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    Acute thrombus formation on an Occlutech ASD Occluder device during transcatheter closure: Case report
    (Ortadoğu Reklam Tanıtım Yayıncılık, 2016) Bilik, Mehmet Zihni; Akıl, Mehmet Ata; Acet, Halit; Kaya, Hasan; Ertaş, Faruk
    Acute thrombosis during transcatheter device closure of atrial septal defect is a very rare but important complication. A 67-year-old woman with secundum type atrial septal defect underwent closure with the Occlutech Figula device. Acetilsalicylic acid and clopidogrel had been started one day before procedure and heparin was given at the beginning of the procedure. During the intervention a thrombus on the left atrial disk was detected by transesophageal echocardiography (TEE). The delivery system and thrombus were succesfully removed from circulation. Additional heparin bolus was given and the procedure was completed succesfully. The control TEE showed good device position and no thrombus formation on the device. The patient was discharged without any complication.
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    Apelin Levels In Isolated Coronary Artery Ectasia
    (Korean Soc Cardiology, 2015) Bilik, Mehmet Zihni; Kaplan, Ibrahim; Yildiz, Abdulkadir; Akil, Mehmet Ata; Acet, Halit; Yuksel, Murat; Polat, Nihat
    Background and Objectives: The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cases, CAE is associated with atherosclerosis; however, isolated CAE has a nonatherosclerotic mechanism. The association between atherosclerotic coronary artery disease and apelin has been examined in previous studies. However, the role of plasma apelin in isolated coronary artery ectasia has not been studied. In this study, we investigated the relationship between plasma apelin levels and isolated coronary artery ectasia. Subjects and Methods: The study population included a total of 54 patients. Twenty-six patients had isolated CAE (53.6 +/- 8.1 years); 28 patients with normal coronary arteries (51.6 +/- 8.8 years) and with similar risk factors and demographic characteristics served as the control group. Apelin levels were measured using an enzyme-linked immunoassay kit. Results: Apelin level in the CAE group was significantly lower (apelin=0.181 +/- 0.159 ng/mL) than that in the control group (apelin=0.646 +/- 0.578 ng/mL) (p=0.033). Glucose, creatinine, total cholesterol, triglyceride, low density lipoprotein cholesterol, and high density lipoprotein cholesterol levels were not significantly different between the two groups. Conclusion: In this study, we showed that patients with isolated CAE have decreased plasma apelin levels compared with the control group. Based on the data, a relationship between plasma apelin and isolated CAE was determined.
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    Assessment of Platelet to Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Acet, Halit; Akil, Mehmet Ata; Polat, Nihat
    [Abstract Not Available]
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    Assessment of Right Ventricular Systolic Functions in Patients with Chronic Renal Failure before and after Hemodialysis
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Akyuz, Abdurrahman; Yuksel, Murat; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Polat, Nihat; Akil, Mehmet Ata
    [Abstract Not Available]
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    The Association between Neutrophil to Lymphocyte Ratio and Presence of Ventricular Premature Contractions
    (Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Polat, Nihat; Acet, Halit; Bilik, Mehmet Zihni; Aydin, Mesut
    [Abstract Not Available]
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    Association between neutrophil to lymphocyte ratio and pulmonary arterial hypertension
    (Türk Kardiyoloji Derneği, 2013) Yıldız, Abdulkadir; Kaya, Hasan; Ertaş, Faruk; Oylumlu, Mustafa; Bilik, Mehmet Zihni; Yüksel, Murat; Polat, Nihat; Akıl, Mehmet Ata; Atılgan, Zuhal; Ülgen, Mehmet Sıddık
    Objectives: Pulmonary hypertension (PH) is composed of a heterogeneous group of disorders marked by increased pulmonary artery resistance leading to right heart failure, with high mortality. Evidence is increasing to propose that inflammation plays a significant role in the pathophysiological mechanism. Increased prevalence of PH in patients with systemic inflammatory diseases is already known. Herein, we sought to evaluate the association between neutrophil to lymphocyte ratio (N/L ratio) and pulmonary arterial hypertension (PAH). Study design: Twenty-five patients with PAH and 25 controls were evaluated. Baseline clinical and echocardiographic variables were obtained. Complete blood counts in all patients and controls were reviewed retrospectively. Results: The N/L ratio was higher in patients with PAH compared to healthy volunteers (p=0.05). A cut-off value of 1.65 for N/L ratio predicted the presence of PAH with 72% sensitivity and 69% specificity. After multivariate analysis, only N/L ratio remained a significant predictor of PAH. Conclusion: We showed for the first time that N/L ratio was significantly increased in patients with PAH compared to controls.
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    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, Sait
    Objective: 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).
