PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item A New And Simple Parameter For Diagnosis Pulmonary Edema: Expiratory Air Humidity(2022) Adar, Adem; Can, Emine Yilmaz; Elma, Yusuf; Ferah, Meryem Akpolat; Kececi, Mete; Muderrisoglu, Haldun; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Cakan, Fahri; Onalan, Orhan; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; 35092906; AAD-5479-2021; AAD-5564-2021Purpose: Acute pulmonary edema is characterized by increased levels of fluid in the interstitial and alveolar space of the lung and requires emergency treatment. In acute pulmonary edema, the amount of fluid in the intra-alveolar, interstitial space, and pleural space vary considerably and this fluid will evaporate in different amounts compared to the physiological fluid. The aim of this study was to compare the humidity rates of expiratory air measured before and after pulmonary edema induced by alpha-naphthylthiourea (ANTU) in rats. Methods: The study included twenty healthy adult rats divided equally into a healthy control group and a pulmonary edema group. Pulmonary edema was induced by administering ANTU intraperitoneally in the rats in the study group. Humidity, temperature, lung weight, pleural effusion, and histopathological changes in the respiratory system due to pulmonary edema were examined in the ANTU group. Control measurments were taken before administration of ANTU and again 4 h after administration of ANTU when lung damage was considred to be at maximum levels. Results: Mean expiratory air humidity was 71.22 +/- 3.59% before ANTU and 56.28 +/- 3.94% after administration of ANTU. The mean humidity difference of -14.94 +/- 5.96% was considered statistically different (p = 0.01). Conclusion: Humidity rate in expiratory air was significantly lower in rats with acute pulmonary edema compared to healthy rats. This result supports the hypothesis that humidity in expiratory air can be considered an important parameter in patients during clinical are follow-up for pulmonary edema. (C) 2022 Elsevier Inc. All rights reserved.Item Evaluation Of Demographic And Clinical Characteristics Of Female Patients Presenting With MINOCA And Differences Between Male Patients: A Subgroup Analysis Of MINOCA-TR Registry(2022) Gok, Gulay; Coner, Ali; Cinar, Tufan; Kilic, Salih; Yenercag, Mustafa; Oz, Ahmet; Ekmekci, Cenk; Ozluk, Ozlem; Zoghi, Mehdi; Ergene, Asim Oktay; Turk, Ugur Onsel; 35197228Objective: Although the prevalence and rate of myocardial infarction with non-obstructive coronary arteries (MINOCA) are higher in women than in men in previous cohorts, potential demographic and clinical differences between women who are diagnosed with MINOCA versus myocardial infarction with obstructive coronary arteries (MIOCA) have not been studied till date. In this study, we aimed to document these characteristics and to compare them between female patients with MINOCA and MIOCA. Methods: The study was a subgroup analysis of the MINO-CA-TR study. The study was a multi-center, observational cohort study that was conducted in Turkey between March 2018 and October 2018. In this study, 477 (29.3%) female patients who had been diagnosed with acute myocardial infarction were evaluated. Results: Of these women, 49 (10.3%) were diagnosed with MINOCA (mean age 58.9 +/- 12.9 years) and 428 (89.7%) had a final diagnosis of MIOCA (mean age 67.4 +/- 11.8 years). The prevalence of hypertension, hyperlipidemia, and diabetes mellitus was significantly lower in the MINOCA group than in the MIOCA group. In addition, the MINOCA group had higher rates of recent flu history and non-ST elevation myocardial infarction (NSTEMI) presentation than the MIOCA group. There were significant clinical differences in patients with MINOCA in terms of sex. The female patients were older, had higher systolic blood pressures, and lower hemoglobin levels than male patients. Conclusion: The study revealed that the prevalence of traditional coronary artery disease risk factors was lower in female patients with MINOCA than in those who had final diagnosis of MIOCA.Item Evaluation of the relationship between para-aortic adipose tissue and ascending aortic diameter using a new method(2022) Adar, Adem; Onalan, Orhan; Cakan, Fahri; Keles, Hakan; Akbay, Ertan; Akinci, Sinan; Coner, Ali; Haberal, Cevahir; Muderrisoglu, Haldun; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; https://orcid.org/0000-0002-5711-8873; https://orcid.org/0000-0002-6496-5050; 