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  • Küçük Resim
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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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    Ankilozan spondilit hastalarında serum ADMA düzeyleri ve aortun elastik özelliklerinin değerlendirilmesi
    (Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, 2013) Kaya, Hasan; Tekbaş, Ebru Öntürk; Ertaş, Faruk; İnci, Ümit; Oylumlu, Mustafa; Yüksel, Murat; Aydın, Mesut; Batmaz, İbrahim; Yüksel, Hatice; Ülgen, Mehmet Sıddık
    Öz: Giriş: Ankilozan spondilit kronik infl amatuvar bir hastalık olup, kardiyovasküler komplikasyonlarla ilişkili olabilmektedir. Bu çalışmada amacımız, kardiyak tutulum olmayan ankilozan spondilit hastalarında aortun elastik özellikleri ile serum asimetrik dimetilarjinin (ADMA) düzeylerinin araştırılmasıdır.Hastalar ve Yöntem: Elli beş ankilozan spondilit hastasıyla benzer yaş ve cinsiyette 30 sağlıklı birey çalışmaya alındı. Açlık glukoz, serum lipidleri, C-reaktif protein (CRP), eritrosit sedimentasyon hızı (ESH) ve ADMA düzeyleri çalışıldı. Aortik strain, distensibilite ve sertlik indeksi transtorasik ekokardiyografi de aort çapı ölçümleri ve eş zamanlı kan basıncı ölçümleriyle hesaplandı. Bulgular: Ankilozan spondilit grubunda ESH ve CRP düzeyleri yüksekti. Serum ADMA düzeyleri ankilozan spondilit grubunda kontrol grubuna göre anlamlı olarak yüksekti (0.76 ± 0.19 ve 0.55 ± 0.12, p< 0.001). Alt grup analizinde, anti-TNF-alfa tedavisi alan grupta konvansiyonel tedavi grubuna göre daha düşük ADMA düzeyi ölçüldü (0.68 ± 0.15 ve 0.87 ± 0.18, p< 0.001). Ortalama aortik strain ve distensibilite değerleri ankilozan spondilit grubunda daha düşük iken, sertlik indeksi daha yüksek saptandı. Korelasyon analizinde ADMA düzeyleri ile aortun elastik özellikleri arasında ilişki izlenmezken, ankilozan spondilit grubunda hastalık süresi ile aortik strain ve distensibilite arasında ters yönde anlamlı korelasyon izlendi.Sonuç: Çalışmamızda elde ettiğimiz sonuçlar kardiyak tutulumun olmadığı ankilozan spondilit hastalarında aortik elastisitenin bozulduğunu ve ADMA düzeylerinin arttığını göstermektedir. Ayrıca, aortun elastik özellikleri ile ADMA düzeyleri arasında anlamlı ilişki saptanamamıştır.
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    Anticoagulant-induced hemopericardium with tamponade: A case report and review of the literature
    (2013) Oylumlu, Mustafa; Ülgen, Mehmet Sıddık; Ertaş, Faruk; Yıldız, Abdulkadir; Polat, Nihat
    Akut kardiyak tamponad acil tanı ve tedavi gerektirir. Biz 43 yaşında, erkek ve mitral valv replasmanı sonrası sekiz aydır warfarin tedavisi alan bir olguyu aldık. Hastanın bir-kaç gündir başlayan nefes darlığı ve halsizlik şikayetikleri mevcuttu. Kardiyak tamponad tanısı konuldu ve 1400 ml mai perikardiyosentezle acil olarak drene edildi. Tanı sı-rasında İNR değeri çok yüksek olan hastaya Vitamin Kantagonistleri ve taze donmuş plazma verilerek yuksekkoagülasyon durumu geriye döndürüldü. Patolojik incele-me sonucunda enfeksiyon ve malingnensi saptanmadı.Hastada kronik inflamasyon düşünüldü. Sonuç olarakwarfarin overdoz acil bir durum olup hemoperikardiyumlatamponada yol açabilmektedir. Bunun için warfarin teda-visi başlanılan hastalarda warfarin dozu ve hedef İNR de- ğerleri sıkı kontrol edilmelidir.