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    Association of Neutrophil-Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis
    (Sage Publications Inc, 2014) Polat, Nihat; Yildiz, Abdulkadir; Yuksel, Murat; Bilik, Mehmet Zihni; Aydin, Mesut; Acet, Halit; Akil, Mehmet Ata
    The aim of the study is to investigate the association between the severity of rheumatic mitral valvular disease (RMVD) and the neutrophil-lymphocyte ratio (NLR). A total of 227 patients were enrolled in the study and divided into 3 groups. Patients in group 1 had rheumatic mitral stenosis (RMS), those in group 2 had RMVD without stenosis, and those in group 3 served as the control group. Group 1 was further divided into 2 groups, severe mitral stenosis (MS) and mild to moderate MS. The NLR was significantly higher in patients with severe MS when compared to those with mild to moderate MS (P = .002) while lymphocyte count was lower (P = .034). Using a cutoff level of 2.56, the NLR predicted severe RMS with a sensitivity of 75% and specificity of 74%. In conclusion, as an inexpensive, simple, and accessible marker of inflammation, the NLR may be useful in predicting the presence and severity of MS in patients with RMVD.
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    A co-anomaly: hourglass-like aorta and giant coronary arteries
    (Turkish Soc Cardiology, 2014) Akil, Mehmet Ata; Bilik, Mehmet Zihni; Acet, Halit; Ertas, Faruk; Yildiz, Abdulkadir
    [Abstract Not Available]
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    Dev disekan aort anevrizmasına bağlı Ortner sendromu
    (2013) Tasal, Abdurrahman; Bilik, Mehmet Zihni; Acet, Halit; Özyurtlu, Ferhat
    Özet– Ortner senromu kardiyovasküler nedenlerle olu şan sol larenjeal reküren sinir basısına bağlı ses kısık lığıdır. Kardiyovasküler nedenler kalp kapak hastalıkları, torasik aort anevrizması, doğuştan kalp hastalıkları gibi geniş bir yelpazeye sahiptir. Bu yazıda, literatürde daha önce bildirilmemiş büyüklükte bir çapa (120 mm) ulaşan dev disekan aort anevrizmasına bağlı olarak gelişen Ort ner sendromu olgusu sunuldu. Yetmiş bir yaşındaki erkek hasta efor dispnesi, halsizlik ve ses kısıklığı yakınmaları ile başvurdu. İndirekt laringoskopik bakıda sol ses teli felci görülen hastanın göğüs radyografisinde sol üst zonu dol duran 120 mm’ye ulaşan kitle saptandı. Toraksın bigisa yarlı tomografisinde aort yayı düzeyinde çapı 120 mm’ye ulaşan diseksiyon gelişmiş aort anevrizması vardı. Öneri len cerrahi tedaviyi kabul etmeyen hasta izlemin 4. ayında kaybedildi.
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    Distribution of Accessory Pathways in Atrioventricular Reentrant Tachycardia in Southeast Anatolian Region of Turkey
    (Duzce Univ, 2015) Aydin, Mesut; Polat, Nihat; Yuksel, Murat; Yildiz, Abdulkadir; Acet, Halit; Bilik, Mehmet Zihni; Akil, Mehmet Ata
    Objective: We aimed to evaluate distribution of accessory pathway (AP) in atrioventricular reentrant tachycardia (AVRT) in southeast Anatolian region of Turkey. Methods: The study was a retrospective cross-sectional design. Consecutive patients who underwent catheter ablation of AVRT between June 2012 and July 2014 were included in the study. All patients were taken to the electrophysiology laboratory in the non-sedated state and underwent an initial diagnostic study using three diagnostic catheters. The one of them was placed in coronary sinus. In those patients, in whom the AP was identified, ablation therapy was carried out using radiofrequency energy. We decided distribution of AP on fluoroscopy. Fluoroscopic images are obtained in and the left anterior oblique orientation. Results: The study population consisted of 64 AVRT patients (63% female; mean age 34 +/- 14). Among AVRT 20(31%) patients had concealed AVRT, 44 (69%) patients had Wolf Parkinson White syndrome. Distribution of AP was 59% at the left free wall, 34% at the posteroseptum, 6% at the right free wall, and 3% at the anteroseptum. The locations of APs were compared. There was no any statistically significant among groups. Conclusion: Distribution of AP location was in accordance with literature. The other characteristic of AVRT were similar with the current data.
