Yazar "Kemal, Hatice S." seçeneğine göre listele
Listeleniyor 1 - 12 / 12
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe 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(2020) Kemal, Hatice S.; Kayıkçıoğlu, Meral; Nalbantgil, Sanem; Can, Levent Hürkan; Moğulkoç, Nesrin; Kültürsay, Kadir 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 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 Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation(Wiley, 2017) Ertugay, Serkan; Kemal, Hatice S.; Kahraman, Umit; Engin, Catagay; Nalbantgil, Sanem; Yagdi, Tahir; Ozbaran, MustafaSignificant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51.7 +/- 10.9 years, 14.4% female) who underwent LVAD implantation (HeartMate II=21, HeartWare569) in a single center between December 2010 and June 2014. Echocardiograms obtained at 3-6 months and over after implantation were analyzed retrospectively. RV systolic function was graded as normal, mild, moderate, and severely depressed. MR (>= moderate) was observed in 43 and 44% of patients at early and late period, respectively. Systolic function of the RV was severely depressed in 16 and 9% of all patients. Initial analysis (mean duration of support 174.3 +/- 42.5 days) showed a statistically significant correlation between less MR and improved systolic function of RV (P=0.01). Secondary echocardiographic analysis (following a mean duration of support of 435.1 +/- 203 days) was also statistically significant for MR degree and RV systolic dysfunction (P= 0.008). Residual MR after LVAD implantation may cause deterioration of RV systolic function and cause right-sided heart failure symptoms. Repair of severe MR, in selected patients such as those with severe pulmonary hypertension and depressed RV, may be considered to improve the patient's clinical course during pump support.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 Prevalence of inappropriate sinus tachycardia and the comparison of the heart rate variability characteristics with propensity score-matched controls(2020) Şimşek, Evrim; Özbay, Benay; Mutlu, İnan; Gürses, Ecem; Kemal, Hatice S.; Yağmur, Burcu; Can, Levent HürkanObjective: 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 Prevalence of inappropriate sinus tachycardia and the comparison of the heart rate variability characteristics with propensity score-matched controls(2020) Şimşek, Evrim; Özbay, Benay; Mutlu, İnan; Gürses, Ecem; Kemal, Hatice S.; Yağmur, Burcu; Can, Levent HürkanObjective: 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 Pulmoner hipertansiyona özgül tedavi altındaki olgularda strain ekokardiyografinin klinik ve prognostik önemi(Ege Üniversitesi, 2015) Kemal, Hatice S.; Can, Levent H.Giriş: Pulmoner arteriyel hipertansiyon (PAH); pulmoner vasküler yeniden şekillenme, sağ kalp yetmezliği ve sınırlı sağkalım ile seyreden bir hastalıktır. Sağ ventrikül (SaV) disfonksiyonu pulmoner hipertansiyon (PH) olan hastalarda klinik seyir ve sağkalımın önemli bir belirleyicisi olmasına rağmen, SaV fonksiyonunun optimal değerlendirilmesi için kesin bilgiler tanımlanmamıştır. Bu çalışmanın amacı SaV serbest duvar speckle izlem strain ekokardiyografinin PAH özgül tedavisi almakta olan olgularda, konvansiyonel ekokardiyografı parametrelerine kıyasla SaV işlevini değerlendirmedeki yararını ortaya koymaktır. Yöntem: Prospektif olarak SaV serbest duvar longitudinal sistolik strain (LS) ölçümü PAH merkezimizde takip edilen 92 hastada (62 kadın, ortalama yaş: 41.4 ± 16 yıl, 49 doğuştan kalp hastalığı ile ilişkili PAH, 21 idiyopatik PAH, 11 bağ dokusu hastalığı ilişkili PAH ve 11 kronik tromboembolik pulmoner hipertansiyon) gerçekleştirildi. SaV serbest duvar longitudinal speckle ekokardiyografı strain değeri, serbest duvarın her üç bölgesel zirve sistolik değerlerinin ortalaması alınarak hesaplandı. Ortalama izlem süresi 222 ± 133 gündü. Konvansiyonel ekokardiyografık parametrelerden SaV fraksiyonel alan değişimi (FAD), Triküspit anüler plan sistolik esneme mesafesi (TAPSE) ve Triküspit anuler pik sistolik