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Öğe The association between platelet/lymphocyte ratio and coronary artery disease severity(Turkish Society of Cardiology, 2015) Yüksel, Murat; Yıldız, Abdulkadir; Oylumlu, Mustafa; Akyüz, Abdurrahman; Aydın, Mesut; Kaya, Hasan; Acet, Halit; Polat, Nihat; Bilik, Mehmet Zihni; Alan, SaitObjective: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). Methods: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. Results: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cut-off value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. Conclusion: Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis. (Anatol J Cardiol 2015; 15: 640-7).Öğe Can empagliflozin improve left ventricular strain parameters in patients with type-2 diabetes mellitus and normal ejection fraction?(Dicle Üniversitesi Tıp Fakültesi, 2022) Işık, Ferhat; Aslan, Burhan; Bilge, Önder; İnci, Ümit; Taştan, Ercan; Akyüz, Abdurrahman; Demir, Muhammed; Özbek, Mehmet; Akın, Halil; Araç, EşrefObjectives: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to improve symptoms and reduce mortality in patients with heart failure (HF). Empagliflozin is an SGLT-2 inhibitor. Although empagliflozin is beneficial in patients with type-2 diabetes mellitus (DM) with or without HF, data on how empagliflozin affects echocardiographic parameters are limited. We aim to evaluate the changes in left ventricular myocardial strain parameters with 2-dimensional speckle-tracking echocardiography (2D-STE) in patients with type-2 DM and normal ejection fraction (EF) after empagliflozin treatment. Methods: A total of 92 participants were included in our study. Forty-eight of them had type-2 DM and 44 were the control group. The left ventricular ejection fraction (LVEF) of the type-2 DM patients was normal, and there were no HF symptoms and findings. Empagliflozin 10 mg once daily was given to the diabetic group. Initial and at the end of the 3rd month, the 2D-STE parameters of the diabetic group were compared. Results: The median age of the study population was 52.0 (46.0-58.0, IQR), and 48 (52.1%) were female. The left ventricle global longitudinal strain (LV-GLS), left ventricle global circumferential strain (LV-GCS), and left ventricular global radial strain (LV-GRS) were less in the diabetic group than in the control group (p value < 0.001, < 0.001, and < 0.001, respectively). There was a significant increase in the LV-GLS and LV-GCS compared to before empagliflozin treatment (-20.0 [-17.6;-20.9] vs -19.2 [-17.5;-20.2], p= 0.005 and -18.9 [-16.0;-20.8] vs -17.1 [-15.8;-18.7], p= 0.003, respectively). Although the LV-GRS increased compared to baseline, the change was not significant (37.0 [31.0-41.6] vs 36.3 [32.4-40.3], p= 0.776). Conclusion: In our study, after empagliflozin treatment left ventricular myocardial strain parameters such as LV-GLS and LV-GCS were improved in patients with type-2 DM and normal EF.Öğe The effect of chronic DOAC treatment on clinical outcomes of hospitalized patients with COVID-19(John Wiley and Sons Inc, 2021) Aslan, Burhan; Akyüz, Abdurrahman; Işık, Ferhat; Çap, Murat; İnci, Umit; Kaya, İlyas; Karahan, Mehmet Zülküf; Aktan, Adem; Bilge, Önder; Özbek, Mehmet NuriBackground: Recent findings indicate that thrombosis is one of the underlying pathophysiology and complication of COVID-19 infection. Therefore, the prognosis of the disease may be more favourable in people who were under oral anticoagulant treatment before the COVID-19 diagnosis. This study aims to evaluate the effects of chronic DOAC use on ICU admission and mortality in hospitalized patients due to COVID-19 infection. Method: Between 1 September and 30 November 2020, 2760 patients hospitalized in our hospital due to COVID-19 were screened. A total of 1710 patients who met the inclusion criteria were included in the study. The patients were divided into two groups as those who use DOAC due to any cardiovascular disease before the COVID-19 infection and those who do not. Results: Seventy-nine patients were enrolled in the DOAC group and 1631 patients in the