Bursa Yuksek Ihtisas Education and Research Hospital

Bursa, Turkey

Bursa Yuksek Ihtisas Education and Research Hospital

Bursa, Turkey

Time filter

Source Type

Demir M.,Yaseminpark sit 4E D11 | Demir C.,Bursa Sevket Yilmaz Education and Research Hospital | Cosar S.,Bursa Yuksek Ihtisas Education and Research Hospital
Therapeutic Advances in Cardiovascular Disease | Year: 2013

Background: The pathophysiology of coronary slow flow (CSF) has not been clearly identified, although multiple abnormalities including arteritis, endothelial dysfunction, and atherothrombosis have been reported. Several studies have demonstrated that higher serum bilirubin inhibits the inflammation and proliferation of vascular smooth muscle cells; in addition, there is a relationship between serum bilirubin and cardiovascular disease. However, the relationship between bilirubin and CSF is still unknown. In our study, we compared serum bilirubin concentrations between CSF patients and controls. Methods: The study included 50 CSF patients (19 male, mean age 65.6 ± 13.7 years) and 30 controls (10 male, mean age 57.86 ± 11.6 years). Concurrent routine biochemical tests and leukocyte count, hemoglobin, hematocrit, and platelet count on whole blood count were performed in patients that underwent a coronary angiogram. These parameters were compared between groups. Results: No statistically significant difference was found between the two groups in terms of basic characteristics. Total, direct, and indirect serum bilirubin levels were significantly lower among CSF patients than controls (14.0 ± 12.0 versus 6.15 ± 6.8, 5.6 ± 3.4 versus 2.6 ± 1.7, and 8.4 ± 8.5 versus 3.6 ± 3.4 ìmol/l; all p < 0.001, respectively). Conclusions: The study revealed a relationship between serum bilirubin and CSF. © The Author(s), 2013.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Demir C.,Bursa Sevket Yilmaz Education and Research Hospital
Vascular Health and Risk Management | Year: 2013

Background: Systemic thromboembolism is a serious, major complication in patients with an atrial septal aneurysm (ASA). Paroxysmal atrial fibrillation (AF) is more common in patients with ASA than in the normal population. Neutrophil/lymphocyte ratio (NLR) has been associated with postoperative AF development in patients who have undergone cardiac surgery. This study investigated NLR in a group of ASA patients compared with a control group of healthy volunteers. Patients and methods: The study group consisted of 40 patients with ASA; the control group consisted of 30 age-, sex-, and body mass index-matched healthy volunteers. All patients and control subjects underwent echocardiographic examination. No patient had a recent history of an acute infection or an inflammatory disease. Baseline NLR was measured by dividing neutrophil count by lymphocyte count. Results: No statistically significant difference was found between the two groups in terms of basic characteristics. Mean NLR was significantly higher among persons with ASA compared with controls (3.4 ± 1.5 vs 1.6 ± 0.97, P< 0.001). Conclusion: Our results suggest that a higher NLR, an emerging marker of inflammation, has a positive correlation with ASA. The measurement of NLR may be used to indicate an increased risk of arrhythmia, such as AF, in ASA patients. © 2013 Demir and Demir, publisher and licensee Dove Medical Press Ltd.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Demir C.,Bursa Sevket Yilmaz Education and Research Hospital
Medical Science Monitor | Year: 2012

