ,R5-920 - Abstract
INTRODUCTION[|]Postoperative atrial fibrillation (POAF) is a frequent and serious complication after aorto-coronary bypass graft (ACBG) surgery which unfortunately increases morbidity and mortality. Postoperative stroke, hemodynamic instability, renal failure, infection, inotropic agent and coronary unit need are complications caused by POAF. Inflammation and oxidative stress are among several mechanisms contributing to the pathogenesis of POAF. Monocyte to HDL ratio (M/H ratio) is a newly defined parameter of both inflammation and oxidative stress. In this study we investigated M/H ratio in predicting POAF after ACBG surgery.[¤]METHODS[|]Total number of 311 patients who underwent ACBG surgery were included in our study. Blood samples were obtained from the patients after 12 hours of fasting for analysis of routine biochemistry and lipid panel in the morning of ACBG surgery. Patients were monitored for the occurrence of POAF continuously through hospitalization. [¤]RESULTS[|]POAF was demonstrated in 71 patients after ACBG operation. M/H ratio was significantly higher in POAF+ group compared to POAF – group (p< 0.001). Median age of POAF (+) patients is 62.0+-10.1 which was significantly higher than POAF (-) patients. Other atrial fibrillation risk factors such as hypertension, diabetes mellitus, smoking or alcohol consumption were similar between groups. Potassium level was statistically lower in POAF+ group compared to POAF- group. (p= 0,01)[¤]DISCUSSION AND CONCLUSION[|]M/H ratio is an indicator of inflammation and oxidative stress which both plays an important role in the pathogenesis of atrial fibrillation. M/H ratio was found be statistically higher in POAF + patients compared to POAF – patients.[¤]
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- 2017
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17. Longest surviving case of unoperated Stanford type A aortic dissection
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Mert İlker Hayıroğlu, Muhammed Keskin, Taha Keskin, Muhsin Nuh Aybay, and Göksel Çinier
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aortic dissection ,computed tomography ,echocardiogra- phy ,stanford type a. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Stanford type A aortic dissection requires urgent intervention and immediate surgical approach in the emergency department. Survival rate is low, even in patients who undergo immediate surgery. Presently described is a case of unoperated Stanford type A aortic dissection that has been in follow-up under beta-blocker treatment for 7 years. To the best of our knowledge, our case is the longest surviving patient with unoperated type A aortic dissection reported in the literature.
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- 2017
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18. Resistant Ventricular Tachycardia due to Idiopathic Left Ventricular Aneurysm: Successful Treatment with Surgery
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Muhammed Keskin, Tufan Çınar, Mert İlker Hayıroğlu, and Ömer Kozan
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Heart ventricles ,Aneurysm ,Tachycardia ,ventricular ,Surgical procedures ,operative ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Left ventricular aneurysms (LVAs) are characterized by a wide connection to the left ventricle and paradoxical systolic motions. Although patients with LVAs are usually asymptomatic, some may present with arrhythmias, heart failure, and even cardiac arrest. In this case report, we describe a 62-year-old male patient who presented to our emergency service with complaints of palpitation and shortness of breath of 2 hours’ duration. His blood pressure was 84/56 mm Hg, and he was in a confused state. An electrocardiogram revealed ventricular tachycardia (VT) with right bundle branch block and a ventricular rate of 188 bpm. The patient’s hemodynamic instability necessitated a direct current cardioversion, which restored the sinus rhythm. During the in-hospital course, he had numerous recurrent VT episodes despite treatment with intravenous amiodarone and magnesium sulfate as well as radiofrequency ablation. Upon consensus with a cardiovascular surgeon’s team, urgent surgery was performed due to the resistant VT episodes. The patient’s clinical course was uneventful, and he was discharged on the 11th postoperative day. We have been following up the patient for almost 1 year, during which he has not experienced palpitations or associated symptoms. Our case indicates that surgery may be a preferable treatment option for patients with heart failure and resistant VT related to LVAs.
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- 2019
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19. Concertina Phenomenon in the Left Anterior Descending Artery: An Unexpected Circumstance in an Unexpected Vessel
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Mert İlker Hayıroğlu, Tufan Çınar, Ahmet Öz Öz, and Muhammed Keskin
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Coronary vessels ,Coronary angiography ,Coronary stenosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The concertina phenomenon is the occurrence of new and transient angiographic series of pseudolesions in a tortuous vessel induced mainly by a stiff guide wire. Here, we describe a 53-year-old man who experienced a concertina effect in the left anterior descending coronary artery (LAD) during an elective percutaneous coronary intervention. After the diagnosis of the concertina phenomenon in the LAD, a percutaneous coronary intervention was performed following the withdrawal of the soft guide wire to the mid level of the LAD. After the intervention, the patient remained in very good clinical status and was discharged on the third postprocedural day.
