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Öğe Association between bifurcation angle and coronary no-reflow following primary percutaneous coronary intervention in patients(TR- Dizin, 2021) Taşbulak, Ömer; Duran, Mustafa; Demir, Ali Rıza; Gülmez, Recep; Ertürk, Mehmet; Şahin, Ahmet AnılObjective: Percutaneous coronary intervention (PCI) has become the treatment method for patients presenting with ST elevation myocardial infarction (STEMI). One of the well-known complications of PCI is no-reflow. Studies demonstrated a relationship between endothelial dysfunction and disturbed vascular flow due to angulation of vascular tree. Although the relationship between hemodynamic alterations and coronary angulation is evident, there is a lack of detailed analysis in terms of hemodynamic changes between vascular geometry and coronary no-reflow. We aimed to elucidate the relationship between vascular geometry and coronary no-reflow. Method: We reviewed PCI database of our hospital and enrolled a total of 120 patients with STEMI, who developed no-reflow following PCI, and sex and age matched 80 patients with normal flow. For each group, demographic and clinical characteristics, laboratory values and two dimensional quantitative coronary angiography measurements were evaluated. Results: Patients with no-reflow had a higher prevalence of hypertension and diabetes mellitus. In addition, serum C-reactive protein levels were higher in patients with no-reflow compared to patients with normal flow (p<0.001). On the other hand, serum hemoglobin levels were significantly lower in patients with no-reflow compared to patients with normal flow (p<0.001). With respect to 3 dimensional coronary measurements, calculated bifurcation angle of left anterior descending artery (LAD) and circumflex artery (CX) was significantly wider in the no-reflow group than in the control group [110.9° (21.8°) vs. 85.9° (15.8°), p<0.001]. Conclusion: Our data showed that a strong association existed between bifurcation angle of LAD-CX and no-reflow phenomenon in STEMI patients who underwent PCI.Öğe Association of dipping pattern of blood pressure and atherosclerotic burden of coronary arteries in hypertensive patients(Russian Heart Failure Soc., 2022) Taşbulak, Ömer; Aktemur, Tuğba; Şahin, Ahmet Anıl; Demir, Ali Rıza; Güler, Arda; Topel, Çağdaş; Türkvatan, Aysel; Pusuroğlu, Hamdi; Ertürk, MehmetAim The aim of this study was to determine the association between the dipping pattern of BP and coronary artery disease in hypertensive patients.Material and methods A total of 356 hypertensive patients were included in the study. The results of ambulatory BP monitoring, echocardiography, and coronary computerised tomographic angiography were evaluated retrospectively. The patients were divided into two groups on the basis of their ambulatory BP monitoring: 1) patients with the dipping pattern of BP; 2) patients with the non-dipping pattern (NDP).Results Among the 356 patients, 145 were male (40.7?%). The smoking status was higher in patients with NDP (p=0.023). The statin usage in patients with the dipping pattern was higher in patients with NDP (p=0.027). There were no significant differences in the echocardiographic findings. 58.6?% of the patients without plaque formation had the dipping pattern of BP (p<0.05), however 84.4?% of patients with >50?% plaque formation had the NDP of BP (p<0.001).Conclusion The NDP of BP might be related to the increased atherosclerotic process in coronary arteries, and pa-tients with NDP might have an increased atherosclerotic burden for coronary arteries when compared with patients with a dipping pattern.Öğe Predictive role of SEC in mitral restenosis following successful percutaneous balloon mitral valvuloplasty (PBMV)(BAYRAKOL, 2022) Taşbulak, Ömer; Duran, Mustafa; Şahin, Ahmet Anıl; Demir, Ali Rıza; Uygur, Begüm; Avcı, Yalçın; Çelik, Ömer; Yalçın, Ahmet Arif; Ertürk, MehmetAim: The aim of this study was to investigate the predictive role of spontaneous echo contrast (SEC) in mitral restenosis after percutaneous balloon mitral valvuloplasty (PBMV). Material and Methods: We retrospectively analyzed 341 consecutive patients who underwent PBMV at our hospital. Subjects who participated in the study were assigned to two groups: patients who had demonstrable SEC in the left atrial cavity and left atrial appendage and patients who did not have SEC in the left atrial cavity and left atrial appendage. For each group, the following variables were analyzed: demographic characteristics, past medical records, laboratory values, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) parameters. Results: Compared to patients without SEC, patients with SEC were older, had a higher incidence of diabetes mellitus (DM), ischemic stroke and AF (p<0.05). With respect to TTE and TEE measurements, patients with SEC had lower estimated pre-procedural left ventricular ejection fraction (LVEF), a smaller calculated mitral valve area (MVA), a larger left atrial (LA) dimension and higher estimated preprocedural Wilkins score (p<0.05). In addition, the incidence of mitral restenosis following PBMV was significantly higher in patients with SEC compared to patients without SEC ( p <0.05), and this difference was more apparent in patients with grade 3-4 SEC compared to those with grade 1-2 SEC (p<0.05) Discussion: Our data showed that there is a strong association between SEC formation in the left atrium and left atrial appendage and mitral restenosis following PBMVÖğe Relationship between fragmented QRS complex and long-term cardiovascular outcome in patients with essential hypertension(Turkish Society of Cardiology, 2022) Altunova, Mehmet; Pusuroğlu, Hamdi; Demir, Ali Rıza; Yılmaz, Emre; Çizgici, Ahmet Yaşar; Ertürk, Mehmet; Şahin, Ahmet Anıl; Karakayalı, MuammerBackground: In patients with essential hypertension, fragmented QRS has been associated with many remodeling components that might lead to adverse cardiovascular effects. This study aimed to evaluate the relationship between fragmented QRS and adverse events and its potential long-term prognostic value. Methods: The patients with essential hypertension were divided into two groups according to the presence of fragmented QRS: fragmented QRS (+) and fragmented QRS (?). During long-term follow-up, the relationship of fragmented QRS to coronary artery disease, congestive heart failure, stroke, cardiovascular death, all-cause death, and major adverse cardiovascular and cerebrovascular events was evaluated. Results: The study group included 542 patients with essential hypertension. Fragmented QRS on ECG was observed in 224 (41.3%) patients. Considering the incidence rates at the end of 5.6 ± 1.3 years’ follow-up, the total incidence rate of major adverse cardiovascular and cerebrovascular events (P < .001), coronary artery disease (P < .001), and congestive heart failure (P < .001) were higher in patients with fragmented QRS. No significant difference was observed between the two groups in terms of stroke (P=.734), cardiovascular death (P=1), and all-cause death (P=.574). As a result of multiple cox regression analysis, fragmented QRS (P=.005) was identified as an independent predictor for major adverse cardiovascular and cerebrovascular events development. Conclusion: In patients with hypertension, the presence of fragmented QRS was found as an independent predictor for major adverse cardiovascular and cerebrovascular events development.Öğe Role of cardiac magnetic resonance imaging in predicting atrial fibrillation in patients with hypertrophic cardiomyopathy(CUKUROVA UNIV, 2022) Güler, Arda; Şahin, Ahmet Anıl; Uçar, Servet Umut; Aydın, Sinem; Uygur, Begüm; Çelik, Ömer; Ertürk, MehmetPurpose: The present study sought to investigate the association between Cardiac magnetic resonance (CMR) imaging parameters including late gadolinium enhancement (LGE), total left ventricular mass (TLVM), mitral regurgitation, and left atrial (LA) volume, with atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM). patients. Materials and Methods: Consecutive 122 patients with the diagnosis of HCM and together with having 48-hour Holter monitoring were included in the present work. Two experienced observers evaluated all CMR images. The correlation between AF and CMR parameters including TLVM, LA volume, the presence and extent of LGE, mitral regurgitation, and the maximum left ventricular thickness were evaluated. Results: Between the LA volume and AF, a significant correlation was observed. Additionally, TLVM was also associated with AF. The logistic multivariate analysis assessing TLVM, LA volume, and the extent of LGE revealed that only the left atrial volume was the independent predictor. Significant correlations were observed between the existence and extent of LGE, TLVM, mitral regurgitation and LA volume. Conclusion: The presence of LGE was positively correlated with LA volume. LA volume appears to be the most important independent predictor of AF in HCM patients.
