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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 Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing(Springer, 2013) Dogan, Umuttan; Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Gok, HasanIncreased sympathetic activity and endothelial dysfunction are the proposed mechanisms underlying exaggerated blood pressure response to exercise (EBPR). However, data regarding heart rate behavior in patients with EBPR are lacking. We hypothesized that heart rate recovery (HRR) could be impaired in patients with EBPR. A total of 75 normotensive subjects who were referred for exercise treadmill test examination and experienced EBPR were included to this cross-sectional case-control study. The control group consisted of 75 age- and gender-matched normotensive subjects without EBPR. EBPR was defined as a peak exercise systolic blood pressure (BP) a parts per thousand yen210 mmHg in men and a parts per thousand yen190 mmHg in women. HRR was defined as the difference in HR from peak exercise to 1 min in recovery; abnormal HRR was defined as a parts per thousand currency sign12 beats/min. These parameters were compared with respect to occurrence of EBPR. Mean values of systolic and diastolic BP at baseline, peak exercise, and the first minute of the recovery were significantly higher in the subjects with EBPR. Mean HRR values were significantly lower (P < 0.001) in subjects with EBPR when compared with those without. Pearson's correlation analysis revealed a significant positive correlation between the decrease in systolic BP during the recovery and degree of HRR in individuals without EBPR (r = 0.42, P < 0.001). Such a correlation was not observed in subjects with EBPR (r = 0.11, P = 0.34). The percentage of abnormal HRR indicating impaired parasympathetic reactivation was higher in subjects with EBPR (29 % vs 13 %, P = 0.02). In logistic regression analyses, HRR and resting systolic BP were the only determinants associated with the occurrence of EBPR (P = 0.001 and P < 0.001, respectively). Decreased HRR was observed in normotensive individuals with EBPR. In subjects with normal BP response to exercise, a linear correlation existed between the degree of HRR and decrease in systolic BP during the recovery period. However, such a correlation was not found in subjects with EBPR. Our data suggest that mechanisms underlying the blunting of the HRR might be associated with the genesis of EBPR. The association between the extent of HRR and adverse cardiovascular outcomes in patients with EBPR needs to be investigated in detail in future research.Öğe Corelation Between the 24-Hour Urine Aldosterone Levels and Atrial Electromechanical Conduction Time(Elsevier Science Inc, 2013) Soylu, Ahmet; Alibasic, Hayrudin; Yildirim, Elif; Toker, Aysun; Erdogan, Halil Ibrahim; Duzenli, Mehmet Akif; Tokac, Mehmet[Abstract Not Availabe]Öğe Effects of Smoking on Very-Long Term Mortality after First ST Elevation Myocardial Infarction(Arquivos Brasileiros Cardiologia, 2022) Kiziltunc, Emrullah; Sahin, Yusuf Bozkurt; Topal, Salih; Duzenli, Mehmet Akif; Karakaya, Ekrem; Aygul, Nazif; Topsakal, RamazanBackground: The smoking paradox has been a matter of debate for acute myocardial infarction patients for more than two decades. Although there is huge evidence claiming that is no real paradox, publications supporting better outcomes in post-MI smokers are still being released. Objective: To explore the effect of smoking on very long-term mortality after ST Elevation myocardial infarction (STEMI). Methods: This study included STEMI patients who were diagnosed between the years of 2004-2006 at three tertiary centers. Patients were categorized according to tobacco exposure (Group 1: non-smokers; Group 2: <20 package*years users, Group 3: 20-40 package*years users, Group 4: >40 package*years users). A Cox regression model was used to estimate the relative risks for very long-term mortality. P value <0.05 was considered as statistically significant. Results: There were 