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Ozluk O.A.,Bursa Ihtisas Training and Research Hospital | Yilmaz M.,Bursa Ihtisas Training and Research Hospital | Topal D.,Sevket Yilmaz Training and Research Hospital | Tenekecioglu E.,Bursa Ihtisas Training and Research Hospital | And 5 more authors.
Central European Journal of Immunology | Year: 2016

Introduction: Neutrophil to lymphocyte ratio (NLR) was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied. Aim of the study: To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD) in anterior miyocardial infarction patients. Material and methods: Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters. Results: Between group I (n = 41, mean age 52.5 ±12.7) and group II (n = 17, mean ages 52.0 ±10.8); NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01). In group I, left ventricular ejection fraction (LVEF) was significantly lower (p = 0.02). In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01) and negatively correlated with LVEF (r = '0.28, p = 0.03). Conclusions: The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients.


Yilmaz M.,Bursa Ihtisas Training and Research Hospital | Arican Ozluk F.O.,Bursa Ihtisas Training and Research Hospital | Peker T.,Bursa Ihtisas Training and Research Hospital | Bekler A.,Medicalpark Hospital | Karaagac K.,Bursa Ihtisas Training and Research Hospital
Turkish Journal of Medical Sciences | Year: 2013

Aim: To investigate right ventricular function using conventional and tissue Doppler echocardiography in patients with coronary slow flow. Materials and methods: Twenty-two patients with slow coronary flow and 22 healthy subjects were included in the study. Right ventricular function was evaluated by conventional and tissue Doppler echocardiography. Additionally, right ventricular global function was assessed by myocardial performance index. Results: The tricuspid annulus peak early diastolic velocity (11.4 ± 2.2 cm/s, 13.9 ± 3 cm/s) and ratio of early to late diastolic velocity (0.70 ± 0.17 cm/s, 1.2 ± 0.38 cm/s) were lower in the patient group than in the controls (P = 0.05, P = 0.002, respectively). Late diastolic velocity (16.4 ± 3 cm/s, 14.4 ± 3 cm/s) and isovolumetric relaxation time (80 ± 9 ms, 66 ± 4 ms) were significantly higher in the patient group than in the controls (P = 0.024, P < 0.001, respectively). Right ventricular myocardial performance index was significantly prolonged in the coronary slow flow group (0.51 ± 0.03, 0.40 ± 0.02, P < 0.001). TIMI frame count was negatively correlated with the tricuspid lateral annulus early diastolic velocity and the ratio of tricuspid lateral annulus early to late diastolic velocity, whereas it was positively correlated with tricuspid isovolumetric relaxation time and right ventricular myocardial performance index. Conclusion: Right ventricular diastolic dysfunction exists in patients with the coronary slow flow phenomenon and it is correlated with TIMI frame count. © TÜBİTAK.


Yilmaz M.,Bursa Ihtisas Training and Research Hospital | Arican Ozluk F.O.,Bursa Ihtisas Training and Research Hospital | Akgumus A.,Bursa Ihtisas Training and Research Hospital | Peker T.,Bursa Ihtisas Training and Research Hospital | And 3 more authors.
Acta Cardiologica | Year: 2013

Objective Metabolic syndrome (MS) is a cluster of risk factors leading to cardiometabolic diseases. The aim of the present study was to investigate the eff ect of MS on left atrial function, which is an important determinant of left ventricular filling. Methods Left atrial (LA) volumes were measured echocardiographically in 32 MS patients and 32 age- and sex-matched controls. LA volumes were determined at the time of mitral valve opening (maximal, Vmax), at the onset of atrial systole (p wave on the electrocardiogram, Vp) and at the mitral valve closure (minimal, Vmin) according to the biplane area-length method in apical 4-chamber and 2-chamber view. All volumes were corrected to the body surface area, and following left atrial emptying functions were calculated. LA passive emptying volume = Vmax - Vp, LA passive emptying fraction = LA passive emptying volume/Vmax. Conduit volume = LV stroke volume - (Vmax - Vmin), LA active emptying volume = Vp - Vmin, LA active emptying fraction = LA active emptying volume/Vp, LA total emptying volume = (Vmax -Vmin), LA total emptying fraction = LA total emptying volume/Vmax. Results LA maximal volume and LA presystolic volume were significantly higher in MS patients than in controls (P < 0.001). But LA minimum volume was significantly lower in MS patients than in controls (P < 0.001). Although LA passive emptying volume (P < 0.03), LA passive emptying fraction (P < 0.001) and conduit volume (P < 0.001) were found to be significantly lower in MS patients than in controls, LA active emptying volume (P < 0.001) and LA active emptying fraction (P < 0.001) were significantly greater in MS patients than in controls. Conclusion In our study, metabolic syndrome was associated with increased left atrial volume, decreased left atrial passive emptying function and increased pump function. Increased left atrial pump function represents a compensatory mechanism in patients with MS. Thus, these results underline the importance of maintaining a sinus rhythm in these patients.


