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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 Arterial Stiffness, Carotid Intima-Media Thickness, Endocan, and A Disintegrin and Metalloproteinase With Thrombospondin Type I Motif 9 Levels and Their Relationship With Disease Activity in Patients With Acromegaly With and Without Cardiovascular Risk Factors(Elsevier Inc, 2022) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Yerlikaya, Fatma Humeyra; Alsancak, Yakup; Turkmen, Kultigin; Kulaksizoglu, MustafaObjective: Cardiovascular complications such as cardiomyopathy and endothelial dysfunction, which are frequently seen in patients with acromegaly, are among the most important causes of morbidity and mortality. In this study, we aimed to investigate arterial stiffness, carotid intima-media thickness, endocan level, and A disintegrin and metalloproteinase with thrombospondin type I motif 9 level and their relationship with disease activity in patients with acromegaly with and without cardiovascular risk factors. Methods: A total of 60 patients with acromegaly-25 with active disease, 26 with well-controlled disease, and 9 with newly diagnosed disease-and 60 age-, sex-, and body mass index (BMI)-matched healthy control subjects were enrolled in this study. All the subjects' height, weight, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG) level, insulin, hemoglobin A1C (HbA1C), C-reactive protein, lipid, endocan, A disintegrin and metalloproteinase with thrombospondin type I motif 9 levels, pulse wave velocity (PWV), and carotid intima-media thickness were measured. Results: The SBP, DBP, FPG level, HbA1C level, and PWV of the acromegaly group were higher than those of the control group. In patients with acromegaly with cardiovascular disease (CVD) risk factors, the PWV was higher than that in the control group, and in patients with acromegaly without CVD risk factors, the PWV was similar to that in the control group. In a correlation analysis, a positive correlation was found between PWV and age, BMI, SBP, DBP, FPG level, and HbA1C level in the acromegaly group. Conclusion: In our study, we found that arterial stiffness increased in patients with acromegaly with CVD risk factors and that increased arterial stiffness was associated with hemodynamic (SBP and DBP) and metabolic (BMI, FPG level, and HbA1C level) parameters. (c) 2021 AACE. Published by Elsevier Inc. All rights reserved.Öğe Association between depression and anxiety scores and inflammation in patients wain isolated coronary artery ectasia(Turkish Soc Cardiology, 2019) Gurbuz, Ahmet Seyfeddin; Alsancak, Yakup; Sakli, Beyza; Duzenli, Mehmet AkifObjective: Depression and anxiety disorders are frequently found in combination with obstructive coronary artery disease. Coronary artery ectasia (CAE) is an atypical form of coronary artery disease, the etiology of which has not yet been clearly defined. The aim of this study was to assess the existence of a relationship between anxiety/depression and CAE. Methods: A CAE group (n=41; mean age: 58.9 +/- 9.0 years) and a control group (n=42; mean age: 58.0 +/- 9.6 years) were compared. The anxiety and depression status of patients was evaluated using the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: Age, sex, ejection fraction, and cardiovascular risk factor data were similar in both groups. The serum C-reactive protein (CRP) and uric acid levels as well as the leukocyte count were significantly higher in the CAE group (p<0.05). The HADS anxiety score was higher in the CAE group, but without statistical significance (p=0.23). The HADS depression score and total HADS score was significantly higher in the CAE group (p<0.001 and p<0.001). The total HADS score and the HADS depression score were correlated with the serum CRP level (r=0.489; p<0.001 and r=0.543; p<0.001, respectively), whereas the anxiety score was not correlated with CRP (r=0.85; p=0.23). Conclusion: The depression score, CRP, and uric acid levels were greater in patients with isolated CAE compared with those of patients with normal coronaries. The anxiety score did not demonstrate a relationship to CAE; however, there was an association between the depression score and CRP, which is an inflammatory marker.