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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 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 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 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 Kalp yetmezliği hastalarında diyastolik global longitudinal strain rate mortalite, rehospitalizasyon ve yatış süresi ile ilişkili midir?(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2020) Tatar, Sefa; Arıbaş, AlpayÇalışmamızın amacı, ejeksiyon fraksiyonu düşük olan kalp yetmezliği hastalarında diyastolik global longitudinal strain rate' in mortalite, rehospitalizasyon ve yatış süresiyle olan ilişkisinin araştırılmasıdır. Yöntem: Hastanemiz kardiyoloji kliniğinde yatan EF ≤ %40 olan ve New York Heart Association sınıf 3 ve 4 semptomları olan 116 hastanın yatışının ilk 24 saatinde klinik, laboratuar ve ekokardiyografik parametrelerine bakıldı. Çalışmaya kalp yetmezliği tanısı olmayan 58 kişi kontrol grubu olarak dahil edildi. Ekokardiyografik ölçümler, doku doppler ve strain rate oranı bakıldı. Standart biyokimyasal ve hematolojik parametrelere ilavaten N-terminal pro-brain natriüretik peptid düzeyine bakıldı. Bulgular: E strain rate ve E/E'SR bir aylık mortalitesi olan hastalarda istatiksel olarak anlamlıydı (p<0.005). Bu parametrelerin hastane içi mortalite ve rehospitalizasyon ile ilişkisi zayıf olup istatiksel olarak anlamlı değildi (p>0.005) Sonuç: Kalp yetmezliği hastalarında E strain rate ve E/E'SR hastalarda prognozu ve mortaliteyi göstermede diğer doku doppler parametrelerine göre üstün bir parametredir.. E/E'SR diğer doku doppler parametrelerine göre üstün olan bir sol ventrikül diyastolik fonksiyon göstergesidir.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 A Rare Involvement of Left Main Coronary Artery Due to Woven Coronary Artery in a Patient with Behcet's Disease(Aves, 2020) Tatar, Sefa; Alsancak, Yakup; Gurbuz, Ahmet Seyfeddin; Icli, AbdullahIn general, woven coronary artery (WCA) is a benign congenital pathology; ocassionally, it may result in adverse cardiovascular events owing to myocardial ischemia. Though all coronary arteries may be affected, the right coronary artery is the most affected. This paper presents an extremely rare WCA effecting the left main coronary artery concurrent with Behcet's disease.Öğe Two-edged Knife: Massive Pulmonary Embolism and Thrombolytic Contraindication(Emergency Medicine Physicians Assoc Turkey, 2020) Kandemir, Serif; Tatar, Sefa; Icli, Abdullah; Sertdemir, Ahmet; Akilli, HakanIntroduction: Pulmonary embolism is a common cause of death among emergency department admissions, and it has a high mortality and morbidity rate. Etiological reasons are generally associated with immobility. Radiological imaging methods are at the forefront in diagnosis. Anticoagulant and thrombolytic therapy may be preferred in treatment according to the hemodynamic condition of the patient. Case Report: A 56-year-old female patient admitted to the emergency department with sudden onset of dyspnea and syncope with a condition of cardiogenic shock, and echocardiography revealed an enlargement of the right heart chambers and impaired functions, and a tomography was performed with the pre-diagnosis of pulmonary embolism. When systemic thrombolytic therapy was contraindicated in the patient who had embolism on tomography, catheter-based thrombectomy and selective low-dose thrombolytic therapy to the pulmonary artery were administered. The patient, who became hemodynamically stable and his shock condition improved, was discharged with anticoagulant therapy. Conclusion: When left untreated, pulmonary embolism is a disease with a high mortality rate. Although systemic thrombolytic treatments are contraindicated in some patients, successful results can be obtained with locally effective interventional treatments in these patient groups.
