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Öğe Akut anterior miyokard infarktüslü hastalarda anjiotensin konverting enzim gen polimorfizmi ile sol ventrikül miyokardiyal performans indeksi (TEİ indeksi) arasındaki ilişki(2016) Öztürk, Önder; Toprak, NizamettinAkut anterior miyokard infarktüslü hastalarda ACE gen polimorfizminin sol ventrikül fonksiyonları üzerindeki etkilerini miyokardiyal performans indeksi ile araştırmak amacıyla bu çalışma planlandı. Çalışma kriterlerine uyan, DD ve İD genotipinde ortalama yaşları 59,3 ± 12,3 olan 128 hasta, II genotipinde ortalama yaşları 56,7 ± 14,9 olan 14 hasta ACE genotip analizine ve ekokardiyografik değerlendirmeye tabi tutuldu. Hastaların miyokardiyal performans indeksleri pulse-Doppler ekokardiyografi mitral kapak uç kısımlarına ve aort kapağının hemen aşağısına yerleştirilerek ölçülen parametrelerden hesaplandı. ACE DD ve İD genotipli hastalar ile ACE II genotipli hastaların miyokard infarktüsünün birinci gün MPİ' leri ile beşinci gün MPİ' leri arasında anlamlı fark bulunmadı. Ancak, ACE DD ve İD genotipli hastaların birinci gün ile beşinci gün MPl'leri ile sol ventrikül ejeksiyon fraksiyonları arasındaki fark anlamlı bulunurken, ACE II genotipli hastaların birinci gün ile beşinci gün MPl'leri ile sol ventrikül ejeksiyon fraksiyonları arasındaki fark anlamlı bulunmadı. D alleli olan grupta MPİ ile ejeksiyon fraksiyonunda anlamlı düzelme gözlenirken, I alleli olan grupta anlamlı bir fark gözlenmedi. DD ve İD genotipli hastalarda birinci gün ile beşinci gün sol ventrikül diyastol çapları arasında anlamlı fark mevcut iken, II genotipli hastalarda anlamlı fark gözlenmedi. D alleli olan grupta beşinci gün sol ventrikül diyastol çapı ile, birinci gün sol ventrikül diyastol çapına göre daha geniş bulundu. Akut anterior miyokard infarktüsünde ACE DD ve İD genotipli hastalarda ACE II genotipli hastalara göre sol ventrikülde anlamlı düzeyde dilatasyon, dolayısyla daha fazla remodeling saptanırken, ACE DD ve İD genotipli hastaların ACE II genotipli hastalara göre ACE inhibisyonundan daha fazla fayda gördüğü sonucuna varıldı. Anahtar Kelimeler : Anterior Miyokard Infarktüsü, Anjiotensin Konverting Enzim Gen Polimorfizmi, Miyokardiyal Performans İndeksi.Öğe Assessment of Myocardial Function by Myocardial Performance Index in Patients with Acute Ischemic Stroke(2019) Tamam, Yusuf; Öztürk, Önder; Öztürk, ÜnalObjective: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an importantcomplication of acute cerebrovascular events. In this study, we aimed to investigate the relationship betweenmyocardial function assessed by myocardial performance index (MPI) and National Institutes of Health Stroke Scale(NIHSS) score in patients with acute ischemic stroke.Method: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) diagnosed with acute ischemicstroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group1, NIHSS score < 16; Group 2, NIHSS score ? 16). Demographic, clinical, and laboratory data for all patients werecollected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to theneurology care unit.Results: There were no significant differences among demographic parameters of patients. MPI was significantlyhigher in Group 2 patients than in Group 1 patients (0.59±0.25 vs 0.48±0.20, p=0.004).Conclusion: Our results suggest that MPI is associated with stroke severity on admission in patients with acuteischemic stroke. MPI is an indicator of global myocardial dysfunction with a different from LVEF. MPI, which includesboth systolic and diastolic time intervals is an option to assess the global cardiac dysfunction.