Öğe Association between fragmented QRS and postprocedural rhythm disturbances in patients who underwent transcatheter aortic valve implantation(Assoc Medica Brasileira, 2021) Duran, Mustafa; Ziyrek, Murat; Alsancak, Yakup; Ayhan, HuseyinINTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation' sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p<0.05) and the incidence of atrioventricular blocks requiring permanent pacing (21.1 versus 0%, p<0.05) following transcatheter aortic valve implantation in patients whose preprocedural electrocardiogram recordings revealed fragmented QRS compared to those without fragmented QRS. Based our collected data, the presence of QRS fragmentation in anterior derivations was the only independent factor associated with postprocedural rhythm disturbances (B-value 0.217; OR 0.805; 95%CI 0.136-4.78; p=0.004). CONCLUSION: Our data showed an increased risk for the development of new-onset left bundle branch block and atrioventricular blocks following transcatheter aortic valve implantation in patients whose baseline electrocardiogram recordings demonstrated QRS fragmentation.Öğe Association between fragmented QRS and postprocedural rhythm disturbances in patients who underwent transcatheter aortic valve implantation(Assoc Medica Brasileira, 2021) Duran, Mustafa; Ziyrek, Murat; Alsancak, Yakup; Ayhan, HuseyinINTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation' sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p<0.05) and the incidence of atrioventricular blocks requiring permanent pacing (21.1 versus 0%, p<0.05) following transcatheter aortic valve implantation in patients whose preprocedural electrocardiogram recordings revealed fragmented QRS compared to those without fragmented QRS. Based our collected data, the presence of QRS fragmentation in anterior derivations was the only independent factor associated with postprocedural rhythm disturbances (B-value 0.217; OR 0.805; 95%CI 0.136-4.78; p=0.004). CONCLUSION: Our data showed an increased risk for the development of new-onset left bundle branch block and atrioventricular blocks following transcatheter aortic valve implantation in patients whose baseline electrocardiogram recordings demonstrated QRS fragmentation.Öğe Association between syndecan-4 and subclinical atherosclerosis in ankylosing spondylitis(Lippincott Williams & Wilkins, 2024) Sertdemir, Ahmet L.; Sahin, Ahmet T.; Duran, Mustafa; Celik, Mustafa; Tatar, Sefa; Oktay, Irem; Alsancak, YakupBackground: Despite advances in the diagnosis and treatment of ankylosing spondylitis (AS), the risk of cardiovascular complications in AS patients is still higher than in the general population. Macrophages are at the intersection of the basic pathogenetic processes of AS and atherosclerosis. Although syndecan-4 (SDC4) mediates a variety of biological processes, the role of SDC4 in macrophage-mediated atherogenesis in AS patients remains unclear. Herein, we aimed to investigate the role of SDC4 in subclinical atherosclerosis in AS patients.Methods: Subjects were selected from eligible AS patients and control subjects without a prior history of AS who were referred to the rheumatology outpatient clinics. All participants' past medical records and clinical, and demographic characteristics were scanned. In addition, carotid intima-media thickness (CIMT) measurement and disease activity index measurement were applied to all patients.Results: According to our data, serum SDC4 level was significantly higher among AS patients compared with the control group (6.7 [1.5-35.0] ng/mL vs 5.1 [0.1-12.5] ng/mL, P < .001). The calculated CIMT was also significantly higher in AS patients than in the control group (0.6 [0.3-0.9] mm vs 0.4 (0.2-0.7), P < .001]. Additionally, serum C-reactive protein level and SDC4 level were independent predictors of AS and strongly associated with CIMT. Linear regression analysis showed that serum SDC4 level was the best predictor of CIMT (P = .004).Conclusion: Our data indicate that serum SDC4 levels provide comprehensive information about the clinical activity of the disease and subclinical atherosclerosis in AS patients.Öğe Association between SYNTAX II Score and late saphenous vein graft failure in patients undergoing isolated coronary artery bypass graft surgery(Assoc Medica Brasileira, 2021) Duran, Mustafa; Tasbulak, Omer; Alsancak, YakupOBJECTIVE: Coronary artery bypass graft (CABG) surgery is a well-established treatment modality for patients with multivessel coronary artery disease (CAD). Syntax II Score has been established as novel scoring system with better prediction of postprocedural outcomes. This study aimed to investigate the prognostic value of SYNTAX II Score for predicting late saphenous vein graft (SVG) failure in patients undergoing isolated CABG. METHODS: The records of 1,875 consecutive patients who