36189879Background Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds the aorta. It contributes significantly to aortic atherosclerosis and enlargement. Studies conducted with computed tomography and magnetic resonance have shown that individuals with aortic aneurysm had more PAT than healthy individuals. In this study, we measured PAT using transthoracic echocardiography (TTE). The aim of this study is to investigate the possible relationship of TTE measured PAT with ascending aortic width. Methods PAT was defined as the hypoechoic space in front of ascending aortic 2 cm above the sinotubular junction at the end of the systole. Patients were divided into 2 groups according to the presence of dilatation in the ascending aorta using Roman's classification (aortic size index, ASI). ASI of less than 21 was considered no aortic dilation and an ASI of 21 mm/m2 or greater was considered to have aortic dilation. Results A total of 321 unselected patients were divided into the ascending aortic dilatation (AAD) group (n = 96) and the normal ascending aorta diameter group (n = 225 patients). PAT was significantly higher in the AAD group compared with the non-ADD group (0.9 (0.48) vs. 0.7 (0.91) mm, p < 0.0001). Univariate and multivariate logistic regression analysis revealed that PAT (OR: 3.005, 95%CI (1.445-6.251)) were significantly associated with AAD. Conclusions This is the first study which evaluated PAT measured by TTE. We found a significant association between PAT measured by TTE and ascending aorta width.Item Which is responsible for target organ damage in masked hypertension? Is it an increase in blood pressure or a disruption of the circadian rhythm?(2021) Akbay, Ertan; Coner, Ali; Akinci, Sinan; Demir, Ali Riza; Toktamis, Aydin; 0000-0002-9146-0621; 0000-0002-5711-8873; 0000-0001-5250-5404; 33870802; AAD-5479-2021; ABD-7321-2021; AAD-5564-2021Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern. Methods Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP >= 135/85 mmHg and night BP >= 120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage. Results 289 patients [mean age 46.6 +/- 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives (p < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI (p < .05, for both). Conclusion Target organ damage seen in MH may be due to the deterioration of the dipping pattern.Item Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg(2021) Coner, Ali; Akbay, Ertan; Akinci, Sinan; Ozyildiz, Gokhan; Genctoy, Gultekin; Muderrisoglu, Haldun; 0000-0002-5711-8873; 0000-0002-9146-0621; 0000-0001-5250-5404; 0000-0002-5145-2280; 34151642; ABD-7321-2021; AAD-5479-2021; AAD-5564-2021; AAJ-5551-2021Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population. Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis. Results: A total of 233 participants were involved in the study population (median age 45 years [40-50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067-1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023-5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern. Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.Item Aortic arch calcification: a novel parameter for prediction of masked hypertension(2021) Akbay, Ertan; Coner, Ali; Akinci, Sinan; Adar, Adem; Cakan, Fahri; Muderrisoglu, Haldun; 0000-0002-9146-0621; 0000-0002-5711-8873; 0000-0001-5250-5404; 0000-0002-5427-3480; 33734125; AAD-5479-2021; ABD-7321-2021; AAD-5564-2021; GPT-4057-2022Background Masked hypertension is directly related to increased cardiovascular morbidity and mortality but remains underdiagnosed in clinical practice. The aim of the study was to search the role of aortic arch calcification (AAC) in the diagnosis of masked hypertension. Methods and results Among the patients who underwent ambulatory blood pressure monitoring (ABPM) in our clinic, those with office blood pressure (OBP) <140/90 mmHg were included in the study population. According to OBP, they were divided into two groups as normal (<130/85 mmHg) and high normal (130-139/85-89 mmHg) OBP groups. Subjects were also investigated for the presence of masked hypertension with ABPM and searched in masked hypertension and control groups. Masked hypertension was defined as in the latest 2017 ACC/AHA Hypertension guideline and was diagnosed as the daytime BP >= 135/85 mmHg and nighttime BP >= 120/70 mmHg. AAC was evaluated on direct X-ray telecardiography. Diagnosis of masked hypertension was searched depending on the presence of AAC and OBP measurements as