Öğe Assessment of myocardial function by myocardial performance index in patients with acute ischemic stroke(Dicle Üniversitesi Tıp Fakültesi, 2019) Öztürk, Ünal; Öztürk, Önder; Tamam, YusufObjective: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. In this study, we aimed to investigate the relationship between myocardial function assessed by myocardial performance index (MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Method: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) diagnosed with acute ischemic stroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit. Results: There were no significant differences among demographic parameters of patients. MPI was significantly higher in Group 2 patients than in Group 1 patients (0.59±0.25 vs 0.48±0.20, p=0.004). Conclusion: Our results suggest that MPI is associated with stroke severity on admission in patients with acute ischemic stroke. MPI is an indicator of global myocardial dysfunction with a different from LVEF. MPI, which includes both systolic and diastolic time intervals is an option to assess the global cardiac dysfunction.Öğe Assessment of myocardial function by tissue Doppler imaging myocardial performance index in patients with acute ischemic stroke(Çukurova Üniversitesi Tıp Fakültesi, 2019) Öztürk, Ünal; Öztürk, Önder; Tamam, YusufPurpose: The aim of this study is to investigate the relationship between myocardial function assessed by tissue Doppler imaging myocardial performance index (TDI-MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 128 patients (males, 55; females, 73; 68 ± 19 years) with acute ischemic stroke. 20 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit. Results: There were no significant differences among demographic parameters of patients. Tissue Doppler myocardial performance index was significantly higher in Group 2 patients than in Group 1 patients (0.62±0.28 vs 0.46±0.16). Conclusion: Our results suggest that TDI-MPI is associated with stroke severity on admission in patients with acute ischemic stroke. TDI-MPI is an indicator of global myocardial dysfunction with a different from LVEF. TDI-MPI, which includes both systolic and diastolic time intervals to assess the global cardiac dysfunctionÖğe Assessment of right atrial function with speckle tracking echocardiography after percutaneous closure of an atrial septal defect(Sociedade Portuguesa de Cardiologia, 2017) Öztürk, Önder; Öztürk, Ünal; Öztürk, ŞengülIntroduction: Speckle tracking echocardiography (STE) for two-dimensional (2D) strain analysis is a new tool to assess myocardial function. The aim of this study was to assess right atrial (RA) function using STE in patients with an atrial septal defect (ASD) before and one month after percutaneous closure. Methods: We prospectively examined 32 consecutive patients (nine male, 23 female) who underwent percutaneous transcatheter closure of a secundum ASD between June 2013 and December 2015. Echocardiography was performed on admission, prior to cardiac catheterization and then one month after ASD closure. Peak global RA longitudinal strain was analyzed by 2D-STE. Results: Patients’ mean age was 34.6±8.2 years. The mean diameter of the occlusive devices was 18.5±7.5 mm. Right ventricular (RV) end-diastolic diameters were significantly increased but decreased significantly after ASD closure (43±5 vs. 38±4 mm, p<0.05). Left atrial (LA) diameters (40±8 vs. 37±6 mm, p<0.05) decreased significantly after the intervention, whereas left ventricular (LV) end-diastolic diameters (45±5 vs. 46±4 mm, NS) remained unchanged. Tricuspid annular plane systolic excursion increased significantly (17.6±5.4 vs. 22.3±8.1 mm, p<0.05). After closure of the defect, a significant increase was observed in longitudinal RA strain (26.5±9.6% vs. 35.3±10.5%, p<0.001). Conclusions: After percutaneous transcatheter closure of a secundum ASD, there was an increase in RA longitudinal strain. 