underwent isolated CABG with at least one SVG were investigated. Those who underwent coronary angiography and SVGs angiography at least 1 year after the CABG were included. Patients were divided into two groups based on the presence or absence of SVG failure. For each group, predictors of late SVG failure and subsequent clinical outcomes were analyzed. RESULTS: According to this study, the presence of hypertension, higher rates of repeat revascularization, and higher SYNTAX II Scores were found to be independent predictors of late SVG failure. In addition, the prognostic value of SYNTAX II Score was found to be significantly higher than anatomical SYNTAX Score in terms of predicting late SVG failure and major adverse cardiovascular and cerebrovascular event. CONCLUSIONS: There was a strong association between SYNTAX II Score and late SVG failure in patients undergoing isolated CABG.Öğe Association between SYNTAX II Score and late saphenous vein graft failure in patients undergoing isolated coronary artery bypass graft surgery(Assoc Medica Brasileira, 2021) Duran, Mustafa; Tasbulak, Omer; Alsancak, YakupOBJECTIVE: Coronary artery bypass graft (CABG) surgery is a well-established treatment modality for patients with multivessel coronary artery disease (CAD). Syntax II Score has been established as novel scoring system with better prediction of postprocedural outcomes. This study aimed to investigate the prognostic value of SYNTAX II Score for predicting late saphenous vein graft (SVG) failure in patients undergoing isolated CABG. METHODS: The records of 1,875 consecutive patients who underwent isolated CABG with at least one SVG were investigated. Those who underwent coronary angiography and SVGs angiography at least 1 year after the CABG were included. Patients were divided into two groups based on the presence or absence of SVG failure. For each group, predictors of late SVG failure and subsequent clinical outcomes were analyzed. RESULTS: According to this study, the presence of hypertension, higher rates of repeat revascularization, and higher SYNTAX II Scores were found to be independent predictors of late SVG failure. In addition, the prognostic value of SYNTAX II Score was found to be significantly higher than anatomical SYNTAX Score in terms of predicting late SVG failure and major adverse cardiovascular and cerebrovascular event. CONCLUSIONS: There was a strong association between SYNTAX II Score and late SVG failure in patients undergoing isolated CABG.Öğe Can the Ratio of Calcium to Albumin Predict the Severity of Aortic Stenosis?(Aves, 2019) Alsancak, Yakup; Sivri, Serkan; Bastug, Serdal; Ayhan, Huseyin; Bozkurt, EnginObjective: Aortic sclerosis is observed in 25% of the elderly population, and 2.5% of these patients have severe aortic stenosis (AS). Numerous studies have reported a relationship between the serum calcium or albumin levels and AS. The present study investigated the relationship between the calcium toalbumin ratio (CAR) and AS. Methods: Our study included 185 patients and 108 subjects as the control group. A routine transthoracic echocardiographic evaluation and laboratory examinations were performed inall participants. The corrected serum calcium levels were calculated using the most commonly used formula: corrected calcium=measured total calcium (mg/dL) + 0.8 (4.0-serum albumin [g/dL]). Results: The serum C-reactive protein CRP, calcium, and corrected calcium levels were significantly different between the study groups (p<0.05), and the albumin levels were significantly decreased parallel with the AS severity (p<0.001). Also, we detected a negative correlation between the albumin and corrected calcium levels and the EuroSCORE. CAR and corrected calcium to albumin ratio (cCAR) were significantly higher in the AS group, as expected (p<0.01). In the logistic regression analysis, albumin, CRP, low-density lipoprotein LDL, theCAR, and cCAR levels were found to be significantly and independently associated with the presence of AS (p<0.05). Moreover, in a regression analysis in the subgroup of AS only, albumin, the cCAR, and CAR were independently associated with the presence of very severe AS. Conclusion: Our study showed an important relationship between the CAR and AS. Therefore, in clinical practice, this simple, inexpensive, and practical method may predict the severity of AS.