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- 2018
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20. Multipolar Left Ventricular Lead Implantation in a Unique Coronary Sinus: Direct Drainage of the Posterior Vein into the Right Atrium
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Ahmet Taha Alper, Mert İlker Hayıroğlu, Hakan Barutça, Ahmet İlker Tekkeşin, and Ceyhan Türkkan
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Heart ventricules • Heart atria • Coronary sinus • Diainage ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The coronary sinus, whose electrical features play an important role in cardiac arrhythmias, is the integral part of the cardiac venous system. Here we describe a 67-year-old male patient with congestive heart failure who was referred to our hospital after the failure of the first cardiac resynchronization therapy defibrillator (CRT-D) implantation. During the cannulation of the coronary sinus, the separate orifice of the posterior cardiac vein was demonstrated by the retrograde filling of the coronary sinus via contrast injection into the posterior cardiac vein. Due to the serious tortuosity of the coronary venous sinus, a multipolar left ventricular lead was implanted using the separate ostium of the posterior cardiac vein. In our patient, the posterior cardiac vein directly drained into the right atrium. At 3 months’ follow-up with the CRT-D, he was asymptomatic (New York Heart Association functional class I).
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- 2018
21. Resolution of left ventricular thrombus with apixaban in a patient with hypertrophic cardiomyopathy
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Adnan Kaya, Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet İlker Tekkeşin, and Ahmet Taha Alper
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apixaban ,atrial fibrillation ,hypertrophic cardiomyopathy ,thrombus. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Summary– Anticoagulation with warfarin is the main treatment of intracardiac thrombus. While novel oral anticoagulants (NOACs) have been approved by the US Food and Drug Administration (FDA) for stroke prevention in patients with nonvalvular atrial fibrillation (AF), they are not indicated for resolution of intracardiac thrombus. The case of a 60-year-old woman with left ventricular (LV) thrombus secondary to hypertrophic cardiomyopathy and AF is described in the present report. Indications for oral anticoagulation were AF and LV thrombus. Thrombus was dissolved after 1 month of apixaban treatment. To the best of our knowledge, this is the first report that describes the resolution of LV thrombus with apixaban treatment in a patient with hypertrophic cardiomyopathy.
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- 2016
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22. Hypertensive emergency due to pheochromocytoma crisis complicated with refractory hemodynamic collapse
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Mert İlker Hayıroğlu, Özlem Yıldırımtürk, Mehmet Bozbay, Mehmet Eren, and Seçkin Pehlivanoğlu
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hypertension ,hypertensive emergency ,pheochromocytoma/complications ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Hypertensive emergency usually appears in older patients with previous recurrent episodes, and is among the most frequent admissions to emergency departments. A 29-year-old woman was referred to our clinic with the diagnosis of hypertensive emergency. The patient complained of severe headache, dyspnea, palpitation, diaphoresis, and confusion due to hypertensive encephalopathy. Her blood pressure was 250/150 mmHg on admission. At the referral hospital, the patient had undergone cranial CT because of her confused state and this excluded acute cerebral hemorrhage. Also at that hospital, thoracoabdominal CT for differential diagnosis depicted an adrenal mass with a necrotic core. After admission to our clinic, initial control of excessive blood pressure was not achieved despite high dose intravenous nitrate therapy. Thereafter intravenous esmolol treatment was initiated simultaneously with oral alpha blocker therapy in order to counterbalance the unopposed alpha adrenergic activity with beta blocker therapy. After 12 hours, sudden onset of hypotension developed and deepened despite IV saline, inotropic and vasopressor agents such as IV dopamine, noradrenaline and adrenaline. The patient died at the 24th hour due to hemodynamic collapse as a result of hyperadrenergic state due to possible pheochromocytoma crisis. This case is an exceptional example of hypertensive emergency secondary to fulminant pheochromocytoma crisis failing to respond to intensive antihypertensive treatment, and in which patient death was unavoidable due to uncontrolled excessive adrenergic activity which led to profound cardiogenic shock.
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- 2015
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23. Unicuspid aortic valve concomitant with interrupted aortic arch and severe aortic stenosis in an adult patient
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Tufan Çınar, Mert İlker Hayıroğlu, Ahmet Öz, Muhammed Keskin, and Mehmet Uzun
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unicuspid unicomissural aortic valve ,severe aortic stenosis ,interrupted aortic arch. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2019
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24. Giant biventricular thrombi presenting with acute myocardial infarction
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Adnan Kaya, Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Öz, and Berat Arıkan Aydın
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Thrombus ,Myocardial infarction ,Pulmonary embolism ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Biventricular thrombi secondary to anterior myocardial infarction is very rare. We present a patient with giant biventricular thrombi subsequent to an old anterior wall myocardial infarction, and devastating consequences, including acute pulmonary artery and femoral artery embolism. We introduce a unique case report with demonstrative and illustrative images.
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- 2016
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25. Simple and effective solution for diaphragm pacing by that uses the transvenous femoral approach in a patient treated with cardiac resynchronization-defibrillator therapy: The wrapping method
- Author
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Ahmet Taha Alper, Prof., Mert İlker Hayıroğlu, MD, Ahmet İlker Tekkeşin, MD, and Ceyhan Türkkan, MD
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Cardiac resynchronization therapy ,Diaphragm pacing ,Phrenic nerve ,Lead complication ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The use of cardiac resynchronization therapy (CRT) has become widespread in patients with heart failure who meet the criteria for implantation. Coronary sinus lead positioning is important to provide the intended biventricular stimulation. Diaphragm pacing is a lead-related complication which occurs secondary to phrenic nerve stimulation. We present the case of a 58-year-old male patient who had diaphragm pacing after CRT with defibrillator implantation. The complication was resolved by using the transvenous femoral approach with the wrapping method.
