Browsing by Author "Gulmez, Oyku"

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Aortic flow propagation velocity, epicardial fat thickness, and osteoprotegerin level to predict subclinical atherosclerosis in patients with nonalcoholic fatty liver disease
(2016) Gulmez, Oyku; Oguz, Didem; Unal, Hakan Umit; Eroglu, Hacer; Cevik, Halime; Altun, Armagan; 0000-0002-9429-5430; 0000-0002-3233-8263; 27025201; ABC-7134-2021; ABB-5844-2020
Objective: Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in Western countries and an independent risk factor for atherosclerotic heart disease. Appropriate noninvasive parameters are lacking for optimal risk stratification of cardiovascular disease in these patients. We evaluated several recently discovered noninvasive parameters for atherosclerosis in patients with nonalcoholic fatty liver disease: epicardial fat thickness, aortic flow propagation velocity, and osteoprotegerin level. Methods: Forty-one patients (27 men and 14 women; mean age, 37.9 +/- 8.9 years) with nonalcoholic fatty liver disease and 37 control subjects (17 men and 20 women; mean age, 34.5 +/- 8.6 years) were enrolled in this observational case-control study. Patients with nonalcoholic fatty liver disease diagnosed at a gastroenterology outpatient clinic were included. Patients with cardiac pathology other than hypertension were excluded. Epicardial fat thickness and aortic flow propagation velocity were measured by echocardiography. The serum concentration of osteoprotegerin was measured using a commercial enzyme-linked immunosorbent assay kit. Results: Nonalcoholic fatty liver disease patients exhibited a significantly lower aortic flow propagation velocity (155.17 +/- 30.00 vs. 179.00 +/- 18.14 cm/s, p=0.000) and significantly higher epicardial fat thickness (0.51 +/- 0.25 vs. 0.29 +/- 0.09 cm, p=0.000) than control subjects. Osteoprotegerin levels were higher, but not significant, in patients with nonalcoholic fatty liver disease (28.0 +/- 13.0 vs. 25.2 +/- 10.8 pg/mL, p=0.244). Binary logistic regression analysis showed that aortic flow propagation velocity (OR, -0.973; 95% CI, 0.947-0.999) and waist circumference (OR, -1.191; 95% CI, 1.088-1.303) were independent predictors of nonalcoholic fatty liver disease. C Conclusion: In this study, epicardial fat thickness and osteoprotegerin level were higher and aortic flow propagation velocity was lower in patients with nonalcoholic fatty liver disease. Early detection of abnormal epicardial fat thickness and aortic flow propagation velocity may warrant a search for undetected cardiovascular disease in patients with nonalcoholic fatty liver disease.
Aortic Root Dissection After Coronary Artery Bypass Operation
(2017) Altay, Hakan; Gulmez, Oyku; Ozker, Emre; 0000-0002-9429-5430; AAE-1392-2021; ABC-7134-2021
Approach to cardiovascular disease in women
(2018) Gulmez, Oyku; Acar, Rezzan Deniz; Aktoz, Meryem; Atamer, Oya; Aytekin, Saide; Polat, Evin Bozcali; Celik, Hulya Gamze; Celik, Omer; Elcioglu, Betul Cengiz; Dincer, İrem; Gazi, Emine; Kayikcioglu, Meral; Keser, Nurgul; Ozer, Necla; Yasar, Ayse Saatci; Sahinarslan, Asife; Kurklu, Turkan Seda Tan; Tokgozoglu, Lale; Yamac, Aylin Hatice; Yildirimturk, Ozlem; Yilmaz, Dilek Cicek; Yilmaz, Neslihan
Cardiovascular disease (CVD) in women is still not completely understood by either patients or physicians. It is perceived as a health problem that becomes manifest only after menopause; however, it is the most frequent cause of mortality in women and is often seen at an earlier age in the presence of risk factors. Moreover, the symptoms, course, and prognosis are quite different from those seen in men, and both physicians and patients remain inadequately aware of the character of the disease. In the approach to female patients, some risk factors inherent to women should be considered in addition to the classic factors. In this review article, aspects of CVD that are different in women, etiological factors, risk factors specific to women, and particular points to be taken into consideration in the treatment and diagnosis are illustrated in the form of questions and responses from experts.
