Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Epicardial Adipose Tissue Thickness and Carotid Intima-Media Thickness in Hemodialysis Patients(2017) Aydin, Elcin; Altin, Cihan; Sakalhoglu, Onur; Yilmaz, Mustafa; Gezmis, Esin; Sade, Leyla Elif; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-0907-3647; 0000-0002-1001-6028; 0000-0003-3737-8595; 28559657; AAG-8233-2020; AAI-8276-2021; AAE-8301-2021; AAQ-7583-2021; HGC-1839-2022Background: It is well-known that cardiovascular risk and all-cause mortality is increased in hemodialysis patients. Epicardial fat thickness (EFT), which reflects visceral adiposity, has been suggested as a new cardiometabolic risk factor. The purpose of this study was to investigate EFT in hemodialysis patients. Methods: A total of 144 consecutive patients (60 hemodialysis patients and 84 controls) were enrolled into the study, and patients with diabetes mellitus and cardiovascular diseases (CVD) were excluded. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Results: The groups were similar in terms of sex distribution, age, blood pressure, heart rate and frequencies of CAD risk factors including smoking status, family history of CAD and hypertension. There were no significant differences between the hemodialysis patients and controls in 2D echocardiographic parameters, including ejection fraction and biochemical parameters except low-density lipoprotein, high-density lipoprotein and c-reactive protein. Despite having lower body mass index, EFT levels were significantly higher in hemodialysis patients compared to the controls (8.0 +/- 2.2 mm vs. 5.8 +/- 1.9 mm; p < 0.01). In multivariate linear regression analysis we determined that hemodialysis patient status was found to be an independent predictor for both EFT ((3 = 0. 700, p = 0.014) and carotid intima-media thickness (CIMT, beta = 0. 614, p = 0.047). Conclusions: Hemodialysis patients are independently associated with high EFT and CIMT.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.Item 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-8233-2020AimGestational 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.Item Comparison of MOLLI and ShMOLLI in Terms of T1 Reactivity and the Relationship between T1 Reactivity and Conventional Signs of Response during Adenosine Stress Perfusion CMR(2020) Gezmis, Esin; Peebles, Charles; Flett, Andrew; Abbas, Ausami; Harden, Stephen; Shambrook, James; 0000-0002-1001-6028; 32319279; AAE-8301-2021Background: One of the most important techniques of cardiac magnetic resonance in assessment of coronary heart diseases is adenosine stress myocardial first-pass perfusion imaging. Using this imaging method, there should be an adequate response to the drug adenosine to make an accurate evaluation. The conventional signs of drug response are not always observed and are often subjective. Methods based on splenic perfusion might possess limitations as well. Therethre, T1 mapping presents as a novel, quantitative and reliable method. There are several studies analyzing this newly discovered property of different T1 mapping sequences. However most of these studies are enrolling only one of the techniques. Aims: To compare modified look-locker inversion recovery and shortened modified look-locker inversion recovery sequences in terms of T1 reactivity and to determine the relationship between T1 reactivity and conventional stress adequacy assessment methods in adenosine stress perfusion cardiac magnetic resonance. Study Design: A cross-sectional study using STARD reporting guideline. Methods: Thirty-tbur consecutive patients, who were referred for adenosine stress perfusion cardiac magnetic resonance with suspect of myocardial ischemia, were prospectively enrolled into the study. Four patients were disqualified, and thirty patients were included in the final analysis. Using both modified look-locker inversion recovery and shortened modified look-locker inversion recovery, midventricular short axis slices of T1 maps were acquired at rest and dining peak adenosine stress before gadolinium administration. Then, they were divided into six segments according to the 17-segment model proposed by the American Heart Association, and separate measurements were made from each segment. Mean rest and mean stress T1 values of remote, ischemic, and infarcted myocardium were calculated individually per subject. During adenosine administration. patients' heart rates and blood pressures are measured and recorded every one minute. Adenosine stress perfusion images were examined for the presence of splenic switch-off. Results: There was a significant difference between rest and stress T1 values of remote myocardium in both modified look-locker inversion recovery and shortened modified look-locker inversion recovery (p<0.001). In both modified look-locker inversion recovery and shortened modified look-locker inversion recovery there was no significant correlation between T1 reactivity and heart rates response (modified look-locker inversion recovery p=0.30, shortened modified look-locker