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Öğe Anxiety and depression scores in patients with coronary artery disease and coronary artery ectasia(Elsevier Ireland Ltd, 2015) Öztürk, Selçuk; Yalvaç, Hayriye Dilek; Sivri, Nasır; Öztürk, Hayriye Mihrimah; Kılıç, Yasemin; Bulut, Eda; Çelik, Arzu; Barlas, YeşimÖğe Coronary artery ectasia is associated with atrial electrical and mechanical dysfunction: an observational study(2012) Öztürk, Serkan; Özyaşar, Mehmet; Ayhan, Selim Suzi; Özlü, Mehmet Fatih; Erdem, Alim; Alçelik, Aytekin; Öztürk, SelçukAmaç: Bizim çalışmamızın amacı, izole koroner arter ektazisi (İKAE) olan hastalarda total atriyal ileti süresi ve sol atriyal (SA) mekanik fonksiyonların araştırılmasıdır. Yöntemler: Enine-kesitli gözlemsel bu çalışmaya, herhangi bir darlığı olmayan 60 İKAE’li hasta alındı. Kontrol grubu yaş ve cinsiyet açısından eşleştirilen 40 bireyden oluşturuldu. Sol atriyal mekanik fonksiyonlar disk metoduyla apikal dört boşluktan ölçüldü. Sol atriyal mekanik fonksiyon parametreleri hesaplandı. P dalga dispersiyonu yüzey elektrokardiyografisinden (EKG) ölçüldü. Total atriyal ileti süresi, yüzey EKG’sinde P dalgasının başından, doku Doppler ile mitral lateral duvardan ölçülen A’ dalgasının tepesine kadar olan zaman aralığı olarak ölçüldü. İstatistiksel analizde; Student t, Mann-Whitney U, Pearson ve Spearman korelasyonu ve çoklu doğrusal regresyon analizi kullanıldı. Bulgular: Klinik ve laboratuvar bulgular açısından gruplar benzerdi. Her iki grupta Vmaks ve SA total boşalma oranı benzerdi (31.9±6.5 karşı 29.0±7.3 mL/$m^{2}$, p=0.082 ve 20.0±5.2 vs. 19.9±5.1 mL/$m^{2}$, p=0.821). Ancak, SA pasif boşalma hacmi ve SA pasif boşalma oranı İKAE hastalarında anlamlı olarak azalmıştı (11.1±3.2 karşı 13.5±3.8 mL/$m^{2}$, p=0.005 ve 35.2±7.2 karşı 47.8±9.4 mL/$m^{2}$, p<0.001). Fakat SA aktif boşalma hacmi ve SA aktif boşalma oranı İKAE hastalarında anlamlı olarak artmıştı (9.1±2.6 karşı 6.4±3.0 mL/$m^{2}$, p< 0.001 ve 45.3±8.1 karşı 40.7±6.7mL/$m^{2}$, p=0.002). Total atriyal ileti süresi İKAE grubunda normal gruba göre anlamlı olarak daha uzun ölçüldü (131.8±5.7 karşı 114.4±9.1 ms, p<0.001). Çoklu doğrusal regresyon analizinde ektazik segment sayısı total atriyal ileti süresinin bağımsız bir faktörü olarak tespit edildi (?=0.581, %95 GA=4.046-6.295, p<0.001). Sonuç: Bu çalışma İKAE’li hastalarda SA elektriksel ve mekanik fonksiyonlarının bozulduğunu gösteren ilk çalışmadır. Bozulmuş olan SA fonksiyonları kardiyak aritmiler, azalmış kardiyak atım hacmi ve kalp yetersizliği ile ilişkili olabilir. (Anadolu Kardiyol Derg 2012; 12: 637-43)Öğe The effects of ivabradine on left atrial electromechanical function in patients with systolic heart failure(Springer, 2016) Öztürk, Serkan; Öztürk, Selçuk; Erdem, Fatma Hizal; Erdem, Alim; Ayhan, Selim; Dönmez, İbrahim; Yazıcı, MehmetAim Heart rate (HR) reduction with ivabradine improves left ventricle filling by the prolongation of the diastolic time and increases stroke volume. But, it remains unclear what ivabradine's effect is on atrial conduction time and atrial mechanical functions. The aim of our study was to evaluate in stable outpatients with systolic heart failure (HF) the 3 months effect of ivabradine on atrial conduction time and mechanical functions. Method We evaluated prospectively 43 (31 males, 12 females) patients with HF. Before and after treatment, all patients were evaluated by transthoracic M mode, two dimensional (2D), pulsed-wave (PW), continuous wave (CW), color flow and tissue Doppler imaging (TDI), and LA volumes were obtained apical four-chamber views by a disc's method. LA maximum volume (Vmax) at the end-systolic phase, LAminimum volume (Vmin) at the end-diastolic phase, and LA volume before atrial systole (Vp) were evaluated. The LA function parameters were calculated as follows: LA passive emptying volume=Vmax -Vp; LA passive emptying fraction = [(Vmax -Vp)/Vmax] x100%, LA active emptying volume= Vp-Vmin; LA active emptying fraction=[(Vp-Vmin)/Vp] x100%. Results Thirty men and 13 women with mean +/- SD age of 63.9 +/- 10.1 years were included in this study. Resting heart rate was significantly reduced after ivabradine treatment. There were no significantly difference