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Gedikli O.,Karadeniz Technical University | Ozturk M.,Caycuma State Hospital | Turan O.E.,Aydin State Hospital | Ilter A.,Karadeniz Technical University | And 2 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2014

Background: Cardiac syndrome X (CSX) is defined as normal coronary arteries with angina pectoris and a positive stress test. Epicardial adipose tissue (EAT) plays an important role in inflammatory process in cardiovascular system, therefore EAT may affect the pathogenesis of different cardiovascular disease. The aim of this study was to investigate the EAT thickness in patients with CSX and compare normal subjects. Methods: We prospectively enrolled 30 consecutive patients with CSX. The control group consisted of 30 age and sex-matched individuals with anginal chest pain and a negative treadmill or myocardial perfusion scan test. EAT thickness was measured by transthoracic echocardiography. Results: There were no differences in baseline clinical, biochemical and echocardiographic characteristics between CSX patients and the control group. Patients with CSX had significantly increased EAT thickness than those of the controls (3.43 ± 0.88 vs. 2.34 ± 0.89 mm, p=0.0001). Conclusion: We found that EAT thickness is increased in patients with CSX. This finding suggests that EAT may contribute to the etiopathogenesis of the CSX.


PubMed | Kafkas University, Izmir University, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Tepecik Education and Research Hospital and 2 more.
Type: Journal Article | Journal: Cardiovascular journal of Africa | Year: 2016

The level of right ventricular (RV) systolic function has prognostic importance in right ventricular ST-segment elevation myocardial infarction (RV-STEMI). This study aimed to evaluate the changes in RV systolic function in patients with RV-STEMI according to the revascularisation method used for their management.The first group consisted of 132 patients who received primary percutaneous coronary intervention (PPCI). The 78 patients who had received thrombolytic therapy (TT) in external centres before referral to our centre for PCI within three to 12 hours of RV-STEMI were included in the second group. All patients were evaluated by conventional and two-dimensional speckle-tracking echocardiography.There were 172 male patients and their mean age was 63.7 11.8 years. There were no significant differences between the two groups with regard to right ventricular systolic parameters at admission and at the one-month follow-up visit. The echocardiographic changes between admission and the one-month follow up were investigated for the patients included in the study groups. Mean values of each parameter observed at the one-month follow up were significantly increased compared to those at admission within each group.Our study demonstrated that PCI within three to 12 hours following TT provided similar benefits on right ventricular systolic function compared to PPCI in patients with RV-STEMI.


PubMed | Samsun Education and Research Hospital, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Kafkas University, Izmir University and Erzurum Region Education and Research Hospital
Type: Journal Article | Journal: Arquivos brasileiros de cardiologia | Year: 2016

GRACE risk score (GS) is a scoring system which has a prognostic significance in patients with non-ST segment elevation myocardial infarction (non-STEMI).The present study aimed to determine whether end-systolic or end-diastolic epicardial fat thickness (EFT) is more closely associated with high-risk non-STEMI patients according to the GS.We evaluated 207 patients who had non-STEMI beginning from October 2012 to February 2013, and 162 of them were included in the study (115 males, mean age: 66.6 12.8 years). End-systolic and end-diastolic EFTs were measured with echocardiographic methods. Patients with high in-hospital GS were categorized as the H-GS group (in hospital GS > 140), while other patients were categorized as the low-to-moderate risk group (LM-GS).Systolic and diastolic blood pressures of H-GS patients were lower than those of LM-GS patients, and the average heart rate was higher in this group. End-systolic EFT and end-diastolic EFT were significantly higher in the H-GS group. The echocardiographic assessment of right and left ventricles showed significantly decreased ejection fraction in both ventricles in the H-GS group. The highest correlation was found between GS and end-diastolic EFT (r = 0.438).End-systolic and end-diastolic EFTs were found to be increased in the H-GS group. However, end-diastolic EFT and GS had better correlation than end-systolic EFT and GS.


