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Öğe Abdominal wall hematoma related to severe cough in a patient under antiaggregant and anticoagulant therapy(Springer-Verlag Italia Srl, 2012) Özlü, Mehmet Fatih; Ayhan, Suzi Selim; Öztürk, Serkan; Erdem, Alim; Yazıcı, MehmetA 56-year-old woman with coronary artery disease presented with the complaint of chest pain. She was hospitalized with the diagnosis of acute coronary syndrome. She was taking acetylsalicylic acid, metoprolol, atorvastatin and isosorbide mononitrate for coronary artery disease. The medical history included: diabetes mellitus, hypertension, and coronary artery bypass grafting surgery. The blood pressure was 170/100 mmHg and the heart rate was 94 beats/min.Öğe Acil servisden akut koroner sendrom nedeniyle yatırılan hastaların birinci derece yakınlarının kalp hastalığı bilirlilik düzeyleri: Anket çalışması(2013) Ocak, Tarık; Duran, Arif; Öztürk, Serkan; Tekelioğlu, Ümit Yaşar; Erdem, Alim; Ayhan, Selim S.Amaç: Çalışmamızda, sağlık sektörü dışındaki genel popüla syonun miyokart enfarktüsü (MI) geçiren hastaların tanınması ve yapılması gereken ilk müdahale konusunda bilgi düzeyi ve yaklaşımlarını incelemeyi amaçladık. Yöntem: Araştırmacılar tarafından, MI geçiren kişilerdeki klinik bulgular ile ilk müdahalede yapılması gerekenleri sorgulayan bir anket oluşturuldu ve 250 gönüllü kişi tarafı ndan doldurulması sağlandı. Gönüllüler özellikle sağlık sektörü dışından seçildi. Bulgular : Katılımcılara sorulan "Sizce hastalıklara bağlı en sık ölüm nedir " sorusuna kadınların %45.1’i kalp krizi, %47.2’si kanser derken aynı soruya erkeklerin ise % 63.9’u kalp krizi, %22.2’si kanser cevabı verdiler. Katılımcıl a ra sorulan "Yalnız başınıza çevrenizde MI geçirdiğini düşü n düğünüz biri ile karşılaşırsanız ne yaparsınız? " sorusuna %92.4’ü acil servisi arayacağını (ka dınlarda %57, erkeklerde %40.7), %31,2’si hastanın bulu n duğu odayı havalandıracağını (kadınlarda %31.7, erkeklerde %30.6), %20.4’ü hastaya aspirin vereceğ ini (kadınlarda %21.8, erkeklerde %18.5), %7.6’sı ise ne yap acağı konusunda bilgisi olmadığını ifade etti (kadınlarda %7.2, erkeklerde %4.3). Sonuç : Bu çalışmanın sonucunda MI yaygınlığı ve mortalitesi konusunda özellikle kadınlarda farkındalığın daha az olduğu görülmüştür. MI’daki tipik bulgular konusunda göğüs ağrısı dışında diğer bulguların yeterince bilinmediği kanısına varılmıştır. MI ile karşılaşılacak bir durumda ise popülasyonun acil servisi arama dışında yapılması gerekenler konusunda yeterli bilgi seviyesine sahip olmadığı anlaşılmıştır. MI’ne müdahalede en önemli kısmı oluşturan tanı ve ilk müdahale konusunda toplum çapında yaygın eğitim programlarının uygulanması gerekli olduğunu düşünmekteyiz.Öğe Acute coronary syndrome developed after vincristine administration(2011) Öztürk, Serkan; Baltacı, Davut; Ayhan, Selim; Yazıcı, Mehmet; Sarıtaş, AyhanVincristine and doxorubicin are among the most effective chemotherapeutic agents used in the treatment of malignancies in combination per protocols. However, these chemotherapeutic agents possess great risk for development of cardiotoxicity. The most common manifestations of cardiotoxicity due to use of those chemotherapeutic agents are arrhythmias, systolic dysfunction, cardiomyopathy, pericardial injury and myocardial ischemia. We present a case of acute coronary syndrome with complete atrio-ventricular (AV) block, developed after vincristine and doxorubicin chemotherapy in a patient with multiple myeloma and no cardiac history.