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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 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 Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma(Hindawi Ltd, 2015) Geredeli, Caglayan; Boruban, Melih Cem; Poyraz, Necdet; Artac, Mehmet; Aribas, Alpay; Koral, LokmanPrimary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.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 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 The impressions on the 11th International Scientific Summer School 2014 in Enez, Turkey(Turkish Soc Cardiology, 2014) Aribas, Alpay; Savelev, Aleksei[Abstract Not Availabe]Öğe Inappropriate sensing events revealing electrocautery-induced implantable cardioverter-defibrillator lead failure(Turkish Soc Cardiology, 2015) Can, Ilknur; Aribas, Alpay; Dereli, Yuksel; Tholakanalli, Venkatakrishna[Abstract Not Availabe]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 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 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.Öğe Prognostic value of Tpeak-Tend interval in patients with acute pulmonary embolism(Biomed Central Ltd, 2015) Icli, Abdullah; Kayrak, Mehmet; Akilli, Hakan; Aribas, Alpay; Coskun, Mukremin; Ozer, Sumeyye Fatma; Ozdemir, KurtulusBackground: The aim of this study was to examine the Tpeak-Tend (Tpe/corrected Tpe) interval, which is an indicator of transmural myocardial repolarization, measured non-invasively via electrocardiogram in patients with acute pulmonary embolism (PE), and to investigate the relationship with 30-day mortality and morbidity. Methods: The study included 272 patients diagnosed with acute PE, comprising 154 females and 118 males, with a mean age of 63.1 +/- 16.8 years. Tpe/cTpe intervals were calculated from the electrocardiograms with a computer program after using a ruler or vernier caliper manual measuring tool to obtain highly sensitive measurements. The relationship between the electrocardiogram values and 30-days mortality and morbidity were measured. Results: The study group was divided into three groups according to cTpe intervals: Group 1, < 113 ms; Group 2, 113-133 ms; and Group 3, > 133 ms. White blood cell count and troponin T levels, corrected QT intervals with QRS complex durations, percentage of right ventricle dilatation with right/left-ventricular ratio, 30-day death, and combinations of these values were seen at a higher rate in Group 3 patients compared to the other groups. Kaplan-Meier analysis showed that the cTpe interval measured at > 126 ms could be used as a cut-off value in the prediction of mortality and morbidity. The cTpe cut-off values of 126 ms had sensivity, specificity, negative predictive value, and positive predictive value of 80.56 %, 59.32 %, 95.2 %, and 23.2 %, respectively. Conclusions: cTpe interval could be a useful method in early risk stratification in patients with acute PE.Öğe The Relationship among Thiazide Like Diuretic, Uric Acid and Erectile Dysfunction in Hypertensive Subjects(Elsevier Science Inc, 2013) Aribas, Alpay; Kayrak, Mehmet; Ulucan, Seref; Keser, Ahmet; Demir, Kenan; Alibasic, Hayrudin; Akilli, Hakan[Abstract Not Availabe]Öğe The relationship between exercise capacity and masked hypertension in sedentary patients with diabetes mellitus(Taylor & Francis Inc, 2014) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Tekinalp, Mehmet; Ayhan, Selim Suzi; Gunduz, Mehmet; Alibasic, HajrudinAim: Although exaggerated blood pressure responses (EBPR) to exercise have been related to future hypertension and masked hypertension (MHT), the relationship between exercise capacity and MHT remains unclear. A sedentary life style has been related to increased cardiovascular mortality, diabetes mellitus (DM), and hypertension. In this study, we aimed to examine the relationship between exercise capacity and MHT in sedentary patients with DM. Methods: This study included 85 sedentary and normotensive patients with DM. Each patient's daily physical activity level was assessed according to the INTERHEART study. All patients underwent an exercise treadmill test, and exercise duration and capacity were recorded. Blood pressure (BP) was recorded during all exercise stages and BP values >= 200/110 mmHg were accepted as EBPR. MHT was diagnosed in patients having an office BP < 140/90 mmHg and a daytime ambulatory BP > 135/85 mmHg. Patients were divided into two groups according to their ambulatory BP monitoring (MHT and normotensive group). Results: The prevalence of MHT was 28.2%. Exercise duration and capacity were lower in the MHT group than in the normotensive group (p < 0.05) and were negatively correlated with age, HbA1c, mean daytime BP, and mean 24 hour BP. Peak exercise systolic BP and the frequency of EBPR were both increased in the MHT group (25.0% and 8.1%, respectively, p = 0.03). According to a multivariate regression, exercise capacity (OR: 0.61, CI95%: 0.39-0.95, p = 0.03), EBPR (OR: 9.45, CI95%: 1.72-16.90, p = 0.01), and the duration of DM (OR: 0.84, CI95%: 0.71-0.96, p = 0.03) were predictors of MHT. Conclusion: Exercise capacity, EBPR, and the duration of DM were predictors of MHT in sedentary subjects with DM.Öğe The Relationship Between Neutrophil / Lymphocyte Ratio and Myocardial Ischemia Detected in Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Alibasic, Hajrudin; Aribas, Alpay; Yildirim, Oguzhan; Karanfil, Mustafa; Sertdemir, Ahmet Lutfi[Abstract Not Availabe]
