Fakülteler / Faculties
Permanent URI for this communityhttps://hdl.handle.net/11727/1395
Browse
12 results
Search Results
Item Previous Gestational Diabetes History is Associated with Impaired Coronary Flow Reserve(2015) Caliskan, Mustafa; Turan, Yasar; Caliskan, Zuhal; Gullu, Hakan; Ciftci, Faika Ceylan; Avci, Enver; Duran, Cevdet; Kostek, Osman; Caklili, Ozge Telci; Koca, Harun; Kulaksizoglu, Mustafa; 0000-0003-2579-9755; 26555575; IXD-5147-2023Background Gestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM). Methods Ninety-three women with GDM history and 95 healthy women without GDM history were recruited. We used transthoracic Doppler echocardiography to assess CFVR, EFT, and left ventricular diastolic function. Insulin resistance of each subject was assessed with homeostasis model assessment insulin resistance (HOMA-IR). Hemoglobin A1c and high-sensitivity C-reactive protein (hsCRP) were also measured in all patients. Results CFVR values were significantly lower (2.34 +/- 0.39 versus 2.80 +/- 0.24, p<0.001) and EFT values were significantly higher in patients with p-GDM than the control group (5.5 +/- 1.3 versus 4.3 +/- 1.1, p<0.001). E/E' ratio (7.21 +/- 1.77 versus 6.53 +/- 1.38, p = 0.003), hemoglobin A1c (5.2 +/- 0.4 and 5.0 +/- 0.3, p = 0.001), HOMA-IR (2.8 +/- 1.4 versus 1.7 +/- 0.9, p = 0.04), and hsCRP levels were significantly higher in the p-GDM group than the control group. Multivariate analysis revealed that gestational diabetes history is independently associated with CFVR. Conclusion Women with a GDM history may be at more risk regarding coronary microvascular dysfunction compared to the healthy ones.Item Impaired Coronary Microvascular and Left Ventricular Diastolic Function in Patients with Inflammatory Bowel Disease(2015) Caliskan, Zuhal; Gokturk, Huseyin Savas; Caliskan, Mustafa; Gullu, Hakan; Ciftci, Ozgur; Ozgur, Gulsum Teke; Guven, Aytekin; Selcuk, Haldun; 0000-0003-2579-9755; 0000-0002-8445-6413; 0000-0002-6463-6070; 25128749; AAJ-8546-2021; JYO-9455-2024; IXD-5147-2023; AAJ-6976-2021; A-7318-2017Background and aim: Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Methods: Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Results: Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1 +/- 3.9 vs. 22.4 +/- 2.9, p < 0.05), and hyperemic DPFV (56.1 +/- 12.5 vs. 70.6 +/- 15.3, p < 0.05) and CFR (2.34 +/- 0.44 vs. 3.14 +/- 0.54, p < 0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. Conclusion: CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP. (C) 2014 Published by Elsevier Inc.Item A Prospective Clinical Study of Flow-Mediated Dilatation in Burn Injury(2014) Turk, Emin; Caliskan, Mustafa; Karagulle, Erdal; Aydogan, Cem; Oguz, Hakan; Kulaksizoglu, Sevsen; Yildirim, Erkan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4766-3373; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0003-1547-1297; https://orcid.org/0000-0002-7613-2240; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24165669; AAJ-5609-2021; JYO-9455-2024; C-6247-2017; AAJ-5296-2021; AAI-8932-2021; ABI-3856-2020; AAE-1041-2021; AAJ-8097-2021Item Increased Morning Blood Pressure Surge and Coronary Microvascular Dysfunction in Patient with Early Stage Hypertension(2014) Caliskan, Mustafa; Caliskan, Zuhal; Gullu, Hakan; Keles, Nursen; Bulur, Serkan; Turan, Yasar; Kostek, Osman; Ciftci, Ozgur; Guven, Aytekin; Aung, Soe Moe; Muderrisoglu, Haldun; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0002-9635-6313; 25224866; IXD-5147-2023; A-7318-2017; AAJ-8546-2021; AAG-8233-2020Morning blood pressure surge (MBPS) is defined as an excessive increase in blood pressure (BP) in the morning from the lowest systolic BP during sleep, and it has been reported as a risk factor for cardiovascular events in current clinical studies. In this study, we evaluated the association between the rate of BP variation derived from ambulatory BP monitoring data analysis and coronary microvascular function in patients with early stage hypertension. One hundred seventy patients with prehypertension and Stage 1 hypertension who fulfilled the inclusion and exclusion criteria were included in the study. We divided our study population into two subgroups according to the median value of coronary flow reserve (CFR). Patients with CFR values <2.5 were defined as the impaired CFR group, and patients with CFR