Öğe Açıklanamayan çarpıntı nedeniyle elektrofizyolojik çalışma yapılan hastalarda yaşam kalitesi ve kaygı düzeylerinin değerlendirilmesi(2013) Özlü, Mehmet Fatih; Yıldırım, Osman; Erdem, Alim; Öztürk, Serkan; Ayhan, Suzi Selim; Canan, Fatih; Yazıcı, MehmetAmaç: Belgelenememiş çarpıntı atakları nedeniyle yapılan elektrofizyolojik çalışma (EFÇ) sonucu normal veya anormal olan hastaların yaşam kalitesi ve kaygı düzeyleri açısındankarşılaştırılması amaçlandı. Çalışma planı: Çalışmaya çarpıntı yakınması olan, aritmileri elektrokardiyografi (EKG) ile belgelenmemiş ve EFÇ yapılan 128 hasta alındı. EFÇ ile supraventriküler taşikardi (SVT) saptanan hastalar ile EFÇ sonucu normal olan hastalar Dünya Sağlık Örgütü yaşam kalitesi ölçeğinin 26 maddelik kısa formu ve durumluk-sürekli kaygı envanteri ile değerlendirilerek yaşam kalitesi ve kaygı düzeyi açısından karşılaştırıldı. Bulgular: Tanısal EFÇ işlemi sonucunda 72 hastada SVT saptandı. SVT’li grubun yaşam kalitesi skorları EFÇ’leri normal grupdakilere göre anlamlı derecede daha kötü bulundu (p=0.000-0.001). Aynı şekilde SVT’li hastalarda kaygı skorları da EFÇ’leri normal gruba göre daha yüksekti (p=0.000). Çok değişkenli regresyon analizinde yaş, bedensel alan yaşam kalitesi, ruhsal alan yaşam kalitesi, durumluk kaygı ve sürekli kaygı SVT’nin bağımsız öngördürücüleri olarak bulundu. Sonuç: Çarpıntı yakınması SVT’ye bağlı olan hastalarda kaygı düzeyi daha yüksek ve yaşam kalitesi de daha düşük bulunmuştur. Klinik uygulamada çarpıntı yakınması olan hastalar değerlendirilirken fark edilen psikiyatrik semptomların altta yatan aritmiye sekonder olabileceği de göz önünde bulundurulmalıdır.Öğe Akut koroner sendrom hastalarında klinik özelliklerin ve transport zamanının akut koroner sendrom sınıflamasına göre karşılaştırılması(2011) Baltacı, Davut; Öztürk, Serkan; Durmuş, İsmet; Kandiş, Hayati; Çelik, ŞükrüAmaç: Akut koroner sendrom hastalarında akut koroner sendrom sınıflarına göre klinik özelliklerin araştırılması amaçlanmıştır. Metot ve Materyal: Çalışma kesitsel tip bir çalışma olup bir universite hastanesi koroner yoğun bakım ünitesinde akut koroner sendrom (AKS) nedeni ile yatırılan hastalarda yapılandırılmış çalışma anketi uygulanarak yapılmıştır. Ankette hastaların klinik ve sosyodemografik özellikleri ile transport zamanaları sorgulanmıştır. Bulgular: 34-88 yaş arası ve yaş ortalaması 60,74±12,43 olan 152 olgu alınmıştır. Olguların 39’u kadın geriye kalan 112’si erkek hastalardan oluşmaktadır. Hastaların çoğunluğu (n=114,%74,5) STsegment Elevasyonlu miyokart Enfarktüsü (STEMI) olgularından oluşurken, %24,5’i ST-segment Elevasyonsuz Miyokart Enfarktüsü (NSTEMI) hastalarından (n=37,%24,5) oluşmuştur. Çalışmadaki olguların çoğunluğunun eğitim düzeyi ilkokul veya altındaydı. Sigara içenlerin sayısı da (n=84, %55,6) yüksek oranda saptandı. Olguların %84,8’inde (n=128) tipik anginal semptomlar gözlemlenmiştir. Hastaların akut koroner sendrom başlangıcı esnasında %36,4’ünün (n=55 ) istirahat halinde olduğu saptanmıştır. Hastalarımızın %60,9 u (n=92) pre-enfarkt angina tariflemiştir. Çalışmadaki hastaların şikayetleri genellikle akşam ve sabah saatlerinde (n= 46, %30,5; n=45, %29,8 sırayla) ortaya çıkmıştır. STEMI olguları NSTEMI olgularına göre yaş ortalaması daha düşük (59,2 ±12,0; 65,5±13,3); kadın/erkek oranı ise NSTEMI grubunda daha yüksek bulunmuştur (13/24 vs 88/26). NSTEMI grubunda bulunan hastalar anlamlı olarak daha çok atipik göğüs ağrısı ile başvurdu (p=0.03) ve yine NSTEMI grubunda, öncesinde Mİ hikayesi olan hasta sayısının da daha fazla olduğu saptanmıştır (p=0.019). Eşlik eden diyabet, hipertansiyon ve koroner arter hastalığı NSTEMI hastalarında STEMI’ e göre sayıca daha fazla bulunmuştur (p=0.02). Sonuç: Çalışmamızda STEMI ve NSTEMI vakaları klinik özellikler açısından aralarında bazı farklılıkların olduğu gösterilmiştirÖğe Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes(2013) Öztürk, Serkan; Erdem, Alim; Özlü, Mehmet Fatih; Ayhan, Selim; Erdem, Kemalettin; Özyaşar, Mehmet; Yazıcı, MehmetObjectives: