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Guney MC, Keles T, Karaduman BD, Ayhan H, Suygun H, Kahyaoglu M, Bozkurt E. Predictors and Prognostic Implications of Myocardial Injury After Transcatheter Aortic Valve Replacement. Tex Heart Inst J 2022; 49:483735. [PMID: 35838644 DOI: 10.14503/thij-20-7380] [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: 11/23/2022]
Abstract
Myocardial injury (MI) is not unusual after transcatheter aortic valve replacement (TAVR). To determine precipitating factors and prognostic outcomes of MI after TAVR, we retrospectively investigated relationships between MI after TAVR and aortic root dimensions, baseline patient characteristics, echocardiographic findings, and procedural features. Of 474 patients who underwent transfemoral TAVR for severe aortic stenosis in our tertiary center from June 2011 through June 2018, 188 (mean age, 77.7 ± 7.7 yr; 96 women [51%]) met the study inclusion criteria. Patients were divided into postprocedural MI (PMI) (n=74) and no-PMI (n=114) groups, in accordance with high-sensitivity troponin T levels. We found that MI risk was associated with older age (odds ratio [OR]=1.054; 95% CI, 1.013-1.098; P=0.01), transcatheter heart valve type (OR=10.207; 95% CI, 2.861-36.463; P=0.001), distances from the aortic annulus to the right coronary artery ostium (OR=0.853; 95% CI, 0.731-0.995; P=0.04) and the left main coronary artery ostium (OR=0.747; 95% CI, 0.616-0.906; P=0.003), and baseline glomerular filtration rate (OR=0.985; 95% CI, 0.970-1.000; P=0.04). Moreover, the PMI group had a longer time to hospital discharge (P=0.001) and a higher permanent pacemaker implantation rate (P=0.04) than did the no-PMI group. Our findings may enable better estimation of which patients are at higher risk of MI after TAVR and thus improve the planning and course of clinical care.
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Affiliation(s)
- Murat Can Guney
- Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Telat Keles
- Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atilim University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Huseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atilim University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hakan Suygun
- Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Muzaffer Kahyaoglu
- Department of Cardiology, Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
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Ayhan H, Duran Karaduman B, Keleş T, Bozkurt E. Transcatheter treatment tricuspid regurgitation by valve-in-ring implantation with a novel balloon-expandable Myval® THV. Kardiol Pol 2022; 80:363-364. [PMID: 35040116 DOI: 10.33963/kp.a2022.0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Medicana International Ankara Hospital, Atılım University, Ankara, Turkey.
| | - Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Medicana International Ankara Hospital, Atılım University, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Bozkurt E, Ayhan H, Duran Karaduman B. Management of left ventricular outflow tract obstruction in transcatheter mitral valve replacement. Anatol J Cardiol 2021; 25:838. [PMID: 34734820 DOI: 10.5152/anatoljcardiol.2021.513] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey;Department of Cardiology, Faculty of Medicine, Atılım University; Ankara-Turkey
| | - Bilge Duran Karaduman
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey;Department of Cardiology, Faculty of Medicine, Atılım University; Ankara-Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. Author`s Reply. Anatol J Cardiol 2021; 25:368-369. [PMID: 35899304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey
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Erol MK, Kayıkçıoğlu M, Kılıçkap M, Güler A, Öztürk Ö, Tuncay B, İnci S, Balaban İ, Tatar F, Çırakoğlu ÖF, Gazi E, Bakırcı EM, Yayla Ç, Astarcıoğlu MA, Duran Karaduman B, Aksu E, Alsancak Y, Emlek N, Tigen MK, Turhan Cağlar N, Düz R, Inanir M, Özdoğan Ö, Yavuzgil O. Time delays in each step from symptom onset to treatment in acute myocardial infarction: Results from a nation-wide TURKMI registry. Anatol J Cardiol 2021; 25:294-303. [PMID: 33960304 DOI: 10.5152/anatoljcardiol.2021.39797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey. METHODS The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT). RESULTS After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median TIT was 195 (115-330) min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI. CONCLUSION The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment.
