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Kavgacı A, Kula S, Berber Maraşlı E, Zinnuroğlu M, Çelik B, Terlemez S, Tunaoğlu S, Oğuz D. Evaluation of handgrip strength in children with pulmonary hypertension. Cardiol Young 2024:1-5. [PMID: 38450520 DOI: 10.1017/s1047951124000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND Handgrip strength is a crucial indicator of upper extremity muscular strength and is vital for monitoring disorders like cardiac diseases that restrict a patient's physical activity and result in muscle atrophy. The aim of our study was to evaluate whether muscle strength loss is present in patients with pulmonary hypertension and whether this test can be an alternative to 6-minute walk test. MATERIALS AND METHODS The study included 39 healthy children who were admitted to the outpatient clinic and 16 children with a diagnosis of pulmonary hypertension who were being followed in our centre. We assessed the differences in upper extremity handgrip strength using the Jamar Hydraulic Hand Dynamometer device among both healthy children and those diagnosed with pulmonary hypertension. Moreover, we compared the handgrip strength of pulmonary hypertension patients with significant prognostic indicators such as NYHA class, 6-minute walk test, and pro-brain natriuretic peptide. RESULTS The mean dominant handgrip strength was 20.8 ± 12 kg in the patient group and 21.6 ± 12.4 kg in the control group (p = 0.970). Handgrip strength was shown to be negatively connected with pro-brain natriuretic peptide (r = -0.565, p = 0.023) and positively correlated with 6-minute walk test (r = 0.586, p = 0.022) during the patient group evaluation. CONCLUSION Six-minute walk test needs a customised physical area (30 m of a straight hallway) and trained personnel for applying the test. The handgrip strength test, a different muscle strength indicator, can be used to more clearly and simply indicate the decline in patients' ability for effort. Additionally, it was found in our study that handgrip strength decreased as pro-brain natriuretic peptide levels rose, a crucial measure in the monitoring of pulmonary hypertension.
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Affiliation(s)
- Akif Kavgacı
- Department of Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Serdar Kula
- Department of Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Elif Berber Maraşlı
- Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Murat Zinnuroğlu
- Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Bülent Çelik
- Department of Statistics, Gazi University Faculty of Science, Ankara, Turkey
| | - Semiha Terlemez
- Department of Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sedef Tunaoğlu
- Department of Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Oğuz
- Department of Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Kavgacı A, Leventoğlu E, Azapağası E, Serdaroğlu E, Fidan K, Kula S. Cardiac Manifestation in a Child With Atypical Hemolytic Uremic Syndrome. Clin Pediatr (Phila) 2024:99228231223656. [PMID: 38243652 DOI: 10.1177/00099228231223656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Affiliation(s)
- Akif Kavgacı
- Department of Pediatric Cardiology, Gazi University, Ankara, Turkey
| | - Emre Leventoğlu
- Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Ebru Azapağası
- Department of Pediatric Intensive Care Unit, Gazi University, Ankara, Turkey
| | - Esra Serdaroğlu
- Department of Pediatric Neurology, Gazi University, Ankara, Turkey
| | - Kibriya Fidan
- Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Serdar Kula
- Department of Pediatric Cardiology, Gazi University, Ankara, Turkey
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Kavgacı A, İncedere F, Tunaoğlu S, Karabörk M, Büyükkaragöz B, Leventoğlu E, Oğuz D, Kula S, Terlemez S. Comparison of echocardiographic aortic stiffness index measurements and pulse wave velocity measurements in obese and overweight children. Cardiol Young 2024; 34:11-17. [PMID: 37340799 DOI: 10.1017/s104795112300166x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Aortic/arterial stiffness is a reliable, independent predictor and a risk factor for cardiovascular mortality. Arterial stiffness is assessed by pulse wave velocity and echocardiography. The purpose of this study is to analyse aortic/arterial stiffness in patients using echocardiographic and pulse wave velocity techniques. MATERIALS AND METHODS The participants of this study consisted of 62 patients who presented to the Gazi University Pediatric Endocrinology and Pediatric Cardiology outpatient clinics, including 21 obese, 20 overweight, and 21 normal-weight patients. Echocardiography was performed on all patients, and echocardiographic measurements were compared to pulse wave velocity measurements. RESULTS The mean (min-max) arterial strain measurements were 0.146 ± 0.0 (0.06-0.3) in the obese group and 0.106 ± 0.0 (0.05-0.18) in the overweight group. In comparison to the overweight group, the obese group had greater arterial strain measurements. The pulse wave velocity measurements in the obese and overweight groups were greater than those in the normal weight group (p > 0.05). Elastic modulus and aortic stiffness ß index values were shown to be positively correlated with pulse wave velocity measurements in the obese group (r = 0.56, r = 0.53, respectively; p = 0.008, p = 0.01, respectively). Systolic and diastolic blood pressure measurements were correlated with pulse wave velocity measurements in the obese group (r = 0.98, p = 0.0001, respectively). CONCLUSION In our study, echocardiographic aortic measurements showing the vessel wall were correlated with pulse wave velocity measurements. Echocardiographic evaluation should be included in the routine follow-up of patients because pulse wave velocity measurement devices are not available in all centres, echocardiography is available in many centres, it is easily applicable, and it facilitates the follow-up of patients.
