Browsing by Author "Muderrisoglu, Haldun"

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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
Adequacy of Infective Endocarditis Prophylaxis Before Dental Procedures among Solid Organ Transplant Recipients
(2019) Karacaglar, Emir; Akgun, Arzu; Ciftci, Orcun; Altiparmak, Nur; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-9635-6313; 31464231; AAG-8233-2020
Infective endocarditis (IE) is a life-threatening condition with high morbidity and mortality. The current IE guidelines recommend antibiotic prophylaxis only in patients with certain cardiac conditions and before certain dental procedures. However, there is not enough data about solid organ transplant (SOT) recipients. In this study, we aimed to investigate the IE prophylaxis in general dental and periodontal surgical procedures among our SOT recipients. Medical records of 191 SOT recipients (32 liver transplant recipients, 54 heart transplant recipients, and 105 kidney transplant recipients) who were admitted to our hospital between January 2016 and January 2018 were evaluated. A total of 65 patients who underwent dental procedures were included in the study. We investigated the adequacy of IE prophylaxis according to the current guidelines. Two groups were created according to whether they received antibiotic prophylaxis or not. The mean age was 44.2 +/- 13.6 years, and 66.1% were male. The majority of patients (67.6%) received antibiotic prophylaxis. The most commonly used antibiotic was amoxicillin (48.8%). Among the procedures, 23.1% were classified as invasive and 76.9% were classified as noninvasive. No complication was observed after invasive and noninvasive dental procedures. There were no complications in both antibiotic prophylaxis and no-prophylaxis groups. According to our results, IE prophylaxis has been used appropriately in SOT recipients in our center. No serious infection has been reported. In addition, no complication due to antibiotic use was also observed.
Adherence to Mediterranean Diet and Its Relation with Cardiovascular Diseases in Turkish Population
(2015) Hoscan, Yesim; Yigit, Fatma; Muderrisoglu, Haldun; 0000-0003-1541-6167; 0000-0002-9635-6313; 25932246; ABC-8170-2021; AAG-8233-2020
Mediterranean diet (MD) is considered a model for healthy eating. However, prospective evidence in Turkey evaluating the relationship between MD and cardiovascular events is scarce. We surveyed the adherence of Alanya population to MD and its association with coronary heart diseases (CHD). The study population consisted of participants in Alanya, a region placed southern Turkey. Followed-up 900 participants (52 percent women) initially free of CHD during 5.1 years. The general dietary habits of study population were detected with a food frequency questionnaire. Data obtained from that questionnaire were tested with Mediterranean diet score in order to find out the relevance to Mediterranean diet. A MD score (scale 0-8) was computed reflecting high ratio of monounsaturated to saturated fat; high intake of legumes, cereals, vegetables, and fruits; low intakes of meat and it's products, milk and dairy products. Scoring <5 was defined as Low-MD consuming, while 5+ as High-MD consuming. We observed 25 incident cases of CHD. Consumption of High-MD was 21% in men and 19% in women. The risk for myocardial infarction, coronary bypass, coronary angioplasty, and any cardiovascular disease in men increased by 1.3 (P = 0.02), 1.4 (P = 0.03), 1.5 (P = 0.01), and 1.3 (P = 0.02), respectively, for each MD score decrease. In women, the risk for myocardial infarction and angioplasty increased by 1.3 (P = 0.02) and 1.5 (P = 0.01), respectively, for each MD score decrease. The risk for coronary bypass, and any cardiovascular disease in women, crude odds ratios ranged from 1.1 to 1.3 but were not statistically significant. The current rate of MD in Alanya is fairly low. There is an inverse association between adherence to MD and the incidence of fatal and non-fatal CHD in initially healthy adults.
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.