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Affiliation(s)
- Mustafa Kemal Erol
- Department Of Cardiology, Şişli International Kolan Hospital; Istanbul-Turkey
| | - Meral Kayıkçıoğlu
- Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey
| | - Mustafa Kılıçkap
- Department of Cardiology, Faculty of Medicine, Ankara University; Ankara-Turkey
| | - Arda Güler
- Department of Cardiology, Health Science University, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
| | - Önder Öztürk
- Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital; Diyarbakır-Turkey
| | - Burcu Tuncay
- Department of Cardiology, Health Science University, Bursa Yüksek İhtisas Training and Research Hospital; Bursa-Turkey
| | - Sinan İnci
- Department of Cardiology, Faculty of Medicine, Aksaray University; Aksaray-Turkey
| | - İsmail Balaban
- Department of Cardiology, Health Science University, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital; İstanbul-Turkey
| | - Fatih Tatar
- Department of Cardiology, Faculty of Medicine, Bülent Ecevit University; Zonguldak-Turkey
| | - Ömer Faruk Çırakoğlu
- Department of Cardiology, Health Science University, Ahi Evran Thoracic and Cardiovascular Surgery Training and Research Hospital; Trabzon-Turkey
| | - Emine Gazi
- Department of Cardiology, Faculty of Medicine, Onsekiz Mart University; Çanakkale-Turkey
| | - Eftal Murat Bakırcı
- Department of Cardiology, Faculty of Medicine, Erzincan Binali Yıldırım University; Erzincan-Turkey
| | - Çağrı Yayla
- Department of Cardiology, Health Science University, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey
| | - Mehmet Ali Astarcıoğlu
- Department of Cardiology, Yıldırım Beyazıt University, Atatürk Training and Research Hospital; Ankara-Turkey
| | - Bilge Duran Karaduman
- Department of Cardiology, Dumlupınar University, Evliya Çelebi Training and Research Hospital; Kütahya-Turkey
| | - Ekrem Aksu
- Department of Cardiology, Faculty of Medicine, Sütçü İmam University; Kahramanmaras-Turkey
| | - Yakup Alsancak
- Department of Cardiology, Faculty of Medicine, Necmettin Erbakan University; Konya-Turkey
| | - Nadir Emlek
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University; Rize-Turkey
| | - Mustafa Kürşat Tigen
- Department of Cardiology, Faculty of Medicine, Marmara University; İstanbul-Turke
| | - Nihan Turhan Cağlar
- Department of Cardiology, Health Science University, Bakırköy Dr. Sadi Konuk Training and Research Hospital; İstanbul-Turkey
| | - Ramazan Düz
- Department of Cardiology, Health Science University, Van Training and Research Hospital; Van-Turkey
| | - Mehmet Inanir
- Department of Cardiology, Faculty of Medicine, Abant İzzet Baysal University; Bolu-Turkey
| | - Öner Özdoğan
- Department of Cardiology, Health Science University, Tepecik Training and Research Hospital; İzmir-Turkey
| | - Oğuz Yavuzgil
- Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. Transcatheter Tricuspid Valve-in-Valve Implantation With a Novel Balloon Expandable Myval THV. Ann Thorac Surg 2021; 112:e435-e437. [PMID: 33737045 DOI: 10.1016/j.athoracsur.2021.03.014] [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] [Received: 02/18/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/26/2022]
Abstract
The transcatheter tricuspid valve-in-valve implantation has not yet been clarified, and several case series have documented results in patients with tricuspid bioprosthetic valve degeneration who underwent transcatheter implantation of Edwards SAPIEN XT and SAPIEN 3 (Edwards Lifesciences, Irvine, CA) and Medtronic (Minneapolis, MN) valves. Here, we present the case of a patient with severe bioprosthetic tricuspid valve stenosis who was successfully treated with the transfemoral route through the 29-mm novel balloon expandable Myval transcatheter heart valve (Meril Life Sciences Pvt Ltd, Vapi, Gujarat, India) system.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey.
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. Impact of transcatheter aortic valve implantation in symptomatic patients with very severe aortic stenosis. Turk Kardiyol Dern Ars 2021; 49:97-107. [PMID: 33709915 DOI: 10.5543/tkda.2021.72273] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Aortic stenosis (AS) is a progressive disease, and valve replacement-the only treatment option-should be performed after it becomes symptomatic and before irreversible myocardial damages develop. Surgical valve replacement is recommended in patients with very severe AS (VSAS), even if they are asymptomatic. However, there is no detailed study on the effect of transcatheter aortic valve implantation (TAVI) in patients with VSAS. Our aim in this study is to show the feasibility and safety of TAVI in symptomatic patients with VSAS. METHODS A total of 505 consecutive patients with symptomatic AD who underwent TAVI in our center were retrospectively studied. The mean age of the patients was 77.8±7.6 years, and 56.4% of them were women. The patients were divided into 2 groups: a group with VSAS (n=134 patients) and a group with high-gradient AS (HGAS) (n=371 patients). RESULTS Female sex, left ventricular ejection fraction, small left ventricle, hypertrophic left ventricle were more common in the group with VSAS; on the other hand, histories of coronary artery disease bypass surgery, myocardial infarction, and atrial fibrillation were less frequent. Predilatation and Edwards SAPIEN 3 were less used in the group with VSAS. There was no statistical difference in major complications and in-hospital mortality (group with VSAS: 5 patients, group with HGAS: 16 patients; p=0.769) according to the Valve Academic Research Consortium-2 criteria. There was a significant difference between the 2 groups in favor of the group with VSAS on the Cox regression model survival curve (p<0.001). CONCLUSION In this study, it has been shown that TAVI can be feasible and safe in symptomatic VSAS, with acceptable complications and higher survival rates. Currently, further randomized studies are required to perform TAVI in patients with asymptomatic VSAS currently indicated for surgical aortic valve replacement.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Atılım University School of Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Atılım University School of Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Sari C, Özer Sarı S, Duran Karaduman B, Koseoglu H, Şimşek EÇ. Assessment of left ventricular contractile functions in inflammatory bowel disease according to disease activity. J Dig Dis 2020; 21:629-638. [PMID: 32964644 DOI: 10.1111/1751-2980.12943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 04/30/2020] [Revised: 06/30/2020] [Accepted: 09/20/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The study aimed to investigate the subclinical involvement of cardiac functions in patients with inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD) according to their disease activity status by two-dimensional speckle tracking echocardiography (2DSTE). METHODS This prospective study included 72 consecutive patients with IBD and 93 age- and sex-matched healthy controls (HC). All participants underwent conventional and 2DSTE assessments. The IBD patients were subdivided into active disease and remission groups for further investigation of the effect of disease activity on left ventricular (LV) contractile functions. RESULTS The longitudinal strain values differed significantly between the IBD group and the control group (global longitudinal strain [GLS] from two-chamber view: [-15.74 ± 6.33]% vs [-18.8 ± 2.87]%, P = 0.001; GLS from four-chamber view: [-16.61 ± 9.91]% vs [-20.12 ± 2.57]%, P = 0.008; GLS: [-15.47 ± 6.87]% vs [-19.48 ± 2.16]%, P = 0.0001). The circumferential strain measurements showed a nonsignificant trend of depressed contractile functions in the IBD group. Patients with active IBD had similar GLS and global circumferential strain (GCS) values as those in remission. A correlation analysis revealed that the neutrophil-lymphocyte ratio was positively correlated and the platelet count was negatively correlated with GCS. Deterioration of LV diastolic functions examined with E/e' and mitral deceleration time was found in the IBD group compared with the controls. CONCLUSIONS LV global longitudinal contractile and diastolic functions were decreased in patients with IBD. Clinicians should maintain patients' remission periods and prevent flare-ups.
