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Öğe Cardiac biomarkers in the setting of asthma exacerbations: a review of clinical implications and practical considerations(Current Medicine Group, 2020) Yalta, Kenan; Yalta, Tülin; Gürdoğan, Muhammet; Palabıyık, Orkide; Yetkin, ErtanPurpose of Review The present paper aims to highlight clinical implications of elevated cardiac biomarkers and associated myocardial dysfunction in a variety of cardiac and non-cardiac scenarios in patients with an asthma exacerbation, and to propose a basic algorithm for cardiovascular evaluation and triage (and hence, for further management) of these patients primarily based on evaluation of cardiac biomarkers along with basic diagnostic modalities and specific cardiac symptoms in the hospital setting. Recent Findings Elevation of cardiac biomarkers in the setting of an asthma exacerbation mostly signifies a new-onset subclinical myocardial dysfunction/injury generally associated with certain asthma-related factors including acute hypoxemia and bronchodilator therapy, and usually has a limited prognostic value in these patients. On the other hand, elevation of these biomarkers in patients with an asthma exacerbation might also denote a variety of certain life-threatening cardiac or non-cardiac conditions associated with significant myocardial dysfunction (acute coronary syndromes (ACSs), sepsis, etc.) that might be masked by the rampant course of the asthma exacerbation, and hence, might possibly go undetected potentially aggravating the prognosis in a portion of these patients. In patients with an asthma exacerbation, it seems imperative to timely diagnose and manage emerging diverse clinical conditions particularly through the guidance of cardiac biomarkers and associated myocardial dysfunction patterns in an effort to improve overall prognosis in these patients.Öğe COVID-19 pandemic: a glimpse into newly diagnosed hypertensive patients(LIPPINCOTT WILLIAMS & WILKINS, 2021) Yetkin, Ertan; Taylan, Gokay; Yalta, KenanThe coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as an immediate and global problem just within a few months after its first description in Wuhan-China. Beyond its alarming mortality rate and easily transmissible nature through air droplets, it has also resulted in significant challenges in the cardiovascular area not only due to its higher mortality rates in cardiovascular disease and certain associated conditions, including diabetes mellitus and hypertension, but also due to the theoretically facilitated inoculation of lung tissue by the culprit agent, SARS-CoV-2 in these conditions [1,2]. This worrisome concern has been largely attributed to the potential upregulation of angiotensin enzyme 2 (ACE2) in hypertensive and diabetic patients, and more interestingly; in those receiving angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) [3].Öğe Hypertension and diabetes mellitus in patients with COVID 19: a viewpoint on mortality(Lippincott Williams and Wilkins, 2020) Akal Taşcıoğlu, Didem; Yalta, Kenan; Yetkin, ErtanThe outbreak of coronavirus disease 2019 (COVID 19) by the novel corona virus SARS-CoV2 is the leading worldwide healthcare problem due to its contagious nature, high morbidity and mortality rates. The present pandemic has also brought an emerging situation regarding the cardiovascular complications and comorbid disease mainly pointing out hypertension (HT) and diabetes mellitus (DM). Early clinical bservations have shown that HT and DM are the main comorbid disease along with cardiovascular disease, chronic obstructive lung disease and malignancies.Öğe Low pulmonary artery size might be associated with subclinical systemic ventricular dysfunction in the Fontan circulation(Bmj Publishing Group, 2019) Yalta, Kenan; Palabıyık, Orkide; Yetkin, ErtanPersistent symptoms and long- term complications in the setting of Fontan circulation (FC) (systemic ventricular failure, etc) still remain as significant clinical challenges in clinical practice.1 In their recently published interesting article,2 Ridderbos et al have suggested pulmonary artery (PA) size (as measured with Nakata index) as an independent predictor for functional clinical status (defined as peak oxygen consumption) in Fontan patients. The authors should be congratulated for the design and novel findings of the study. However, we would like to make a few comments regarding further implications of PA size in Fontan patients:Öğe Nitrate-Induced Headache Response in Patients with Coronary Artery Disease and Coronary Artery Ectasia: A Retrospective Case-Control Study(Wolters Kluwer Medknow Publications, 2024) Aksu, Ekrem; Çuğlan, Bilal; Öztürk, Selçuk; Eren, Ali; Yalta, Kenan; Turhan, Hasan; Atmaca, Hasan; Yetkin, ErtanBackground: Coronary artery ectasia (CAE), while being considered a variant of atherosclerosis, harbors distinct features that significantly differ from atherosclerosis in terms of pathophysiological mechanisms. On the other hand, headache appears to be the most common side effect of nitrates that have been used traditionally for decades. In this context, we aimed to compare the frequency and temporal characteristics of nitrate-induced headache (NIH) between subjects with sole coronary artery disease (CAD) and subjects with CAD and coexisting CAE. Materials and Methods: Two hundred and forty-four patients who had undergone coronary angiogram (CAG) and received a single