Browsing by Author "Aydinalp, Alp"

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Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography
(2015) Yilmaz, Mustafa; Aydinalp, Alp; Okyay, Kaan; Tekin, Abdullah; Bal, Ugur Abbas; Bayraktar, Nilufer; Yildirir, Aylin; Muderrisoglu, Haldun; 26195972
Aims: Contrast-induced nephropathy (CIN) is one of the most common causes of hospital-acquired acute renal failure. Oxidative stress and vasoconstriction might play key roles in its pathogenesis. In a few experimental models, antioxidant properties of carvedilol have been documented. The aim of this study was to analyze and compare the effects of carvedilol and metoprolol on the development of CIN in patients undergoing coronary angiography. Methods: One hundred patients currently taking metoprolol and 100 patients currently taking carvedilol were enrolled into the study. Venous blood samples were obtained before and 48 h after contrast administration. Cystatin C and malondialdehyde values were examined and compared. CIN was defined as a creatinine increase of at least 25% or 0.5 mg/dl from the baseline value. Results: Seven patients in the carvedilol group (7%) and 22 patients in the metoprolol group (22%) developed CIN (p = 0.003). In the metoprolol group, the median cystatin C concentration increased significantly from 978 to 1,086 ng/ml (p = 0.001) 48 h after radiocontrast administration. In the carvedilol group, the median cystatin C concentration did not change significantly (1,143 vs. 1,068 ng/ml; p = 0.94). In the metoprolol group, the mean malondialdehyde concentration increased significantly from 7.09 +/- 1.48 to 8.38 +/- 2.6 nmol/l (p < 0.001). In the carvedilol group, the mean serum malondialdehyde concentration did not change significantly (7.44 +/- 1.21 vs. 7.56 +/- 1.11 nmol/l; p = 0.59). Conclusion: When compared to metoprolol, carvedilol might decrease oxidative stress and subsequent development of CIN. (C) 2015 S. Karger AG, Basel
Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study
(2015) Altin, Cihan; Kanyilmaz, Suleyman; Koc, Sahbender; Gursoy, Yusuf Cemil; Bal, Ugur; Aydinalp, Alp; Yildirir, Aylin; Muderrisoglu, Haldun; 25502334
INTRODUCTION The incidence of coronary artery anomalies (CAAs) varies from 0.2% to 8.4%. Knowledge of such anatomical variations is important as coronary procedures are regularly performed these days. We aimed to find the coronary dominance pattern, intermediate artery (IMA) frequency and CAA incidence in our clinic, and compare them to those in the literature. METHODS The medical reports of 5,548 patients who had undergone coronary angiography (CAG) between 2005 and 2009 were retrospectively investigated. Dominance pattern and presence of IMA and CAA were recorded. CAAs were described using two different classifications: Angelini and Khatami's classification, and a new modified classification that was derived from Angelini and Khatami's classification. Some procedural details and clinical features of the patients with CAA were also investigated. RESULTS Coronary dominance pattern was: 81.6% right coronary artery, 12.2% circumflex artery and 6.2% co-dominant. IMA was present in 613 (11.0%) patients. The incidences of overall anomaly were 2.7% and 1.4%, according to the different classifications. Absent left main coronary artery, which was the most common anomaly in the present study, was found in 51 (0.9%) patients. Incidences of myocardial bridge, coronary arteriovenous fistulae and aneurysms were 1.1%, 0.2% and 0.3%, respectively. CONCLUSION CAAs are generally asymptomatic, isolated lesions. Some may lead to anginal symptoms, myocardial infarction or sudden death. We found that CAA was associated with increased radiation and contrast exposure in patients who underwent CAG. This risk could be reduced if appropriate catheters were designed and training programmes on ostial cannulation were developed.
Could Plasma Asymmetric Dimethylarginine Level Be A Novel Predictor Beyond The Classic Predictors of Stent Restenosis?
