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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 Assessment of serum prolidase levels in patients with coronary artery in-stent restenosis: Serum prolidase levels in stent restenosis(Bayrakol Medical Publisher, 2021) Memioğlu, Tolga; Ayhan, Selim; Dönmez, İbrahimAim: Prolidase is an enzyme, which plays a role in the formation of a new matrix, collagen metabolism and cell development. It is known that the most Important mechanism underlying in-stent restenosis is neointimal hyperplasia. Neointimal hyperplasia is associated with collagen synthesis and matrix proteins. The objective of our study was to reveal the relationship between serum prolidase levels and in-stent restenosis. Material and Methods: This study included a total of 70 patients who were identified to be at a moderate and high risk as a result of clinical or non-invasive tests in the cardiology and emergency clinics of the Abant Izzet Baysal University training and Research Hospital and who underwent angiography. In-stent restenosis was identified in 40 patients. In the remaining 30 patients, there was no angiographically determined critical lesion. Serum prolidase levels were measured in all patients. Results: The mean serum level of prolidase was found to be statistically significantly higher in the in-stent restenosis group compared to the restenosis-free group (p=0.02). The mean serum level of prolidase level was significantly higher in smokers compared to the non-smoker patients (p=0.04). It was observed that serum prolidase levels statistically significantly increased proportionally to the in-stent restenosis percentage (p=0.04). Discussion: The results of this study indicate that prolidase enzyme levels may enable timely and correct assessment of in-stent restenosis, and may contribute to the decision for changing the treatment or timing to increase the intensity of the treatment in patients undergoing percutaneous coronary intervention (PCI) with coronary stenting.Öğe 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 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 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 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 Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Özyaşar, Mehmet; Ayhan, Selim; Özlü, Fatih; Erdem, Alim; Yazıcı, Mehmet; Alçelik, Aytekin; Tosun, MehmetBackground: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Infra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 +/- 6.1 vs 18.0 +/- 2.7, p < 0.001; and 10.6 +/- 3.4 vs 6.9 +/- 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 +/- 6.2 vs 44.3 +/- 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction. (Cardiol J 2012; 19, 3: 287-294)Öğe Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism(Via Medica, 2012) Öztürk, Serkan; Alçelik, Aytekin; Özyaşar, Mehmet; Dikbaş, Oğuz; Ayhan, Selim; Özlü, Fatih; Erdem, Alim; Yazıcı, MehmetBackground: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients. (Cardiol J 2012; 19, 4: 374-380)Öğe Hematological parameters and coronary collateral circulation in patients with stable coronary artery disease(Pulsus Group Inc, 2013) Ayhan, Selim; Öztürk, Serkan; Erdem, Alim; Fatih, Mehmet Fatih; Memioğlu, Tolga; Özyaşar, Mehmet; Yazıcı, MehmetBACKGROUND: Although hematological parameters have been associated with prognosis in patients with various cardiovascular diseases, their relationship with coronary collateral (CC) circulation in patients with stable coronary artery disease (CAD) is unknown. OBJECTIVE: To investigate the relationship between hematological parameters and CC vessel development in patients with stable CAD. METHODS: A total of 96 patients who underwent coronary angiography were retrospectively enrolled. All study participants had at least one occluded major coronary artery. Development of CCs was classified using the method of Rentrop. Rentrop grades of 0 and 1 indicate poor CCs, whereas grades 2 and 3 indicate good CCs. Hematological parameters, including mean platelet volume (MPV) and neutrophil/lymphocyte (N/L) ratio, were measured. Multivariate