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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.
Apparently low serum asymmetric dimethylarginine is associated with fasting glucose and tends toward association with type-2 diabetes
(Turkish Soc Cardiology, 2014) Onat, Altan; Koroglu, Bayram; Can, Gunay; Karagoz, Ahmet; Yuksel, Murat; Aydin, Mesut
Objective: We investigated the association of serum asymmetric dimethylarginine (ADMA) with metabolic syndrome (MetS), type-2 diabetes and coronary heart disease (CHD) in the general population. Methods: Cross-sectional and, at 2000 person-years' follow-up, prospective analysis. Adults with measured serum ADMA level (n=848) were analyzed using tertiles or dichotomized values. ADMA concentrations were measured by a validated commercial ELISA kit. Results: Dichotomized subjects of combined sexes with low (<= 0.68 mu ol/L) ADMA values had significantly higher fasting glucose, total cholesterol, apolipoprotein B and lower diastolic blood pressure. In linear regression analyses comprising age, smoking, triglyceride, HDL-cholesterol, C-reactive protein and waist circumference as well, creatinine was significantly and independently associated with ADMA, further in women glucose (inversely). In logistic regression analyses uniformly adjusted for age, smoking status and waist girth, prevalent MetS tended to positive independent association with ADMA tertiles only in men. Combined prevalent and incident diabetes weakly tended to be associated with the lowest (vs mid-and highest) ADMA tertiles in combined gender; and prevalent and incident CHD was not associated with ADMA tertiles in either sex. Conclusion: Apparently low circulating ADMA is independently associated with fasting glucose and tends to be so with type-2 diabetes. The lack of anticipated positive associations of ADMA with cardiometabolic disorders is likely due to autoimmune responses operating against serum ADMA under oxidative stress, rendering partial failure in immunoassay.
The assessment of arterial stiffness in pre-eclamptic patients RESPONSE
(Informa Healthcare, 2014) Oylumlu, Mustafa; Yildiz, Abdulkadir; Yuksel, Murat
[Abstract Not Available]
Assessment of atrial electromechanical delay and P-Wave dispersion in patients with Psoriasis
(Echocardiography- A Journal Cardiovascular Ultrasound and Allied Techniques, 2014) Yildiz, Abdulkadir; Ucmak, Derya; Oylumlu, Mustafa; Akkurt, Meltem Z.; Yuksel, Murat; Akil, Mehmet Ata; Polat, Nihat; Aydin, Mesut; Bilik, M. Zihni; Acet, Halit
Background: In this study, we sought to evaluate atrial electromechanical properties and conduction homogeneity by tissue Doppler imaging and electrocardiography in patients with psoriasis. Methods: Thirty-four patients with psoriasis and 30 age-and gender-matched healthy controls were included in the study. Atrial electromechanical coupling intervals were assessed by means of tissue Doppler echocardiography and P-wave dispersion (Pd) was calculated from electrocardiogram. Results: A total of 64 subjects (33 male) with a mean age of 36.8 +/- 11.9 years were included in the study. Basal characteristics were similar between 2 groups. Intra-atrial (15 +/- 7 ms vs. 12 +/- 5 ms, P = 0.009) and inter-atrial (28 +/- 7 ms vs. 23 +/- 7 ms, P = 0.002) electromechanical delays were significantly higher in patients with psoriasis compared with control groups. P-maximum (112 +/- 16 ms vs. 103 +/- 8 ms, P = 0.006) and Pd (35 +/- 9 ms vs. 20 +/- 6 ms, P < 0.001) were also prolonged in patients with psoriasis. Conclusion: This study demonstrated that atrial electromechanical coupling intervals and P-wave dispersion were prolonged in patients with psoriasis, which may cause an increased risk of atrial fibrillation in this patient group.
