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  • Küçük Resim
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    Association between fragmented QRS complexes and left-ventricular dysfunction in anabolic androgenic steroid users
    (Taylor & Francis Ltd, 2020) Kaya, Ülker; Eren, Hayati; Öcal, Lütfi; İnanır, Mehmet; Balaban, İsmail
    Background: Anabolic androgen steroid (AS) use has adverse effects on left ventricular functions, such as fibrosis development. Fragmented QRS is an important marker of myocardial fibrosis, while speckle-tracking echocardiographyis a method used to show subclinical left ventricle dysfunction. In this study, we examined the the ability of fQRS + to detect left ventricle fibrosis by speckle tracking echocardiography (STE) in AS users. Methods: The study included a total of 181 healthy athletes. Athletes were divided into two groups as AS users (n = 89) and non-AS users (n = 92). Then, athletes using AS were divided into two groups as fQRS+ (n = 52) and fQRS- (n = 37). In both groups, the arithmetic mean of three images was used to obtain the left ventricle global longitudinal strain (LV-GLS). The E/SRe ratio was also calculated and analysed. Results: There were significant differences between the AS users and non-AS users in terms of, E/SRe (55.7 +/- 17.9 vs 50.3 +/- 14.8; p = 0.015), LV-GLS (23.1 +/- 1.9 vs 24.0 +/- 1.7; p = 0.001), and fQRS (18.5% vs 6%; p = 0.005). When subgroup analysis was performed, both LV-GLS and E/SRivr were found to be poor in the fQRS + group. When multiple linear regression analysis was performed, we determined fQRS as an independent predictor for LV-GLS and E/SRivr ratio. Conclusion: In conclusion, our study demonstrated that fQRS is a parameter that can beused to determine left ventricle subclinical systolic and diastolic dysfunction in AS users. It can be used for cessation of drug use, especially in long-term use.
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    Diyabetik Hastalarda Nötrofil/Lenfosit Oranı ve Trombosit/ Lenfosit Oranı ile Koroner Yavaş Akım Arasındaki İlişki
    (2021) Eren, Hayati; Inanir, Mehmet
    Amaç: Koroner yavaş akım fenomeni, anjiyografik olarak koroner arterlerin normal olması ve aynı zamanda distal koroner arter yata? ğının kontrast madde ile doluşunun gecikmesi olarak tanımlanmıştır. Diabetes mellitus ve kronik inflamasyonun koroner yavaş akım ge? lişimine neden olduğu gösterilmiştir. inflamasyon belirteçleri olan nötrofil?lenfosit oranının ve trombosit?lenfosit oranının diyabetik has? talarda koroner yavaş akım ile ilişkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Koroner yavaş akım tespit edilen 112 diyabetik hasta ile 112 normal koroner arterlere sahip diyabet hastası kontrol gurubu olarak çalışmaya dahil edildi. Nötrofil?lenfosit oranı ve trombosit?lenfosit oranı değerleri gruplar arasında karşılaştırıldı ve koro? ner yavaş akım ile trombosit?lenfosit oranı ve nötrofil?lenfosit oranı arasındaki ilişkiyi araştırmak için regresyon analizi yapıldı. Bulgular: Diyabetik koroner yavaş akım olan hastalarda trombosit?lenfosit oranı ve nötrofil?lenfosit oranı değerleri anlamlı olarak daha yüksekti (p <0,001). Çok değişkenli lojistik regresyon analizinde, nötrofil?lenfosit oranı ve trombosit?lenfosit oranı diyabetik hastalarda koroner yavaş akım için bağımsız birer prediktör olduğunu bulduk. Sonuç: Bu çalışma, diyabetik hastalarda koroner yavaş akım ile trombosit?lenfosit oranı ve nötrofil?lenfosit oranı arasında bir ilişki ol? duğunu göstermiştir. Kesin mekanizma açıklanamasa da, bulgularımız diabetes mellituslu hastalarda koroner yavaş akım fizyopatoloji? sinde inflamasyonun olası rolünü desteklemektedir.