Background: In this study we examined right and left ventricular systolic functions in hepatitis B virus (HBV) patients. Material/Methods: The study included 50 HBsAg-positive patients (mean age; 33±13 years) and 50 other persons (mean age; 28±11 years) as a control group. Transthoracic echocardiography was performed in all the participants. Right and left ventricle systolic parameters were compared between these 2 groups. Results: In the group of the patients with HBsAg positivity, the right ventricular fractional area change (RV FAC), tricuspid annular plane excursion (TAPSE) and RV myocardial systolic velocity (St) values were lower than in the control group (33±11 vs. 52±13%, p=0.001; 14.6±1.1 vs. 22.2±2.4 mm, p<0.001; 8.6±1.2 vs. 15.8±2.3 cm/s, p<0,001, respectively); the right atrium (RA) and RV diameters were higher than in controls (5.1±1.2 vs. 3.7±0.5 cm, p<0.001; 4.9±0.8 vs. 3.4±0.5 cm p<0.001, respectively); and systolic pulmonary artery pressure was higher than in control (39.3±9.5 vs. 22±8.4 mmHg, p<0.001). Conclusions: The findings showed that HBV infection may be associated with right ventricular systolic dysfunction and pulmonary hypertension.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital
Experimental and Clinical Cardiology | Year: 2013

Background: Systemic thromboembolism is a serious, major complication in patients with an atrial septal aneurysm (ASA). Atrial dysfunction resulting from paroxysmal atrial fibrillation is more common in patients with ASA than in the general population. The autonomic nervous system plays an important role in the initiation of atrial fibrillation. Objective: To investigate autonomic function and its impact on ventricular and atrial arrhythmia in a group of ASA patients compared with a control group of healthy volunteers. Methods: The study group consisted of 40 patients with ASA; the control group consisted of 30 age-, sex- and body mass index-matched healthy volunteers. All patients and control subjects underwent echocardiographic examination. Autonomic function was assessed by determining heart rate variability (HRV) indexes. Results: HRV time and frequency domain indexes were lower in patients with ASA compared with healthy controls (188±32 ms2 and 323±42 ms2 for low-frequency HRV; 195±39 ms2 and 377±43 ms 2 for highfrequency HRV; P<0.001 for all). Statistically significant differences with respect to other HRV indexes were also found between the two groups. Conclusion: ASA appears to be associated with cardiac autonomic dysfunction; however, the mechanisms of this association are not known in detail. © 2013 Pulsus Group Inc. All rights reserved.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital
Experimental and Clinical Cardiology | Year: 2013

BACKGROUND: The bicuspid aortic valve (BAV) represents the most common cardiac congenital malformation in adults. It is frequently associated with dilation, aneurysm and dissection of the ascending aorta. OBJECTIVE: To evaluate left ventricular systolic and diastolic function in subjects with BAVs. METHODS: Thirty-five subjects with BAV (mean [± SD] age 25.9±5.7 years [range 17 to 36 years]; 18 male, 17 female) with either no valvular impairment or mild valvular impairment were recruited along with 30 control subjects (24.5±4.4 years of age [range 15 to 35 years]; 15 male, 15 female) who were matched for age, sex and body surface area. Left ventricular systolic and diastolic function were evaluated using conventional and tissue Doppler echocardiography. Left ventricular systolic and diastolic parameters were compared between the two groups. RESULTS: In subjects with BAVs, the ratio of mitral early diastolic velocity to late diastolic velocity was lower (0.95±0.4 versus 1.27±0.9; P=0.001), the ratio of mitral early diastolic velocity to myocardial early diastolic velocity was higher (10.1±3.2 versus 6.5±2.4; P=0.001) and the myocardial early diastolic velocity was lower (8.4±2.1 versus 15.3±3.6; P<0.001) compared with control subjects. In addition, the myocardial performance index was higher in subjects with BAVs than in control subjects (P=0.03). The left ventricular ejection fraction was also lower (53±11% versus 64±13%; P<0.001). No other statistically significant differences were observed between the two groups with regard to left ventricular systolic and diastolic parameters. In addition, the number of mitral valve prolapses and atrial septal aneurysms was higher in subjects with BAVs. CONCLUSION: BAVs may be associated with left ventricular systolic and diastolic dysfunction. ©2013 Pulsus Group Inc. All rights reserved.