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    Diurnal Blood Pressure Pattern in Patients with Ischemic and Dilated Cardiomyopathy
    (Elsevier Science Inc, 2013) Tastan, Ercan; Ugurlu, Hasan Murat; Mercen, Mehmet Han; Kaya, Ilyas; Bilik, Mehmet Zihni; Soydinc, Mehmet Serdar
    [Abstract Not Available]
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    The effect of atherogenic plasma index on collateral development in patients with chronic coronary total occlusion
    (2021) Güzel, Tuncay; Bilik, Mehmet Zihni; Arslan, Bayram; Kılıç, Raif; Aktan, Adem
    Aim: To demonstrate the correlation between coronary collateral circulation (CCC) and atherogenic plasma index (AIP), one of the factors associated with the formation of collateral vessels. Methods: Hospital records of patients with chronic total occlusion (100% stenosis) in at least one coronary artery were evaluated. Triglycerides, HDL level, triglyceride/HDL ratio and atherogenic plasma index before coronary angiography were assessed for the 451 patients who met the study criteria. Results: Comparison of the two groups in terms of laboratory findings showed that triglyceride/HDL ratio (5.04±3.13 vs 3.56±2.12, p<0.001) and AIP (0.63±0.25 vs 0.48±0.25, p<0.001) were higher with statistical significance in the weak collateral group. The ROC analysis revealed an association between weak collateral formation and atherogenic plasma index with 64.7% sensitivity and 66.2% specificity using a cut-off value of 0.58 for AIP. Accordingly, low AIP was found to be an independent predictor of good collateral artery formation. Conclusion: This study suggests that a high atherogenic plasma index may be an independent factor associated with poor collateral formation.
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    A giant congenital left ventricular diverticulum
    (Turkish Soc Cardiology, 2014) Oylumlu, Mustafa; Yuksel, Murat; Yildiz, Abdulkadir; Bilik, Mehmet Zihni
    [Abstract Not Available]
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    Global longitudinal strain score predicts all cause death in patients with chronic total occlusion with preserved ejection fraction
    (Verduci Editore s.r.l, 2022) Özbek, Mehmet; Bilik, Mehmet Zihni; Demir, Muhammed; Arık, Baran; Şimşek, Hakkı; Ertaş, Faruk; Toprak, Nizamettin
    OBJECTIVE: Change in LVEF is one of the most important indicators of prognosis in CTO cases. Studies in patients with CTO have shown improvement in LVEF approximately at 3 and 6 months after successful PCI. It has been shown that LV global longitudinal strain (GLS) starts to improve even 1 day after CTOPCI. We aimed at investigating the effect of subclinical echocardiographic involvement on allcause mortality in the group with CTO and preserved ejection fraction by evaluating the LV GLS score. PATIENTS AND METHODS: Patients with LVEF ≥ 50% were considered to have preserved ejection fraction and were included in the study. The endpoint of the study was all-cause death. For this retrospective study, 1,171 patients with coronary angiography who had had CTO in any of their vessels were screened. RESULTS: A total of 86 consecutive patients were reviewed in the study. The optimum GLS score cut-off value (≥ 14.18) for predicting mortality was determined using receiver operating characteristic (ROC) curve analysis (AUC: 0.897, sensitivity 87.5%, specificity 81.5% p<0.001). At a mean follow-up of 49 months, a significant difference was found between the two groups in all-cause mortality determined by the GLS score [2 (3.4%) vs. 14 (51.9%), p<0.001]. A significant difference in mortality was observed between the group with a low GLS score and the group with a high GLS score, according to Kaplan-Meier analysis. The effect of GLS score in predicting all-cause mortality was demonstrated in multivariate cox regression analysis (Low GLS score; OR: 6.36 95%CI (1.039-39.013), p=0.045). Cox regression multivariate analysis and the effect of GLS score in predicting mortality were observed [Low GLS score; OR: 6.368 95%CI (1.039-39.013), p=0.045]. CONCLUSIONS: As a predictor, GLS may be a valuable marker of cardiac subclinical dysfunction for all caused mortality in CTO patients.
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    Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels
    (Georg Thieme Verlag Kg, 2015) Akil, Esref; Tamam, Yusuf; Akil, Mehmet Ata; Kaplan, Ibrahim; Bilik, Mehmet Zihni; Acar, Abdullah; Tamam, Banu
    Objective: This study aimed to evaluate changes in the autonomic nervous system caused by cerebral lesions due to acute stroke. We assessed heart rate variability and catecholamine levels in lieu of stroke lesion localization. Materials and Methods: A total of 60 stroke patients and 31 healthy controls were enrolled in the study. Plasma epinephrine and norepinephrine levels were measured on the first, third, and seventh days following the stroke event. Heart rate variability was evaluated with time-domain and frequency-domain analyses via 24-hour Holter monitor recordings. Results: On the first and third day following the stroke, norepinephrine levels were significantly higher in all patient groups as compared to controls. Epinephrine levels on the first, third and seventh days after the stroke were significantly higher in patients with lesions in the right middle cerebral artery territory than controls. In frequency-domain analysis, patients with right middle cerebral artery territory lesions had greater low frequency and low frequency to high frequency ratio values than controls. Time-domain analysis revealed significant decreases in the standard deviation from the mean for 5-minute 288 R-R intervals in patients with lesions in the right middle cerebral artery and posterior cerebral artery territory when contrasted with controls. Patients with lesions in the right middle cerebral artery territory demonstrated the highest increase in the percentage of consecutive R-R intervals differing by more than 50 ms (pNN50) as compared to the control group. Conclusion: These findings indicate that autonomic dysfunction favoring an increase in sympathetic activity occurs in acute stroke patients.