It is well known that inflammation plays a key role in both initiation and propagation of acute coronary syndrome (ACS). White blood cell (WBC) and its subtypes are an indicator of inflammation in patients with ACS. We aimed to evaluate the WBC and its subtypes in patients aged <45 year with acute coronary syndromes. Study design: We retrospectively analyzed WBC and its subtypes (including neutrophil and lymphocyte) in 84 patients (<45 year) who were admitted to the emergency department for chest pain suggestive of ACS (44 unstable angina pectoris, 40 non-ST-segment elevation myocardial infarction [NSTEMI]), and 40 healthy controls. Results: Hypertension, diabetes mellitus, smoking, and family history were significantly higher in NSTE-ACS patients. Also, LDL levels was significantly higher and HDL levels was significantly lower in NSTE-ACS patients (p=0.041 and p=0.009). The difference in percent of lymphocytes between the groups was significant (p=0.048). N/L ratio was significantly different between all groups and between the NSTEMI and USAP (p<0.001 and p=0.041). Our results demonstrated that hypertension, percent of neutrophils, and N/L ratio was a significant independent predictor of NSTE-ACS (Beta=0.251, 95% CI=0.002-0.523, p=0.048; beta=0.561, 95% CI=0.008-0.137, p=0.028 and beta=0.260, 95% CI=0.042-0.438, p=0.018, respectively). Conclusion: N/L was found to be elevated in young patients with NSTE-ACS compared with control group. The inflammation assessed using WBC and its subtypes may be more important in young NSTE-ACS patients.Öğe Assessment of the relationship between aortic pulse wave velocity and aortic arch calcification(2012) Öztürk, Serkan; Baltacı, Davut; Ayhan, Suzi Selim; Durmuş, İsmet; Gedikli, Ömer; Yazıcı, MehmetObjectives: We aimed to assess arterial stiffness parameters and to investigate the relationship between these parameters and aortic calcification in patients with aortic arch calcification and without symptomatic atherosclerotic disease. Study design: The population of this study consisted of 41 patients with aortic arch calcification verified by chest X-ray (group I, 17 males, mean age 70±5 years) and individuals without aortic arch calcification (group II, 17 males, mean age 68±6 years). Subjects with symptomatic or known vascular disease were excluded from the study. The arterial stiffness parameters of all subjects were measured noninvasively with a SphygmoCor device. Aortic pulse wave velocity (PWV), augmentation pressure (AP), augmentation index (AIx) and heart rate normalized augmentation index (AIx@75) were used as parameters of arterial stiffness. Results: The two groups were compared according to demographic characteristics, medications currently being taken, and levels of serum lipids. There was no significant difference between the groups. AP in group I was significantly higher than that of group II (p=0.002). AIx and AIx@75 were similar in both groups. Aortic PWV of group I was significantly higher than that of group II (p<0.0001). Conclusion: According to the results of this study, the presence of aortic calcification, verified by chest radiography, was associated with increased aortic PWV.Öğe Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose(Springer, 2012) Ayhan, Selim; Öztürk, Serkan; Alçelik, Aytekin; Özlü, Mehmet Fatih; Erdem, Alim; Memioğlu, Tolga; Özdemir, Mesut; Yazıcı, MehmetProlonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography. Thirty patients with IFG (19 males and 11 females; age, 46.9 +/- 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 +/- 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area-length method. LA mechanical function parameters were calculated. LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (beta = 0.753, p < 0.001). We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.