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    Comparison of Balloon-Expandable and Self-Expandable Valves in Patients with Transcatater Aortic Valve Implantation in Terms of Demographic and Complications and Evaluation of the Predictors of Complications: A Retrospective Single Center Experience
    (OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2023) Kiliç R.; Güzel T.; Aktan A.; Arslan B.; Ertaş F.
    Transcatheter aortic valve implantation (TAVI) offers an alternative to surgery for patients with symptomatic severe aortic stenosis. Currently, the most commonly used valves for clinical use are the Balloon-expandable Edwards SAPIEN and Self-expandable CoreValve Revalving valves. The aim of our study is to compare these valve types used in TAVI procedures performed in our center and to determine the predictors of complications. Material and Methods: 96 patients who underwent TAVI in our center were included in our study. Pre-procedural clinical, laboratory and echocardiographic data of patients who underwent TAVI were reviewed retrospectively. Results: Complications developed in 31 (32.3%) of the patients. Total complications were found to be higher in patients with balloon-expandable valve (18 vs. 13, p=0.036, respectively). In patients who developed complications, hemoglobin and hematocrit values at the time of admission to the hospital were found to be significantly lower, and C-reactive protein was found to be high. Among the echocardiographic findings at admission, the aortic valve area was found to be narrower and the maximum and mean gradient was higher in patients with complications. Conclusion: In our study, a lower complication rate was observed in self-expandable valves. Some independent markers of TAVI-specific complications and mortality were identified. Examination of new predictors and development of a TAVI-specific scoring system may be considered in future prospective controlled studies. 2146-9032 / Copyright © 2023 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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    Effect of sleep quality on hemodynamic response to exercise and heart rate recovery in apparently healthy individuals
    (The Canadian Society for Clinical Investigation, 2014) Yuksel M.; Yildiz A.; Demir M.; Bilik M.Z.; Ozaydogdu N.; Aktan A.; Isik F.
    Purpose: Poor sleep quality has an unfavorable impact on autonomic nervous system activity, especially that of the cardiovascular (CV) system. The heart rate (HR) and blood pressure (BP) at rest and during exercise, along with the heart rate recovery (HRR), were examined in poor sleepers and compared with individuals with good sleep quality. Methods: A total of 113 healthy individuals were enrolled to the study. All participants performed treadmill stress testing. Sleep quality of participants was assessed by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire: 48 subjects were categorized as 'poor sleepers' (PSQI score > 6 points), and the rest were grouped as 'good sleepers'. Results: The poor sleepers showed higher resting HR (p<0.001), higher diastolic BP (p=0.006), similar systolic BP (p=0.095), more frequent hypertensive response to exercise (p=0.046) and less HR increase with exercise (chronotropic incompetence) (p=0.002) compared with individuals who reported good sleep quality. In addition, the poor sleepers demonstrated reduced heart rate recovery at the 1st and 3rd minute of recovery (p=0.005 and 0.037, respectively) compared with good sleepers. Multivariate logistic regression analysis revealed that only resting diastolic BP was the independent predictor of HRE. The PSQI score was positively correlated with resting HR; while it was negatively correlated with HR response to exercise, HRR1 and HRR index-1. Conclusion: This cross-sectional study emphasizes the effect of poor sleep quality on unfavorable cardiovascular outcome indicators of the treadmill stress test. © 2012 CIM.