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]
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]
Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients With Ankylosing Spondilitis
(Elsevier Science Inc, 2013) Kaya, Hasan; Tekbas, Ebru Onturk; Ertas, Faruk; Inci, Umit; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut
[Abstract Not Available]
Assessment of the neutrophil/lymphocyte ratio in patients with supraventricular tachycardia
(Turkish Soc Cardiology, 2016) Aydin, Mesut; Yildiz, Abdulkadir; Yuksel, Murat; Polat, Nihat; Aktan, Adem; Islamoglu, Yahya
Objective: The neutrophil/lymphocyte ratio (NLR) has been evaluated as a new predictor of cardiovascular risk. Inflammation has been shown to be associated with various arrhythmias including supraventricular tachycardias (SVTs). In this study, we aimed to investigate the relation between NLR and SVT in patients with a documented atrial tachyarrhythmia. Methods: The study used a retrospective cross-sectional design. Patients who had SVT but were otherwise healthy were included. The exclusion criteria included drug use (except antiarrhythmic agents), morbid obesity, acute or chronic infection, inflammatory diseases, systemic diseases, and cancer. Total and differential leukocyte counts and routine biochemical tests were performed before the ablation procedure. Results: The study included 150 patients with SVT and 98 healthy controls. The biochemical and hematological parameters were comparable between the groups, except neutrophil and lymphocyte counts. The neutrophil count was significantly higher (4.7 +/- 1.5x10(3)/mu L versus 4.1 +/- 1.0x10(3)/mu L; p<0.001) and lymphocyte count was significantly lower (2.2 +/- 0.6x10(3)/mu L versus 2.5 +/- 0.6x10(3)/mu L; p=0.001) in the SVT group than in the control group. As a result, the SVT group had significantly higher NLR values than the control group (2.2 +/- 0.9 versus 1.7 +/- 0.5; p<0.001). In addition, NLR values were higher in patients in whom tachycardia was induced during an electrophysiological study (EPS) (2.3 +/- 0.9 versus 2.0 +/- 0.8; p=0.02). The association between NLR and SVT remained significant after multivariate analysis (odds ratio: 1.5, 95% confidence interval: 1.001-2.263, p=0.049). Conclusion: Our study indicated that NLR values were significantly higher in patients with documented SVT than in control subjects. Inducibility of SVT during EPS was associated with higher NLR values.
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]
The Association between Neutrophil/Lymphocyte Ratio and Functional Capacity in Patients with Idiopathic Dilated Cardiomyopathy
(Elsevier Science Inc, 2013) Yildiz, Abdulkadir; Tuncez, Abdullah; Grbovic, Enis; Polat, Nihat; Yuksel, Murat; Aydin, Mesut; Oylumlu, Mustafa
[Abstract Not Available]
The Association Between the Neutrophil-to-Lymphocyte Ratio and the Presence of Ventricular Premature Contractions in Young Adults
(Sage Publications Inc, 2015) Yildiz, Abdulkadir; Oylumlu, Mustafa; Yuksel, Murat; Aydin, Mesut; Polat, Nihat; Acet, Halit; Akil, Mehmet Ata
Inflammation has recently emerged in the pathogenesis of several cardiovascular disorders, including arrhythmias. The neutrophil-lymphocyte ratio (NLR) is a simple marker for the assessment of inflammatory status. Therefore, we aimed to investigate the relationship between the NLR and the ventricular premature contraction (VPC) existence. Patients aged between 18 and 40 years who were referred to the cardiology clinic were enrolled in the study. All patients' complete blood counts and 24-hour Holter recordings were analyzed. The NLR was higher within the VPC group compared to the control group (P < .001). According to the NLR tertiles, VPCs were more common in the higher NLR tertile (P < .001). A cutoff point of 1.80 for the NLR had 71% sensitivity and 60% specificity in predicting VPC in apparently healthy individuals. After multivariate analysis, only the NLR remained significant predictor of presence of VPC. In conclusion, the NLR is independently and significantly associated with VPC existence.