313 patients (201 smokers, 112 non-smokers) who were followed-up for a median period of 174 months. Smokers were younger (54 +/- 9 vs. 62 +/- 11, p: <0.001), and the presence of cardiometabolic risk factors were more prevalent in non-smokers. A univariate analysis of the impact of the smoking habit on mortality revealed a better survival curve in Group 2 than in Group 1. However, after adjustment for confounders, it was observed that smokers had a significantly increased risk of death. The relative risk became higher with increased exposure (Group 2 vs. Group 1; HR: 1.141; 95% CI: 0.599 to 2.171, Group 3 vs Group 1; HR: 2.130; 95% CI: 1.236 to 3.670, Group 4 vs Group 1; HR: 2.602; 95% CI: 1.461 to 4.634). Conclusion: Smoking gradually increases the risk of all-cause mortality after STEMI.Öğe Full metal jacket: transfemoral aortic valve implantation for regurgitant valve after endovascular aortic repair(Oxford Univ Press, 2017) Tanyeli, Omer; Dereli, Yuksel; Gormus, Niyazi; Duzenli, Mehmet AkifTransfemoral aortic valve implantation has become an almost routine interventional procedure for severe aortic stenosis in high-risk patients. Over time an increased number of experiences has led to unusual procedures. In this report, we present a successful valve-in-valve transfemoral aortic valve implantation in a patient with aortic regurgitation, who previously had debranching and thoracic endovascular aortic repair operations.Öğe An impressive image of unilateral pulmonary artery agenesis associated with coronary collateralization in an adult(Turkish Soc Cardiology, 2020) Alsancak, Yakup; Tatar, Sefa; Gurbuz, Ahmet Seyfeddin; Korkmaz, Celalettin; Duzenli, Mehmet Akif[Abstract Not Availabe]Öğe An impressive image of unilateral pulmonary artery agenesis associated with coronary collateralization in an adult(Turkish Soc Cardiology, 2020) Alsancak, Yakup; Tatar, Sefa; Gurbuz, Ahmet Seyfeddin; Korkmaz, Celalettin; Duzenli, Mehmet Akif[Abstract Not Availabe]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 Paradoxical Embolism After a Traffic Accident: A Rare Case of Thrombus Entrapped in a Patent Foramen Ovale(Istanbul Training & Research Hospital, 2021) Kandemir, Serif Ahmet; Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Duzenli, Mehmet AkifParadoxical embolism is the passage of a thrombus formed in the venous system through shunts in the lung or heart into the systemic circulation. The most common intracardiac shunt is a patent foramen ovale (PFO). Since the transition of a thrombus formed in the right heart to the left heart and systemic circulation through the PFO is a temporary situation, the entrapped thrombus in the PFO is extremely rare. Herein, we present a case, including the diagnosis and treatment, of a paradoxical embolism in a 53-year-old female with a non-vehicle traffic accident who developed a pulmonary embolism and acute cerebral infarction.Öğe A rare echocardiographic image of aortic prosthetic valve endocarditis complicated with paravalvular abscess, pseudoaneurysm and aorto-right atrial fistula(Wiley, 2018) Gurbuz, Ahmet Seyfeddin; Alsancak, Yakup; Ozcelik, Abdullah; Ozer, Sumeyye Fatma; Duzenli, Mehmet AkifEarly infectious endocarditis (IE) occurs in 3% of prosthesis in the first 12months. Early IE is more aggressive than late prosthetic valve endocarditis. Mortality remains high, despite combined medical and surgical treatment. We present a case of early IE in aortic prosthetic valve complicated with paravalvular abscess, pseudoaneurysm and aorto- right atrial fistula.Öğe Relation of 24-Hour Urinary Aldosterone Levels with Nondipper Blood Pressure Pattern in Normotensive Individuals(Elsevier Science Inc, 2013) Soylu, Ahmet; Alibasic, Hayrudin; Yildirim, Elif; Toker, Aysun; Erdogan, Halil Ibrahim; Duzenli, Mehmet Akif; Tokac, Mehmet[Abstract Not Availabe]Öğe Sturge-Weber syndrome and dilated cardiomyopathy: coincidence or associated disease?(Aves Yayincilik, 2012) Erdogan, Halil Ibrahim; Gul, Enes Elvin; Yildirim, Oguzhan; Duzenli, Mehmet Akif[Abstract Not Availabe]