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- 2017
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26. Unruptured non-coronary sinus of Valsalva aneurysm presenting with nausea secondary to functional tricuspid stenosis
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Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Yavuz Balcı, Servet Altay, and Tolga Sinan Güvenç
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sinus of valsalva ,aneurysm ,tricuspid stenosis ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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27. Electrolyte Imbalances as a predisposing factor for arrhythmias
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Mert İlker Hayıroğlu, Muhammed Keskin, and Ömer Kozan
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arrhythmia ,electrocardiography ,extracorporeal shock wave lithotripsy. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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28. Hiatal hernia presenting like a large left atrial mass
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Muhammed Keskin, Mert İlker Hayıroğlu, Taha Keskin, Adnan Kaya, and Ömer Kozan
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atrial mass ,computed tomography ,echocardiography ,hiatal hernia ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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29. Detection and management of ICD lead implanted in middle cardiac vein
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Ahmet Taha Alper, Ahmet İlker Tekkeşin, Mert İlker Hayıroğlu, Yasin Çakıllı, and Göksel Çinier
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intra-cardiac defibrillator ,lead misplacement ,coronary sinus. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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30. Preoperative evaluation of a pannus over an annuloplasty ring with live/real-time three-dimensional echocardiography
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Tolga Sinan Güvenç, Mert İlker Hayıroğlu, Cevdet Uğur Koçoğulları, İlyas Kayacıoğlu, and Mehmet Eren
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ring annuloplasty ,pannus ,three-dimensional transesophageal echocardiography. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2017
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31. Cervical adenocarcinoma presenting with a terrible combination: a giant cardiac mass, cardiac tamponade and pulmonary embolism
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Muhammed Keskin, Mert İlker Hayıroğlu, Taha Keskin, Emir Renda, and Ahmet Ekmekçi
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cervical cancer ,pericardial tamponade ,right ventricle ,free wall rupture ,cardiac imaging. ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
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32. Aortic graft distortion
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Regayip Zehir, Mert İlker Hayıroğlu, Tolga Sinan Güvenç, Abdullah Kemal Tuygun, and Şennur Ünal Dayı
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ascending aorta ,endovascular repair ,aortic graft ,Medicine ,Internal medicine ,RC31-1245 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
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33. The Association of Serum Uric Acid/Albumin Ratio with No-Reflow in Patients with ST Elevation Myocardial Infarction
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Tufan Çınar, Faysal Şaylık, Mert İlker Hayıroğlu, Suha Asal, Murat Selçuk, Vedat Çiçek, and İbrahim Halil Tanboğa
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
The goal of this investigation was to explore the relationship between serum uric acid/albumin ratio (UAR) and no-reflow (NR) in ST elevation myocardial infarction (STEMI) patients (n = 838) who underwent primary percutaneous coronary intervention (pPCI). Angiographic NR was defined as thrombolysis in myocardial infarction (TIMI) flows 0, 1, and 2 in the absence of coronary spasm or dissection. NR developed in 91 (10.9%) STEMI patients. Patients with NR had higher UAR and according to multivariable logistic regression models, a high UAR was an independent risk factor for NR. The area under the curve (AUC) value of the UAR was .760 (95%CI: .720-.801) in a receiver-operating characteristics curve (ROC) assessment. Notably, the UAR AUC value was greater than that of its components: albumin (AUC: .642) and serum uric acid (AUC: .637) ( P < .05 for both comparisons). The optimum UAR value in detecting NR in STEMI patients was >1.21 with a sensitivity of 82% and a specificity of 67%. This was the first study to report that the UAR was independently associated with NR in STEMI patients who underwent pPCI.
- Published
- 2022
34. Prognostic value of serum albumin for long-term mortality in patients with dual-chamber permanent pacemakers
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Mert İlker Hayıroğlu, Tufan Çınar, Göksel Çinier, Gizem Yüksel, Levent Pay, Kıvanç Keskin, Cahit Coşkun, Gökçem Ayan, Vedat Çiçek, and Ahmet İlker Tekkeşin
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Pacemaker, Artificial ,Biochemistry (medical) ,Clinical Biochemistry ,Drug Discovery ,Humans ,Prognosis ,Serum Albumin - Abstract
Background: This investigation aims to examine the prognostic utility of albumin concentrations for long-term all-cause mortality in patients undergoing permanent pacemaker implantation. Methods: A total of 1798 patients who received permanent pacemaker implantation were divided into quartiles according to serum albumin concentrations. The significance of albumin in predicting long-term mortality was compared in these quartiles. Results: There was a higher rate of long-term mortality in the Q4 group compared with the Q1–3 groups (49.9 vs 15.8%). The risk of long-term mortality in the Q4 group was 3.6-times higher compared with the Q1–3 groups after adjustment for confounders. Conclusion: Serum albumin level at the time of device implantation has great value when assessing long-term mortality in patients with permanent pacemakers.
