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Öğe Acute mesenteric ischemia: The diagnostic value of QT parameters and their relationship with CT findings(Bentham Science Publ Ltd, 2024) Alan, Bircan; Alan, Sait; Gürel, Safiye; İnanır, Mehmet; Acar, Emrah; Dönmez, İbrahim; Kalaycıoğlu, OyaBackground: 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.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 Blood group as a novel predictor of postoperative atrial fibrillation after off-pump coronary artery bypass grafting(Associação Médica Brasileira, 2023) Dönmez, İbrahim; Müdüroğlu, AyhanOBJECTIVE: The objective of this study was to reveal whether there was a possible relationship between the blood group and postoperative atrial fibrillation after off-pump coronary artery bypass grafting.METHODS: Between January 2020 and January 2022, 452 patients undergoing off-pump coronary artery bypass grafting surgery consisted of the research population. Patients were divided into two groups based on the occurrence of new-onset atrial fibrillation from the time of operation until discharge. Group 1 (atrial fibrillation group) had 122 patients, whereas group 2 (non-atrial fibrillation group) contained 350 patients. Patients' baseline clinical characteristics and operative and postoperative data were recorded and then compared between the groups. Moreover, a multivariate logistic regression analysis was also conducted to identify the predictors of postoperative atrial fibrillation.RESULTS: Non-O blood groups were substantially more common in the atrial fibrillation group than in the non-atrial fibrillation group. Patient age differences between the atrial fibrillation and non-atrial fibrillation groups were statistically significant, and patients in the atrial fibrillation group were detected to be older. Mean left atrial diameter, rates of obesity and prior percutaneous coronary intervention history, and perioperative intraaortic balloon pump requirement were significantly greater in the atrial fibrillation group than in the non-atrial fibrillation group. According to logistic regression analysis, blood group, age, left atrial diameter, obesity, and prior percutaneous coronary intervention were identified as predictors of postoperative atrial fibrillation.CONCLUSION: We demonstrated for the first time in the literature that ABO blood type was a novel and significant predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting.Öğe Clinical characteristics and outcome of cardiovascular implantable electronic device infections in Turkey(Sage Publications Inc, 2016) Aydın, Mesut; Yıldız, Abdulkadir; Kaya, Zeynettin; Kaya, Zekeriya; Başarır, Ahmet Özgür; Çakmak, Nazmiye; Dönmez, İbrahimInfection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality.Öğe Combined systolic velocities using tissue Doppler imaging could predict the severity of cirrhosis: A prospective cohort study(Clinics Cardive Publishing Pty Ltd, 2023) Dönmez, İbrahim; Acar, EmrahAim: Recent research has demonstrated that the contractile characteristics of the right ventricular outflow tract (RVOT) play a significant role in right ventricular function. Pulmonary annular motion velocity (PAMVUT) is a reliable marker of RVOT function. Also, combined systolic velocity [PAMVUT added to tricuspid annular systolic velocity (St)] has been revealed as a suitable parameter for right ventricular systolic function. In this study, we examined the association between the severity of the illness in cirrhotic patients and the combined S velocities (CSV). Methods: Seventy-four patients with cirrhosis went to the echocardiography laboratory of the Cardiology Department in our centre. Traditional echocardiographic measurements, PAMVUT and CSV values were recorded. The Child-Pugh classes of the patients were determined. Results: Receiver operating characteristic curve analysis demonstrated that a CSV of 23 cm/s constituted the cut-off value for predicting a moderate-to-severe form of cirrhosis with 76% sensitivity and 65.3% specificity (area uder the curve = 0.735, p < 0.001). Conclusion: CSV values could predict the severity of cirrhosis more precisely than traditional right ventricular systolic function parameters.