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2. İrritabıl Barsak Sendromunda Otonomik Fonksiyon Değerlenirmede Yeni Bir Belirteç Olarak Kalp Hızı Toparlanma İndeksi

Author

Cengiz Karacaer, Muhammed N Murat Aksoy, Ceyhun Varım, and Perihan Varım

Subjects
irritabıl barsak sendromu, kalp hızı toparlanma indeksi, otonomik disfonksiyon, heart rate recovery index, irritable bowel syndrome, Medicine
Abstract

AMAÇ: İrritabıl barsak sendromunda (IBS) otonomik fonksiyon değerlendirilmesi ile ilgili yapılan çalışmalarda sıklıkla kalp hızı değişkenliği indeksi kullanılmış ve çelişkili sonuçlar elde edilmiştir. Biz bu çalışmada kalp hızı toparlanma indeksini (KHTİ) bu hasta grubunda otonom fonksiyon değerlendirmesinde yeni bir belirteç olarak önerdik ve çalıştık YÖNTEM: Çalışmaya 35 adet IBS hastası ile yaş ve cinsiyet açısından eşitlenmiş 35 adet sağlıklı kontrol hastası dahil edildi. Bütün hastalara transtorasik ekokardiyografi ve modifiye Bruce protokolü ile egzersiz ekg testi (efor testi) uygulandı. KHTİ ölçümleri egzersiz testi ani şekilde sonlandırıldıktan sonraki 1. ve 2. Dakikalarda ölçülerek kayıt altına alındı. BULGULAR: IBS ve kontrol hasta grubu yaş, cinsiyet, hipertansiyon ve sigara içiciliği açısından karşılaştırıldığında birbirlerine benzerdi. Vücut kitle indeksi ölçümlerinde IBS grubu istatiksel anlamlı olarak daha düşük ölçülere sahipti (26±3 vs 28±5, p=0.028). KHTİ ölçümleri açısından iki grup arasında anlamlı fark saptanmadı (IBS; 34±11 vs Kontrol; 36±11, p=0.459). SONUÇ: KHTİ göz önüne alındığında, otonom fonksiyon bozukluğu İBS hastalarında primer fizyopatolojik sebep olmayabilir.

Published
2021
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3. A Case of Myocarditis Related to Salmonella Enteritis Presenting with Acute Coronary Syndrome Clinic

Author

Muhammet Raşit AYDIN, Siraceddin DELİCE, and Perihan VARIM

Subjects
Infectious Diseases, Salmonella, Miyokarditler, Gıda Zehirlenmesi, Kalp ve Kalp Damar Sistemi, Myocarditis, Food Poisoning, Cardiac and Cardiovascular Systems, Enfeksiyon Hastalıkları
Abstract

ÖZETEnfektif miyokardit bazen bakterilerle ilişkilendirilse de en yaygın olarak viral bir enfeksiyon kaynaklı olarak görülmektedir. Gastrointestinal enfeksiyonlarla ilişkili miyokardit nadir görülebilinen ve patogenezi net olarak tanımlanamamıştır. Şikâyetleri ateş, ishal ve göğüs ağrısı olan hastada akut koroner sendromu taklit eden bir miyokardit olgusunu sunuyoruz. Koroner arter risk faktörleri olmayan hastanın koroner anjiyografi ve ekokardiyografi (EKO) sonuçları normaldi. Gaita kültüründe Non-Tifoidal Salmonella (NTS) üredi ve başka hiçbir patojen bulunmadı. Miyokardit tanısı; gaita kültüründe bulunan NTS, miyokardit kliniği, laboratuvar, elektrokardiyografi (EKG) ve EKO bulgularına göre yapılmıştır. Hastaya verilen Asetilsalisilik asit, Metoprolol, Seftriakson tedavisi sonrasında hasta kliniğinde hızlı düzelme görüldü, Although infective myocarditis is sometimes associated with bacteria, it is most commonly caused by a viral infection. Myocarditis associated with gastrointestinal infections is rare and its pathogenesis has not been clearly defined.We present a case, which have complaints of fever, diarrhea and chest pain of myocarditis mimicking acute coronary syndrome. of the patient who did not have coronary artery risk factors were result normal Coronary angiography and echocardiography (ECHO). in stool culture was positive for Non-Typhoidal Salmonella (NTS) and no other pathogens were found. Myocarditis was diagnosed as a result of the detection of NTS in the stool culture, compatible clinical situation, laboratory, ECG and ECHO findings. After the Acetylsalicylic acid, Metoprolol, Ceftriaxone treatment given to the patient, rapid improvement was observed in the patient's clinic.