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Affiliation(s)
- Cenk Sari
- Department of Cardiology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Sevil Özer Sarı
- Department of Gastroenterology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
| | - Bilge Duran Karaduman
- Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
| | - Huseyin Koseoglu
- Department of Gastroenterology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
| | - Ersin Çağrı Şimşek
- Department of Cardiology, Tepecik Education and Research Hospital, İzmir, Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. The playmaker of the mitral valve disease: Mitral annulus. Int J Cardiol 2020; 316:205-206. [PMID: 32387253 DOI: 10.1016/j.ijcard.2020.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Bilge Duran Karaduman
- Atılım University, Faculty of Medicine, Department of Cardiology, Medicana International Ankara Hospital, Turkey.
| | - Hüseyin Ayhan
- Atılım University, Faculty of Medicine, Department of Cardiology, Medicana International Ankara Hospital, Turkey.
| | - Telat Keleş
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Cardiology, Ankara City Hospital, Turkey
| | - Engin Bozkurt
- Medicana International Ankara Hospital, Department of Cardiology, Turkey
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Duran Karaduman B, Ayhan H, Bulguroğlu S, Keleş T, Bozkurt E. Transcatheter valve-in-valve implantation Edwards Sapien XT in a direct flow valve after early degeneration. J Card Surg 2020; 35:3592-3595. [PMID: 32939855 DOI: 10.1111/jocs.15016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/27/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 01/05/2023]
Abstract
In recent years, the use of bioprosthetic valve (BPV) has increased significantly with both surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) due to reasons such as the advantage of not using anticoagulants. Nevertheless, major disadvantage of all BPV is the risk of early structural valve deterioration, leading to valve dysfunction, and requires reoperation, which significantly increases the risk of mortality or major morbidity especially after SAVR. There are a limited number of TAV-in-TAV case reports due to TAVI BPV degeneration. In our knowledge, this is the second report of TAV-in-TAV implantation wherein a previously implanted transfemoral 25-mm nonmetallic Direct Flow SVD valve treated with ViV TAVI via Edwards Sapien XT.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Serkan Bulguroğlu
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Karaduman BD, Ayhan H, Keleş T, Bozkurt E. Author`s Reply. Anatol J Cardiol 2020; 24:211-212. [PMID: 33643676 PMCID: PMC7585968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey,Address for Correspondence: Dr. Engin Bozkurt, Medicana International Ankara Hastanesi, Kardiyoloji Kliniği, Ankara-Türkiye Phone: +90 530 694 53 53 E-mail:
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Karaduman BD, Ayhan H, Keleş T, Bozkurt E. Author`s Reply. Anatol J Cardiol 2020; 24:211-212. [PMID: 32870180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital; Ankara-Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. The triglyceride-glucose index predicts peripheral artery disease complexity. Turk J Med Sci 2020; 50:1217-1222. [PMID: 32718124 PMCID: PMC7491281 DOI: 10.3906/sag-2006-180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/25/2020] [Indexed: 01/12/2023] Open
Abstract
Background/aim High levels of triglyceride (TG) and fasting blood glucose (FBG) values increase atherosclerosis risk. This study evaluates the relationship between peripheral artery disease (PAD) severity and complexity, as assessed by TransAtlantic InterSociety Consensus-II (TASC-II) classification and the triglyceride-glucose (TyG) index. Materials and methods A total of 71 consecutive patients with PAD (males 93%, mean age 63.3 ± 9.7), who underwent percutaneous peripheral intervention were included retrospectively. The patients were divided into two groups according to the angiographically detected lesions. Those with TASC A-B lesions were included in Group 1, and those with TASC C-D lesions were included in Group 2. TyG index was calculated as formula: ln[fasting TG (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results There were 40 patients in Group 1 (90.3% men, with a mean age of 63.6 ± 9.3 years) and 31 patients in Group 2 (96.8% men, with a mean age of 62.0 ± 8.6 years). In the majority of patients in both groups, the target vessels are iliac arteries and femoral arteries. In Group 2, platelet count and TyG index were significantly high, according to Group 1. The TyG index was significantly correlated with TASC-II, Rutherford category, HbA1c, and HDL-C. Conclusion In this present study, we showed that the TyG index was an independent predictor of peripheral artery disease complexity, according to TASC-II classification, for the first time in the literature.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. Association between monocyte to high-density lipoprotein cholesterol ratio and bicuspid aortic valve degeneration. Turk J Med Sci 2020; 50:1307-1313. [PMID: 32777897 PMCID: PMC7491300 DOI: 10.3906/sag-2006-60] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/09/2020] [Indexed: 11/05/2022] Open
Abstract