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 Does pulmonary hypertension affect early-term outcomes of off-pump coronary artery bypass surgery?(Assoc Medica Brasileira, 2022) Velioğlu, Yusuf; Yüksel, Ahmet; Topal, Dursun; Korkmaz, Ufuk Turan Kürşat; Dönmez, İbrahim; Badem, Serdar; Uçaroğlu, Erhan RenanOBJECTIVE: This study aimed to investigate the effect of preoperative pulmonary hypertension (PHT) on postoperative early mortality and morbidity in patients undergoing off-pump coronary artery bypass grafting (CABG).METHODS: A total of 1107 patients undergoing elective first-time off-pump CABG between January 2011 and April 2022 were included in this retrospective observational cohort study. The patients were categorized into two groups according to their preoperative systolic pulmonary artery pressure (SPAP) values. The PHT group (n=104) consisted of patients with a SPAP value >30 mmHg, while the non-PHT group (n=1003) consisted of patients with a SPAP value <= 30 mmHg. Patients' preoperative demographics and clinical features, operative data, and postoperative outcomes were recorded and then compared between the groups.RESULTS: In the PHT group, the median age was significantly higher (66 vs. 63 years, p=0.001) and the median left ventricular ejection fraction level was significantly lower (45 vs. 50%, p=0.045) as compared to the non-PHT group. Additionally, the PHT group included a significantly greater percentage of patients with chronic obstructive pulmonary disease (22.1 vs. 7.4%, p=0.019). As perioperative early-term outcomes, complications, and mortality were considered, the groups were statistically similar, and there were no significant differences between the groups, except for the development of atrial fibrillation.CONCLUSION: For the first time in the literature, this study revealed that mild PHT (mean SPAP=38.9 +/- 8.7 mmHg) did not significantly affect early -term outcomes of off-pump CABG.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 Epicardial fat thickness in patients with rheumatoid arthritis(Makerere Univ, Fac Med, 2015) Erdem, Fatma; Koç, Bünyamin; Sarıkaya, Savaş; Uçar, Mehmet; Yazıcı, Selma; Boyraz, İsmail; Çağlar, Sabri; Özyalvaçlı, Gülzade; Dönmez, İbrahim; Yazıcı, MehmetBackground: Epidemiologic data indicates that rheumatoid arthritis is an independent risk factor for cardiovascular disease. Epicardial adipose tissue is a novel cardio-metabolic risk factor. Our aim was to evaluate epicardial fat thickness (EFT) using echocardiography in patients with rheumatoid arthritis compared to healthy control subjects. Secondly, we investigated relationship between epicardial fat thickness and clinical and echocardiographic parameters in patients with rheumatoid arthritis. Method: The study population included 76 consecutive patients with rheumatoid arthritis (64 female; mean age, 53 +/- 11 years, median disease duration, 7.8 years) and 50 healthy subjects as controls (39 female; mean age, 52 +/- 6 years). All patients underwent echocardiography to assess left ventricular diastolic dysfunction, left ventricular hypertrophy and EFT. All values were compared between groups. Results: EFT was higher in rheumatoid arthritis patients than in healthy controls (0.66 +/- 0.20 vs. 0.54 +/- 0.18; p=0.003). Thickness of Intra Ventricular Septum (IVS) (1.1 +/- 0.06 and 9.8 +/- 0.08; p=0.001) and posterior wall (PW) (0.98 +/- 0.05 and 0.93 +/- 0.08; p=0.015) was higher in patients with rheumatoid arthritis compared to healthy controls. Early diastolic myocardiac peak velocity or late diastolic mitral peak velocity (E/A) ratio was lower in rheumatoid arthritis patients compared to healthy patients (1.1 +/- 0.8 and 1.24 +/- 0.1 p=0.001) as well as, E/e' was higher in Rheumatoid arthritis (RA) patients than healthy patients. (E/e': 8.7 +/- 1.6 and 8.0 +/- 1.4 p=0.020). In patients with rheumatoid arthritis, EFT was positively correlated with hypertension and duration of disease and E/e' (r: 0.10, p: 0.010, r: 0.306, p: 0.004 and r: 0.465 p: 0.007 respectively) and EFT was negatively correlated with E/A (r: -. 