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Güzel T, Demir M, Aktan A, Kılıç R, Arslan B, Günlü S, Altıntaş B, Karahan MZ, Özbek M, Aslan B, Arpa A, Coşkun MS, Altunbaş M, Tüzün R, Akgümüş A, Karadeniz M, Aydın S, Güzel H, Aslan SF, Söner S, Taş A, Ertaş F. The effect of body mass index on complications in cardiac implantable electronic device surgery. Pacing Clin Electrophysiol 2024; 47:292-299. [PMID: 38078545 DOI: 10.1111/pace.14903] [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: 11/02/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications. METHODS 1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m2 ), overweight (25 ≤ BMI < 30 kg/m2 ), and obese (BMI ≥ 30 kg/m2 ). The primary endpoint was accepted as cumulative events, including the composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of cumulative events. RESULTS The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156-3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470-9.204, p < .001), BMI (OR:1.069, 95%CI:1.012-1.129, p = .01) were independent predictors of cumulative events rates. CONCLUSIONS Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.
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Affiliation(s)
- Tuncay Güzel
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Muhammed Demir
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Adem Aktan
- Department of Cardiology, Mardin Training and Research Hospital, Mardin, Turkey
| | - Raif Kılıç
- Department of Cardiology, Çermik State Hospital, Diyarbakır, Turkey
| | - Bayram Arslan
- Department of Cardiology, Ergani State Hospital, Diyarbakır, Turkey
| | - Serhat Günlü
- Department of Cardiology, Mardin Artuklu University Medical Faculty, Mardin, Turkey
| | - Bernas Altıntaş
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Mehmet Özbek
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Burhan Aslan
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Abdulkadir Arpa
- Department of Cardiology, Bismil State Hospital, Diyarbakır, Turkey
| | | | - Mahsum Altunbaş
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Rohat Tüzün
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Alkame Akgümüş
- Department of Cardiology, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | | | - Saadet Aydın
- Department of Cardiology, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey
| | - Hamdullah Güzel
- Department of Cardiology, Düzce University Faculty of Medicine, Düzce, Turkey
| | - Selen Filiz Aslan
- Department of Physiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Serdar Söner
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Ahmet Taş
- Department of Cardiology, Diyarbakır Memorial Hospital, Diyarbakır, Turkey
| | - Faruk Ertaş
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Akgümüş A, Kurtoğlu A, Aydın E, Balun A, Çar B, Eken Ö, Aldhahi MI. The insufficiency of recreational exercises in improving cardiovascular fitness: an investigation of ventricular systolic and diastolic parameters and left atrial mechanical functions. BMC Cardiovasc Disord 2023; 23:486. [PMID: 37794316 PMCID: PMC10552377 DOI: 10.1186/s12872-023-03508-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
AIM This study aimed to compare the left ventricular (LV) systolic and diastolic parameters and left atrial (LA) mechanical functions of individuals engaging in recreational sports and resistance exercises on a weekly basis. METHODS A total of 43 male amateur athletes were included in this study, of which 24 performed resistance exercises (REs) (29.70 ± 8.74 year, weight: 81.70 ± 12.64 kg, height: 176.05 ± 7.73 cm, BMI: 27.64 ± 4.97 kg/m2), and 19 participated in recreational football training and were included in the recreational sports group (31.73 ± 6.82 year, weight: 86.00 ± 18.52 kg, height: 178.62 ± 4.95 cm, BMI: 25.55 ± 3.42 kg/m2). The exercises were standardized according to the weekly exercise frequency and volume. After recording the participants' demographic information, the LV systolic and diastolic parameters and LA mechanical functions were measured using echocardiography (ECHO) and Tissue Doppler Imaging. RESULTS Significant differences were observed in various cardiac parameters between the recreational sports group (REG) and resistance exercise Group (RSG). Specifically, the left ventricular (LV) diastolic diameter, LV end diastolic volume index (LVEDVi), and stroke volume index were notably higher in the REG compared to the RSG (t = 2.804, p = .010, effect size (ES) = 2.10; t = 3.174, p = .003, ES = 0.98; t = 3.36, p = .002, ES = 1.02, respectively). Notably, the RSG exhibited higher values for LV mass index (LVMi) and isovolumic relaxation time (IVRT) than the REG (t = 2.843, p = .007, ES = 0.87; t = 2.517, p = .016, ES = 0.76) in terms of LV systolic and diastolic parameters. Regarding left atrial (LA) mechanics, the REG demonstrated increased LA total emptying volume index, LA maximum volume index, LA volume before systole measured at the onset of the p-wave index, and conduit volume index compared to RSG (t = 2.419, p = .020, ES = 0.75; t = 2.669, p = .011, ES = 0.81; t = 2.111, p = .041, ES = 0.64; t = 2.757, p = .009, ES = 0.84, respectively). CONCLUSION Our study revealed significant variations in LV and LA functions between REG and RSG. Our data suggest that REs led to substantial cardiac remodeling, altering myocardial structure and function. In contrast, the effect of recreational exercise on cardiac adaptation was less pronounced than that of resistance exercise. Consequently, we propose that individuals engaging in recreational exercise should consider modalities that impose higher cardiovascular demand for more effective cardiac conditioning.