non-DOAC group. Median age of all study patient was 62 (52-71 IQR) and 860 (50.5%) of them were female. The need for intensive care, in-hospital stay, and mechanical ventilation were observed at higher rates in the DOAC group. Mortality was observed in 23 patients (29%) in the DOAC group, and it was statistically higher in the DOAC group (P =.002). In the multivariable analysis, age (OR: 1.047, CI: 1.02-1.06, P <.001), male gender (OR: 1.8, CI: 1.3-2.7, P =.02), lymphocyte count (OR: 0.45, CI: 0.30-0.69, P <.001), procalcitonin (OR: 1.12, CI: 1.02-1.23, P =.015), SaO2 (OR: 0.8, CI: 0.77-0.82, P <.001) and creatinine (OR: 2.59, CI: 1.3-5.1, P =.006) were found to be associated with in-hospital mortality. DOAC treatment was not found to be associated with lower in-hospital mortality in multivariable analysis (OR:1.17, CI: 0.20-6.60, P =.850). Conclusion: Our study showed that the use of DOAC prior to hospitalization had no protective effect on in-hospital mortality and intensive care need in hospitalized COVID-19 patients.Öğe The effect of RAAS inhibitors on acute hypoxemic respiratory failure and in-hospital mortality in the hypertensive Covid-19 patients(Taylor & Francis, 2021) Akyüz, Abdurrahman; Işık, Ferhat; Aslan, Burhan; Çap, Murat; Kaya, İlyas; Atlı, Özgür; İnci, Ümit; Taştan, Ercan; Aktan, Adem; Bilge, Önder; Okşul, Metin; Aydın, Emre; Karahan, Zülküf; Altıntaş, Derya Deniz; Altındağ, Rojhat; Adıyaman, Mehmet Şahin; Altıntaş, BernasIntroduction We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients. Material and method Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters. Results Median age was 68 (60-76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049-1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238-2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007-1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048-1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006-1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521-0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001-1.010; p = .010) were found associated with in-hospital mortality. Conclusion In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.Öğe The effect of resistant hypertension on in-hospital mortality in patients hospitalized with COVID-19(Springer Nature, 2021) Işık, Ferhat; Çap, Murat; Akyüz, Abdurrahman; Bilge, Önder; Aslan, Burhan; İnci, Ümit; Kaya, İlyas; Taştan, Ercan; Okşul, Metin; Çap, Neşe Kanbal; Karagöz, Ali; Baysal, ErkanHypertension is a major concomitant disease in hospitalized patients with COVID-19 (Coronavirus disease 2019) infection. The adverse effect of hypertension on prognosis in COVID-19 is known. Nevertheless, it is not known how COVID-19 progresses in resistant hypertensive patients. In this study, we aimed to examine the effect of resistant hypertension (ResHT) on in-hospital mortality in patients hospitalized with COVID-19. In our single-center retrospective study, included 1897 COVID-19 patients. The patients were divided into three groups according to the non-hypertensive (n = 1211), regulated HT (RegHT) (n = 574), and ResHT (n = 112). These three groups were compared according to demographic features, clinical signs, laboratory findings, and follow-up times. The median age of the study population was 62 (50–72 IQR) and 1000 (52.7%) of patients were male. The total mortality of the study population was 18.7% (n = 356). Mortality rates were similar in the hypertensive patient group (27.5% for the RegHT and 32.1% for ResHT, p = 0.321). In a multivariable analysis, ResHT was independently associated with a significantly increased risk of inhospital mortality of COVID-19, while no significant increased risk was observed with RegHT [respectively, Odds Ratio (OR) = 2.013, Confidence Interval (CI) 1.085–3.734, p = 0.026 and OR = 1.194, CI 0.795–1.794, p = 0.394]. Also, age, male gender, chronic renal failure, lymphocyte, procalcitonin, creatinine, and admission SpO2 levels were determined as independent predictors of in-hospital mortality. In our study, it was found that ResHT was an independent predictor of mortality in patients hospitalized with COVID-19; however, this situation was not found in RegHT.