Background/aim From a pathophysiological point of view, inflammation is thought to be more dominant in bicuspid aortic valve (BAV) stenosis than tricuspid aortic valve (TAV) stenosis. Our study aimed to determine the association between monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR), a new inflammatory marker, and the speed of progression of stenosis and pathophysiology of BAV stenosis. Materials and methods A total of 210 severe aortic stenosis patients (70 consecutive BAV patients, 140 matched TAV patients) were retrospectively enrolled in the study. Clinical and echocardiographic data and laboratory results related to our research were collected retrospectively from the patients’ records. MHR was measured as the ratio of the absolute monocyte count to the HDL-C value. Results Seventy BAV (mean age: 72.0 ± 9.1 years, 42.9% female) and 140 TAV patients (mean age: 77.9 ± 8.3 years, 51.4% female) with severe aortic stenosis were enrolled in this study. There was no difference between the two groups in terms of another baseline demographic or clinic findings except age (P < 0.001). Monocyte count, hemoglobin level, mean platelet volume was significantly higher, and HDL-C level was significantly lower in the BAV group, while other lipid and CBC parameters were found to be similar. In the multivariate analysis, MHR (P = 0.005, 95% CI: 0.90–0.98) and, as expected, age (P = 0.001, 95% CI: 1.02–1.11) were found to be significant as the independent predictor of BAV, after adjusting for other risk factors. Conclusion Our study showed a significant correlation between increased MHR and BAV. MHR was determined as a significant independent predictor for the speed of progression and diagnosis of severe BAV stenosis in multivariate analysis.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Engİn Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Duran Karaduman B, Torun AN, Ayhan H, Keleş T, Bozkurt E. Stenotic double-orifice mitral valve after surgical repaired partial atrioventricular septal defect. Echocardiography 2020; 37:1091-1094. [PMID: 32535933 DOI: 10.1111/echo.14688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/14/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 11/28/2022] Open
Abstract
Double-orifice mitral valve (DOMV) is an uncommon congenital anomaly account for 1% of congenital heart disease. However, accurate diagnosis and evaluation of valve stenosis or regurgitation and other concomitant congenital anomalies due to DOMV are required to obtain suitable treatment. Two- and three-dimensional echocardiography can contribute valuable functional and anatomic information that can support to reach this goal. Here, we present a case of complete bridge-type DOMV that causes mitral stenosis after surgical repair of the partial atrioventricular septal defect in childhood.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Faculty of Medicine, Medicana International Ankara Hospital, Atılım University, Ankara, Turkey
| | - Ayşe Nur Torun
- Department of Cardiology, Faculty of Medicine, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Medicana International Ankara Hospital, Atılım University, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Duran Karaduman B, Ayhan H, Keleş T, Bozkurt E. Left ventricular geometry as a predictor of carotid artery stenosis severity in patients undergoing carotid artery stenting. Echocardiography 2020; 37:663-669. [PMID: 32347585 DOI: 10.1111/echo.14672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/12/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND AIM Cerebrovascular diseases are the second most common cause of death worldwide. Moderate and severe carotid artery stenosis causes nearly 10% of all strokes. LV geometry is a familiar prognostic and diagnostic factor in several populations; yet, data on its role in carotid artery stenosis are unknown. In our study, we investigated the prognostic value of LV geometry in predicting carotid artery stenosis severity in patients undergoing carotid artery stenting. METHODS Patients who underwent carotid artery stenting between January 2012 and January 2016 at our tertiary care center were evaluated retrospectively. Two hundred fifty-five patients who underwent carotid artery stenting were included in the study. Accessible echocardiographic documentation of ninety-eight patients was accessed and evaluated. RESULTS LV normal geometry was detected in 37 (37.7%) of the 98 carotid artery stenting (CAS) patients, concentric hypertrophy in 13 (13.2%), eccentric hypertrophy in 9 (9.1%), and concentric remodeling in 39 (39.7%). By a majority, distal filter was used in normal geometry and eccentric hypertrophy groups (82.9% vs 100%, P: .017). Considering the relationship between carotid artery stenosis severity and LV geometry, we determined that the stenosis severity was statistically significantly higher in the concentric hypertrophy group (p:0.012). However, although no complications were detected in the concentric hypertrophy group, it did not reach statistical significance between the groups (P: .058). LVMi and as expected, Doppler velocity showed a significant correlation with stenosis severity (r = .23 vs .54; P: .021, <.001, respectively). CONCLUSION Echocardiographic evaluation of LV geometry provided prognostic information in the development of carotid artery stenosis. Abnormal LV geometry is an independent predictor in detecting the severity of carotid artery stenosis undergoing carotid artery stenting.
