Browsing by Author "Akinci, Sinan"

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Acquired Aneurysm of Sinus of Valsalva
(2017) Coner, Ali; Akinci, Sinan; Cicek, Davran; Saba, Tonguc; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0001-5250-5404; 0000-0002-5711-8873; AAG-8233-2020; AAC-8036-2020; AAD-5564-2021; ABD-7321-2021
Acquired pseudoaneurysm of the sinus of Valsalva
(2017) Coner, Ali; Akinci, Sinan; Cicek, Davran; Saba, Tonguc; Muderrisoglu, Haldun; 0000-0001-5250-5404; 0000-0002-9635-6313; 0000-0002-5711-8873; 28902654; AAD-5564-2021; AAG-8233-2020; ABD-7321-2021; AAC-8036-2020
Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents
(2020) Coner, Ali; Akinci, Sinan; Akkucuk, Mehmet Husamettin; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-4569-1143; 0000-0001-5250-5404; 31974326; AAG-8233-2020; AAJ-2828-2021; AAD-5564-2021
Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5 +/- 11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.
Answer Regarding: Potent P2Y12 Inhibitors and Bleeding Complications
(2022) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Adar, Adem; Muderrisoglu, Haldun; 36200724
Aortic arch calcification: a novel parameter for prediction of masked hypertension
(2021) Akbay, Ertan; Coner, Ali; Akinci, Sinan; Adar, Adem; Cakan, Fahri; Muderrisoglu, Haldun; 0000-0002-9146-0621; 0000-0002-5711-8873; 0000-0001-5250-5404; 0000-0002-5427-3480; 33734125; AAD-5479-2021; ABD-7321-2021; AAD-5564-2021; GPT-4057-2022
Background Masked hypertension is directly related to increased cardiovascular morbidity and mortality but remains underdiagnosed in clinical practice. The aim of the study was to search the role of aortic arch calcification (AAC) in the diagnosis of masked hypertension. Methods and results Among the patients who underwent ambulatory blood pressure monitoring (ABPM) in our clinic, those with office blood pressure (OBP) <140/90 mmHg were included in the study population. According to OBP, they were divided into two groups as normal (<130/85 mmHg) and high normal (130-139/85-89 mmHg) OBP groups. Subjects were also investigated for the presence of masked hypertension with ABPM and searched in masked hypertension and control groups. Masked hypertension was defined as in the latest 2017 ACC/AHA Hypertension guideline and was diagnosed as the daytime BP >= 135/85 mmHg and nighttime BP >= 120/70 mmHg. AAC was evaluated on direct X-ray telecardiography. Diagnosis of masked hypertension was searched depending on the presence of AAC and OBP measurements as well. A total of 216 volunteers were involved in the study [mean age 45.2 +/- 12.2 years; female gender 120 (55.5%)]. One hundred ten volunteers (50.9%) had masked hypertension according to the ABPM. AAC was significantly more common in the masked hypertension group (44.5% vs. 26.4%) (P = 0.005). AAC had a positive predictive value of 79% in those with high normal OBP in the diagnosis of masked hypertension, and also AAC had a negative predictive value of 74% in those with normal OBP. Conclusion AAC can be used as a reliable diagnostic tool to exclude and predict masked hypertension during office examination.