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Affiliation(s)
- Akif Kavgacı
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Fatma İncedere
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sedef Tunaoğlu
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Bahar Büyükkaragöz
- Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emre Leventoğlu
- Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Oğuz
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Serdar Kula
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Semiha Terlemez
- Pediatric Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Leventoğlu E, Büyükkaragöz B, Kavas FÇ, Holoğlu MC, Kavgacı A, Fidan K, Dalgıç A, Bakkaloğlu SA, Tunaoğlu FS, Söylemezoğlu O. Electrocardiographic measurements in children with pre-dialysis chronic kidney disease and undergoing kidney replacement therapy. Eur J Pediatr 2023; 182:4993-5005. [PMID: 37624446 DOI: 10.1007/s00431-023-05154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Cardiovascular diseases are the main causes of morbidity in children with chronic kidney disease (CKD). Electrocardiography (ECG) can provide important information about cardiac functions and parameters associated with sudden cardiac death. This study aims to evaluate the potentially dangerous changes in CKD and kidney replacement therapies by ECG and to determine the value of ECG in predicting cardiovascular outcome compared with echocardiography. 101 patients with CKD were divided into subgroups according to treatment modalities as pre-dialysis CKD, hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KTx). Differences in anthropometric measurements, laboratory results, blood pressures, ECG monitoring were compared within groups as well as with 40 healthy controls. Available echocardiographic findings were noted. In the patients, HD group had highest frequency of hypertension. ECG revealed prolonged QTc as more frequent (16.8% vs 0%, p = 0.006) and higher QTcD (56.7 ± 6.5 vs 39.9 ± 5.1 ms, p = 0.001) in the patients compared to controls, especially in dialysis patients, whereas lowest values were in KTx subgroup. Left ventricular (LV) hypertrophy (LVH) was more frequent (47.1%) in HD compared to other CKD subgroups in ECG (p = 0.052). Echocardiography also showed LV mass index as highest in HD and lowest in KTx (121.4 ± 55.7 vs 63.7 ± 18.3 g/m2, p = 0.000), with numerically highest LVH in HD (58.3%, p = 0.063). Conclusion: ECG can be used to detect cardiovascular problems in patients with CKD, especially in HD. As ECG results were in line with echocardiography, patients with ECG abnormalities suggestive of LVH should be referred for echocardiographic assessment. What is Known: • Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias and sudden cardiac death are major causes of morbidity and mortality in chronic kidney disease. • Electrocardiography has significant advantages in demonstrating cardiac functions in children because it is readily available, non-invasive and often non-experts can interpret the results. What is New: • The heart rate is higher, QTc is longer and QTcD is higher in dialysis patients and the prolonged QTc is more frequent in patients with underlying glomerular diseases. • Left ventricular hypertrophy is more common in HD patients and those with hypertension, hypercalcemia, anemia or glomerular etiology. The cardiovascular risky conditions are less frequent in the patients with kidney transplantation.