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    Effects of sleeve gastrectomy surgery on electrocardiographic ventricular arrhythmia markers
    (Bayrakol Medical Publisher, 2022) İnanir, Mehmet; Memioğlu, Tolga; Yılmaz, Fatih; Eren, Hayati; Toprak, Kenan; Şengül, Neriman
    Aim: Severely obese patients are known to be at risk of malignant arrhythmias. The frequency of ventricular arrhythmia and sudden death is increasing in morbidly obese patients. Ventricular depolarization and repolarization parameters on the electrocardiogram can predict mortality and morbidity. Electrocardiographic (ECG) markers of ventricular depolarization and repolarization parameters like QT, QTc, QTd, QTdc, JT, JTc and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios were evaluated before and after sleeve gastrectomy surgery. Material and Methods: ECG recordings of 35 (24 females and 11 males) morbid obese patients without evident cardiovascular disease were analyzed before and 20.3 +/- 9.6 (6-36) months after sleeve gastric surgery. QT, QRS, JT, and Tp-e intervals were measured. QTc, QTd, QTdc, and JTc intervals and Tp-e/QT, Tp-e/ QTc, Tp-e/JT and Tp-e/JTc ratios were calculated. Results: Body mass index (48.29 +/- 7.65 to 31.38 +/- 4.94 kg/m2, p<0.001), QTc interval (405.6 +/- 17.3 to 389.2 +/- 16.6 milisecond (ms), p<0.001), QTd (27.5 +/- 12.4 to 18.3 +/- 9.0 ms, p<0.001), QTdc (30.7 +/- 14.4 to 19.1 +/- 9.1 ms, p<0.001), JTc interval (315.0 +/- 19.0 to 301.2 +/- 20.4 ms, p=0.001), Tp-e interval (81.6 +/- 7.8 to 69.5 +/- 9.3 ms, p<0.001), Tp-e/QT ratio (0.22 +/- 0.03 to 0.19 +/- 0.02, p<0.001), Tp-e/QTc ratio (0.20 +/- 0.02 to 0.18 +/- 0.02, p<0.001), Tp-e/JT ratio (0.29 +/- 0.04 to 0.24 +/- 0.03, p<0.001) and Tp-e/JTc ratio (0.26 +/- 0.03 to 0.23 +/- 0.03, p<0.001) were significantly decreased after sleeve gastrectomy surgery. Discussion: QTc, QTd, QTdc, JTc, and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios, which are potential ECG ventricular arrhythmia predictors were significantly decreased. Therefore weight reduction with sleeve gastrectomy surgery may be associated with decreased malign arrhythmia tendency and sudden cardiac death.
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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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    Increased epicardial adipose tissue thickness is associated with microalbuminuria in hypertensive patients with left ventricular hypertrophy
    (Taylor & Francis Inc, 2021) Eren, Hayati; Omar, Muhammed Bahadır; Kaya, Ülker; Öcal, Lütfi; İnanır, Mehmet; Öcal, Asli Gözek; Genç, Ömer
    Objective Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been previously reported. Microalbuminuria (MA) is associated with target-organ damage, especially in patients with hypertension with left ventricular hypertrophy (LVH) and suggest endothelial dysfunction. This study aimed to investigate the relationship between echocardiographic EAT thickness and presence of MA in patients with hypertension. Methods A total of 297 newly diagnosed hypertension patients who applied to the outpatient clinic were enrolled consecutively in this study. Patients were divided into two groups regarding the presence of LVH in echocardiography. An age and gender matched control group was set including 156 healthy patients without HT. All subjects underwent transthoracic echocardiography for the measurement of EAT thickness. Spot urine samples were collected for the assessment of MA. Results In hypertensive patients with LVH, the EAT thicknesses (6.6 +/- 1.8 vs 5.3 +/- 1.5 vs 5.1 +/- 1.3, p < .001; respectively) and prevalence of MA (41.2 vs 20.1 vs 3.2%; p < .001 respectively) were significantly higher than the other two groups. In hypertensive patiens without LVH, no relationship was found between the presence of MA and EAT thickness. In multivariate regression analyses, EAT thickness (OR: 3.141, 95%CI: 2.425-6.123,p< .001) and left ventricular mass index (OR: 1.339, 95%CI: 1.145-2.143,p= .003) were determined as independent predictors for MA development in hypertensive patients with LVH. Conclusion Measurement of EAT thickness may help to identify high-risk hypertensive patients for target-organ damage especially among patients with LVH.