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Öğe Assessment of aortic stiffness by transthoracic echocardiographic in young COVID-19 patients(Wolters Kluwer Medknow Publications, 2022) Mansiroglu, Asli Kurtar; Disikirik, Tuba; Seymen, Hande; Cosgun, Mehmet; Sincer, IsaBackground: Deteriorated aortic elasticity is part of the atherosclerotic process. Inflammation is an underlying factor in both COVID-19 and atherosclerosis. Aims and Objectives: Using aortic elastic properties, we aimed to assess the subclinical indicators of susceptibility to inflammatory atherosclerosis in patients with COVID-19. Materials and Methods: Out of 194 participants included in this study, 100 were diagnosed with COVID-19 in the last 6 months (60 women and 40 men with a mean age of 34.13 ± 6.45 years) and 94 were healthy controls (55 women and 39 men with a mean age of 30.39 ± 7.21 years). We analyzed transthoracic echocardiographic and aortic stiffness parameters in all participants. Results: Values of systolic blood pressure (110 [85-140] vs. 110 [80-140], P = 0.037) and pulse pressure (PP) (37 [25-55] vs. 40 [25-55], P < 0.01) were significantly different between the groups. As for laboratory parameters, levels of glucose (97.89 ± 20.23 vs. 92.00 ± 9.95, P = 0.003) and creatinine (0.80 ± 0.13 vs. 0.75 ± 0.09, P = 0.003) were significantly higher in the COVID-19 group. Echocardiographic parameters showed that both groups differed significantly in diastolic aortic diameter (2.42 ± 0.28 vs. 2.31 ± 0.35, P = 0.017), aortic strain (9.66 [1.20-31.82] vs. 12.82 [2.41-40.11], P = 0.025), aortic distensibility (0.502 [0.049-2.545] vs. 0.780 [0.120-2.674], P < 0.01), and aortic stiffness (16.67 [4.19-139.43] vs. 11.71 [3.43-65.21], P = 0.006). Conclusion: Measurement of aortic stiffness is a simple, practical yet inexpensive method in COVID-19 patients, and therefore, may be used as an early marker for COVID-19-induced subclinical atherosclerosis. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.Öğe Association of SYNTAX Score withPATIMA Index, Carotid Intima- andExtra- Media Thicknesses(2021) Coşgun, Mehmet; Cosgun, Zeliha; Güneş, Yılmaz; Sincer, Isa; Erdal, Emrah; Mansiroğlu, Aslı; Inanir, MehmetObjectives: Several risk scoring systems have been validated for cardiovascular risk prediction and prognosis. Periarterial adipose tissue intima media adventitia (PATIMA) index combining carotid intima media thickness (CIMT), carotid extra media thickness (CEMT), cardiac epicardial fat thickness (EFT), and body mass index (BMI) are related to coronary artery disease (CAD).Materials and Methods: One-hundred-twenty-four patients were categorized as low synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) (<22) (n=84) or high SYNTAX (?22) (n=40) score groups. Association of PATIMA index and its components with SYNTAX score were analyzed.Results: CIMT, CEMT, BMI, EFT, and PATIMA index were not significantly different between groups. SYNTAX score was not significantly correlated with traditional CVS risk factors (diabetes, hypertension, hyperlipidemia, smoking, age). There was a significant correlation between the PATIMA index and age (r=0.308, p=0.001) but not with other risk factors. Age was significantly correlated with CIMT (r=0.289, p=0.001) and EFT (r=0.208, p=0.02) but not with CEMT (r=0.091, p=0.313). There was a significant correlation between CIMT and CEMT (r=0.414, p<0.001) and between CIMT and EFT (r=0.267, p=0.004).Conclusion: We have found that the recently described PATIMA index and its components, CIMT, CEMT, and EFT are not associated with the severity of CAD assessed by the SYNTAX score. Furthermore, they have not correlated with classical risk factors apart from age.