Öğe CHA2DS2-VASc and HAS-BLED scores are not associated with cardiac defibrillators therapies(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Alsancak, Yakup; Sari, Hasan; Gurbuz, Ahmet Seyfeddin; Sertdemir, Ahmet Lutfi; Aribas, Alpay; Soylu, AhmetAim: The CHA(2)DS(2)-VASc (heart failure, hypertension, age >75, diabetes mellitus, stroke history, vascular disease, 65-74 age range, gender) and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history, labile INR, elderly, drugs/alcohol) are scoring system for using to estimate stroke and bleeding development in cases with atrial fibrillation. We aim to evaluate the relationship between the implantable cardioverter defibrillator (ICD) therapies and CHAIDSi-VASc and HAS-BLED scores. Methods: 398 patients were included in this retrospective study after reviewing the data of the patients above the age of 18 who had ICD implantation for any reason between 2014-2019 and who were found to have at least two pacemaker check-ups with 6-month intervals. CHA(2)DS(2)-VASc and HAS-BLED scores were calculated during the device implantation and last control visit date. Results: 148 of the patients received ICD therapy (appropriate shock [n = 1181 and in appropriate therapy In = 301) and 250 of them did not receive any therapy. It was observed that the CHA(2)DS(2)-VASc and HAS-BLED scores were similar in the groups receiving and not receiving therapy (respectively, p = 0.64 and p = 0.60). CHA(2)DS(2)-VASc and HAS-BLED scores were similar in patients with appropriate shock or not (respectively p = 0.89 and p = 0.85) with median follow-up period 5.5 years. Multivariate regression analysis showed that reduced ejection fraction, presence of single-chamber ICD, lapsing of a long time after the implantation were independent risk factors for ICD device therapies (p < 0.05). Conclusions: CHA(2)DS(2)-VASc and HAS-BLED scores are not associated with device-based ICD therapies.Öğe Dynamic changes in aortic stiffness after substantial weight loss by laparoscopic sleeve gastrectomy in patients with obesity: a 1-year follow-up study(Sage Publications Ltd, 2021) Gul, Murat; Inci, Sinan; Aktas, Halil; Yildirim, Oguz; Alsancak, Yakup; Ozkan, NamikArterial stiffness has been identified as a powerful and independent risk factor for cardiovascular disease. Obesity is associated with an increased risk of aortic stiffness (AS) and adverse cardiovascular events. Herein, we aimed to evaluate the effects of weight loss after laparoscopic sleeve gastrectomy (LSG) on AS in individuals with morbid obesity by using the transthoracic echocardiography (TTE). A total of 53 patients with obesity (17 males, 36 females) who underwent LSG and did not have any known heart disease were included in the study. The AS parameters were measured with TTE. The demographic and echocardiographic data of the patients were studied before, at 1 month and 12 months after surgery. The mean age of the study group was 34.41 +/- 11.62, 68% of whom were female. There were no significant differences in terms of the standard echocardiography and Doppler measurements as compared with preoperative values (all p>0.05). When the elastic parameters of the aorta were compared, no significant differences were detected regarding aortic strain (%) ((16.28 +/- 4.11) vs (16.68 +/- 4.56), p=(0.998)), distensibility (cm(2)/dyn) ((6.74 +/- 1.78) vs (7.03 +/- 2.31), p=(0.997)) and Aortic Stiffness Index values ((10.73 +/- 3.84) vs (10.63 +/- 3.34), p=0.998) between baseline and first month after surgery. In the 12-month follow-up, it was determined that the aortic strain ((16.28 +/- 4.11) vs (22.74 +/- 5.79), p <= 0.001) and distensibility ((6.74 +/- 1.78) vs (10.34 +/- 3.059), p<0.001)) values increased at significant levels. Weight loss by LSG improves arterial stiffness parameters in patients with obesity over a 1-year follow-up.Öğe Effect of Coronary Tortuosity on Exercise Stress Test(Istanbul Training & Research Hospital, 2020) Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Ozcelik, Abdullah; Icli, AbdullahIntroduction: Coronary tortuosity (CT) is a common anatomical finding during coronary angiography (CA); however, its aetiology and clinical importance have not been clearly defined. We aimed to evaluate the effect of the presence or severity of CT and effect of the sigma-shaped right coronary artery (RCA) on the exercise stress test (EST). Methods: The study included 175 patients who underwent CA due to cardiac symptoms and positive EST and had no obstructive coronary artery disease in a single centre between 2017 and 2018 June. The patients were divided into two groups: Group 1, patients with CT (n=88), and group 2, patients without CT (n=87). The patients were also categorised as low and