Arrhythmogenic Evidence for Epicardial Adipose Tissue: Heart Rate Variability and Turbulence are Influenced by Epicardial Fat Thickness
(2015) Balcioglu, Akif Serhat; Cicek, Davran; Akinci, Sinan; Eldem, Halil Olcay; Bal, Ugur Abbas; Okyay, Kaan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0001-6134-8826; 0000-0001-5250-5404; 0000-0002-9446-2518; 25224491; AAC-8036-2020; AAG-8233-2020; AAK-7355-2020; AAD-5564-2021; AAK-4322-2021
BackgroundEpicardial adipose tissue (EAT) is a local source of various hormones, cytokines, and vasoactive substances affecting the myocardium. EAT contains abundant ganglionic plexi that interact with the autonomic nervous system. Evidence of the association between EAT and arrhythmia is limited, with the exception of atrial fibrillation. This study aimed to investigate the relation between EAT and cardiac autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) parameters. MethodsAll subjects underwent a 24-hour Holter recording to assess HRV and HRT parameters and a transthoracic echocardiography to measure EAT thickness. Patients were divided into two groups according to the median EAT thickness (3.9 mm). The higher EAT group consisted of 111 patients with a >3.9-mm thickness and the lower EAT group 113 patients with a 3.9-mm EAT thickness. ResultsHRV and HRT parameters were significantly influenced in the higher EAT group. Moreover, we observed significant correlations between EAT thickness and Holter findings (standard deviation of all NN intervals [SDNN]: r = -0.462, P < 0.001; SDNN index: r = -0.349, P < 0.001; standard deviation of the average NN intervals: r = -0.465, P < 0.001; root mean square of successive differences: r = -0.251, P < 0.001; pNN50: r = -0.354, P < 0.001; turbulence onset: r = 0.172, P = 0.010; turbulence slope: r = -0.279, P < 0.001, HRT category: r = 0.169, P = 0.011). In multivariate regression analysis, EAT thickness was independently associated with all measures of HRV and HRT, with the exception of turbulence onset. ConclusionsSympathovagal imbalance, detected by HRV and HRT parameters, is related to EAT thickness. As sympathovagal imbalance is a predictor of arrhythmic events, EAT may play an important arrhythmogenic role not limited to atrial fibrillation.
Assessment of vascular inflammation and subclinical nephropathy in exaggerated blood pressure response to exercise test
(2019) Coner, Ali; Genctoy, Gultekin; Akinci, Sinan; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 30969228; AAG-8233-2020
Objectives Exaggerated blood pressure response (EBPR) to exercise tests is an additional cardiovascular risk factor and predictor of future development of hypertension. However, there are conflicting data on the diagnostic threshold of EBPR and its clinical importance in kidney disease. The aim of this study was to investigate vascular inflammation and subclinical nephropathy in otherwise healthy volunteers with EBPR. Patients and methods The study included 170 middle-aged, healthy volunteers (mean age: 43.3 +/- 6.9; range: 35-65 years: 100 men and 70 women). Participants performed a treadmill exercise test until they reached their age-adjusted maximum heart rate and were divided into EBPR and normal/physiological blood pressure response groups. Before exercise tests, serum high sensitive C-reactive protein (hs-CRP) and urine albumin-to-creatinine ratio were measured to evaluate vascular inflammation and subclinical nephropathy, respectively. Anthropometrical measurements, fasting serum glucose, fasting lipid profile, and the full blood count of participants were also evaluated. Results EBPR was detected in 31 (18.2%) participants. Hs-CRP levels (1.03 vs. 0.46 mg/l) (P<0.001) and albumin-to-creatinine ratio levels (6.90 vs. 5.22 mg/g) (P=0.002) were higher in the EBPR group. BMI, abdominal obesity, and hs-CRP levels were found to be related to increased development of EBPR. Conclusion EBPR is an overlooked clinical finding during exercise tests and should be evaluated in apparently healthy, middle-aged populations for the early detection of possible subclinical nephropathy. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.
Association Between Mitral Valve Prolapse, Migraine, and White Matter Hyperintensities on Magnetic Resonance Imaging
(2018) Avci, Aynur Yilmaz; Toprak, Munire Kilinc; Lakadamyali, Liatioe; Akinci, Sinan
Objective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors. Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging co evaluate the presence of any WMHs. Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively). Conclusion: MVP is found CO be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might nor be involved in the evolution of WMHs in migraine
Association of Morning Surge and Postexercise Heart Rate and Blood Pressure Recovery
(2022) Akbay, Ertan; Akinci, Sinan; Adar, Adem; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; 35325411; AAD-5479-2021; AAD-5564-2021
Introduction The autonomic nervous system plays an active role in the regulation of early morning blood pressure (BP) and BP/pulse regulation in the treadmill exercise test (TET). Aim We evaluated the relationship between BP/pulse changes during TET and morning blood pressure surge (MS). Methods Patients who underwent ambulatory blood pressure measurement (ABPM) and TET in the same visit between 2017 and 2020 were evaluated retrospectively. Patients with previously diagnosed hypertension and/or using antihypertensives and office BP >= 140/90 were excluded from the study.MS values and dipping percentage were calculated from ABPM data. The patients were analyzed by dividing them into two groups according to the MS median, and BP/pulse values during exercise and recovery periods were compared in these groups. Results 202 patients [median age 45 (39-51), male 134 (66.3%)] were included in the study. MS median was 18.5 (10.75-27) mmHg. TET recovery period 3rd-min systolic blood pressure (RSBP) was higher in the group with high MS (p: 0.017). Systolic and diastolic dipping percentages were higher in the group with higher MS (p: 0.015, p: 0.040, respectively). Peak systolic and diastolic BP, RSBP, and recovery 3rd min diastolic BP were positively correlated with MS (p < 0.05, for all). Additionally, an independent relationship was observed between RSBP and MS (beta: 0.205, p: 0.028). Conclusion We found an independent association between RSBP and MS. Increased RSBP may be associated with target organ damage and cardiovascular events such as MS.