hızı ve hemodinamik parametrelerden fonksiyonel sınıf, 6-DYM ve NT-proBNP düzeyi değerlendirildi. Veriler uygun istatistiksel analizler kullanılarak değerlendirildi. Bulgular: Tüm hastaların ortalama SaV serbest duvar LS değeri % -13,16 ± 6.3 idi. SaV serbest duvar LS ile fonksiyonel sınıf (Rho= 0.312, p=0.01) ve NT-proBNP düzeyi (Rho= 0.423, p=0.0001) arasında pozitif anlamlı ilişki varken, FAD (Rho = -0,637 p = 0.0001), TAPSE (Rho = -0,524, p = 0.0001) ve Triküspit anuler pik sistolik hızı (Rho = -0,450, p = 0.0001) ve 6-DYM (Rho =-0.333, p=0.002) ile negatif anlamlı ilişki vardı. Ayrıca SaV serbest duvar LS değeri, loop diüretik kullanımı ile ilişkili bulunmuşdu (p=0.0001). Takipte gelişen istenmeyen olaylar, ölüm ve klinik sağ kalp yetersizliği ile SAV serbest duvar LS arasında anlamlı ilişki saptandı (p=0.04, p=0.03, p=0.02, sırasıyla). Sonuç: SaV serbest duvar LS, PAH özgül tedavisi altındaki hastalarda sağ kalp yetersizliği, klinik bozulma ve sağkalımının değerlendirilmesi için güçlü ve uygun bir yöntemdir.Öğe Right ventricular free-wall longitudinal speckle tracking strain in patients with pulmonary arterial hypertension under specific treatment(Wiley, 2017) Kemal, Hatice S.; Kayikcioglu, Meral; Kultursay, Hakan; Vuran, Ozcan; Nalbantgil, Sanem; Mogulkoc, Nesrin; Can, LeventBackground Right ventricular (RV) dysfunction is a major determinant of outcomes in patients with pulmonary arterial hypertension (PAH), although the optimal measure of RV function is poorly defined. We evaluated the utility of RV free-wall speckle tracking strain as an assessment tool for RV function in patients with PAH who are already under specific treatment compared with conventional echocardiographic parameters and investigated the relationship of RV free-wall strain with clinical hemodynamic parameters of RV performance. Methods Right ventricular free-wall strain was evaluated in 92 patients (Group-1 and Group-4 pulmonary hypertension) who were on PAH-specific treatment for at least 3 months. Right atrial (RA) area, RV FAC, TAPSE, tricuspid S, functional class, 6-minute walking distance, and NT-proBNP were studied. The mean duration of follow-up was 222 +/- 133 days. Results All patients were under PAH-specific treatment, and mean RV free-wall strain was -13.16 +/- 6.3%. RV free-wall strain correlated well with functional class (r=.312, P=.01), NT-proBNP (r=.423, P=.0001), RA area (r=.427, P=.0001), FAC (r=-.637, P=.0001), TAPSE (r=-.524, P=.0001), tricuspid S (r=-.450, P=.0001), 6-minute walking distance (r=-.333, P=.002). RV free-wall strain significantly correlated with all follow-up adverse events, death, and clinical right heart failure (RHF) (P=.04, P=.03, P=.02, respectively). According to the receiver operator characteristic analysis, the cutoff value for RV free-wall strain for the development of clinical RHF was -12.5% (sensitivity: 71%, specificity: 67%) and for all cardiovascular adverse events (death included) was -12.5% (sensitivity: 54%, specificity: 64%). Conclusion Assessment of RV free-wall strain is a feasible, easy-to-perform method and may be used as a predictor of RHF, clinical deterioration, and mortality in patients already under PAH-specific treatment.Öğe Risk Factors of Gastrointestinal Bleeding After Continuous Flow Left Ventricular Assist Device(Lippincott Williams & Wilkins, 2018) Balcioglu, Ozlem; Kemal, Hatice S.; Ertugay, Serkan; Ozturk, Pelin; Engin, Yaprak; Nalbantgil, Sanem; Engin, Cagatay; Yagdi, Tahir; Ozbaran, MustafaThis study aimed to compare von Willebrand factor (vWF) levels, ristocetin cofactor levels, platelet counts, aortic valve movements, and right heart failure (RHF) as risk factors of gastrointestinal (GI) bleeding in patients with continuous flow left ventricular assist device (cf-LVAD). In a single centre, 90 patients (mean age 52.0 +/- 10.5 years), of which 59 were male and 31 were female, had cf-LVAD implantation from October 2010 to November 2012. Seventy-six (84.4%) patients had HeartWare (Medtronic, Mounds View, MN) and 14 (15.5%) had