Öğe Electrolyte Imbalance and Its Effect on QTc Interval in PatientsHospitalized with COVID-19(2020) Kanbal, Neşe; Çap, Murat; İnci, Ümit; Altındağ, Rojhat; Akyüz, Abdurrahman; Adıyaman, Mehmet Şahin; Baysal, ErkanObjective: Studies have shown that electrolyte abnormalities can be seen in Coronavirus disease 2019 (COVID-19) patients and are associated with the severity of the disease. We aimed to investigate the electrolyte imbalance such as hypocalcemia and hypokalemia in patients hospitalized with COVID-19 and its effect on the QTc interval.Materials and Methods: 185 hospitalized patients with COVID-19 whose diagnosis was confirmed by a real-time reverse transcriptasepolymerase chain reaction and/or Computed Tomography of the chest were included in the study. The potassium and calcium measurements on the admission and third day of hospitalization were recorded. The QTc interval measurement was performed on the admission (QTc-B) and the 3rd-day (QTc-AT) electrocardiography.Results: The median age was 43 (31-56 IQR) and 102 (55.1%) of patients were male. Median baseline potassium level was 4.0 mEq/L (3.7-4.3 IQR) and corrected calcium level was 8.48 mg/dl (8.24-8.73 IQR), whereas the 3rd-day median potassium level was 4.2 mEq/L (3.9-4.5 IQR) and corrected calcium level was 8.42 mg/dl (8.16-8.70 IQR).The median QTc-B interval was found as 427 ms (409-447 IQR) whereas the median QTc-AT interval was found as 438 ms (414-459 IQR). Median 9 ms (-5- 28 IQR) prolongation was observed in the QTc interval, which was statistically significant (p <0.001). There was a significant relationship between QTc-AT and baseline potassium level, potassium level on the 3rd day (respectively ? coefficient= -2.083, 95% CI -27.134- -0.577, p value= 0.041, ? coefficient= -2.547, 95% CI -27.925 - -3.385, p value= 0,013 ) but there was no significant relationship with baseline and 3rd day calcium level. (respectively ? coefficient= -0.848, 95% CI -22.102- 8.919, p value= 0.399, ? coefficient= 0.707, 95% CI -8.685 - 20.784, p value= 0.415)Conclusion: Electrolyte disorders such as hypocalcemia and hypokalemia can be seen in patients hospitalized with COVID-19. After treatment, a significant prolongation was observed in the QTc interval and a significant relationship was observed between QTc-AT and potassium levels, but no significant relationship with calcium was observed.Öğe Kronik böbrek yetersizliği olan hastalarda hemodiyaliz öncesi ve sonrası sağ ventrikül sistolik fonksiyonlarının farklı ekokardiyografi yöntemleri ile değerlendirilmesi(Türk Kardiyoloji Derneği, 2014) Akyüz, Abdurrahman; Yıldız, Abdulkadir; Akıl, Mehmet Ata; Bilik, Mehmet Zihni; İnci, Ümit; Kayan, Fethullah; Yıldız, İsmail; Yılmaz, Zülfikar; Yıldırım, Yaşar; Ülgen, Mehmet SıddıkÖz: Amaç: Bu çalışmadaki amacımız kronik böbrek yetersizliği (KBY) olan hastalarda önyükteki azalmanın sağ ventrikül sis- tolik fonksiyonlarını belirlemede kullanılan yeni ve eski eko- kardiyografi parametreleri üzerine etkisini araştırmaktır. Çalışma planı: Yaş ortalaması 48±15 olan 19u kadın top- lam 30 KBYli hasta çalışmaya alındı. Hastaların hemodiyaliz öncesi ve sonrasında ekokardiyografi ile sol ventrikül ejeksi- yon fraksiyonu (SVEF), sol atriyum hacmi, sağ atriyum alanı, sağ ventrikül diyastol sonu alanı, sistolik pulmoner arter ba- sıncı, sağ ventrikül fraksiyonel alan değişikliği (FAD), nabız sağ ventrikül miyokart performans indeksi (Tei indeksi), sağ ventrikül doku Doppler S hızı, izovolumetrik miyokardiyal ak- selerasyon (IVA), triküspit anuler plan yer değiştirme (TAP- SE), sağ ventrikül çıkış yolu sistolik yer değiştirme (RVOT SE) parametreleri değerlendirildi. Bulgular: Sağ ventrikül sistolik fonksiyonlarını belirlemeye yarayan sağ ventrikül S hızı ve RVOT SE parametrelerinde hemodiyaliz sonrası anlamlı bir değişiklik olmadığı (sırası ile p=0.919 ve p=0.186); FAD, Tei indeksi, IVA ve TAPSE değer- lerinin ise belirgin bir şekilde arttığı (tümü için p<0.001) bu- lundu. Ayrıca TAPSE ile çekilen sıvı miktarı arasında pozitif korelasyon (r=0.375 ve p=0.041) saptandı. Sonuç: Sağ ventrikül sistolik fonksiyonlarının değerlendiril- mesinde kullanılan sağ ventrikül S velositesi ve RVOT SEnin önyükten bağımsız, FAD, Tei indeksi, IVA ve TAPSEnin ön- yüke bağımlı olduğu belirlenmiştir. Ayrıca sadece TAPSEnin çekilen sıvı miktarı ile ilişkili olduğu saptanmıştır.