  • Küçük Resim
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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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    Association of Primum-Type Atrial Septal Defect and Patent Foramen Ovale in a Patient with Holt-Oram Syndrome
    (2019) Kaya, Hasan; Yavuz, Celal; Ertaş, Faruk; Çoşkun, Mehmet Sait
    A 49-year-old woman with dwarfism reported signs of shortness of breath. A physical examination of the patient revealed congenital deformities in the hands and feet (Figure 1). Radiographs showed that the extremities of both her hands had metatarsal polydactyly; moreover, with her feet seem to have epiphyseal dysplasia and polysyndactyly were determined (Figure 2). Telecardiography showed cardiomegaly, and electrocardiography showed rightaxial deviation and right ventricular hypertrophy
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    Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study design
    (2013) Soydinç, Mehmet Serdar; Ertaş, Faruk; Yüksel, Murat; Kaya, Hasan; Ülgen, Mehmet Sıddık; Alan, Sait
    Amaç: Atriyal fibrilasyon (AF) ülkemiz için önemli bir sağlık sorunudur. Ülkemizde ileriye dönük, çok merkezli ve ülke epidemiyolojisini yansıtan ölçekte herhangi bir çalışma mevcut değildir. Bu çalışmayla ülkemizde çok merkezli bir çalışmada AF hastalarının epidemiyolojik verilerinin öne dönük olarak analizi, takibi ve değerlendirilmesi amaçlandı. Yöntemler: Ülkemizden yedi coğrafi bölgeye ait nüfusu yansıtacak şekilde elektrokardiyografisinde en az bir defa AF atağı tespit edilmiş olan ardışık 2300 hasta çalışmaya alınacaktır. Hastalar ikinci yılın sonunda majör kardiyak sonlanım noktaları (ölüm, geçici iskemik atak, inme, siste- mik tromboembolizm, major kanama ve hastane yatışı) açısından değerlendirilecektir. Bulgular: Çalışma sonunda elde edilecektir. İlk bulguların Aralık 2012 tarihinde elde edilmesi planlanmaktadır. Sonuç: AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) çalışması ile kılavuzların önerileri doğrultusunda ülkemizdeki AF hastalarının genel risk profili, oral antikoagülan tedavi kullanım sıklığı, tedavi alan hastalarda hedef INR değerlerine ulaşılıp ulaşılmadığı ve hastaların kana- ma riskleri belirlenecektir. Çalışma sonunda ülkemizde AF’li hastalarda majör istenmeyen olay sıklığı ve bu olayların bağımsız belirteçleri de belirlenecektir.
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    Authors reply
    (2013) Kaya, Hasan; Özhan, Hakan; Ertaş, Faruk
    [Abstract Not Available]
  • Küçük Resim
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    Baseline characteristics and clinical insights from the ARTEMIS registry: A comprehensive study of peripartum cardiomyopathy in Türkiye
    (Kare Publ, 2024) Kayıkçıoğlu, Meral; Biteker, Murat; Mutluer, Ferit Onur; Güzel, Tuncay; Yılmaz, Emre; Demir, Emre; Nalbantgil, Sanem; Ertaş, Faruk
    Objective: Peripartum Cardiomyopathy (PPCM) is a life-threatening, rare disorder that occurs during the late stages of pregnancy or the early postpartum period. The ARTEMIS (A RegisTry of pEripartuM cardIomyopathy in Turkish patientS) aims to investigate the clinical characteristics and outcomes of PPCM in Turkiye, providing insights into its management within this specific population. Methods: The ARTEMIS registry retrospectively enrolled patients diagnosed with PPCM within the last five years at 44 cardiology centers across Turkiye. Eligible participants were women over 18 years old, diagnosed with PPCM and without other known cardiac pathology. Data collected included demographic information, clinical presentation, diagnostic modalities, treatment regimens, and outcomes. Results: The study included 293 patients, predominantly between 25 and 35 years old. The majority presented with symptoms such as dyspnea and palpitations, diagnosed postpartum via echocardiography. A low use of advanced diagnostic imaging was noted, relying primarily on echocardiography for evaluation. Common treatments included beta blockers (97.8%), angiotensin-converting enzyme (ACE) inhibitors (71.3%), and in severe cases, bromocriptine (6.9%). The study highlighted a mortality rate of 5.1%, with surviving patients often requiring continued management for heart failure. Diagnostic challenges and variations in treatment responses were noted, reflecting the complexity of PPCM diagnosis and care. Conclusion: The ARTEMIS registry provides valuable insights into the management of PPCM in Turkiye, highlighting the need for targeted educational programs for healthcare providers and patients. It also underscores the importance of national registries in understanding and improving outcomes for rare diseases like PPCM.
