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    Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients
    (Lithographia, 2012) Hur, E.; Yildiz, G.; Kose, Budak S.; Kokturk, F.; Musayev, O.; Gungor, O.; Magden, K.; Yildirim, I; Duman, S.; Ok, E.
    Background: Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control. Methods: From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices. Results: Patients were younger (47.6 +/- 14. 5 and 53.1 +/- 11.8 years, p< 0.05), daily urine volume higher (1068 +/- 926 vs 290 +/- 444 ml, p <0.001) and dialysis vintage was shorter (30.1 +/- 18.6 vs 53.6 +/- 35.4 months, p<0.001), systolic blood pressure was lower (127.5 +/- 15.4 vs 140.3 +/- 18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p< 0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R-2:0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41 +/- 0.24 and 159.6 +/- 48.2 vs. 1.27 +/- 0.17 cm and 115.8 +/- 37 g/m(2), p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly. Conclusion: Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration.
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    Clinical and prognostic significance of heart rate variability in pulmonary arterial hypertension
    (Oxford Univ Press, 2014) Kayikcioglu, M.; Musayev, O.; Nalbantgil, S.; Mogulkoc, N.; Vuran, O.; Musayev, K.; Kultursay, H.
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    Clinical and Prognostic Significance of Heart Rate Variability in Pulmonary Hypertension
    (Elsevier Science Inc, 2014) Musayev, O.; Kayikcioglu, M.; Nalbantgil, S.; Mogulkoc, N.; Vuran, O.; Musayev, K.; Kultursay, H.
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    Kalp Hızı Değişkenliği, Pulmoner Hipertansiyon Hastalarında Bir Prognostik Gösterge Olarak Kullanılabilir Mi? Tek Merkezli Bir Pilot Çalışma
    (2023) Musayev, O.; Kayıkçıoğlu, M.; Shahbazova, S.; Nalbantgil, S.; Moğulkoç, N.; Ibrahimov, F.; Kültürsay, H.
    OBJECTIVE: Heart rate variability (HRV), which is defined as cyclic changes in sinus rate with time, is used as a measure of cardiac autonomic tone. Our aim was to determine the impact of HRV on short-term prognosis in pulmonary hypertension (PH). METHODS: We enrolled 64 PH patients and 69 healthy subjects (control group). Patients were evaluated by Holter-ECG, echocardiography, and laboratory tests. 24-h Holter-ECG monitoring was used for HRV. The development of adverse events (right heart failure, hospitalization, syncope, and death) during the 6-month follow-up was evaluated in PH group. RESULTS: PH group (39 ± 16 years, 37.5% males) comprised of 16 patients with idiopathic pulmonary arterial hypertension (PAH) (25%), 36 patients with PAH associated with congenital heart disease (56.3%), 3 PAH associated with connective tissue disease (4.7%), 1 with portopulmonary (1.6%), and 8 chronic thromboembolic PH (12.5%). The time-dependent (standard deviation of all NN intervals for a selected time period [SDNN], standard deviation of the 5-min mean R-R intervals tabulated over an entire day [SDANN], SDNN Index, and Triangular Index) and frequency-dependent HRV indices (low frequency, high-frequency power, and total power,) were significantly reduced in those with PH. Functional class was negatively associated with SDNN, SDANN, SDNN Index, and Triangular Index. Adverse events developed in 25% of the patients during the 6-month follow-up period (200 ± 92 days) (7 patients had right-heart failure, 5 syncope, 12 patients were hospitalized, and 9 had died). All the time and frequency-dependent indices significantly associated with adverse events. Mortality correlated with SDNN (rS = -0.354, P = 0.005), SDANN (rS = -0.368, P = 0.004), SDNN Index (rS = -0.257, P = 0.045), Triangular Index (rS = -0.310, P = 0.014), and VLF (rS = -0.265, P = 0.039). CONCLUSION: HRV is significantly depressed in patients with PH and is associated with the clinical status. HRV indices might predict clinical deterioration, adverse events, and mortality for 6 months. Non-invasive assessment of HRV through Holter-ECG may be a valuable and practical tool in risk stratification of patients with PH for short-term outcomes.