Published
2022

4. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author

Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Clinical Decision-Making, Risk Assessment, Severity of Illness Index, decision making, surgery, Risk Factors, Internal medicine, Intervention (counseling), medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, guidelines, Symptomatic aortic stenosis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, valvular heart disease, Disease Management, aortic stenosis, Aortic Valve Stenosis, Odds ratio, medicine.disease, Europe, Stenosis, Treatment Outcome, Echocardiography, Aortic Valve, Charlson comorbidity index, transcatheter aortic valve replacement, Female, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, surgical aortic valve replacement
Abstract

BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.

Published
2021

5. Heart Rate Recovery Index as a Novel Indicator of Autonomic Status in Irritable Bowel Syndrome

Author

Perihan Varim, Ceyhun Varim, Cengiz Karacaer, and Muhammed Necati Murat Aksoy

Subjects
Gynecology, medicine.medical_specialty, business.industry, Health Care Sciences and Services, irritabıl barsak sendromu,kalp hızı toparlanma indeksi,otonomik disfonksiyon, medicine, General Medicine, heart rate recovery index,irritable bowel syndrome, Sağlık Bilimleri ve Hizmetleri, business
Abstract

AMAÇ: İrritabıl barsak sendromunda (IBS) otonomik fonksiyon değerlendirilmesi ile ilgili yapılan çalışmalarda sıklıkla kalp hızı değişkenliği indeksi kullanılmış ve çelişkili sonuçlar elde edilmiştir. Biz bu çalışmada kalp hızı toparlanma indeksini (KHTİ) bu hasta grubunda otonom fonksiyon değerlendirmesinde yeni bir belirteç olarak önerdik ve çalıştıkYÖNTEM: Çalışmaya 35 adet IBS hastası ile yaş ve cinsiyet açısından eşitlenmiş 35 adet sağlıklı kontrol hastası dahil edildi. Bütün hastalara transtorasik ekokardiyografi ve modifiye Bruce protokolü ile egzersiz ekg testi (efor testi) uygulandı. KHTİ ölçümleri egzersiz testi ani şekilde sonlandırıldıktan sonraki 1. ve 2. Dakikalarda ölçülerek kayıt altına alındı.BULGULAR: IBS ve kontrol hasta grubu yaş, cinsiyet, hipertansiyon ve sigara içiciliği açısından karşılaştırıldığında birbirlerine benzerdi. Vücut kitle indeksi ölçümlerinde IBS grubu istatiksel anlamlı olarak daha düşük ölçülere sahipti (26±3 vs 28±5, p=0.028). KHTİ ölçümleri açısından iki grup arasında anlamlı fark saptanmadı (IBS; 34±11 vs Kontrol; 36±11, p=0.459).SONUÇ: KHTİ göz önüne alındığında, otonom fonksiyon bozukluğu İBS hastalarında primer fizyopatolojik sebep olmayabilir., Objective: There are numerous studies with conflicting results using heart rate variability as a marker for parasympathetic dysfunction in irritable bowel syndrome. In this study we aim to investigate heart rate recovery as a new tool to document autonomic status in IBS patients. Methods: We enrolled 35 IBS patients and 35 healthy age and sex matched controls in the study. All patients underwent transthoracic echocardiography and exercise ecg test with modified bruce protocol. Heart rate recovery measurements were taken at first and second minute after abrupt cessation of exercise.Results: IBS and control group were similar with respect to age, sex, hypertension and smoking status except BMI which was lower in IBS group. (26±3 vs 28±5, p=0.028). HRR values did not differ statistically between groups (IBS;34±11 vs Control;36±11, p=0,459).Conclusions: Our results suggest that autonomic imbalance might not be the primary pathophysiological mechanism in IBS patients according to HRR index.Keywords: heart rate recovery index, irritable bowel syndrome, autonomic dysfunction