262 p: 0.022) Conclusion: To our knowledge, this is the first report about epicardial adipose tissue in rheumatoid arthritis patients. Epicardial fat thickness as an indicator of cardiovascular involvement was higher in rheumatoid arthritis patients.Öğe Evaluation of the effects of 3D mapping ablation on atrial conduction times in patients with paroxysmal atrial fibrillation(Bayrakol Medical Publisher, 2022) Dönmez, İbrahim; Memioğlu, Tolga; Acar, Emrah; Erdem, FatmaAim: Atrial fibrillation (AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra-and interatrial conduction time, indicates structural and electrical remodeling in the atrium. This study aimed to evaluate the effect of pulmonary vein isolation applied with radiofrequency ablation (RF) therapy on intra-and interatrial conduction time and to investigate the structural and electrically remodeling after treatment.Material and Methods: Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 +/- 11.731; mean left atrial diameter: 36.79 +/- 4.318) who underwent CARTO (R) 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra-and inter-atrial electromechanical delay was measured in all patients using tissue doppler echocardiography before and three months after RF ablation.Results: All intra-and interatrial conduction times were significantly decreased 3 months after RF ablation procedure (PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029).Discussion: The results of our study suggest that providing stable sinus rhythm with RF ablation may slow down, stop or even improve structural remodeling at substrate level secondary to AF even in patients with paroxysmal AF who did not yet develop atrial fibrosis and permanent structural changes.Öğe Lipoprotein(a) level and MIF gene variant predict incident metabolic syndrome and mortality(Bmj Publishing Group, 2016) Onat, Altan; Can, Günay; Çoban, Neslihan; Dönmez, İbrahim; Çakır, HakanOwing to the scarcity of available information, we aimed to assess the association of migration inhibitory factor (MIF)-173 G/C genotypes and serum lipoprotein(Lp)(a) with incident metabolic syndrome (MetS) and all-cause mortality, respectively. In population based, middle-aged adults (n=1297), stratified by gender and presence of MetS, we used Lp(a) quintiles to identify non-linear associations with outcomes using Cox regression models, adjusted for MIF genotype, age, smoking status, high density lipoprotein cholesterol, and systolic blood pressure. After 5.2years of follow-up, 151 cases of incident MetS and 123 deaths were recorded. For incident MetS, adjusted HRs increased in each gender across four declining quintiles, starting from the highest quintile in men and from quintile 4 in women. The MIF CC-GC genotype appeared to contribute to the risk estimates in men. Similarly adjusted models in the whole sample disclosed that all-cause mortality tended to be inversely associated with Lp(a) quintiles and yielded an HR (2.42 (95% CI 1.03 to 5.81)) in men in quintile 2, whereas the MIF genotype additively predicted mortality (HR 1.79 (95% CI 1.01 to 3.18)) only in men. Excess risk of death was additively conferred on Turkish men by the MIF CC-GC genotype and by apparently reduced circulating Lp(a) assays, supporting the notion that low' serum Lp(a), mediating autoimmune activation, is a major determinant of metabolic disease risk and death. Damaged MIF protein and more complex autoimmune activation in women may be responsible from lack of relationship to MetS/mortality.