- Published
- 2022
35. Comparison of outcomes between single long stent and overlapping stents: a meta-analysis of the literature
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Faysal Şaylık, Tufan Çınar, Murat Selçuk, Vedat Çiçek, Mert Ilker Hayıroğlu, and Ahmet Lütfullah Orhan
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Cardiology and Cardiovascular Medicine - Published
- 2023
36. Evaluating systemic immune‐inflammation index in patients with implantable cardioverter defibrillator for heart failure with reduced ejection fraction
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Mert İlker Hayıroğlu, Tufan Çınar, Göksel Çinier, Levent Pay, Ahmet Çağdaş Yumurtaş, Ozan Tezen, Semih Eren, Zeynep Kolak, Tuğba Çetin, Vedat Çiçek, and Ahmet İlker Tekkeşin
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Heart Failure ,Inflammation ,Male ,Predictive Value of Tests ,Humans ,Female ,Stroke Volume ,General Medicine ,Middle Aged ,Cardiology and Cardiovascular Medicine ,Aged ,Defibrillators, Implantable ,Retrospective Studies - Abstract
Background Pro-inflammatory pathways play a serious role in the follow-up of patients with intracardiac defibrillator (ICD) for heart failure reduced with ejection fraction (HFrEF). A newly defined index, which is named as systemic immune-inflammation index (SII), has been recently reported to have prognostic value in patients with cardiovascular disease. Purpose The aim of this investigation is to evaluate the value of SII in terms of its association with long-term mortality and appropriate ICD therapy during in 10-year follow-up. Methods This retrospective study included 1011 patients with ICD for HFrEF. The study population was divided into two groups according to optimal cut-off value of SII to predict long-term mortality. The long-term prognostic impact of SII on these patients were evaluated in terms of mortality and appropriate ICD therapy. Results A receiver operating characteristic curve analyses of systemic immune-inflammation index, platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in long-term mortality and appropriate intracardiac defibrillator therapy for patients intracardiac defibrillator for heart failure reduced with ejection fraction were presented in Figure 1A and 1B respectively. The patients with higher SII had significantly higher long-term mortality and appropriate ICD therapy. After adjustment for all confounding factors, the long-term mortality had 5.1 higher rates at higher SII. (95% CI: 2.9–8.1). The long-term appropriate ICD therapy also had 2.0 higher rates at higher SII (95% CI: 1.4–3.0). Kaplan Meier survival analysis of patients according to the systemic immune-inflammation index was presented in Figure 2. Conclusion SII, calculated using neutrophil, platelet, and lymphocyte counts, may be an independent predictive marker for both long-term mortality and appropriate ICD therapy in patients with HFrEF. Funding Acknowledgement Type of funding sources: None.
- Published
- 2022
37. Efficacy of atrial fibrillation predictors including MVP ECG risk score compared between single or bilateral internal thoracic artery use
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Ozan Erturk, Mert Ilker Hayıroglu, Anıl Karaagac, Yusuf Kagan Pocan, Mehmet Inanc Yesilkaya, Burak Bozkurt, Hakkı Aydogan, and Mehmet Kaplan
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Surgery ,RD1-811 ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background Atrial fibrillation (AF) is the most common complication after Coronary Artery Bypass Surgery (CABG). Despite advanced treatment methods, primary prevention is crucial. Many factors have been investigated as markers for AF, but further research is required. CABG is currently superior to Primary Coronary Intervention (PCI) in some cases due to Left Anterior Descending Artery (LAD)- Internal Thoracic Artery (ITA) anastomosis. However, graft choice for non-LAD vessels is still controversial. Our study compared the incidence of arrhythmia between patients with single ITA or bilateral ITA (BITA). Methods The study included 84 isolated CABG patients. The patients were divided into two groups: single ITA and BITA. Patients who developed AF were recorded and compared. Results 73.8%(n = 62) of the patients were male and 26.2%(n = 22) were female. While single ITA was used in 48.8%(n = 41) of the patients, BITA was used in 51.2%(n = 43). AF was detected in 15.5%(n = 13) of the patients. AF was observed in 5(12.2%) patients in the single ITA group and 8(18.6%) in the BITA group. 76.9%(n = 10) of the patients with AF rhythm had Diabetes Mellitus (DM)(p = 0.011). Biphasic P wave, length of P wave duration, and total Morpholog-Voltage-P Wave ECG (MVP ECG) score height were statistically significantly different. Conclusions The development of AF was similar in both groups. The presence of DM, high blood glucose levels, and ECG findings can detect a predisposition to postoperative AF. MVP ECG risk score is effective as an AF marker and can be used in surgical patient groups.
- Published
- 2024
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38. The significance of the morphology-voltage-P-wave duration (MVP) ECG score for prediction of in-hospital and long-term atrial fibrillation in ischemic stroke
- Author
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Murat Selçuk, Bryce Alexander, Tufan Çınar, Göksel Çinier, Selami Doğan, Vedat Çiçek, Adrian Baranchuk, Ahmet Lütfullah Orhan, Şahhan Kılıç, Mert İlker Hayıroğlu, and Mert Murat Atmaca
- Subjects
medicine.medical_specialty ,Brain Ischemia ,Electrocardiography ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Humans ,Medicine ,cardiovascular diseases ,Stroke ,Ischemic Stroke ,Framingham Risk Score ,medicine.diagnostic_test ,business.industry ,Confounding ,Atrial fibrillation ,medicine.disease ,Hospitals ,Ischemic stroke ,Cardiology ,Population study ,Observational study ,Cardiology and Cardiovascular Medicine ,business - Abstract
Atrial fibrillation (AF) is the most common preventable cause of stroke. Diagnosis of new AF is frequent after acute ischemic stroke (AIS). We aimed to evaluate the predictive value of the recently developed morphology-voltage-P-wave duration (MVP) ECG risk score for in-hospital and long-term AF diagnosis following AIS.In this observational investigation, we evaluated the ability of the MVP ECG risk score to predict AF in 266 consecutive patients with AIS. The study population was divided into three groups according to their calculated MVP ECG risk score on admission electrocardiography. The groups were compared in terms of their predictive value for in-hospital and long-term AF diagnosis.After adjustment for confounding baseline variables, MVP ECG risk score 5-6 group had 13.2 times higher rates of in-hospital AF compared to MVP ECG risk score 0-2 group, which was used as the reference group. For long-term follow-up, MVP ECG risk score 5-6 group had 5.2 times higher rates of long-term AF compared to MVP ECG risk score 0-2 group. A ROC analysis showed that the optimal cut-off value of the MVP ECG risk score to predict in-hospital AF was 4 with 78% sensitivity and 76% specificity (AUC: 0.80; 95% CI: 0.64-0.96; p 0.001), the optimal cut-off value of the MVP ECG risk score to predict long-term AF was 3 with 85% sensitivity and 59% specificity (AUC: 0.81; 95% CI: 0.76-0.86; p 0.001).The MVP ECG risk score, which can be easily calculated from a surface ECG, can be used to guide who needs stricter monitoring for the diagnosis of long-term AF in patients with AIS.