Published
2020

6. Badanie służące ocenie występowania choroby wieńcowej w młodym wieku

Author

Ersan Tatli, Mustafa Tarık Ağaç, Mehmet Akif Cakar, Sabiye Yilmaz, Mehmet Bülent Vatan, Huseyin Gunduz, Saadet Demirtaş, Ercan Aydin, and Perihan Varim

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Retrospective cohort study, 030204 cardiovascular system & hematology, Overweight, medicine.disease, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, 030212 general & internal medicine, medicine.symptom, Family history, Risk factor, business, Dyslipidemia
Abstract

Introduction. An increasing number of younger patients are being hospitalized with acute coronary syndromes. Earlier risk assessment is essential to prevent or delay coronary artery disease (CAD). This study aimed to assess the rate, risk factor profile, presentation, management and prognosis in young patients with CAD and compared with the same age group without CAD. Material and methods. In this retrospective study, 4325 patients who had undergone coronary angiography from 2011 to 2014 were identified. A total of 627 patients were ≤ 45 years age; 412 of them had CAD, and 215 had normal coronary arteries (control group). Results. The mean age of the patients was 41.7 ± 4.1 years in the CAD group and 41.5 ± 4.5 years in the control group. The prevalences of dyslipidemia, smoking, family history of CAD, hypertension, diabetes, and overweight were higher in the CAD than in the control group. However, the obesity rate was not significantly different between the two groups. Patients with ACS often presented with ST elevation myocardial infarction (STEMI) (49.3%), and single-vessel involvement (55.3%) predominated. Percutaneous coronary intervention (PCI) was the main myocardial reperfusion therapy (68.4%). Conclusions. Among the young patients studied, CAD had a higher incidence in males. Smoking was the most important modifiable risk factor. Also, patients showed high prevalences of dyslipidemia, overweight, diabetes, and family history of CAD. This study re-emphasizes the relationship between traditional cardiovascular risks and CAD in young.

Published
2017

7. Demographics of patients ≥ 80 years with heart failure who were admitted to the cardiology clinics in Turkey

Author

Lütfü Bekar, Sinan Cersit, Alper Buğra Nacar, Fatih Mehmet Uçar, Ahmet Sayın, Uğur Canpolat, Erdal Belen, Kaan Okyay, Şükrü Çetin, İbrahim Ersoy, Kadir Uğur Mert, Gülten Taçoy, Mehmet Erturk, Atike Nazlı Akciğer, Namik Ozmen, Yeşim Hoşcan, Servet Altay, Oğuzhan Çelik, Muhammed Bora Demirçelik, Sabiye Yilmaz, Volkan Doğan, Şeref Alpsoy, Hatem Ari, Sedat Köroğlu, Erkan Yildirim, Sabahattin Gündüz, Mustafa Ozan Gürsoy, Aykut Yılmaz, Süleyman Karakoyun, Kadriye Memiç Sancar, Selami Demirelli, Abdullah Tuncez, Mahmut Yesin, Sibel Çatırlı Enar, Ersel Onrat, Seref Ulucan, Ebru İpek Türkoğlu, Özcan Başaran, Cengiz Ozturk, Çiğdem Koca, Perihan Varim, Nazile Bilgin Doğan, Mehdi Zoghi, Emine Altuntas, Gültekin Günhan Demir, Elif Tunc, Onur Aslan, İsmail Türkay Özcan, Ayşen Helvacı, Gülay Gök, Derya Baykız, Şeyda Günay, İsa Öner Yüksel, Salih Kilic, Cevat Şekuri, Görkem Kuş, Yılmaz Ömür Otlu, Kürşat Arslan, Meltem Didem Kemaloğlu, Feza Güzet, Raşit Coşkun, Mutlu Çagan Sümerkan, Müjgan Tek Öztürk, Emre Yalçınkaya, Dilek Çiçek YIlmaz, Alparslan Birdane, Gökhan Aksan, Ahmet Yanık, Turhan Turan, Yusuf Emre Gürel, Vedat Davutoğlu, Mehmet Reşat Baha, Gonul Aciksari, Bülent Özlek, Lale Tokgozoglu, İsmail Şahin, Sinan Inci, Mehmet Hayri Alıcı, Volkan Kozluca, Utku Şenol, Hasan Aydın Bas, Volkan Emren, Ibrahim Altun, Dursun Çayan Akkoyun, Murat Biteker, Vedat Aslan, and Ümit Yaşar Sinan

