Araştırma Çıktıları | TR-Dizin | WoS | Scopus | PubMed
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Item The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement(2014) Bal, Ugur; Aydinalp, Alp; Yilmaz, Kerem; Ozcalik, Emre; Hasirci, Senem; Atar, Ilyas; Gultekin, Bahadir; Sezgin, Atilla; Muderrisoglu, HaldunBackground: Mechanical heart valve replacement has an inherent risk of thromboembolic events (TEs). Current guidelines recommend an international normalized ratio (INR) of at least 2.5 after mechanical mitral valve replacement (MVR). This study aimed to evaluate the effects of a low INR (2.0-2.5) on thromboembolic and bleeding complications in patients with mechanical MVR on warfarin therapy. Methods: One hundred and thirty-five patients who underwent mechanical MVR were enrolled in this study. The end points of this study were defined as TEs (valve thrombosis, transient ischemic attack, stroke) and bleeding (all minor and major bleeding) complications. Patients were followed up for a mean of 39.6 months and the mean INR of the patients was calculated. After data collection, patients were divided into 3 groups according to their mean INR, as follows: group 1 (n = 34), INR < 2.0; group 2 (n = 49), INR 2.0-2.5; and group 3 (n = 52), INR > 2.5. Results: A total of 22 events (10 [7.4%] thromboembolic and 12 [8.8%] bleeding events) occurred in the follow-up period. The mean INR was an independent risk factor for the development of TEs. Mean INR and neurological dysfunction were independent risk factors for the development of bleeding events. A statistically significant positive correlation was found between the log mean INR and all bleeding events, and a negative correlation was found between the log mean INR and all TEs. The total number of events was significantly lower in group 2 than in groups 1 and 3 (P = 0.036). Conclusions: This study showed that a target INRs of 2.0-2.5 are acceptable for preventing TEs and safe in terms of bleeding complications in patients with mechanical MVR.Item Epicardial adipose tissue thickness and plasma homocysteine in patients with metabolic syndrome and normal coronary arteries(2014) Balcioglu, Akif Serhat; Durakoglugil, Murtaza Emre; Cicek, Davran; Bal, Ugur Abbas; Boyaci, Bulent; Muderrisoglu, HaldunBackground: Increased epicardial adipose tissue thickness and plasma homocysteine levels are associated with Metabolic Syndrome (MS) and coronary artery disease. The majority of patients with MS have subclinical or manifest coronary artery disease. The aim of this study was to evaluate the relationship between MS and plasma homocysteine levels and epicardial adipose tissue thickness in subjects without epicardial coronary artery disease. Methods: Patients who underwent coronary angiography due to angina or equivocal symptoms and/or abnormal stress test results and were found to have normal coronary arteries were evaluated for the presence of MS. The study group comprised 75 patients with normal coronary arteries and MS, and the control group included 75 age-gender matched subjects without coronary artery disease or MS. Results: Epicardial adipose tissue thickness (5.8 +/- 1.9 mm vs. 4.3 +/- 1.6 mm, p <0.001) and plasma homocysteine levels (21.6 +/- 6.1 mu mol/L vs. 15.1 +/- 5.8 mu mol/L, p <0.001) were significantly higher in the MS group. Body mass index, triglyceride level, weight, age and waist circumference were positively and HDL cholesterol level were negatively correlated with both epicardial adipose tissue thickness and plasma homocysteine level. Epicardial adipose tissue thickness had the strongest correlation with plasma homocysteine level (r = 0.584, p < 0.001). For each 1 mm increase in epicardial adipose tissue thickness, an increase of 3.51 mu mol/L (95% CI: 2.24-4.79) in plasma homocysteine level was expected. Conclusions: We observed a close relationship between MS and epicardial adipose tissue thickness and plasma homocysteine levels, even in the absence of overt coronary artery