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    Correlation between the body fat composition and high sensitive C-reactive protein in Turkish adults
    (2012) Aydın, Mesut; Dumlu, Talha; Alemdar, Recai; Kayapınar, Osman; Celbek, Gökhan; Karabacak, Ahmet; Türker, Yasin; Kaya, Hasan; Ertaş, Faruk; Atılgan, Zuhal Arıtürk
    objectives. Te adipose tissue is an active immune organ. High sensitive C-reactive protein CRP (hs-CRP) is a strong independent predictor of a possible future myocardial infarction and stroke, and it has also been shown to be related to the sub clinical atherosclerosis. Te aim of this study was to investigate the relation between the body fat composition, metabolic syndrome, and the hs-CRP plasma levels. Methods. Total 246 consecutive Turkish subjects, admitted to the internal medicine clinic with the diagnosis of diabetes mellitus, insulin resistance or metabolic syndrome, were included into the study. Te total body fat composition was measured in every participant with a commercially available bio-impedance meter. Te hs-CRP levels, body composition parameters, and biochemical variables were compared. Results. Te hs-CRP levels increased in parallel with the body weight in Turkish subjects. Tis increase was significant especially in the women. Te waist circumference, body mass index (BMI), and body composition variables (visceral fat level, total body fat, and total body muscle mass) were significant correlates of the hs-CRP. Te waist circumference and BMI were independent predictors of the hs-CRP. Conclusion. Te waist circumference, BMI, and body composition variables (visceral fat level, total body fat and total body muscle mass) were significant correlates of the hs-CRP in Turkish adults. Body weight control may account for an important target especially in patients with the metabolic syndrome.
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    Epidemiological approach to the atrial fibrillation patients
    (Dicle Üniversitesi Tıp Fakültesi, 2013) Ertaş, Faruk
    Atrial Fibrillation (AF) is the most common arrhythmia observed in clinical practice. While the thromboembolic events are the most feared complications, these complications alone are responsible for 15% of all strokes. Anticoagulation therapy is the most effective way to prevent this significant complication caused by AF. Due to the disadvantages related to the recently launched new oral anticoagulants, warfarin still maintains its dominance as the gold standard agent. Pharmaceutical agents as well as demographic characteristics (age, sex, the type of AF, co-morbidities etc.) of the patients are crucial to provide effective coagulation. Since most of the studies on demographic characteristics of AF patients and the profile of oral anticoagulant use originate from the West and Far East, they do not reflect the real characteristics of our country. In this study, by analyzing the epidemiological studies conducted among AF patients in our country, we aimed to bring literature in data related to our society.