Cardiac autonomic nervous dysfunction detected by both heart rate variability and heart rate turbulence in prediabetic patients with isolated impaired fasting glucose
(2016) Balcioglu, Akif Serhat; Akinci, Sinan; Cicek, Davran; Coner, Ali; Bal, Ugur Abbas; Muderrisoglu, Ibrahim Haldun; 0000-0002-9446-2518; 0000-0002-5711-8873; 0000-0001-5250-5404; 27025199; AAK-4322-2021; ABD-7321-2021; AAD-5564-2021; AAC-8036-2020
Objective: Cardiac autonomic nervous dysfunction (CAND), a severe complication of diabetes, has also been shown to affect prediabetic patients. The role of isolated impaired fasting plasma glucose (IFG), a subtype of prediabetes, is not clear in the pathogenesis of CAND. The aim of this study was to examine the relationship between isolated IFG and cardiac autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) indices derived from 24-h Holter-electrocardiogram recordings. Methods: This observational, prospective, cross-sectional study examined 400 consecutive subjects divided into three groups according to oral glucose tolerance test results: the control group [Group I, fasting plasma glucose (FPG) <100 mg/dL and normal glucose tolerance, n=193], the isolated IFG group (Group II, FPG >= 100 and <126 mg/dL, n=134), and the isolated impaired glucose tolerance (IGT), both IFG and IGT, or newly diagnosed diabetes' group (Group III, n=73). Patients with non-sinus rhythm, known diabetes mellitus, coronary artery disease, heart failure, severe valvular disease, or receiving medical therapy that may affect HRV and HRT indices were excluded. Time domain HRV parameters, turbulence onset (TO), turbulence slope (TS), and HRT category were examined. Chi-square, one-way analysis of variance, Kruskal-Wallis H, and Mann-Whitney U tests were used to compare variables where appropriate. The correlation between Holter data and FPG levels was analyzed using the Spearman's test. Multiple linear regression analysis was performed to identify independent predictors of the HRV and HRT parameters. Results: Median (interquartile range 25-75) FPG levels in Groups I, II, and III were 89 (83/93) mg/dL, 109 (104/116) mg/dL, and 174 (150.5/197) mg/dL, respectively. There were significant differences in HRV and HRT parameters between and among all groups. While HRV parameters and TS decreased from Group I to Group III, TO and HRT category gradually increased. Additionally, FPG level was significantly correlated with SDNN, r=-0.220; SDNN index, r=-0.192; SDANN, r=-0.207; RMSSD, r=-0.228; pNN50, r=-0.226; TO, r=0.354; and TS, r=-0.331 (all p<0.001). Conclusion: CAND, as detected by both HRV and HRT, appear to be present in the isolated IFG subtype of prediabetes.
Chronic Aortic Dissection and Recoarctation As A Late Complication of Aortic Coarctation Surgery
(2015) Coner, Ali; Balcioglu, Serhat; Akinci, Sinan; Cicek, Davran; Muderrisoglu, Haldun; 0000-0001-5250-5404; 0000-0002-9635-6313; 0000-0002-5711-8873; 26717344; AAC-8036-2020; AAD-5564-2021; AAG-8233-2020; ABD-7321-2021
Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg
(2021) Coner, Ali; Akbay, Ertan; Akinci, Sinan; Ozyildiz, Gokhan; Genctoy, Gultekin; Muderrisoglu, Haldun; 0000-0002-5711-8873; 0000-0002-9146-0621; 0000-0001-5250-5404; 0000-0002-5145-2280; 34151642; ABD-7321-2021; AAD-5479-2021; AAD-5564-2021; AAJ-5551-2021
Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population. Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis. Results: A total of 233 participants were involved in the study population (median age 45 years [40-50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067-1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023-5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern. Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.
