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    Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis
    (Medical Association of Zenica-Doboj Canton, 2016) Boyraz, İsmail; Çağlar, Sabri Onur; Erdem, Fatma; Yazıcı, Mehmet; Yazıcı, Selma; Koç, Bünyamin
    Aim To investigate whether there is a relation between neutrophil-lymphocyte (N/L) and platelet- lymphocyte (P/L) ratios and epicardial adipose tissue (EAT) thickness in patients with ankylosing spondylitis (AS). Methods Thirty patients diagnosed with ankylosing spondylitis and 25 healthy people (controls) were included in the study. Age, gender, body mass index (BMI), height, hemogram, sedimentation, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, CRP, hepatic and renal function tests, lipid profile of the all patients were recorded. Data related to duration of the disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values of the cases in the patient group were obtained. A cardiologist measured EAT thickness by ECHO in both patient and control groups. Results In the patient group, mean BASDAI and BASFI scores were 2.48±2.21 and 1.5±2.07, respectively. Age, gender, BMI values did not show statistically significant difference between the patient and the control groups. N/L and P/L ratios did not change significantly in the patient group having higher EAT, BASFI values and taking anti-TNF compared to the control group. Conclusion In patients with AS, EAT measurements, which are related to inflammatory response increase, can be used for monitoring of the risk of development of cardiac disease. We could not find the relation between EAT and N/L, P/L ratios in terms of evaluation of inflammatory response. © 2016, Medical Association of Zenica-Doboj Canton. All rights reserved.
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    Batı Karadeniz bölgesindeki akut koroner sendromlu hastalarda psikiyatrik hastalıkların görülme sıklığı
    (2013) Yıldırım, Osman; Çağlar, Sabri Onur; Canan, Fatih; Erdem, Alim
    Amaç: Koroner yoğun bakım ünitesine Akut Koroner Sen drom (AKS) tanısı ile yatırılan hastalardaki yatış öncesi psik iyatrik hastalık sıklığını belirlenmesi amaçlandı . Yöntem: Bu çalışmada Ocak 2011 - Nisan 2013 yılları arasında Abant İzzet Baysal Üniversitesi Hastanesine başvurup Koroner yoğun bakım ünitesine AKS tanısı ile yatırılan hastaların retrospektif olarak dosyalar ve bilgisayar ortamındaki hasta bilgileri taranarak bu grup hastalardaki psikiyatrik ilaç kull anımı ve bu hastalara konulan psikiyatrik tanılar saptandı. Bulgular : Bu tarihler arasında koroner yoğun bakıma yatış yapılmış toplam 467 hasta saptandı. Bu hastaların 373 tanesi erkek, 94 tanesi kadın olup, bu hastaların yaş ortalaması 63,2 ± 15.4 yıldı. Bu hastaların %17.5’ünde (n=82) psikiyatrik hastalık tanısı mevcuttu. Bu hastaların % 42.2 depresyon, %30.6 anksiyete bozukluğu, %10.5’nin anksiyete bozukl uğu+depresyon, %10.2’sindede somatoform bozukluk, %4.8’nin psikotik bozukluk ve %1.7’ninde bipolar bozukluk olduğu saptandı. Psikiyatrik hastalık tanısı alan hastaların %64.6’i kadın (n=53), %35.4’ü erkekti (n=29) (p<0.05) Bu hastaların yaş ortalaması 58.2 ± 12.1 yıl iken, kadınlarda bu ortalama 52.12 ± 10.98 yıl iken erkekle rde ise 59.13 ± 13.24 yıl idi (p<0.05). Sonuç : Bu bölgedeki AKS tanısı ile koroner yoğun bakıma yatırılan hastaların psikiyatrik hastalık sıklığı literatürde bildirilen genel dağılımla benzerlik göstermekte olduğunu saptadık. Bu hasta grubunda hastalık öncesi özellikle kadın hastalarda psikiyatrik tanıya sahip olunmasının ve tedavi takibinin önemli olduğunu düşünmekteyiz.
