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Öğe Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients(Springer, 2016) Demirtas, Levent; Turkmen, Kultigin; Buyuklu, Mutlu; Kocyigit, Ismail; Orscelik, OzcanLeft atrium (LA) mechanical functions and atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity in general population. Data are scant about these parameters in end-stage renal disease (ESRD) patients receiving hemodialysis (HD) and peritoneal dialysis (PD). We aimed to evaluate AEMD times and LA mechanical functions and associated risk factors in HD and PD patients. Forty-four healthy individuals, 62 HD and 50 PD patients were enrolled in the study. Echocardiography was performed before midweek dialysis session for HD patients and on admission for PD patients. Data were expressed as mean +/- A SD. Spearman's test was used to assess linear associations. Predictors of left intra-atrial EMD time and LA active emptying volume (LAaeV) were assessed by regression analysis. Left intra-atrial-AEMD times were significantly longer in HD patients compared to PD patients. LAaeV was positively correlated with inter-atrial time, left intra-atrial time, systolic and diastolic BP, calcium and neutrophil-to-lymphocyte ratio (NLR) (r 0.22, p 0.016; r 0.28, p 0.002; r 0.34, p < 0.001; r 0.35, p < 0.001; r 0.37, p < 0.001; r 0.46, p < 0.001, respectively) and negatively correlated with serum uric acid (r -0.31, p 0.013) in ESRD patients. We found positive correlations between left intra-atrial time and LAaeV, LAV(max), LAV(p) and NLR (r 0.28, p 0.002; r 0.27, p 0.003; r 0.27, p 0.003; r 0.22, p 0.03, respectively) and negative correlations with albumin, uric acid and potassium (r -0.24, p 0.008; r -0.19, p 0.04; r -0.26, p 0.037, respectively). Advanced age, decreased serum albumin and increased NLR were found to be independent predictors of LAaeV; however, only NLR was found to be an independent predictor of AEMD time in this population. Increased inflammation might be a risk factor of AEMD and LA mechanical dysfunction in ESRD patients.Öğe Predictive Value of Atrial Electromechanical Delay on Long-Term Cardiovascular Outcomes in Hemodialysis Patients(Karger, 2015) Turkmen, Kultigin; Demirtas, Event; Topal, Ergun; Gaipov, Abduzhappar; Kocyigit, Ismail; Orscelik, Ozcan; Guney, IbrahimBackground: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients. (C) 2015 S. Karger AG, BaselÖğe PREDICTORS OF ATRIAL CONDUCTION DELAY IN HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS: THE ROLE OF INFLAMMATION(Oxford Univ Press, 2015) Turkmen, Kultigin; Demirtas, Levent; Akbas, Emin M.; Buyuklu, Mutlu; Bakirci, Eftal; Kocyigit, Ismail; Orscelik, Ozcan[Abstract Not Availabe]Öğe PREDICTORS OF LEFT ATRIAL MECHANICAL FUNCTIONS IN END STAGE RENAL DISEASE PATIENTS(Oxford Univ Press, 2015) Turkmen, Kultigin; Demirtas, Levent; Buyuklu, Mutlu; Kocyigit, Ismail; Kocyigit, Ismail; Orscelik, Ozcan[Abstract Not Availabe]Öğe The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2015) Kocyigit, Ismail; Turkmen, Kultigin; Dogan, Ender; Gungor, Ozkan; Orscelik, Ozcan; Karakukcu, Cigdem; Eroglu, ErayOBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx). Osteoprotegerin (OPG) is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL) and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV) machine. RESULTS: Patients were divided into two groups as normal (n:24) and osteopenia/osteoporosis group (n: 56). Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072), osteoprotegerin (r:0.219,p:0.052), calcium x phosphate product (r:0.605,p:<0.001), and systolic blood pressure (r:0.198,p:0.058) and negatively correlated with RANKL (r:-0.261,p:0.020) and creatinine clearance (r:-0.220,p:0.051). PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.