logistic regression analysis was performed to identify independent variables. RESULTS: The MPV and N/L ratio were significantly higher in the poor CC group compared with the good CC group. Negative correlations were found in the analyses comparing Rentrop score with MPV and N/L ratio (r=-0.274; P=0.012 and r=-0.339; P=0.001, respectively). In multivariate analysis, the N/L ratio was independently related to CC circulation (OR 0.762 [95% CI 0.587 to 0.988]; P=0.04). CONCLUSION: The results suggest that N/L ratio and MPV are associated with poor CCs, and a high N/L ratio is a significant predictor of poor CC development in patients with stable CAD.Öğe N-terminal pro-b-type natriuretic peptide and insulin resistance in overweight and obese subjects(2012) Alçelik, Aytekin; Aytekin, Eyüp; Tosun, Mehmet; Aktaş, Gülali; Ayhan, Selim; Öztürk, Serkan; Özlü, Mehmet Fatih; Şavlı, Haluk; Yazıcı, MehmetSeveral studies have been conducted to investigate B-type natriuretic peptide (BNP) levels in different obese populations. However, in these studies BNP levels were lower in obese population with an unclear mechanism which has not been explained yet. We sought to investigate the relationship among plasma NT-proBNP levels, obesity and insulin resistance in subjects with no known heart disease. The study population consists of two groups. Subjects with a body mass indexs (BMI) of ?25 kg/m2 were classified as lean group (LG, n=30), BMI of >25 kg/m2 were classified as overweight and obese group (OG, n=78). Severe hypertension, heart failure, ischemic heart disease, renal or hepatic insufficiency, age >65, pregnancy and malignancy were excluded. There was a negative correlation between NT-proBNP and weight (r=-0.379, p=0.004) and BMI (r=-0.286, p=0.030) in LG, but there was no such reverse correlation between NT-proBNP and BMI (r=-0.057, p=0.463) in OG. We performed multivariable logistic regression analyses to examine predictors of obesity levels. There were not any significant relation between these predictors and obesity. Insulin levels had a strong association with obesity level however this association was still insignificant (p=0.054). In LG group, there was a negative correlation between NT-proBNP and BMI. There was no correlation between NT-proBNP and homeostatic model assessment (HOMA) and insulin levels (r=-0.035, p=0.789) in LG group, but there was a statistically significant negative correlation between BNP and HOMA (r=-0.219, p=0.009) and insulin levels (r=-0.252, p=0.002) in OG group. Race and ethnicity may contribute this association. © 2012 OMU.Öğe Predictive value of aortic knob width for postoperative atrial fibrillation in coronary artery bypass surgery(Aves, 2014) Erdem, Kemalettin; Öztürk, Serkan; Ayhan, Selim; Buğra, Onursal; Bozoğlan, Orhan; Tekelioğlu, Ümit Yaşar; Yazıcı, MehmetObjective: The aim of our study was determine whether aortic knob width (AKW) is associated with the development of atrial fibrillation (AF) after isolated coronary artery bypass surgery (CABG). Methods: In this retrospective observational cohort study, we evaluated 135 patients without hemodynamically significant valvular problems. AKW was measured on chest X-ray by digital system. Multiple logistic regression analysis was used to find independent associates of postoperative AF (POAF). The diagnostic value of AKW was assessed using ROC analysis. Results: POAF occurred in 43 (31.8%) of all patients. The age, AKW, left atrial (LA) diameter and C-reactive protein (CRP) were significantly higher in patients with POAF than without POAF (67.2 +/- 8.6 vs 61.3 +/- 9.8 years, p=0.004; 45.6 +/- 5.8 vs 36.1 +/- 3.8 mm, p<0.001; 37.9 +/- 3.5 vs 35.8 +/- 3.1mm, p=0.002 and 10.6 +/- 8.5 vs 5.6 +/- 6.5 mg/L, p=0.001 respectively). Multiple logistic regression analysis demonstrated that AKW, LA diameter and CRP were independently associated with POAF (OR=4.527, 95% CI=1.315 -15.588, p=0.017; OR=2.834, 95% CI=1.091-7.360, p=0.032 and OR=1.300, 95% CI=1.038-1.628, p=0.022 respectively). ROC analysis has demonstrated that aortic knob of 36.5 mm constitutes the cut-off value for the occurrence of POAF with 84.4% sensitivity and 64.6% specificity (AUC=0.84, 95% CI=0.75-0.94, p<0.001). Conclusion: We have demonstrated a significant association between the AKW and AF development after isolated CABG. PA chest radiography is a cheap and readily available clinical tool and it can be examined easily by every cardiovascular surgeons.