Öğe Atrial electrical and mechanical dysfunction in non-diabetic, nonhypertensive hemodialysis patients(Carbone Editore, 2014) Tekçe, Hikmet; Öztürk, Serkan; Aktaş, Gülali; Tekçe, Buket Kın; Erdem, Alim; Üyetürk, Uğur; Özyaşar, Mehmet; Duman, Tuba Taslamacıoğlu; Yazıcı, MehmetBackground: Abnormalities in atrial conduction times and mechanical functions are considered as independent predictors of atrial fibrillation. However, there is no data in literature about functional parameters and electromechanical delay intervals in nondiabetic, non-hypertensive hemodialysis (HD) patients. We aimed to study atrial electromechanical conduction times and mechanical functions in this population. Methods: Forty-two non-diabetic, normotensive hemodialysis patients and age and sex matched control subjects have been enrolled in the study. Standard and Tissue Doppler Echocardiography have been performed before mid-week dialysis session for HD group and on admission for control group. Results: PA(lateral,), PA(septum) durations of the hemodialysis group were significantly longer than control group (70.6 +/- 9.1 vs 55.3 +/- 2.7, 50.8 +/- 5.2 vs 44.4 +/- 2.1; p<0.01). Interatrial and left-right intraatrial electromechanical delay intervals were significantly longer in hemodialysis group compared to controls (31.6 +/- 7.2 vs 18.0 +/- 2.6, 19.8 +/- 7.9 vs 10.9 +/- 2.7, 11.8 +/- 5.1 vs 7.1 +/- 1.2, respectively; all p<0.01). Measurements of left atrial diameter, maximum, minimum and before atrial systole, volumes and passive-active emptying volumes were both elevated in hemodialysis group compared to controls (all p<0.01). Conclusions: This is the first study enlightening deterioration in atrial mechanical and electromechanical functions in nondiabetic, non-hypertensive HD population. Results of the present study reflect not only negative effects of structural remodeling, which has been mentioned in previous studies in literature, but also negative effects of electrical remodeling. Prolonged inter- and intra-atrial electromechanical delay intervals should be the underlying pathophysiological factors increasing the rate of atrial fibrillation in hemodialysis population.Öğe Atrial electrical and mechanical dysfunction in non-diabetic, nonhypertensive hemodialysis patients(Oxford Univ Press, 2014) Tekçe, Hikmet; Öztürk, Serkan; Aktaş, Gülali; Tekçe, Buket Kın; Erdem, Alim; Üyetürk, Uğur; Özyaşar, MehmetÖğe Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?(Termedia Publishing House Ltd, 2016) Polat, Mualla; Buğdaycı, Güler; Şahin, Aslı; Kaya, Hatice; Sezer, Tuna; Öztürk, SerkanIntroduction: Psoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury. Aim: To examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers. Material and methods: Forty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group. Results: Statistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease. Conclusions: As a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.Öğe Cardiac autonomic function in healthy young smokers(Sage Publications Inc, 2015) Erdem, Alim; Ayhan, Suzi Selim; Öztürk, Serkan; Özlü, Mehmet Fatih; Alçelik, Aytekin; Tosun, Mehmet; Gümüştekin, Kenan; Yazıcı, MehmetThe present study examined the heart rate turbulence (HRT) and heart rate variability (HRV) parameters in healthy young smokers (<40years) to assess the effects of smoking on cardiac autonomic function. The study included 75 smokers with a history of habitual smoking for at least 1year (41 males and 34 females; mean age, 29.3 +/- 7.3years) and 30 nonsmokers (hospital staff; 16 males and 14 females; mean age, 29.0 +/- 6.1years). Addiction to smoking was evaluated using the