(2014) Bal, Ugur Abbas; Yildirir, Aylin; Aydinalp, Alp; Kaynar, Gamze; Kanyilmaz, Suleyman; Murat, Koza; Muderrisoglu, Ibrahim Haldun; https://orcid.org/0000-0002-9446-2518; https://orcid.org/0000-0001-8750-5287; https://orcid.org/0000-0002-3761-8782; 25233494; AAK-4322-2021; A-4947-2018; AAD-5841-2021
Objective: The aim of this study was to investigate the factors associated with coronary stent restenosis and if there is an association between plasma asymmetric dimethylarginine (ADMA) levels and stent restenosis. Methods: Ninety-one patients, who had a history of coronary bare metal stent implantation due to any cause in the last one year period, were admitted to this observational cross-sectional study. Coronary angiography was performed to all patients and quantitative angiography was used to determine the presence of stent restenosis. Laboratory parameters and angiographic features that contribute to stent restenosis were evaluated. Plasma ADMA levels were measured by using high performance liquid chromatography. Logistic regression analysis was used to determine the independent factors of stent restenosis. Results: Angiographic restenosis was found in 35 patients (38.5%). Stent diameter (p=0.038) and left ventricular ejection fraction (p=0.023) were lower and stent implantation history due to acute coronary syndrome (p=0.029), plasma ADMA level (5.0 +/- 1.8x10(-4) mmol/L vs. 3.9 +/- 1.0x10(-4) mmol/L, p=0.001), C-reactive protein concentration (p=0.016), white blood cell count (p=0.044) and stent length (p=0.005) were higher in patients with restenosis. Plasma ADMA level (beta=0.536; OR: 1.710; CI: 1.022-2.861; p=0.041), C-reactive protein concentration (beta=0.062; OR: 1.064; CI: 1.003-1.129; p=0.041), stent diameter (beta=-3.047; OR: 0.048; CI: 0.007-0.313; p=0.002) and length (beta=0.165; OR: 1.179; CI: 1.036-1.343; p=0.013) were found to be the independent predictors of stent restenosis in logistic regression analysis. Conclusion: We conclude that plasma ADMA levels may be used as a novel marker for stent restenosis beyond the classic stent restenosis markers.
Determinants of Coronary Artery Disease in Liver Transplant Candidates
(Başkent Üniversitesi, 2010-06) Muderrisoglu, Haldun; Haberal, Mehmet; Aydinalp, Alp; Atar, Ilyas; Bal, Ugur; Aktas, Ayse; Ertan, Cagtay; Atar, Asli; Yildirir, Aylin; Ozin, Bulent
Objectives: The potential for perioperative and late cardiovascular complications in liver transplant candidates makes careful preoperative risk assessment imperative. We sought to identify the determinants of coronary artery disease in liver transplant candidates. Materials and Methods: Liver transplant candidates with end-stage liver disease who were more than 40 years old and undergoing coronary angiography were retrospectively included in this study. Patients with known coronary heart disease or valvular heart disease were excluded. Symptoms, coronary artery disease risk factors, blood tests, electrocardiogram, echocardiography, treadmill stress test, myocardial perfusion scintigraphy, and coronary angiography results were recorded. A multivariable logistic regression model was used to assess the independent predictors of coronary artery disease. Results: A total of 139 patients (mean age, 52 ± 8; 110 male [79%]) were included in the analysis. Coronary angiography revealed that 13 patients (9.4%) had coronary artery disease. The frequency of diabetes mellitus, stable angina symptoms, positive smoking status, presence of 2 or more risk factors for coronary artery disease, and mean low-density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than in patients without coronary artery disease. The electrocardiogram, echocardiography, and noninvasive stress test results were not valuable tools in liver transplant candidates for the diagnosis of coronary artery disease. In multivariate analysis, typical angina symptoms and low-density lipoproteins cholesterol levels appeared to be independent factors that were predictive of coronary artery disease. Conclusions: Typical anginal symptoms and low-density lipoprotein cholesterol levels seem to be the best predictors of coronary artery disease in liver transplant candidates.
