Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Multiple Giant Aneurysms and Stenoses of the Coronary and Systemic Arteries in an Infant with Kawasaki Disease at the Early Stage of Convalescent Period(2014) Ekici, Filiz; Varan, Birgul; Kocabas, Abdullah; Erdogan, Ilkay; Eminoglu, Sancar; Aktas, Dogukan; https://orcid.org/0000-0002-6719-8563; 24528198; ABB-1767-2021; AAD-2644-2019; AAJ-2305-2021Myocardial infarction and systemic arterial aneurysms are rarely seen during the course of the Kawasaki disease (KD). Herein, we report the case of a 4-month-old Turkish infant who was diagnosed with KD on the 17th day of the illness. On admission, echocardiogram showed multiple coronary arterial aneurysms (CAAs) and massive pericardial effusion. He was given intravenous immunoglobulin, aspirin and anticoagulant drugs. However, the aneurysms progressed to super giant CAAs, multiple huge coronary arterial thromboses developed recurrently and caused myocardial ischemia. Furthermore, the conventional angiography revealed multiple giant aneurysms and stenoses in the subclavian, celiac, and iliac arteries, besides CAAs. Mini-Abstract We report the case of a 4-month-old Turkish infant who was diagnosed with Kawasaki disease associated with multiple super giant coronary aneurysms, huge coronary thromboses, and massive pericardial effusion. Multiple systemic arterial aneurysms and stenoses were also detected in subclavian, axillary, renal, and iliac arteries as well as coronary arteries at the beginning of convalescent period.Item Serum YKL-40/chitinase 3-Like Protein 1 Level Is an Independent Predictor of Atherosclerosis Development in Patients with Obstructive Sleep Apnea Syndrome(2015) Bakirci, Eftal Murat; Unver, Edhem; Degirmenci, Husnu; Kivanc, Tulay; Gunay, Murat; Hamur, Hikmet; Buyuklu, Mutlu; Ceyhun, Gokhan; Topal, Ergun; Coban, Taha Abdulkadir; 26142786Objective: The inflammatory process plays an important role in the development of cardiovascular complications in patients with obstructive sleep apnea syndrome (OSAS). YKL-40/chitinase 3-like protein 1 is a novel biomarker of systemic inflammation. This study aimed to investigate whether carotid intima-media thickness (CIMT), a useful marker for early atherosclerosis, is associated with serum YKL-40/chitinase 3-like protein 1 levels in patients with normotensive and nondiabetic OSAS. Methods: The study included 40 OSAS patients and 40 agesex- and body mass index-matched healthy controls. Serum YKL-40 levels were detected by enzyme-linked immunosorbent assay. CIMT was measured by B-mode ultrasound. Results: The patients with OSAS had significantly increased CIMT and higher YKL-40 and high sensitivity C-reactive protein (hsCRP) levels than those of the controls. CIMT was strongly correlated with serum YKL-40 levels (r=0.694, p<0.001), hsCRP (r=0.622, p<0.001), age (r=0.525, p=0.001), and weakly correlated with apnea-hypopnea index (AHI) (r=0.365, p=0.021) and the percentage of recording time spent (PRTS) of oxygen saturation <90% (r=0.488, p=0.001). Moreover, it was detected that serum YKL-40 levels were strongly correlated with AHI (r=0.617, p<0.001), and weakly correlated with SaO 2 <90% of PRTS (r=0.394, p=0.012) and hsCRP (r=0.486, p=0.001). In multiple regression analyses, age and serum levels of YKL-40 and hsCRP were found to be independent predictors of CIMT. Conclusion: In patients with OSAS, CIMT was increased. This increase was associated with serum YKL-40 level. Increased serum level of YKL-40 may be an early predictor of atherosclerosis development in patients with OSAS.Item Predictors of Obstructive Coronary Artery Disease vs Non-obstructive Lesions on Coronary Angiography in Patients with Non-ST Elevation Myocardial Infarction. A Retrospective Analysis from a University Hospital(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Karacaglar, Emir; Yilmaz, Kerem Can; Muderrisoglu, Ibrahim Haldun; 0000-0001-8926-9142; 0000-0002-2538-1642; AAC-2597-2020; AAJ-1331-2021; W-5233-2018; ABI-6723-2020Item Coronary Artery Disease Detected by Coronary Computed Tomography Angiography is Associated with Red Cell Distribution Width(2016) Karacaglar, Emir; Bal, Ugur; Hasirci, Senem; Yilmaz, Mustafa; Doganozu, Ersin; Coskun, Mehmet; Atar, Ilyas; Yildirir, Aylin; Muderrisoglu, Haldun; 0000-0002-2538-1642; 