2D-STE strain analysis appears to be helpful for the assessment of RA function and of response to correction of volume overload after percutaneous transcatheter closure of a secundum ASD.Öğe “The association between HALP score and infection in acute ischemic stroke patients”(W.B. Saunders, 2024) Öztürk, Ünal; Nergiz, Şebnem; Öztürk, ÖnderBackground and purpose: Stroke-associated infection (SAI) is related to increased mortality in acute ischemic stroke (AIS) cases. The HALP index is used to evaluate nutrition and inflammation. Our research aimed to assess the relation between HALP scores and infection risk in AIS cases. Materials and methods: 132 cases of acute ischemic stroke were registered. 77 cases were male and 55 cases were female. The median age of the attending cases was 66 (35–104) years. Laboratory variables were assessed within 24 h after hospitalization in the neurology care unit. The HALP score is evaluated utilizing the formula “Hemoglobin (g/dL) × Albumin (g/dL) × Lymphocyte (/10^3/uL) / Platelet (/10^3/uL)”. Results: Cases were separated into two groups according to their corresponding HALP score. Group-1 cases have a low HALP score (HALP score ≤ 18227,93). Group-2 cases have a high HALP score (HALP score > 18227,93). 26 (19.6 %) cases were diagnosed with various infections after hospitalization in the neurology care unit. Urinary tract infections were frequent infection causes in AIS cases (13 cases, 50 %). Pneumonia was observed in 8 cases, making up 30 % of the total cases. Another infection was seen in 5 (20 %) of the cases. The frequently encountered bacteria were Escherichia coli ESBL + (n = 7, 27 %) and Staphylococcus aureus (n = 6, 23 %). The mortality ratio was higher in Group-1 cases than in Group-2 cases (34 % vs 7 %). Conclusions: This investigation has suggested a relationship between infection and HALP score in AIS patients.Öğe The impact of prognostic nutritional index on mortality in patients with COVID-19(Emerald Publishing, 2023) Nergiz, Şebnem; Öztürk, ÖnderPurpose: Malnutrition has a significant effect on the onset and progression of infective pathology. The malnutrition status in COVID-19 cases are not understood well. Prognostic Nutritional Index (PNI) is a new and detailed assessment of nutrition and inflammation cases. This study aims to investigate the effect of PNI on mortality in COVID-19 patients. Design/methodology/approach: In total, 334 patients (males, 142; females, 192; 64.5 ± 12.3 years of age) with COVID-19 bronchopneumonia were enrolled in this investigation. Cases were divided into two groups with respect to survival (Group 1: survivor patients, Group 2: non-survivor patients). Demographic and laboratory variables of COVID-19 cases were recorded. Laboratory parameters were calculated from blood samples taken following hospital admission. PNI was calculated according to this formula: PNI = 5 * Lymphocyte count (109/L) + Albumin value (g/L). Findings: When the patients were assessed with respect to laboratory values, leukocytes, neutrophils, CRP, ferritin, creatinine and D-Dimer parameters were significantly lower in Group 1 patients than Group 2 patients. Nevertheless, serum potassium value, lymphocyte count, calcium and albumin values were significantly higher in Group 1 cases than in Group 2 cases. PNI value was significantly lower in Group 2 cases than in Group 1 cases (39.4 ± 3.7 vs 53.1 ± 4.6). Originality/value: In this retrospective study of COVID-19 cases, it can be suggested that PNI may be a significant risk factor for mortality. In conclusion of this research, high-risk patients with COVID-19 can be determined early, and suitable medical therapy can be begun in the early duration.