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    İmplante edilen kardiyoverter defi brilatörlerin uygunsuz şokunun nadir bir nedeni: Tremor
    (Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, 2013) Oylumlu, Mustafa; Oylumlu, Muhammed; Ertaş, Faruk; Kaya, Hasan; Bilik, Mehmet Zihni; Soydinç, Serdar
    İmplante edilen kardiyoverter defi brilatörler primer ve sekonder korumada ani ölümü önlemek amacıyla yaygın olarak kullanılmaktadır. Bu cihazlar gerektiği zaman doğru akım şoku uygulayarak ventriküler taşikardi ve ventriküler fi brilasyon ataklarını sonlandırmaktadır. Ancak bu yararlı etkilerine rağmen uygunsuz şok implante edilen kardiyoverter defi brilatörlerin önemli bir yan etkisi olarak kalmaya devam etmektedir. Uygunsuz implante edilen kardiyoverter defi brilatör şokları hastalarda ağrı ve psikolojik yan etkilere neden olarak yaşam kalitesini bozmakta, hatta yeni aritmi gelişimini indükleyebilmektedir. Bu yazıda tremorun neden olduğu uygunsuz implante edilen kardiyoverter defi brilatör şoku alan bir olgu sunulmaktadır.
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    The importance of hematologic indices in the risk stratification of patients with acute decompensated systolic heart failure
    (Aves, 2015) Polat, Nihat; Yildiz, Abdulkadir; Bilik, Mehmet Zihni; Aydin, Mesut; Acet, Halit; Kaya, Hasan; Demir, Muhammed
    Objectives: In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). Study design: Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction <= 40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. Results: 119 patients with ADHF (mean-age 67 +/- 14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower estimated glomerular-filtration-rate (eGFR) and unused angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were associated with mortality. Age, presence of hypertension, right-ventricular diameter, eGFR, ACE/ARB treatment, hemoglobin levels, RDW and platelet, leukocyte, lymphocyte, basophil, neutrophil, monocyte, and eosinophil-counts were found to have prognostic significance in univariate analysis. In multivariate analysis, decreased platelet, lymphocyte-counts and hemoglobin level on admission and unused ACE/ARB treatment at discharge (p<0.05) were found to be independent factors predicting one-year-mortality. Conclusion: Among hematological indices; hemoglobin level, platelet and lymphocyte counts are readily available, useful and inexpensive markers for the prediction of one-year all-cause mortality in ADHF patients.
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    Kalp dışı cerrahi hastalarında perioperatif değerlendirme
    (2007) Alan, Sait; Bilik, Mehmet Zihni; Akıl, Mehmet Ata; Kara, Alifuat
    Bilinen bir kalp hastalığı olup ta kalp dışı bir cerrahi işlem yapılacak hastalarda kardiyak mortalite ve morbidite yüksektir. Bu yüksek komplikasyon riski ileri yaşla daha da artar. Kalp dışı cerrahi işlemlerde preoperatif değerlendirme non ope^atif değerlendirmeye benzerdir ve temel olarak ameliyatın aciliyetine, ameliyat tipine ve risk faktörlerin varlığına dayanır. Risk değerlendirmede birinci amaç hastada bir koroner arter hastalığı olma ihtimalidir. İkinci adım hastada kalp dışı ameliyat'tan bağımsız olarak var olan kalp hastalığının prognozunu saptamaktır, sonraki adım ise kalp hastalığının kalp dışı cerrahi işlem üzerine olası etkilerini değerlendirmektir. Hastanın değerlendirilmesi kardiyolog, anestezist ve cerrahla ile ortaklaşa yapılmalıdır. Kalp dışı cerrahi işlemlerde en önemli komplikasyonlar, kardiyak ölüm, miyokard infarktüsü ve pulmoner ödemdir. Bu konudaki bütün çabalar olası komplikasyonları tahmin etmek ve onlardan korunmak içindir.
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    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 Sıddık
    Öz: 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.