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    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, Mehmet
    Introduction 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.
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    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 Onur
    Introduction: 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.
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    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, Mehmet
    Background: 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.
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    Usefulness of CHA2DS2-VASc scoring system in predicting atrial fibrillation after coronary artery bypass grafting
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Erdem, Kemalettin; Yazıcı, Mehmet; Öztürk, Serkan; Avcı, Anıl; Güler, Yeliz; Erdem, Fatma Hızal; Dağlar, Bahadır; Dönmez, İbrahim
    Background: This study aims to assess whether CHADS2 and CHA2DS2-VASc scoring systems are useful in predicting atrial fibrillation after coronary artery bypass grafting. Methods: Between January 2010 and July 2013, a total of 478 patients (305 males, 173 females; mean age 62.1 years; range 40 to 83 years) who underwent coronary artery bypass grafting in our clinic were enrolled in the study. Data were obtained from the medical files of the patients and hospital records. All patients were monitored in the intensive care unit after surgery. Atrial fibrillation lasting more than 30 seconds in irregular rhythm without P waves on telemetry was classified as postoperative atrial fibrillation. All patients were evaluated using CHADS2 and CHA2DS2-VASc scoring systems. Results: Of 478 patients, 102 had postoperative atrial fibrillation. CHADS2 and CHA2DS2-VASc scores were statistically significantly higher in patients with postoperative atrial fibrillation than others (2.1 +/- 0.8 vs 1.1 +/- 0.8, p< 0.001 and 4.3 +/- 1.1 vs 2.2 +/- 1.1, p< 0.001). Age, left atrial diameter, left ventricular ejection fraction, and CHA2DS2-VASc scores were independently associated with postoperative atrial fibrillation. A CHA2DS2-VASc score of >= 2 predicted postoperative AF with % 96.3 sensitivity and % 74.6 specificity (AUC= 0.906, 95% CI= 0.875-0.938, p< 0.001). Conclusion: The CHA2DS2-VASc score is a strong predictor of atrial fibrillation development after isolated coronary artery bypass grafting surgery. Therefore, the CHA2DS2-VASc scoring system can be used as a stratification tool to estimate atrial fibrillation after coronary artery bypass grafting.