Subjects
medicine.medical_specialty, Turkish population, Ejection fraction, business.industry, Mortality rate, Prevalence, 030204 cardiovascular system & hematology, medicine.disease, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Heart failure, Internal medicine, Diabetes mellitus, Epidemiology, medicine, Cardiology, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVE Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. METHODS The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: ≥50%). RESULTS A total of 1098 patients (male, 47.5%; mean age, 83.5+-3.1 years) aged ≥80 years and 4596 patients (male, 50.2 %; mean age, 71.1+-4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were ≥80 years and 27.1% for patients 65-79 years old. For patients aged ≥80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p

Published
2019

8. RELATIONSHIP BETWEEN CAROTID ARTERY DOPPLER FLOW VELOCITY AND EXTENT OF CORONARY ARTERY DISEASE

Author

Gündüz, Yasemin, Akdemir, Ramazan, Gündüz, Hüseyin, Perihan Varim, Lacin Tatli Ayhan, Çakar, Mehmet Akif, Vatan, Mehmet Bülent, Kılıç, Harun, Gunduz, Y, Akdemir, R, Gunduz, H, Varim, P, Ayhan, LT, Cakar, MA, Vatan, MB, Kilic, H, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Gündüz, Yasemin, Akdemir, Ramazan, Gündüz, Hüseyin, Çakar, Mehmet Akif, Vatan, Mehmet Bülent, and Kılıç, Harun

Subjects
cardiovascular system, Cardiovascular System & Cardiology, cardiovascular diseases
Abstract

Conclusion: To Patients with carotid artery disease have a high incidence of concomitant coronary artery disease, which is not different between the patients treated conservatively and stenting. In addition, the extension of coronary artery disease (not the presence) were associated with these two Doppler parameters.

Published
2019

9. Usefulness of the platelet-to-lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography

Author

Mehmet Sevki Uyanık, Bilgehan Atılgan Acar, Ramazan Akdemir, Türkan Acar, Perihan Varim, Ceyhun Varim, Mehmet Bülent Vatan, Tezcan Kaya, Varim, C, Varim, P, Acar, BA, Vatan, MB, Uyanik, MS, Kaya, T, Acar, T, Akdemir, R, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Varım, Ceyhun, Acar, Bilgehan Atılgan, Vatan, Mehmet Bülent, Kaya, Tezcan, Acar, Türkan, and Akdemir, Ramazan

Subjects
Male, medicine.medical_specialty, Lymphocyte, Research & Experimental Medicine, 030204 cardiovascular system & hematology, Severity of Illness Index, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Severity of illness, Humans, Medicine, Carotid Stenosis, Carotid artery stenosis, Platelet, Lymphocyte Count, Aged, Medicine(all), lcsh:R5-920, medicine.diagnostic_test, Platelet Count, business.industry, Angiography, Area under the curve, General Medicine, Middle Aged, medicine.disease, Confidence interval, body regions, Stenosis, Carotid Arteries, medicine.anatomical_structure, ROC Curve, Cardiology, Female, Radiology, medicine.symptom, lcsh:Medicine (General), business, 030217 neurology & neurosurgery
Abstract

Carotid artery stenosis (CAS) is primarily caused by atherosclerotic plaque. Progressive inflammation may contribute to the rupture of an atherosclerotic plaque. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study, we aimed to investigate the use of the PLR to determine the severity of CAS. One hundred forty patients were chosen from among patients who underwent carotid angiography in our institution. Symptomatic patients with stenosis >50% in the carotid arteries and asymptomatic patients with stenosis >80% were diagnosed via carotid angiography as having critical stenosis. Patients were classified into two groups. Group 1 included patients who had critical CAS, whereas Group 2 included patients with noncritical CAS, as determined by carotid angiography. Correlations between the PLR and the severity of CAS were analyzed. There were no significant differences in sex and age between the two groups. The PLR was 162.5 +/- 84.7 in the noncritical CAS group patients and 94.9 +/- 60.3 in the critical CAS group patients (p < 0.0001). The PLR value of 117.1 had 89% sensitivity and 68% specificity for CAS [95% confidence interval, 0.043-0.159; area under the curve, 0.101 +/- 0.03)]. In this study, we have shown that PLR values may be associated with critical stenosis in at least one of the carotid arteries. Furthermore, PLR values may be used to predict critical stenosis in the carotid arteries. Copyright (C) 2016, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.