values >= 2.5 were defined as the preserved CFR group, and we compared the MBPS measurements of these two subgroups. CFR was measured using transthoracic Doppler echocardiography (TTDE). Ambulatory 24-hour systolic and diastolic BP, uric acid, systolic MBPS amplitude, diastolic MBPS amplitude, high-sensitivity C-reactive protein, and mitral flow E/A ratio were statistically significant. These predictors were included in age- and gender-adjusted multivariate analysis; ambulatory 24-hour systolic BP (beta = 0.077, P <.001; odds ratio [OR] = 1.080; 95% confidence interval [CI] [1.037-1.1241) and systolic MBPS amplitude (beta = 0.043, P =.022; OR = 1.044; 95% CI [1.006-1.0841) were determined to be independent predictors of impaired CFR (Hosmer-Lemeshow test, P=.165, Nagelkerke's R-2 = 0.320). We found that increased changes in MBPS values in patients with prehypertension and Stage 1 hypertension seemed to cause microvascular dysfunction in the absence of obstructive coronary artery disease. (C) 2014 American Society of Hypertension. All rights reserved.Item Impaired Coronary Microvascular Function and Increased Intima-Media Thickness in Preeclampsia(2014) Ciftci, Faika C.; Caliskan, Mustafa; Ciftci, Ozgur; Gullu, Hakan; Uckuyu, Ayla; Toprak, Erzat; Yanik, Filiz; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-2877-1232; 25455007; A-7318-2017; IXD-5147-2023; GRR-9885-2022There is an association between preeclampsia (PE) and excessive morbidity and mortality. Some recent studies have revealed the presence of endothelial dysfunction in PE patients with inflammatory activity. Moreover, it has been argued that the chronic inflammatory state involved in PE leads to an acceleration in atherosclerosis. Accordingly, our goal in this study is to determine whether there is any coronary microvascular dysfunction and increase in the intima-media thickness in patients who had mild PE 5 years before, without the presence of any traditional cardiovascular risk factors. The study included 33 mild PE patients (mild preeclampsia is classified as a blood pressure (BP) of 140/90 mm Hg or higher with proteinuria of 0.3 to 3 g/d) whose mean age was 33.7 years old, and 29 healthy women volunteers whose mean age was 36.1 years old. Each subject was examined using transthoracic echocardiography 5 years after their deliveries. During the echocardiographic examination, coronary flow reserve (CFR) and carotid intima-media thickness (IMT) were measured. There was a statistically. lower CFR value in PE patients as compared with controls (2.39 +/- 0.48 vs. 2.90 +/- 0.49; P < .001). On the other hand, there was a significant increase in their IMT and high-sensitivity C-reactive protein (hs-CRP) values (respectively, 0.59 +/- 0.15 vs. 0.46 +/- 0.10; P < .001 and 3.80 +/- 2.10 vs. 2.33 +/- 1.79; P = .004). There was a negative correlation between the CFR values of the PE patients and hs-CRP (r = -0.568; P = .001) and IMT (r = -0.683, P < .001) results. We deteinfined in the study that there was impaired CFR and increased carotid IMT in patients with PE, and, moreover, that these adverse effects were significantly correlated with hs-CRP. (C) 2014 American Society of Hypertension. All rights reserved.Item Serum Uric Acid and Carotid Artery Intima Media Thickness in Patients with Masked Hypertension(2014) Caliskan, Mustafa; Guven, Aytekin; Ciftcl, Ozgur; Ozulku, Mehmet; Gunday, Murat; Barutcu, Irfan; https://orcid.org/0000-0002-6463-6070; 25181917; AAJ-8546-2021; A-7318-2017Background Serum uric acid is related to hypertension and cardiovascular diseases. Masked hypertension is associated with an increase in cardiovascular risk. The aim of our study was to evaluate the serum uric acid level and its relationship with carotid intima-media thickness (IMT) in patients with masked hypertension. Subjects and methods A total of 114 untreated masked hypertension patients (62 men, 52 women; mean age 44.6 +/- 7.9 years) and 38 controls (20 men, 18 women; mean age 44.8 +/- 7 years) were included in the study. All patients underwent 24-hour ambulatory blood pressure. Serum uric acid and carotid IMT were measured. Results Serum uric acid was significantly higher in masked hypertension patients when compared to the control group (5.14 +/- 1.42 mg/dl, 4.84 +/- 1.45 mg/ dl, P=0.01). Masked hypertension patients had significantly higher carotid IMT