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    An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER*-2 study design
    (Türk Kardiyoloji Derneği, 2015) Ertaş, Faruk; Kaya, Hasan; Yıldız, Abdulkadir; Davutoğlu, Vedat; Kiriş, Abdulkadir; Dinç, Lale; Kafes, Habibe; Avcı, Anıl; Çalapkorur, Bekir; Ertaş, Gökhan; Gül, Mehmet; Ay, Nuray Kahraman; Bulur, Serkan; Durukan, Mine; Eren, Murat; İlhan, İbrahim; Küçük, Murathan; Özpelit, Ebru; Şimşek, Hakkı; Uçar, F. Mehmet; Yıldız, Ahmet; Şahin, Yıldıray; Ayhan, Erkan; Çağlayan, Emre; Güngör, Hasan; Özyurtlu, Ferhat; Şen, Nihat; Vatan, Bülent; Vatansever, Fahriye; Kobat, Mehmet Ali; Temiz, Ahmet; Taylan, Gökay; Dönmez, İbrahim; Erkuş, M. Emre; Söylemez, Selami; Zengin, Halit; Gündüz, Mahmut; Tuncez, Abdullah; Karavelioğlu, Yusuf; Gökdeniz, Tayyar; Koza, Yavuzer; Aktop, Ziyaeddin; Katlandur, Hüseyin; Özer, Pelin Karaca; Yüksel, Murat; Acet, Halit; Çil, Habib; Alan, Sait; Toprak, Nizamettin
    Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).
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    Erişkinlerde sekundum atriyal septal defektlerin balon ölçümü yapılmadan perkütan yolla kapatılması: Üçüncü basamak bir merkezin deneyimi
    (Modestum Publishing Ltd., 2013) Kaya, Hasan; Ertaş, Faruk; Yıldız, Abdulkadir; Oylumlu, Mustafa; Polat, Nihat; Özaydoğdu, Necdet; Alan, Sait; Ülgen, Mehmet Sıddık
    Amaç: Bu çalışmada erişkinlerde sekundum atriyal septal defektlerin (ASD) perkütan yolla kapatılması işlemindeki klinik deneyimlerimiz ve erken dönem sonuçlarımızı değerlendirmeyi amaçladık. Yöntemler: Kliniğimizde Ocak 2010-Ekim 2012 tarihleri arasında sekundum ASD tanısı ile perkütan kapatma işlemi uygulanan 49’u kadın 22’si erkek toplam 71 hasta (ortalama yaşı 35±14 yıl) çalışmaya dâhil edildi. Hastalara sedoanaljezi eşliğinde ve balon ölçümü işlemi uygulanmadan perkütan ASD kapatma işlemi uygulandı. Hastaların klinik özellikleri, yapılan perkütan kapatma girişimlerinin özellikleri, gelişen komplikasyonlar ve erken dönem sonuçları değerlendirildi. Bulgular: Transözofageal ekokardiyografik incelemede hastaların ASD çapı 19,8±6,4 mm olarak ölçüldü. Bu hastalarda kullanılan kapatma cihazı çapı ortalaması 24,7±6,7 mm olarak saptandı. Toplam 71 hastadan 67’sinde (%94) işlem başarılı oldu. Dört hastada işlem başarısız olarak kabul edilerek cerrahi tedavi kararı alındı. İşlem sırasında bir hastada geçici 2. derece AV blok gelişirken başka bir hastada ise cihaz üzerinde trombüs gelişimi izlendi. Üç hastada birinci gün kontrollerinde rezidü ASD geçişi izlendi. Ortalama 13±8 ay (1-31) boyunca izlenen hastalarda rezidü geçiş, aritmi ve embolik komplikasyonlar izlenmedi. Sonuç: Perkütan ASD kapatma işlemi deneyimli merkezlerde yüksek başarı ve düşük komplikasyon oranları ile etkin ve güvenli bir tedavi yaklaşımıdır.
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    Extreme mechanical aortic valve dehiscence: “Rocking motion” clearly assessed with echocardiography and fluoroscopy
    (Turkish Society of Cardiology, 2019) Kaya, Hasan; Arslan, Bayram; Coşkun, Mehmet Sait; Ertaş, Faruk
    A 19-year-old man was admitted due to sudden onset and progressively increasing shortness of breath, cough, nausea, and vomiting. The patient had undergone aortic and mitral valve replacement with mechanical prosthesis for the treatment of infective endocarditis 4 years ago.
