Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Effects of Continuous-Flow Left Ventricular Assist Device Therapy on Peripheral Vascular Function(2022) Kaya, Ersin; Kocabas, Umut; Simsek, Evrim; Nalbantgil, Sanem; Kahraman, Umit; Engin, Cagatay; Yagdi, Tahir; Ozbaran, Mustafa; Akilli, Azem; 35089263; GXG-7709-2022The peripheral vascular effects of continuous-flow left ventricular assist device (CF-LVAD) implantation are still unclear. The aim of the current study was to determine peripheral vascular function before and after implantation of CF-LVAD in patients with end-stage heart failure (HF), and to compare this data to age- and sex-matched chronic heart failure with reduced ejection fraction (HFrEF) patients. Forty-three consecutive end-stage HF patients (New York Heart Association [NYHA] class III/IV; three women and 40 men; mean age 53 +/- 11 years) who planned to receive CF-LVAD implantation comprised the LVAD patient population, and their clinical characteristics, preoperative and third postoperative month peripheral vascular function assessment data including flow-mediated dilation (FMD) and pulsatility index (PI) assessed by ultrasound Doppler in brachial artery were compared to age- and sex-matched chronic, stable HFrEF patients (NYHA class II; five women and 30 men; mean age 51 +/- 10 years). After CF-LVAD implantation, median FMD decreased from 5.4 to 3.7% (p < 0.001), and median PI decreased from 6.9 to 1.4 (p < 0.001). In patients with end-stage HF before CF-LVAD implantation, FMD and PI were significantly lower compared to the chronic HFrEF patients (FMD: 5.4% +/- 0.9% vs. 7.6% +/- 1.1%; p < 0.001, respectively) and (PI: 6.9 +/- 1.3 vs. 7.4 +/- 1.2; p = 0.023, respectively). The current study revealed impaired peripheral vascular function in the end-stage HF patients compared to stable HFrEF patients, and documented the deterioration of peripheral vascular function after CF-LVAD implantation. These results suggest that impaired peripheral vascular function in the CF-LVAD patients compared to preoperative assessment is a consequence of the nonpulsatile blood flow due to the continuous-flow mechanical support.Item Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes(2021) Altay, HakanAn array of medical practitioners, including endocrinologists, family physicians, internal medicine specialists in nephrology and cardiology, unceasingly investigate, diagnose and treat over 8 million diabetic patients in Turkey. Apart from routine glycemic regulation, several frequent coexisting comorbidities such as obesity, hypertension, dyslipidemia, and their associated complications should also be promptly managed. Due to the concomitant occurrence of complications, the involvement of additional specialties in the precise management of such conditions becomes indispensable. Owing to the ever-expanding knowledge about the prevalence and clinical manifestations of diabetes, various international medical societies publish annual diabetes guidelines, which makes it too cumbersome as well as challenging for the practicing physicians to follow these comprehensive guidelines in clinical practice. There is an unmet need for an easyto-read and concise document for all physicians working for diabetes management for a standardized approach for better management of diabetes and improved patient care. This consensus report was prepared collectively by the Society of Endocrinology and Metabolism Turkey, Turkish Society of Cardiology, Turkish Society of Nephrology, Turkish Society of Hypertension and Renal Diseases to prevent cardiac and renal complications of diabetes, to timely detect these complications by using pertinent measures and to develop, implement and monitor strategies for managing them effectively.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.