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Affiliation(s)
- Bilge Duran Karaduman
- Faculty of Medicine, Department of Cardiology, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Faculty of Medicine, Department of Cardiology, Atılım University, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Faculty of Medicine, Department of Cardiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Karaduman BD, Ayhan H, Keleş T, Bozkurt E. Association between Rutherford Classification and CHA 2DS 2-VASc, CHADS 2 and ASCVD Scores in Peripheral Artery Disease Patients. Artery Res 2020. [DOI: 10.2991/artres.k.200504.001] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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18
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Karaduman BD, Ayhan H, Keleş T, Bozkurt E. Efficacy and safety of carotid artery stenting: Experience of a single center. Turk Kardiyol Dern Ars 2020; 48:646-655. [PMID: 33034583 DOI: 10.5543/tkda.2020.77167] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Moderate and severe carotid artery stenosis in the internal carotid artery causes 10% to 15% of all strokes. The aim of this study was to evaluate the safety and short-term efficacy of carotid artery stenting (CAS) performed at a tertiary referral center. METHODS The records of patients who underwent CAS between January 2017 and May 2018 at a tertiary care center were analyzed retrospectively and a total of 145 patients were included in the study. RESULTS The mean age of the patients was 70.1±8.6 years, 75.2% of the study group was male, and 37.9% had hypertension. Of the patients evaluated, 81 (55.9%) were classified as symptomatic and 64 (44.1%) were classified as asymptomatic. A percutaneous coronary intervention was performed after CAS more often in symptomatic patients (38.9%), while it was observed at the same rate both before (25.9%) and after (25.9%) CAS in the asymptomatic group, but the difference between the groups was not statistically significant. A distal embolic protection device (EPD) was used in symptomatic patients (59.2%) and in the asymptomatic group (78.7%); however, a proximal EPD was used significantly more often in symptomatic patients (45.6%) compared with asymptomatic patients. No patient death was recorded while in hospital, and stroke/transient ischemic attack (TIA) development was observed in 5 (3.4%) patients. Stroke was seen in 2 patients (2.4%) and TIA in 3 patients (3.7%) in the symptomatic group; TIA or stroke was not seen in the asymptomatic group. CONCLUSION The results of this study revealed that CAS was a safe and practical procedure with an acceptable complication rate. In the appropriate patients, experienced interventionists can achieve good results when aggressive risk modification is applied and an EPD and optimal medical therapy are used.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Atılım University Faculty of Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Atılım University Faculty of Medicine, Medicana International Ankara Hospital, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara City Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey
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Kanat S, Duran Karaduman B, Tütüncü A, Tenekecioğlu E, Mutluer FO, Akar Bayram N. Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation. Balkan Med J 2019; 36:324-330. [PMID: 31347351 PMCID: PMC6835166 DOI: 10.4274/balkanmedj.galenos.2019.2019.4.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Idiopathic premature ventricular contractions are frequently detected ventricular arrhythmias, and radiofrequency ablation is an effectively treatment for improving symptoms and eliminating premature ventricular contractions. Studies have reported a relationship between an elevated epicardial adipose tissue thickness and myocardial structural pathologies. However, the association between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation has not yet been investigated. Aims: To assess the relationship between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation. Study Design: Retrospective case-control study. Methods: This study enrolled a total of 106 consecutive patients who have had a high premature ventricular contraction burden of >10,000/24-h assessed using ambulatory Holter monitorization and underwent catheter ablation. A frequency of premature ventricular contractions of more than 10,000/day was defined as frequent premature ventricular contraction. Epicardial adipose tissue thickness was measured using 2D transthoracic echocardiography. A successful ablation was defined as >80% decrease in pre-procedural premature ventricular contraction attacks with the same morphology during 24-h Holter monitorization after a 1-month follow-up visit from an ablation procedure. Results: Successful premature ventricular contraction ablation was achieved in 87 (82.1%) patients. Epicardial adipose tissue thickness was significantly higher in patients with unsuccessful ablation (p<0.001). Procedure time, total fluoroscopy time, and radiofrequency ablation time were statistically higher in the unsuccessful group (p<0.001). Stepwise multivariate logistic regression analysis showed that epicardial adipose tissue thickness and pseudo-delta wave time were independently associated with procedural success (both p values <0.001). In the receiver-operating curve analysis, epicardial adipose tissue thickness was found to be an important predictor for procedural success (area under the receiver-operating characteristic curve= 0.85, p=0.001), with a cutoff value of 7.7 mm, a sensitivity of 92%, and a specificity of 68%. Conclusion: Epicardial adipose tissue thickness is higher in patients with premature ventricular contraction ablation failure, which may be indicative of procedural success.
