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Öğe Assessment of serum asymmetric dimethylarginine levels and left ventricular diastolic function in patients with ankylosing spondylitis(Wiley, 2017) Inci, Umit; Yildiz, Abdulkadir; Batmaz, Ibrahim; Tekbas, EbruAim: To assess left ventricular diastolic functions and serum dimethylarginine (ADMA) concentrations, as well as the effect of different treatment strategies on ADMA concentrations and diastolic function parameters, in patients with ankylosing spondylitis (AS). Method: Sixty AS patients and 40 control subjects without classical cardiovascular (CV) risk factors were included in the study. Baseline clinical and echocardiographic variables were obtained. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ADMA levels were measured. Spinal mobility, disease activity and functional status were assessed using Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index. Results: CRP, ESR and ADMA levels were significantly higher in the AS group as compared to the control group. Two (5%) control subjects and six (10%) AS patients met the criteria for left ventricular diastolic dysfunction (DD) on conventional Doppler echocardiography, but the difference was not statistically significant (P = 0.36). However, using tissue Doppler imaging, 12 (20%) patients in the AS group and three (8%) subjects in the control group were diagnosed with left ventricular DD (P = 0.08). The anti-tumor necrosis factor (TNF)-alpha group, conventional therapy group and control group were compared in terms of ADMA, CRP, ESR levels and echocardiographic parameters. ADMA levels were significantly lower in anti-TNF-alpha group as compared to the conventional therapy group (P < 0.001). In the control group, ADMA levels were significantly lower than both treatment groups (P < 0.001). Conclusion: Increased ADMA levels reveal impaired nitric oxide metabolism in a relatively young group of patients with AS, who have no classical CV risk factors. Anti-TNF-alpha may have beneficial effect on endothelial function in AS patients by reducing ADMA levels.Öğe Cardiac aspergillosis: endocardial or endomyocardial?(Elsevier Sci Ltd, 2011) Davutoglu, Vedat; Ercan, Suleyman; Tekbas, Ebru[Abstract Not Available]Öğe Comparison of left ventricular functional parameters obtained from three different commercial automated software cardiac quantification program packages and their intraobserver reproducibility(Springer, 2011) Dostbil, Zeki; Ariturk, Zuhal; Cil, Habib; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, Mehmet; Yildiz, IsmailObjective ECG-gated myocardial perfusion scintigraphy (MPS) can be used to determine several cardiac functional parameters (e. g., left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV)). In this study, we aimed to compare these cardiac functional parameters calculated by the following cardiac quantification programs: Emory Cardiac Toolbox (ECTb), Quantitative Gated SPECT (QGS), and Myometrix. We also evaluated reproducibility of the cardiac programs. Methods Fifty-seven patients (27 male, 30 female) at Elazig Research and Training Hospital from 2008 to 2009 were included in this study. In all patients, (99m)Tc-MIBI ECG-Gated (8-bin frame mode) myocardial perfusion scintigraphies were performed. By using 3 different cardiac quantification programs (ECTb, QGS, and Myometrix); LVEF, EDV, and ESV were calculated. The same raw data of MPS images were reprocessed at different time periods, and these 3 parameters were recalculated. LVEF, EDV, and ESV yielded by 3 different programs were compared for interprogram variability assessment, and parameters calculated at two different time periods were compared to evaluate intraprogram reproducibility. Results There were statistically significant differences between ECTb, QGS, and Myometrix programs for LVEF, EDV, and ESV (p < 0.001). There was also a statistically significant correlation between LVEF and EDV (p < 0.001, r = 0.546; p < 0.001, r = 0.45, respectively), but no statistically significant correlation was present between the ESV values (p > 0.05, r = 0.09). Statistically significant differences were not found between the values of LVEF, EDV, and ESV obtained from the first and second reconstruction analysis of 3 cardiac quantification programs. Discussion Different MPS cardiac software programs give variable (but correlated) LVEF and left ventricular volumetric measures. Those obtained from different cardiac softwares cannot be used interchangeably. Our findings have shown that ECTb, QGS, and Myometrix programs are reproducible, with respect to LVEF, EDV, and ESV.