Öğe The comparison of complete blood count parameters between acute and chronic peripheral arterial disease(2022) Coşgun, Mehmet; Güneş, Yılmaz; Mansiroğlu, Aslı; Sincer, Isa; Aktaş, Gülali; Erdoğdu, TayfurRecently published data demonstrated that peripheral arterial disease (PAD) is well associated with some hematological parameters. However, data in acute onset PAD\ris scarce. We aimed to search baseline hematological parameters in angiographically proven lower extremity PAD with chronic and acute thrombotic occlusions. In this\rretrospective study, angiographically proven 172 PAD patients (121 chronic and 51 acute thrombotic cases) and 80 control subjects (without documented coronary and\rperipheral arterial disease) were enrolled to this study and divided into three groups as chronic, acute PAD and control groups. Demographic characteristics, laboratory\rdata and angiography findings of the participants were obtained from computerized database and patient files. All groups were statistically similar with regards to baseline\rclinical and demographic features. WBC and the neutrophils count were found higher whereas the lymphocyte and eosinophil counts were found lower in acute PAD group\rthan chronic PAD and control group. In PAD group (acute and chronic), the median Fontaine stage was significantly positive correlated with N/L ratio and significantly\rnegative correlated with eosinophil count. In multivariable logistic regression analysis, in addition to sex presence of diabetes mellitus and smoking, eosinophil count was\rfound an independent predictor for the development of acute PAD. As well as N/L ratio, eosinophil count is associated with acute development of PAD rather than chronic\rprocess and may be used as a diagnostic marker for this purpose in patients undergoing percutaneous intervention.Öğe Comparison of eosinophil counts in patients with acute pulmonary embolism: Could itbe a predictor factor?(2021) Mansiroğlu, Aslı; Coşgun, Mehmet; Sincer, Isa; Güneş, YılmazAim: To investigate whether there is a relationship between both massive and sub-massive pulmonaryembolism (PE) and eosinophil counts in order to evaluate it as a predictor factor.Methods: This retrospective study included 108 patients (64 sub-massive and 44 massive) who received bothtomographic and clinical diagnoses of pulmonary embolism, and 75 subjects served as controls. Hemogramparameters were compared between patients with massive and sub-massive pulmonary embolism and those ofcontrol groups. Results: In terms of white blood cell and eosinophil counts, the lowest value was evident in the massive PEgroup whereas the control group had the highest value. The eosinophil counts increased significantly one weekafter the treatment when compared to those at the presentation with PE (0.112 (0.003-0.853) vs. (0.144 (0.011- 0.914), p=0.01). Spearman correlation test showed a significant positive correlation between right ventricular dysfunction or elevated cardiac troponin level and massive PE (r=0.54, p <0.001), whereas a negativecorrelation was detected between eosinophil count and the presence of massive PE (r=-0.36, p<0.001). Conclusion: The results of our study suggest that lower eosinophil counts may lead a physician to suggest ahigher probability of acute massive pulmonary embolism rather than sub-massive pulmonary embolism. However, further randomized studies are required to confirm these findings.Öğe Does serum uric acid to high-density lipoprotein cholesterol ratio predict coronary slow flow?(2020) Çekici, Yusuf; Sincer, Isa; Kaplangoray, Mustafa; Yilmaz, Mücahid; Yildirim, ArafatAim: Several studies have found a correlation between coronary slow flow (CSF) and low serum high-density lipoprotein cholesterol (HDL-C) levels or high serum uric acid levels. The present study aimed to evaluate whether serum uric acid to HDL-C ratio predicts CSF.Material and Methods: The experimental (CSF) group included 91 patients (40 females, 51 males, mean age: 52±9) who had angiographically normal coronary arteries but had slow flow in one or more coronary arteries. The control group included 96 patients (57 females, 39 males, mean age: 50±9) with normal coronary anatomy and without slow flow. The uric acid to HDL-C ratio was calculated for the two groups and compared.Results: The HDL-C levels of the CSF group (37±8 mg/dL) were significantly lower compared to the controls (49±10 mg/dL, p<0.001), whereas serum uric acid levels (5.33±0.97 mg/dL) and uric acid to HDL-C ratio (0.14±0.03) of the CSF group were significantly higher compared to the controls (4.37±0.88 mg/dL and 0.09±0.02, p<0.001 and p<0.01, respectively).The receiver operating curve (ROC) analysis revealed that a cut-off >4.64 mg/dL uric acidand >0.119 % uric acid to HDL-C ratio had a sensitivity of 81% and 85% and specificity of 76% and 80% for determination of CSF, respectively (AUC=0.850, 95% CI: 0.792 - 0.908 and AUC=0.890, 95% CI: 0.841 - 0.940,respectively).Spearman's correlation test has been performed and a significant positive correlation has been detected between the uric acid to HDL-C ratio and the mean thrombolysis in myocardial infarction (TIMI) frame count (r=0.62, p<0.001).Conclusion: In this study, higher uric acid to HDL-C ratio values of the CSF group was found compared to the control group. Furthermore, uric acid to HDL-C ratio performed better than serum uric acid levels in predicting CSF.