Effect of Dobutamine Stress Echocardiography on Serum Heart Fatty Acid Binding Protein Levels
(2017) Akinci, Sinan; Balcioglu, Akif Serhat; Tacoy, Gulten; Tavil, Yusuf; Guslbahar, Ozlem; Ozdemir, Murat; https://orcid.org/0000-0001-5250-5404; 28597800; AAD-5564-2021
Objective Heart fatty acid binding protein (HFABP) is a low-molecular-weight free protein that is abundant in the intracytoplasmic space of myocytes. Due to its unique features, serum HFABP levels may increase in myocardial ischaemia. The aim of this study was to evaluate the effect of myocardial ischaemia induced by dobutamine stress echocardiography (DSE) on serum HFABP levels. Methods and results A total of 30 consecutive patients with suspected myocardial ischaemia underwent DSE examination. HFABP levels were measured immediately before and 1 hour after DSE. HFABP rose significantly in individuals in the DSE positive group (1.66 +/- 1.18 ng/ml vs 2.65 +/- 1.34 ng/ml, P = 0.004), but remained unchanged in the DSE negative group (1.61 +/- 0.77 ng/ml vs 1.85 +/- 0.76 ng/ml, P = 0.066). Conclusion Serum HFABP levels increased significantly at 1 hour in the presence of ischaemia induced by DSE in patients with stable clinical coronary syndromes. No such increase was evident in the absence of ischaemia.
Evaluation of the relationship between para-aortic adipose tissue and ascending aortic diameter using a new method
(2022) Adar, Adem; Onalan, Orhan; Cakan, Fahri; Keles, Hakan; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Muderrisoglu, Haldun; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; https://orcid.org/0000-0002-5711-8873; https://orcid.org/0000-0002-6496-5050; 36189879
Background Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds the aorta. It contributes significantly to aortic atherosclerosis and enlargement. Studies conducted with computed tomography and magnetic resonance have shown that individuals with aortic aneurysm had more PAT than healthy individuals. In this study, we measured PAT using transthoracic echocardiography (TTE). The aim of this study is to investigate the possible relationship of TTE measured PAT with ascending aortic width. Methods PAT was defined as the hypoechoic space in front of ascending aortic 2 cm above the sinotubular junction at the end of the systole. Patients were divided into 2 groups according to the presence of dilatation in the ascending aorta using Roman's classification (aortic size index, ASI). ASI of less than 21 was considered no aortic dilation and an ASI of 21 mm/m2 or greater was considered to have aortic dilation. Results A total of 321 unselected patients were divided into the ascending aortic dilatation (AAD) group (n = 96) and the normal ascending aorta diameter group (n = 225 patients). PAT was significantly higher in the AAD group compared with the non-ADD group (0.9 (0.48) vs. 0.7 (0.91) mm, p < 0.0001). Univariate and multivariate logistic regression analysis revealed that PAT (OR: 3.005, 95%CI (1.445-6.251)) were significantly associated with AAD. Conclusions This is the first study which evaluated PAT measured by TTE. We found a significant association between PAT measured by TTE and ascending aorta width.
Heart Rate Variability And Heart Rate Turbulence In Patients With Vasovagal Syncope
(2021) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Muderrisoglu, Ibrahim Haldun; 0000-0002-9146-0621; 0000-0001-5250-5404; 0000-0002-5711-8873; 34549694; AAD-5479-2021; AAD-5564-2021; ABD-7321-2021
Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope. Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24-hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured. Results The age of the patients varied from 16 to 75 yrs (mean: 44.8 +/- 18.5 yrs). HUTT results of 60 (37.2%) patients were evaluated as positive. There were no significant differences in the basal demographic, clinical, or laboratory findings of the tilt-positive and tilt-negative patient groups. Likewise, there were no significant differences between the time domain HRV parameters and HRT parameters of both groups. Conclusion HRV and HRT parameters reflecting basal autonomic function were not different between HUTT positive and HUTT negative patient groups. These findings suggest that basal autonomic functions have no effect on vasovagal syncope pathogenesis.