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    Coexistence of Ectasia and Myocardial Bridge on the Same Coronary Artery Segment
    (2015) Çağlar, Sabri Onur; Erdem, Fatma; Alçelık, Aysegül
    Coronary artery ectasia (CAE) is the dilatation of coronary artery segment just about 1.5 times than normal adjacent segment. Myocardial bridge (MB) is rare congenital anomaly of coronary arteries, characterized by systolic compression of the vessel segment. In this article, we report on a case of the coexistence of CAE and MB in the same segment of left anterior descending artery (LAD) in an 82 year old patient with acute coronary syndrome.
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    Electrophysiological validation of total atrial conduction time measurement by tissue doppler echocardiography according to age and sex in healthy adults
    (Elsevier Science Bv, 2016) Erdem, Fatma Hizal; Erdem, Alim; Özlü, Fatih; Öztürk, Serkan; Ayhan, Suzi Selim; Çağlar, Sabri Onur; Yazıcı, Mehmet
    Background: We sought to validate total atrial conduction time (TACT) measurement via tissue Doppler imaging (TDI) by comparing the electrophysiological study (EPS) measurements of healthy subjects, according to age and sex. Methods: Eighty patients with normal EPS results were included. TACT was measured by EPS and TDI. For validation, the results of TDI were compared with those of EPS. TACT was assessed by measuring the time interval between the beginning of the P-wave on the surface ECG, and the peak A-wave on TDI from the left atrial lateral wall, just over the mitral annulus. Electrophysiological TACT was defined as the time from the high right atrial electrogram to the distal coronary sinus atrial electrogram around the left lateral portion of the mitral ring. Results: EPS and TDI measurements of the TACT were significantly and positively correlated among men and women in 20-30 years (p=0.008, r=0.412; p > 0.001, r=0.706, respectively), and those in the 30-40 years group (p=0.001, r=0.649; p=0.001, r=0.696). In contrast, EPS and TDI measurements of TACT were not significantly different among men and women in the 20-30 years and those in the 30-40 years group (p > 0.05, for both). On univariate regression analyses, TACT was independently associated with age (beta=0.342, =0.001). Conclusions: When assessed according to the age and sex of healthy participants, TDI and EPS measurements during TACT assessments were similar and correlated with each other. The measurement of TACT via TDI may be used accurately and confidently than the measurement via EPS in healthy individuals. (C) 2015 Japanese Heart Rhythm Society. Published by Elsevier B.V.
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    Evaluation of atrial conduction times, epicardial fat thickness and carotid intima-media thickness in patients with ankylosing spondylitis
    (Turkish League Against Rheumatism, 2016) Çağlar, Sabri Onur; Boyraz, İsmail; Erdem, Fatma; Yazıcı, Selma; Çağlar, Hilal
    Objectives: This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature. Patients and methods: The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3 +/- 8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2 +/- 8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups. Results: Interatrial (29.5 +/- 5.8 ms vs. 17.9 +/- 5.3 ms) left and right intraatrial EMD (18.2 +/- 4.6 ms and 11.7 +/- 3.5 ms vs. 11.9 +/- 3.2 ms and 7.1 +/- 3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50 +/- 0.11 mm and 0.44 +/- 0.06 mm vs. 0.51 +/- 0.11 mm and 0.43 +/- 0.04 mm, respectively) and EFT (0.73 +/- 0.15 cm and 0.63 +/- 0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01). Conclusion: To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.
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    Evaluation of Atrial Conduction Times, Epicardial Fat Thickness and Carotid Intima-Media Thickness in Patients With Ankylosing Spondylitis
    (2016) Çağlar, Sabri Onur; Boyraz, Ismail; Erdem, Fatma; Yazici, Selma; Caglar, Hilal; Koç, Bünyamin; Çağlar, Emrah
    Objectives: This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature.Patients and methods: The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3±8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2±8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups.Results: Interatrial (29.5±5.8 ms vs. 17.9±5.3 ms) left and right intraatrial EMD (18.2±4.6 ms and 11.7±3.5 ms vs. 11.9±3.2 ms and 7.1±3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50±0.11 mm and 0.44±0.06 mm vs. 0.51±0.11 mm and 0.43±0.04 mm, respectively) and EFT (0.73±0.15 cm and 0.63±0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01).Conclusion: To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.