Öğe Koroner arter hastalığının değişik klinik yelpazelerinde C-reaktif protein, fibrinojen ve klamidyaların rolü(2001) Karadede, A. Aziz; Toprak, Nizamettin; Öztürk, Önder; Karabulut, Aziz; Ülgen, Sıddık; Aydınalp, Özlemİnflamasyon atheroskleroz gelişimine katkıda bulunabilir. Ancak yüksek C-reaktif protein (CRP), fibrinojen ve klamidya serolji düzeyleri ile koroner olay riskleri arasında oldukça çelişkili sonuçlar bildirilmiştir ve bu konu hala tartışılmaktadır. Bu amaçla, CRP ve fibrinojen değerlerini, koroner arter hastalığı anjiyografik olarak gösterilen hastalar ve bunların alt gruplarıyla, sağlıklı gönüllüler ve koroner anjiyografi sırasında koroner arterleri normal çıkan hastalar arasında karşılaştırdık. Koroner arter hastalığı olan 95 hasta (grup 1), normal koroner anjiyografili 30 hasta (grup 2) ve 35 sağlıklı gönüllü kontrol hastanın (grup 3) CRP ve fibrinojen düzeyleri tubidimetric ve kuagulometric metod ile değerlendirildi. Grup 1'in CRP düzeyi grup 2 ve 3'e göre daha yüksekti (sırasıyla 14.5±20 mg/L, 7.5±10 mg/L; p<0,05 grup 1ve 3'e göre ve 2.3±3.6 mg/L; p<0.001grup 1'e göre). Grup 1 içindeki akut miyokard infarktüsü (MI) geçiren (28.6±29 mg/L p<0.01) yada son iki ay içinde MI geçirmiş olan (9.1±12mg/L p=NS) ve unstabil anjina pektorisili (16,7±19mg/L p<0,05) hastaları içeren alt gruplarda CRP seviyesi daha yüksekti. Ancak grup 1 içinde stabil anjina pektorisi olan alt grubun CRP düzeyi hem sağlıklı kontrol grubuyla (5.5±7.7 mg/L ve 5.3±3.6 mg/L) hem de koroner anjiyosu normal olanlarla benzer idi. Fibrinojen düzeyleri ise grup 1 ve 2 de sağlıklı gönüllülere göre daha yüksek olmakla birlikte kendi aralarında ve grup 1'in alt grupları arasında anlamlı farklılık yoktu. Ayrıca Klamidya ve Mikoplazma serolojileri ile koroner arter hastalığı arasında hiçbir grupta ilişki bulunamadı. CRP ve fibrinojen düzeyi arasında pozitif korelasyon olduğu halde (r=0.35 p<0.01), klamidya ve mikoplazma serolojileri ile CRP arasında böyle bir korelasyon yoktu.Sonuç olarak, koroner arter hastalığının akut koroner sendrom alt gruplarıyla, CRP arasında kuvvetli ilişki olmasına rağmen, kronik stabil koroner hastalıklarını belirlemede CRP'nin potansiyel bir rolünün olmadığı tespit edildi. Fibrinojenin ise akut koroner sendromları belirlemede anlamlı rolü yoktur. Koroner arter hastalığı ile klamidya ve mikoplazmalar arasında da herhangi bir ilişki bulunamamıştır.Öğe A lethal but treatable complication: Free wall rupture after acute myocardial infarction(TIP ARASTIRMALARI DERNEGI, 2006) Ülgen, Mehmet Sıddık; Öztürk, Önder; Kayrak, Mehmet; Soylu, Ahmet; Düzenli, Mehmet Akif; Koç, FatihA 43-year-old male patient was admitted to coronary intensive care unit with the diagnosis of acute inferolateral myocardial infarction and with a picture of cardiogenic shock. In physical examination, systolic blood pressure was 50 mmHg and diastolic blood pressure could not be taken. The patient was diagnosed with cardiogenic shock and was started on saline, dopamine and dobutamine infusion. His blood pressure did not increase although the dosage of positive inotropic agents was increased. A cardiac tamponade revealed with urgent echocardiographic evaluation and pericardiocentesis was carried out. Blood pressure returned to normal range within hours after pericardiosentesis. Echocardiographic examination performed on the second day of AMI on the asymptomatic patient revealed thrombosed myocardial rupture. The patient was referred to emergency surgery with the diagnosis of three-vessel disease and myocardial rupture according to urgent angiography. In the operation, the ruptured region in the ventricle free wall was primarily repaired. By-pass surgery was performed with saphenous vein graft to the LAD and CV-OM1 coronary arteries.