disease.Item Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, HaldunObjective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.Item A clinical dilemma about a new oral anticoagulant treatment(2014) Altin, Cihan; Ozturkeri, Ovgu Anil; Gezmis, Esin; Muderrisoglu, Haldun; 25341482Item Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography(2015) Aslan, Gamze; Aslan, Recep Cagdas; Sade, Leyla Elif; Bal, Ugur; Onalan, Gogsen; Zeyneloglu, Hulusi Bulent; Kuscu, Esra; Muderrisoglu, HaldunObjectives: Polycystic Ovary Syndrome (PCOS) is characterized by several metabolic abnormalities that may lead to insulin resistance, diabetes, and atherosclerosis which are associated with chronic inflammatory processes and oxidative stress. Due to this fact PCOS patients are at increased risk of cardiovascular diseases. We used echocardiographic quantification tools to detect subclinical changes in myocardial functions. Materials and Methods: Echocardiographic, hormonal and metabolic measurements were performed in twenty-six women with PCOS and twenty-three healthy volunteers. The age of the attendants ranged between 20 and 31 years. PCOS was diagnosed by using the Rotterdam criteria. We compared the myocardial functions of PCOS patients without any cardiovascular symptoms with healthy volunteers by using strain echocardiography. Results: No differences were found between the two groups' strain, strain rate and myocardial velocity measurements. Conclusion: According to our study PCOS patients without any clinical cardiovascular symptoms have no impairment in myocardial functions. These results should be further confirmed in larger controlled studies.Item Effects of Three Month Nasal Continuous Positive Airway Pressure Treatment on Electrocardiographic, Echocardiographic and Overnight Polysomnographic Parameters in Newly Diagnosed Moderate/Severe Obstructive Sleep Apnea Patients(2015) Cicek, Davran; Balcioglu, Akif Serhat; Lakadamyali, Huseyin; Muderrisoglu, Haldun; 25503651The objective of the study was to determine the effects of nasal continuous positive airway pressure (nCPAP) therapy on left ventricular (LV) function and electrocardiographic parameters in newly diagnosed moderate/severe obstructive sleep apnea (USA) patients without cardiovascular comorbidities and medical treatments. We examined 44 patients who underwent overnight polysomnography together with 24-hour Ho lter electrocardiography, cardiopulmonary exercise testing including heart rate recovery at 1 minute (HRR-1), echocardiography, surface electrocardiography, and those who were diagnosed with moderate/severe USA apnea-hypopnea index >= 15. After 3 months of nCPAP treatment, the above-mentioned examinations were repeated. Forty-four patients completed the treatment period. Twelve weeks on effective nCPAP induced a significant increase in the mitral E/A ratio (P = 0.001), as well as reductions in isovolumic relaxation time (P = 0.001) and mitral deceleration time (DT) (P = 0.002). There were no significant differences in LV ejection fraction, LV mass index, and pulsed wave Doppler parameters. Mean heart rate was 79.2 +/- 12.5 pulses/minute, maximum P-wave duration 117.5 +/- 8.6 msec, P-wave dispersion (PWd) 54.6 +/- 10.2 msec, corrected QT interval (QTc) 436.5 +/- 40.5 msec, and QT dispersion (QTd) 46.3 +/- 7.1 msec, which significantly decreased to 70.4 +/- 9.6 pulses/minute (P <0.001), 111.5 +/- 8.7 msec (P <0.001), 51.6 +/- 8.9 msec (P <0.001), 418.4 +/- 31.2 msec (P <0.001), and 33.8 +/- 3.4 msec (P < 0.001), respectively. Exercise capacity at baseline determined as 10.5 +/- 2.2 metabolic equivalents (METS) and HRR-1 (20.6 +/- 11.7 bpm) significantly increased (12.1 +/- 1.5 METS and 27.4 +/- 8.6 bpm). There was no significant difference in aortic root parameters. Three-month nCPAP therapy significantly increased LV shortening fraction, with no effect on systolic function or aortic root diameters and a positive effect on heart rate, PWd, HRR-1, QTc and QTd time following nCPAP therapy.Item A novel oral anticoagulant, dabigatran, in acute renal infarction(2015) Altin, Cihan; Sakallioglu, Onur; Gezmis, Esin; Muderrisoglu, Haldun; 