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Öğe AORTIC ELASTIC PROPERTIES OF FAMILIAL HYPERCHOLESTEROLEMIA PATIENTS(Elsevier Ireland Ltd, 2017) Kaya, Esra; Kayikcioglu, Meral; Payzin, Serdar; Can, Levent HurkanÖğe Assessment of right ventricular function in patients with pulmonary arterial hypertension-congenital heart disease and repaired and unrepaired defects: Correlation among speckle tracking, conventional echocardiography, and clinical parameters(Turkish Soc Cardiology, 2020) Kemal, Hatice S.; Kayikcioglu, Meral; Nalbantgil, Sanem; Can, Levent Hurkan; Mogulkoc, Nesrin; Kultursay, HakanObjective: the purpose of this study is to compare the analysis of right ventricular (RV) free wall strain via 2D speckle tracking echocardiography with conventional echocardiography and clinical parameters in patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) receiving specific treatment. This study also aims to describe the differences between patients with repaired and unrepaired defects. Methods: This prospective study included 44 adult patients with PAH-CHD who were receiving PAH-specific treatment in a single center. This study excluded patients with complex congenital heart disease. the authors studied the conventional echocardiographic parameters, such as RV fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), right atrial (RA) area, Tricuspid S', and hemodynamic parameters, such as functional class, 6-minute walking distance (6MWD), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Results: the mean age of participants was 33.8 +/- 11.6 years, and 65.9% of participants were female. the mean RV free wall strain was -14.8 +/- 4.7%. Majority of the patients belonged to WHO functional class 2 (61.4%) with a mean NT-proBNP level of 619.2 +/- 778.4 and mean 6MWD of 400.2 +/- 86.9 meters. During the follow-up of 30.8 +/- 9.0 months, 6 patients (13.6%) developed clinical right heart failure, whereas 9 (20.5%) of them died. There was a positive and significant correlation between RV free wall strain and WHO functional class (r=0.320, p=0.03), whereas there was a negative correlation between RV free wall strain and FAC (r=-0.392, p=0.01), TAPSE (r=-0.577, p=0.0001), and Tricuspid S' (r=-0.489, p=0.001). There was no significant correlation of RV free wall strain with either RA area or 6MWD. Patients with repaired congenital heart defects had worse RV functional parameters and RV free wall strain than patients with unrepaired defects. Conclusion: the assessment of RV free wall strain via 2D speckle tracking echocardiography is a feasible method and correlates well with conventional echocardiography and clinical parameters in patients with PAH-CHD receiving specific treatment.Öğe Lipid profile, familial hypercholesterolemia prevalence, and 2-year cardiovascular outcome assessment in acute coronary syndrome: Real-life data of a retrospective cohort(Turkish Soc Cardiology, 2019) Kayikcioglu, Meral; Alan, Bahadir; Payzin, Serdar; Can, Levent HurkanObjective: The aim of this retrospective study based on real-life data was to evaluate the lipid profile and demographic, clinical, and laboratory features of patients with acute coronary syndrome (ACS) at a tertiary center and to examine the mortality rate. Methods: Information including endpoint data for at least 2 years following the index ACS event was retrieved from hospital records. Patients without sufficient follow-up data were called by phone. Modified Dutch Lipid Clinic Network criteria were used to identify the presence of familial hypercholesterolemia (FH). Factors affecting mortality in the 2-year follow-up period were evaluated using Cox regression analysis. Results: A total of 985 ACS patients (215 females) between 21 and 93 years of age were included. The females were older and had a lower smoking rate than the males. In females, the history of obesity and hypertension, the diabetes rate, and the thyroid-stimulating hormone level were higher than those of the males. In 95.6% of the patients, lipid parameters were measured upon hospital admission. No significant difference in dyslipidemia frequency was observed between genders. The frequency of FH was 7.6%. The rate of lipid-lowering drug use was <20% at admission, >90% at discharge, and decreased to 50% in the follow-up period. The mortality rate was 3.8% in the in-hospital period and 8.1% during the 2 years of follow-up. Conclusion: The mortality rate in ACS patients was 3.8% in the in-hospital period and 8.1% in the 2-year follow-up period. The frequency of hypercholesterolemia was 89.5% and the rate of lipid-lowering drug use was insufficient. Secondary prevention after ACS was not adequately employed even at a tertiary center. The FH frequency was 7.6% and those with FH were observed to have ACS at a younger age than those without.Öğe Predictive value of CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores for failed reperfusion after thrombolytic therapy in patients with ST-segment elevation myocardial infarction(Via Medica, 2019) Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oguz; Cetin, Mustafa; Zoghi, MehdiBackground: Thrombolytic therapy is recommended for patients with acute ST-segment elevation myocardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study was to demonstrate the value of CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy. Methods: A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined with the lack of symptom relief < 50% ST resolution-related electrocardiography within 90 min from initiation of the thrombolytic therapy, presence of hemodynamic or electrical instability or in-hospital mortality. CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores, which incorporate hyperlipidemia, smoking, switches between female and male gender; were previously shown to be markers of the severity of coronary artery disease (CAD). Results: History of hypertension, diabetes mellitus, hyperlipklemia, heart failure, smoking, and CAD were significantly common in failed reperfusion patients (far all; p < 0.05). Far prediction of failed reperfusion, the cut-off value of CHA(2)DS(2)-VASc score was >= 2 with a sensitivity of 80.90% and a specificity of 41.01% (area under curve IAUC] 0.660; 95% confidence interval [CI] 0.618-0.700; p < 0.001) and the cut-off value of CHA(2)DS(2)-VASc-HS score was 3 with a sensitivity of 76.13% and a specificity of 67.63% (AUC 0.764; 95% CI 0.725-0.799; p < 0.001). The CHA,DS r VASc-HS score was found to be statistically and significantly better than CHA(2)DS(2)-VASc score to predict failed reperfusion (p < 0.001). Conclusions: The findings suggest that the CHA(2)DS(2)-VASc and especially CHA(2)DS(2)-VASc-HS scores could be considered as predictors of risk of failed repolusion in STEMI patients.