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Affiliation(s)
- Emre Leventoğlu
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey.
| | - Bahar Büyükkaragöz
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Furkan Çağrı Kavas
- Faculty of Medicine, Department of Pediatrics, Gazi University, Ankara, Turkey
| | - Mert Can Holoğlu
- Faculty of Medicine, Department of Pediatrics, Gazi University, Ankara, Turkey
| | - Akif Kavgacı
- Faculty of Medicine, Department of Pediatric Cardiology, Gazi University, Ankara, Turkey
| | - Kibriya Fidan
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Aydın Dalgıç
- Faculty of Medicine, Department of Transplantation Surgery, Gazi University, Ankara, Turkey
| | - Sevcan A Bakkaloğlu
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Fatma Sedef Tunaoğlu
- Faculty of Medicine, Department of Pediatric Cardiology, Gazi University, Ankara, Turkey
| | - Oğuz Söylemezoğlu
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
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Kavgacı A, Incedere F, Terlemez S, Kula S. Successful treatment of two cases of acute myocarditis with colchicine. Cardiol Young 2023; 33:1741-1742. [PMID: 36938910 DOI: 10.1017/s1047951123000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Colchicine is an FDA-approved medicine that has been used for many years to prevent and treat gout flares as well as familial mediterranean fever. It is also used off-label to treat pericarditis, calcium pyrophosphate illness, and Behçet's syndrome. There are additional studies on the use of colchicine, which is accepted as the standard treatment for pericarditis in adults, post-pericardiotomy syndrome, post-operative and post-ablation atrial fibrillation, coronary artery disorders, prior to percutaneous coronary procedures, and myocarditis. Colchicine appears to be a promising oral cardiovascular treatment targeting the inflammatory axis, owing to its low cost and moderate side-effect profile. Our aim is to emphasise that colchicine treatment, which has a strong and effective anti-inflammatory effect profile, should be kept in mind in addition to conventional treatment in childhood myocarditis.
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Affiliation(s)
- Akif Kavgacı
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatma Incedere
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Semiha Terlemez
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Serdar Kula
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Leventoğlu E, Kavgacı A, İncedere F, Tokgöz S, Büyükkaragöz B. Arterial Stiffness and Cardiac Functions in Children with Idiopathic Nephrotic Syndrome. Indian J Pediatr 2023; 90:413. [PMID: 36757653 DOI: 10.1007/s12098-023-04500-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Affiliation(s)
- Emre Leventoğlu
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Akif Kavgacı
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Fatma İncedere
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Semiha Tokgöz
- Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bahar Büyükkaragöz
- Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Kavgacı A, Bayrakoğlu D, Bal SK, Haskoloğlu Ş, Çullas-İlarslan NE, Topçu S, Okulu E, İslamoğlu C, Arıkan M, Doğu F, İkincioğulları KA. Evaluation of thymopoiesis in healthy Turkish children aged 0-6 years. Turk J Pediatr 2023; 65:73-80. [PMID: 36866987 DOI: 10.24953/turkjped.2021.5190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Early diagnosis and effective treatment serve as life-saving procedures for primary immunodeficiencies (PIDs) which are very common and a major public health problem in Turkey. Severe combined immunodeficiency (SCID) is constitutively a T-cell defect in which naïve T-cell development is defective due to the mutations in genes responsible for the T cell differentiation and insufficient thymopoiesis. So, assessment of thymopoiesis is very important in the diagnosis of SCID and several combined immune deficiencies (CIDs). METHODS The purpose of this study is to examine thymopoiesis in healthy children via measurement of recent thymic emigrants (RTE); T lymphocytes that express CD4, CD45RA and CD31 to establish the RTE reference values in Turkish children. RTE were measured in the peripheral blood (PB) of 120 healthy infants and children between 0-6 years including cord blood samples, by flow cytometry. RESULTS The absolute count of RTE cells and their relative ratios were found to be higher during the first year of life, being highest at the 6th month and tending to decrease significantly by age following birth (p=0.001). In the cord blood group, both values were lower than those in the 6-month-old group. The absolute lymphocyte count (ALC) varying by age, was found to reduce to 1850/mm³ in 4-years and after. CONCLUSIONS Here we evaluated normal thymopoiesis and established the normal reference levels of RTE cells in the peripheral blood of healthy children aged between 0-6 years. We believe that the collected data will contribute to early diagnosis and monitoring of immune reconstitution; serving as an additional fast and reliable marker for many PID patients especially for SCID including many other CIDs, especially in nations where newborn screening (NBS) via T cell receptor excision circles (TREC) has not yet become available.
