Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-3707-2015Objectives: 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.Item 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-1582-2021Introduction: 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.Item 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-8233-2020Impaired 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.