25625445Item Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography(2015) Yilmaz, Mustafa; Aydinalp, Alp; Okyay, Kaan; Tekin, Abdullah; Bal, Ugur Abbas; Bayraktar, Nilufer; Yildirir, Aylin; Muderrisoglu, Haldun; 26195972Aims: Contrast-induced nephropathy (CIN) is one of the most common causes of hospital-acquired acute renal failure. Oxidative stress and vasoconstriction might play key roles in its pathogenesis. In a few experimental models, antioxidant properties of carvedilol have been documented. The aim of this study was to analyze and compare the effects of carvedilol and metoprolol on the development of CIN in patients undergoing coronary angiography. Methods: One hundred patients currently taking metoprolol and 100 patients currently taking carvedilol were enrolled into the study. Venous blood samples were obtained before and 48 h after contrast administration. Cystatin C and malondialdehyde values were examined and compared. CIN was defined as a creatinine increase of at least 25% or 0.5 mg/dl from the baseline value. Results: Seven patients in the carvedilol group (7%) and 22 patients in the metoprolol group (22%) developed CIN (p = 0.003). In the metoprolol group, the median cystatin C concentration increased significantly from 978 to 1,086 ng/ml (p = 0.001) 48 h after radiocontrast administration. In the carvedilol group, the median cystatin C concentration did not change significantly (1,143 vs. 1,068 ng/ml; p = 0.94). In the metoprolol group, the mean malondialdehyde concentration increased significantly from 7.09 +/- 1.48 to 8.38 +/- 2.6 nmol/l (p < 0.001). In the carvedilol group, the mean serum malondialdehyde concentration did not change significantly (7.44 +/- 1.21 vs. 7.56 +/- 1.11 nmol/l; p = 0.59). Conclusion: When compared to metoprolol, carvedilol might decrease oxidative stress and subsequent development of CIN. (C) 2015 S. Karger AG, BaselItem Possible renoprotective effects of dabigatran Reply(2015) Altin, Cihan; Sakallioglu, Onur; Gezmis, Esin; Muderrisoglu, Haldun; 26258187Item The effect of raloxifene on left ventricular hypertrophy in postmenopausal women: A prospective, randomized, and controlled study(2015) Bal, Ugur Abbas; Atar, Ilyas; Oktem, Mesut; Zeyneloglu, Hulusi Bulent; Yildirir, Aylin; Kuscu, Esra; Muderrisoglu, Haldun; 25430415Objective: In healthy women, there is a progressive age-related increase in myocardial mass that is not seen in their male counterparts and occurs primarily in postmenopausal women. Raloxifene is a selective estrogen receptor modulator that has estrogenic actions on bone and the cardiovascular system. The aim of this study was to investigate the effect of raloxifene on myocardial hypertrophy in postmenopausal patients. Methods: A total of 22 postmenopausal osteoporotic women were included in this open-label, randomized, prospective, controlled study. Patients were randomized into two groups: 11 of the patients (group 1) were treated with raloxifene 60 mg/day, and the other 11 patients (group 2) were defined as the control group. Quantitative 2-dimensional and M-mode echocardiographic examination was performed in all patients at the beginning and repeated at the end of the 6-month follow-up period. Left ventricle mass (LVM) and left ventricle mass index (LVMI) were calculated for all patients. Results: The mean age of the patients was 57.2 +/- 3.9 years, and baseline clinical characteristics and echocardiographic parameters were similar between the two groups. After 6 months of raloxifene treatment, there was no difference in echocardiographic parameters of LVM and LVMI compared with the control group (201.2 +/- 25.9 gr vs. 169.7 +/- 46.2 gr, p=0.14 and 120.4 +/- 25.9 gr/m(2) vs. 105.5 +/- 26.3 gr/m(2), p=0.195, respectively). There was also no significant difference in LVM and LVMI in the within-group analysis of both groups. Conclusion: Raloxifene therapy does not affect myocardial hypertrophy in postmenopausal women after 6 months of treatment.
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