modified Fagerstrom test for nicotine-dependence index (NDI). HRT, HRV, basic clinical and echocardiographic, and Holter test parameters were compared between groups. No significant differences between the two groups were found in the basic clinical and echocardiographic variables. Turbulence onset (TO) was significantly higher in the smoking group than in the controls, and turbulence slope was significantly lower in the smokers, than in the controls (p<0.05). Standard deviation of all normal-to-normal (NN) interval index (SDNNI) was the only HRV parameter that was significantly different between the smoking and control groups (p<0.05). The NDI was positively correlated with the TO (p<0.05). Smoking impairs the baroregulatory function in healthy young smokers, particularly the HRT parameters and SDNNI. Our findings highlight the importance of complete smoking cessation.Öğe Comparison of clinical fatures and transport times in patients with acute coronary syndrome according to classification of acute coronary syndrome(Duzce University Medical School, 2011) Baltaci, Davut; Öztürk, Serkan; Durmuş, Ismet; Kandiş, Hayati; Çelik, ŞükrüAim: Aimed to investigate clinical features in patients with acute coronary syndrome according to acute coronary syndrome classes. Materials and Methods: This cross-sectional study was conducted in coronary unit of a university hospital, applying structured study survey to patients who were hospitalized for acute coronary syndrome (ACS). With study survey, clinical and socio-demographic features along with transportation data of patients were interrogated. Findings: The study included 152 subjects with average age of 60.74±12.43 years between 34-88 yrs (Male=112, female=39). Whereas majority of patients were ST-segment elevation myocardial infarction (n=114, 74.5%), remaining 37 had non-ST-segment elevation myocardial infarction (24.5%). Education level of majority in the study were primary school or under. Rate of smoking was detected as high (n=84, 55.6%). 84.5% of subjects (n=128) defined typical anginal chest pain. 36.6% of patients (n=55) expressed that they were at rest at onset of ACS. Pre-infarct angina was detected in 92 patients (60.9%). Onset of acute coronary syndrome was usually seen in morning and evening time (n=45, 29.8%; n= 46, 30.5 % respectively). Mean of age in patients with STEMI was lower than in NSTEMI (59.2 ±12.0; 65.5±13.3), and femaleto- male ratio in patients with NSTEMI was greater than in STEMI (13/24 versus 88/26). Atypical chest pain was significantly higher in patients with NSTEMI (p=0.03). Previous MI in patients with NSTEMI was more in number, compared with STEMI (p=0.019). Co-morbid diseases such as diabetes, hypertension, coronary artery disease were seen more in NSTEMI than in STEMI (p=0.02). Conclusion: some differences in respect of clinical features in STEMI and NSTEMI were shown in our study. © 2011 Düzce Medical Journal.Öğe Comparisons of clinical and inflammatory parameters of metabolically healthy and unhealthy obese with healthy lean body individuals in Turkish adults(Carbone Editore, 2015) Türker, Yasemin; Baltacı, Davut; Türker, Yasin; Öztürk, Serkan; Iliev, DarkoAims: Aimed to determine the frequency, demographic, clinical and inflammatory parameters of metabolically healthy obese (MHO), metabolically unhealthy obese (MuHO) and metabolically healthy lean body individuals (MHLB). Materials and methods: The cross-sectional study was carried out between February 2013 and January 2014. The consecutive patients who admitted to outpatient clinic of obesity and check-up of family medicine, Duzce University, school of medicine, were enrolled. The socio-demographic features and medical history, anthropometric measurements, blood pressure