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Affiliation(s)
- Alkame Akgümüş
- Department of Cardiology, Medical Faculty, Bandirma Onyedi Eylul University, Bandırma, 10200 Turkey
| | - Ahmet Kurtoğlu
- Department of Coaching Education, Faculty of Sport Science, Bandirma Onyedi Eylul University, Bandırma, 10200 Turkey
| | - Engin Aydın
- Department of Pediadrics, Medical Faculty, Bandirma Onyedi Eylul University, Bandırma, 10200 Turkey
| | - Ahmet Balun
- Department of Cardiology, Medical Faculty, Bandirma Onyedi Eylul University, Bandırma, 10200 Turkey
| | - Bekir Çar
- Department of Physical Education and Sport Teaching, Faculty of Sport Sciences, Bandirma Onyedi Eylul University, Bandırma, 10200 Turkey
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Faculty of Sports Sciences, Inonu University, Malatya, Turkey
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671 Saudi Arabia
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Balun A, Akgümüş A, Çetin ZG, Demirtaş B. The Prognostic Value of Geriatric Nutritional Risk Index in Evaluating Rehospitalization and One-Year Mortality in Patients With Heart Failure. Cureus 2023; 15:e44460. [PMID: 37791200 PMCID: PMC10544181 DOI: 10.7759/cureus.44460] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Malnutrition is frequently observed in patients with heart failure, and malnutrition causes poor prognosis in these patients. Various calculation tools are used to assess malnutrition, with the geriatric nutritional risk index (GNRI) being one that is frequently used. In our study, we aimed to investigate the value of GNRI in assessing one-year mortality and rehospitalization in patients with heart failure. METHOD A total of 196 patients aged 60 years and older were included in this retrospective study. A GNRI ≤ 98 was defined as malnutrition. Patients were divided into two groups: GNRI ≤ 98 (malnutrition) and GNRI > 98 (non-malnutrition). Rehospitalization due to heart failure and mortality were compared between both groups in the one-year follow-up. RESULTS The duration of hospitalization was significantly lower in the malnourished group compared to the non-malnutrition group (11.5 ± 7.5 days vs. 20.9 ± 16.3 days). All-cause mortality was significantly higher in the malnutrition group (30.8% vs. 18.1, p = 0.045). Risk factors were evaluated to predict all-cause death by Cox regression analysis, and GNRI (hazard ratio (HR) = 0.968; 95%CI: 0.942-0.995; p = 0.018) was associated with all-cause mortality. CONCLUSIONS GNRI, which is used as an indicator of malnutrition, is associated with all-cause mortality at one-year follow-up. Higher mortality was observed in the group with low GNRI, but it was observed that this group was hospitalized for less time due to heart failure.