in LVEF, and E/A before and after ivabradine treatment. LA diameter and Vmin were similar before and after ivabradine treatment (p= 0.793 and p = 0.284). However, Vmax and Vp were significantly decreased after ivabradine treatment (p = 0.040 and p = 0.012). Moreover, LA active emptying volume and LA active emptying fraction were significantly decreased after ivabradine treatment (p= 0.030 and p= 0.008). The PA lateral, septal, and tricuspid durations were significantly reduced after ivabradine treatment (p< 0.001, p< 0.001, and p= 0.002, respectively). Interatrial electromechanical delay and right intraatrial electromechanical delay were significantly decreased after ivabradine treatment (33.7 +/- 12.7 vs 26.2 +/- 10.1, p = 0.001; and 14.1 +/- 6.1 vs 9.2 +/- 6.8, p< 0.001). Conclusions The present study demonstrated that adding ivabradine to the standard therapy reduced HR and improves significantly LA electrical and mechanical functions in systolic HF patients.Öğe The effects of ivabradine on left ventricular synchronization and Tei index in patients with systolic heart failure(Taiwan Soc Cardiology, 2017) Erdem, Fatma Hizal; Öztürk, Serkan; Öztürk, Selçuk; Erdem, Alim; Ayhan, SelimBackground: The aim of our study was to evaluate in stable outpatients with systolic heart failure (HF) the 3 months effect of ivabradine on LV synchronization and Tei index in stable outpatients with systolic HF. Methods: We evaluated prospectively 40 (30 males, 10 females) patients with HF. All patients were evaluated before and after treatment by transthoracic M mode, two dimensional (2D), pulsed-wave (PW), continuous wave (CW), color flow and tissue Doppler imaging (TDI) and tissue synchronization imaging (TSI). Standard deviation of Ts of the 12 LV segments (Ts-SD-12) is the most widely used parameter of intra-LV asynchrony. Results: Thirty men and 10 women with mean +/- SD age of 64.7 +/- 9.9 years were included in this study. Most of the patients benefitted from some degree of clinical improvement, 12/16 (75.0%) from NYHA III to II and 18/24 (75.0%) from II to I, respectively. Resting heart rate was significantly reduced after ivabradine treatment (84.3 +/- 11.4 vs. 66.5 +/- 11.5 bpm, p <0.001). E/E' and Tei index were significantly changed after ivabradine treatment (17.3 +/- 9.0 vs. 14.8 +/- 7.1, p = 0.02 and 0.86 +/- 0.74 vs. 0.81 +/- 0.69, p = 0.02). Intra-LV synchrony parameters Ts-SD-12 and Ts-12 were significantly reduced after ivabradine (46.8 +/- 13.6 vs. 42.7 +/- 13.1, p = 0.01 and 142.5 +/- 44.0 vs. 128.5 +/- 45.2, p = 0.009). Conclusions: The present study demonstrated that adding ivabradine to the standard therapy reduced HR and significantly improved LV ventricular asynchrony and Tei index in systolic HF patients.Öğe Effects of patients anxiety and depression scores on coronary flow in patients with normal coronary arteries(Elsevier Ireland Ltd, 2015) Yalvaç, Dilek; Öztürk, Selçuk; Sivri, Nasır; Kılıç, Yasemin; Bulut, Eda; Çelik, Arzu; Barlas, YeşimCoronary slow flow phenomenon first described by Tambe et al. in 1972, is a coronary microvascular disorder characterized by the delayed passage of contrast in the absence of obstructive epicardial coronary disease [1], [2]. Quantitatively, it is measured as increased Thrombolysis in Myocardial Infarction (TIMI) frame count. TIMI frame count, introduced by Gibson [3], is a reproducible index of coronary flow. Although the exact processes are not known well yet, microvascular dysfunction or abnormal vasomotion is one of the most forthcoming mechanism underlying SCF phenomenon [2], [4], [5], [6], [7], [8], [9], [10]. Anxiety and depression has been shown to be associated with increased risk of cardiovascular events, progression of atherosclerosis and death [11]. Accordingly we aimed to assess the possible relation of patients' anxiety and depression status on coronary flow pattern in patients with angiographically normal coronary arteries, and slow coronary flow phenomenon.