Scopus İndeksli Açık & Kapalı Erişimli Yayınlar
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Item New Perspective On Fatigue In Hemodialysis Patients With Preserved Ejection Fraction: Diastolic Dysfunction Fatigue And Diastolic Dysfunction(2022) Akbay, Ertan; Akinci, Sinan; Coner, Ali; Adar, Adem; Genctoy, Gultekin; Demir, Ali Riza; https://orcid.org/0000-0002-9146-0621; https://orcid.org/0000-0001-5250-5404; AAD-5479-2021; AAD-5564-2021The relationship between diastolic dysfunction and fatigue in hemodialysis patients with preserved ejection fraction is unknown. In this context, the objective of this study is to assess fatigue using the relevant scales and to demonstrate its relationship with diastolic dysfunction. The patients who underwent hemodialysis were evaluated prospectively. Patients' fatigue was assessed using the Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F). The echocardiographic works were performed as recommended in the American Society of Echocardiography guidelines. A total of 94 patients [mean age 64.7 +/- 13.5 years, 54 males (57.4%)] were included in the study. The median VAS-F score of these patients was 68.5 (33.25-91.25), and they were divided into two groups according to this value. Peak myocardial velocities during early diastole (e ') and tricuspid annular plane systolic excursion (TAPSE) values were found to be significantly lower in the group with high VAS-F scores, whereas the early diastolic flow velocities (E)/e ' ratio and pulmonary artery peak systolic pressures (PAP) were found to be significantly higher (p < 0.05, for all). E/e ' ratio (r 0.311, p 0.002) and PAP (r 0.281, p 0.006) values were found to be positively correlated with the VAS-F score, as opposed to the TAPSE (r - 0.257, p 0.012) and e ' (r - 0.303, p 0.003) values, which were found to be negatively correlated with the VAS-F score. High fatigue scores in hemodialysis patients may be associated with diastolic dysfunction. In addition, in our study, we determined the correlation of VAS-F score with E/e ' ratio, PAP and TAPSE.Item Characterization of Responder Profiles for Cardiac Resynchronization Therapy through Unsupervised Clustering of Clinical and Strain Data(2021) Gallard, Alban; Bidaut, Auriane; Hubert, Arnaud; Sade, Elif; Marechaux, Sylvestre; Sitges, Martha; Separovic-Hanzevacki, Jadranka; Le Rolle, Virginie; Galli, Elena; Hernandez, Alfredo; 33524492Background: The mechanisms of improvement of left ventricular (LV) function with cardiac resynchronization therapy (CRT) are not yet elucidated. The aim of this study was to characterize CRT responder profiles through clustering analysis, on the basis of clinical and echocardiographic preimplantation data, integrating automatic quantification of longitudinal strain signals. Methods: This was a multicenter observational study of 250 patients with chronic heart failure evaluated before CRT device implantation and followed up to 4 years. Clinical, electrocardiographic, and echocardiographic data were collected. Regional longitudinal strain signals were also analyzed with custom-made algorithms in addition to existing approaches, including myocardial work indices. Response was defined as a decrease of $15% in LV end-systolic volume. Death and hospitalization for heart failure at 4 years were considered adverse events. Seventy features were analyzed using a clustering approach (k-means clustering). Results: Five clusters were identified, with response rates between 50% in cluster 1 and 92.7% in cluster 5. These five clusters differed mainly by the characteristics of LV mechanics, evaluated using strain integrals. There was a significant difference in event-free survival at 4 years between cluster 1 and the other clusters. The quantitative analysis of strain curves, especially in the lateral wall, was more discriminative than apical rocking, septal flash, or myocardial work in most phenogroups. Conclusions: Five clusters are described, defining groups of below-average to excellent responders to CRT. These clusters demonstrate the complexity of LV mechanics and prediction of response to CRT. Automatic quantitative analysis of longitudinal strain curves appears to be a promising tool to improve the understanding of LV mechanics, patient characterization, and selection for CRT.Item EVALUATION OF EPICARDIAL FAT AND CAROTID AND FEMORAL INTIMA-MEDIA THICKNESSES IN GERIATRIC PATIENTS WITH END-STAGE RENAL DISEASE(2020) Gunesli, Aylin; Yilmaz, Mustafa; Yalcin, Cigdem; Tekkarismaz, Nihan; Alkan, Ozlem; 0000-0002-2557-9579; 0000-0001-5483-8253; 