Yazar "Akilli, Hakan" seçeneğine göre listele
Listeleniyor 1 - 20 / 39
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Acute myocardial infarction triggered by bee sting(Wiley-Blackwell, 2013) Aribas, Alpay; Akilli, Hakan; Aribas, Fusun Zeynep; Kayrak, Mehmet; Turan, Yasar[Abstract Not Availabe]Öğe Aortic Insufficiency due to Quadricuspid Aortic Valve(Gazi Univ, Fac Med, 2020) Ozer, Huseyin; Alsancak, Yakup; Akilli, HakanQuadricuspid aortic valve is an extremely rare congenital anomaly. Although it has a benign clinical features, some patients may present as with symptoms of severe aortic regurgitation. Herein, we showed an excellent view of a quadricuspid aortic valve with moderate aortic regurgitation in a young woman.Öğe Aortic Insufficiency due to Quadricuspid Aortic Valve(Gazi Univ, Fac Med, 2020) Ozer, Huseyin; Alsancak, Yakup; Akilli, HakanQuadricuspid aortic valve is an extremely rare congenital anomaly. Although it has a benign clinical features, some patients may present as with symptoms of severe aortic regurgitation. Herein, we showed an excellent view of a quadricuspid aortic valve with moderate aortic regurgitation in a young woman.Öğe Assessment of right ventricular functions in patients with sepsis, severe sepsis and septic shock and its prognostic importance: A tissue Doppler study(W B Saunders Co-Elsevier Inc, 2013) Harmankaya, Atif; Akilli, Hakan; Gul, Mehmet; Akilli, Nazire Belgin; Ergin, Mehmet; Aribas, Alpay; Cander, BasarPurpose: This study aims to investigate the potential contributions of the right ventricle (RV) performance evaluated using tissue Doppler imaging (TDI) on the assessment of the severity and prognosis of sepsis. Methods: The study was completed with 55 patients (male/female 26/29, age 66.9 +/- 20.3 years) and 28 healthy controls (male/female 14/14, age 59.4 +/- 18.3 years). The RV-TDI parameters, mainly the RV myocardial peak systolic velocities (Sm, cm/s) and myocardial performance index (MPI) were recorded, in addition to the standard echocardiographic evaluation. Results: The patients were classified into 3 groups based on the severity of sepsis. The RV-Sm value was significantly lower in the severe sepsis-septic shock (n=31) than that of the sepsis (n=24) and the control groups (n=28) (P=.001). The RV-MPI was high both in the severe sepsis-septic shock and the sepsis compared with the control group (P=.02). The patients were classified into 3 groups based on in-hospital mortality. The RV-Sm was lower in non-surviving (n=27) than in the surviving (n=28) and the control groups (n=28) (P=.002). The RV-MPI was found to be higher in the non-surviving patients than the surviving and the control groups (P<.001). Conclusion: Our study shows that the RV dysfunction evaluated using TDI, particularly the RV-Sm and MPI values, were related with the severity of sepsis and mortality. (C) 2013 Elsevier Inc. All rights reserved.Öğe Atrial Functions in Prediabetic Patients(Elsevier Science Inc, 2013) Abdulhalikov, Turyan; Gul, Enes Elvin; Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Yazici, Mehmet; Gok, Hasan[Abstract Not Availabe]Öğe Effect of serum uric acid on the positive predictive value of dobutamine stress echocardiography(Springer, 2016) Aribas, Alpay; Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hayrudin; Yildirim, Oguzhan; Sertdemir, Ahmet Lutfi; Karanfil, MustafaThere is controversial data regarding the relationship between uric acid (UA) and coronary artery disease and cardiovascular events. Despite the deleterious effects of hyperuricemia on endothelial function, the effect of UA on myocardial ischemia has not been previously studied. We aimed to investigate the relationship between UA and myocardial ischemia that was identified using dobutamine stress echocardiography (DSE). In this retrospective study, the laboratory and DSE reports of 548 patients were reviewed. The patients were divided into two groups based on the presence of ischemia and further subdivided into three groups according to the extent of ischemia (none, ischemia in 1-3 segments, ischemia in > 3 segments). Serum UA levels were compared. Determinants of ischemia were assessed using a regression model. UA was increased in patients with ischemia and was correlated with the number of ischemic segments (p < 0.001). A cutoff value of UA > 5 mg/dl had 63.9 % sensitivity, 62.0 % specificity, 42.5 % positive predictive value (PPV), and 79.6 % negative predictive value for ischemia. When the positive DSE exams were further sorted according to the UA cutoff, the PPV of DSE increased from 80.2 to 94.0 %. Uric acid (odds ratio 1.51; 95 % CI 1.14-1.99), diabetes mellitus, HDL and glomerular filtration rate were found to be independent determinants of myocardial ischemia in DSE. Increased UA is associated with both the presence and extent of DSE-identified myocardial ischemia. A UA cutoff may be a good method to improve the PPV of DSE.