Öğe Evaluation of electrocardiographic ventricular repolarization parameters in stable coronary artery disease(2021) Coşgun, Mehmet; Erdal, Emrah; Güneş, Yılmaz; Sincer, Isa; Mansiroğlu, AslıAim: To examine the relationship between the SYNTAX score (SS) and cardiac repolarization parameterssuch as cQTd and Tp-e values, and Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios in patients who havestable angina pectoris.Methods: 12-lead resting electrocardiograms (ECGs) and SS of 160 patients (51 female and 109 male)undergoing coronary angiography with the pre-diagnosis of stable angina pectoris were evaluated. Patientswith a SS below 22 were classified as Group 1 (low-SYNTAX), and those above 22 (high-SYNTAX) as Group2. Forty-four patients with normal coronary angiography were included in Group 3.Results: Mean age of the patients was 62.4±9.1 years. The heart rate, QRS, QT, cQT and JT durations betweenthe groups were similar. In addition, relatively recent ventricular repolarization indices such as Tp-e intervaland Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios were also not substantially different between groups.Conclusion: Several surface ECG predictors of ventricular arrhythmias, including QTd, JT and Tp-e intervalsand their ratios to QT and JT, are not significantly correlated with SYNTAX score-assessed CAD severity inpatients with stable angina pectorisÖğe Evaluation of epicardial fat tissue thickness in patients with multiple sclerosis(2021) Coşgun, Mehmet; Sincer, Isa; Yilmaz, Güneş Nurdan; Kök, Zafer; Türkoğlu, Şule AydinAim: Multiple sclerosis (MS), which is inflammatory in its pathogenesis, damages the myelin sheath in the central nervous system (CNS) and causes axonal loss. Epicardial fat tissue (EFT), located between the myocardium and the visceral layer of the pericardium, surrounds the heart and several inflammatory cytokines is secreted from this tissue. In this study, we aimed to investigate EFT thickness in MS patients and compared with that of volunteer non-MS subjects. Methods: A total of 154 subjects comprising 61 MS patients and 93 volunteers matched for gender and age were included in our study. Epicardial fat tissue thickness was measured by echocardiography. All values were compared between groups.Results: Echocardiographic parameters were similar in both groups. However, the mean EFT thickness was significantly higher in the MS group than in the control group (p<0.001). Epicardial fat tissue thickness was also significantly correlated with the presence of MS (r=0.33, p<0.001). Conclusion: The results of our study suggest that the increase in epicardial adipose tissue thickness in MS patients may be a predictive factor for cardiovascular disease. However, the clinical significance of this finding and its relevance to MS pathogenesis should be investigated in further studies.Öğe P-wave duration and dispersion in lone obesity(College of Physicians and Surgeons Pakistan, 2021) Cosgun, Mehmet; Sincer, Isa; Inanir, Mehmet; Erdal, Emrah; Mansiroglu, Asli Kurtar; Gunes, YilmazObjective: To assess P-wave duration and dispersion (PD) in morbidly obese young subjects who do not have co-associated atrial fibrillation (AF) risk factors, such as hypertension, diabetes, atrial enlargement and diastolic dysfunction. Study Design: An observational cross-sectional study. Place and Duration of Study: Bolu Abant Izzet Baysal University Medical Faculty, Turkey; and the study was conducted between October 2017 and June 2018. Methodology: P-wave duration and dispersions were determined on 12-lead surface ECG in 47 morbidly obese and 44 healthy weight subjects, aged between 21-40 years. Above mentioned risk factors were