Direct aortic transcatheter aortic valve implantation
(2021) Karacaglar, Emir; Akgun, Arzu Neslihan; Aydinalp, Alp; Beyazpinar, Deniz Sarp; Sezgin, Atila; Muderrisoglu, Haldun; 34623302
Transcatheter aortic valve implantation (TAVI) is a safe and effective alternative to surgical valve replacement in intermediate and even in low-risk patient cohorts. Direct aortic (DAo) route may be used in patients with severe peripheral vascular disease. Here, we present an 88-year old patient hospitalized with cardiogenic shock. Echocardiography revealed severe aortic valve stenosis with aortic valve area 0.5 cm(2), mean gradient of 55 mmHg, and peak gradient 92 mmHg. TAVI was considered by the Institutional Heart Team. Multislice computed tomography (MSCT) revealed severe peripheral vascular disease, decreased calibration of abdominal aorta, and multiple large vulnerable atherosclerotic plaques. The patient was scheduled for a DAo TAVI. A 26-mm Medtronic CoreValve Evolut R valve was implanted after predilatation with median sternotomy. The patient was discharged after 96 hours. Although transfemoral (TF) access is used as the default approach for TAVI, it was contraindicated in our patient owing to severe peripheral vascular disease and decreased calibration of the abdominal aorta at its narrowest point (4.5 mm) with multiple large vulnerable atherosclerotic plaques. Careful preprocedural MSCT evaluation is essential and directly affects the success of the procedure. MSCT is also mandatory to confirm the best cannulation zone that must be met for a successful DAo TAVI.
The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement
(2014) Bal, Ugur; Aydinalp, Alp; Yilmaz, Kerem; Ozcalik, Emre; Hasirci, Senem; Atar, Ilyas; Gultekin, Bahadir; Sezgin, Atilla; Muderrisoglu, Haldun
Background: Mechanical heart valve replacement has an inherent risk of thromboembolic events (TEs). Current guidelines recommend an international normalized ratio (INR) of at least 2.5 after mechanical mitral valve replacement (MVR). This study aimed to evaluate the effects of a low INR (2.0-2.5) on thromboembolic and bleeding complications in patients with mechanical MVR on warfarin therapy. Methods: One hundred and thirty-five patients who underwent mechanical MVR were enrolled in this study. The end points of this study were defined as TEs (valve thrombosis, transient ischemic attack, stroke) and bleeding (all minor and major bleeding) complications. Patients were followed up for a mean of 39.6 months and the mean INR of the patients was calculated. After data collection, patients were divided into 3 groups according to their mean INR, as follows: group 1 (n = 34), INR < 2.0; group 2 (n = 49), INR 2.0-2.5; and group 3 (n = 52), INR > 2.5. Results: A total of 22 events (10 [7.4%] thromboembolic and 12 [8.8%] bleeding events) occurred in the follow-up period. The mean INR was an independent risk factor for the development of TEs. Mean INR and neurological dysfunction were independent risk factors for the development of bleeding events. A statistically significant positive correlation was found between the log mean INR and all bleeding events, and a negative correlation was found between the log mean INR and all TEs. The total number of events was significantly lower in group 2 than in groups 1 and 3 (P = 0.036). Conclusions: This study showed that a target INRs of 2.0-2.5 are acceptable for preventing TEs and safe in terms of bleeding complications in patients with mechanical MVR.
The Effects of the Radial Coronary Angiography on the Cannulated Arm Strength
(2017) Ozcalik, Emre; Aydinalp, Alp; 0000-0002-3761-8782; AAD-5841-2021
The Effects of the Radial Coronary Angiography on the Flow Mediated Endothelial Functional of the Radial Artery
(2017) Ozcalik, Emre; Aydinalp, Alp; 0000-0002-3761-8782; AAD-5841-2021
The Effects of the Radial Coronary Angiography on the Nitroglycerine Mediated Endothelial-Independent Vasodilatation of the Radial Artery
(2017) Ozcalik, Emre; Aydinalp, Alp; 0000-0002-3761-8782; AAD-5841-2021
The Effects of the Radial Coronary Angiography on the Radial Artery Patency
(2017) Aydinalp, Alp; Ozcalik, Emre; 0000-0002-3761-8782; AAD-5841-2021
Evaluation of hs-CRP and sLOX-1 Levels in Moderate-to-High Risk Acute Coronary Syndromes
(2020) Coner, Ali; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-3761-8782; 30961517; AAG-8233-2020; AAD-5841-2021
Objective: Risk stratification and prompt treatment are essential for the management of acute coronary syndromes (ACS) and prediction of future prognosis. Subclinical vascular inflammation and novel biomarkers play an important role in the clinical evaluation of ACS patients. Methods: We enrolled patients who were admitted to emergency service with unstable angina or non-ST segment elevated ACS (NSTE-ACS) in the study population. Coronary artery disease (CAD) complexity was determined via evaluation of angiographical views and peripheral venous blood samples were collected to measure highly sensitive C-reactive protein (hs-CRP) and soluble form of Lectin-like OxLDL receptor-1 (sLOX-1) levels. Results: A total of 40 patients were enrolled in the study population, mean age was 65.1 +/- 13.8 years and male gender percentage was 52.5%. Twenty-nine of patients had NSTE-ACS and 11 patients had unstable angina presentation. The modified Gensini scores were higher for patients with elevated hs-CRP and sLOX-1 levels. Conclusion: Vascular inflammation displays the onset of ACS and it is related to more complex CAD in these patients. An increase in sLOX-1 expression is closely related to anatomical complexity of CAD in ACS.