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Affiliation(s)
- Selçuk Kanat
- Clinic of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | | | - Ahmet Tütüncü
- Clinic of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Erhan Tenekecioğlu
- Clinic of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | | | - Nihal Akar Bayram
- Department of Cardiology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Kanat S, Mutluer FO, Tütüncü A, Karaduman BD, Bozkaya VO, Keskin M, Uslu A, Çay S, Tenekecioglu E. Left Atrial Function Is Improved in Short-Term Follow-Up after Catheter Ablation of Outflow Tract Premature Ventricular Complexes. ACTA ACUST UNITED AC 2019; 55:medicina55060241. [PMID: 31163695 PMCID: PMC6630603 DOI: 10.3390/medicina55060241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/04/2019] [Accepted: 05/27/2019] [Indexed: 12/13/2022]
Abstract
Background: Association of premature ventricular complexes (PVC) with left ventricular systolic dysfunction (LVSD) and efficacy of catheter ablation treatment have been demonstrated in studies. The role of left atrial (LA) mechanics in the etiopathogenesis of PVC-induced cardiomyopathy (PVC-CMP) as well as changes in LA mechanics with catheter ablation have not been studied before. Methods: A total number of 61 patients (Mean Age 43 ± 3) with idiopathic outflow tract (OT) PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. ECG, 24 h Holter, and echocardiographic evaluation with left ventricular (LV) diastolic functions and LA volumetric assessments were performed before and three months after RFCA. Results: Along with a marginal increase in left ventricle ejection fraction (LVEF), improvement in diastolic functions and left atrial mechanics were observed in the study (LVEF 53 ± 7 versus 57 ± 6, p < 0.01) in short-term follow-up. The frequency of LV diastolic dysfunction (LVDD) decreased with catheter ablation (n = 5 to 0, p = 0.02). The overall LA function improved. Left atrium passive and overall emptying fraction (LAEF) increased significantly (0.32 ± 0.04 to 0.41 ± 0.04, p < 0.05 and 0.62 ± 0.04 to 0.65 ± 0.004, p < 0.05, respectively). Active LAEF decreased significantly (0.29 ± 0.005 to 0.24 ± 0.006, p < 0.05). Conclusions: The results of this study are indicative of “PVC-induced atriomyopathy” which responds to RFCA in short-term follow-up. Atrial dysfunction might play a role in symptoms and etiopathogenesis of LVSD.
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Affiliation(s)
- Selçuk Kanat
- Department of Cardiology, Bursa Education and Research Hospital, Health Sciences University Bursa, 16310 Bursa, Turkey.
| | - Ferit Onur Mutluer
- Department of Cardiology, Erasmus MC, Erasmus University, 3000 CA Rotterdam, The Netherlands.
| | - Ahmet Tütüncü
- Department of Cardiology, Bursa Education and Research Hospital, Health Sciences University Bursa, 16310 Bursa, Turkey.
| | - Bilge Duran Karaduman
- Department of Cardiology, Atatürk Education and Research Hospital, Yildirim Bayezit University, 06760 Ankara, Turkey.
| | - Veciha Ozlem Bozkaya
- Department of Cardiology, Zekai Tahir Burak Education and Research Hospital, 06230 Ankara, Turkey.
| | - Muhammed Keskin
- Department of Cardiology, Istanbul Sultan Abdulhamid Han Education and Research Hospital, 34668 Istanbul, Turkey.
| | - Abdulkadir Uslu
- Department of Cardiology, Kosuyolu Education and Research Hospital, 34865 Istanbul, Turkey.
| | - Serkan Çay
- Department of Cardiology, Ankara Yüksek İhtisas Education and Research Hospital, 06100 Ankara, Turkey.
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Education and Research Hospital, Health Sciences University Bursa, 16310 Bursa, Turkey.
- Department of Cardiology, Erasmus MC, Erasmus University, 3000 CA Rotterdam, The Netherlands.
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Kasapkara HA, Şentürk A, Bilen E, Ayhan H, Karaduman BD, Turinay ZŞ, Güney MC, Durmaz T, Keleş T, Bozkurt E. Evaluation of QT dispersion and T-peak to T-end interval in patients with early-stage sarcoidosis. Rev Port Cardiol 2017; 36:919-924. [DOI: 10.1016/j.repc.2017.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/26/2017] [Accepted: 05/08/2017] [Indexed: 10/18/2022] Open
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Özen MB, Ayhan H, Kasapkara HA, Keleş T, Durmaz T, Erdoğan KE, Duran Karaduman B, Baştuğ S, Sari C, Aslan AN, Bozkurt E. The effect of transcatheter aortic valve implantation on mean platelet volume. Turk J Med Sci 2017; 47:385-390. [PMID: 28425248 DOI: 10.3906/sag-1510-139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/21/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Transcatheter aortic valve implantation (TAVI) is an innovative approach to the treatment of aortic stenosis (AS) as an alternative to surgery in high-risk patients. Mean platelet volume (MPV) is considered an indicator of endothelial dysfunction, platelet function, and activation. In this study, we aimed to investigate MPV changes in patients undergoing TAVI. MATERIALS AND METHODS This study included 100 patients diagnosed with symptomatic severe AS and treated with TAVI between July 2011 and August 2013. Hematological parameters of the patients were examined prior to the procedure and 24 h, 1 month, and 6 months after TAVI. RESULTS A statistically significant change in patients' MPV was detected after TAVI compared to the baseline situation (P: 0.001). While no statistically significant change was observed on the first day after TAVI, at discharge, compared to the baseline situation, a statistically significant decrease was seen 1 month and 6 months after discharge. CONCLUSION We have demonstrated a decrease in MPV after surgery compared to the value before surgery. We have sought to propound the change in MPV as an indication of endothelial function after TAVI.