Öğe Primary PCI in a patient with congenitally corrected transposition of the great arteries(Elsevier B.V., 2016) Öztürk, Önder; Öztürk, Ünal; Nergiz, Şebnem; Karahan, Mehmet Zülkif; 0000-0002-0166-9668Congenitally corrected transposition of the great arteries (CCTGA) is a rare disease in which there is both ventriculoarterial and atrioventricular discordance. The systemic ventricle is of right morphology and patients are at high risk of developing systemic ventricular dysfunction. We report on a 41 year old male patient with primary PCI and congenitally corrected transposition of the great arteries.Öğe Relation between angiotensin-converting enzyme I/D gene polymorphism and pulse pressure in patients with a first anterior acute myocardial infarction(2009) Öztürk, Ünal; Öztürk, ÖnderAmaç: Kanıtlar nabız basıncındaki artışın kardiyovasküler morbidite ve mortalite riskinde artışa yol açtığını göstermektedir. Bu çalışmanın amacı, ilk kez anteriyor akut miyokard infarktüs geçiren hastalarda, nabız basıncı üzerinde anjiyotensin dönüştürücü enzim (ACE) gen polimorfizminin etkilerini belirlemekti. Yöntemler: Bu enine kesitli çalışmaya ilk kez anteriyor akut miyokard infarktüsü geçiren 116 hasta alındı. DNA periferik lökositlerden izole edildi. ID durumu, klinik bulgulardan habersiz laboratuvar üyesi tarafından, polimeraz zincir reaksiyonuyla belirlendi. ACE gen polimorfizmine göre hastalar 3 gruba ayrıldı. Delesyon/Delesyon (DD) Genotip (Grup 1, n=45), İnsersiyon/Delesyon (I/D) Genotip (Grup 2, n=58), İnsersiyon/İnsersiyon (II) Genotip (Grup 3, n=13).Kan basıncı ölçümleri hastalar koroner yoğun bakım ünitesine yatırıldıktan sonraki ilk 10 dk içerisinde ölçüldü. Nabız basıncı, sistolik kan basıncından diyastolik kan basıncının çıkarılması ile elde edildi. Ekokardiyografik inceleme Amerikan Ekokardiyografi Komitesi önerilerine uygun olarak, parasternal uzun aks ve apikal dört boşluk pencereler kullanılarak yapıldı. Farklı genotiplere sahip örnekler arasındaki farklılığı karşılaştırmak için ANOVA ve Ki-kare testleri kullanıldı. Bulgular: Klinik özellikler bakımından hastalar arasında fark yoktu. Nabız basıncı ACE DD ve ID genotipli hastalarda ACE II genotipli hastalara göre anlamlı derecede yüksek bulundu (sırası ile 47±16, 47±14 ve 39±12, F=3.4, p<0.05). Fakat sistolik kan basıncı, diyastolik kan basıncı ve kalp hızı bakımından gruplar arasında anlamlı fark saptanmadı.Sonuç: Yapmış olduğumuz bu çalışmada ACE Gen I/D polimorfizmi D alleli ilk kez anteriyor akut miyokard infarktüsü geçiren hastalarda nabız basıncını etkileyebileceğini gösterdik.Öğe Relationship between stroke severity and repolarization parameters in patients with acute ischemic stroke(Çukurova Üniversitesi Tıp Fakültesi, 2019) Öztürk, Ünal; Öztürk, Önder; Tamam, YusufThe aim of this study was to investigate the relationship between repolarization parameters and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) with acute ischemic stroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. A 12-lead resting ECG was recorded at admission to the neurology care unit in patients with acute ischemic stroke and were manually measured with a ruler. QTc, QTd, QTcd, Tpe, Tpe/QT parameters were measured. Results: There were no significant differences among demographic parameters of patients. We found that QTc, QTd, QTcd, Tpe, Tpe/QT parameters were significantly higher in Group 2 than Group 1 patients. Conclusion: In this study, we found that acute ischemic stroke has been shown to cause changes in repolarization parameters. Repolarization parameters are associated with stroke severity on admission in patients with acute ischemic stroke. Increased dispersion of repolarization parameters make independent contributions to the risk of arrhythmic cardiac death in patients with acute ischemic stroke. We suggested that especially severe ischemic stroke patients closely using cardiac monitoring during the first 24 h.