studied. The correlation between BMI, PD and Pmax were investigated by Pearson correlation analysis. Results: Average body mass index (BMI) of obese and control groups were 42.3 (8.5) vs. 19.5 (1.5) (P <0.001). Maximum P-wave duration [(Pmax), 105.3±9.8 vs. 95.6±8.5, p<0.001] and PD [27.6 (7.6) vs. 12.2(8.3), p<0.001] were statistically significantly prolonged in obese patients when compared to the normal weight group. BMI correlation with Pmax and PD (r=0.485; p<0.001 and r=0.620; p<0.001, respectively) were significant. Conclusion: Pmax and PD, which are potential electrocardiographic AF predictors, may increase in lone obese patients having no comorbidities. © 2021 College of Physicians and Surgeons Pakistan. All rights reserved.Öğe Prediction of new-onset atrial fibrillation after off-pump coronary artery bypass surgery using left atrial area and area index(2022) Mansiroğlu, Aslı; Sincer, Isa; Güneş, Yılmaz; Unal, Osman; Erdem, KemalettinAim: This study aimed to determine preoperative echocardiographic predictors of postoperative atrial fibrillation (POAF) in patients undergoing beating-heart coronary artery bypass grafting (CABG) surgery. Materials and Methods: 84 patients undergoing off-pump isolated CABG were prospectively enrolled. The left atrium area (LAA) was measured from the apical fourchamber projection at the end-ventricular systole, and then indexed to BSA for the left atrial area index (LAAI). POAF was detected with continuous telemetry and surface 12 electrocardiograms throughout hospitalization. Results: We observed postoperative atrial fibrillation (AF) in 32 patients (38%, 64.9±10.2 years); of whom 87.5% ( 28 patients) were men. Patients with POAF had significantly larger left atrium (LA) area (18.9 ± 3.7 vs. 21.3 ± 4.9 cm2, p=0.016 ), higher LAAI (10.4 ± 2.0 vs. 12.0 ± 2.6 cm2/m2, p= 0.001), and higher systolic pulmonary artery pressure (30 (2-37) vs. 33 (20-64), p=0.05). In addition, lateral wall Em (9 (3-14) vs. 7 (3-15), p= 0.047), Am (10.8 ± 2.6 vs. 8.3 ± 3.0, p=0.05), and left ventricular ejection fraction (LVEF) (60.5 (23- 78.50) vs. 57.15 (33.10-74.90), p=0.05) were significantly lower in patients with POAF. Based on the backward stepwise model of multivariate analysis, LAAI (p=0.007, 95% CI for OR:1.374 (1.092-1.729)) and LVEF (p=0.039, 95% CI for OR:0.889 (0.796-0.994)) were found to be the strongest independent predictors of POAF. Conclusion: In this study, LAAI and LVEF were independent predictors of POAF development after off-pump CABG surgery. These predictors may be helpful in risk assessment for the possibility of POAF in patients undergoing off-pump CABG surgery.Öğe A promising marker in patients with coronary artery ectasia: Uric acid / HDL ratio(2021) Mansiroğlu, Aslı; Coşgun, Mehmet; Sincer, Isa; Güneş, YılmazAim: Elevated levels of uric acid and low levels of high-density lipoprotein (HDL) cholesterol are associated with cardiovascular events and mortality. We investigated a novel marker, uric acid/HDLratio (UHR), in coronary artery ectasia patients (CAE). Materials and Methods: The present study included 104 patients (58 male, 46 female; mean age, 61±12 years) diagnosed as having isolated CAE and 110 controls (44 male, 66 female; mean age, 60±12 years) whose coronary artery findings were normal as revealed by coronary angiography. Medical records of all the patients were reviewed and the data were collected retrospectively. Baseline characteristics, hematologic and biochemistry parameters were recorded, and we calculated the value of UHRResults: The CAE group had significantly higher values of uric acid (6.48±1.62 vs. 5.37±1.12; p<0.001) and UHR (0.15±0.05 vs. 0.11±0.05; p<0.001). Spearman’s correlation test showed a significant association of uric acid and UHR with CAE (r=0.40, p<0.001 and r=0.51, p<0.001, respectively). On the other hand, HDL had a negative correlation with the presence of CAE (r=0.44, p<0.001). A receiver operating curve (ROC) analysis revealed that a cut-off>0.120 UHR (%) values had a sensitivity of 72% and specificity of 68% for the determination of CEA.Conclusion: We observed in our study the finding in which the uric acid and UHR values were higher in individuals with CAE compared to non-CAE subjects. There was an association between UHR and CAE.