Öğe Kronik böbrek yetmezliği hastalarında hemodiyaliz öncesi ve sonrası sağ ventrikül sistolik fonksiyonlarının ekokardiyografi ile değerlendirilmesi(2016) Akyüz, Abdurrahman; Yıldız, AbdulkadirAmaç: Hemodiyaliz (HD) tedavisi gören Kronik Böbrek Yetmezliği (KBY) hastalarında HD esnasında uygulanan ultrafiltrasyon ile çekilen sıvıya bağlı olarak önyükte azalma meydana gelir. Bu çalışmadaki amacımız KBY hastalarında önyükteki azalmanın sağ ventrikül sistolik fonksiyonlarını belirlemede kullanılan yeni ve eski ekokardiyografik parametreler üzerine etkisini araştırmak ve bu ekokardiyografik parametrelerdeki değişimin çekilen sıvı miktarı ile ilişkili olup olmadığını belirlemektir. Metod: Sol ventrikül sistolik fonksiyonları normal, ciddi kalp kapak hastalığı olmayan ve HD tedavisi gören (yaş ortalaması 48 ± 15) 19?u kadın 11?i erkek olmak üzere toplam 30 KBY?li hasta çalışmaya alındı. Hastaların HD öncesi ve sonrasında ekokardiyografi ile; sol ventrikül ejeksiyon fraksiyonu (LVEF), sol atriyum (LA) hacmi, sağ atriyum (RA) alanı, sağ ventrikül (RV) diyastol sonu alanı, pulmoner arter (PA) sistolik basıncı, sağ ventrikül fraksiyonel alan değişikliği (RV FAC), nabız dalgalı Doppler (PW) ve doku Doppler (TD) ile bakılan sağ ventrikül miyokard performans indeksi (RV MPI), sağ ventrikül doku dopler S?(RV S?) velositesi, izovolümetrik miyokardiyal akselerasyon (IVA), triküspit anuler plan yerdeğiştirme (TAPSE), sağ ventrikül çıkış yolu sistolik yerdeğiştirme (RVOT SE) parametreleri değerlendirildi. Bulgular: HD sonrası LV EF değerinin arttığı, LA hacmi, RA alanı, RV diyastol sonu alan ve PA sistolik basıncının belirgin bir şekilde azaldığı bulundu (p=0.001). Sağ ventrikül sistolik fonksiyonlarını belirlemeye yarayan PW ile bakılan RV MPI, RV S? ve RVOT SE parametrelerin HD sonrası anlamlı bir değişiklik olmadığı (sırası ile p=0.548, p=0.942, p=0.186) RV FAC, TD ile bakılan RV MPI, IVA ve TAPSE değerlerinin ise belirgin bir şekilde arttığı (sıra ile p=0.0001, p=0.001, p=0.0001, p=0.0001) bulundu. Sağ ventrikül sistolik fonksiyonlarını belirlemek için kullanılan bu parametrelerden sadece TAPSE?nin çekilen sıvı miktarı ile pozitif bir korelasyon (p=0.041 ve r=0.375) gösterdiği saptandı. Sonuç: Yaptığımız bu çalışma hipervolemik olup kalp boşlukları normal ve sol ventrikül sistolik fonksiyonları normal olan hastalardaki önyük azalmasının kalp boşluklarında küçülmeye ve sol ventrikül sistolik fonsiyonlarında artmaya neden olduğunu göstermiştir. Sağ ventrikül sistolik fonksiyonlarını belirlemeye yarayan PW ile bakılan RV MPI, RV S? ve RVOT SE parametrelerinin önyükten bağımsız olduğu; RV FAC, TD ile bakılan RV MPI, IVA ve TAPSE değerlerinin ise önyük bağımlı olduğu belirlenmiştir. Ayrıca TAPSE?nin çekilen sıvı miktarı ile korele olduğu saptanmıştır. Anahtar kelimeler: Kronik böbrek yetmezliği, hemodiyaliz, sağ ventrikül sistolik fonksiyonları, ekokardiyografiÖğe Normal echocardiographic measurements in a Turkish population: The healthy Heart Echo-Tr trial(Turkish Society of Cardiology, 2019) Şafak, Özgen; Gürsoy, Ozan Mustafa; Karakoyun, Süleyman; Çaǧdaş, Metin; Asarcıklı, Lale Dinç; Demir, Fulya Avcı; Ersoy, İbrahim; Akyüz, Abdurrahman; Özlük, Özlem Arıcan; Er, Fahri; Baktır, Ahmet Oǧuz; Yesin, Mahmut; Eren, Hayati; Sungur, Aylin; Kurmuş, Özge; Emren, Volkan; Tülüce, Selcen Yakar; Akçay, Filiz Akyıldız; Akıl, Mehmet Ata; Makca, Tuba; Ergene, Oktay; Özkan, MehmetObjective: Normal reference values for the cardiac chambers are widely based on cohorts from European or American populations. In this study, we aimed to obtain normal echocardiographic measurements of healthy Turkish volunteers to reveal the age, gender, and geographical region dependent differences between Turkish populations and other