Öğe Golden ratio and the heart: a review of divine aesthetics(Elsevier Ireland Ltd, 2016) Yalta, Kenan; Öztürk, Selçuk; Yetkin, ErtanIn human history, certain mathematical figures or concepts had gained a significant reputation largely due to their occult and esoteric meanings. Among these, Golden Ratio and associated concepts, namely golden proportions, had elicited a tremendous breakthrough in our human awareness and perception regarding mundane and spiritual aspects of physical existence. Golden Ratio or Number (with a numerical value of 1.618) that is also referred to as the Greek letter Phi (phi), has been universally expressed on a line partitioned into two unequal lengths (L, the longer and S, the shorter) in such a manner that L / S = (L + S) / L. Besides, appearing in certain number sequences (Fibonacci Series, etc.), golden proportions, to the consternation of observers, appear to be strikingly prevalent across all levels of physical existence from the innermost structures to the colossal galaxies of the universe potentially labeling these concepts as the measures of divine aesthetics. Accordingly, the human body also serves as an epitome of these mysterious concepts as exemplified by its outward appearance including general stature and extremities along with a variety of inner organ systems. Based on preliminary studies, the human cardiovascular system might also be suggested to serve as a major predilection site of divine aesthetics as measured with Golden Ratio and its allies. This appears to be completely in line with the ancient knowledge associating the human heart with the esoteric and spiritual components of human nature including human soul. Within this context, the present paper primarily aims to discuss human manifestations of divine aesthetics as measured with 'Golden Ratio' and associated indices with a particular and detailed emphasis on their potential link with the human cardiovascular system.Öğe Golden ratio: a subtle regulator in our body and cardiovascular system?(Elsevier Ireland Ltd, 2016) Öztürk, Selçuk; Yalta, Kenan; Yetkin, ErtanGolden ratio, which is an irrational number and also named as the Greek letter Phi (phi), is defined as the ratio between two lines of unequal length, where the ratio of the lengths of the shorter to the longer is the same as the ratio between the lengths of the longer and the sum of the lengths. The so-called formula is a mathematical ratio and there exist a variety of examples in natural andman-made structures of great beauty. Moreover, golden ratio is expressed throughout the human body in some ways, including digits, uterus, teeth, and cardiovascular system. Although the association of Fibonacci series or golden ratio with systems and organs of human being has not been assessed in depth yet, the mainstream regulation of cardiovascular system seems to be associated with golden ratio. This raises the idea that there might have been a fine and subtle regulator in our body. In this article, we aimed to elaborate the relationship between the existence of golden ratio and the human body and to discuss the golden ratio and its association with cardiovascular system. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Identifying symptoms in chronic venous diseases(Elsevier Science Bv, 2016) Öztürk, Selçuk; Yetkin, ErtanDear Editors, We have read the article published by Hansrani et al. [1] with great interest. In their well defined case control study, they have evaluated the venous symptoms in patients with pelvic vein incompetence (PVI) and varicose veins (VV). They have recruited 40 premenopausal women with PVI and VV, 40 premenopausal women only with VV and 40 healthy controls without PVI and VV. They have found that, PVI patients suffer more pelvic pain than the VV patients and healthy controls. They have also found that quality of life in PVI patients are lower than healthy controls and these patients need more national health system resources. According to these results, there are several take home messages. Peripheral varicose veins and pelvic peins are linked by a volume or pressure load or direct connections. In the light of this association, we can state that venous reflux or dilatation in these vascular systems might be originated from a generalized vascular wall disease [2]. It is very important to identify the symptoms in this patient group because of the decreased quality of life and increased hospital admissions in