The association between the neutrophil/lymphocyte ratio and functional capacity in patients with idiopathic dilated cardiomyopathy
(Turkish Soc Cardiology, 2015) Yildiz, Abdulkadir; Yuksel, Murat; Oylumlu, Mustafa; Polat, Nihat; Akil, Mehmet Ata; Acet, Halit
Objective: The neutrophil/lymphocyte ratio (NLR) is an inexpensive, readily available and reliable inflammatory marker, which has a predictor value in different cardiovascular disorders. Functional capacity is one of the most important prognostic factors in patients with heart failure, which is usually stated as metabolic equivalents (MET). The goal of the study was to investigate the relationship between the NLR and functional capacity (FC) in patients with idiopathic dilated cardiomyopathy (IDC). Methods: Treadmill test according to modified-Bruce protocol was performed in 37 patients with IDC (mean age 46.7 +/- 11.7 years, 81.1% male) to assess their functional capacity. Baseline clinical and echocardiographic variables were obtained. Hematological and biochemical parameters were measured using standard techniques. Results: The patients were divided into low (<5 MET, n=18) and high (>5 MET, n=19) FC groups according to their functional status in the exercise test. The 2 groups were similar regarding age, gender and the presence of hypertension and diabetes mellitus. There was no significant difference between groups regarding echocardiographic parameters such as left ventricular ejection fraction and diameters. However, the NLR was significantly higher in low FC group compared to high FC group (3.62 +/- 2.24 vs. 2.24 +/- 0.67, p=0.002; respectively). There were significant negative correlations between the NLR, MET and left ventricular ejection fraction (r=-0.405, p=0.013 and r=-0.028, p=0.028; respectively). Diastolic dysfunction was present in all the patients with low functional capacity. A cut-off point of 2.26 for the NLR had 83% sensitivity and 69% specificity in predicting poor FC. After multivariate analysis, only the NLR remained significant predictor of poor functional status. Conclusion: We detected a significant association between the NLR and low FC, both of which has predictive and prognostic value in patients with heart failure. Functional capacity may depend on diastolic function rather than left ventricular ejection fraction in patients with IDC.
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.
Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study design
(Turkish Soc Cardiology, 2013) Ertas, Faruk; Kaya, Hasan; Yuksel, Murat; Soydinc, Mehmet Serdar; Alan, Sait; Ulgen, Mehmet Siddik
Objective: Atrial fibrillation (AF) is an important health problem in Turkey. However, no prospective, multicenter, large trial reflecting national data has been published so far. Therefore, the aim of this study was to follow, analyze and evaluate patients with AF in a large multicenter nation-wide trial. Methods: Two thousand three hundred consecutive patients with AF in their electrocardiogram, reflecting all the population of seven geographical regions of Turkey will be included in the study. The patients will be followed up for two years and death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding, hospitalization will be recorded as the primary end-point. Results: Will be available at the end of the study; preliminary results will be due December 2012. Conclusion: General risk profile of patients with AF, frequency of anticoagulation, frequency of effective treatment and risks of bleeding will be evaluated according to the current guidelines. Major adverse events and their independent predictors will be determined.