Published
2016
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11. Does Vitamin D Deficiency Effect Heart Rate Variability in Low Cardiovascular Risk Population?

Author

Ahmet Nalbant, Tezcan Kaya, Ali Tamer, Mehmet Bülent Vatan, Perihan Varim, and Ceyhun Varim

Subjects
medicine.medical_specialty, vitamin D deficiency, Autonomic dysfunction, Population, Cardiology, lcsh:Medicine, 030204 cardiovascular system & hematology, QT interval, sudden cardiac death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Heart rate, medicine, Vitamin D and neurology, Heart rate variability, 030212 general & internal medicine, education, education.field_of_study, medicine.diagnostic_test, business.industry, lcsh:R, heart rate variability, General Medicine, Clinical Science, medicine.disease, Medicine, business, Electrocardiography
Abstract

AIM: This study aimed to evaluate the cardiac autonomic dysfunction and the cardiac arrhythmia risk using heart rate variability parameters in subjects with vitamin D deficiency and low cardiovascular risk.MATERIAL AND METHODS: One hundred five consecutive individuals, 54 patients with low vitamin D status and 51 healthy controls were enrolled in this study. The overall cardiac autonomic tone was quantified by using various heart rate variability parameters included mean RR interval, mean Heart Rate, mean of standard deviations of intervals for 24 hours (SDNN), standard deviation of averages of intervals (SDANN), mean of standard deviation of intervals for 5 minutes (SDNNI), root mean square of difference of successive intervals (rMSSD) and the proportion of intervals differing more than 50 ms (pNN50) values. The 12-lead ECG was recorded from each participant, and QT intervals were measured.RESULTS: Baseline demographic profiles were similar between two groups. The heart rate variability parameters such as mean RR interval, mean HR, SDNN, SDANN, SDNNI, rMSSD and pNN50 (%) values were not significantly different in patients with low vitamin D status compared to control group. The electrocardiography analysis revealed only slight but significant prolongation of corrected QT (QTc) intervals in the control group.CONCLUSION: HRV variables were not significantly altered in patients with vitamin D deficiency in low cardiovascular risk profile group. Further studies evaluating these findings in other cohorts with high cardiovascular risk are required.

Published
2017

12. QT dispersion in irritable bowel syndrome

Author

Mehmet Bülent Vatan, Selcuk Yaylaci, Ceyhun Varim, Cengiz Karacaer, and Perihan Varim

Subjects
medicine.medical_specialty, business.industry, Qt dispersion, Internal medicine, medicine, medicine.disease, business, Gastroenterology, Irritable bowel syndrome
Abstract

Background: The pathogenesis of irritable bowel syndrome (IBS) has not been fully elucidated. The gastrointestinal tract have a well-differentiated intrinsic nervous system and also this system is connected with nervous system. The symptoms of IBS are related with autonomic nervous system (ANS). It was also possible to see cardiovascular symptoms due to this link. This link can influence QT dispersion (QTd). The aim of this case control study is to show the cardiac effects of IBS by changes in QTd.Methods: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in this study. IBS was diagnosed using the new Roma IV Criterias. Standard 12-lead electrocardiogram (ECG) were taken in both two groups. QTd and corrected QTd (QTcd), QT max, QT min, QT avarage, Corrected QT (QTc) min, QTc max, QTc avarage values were calculated with Bazzet Formula from rest ECGs.Results: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in the study (p:0.94). The mean age of the patients and control patients were 51.75±10.41 years and 48.41±9.72 (p: 0.53) years, respectively. QTd and corrected QTd (QTcd), QT max, QT min, QT mean, Corrected QT (QTc) min, QTc max, QTc mean values were calculated. QTd and QTcd values were found to be significantly higher in the patients with IBS (40.2±7.18; 34.1±6.18 / 52±9.8; 50.6±7.61 Msec, respectively). It is concluded that, QTd (p: 0.022) and QTcd (p: 0.032) were significantly incresased in the IBS.Conclusions: Activation of ANS in the patients with IBS can affect QT period in ECG.