records, blood samples and body fat analysis of total of 1958 patients were obtained. The patients were assigned into three groups as: MHO. MuHO and MHLB. Results: A total of 1958 patients were included. Mean homeostatic model assessment of insulin resistance (HOMAIR) value was significantly higher in subjects with MuHO than with MHO and MHLB (p<0.001 and p<0.001, respectively). Mean high density lipoprotein cholesterol (HDL-chol) was significantly lower in subjects with MuHO than in both MHO and MHLB (p<0.001). Mean low density lipoprotein cholesterol (LDL-chol) and total cholesterol was significantly higher in MuHO subjects than in MHO and MHLB (p=0.001 and p<0.001; p=0.002 and p<0.001), and lower in MHLB subjects than MHO and MuHO subjects (p<0.001 and p<0.001). Mean high-sensitivity C-reactive protein level was significantly different between groups (p<0.001), and lowest mean level was observed in subjects with MHLB (1.49 +/- 2.27 mg/dL) and highest mean level was observed in subjects with MuHO (5.32 +/- 5.71 mg/dL). Similarly, mean uric acid level was significantly higher in subjects with MuHO than in those with MHO and MHLB (p<0.001 and p<0.001. respectively). Mean uric acid level in MHLB group was lower than MHO and MuHO (p<0.001 and p<0.001, respectively). Conclusion: Obese individuals with metabolically healthy carried high risk for cardiovascular diseases and subclinical inflammation as well as metabolically unhealthy obese individuals, but carried greater risk than individuals with metabolically healthy lean body.Öğe 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 Detection of atrial electrical and mechanical dysfunction in non-dipper pre-hypertensive subjects(Taylor & Francis Inc, 2014) Sarıkaya, Savaş; Şahin, Şafak; Öztürk, Serkan; Akyol, Lütfi; Altunkaş, Fatih; Alçelik, AytekinIntroduction: A relationship between atrial conduction time and hypertension was shown in previous studies. Increased atrial electromechanical intervals used to predict atrial fibrillation by measured tissue Doppler imaging (TDI). So we aimed to search if there was any association between the non-dipping status and atrial electromechanical intervals in pre-hypertensive patients. Methods: Forty-one non-dipper and 33 dipper pre-hypertensive subjects enrolled in the study. Systolic and diastolic blood pressures were measured with a mercury sphygmomanometer. Twenty-four hours blood pressure was measured with cuff-oscillometric method. All patients were evaluated by transthoracic echocardiography. Using tissue Doppler imaging (TDI), atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). Results: Systolic and diastolic blood pressures were significantly higher in subjects with non-dipper phenomenon than dipper ones at night. Twenty-four hours average systolic and diastolic blood pressures were higher in non-dipper pre-hypertensive subjects, but this elevation was not significant. Left and right intraatrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) electromechanical coupling intervals were measured significantly higher in non-dipper pre-hypertensive patients (31.3 +/- 3.9 versus 24.1 +/- 2.3, p = 0.001; 19.5 +/- 4.3 versus 13.8 +/- 2.1, p = 0.001; and 11.4 +/- 2.8 versus 8.8 +/- 1.5, p = 0.001). Also, interatrial electromechanical delay was negatively correlated with dipping levels. Conclusion: This study showed that prolonged atrial electromechanical intervals were related non-dipper pattern in pre-hypertensive patients. Prolonged electromechanical intervals may be an early sign of subclinical atrial dysfunction and arrhythmias' in non-dipper pre-hypertensive patients.