Öğe A mix of aminophylline and heparin plus nitroglycerin can reduce bradycardia during rotational atherectomy on the right coronary artery and dominant circumflex artery(Urban & Vogel, 2023) Acar, Emrah; İzci, Servet; Dönmez, İbrahim; Özgül, Neryan; Özcan, Eda; Kaygusuz, TubaBackgroundRotational atherectomy (RA) may cause bradyarrhythmias and transitory atrioventricular block when performed in the right coronary artery (RCA) or a dominant circumflex (CX) coronary artery. However, there are no studies of a solution that can prevent coronary flow deterioration and bradycardia complications that may occur during RA. We aimed to create an alternative rota-flush solution to minimize the risk of bradycardia and complete atrioventricular block (AVB) that can occur during RA.Materials and methodsThe study comprised 60 patients who were randomly divided into two groups: 30 received rotaphylline (= 240 mg aminophylline, 10,000 U unfractionated heparin, and 2000 mcg nitroglycerin to 1000 mL saline), and 30 received the traditional rota-flush (= 10,000 U unfractionated heparin, 2000 mcg nitroglycerin, and 1000 mL saline). The incidence of bradycardia or high-grade AVB (HAVB) during RA, coronary slow-flow phenomenon or no-reflow phenomenon, and coronary spasm were the primary endpoints of the study. Procedure success and RA-related procedural complications were secondary endpoints.ResultsThe use of rotaphylline was an independent predictor of bradycardia and HAVB after accounting for all other factors (OR: 0.47, 95% CI: 0.24-0.79, p < 0.001). Lesion length (OR: 2.17, 95% CI: 1.24-3.04, p < 0.001), burr-to-artery ratio (OR: 0.59, 95% CI: 0.39-1.68, p < 0.001), and total run duration (OR: 0.79, 95% CI: 0.35-1.43, p < 0.001) were additional independent predictors.ConclusionBradycardia and the development of HAVB may be avoided by rotaphylline intracoronary infusion during RA applied to the RCA and dominant CX lesions. Multicenter studies including sizable patient populations should be conducted to validate the present findings.Öğe A new diagnostic tool for masked hypertension: impaired sleep quality(Termedia Publishing House Ltd, 2016) Erdem, Fatma Hızal; Çakır, Uğur; Yıldırım, Osman; Alçelik, Aytekin; Dönmez, İbrahim; Tuman, Taha Can; Çağlar, Sabri OnurIntroduction: The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension. Material and methods: A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Hotter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results: The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 +/-2.43 vs. 2.33 +/-1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 +/-3.21 vs. 3.58 +/-2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI. Conclusions: This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.Öğe New diagnostic tool for masked hypertension; impaired sleep quality(2015) Erdem, Fatma Hızal; Çakır, Uğur; Yıldırım, Osman; Alçelik, Aytekin; Dönmez, İbrahim; Tuman, Taha Can; Çağlar, Sabri Onur; Erdem, Alim; Yazıcı, MehmetBackground: The aim of this study was to evaluate a relationship between MHTand impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension (MHT). Methods: A total of 112 individuals, 72 patients with new diagnosed MHT and 40 normotensive healthy volunteers were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography (ECG), transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests.Additionally,all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). Results: The total PSQI score was significantly higher in the MHT group than in the normotensive healthy volunteers (4.13±2.43 vs. 2.33±1.67, p<0.001). A PSQI score >5 was found in 45.8% (n=33) of patients in the MHT group and 15% (n=6) of patients in the normotensive group (p<0.001). Non-dipper pattern was found %17.5 in healthy volunteer group, however %59.94 (n=41) in MHT group (p<0.001). When we compared the dipping pattern of the MHT groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87±3.21 vs. 3.58±2.33, p<0.001). Conclusions: This study demonstrates impaired sleep quality in subjects with MHT, particularly those with a non-dipper pattern. Additionally, this study indicates impaired sleep quality maybe helped diagnose of MHT, particularly in the nondipper group.