populations. Methods: Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination. Blood biochemical parameters were also obtained for all patients on admission. The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used to assess the echocardiographic cardiac chamber quantification. Results: The study included 1154 volunteers (men: 609; women: 545), with a mean age of 33.5±11 years. Compared to men, women had a smaller body surface area, lower blood pressure and heart rate, lower hemoglobin, total cholesterol, lower low-density lipoprotein (LDL) levels, and higher high density lipoprotein (HDL) levels. Cardiac chambers were also smaller in women and their size varied with age. When we compared the regions in Turkey, the lowest values of left cardiac chamber indices were seen in the Marmara region and the highest values were observed in the Mediterranean region. Regarding the right cardiac indices, the Mediterranean region reported the lowest values, while the Black Sea region and the Eastern Anatolia region reported the highest values. Conclusion: This is the first study that evaluates the normal echocardiographic reference values for a healthy Turkish population. These results may provide important reference values that could be useful in routine clinical practice as well as in further clinical trials.Öğe Novel predictors of infarct-related artery patency for ST-segment elevation myocardial infarction: Platelet-to-lymphocyte ratio, uric acid, and neutrophil-to-lymphocyte ratio(Turkish Society of Cardiology, 2015) Acet, Halit; Ertaş, Faruk; Akıl, Mehmet Ata; Özyurtlu, Ferhat; Yıldız, Abdülkadir; Polat, Nihat; Bilik, Mehmet Zihni; Aydın, Mesut; Oylumlu, Mustafa; Kaya, Hasan; Yüksel, Murat; Akyüz, Abdurrahman; Ayçiçek, Hilal; Alan, Sait; Toprak, NizamettinObjective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p<0.004, p<0.001, p<0.001, respectively). In the multivariate analysis, serum UA level and PLR were found to be independent predictors of pre-PCI IRA patency. In the ROC curve analysis, PLR >190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI. (Anatol J Cardiol 2015; 15: 648-56)Öğe Progressive pulmonary stenosis due to huge mediastinal thymoma(Turkish Society of Cardiology, 2021) Çap, Murat; Erdoğan, Emrah; Akyüz, Abdurrahman; Çap, Neşe Kanbal; Erdur, ErkanA 61-year-old male was presented with shortness of breath, and there was a mediastinal enlargement in the chest radiography. Thorax computed tomography (CT) showed an anterior mediastinal mass with 18×10×12 cm size that pushed the heart and main vascular structures posteriorly (Fig. 1). Positron emission tomography showed an increased fluorodeoxyglucose uptake. Therefore, a biopsy was performed, which proved that thymoma Type B2 is present. Although external mild right pulmonary artery (RPA) compression was observed on CT, transthoracic echocardiography (TTE) did not show a significant gradient. After 9 months, the patient presented with increased dyspnea and chest pain. The admission CT showed increased diameters of thymoma (19×12×15 cm), with severe compression on the left atrium (LA) and RPA (Fig. 2). TTE showed an anteriorly located mass image in the parasternal view that pushed the heart posteriorly (Fig. 3a), LA compression in the apical views (Fig. 3b and 3c), and moderate pulmonary stenosis with 48 mm Hg maximum gradient in the subcostal view, as parasternal short axis view was poor (Fig. 3d). Surgical excision was planned after chemotherapy by the multidisciplinary team.Öğe The relationship between atrial electromechanical delay and left atrial mechanical function in stroke patients(Turkish Society of Cardiology, 2015) Akıl, Mehmet Ata; Akıl, Eşref; Bilik, Mehmet Zihni; Oylumlu, Mustafa; Acet, Halit; Yıldız, Abdulkadir; Akyüz, Abdurrahman; Ertaş, Faruk; Toprak, NizamettinAbstract: Objective: The aim of this study was to evaluate the relationship between atrial electromechanical delay (EMD) measured with tissue Doppler imaging (TDI) and left atrial (LA) mechanical functions in patients with ischemic stroke and compare them with healthy controls. Methods: Thirty patients with ischemic stroke were enrolled