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Affiliation(s)
- Akif Kavgacı
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara
| | - Deniz Bayrakoğlu
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
| | - Sevgi Köstel Bal
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
| | - Şule Haskoloğlu
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
| | | | - Seda Topçu
- Department of Social Pediatrics, Ankara University Faculty of Medicine, Ankara
| | - Emel Okulu
- Department of Neonatology, Ankara University,Faculty of Medicine, Ankara, Türkiye
| | - Candan İslamoğlu
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
| | - Meltem Arıkan
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
| | - Figen Doğu
- Department of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara
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Chamorro D, Luna B, Ourcival JM, Kavgacı A, Sirca C, Mouillot F, Arianoutsou M, Moreno JM. Germination sensitivity to water stress in four shrubby species across the Mediterranean Basin. Plant Biol (Stuttg) 2017; 19:23-31. [PMID: 26998911 DOI: 10.1111/plb.12450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 03/14/2016] [Indexed: 06/05/2023]
Abstract
Mediterranean shrublands are generally water-limited and fire-driven ecosystems. Seed-based post-fire regeneration may be affected by varying rainfall patterns, depending on species sensitivity to germinate under water stress. In our study, we considered the germination response to water stress in four species from several sites across the Mediterranean Basin. Seeds of species with a hard coat (Cistus monspeliensis, C. salviifolius, Cistaceae, Calicotome villosa, Fabaceae) or soft coat (Erica arborea, Ericaceae), which were exposed or not to a heat shock and smoke (fire cues), were made to germinate under water stress. Final germination percentage, germination speed and viability of seeds were recorded. Germination was modelled using hydrotime analysis and correlated to the water balance characteristics of seed provenance. Water stress was found to decrease final germination in the three hard-seeded species, as well as reduce germination speed. Moreover, an interaction between fire cues and water stress was found, whereby fire cues increased sensitivity to water stress. Seed viability after germination under water stress also declined in two hard-seeded species. Conversely, E. arborea showed little sensitivity to water stress, independent of fire cues. Germination responses varied among populations of all species, and hydrotime parameters were not correlated to site water balance, except in E. arborea when not exposed to fire cues. In conclusion, the species studied differed in germination sensitivity to water stress; furthermore, fire cues increased this sensitivity in the three hard-seeded species, but not in E. arborea. Moreover, populations within species consistently differed among themselves, but these differences could only be related to the provenance locality in E. arborea in seeds not exposed to fire cues.
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Affiliation(s)
- D Chamorro
- Departamento de Ciencias Ambientales, Universidad de Castilla-La Mancha, Toledo, Spain
| | - B Luna
- Departamento de Ciencias Ambientales, Universidad de Castilla-La Mancha, Toledo, Spain
| | - J-M Ourcival
- Centre d'Ecologie Fonctionnelle et Evolutive (CEFE), UMR 5175 CNRS/Université de Montpellier/Université Paul Valery Montpellier/EPHE, Montpellier, France
| | - A Kavgacı
- Batı Akdeniz Ormancılık Arastirma Enstitüsü, Southwest Anatolia Forest Research Institute, Antalya, Turkey
| | - C Sirca
- DIPNET, Dipartimento di Scienze della Natura e del Territorio, University of Sassari, Sassari, Italy
- IAFES Division of the CMCC, Euro-Mediterranean Centre on Climate Change, Sassari, Italy
| | - F Mouillot
- Centre d'Ecologie Fonctionnelle et Evolutive (CEFE), UMR 5175 CNRS/Université de Montpellier/Université Paul Valery Montpellier/EPHE/IRD, Montpellier, France
| | - M Arianoutsou
- Department of Ecology and Systematics, Faculty of Biology, University of Athens, Athens, Greece
| | - J M Moreno
- Departamento de Ciencias Ambientales, Universidad de Castilla-La Mancha, Toledo, Spain
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