- Published
- 2021
39. Evaluation of N/LP Ratio as a Predictor of Disease Progression and Mortality in COVID-19 Patients Admitted to the Intensive Care Unit
- Author
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Basak Cakir Guney, Didar Senocak, Mustafa Kaplan, Tufan Çınar, Mert İlker Hayıroğlu, and Vedat Çiçek
- Subjects
Mechanical ventilation ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,predictive value ,business.industry ,Lymphocyte ,medicine.medical_treatment ,Disease progression ,COVID-19 ,General Medicine ,KOVID-19 ,N/LP oranı ,Anahtar kelimeler ,Intensive care unit ,law.invention ,medicine.anatomical_structure ,law ,Internal medicine ,Medicine ,Original Study ,business ,N/LP ratio ,tahmini değer ,in-hospital mortality ,hastane içi ölüm oranı - Abstract
This research aimed to evaluate whether the neutrophil to lymphocyte and platelet (N/LP) ratio may be used to predict the risk of admission to the intensive care unit (ICU), the need for mechanical ventilation and in-hospital mortality in Coronavirus disease 2019 (COVID-19) cases.The study was conducted retrospectively on the data of 134 COVID-19 patients who were admitted to the ICU. The N/LP ratio was calculated as follows: neutrophil count x 100 / (lymphocyte count x platelet count). Each member of the research cohort was categorised into 1 of 2 groups based on their survival status (survivor and non-survivor groups).In total, 82 (61%) patients died during the ICU stay. Patients who required mechanical ventilation and died in the ICU stay had significantly higher N/LP ratio than those who did not require it and survived [10 (IQR=4.94-19.38) vs 2.51 (IQR=1.67-5.49), p0.001] and [11.27 (IQR=4.53-30.02) vs 1.65 (IQR=1-3.24), p0.001], respectively. The N/LP ratio was linked with the requirement of mechanical ventilation and in-hospital death according to multivariable analysis. In receiver operating characteristic curve analysis, we found that N/LP in predicting admission to the ICU was4.18 with 61% sensitivity and 62% specificity, it was5.07 with 74% sensitivity and 73% specificity for the need for mechanical ventilation, and3.69 with 81% sensitivity and 81% specificity to predict in-hospital death.To our knowledge, this is the first study showing that the N/LP ratio, which is a novel and widely applicable inflammatory index, may be used to predict the risk of ICU admission, mechanical ventilation and in-hospital death in patients with COVID-19 disease.Bu araştırma, Koronavirüs hastalığı 2019 (KOVID-19) hastalarında nötrofil/lenfosit ve platelet (N/LP) oranının yoğun bakım ünitesine (YBÜ) kabul riskini, mekanik ventilasyon ihtiyacını ve hastane içi mortaliteyi tahmin etmek için kullanılıp kullanılamayacağını değerlendirmeyi amaçlamıştır.Çalışma, yoğun bakım ünitesine yatırılan 134 KOVID-19 hastasının verileri üzerinden geriye dönük olarak yapıldı. N/LP oranı şu şekilde hesaplandı: nötrofil sayısı x 100/(lenfosit sayısı x platelet sayısı). Araştırma grubunun her bir üyesi, hayatta kalma durumlarına göre (hayatta kalan ve hayatta kalmayan gruplar) 2 gruptan 1’ine ayrılmıştır.Toplamda 82 (%61) hasta yoğun bakımda kalış sırasında öldü. Yoğun bakım ünitesinde mekanik ventilasyona ihtiyaç duyan ve ölen hastaların N/LP oranı, gerektirmeyen ve hayatta kalanlara göre anlamlı olarak daha yüksekti [10 (IQR=4,94-19,38) vs. 2,51 (IQR=1,67-5,49), p0,001] ve sırasıyla [11,27 (IQR=4,53-30.02) vs. 1.65 (IQR=1-3,24), p0,001]. N/LP oranı, çok değişkenli analize göre mekanik ventilasyon gereksinimi ve hastane içi ölümle bağlantılıydı. Alıcı işletim karakteristik eğrisi analizinde, yoğun bakım ünitesine kabulü öngörmede N/LP’nin %61 duyarlılık ve %62 özgüllük ile4,18, mekanik ventilasyon ihtiyacı için %74 duyarlılık ve %73 özgüllük ile5.07, hastane içi ölümü öngörmede %81 duyarlılık ve %81 özgüllük ile3,69 olduğunu bulduk.Bildiğimiz kadarıyla bu, yeni ve yaygın olarak uygulanabilir bir enflamatuvar indeks olan N/LP oranının KOVID-19 hastalarında yoğun bakıma yatış, mekanik ventilasyon ve hastane içi ölüm riskini tahmin etmek için kullanılabileceğini gösteren ilk çalışmadır.