these patients as the authors mentioned in their study [1]. These patients should be assessed with a more detailed history of their complaints. The prevalence of chronic venous diseases is high in elderly population and these patients have comorbid diseases. Also assessment of venous symptoms is difficult in this population [3]. Due to the selection of younger patients and the absence of comorbid diseases like pregnancy, renal failure, heart failure, liver failure, venous thromboembolism, malignancy, hysterectomy allowed the authors to evaluate the venous symptoms more detailed. This condition makes their study more valuable. However, we need further studies to explain the symptomatology and pathophysiology of chronic venous diseases.Öğe Kronik kalp yetmezliği hastalarında ivabradin tedavisinin atriyal ileti sürelerine etkisinin değerlendirilmesi(Bolu Abant İzzet Baysal Üniversitesi, 2014) Öztürk, Selçuk; Öztürk, SerkanAmaç: İvabradin tedavisiyle kalp hızının azaltılması diyastol süresinin uzaması neticesinde sol ventrikül dolumunu arttırır ve bu durum da kalbin atım hacmini arttırır. İvabradinin atrial ileti sürelerine ve atrial mekanik fonksiyonları üzerindeki etkisi yeterince çalışılmamıştır. Bu çalışmada biz stabil kalp yetersizliği bulunan hastalarda ivabradin tedavisinin atrial ileti süreleri ve atrial mekanik fonksiyonları üzerindeki kısa dönem etkisini (3 ay) incelemeyi amaçladık. Yöntem: Çalışmaya Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi' nin kardiyoloji polikliniğine başvuran hastalar dahil edildi. Hastalar yaş ve cinsiyete göre sınıflandırıldıktan sonra azalmış sol ventrikül ejeksiyon fraksiyonu (? 35 %), NYHA 2- 3 kalp yetersizliği olan ve en az 5 dakika istirahat neticesinde çekilen 12 derivasyonlu elektrokardiyografide kalp hızı 70/ dk ve üzerinde olan hastalar çalışmaya dahil edildi. 34 erkek ve 9 kadın hasta olmak üzere toplamda 43 hastayı inceledik. Tedavi öncesinde ve 3 aylık tedavi sonrasında hastaların transtorasik M mode, iki boyutlu, noktasal akım, devamlı akım, renkli akım ve doku doppler ölçümleri yapıldı. Tedavi öncesinde ve sonrasında sol atriyum hacimleri hesaplandı. Doku doppler ölçümleriyle intraatrial ve interatrial elektromekanik gecikme süreleri hesaplandı. Sonuçlar: Çalışmaya yaş ortalamaları 64.7 ± 9.9 olan, 33 erkek ve 9 kadın hasta dahil edildi. Bütün hastalar çalışmaya dahil edilme sürecinde NYHA 2- 3 sınıfındaydı. İstirahat sırasında çekilen elektrokardiyografilerinde hastaların hepsi sinüs ritmindeydi ve ortalama kalp hızları dakikada 84.4 ± 12.2 atım olarak hesaplandı. Vmax ve Vp değerlerinin ivabradin tedavisi sonrasında anlamlı olarak azaldığı gözlendi (94.6 ± 37.7, 85.9 ± 28.6, p = 0.04, 75.6 ± 34.3, 67.7 ± 28.6, p = 0.012). Ayrıca sol atriyum boşalma fraksiyonunun da tedavi sonrası azaldığı gözlendi (22.4 ± 10.6, 17.6 ± 9.1, p= 0.03). İnteratriyal elektromekanik gecikme süresinin (PA lateral-PA tricuspit) ivabradin tedavisi sonrasında anlamlı olarak azaldığı tespit edildi (33.7 ± 12.7, 26.2 ± 10.1 , p = 0.001). Tartışma: Çalışmamızın sonuçları göstermektedir ki, üç aylık ivabradin tedavisi sonrasında atrial ileti süreleri anlamlı olarak kısalmaktadır ve atrial elektromekanik fonksiyonlar anlamlı olarak düzelmektedir.Öğe Successful thrombolytic therapy in a patient with congenital corrected transposition of the great arteries(2016) Öztürk, Selçuk; Erdem, Fatma; Öztürk, Serkan; Ayhan, SelimOBJECTIVE: The aim of this report is to emphasize the importance of thrombolytic therapy in selected patients, such as those with congenital heart defects in whom a coronary artery anomaly can be observed.CASE REPORT: We present here a 63 year-old female patient who was admitted to our emergency department with ST segment elevation myocardial infarction and a history of a congenital heart defect. We treated the patient successfully with thrombolytic therapy instead of primary percutaneous intervention, because of the suspicion of a coronary artery anomaly. On the following day, we performed coronary angiography on the patient, which revealed the anomalous origin of the coronary arteries, with the left and right coronary arteries originating from the right sinus of Valsalva and the circumflex artery originating from the left sinus of Valsalva. This anomaly in this patient group is described for the first time.CONCLUSION: Coronary artery anomaly may be observed in patients with congenitally corrected transposition of the great arteries, and in the case of requiring emergency reperfusion, thrombolytic treatment can be an alternative strategy in this patient group. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.Öğe Very late stent thrombosis in a patient presenting with acute carbon monoxide poisoning(Aves, 2017) Öztürk, Selçuk; Ayhan, Selim; Dönmez, İbrahim; Erdem, Fatma; Erdem, AlimIntroduction: Carbon monoxide (CO), which is commonly referred to as the silent killer, can cause deleterious and unwanted cardiac effects. Some of these are arrhythmias, acute myocardial infarction (AMI), cardiogenic shock, heart failure, and pulmonary edema. Case Report: A 50-year-old man, complaining of dyspnea and chest pain, presented to the emergency room approximately half an hour after exposure to fire smoke. He had a history of anterior myocardial infarction 3 years previously and had been treated with a tacrolimus-eluting stent at that time. On admission, electrocardiography showed ST segment elevation in the leads D1, aVL, and V1-3, and ST segment depression in the reciprocal leads. The patient was transferred to the cardiac catheterization laboratory, and coronary angiography revealed stent thrombosis in the proximal part of the left anterior descending artery, causing 100% occlusion. The patient underwent successful balloon angioplasty and stenting. For the treatment of acute CO poisoning, he was administered oxygen. The patient's condition continued to be stable, and he was discharged from the coronary intensive care unit. Conclusion: Patients who have undergone coronary stenting, particularly those in whom drug-eluting stents have been implanted, should be carefully investigated for AMI, stent thrombosis, or any other cardiac complications in the emergency room after CO poisoning.Öğe Where to begin: from the electrocardiogram or the symptoms?(Elsevier Ireland Ltd, 2016) Öztürk, Selçuk; Turhan, Hasan; Yetkin, ErtanDear Editor, We have read the article published by Brembilla-Perrot et al. [1] with great interest. In their study, they have aimed to search the symptom characteristics in patients suspected of supraventricular tachycardiam (SVT) in which the SVT cannot be documented noninvasively. Briefly, they have analyzed 2650 patients, age ranging from 6 to 97, and ran- domized them according to their electrophysiological study (EPS) re- sults whether SVT was inducible during EPS or not. In their study, they have found that among patients whom suspected of SVT but not docu-mented noninvasively, chest pain and/or syncope and age b 40 years is associated with negative EPS results. They have concluded that, in this patient group in the absence of documented SVT, EPS is not indicated [1]. Although, there are several take home messages that might be gath-ered from these results, we believe that symptomatology of SVT pa-tients needs to be discussed in the light of this study. The main and most common types of symptoms in SVT are palpita-tion, pulsation in the neck, chest discomfort, dyspnea, hyperventilation, lightheadedness and anxiety. Chest pain, nausea and syncope are less frequent symptoms in this patient group. Sometimes, these patients can survive asymptomatic [2]. In non-documented tachycardia attacks, symptoms of the patients can be misleading because of the short dura- tion and atypical presentation of the episodes. Due to the elevation of troponin levels and chest pain or chest discomfort, these patients are diagnosed as acute coronary syndrome occasionally and sometimes coronary angiography is performed [3]. Although it is not the aim of this study, it would be nice to know whether coronary angiography was performed in these patients. And their biomarker levels might be suggestive of myocardial ischemia, especially in the older patient group. Moreover possible cross-talk through the cardiac plexus, cervi-cal, thoracic plexus, and cranial nerves has been supposed to be the mechanism of extraordinary symptoms of SVT such as burping, tinnitus, and cough attacks.
