Tıp Fakültesi / Faculty of Medicine

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

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2016 - 20172

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Author: search.filters.author.Ciftci, OzgurSubject: search.filters.subject.Diastolic function

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    The Influence of On-pump Versus Off-pump Surgery on Short- and Medium-term Postoperative Coronary Flow Reserve After Coronary Artery Bypass Grafting
    (2016) Ozulku, Mehmet; Caliskan, Mustafa; Saba, Tonguc; Aksu, Feyza; Ciftci, Ozgur; Gullu, Hakan; Guven, Aytekin; Kostek, Osman; Caklili, Ozge Telci; Aslamaci, Sait; 0000-0001-7566-5427; 0000-0002-9635-6313; 0000-0002-1901-5603; 27269474; AAT-7733-2020; AAG-8233-2020; AAA-3604-2019; AAJ-8546-2021
    Background Although several clinical trials have compared surgical outcomes between off-pump and on-pump coronary artery bypass grafting (CABG), whether there is a difference in the early- and medium-term postoperative coronary microvascular functions is not fully understood. We compared short- and medium-term coronary microvascular function after off-pump and on-pump CABG. Methods A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery. Each participant's coronary flow reserve (CFR) and diastolic function were measured with transthoracic Doppler echocardiography six and 12 months after surgery. Results Baseline and hyperaemic diastolic peak flow velocity in the left anterior descending artery were similar in both groups, as was CFR (2.22 +/- 0.66) in the off-pump group compared with (2.13 +/- 0.61) in the on-pump group, (P = 0.54). Coronary flow reserve was significantly and inversely correlated with high sensitivity C-reactive protein concentration (r = -0.416; P < 0.001) and positively correlated with mitral E/ A-wave velocity ratio (r = 0.247; P = 0.02). Stepwise linear regression analysis revealed that only high sensitivity C-reactive protein concentration was independently correlated with CFR (beta = -0.272, P = 0.02). Conclusions Heart-lung bypass technique had no medium-term influence on the coronary microcirculation, despite a possible initial unfavourable effect. Serum hs-CRP concentration was an independent predictor of medium-term coronary microvascular dysfunction.
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    The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functions
    (2017) Caldir, Mehmet Vedat; Celik, Guner Koyuncu; Ciftci, Ozgur; Muderrisoglu, Ibrahim Haldun; 27965510
    Objective: The cardiovascular effects of short-term high-dose steroid treatment (pulse steroid treatment) have not yet been clarified. We examined the short-and long-term effects of pulse steroid treatment in demyelinating diseases on endothelial and cardiac functions. Methods: In this prospective study, we included 35 patients (20 females and 15 males; mean age, 32.8 +/- 9.3 years) who were not treated with steroids and who were previously diagnosed with multiple sclerosis or neuromyelitis optica. Patients were evaluated before, 1 week after, and 3 months after the steroid treatment. Brachial artery flow-mediated relaxation and cardiac systolic/diastolic function were evaluated using echocardiography to assess physical examination results, carotid intima-media thickness, and endothelial function. Results: There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intima-media thicknesses in the three evaluation periods. There were significant increases in the body mass index, body weight, and systolic/diastolic blood pressure measurements at 1 week and 3 months after treatment (p<0.001). There was a significant decrease in brachial artery flow-mediated relaxation at 1 week and 3 months (1 versus 2, p=0.042; 1 versus 3, p=0.003). In Doppler measurements at 1 week and 3 months, there was an increase in mitral A velocity, IVRT, and EDT values and a decrease in the E/A ratio in line with diastolic dysfunction. Conclusion: Pulse steroid therapy used for demyelinating diseases deteriorated endothelial and left ventricular diastolic functions in the early and late periods. Future studies are needed to evaluate the development of cardiovascular mortality and morbidity in patients receiving this type of treatment.