dose of sublingual isosorbide dinitrate during the procedure comprised in this retrospective study population. CAG is performed in the indications due to guidelines. All patients who had undergone CAG were held under close supervision, at least, for 6 h following CAG (and administration of sublingual nitrate); duration and emergence time of NIH were recorded for all patients. Of these 244 patients, 225 patients having sole CAD were assigned to Group I, whereas 19 patients having both CAD and CAE were assigned to Group II. Results: NIH was observed in 19 out of 225 patients (8%) with sole CAD and in 9 out of 19 patients (56%) with CAD and CAE (P = 0.003). The mean interval between the administration of sublingual isosorbide dinitrate and NIH onset was significantly lower in Group II in comparison to Group I (44 ± 14 min vs. 87 ± 63 min, respectively, P = 0.018). However, the duration of NIH was comparable between the two groups (Group I: 203 ± 53 min vs. Group II: 173 ± 61 min, P = 0.24); logistic regression analysis revealed an independent association between NIH and CAE (odds ratio: 11.5, 95% confidential interval: 3.9-33.8, P < 0.001). Conclusion: We have demonstrated that sublingual nitrates might induce NIH more frequently in subjects with CAE and CAD in comparison to those with sole CAD. Furthermore, NIH has been demonstrated to be independently associated with CAE. © 2024 Heart and Mind.Öğe Recurrent takotsubo cardiomyopathy: further insights into morphological patterns(Elsevier Science Inc, 2020) Yalta, Kenan; Yetkin, Ertan; Yalta, TülinTakotsubo cardiomyopathy (TTC) has been widely recognized as a specific form of transient myocardial dysfunction, and is well known to have a potential recurrence risk following the index event [1-11]. In a recent systematic review [3], certain factors in-cluding female gender, temporal proximity to the first TTC event, lower body mass index (BMI) and an existing mid-ventricular gra-dient (MVG) (potentially suggestive of a mechanical basis for TTC evolution) have been suggested as fundamental predictors of TTC recurrence. On the other hand, extreme adrenergic discharge in the setting of index TTC (regardless of its association with these sug-gested predictors) might potentially be regarded as central to the evolution of future TTC recurrences, and might present with in-direct clinical signs including left ventricular outflow tract (LVOT) gradient and coronary slow flow (CSF) in this setting [5-7]. In their recently published article [1], Ahmadjee A, et al have reported a female patient who had suffered a recurrent TTC episode with a completely different morphological pattern compared with the in-dex TTC (classical followed by a reverse TTC pattern). Accordingly; we would like to make a few comments on this interesting case and potential implications of morphological patterns in the setting of TTC recurrencesÖğe Serum Copeptin in Cardiooncology Practice: Review of Pathophysiological and Clinical Implications(Galenos Publ House, 2023) Yalta, Kenan; Yetkin, Ertan; Yalta, TuelinIn cardiooncology practice, early cardiotoxicity refers to an emerging subclinical myocardial dysfunction/injury in response to certain chemotherapeutic regimens. This condition can progress to overt cardiotoxicity in time and hence warrants proper and timely diagnostic and preventive strategies. Current diagnostic strategies for early cardiotoxicity are largely based on conventional biomarkers and certain echocardiographic indices. However, a significant gap still exists in this setting, warranting further strategies to improve diagnosis and overall prognosis in cancer survivors. Copeptin (surrogate marker of the arginine vasopressine axis) might serve as a promising adjunctive guide for the timely detection, risk stratification, and management of early cardiotoxicity on top of conventional strategies largely due to its multifaceted pathophysiological implications in the clinical setting. This work aims to focus on serum copeptin as a marker of early cardiotoxicity and its general clinical implications in patients with cancer.Öğe Takotsubo cardiomyopathy: an obscure cause of emerging cardiovascular manifestations in the setting of Bickerstaff’s brainstem encephalitis(Springer-Verlag Italia s.r.l., 2020) Yalta, Kenan; Yetkin, Ertan; Yalta, Tülin DenizBickerstaff’s brainstem encephalitis (BBE) has been regarded as a specific form of post-infectious and potentially autoimmune neurological disorder with a relatively favorable prognosis and usually presents with sensorial changes, ophthalmoplegia, and ataxiaÖğe Where cystatin C acts: inside or outside of the plaque(Springer-Verlag Italia Srl, 2020) Yetkin, Ertan; Çuğlan, Bilal; Turhan, Hasan; Yalta, KenanWe have read the impressive article recently published by Ren et al. evaluating the plasma cystatin C (Cyst C) in patients with acute ischemic stroke (AIS) and carotid stenosis [1]. Briefly, they have divided the patients into two groups based on their plasma Cyst C levels and assessed their relation with the degree of carotid stenosis, plaque burden, and morphology. The degree of atherosclerosis, the severity of plaques, and stenosis of the common carotid artery (CCA) of patients with AIS have been found to be significantly higher in the patients with high cystatin C levels. They have concluded that Cyst C levels are strongly correlated with symptomatic CCA stenosis and the rate of unstable plaques
