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    Acute Mesenteric Ischemia: The Diagnostic Value of QT Parameters and their Relationship with CT Findings
    (Bentham Science Publ Ltd, 2024) Alan, Bircan; Alan, Sait; Gurel, Safiye; Inanir, Mehmet; Acar, Emrah; Donmez, Ibrahim; Kalaycioglu, Oya
    Background: One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings. Materials and Methods: Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system. Grouping was carried out on the basis of AMI (n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations. Results: The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001). In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper-thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found. Conclusion: We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD and a significant relationship between survival and QTc in the AMI group.
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    The combined S velocity achieved from tricuspid annulus and pulmonary annulus with tissue Doppler imaging could predict the proximal right coronary artery occlusion in patients with inferior myocardial infarction
    (2022) Acar, Emrah; Ozgul, Neryan; Donmez, Ibrahim; Yalcin, Osman Yasin; Kayabas, Oguz; Alan, Sait; Izgi, Ibrahim Akin
    Aim: To investigate if combined S velocity (CSV) calculated from tricuspid annulus and pulmonary annulus\rwith tissue Doppler imaging in individuals with acute inferior myocardial infarction were linked to proximal\rRCA lesions.\rMethods: The study comprised 48 patient who had been diagnosed with acute inferior myocardial infarction\rand had culprit lesions in the right coronary artery. The RCA occlusion in Group A was proximal to the right\rventricular branch, while the RCA occlusion in Group B was distant to the RV branch. The combined S\rvelocity was tested, as well as other echocardiographic parameters.\rResults: In terms of metrics indicating right ventricular function, there were substantial disparities between\rthe groups. A favorable association was established in the univariate correlation analysis between CSV and\rtissue Doppler imaging derived tricuspid annulus systolic velocity (St), pulmonary annulus motion velocity\revaluated by TDI (PAMVUT), RV tricuspid annular plane systolic excursion (TAPSE), and fractional area\rchange (FAC). CSV was identified as an independent predictor of proximal RCA occlusion in a multivariate\rlogistic regression test. In the ROC analysis, CSV<18.3 cm/s and PAMVUT<8.6 cm/s indicated proximal\rRCA occlusion with 83 percent sensitivity and 71 percent specificity (AUC=0.83, p<0.001), and 85 percent\rsensitivity and 71 percent specificity (AUC=0.81, p<0.001), respectively.\rConclusion: CSV measurements were revealed to be an important predictor of proximal RCA occlusions in\rthis investigation.
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    Evaluation of carotid artery stiffness in patients with coronary artery disease using acoustic radiation force impulse elastography
    (Sage Publications Ltd, 2023) Alan, Bircan; Alan, Sait
    Objectives We evaluated carotid artery stiffness in patients with coronary artery disease (CAD) using acoustic radiation force impulse (ARFI) elastography and investigated the relationship between stiffness and CAD. Methods This study examined 76 CAD patients (aged 60.7 +/- 11) and 70 healthy individuals (aged 59.6 +/- 9). The left common carotid artery mean shear wave velocity (LCmeanSWV) and the right common carotid artery mean shear wave velocity (RCmeanSWV) of the anterior walls were measured using ARFI elastography, and the results of the patient group and the healthy group were compared. The common carotid intima-media thickness (CIMT) was measured in both groups and compared with mean SWV. Results The RCmeanSWVs in the patient and healthy groups were 3.47 +/- 1 m/s and 2.69 +/- 0.90 m/s, respectively (p < 0.001). The LCmeanSWVs in the patient and healthy groups were 3.60 +/- 0.9 m/s and 2.90 +/- 0.80 m/s, respectively (p < 0.001). A significant correlation was found between the RCmeanSWV and the right CIMT values and between the LCmeanSWV and the left CIMT values (r = 0.231, p = 0.03 and r = 0.331, p = 0.002, respectively). Conclusions The mean SWV values of carotid arteries of CAD patients measured with ARFI elastography were significantly higher than the mean SWV values of the carotid arteries of healthy individuals. Thus, measurement of the carotid artery SWV could be a potential tool in the risk evaluation of cardiovascular disease. Nonetheless, new studies are required to determine whether this method serves as a useful additional tool.