Öğe Paroksismal atriyal fibrilasyonu olan hastalarda sol atriyal katater ablasyonu yöntemiyle pulmoner ven izolasyonu tedavisinin atriyal ileti süreleri üzerine etkisinin incelenmesi(Bolu Abant İzzet Baysal Üniversitesi, 2016) Dönmez, İbrahim; Erdem, FatmaAmaç : Atriyal Fibrilasyon(AF) atriyumda yapısal, elektriksel ve hücresel remodelinge neden olmaktadır. Atriyum içi/atriyumlar arası ileti zamanı değerlendirmesi atriyumda yapısal ve elektriksel remodelingi göstermekte olup ekokardiyografik olarak doku doppler yöntemi ile ölçülebilmektedir. Paroksizmal Atriyal Fibrilasyon(PAF)'da ritim kontrolü tedavisi stratejisini araştıran çalışmaların meta-analizinde sinüs ritmini sağlamada ve korumada radyofrekans(RF) ablasyonun anti-aritmiklere üstün olduğu gösterilmiştir. Bu çalışmanın amacı PAF'ı olan hastalarda atriyal ileti süreleri üzerine RF ablasyon ile uygulanan pulmoner ven izolasyon tedavisinin atriyum içi/atriyumlar arası ileti zamanı üzerine olan etkisini değerlendirerek, tedavi sonrası yapısal ve eletriksel remodelingi araştırmaktır. Gereç ve Yöntem : Çalışmaya en az bir antiaritmik ilaca karşın PAF'ı olan yapısal kalp hastalığı olmayan 52 hasta alındı. İki hasta işlem esnası ve sonrasında gelişen komplikasyonlar nedeniyle çalışma dışı bırakıldı. CARTO 3D pulmoner ven izolasyonu sistemiyle RF ablasyon yapılan 50 hasta (28 kadın ; ortalama yaş: 51,68±11,731 ; ortalama sol atriyum çapı : 36,79±4,318) izleme alındı. Tüm hastalara işlem öncesinde ve işlemden 3 ay sonra doku doppler ekokardiyografi yöntemiyle atriyum içi ve atriyumlar arası elektromekanik gecikme bakıldı. Bulgular : Hastalarda RF ablasyon işlemi sonrası üç ay sonra ölçülen tüm atriyum içi/atriyumlar arası ileti sürelerinde anlamlı azalma saptandı. (PA lateral p: 0,022 ; PA septum p: 0,002 ; PA triküspit p: 0,019, İnteratriyal ileti gecikmesi p:0,012 ; İntra-atriyal ileti gecikmesi p: 0,029). Sonuç : Çalışmamızın sonucu; RF ablasyon pulmoner ven izolasyonu sonrası başlatıcı mekanizmaların ortadan kaldırılması ile henüz atriyal fibrozis ve kalıcı yapısal değişiklikler oluşmamış hastalarda bile kalıcı sinüs ritmi sağlanmasıyla substrat düzeyinde AF'ye seconder yapısal yeniden şekillenmeyi yavaşlatma, durdurma hatta iyileşme olasılığını akla getirmektedir. Anahtar Kelimeler: Pulmoner Ven İzolasyonu, Radyofrekans Ablasyon, Atriyal İleti SüresiÖğe The right ventricle systolic force ratio could predictthe severity of the tricuspid regurgitation-RIVIERA ratio(Wiley, 2023) Acar, Emrah; İzci, Servet; Dönmez, İbrahim; Yılmaz, Mehmet Fatih; Özgül, Neryan; Seymen, Hande; Özcan, Eda; Güneş, YılmazPurpose: For assessing the severity of tricuspid regurgitation (TR), there is no gold standard. We developed a parameter, the right ventricular systolic force ratio-RIVIERA, using the continious wave Doppler analysis of TR and pulsed-wave analysis of the right ventricle outflow tract. We hypothesized that the RIVIERA would facilitate the ability to identify severe TR in clinical settings.Materials and Methods: We obtained data from routine transthoracic echocardiograms. All records reporting no or mild TR (n = 732), moderate TR (n = 584), and severe TR (n = 519) TR were reanalyzed to measure vena contracta (VC) width, TR jet area, effective regurgitant orifice (EROA) derived with the proximal isovelocity surface area method, the RIVIERA, and right-sided chamber volumes.Results: Significant linear trends were demonstrated for right atrial volume index, end-diastolic volume index, RVOT velocity time integral, TR jet area, TR-Vmax, TR-VTI, TR acceleration, VC width, EROA with increasing TR severity. Independent predictors of severe RT included RIVIERA <4.8, VC width =0.7 cm, TR jet area > 10 cm(2), and EROA =0.4 cm(2).Conclusion: The RIVIERA is a feasible, effective, and independent predictor of severe TR that enhances established techniques for estimating TR severity. For clinical decision-making and management, accurate measurement and classification of TR severity are essential. Therefore, it should be thought about include the RIVIERA in the integrative method to assessing TR severity.