than control subjects (0.58 +/- 0.09, 0.52 +/- 0.09, P < 0.001). The masked hypertension group was also divided into two groups according to the median value of the serum uric acid levels (median value: 5 mg/dl). Carotid IMT was significantly higher in patients with a higher uric acid when compared to those with a lower uric acid (P < 0.001). We also found that the serum uric acid level was a good predictor of increased carotid IMT at the receiver-operating characteristic curve. The area under the curve was 66% (95% confidence interval, 0.56-0.77), and the serum uric acid level was significantly predictive of a high carotid IMT (P=0.001). Conclusions Our data suggest that the uric acid levels were significantly higher in the masked hypertension group and elevated uric acid levels were associated with increased carotid IMT, indicating that elevated serum uric acid levels might contribute to the increase in cardiovascular risk in masked hypertension.Item The Influence of On-pump Versus Off-pump Surgery on Short- and Medium-term Postoperative Coronary Flow Reserve After Coronary Artery Bypass Grafting(2016) Ozulku, Mehmet; Caliskan, Mustafa; Saba, Tonguc; Aksu, Feyza; Ciftci, Ozgur; Gullu, Hakan; Guven, Aytekin; Kostek, Osman; Caklili, Ozge Telci; Aslamaci, Sait; 0000-0001-7566-5427; 0000-0002-9635-6313; 0000-0002-1901-5603; 27269474; AAT-7733-2020; AAG-8233-2020; AAA-3604-2019; AAJ-8546-2021Background Although several clinical trials have compared surgical outcomes between off-pump and on-pump coronary artery bypass grafting (CABG), whether there is a difference in the early- and medium-term postoperative coronary microvascular functions is not fully understood. We compared short- and medium-term coronary microvascular function after off-pump and on-pump CABG. Methods A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery. Each participant's coronary flow reserve (CFR) and diastolic function were measured with transthoracic Doppler echocardiography six and 12 months after surgery. Results Baseline and hyperaemic diastolic peak flow velocity in the left anterior descending artery were similar in both groups, as was CFR (2.22 +/- 0.66) in the off-pump group compared with (2.13 +/- 0.61) in the on-pump group, (P = 0.54). Coronary flow reserve was significantly and inversely correlated with high sensitivity C-reactive protein concentration (r = -0.416; P < 0.001) and positively correlated with mitral E/ A-wave velocity ratio (r = 0.247; P = 0.02). Stepwise linear regression analysis revealed that only high sensitivity C-reactive protein concentration was independently correlated with CFR (beta = -0.272, P = 0.02). Conclusions Heart-lung bypass technique had no medium-term influence on the coronary microcirculation, despite a possible initial unfavourable effect. Serum hs-CRP concentration was an independent predictor of medium-term coronary microvascular dysfunction.Item Coronary Flow Velocity Reserve in Burn Injury: A Prospective Clinical Cohort Study(2016) Caliskan, Mustafa; Turk, Emin; Karagulle, Erdal; Ciftci, Ozgur; Oguz, Hakan; Kostek, Osman; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0002-8522-4956; 0000-0002-1901-5603; 0000-0003-4766-3373; 26284645; AAJ-8097-2021; AAE-1041-2021; C-6247-2017; AAA-3604-2019; AAJ-5609-2021The authors sought to evaluate coronary microvascular function and left ventricular diastolic dysfunction using transthoracic Doppler echocardiography in burn patients. In this study, 32 adult burn patients with partial or full-thickness scald burns that were hospitalized and treated were included. The control group was matched for age and sex and was composed of otherwise healthy volunteers. Transthoracic Doppler echocardiography examinations and simultaneous laboratory tests for cardiac evaluation were performed on the sixth month after burn injury as well as with the control group. High-sensitivity C-reactive protein levels were significantly higher in the burn patients than in controls (5.17 +/- 3.86 vs 2.42 +/- 1.78; P =.001). Lateral isovolumic relaxation time was significantly higher in the burn injury group than in the control group (92.7 +/- 15.7 vs 85.5 +/- 8.3; P =.03). Baseline coronary diastolic peak flow velocity of the left anterior descending artery was similar in both groups. However, hyperemic diastolic peak flow velocity and coronary flow velocity