into this cross-sectional, observational study. The control group consisted of 35 age- and gender-matched apparently healthy individuals patients. Acute cerebral infarcts of probable embolic origin were diagnosed via imaging and were confirmed by a neurologist. Echocardiographically, time intervals from the beginning of P wave to beginning of A wave from the lateral and septal mitral and right ventricular tricuspid annuli in TDI were recorded. The differences between these intervals gave the mechanical delays (inter- and intra-atrial). Left atrial (LA) volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated. Statistical analysis was performed using student s t-test, chi-squared test, and Pearson s test. Results: The laboratory and clinical characteristics were similar in the two groups. Increased left atrial EMD (21.36±10.38 ms versus 11.74±6.06 ms, p<0.001), right atrial EMD (13.66±8.62 ms versus 9.66±6.81 ms, p=0.040), and interatrial EMD (35.03±9.95 ms versus 21.40±8.47 ms, p<0.001) were observed in stroke patients as compared to controls. Active LA emptying volume and fraction and passive LA emptying volumes and fraction were similar between controls and stroke patients. Total LA emptying volumes were significantly increased in stroke patients as compared to healthy controls (33.19±11.99 mL/m2 versus 27.48±7.08 mL/m2, p=0.021). Conclusion: According to the results of our study, interatrial electromechanical delay may be a new predictor for ischemic stroke.Öğe The relationship between neutrophil to lymphocyte ratio and SYNTAX score in patients with ST-segment elevation myocardial infarction(Modestum Publishing Ltd., 2014) Acet, Halit; Ertaş, Faruk; Bilik, Mehmet Zihni; Kayan, Fethullah; Akıl, Mehmet Ata; Aydın, Mesut; Akyüz, Abdurrahman; Yüksel, Murat; Ayçiçek, Hilal; Özbek, Mehmet; Oylumlu, Mustafa; Yıldız, Abdulkadir; Alan, SaitObjective: We aimed to assess relationship between the severity of coronary atherosclerosis assessed by SYNTAX score (SS) and neutrophil to lymphocyte ratio (NLR) in patients with ST elevation myocardial infarction (STEMI. Methods: After accounting for exclusion criteria, a total of 291 patient with STEMI in whom primary percutaneous coronary intervention was performed were retrospectively included (216 male, 75 female; mean age 61.6+14.0 years). Total and differential leukocyte counts and other biochemical markers were measured at admission. Patients were categorized into tertiles on the basis of SS. Monitoring for major adverse cardiac events (MACEs) was performed during the in hospital follow-up period. Results: The SS high group leukocyte (p=0.009), neutrophil (p=0.008), NLR (p=0.048), peak troponin (p<0.001), peak CK-MB (p=0.001) lactate dehydrogenase (p=0.005), aspartate aminotransferase (p=0.004) values were significantly higher compared with SSlow and SSmid groups. SS was increased, left ventricular ejection fraction was decrease (p<0.001) and left ventricular systolic diameter was increased (p=0.007). The in-hospital death rate and MACEs were greater in the high SS group than in the other groups (p<0.001 both of). Conclusion: We found that high NLR was significantly and correlated increased with SS. In addition, high SS were significantly associated with increased in-hospital MACE and in-hospital death. Further prospective studies assessing the predictive role of both SS and NLR in conjunction for risk stratification might improve risk prediction in patients with STEMI. J Clin Exp Invest 2014; 5 (2): 211-218.Öğe Taşikardiyomiyopatili bir hastada çoklu aksesuar yolların başarılı radyofrekans ablasyonu(2012) İslamoğlu, Yahya; Tekbaş, Ebru; Elbey, Mehmet Ali; Akyüz, Abdurrahman; Aktaş, Mehmet KemalTaşikardiyomiyopati, taşikardik aritmilerin neden olduğu bir kardiyomiyopati grubudur. Taşikardik aritmiler içerisinde ise multiple aksesuar yollar çok nadirdir ve genelde ek bir patoloji ile birlikte görülür. Bizler vakamızda ek bir hastalığı olmayan 58 yaşında bayan hastada çoklu aksesuar yolların olduğunu ve buna bağlı gelişen taşikardiyomiyopatinin başarılı radyofrekans ablasyonu ile düzeldiğini gösterdik.