- Published
- 2021
40. Comparison of mortality prediction scores in elderly patients with ICD for heart failure with reduced ejection fraction
- Author
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A I Tekkesin, T Cetin, Kazım Serhan Özcan, Mert İlker Hayıroğlu, K Gurkan, AC Yumurtas, AT Alper, C Turkkan, Göksel Çinier, O Tezen, N Ozbilgin, L Pay, S Eren, Tufan Çınar, and Z Kolak
- Subjects
Heart Failure ,Aging ,medicine.medical_specialty ,Ejection fraction ,business.industry ,Stroke Volume ,Retrospective cohort study ,medicine.disease ,Defibrillators, Implantable ,Icd implantation ,Risk Factors ,Internal medicine ,Baseline characteristics ,Heart failure ,medicine ,Cardiology ,Humans ,Cutoff ,Observational study ,Mortality prediction ,Geriatrics and Gerontology ,Cardiology and Cardiovascular Medicine ,business ,Aged ,Retrospective Studies - Abstract
Background This investigation aimed to examine and compare the predictive value of MADIT-II, FADES, PACE and SHOCKED scores in predicting 1-year and long-term all-cause mortality in implantable cardioverter-defibrillator (ICD) implanted patients who were 75 years and over since there has been an area of uncertainty about the utility and usefulness of available risk scores in such cases. Methods In this observational, retrospective study, ICD implanted 189 geriatric patients are divided into two groups according to the presence of long-term mortality in follow-up. The baseline characteristics and laboratory variables were compared between the groups. MADIT-II, FADES, PACE and SHOCKED scores were calculated at the time of ICD implantation. 1-year and long-term predictive value of these scores were compared by a receiver operating curve (ROC) analysis. Results A ROC analysis showed that the best cut-off value of the MADIT-II score to predict 1-year mortality is 3 with 87% sensitivity and 74% specificity (AUC: 0.83; 95% CI: 0.73–0.94; p Conclusion MADIT-II score has a significant prognostic value compared to FADES, PACE and SHOCKED scores for the prediction of 1-year and long-term follow-up in geriatric patients implanted ICD for heart failure with reduced ejection fraction. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2
- Published
- 2021
41. Comment on: 'Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients'
- Author
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Tufan Çınar, Mert İlker Hayıroğlu, Vedat Çiçek, and Murat Selçuk
- Subjects
General Medicine - Published
- 2022
42. Evaluation of cardiac-electrophysiological balance according to National Institutes of Health Stroke Scale score at admission and discharge in acute ischemic stroke patients: A pilot study
- Author
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Yetkin Korkmaz, Mert İlker Hayıroğlu, Murat Selçuk, Vedat Çiçek, Selami Doğan, Murat Mert Atmaca, and Tufan Çınar
- Subjects
Adult ,Ischemic stroke ,Acute ischemic stroke ,Pilot Projects ,General Medicine ,United States ,Patient Discharge ,Stroke ,National Institutes of Health (U.S.) ,Humans ,Cardiac electrophysiologic study ,Cardiac Arrhythmia ,Ischemic Stroke ,Retrospective Studies - Abstract
SUMMARY OBJECTIVE: The main objectives of this investigation were to determine whether there were any relationships between corrected cardiac-electrophysiological balance value and National Institutes of Health Stroke Scale scores at admission and discharge in patients with acute ischemic stroke and to assess whether cardiac-electrophysiological balance value was an independent predictor of high National Institutes of Health Stroke Scale scores (National Institutes of Health Stroke Scale score ≥5). METHODS: In this retrospective and observational study, 231 consecutive adult patients with acute ischemic stroke were evaluated. The cardiac-electrophysiological balance value was obtained by dividing the corrected QT interval by the QRS duration measured from surface electrocardiography. An experienced neurologist used the National Institutes of Health Stroke Scale score to determine the severity of the stroke at the time of admission and before discharge from the neurology care unit. The participants in the study were categorized into two groups: those with minor acute ischemic stroke (National Institutes of Health Stroke Scale score=1–4) and those with moderate-to-severe acute ischemic stroke (National Institutes of Health Stroke Scale scores ≥5). RESULTS: Acute ischemic stroke patients with National Institutes of Health Stroke Scale score ≥5 had higher heart rate, QT, corrected QT interval, T-peak to T-end corrected QT interval, cardiac-electrophysiological balance, and cardiac-electrophysiological balance values compared with those with an National Institutes of Health Stroke Scale score of 1–4. The cardiac-electrophysiological balance value was shown to be independently related to National Institutes of Health Stroke Scale scores ≥5 (OR 1.102, 95%CI 1.036–1.172, p
- Published
- 2022
43. Evaluation of Naples Score for Long-Term Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
- Author
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Faysal Şaylık, Tufan Çınar, Murat Selçuk, Tayyar Akbulut, Mert İlker Hayıroğlu, and İbrahim Halil Tanboğa
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
The Naples score (NS), which is a composite of cardiovascular adverse event predictors including neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, albumin, and total cholesterol, has emerged as a prognostic risk score in cancer patients. We aimed to investigate the predictive value of NS for long-term mortality in ST-segment elevation myocardial infarction patients (STEMI). A total of 1889 STEMI patients were enrolled in this study. The median duration of the study was 43 months (IQR: 32–78). Patients were divided into 2 groups according to NS as group 1 and group 2. We created 3 models as a baseline model, model 1 (baseline + NS in continuous), and model 2 (baseline + NS as categorical). Group 2 patients had higher long-term mortality rates than group 1 patients. The NS was independently associated with long-term mortality and adding NS to a baseline model improved the model performance for prediction and discrimination of long-term mortality. Decision curve analysis demonstrated that model 1 had a better net benefit probability for detecting mortality compared with the baseline model. NS had the highest contributive significant effect in the prediction model. An easily accessible and calculable NS might be used for risk stratification of long-term mortality in STEMI patients undergoing primary percutaneous coronary intervention.