Approach To Optimal Assessment Of Right Ventricular Remodelling In Heart Transplant Recipients: Insights From Myocardial Work Index, T1 Mapping, And Endomyocardial Biopsy
(2023) Colak, Ayse; Duzgun, Selin Ardali; Hazirolan, Tuncay; Sezgin, Atilla; Donal, Erwan; Butcher, Steele C.; Ozdemir, Handan; Pirat, Bahar; Eroglu, Serpil; Muderrisoglu, Haldun; Sade, Leyla Elif; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0003-3737-8595; 35666833; X-8540-2019; AAQ-7583-2021
Aims Right ventricular (RV) dysfunction is an important cause of graft failure after heart transplantation (HTx). We sought to investigate relative merits of echocardiographic tools and cardiac magnetic resonance (CMR) with T1 mapping for the assessment of functional adaptation and remodelling of the RV in HTx recipients. Methods and results Sixty-one complete data set of echocardiography, CMR, right heart catheterization, and biopsy were obtained. Myocardial work index (MWI) was quantified by integrating longitudinal strain (LS) with invasively measured pulmonary artery pressure. CMR derived RV volumes, T1 time, and extracellular volume (ECV) were quantified. Endomyocardial biopsy findings were used as the reference standard for myocardial microstructural changes. In HTx recipients who never had a previous allograft rejection, longitudinal function parameters were lower than healthy organ donors, while ejection fraction (EF) (52.0 +/- 8.7%) and MWI (403.2 +/- 77.2 mmHg%) were preserved. Rejection was characterized by significantly reduced LS, MWI, longer T1 time, and increased ECV that improved after recovery, whereas RV volumes and EF did not change MWI was the strongest determinant of rejection related myocardial damage (area under curve: 0.812, P < 0.0001, 95% CI: 0.69-0.94) with good specificity (77%), albeit modest sensitivity. In contrast, T1 time and ECV were sensitive (84%, both) but not specific to detect subclinical RV damage. Conclusion Subclinical adaptive RV remodelling is characterized by preserved RV EF despite longitudinal function abnormalities, except for MWI. While ultrastructural damage is reflected by MWI, ECV, and T1 time, only MWI has the capability to discriminate functional adaptation from transition to subclinical structural damage.
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.
Assesment of Spatial QRS-T Angle in Patients with Cardiac Syndrome X
(2019) Muderrisoglu, Mustafa; Muderrisoglu, Haldun; 0000-0002-9635-6313; AAG-8233-2020
Objective: Cardiac syndrome x (CSX) is defined as typical exertional angina, one or more abnormal cardiac stress test(s), and normal coronary arteries after exclusion of spontaneous or inducible epicardial coronary spasm. The aim of this study was to investigate cardiovascular adverse events risks in patients with CSX. For this purpose, spatial QRS-T angle that is predictor of these risks was evaluated in patients with CSX and control subjects. Methods: In a retrospective study, a total of 179 subjects (95 patients with CSX, 84 control) were examined. Control subjects had a normal coronary computed tomography. Spatial QRS-T angle value was calculated and compared in patients with CSX and control group, p values <0.05 were considered as statistically significant. Results: There was a statistically significant difference between the groups in terms of spatial QRS-T angle values [control group spatial QRS-T angle value median 35 (12.5 - 60), CSX group spatial QRS-T angle value median 51 (27 - 115), p<0.001]. Conclusion: According to our results, spatial QRS-T angle value was elevated in patients with CSX than in normal population. Furthermore, these results may indirectly suggest that the risk of adverse cardiac events may be increased in patients with CSX.
Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion
(2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Erol, Tansel; Arer, Ilker; Nursal, Tarik Zafer; Torer, Nurkan; Erol, Varlik; Muderrisoglu, Haldun; 0000-0002-3628-4661; 0000-0002-5658-870X; 0000-0002-2557-9579; 0000-0002-9635-6313; 28900850; AAN-5153-2021; ABD-7304-2021; IQV-1169-2023; S-6973-2016; AAG-8233-2020
The association of obesity with atrial fibrillation (AF) and with ventricular arrhythmias is well documented. The aim of this study was to investigate whether weight reduction by a laparoscopic sleeve gastrectomy has any effect on P wave dispersion (PWD), a predictor of AF, and corrected QT interval dispersion (CQTD), a marker of ventricular arrhythmias, in obese individuals. In a prospective study, a total of 114 patients (79 females, 35 males) who underwent laparoscopic sleeve gastrectomy were examined. The patients were followed 1 year. PWD and CQTD values before and 3rd, 6th, and 12th months after the surgery were calculated and compared. There was a statistically significant decline in body mass index (BMI), PWD, and CQTD values among baseline, 3rd, 6th, and 12th months (p < 0.001 for all comparisons). Correlation analysis showed a statistically significant correlation between Delta PWD and Delta BMI (r = 0.719, p < 0.001), Delta PWD and Delta left ventricular end-diastolic diameter (LVEDD) (r = 0.291, p = 0.002), Delta PWD and Delta left atrial diameter (LAD) (r = 0.65, p < 0.001), Delta CQTD and Delta BMI (r = 0.266, p = 0.004), Delta CQTD and Delta LVEDD (r = 0.35, p < 0.001), Delta CQTD and Delta LAD (r = 0.289, p = 0.002). In multiple linear regression analysis, there was a statistically significant relationship between Delta PWD and Delta BMI (beta = 0.713, p < 0.001), Delta PWD and Delta LVEDD (beta = 0.174, p = 0.016), Delta PWD and Delta LAD (beta = 0.619, p < 0.001), Delta CQTD and Delta BMI (beta = 0.247, p = 0.011), Delta CQTD and Delta LVEDD (beta = 0.304, p < 0.001), Delta CQTD and Delta LAD (beta = 0.235, p = 0.009). PWD and CQTD values of patients were shown to be attenuated after bariatric surgery. These results indirectly offer that there may be a reduction in risk of AF, ventricular arrhythmia, and sudden cardiac death after obesity surgery.
Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Transplantation in Patients with End Stage Renal Disease by P Wave/QT Interval Dispersion, Tp-e Interval, Tp-e/QT Interval Ratio
(2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Arer, Ilker; Yabanoglu, Hakan; Caliskan, Kenan; Moray, Gokhan; Ozin, Bulent; Muderrisoglu, Haldun; Haberal, Mehmet; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-8767-5021; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0003-3821-412X; https://orcid.org/0000-0002-9635-6313; https://orcid.org/0000-0002-3462-7632; S-6973-2016; ABD-7304-2021; AAJ-7865-2021; AAJ-7201-2021; AAE-1041-2021; AAD-9938-2021; AAG-8233-2020; AAJ-8097-2021
Assessment of Epicardial Fat and Carotid Intima Media Thickness in Gestational Hypertension
(2018) Altin, Cihan; Yilmaz, Mustafa; Ozsoy, Hasmet M.; Gezmis, Esin; Balci, Serdar; Tekindal, Mustafa A.; Sade, Leyla E.; Muderrisoglu, Haldun; 0000-0002-3996-5681; 0000-0002-2557-9579; 0000-0002-1001-6028; 0000-0002-1782-7325; 0000-0002-4060-7048; 0000-0003-3737-8595; 0000-0002-9635-6313; 29603491; S-6973-2016; AAE-8301-2021; AAJ-1097-2021; U-9270-2018; AAQ-7583-2021; AAG-8233-2020
AimGestational hypertension (GHT) is a common disorder of pregnancy characterized by new onset hypertension without the presence of detectable proteinuria after 20 weeks of gestation. Epicardial fat thickness (EFT) and carotid intima media thickness (CIMT) are suggested as new predictors of subclinical atherosclerosis. Although the relationship between these parameters and essential hypertension has been demonstrated, this association in patients with GHT is still unknown. We aimed to investigate CIMT and EFT in patients with GHT. MethodsA total of 90 patients (44 GHT and 46 controls) were enrolled. Patients with diabetes mellitus, chronic hypertension and cardiovascular disease (CVD) were excluded. In the third trimester, the mean CIMT at the far wall of both left and right common carotid arteries was measured on B-mode duplex ultrasound. EFT was measured on the free wall of the right ventricle at the end systole in the parasternal long-axis view by standard transthorasic 2D echocardiography. ResultsUnlike the mean CIMT (0.52 0.13 mm vs 0.47 +/- 0.11 mm; P = 0.078), the mean EFT was significantly higher in the GHT group compared to the controls (5.31 +/- 1.68 mm vs 4.17 +/- 1.16 mm; P = 0.002). In multivariate logistic regression analysis, among the most pertinent clinical variables, only EFT is an independent determinant of GHT (OR: 2.903; 95% confidence interval [CI]: 1.454-5.796; P = 0.003). In receiver operating characteristic (ROC) analysis, EFT >5.5 mm had 82.6% specificity and 52.3% sensitivity in predicting a diagnosis of GHT (ROC area under curve: 0.689, 95% CI: 0.577-0.802, P = 0.002). ConclusionMaternal EFT may be higher in pregnant women with GHT in comparison with those of controls.