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    Giant coronary artery and slow flow phenomenon in young patient with acute coronary syndrome
    (2015) Çağlar, Sabri Onur; Erdem, Fatma; Suzi, Selim Ayhan; Yazıcı, Mehmet
    [No Abstract Available]
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    A new diagnostic tool for masked hypertension: impaired sleep quality
    (Termedia Publishing House Ltd, 2016) Erdem, Fatma Hızal; Çakır, Uğur; Yıldırım, Osman; Alçelik, Aytekin; Dönmez, İbrahim; Tuman, Taha Can; Çağlar, Sabri Onur
    Introduction: The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension. Material and methods: A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Hotter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results: The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 +/-2.43 vs. 2.33 +/-1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 +/-3.21 vs. 3.58 +/-2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI. Conclusions: This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.
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    New diagnostic tool for masked hypertension; impaired sleep quality
    (2015) Erdem, Fatma Hızal; Çakır, Uğur; Yıldırım, Osman; Alçelik, Aytekin; Dönmez, İbrahim; Tuman, Taha Can; Çağlar, Sabri Onur; Erdem, Alim; Yazıcı, Mehmet
    Background: The aim of this study was to evaluate a relationship between MHTand impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension (MHT). Methods: A total of 112 individuals, 72 patients with new diagnosed MHT and 40 normotensive healthy volunteers were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography (ECG), transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests.Additionally,all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results: The total PSQI score was significantly higher in the MHT group than in the normotensive healthy volunteers (4.13±2.43 vs. 2.33±1.67, p<0.001). A PSQI score >5 was found in 45.8% (n=33) of patients in the MHT group and 15% (n=6) of patients in the normotensive group (p<0.001). Non-dipper pattern was found %17.5 in healthy volunteer group, however %59.94 (n=41) in MHT group (p<0.001). When we compared the dipping pattern of the MHT groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87±3.21 vs. 3.58±2.33, p<0.001). Conclusions: This study demonstrates impaired sleep quality in subjects with MHT, particularly those with a non-dipper pattern. Additionally, this study indicates impaired sleep quality maybe helped diagnose of MHT, particularly in the nondipper group.
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    NORMAL BASINÇLI HİDROSEFALİNİN NEDEN OLDUĞU PAROKSİSMAL ATRİYAL FİBRİLASYON OLGUSU
    (2015) Çağlar, Sabri Onur; Erdem, Fatma; Türkoğlu, Şule Aydın
    ÖZET Atriyal fibrilasyon (AF) klinik pratikte sık görülen bir ritim bozukluğudur. Yaş, diabetes mellitus, hipertansiyon, kalp yetmezliği, sigara, obezite, erkek cinsiyet, miyokard infarktüsü, valvüler kalp hastalığı, pulmoner hastalıklar ve hipertiroidi AF için risk faktörleridir. Mevcut bilgilerimize göre paroksismal AF ile normal basınçlı hidrosefali (NPH)birlikteliği daha önce bildirilmedi. Burada yeni başlangıçlı AF ile NPH birlikteliğini sunuyoruz. 53 yaşında bayan hasta acil sevişe 45 dakika önce başlayan çarpıntı şikayeti ile başvurdu. Çekilen elektrokardiyografi (EKG)’si AF ile uyumluydu. Medikal kardiyoversiyon uygulandı. Medikal kardi- yoversiyon sonrası normal sinüs ritmi(NSR)’ne dönmedi. Daha sonra 100 j ile bifazik elektriksel kardiyoversiyon uygulandı. Elektriksel kardiyoversiyon sonrası NSR elde edildi. Hastanın anamne- zinde bir haftadır olan yürüme güçlüğü mevcuttu. Nöroloji tarafından değerlendirilen hastaya be- yin MR istendi. MR ventrikülomegali ile uyumluydu. 25 ml’lik beyin omurilik sıvısının boşaltılması sonrası hastanın klinik bulguları normale döndü. Bu yüzden hekimler, NPH’ın AF’ye yol açabilece- ğini akılda bulundurmalıdır.