Öğe Relationship between systemic immune inflammation index and prognosis in patients with COVID-19(Dicle Üniversitesi Tıp Fakültesi, 2022) Nergiz, Şebnem; Öztürk, ÖnderObjectives: Inflammation and coagulation perform a substantial act in the pathophysiology of COVID-19 cases. The systemic immune-inflammation index (SII) is a novel prognosis and inflamation index. In this study, we aimed to research the relation between SII and prognosis in COVID-19 patients. Methods: 315 cases (males, 136 ; females, 179 ; 63.2 ± 11.4 years) with positive PCR and lung tomography evidences compatible with COVID-19 pneumonia were recorded in the research. Patients were separated into 2 groups according to the mortality (Group 1; Surviving patients, Group 2; Ex patients). Clinical, demographic, and laboratory datas for whole patients were registered Laboratory datas were measured from blood parameters taken during hospitalization. The SII was calculated as “ SII = neutrophil count × platelet count / lymphocyte count ”. Results: The mean hospital stay of the patients is 12 (5-26) days. When the patients were assessment of according to clinical features, an important distinction was found between the two groups according to age, gender, cardiovascular disease, chronic renal failure, neurolvascular disease, and diabetes mellitus. When the patients were evaluated according to laboratory parameters, white blood cells, neutrophils, creatinine, D-Dimer, ferritin, CRP values were observed to be significantly higher in Group 2 patients than Group-1 patients. However, lymphocyte count, serum potassium level, albumin and calcium levels were observed to be significantly lower in Group-2 patients than in Group-1 patients. SII level was significantly higher in Group 2 patients than Group-1 patients (1813.4 ±118.7 vs 978.2 ± 93.1, p<0.001). Conclusions: Our results suggested that a relation between a higher SII value and a death in COVID-19 patients. As a simple parameter, SII is a significantly estimating of death in COVID-19 patients.Öğe Viral kökenli karaciğer sirozunda kardiyak fonksiyonlar(2003) İltümür, Kenan; Alan, Sait; Toprak, Nizamettin; Yalçın, Kendal; Öztürk, Önder; Karabulut, AzizAmaç: Kalp hastalıkları karaciğer (KC) hastalıklarının örneğin kardiyak siroz, KC hastalıklarıda kalp hastalıklarının (sirotik kardiyomiyopati gibi) gelişmesini etkileyebilir.Viral kökenli karaciğer sirozu (KC-S) ile ilgili az çalışma vardır. Bu çalışmada viral kökenli sirotik hastaların ve kontrol grubunun kardiyak yapı ve fonksiyonları incelendi. Gereç ve Yöntem: Otuz viral kökenli KC-S'li hasta ile (ortalama yaş, 43±12), 30 kontrol vakasında (ortalama yaş, 37±11), sol ve sağ ventrikülün hem sistolik hem de diyastolik parametreleri karşılaştırıldı. M mod, iki boyutlu ve Doppler ekokardiyografi ile sağ ve sol ventrikül fonksiyonları ile kardiyak ölçümler yapıldı. Diyastolik fonksiyonlar mitral ve triküspit doluş parametrelerinden erken doluş (E dalgası), geç doluş (A dalgası), E/A oranı ve E dalgasının yavaşlama zamanı alındı.Ayrıca pulmoner arter basıncı da (PAB) değerlendirildi. Bulgular: Kontrollerle karşılaştırıldığında KC-S grubunda sol atriyum ve sağ kalp boşlukları önemli derecede büyümüştü (p<0.05). Ayrıca kontrol grubuna göre hem sol hemde sağ ventrikülün duvar kalınlıkları artmıştı (p<0.05).Sol ventrikülün sistolik ve diyastolik fonksiyonları bozulmamıştı ancak sağ ventrikülün diyastolik fonksiyonları bozulmuştu (p<0.05). KC-S grubunda daha düşük triküspit E/A oranı, daha düşük pik E, daha yüksek pik A vardı (p<0.05). Ayrıca PAB sirotik hastalarda artmıştı (p<0.05). Sonuç: Viral kökenli sirozda sol atriyum ve sağ kalp boşlukları genişlemektedir.Ayrıca karaciğer sirozu sağ ventrikül diyastolik fonksiyonlarının bozulmasına ve pulmoner arter basıncının da artmasına yol açmaktadır.