Öğe Relation of neutrophil/lymphocyte ratio with the presence and extent of coronary artery ectasia(Turkish Soc Cardiology, 2013) Ayhan, Selim; Ozturk, Serkan; Erdem, Alim; Ozlu, Mehmet Fatih; Ozyasar, Mehmet; Erdem, Kemalettin; Yazici, MehmetObjectives: It has been shown that the neutrophil to lymphocyte ratio (N/L ratio) is associated with cardiovascular events and mortality. In this study, we investigated the N/L ratio in patients with coronary artery ectasia (CAE). Study design: Fifty patients (29 men, 21 women; mean age, 51.1+/-7.1 years) diagnosed as CAE using coronary angiography were included in the study. The control group consisted of 28 patients (16 men, 12 women; mean age, 49.5+/-9.4 years) who had normal coronary arteries as determined by coronary angiography. Baseline characteristics were recorded. The number of ectatic segments was noted. Hematologic parameters were measured and the N/L ratio was calculated. Results: The N/L ratio was significantly higher in the CAE group compared with the control group (median [25-75% percentile] 2.2 [1.6-3.0] vs. 1.8 [1.4-2.0], p=0.014, respectively). The Spearman correlation analysis demonstrated that the N/L ratio positivelyÖğe 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 Usefulness of the mean platelet volume for predicting new-onset atrial fibrillation after isolated coronary artery bypass grafting(Informa Healthcare, 2014) Erdem, Kemalettin; Ayhan, Selim; Öztürk, Serkan; Buğra, Onursal; Bozoğlan, Orhan; Dursin, Hüseyin; Yazıcı, MehmetPostoperative atrial fibrillation (AF) is a common complication of coronary artery bypass grafting (CABG). The mean platelet volume (MPV) is an important marker of platelet activity and is associated with cardiovascular risk factors. We investigated whether the MPV is associated with the development of AF after CABG. This study included 208 patients undergoing elective isolated CABG. We evaluated the standard preoperative 12-lead electrocardiograph (ECG) recorded at a paper speed of 25 mm/s obtained for each patient from our hospital records before surgery. All study patients underwent standard CABG requiring cardiopulmonary bypass without concurrent valvular surgery. Forty-three patients were excluded. After CABG, all patients were monitored by telemetry and 12-lead ECGs. AF was defined using the established Society of Thoracic Surgeons definition. Postoperative AF occurred in 38 (22%) patients. The hemoglobin and platelet and leukocyte counts were similar in the groups with and without AF. However, the MPV and neutrophil/lymphocyte ratio were significantly higher in the AF group (8.9 [1.4] vs. 7.9 [1.2], p< 0.001 and 3.2 +/- 1.9 vs. 2.6 +/- 1.2, p = 0.005, respectively). In addition, the C-reactive protein (CRP) levels were significantly higher in the AF group (8.9 [19.6] vs. 5.3 [8.7], p = 0.025). Multivariate logistic regression analysis showed that MPV and CRP were independent predictors of postoperative AF (odds ratio [OR] 2.564, 95% confidence interval [CI] 1.326-4.958, p = 0.005; OR 1.055, 95% CI 1.000-1.114, p = 0.050, respectively). Our results show that increased platelet activity is associated with the development of AF after CABG.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 Woven coronary artery anomaly associated with acute coronary syndrome(2013) Ayhan, Selim; Öztürk, Serkan; Tekelioğlu, Ümit Yaşar; Ocak, TarıkThe woven coronary artery anomaly is a rare congenital anomaly in which a coronary artery is divided into thin channels that merge again into the distal lumen. Only a few cases of woven coronary artery have been reported in the literature. This anomaly is accepted as a benign condition. We describe a case of acute coronary syndrome in a patient with woven coronary artery anomaly. Copyright © 2013 by Thieme Medical Publishers, Inc.
