Tıp Fakültesi / Faculty of Medicine

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    Does Brucellosis Cause Arterial Stiffness and Ventricular Remodelling Through Inflammation?
    (2015) Togan, Turhan; Ciftci, Ozgur; Gunday, Murat; Narci, Huseyin; Arslan, Hande; 0000-0002-6636-9391; 0000-0002-5708-7915; 0000-0002-6463-6070; 26148379; L-7182-2015; ABG-7034-2021; A-7318-2017
    Background Like other acute and chronic infections, Brucella infection leads to endothelial dysfunction. Furthermore, it has been suggested that the chronic inflammatory state present in chronic infectious diseases leads to an acceleration in atherosclerosis. For the prediction of CAD, it is possible to use epicardial fat thickness (EFT) as an adjunctive marker beside the classical risk factors, as it is easily and non-invasively evaluated by transthoracic echocardiography. The purpose of this study was to investigate the presence of impaired myocardial performance as well as of increased arterial stiffness and EFT in patients who had been infected with brucellosis in the past. Methods Included in the study were twenty-seven brucellosis patients and twenty-six healthy volunteers. Using EFT and transthoracic echocardiography, which included Doppler echocardiography in combination with tissue Doppler imaging (TDI), all the patients were examined to measure their aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values. Results A statistically significant increase was observed in hs-CRP, aortic stiffness index, aortic elastic modulus and EFT in brucellosis patients when compared with the controls (2.46 +/- 1.40 vs 1.71 +/- 0.61, P=0.016; 9.69 +/- 6.99 vs 2.14 +/- 0.72, P < 0.001; 11.17 +/- 8.60 vs 2.18 +/- 0.90, P < 0.001; 0.76 +/- 0.08 vs 0.63 +/- 0.10, P < 0.001). On the other hand, there was a significant decrease in aortic strain and aortic distensibility (7.41 +/- 6.82 vs 18.26 +/- 5.83, P < 0.001; 1.83 +/- 1.71 vs 5.22 +/- 1.72, P < 0.001, respectively). No difference was observed between the two groups with respect to the left ventricular myocardial performance index (MPI) (0.62 +/- 0.15 vs 0.61 +/- 0.13, P=0.859). Conclusions In this study, we demonstrated for the first time in the literature that there was impaired aortic elasticity and increased EFT in patients with brucellosis, while the myocardial performance index remained unaffected. We also determined that these effects had a significant correlation with inflammation.
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    Morning Blood Pressure Surge In Renal Transplant Recipients: Its Relation To Graft Function And Arterial Stiffness
    (2022) Demirci, Bahar Gurlek; Afsar, Baris; Tutal, Emre; Colak, Turan; 35704743
    Background: When the blood pressure rises before awakening in the morning, it is called as morning blood pressure pulse (MBPS). MBPS is considered to be an independent risk factor for cardiovascular disease. The aim of this study was to investigate the associations between MBPS, graft function, arterial stiffness and echocardiographic indices in renal transplant recipients. Methods: Among 600 renal transplant recipients, 122 patients who had a history of hypertension and were taking at least one anti hypertensive medication were enrolled in the study. Arterial stiffness was measured by carotid-femoral pulse wave velocity (PWv), and echocardiographic indices were assessed. 24 h ambulatory blood pressure was monitored for all patients. MBPS was calculated by subtracting morning systolic blood pressure from minimal asleep systolic blood pressure. Results: Mean morning, day time and asleep systolic blood pressure values were 171.2 +/- 23.9, 137.9 +/- 18.1, and 131.7 +/- 18.9, respectively. Nondipper hypertension status was observed in 93 patients. Mean MBPS was 35.6 +/- 19.5 mm Hg, means PWv was 6.5 +/- 2.0 m/s. Patients with MBPS >= 35 mm Hg, had significantly lower eGFR and higher proteinuria, PWv. higher left atrium volume and LVMI. In regression analysis, day time systolic blood pressure, asleep systolic blood pressure, morning blood pressure surge, nondipper status and left ventricular mass index were detected as the predictors of graft function. Conclusions: Increased morning blood pressure surge is associated with graft dysfunction, increased arterial stiffness and LVMI that contribute to cardiovascular mortality and morbidity in renal transplant recipients.