Öğe Detection of atrial electromechanical dysfunction in obesity(Taylor & Francis Ltd, 2015) Erdem, Fatma Hızal; Öztürk, Serkan; Baltacı, Davut; Dönmez, İbrahim; Alçelik, Aytekin; Ayhan, Selim Suzi; Yazıcı, MehmetIntroduction Obesity is associated with atrial fibrillation and is known as an independent risk factor. The aim of our study was to investigate if there was any association between the body mass index and atrial electromechanical intervals in obese and non-obese patients. Methods Seventy patients were enrolled in the study. Body mass index (BMI), functional capacity, and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had a BMI >= 30 were known as obese (35 patients) and those who had a BMI <30 were known as non-obese patients. All patients were evaluated by transthoracic echocardiography. LA volumes were measured by the discs method in the apical four-chamber view. LA active and passive emptying volumes and fraction were calculated. Using TDI, atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). Results LA diameter was significantly higher in obese patients (P=0.021). LA passive emptying volume and fraction were significantly decreased in obese patients (P = 0.038 and P = 0.011). LA active emptying volume and fraction were significantly increased in obese patients (P = 0.001 and P = 0.001). Left intraatrial and interatrial electromechanical delay were significantly higher in obese patients (18.9 +/- 3.8 vs 11.9 +/- 2.0, P < 0.001 and 29.5 +/- 4.1 vs 17.9 +/- 2.5, P < 0.001). Also interatrial electromechanical delay correlated positively with BMI. Conclusion This study revealed that delayed atrial electromechanical interval and impaired LA mechanical functions were related to BMI in obese patients. These findings may be an early sign of subclinical atrial dysfunction and arrhythmias in obese patients.Öğe Detection of left ventricular asynchrony and its relationship with the Tei index in patients with coronary artery ectasia(Pulsus Group Inc, 2013) Öztürk, Serkan; Ayhan, Selim; Aslantaş, Yusuf; Erdem, Alim; Özlü, Mehmet Fatih; Ekinözü, İsmail; Yazıcı, MehmetOBJECTIVE: To evaluate left ventricular (LV) systolic asynchrony and its relationship with the Tei index using tissue Doppler imaging (TDI); and to evaluate the relationship of thrombolysis in myocardial infarction frame count (TFC) and Tei index with LV asynchrony in patients with coronary artery ectasia (CAE). METHODS: A total of 50 CAE patients and 40 control subjects were evaluated. Diagnosis of CAE was made angiographically and TFC was calculated. LV systolic and diastolic function was assessed by conventional echocardiography and TDI. Evaluation of intra-LV systolic asynchrony was performed using tissue synchronization imaging (TSI). RESULTS: In patients with CAE, the Tei index was significantly higher than in controls (0.63 +/- 0.12 versus 0.52 +/- 0.12; P<0.001). LV systolic asynchrony parameters of TSI including SD of the peak tissue velocity (Ts) of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments (Ts-12), SD of the Ts of the six basal LV segments (Ts-SD-6), maximal difference in Ts between any of the six basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism compared with controls (P<0.001, P<0.001, P<0.001 and P<0.001, respectively). In addition, a positive correlation was found between Ts-SD-12 and the Tei index in patients with CAE (r=0.841; P<0.001) and mean TFC was positively correlated with Ts-SD-12 and the Tei index (r=0.345; P=0.013 and r=0.291; P=0.021, respectively). CONCLUSION: Patients with CAE exhibit evidence of LV systolic asynchrony according to TSI. LV systolic asynchrony is related to the Tei index and mean TFC. Furthermore, the Tei index is an independent risk factor for LV systolic asynchrony.