An Experimental Case-Based Role Model Study of Mitral NeoChord Implantation with New Tools via Transapical Approach
(2023) Doganozu, Ersin; Doganozu, Ayse Ceren; Beyazpinar, Deniz Sarp; Sezgin, Atilla; Muderrisoglu, Ibrahim Haldun; Aydinalp, Alp
Increasing fragility with the aging population compels less invasive procedures. Even if cardiac surgeries are getting minimally invasive with new techniques and technological development in the fi eld, many valve surgery candidates suffer from being qualifi ed as inoperable due to fragility, unstable circulatory system, and to be post-myocardial infarction and their life is in danger every day that they are not operated. The main purpose of this case-based role model study is to invent a new technique for implanting a transapical mitral valve NeoChord implantation with new tools.
Follow-Up of Heart Transplant Recipients with Serial Echocardiographic Coronary Flow Reserve and Dobutamine Stress Echocardiography to Detect Cardiac Allograft Vasculopathy
(2014) Sade, Leyla Elif; Eroglu, Serpil; Yuce, Deniz; Bircan, Asli; Pirat, Bahar; Sezgin, Atilla; Aydinalp, Alp; Muderrisoglu, Haldun; https://orcid.org/0000-0003-3737-8595; https://orcid.org/0000-0003-3055-7953; https://orcid.org/0000-0003-4576-8630; https://orcid.org/0000-0002-3761-8782; https://orcid.org/0000-0002-9635-6313; 24613313; AAQ-7583-2021; ABG-1582-2021; AAI-8897-2021; AAD-5841-2021; AAG-8233-2020
Background: Implementation of reliable noninvasive testing for screening cardiac allograft vasculopathy (CAV) is of critical importance. The most widely used modality, dobutamine stress echocardiography (DSE), has moderate sensitivity and specificity. The aim of this study was to assess the potential role of serial coronary flow reserve (CFR) assessment together with DSE for predicting CAV. Methods: A total of 90 studies were performed prospectively over 5 years in 23 consecutive heart transplant recipients who survived > 1 year after transplantation. Assessment of CFR with transthoracic Doppler echocardiography, DSE, coronary angiography, and endomyocardial biopsy was performed annually. Results of CFR assessment and DSE were compared with angiographic findings of CAV. Results: Acute cellular rejections were excluded by endomyocardial biopsies. CAV was detected in 17 of 90 angiograms. Mean CFR was similarly lower in both mild (CAV grade 1) and more severe (CAV grades 2 and 3) vasculopathy, but wall motion score index became higher in parallel with increasing grades of vasculopathy. Any CAV by angiography was detected either simultaneously with or later than CFR impairment, yielding 100% sensitivity for CFR. The combination of CFR and DSE increased the specificity of the latter from 64.3% to 87.2% without compromising sensitivity (77.8%). Conclusions: CFR is very sensitive for detecting CAV and increases the diagnostic accuracy of DSE, raising the potential for patient management tailored to risk modification and to avoid unnecessary angiographic procedures.