In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors
(2022) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Adar, Adem; Muderrisoglu, Haldun; 35860883
Objective: In this study, we aimed to determine whether potent agents affect in-hospital bleeding and mortality compared to clopidogrel in patients with the acute coronary syndrome in whom tirofiban and P2Y12 inhibitor are used together. Methods: Patients who were treated interventionally between 2015 and 2020 and were using tirofiban were retrospectively screened. Clinical, laboratory, and angiographic findings were obtained from the hospital database. Patients were analyzed by dividing them into clopidogrel and prasugrel/ticagrelor groups. Results: Acute coronary syndrome patients (n = 227) who were treated interventionally were included in this retrospective study. Clopidogrel was given to 93 (41%), ticagrelor to 112 (49.3%), and prasugrel to 22 of the patients (9.7%). Compared to the ticagrelor/prasugrel group, the clopidogrel group was older and more were women, and the history of hypertension and previous coronary artery disease was higher (P, respectively: <.001; .001; .008; .0045). The creatinine value was higher, the basal hemoglobin was lower, and the GRACE (Global Registry of Acute Coronary Events) and CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) scores were higher (P, respectively:.026; .002;.002; <.001). The in-hospital bleeding rate was significantly higher in the clopidogrel group (P <.001). Although the in-hospital mortality rate was higher, it was not statistically significant (P = .07). Regression analysis showed that GRACE score and gender were associated with in-hospital mortality (P <.001; P = .031, respectively), and only age was associated with in-hospital bleeding (P <.001). No relationship was found with P2Y12 inhibitor. Conclusion: In our study, we found that the combined use of potent P2Y12 inhibitor with tirofiban in acute coronary syndrome patients treated interventionally was not different from the use of clopidogrel in terms of in-hospital bleeding and mortality.
In-Hospital Cardiac Complications in Legionnaires' disease: A Single Center Experience of 32 Patients
(2021) Akinci, Sinan; Coner, Ali; 0000-0001-5250-5404; 0000-0002-5711-8873; AAD-5564-2021; ABD-7321-2021
Introduction: Legionella species frequently causes Legionnaires' disease (LD), a community-acquired pneumonia (CAP). Although data on cardiac events during the course of CAP can be found in the literature, there has been little research on the same issue in LD patients specifically. This study aimed to investigate cardiac complications in the course of LD. Materials and Methods: A total of 32 patients hospitalized with CAP and who received a definitive diagnosis of Legionella infection were identified from the hospital database and included in the study population. The patients' electronic and written records were evaluated for possible cardiac complications. Results: Mean age was 65 +/- 13.5 years and 50% of the subjects were males. Seven patients died during hospitalization. Cardiovascular events were detected in 11 patients. New-onset atrial fibrillation was the most frequent event and was detected in 8 patients (25%), while two patients experienced a myocardial infarction, and one patient was diagnosed with myocarditis. The cardiovascular events were significantly related to the pneumonia severity index (PSI) score and need for intensive care unit. Conclusion: Although LD rarely involves the heart, it can often cause cardiac complications, and the frequency increases in parallel with the severity of the disease. This study indicates that patients with LD should be carefully followed for possible cardiac complications.
Mid-term clinical outcomes of new generation drug-eluting stents for treatment of diffuse coronary artery disease
(2018) Coner, Ali; Cicek, Davran; Akinci, Sinan; Balcioglu, Serhat; Altin, Cihan; Muderrisoglu, Haldun; 30516523
Objective: Diffuse coronary artery disease (CAD) is a challenging issue in clinical cardiology practice. There are limited data about percutaneous revascularization in these patients. Methods: This study was an observational clinical evaluation. The records of patients with diffuse CAD revascularized with new-generation drug-eluting stents (DES) were researched retrospectively. Patients treated with multiple, overlapping new-generation DES (at least 60mm in length per vessel) were included. The incidence of major adverse cardiac events (MACE), defined as cardiac death, stent thrombosis, non-fatal myocardial infarction, and target lesion revascularization (TLR), at the end of the first year following the index procedure was recorded. Results: A total of 71 patients (with 75 coronary vessels) treated with new-generation DES for diffuse CAD were enrolled in the study. Zotarolimus-eluting stents were used in 48 vessels and biolimus A9-eluting stents were used in 27 vessels. The median total stent length per vessel was 75.0 mm (60.0-106.0) and the median number of stents implanted was 3 (2-4) for each vessel. The cumulative incidence of MACE at the end of the first year was 11.2% (8 patients). The presence of diabetes mellitus (DM) and ST-segment elevated myocardial infarction (STEMI) were defined as independent clinical risk factors related to MACE development. Conclusion: Coronary artery revascularization with new-generation drug-eluting stents can be a good choice in the treatment of selected patients with diffuse CAD. DM and STEMI were found to be related to poorer clinical outcomes with this treatment option in our study.