Heartmate II (Thoratec, Pleasanton, CA) implanted. vWF level, ristocetin cofactor level, and platelet count were measured before and after implantation to determine the presence of acquired von Willebrand Syndrome; aortic valve movement and postoperative RHF were evaluated to compare the difference in bleeding and nonbleeding patient groups. Fifteen patients (16.6%) suffered GI bleeding after cf-LVAD implantation. A statistically significant decrease was found in vWF and ristocetin cofactor levels from preoperative period to postoperative period in both bleeding and nonbleeding patient groups (p < 0.05). There was no significant difference in bleeding and nonbleeding groups regarding aortic valve movements (p 0.05). Postoperative RHF incidence was significantly high in the bleeding patient group compared with the nonbleeding group (p < 0.05). Therefore, depending on the findings of this study, acquired von Willebrand Syndrome was seen in all cf-LVAD patients, and postoperative RHF was an important risk factor for GI bleeding.Öğe Takotsubo syndrome after treatment with non-cardiotoxic chemotherapy agents(Turkish Soc Cardiology, 2021) Ozbay, Benay; Guerses, Ecem; Kemal, Hatice S.; Simsek, Evrim; Kultursay, HakanTakotsubo syndrome (TTS), acute stress-induced cardiomyopathy, is known to have a dramatic clinical presentation mimicking acute myocardial infarction. Recently developed chemotherapeutic drugs have resulted in improvements in morbidity and mortality in many forms of cancer. However, some chemotherapeutic drugs are cardiotoxic and may cause heart failure. Gemcitabine and vinorelbine are commonly used drugs for various solid organ neoplasms. While neither of these chemotherapeutic drugs has been directly associated with cardiotoxicity, there are a few case reports in the literature related to gemcitabine treatment-induced cardiomyopathy. This case report describes a case of TTS developing within hours of gemcitabine and vinorelbine chemotherapy.Öğe Utility of CHA(2)DS(2)-VASc and HAS-BLED Scores as Predictor of Thromboembolism and Bleeding After Left Ventricular Assist Device Implantation(Lippincott Williams & Wilkins, 2017) Kemal, Hatice S.; Ertugay, Serkan; Nalbantgil, Sanem; Ozturk, Pelin; Engin, Cagatay; Yagdi, Tahir; Ozbaran, MustafaIschemic and hemorrhagic events are the common causes of morbidity and mortality after continuous-flow left ventricular assist device (CF-LVAD) implantation. CHA(2)DS(2)-VASc score predicts thromboembolic (TE) event risk and HAS-BLED score predicts bleeding risk in patients on anticoagulant with atrial fibrillation (AF). We aimed to evaluate whether these scoring systems would be predictive of TE and bleeding complications after CF-LVAD implantation. From December 2010 to December 2014, 145 patients who underwent CF-LVAD implantation at a single center were included. Mean age was 50.7 +/- 11.2 years, and 85.5% were male. Baseline CHA(2)DS(2)-VASc and HAS-BLED scores were retrospectively determined for patients with CF-LVADs. After device implantation, all patients were on warfarin (target international normalized ratio 2-3) as well as 300 mg of aspirin daily. Median length of support was 316 days (range 31-1,060), with 22 TE events (15.2%) and 32 bleeding (22.1%) events. The mean CHA(2)DS(2)-VASc score was 2.3 +/- 1.4 and 2.5 +/- 1.2 (p = 0.2) in patients with and without TE event, respectively. The mean HAS-BLED score was 1.8 +/- 0.8 and 1.42 +/- 0.6 (p = 0.004) in patients with and without bleeding, respectively. Baseline high HAS-BLED score was predictive of bleeding events after CF-LVAD implantation, whereas baseline CHA(2)DS(2)-VASc score was not predictive of TE events.Öğe VALUE OF SPECKLE TRACKING FOR THE ASSESSMENT OF RIGHT VENTRICULAR FUNCTION IN PATIENTS WITH CONGENITAL HEART DISEASE ASSOCIATED PULMONARY HYPERTENSION: CORRELATION WITH CONSERVATIVE ECHOCARDIOGRAPHY AND CLINICAL PARAMETERS(Elsevier Science Inc, 2016) Kemal, Hatice S.; Kayikcioglu, Meral; Can, Levent H.; Nalbantgil, Sanem; Vuran, Ozcan; Mogolkoc, Nesrin; Kultursay, Hakan