Öğe Evaluation of pulmonary vein variations and anomalies with 64 slice multi detector computed tomography(Springer Wien, 2012) Tekbas, Guven; Gumus, Hatice; Onder, Hakan; Ekici, Faysal; Hamidi, Cihad; Tekbas, Ebru; Gulicetincakmak, MehmetPulmonary Veins are one of the major structures of circulation. In the last decade, pulmonary veins have been known to play an important role as the triggering focus of the electrical activity in atrial fibrillation. Primary treatment method of AF is RF ablation of the focus. For the best ablation, the anatomy of PVs should be well established before the procedure. MATERIAL AND METHODS: In our radiology department, 783 patients underwent computed tomography angiography between January 2008 and May 2010. Patients were referred for coronary CTA because of known or suspected coronary artery disease or computed tomography pulmonary angiography (CTPA) because of known or suspect pulmonary embolism. All scanning was performed on Philips Brilliance 64 slice Multidetector CT. The group consisted of 402 male and 381 female patients with the average age of 48 (range 14-89). CT data of patients were retrospectively reviewed to identify the PV anatomy and to determine anatomic variants and anomalies. RESULTS: In the majority of cases, two pulmonary veins drain into the left atrium on each side. Eighteen and eight variations were found in the right and left sides, respectively. Most frequent combined variations were 2R-4L (32.3%) and 4L was the more frequent single variation type (76%). In addition to that one Situs inversus totalis (0.12%), two partial anomalous pulmonary venous returns (0.25%) and one scimitar syndrome (0.12%) were found. CONCLUSION: This study showed that multiple types of variations of PVs can be found with increasing patient number. Therefore, for the successful ablation and surgery without any complications, the anatomy of PVs should be known before the procedure. MDCT is a reliable imaging method for the detailed cross-sectional and 3D anatomy.Öğe Famotidine-induced acquired long QT syndrome: a case report(Aves Press Ltd, 2012) Tekbas, Ebru; Ariturk, Zuhal; Cil, Habib; Islamoglu, YahyaIt is known that a number of drugs caused acquired long QT syndrome. Although the often use of famotidine, acquired long QT syndrome associated with this drug has rarely been reported. We presented a case of famotidine associated with acquired long QT syndrome.Öğe Giant Right Coronary Artery and Coronary Sinus Aneurysm due to Fistula(Texas Heart Inst, 2011) Tekbas, Guven; Onder, Hakan; Tekbas, Ebru; Yavuz, Celal; Bilici, Asian[Abstract Not Available]Öğe HIGH OCCURRENCE OF METABOLIC SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS(Oxford Univ Press, 2011) Karakoc, Mehmet; Batmaz, Ibrahim; Tahtasiz, Mehmet; Nas, Kemal; Cevik, Remzi; Tekbas, Ebru; Yildiz, Ismail[Abstract Not Available]Öğe Increased echocardiographic epicardial fat thickness is related to impaired diurnal blood pressure profiles(Taylor & Francis Ltd, 2012) Ertas, Faruk; Kaya, Hasan; Acet, Halit; Cil, Habib; Akyuz, Abdurrahman; Islamoglu, Yahya; Tekbas, EbruObjective. Epicardial fat has been proposed as a new cardiometabolic risk factor. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between diurnal blood pressure profiles and EFT is still unknown. The purpose of this study is to investigate the association between the echocardiographic EFT and diurnal blood pressure profiles in hypertensive patients. Methods. After the ambulatory blood pressures of 123 patients were monitored, they were divided into three groups according to the clinical diagnoses: 41 patients (33.3%) were in the normotensive group, 40 patients (32.5%) were in the dipper hypertensive group and 42 patients (34.1%) were in the non-dipper hypertensive group. All participants underwent transthoracic echocardiography and ambulatory blood pressure monitoring to measure the EFT and blood pressure responses. Results. The mean EFT measurements of the dipper group were significantly higher than the normotensive group (6.5 +/- 0.6 vs 5.8 +/- 0.6; p < 0.0001). On the other hand, the mean EFTs of the non-dipper group were also significantly higher than the dipper group (7.4 +/- 0.7 vs 6.5 +/- 0.6, p < 0.0001). An EFT of >= 7 mm predicted the non-dipper profile in hypertensive patients with 74% sensitivity and 71% specificity (receiving operator characteristic area under the curve: 0.826, 95% CI 0.738-0.913; p < 0.0001). EFT was associated with both dipper (OR 8.9, 95% CI 3.03-26.3; p < 0.0001) and non-dipper blood pressure profiles (OR 12.3, 95% CI 1.75-86.31; p < 0.0001), and this relationship was also independent from all the risk factors. Conclusion. Echocardiographic EFT assessment is independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. Thus, the echocardiographic assessment of the EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.