Published
2019

13. Frequency of cardiovascular diseases in the patients with restless legs syndrome

Author

Cengiz Karacaer, Feyzi Gokosmanoglu, Selcuk Yaylaci, Ceyhun Varim, Bilgehan Atılgan Acar, Perihan Varim, Türkan Acar, and Hasret Cengiz

Subjects
0301 basic medicine, medicine.medical_specialty, Ambulatory blood pressure, business.industry, Case-control study, Atrial fibrillation, medicine.disease, Left ventricular hypertrophy, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Blood pressure, Internal medicine, mental disorders, medicine, Cardiology, Restless legs syndrome, business, Body mass index, 030217 neurology & neurosurgery, Dyslipidemia
Abstract

Background: Restless Legs Syndrome (RLS) is a sensory-motor neurological disease characterized by discomfort, unpleasant sensations, an urge to move the legs. There are a lot of studies showing the association between Restless Legs Syndrome (RLS), Cardiovascular Diseases (CVD), Hypertension (HT) and Body Mass Index (BMI). The potential underlying mechanism of an increased risk of CVD in RLS is not clear but may involve hypertension, as Periodic Limb Movements during Sleep (PLMS) were shown to be related to blood pressure increases. These studies were inconsistent. The aim of this case control study was to show the prevalence of CVD in the patients with RLS compared with a control group.Methods: A total of 37 newly diagnosed patients with RLS (group 1) who were applied to neurology polyclinic of Sakarya University Hospital between March 2016 and May 2017 and 37 control subjects (group 2) were included in this case control study. RLS was diagnosed using the criteria of the International RLS Study Group. Both groups were screened for HT, dyslipidemia, coronary artery diseases, atrial fibrillation. 24hour Ambulatory Blood Pressure Monitoring (ABPM) were enrolled for both groups. Interventricular septum was measured with echocardiography by cardiologist for diagnosis of left ventricular hypertrophy.Results: There were no significant differences in sex (p:0.11) and age (p:0.33) between the two groups. Hypertension (p:0.001) and non-dipper hypertension (p:0.004), BMI (p:0.004), left ventricular hypertrophy (p:0,002) were found statistically significantly higher than the control group. There were no differences in atrial fibrillation (p:1) and hyperlipidemia (p:0.69) between two groups.Conclusions: Patients with RLS should be followed closely for cardiovascular diseases.

Published
2019

14. Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine

Author

Tezcan Kaya, Perihan Varim, Ceyhun Varim, Ali Tamer, Hakan Cinemre, Ahmet Nalbant, Nalbant, A, Cinemre, H, Kaya, T, Varim, C, Varim, P, Tamer, A, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Nalbant, Ahmet, Cinemre, Hakan, Kaya, Tezcan, Varım, Ceyhun, and Tamer, Ali

Subjects
Acute coronary syndrome, medicine.medical_specialty, Population, Acute myocardial infarction, 030204 cardiovascular system & hematology, Chest pain, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, General & Internal Medicine, Internal medicine, medicine, Myocardial infarction, cardiovascular diseases, Neutrophil to lymphocyte ratio, Renal insufficiency, education, education.field_of_study, biology, business.industry, fungi, General Medicine, medicine.disease, Troponin, Elevated serum creatinine, biology.protein, Cardiology, Original Article, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Background and objective Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio(NLR) is an independent predictor of acute coronary syndrome. Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction (AMI) among patients with elevated serum creatinine. Methods Patients with elevated creatinine levels evaluated for coronary artery disease were included (n=284). Patients were divided into two groups according to having AMI or non-specific chest pain. AMI diagnosis was made based on clinical and laboratory data, including serial EKG and cardiac enzymes, ECHO and coronary angiography. Results Troponin, neutrophil, and NLR were found to be higher in patients with AMI, compared to patients without AMI (P= 0.001, P= 0.001 and P=0.028, respectively). ROC curve analysis for NLR in diagnosing AMI was significant (AUC: 0.607; P=0.003). Sensitivity, specificity, LR +, LR-, PPV and NPV for NLR>7.4 were found as 42.3%, 74.7%, 1.68%, 0.77%, 77% and 40%, respectively. Logistic regression analysis revealed that patients whose NLR>7.4 were 2.18 times as likely to have AMI. Conclusions NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending.