0000-0002-9446-2518; 0000-0002-8342-679X; 0000-0002-2557-9579; 0000-0001-8750-5287; 0000-0002-9635-6313; 27774965; ABI-6723-2020; AAK-4322-2021; AAK-7805-2021; S-6973-2016; A-4947-2018; AAG-8233-2020Objective: Increased red blood cell distribution width (RDW) is associated with severity of coronary artery disease (CAD). The aim of the present study was to retrospectively evaluate the relationship between CAD detected by coronary computed tomography angiography (CCTA) and RDW. Methods: Records of 291 patients who underwent 16-slice CCTA due to the presence of angina-like chest pain were retrospectively evaluated. Exclusion criteria were applied. Clinical characteristics, risk factors for CAD, and RDW values on CCTA were noted. Results: RDW levels in patients with CAD were significantly higher than in those with normal coronary arteries (NCAs) (15.50 +/- 1.57 compared to 14.80 +/- 1.41, p=0.001). Diabetes mellitus, hypertension, and history of smoking were significantly more common in the CAD group (p=0.018, p=0.007, and p=0.013, respectively). On multivariate logistic regression analysis, RDW (p=0.009 [odds ratio (OR): 1.352; 95% confidence interval (CI): 1.081-1.683]), age (p<0.001 [OR: 1.063; 95% CI 1.031-1.090]), and history of smoking (p=0.003 [OR: 2.672; 95% CI: 1.360-5.232]) were shown to be independent predictors for CAD detected by CCTA. Conclusion: The present results suggest that higher RDW levels are independently associated with presence of CAD detected by CCTA in patients without known CAD. Further studies are warranted to clarify the exact role of RDW in risk stratification.Item Cardiovascular Magnetic Resonance In Autoimmune Rheumatic Diseases: A Clinical Consensus Document By The European Association Of Cardiovascular Imaging(2022) Mavrogeni, S.; Pepe, A.; Nijveldt, R.; Ntusi, N.; Sierra-Galan, L. M.; Bratis, K.; Wei, J.; Mukherjee, M.; Markousis-Mavrogenis, G.; Gargani, L.; Sade, L. E.; Ajmone-Marsan, N.; Seferovic, P.; Donal, E.; Nurmohamed, M.; Cerinic, M. Matucci; Sfikakis, P.; Kitas, G.; Schwitter, J.; Lima, J. A. C.; 35808990Autoimmune rheumatic diseases (ARDs) involve multiple organs including the heart and vasculature. Despite novel treatments, patients with ARDs still experience a reduced life expectancy, partly caused by the higher prevalence of cardiovascular disease (CVD). This includes CV inflammation, rhythm disturbances, perfusion abnormalities (ischaemia/infarction), dysregulation of vasoreactivity, myocardial fibrosis, coagulation abnormalities, pulmonary hypertension, valvular disease, and side-effects of immunomodulatory therapy. Currently, the evaluation of CV involvement in patients with ARDs is based on the assessment of cardiac symptoms, coupled with electrocardiography, blood testing, and echocardiography. However, CVD may not become overt until late in the course of the disease, thus potentially limiting the therapeutic window for intervention. More recently, cardiovascular magnetic resonance (CMR) has allowed for the early identification of pathophysiologic structural/functional alterations that take place before the onset of clinically overt CVD. CMR allows for detailed evaluation of biventricular function together with tissue characterization of vessels/myocardium in the same examination, yielding a reliable assessment of disease activity that might not be mirrored by blood biomarkers and other imaging modalities. Therefore, CMR provides diagnostic information that enables timely clinical decision-making and facilitates the tailoring of treatment to individual patients. Here we review the role of CMR in the early and accurate diagnosis of CVD in patients with ARDs compared with other non-invasive imaging modalities. Furthermore, we present a consensus-based decision algorithm for when a CMR study could be considered in patients with ARDs, together with a standardized study protocol. Lastly, we discuss the clinical implications of findings from a CMR examination.Item Relationship Between Melatonin and Cardiovascular Disease(2021) Ozkalayci, Flora; Kocabas, Umut; Altun, Betul U.; Pandi Perumal, Seithikurippu; Altun, Armagan; 0000-0002-3233-8263; 33654615; ABB-5844-2020Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide. The coronary atherosclerotic process involves different pathological