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Öğe Dysphagia due compression of right pulmonary artery aneurysm to the esophagus(Turkish Soc Cardiology, 2013) Kayrak, Mehmet; Erdogan, Halil Ibrahim; Yildirim, Oguzhan[Abstract Not Availabe]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 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]Öğe The relationship between red blood cell distribution width and myocardial ischemia in dobutamine stress echocardiography(Lippincott Williams & Wilkins, 2014) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Alibasic, Hajrudin; Yildirim, Oguzhan; Sertdemir, Ahmet Lutfi; Ozdemir, KurtulusObjectivesAlthough elevated red blood cell distribution width (RDW) is associated with adverse outcomes in patients with cardiovascular disease, its role in demonstrating the presence and extent of myocardial ischemia for coronary artery disease is not known. The purpose of this study is to investigate the relationship between RDW and myocardial ischemia by using dobutamine stress echocardiography (DSE).MethodsA total of 917 patients were included in this prospective study. A complete blood analysis was performed for RDW before DSE. According to DSE results, patients were divided into two groups: DSE negative and DSE positive. According to the number of ischemic segments in DSE, patients were divided into three groups: no-ischemic segment, 1-3 ischemic segments, and 4 ischemic segments. In addition, coronary angiography results of DSE-positive groups were assessed in respect of RDW.ResultsThe RDW of the DSE-positive group (n=277) was higher than for the DSE-negative group (n=640) (13.51.5 vs. 12.7 +/- 1.3%, P<0.001, respectively). Elevated RDW values were also related to higher number of ischemic segments (no-ischemic segment group: 12.7 +/- 1.3, 1-3 ischemic segments group: 13.2 +/- 1.5, and 4 ischemic segments group: 14.2 +/- 1.3, P<0.001). A receiver operating curve analysis showed a cut-off value of RDW greater than 13.5% for predicting myocardial ischemia (sensitivity: 57.0%, specificity: 77.8%, positive predictive value: 52.7%, negative predictive value: 80.7%). In addition, positive predictive value of DSE was increased from 82.4 to 94.2% for detecting coronary artery disease by coronary angiography, when RDW (>13.5%) was used.ConclusionRDW is related to the presence and extent of myocardial ischemia in DSE. A high RDW increases the diagnostic accuracy of DSE.Öğe The Relationship Between Red Blood Cell Distribution Width and Myocardial Ischemia in Dobutamine Stress Echocardiography(Elsevier Science Inc, 2013) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Alibasic, Hajrudin; Yildirim, Oguzhan; Sertdemir, Ahmet Lutfi; Ozdemir, Kurtulus[Abstract Not Availabe]Öğe Self-Reported Sleep Quality of Patients with Atrial Fibrillation and the Effects of Cardioversion on Sleep Quality(Wiley, 2013) Kayrak, Mehmet; Gul, Enes Elvin; Aribas, Alpay; Akilli, Hakan; Alibasic, Hajrudin; Abdulhalikov, Turyan; Yildirim, OguzhanBackground Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance encountered in clinical practice and is associated with impaired quality of life. Data from the previous studies have shown that sleep quality (SQ), as a component of life quality, may also deteriorate in patients with AF. However, it remains unclear; we do not know whether SQ improves after sinus rhythm is maintained. Therefore, we aimed to examine the relationship between SQ and AF, as well as the effects of sinus rhythm restoration with direct current cardioversion (DCC) on SQ among patients with persistent AF. Methods One hundred fifty-three patients with a diagnosis of nonvalvular AF and 150 age-matched control subjects with sinus rhythm were recruited. SQ was assessed using the Pittsburgh Sleep Quality Index (PSQI). The study was designed with two stages. First, the difference in SQ between AF patients and age-matched controls was examined. Patients with global PSQI scores greater than 5 were defined as poor sleepers. Thus, a higher global PSQI score indicated worsened SQ. Predictors of poor SQ were also analyzed using a regression model. Second, the effect of rhythm control on SQ was studied in patients with AF who were eligible for DCC. Of the 65 patients with persistent AF, 54 patients with successful cardioversion were followed for 6 months. The remaining 11 patients, whose cardioversion was unsuccessful, were not followed. After 6 months of follow-up, the PSQI scores of patients with sinus rhythm maintenance (n = 39) and patients with AF recurrence (n = 15) were reassessed. Changes in global PSQI scores (baseline vs after 6 months) were analyzed. Results The PSQI scores were significantly higher in the AF group compared to the control group (9.4 +/- 4.6 vs 5.8 +/- 4.1, P = 0.001, respectively). The prevalence of poor sleepers was significantly higher in the AF group (76%) than in the control group (45%) (P < 0.001 by the (2) test). Multivariate logistic regression analysis showed that AF (odds ratio [OR]: 3.36, 95% confidence interval [CI]: 2.00-5.55), age (OR: 1.02, 95% CI: 1.00-1.04), and diabetes mellitus (OR:1.79, 95% CI: 1.03-3.14) were independent predictors of poor SQ. In the second stage, the effect of rhythm control on the SQ of the 54 patients with successful DCC was analyzed. PSQI scores improved significantly between baseline and the 6 months in sinus rhythm maintenance group (8.7 +/- 4.1 vs 7.2 +/- 3.8, P < 0.001, respectively). However, in the AF recurrence group, the change in global PSQI scores between baseline and the sixth month was not statistically significant (9.8 +/- 4.5 vs 9.2 +/- 4.2, P = 0.56, respectively). Conclusion Patients with AF have shorter sleep duration and poor SQ. Maintenance of sinus rhythm after DCC may have a favorable effect on the SQ of patients with AF. Nevertheless, AF is an independent predictor of poor SQ.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]Öğe The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism(Springer, 2014) Aribas, Alpay; Keskin, Suat; Akilli, Hakan; Kayrak, Mehmet; Erdogan, Halil Ibrahim; Guler, Ibrahim; Yildirim, OguzhanTo evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE). A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD. RV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02-279.46 95 % CI), p = 0.01] and PA axial diameter [OR 5.02 (1.02-1.26 95 % CI), p = 0.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of > 1.08 had 81.43 % sensitivity, 52.08 % specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD. Tomographic axial diameters enable more accurate predictions of RVD than OS scores do.Öğe The Value of Axial Diameters and Obstruction Scores for Determining the Echocardiographic Right Ventricular Dysfunction in Acute Pulmonary Embolism(Elsevier Science Inc, 2013) Aribas, Alpay; Keskin, Suat; Akilli, Hakan; Kayrak, Mehmet; Erdogan, Halil Ibrahim; Guler, Ibrahim; Yildirim, Oguzhan[Abstract Not Availabe]