Assessment of Myocardial Mechanics in Patients with End-Stage Renal Disease and Renal Transplant Recipients Using Speckle Tracking Echocardiography
(2015) Pirat, Bahar; Bozbas, Huseyin; Simsek, Vahide; Sade, L. Elif; Sayin, Burak; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-9635-6313; 0000-0003-4576-8630; 0000-0003-3737-8595; 0000-0002-3462-7632; 0000-0001-8287-6572; 25894162; AAG-8233-2020; AAI-8897-2021; AAQ-7583-2021; AAJ-8097-2021; J-3707-2015
Objectives: Velocity vector imaging allows quantitation of myocardial strain and strain rate from 2-dimensional images based on speckle tracking echocardiography. The aim of this study was to analyze the changes in myocardial strain and strain rate patterns in patients with end-stage renal disease and renal transplant recipients. Materials and Methods: We studied 33 patients with end-stage renal disease on hemodialysis (19 men; mean age, 36 +/- 8 y), 24 renal transplant recipients with functional grafts (21 men; mean age, 36 +/- 7 y) and 26 age- and sex-matched control subjects. Longitudinal peak systolic strain and strain rate for basal, mid, and apical segments of the left ventricular wall were determined by velocity vector imaging from apical 4- and 2-chamber views. The average longitudinal strain and strain rate for the left ventricle were noted. From short-axis views at the level of papillary muscles, average circumferential, and radial strain, and strain rate were assessed. Results: Mean heart rate and systolic and diastolic blood pressure during imaging were similar between the groups. Longitudinal peak systolic strain and strain rate at basal and mid-segments of the lateral wall were significantly higher in renal transplant recipients and control groups than end-stage renal disease patients. Average longitudinal systolic strain from the 4-chamber view was highest in control subjects (-14.5% +/- 2.9%) and was higher in renal transplant recipients (-12.5% +/- 3.0%) than end-stage renal disease patients (-10.2% +/- 1.6%; P <= .001). Radial and circumferential strain and strain rate at the level of the papillary muscle were lower in patients with end-stage renal disease than other groups. Conclusions: Differences in myocardial function in patients with end-stage renal disease, renal transplant recipients, and normal controls can be quantified by strain imaging. Myocardial function is improved in renal transplant recipients compared with end-stage renal disease patients.
Assessment Of P Wave/Qt Interval Dispersion, Tp-E Interval, Tp-E/Qt Ratio After Transcatheter Aortic Valve Implantation In Geriatric Patients With Aortic Stenosis
(2018) Yilmaz, Mustafa; Gullu, Hakan; Demircan, Senol; Sezgin, Alpay Turan; Bilgel, Ziya Gokalp; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0002-9635-6313; S-6973-2016; AAG-8233-2020
Introduction: One of the most important reasons for a high mortality and morbidity rate in geriatric patients with calcific aortic stenosis is arrhythmias. Transcatheter aortic valve implantation is an alternative to conventional aortic valve surgery for high-risk patients because of its less-invasive nature. Although hemodynamic and functional recoveries are established after transcatheter aortic valve implantation, whether it leads to a decrease in the risk of atrial fibrillation, ventricular arrhythmia and sudden cardiac death remains unclear. Thus, this study aimed to evaluate the risks associated with aortic stenosis by assessing the rates of P wave dispersion for estimating the atrial fibrillation risk and QT interval dispersion, Tp-e interval, and Tp-e/QT ratio for ventricular arrhythmia and assessing sudden cardiac death risk before and after implantation. Materials and Method: In a retrospective study, a total of 39 subjects [14 males (35.89%) and 25 females (64.11%); mean age=81.51 +/- 8.79 years] were enrolled. P wave/QT interval dispersion, Tp-e interval and Tp-e/QT ratio values before and 3rd months after implantation were calculated and compared. Results: There was a statistically significant decline in P wave/QT interval dispersion, Tp-e interval, Tp-e/QT ratio values between preoperative, and 3rd, months (43.72 +/- 7.78 vs. 35.15 +/- 8.92, 61.64 +/- 17.36 vs. 49.41 +/- 12.64, 84.59 +/- 7.64 vs. 73.21 +/- 6.46, 0.21 +/- 0.01 vs. 0.18 +/- 0.01, respectively, p<0.001 for all comparisons). Conclusion: P wave/QT interval dispersion, Tp-e interval and Tp-e/QT ratio were shown to be attenuated after transcatheter aortic valve implantation. These results indirectly offer that there may be a reduction in risk of atrial fibrillation, ventricular arrhythmias and sudden cardiac death.