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Affiliation(s)
- Mehmet Burak Özen
- Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Hacı Ahmet Kasapkara
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Tahir Durmaz
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Kemal Eşref Erdoğan
- Department of Cardiovascular Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | | | - Serdal Baştuğ
- Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey
| | - Cenk Sari
- Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey
| | - Abdullah Nabi Aslan
- Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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Duran Karaduman B, Akçay M, Ayhan H, Kasapkara HA, Güney MC, Durmaz T, Keleş T, Akar Bayram N, Bilen E, Bozkurt E. Comparison between fractional flow reserve and visual assessment for moderate coronary artery stenosis. Kardiol Pol 2017; 75:545-553. [PMID: 28281728 DOI: 10.5603/kp.a2017.0037] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 12/30/2016] [Accepted: 12/29/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fractional flow reserve (FFR) is an interventional diagnostic method, based on intracoronary pressure measurement, used for the assessment of the severity of coronary artery stenoses. AIM Our study aimed to compare visual measurements made by multiple observers with FFR measurement in the assessment of angiographically moderate coronary artery stenosis. METHODS The angiographic images of moderate coronary artery lesions of 359 patients enrolled in the study were interpreted independently by three interventional cardiologists assigned as observers (O1, O2, O3). RESULTS In FFR, 37.9% were haemodynamically significant, while 62.1% were insignificant. 40.3% of the lesions were considered severe by O1, 39.9% by O2, and 44.4% by O3. When we compare the FFR results to the observers' decisions about lesion severity, the serious lesion percentages of all three observers were different both from each other and from the FFR result, at a statistically significant level (respectively, p < 0.001, p < 0.001). The kappa analysis performed to check the agreement between the observers' decisions and FFR revealed significant difference between FFR results and the decisions made by all observers (p < 0.001). The kappa agreement analysis performed by matching observers' decisions in pairs revealed a good agreement between O1 and O2 and a moderate agreement between O2 and O3 as well as O1 and O3, although there was still a significant disagreement between all pairs of observers (p < 0.001). CONCLUSIONS Visual assessment, even when performed by experienced interventional cardiologists, does not yield similar results with FFR procedure in the process of determination of the functional importance of moderately severe coronary artery stenoses.
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Affiliation(s)
| | | | - Hüseyin Ayhan
- Department of Cardiology, Yıldırım Beyazıt University, Faculty of Medicine, Turkey, Turkey.
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Duran Karaduman B, Bayram H, Kasapkara HA, Keleş T, Durmaz T. [Long-term survival in a case of unoperated single ventricle]. Turk Kardiyol Dern Ars 2016; 44:338-41. [PMID: 27372621 DOI: 10.5543/tkda.2015.90195] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Single ventricle is a rare congenital heart disease, typically diagnosed with dyspnea and cyanosis. The number of patients who reach adulthood without having undergone surgical treatment is limited due to poor prognosis. While some reports describe patients who have reached the 2nd and 3rd decades of life, it is very interesting that the case of the patient who has lived the longest with unoperated single ventricle is reported in Turkey.
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Affiliation(s)
- Bilge Duran Karaduman
- Department of Cardiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Hüseyin Bayram
- Department of Cardiovascular Surgery, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Hacı Ahmet Kasapkara
- Department of Cardiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Tahir Durmaz
- Department of Cardiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Sarı C, Durmaz T, Karaduman BD, Keleş T, Bayram H, Baştuğ S, Özen MB, Bayram NA, Bilen E, Ayhan H, Kasapkara HA, Bozkurt E. Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE. Hellenic J Cardiol 2016; 57:119-23. [PMID: 27445028 DOI: 10.1016/j.hjc.2015.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 04/12/2014] [Accepted: 03/24/2015] [Indexed: 11/27/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR) with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE) seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT) with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D) echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE) and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE).
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Affiliation(s)
- Cenk Sarı
- Department of Cardiology, Ataturk Research and Training Hospital, Ankara, Turkey.
| | - Tahir Durmaz
- Yıldırım Beyazıt University, Cardiology Department, Ankara, Turkey
| | | | - Telat Keleş
- Yıldırım Beyazıt University, Cardiology Department, Ankara, Turkey
| | - Hüseyin Bayram
- Department of Cardiovascular Surgery, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Serdal Baştuğ
- Department of Cardiology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Mehmet Burak Özen
- Department of Cardiology, Ataturk Research and Training Hospital, Ankara, Turkey
| | | | - Emine Bilen
- Department of Cardiology, Ataturk Research and Training Hospital, Ankara, Turkey
| | - Hüseyin Ayhan
- Yıldırım Beyazıt University, Cardiology Department, Ankara, Turkey
| | | | - Engin Bozkurt
- Yıldırım Beyazıt University, Cardiology Department, Ankara, Turkey
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Sarı C, Ayhan H, Baştuğ S, Kasapkara HA, Karaduman BD, Aslan AN, Özen MB, Bilen E, Bayram NA, Keleş T, Durmaz T, Bozkurt E. Transcatheter aortic valve implantation in the presence of hematologic malignancies. Turk Kardiyol Dern Ars 2015; 43:529-35. [PMID: 26363745 DOI: 10.5543/tkda.2015.99442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Cardiac surgery may be performed in patients with hematologic disorders, but carries an increased risk of morbidity. This series describes an experience of transcatheter aortic valve implantation (TAVI) in patients with hematologic malignancies, and highlights the technical considerations to be kept in mind. METHODS Between June 2011 and April 2014, 133 consecutive high-risk patients with symptomatic severe aortic stenosis were treated with TAVI at our centre. Based on consensus among the local heart team, five patients with hematologic malignancies (myelodysplastic syndrome [2],chronic lymphocytic leukemia [2], Hodgkin lymphoma [1]) were considered high risk for surgery (Logistic EUROSCORE 17.2±14.0% and STS score 5.8±4.3%). Serial echocardiographic and clinical follow-ups were done pre- and post-procedure, at discharge, and at 1, 3, 6 and 12 months. RESULTS Our procedural success rate was 80%. Two heart valves were implanted in one patient due to aortic embolization of the previous valve. Perforation of the right ventricle and cardiac tamponade occurred in the same patient. Mean blood transfusion requirement was 1.0±1.4 U (range: 0 to 3 U). Mean aortic valve gradient was reduced from baseline to 9.2±3.27 mmHg, and the effective orifice area was significantly increased to 1.96±0.29 cm2. Paravalvular aortic regurgitation (AR) was absent-mild in all the patients. CONCLUSION This present series demonstrates that TAVI with a balloon-expandable valve can be performed safely and effectively and is technically feasible in high-risk patients with hematologic malignancies.
