Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Bal, Ugur AbbasHas files: No

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    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.
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    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.
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    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.
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    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
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    Which Is Responsible for Cardiac Autonomic Dysfunction in Non-Diabetic Patients with Metabolic Syndrome: Prediabetes or the Syndrome Itself
    (2016) Balcioglu, Akif Serhat; Akinci, Sinan; Cicek, Davran; Eldem, Halil Olcay; Coner, Ali; Bal, Ugur Abbas; Muderrisoglu, Haldun; https://orcid.org/0000-0001-5250-5404; https://orcid.org/0000-0002-5711-8873; https://orcid.org/0000-0002-9446-2518; 26610403; AAD-5564-2021; ABD-7321-2021; AAK-4322-2021
    Aims: Cardiac autonomic dysfunction (CAD) is associated with both prediabetes and metabolic syndrome (MS). Heart rate variability (HRV) and heart rate turbulence (HRT) are reliable 24-h Holter-ECG findings of cardiac autonomic function. This study aimed to investigate the relation between MS and its components and CAD using HRV and HRT. Materials and methods: The study included 80 non-diabetic patients with MS and 70 control subjects. All study population and the patients with MS were further analyzed for each diagnostic component of MS to investigate which criteria impaired HRV and HRT. Results: HRV and HRT parameters were disturbed in patients in the MS group. While impairment in HRV and HRT was significantly related to the presence of the fasting plasma glucose (FPG) criterion, there were no differences between groups in terms of the other 4 MS criteria. Moreover, FPG level was significantly correlated with SDNN (r = -0.352, p < 0.001), SDNN index (r = -0.423, p < 0.001), SDANN (r = -0.301, p < 0.001), RMSSD (r = -0.237, p < 0.001), pNN50 (r = -0.237, p < 0.001), turbulence onset (TO) (r = 0.365, p < 0.001) and turbulence slope (TS) (r = -0.365, p < 0.001). Among the MS diagnostic criteria, only FPG level was an independent determinant of all HRV and HRT parameters. Conclusions: This study confirms the relation between MS and CAD. Increased FPG alone appears to be responsible for the mentioned findings among the 5 diagnostic criteria. Accordingly, CAD may be the result of prediabetes, not MS in patients with MS. (C) 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.