- Published
- 2023
44. The effect of 1-year mean step count on the change in the atherosclerotic cardiovascular disease risk calculation in patients with high cardiovascular risk: a sub-study of the LIGHT randomized clinical trial
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Pınar Demir Gündoğmuş, Ahmet Öz, Mustafa Kaplan, Basak Cakir Guney, Yavuz Karabağ, Selin Cilli Hayıroğlu, Muhammet Yıldırım, Ahmet İlker Tekkeşin, Göksel Çinier, Arif Karakaya, Altuğ Ösken, Asibe Özkan, Can Altundaş, Mert İlker Hayıroğlu, and Tufan Çınar
- Subjects
medicine.medical_specialty ,Atherosclerotic cardiovascular disease ,business.industry ,MEDLINE ,Atherosclerosis ,Cardiovascular System ,law.invention ,Randomized controlled trial ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Risk Factors ,law ,Internal medicine ,medicine ,Humans ,Step count ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment - Published
- 2021
45. The Triglyceride-Glucose Index Can Predict Long-Term Major Adverse Cardiovascular Events in Turkish Patients With High Cardiovascular Risk
- Author
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Mert İlker Hayıroğlu, Tufan Çınar, Vedat Çiçek, Ali Palice, Görkem Ayhan, and Ahmet İlker Tekkeşin
- Subjects
Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
There is an evidence gap regarding the predictive accuracy of the triglyceride-glucose (TyG) index for long-term major adverse cardiovascular events (MACEs) in individuals with high cardiovascular risk. The aim of this investigation was to evaluate the predictive value of the TyG index for long-term MACEs in patients at high cardiovascular risk.In total, 483 patients with high cardiovascular risk were included in this analysis. The study population was separated into 2 groups depending on the occurrence of long-term MACEs. The independent predictors of long-term MACEs in patients with high cardiovascular risk were investigated. The long-term prognostic value of the TyG index in these patients was evaluated in terms of MACEs.Age, male sex, diabetes mellitus, and the TyG index were demonstrated to be independent predictors of long-term MACE occurrence in patients with high cardiovascular risk. The TyG index was independently related to long-term MACEs in patients with high cardiovascular risk (hazard ratio, 1.003; 95% confidence interval [CI], 1.001-1.006;The TyG index was demonstrated to be an independent predictor of long-term MACE occurrence in patients with high cardiovascular risk who had not been previously diagnosed with cardiovascular disease.
- Published
- 2022
46. Evaluation of Intermountain Risk Score for Short- and Long-Term Mortality in ST Elevation Myocardial Infarction Patients
- Author
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Tufan Çınar, Faysal Şaylık, Tayyar Akbulut, Yetkin Korkmaz, Vedat Çiçek, Suha Asal, Almina Erdem, Murat Selçuk, and Mert İlker Hayıroğlu
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
The aim of this study was to examine the Intermountain Risk Score (IMRS) for short- and long-term mortality in ST elevation myocardial infarction (STEMI) patients and compare it with the well-known risk scores, such as the Thrombolysis in Myocardial Infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE). In this retrospective and cross-sectional study, 1057 consecutive patients with STEMI were evaluated. The end-points of the study were short- and long-term mortality. The overall mortality rate was 16% (n = 170 patients). The IMRS was significantly higher in STEMI patients who did not survive compared with those who survived. According to multivariable COX proportional regression analysis, the IMRS was independently related to both short- (HR: 1.482, 95% CI: 1.325–1.675, p < .001) and long-term mortality (HR: 1.915, 95% CI: 1.711–2.180, p < .001). The comparison of receiver operating characteristic curves revealed that the IMRS had non–inferior predictive capability for short- and long-term mortality than the TIMI and GRACE risk scores. To the best of our knowledge, this is the first study to show that the IMRS can predict short- and long-term prognosis of patients with STEMI. Further, the IMRS’ predictive value for overall mortality was non-inferior compared with TIMI and GRACE scores.