Öğe Investigation of the Effects of Leptin on the Cardiovascular System in Patients With Systemic Sclerosis(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Atilgan, Zuhal Ariturk; Islamoglu, Yahya; Tekbas, Ebru; Budulgan, Mahmut; Batmaz, Ibrahim; Tahtasiz, Mehmet; Yuksel, HaticeObjective: Cardiac involvement in systemic sclerosis can be seen, and often remains silent. Leptin, which is often associated with hypertension and regulation of sympathetic tone, has been reported to contribute to the development of atherosclerosis, endothelial dysfunction and thrombosis by acting directly. The aim of this study was to investigate the effects of leptin on the cardiovascular system in patients with systemic sclerosis. Materials and Methods: Twenty-seven patients with systemic sclerosis and 28 healthy subjects as a control group were included in the study. Clinical and laboratory parameters, 24-hour Holter ECG and ambulatory blood pressure monitorings were recorded and serum leptin levels were measured in all subjects. Results: Mean leptin levels were lower in patients with systemic sclerosis than in controls. In 24-hour ambulatory blood pressure Holter recordings, the mean systolic and diastolic blood pressure, daytime systolic and diastolic blood pressure, systolic and diastolic blood pressure values at night were lower in patients when compared with controls. There was no relationship between leptin and heart rate variability parameters. A positive correlation was found between leptin levels and 24-hour ambulatory blood pressure parameters. Conclusion: Decreased serum leptin levels and increased mean heart rate in patients with systemic sclerosis may be the result of increased sympathetic tone.Öğe Mean platelet volume in functional and thrombotic prosthetic mitral valve(Lippincott Williams & Wilkins, 2012) Tekbas, Ebru; Akdemir, Ilyas; Soydinc, Serdar; Alici, Hayri; Yavuz, Fethi; Yuce, Murat; Cakici, MusaThe mean platelet volume (MPV) values reflect platelet size and are accepted as marker of platelet activation. We sought to test the hypothesis that platelet activation occurs independently from presence or absence of thrombus in prosthetic mitral valve. A total of 168 patients were included in the study. Study participants were divided in three groups: group 1 (n=62) - patients with normal prosthetic mitral valve; group 2 (n=37) - patients with prosthetic mitral valve thrombosis; and group 3 (n=69) - healthy individuals. MPV values were significantly higher in normal and thrombotic prosthetic mitral valve patients than in healthy individuals (P=0.008 and P=0.01, respectively). MPV values were not different between normal prosthetic mitral valve and thrombotic prosthetic mitral valve. This is the first study indicating that increased MPV is present in normal and thrombotic prosthetic mitral valve, implying that platelet reactivity occurs in prosthetic mitral valve irrespective of development of thrombus formation. Blood Coagul Fibrinolysis 23:91-93 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction(Informa Healthcare, 2011) Tekbas, Ebru; Kara, Ali F.; Ariturk, Zuhal; Cil, Habib; Islamoglu, Yahya; Elbey, Mehmet A.; Soydinc, SerdarMean platelet volume (MPV) is a marker of platelet activation. An increased MPV is associated with acute myocardial infarction (AMI) and long-term mortality. The aim of this study was to compare MPV in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Also, we investigated the value of MPV on in-hospital mortality and long-term prognosis of patients with STEMI and NSTEMI. We studied 429 patients with AMI (70.4% male, 61.9 +/- 12.4 years; 279 patients with STEMI, 150 patients with NSTEMI). MPV and platelet count were similar in both groups. Elevated MPV increased the risk of death by 3.1-fold (p < 0.001) in STEMI group during the hospitalization. However, increased MPV was not associated with in-hospital mortality in NSTEMI group. The area under the receiver operating characteristic curve of MPV was 0.868 (95% CI, 0.830-0.907) for predicting two-year mortality. A cut-off point of 11.1 fL showed a sensitivity of 81% and a specifity of 77% for prediction of two-year mortality. Kaplan-Meier survival curve showed two-year mortality rate of 12.5% in patients with MPV > 11.1 fL versus 9.9% in patients with MPV < 11.1 fL (p < 0.001). Cox regression analysis showed MPV to be an independent predictor of two-year mortality (Hazard ratio 1.7; 95% CI 1.5-1.9; p < 0.001). An increased MPV is an independent predictor of in-hospital mortality in patients with STEMI. However, elevated levels of MPV did not predict in hospital mortality in NSTEMI group. The increase in MPV values was independently correlated with two-year mortality in all study patients.