Öğe Epicardial Adipose Tissue and Atherosclerosis In Patients With Familial Mediterranean Fever(Wiley-Blackwell, 2013) Kucuk, Adem; Solak, Yalcin; Akilli, Hakan; Yildirim, Oguzhan; Guler, Ibrahim; Ucar, Ramazan; Aribas, Alpay[Abstract Not Availabe]Öğe Gender-Related Changes of the Epicardial Fat Thickness and Leptin in Obstructive Sleep Apnea(Wiley, 2014) Akilli, Hakan; Kayrak, Mehmet; Bekci, Taha Tahir; Erdogan, Halil Ibrahim; Aribas, Alpay; Yildirim, Oguzhan; Taner, AlpaslanBackgroundEpicardial fat thickness (EFT), an indicator of visceral obesity, and leptin are 2 novel markers for studying the obstructive sleep apnea (OSA) population. This study aimed to investigate the effects of gender on leptin levels and EFT, and the relation with OSA severity. MethodsA total of 149 patients with OSA (female/male 55/94 and mean age 50.89.2 years) and 50 control patients (female/male 24/26 and mean age 48.98.8 years) were included in the study. The study population was divided into 4 groups according to apnea/hypopnea index (AHI) as control (AHI <5), the mild OSA (AHI 5-14), the moderate OSA (AHI 15-29), and the severe OSA (AHI 30). EFT was obtained from parasternal long-axis and parasternal short-axis echocardiographic images. ResultsLeptin levels among females were significantly higher than among males (10.5 [7.8] vs. 5.4 [4.5] ng/mL, P=0.001, respectively). Among women, leptin levels were significantly higher in the severe OSA group compared to the control group (9.8 [9.0] vs. 15.5 [10.1] ng/mL, P=0.05, respectively). Conversely, no relation was observed between OSA severity and the leptin levels among men. EFT was not significantly different between the 2 genders (P>0.05). EFT was thicker in the severe OSA group than in the control and mild OSA groups among women, whereas EFT was not changed according to OSA severity among males (P>0.05). ConclusionLeptin and EFT may be a valuable parameter in the evaluation of OSA severity in women than in men.Öğe Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism(Assoc Medica Brasileira, 2020) Alsancak, Yakup; Sahin, Ahmet Taha; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Icli, Abdullah; Akilli, Hakan; Duzenli, Mehmet AkifOBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT First, the high-risk APE patients' ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups' ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group (P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group (P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio (P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P-value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT (P-value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.Öğe Index of cardiac-electrophysiological balance and the effects of thrombolytic therapy on the electrocardiogram of patients with pulmonary embolism(Assoc Medica Brasileira, 2020) Alsancak, Yakup; Sahin, Ahmet Taha; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Icli, Abdullah; Akilli, Hakan; Duzenli, Mehmet AkifOBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT First, the high-risk APE patients' ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups' ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group (P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group (P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio (P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P-value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT (P-value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period.Öğe Is Computed Tomography the Gold Standard in Aortic Dissection?