Assessment of Subclinical Atherosclerosis by Carotid Intima-Media Thickness and Epicardial Adipose Tissue Thickness in Prediabetes
(2016) Altin, Cihan; Sade, Leyla Elif; Gezmis, Esin; Ozen, Necmi; Duzceker, Ozkan; Bozbas, Huseyin; Eroglu, Serpil; Muderrisoglu, Haldun; 0000-0002-1001-6028; 0000-0003-3737-8595; 0000-0002-9635-6313; 0000-0003-3055-7953; 27069111; AAE-8301-2021; AAQ-7583-2021; ABG-1582-2021; AAG-8233-2020
Impaired fasting glucose (IFG) and impaired glucose intolerance (IGT) are predictors of cardiovascular disease (CVD). We tested the hypothesis that epicardial fat thickness (EFT) and carotid intima-media thickness (cIMT), as markers of early atherosclerosis, are increased in patients with prediabetes. We prospectively enrolled 246 patients (162 with prediabetes and 84 controls). Prediabetes was defined according to American Diabetes Association criteria, and patients were divided into 3 groups: group 1IFG, group 2IGT, and group 3IFG + IGT. Both cIMT and EFT were significantly greater in patients with prediabetes compared with controls (0.81 +/- 0.20 mm vs 0.68 +/- 0.16 mm, P < .001 and 7.0 +/- 2.0 mm vs 5.6 +/- 1.6 mm, P < .001, respectively). This difference was mainly attributed to patients with IGT. Age, waist circumference, and 2-hour glucose independently predicted cIMT, while 2-hour glucose was the only independent predictor of EFT in multivariate analysis among other relevant parameters for cIMT and EFT. The cIMT and EFT (measured noninvasively) could be useful indicators of CVD risk in these patients. In order to prove this hypothesis, long-term prospective studies with greater patient numbers are required.
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 Coronary Flow Reserve and Exercise Capacity
(2015) Eroglu, Serpil; Sade, Leyla Elif; Polat, Ezgi; Bozbas, Huseyin; Muderrisoglu, Haldun; 0000-0003-3737-8595; 0000-0002-9635-6313; 0000-0003-3055-7953; 26021241; AAQ-7583-2021; AAG-8233-2020; ABG-1582-2021
Introduction: Reduced exercise capacity is of clinical importance. Sometimes no corresponding cardiovascular disease can be found to explain this condition. We hypothesized that coronary microvascular dysfunction may have an effect on exercise capacity in patients without apparent cardiovascular disease. Methods: Fifty patients (33 female, mean age 46.8 +/- 12.4 years) without coronary artery or other cardiac disease were enrolled. Coronary microvascular function was evaluated by measurement of coronary flow reserve (CFR) during transthoracic pulsed-wave Doppler echocardiography with pharmacological stress. CFR was calculated as the ratio of hyperemic to baseline peak diastolic velocities after dipyridamole infusion. Exercise capacity was determined by treadmill exercise testing. Exercise time, metabolic equivalent (MET), and Duke treadmill score (DTS) were recorded and compared with the CFR data. Results: CFR was correlated with exercise time (r=0.376, p=0.007), MET (r=0.435, p=0.002) and DTS (r=0.458, p=0.001). Exercise time, MET, and DTS were lower in patients with impaired CFR (<2) than in those with normal CFR (2) (5.3 +/- 1.8 min vs. 8.6 +/- 2.7 min, p<0.001; 7.3 +/- 3.1 vs. 11.4 +/- 2.8, p=0.002; -1.75 (-5.9, 5.0) vs. 7.5 (5.2, 9.41), p<0.001; respectively). CFR was lower in patients with MET <= 7 as compared to patients with MET>7 (2.0 +/- 0.5 vs. 2.6 +/- 0.6, p=0.015). Conclusions: CFR is associated with exercise capacity. Thus coronary microvascular dysfunction may be a reason for reduced exercise capacity in patients who have no apparent cardiovascular disease.
THE CHANGE OF FRONTAL QRS-T ANGLE AFTER RENAL TRANSPLANTATION IN DIALYSIS PATIENTS
(2020) Acibuca, Aynur; Yilmaz, Mustafa; Okar, Sefa; Kus, Murat; Caliskan, Kenan; Torer, Nihan; Torun, Dilek; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet A.
Chronic Aortic Dissection and Recoarctation As A Late Complication of Aortic Coarctation Surgery
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