well. A total of 216 volunteers were involved in the study [mean age 45.2 +/- 12.2 years; female gender 120 (55.5%)]. One hundred ten volunteers (50.9%) had masked hypertension according to the ABPM. AAC was significantly more common in the masked hypertension group (44.5% vs. 26.4%) (P = 0.005). AAC had a positive predictive value of 79% in those with high normal OBP in the diagnosis of masked hypertension, and also AAC had a negative predictive value of 74% in those with normal OBP. Conclusion AAC can be used as a reliable diagnostic tool to exclude and predict masked hypertension during office examination.Item Heart Rate Variability And Heart Rate Turbulence In Patients With Vasovagal Syncope(2021) Akinci, Sinan; Coner, Ali; Akbay, Ertan; Muderrisoglu, Ibrahim Haldun; 0000-0002-9146-0621; 0000-0001-5250-5404; 0000-0002-5711-8873; 34549694; AAD-5479-2021; AAD-5564-2021; ABD-7321-2021Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope. Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24-hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured. Results The age of the patients varied from 16 to 75 yrs (mean: 44.8 +/- 18.5 yrs). HUTT results of 60 (37.2%) patients were evaluated as positive. There were no significant differences in the basal demographic, clinical, or laboratory findings of the tilt-positive and tilt-negative patient groups. Likewise, there were no significant differences between the time domain HRV parameters and HRT parameters of both groups. Conclusion HRV and HRT parameters reflecting basal autonomic function were not different between HUTT positive and HUTT negative patient groups. These findings suggest that basal autonomic functions have no effect on vasovagal syncope pathogenesis.Item Pheochromocytoma: An overlooked reversible cause of heart failure with reduced ejection fraction(2021) Coner, Ali; Ozyildiz, Ali Gokhan; 0000-0002-5711-8873; 34523598; ABD-7321-2021Pheochromocytoma is a rare, benign tumor of adrenal medulla, and its clinical symptoms are related to catecholamine production. Clinical presentation may vary in a broad spectrum. Dilated or hypertrophied cardiomyopathies are the possible clinical outcomes of pheochromocytoma. Pheochromocytoma should be kept in mind in the differential diagnosis where resistant hypertension, palpitations, headache, and sweating accompany cardiomyopathy. Excessive adrenergic stimulation causing catecholamine discharge can trigger hypertension crisis, pulmonary edema, and myocardial necrosis. Here in this report, we aimed to present the case of a patient with pheochromocytoma related cardiomyopathy who was totally recovered after surgical excision of the tumor.Item Evaluation of hs-CRP and sLOX-1 Levels in Moderate-to-High Risk Acute Coronary Syndromes(2020) Coner, Ali; Aydinalp, Alp; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0002-3761-8782; 30961517; AAG-8233-2020; AAD-5841-2021Objective: Risk stratification and prompt treatment are essential for the management of acute coronary syndromes (ACS) and prediction of future prognosis. Subclinical vascular inflammation and novel biomarkers play an important role in the clinical evaluation of ACS patients. Methods: We enrolled patients who were admitted to emergency service with unstable angina or non-ST segment elevated ACS (NSTE-ACS) in the study population. Coronary artery disease (CAD) complexity was determined via evaluation of angiographical views and peripheral venous blood samples were collected to measure highly sensitive C-reactive protein (hs-CRP) and soluble form of Lectin-like OxLDL receptor-1 (sLOX-1) levels. Results: A total of 40 patients were enrolled in the study population, mean age was 65.1 +/- 13.8 years and male gender percentage was 52.5%. Twenty-nine of patients had NSTE-ACS and 11 patients had unstable angina presentation. The modified Gensini scores were higher for patients with elevated hs-CRP and sLOX-1 levels. Conclusion: Vascular inflammation displays the onset of ACS and it is related to more complex CAD in these patients. An increase in sLOX-1 expression is closely related to anatomical complexity of CAD in ACS.Item Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents(2020) Coner, Ali; Akinci, Sinan; Akkucuk, Mehmet Husamettin; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-4569-1143; 0000-0001-5250-5404; 31974326; AAG-8233-2020; AAJ-2828-2021; AAD-5564-2021Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5 +/- 11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.