(Emergency Medicine Physicians Assoc Turkey, 2020) Tatar, Sefa; Icli, Abdullah; Akilli, Hakan; Gormus, Niyazi; Sertdemir, Ahmet LutfuIntroduction: Aortic dissection is a disease with high mortality, which is characterized by a tear in the aortic wall. Thanks to early diagnosis and treatment, patients' survival rates are high. Chest pain is the most common symptom. Imaging methods help in diagnosis. Its treatment is surgery. Case Report: A 47-year-old male patient was admitted to the emergency department with chest pain. The diagnosis of aortic dissection in computed tomography was evaluated as motion artifact and valve motion, and he was asked to be discharged from the emergency service after his diagnosis was missed. However, transesophageal echocardiography was performed because of the patient's clinical symptom and echocardiographic findings supported the aortic dissection. When a dissection flap was seen in transesophageal echocardiography, the patient was transferred to surgery. In surgery, a dacron graft was placed in the patient's aorta and a prosthetic valve was placed on the aortic valve, and left main coronary repair and right coronary is bypass were performed. The patient was discharged without any problem. Conclusion: Aortic dissection is a clinical diagnosis, it is a disease with high mortality. Imaging methods are helpful in diagnosis, but the fact that imaging methods rule out dissection does not always rule out the disease. The important thing is to suspect the disease and to consider the patient's current clinical symptoms and signs.Öğe Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience(Aves Yayincilik, 2013) Akilli, Hakan; Gul, Enes Elvin; Aribas, Alpay; Ozdemir, Kurtulus; Kayrak, Mehmet; Erdogan, Halil IbrahimObjective: The mortality of right heart thrombi (RHT) associated with pulmonary embolism (PE) is increased about three to four times. The most devastating scenario is fragmentation of RHT and occurrence of recurrent PE. The reports regarding the management of RHT complicated with PE are very scarce in the current literature. Therefore, we report a single-center experience in this paper. Methods: From January 2006 to December 2011, data of all patients diagnosed with acute PE were analyzed retrospectively. Of the 312 acute PE cases confirmed with computed tomography, total 35 patients who were diagnosed with concomitant RHT (prevalence of 11%) by echocardiography were recruited. After excluding of six patients with metastatic malignancy a total 29 patients were accepted eligible for the analysis. In addition, catheter -induced thrombus (type B) were not included to the study. The difference between categorical variables was analyzed with Chi-square test and continuous variables were analyzed with Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: Overall mortality was high (34%) in study population: among undergoing surgery-100%, therapy with thrombolytics -18%, and heparin -27%. Troponin levels were found significantly higher in died patients than that in survived patients (p=0.03). There was no significant difference regarding to clinical and echocardiographic characteristics of patients received heparin versus thrombolytic except for shock index (p=0.02). In addition, patients treated with heparin had increased duration of hospitalization compared to subjects treated with thrombolytic (median: 8 vs 3 days p<0.01). Conclusion: Despite of the low incidence of RHT, a mortal course is still an important problem during PE. The decision on treatment modality should be performed based on the hemodynamic parameters, laboratory findings, and bleeding risk of the patients.Öğe The neutrophil to lymphocyte ratio improves the positive predictive value of dobutamine stress echocardiography(E-Century Publishing Corp, 2015) Icli, Abdullah; Kayrak, Mehmet; Akilli, Hakan; Aribas, Alpay; Coskun, Mukremin; Ozer, Sumeyye Fatma; Ozdemir, KurtulusThe neutrophil to lymphocyte ratio (NLR) predicts cardiovascular events. The aim of this study was to determine whether NLR improved the positive predictive value (PPV) of dobutamine stress echocardiography (DSE) in patients with stable coronary artery disease (CAD). We conducted a retrospective review of laboratory and DSE data from the medical records of 1,012 patients who were divided into two groups according to the presence of ischemia and further subdivided into three groups according to the extent of ischemia (nonischemic segments, 1-3 ischemic segments, or > 3 ischemic