TR-Dizin Açık Erişimli Yayınlar

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    Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease
    (2019) Akinci Ozyurek, Berna; Savas Bozbas, Serife; Aydinalp, Alp; Bozbas, Huseyin; Ulubay, Gaye; 31414640
    Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), maximum work rate (WR), Delta VO2/Delta WR and O-2 pulse (VO2/HR) values were calculated. Significant CAD was defined as >= 50% narrowing in at least one of the coronary arteries. Results: The mean age was 60.4 +/- 8.9 years ve 21 (65.6%) of subjects were male. On CAG, CAD was detected in 19 (59.4%) patients. Maximum heart rate, heart rate reserve (HRR), VE/VCO2 measured at anaerobic threshold AT) and VO2 (mL/kg/min) were significantly differed in patients with CAD than those without (p= 0.031; p= 0.041; p= 0.028; p= 0.03 respectively). Peak VO2, VO2/WR and O-2 pulse values were higher in patients with normal angiographic results than those with CAD but the difference did not reach to statistical significance. Conclusion: The findings of our study indicate that among CPET parameters AT VE/VCO2, ATVO(2) (mL/kg/dk) and HRR can have predictive value in the diagnosis of CAD. We think that these parameters might be used in the evaluation of patients with angina and dyspnea suspected of CAD. In conclusion parameters obtained during the test that are not influenced by patient's effort might increase the value of CPET in the diagnosis CAD.
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    Serum cystatin C and neutrophil gelatinase-associated lipocalin in predicting the severity of coronary artery disease in diabetic patients
    (2016) Okyay, Kaan; Yildirir, Aylin; Cicek, Mutlu; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0001-8750-5287; 0000-0002-3761-8782; 0000-0001-6134-8826; 27182610; AAG-8233-2020; A-4947-2018; AAD-5841-2021; AAK-7355-2020
    Objective: Cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) are biomarkers of renal functions. We evaluated their roles in predicting the severity of coronary artery disease (CAD). Methods: Fifty-two consecutive type 2 diabetic patients (32 males, 65.7 +/- 8.6 years) who underwent coronary angiography (CAG) for stable CAD were included in this single-center, prospective, cross-sectional study. Patients with an estimated glomerular filtration rate <60mL/min/1.73m(2) and with a history of by-pass surgery and/or coronary stent implantation were excluded. The vessel score and Gensini score were calculated to assess the presence and severity of CAD. Mann-Whitney U test, Spearman test, and multiple linear regression analysis were used for the main statistical analyses. Results: Serum cystatin C levels were higher in patients with multivessel disease than in those with single vessel disease [1260 ng/mL (953-1640) vs. 977 ng/mL (599-1114), p=0.017]. According to the median Gensini score, the higher score group also had higher cystatin C levels than the lower score group [1114 ng/mL (948-1567) vs. 929 ng/mL (569-1156), p=0.009]. However, serum NGAL levels were similar between these subgroups. There was a positive correlation between cystatin C and Gensini score (r=0.334, p=0.016). Multiple linear regression analysis revealed serum cystatin C as an independent predictor of the Gensini score (beta=0.360, t=2.311, p=0.026). These results may aid in defining cystatin C as a surrogate marker of the extent of CAD in further clinical trials. Conclusion: Serum Cystatin C, but not NGAL levels, could predict the severity of CAD in diabetic patients.
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    Is there a relationship between resistin levels and left ventricular end-diastolic pressure?
    (2018) Yildirir, Aylin; Yildirim, Ozge Turgay; Sade, Leyla Elif; Hasirci, Senem Has; Kozan, Hatice; Ozcalik, Emre; Okyay, Kaan; Bal, Ugur Abbas; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-6731-4958; 29615544; AAK-7355-2020; AAG-8233-2020
    Objective: Resistin, a cysteine-rich peptide, is associated with atherosclerosis and diabetes. Resistin levels increase corresponding to coronary artery disease (CAD) and heart failure severity. Since resistin level tends to elevate with symptomatic heart failure, it is expected to be associated with left ventricular end-diastolic pressure (LVEDP). However, there is no relevant literature on the relationship between resistin levels and LVEDP. We aimed to evaluate the association between resistin levels and LVEDP, severity of CAD, carotid intima-media thickness (CIMT), and echocardiographic diastolic dysfunction parameters. Methods: For this study, 128 euvolemic patients with creatinine clearance >50 mg/dL and without acute coronary syndrome, who had typical chest pain or were stress test positive, were enrolled. Resistin level was measured by Enzyme-linked immunosorbent assays (ELISA) method. Severe CAD is defined as >= 50% stenosis in one of the major coronary arteries. LVEDP was measured during left heart catheterization. Results: After coronary angiography, 60 patients (46.9%) had severe CAD. The mean LVEDPs were similar for patients with and without severe CAD (p=0.480). The resistin levels did not differ between the groups (p=0.154). The resistin levels did not correlate with LVEDP (r=-0.045, p=0.627), ejection fraction (EF; r=0.110, p=0.228), the Gensini score (r=-0.091, p=0.328), and CIMT (r=0.082, p=0.457). No significant correlation was found between the echocardiographic diastolic dysfunction parameters and resistin levels. Conclusion: There was no significant correlation between resistin level and LVEDP, CAD severity, echocardiographic diastolic dysfunction parameters, and CIMT. Further studies are warranted to determine the efficacy of resistin in clinical use.