reserve (2.26 +/- 0.48 vs 2.94 +/- 0.47; P <.001) were significantly lower in the burn injury group than in the control group. Coronary flow velocity reserve was significantly and inversely correlated with high-sensitivity C-reactive protein, burn ratio, creatinine, and mitral A-wave max velocity. At the sixth month of treatment, burn patients had high-sensitivity C-reactive protein levels during this period, suggesting that inflammation still exists. In addition, subclinical coronary microvascular and left ventricular diastolic dysfunction can occur in burn patients without traditional cardiovascular risk factors. However, these results must be supported by additional studies.Item Morning Blood Pressure Surge Is Associated with Carotid Intima-Media Thickness in Prehypertensive Patients(2017) Alpaydin, Sertac; Turan, Yasar; Caliskan, Mustafa; Caliskan, Zuhal; Aksu, Feyza; Ozyildirim, Serhan; Buyukterzi, Zafer; Kostek, Osman; Muderrisoglu, Haldun; https://orcid.org/0000-0002-9635-6313; 28272109; AAG-8233-2020Objective Morning blood pressure (BP) surge (MBPS) is defined as an excessive increase in the morning BP from the lowest systolic BP during sleep and is reported as a risk factor for cardiovascular events in current clinical studies. In this study, we aimed to investigate the relationship between MBPS and carotid intima-media thickness (C-IMT) in prehypertensive patients. Patients and methods We evaluated the association between the rate of BP variation derived from ambulatory BP monitoring and C-IMT in patients with prehypertension. Results One hundred and seventy patients with prehypertension were included in the study. All office BP measurements and ambulatory 24-h, day-time, and night-time measurements were similar between each group. C-IMT [0.60 (range: 0.57-0.65) vs. 0.55 (range: 0.50-0.60) cm; P < 0.001] and the mean platelet volume [8.7 (range: 7.9-9.1) vs. 7.9 (range: 7.3-8.8) fl; P = 0.002] were significantly higher in the greater MBPS group than the lower group. In multivariate analysis, male sex [odds ratio (OR): 2.271, confidence interval (CI): 1.011-5.100, P = 0.047], greater MBPS (OR: 8.474, CI: 3.623-19.608, P < 0.001), and elevated mean platelet volume levels (OR: 3.359, CI: 1.978-5.705, P < 0.001) were found to be independent predictors of greater C-IMT in prehypertensive patients. Conclusion Our study suggests that greater MBPS is associated independently with C-IMT in prehypertensive patients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.Item Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction(2021) Kul, Seref; Guvenc, Tolga Sinan; Baycan, Omer Faruk; Celik, Fatma Betul; Caliskan, Zuhal; Guvenc, Rengin Cetin; Ciftci, Faika Ceylan; Caliskan, Mustafa; 33189732Background: A history of preeclampsia (pPE) and gestational diabetes (pGDM) are female-specific risk markers for atherosclerosis and future cardiovascular risk. In addition to increasing the risk of established risk factors for atherosclerosis, such as hypertension or diabetes, evidence suggests that pregnancy-related complications can also directly accelerate atherosclerosis by inducing endothelial dysfunction. A combination of both conditions is seen in a subset of patients with pregnancy, though it is not known whether this combination increases the overall risk for cardiovascular events. Aims: Present study aimed to find the impact of combined pPE/pGDM on the prevalence of coronary micro vascular dysfunction (CMD). Methods: A total of 24 patients with combined pPE/pGDM, 19 patients with isolated pPE and 63 patients with pGDM were included to the present study and a further 36 healthy women with no previous pregnancy-related complications served as controls. Coronary flow reserve was measured using echocardiography and CMD was defined as a coronary flow reserve <= 2.5. Results: Patients with combined pPE/pGDM had a high prevalence of CMD (91%), which was significantly higher than controls (5.6%, p < 0.001) and patients with pGDM (55%, p = 0.01). A history of pPE on top of pGDM was associated with an increased risk of CMD (HR:6.28, 95%CI:1.69-23.37, p = 0.006) after multivariate adjustment, but pGDM did not increase the odds for CMD in those with pPE. Conclusions: Combined pPE/pDM is associated with a very high prevalence of CMD, which may indicate an increased risk for future cardiovascular events.