segments). NLRs were compared among these groups. NLRs increased in patients with ischemia and correlated with the number of ischemic segments (P < 0.001). The optimal cutoff value of NLR determined using receiver operating characteristic analysis was > 2.04, and the diagnostic value of NLR for discriminating patients with >= 50% coronary stenosis in at least one of the coronary arteries from those without significant CAD was high [area under the curve (AUC) = 0.671, standard error = 0.052, P < 0.001, 95% confidence interval (CI) = 0.569-0.773)]. An NLR cutoff value of > 2.04 predicted CAD presence with significant stenosis (62.10% sensitivity and 64.10% specificity). PPV of DSE for a significant coronary artery lesion identified using coronary angiography was 73.8% (95% CI = 75.1-88.5, P < 0.001, AUC = 0.818). On including a cut-off value of > 2.04 for NLR in this multivariable predictive model, the AUC value slightly increased to 0.905 (95% CI = 85.4-95.6) and PPV of DSE increased from 73.8% to 92.6%. NLR improved PPV of DSE for patients with stable CAD.Öğe A new marker for myocardial injury in carbon monoxide poisoning: T peak-T end(W B Saunders Co-Elsevier Inc, 2013) Akilli, Nazire Belgin; Akinci, Emine; Akilli, Hakan; Dundar, Zerrin Defne; Koylu, Ramazan; Polat, Mustafa; Cander, BasarObjectives: Carbon monoxide (CO) poisoning frequently affects repolarization, resulting in abnormal electrocardiography findings. The goal of this study was to examine the effect of CO poisoning on the novel transmyocardial repolarization parameters T peak-T end (Tp-e), Tp-e dispersion, and Tp-e/QT and the relationship of these parameters to myocardial injury (MI). Methods: This prospective study included 94 patients with CO poisoning and 40 healthy controls. Participants received an electrocardiography and had their blood drawn at admission and 6 and 24 hours after admission. The QT, Tp-e, Tp-e dispersion, and the Tp-e/QT ratio were calculated. Myocardial injury was determined based on an elevation in troponin any time during the first 24 hours. The patients were divided into 2 subgroups: those with and without MI. Results: T peak-T end, Tp-e dispersion, and the Tp-e/QT ratio were higher at admission than after 6 and 24 hours of hospitalization and were higher than the control group (P < .001). There was a correlation between the carboxyhemoglobin level at admission and Tp-e and Tp-e dispersion (P < .001). The MI subgroup (n = 14) had a higher Tp-e at admission than did the non-MI subgroup (n = 80) (96 [11] milliseconds vs 87 [12] milliseconds, P = .03). There were no any significant differences in the Tp-e dispersion or the Tp-e/QT ratio between the 2 MI subgroups. Receiver operating characteristic analysis showed that a Tp-e cutoff value for MI of 91.5 milliseconds had a sensitivity of 72.7% and a specificity of 67.2%. Conclusion: Transmyocardial repolarization parameters indicative of arrhythmia were prolonged in patients with CO poisoning. T peak-T end was associated with MI. (C) 2013 Elsevier Inc. All rights reserved.Öğe A new piece of puzzle: inflammation in the prediction of recurrence after successful electrical cardioversion in patients with nonvalvular atrial fibrillation Reply(Aves Yayincilik, 2013) Aribas, Alpay; Akilli, Hakan; Kayrak, Mehmet[Abstract Not Availabe]Öğe Our Experiences of Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Aribas, Alpay; Dogan, Umuttan; Yazici, Mehmet; Gok, Hasan[Abstract Not Availabe]Öğe Predictive Value of Increased Ankle-Brachial Index in Contrast Nephropathy Development Due to Coronary Angiography(Elsevier Science Inc, 2013) Yildirim, Serkan; Kayrak, Mehmet; Eris, Mehmet Doguscan; Akilli, Hakan; Solak, Yalcin; Sertdemir, Ahmet Lutfi[Abstract Not Availabe]Öğe Predictive value of transmitral A-wave acceleration time for paroxysmal atrial fibrillation(Wiley, 2019) Akilli, Hakan; Aribas, Alpay; Icli, Abdullah; Tatar, Sefa; Gurbuz, Ahmet SeyfeddinBackground It has been shown that transmitral A-wave (TMAW) is affected in paroxysmal atrial fibrillation (PAF), and decreased left atrial contractions cause a decrease in the TMAW velocity. The relationship between TMAW acceleration time (TMAW-AccT) and PAF is unknown. In this study, the predictive value of TMAW-AccT for PAF was investigated. Methods Seventy PAF patients (mean age: 57.8 +/- 11.0 