- Published
- 2022
47. Comparison of catheter ablation and medical therapy for atrial fibrillation in heart failure patients: A meta-analysis of randomized controlled trials
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Faysal Şaylık, Tufan Çınar, Tayyar Akbulut, and Mert İlker Hayıroğlu
- Subjects
Pulmonary and Respiratory Medicine ,Heart Failure ,Treatment Outcome ,Atrial Fibrillation ,Catheter Ablation ,Humans ,Stroke Volume ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,Anti-Arrhythmia Agents ,Randomized Controlled Trials as Topic - Abstract
The results of studies comparing the outcomes of catheter ablation (CA) to those of medical therapy (MT) for atrial fibrillation (AF) in heart failure (HF) patients are contradictory.Our objective was to conduct a meta-analysis that included randomized controlled trials (RCTs) that compared these two therapy options for AF in HF patients.We searched PubMed, Google Scholar, and the Cochrane Library for eligible studies. After reviewing all potential studies, we conducted this meta-analysis with the remaining 10 RCTs. We used a modified Jadad scale to assess the publications' quality, and we used the Risk of Bias 2 tool to assess the RCTs' bias risk.The meta-analysis comprised 2,187 patients. Patients treated with CA had a lower risk of all-cause mortality than patients treated with MT (RR=0.64 [0.5, 0.82]; p 0.01). The CA group had greater improvement in left ventricular ejection fraction (LVEF) than the MT group (mean difference [MD]=5.38 [1.80, 8.97]; p 0.01). Patients in the CA group had longer 6-min walking distances than patients in the MT group (MD=20.3 [-4.37, 44.9], p 0.01). Compared to the MT group, the CAD group demonstrated a greater reduction in scores on the Minnesota Living with Heart Failure Questionnaire (MD= -9.59 [-16.72, -2.45], p 0.01).This meta-analysis highlights the importance of CA in terms of all-cause mortality and includes the highest number of patients of any study on this topic. Moreover, compared to MT, CA therapy is associated with greater improvements in LVEF and quality of life.
- Published
- 2022
48. Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings
- Author
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George Bazoukis, Sebastian Garcia-Zamora, Göksel Çinier, Sharen Lee, Enes Elvin Gul, Jesús Álvarez-García, Gabi Miana, Mert İlker Hayıroğlu, Gary Tse, Tong Liu, and Adrian Baranchuk
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
Cardiac magnetic resonance (CMR) is a unique tool for non-invasive tissue characterization, especially for identifying fibrosis.To present the existing data regarding the association of electrocardiographic (ECG) markers with myocardial fibrosis identified by CMR - late gadolinium enhancement (LGE).A systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February 2021. In addition, we conducted a relevant search byA total of 32 studies were included. In hypertrophic cardiomyopathy (HCM), fragmented QRS (fQRS) is related to the presence and extent of myocardial fibrosis. fQRS and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients, while fQRS has also been related to fibrosis in myocarditis. Selvester score, abnormal Q waves, and notched QRS have also been associated with LGE. Repolarization abnormalities as reflected by increased Tp-Te, negative T-waves, and higher QT dispersion are related to myocardial fibrosis in HCM patients. In patients with Duchenne muscular dystrophy, a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was observed. In atrial fibrillation patients, advanced inter-atrial block is defined as P-wave duration ≥ 120 ms, and biphasic morphology in inferior leads is related to left atrial fibrosis.Myocardial fibrosis, a reliable marker of prognosis in a broad spectrum of cardiovascular diseases, can be easily understood with an easily applicable ECG. However, more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.
- Published
- 2022
49. Machine Learning Approach on High Risk Treadmill Exercise Test to Predict Obstructive Coronary Artery Disease by using P, QRS, and T waves’ Features
- Author
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Abdurrahim Yilmaz, Mert İlker Hayıroğlu, Serkan Salturk, Levent Pay, Ali Anil Demircali, Cahit Coşkun, Rahmetullah Varol, Ozan Tezen, Semih Eren, Tuğba Çetin, Ahmet İlker Tekkeşin, and Huseyin Uvet
- Subjects
General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Treadmill Exercise Test (TET) results and patients' clinical symptoms influence cardiologists' decision to perform Coronary Angiography (CAG) which is an invasive procedure. Since TET has high false positive rates, it can cause an unnecessary invasive CAG. Our primary objective was to develop a machine learning model capable of optimizing TET performance based on electrocardiography (ECG) waves characteristics and signals. TET reports from 294 patients who underwent CAG following high risk TET were collected and categorized into those with critical CAD and others. The signal was converted to time series format. A dataset containing the P, QRS, and T wave times and amplitudes was created. Using this dataset, 5 machine learning algorithms were trained with 5-fold cross validation. All these models were then compared to the performance of cardiologists on V5 signal. The results from 5 machine learning models were clearly superior to the cardiologists' V5 signal performance (P0.0001). In addition, the XGBoost model, with an accuracy of 80.92±6.42% and an area under the curve (AUC) of 0.78±0.06, was the most successful model. Machine learning models can produce high-performance diagnoses using the V5 signal markers only as it does not require any clinical markers obtained from TET reports. This can lead to significant contributions to improving clinical prediction in non-invasive methods.
- Published
- 2023
50. The Plasticity of R Wave Amplitude Due to Transmural Ischemia Triggered by Exercise Stress Test
- Author
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Ahmet Lütfullah Orhan, Mert İlker Hayıroğlu, Vedat Çiçek, Selami Doğan, and Tufan Çınar
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Internal medicine ,Cardiology ,medicine ,Ischemia ,Exercise stress ,R wave amplitude ,Plasticity ,medicine.disease ,business ,Electrocardiography - Published
- 2020
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