A New And Simple Parameter For Diagnosis Pulmonary Edema: Expiratory Air Humidity
(2022) Adar, Adem; Can, Emine Yilmaz; Elma, Yusuf; Ferah, Meryem Akpolat; Kececi, Mete; Muderrisoglu, Haldun; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Cakan, Fahri; Onalan, Orhan; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; 35092906; AAD-5479-2021; AAD-5564-2021
Purpose: Acute pulmonary edema is characterized by increased levels of fluid in the interstitial and alveolar space of the lung and requires emergency treatment. In acute pulmonary edema, the amount of fluid in the intra-alveolar, interstitial space, and pleural space vary considerably and this fluid will evaporate in different amounts compared to the physiological fluid. The aim of this study was to compare the humidity rates of expiratory air measured before and after pulmonary edema induced by alpha-naphthylthiourea (ANTU) in rats. Methods: The study included twenty healthy adult rats divided equally into a healthy control group and a pulmonary edema group. Pulmonary edema was induced by administering ANTU intraperitoneally in the rats in the study group. Humidity, temperature, lung weight, pleural effusion, and histopathological changes in the respiratory system due to pulmonary edema were examined in the ANTU group. Control measurments were taken before administration of ANTU and again 4 h after administration of ANTU when lung damage was considred to be at maximum levels. Results: Mean expiratory air humidity was 71.22 +/- 3.59% before ANTU and 56.28 +/- 3.94% after administration of ANTU. The mean humidity difference of -14.94 +/- 5.96% was considered statistically different (p = 0.01). Conclusion: Humidity rate in expiratory air was significantly lower in rats with acute pulmonary edema compared to healthy rats. This result supports the hypothesis that humidity in expiratory air can be considered an important parameter in patients during clinical are follow-up for pulmonary edema. (C) 2022 Elsevier Inc. All rights reserved.
A New Chest Radiography Clue to Predict Saphenous Vein Graft Failure
(2022) Akbay, Ertan; Coner, Ali; Akinci, Sinan; Adar, Adem; Demir, Ali Riza; Uygur, Begum; Saba, Tonguc; Budak, Ali Baran; Muderrisoglu, Ibrahim Haldun
Objective: Saphenous vein graft failure (VGF) is a measure of the short-and long-term success of coronary artery bypass graft surgery (CABG). Aortic arch calcification (AAC) is a long-term finding of atherosclerosis in large vessels. The aim of this study was to evaluate the relationship between AAC and VGF.Materials and Methods: Patients who underwent CABG surgery and subsequent coronary angiography in a single hospital between January 2010 and January 2021 were included in the study. The presence and stage of AAC was evaluated using preoperative chest X-rays. VGF was defined as >= 75% stenosis and/or total occlusion in the saphenous vein graft. In addition, the effect of AAC on VGF was evaluated based on the time elapsed since the CABG procedure. Results: Of the 594 patients who underwent CABG during the study period, 91 patients (mean age 63.6 +/- 10.0; 71 [78.0%] male) were included in the study. VGF was observed in 49 (53.8%) patients. AAC was found to be an independent predictor of VGF (odds ratio [OR]: 2.788, 95% confidence interval [CI]: 1.068-7.278). The results indicated no association between AAC and VGF in patients whose coronaries were screened within 1 year (OR: 1.143, 95% CI: 0.279-4.683), while there was a strong association between AAC and VGF in patients who were screened 1 year after the surgery (OR: 5.355, 95% CI: 1.618-17.720).Conclusion: AAC evaluation may be a valuable diagnostic method to predict VGF after CABG, and particularly late VGF.