moderate-to-high risk based on Duke treadmill score (DTS). Results: The running distance and DTS were lower, and the rate of sigma-shaped RCA was higher in the CT group (p<0.006). The DTS was lower (p=0.024) in the presence of tortuosity in the left anterior descending coronary artery and negatively influenced as the number of coronary arteries affected by tortuosity increased (p<0.001). Based on the DTS score, patients with moderate-to-high risk have a higher number of vessels affected by tortuosity, involvement of left anterior descending coronary artery, and proportion of sigma-shaped RCA (p<0.001). Conclusion: In the presence of CT, the rate of positivity is significantly higher, and the DTS is lower in the stress test.Öğe Effect of Pericardial Effusion on Right Ventricular Functions in Oncology Patients Receiving Chemotherapy(Galenos Publ House, 2023) Tatar, Sefa; Yavuz, Yunus Emre; Oktay, Irem; Aydin, Nergiz; Alsancak, Yakup; Icli, AbdullahIntroduction: Pericardial effusion is an indicator of poor prognosis in patients with cancer. We investigated the effect of pericardial effusion development on right ventricular function in oncology patients receiving chemotherapy for malignancy. Methods: A total of 90 patients who were followed up in the oncology clinic and who applied to our outpatient clinic for routine cardiac examination were included in the study. Echocardiography was performed on the patients, and they were divided into two groups: patients with and without pericardial effusion. Demographic characteristics and, clinical and laboratory findings of the patients were recorded. The right ventricular functions of the patients were then evaluated. Results: Pericardial effusion was in 30 (33.3%) of 90 patients included in the study. The mean age of patients without pericardial effusion was 57.33 +/- 15.59, and the mean age of patients with effusion was 60.27 +/- 13.51, and it was similar between the groups (p=0.36). No statistically significant difference was detected between the groups in right ventricular (RV) fractionated area change, RV-early peak, tricuspid annular plane systolic excursion, pulmonary artery pressure, E/E', and heart failure with preserved ejection fraction values, which are parameters that indicate right ventricular functions and diastolic dysfunction. However, RV systolic velocity and RV-AM, which are indicators of diastolic dysfunction, were found at higher rates in the patient group with pericardial effusion (p-value 0.041 and 0.001, respectively). In addition, Mitral E velocity was found to be lower in the patient group with pericardial effusion (p=0.032). Conclusion: In malignancy patients who develop pericardial effusion, we recommend that diastolic parameters be checked and close clinical follow-up of the patients be performed before overt heart failure clinic develops. It should be kept in mind that the development of pericardial effusion in oncology patients receiving chemotherapy does not mean right ventricular failure.Öğe Effects of oral colchicine administration as first-line adjunct therapy in myopericarditis(Urban & Vogel, 2022) Duran, Mustafa; Alsancak, Yakup; Ziyrek, MuratBackground Although current guidelines recommend routine use of oral colchicine as a first-line adjunct therapy to aspirin/nonsteroidal anti-inflammatory drugs (NSAIDs) for acute and recurrent pericarditis, there are insufficient data to recommend routine use of colchicine for the initial management of myopericarditis. Methods The records of 194 patients who were admitted for myopericarditis were investigated retrospectively. Patients receiving oral colchicine (n = 33) as an adjunct to aspirin/NSAIDs comprised the study group and patients who received conventional therapy (n = 31) formed the control group. Plasma C-reactive protein (CRP) levels, cardiac biomarkers, and several electrocardiographic parameters of atrial activation were evaluated before the start of treatment and at the 6-month follow-up. Results Assessments before and after treatment with regard to cardiac biomarkers and plasma CRP levels showed improvements in both groups (p > 0.05). There were statistically significant improvements in P wave indices including P wave duration, PR interval length, P wave dispersion, P terminal force, and isoelectric interval in the colchicine therapy group compared with the control group (p < 0.01). Conclusion Routine use of colchicine for the initial management of myopericarditis as a first-line adjunct therapy to aspirin/NSAIDs in patients with myopericarditis has favorable effects on electrocardiographic indices of atrial activation parameters.