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Affiliation(s)
- Cenk Sarı
- Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
| | - Hüseyin Ayhan
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Serdal Baştuğ
- Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Hacı Ahmet Kasapkara
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | | | - Abdullah Nabi Aslan
- Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Mehmet Burak Özen
- Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Emine Bilen
- Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey
| | - Nihal Akar Bayram
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Telat Keleş
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Tahir Durmaz
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Kırbaş Ö, Kurmuş Ö, Köseoğlu C, Duran Karaduman B, Saatçi Yaşar A, Alemdar R, Ali S, Bilge M. Association between admission mean platelet volume and ST segment resolution after thrombolytic therapy for acute myocardial infarction. ACTA ACUST UNITED AC 2014; 14:728-32. [PMID: 25188762 DOI: 10.5152/akd.2014.5078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Mean platelet volume (MPV), one of the indices of platelet reactivity has been shown to be related to impaired angiographic reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary angioplasty or thrombolytics. However data regarding MPV and its association with ST-segment resolution; an indicator of epicardial and tissue level reperfusion in the setting of STEMI are limited. In this study, we aimed to investigate whether MPV on admission is associated with ST-segment resolution in STEMI patients treated with thrombolytics. METHODS We retrospectively evaluated 232 consecutive patients with a diagnosis of first STEMI who were administered thrombolytic therapy within 12 hours of onset of chest pain. ST segment resolution based on baseline and 90 minute electrocardiographies were measured. Patients were grouped into two as with <50% and ≥50% ST-segment resolution. Admission MPV was measured and compared between two groups. RESULTS Admission MPV was higher in patients with <50% ST-segment resolution than patients with ≥50% ST-segment resolution (9.9±1.3 fL vs. 8.5±1.1 fL respectively, p<0.001). The receiver operating characteristic analysis yielded a cut-off value of 9.3 fL to predict ST-segment resolution, with sensivity and specifity being 66.7% and 77.9%, respectively. In-hospital mortality rate was high in patients with <50% ST -segment resolution (p=0.002). CONCLUSION High MPV on admission in STEMI patients treated with thrombolytics is associated with impaired ST segment resolution.
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Affiliation(s)
- Özgür Kırbaş
- Clinic of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara-Turkey.
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Ertem AG, Erayman A, Efe TH, Duran Karaduman B, Aydın HI, Bilge M. Is there a relationship between serum paraoxonase level and epicardial fat tissue thickness? ACTA ACUST UNITED AC 2014; 14:115-20. [PMID: 24449622 DOI: 10.5152/akd.2014.4742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to show the relationship between serum paraoxonase 1 level and the epicardial fat tissue thickness. METHODS Two hundred and seven patients without any atherosclerotic disease history were included in this cross-sectional observational study. Correlation analysis was performed to determine the correlation between epicardial fat tissue thickness, which was measured by echocardiography and serum paraoxonase 1 level. Also correlation analysis was performed to show correlation between patients' clinical and laboratory findings and the level of serum paraoxonase 1 (PON 1) and the epicardial fat tissue thickness. Pearson and Spearman test were used for correlation analysis. RESULTS No linear correlation between epicardial fat tissue thickness and serum PON 1 found (correlation coefficient: -0.127, p=0.069). When epicardial fat tissue thickness were grouped as 7 mm and over, and below, and 5 mm and over, and below, serum PON 1 level were significantly lower in ≥7 mm group (PON1 : 168.9 U/L) than <7 mm group (PON 1: 253.9 U/L) (p<0.001). Also hypertension prevalence was increased in ≥7 mm group (p=0.001). Serum triglyceride was found to be higher in ≥7 mm group (p=0.014), body mass index was found higher in ≥5 mm group (p=0.006). CONCLUSION Serum PON 1 level is not correlated with the epicardial fat tissue thickness. But PON 1 level is lower in patients with epicardial fat tissue thickness 7 mm and over. Therefore, increased atherosclerosis progression can be found among patients with 7 mm and higher epicardial fat tissue thickness.
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Affiliation(s)
- Ahmet Göktuğ Ertem
- Clinic of Cardiology, Ankara Penal Instution Campus State Hospital; Ankara-Turkey.
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Bayram NA, Ayhan H, Durmaz T, Keleş T, Köseoğlu C, Karaduman BD, Sarı C, Kasapkara HA, Baştuğ S, Bilen E, Akçay M, Bozkurt E. QT Dispersion in the Severe Aortic Stenosis, before and after Transaortic Valve Implantation. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.669] [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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