years) and 70 control patients (mean age: 58.1 +/- 10.5 years) were included in the study. Transthoracic echocardiography was performed in sinus rhythm in all patients. For TMAW-AccT, the time between the basal point of the A-wave and the highest point reached was measured. Results Transmitral A-wave -AccT was significantly longer in the PAF group than the control group (TMAW-AccT; 88.5 +/- 18.1 vs 77.2 +/- 16.4 ms, P = .000, respectively). The left atrial diameter and the left atrial volume index were similar between the groups (P = .07, P = .18, respectively). According to a multivariate logistic regression analysis, the TMAW-AccT (OR: 1.02, 95% confidence interval 1.02-1.07, P < .001) was a predictor of PAF. A receiver operating characteristic curve analysis showed a cutoff value of TMAW-AccT of >82 ms (sensitivity: 65.7%, specificity: 64.3%, positive predictive value: 64.8%, negative predictive value: 65.2%). Conclusion Transmitral A-wave-AccT can be used as an early marker in detecting PAF without dilated left atrium.Öğe Prognostic nutritional index and the risk of acute kidney injury in patients with acute coronary syndrome(Assoc Medica Brasileira, 2021) Sertdemir, Ahmet Lutfu; Icli, Abdullah; Aribas, Alpay; Tatar, Sefa; Akilli, Nazire Belgin; Alsancak, Yakup; Akilli, HakanOBJECTIVE: Recent studies have linked malnutrition with undesirable outcomes in cardiovascular diseases. However, the underlying mechanism is unknown. Contrast-induced acute kidney injury (CI-AKI) increased cardiovascular mortality after percutaneous coronary intervention (PCI). This study hypothesizes that prognostic nutritional index (PNI) plays a role in the development of CI-AKI in patients with acute coronary syndrome undergoing emergency PCI. METHODS: This study enrolled 551 patients. PNI was determined as 10x serum albumin (g/dL)+0.005xtotal lymphocyte count (mm(3)). CI-AKI was characterized as the increase in serum creatinine >= 0.3 mg/dL level within 48 h after PCI. Patients were classified as either CI-AKI (+) or CI-AKI (-). RESULTS: CI-AKI has occurred in 72 of 551 patients (13.1%). PNI was significantly lower in the CI-AKI (+) group than in the CI-AKI (-) group (44.4 +/- 6.6 versus 47.2 +/- 5.8, p<0.001, respectively). Multivariate logistic regression analysis showed that PNI [odds ratio, OR: 1.631, 95% confidence interval (CI): 1.168-2.308, p=0.02] and estimated glomerular filtration rate (OR: 3.26, 95%CI 1.733-6.143, p<0.001) were independent risk factors for CI-AKI. CONCLUSIONS: PNI is an independent risk factor for CI-AKI. The development of CI-AKI may be the mechanism responsible for the relationship between poor nutritional status and adverse cardiac events.Öğe Prognostic nutritional index and the risk of acute kidney injury in patients with acute coronary syndrome(Assoc Medica Brasileira, 2021) Sertdemir, Ahmet Lutfu; Icli, Abdullah; Aribas, Alpay; Tatar, Sefa; Akilli, Nazire Belgin; Alsancak, Yakup; Akilli, HakanOBJECTIVE: Recent studies have linked malnutrition with undesirable outcomes in cardiovascular diseases. However, the underlying mechanism is unknown. Contrast-induced acute kidney injury (CI-AKI) increased cardiovascular mortality after percutaneous coronary intervention (PCI). This study hypothesizes that prognostic nutritional index (PNI) plays a role in the development of CI-AKI in patients with acute coronary syndrome undergoing emergency PCI. METHODS: This study enrolled 551 patients. PNI was determined as 10x serum albumin (g/dL)+0.005xtotal lymphocyte count (mm(3)). CI-AKI was characterized as the increase in serum creatinine >= 0.3 mg/dL level within 48 h after PCI. Patients were classified as either CI-AKI (+) or CI-AKI (-). RESULTS: CI-AKI has occurred in 72 of 551 patients (13.1%). PNI was significantly lower in the CI-AKI (+) group than in the CI-AKI (-) group (44.4 +/- 6.6 versus 47.2 +/- 5.8, p<0.001, respectively). Multivariate logistic regression analysis showed that PNI [odds ratio, OR: 1.631, 95% confidence interval (CI): 1.168-2.308, p=0.02] and estimated glomerular filtration rate (OR: 3.26, 95%CI 1.733-6.143, p<0.001) were independent risk factors for CI-AKI. CONCLUSIONS: PNI is an independent risk factor for CI-AKI. The development of CI-AKI may be the mechanism responsible for the relationship between poor nutritional status and adverse cardiac events.