Öğe Multimodality imaging of huge coronary cameral fistula(Turkish Soc Cardiology, 2017) Arslan, Bayram; Oylumlu, Mustafa; Tekbas, Ebru; Kaya, Hasan[Abstract Not Available]Öğe Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide(Via Medica, 2012) Islamoglu, Yahya; Cil, Habib; Atilgan, Zuhal; Elbey, Mehmet Ali; Tekbas, Ebru; Yazici, MehmetIngestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (ML) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol J 2012; 19, 1: 86-88)Öğe Noninvasive Electrophysiological Effects of Lightning Strike: Case Series(Aves, 2011) Islamoglu, Yahya; Cil, Habib; Basturk, Mustafa; Tekbas, Ebru; Elbey, Mehmet AliObjectives: Lightning is a frequent natural disasters, and may result in death at a rate of up to 20-30% of affected patients. The most common cause of death in these cases is cardiac arrest. In addition, deaths can occur due to injury of the respiratory center. Material and Methods: In the literature, there are many case reports regarding lightning injuries. Howewer, there are only a few studies on the effects of lightning strike on the heart. In this paper, we specifically investigate the noninvasive electrophysiological effects of lightning strike on the heart. Results: Ventricular fibrillation, asystole, supraventricular tachycardia, QT prolongation and nonspecific ST-T changes may occur in patients with lightning injury. However, there is no typical electrocardiogram (ECG) sign/signs of lightning injury. Conclusion: Electrocardiographic changes due to lightning strike depend on the severity and duration of exposure of the body.Öğe Paraoxonase and Arylesterase Activities in Dipper and Non-Dipper Prehypertensive Subjects(Lippincott Williams & Wilkins, 2015) Yuksel, Murat; Yildiz, Abdulkadir; Tekbas, Ebru; Gunduz, Ercan; Ekinci, Aysun; Bilik, Mehmet Zihni; Ozaydogdu, NecdetParaoxonase-1, a high-density lipoprotein linked enzyme complex, was shown to be decreased in several cardiovascular diseases. We aimed to explore whether serum paraoxonase and arylesterase activities differ in dipper and non-dipper prehypertensive subjects compared to healthy controls. Sixty prehypertensive subjects and 30 controls were enrolled. All subjects underwent echocardiographic assessment and 24-hour ambulatory blood pressure monitoring (ABPM). According to the blood pressure (BP) course on ABPM, prehypertensive subjects were categorized into two: non-dipper prehypertensive (NDPH) and dipper prehypertensive (DPH) groups. Serum paraoxonase and arylesterase activities were detected spectrophotometrically. Paraoxonase and arylesterase activities were significantly lower in patients with NDPH compared to both DPH and control groups. Both paraoxonase and arylesterase activities showed significant negative correlations with BP and left ventricular mass index. We have demonstrated that NDPH subjects have lower paraoxonase and arylesterase activities compared to DPH subjects and normotensives. Further prospective studies are needed to clarify the role of paraoxonase and arylesterase activities in the development of overt hypertension in prehypertensive subjects.Öğe The relationship between coronary collateral circulation and palmar circulation(Duzce Univ, 2013) Islamoglu, Yahya; Cil, Habib; Atilgan, Zuhal; Tekbas, Ebru; Elbey, Mehmet Ali; Inci, Umit; Ozaydogdu, NejdetCoronary collateral vessels, provide link between coronary arteries, decreased both mortality and morbidity in patients with myocardial infarction. Palmar collateral circulation locates between ulnar and radial arteries, and its adequacy can be evaluated by noninvasive tests. We aimed in this study to investigate relationship between coronary collateral circulation and palmar collateral circulation. 96 patient, detected in coronary arteries at least 70% stenosis, were included the study. Coronary collateral circulation was evaluated according to rentrop classification as adequate and inadequate collateral circulation. Hand circulations of the patients were evaluated with Allen Test and Modified Allen Test. Incomplete palmar arch were detected in patients with adequate and inadequate coronary collateral circulation 22% and 29%, respectively. There was no significant different between two groups according to presence of incomplete or complete palmar circulation. In our study, we demonstrated that there was no relationship between coronary collateral circulation and palmar collateral circulation.