Browsing by Author "Cayli, Murat"

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The Association between Aortic Distensibility and Coronary Flow Reserve in Newly Diagnosed Diabetic Patients
(2015) Kalkan, Gulhan Yuksel; Gur, Mustafa; Haydardedeoglu, Filiz Eksi; Kirim, Sinan; Baykan, Ahmet Oytun; Kuloglu, Osman; Ucar, Hakan; Sahin, Durmus Yildiray; Elbasan, Zafer; Seker, Taner; Turkoglu, Caner; Yildirim, Arafat; Cayli, Murat; 0000-0002-0179-9673; 24815036; AAK-5003-2021
IntroductionAortic distensibility (AD) is an important parameter affecting coronary hemodynamics. Coronary flow velocity reserve (CFVR) is a reliable marker of coronary endothelial function in diabetic patients. The aim of this study was to investigate the association between AD and CFVR in newly diagnosed diabetic patients. MethodWe studied 77 patients with newly diagnosed diabetes mellitus (DM) and 30 age- and sex-matched healthy control subjects. CFVR was calculated as the hyperemic to resting coronary diastolic velocities ratio by using transthoracic echocardiography. Pulse pressure (PP) and AD were calculated. ResultsFasting blood glucose, HbA1c and PP were significantly higher in patients with diabetes (P<0.001, P<0.001 and P=0.009, respectively). Other clinical and demographical characteristics, laboratory findings and echocardiographic findings were similar in both groups (P>0.05, for all). The measurement of CFVR and AD in patients with diabetes were significantly lower compared with the controls (P<0.001 and P=0.001, respectively). CFVR was significantly negatively correlated with age, body mass index, HbA1c, systolic blood pressure, and PP, while significantly positively correlated with AD (P<0.05, for all). Multivariate regression analysis showed that only AD (=0.485, P<0.0001) and HbA1c (=-0.362, P<0.0001) were independently associated with CFVR. The cutoff value of AD obtained by the receiver operator characteristic (ROC) curve analysis was 2.44 for the prediction of impaired CFVR. ConclusionAortic distensibility and HbA1c were independently associated with CFVR. The decrease in AD may be used as a marker of impaired coronary microcirculation in asymptomatic diabetic patients.
Left Ventricle Geometry Affects Coronary Flow Reserve in Diabetic Patients
(2015) Kalkan, Gulhan Yuksel; Gur, Mustafa; Elbasan, Zafer; Baykan, Ahmet Oytun; Kuloglu, Osman; Sahin, Durmus Yildiray; Seker, Taner; Haydardedeoglu, Filiz Eksi; Sen, Omer; Ucar, Hakan; Kirim, Sinan; Cayli, Murat; 0000-0002-0179-9673; 25655851; AAK-5003-2021
Objectives: The aim of this study was to investigate the association between coronary flow reserve (CFR) and left ventricle (LV) geometric patterns in patients with newly-diagnosed diabetes mellitus (DM). Study design: We studied 116 patients with newly-diagnosed DM and 31 healthy control subjects. Echocardiographic examination was performed on all subjects. Four different geometric patterns were identified in diabetic patients, according to LV mass index (LVMI) and relative wall thickness (RWT) [NG: Normal geometry; CR: Concentric remodeling; EH: Eccentric hypertrophy; CH: Concentric hypertrophy]. CFR was calculated as the hyperemic to resting coronary diastolic peak velocities ratio. Results: Compared with controls, CFR was decreased in diabetic patients (p<0.05). The lowest CFR values were observed in the CH group compared with control and other groups (p<0.05, for all). Also, CFR values of the CR and EH groups were lower than NG and the control group (p<0.05, for all). CFR was associated with LV geometry (r=-0.449, p=0.001), LVMI (r=-0.401, p<0.001), RWT (r=-0.247, p=0.008), HbA1c (r=-0.576, p<0.001) and mitral valve E/A ratio (r=0.239, p=0.01) in bivariate analysis. CFR was independently associated with LV geometry (beta=-0.449, p<0.001), LVMI (beta=-0.192, p=0.016), and HbA1c (beta=-0.576, p<0.001) in multivariate analysis. Conclusion: CFR was impaired in newly-diagnosed DM. The degree of this deformation increases from normal geometry towards to concentric hypertrophy. This condition suggests that myocardial structural remodeling due to diabetes might be effective on CFR.
Predictors of in-hospital mortality following redo cardiac surgery: Single center experience
(2015) Colkesen, Yucel; Coskun, Isa; Cayli, Murat; Gulcan, Oner; 26527452
Purpose: Redo cardiac operations represent one of the main challenges in heart surgery. The purpose of the study was to analyze the predictors of in-hospital mortality in patients undergoing reoperative cardiac surgery by a single surgical team. Methods: A total of 1367 patients underwent cardiac surgical procedures and prospectively entered into a computerized database. Patients were divided into 2 groups based on the reoperative cardiac surgery (n = 109) and control group (n = 1258). Uni-and multivariate logistic regression analysis were performed to evaluate the possible predictors of hospital mortality. Results: Mean age was 56 +/- 13, and 46% were female in redo group. In-hospital mortality was 4.6 vs. 2.2%, p = 0.11. EuroSCORE (6 vs. 3; p < 0.01), cardiopulmonary bypass time (90 vs. 71 min; p < 0.01), postoperative bleeding (450 vs. 350 ml; p < 0.01), postoperative atrial fibrillation (AF) (29 vs. 16%; p < 0.01), and inotropic support (58 vs. 31%; p = 0.001) were significantly different. These variables were entered into uni- and multivariate regression analysis. Postoperative AF (OR 1.76, p = 0.007) and EuroSCORE (OR 1.42, p < 0.01) were signifi cant risk factors predicting hospital mortality. Conclusions: Reoperative cardiac surgery can be performed under similar risks as primary operations. Postoperative AF and EuroSCORE are predictors of in-hospital mortality for redo cases.