BLOOD PRESSURE DIURNAL RHYTHM IS RELATED WITH HEMATOLOGICAL INDICES IN GESTATIONAL DIABETES MELLITUS PATIENTS
(Carbone Editore, 2013) Soydinc, Serdar; Oylumlu, Mustafa; Yuksel, Murat; Turgut, Abdulkadir; Soydinc, Hatice Ender
Objective: Gestational diabetes mellitus (GDM) is related with cardiovascular risk factors. Non-dipping blood pressure pattern and high mean platelet volume, which is an indicator of increased platelet activation, are associated with cardiovascular morbidity and inortality. The aim of our study is to determine circadian variation of blood pressure and to study the impact of hematological indices on blood pressure dipping and non-dipping patterns in patient with GDM. Material and methods: A total of 42 patients who were diagnosed with GDM and 33 patients with healthy pregnancies were included into the study. Patients' blood pressures were monitored and were grouped due to their blood pressure circadian pattern. If the blood pressure while sleeping decreased more than 10% from the blood pressure while awake, the patient was classified as a dipper. If the decrease was less than 10%. the patient was classified as a non-dipper. Biochemical and hematological parameters were measured and clinical features were recorded for all study groups. Results: Ambulatory blood pressures monitoring of two groups revealed that average systolic and diastolic blood pressures as well as the day-phase diastolic and night-phase systolic and diastolic blood pressures of GDM patients were significantly increased than those of the control group. Besides, control patients had a more significant decrease in night-phase systolic and diastolic blood pressures than GDM patients (p<0.001). There was no significant difference between hematological indices and dipping status, except for mean platelet volume (MPV). MPV in non-dippers was significantly higher than dippers one (p<0.001). Step-wise multivariate linear regression demonstrated that MPV and GDM can be used as independent predictors of non-dipping status. Conclusion: According to our results the circadian variation of blood pressure is impaired and MPV is increased in GDM patients. Increasing in MPV is associated with non-dipping status of blood pressure. It is possible that non-dipping status and increased MPV levels may be additional risk factors for increased cardiovascular disease events in gestational diabetes patients.
Coexistence of permanent junctional reciprocating tachycardia with rheumatic valvular disease; a case sucessfully treated with radiofrequency ablation
(Aves Press Ltd, 2015) Aydin, Mesut; Yildiz, Abdulkadir; Yuksel, Murat; Islamoglu, Yahya
A seventeen years old female had presented with palpitation. On the electrocardiography (ECG), long RP, narrow QRS tachycardia, inverted P waves in leads D2, D3 and aVF were noticed. On transthoracic echocardiography, rheumatic mitral valvular disease (RMVD) with normal ventricular systolic function was observed. Eccentric mitral regurgitation was also present. Electrophysiology study (EPS) was performed at our institution. According to EPS and surface ECG findings our diagnosis was permanent junctional reciprocating tachycardia (PJRT). Atrial activation appeared earliest and nearly ostium of the coronary sinus. The accessory pathway was detected near the coronary sinus ostium. RF ablation was performed, successfully. Tachycardia was terminated in three seconds. Permanent junctional reciprocating tachycardia can rarely coexist with RMVD. Here, we are reporting a case of PJRT and RMVD coexistence that underwent successful radiofrequency (RF) catheter ablation. This case report confirms that RF catheter ablation should be considered as the treatment of choice in adult patients with PJRT for the following reasons: catheter ablation is highly successful, the complication rate is low, and PJRT may lead to tachycardia induced cardiomyopathy, which is reversible.
Distinction of hypertriglyceridemic waist phenotype from simple abdominal obesity: interaction with sex hormone-binding globulin levels to confer high coronary risk
(Taylor & Francis Ltd, 2017) Karagoz, Ahmet; Onat, Altan; Aydin, Mesut; Can, Gunay; Simsek, Baris; Yuksel, Murat
Objective: The associations of total testosterone (TT) and sex hormone-binding globulin (SHBG) with the hypertriglyceridemic waist (HtgW) phenotype and coronary heart disease (CHD) risk have scarcely been examined. We explored such cardiometabolic risk mediations in middle-aged adults. Methods: Participants (n = 1924) in a population-based study were studied by forming categories consisting of abdominal obesity, hypertriglyceridemia, both (HtgW), or none ('healthy'). Cardiometabolic risk was prospectively analyzed (mean follow-up 5.7 years). Results: With reference to the healthy group, SHBG values in HtgW were significantly lower, alike serum HDL-cholesterol. ApolipoproteinB-containing lipoproteins, fasting glucose and complement C3 levels, inverse to lipoprotein[Lp](a) especially in female participants with HtgW phenotype compared with those in the 'healthy' category, suggested the operation of aggregation to Lp(a). Multivariable Cox regression analysis in a model comprising age, waist circumference and systolic blood pressure showed significant protection by SHBG against incident diabetes which tended to be so with TT in men. Sex hormones were not associated with risk of incident CHD or MetS. In another multivariable model, compared to the ` healthy' and the hypertriglyceridemia categories, dichotomized high and, in females, low SHBG values within the HtgW category, positively predicted CHD at significant over 2-fold relative risks. Conclusion: HtgW phenotype distinguishes itself from the (virtually neutral) simple abdominal obesity in independently conferring high CHD risk when elevated or reduced SHBG levels interact. Underlying operation of Lp(a) aggregation is suggested.