Öğe Effects of SGLT2 Inhibitors as an Add-on Therapy to Metformin on Electrocardiographic Indices of Ventricular Repolarization(Taiwan Soc Cardiology, 2020) Duran, Mustafa; Ziyrek, Murat; Alsancak, YakupBackground: According to EMPA-REG OUTCOME, trial use of empagliflozin in patients with a history of cardiovascular disease improves hospitalization for heart failure and decreases cardiovascular morbidity and mortality. Recent studies have shown that a prolonged T-peak to T-end interval on the resting electrocardiography is associated with an increased risk of cardiovascular mortality. Tp-e/corrected QT interval (QTc) ratio is a reliable index of prolonged ventricular repolarization. Objectives: In this study, we examined the effects of sodium glucose co-transporters 2 (SGLT2) inhibitors as an add-on therapy to metformin on electrocardiographic indices of ventricular repolarization. Methods: Electrocardiographic recordings before combination therapy along with three months and six months follow-up of 141 consecutive patients who were switched from monotherapy to combination therapy with two oral agents due to inadequate glycemic control were derived. QT interval (QT), QTc, Tp-e intervals and Tp-e/QT, Tp-e/QTc ratios were calculated and analyzed. Results: After the six month follow-up, there was a significant decrease in the QT interval in patients who were using SGLT2 inhibitors as an add-on therapy to metformin compared to other glucose-lowering agents (373.4 +/- 9.9 ms vs. 385.4 +/- 12.5 ms, 382.9 +/- 11.2 ms; p < 0.001 respectively). Furthermore, Tp-e/QT and Tp-e/QTc ratios were significantly lower in this patient population compared to control groups (0.186 +/- 0.023 vs. 0.196 +/- 0.021, 0.191 +/- 0.017; p < 0.001 and 0.174 +/- 0.021 vs. 0.199 +/- 0.022, 0.195 +/- 0.016; p < 0.001 respectively). Conclusion: Our data showed that using SGLT2 inhibitors as an add-on therapy to metformin favorably alters ventricular repolarization indices in patients with type 2 diabetes mellitus.Öğe Electrocardiographic Alterations in Patients with Common Variable Immune Deficiency(Istanbul Training & Research Hospital, 2020) Alsancak, Yakup; Colkesen, FatihIntroduction: Common variable immunodeficiency (CVID) is the most heterogeneous group among the antibody deficiency syndromes, but its effects on the cardiovascular system have not yet been clearly identified. Here, we aimed to investigate the arrhythmogenic effects of this disease with electrocardiography. Methods: The study included 30 CVID patients and 30 control subjects matched for age and comorbidities. Electrocardiographic and echocardiographic values of all participants were recorded. QRS, QT, Tp-e were measured manually. QTc was calculated using Bazett's formula. Then, Tp-e/QT, Tp-e/QTc, QT/QRS, and QTc/QRS ratios were calculated and compared between the groups. Results: PR interval and P-wave dispersion were found to be higher in the CVID group. In addition, the QT interval and corrected QT interval, T peak-to-end interval were higher in the CVID arm, and the index of cardiac electrophysiological balance value obtained with the QT/QRS ratio was also higher in the CVID group. The number of patients with P terminal force was also higher in the CVID group. Conclusion: As a result of this study, it was found that CVID patients have a higher incidence of developing arrhythmia than normal healthy individuals.Öğe Evaluation of subclinical cardiovascular disease by carotid intima media thickness, epicardial adipose tissue thickness, serum endocan, and nesfatin-1 levels in patients with primary hyperparathyroidism(Tubitak Scientific & Technological Research Council Turkey, 2022) Kocabas, Muhammet; Alsancak, Yakup; Can, Mustafa; Cordan, Ilker; Burgucu, Hatice Caliskan; Karakose, Melia; Yerlikaya, Fatma HumeyraBackground/aim: Data on the presence and extent of cardiovascular disease (CVD) risk in primary hyperparathyroidism (PHPT) are conflicting. In our study, we aimed to investigate the increased CVD risk in patients with PHPT by carotid intima-media thickness (CIMT), epicardial adipose tissue (EAT) thickness, and serum levels of endocan and nesfatin-1. Materials and methods: Patients with PHPT (n = 44) and age- and sex-matched healthy control subjects (n = 40) were enrolled in this study. Demographic data of the participants were questioned. Serum endocan and nesfatin-1 concentrations were assessed using commercially available ELISA kits. Noninvasive measurements of CIMT and EAT