Öğe Detection of subclinical atrial dysfunction by two-dimensional echocardiography in patients with overt hyperthyroidism(Elsevier Masson, 2012) Ayhan, Selim; Öztürk, Serkan; Dikbaş, Oğuz; Erdem, Alim; Özlü, Mehmet Fatih; Baltacı, Davut; Alçelik, AytekinBackground. - Hyperthyroidism is an important cardiovascular risk factor in the development of atrial fibrillation and heart failure. Increased atrial electromechanical intervals are used to predict atrial fibrillation, measured by tissue Doppler imaging (TDI). Aims. - To evaluate atrial electromechanical delay (EMD) and left atrial (LA) mechanical function in patients with overt hyperthyroidism. Methods. - Thirty-four patients with overt hyperthyroidism and 34 controls were included. A diagnosis of overt hyperthyroidism was reached with decreased serum thyroid-stimulating hormone (TSH) and increased free T4 (fT4) concentrations. Using TDI, atrial electromechanical coupling (PA) was obtained from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). LA volumes (maximum, minimum and presystolic) were measured by the disks method in apical four-chamber view and indexed to body surface area. LA active and passive emptying volumes and fractions were calculated. Results. - LA diameter was significantly higher in hyperthyroid patients (P = 0.001). LA passive emptying volume and fraction were significantly decreased in hyperthyroid patients (P = 0.038 and P < 0.001). LA active emptying volume and fraction were significantly increased in hyperthyroid patients (P < 0.001 and P < 0.001). Left and right intra-atrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) EMDs were significantly higher in hyperthyroid patients (29.2 +/- 4.4 vs 18.1 +/- 2.6, P < 0.001; 18.7 +/- 4.3 vs 10.6 +/- 2.0, P < 0.001; and 10.5 +/- 2.9 vs 7.1 +/- 1.2, P < 0.001, respectively). Stepwise linear regression analysis demonstrated that fT4 and TSH concentrations were independent predictors of interatrial EMD (beta = 0.436, P < 0.001 and beta = -0.310, P = 0.005, respectively). Conclusion. - This study showed prolonged atrial electromechanical intervals and impaired LA mechanical function in patients with overt hyperthyroidism, which may be an early sign of subclinical cardiac involvement and dysrhythmias in overt hyperthyroidism. (c) 2012 Elsevier Masson SAS. All rights reserved.Öğe Diabetes mellitus increases plasma cardiothrophin-1 levels independently of heart failure and hypertension(Carbone Editore, 2013) Aktaş, Gülali; Alçelik, Aytekin; Tosun, Mehmet; Öztürk, Serkan; Özlü, Mehmet Fatih; Savlı, Haluk; Yazıcı, MehmetAims: Cardiothrophin-1 (CT-1) is a novel 201 amino acid cytokine that has pleiotropic protective effects in apoptosis, hepatic injury, myocardial infection and contrast nephropathy. CT-1 predicts a variety of disorders including atherosclerosis, heart failure, hypertension and cardiomyopathy. However, CT-1 has not been studied previously in diabetic patients without heart failure. The aim of this study was, therefore, to compare CT-1 levels in diabetic and non-diabetic patients. Methods: Thirty-eight patients with type 2 diabetes mellitus and 32 non-diabetic controls have been enrolled into the study. Subjects with severe hypertension, renal diseases, pregnancy and malignancy were excluded. The statistical analysis was performed with SPSS for Windows version 15.0. Results: There were no significant differences between the diabetic and non-diabetic groups with regard to age, hypertension, serum creatinine, systolic and diastolic blood pressure. Median plasma CT-1 was 9.05 (5.70-24.94) pg/ml in diabetic group and 7.16 (5.53-9.64) pg/ml in non-diabetic group (P<0.001). Conclusion: Plasma CT-1 levels increased in diabetic patients independently of hypertension (HT) and heart failure. Prospective studies with a larger cohort are now needed to observe the effects of CT-1 treatment in a diabetic population.