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.
Effect of Sleep Quality on Hemodynamic Response to Exercise and Heart Rate Recovery in Apparently Healthy Individuals
(Canadian Soc Clinical Investigation, 2014) Yuksel, Murat; Yildiz, Abdulkadir; Demir, Melike; Bilik, Mehmet Z.; Ozaydogdu, Necdet; Aktan, Adem; Isik, Ferhat
Purpose: Poor sleep quality has an unfavorable impact on autonomic nervous system activity, especially that of the cardiovascular (CV) system. The heart rate (HR) and blood pressure (BP) at rest and during exercise, along with the heart rate recovery (HRR), were examined in poor sleepers and compared with individuals with good sleep quality. Methods: A total of 113 healthy individuals were enrolled to the study. All participants performed treadmill stress testing. Sleep quality of participants was assessed by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire: 48 subjects were categorized as 'poor sleepers' (PSQI score > 6 points), and the rest were grouped as 'good sleepers'. Results: The poor sleepers showed higher resting HR (p<0.001), higher diastolic BP (p=0.006), similar systolic BP (p=0.095), more frequent hypertensive response to exercise (p=0.046) and less HR increase with exercise (chronotropic incompetence) (p=0.002) compared with individuals who reported good sleep quality. In addition, the poor sleepers demonstrated reduced heart rate recovery at the 1st and 3rd minute of recovery (p=0.005 and 0.037, respectively) compared with good sleepers. Multivariate logistic regression analysis revealed that only resting diastolic BP was the independent predictor of HRE. The PSQI score was positively correlated with resting HR; while it was negatively correlated with HR response to exercise, HRR1 and HRR index-1. Conclusion: This cross-sectional study emphasizes the effect of poor sleep quality on unfavorable cardiovascular outcome indicators of the treadmill stress test.
Elevated serum uric acid in nondiabetic people mark pro-inflammatory state and HDL dysfunction and independently predicts coronary disease
(Springer London Ltd, 2013) Onat, Altan; Can, Gunay; Ornek, Ender; Altay, Servet; Yuksel, Murat; Ademoglu, Evin
We explored the association of serum uric acid (UA) concentrations with pro-inflammatory state and high-density lipoprotein (HDL) dysfunction. UA tertiles in tracked 1,508 nondiabetic participants were analyzed cross-sectionally for associations with inflammation biomarkers and protective proteins over a mean follow-up of 4.9 years for incident coronary heart disease (CHD) using Cox proportional hazards regression. In the absence of metabolic syndrome (MetS), UA tertiles significantly distinguished, in each sex, increasing categories of three MetS components (inflammation/oxidation markers, apolipoprotein (apo)B) and (inversely) current smoking (but not protective proteins such as HDL, apoA-I, and adiponectin). Distinctions attenuated in the presence of MetS. Linear regression model revealed fasting triglycerides (1.86 mg/dl variance), male sex, and gamma-glutamyl transferase and age as covariates of UA levels in women. In Cox analysis, incident CHD (n = 137) was predicted by mid and upper UA tertile in men alone at significant hazard ratios of 2.7, additively to conventional risk factors. Elevated serum UA levels, linked to triglycerides, mark in nondiabetic people pro-inflammatory state, and, notably, HDL dysfunction. CHD risk is independently predicted by elevated UA levels in nondiabetic men and is modulated by MetS and gender.

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