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    Evaluation of the neutrophil-lymphocyte ratio and mean platelet volume in hypertensive patients with coronary artery ectasia
    (2020) İnanır, Mehmet; Alıcı, Gökhan; Acar, Emrah; Eren, Hayati; Gürler, Müjgan; Alan, Sait
    Introduction: Coronary artery ectasia (CAE) is associated with increased morbidity and mortality, and is known to also be associated with atherosclerosis. CAE is considered a variant of coronary artery disease, and is more common in patients with hypertension. We aimed to evaluate the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) in hypertensive patients with CAE.Patients and Methods: The study was designed retrospectively in the cardiology unit of Bolu Abant Izzet Baysal University Medical Faculty Hospital between January 2017 and October 2019. A total of 7287 coro-nary angiographies were retrospectively analyzed to detect the incidence of ischemic heart disease. Diagnosis of CAE was made visually by two cardiologists who were blinded to the study aims. All included patients had a diagnosis of hypertension. After appropriate exclusions, hypertensive patients were divided into CAE and normal coronary artery groups, and the laboratory parameters of the two groups were compared.Results: The neutrophil counts [4.2 (2.4-8.6) vs. 4.2 (2.0-6.7) u/mm3, p= 0.015], red cell distribution width [15.7 (12.8-21.6) vs. 15.3 (13.2-18.6) %, p= 0.002], platelet distribution width [17.9 (15.5-23.0) vs. 17.5 (15.9-20.8) %, p= 0.001], NLR [2.1 (0.7-12.8) vs. 1.9 (0.8-4.5), p< 0.001], platelet-lymphocyte ratio [109.8 (63.0-321.8) vs. 100.9 (34.7-223.6), p= 0.001], MPV (8.4 ± 1.4 vs. 7.9 ± 1.0 fL, p< 0.001), and plateletcrit (0.19 ± 0.05 vs. 0.18 ± 0.4 %, p= 0.007) were significantly higher, and the lymphocytes counts [2.1 (0.5-4.2) vs. 2.2 (1.1-6.7) u/mm3, p= 0.013] were significantly lower in hypertensive patients with CAE than in those without.Conclusion: Hemogram parameters could be useful biomarkers for determining a thrombotic state and in-flammatory response in hypertensive patients with CAE.
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    The pulmonary annular motion velocity assessed using tissueDoppler imaging could predict the proximal right coronary arteryocclusion in patients with inferior myocardial infarction
    (2021) Acar, Emrah; Özgül, Neryan; Dönmez, Ibrahim; Yalçin, Osman Yasin; Alan, Sait
    Objective: The right ventricle myocardial infarction (RVMI) is one of the leading reasons for right ventricle(RV) dysfunction. RVMI occurs in 20-50% of inferior infarctions. Echocardiography was applied to study RV involvement and proximal right coronary artery (RCA) occlusion in individuals with acute inferior MI. The objective of this study was to investigate if pulmonary annulus motion velocity (PAMVUT) levels in individuals with acute inferior myocardial infarction were linked to proximal RCA lesions.Method: The study comprised 50 people who had been diagnosed with acute inferior myocardial infarction and had culprit lesions in the right coronary artery. The RCA occlusion in Group A was proximal to the right ventricular branch, while the RCA occlusion in Group B was distant to the RV branch. The PAMVUT was tested, as well as other echocardiographic parameters.Results: In terms of metrics indicating right ventricular function, there were substantial disparities between the groups. A favorable association was established in the univariate correlation analysis between PAMVUT and RV TAPSE, with FAC, and with St.PAMVUT was identified as an independent predictor of proximal RCA occlusion in a multivariate logistic regression test. In the ROC analysis, PAMVUT<8,5 cm/s indicated proximal RCA occlusion with 85 percent sensitivity and 69 percent specificity (AUC=0.80, p<0.001).Conclusion: PAMVUT measurements were revealed to be an important predictor of proximal RCA occlusions in this investigation.