Öğe Significance of mitral early diastolic inflow velocity to left atrial strain ratio in patients with Acute Coronary Syndrome (AYISIT-ACS study)(Kare Publ, 2022) Acar, Emrah; Dönmez, İbrahim; İnanır, Mehmet; Kırma, Cevat; Kılıçgedik, Alev; Güneş, Yılmaz; Sincer, İsa: The ratio of mitral early-diastolic inflow peak velocity (E) to left atrial strain (E/LASr) is a novel parameter of the left ventricle diastolic dysfunction.It was shown that E/LASr was a significant predictor of cardiac outcomes in patients with heart failure. This study aims to evaluate the predictive value of E/LASr for death and hospitalisation due to heart failure following acute coronary syndrome (ACS)Öğe Systemic immune-inflammation index as a novel hematological marker for predicting the recurrence of deep venous thrombosis(Sage Publications Ltd, 2024) Dönmez, İbrahim; Müdüroğlu, AyhanObjective To determine whether there was a possible predictive relationship between systemic immune-inflammation index (SII) and recurrence of deep venous thrombosis (DVT).Methods A total of 231 patients with DVT who met the study criteria and whose data could be accessed were enrolled to this retrospective single-centered cross-sectional study. Of them 26 patients with DVT recurrence consisted of the study group (Group 1) while remaining 205 cases without recurrence were considered as the control population (Group 2). The patients' basic clinical features and laboratory results from the complete blood count (CBC) test were recorded and compared between groups. Following univariate analyses, a multivariate logistic regression analysis was performed to identify the independent predictors of the recurrence of DVT. Additionally, a receiver-operating characteristic (ROC) curve analysis was performed to detect the cut-off values of the predictors with sensitivity and specificity rates.Results There were no significant differences between the groups for basic clinical features, except for diabetes mellitus, pulmonary embolism, and atrial fibrillation. Although the univariate analysis revealed that the median values of NLR, PLR, and SII were significantly higher in the DVT recurrence group, only SII was determined to be a significant and independent predictor of DVT recurrence in the multivariate logistic regression analysis. According to ROC curve analysis, SII of 1685 x 103/mm3 constituted the cut-off value for predicting DVT recurrence with 61.5% sensitivity and 76.6% specificity (AUC = 0.686, p = .001).Conclusion The present study demonstrated for the first time in the literature that SII significantly predicted the recurrence of DVT.Öğe Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting(Assoc Medica Brasileira, 2022) Topal, Dursun; Korkmaz, Ufuk Turan Kürşat; Velioglu, Yusuf; Dönmez, İbrahim; Uçaroğlu, Erhan Renan; Kayış, Seyit Ali; Yüksel, AhmetOBJECTIVE: This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. METHODS: A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients' baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation. RESULTS: The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune -inflammation in the atrial fibrillation group were significantly greater than in those in the non-atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative new -onset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7x103/mm3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity. CONCLUSION: Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.Öğe Turkish adult risk factor survey 2013: Rapid rise in the prevalence of diabetes(2014) Onat, Altan; Çakır, Hakan; Karadeniz, Yusuf; Dönmez, İbrahim; Karagöz, AhmetObjectives: To analyze (1) the sex-specific and age-brack- et defined all-cause and coronary mortality in the 23-years’ follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Study design: Information on the mode of death was ob- tained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes As- sociation without the use of glycated hemoglobin. Results: Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person- years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in over- all mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Conclusion: Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.