Published
2016

15. Echocardiographic Evaluation of Biventricular Function in Patients with Euthyroid Hashimoto's Thyroiditis

Author

Sabiye Yilmaz, Mustafa Tarık Ağaç, Mehmet Akif Cakar, Ceyhun Varim, Murat Aksoy, Harun Kilic, Perihan Varim, Mehmet Bülent Vatan, Hakan Erkan, Ramazan Akdemir, Huseyin Gunduz, Vatan, MB, Varim, C, Agac, MT, Varim, P, Cakar, MA, Aksoy, M, Erkan, H, Yilmaz, S, Kilic, H, Gunduz, H, Akdemir, R, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Vatan, Mehmet Bülent, Varım, Ceyhun, Ağaç, Mustafa Tarık, Çakar, Mehmet Akif, Aksoy, Muhammed Necati Murat, Kılıç, Harun, Gündüz, Hüseyin, and Akdemir, Ramazan

Subjects
Male, Thyroiditis, medicine.medical_specialty, Heart Ventricles, Hashimoto Disease, Ventricular Function, Left, Biventricular function, Internal medicine, General & Internal Medicine, Ventricular Dysfunction, Humans, Medicine, Euthyroid, In patient, Original Paper, Ejection fraction, business.industry, General Medicine, Fractional shortening, Left ventricle, Middle Aged, Control subjects, medicine.disease, Echocardiography, Doppler, Endocrinology, Echocardiography, Cardiology, Right ventricle, Female, Tei index, Tricuspid Valve, business
Abstract

Objective: The aim of this study was to evaluate the left (LV) and right (RV) ventricular function in euthyroid Hashimoto's thyroiditis (eHT) patients. Subjects and Methods: Forty-five patients diagnosed with eHT and 45 age- and gender-matched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities (E, A, E', A'), isovolumic relaxation (IVRT) and contraction (IVCT) times, ejection time (ET), deceleration time (DT), Tei index, pulmonary acceleration time (PAcT) and tricuspid annular plane systolic excursion (TAPSE) of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signed-rank test. Results: Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index (0.6 ± 0.2 vs. 0.4 ± 0.1, p < 0.001), higher DT (p < 0.001) and IVRT (p < 0.001) values, and higher E/E' ratios (p = 0.04). In contrast, the peak E wave velocity (p = 0.02), E/A ratio (p = 0.01) and ET (p = 0.02) were significantly lower in the eHT group than amongst the controls. The RV, Tei index (0.40 ± 0.11 vs. 0.28 ± 0.07, p < 0.001), TAPSE (2.0 ± 0.3 vs. 2.2 ± 0.2 mm, p < 0.001), PAcT (124.3 ± 22.6 vs. 149.4 ± 18.3 ms, p < 0.001), A' (p = 0.007) and IVCT (p = 0.001) were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio (p = 0.01), E' (p = 0.03) and E'/A' ratio (p = 0.001) were significantly lower in the eHT patients than the control group. Conclusions: This study demonstrated that both RV and LV functions were impaired in patients with eHT.

Published
2016

16. A probable case of kounis syndrome after bee stings

Author

Ceyhun Varim, Sabiye Yilmaz, Perihan Varim, Harun Kilic, and Bülent Vatan

Subjects
medicine.medical_specialty, Cath lab, business.industry, medicine.medical_treatment, Kounis syndrome, General Medicine, medicine.disease, Bee stings, Sting, Right coronary artery, medicine.artery, Internal medicine, Angioplasty, medicine, Cardiology, Coronary care unit, Myocardial infarction, business
Abstract

Bee sting may cause hypersensitivity reaction with a range from simple allergic reaction to life-threatening anaphylactic response. Although rare, cardiac involvement is a possible complication, varying from vasospasm to acute ST-elevation myocardial infarction. In this case, a 61-year old man was presented to our hospital with ST elevation acute myocardial infarction of inferior wall after bee sting and he was immediately transferred to the cath lab for primary percutaneous coronary interventions. Coronary angiogram showed that the right coronary artery was occluded, angioplasty of the infarct related artery was successfully performed and the patient was transferred to the coronary care unit for further treatment. Patient status stabilized during the further clinical course and he was finally discharged with the appropriate maintenance drug therapy. The emergency physicians could be aware of the possibility of Kounis syndrome during hypersensitivity reactions in order to perform appropriate diagnostic and therapeutic measures in due time.