thickness were made with high-resolution ultrasonography and B-mode echocardiography. Results: There was no statistically significant difference in serum endocan and nesfatin-1 levels and EAT thickness in the PHPT group compared to controls. CIMT was statistically significantly higher in the PHPT group compared to controls (p = 0.001). A negative correlation was found between PTH and low-density lipoprotein cholesterol level (p = 0.001) but no significant relationship was found between other parameters. Conclusion: We found that CIMT is increased in patients with PHPT and consequently, CVD risk is high in these patients. More comprehensive studies are needed to identify other markers that predict increased CVD risk in patients with PHPT.Öğe Favorable electrocardiographic changes after substantial weight loss in patients with morbid obesity Results of a prospective study(Urban & Vogel, 2021) Gul, Murat; Inci, Sinan; Ozkan, Namik; Alsancak, YakupBackground Obese patients have an increased risk of arrhythmias and sudden death, even in the absence of structural heart disease and cardiac dysfunction. This study aimed to determine whether weight loss by bariatric surgery has an effect on arrhythmia-related electrocardiographic (ECG) variables in morbidly obese patients. Methods In this prospective study, the data of 48 patients were analyzed. All ECG variables that have the potential to predict ventricular arrhythmia were evaluated before surgery, and were compared with the 1-month and 6-month follow-up results. Results The mean body mass index was 45.74 +/- 5.60 kg/m(2) before surgery. There was a statistically significant decline in body mass index in the first and sixth month after surgery (39.26 +/- 5.00 kg/m(2) and 31.71 +/- 4.49 kg/m(2), respectively; p < 0.001). Furthermore, notable reduction was found in terms of heart rate measurements-QTc-d, JTc, JTc-d, Tp-e, TP-e/QT, TP-e/QTc-in the first month and sixth month compared with baseline (p < 0.001 for all comparisons). Several ECG variables, such as heart rate (r = 0.369, p = 0.001), QTc-d (r = 0.449, p = 0.001), JTc-d (r = 0.324, p = 0.002), Tp-e (r = 0.592, p = 0.001), Tp-e/QTc (r = 0.543, p = 0.001), Tp-e/JTc (r = 0.515, p = 0.001), exhibited a positive and significant correlation with weigh loss. Moreover, a negative and weakly significant correlation was found between the index of cardiac electrophysiological balance (r = -0.239, p = 0.004) and body mass index. Conclusion Substantial weight loss following laparoscopic sleeve gastrectomy in obese patients is accompanied by a significant improvement in ventricular repolarization. Therefore, this effect may lead to a decrease in the incidence of lethal ventricular arrhythmia and sudden cardiac death.Öğe A Google Trends Analysis: Change in internet searches related to cardiovascular disease during COVID-19 outbreak(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2020) Alsancak, Yakup; Gul, MuratAim: A rapidly grown up information about coronavirus (COVID-19) has been regularly broadcast on internet websites or social media. We investigated the Google research trends in searches regarding cardiovascular system diseases or symptoms such as chest pain, hypertension, hyperlipidemia, heart attack during the COVID-19 pandemic in two countries, Turkey and Italy, which are most affected by this disease. Methods: The Google Trends (TM) (GT (TM)) was used to retrieve data on Internet user search activities and patterns of Google search queries. We searched most known keywords related to cardiovascular disease and symptoms such as chest pain, heart attack, heart diseases, hypertension, high cholesterol in GTTM between January 1, 2020 and May 5, 2020 in Turkish and Italian. Results: Search interest about coronavirus in Turkey and Italy appeared to have an increasing pattern and it has gradually tended to fall after a short time. Searching trends were higher both of countries about chest pain, hypertension, ACE inhibitor and death between January and May 2020. Searching rates about heart attack was not different for all year, but a significant decrease was remarkable for cholesterol. It was also revealed that as the duration of the pandemic increases in both countries, these research rates decrease. Conclusion: Internet could be used to determine behaviours of people for searching cardiovascular disease and their symptoms during the outbreak. These data illustrate that internet users in both countries conducted an intense research on cardiac symptoms or diseases during the COVID-19 pandemic.