Complicated left-sided infective endocarditis in chronic hemodialysis patients: a case report
(2017) Gulmez, Oyku; Aydin, Mehtap; 0000-0002-9429-5430; 28106022; ABC-7134-2021; AAE-6201-2021
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level. Blood cultures revealed growth of S. aureus. Good quality transthoracic echocardiography (TTE) displayed calcified mitral and aortic valves with no vegetation or abscess formation. Myocardial necrosis as result of catheter infection was considered. Both patients had persistent positive blood cultures 3 and 5 days after initiation of antibiotic treatment. Therefore, transesophageal echocardiogram (TEE) was scheduled. Results revealed perivalvular abscess in the older patient, and highly mobile vegetation in the younger patient. The older patient refused surgery and died soon after due to refractory shock. Mitral valve surgery was planned for the other patient; however, she developed left ventricular failure and bleeding, and also subsequently died as result of refractory shock. Patient evaluations were particularly unfavorable: they had catheter infection as primary focus, and TTE did not detect vegetation or annular abscess. Diagnosis of IE in patients with ESRD using Duke criteria is problematic; we have to keep use of TEE in mind to detect vegetation or abscess formation when there is clinical suspicion regarding ESRD patients even after good quality TTE.
Early Changes in Atrial Electromechanical Coupling in Patients with Hypertension: Assessment by Tissue Doppler Imaging
(2016) Avci, Burcak Kilickiran; Gulmez, Oyku; Donmez, Guclu; Pehlivanoglu, Seckin; 27231168
Background: Hypertension (HT) is associated with atrial electrophysiological abnormalities. Echocardiographic pulsed wave tissue Doppler imaging (TDI) is one of the noninvasive methods for evaluation of atrial electromechanical properties. The aims of our study were to investigate the early changes in atrial electromechanical conduction in patients with HT and to assess the parameters that affect atrial electromechanical conduction. Methods: Seventy-six patients with HT (41 males, mean age 52.6 +/- 9.0 years) and 41 controls (22 males, mean age 49.8 +/- 7.9 years) were included in the study. Atrial electromechanical coupling at the right (PRA), left (PLA), interatrial septum (PIS) were measured with TDI. Intra- (right: PIS-PRA, left: PLA-PIS) and inter-atrial (PLA-PRA) electromechanical delays were calculated. Maximum P-wave duration (Pmax) was calculated from 12-lead electrocardiogram. Results: Atrial electromechanical coupling at PLA (76.6 +/- 14.1 ms vs. 82.9 +/- 15.8 ms, P = 0.036), left intra-atrial (10.9 +/- 5.0 ms vs. 14.0 +/- 9.7 ms, P = 0.023), right intra-atrial (10.6 +/- 7.8 ms vs. 14.5 +/- 10.1 ms, P = 0.035), and interatrial electromechanical (21.4 +/- 9.8 ms vs. 28.3 +/- 12.7 ms, P = 0.003) delays were significantly longer in patients with HT. The linear regression analysis showed that left ventricular (LV) mass index and Pmax were significantly associated with PLA (P = 0.001 and P = 0.002, respectively), and the LV mass index was the only related factor for interatrial delay (P = 0.001). Conclusions: Intra- and interatrial electromechanical delay, PLA were significantly prolonged in hypertensive patients. LV mass index and Pmax were significantly associated with PLA, and the LV mass index was the only related factor for interatrial delay. The atrial TDI can be a valuable method to assess the early changes of atrial electromechanical conduction properties in those patients.
The Role of Osteoprotegerin as a Cardioprotective Versus Reactive Inflammatory Marker: the Chicken or the Egg Paradox
(2018) Ozkalayci, Flora; Gulmez, Oyku; Ugur-Altun, Betul; Pandi-Pemural, Seithikurippu Ratnas; Altun A, Armagan
Cardiovascular disease is one of the most frequent causes of mortality and morbidity worldwide. Several variables have been identified as risk factors for cardiovascular disease. Recently, the role of receptor activator of nuclear factor kappa B, receptor activator of nuclear factor kappa B ligand, and the osteoprotegerin system has been recognized as more important in the pathogenesis of cardiovascular disease. Besides their roles in the regulation of bone resorption, these molecules have been reported to be associated with the pathophysiology of cardiovascular disease. There are conflicting data regarding the impact of osteoprotegerin, a glycoprotein with a regulatory role in the cardiovascular system. The aim of this review is to discuss the current knowledge and the role of osteoprotegerin in cardiovascular disease.