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Affiliation(s)
- Ahmet Balun
- Cardiology, Bandırma Onyedi Eylül University, Balıkesir, TUR
| | - Alkame Akgümüş
- Cardiology, Bandırma Onyedi Eylül University, Balıkesir, TUR
| | - Zehra G Çetin
- Cardiology, Ankara Bilkent City Hospital, Ankara, TUR
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Kurtoğlu A, Kurtoğlu E, Akgümüş A, Çar B, Eken Ö, Sârbu I, Ciongradi CI, Alexe DI, Candussi IL. Evaluation of electrocardiographic parameters in amputee football players. Front Psychol 2023; 14:1189712. [PMID: 37554132 PMCID: PMC10405824 DOI: 10.3389/fpsyg.2023.1189712] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/17/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE The present study aimed to compare electrocardiographic (ECG) parameters of amputee football players (AF) with football players without disability (FP) and sedentary individuals without disability (SI). METHODS A total of 32 participants (AF = 9, FP = 11, SI = 12) were included in the study. ECG parameters including P-wave amplitude, P-wave duration, PR interval, QRS duration, RR interval, QT interval, corrected-QT interval (QTc), ST segment duration, Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were assessed in all the study participants by using a 12-lead ECG device. OneWay ANOVA Test was used for statistical analysis. RESULTS Of all ECG parameters, P-wave amplitude and QTc were significantly higher in the AF group in comparison to FP and SI groups. QRS duration was found to be lower in the AF group when compared to FP and SI groups. Myocardial repolarization parameters including Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were similar between groups, as were other parameters such as P-wave duration, PR interval, RR interval, QRS duration and QT interval. CONCLUSION It was found that some ECG parameters of amputee football players differ from those with non-disabled players and non-disabled sedentary individuals. These different parameters were within normal limits.
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Affiliation(s)
- Ahmet Kurtoğlu
- Department of Coaching Education, Faculty of Sport Science, Bandirma Onyedi Eylul University, Balikesir, Türkiye
| | - Ertuğrul Kurtoğlu
- Department of Cardiology, Medical Faculty, Malatya Turgut Ozal University, Malatya, Türkiye
| | - Alkame Akgümüş
- Department of Cardiology, Medical Faculty, Bandirma Onyedi Eylul University, Balikesir, Türkiye
| | - Bekir Çar
- Department of Physical Education and Sport Teaching, Faculty of Sport Sciences, Bandirma Onyedi Eylul University, Balikesir, Türkiye
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Faculty of Sport Sciences, Inonu University, Malatya, Türkiye
| | - Ioan Sârbu
- Second Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iași, Romania
| | - Carmen Iulia Ciongradi
- Second Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Iași, Romania
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, Faculty of Movement, Sports and Health, Sciences, “Vasile Alecsandri” University of Bacau, Bacau, Romania
| | - Iuliana Laura Candussi
- Clinical Surgery Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
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Akgümüş A, Balun A, Peker T, Boyraz B. The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study. Medicine (Baltimore) 2023; 102:e34282. [PMID: 37417638 PMCID: PMC10328619 DOI: 10.1097/md.0000000000034282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 (P = .003), SDNN index was 66 ± 20 versus 56 ± 12 (P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 (P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 (P = .001), HF was 450 ± 270 versus 225 ± 130 (P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 (P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.
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Affiliation(s)
- Alkame Akgümüş
- Bandirma Onyedi Eylül University, Faculty of Medicine, Cardiology Department, Balikesir, Turkey
| | - Ahmet Balun
- Bandirma Onyedi Eylül University, Faculty of Medicine, Cardiology Department, Balikesir, Turkey
| | - Tezcan Peker
- Mudanya University, Medicalpark Hospital, Cardiology Department, Bursa, Turkey
| | - Bedrettin Boyraz
- Mudanya University, Medicalpark Hospital, Cardiology Department, Bursa, Turkey
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Balun A, Akgümüş A. Charlson comorbidity index and 1-year poor outcomes in elderly patients undergoing successful percutaneous coronary intervention: A retrospective study. Medicine (Baltimore) 2023; 102:e33792. [PMID: 37171311 PMCID: PMC10174379 DOI: 10.1097/md.0000000000033792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Elderly patients with acute syndrome are frailer due to the burden of comorbidity. Comorbidities that increase with age result in an increased risk of mortality in patients with acute coronary syndrome (ACS). Many scales have been developed to assess the burden of comorbidity, including the Charlson Comorbidity Index (CCI). The aim of our study is to show the effect of the CCI on 1-year mortality and poor clinical outcomes in elderly patients who underwent percutaneous coronary intervention due to ACS. This single-center retrospective study included 704 patients aged 75 years and older. The study population consisted of patients who were admitted to the hospital with ACS between April 2017 and September 2021 and underwent successful percutaneous intervention. The patients were divided into 3 groups according to their CCI scores as CCI 0 (n:156), 1 (n:266), and ≥2 (n:282). Stroke development was significantly higher in patients with CCI scores ≥ 2 compared to the other 2 groups (P = .005). Mortality rates were found to be 28.4%, 7.5%, and 2.6% in patients with CCI ≥ 2, CCI 1, and CCI 0, respectively. The mortality rate of the CCI ≥ 2 group was significantly higher than those of the other 2 groups (P < .001). The multivariate Cox proportional hazard regression model showed that CCI was an independent predictor for 1-year all-cause mortality (hazard ratio: 1.632; 95% confidence interval: 1.403-1.898; P < .001). CCI may contribute to treatment and follow-up management, as it indicates a poor prognosis in elderly patients who have undergone percutaneous coronary intervention.