Korkmaz L.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital | Sahin S.,Trabzon Numune Training and Research Hospital | Akyuz A.R.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital | Ziyrek M.,Trabzon Numune Training and Research Hospital | And 5 more authors.
Medical Principles and Practice | Year: 2013

Objective: To investigate whether or not patients with subclinical hypothyroidism (SH) have increased epicardial adipose tissue (EAT). Subjects and Methods: Sixty-one patients with newly diagnosed SH and without any known cardiovascular disease were enrolled. Twenty-four subjects matched for age, gender and body mass index without any thyroid dysfunctions were included as a control group. The EAT was measured by echocardiography and thyroid functions were assessed by routine blood examination. Results: Patients with SH had higher EAT values than control subjects (3.6 ± 0.9 vs. 2.8 ± 1.4, p = 0.005). Also, SH patients with thyroid-stimulating hormone (TSH) ≥10 mU/l had higher EAT than those with SH with TSH <10 mU/l and control subjects (p = 0.013). In addition, while there was significant correlation between EAT and TSH (r = 0.31, p = 0.014) in patients with SH, there was no significant relation between EAT and TSH in normal subjects (r = 0.09, p = 0.64). Conclusions: There was a higher level of EAT in patients with SH compared with normal subjects and a significant correlation between EAT and TSH was found. Copyright © 2012 S. Karger AG, Basel.


Usta S.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital | Basbug H.S.,Kafkas University | Haliloglu E.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2016

Acute dissection is the most dangerous aortic disease with a high mortality, if remained untreated. The standard treatment varies as surgical, medical and endovascular depending on the morphology of the dissection and the presence of associated complications. Endovascular treatment options are gradually evolving and becoming more popular in surgical practice. In this article, we report a successful endovascular treatment of an acute type-1 dissection in a 62-year-old female case who underwent coronary artery bypass grafting two months prior.


Ulusoy S.,Karadeniz Technical University | Ozkan G.,Karadeniz Technical University | Adar A.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital | Bektas H.,Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital | And 2 more authors.
Progress in Transplantation | Year: 2014

Background-Kidney transplant is a most important replacement therapy. It reduces cardiovascular mortality and morbidity but does not fully correct impairments in cardiac function. Fragmented QRS (fQRS) complex includes various RSR' patterns with different QRS complex morphologies on electrocardiograms. Objective-To analyze fQRS frequency and the relationship between fQRS and left ventricular function in kidney transplant patients.Method-After demographic data on 39 kidney transplant patients were recorded and biochemical parameters were investigated, electrocardiograms were evaluated for the presence of fQRS. Left ventricular ejection fraction, mitral annular plane systolic excursion, peak early diastolic mitral annular velocities, late diastolic mitral annular velocities, and systolic mitral annular velocity were analyzed.Results- Fragmented QRS was detected in 16 patients. A history of hypertension was associated with the presence of fQRS. Patients with fQRS had significantly lower systolic and peak early diastolic mitral annular velocities, mitral annular plane systolic excursion, and left ventricular ejection fraction than did patients without fQRS (P= .03, .01, <.001, and .03, respectively).Conclusion- Detection of fQRS on electrocardiograms may be useful in predicting systolic and diastolic dysfunction of the left ventricle in kidney transplant patients. © 2014 NATCO.