Ozluk O.A.,Bursa Ihtisas Training And Research Hospital | Topal D.,Bursa Ihtisas Training And Research Hospital | Tenekecioglu E.,Bursa Ihtisas Training And Research Hospital | Peker T.,Bursa Ihtisas Training And Research Hospital | And 5 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Aim: Coronary artery disease (CAD) and its serious clinical form, ST segment elevated myocardial infarction (STEMI) has been the leader within the death causes around the world and in our country. In STEMI, the main objective is providing the myocardial reperfusion. In our study, it was aimed to investigate the predictive value of tenascin-C level for the degree of myocardial reperfusion in patients with STEMI. Methods: In our study, 58 patients admitted to our hospital with acute anterior STEMI were included. All the patients had underwent primary percutaneous intervention for the single-vessel disease at left anterior descending coronary artery. After admission to coronary care unit tenascin-C levels were measured. Subjects were classified according to their myocardial blush grades (MBG); MBG 0, MBG 1 and MBG 2 were groupped as Group I, MBG 3 was groupped as Group II. The groups were compared according to their tenascin-C levels and other parameters. Results: Between group I (n = 31, mean age 55 ± 12.5) and group II (n = 27, mean ages 49.3 ± 11.1); tenascin-C, troponin I and CK-MB levels were significantly higher in group I compared to the group-II (P < 0.001; P < 0.001 and P < 0.05; respectively). In group I, left ventricular ejection fraction (LVEF) was significantly lower (P < 0.001), left ventricular end-diastolic volume and left ventricular end-systolic volume were significantly higher (P = 0.03) as compared to group II. In group I, ST-segment resolution at ECG was worse (P = 0.003). In correlation analyzes, tenascin-C was significantly positively correlated with troponin-I (r = 0.596; P < 0.001) and CRP (r = 0.615, P < 0.001). Tenascin-C was significantly negatively correlated with MBG, LVEF and ST-segment resolution (r =-0.626, P < 0.001, r =-0.411, P = 0.002 and r =-0.631; P < 0.001, respectively). Conclusion: Based on our study, it can be estimated that in patients with high tenascin-C levels myocardial reperfusion was inadequate, even underwent successfull PCI. In this context, increased tenascin-C may help predict not only left ventricular remodelling and prognosis but also the effectiveness of primary PCI. © 2015, Int J Clin Exp Med.All rights reserved.


Ozluk O.A.,Bursa Ihtisas Training and Research Hospital | Ber I.,Tavsanli Doc Dr Mustafa Kalemli State Hospital | Peker T.,Bursa Ihtisas Training and Research Hospital | Yilmaz M.,Bursa Ihtisas Training and Research Hospital | And 3 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Aim: Increased mean platelet volume (MPV) have been shown to be associated with peripheral artery disease (PAD). However in these studies, noninvasive methods for the diagnosis of PAD was used. In the literature, there is no studies examining the values of MPV in the angiographically documented PAD. We aimed to evaluate the relationship between angiographically documented PAD and MPV levels in the peripheral blood samples. Methods: In this study, retrospective analysis of 1386 patients was performed who underwent peripheral angiography at the cardiology service of the our hospital, between 2006 and 2012 for a suspected diagnosis of lower extremity peripheral arterial disease. Patients with a stenosis percent of 50% or above in the peripheral angiography were considered as having peripheral arterial disease. MPV values are affected by many factor. Only 84 patients who complied with the inclusion criteria were detected. The study patients were divided into 2 groups according to the results of peripheral angiography. 56 patients diagnosed with PAD based on the specified criteria were grouped into Group I (mean age 59 ± 10 years) while 28 patients without peripheral arterial disease were grouped into Group II (mean age 60 ± 11 years). Blood tests and angiographic images were analyzed from patients’ data. Results: Both groups were similar in terms of basic parameters of anemia including hemoglobin, hematocrit and red cell distribution width levels. There were no significant differences between MPV levels in both groups (8.08 ± 0.91 vs 8.28 ± 1.16, P > 0.05). Mean corpuscular volume and mean corpuscular hemoglobin levels, on the other hand, were significantly higher in Group I (P < 0.05). Conclusions: In our study, we did not found any significant changes in the MPV levels of angiographically documented PAD diseases. The use of MPV level as a risk factor for peripheral arterial disease is impractical due to the fact that MPV is affected by a lot of factors and there are several technical factors. Because of this, in the real life, we are not recommend to use MPV values as an indicator for peripheral artery disease. © 2015, E-Century Publishing Corporation. All rights reserved.


Yildiz A.,Cekirge State Hospital | Gul C.B.,Uludag University | Ersoy A.,Uludag University | Asiltas B.,Uludag University | And 9 more authors.
Iranian Journal of Kidney Diseases | Year: 2014

Conclusions. Fibroblast growth factor 23 was found substantially elevated and arterial compliance was found significantly decreased in early ADPKD patients regardless of hypertension. However, there was no significant correlation between FGF23 levels and arterial function parameters. Additional studies are required to determine possible mechanisms of these disturbances and cardiovascular effects of FGF23 in ADPKD patients.Introduction. Recent studies report reduced vascular compliance and elevated levels of fibroblast growth factor 23 (FGF23) in patients with autosomal dominant polycystic kidney disease (ADPKD) and preserved kidney function. In the present study, we investigated the relationship between vascular compliance and FGF23 in patients in early phases of ADPKD.Materials and Methods. We studied 54 ADPKD patients with preserved kidney function and 24 healthy individuals. All participants underwent noninvasive pulse wave analysis in order to determine large arterial elasticity index (LAEI) and small arterial elasticity index (SAEI) using a modified Windkessel model. Levels of FGF23 in addition to several cardiovascular risk factors were evaluated. Linear regression analyses were performed to determine independent correlates of LAEI, SAEI, and FGF23.Results. In the ADPKD group, 33 patients were hypertensive and the remaining patients were normotensive. Serum FGF23 levels of both ADPKD groups were significantly higher than that in the controls. Both hypertensive and normotensive ADPKD patients had lower LAEI and SAEI levels compared to the controls. There was no significant correlation between vascular compliance parameters and FGF23 levels. Having ADPKD was independently associated with increased FGF23 levels and decreased SAEI. © 2014, Iranian Journal of Kidney Diseases. All rights reserved.

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