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    Fibrinogen to albumin ratio predicts burden of coronary artery disease in patients with NSTEMI
    (Dicle Üniversitesi Tıp Fakültesi, 2021) Demir, Muhammed; Özbek, Mehmet; Aktan, Adem; Ertaş, Faruk
    Objective: Fibrinogen plasma level rises in the event of inflammatory cases. It is known that there is a powerful intercourse between fibrinogen level and plasma viscosity. Albumin plasma level dropes during the inflammatory cases. The aim of this work determine significance of fibrinogen albumin ratio (FAR) as a indicator emphases the burden of atherosclerosis. Method: The study included 83 patients diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) between January and September 2015. The definition of NSTEMI was made according to “Definition of Third Universal Myocardial Infarction” guidelines published on 2013 by European Society of Cardiology. Burden of atherosclerosis was evaluated by Syntax score (SS) and Gensini Score. Patients were seperated two groups as medium-high SS (n=23) and low SS (n=60). FAR levels were compared. Results: FAR was 80.71 ± 30.3 in low SS group and 120 ± 49.72 in the mid-high SS group respectively (p <0.001). In correlation evaluation, FAR and SS showed a poor positive correlation (r = 0.496, p <0.001). In multivariate logistic regression assesment of elements impacting the SS, prominent variable was found to be FAR [p = 0.01, 95% CI (1005- 1042)]. In ROC evaluation FAR values of 85 and over demonstrated 83% sensitivity and 68% specificity in determining the burden of coronary artery disease (CAD). Conclusions: In moderate-high SS group FAR value is considerably higher than those with a low SS group. FAR value may be usefull indicator in clinical practice to determine the burden of coronary artery disease.
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    Geçici kalp pili implante edilen hastaların klinik özellikleri, altta yatan hastalıkları ve hastane içi mortalite oranları
    (2013) Ertaş, Faruk; Acet, Halit; Berilgen, Rida; Düzel, Barış; Eren, N. Kahya; Kocabaş, Uğur; Yeşil, İrfan
    Amaç: Geçici kalp pili implante edilen hastaların klinik özellikleri, komorbiditeleri, altta yatan hastalıkları ve hastane içi mortalitelerinin belirlenmesi amaçlanmıştır.Yöntemler: Çalışmamıza değişik sebeplerle geçici kalp pili takılması gerekli olan, Ocak 2008-Mayıs 2012 tarihleri arasında hastanemizde yatırılarak takip edilen 545 hasta dahil edilmiştir. Bulgular: Çalışmamızda geriye dönük olarak taranan 545 hastadan 235’i kadın (%43) ve 310’u erkekti (%57). Hastaların yaş ortalaması 70±14,2 (aralığı, 20-100) olarak hesaplandı. En sık kalp pili takılma sebebi olarak atriyoventriküler tam blok (178 hasta, %32,6) saptandı. Bunu koroner anjiografi, kateter vb. işlemler sırasında gelişen bradikardi, asistol (101 hasta, %18,5), semptomatik sinüs bradikardisi (70 hasta, %12,8), kalp pili ömrünün bitmesi (kalp pili değişim işlemi sırasında,65 hasta, %11,9) gibi nedenler izledi. İlaca ve hiperpotasemiye bağlı olarak sırasıyla 34 ve 20 hastaya (%6,2,%3,6), her iki nedene bağlı 6 hastaya (%1,1) geçici kalp pili implantasyonu yapılmıştı. 8 hastada intihar amaçlı ilaç içimi gözlendi. En sık geçici kalp pili takılmasına gerek duyulan ilaçlar digoksin, B blokerler ve kalsiyum kanal blokerleri olurken; sadece 1 hastada direkt kardiyak endikasyonla kullanılmayan ilaç saptandı (okskarbamazepin). Hastaların yaklaşık yarısında koroner arter hastalığı saptandı (276 hasta, %51). 101 hastada (%18,5) miyokart enfarktüsüne bağlı blok nedeniyle geçici kalp pili implantasyonu yapılmıştı. Hastaların 85 tanesi hastanede yatışı sırasında eksitus olmuştu (%15,5). Sonuç: Geçici kalp pili takılma nedenleri zaman içerisinde değişiklik göstermesine rağmen, geçici kalp pili takılsa bile, miyokart enfarktüsü sırasında blok gelişimi oldukça ölümcül seyretmektedir.