Head to Head Comparison of Speckle Tracking Strain Echocardiography with Invasive Hemodynamic Assessment for the Detection of Acute Cellular Rejection in Cardiac Allograft Recipients
(2018) Sade, Leyla Elif; Eroglu, Serpil; Pirat, Bahar; Sezgin, Atilla; Aydinalp, Alp; Ozdemir, Handan; Muderrisoglu, Haldun; 0000-0003-3737-8595; 0000-0003-4576-8630; 0000-0002-3761-8782; 0000-0002-7528-3557; AAQ-7583-2021; ABG-1582-2021; AAI-8897-2021; AAD-5841-2021; X-8540-2019
Hematological Parameters Can Predict the Extent of Coronary Artery Disease in Patients with End-Stage Renal Disease
(2015) Bal, Zeynep; Bal, Ugur; Okyay, Kaan; Yilmaz, Mustafa; Balcioglu, Serhat; Turgay, Ozge; Hasirci, Senem; Aydinalp, Alp; Yildirir, Aylin; Sezer, Siren; Muderrisoglu, Haldun; 0000-0002-8342-679X; 0000-0001-6134-8826; 0000-0002-6731-4958; 0000-0002-9635-6313; 0000-0002-3761-8782; 0000-0002-9446-2518; 0000-0001-8750-5287; 0000-0002-2557-9579; 26246038; AAK-7805-2021; AAK-7355-2020; GPX-1387-2022; AAG-8233-2020; AAD-5841-2021; AAK-4322-2021; AAZ-5795-2021; A-4947-2018; S-6973-2016
Aside from traditional factors (e.g., diabetes, age, and hypertension), some hematological parameters, such as neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), have increasingly been reported as measures of systemic inflammation and atherosclerosis in patients with end-stage renal disease (ESRD). This study aimed to determine whether there is an association between these hematological parameters and the extent of coronary artery disease (CAD) in patients with ESRD. A total of 149 consecutive ESRD patients (66 % males) without established CAD were studied. NLR, RDW, and MPV values in all patients were calculated from the complete blood count before coronary angiography. Angiographic views were assessed by an experienced interventional cardiologist, and the extent of CAD was evaluated by the Gensini score. The patients were divided into quartiles of the Gensini score. Age, time on dialysis, calcium-phosphorus product, C-reactive protein levels, NLR, and MPV were significantly different among the groups (all p < 0.05). The Gensini score was correlated with age, time on dialysis (both p < 0.001), NLR (p = 0.004), and C-reactive protein levels (p = 0.034) and inversely correlated with left ventricular ejection fraction (p = 0.023). Multivariate regression analysis showed that age (p = 0.001), time on dialysis (p < 0.001), NLR (p = 0.001), and MPV (p = 0.005) were independent predictors of the extent of CAD. Aside from the well-known traditional factors, NLR and MPV are independent predictors of the extent of CAD in patients with ESRD.
Is there a relationship between resistin levels and left ventricular end-diastolic pressure?
(2018) Yildirir, Aylin; Yildirim, Ozge Turgay; Sade, Leyla Elif; Hasirci, Senem Has; Kozan, Hatice; Ozcalik, Emre; Okyay, Kaan; Bal, Ugur Abbas; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-6731-4958; 29615544; AAK-7355-2020; AAG-8233-2020
Objective: Resistin, a cysteine-rich peptide, is associated with atherosclerosis and diabetes. Resistin levels increase corresponding to coronary artery disease (CAD) and heart failure severity. Since resistin level tends to elevate with symptomatic heart failure, it is expected to be associated with left ventricular end-diastolic pressure (LVEDP). However, there is no relevant literature on the relationship between resistin levels and LVEDP. We aimed to evaluate the association between resistin levels and LVEDP, severity of CAD, carotid intima-media thickness (CIMT), and echocardiographic diastolic dysfunction parameters. Methods: For this study, 128 euvolemic patients with creatinine clearance >50 mg/dL and without acute coronary syndrome, who had typical chest pain or were stress test positive, were enrolled. Resistin level was measured by Enzyme-linked immunosorbent assays (ELISA) method. Severe CAD is defined as >= 50% stenosis in one of the major coronary arteries. LVEDP was measured during left heart catheterization. Results: After coronary angiography, 60 patients (46.9%) had severe CAD. The mean LVEDPs were similar for patients with and without severe CAD (p=0.480). The resistin levels did not differ between the groups (p=0.154). The resistin levels did not correlate with LVEDP (r=-0.045, p=0.627), ejection fraction (EF; r=0.110, p=0.228), the Gensini score (r=-0.091, p=0.328), and CIMT (r=0.082, p=0.457). No significant correlation was found between the echocardiographic diastolic dysfunction parameters and resistin levels. Conclusion: There was no significant correlation between resistin level and LVEDP, CAD severity, echocardiographic diastolic dysfunction parameters, and CIMT. Further studies are warranted to determine the efficacy of resistin in clinical use.