PubMed | Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital and Karadeniz Technical University
Type: Journal Article | Journal: Progress in transplantation (Aliso Viejo, Calif.) | Year: 2014

Kidney transplant is a most important replacement therapy. It reduces cardiovascular mortality and morbidity but does not fully correct impairments in cardiac function. Fragmented QRS (fQRS) complex includes various RSR patterns with different QRS complex morphologies on electrocardiograms.To analyze fQRS frequency and the relationship between fQRS and left ventricular function in kidney transplant patients.-After demographic data on 39 kidney transplant patients were recorded and biochemical parameters were investigated, electrocardiograms were evaluated for the presence of fQRS. Left ventricular ejection fraction, mitral annular plane systolic excursion, peak early diastolic mitral annular velocities, late diastolic mitral annular velocities, and systolic mitral annular velocity were analyzed.Fragmented QRS was detected in 16 patients. A history of hypertension was associated with the presence of fQRS. Patients with fQRS had significantly lower systolic and peak early diastolic mitral annular velocities, mitral annular plane systolic excursion, and left ventricular ejection fraction than did patients without fQRS (P= .03, .01, <.001, and .03, respectively).Detection of fQRS on electrocardiograms may be useful in predicting systolic and diastolic dysfunction of the left ventricle in kidney transplant patients.


PubMed | Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Sanliurfa Mehmet Akif Inan Training and Research Hospital and Karadeniz Technical University
Type: Journal Article | Journal: Clinical rheumatology | Year: 2016

Arterial stiffness (AS) has a detrimental effect on cardiovascular system particularly on left ventricle (LV). The aim of the study was to evaluate the impact of AS on LV functions in patients with rheumatoid arthritis (RA). Forty patients with RA and 25 age-sex matched control subjects (mean age 48.56.3 vs. 45.16.9years, respectively, p=0.06) were enrolled in study. AS was assessed by carotid-femoral pulse wave velocity (CF-PWV) and heart rate corrected augmentation index (AIx@75) measured by applanation tonometry (SphygmoCor). LV function was evaluated using tissue Doppler-derived myocardial performance index (MPI) from lateral mitral annulus. CF-PWV (28.310.3 vs. 21.89.3m/s, p=0.03), AIx@75 (10.22.3 vs. 9.21, %, p=0.01) and MPI (0.460.12 vs. 0.360.1, p<0.001) were significantly higher in patients with RA than in controls. LV MPI was found to be significantly positive correlated with CF-PWV, AIx@75, and ESR (r=0.360, p=0.005; r=0.334, p=0.009; r=0.293, p=0.023, respectively). Arterial stiffness parameters including CF-PWV and AIx@75 are associated with subclinical left ventricular dysfunction in patients with RA.


PubMed | Karabük University and Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital
Type: Journal Article | Journal: VASA. Zeitschrift fur Gefasskrankheiten | Year: 2015

We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low- and high-risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC).Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64-slice MDCT scanner for the evaluation of CAC score. A four-point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior-anterior chest radiography images.The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of 2 was the strongest independent predictor of a high-risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of 100 (AUC = 0.892, P < 0.0001), and 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of 2 predicted a CAC score of 400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively.AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low- and high-risk CAC scores.


PubMed | Gumushane University, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Karadeniz Technical University, Sakarya University and Kanuni Training and Research Hospital
Type: | Journal: TheScientificWorldJournal | Year: 2014

The aim of this study was to evaluate the changes in perioperative oxidant-antioxidant balance in ONCABG.Twenty-three patients were included in this study. Serum total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) values were assessed preoperatively, at 20 minutes after aortic clamping and at 30 minutes, 6 hours, and 48 hours after declamping (reperfusion). The patients were divided into 2 groups according to the median aortic cross clamping (XC) time: group 1 (XC time < 42 minutes) and group 2 (XC time 42 minutes).TOS and OSI values of whole patients at 30 minutes after reperfusion were higher than preoperative values (P = 0.045, P = 0.015), while perioperative TAS levels of the patients were similar to the preoperative levels (P = 0.173). XC time was correlated with TOS levels at 30 minutes after reperfusion (r = 0.43, P = 0.041). In group 2, TOS and OSI values at 30 minutes after reperfusion were higher than preoperative values (P = 0.023, P = 0.048), whereas a significant difference was not found in group 1 (P = 0.601, P = 0.327).Oxidative imbalance and increase in TOS at reperfusion in ONCABG may be associated with XC time.

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