Öğe The Relationship Between Serum Levels of Zn and Cu and Severity of Coronary Atherosclerosis(Humana Press Inc, 2011) Islamoglu, Yahya; Evliyaoglu, Osman; Tekbas, Ebru; Cil, Habib; Elbey, Mehmet Ali; Atilgan, Zuhal; Kaya, HasanThe essential trace elements play important roles in the maintainance of the normal structure and physiology of cells. Several research groups have demonstrated that they also play important roles in states of cardiovascular diseases. Our aim is to investigate whether there is a relationship between trace elements (Zn and Cu) and the degree of atherosclerosis. The sample consisted of 67 patients with coronary artery disease and 26 clinically healthy individuals. Ninety-three subjects were separated into four groups according to their Gensini scores, the number of diseased vessels, the presence of acute coronary syndrome, and ejection fraction. Each group was divided into three subgroups, and serum zinc and copper levels were measured for each individual. The serum levels of zinc and copper were found to be significantly lower in patients with atherosclerosis than in the control group, but there were no significant differences in the serum levels of Cu and Zn between severe atherosclerosis and mild atherosclerosis. In Spearman's rank correlation, the zinc and copper levels were correlated with the Gensini score and the number of diseased vessels. The present study revealed a relationship between the serum levels of zinc and copper and atherosclerosis, but not between these levels and the severity of the disease.Öğe Resolution of Intracoronary Thrombus with Tirofiban Infusion: A Case Report(Aves Press Ltd, 2010) Ariturk, Zuhal; Tekbas, Ebru; Cil, Habib; Islamoglu, Yahya; Elbey, M. Ali; Yazici, MehmetA 27 year-old man presented with chest pain lasting for fourteen-hour duration. The patient had electrocardiographic evidence of subacute anterior wall myocardial infarction. Coronary angiography revealed total occlusion of the left anterior descending coronary artery. Tirofiban infusion was administered for 48 hours. Then, coronary angiography showed intraluminal filling defects due to a massive thrombus in the proximal segment of the left anterior descending coronary artery. Vie present a case of effective thrombolysis with tirofiban in young myocardial infarction case.Öğe Romatoid artritli hastalarda kardiyak tutulumun noninvaziv elektrofizyolojik parametrelerle değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2010) Çevik, Figen Ceylan; Yazıcı, Selma; Tahtasız, Mehmet; Kara, Ali Fuad; Çil, Habib; Atılgan, Zuhal; Tekbas, Ebru; Saraç, Ayşegül JaleAmaç: Romatoid artrit (RA)’te hem hastalığa ve hem de kullanılan ilaçlara bağlı olarak kalp tutulumu olabilmekte ve çoğunlukla sessiz seyretmektedir. Bu çalışmada RA’li hastalarda non-invaziv elektrofi zyolojik parametreler aracılığıyla kardiyak etkilenimin varlığı araştırıldı. Gereç ve yöntemler: Bu çalışmaya benzer yaşta 49 RA’li hasta ve 28 sağlıklı birey kontrol grubu olarak alındı. Tüm bireyler klinik ve laboratuar parametreleri açısından değerlendirildi ve 24 saatlik Holter elektrokardiografi k monitorizasyonları yapıldı. Bulgular: Maksimum QT aralığı kontrollere göre RA’lı hastalarda daha düşük iken (p<0.05), minimum, maksimum ve ortalama kalp hızı (sırasıyla; p<0.05, p<0.01, p<0.01) ise daha yüksekti. P dalga parametreleri (P maksimum, P minimum and P dispersiyonu) her iki grupta benzerdi. Korelasyon analizlerinde sadece düzeltilmiş QT dispersiyonu ile eritrosit sedimantasyon hızı arasında anlamlı ters bir ilişki mevcuttu (p<0.05). Bununla beraber, P dalga süresi ve QT parametreleri ile herhangi bir klinik veya laboratuar parametresi arasında anlamlı bir ilişki bulunmadı (p>0.05). Sonuç: Romatoid artritli hastalarda QT dispersiyonu gibi nonivaziv parametrelerin geleneksel risk faktörlerine ek olarak kardiyovasküler riskin değerlendirilmesi ve ani kardiyak ölüm riskinin öngörülmesinde ılımlı bir rolü olabilir. Fakat daha kesin bir yargı için farklı ve daha fazla sayıda içeren, prospektif ve uzun süreli çalışmalara gereksinim vardırÖğe Successful VT ablation in a patient with ventricular assist device and implantable cardiac defibrillator(Aves Yayincilik, 2011) Islamoglu, Yahya; Aktas, M. Kemal; Cil, Habib; Ariturk, Zuhal; Tekbas, Ebru; Elbey, Mehmet Ali[Abstract Not Available]