0000-0001-7631-7395; S-6973-2016; AAM-4284-2021; AAD-9088-2021Introduction: Although atherosclerotic cardiovascular diseases and cardiovascular risks are known to increase in patients with end-stage renal disease, it is not clear whether these risks increase in the geriatric patient population as well. This study aims to evaluate these risks in geriatric patients with end-stage renal disease by evaluating epicardial fat and carotid and femoral intima-media thicknesses, known as markers, for subclinical atherosclerosis and cardiovascular risks. Materials and Methods: This cross-sectional study included 52 patients who started to receive chronic hemodialysis treatment after the age of 65 years (mean age 73.92 +/- 5.63) years with end-stage renal failure and 51 healthy volunteers (mean age: 74.49 +/- 4.63 years). Epicardial fat and carotid and femoral intima-media thicknesses were measured and compared between these groups. Results: Carotid intima-media and epicardial fat thicknesses were significantly higher in the patient group than in the control group (0.91 +/- 0.08 vs. 0.71 +/- 0.1 mm, p<0.001 and 0.84 +/- 0.17 vs. 0.75 +/- 0.17 cm, p=0.01, respectively). However, no significant difference was observed in femoral intima-media thickness between the two groups (0.58 +/- 0.07 vs. 0.56 +/- 0.97 mm, p=0.266). Correlation analysis revealed a significant positive correlation between the duration of dialysis and epicardial fat and carotid intima-media thicknesses (r=0.611, p<0.001 and r=0.337, p=0.015, respectively). Furthermore, regression analysis revealed a significant relationship between the duration of dialysis and carotid intima-media thickness (beta=0.657, p=0.001). Conclusion: Epicardial fat and carotid intima-media thicknesses increase in geriatric patients with end-stage renal disease but with no significant changes in femoral intima-media thickness, indirectly suggesting that subclinical atherosclerosis and cardiovascular risks are increased in these patients.Item Relation of Preoperative and Postoperative Echocardiographic Parameters With Rejection and Mortality in Liver Transplant Patients(2020) Yilmaz, Kerem Can; Ciftci, Orcun; Akgun, Arzu Neslihan; Muderrisoglu, Haldun; Boyacioglu, Sedat; Haberal, Asuman Nihan; Moray, Gokhan; Haberal, Mehmet; 0000-0001-8926-9142; 0000-0002-9635-6313; 0000-0003-2498-7287; 0000-0002-9370-1126; 0000-0001-9852-9911; 0000-0002-3462-7632; 29790458; W-5233-2018; AAG-8233-2020; AAJ-1331-2021; AAE-1041-2021; AAE-7637-2021; AAK-4587-2021; AAJ-8097-2021Objectives: Survival in liver transplant after end-stage liver disease is associated with major cardiac functions. In a significant number of patients with end-stage liver disease, cardiac dysfunctions may be observed, which can include high-output heart failure, cardiac valve disease, and pulmonary venous and arterial hypertension. All of these affect perioperative survival. The aim of our study was to determine whether preoperative and postoperative echocardiographic parameters, specifically right heart-related tricuspid regurgitation, estimated systolic pulmonary arterial pressure, and tricuspid annular plane systolic excursion, are associated with rejection and mortality in liver transplant patients. Materials and Methods: Adult patients (> 18 years old) who underwent liver transplant at our center between January 2011 and March 2017 were included in the study, with 64 patients retrospectively screened. The echocardiographic images that were taken immediately before and immediately after liver transplant were evaluated. The patients were divided into 2 groups according to rejection data and mortality. All parameters were analyzed for both variables. Results: For the 24 patients with liver rejection and 40 patients without liver rejection, there were no statistically significant differences in terms of demographic data, echocardiographic parameters, and laboratory data. However, when patients were evaluated according to survival, there was a statistically significant difference between these 2 groups concerning the echocardiography parameters of systolic pulmonary arterial pressure (P = .005), tricuspid annular plane systolic excursion (P = .001), and postoperative right ventricular width (P = .01). Conclusions: Echocardiography, being a simple and easily accessible technique that is reliable in excluding pulmonary hypertension diagnosis, can be used as a guide in the evaluation of right ventricular function and tricuspid regurgitation, particularly in patients who are not hemodynamically stable before and after liver transplant.