Longitudinal Strain and Strain Rate for Estimating Left Ventricular Filling Pressure in Heart Transplant Recipients
(2020) Colak, Ayse; Muderrisoglu, Haldun; Pirat, Bahar; Eroglu, Serpil; Aydinalp, Alp; Sezgin, Atilla; Sade, Leyla Elif; 0000-0002-3761-8782; 0000-0003-4576-8630; 32998008; AAD-5841-2021; AAI-8897-2021
Traditional parameters have limited value to estimate left ventricular filling pressure (LVFP) in orthotropic heart transplant (OHT) recipients. We hypothesized that global longitudinal strain (GLS), diastolic, and systolic strain rate (SR) would be depressed in OHT recipients with elevated LVFP and could overcome the limitations of traditional parameters. We studied consecutively OHT patients at the time of endomyocardial biopsies and retrospectively pretransplantation studies conforming to the same protocol. Comprehensive echocardiography with strain measurements was performed. Results were compared with pulmonary capillary wedge pressure (PCWP) obtained from right heart catheterization that was performed just after the echocardiography study. In all, 74 studies were performed in 50 OHT recipients. Mean PWCP was 11.8 +/- 4.3 mm Hg (range: 4 to 25 mm Hg). Several parameters, but not left atrial volume index, mitral inflow velocities, annular velocities, and their ratio (E/e'), were different between studies with normal (n = 47) and elevated PCWP (n = 27). Area Under Curve for GLS (0.932*), E/e'SR (0.849*), and systolic SR (0.848*) (*p 0.0001) were more accurate than traditional parameters for predicting PCWP 12 mm Hg. GLS, systolic SR and E/e'SR remained accurate regardless of LV ejection fraction and allograft vasculopathy. Meanwhile, E/e' was accurate to predict PWCP in native failing hearts before transplantation. Changes in GLS and E/e'SR tracked accurately changes in PCWP. In conclusion, traditional indices of diastolic function perform poorly in OHT recipients, whereas GLS and E/e'SR provide reliable means of LVFP, irrespective of ejection fraction and allograft vasculopathy. These parameters also track reasonably well the changes in LVFP. (c) 2020 Elsevier Inc. All rights reserved.
Multiparametric Assessment of Right Ventricular Function in Heart Transplant Recipients by Echocardiography and Relations with Pulmonary Hemodynamics
(2023) Colak, Ayse; Erdemir, Ahmet Gurkan; Hazirolan, Tuncay; Pirat, Bahar; Eroglu, Serpil; Aydinalp, Alp; Muderrisoglu, Haldun; Sade, Leyla Elif; 0000-0002-1958-6158; 0000-0002-3761-8782; 37955614
Objective: Right ventricular (RV) dilatation and dysfunction are usually present in heart transplant (HTx) patients and worsened with residual pulmonary hypertension (PH). We aimed to determine the ability of different echocardiographic modalities to evaluate RV function in comparison with cardiac magnetic resonance (CMR) and their relations with pulmonary hemodynamics in HTx patients.Methods: A total of 62 data sets [echocardiographic, hemodynamic, and CMR] were acquired from 35 HTx patients. Comprehensive echocardiography, including two-dimensional (2D) transthoracic echocardiography, speckle tracking echocardiography, and three-dimensional (3D) echocardiography, was performed. Mean pulmonary artery pressure (mPAP) was obtained invasively from right heart catheterization. The correlations between all echocardiographic parameters and CMR imaging data and the differences between patients with and without residual PH were evaluated.Results: Diastolic and systolic RV volumes and RV ejection fraction (RVEF) by 3D echocardiography correlated strongly with CMR-derived volumes and RVEF (r = .91, r = .79, r = .64; p < .0001 for each, respectively). Among other parameters, RV fractional area change (r = .439; p < .001) and RV free wall longitudinal strain (RVFW-LS) (r = -.34; p < .05) correlated moderately with CMR-RVEF, whereas tricuspid annulus S' velocity (r = .29; p < .05) and tricuspid annular systolic plane excursion (r = .27; p < .05) correlated weakly with CMR-RVEF. Additionally, 3D-RVEF and RVFW-LS were significantly decreased in studies with mPAP >= 20 mm Hg in comparison to those with mPAP < 20 mm Hg (47.7 +/- 3.7 vs. 50.9 +/- 5.3, p = .04 and -15.5 +/- 3.1 vs. -17.5 +/- 3, p = .03, respectively).Conclusion: The best method for the evaluation of RV function in HTx recipients is 3D echocardiography. Besides, the subclinical impact of residual PH on RV function can be best determined by RVFW-LS and 3D-RVEF in these patients.