inversion recovery p=0.10), blood pressures response (modified look-locker inversion recovery p=0.062, shortened modified look-locker inversion recovery p=0.078), splenic perfusion (modified look-locker inversion recovery p=0.35, shortened modified look-locker inversion recovery p=0.053). There was no statistically significant difference between modified look-locker inversion recovery and shortened modified look-locker inversion recovery regarding Ti reactivity of remote (p=0.330), ischemic (p=0.068), and infarcted (p=0.116) myocardium. Conclusion: T1 reactivity is independent of the other stress response signs and modified look-locker inversion recovery and shortened modified look-locker inversion recovery do not differ in terms of T1 reactivity.Item Assessment of Carotid Artery Distensibility and Elasticity After Laparoscopic Sleeve Gastrectomy: a Prospective Study(2020) Gunesli, Aylin; Yilmaz, Mustafa; Altin, Cihan; Gezmis, Esin; Yabanoglu, Hakan; Erol, Varlik; 0000-0002-2557-9579; 0000-0002-8337-6905; 0000-0002-1161-3369; 0000-0002-1001-6028; 0000-0003-0268-8999; 32813160; S-6973-2016; AAK-3065-2021; AAJ-7865-2021; AAE-8301-2021; AAK-2011-2021Purpose Although it is well known that obesity increases the risk of atherosclerosis in carotid arteries, it is not clear whether this risk changes after obesity surgery. The aim of this study was to investigate whether weight reduction with a laparoscopic sleeve gastrectomy (LSG) has any effect on distensibility and elasticity which show subclinical atherosclerosis in the carotid arteries of obese individuals. Materials and Methods This prospective study included 130 patients (body mass index (BMI) 48.21 +/- 6.97 kg/m(2)) who underwent LSG. The patients were followed up for 1 year. Comparisons were made of the distensibiliy and elasticity values calculated preoperatively and at 1, 3, 6, and 12 months, postoperatively. Results There was a statistically significant increase in distensibility and elasticity values from baseline to 1, 3, 6, and 12 months postoperatively (p < 0.001 for both comparisons). The multiple linear regression analysis was used to find the variables affecting both distensibility and elasticity. According to the results, the presence of BMI decreases distensibility percentage change level by 0.38 units (beta= - 0.38, 95% CI - 0.51;- 0.25,p < 0.001). The presence of fasting plasma glucose decreases elasticity percentage change level by 0.20 units. (beta= - 0.20, 95% CI - 0.39; - 0.01,p = 0.037). Conclusion Carotid artery distensibility and elasticity values increase after LSG, and this change could be caused by the change in metabolic parameters and heart geometry. These results may indirectly suggest that subclinical atherosclerosis in carotid arteries has decreased after obesity surgery.Item Blood pressure limits affecting carotid artery injury: a cross sectional study(2020) Guenesli, Aylin; Acibuca, Aynur; Altin, Cihan; Gezmis, Esin; Tekindal, Mustafa Agah; Yalcin, Cigdem; Alkan, Ozlem; 0000-0002-3444-8845; 0000-0001-7526-3460; 0000-0002-1001-6028; 0000-0001-5483-8253; AAE-8301-2021; ABG-4047-2020; AAM-4169-2021; AAM-4284-2021Purpose: Although it is well known that high blood pressure causes undesirable effects on carotid arteries, it is not clear as to which threshold value this effect starts. The aim of this study is to evaluate and determine this threshold. Materials and Methods: This cross-sectional study included a total of 308 individuals in the following groups; group 1: individuals with systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <80 mmHg (optimal), group 2: SBP 120-129 mmHg and/or DBP 80-84 mmHg (normal), group 3: SBP 130-139 mmHg and/or DBP 85-89 mmHg (high-normal), group 4: SBP 140-159 mmHg and/or DBP 90-99 mmHg, group 5: SBP 160-179 mmHg and/or DBP 100-109 mmHg, and group 6: SBP >= 180 mmHg and/or DBP >= 110 mmHg. Carotid distensibility and elasticity were measured in all groups. Results: A statistically significant difference was determined between the groups in carotid distensibility and elasticity. SBP>135.5 mmHg started to affect carotid distensibility with 78.2% sensitivity and 74.6% specificity, and DBP>86.5 mmHg with 79.3% sensitivity and 71.6% specificity. Carotid elasticity was seen to be affected by SBP>137.5 mmHg with 80.4% sensitivity and 73.1% specificity, and DBP>88.5 mmHg with 79.1% sensitivity and 73.8% specificity. Conclusion: Carotid distensibility and elasticity decreases with increasing blood pressure. Individuals in high-normal group should be evaluated in terms of carotid disease, and it may be necessary to start treatment early in these patients.Item A rare cause of circulatory shock(2014) Altin, Cihan; İzmir, Arzu; Osmanoglu, Sevda; Gezmis, Esin; Sagduyu, Afsin; 25233504Item A clinical dilemma about a new oral anticoagulant treatment(2014) Altin, Cihan; Ozturkeri, Ovgu Anil; Gezmis, Esin; Muderrisoglu, Haldun; 25341482Item A novel oral anticoagulant, dabigatran, in acute renal infarction(2015) Altin, Cihan; Sakallioglu, Onur; Gezmis, Esin; Muderrisoglu, Haldun; 25625445