Keceoglu S.,Bursa Yuksek Ihtisas Education and Research Hospital | Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Uyan U.,Bursa Yuksek Ihtisas Education and Research Hospital | Melek M.,Bursa Yuksek Ihtisas Education and Research Hospital
Clinical and Applied Thrombosis/Hemostasis | Year: 2014

Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder. Atrial fibrillation causes a 5-fold increased risk for thromboembolic stroke. It is known that eosinophils play an important role in thrombosis. We aimed to compare the number of eosinophil counts of the patients with and without thrombi in the left atrium (LA) or in the left atrial appendage (LAA) and to ascertain the association of eosinophil counts with the presence of thrombi. Method: The study included 89 patients diagnosed with persistent AF who underwent transesophageal echocardiography and designated to undergo cardioversion. The patients were divided into 2 groups: group 1 consisted of 40 patients (18 male; average age 63.27 ± 1.4) who had thrombus formation in the LA or LAA, and group 2 consisted of 49 patients (23 male; average age 66.53 ± 1.56) who did not have any thrombus in the LA or LAA. These patients underwent concurrent routine biochemical tests and eosinophil count on whole blood count was also performed. Results: Baseline characteristics of the study groups were comparable. Group 1 patients had higher eosinophil and mean platelet volume values than group 2 (233.0 ± 30.7 vs 118.9 ± 11.8 and 9.77 ± 0.20 vs 8.27 ± 0.12 fL, P <.001, respectively). In group 1, the patients' LA diameter is higher than that in group II. Conclusion: As a result, our study revealed a relationship between eosinophil count and LA thrombus in patients with nonvalvular AF. © 2012 The Author(s).


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Uyan U.,Bursa Yuksek Ihtisas Education and Research Hospital | Melek M.,Bursa Yuksek Ihtisas Education and Research Hospital
Clinical and Applied Thrombosis/Hemostasis | Year: 2014

Background: Vitamin D deficiency is associated with cardiovascular disease such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin-angiotensin-aldosterone system, which affects the cardiovascular system. For this reason, it could be suggested that there is a relationship between vitamin D deficiency and atrial fibrillation (AF). In our study, we compared 25-hydroxyvitamin D (25-OHD) levels between nonvalvular AF, valvular AF, and control groups in sinus rhythm. Method: A total of 102 patients with nonvalvular chronic AF without any other cardiovascular disease (mean age 62.51±5.88; group I) and 96 patients with AF, which is associated with mitral valve disease (mean age 61.51±5; group II) were included in our study. Of all, 100 age-matched healthy people with sinus rhythm were accepted as control groups (mean age 61.35 ±5.44). Routine biochemical parameters, 25-OHD and parathormone levels were performed. Results: Baseline characteristics of the study groups were comparable. Group I patients had a lower vitamin D level than group II and the control group (6.51±4.89, 9.24 ± 7.39, and 11.18 ± 6.98 ng/mL, P < .001, respectively). In groups I and II, the patients' left atrium diameter and systolic pulmonary artery pressure are higher than the control group. Conclusion: As a result, our study revealed a relationship between vitamin D deficiency and nonvalvular AF. © The Author(s) 2012.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital
Prague medical report | Year: 2013

Vitamin D deficiency actives renin-angiotensin-aldosterone system (RAAS) which affects cardiovascular system. Activation of RAAS is associated with pulmonary hypertension (PHT). Relation between vitamin D deficiency and PHT could be therefore suggested. In our study we compared pulmonary artery pressure between vitamin D deficiency and control groups. 115 consecutive patients (average age: 61.86 ± 5.86) who have detected very low vitamin D (vitamin D levels < 10 ng/ml) were enrolled. 117 age matched persons (average age: 61.74 ± 5.99) were selected as the control group. All groups underwent transthoracic echocardiography. Routine biochemical measurement of 25-OH vitamin D and parathormon (PTH) levels were performed. Baseline characteristics of the study groups were comparable. Systolic pulmonary artery pressure (SPAP) of patients in the low vitamin D group was higher than the control groups. As a result our study, a relation between vitamin D deficiency and pulmonary artery hypertension was revealed.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Gunay T.,Bursa Yuksek Ihtisas Education and Research Hospital | Ozmen G.,Bursa Yuksek Ihtisas Education and Research Hospital | Melek M.,Bursa Yuksek Ihtisas Education and Research Hospital
Clinical and Experimental Hypertension | Year: 2013