Neutrophil/Lymphocyte Ratio in Coronary Bare Metal Stent Restenosis
(2017) Yilmaz, Kerem Can; Ciftci, Orcun; Karacaglar, Emir; Bal, Ugur Abbas; Okyay, Kaan; Aydinalp, Alp; Yildirir, Aylin; Muderrisoglu, Ibrahim Haldun; 0000-0002-9446-2518; 0000-0002-2538-1642; 0000-0002-3761-8782; 0000-0001-8926-9142; 0000-0001-8750-5287; 0000-0001-6134-8826; 0000-0003-3320-9508; AAK-4322-2021; ABI-6723-2020; AAJ-1331-2021; AAD-5841-2021; W-5233-2018; A-4947-2018; AAK-7355-2020
Plasma Osteopontin Concentration is Elevated in Patients with Coronary Bare Metal Stent Restenosis
(2018) Yilmaz, Kerem Can; Bal, Ugur Abbas; Karacaglar, Emir; Okyay, Kaan; Aydinalp, Alp; Yildirir, Aylin; Muderrisoglu, Haldun; 0000-0002-2538-1642; 0000-0002-9446-2518; 0000-0002-9635-6313; 0000-0002-3761-8782; 0000-0001-8750-5287; 0000-0001-6134-8826; 0000-0003-3320-9508; 28841817; ABI-6723-2020; AAJ-1331-2021; AAK-4322-2021; AAG-8233-2020; AAD-5841-2021; A-4947-2018; AAK-7355-2020
Objective: Osteopontin is a component of atherosclerotic lesions, secreted by monocytes, macrophages and endothelial and vascular smooth muscle cells, which together are responsible for neointimal proliferation. We examined whether elevated plasma osteopontin concentration was associated with in-stent restenosis in patients with coronary artery disease. Subjects and methods: We enrolled 91 patients who underwent coronary artery stenting, and 60 control patients with normal findings on coronary angiography, between June 2012 and September 2013. For patients with stents, we measured plasma osteopontin concentration at the first follow-up coronary angiogram. For controls, plasma osteopontin concentration was measured at the time of angiography. Results: Of the 91 patients who had undergone coronary artery stenting, 31 (34.1%) had developed in-stent restenosis and the mean time passed to control coronary angiography was 36.7 months (+/- SD 35.1 months). Mean plasma osteopontin concentration in this group was 2721.4 +/- 1787.8 pg/ml, significantly higher than the 60 patients (65.9%) with no in-stent restenosis (1770.4 +/- 1208.2 pg/ml, p = .011) and the 60 patients with a normal coronary angiogram (1572.4 +/- 904.8 pg/ml, p = .002). There was no significant difference in mean osteopontin concentration between the patients with no in-stent restenosis and the control group (p = .312). Conclusions: Elevated plasma osteopontin concentration is associated with in-stent stenosis in patients with coronary artery disease. Further studies will be needed to establish whether osteopontin can predict in-stent restenosis and guide clinical management strategies.