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Affiliation(s)
- Ahmet Balun
- Bandirma Onyedi Eylül University, Department of Cardiology, Balikesir, Turkey
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Balun A, Akgümüş A, Özbek K, Güven Çetin Z. Prognostic Nutritional Index as a Novel Predictor of In-Stent Restenosis: A Retrospective Study. Medicina (B Aires) 2023; 59:medicina59040663. [PMID: 37109621 PMCID: PMC10146245 DOI: 10.3390/medicina59040663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/16/2023] [Accepted: 03/25/2023] [Indexed: 03/29/2023] Open
Abstract
Background and Objectives: In-stent restenosis (ISR) is a major problem in patients undergoing percutaneous coronary intervention. The prognostic nutritional index (PNI) is a nutritional status score used in the literature to determine the prognosis of coronary artery disease. In this study, we aimed to investigate the effect of preprocedural PNI values on the risk of ISR in patients with stable coronary artery disease who underwent successful percutaneous coronary intervention. Materials and Methods: This retrospective study included 809 patients. Stent restenosis was evaluated in the follow-up coronary angiography of the patients due to stable angina pectoris or acute coronary syndrome. The patients were divided into two groups based on those with (n = 236) and without (n = 573) in-stent restenosis, and their nutritional status was compared with PNI. The PNI values before the first angiography of the patients were calculated. Results: The mean PNI score was significantly lower in patients with ISR than in those without ISR (49.5 vs. 52.3, p < 0.001). Concerning the results of the Cox regression hazard model for predictors of ISR, PNI was significantly associated with the development of ISR (HR = 0.932, 95% CI: 0.909–0.956, p < 0.001). In addition, stent type, stent length, and diabetes mellitus were associated with the development of ISR. Conclusions: A low PNI value indicates poor nutritional status, which is thought to accelerate inflammation processes and cause atherosclerosis and ISR.
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Boyraz B, Peker T, Akgümüş A, Balun A. Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow-up. Egypt Heart J 2023; 75:14. [PMID: 36811731 PMCID: PMC9947199 DOI: 10.1186/s43044-023-00340-x] [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] [Received: 11/30/2022] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings. RESULTS A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction. CONCLUSIONS Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.
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Affiliation(s)
- Bedrettin Boyraz
- Cardiology Department, Medicalpark Hospital, Mudanya University, Kırcaali, Fevzi Çakmak Cd. No:76, 16220, Osmangazi, Bursa, Turkey.
| | - Tezcan Peker
- Cardiology Department, Medicalpark Hospital, Mudanya University, Kırcaali, Fevzi Çakmak Cd. No:76, 16220 Osmangazi, Bursa Turkey
| | - Alkame Akgümüş
- grid.484167.80000 0004 5896 227XCardiology Department, Medical Faculty, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Ahmet Balun
- grid.484167.80000 0004 5896 227XCardiology Department, Medical Faculty, Bandırma Onyedi Eylül University, Balıkesir, Turkey
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Yılmaz M, Özlük O, Akgümüş A, Peker T, Bekler A, Karaagaç K, Vatansever F. PP-060 LEFT ATRIAL MECHANICAL FUNCTIONS IN PATIENTS WITH METABOLIC SYNDROME. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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