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    Gender differences in patients undergoing transcatheter aortic valve replacement: a cross-sectional study
    (2022) Aktan, Adem; Ertaş, Faruk
    Aim: Transcatheter aortic valve replacement (TAVR) is an effective treatment modality for patients with high-risk symptomatic severe aortic stenosis (AS) who are not suitable for surgery. Gender-related differences in TAVR are still deliberated, thus in this study we aimed to investigate the effect of gender on clinical outcomes in patients who underwent TAVR in our clinic.Methods: 270 consecutive patients who underwent TAVR between January 2015 and January 2022 were included in the study. In addition to the patient's medical history, transthoracic or transesophageal echocardiography and computed tomography findings were examined to evaluate AS. Patients with symptomatic, high-risk severe aortic stenosis were treated with self-expanding Evolute-R devices. The patients were followed up for the first year after discharge. Follow-up was done by clinical visits and phone calls.Results: In-hospital mortality (5.4% vs. 7.4%; p=0.507), death at one-year follow-up (14.9% vs. 13.1%, p=0.681), and major adverse cardiovascular and cerebrovascular events (MACCE) at one-year follow-up (26.4% versus 23.8%, p =0.627) rates, there was no statistically significant difference between male and female genders. Kaplan Meier curves were used for survival analysis, including one-year mortality and MACCE rates. Accordingly, no statistically significant difference was found between the two genders in terms of mortality and MACCE (respectively; p= 0.910; p=0.889).Conclusion: In our patient group who underwent TAVR, we could not detect a significant difference in clinical outcomes between both genders. In recent years, the effect of gender on clinical outcomes may decrease with device and procedural developments.
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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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    Impact of the recovery of left ventricular ejection fraction after TAVI on mortality in patients with aortic stenosis
    (NLM (Medline), 2021) Kılıçaslan, Barış; Ünal, Barış; Arslan, Bayram; Ekin, Tuba; Özel, Erdem; Ertaş, Faruk; Dursun, Hüseyin
    OBJECTIVE: To assess the effects of transvalvular aortic valve implantation (TAVI) on the outcomes of the patients with symptomatic severe aortic stenosis (AS), and predict the effect of left ventricular ejection fraction (LVEF) and cardiac structural recovery on mortality after the TAVI in patients with different stage of LV function. METHODS: Out of 191 patients, 151 consecutive patients in 3 centers were evaluated for outcome analysis. Patients were classified into 3 subgroups as AS with reduced ejection fraction (ASrEF) (LVEF <40%), AS with mildly reduced EF (ASmrEF) (LVEF 40-49%) and AS with preserved EF (ASpEF) (LVEF ≥50%). RESULTS: The mean follow-up period was 19.4±12.4 (up to 54) months. All-cause mortality was not different among all 3 groups. (p=0.901). In multivariate analysis, stroke volume index (SVI) (Exp(B): 0.039, 95% confidence interval [CI]: 0.011-0.013, p<0.001), baseline blood urea nitrogen (Exp(B): 1.022, 95% CI: 1.006-1.038, p=0.006), and percent LVEF change after TAVI (d-LVEF) (Exp(B): 0.046, 95% CI: 0.004-0.610, p=0.046) were the independent predictors for mortality after TAVI. The receiver operating characteristic curve analysis showed that the cutoff value of "≤10%" for d-LVEF had sensitivity of 50%, specificity of 75%, and an area under the curve of 0.72 in predicting mortality in patients with SVI <35 mL/m2. CONCLUSION: Improvement of LVEF after TAVI, which reflected the marked LV reverse remodeling, has an impact on the prediction of the survival in patients with AS, and this is more prominent in patients with low SVI.
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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.