Nondipper hypertension is associated with increased cardiovascular morbidity and mortality. Vitamin D deficiency is associated with cardiovascular diseases such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin-angiotensin-aldosterone system, which affects the cardiovascular system. For this reason, a relationship between vitamin D deficiency and nondipper hypertension could be suggested. In this study, we compared 25-OH vitamin D levels between dipper and nondipper hypertensive patients. The study included 80 hypertensive patients and they were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 nondipper patients (17 male, mean age 50.6 ± 5.4 years). All the patients were subjected to transthoracic echocardiography and ambulatory 24-hour blood pressure monitoring. In addition to routine tests, 25-OH vitamin D and parathormone (PTH) levels were analyzed. All the patients received antihypertensive drug therapy for at least 3 months prior to the evaluations. 25-OH vitamin D and PTH levels were compared between the two groups. No statistically significant difference was found between the two groups in terms of basic characteristics. The average PTH level of hypertensive dipper patients was lower than that of nondipper patients (65.3 ± 14.2 vs. 96.9 ± 30.8 pg/mL, P < .001). The average 25-OH vitamin D level of hypertensive dipper patients was higher than that of nondipper patients (21.9 ± 7.4 vs. 12.8 ± 5.9 ng/mL, P = .001). The left ventricular mass and left ventricular mass index were lower in the dipper patients than in the nondipper patients (186.5 ± 62.1 vs. 246.3 ± 85.3 g, P = .022; and 111.6 ± 21.2 vs.147 ± 25.7 g/m, P < .001, respectively). Other conventional echocardiographic parameters were similar between the two groups. Daytime systolic and diastolic blood pressure measurements were similar between dippers and nondippers, but there was a significant difference between the two groups with regard to nighttime measurements (nighttime systolic 118.5 ± 5.8 vs.130.2 ± 9.6 mm Hg, P < .001; and nighttime diastolic 69.3 ± 4.8 vs.78.1 ± 7.2 mm Hg, P < .001, respectively). Our results suggest that vitamin D deficiency has a positive correlation with blood pressure and vitamin D deficiency could be related to nondipper hypertension. The measurement of vitamin D may be used to indicate increased risk of hypertension-related adverse cardiovascular events. © 2013 Informa Healthcare USA, Inc.


Demir M.,Bursa Yuksek Ihtisas Education and Research Hospital | Senturk M.,Bursa Yuksek Ihtisas Education and Research Hospital | Kuzeytemiz M.,Bursa Yuksek Ihtisas Education and Research Hospital
Clinical and Applied Thrombosis/Hemostasis | Year: 2015

Aim: The pathophysiology of cardiac syndrome X (CSX) has not been clearly identified, although multiple abnormalities including microvascular spasm, endothelial dysfunction, and atherothrombosis have been reported. It is known that eosinophils play an important role in vasoconstruction and thrombosis. We aimed to compare the eosinophil counts in patients with CSX versus controls. Materials and Methods: This study included 50 patients with CSX (20 male, mean age 50.42±9.6 years) and 30 control persons (10 male, mean age 49.16.11±9.2 years). These participants underwent concurrent routine biochemical tests, and their eosinophil counts were obtained on whole blood count. These parameters were compared between groups. Results: Baseline characteristics of the study groups were comparable. Patients with CSX had a higher eosinophil count and mean platelet volume (MPV) value than the controls (339.4±188 vs 132.7±75 and 8.8±0.2 vs 7.2±0.1 fL; P < .001, respectively). Conclusion: As a result, our study revealed a relationship between eosinophil count and MPV in patients with CSX. © 2014 The Author(s).

Loading Bursa Yuksek Ihtisas Education and Research Hospital collaborators
Loading Bursa Yuksek Ihtisas Education and Research Hospital collaborators