Öğe Prevalence of inappropriate sinus tachycardia and the comparison of the heart rate variability characteristics with propensity score-matched controls(Aves, 2020) Simsek, Evrim; Ozbay, Benay; Mutlu, Inan; Gurses, Ecem; Kemal, Hatice S.; Yagmur, Burcu; Can, Levent HurkanObjective: Inappropriate sinus tachycardia (IST) is a syndrome characterized by an elevated resting heart rate with distressing symptoms and no secondary cause of sinus tachycardia. This study was conducted to evaluate both the prevalence of IST among symptomatic patients and heart rate variability (HRV) characteristics. Methods: The records of all consecutive symptomatic patients who had undergone 24-hour Holter monitoring between September 2015 and November 2016 at a single center were retrospectively evaluated. IST was defined as a 24-hour mean heart rate (HR) of >= 90 beats/minute and a resting HR of >= 100 beats/minute in the absence of any secondary cause of sinus tachycardia. All of the study data related to clinical characteristics, symptoms, concomitant diseases, and Holter electrocardiogram parameters were obtained from the electronic hospital records. A propensity age- and sex-matched control group was selected from a non-IST patient cohort. Results: A total of 1865 consecutive patients were evaluated and 32% were excluded due to an inadequate Holter recording period or insufficient quality, atrial fibrillation episodes, atrioventricular block, or >1% atrial or ventricular extrasystoles. Among 1265 patients with sinus rhythm, 4.98% (n=63) had IST The IST patients were younger (39.6 +/- 17.4 vs. 50.2 +/- 17.2 years; p<0.001), and female gender was more prominent (60.3% vs. 43.8%; p=0.009). All of the time and frequency domain parameters of HRV except the low frequency/high frequency ratio were significantly reduced in the IST group compared with the propensity-matched controls. Conclusion: The IST prevalence among symptomatic patients in sinus rhythm was 4.98%. IST was primarily seen in younger women, and they had diminished time and frequency domain HRV parameters.Öğe Serum Endocan Levels Predict Angiographic No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention(Sage Publications Inc, 2020) Dogdus, Mustafa; Yenercag, Mustafa; Ozyasar, Mehmet; Yilmaz, Ahmet; Can, Levent Hurkan; Kultursay, HakanNo-reflow phenomenon (NRP) is an important problem in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Endocan is synthesized and secreted by activated vascular endothelium, and it has been shown to be related to endothelial dysfunction and inflammation. We aimed to evaluate the relationship between endocan levels and NRP. Consecutive patients (n = 137) with STEMI who had undergone coronary angiography and pPCI were enrolled into the study. the clinical characteristics of the patients were obtained and endocan levels were measured. Endocan levels were significantly higher in the NRP (+) group compared with the NRP (-) group (P< .001). in multivariate analysis, endocan (P< .001, OR = 2.39, 95% CI = 1.37-4.15) was found to be an independent predictor of NRP. An endocan value of >2.7 ng/mL has 89.6% sensitivity and 74.2% specificity for the prediction of the NRP (area under the curve: 0.832,P< .001). the present study demonstrated that the endocan level is an independent predictor of the NRP in patients with STEMI who underwent pPCI. Endocan levels may be helpful in detecting patients with a higher risk of insufficient myocardial perfusion and worse clinical outcome.Öğe The Severity of Coronary Arterial Stenosis in Patients With Acute ST-Elevated Myocardial Infarction: A Thrombolytic Therapy Study(Elmer Press Inc, 2018) Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oguz; Zoghi, MehdiBackground: It is widely believed that ST-elevated myocardial infarction (STEMI) generally occurs at the site of mild to moderate coronary stenosis. The aim of this study was to determine the degree of stenosis of infarct-related artery (IRA) in STEMI patients who underwent coronary angiography (CAG) after successful reperfusion with thrombolytic therapy (TT). Methods: A total of 463 consecutive patients between January 2008 and December 2013 with acute STEMI treated with TT were evaluated retrospectively. The patients in whom reperfusion failed (n = 120), death occurred before CAG (n = 12), IRA cannot be determined (n = 10), and CAG was not performed in index hospitalization (n = 54) were excluded from the study. To determine the severity of stenosis of IRA, two experienced cardiologists who were unaware of each other used quantitative CAG analysis. Significant stenosis was defined as a >= 50% stenosis in the coronary artery lumen. A total of 267 patients who were successfully reperfused with TT and in whom CAG was performed during hospitalization with median 8 (1 - 17) days after myocardial infarction were included in the study. Results: The mean age of patients was 55.7 +/- 10.8 years (85.5% male). Most of the patients had a significant stenosis in IRA (>= 50%, n = 236, group 1) after successful TT; whereas only 11.6% had stenosis < 50% (n = 31, group 2). In addition, majority of the patients had >= 70.4% (n = 188, 70.4%) stenosis in IRA. Average of stenosis in IRA was 74 +/- 16%. Conclusions: In contrast to the general opinion, we detected that majority of STEMI patients had a significant stenosis in IRA.