mechanisms; inflammation is one of the major triggers for the development of atherosclerotic plaque. Although several studies showed the favorable effects of melatonin on the cardiovascular system (CVS), melatonin seems not to take its rightful place in today's clinical practice. This review aims to point out the role of melatonin on cardiovascular disease (CVD) and its' risk factors. All data were obtained via PuhMed, Wikipedia, and Google.Item Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients(2020) Kaya, Hakki; Sahin, Anil; Gunes, Hakan; Bekar, Lutfu; Celik, Ahmet; Cavusoglu, Yuksel; Caldir, Vedat; Gungor, Hasan; Yilmaz, Mehmet Birhan; 32812491Background Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before. Methods Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea. Results To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 +/- 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2,p < .001- HR:2.8,p = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1,p < .001- HR:3.0,p < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group. Conclusion For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.Item The Novel CHA(2)DS(2)-VASC-FSH Score is Predictive of Severe Coronary Artery Disease on Coronary Angiography in Patients with Atrial Fibrillation and Unstable Symptoms(2019) Ciftci, Orcun; Yilmaz, Kerem Can; Karacaglar, Emir; Yilmaz, Mustafa; Ozin, Bulent; Muderrisoglu, Ibrahim Haldun; 31258358Objective: AF may create confusion about the presence of severe or unstable coronary artery disease in cases with unstable symptoms. Novel scores and markers are needed to determine severe coronary artery disease in such patients. We aimed to test the newly developed CHA(2)DS(2)-VASc-FSH score, developed by adding family history for coronary artery disease, hyperlipidemia, and smoking to the original CHA(2)DS(2)-VASc score, in the prediction of severe CAD in patients with AF and unstable symptoms. Materials and Methods: We retrospectively analyzed 72 patients presenting to Baskent Universtiy School of Medicine Hospital between April 2011 and January 2016. The CHA(2)DS(2)-VASc-FSH score was assessed for the prediction of severe CAD. Results: Seventy-two patients aged 65.7 +/- 11.2 years were enrolled. Thirty-five (48.6%) patients had severe CAD and 11 (15.3%) had unstable CAD. patients with severe coronary artery disease had a significantly greater CHA(2)DS(2)-VASC-FSH score (5 (1-8) vs 3(0-7); p< 0.05). The CHA(2)DS(2)-VASC-FSH score independently predicted severe CAD, with a CHA(2)DS(2)-VASc-FSH score of 3 or greater having a sensitivity of 77.1% and a specificity of 56.8% for severe CAD. Conclusion: Among patients with AF and unstable symptoms, the CHA(2)DS(2)-VASc-FSH score independently predicts severe CAD.Item The curative treatment of familial hypercholesterolemia: Liver transplantation(2019) Kirnap, Nazli Gulsoy; Kirnap, Mahir; Tutuncu, Neslihan Bascil; Moray, Gokhan; Haberal, Mehmet; 31626710; AAH-9198-2019Background Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by premature mortal cardiovascular complications. Liver transplantation (LT) is the only curative treatment option. In this study, the long-term clinical follow-up data of 8 patients who underwent LT with a diagnosis of FH in our center are presented. Materials and Methods A total of 638 LT were performed between December 1985 and June 2019 at Baskent University, of which 8 patients underwent LT with a diagnosis of FH and were evaluated retrospectively. Results Of the 8 patients, 4 underwent deceased donor and 4 living donor transplantation. Five patients had preoperative cardiovascular disease and consequent interventional operations. There was significant reduction in postoperative LDL-C and TC levels starting from the first week, and stabilizing at the first month and first year. The median survival time of patients was 5 years (2-12 years). All patients are still alive. None of the complications of patients with preoperative cardiovascular complications had progressed. Conclusion Liver transplantation is the preferred curative treatment for the pathophysiology of FH. In our study, LDL-C levels were brought under control with LT performed on patients with FH. Median 5-year follow-up of patients showed that the progression of cardiac complications was abated.