Published
2014

17. Recurrent Embolization of a Left Atrial Myxoma Resulting in Acute Cerebral Ischemia

Author

Saadet Demirtaş, Ercan Aydin, Selcuk Atakay, Mehmet Bülent Vatan, Huseyin Gunduz, Perihan Varim, Mehmet Akif Cakar, and Yasemin Gunduz

Subjects
Ischemic Heart Diseases, medicine.medical_specialty, Acute coronary syndrome, Arterial dissection, business.industry, medicine.medical_treatment, Ischemia, Omics, medicine.disease, Surgery, Internal medicine, Cardiology, medicine, Embolization, Left Atrial Myxoma, Cardiology and Cardiovascular Medicine, business
Published
2011

18. Acute myocardial infarction due to simultaneous occlusions of the left anterior descending artery and right coronary artery

Author

Mehmet Bülent Vatan, Efe Edem, Mustafa Türker Pabuccu, and Perihan Varim

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Coronary Angiography, Article, Sudden cardiac death, Electrocardiography, medicine.artery, Internal medicine, medicine, Humans, cardiovascular diseases, Myocardial infarction, business.industry, Cardiogenic shock, General Medicine, Emergency department, Middle Aged, medicine.disease, Thrombosis, Coronary arteries, medicine.anatomical_structure, Coronary Occlusion, Right coronary artery, Cardiology, Stents, business, Artery
Abstract

Thrombosis of multiple coronary arteries at the same time is an uncommon angiographic finding during the course of ST-segment elevation myocardial infarction (STEMI). This clinical condition usually leads to cardiogenic shock or even sudden cardiac death. We present a case of a man who presented with STEMI due to simultaneous occlusions of the left anterior descending artery (LAD) and right coronary artery (RCA). A 57-year-old man was referred to our emergency department due to central chest pain and ST-segment elevations in anterior and inferior leads (figure 1). He did not have any particular diseases or well-described risk factors in his medical history. Based on ECG findings, his LAD was thought to …

Published
2015

19. Usefulness of the platelet-to-lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography

Author

Ceyhun Varım, Perihan Varım, Bilgehan Atılgan Acar, Mehmet Bülent Vatan, Mehmet Sevki Uyanık, Tezcan Kaya, Turkan Acar, and Ramazan Akdemir

Subjects
Carotid artery stenosis, Lymphocyte, Platelet, Medicine (General), R5-920
Abstract

Carotid artery stenosis (CAS) is primarily caused by atherosclerotic plaque. Progressive inflammation may contribute to the rupture of an atherosclerotic plaque. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study, we aimed to investigate the use of the PLR to determine the severity of CAS. One hundred forty patients were chosen from among patients who underwent carotid angiography in our institution. Symptomatic patients with stenosis >50% in the carotid arteries and asymptomatic patients with stenosis >80% were diagnosed via carotid angiography as having critical stenosis. Patients were classified into two groups. Group 1 included patients who had critical CAS, whereas Group 2 included patients with noncritical CAS, as determined by carotid angiography. Correlations between the PLR and the severity of CAS were analyzed. There were no significant differences in sex and age between the two groups. The PLR was 162.5 ± 84.7 in the noncritical CAS group patients and 94.9 ± 60.3 in the critical CAS group patients (p

Published
2016
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20. Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine.

Author

Nalbant A, Cinemre H, Kaya T, Varim C, Varim P, and Tamer A

Abstract

Background and Objective: Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio(NLR) is an independent predictor of acute coronary syndrome. Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction (AMI) among patients with elevated serum creatinine., Methods: Patients with elevated creatinine levels evaluated for coronary artery disease were included (n=284). Patients were divided into two groups according to having AMI or non-specific chest pain. AMI diagnosis was made based on clinical and laboratory data, including serial EKG and cardiac enzymes, ECHO and coronary angiography., Results: Troponin, neutrophil, and NLR were found to be higher in patients with AMI, compared to patients without AMI (P= 0.001, P= 0.001 and P=0.028, respectively). ROC curve analysis for NLR in diagnosing AMI was significant (AUC: 0.607; P=0.003). Sensitivity, specificity, LR +, LR-, PPV and NPV for NLR>7.4 were found as 42.3%, 74.7%, 1.68%, 0.77%, 77% and 40%, respectively. Logistic regression analysis revealed that patients whose NLR>7.4 were 2.18 times as likely to have AMI., Conclusions: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending.

Published
2016
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