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Tanriverdi A, Ozcan Kahraman B, Sezgin NH, Erez Y, Acar S, Birlik AM, Ozpelit E, Savci S. Functional capacity, physical activity, and arterial stiffness in patients with systemic sclerosis. Clin Rheumatol 2024; 43:1657-1664. [PMID: 38573481 DOI: 10.1007/s10067-024-06953-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is a complex immune-mediated connective tissue disease, involving skin manifestations, vascular features, and organ-based complications that may affect functional capacity and physical activity. Functional capacity and physical activity are associated with arterial stiffness; however, this relationship has not been evaluated in patients with SSc. Therefore, the objective of this study was to investigate the association of functional capacity and physical activity with arterial stiffness in patients with SSc. METHODS Sixty-five patients with SSc were enrolled in this cross-sectional study. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Functional capacity and physical activity were assessed with a six-min walk test (6MWT) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. RESULTS All participants were women, and the mean age was 54.91 ± 11.18 years. 6MWT distance and IPAQ-SF were inversely associated with cf-PWV in crude analysis (p < 0.05). The relationship between 6MWT distance and cf-PWV was maintained in the fully adjusted model (β = - 0.007, 95% CI, - 0.013 to 0.000). Similarly, the association between IPAQ-SF and cf-PWV remained significant in the fully adjusted model (β = - 0.001, 95% CI, - 0.002 to - 0.001). CONCLUSION The present study indicates that functional capacity and self-reported physical activity are independently associated with arterial stiffness in patients with SSc. Exercise interventions targeted to increase functional capacity and physical activity may help to regulate arterial stiffness in patients with SSc. Key Points • Arterial stiffness is an independent predictor of cardiovascular risk. • SSc patients exhibit decreased exercise capacity and functional capacity. • The association of functional capacity and physical activity with arterial stiffness in patients with SSc is unknown. • Functional capacity and self-reported physical activity are independently associated with arterial stiffness in patients with SSc.
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Affiliation(s)
- Aylin Tanriverdi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey.
- Present address: Çankırı Karatekin University Uluyazı Campus, Çankırı, Turkey.
| | - Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | | | - Yesim Erez
- Cigli Training and Research Hospital, Izmir, Turkey
| | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Merih Birlik
- Department of Internal Disease, Rheumatology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Ozcan Kahraman B, Tanriverdi A, Sezgin NH, Acar S, Birlik AM, Koken Avsar A, Akdeniz B, Ozpelit E, Savci S. Comparison of physiological responses after incremental shuttle walking test and 6-minute walk test in patients with systemic sclerosis. Wien Klin Wochenschr 2024; 136:169-176. [PMID: 36161531 DOI: 10.1007/s00508-022-02087-y] [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: 11/26/2021] [Accepted: 08/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The 6‑minute walk test (6MWT) is a commonly used to evaluate exercise capacity in patients with systemic sclerosis (SSc), but there was no study using the incremental shuttle walking test (ISWT) for assessing exercise capacity and comparing the patient's cardiorespiratory responses to these tests. The aim was to investigate the usability and determinants of the ISWT in patients with SSc and compare the physiological responses after the ISWT and 6MWT. METHODS A total of thirty four female patients with SSc were included. Dyspnea during daily activities and knee extensor muscle strength was assessed, skin fibrosis and disease severity were recorded, and 6MWT and ISWT were carried out for the exercise capacity measurement. Pulmonary function test results were recorded from the individuals' medical records for SSc with interstitial lung disease (SSc-ILD) patients. RESULTS The ISWT distance was significantly correlated with the 6MWT distance (p < 0.001). The 6MWT was correlated with age, modified Rodnan skin score, Medsger severity score, modified British Medical Research Council Questionnaire (mMRC) score, and knee extensor muscle strength (p < 0.05). The 6MWT was correlated with the forced expiratory volume in the first second (FEV1) (lt) and forced vital capacity (FVC) (lt) in patients with SSc-ILD (p < 0.05). The ISWT distance was correlated with age, modified Rodnan skin score, mMRC score, and knee extensor muscle strength (p < 0.05). Age, mMRC, and knee extensor muscle strength explained 33.8% of the variance in 6MWT distance, while age, mMRC, and knee extensor muscle strength explained 51.7% of the variance in the ISWT distance. CONCLUSION Because of the higher cardiopulmonary responses, and having a more standardized procedure, the ISWT may be preferable for investigating symptom-limited exercise capacity in patients with SSc. Age, dyspnea, and knee extensor muscle strength were the determinants of exercise capacity in patients with SSc.
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Affiliation(s)
- Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Aylin Tanriverdi
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | | | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Merih Birlik
- Department of Internal Disease, Rheumotology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Aydan Koken Avsar
- Department of Internal Disease, Rheumotology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Tanriverdi A, Savci S, Ozcan Kahraman B, Odaman H, Ozpelit E, Senturk B, Ozsoy I, Baran A, Akdeniz B, Acar S, Balci A. Effects of high intensity interval-based inspiratory muscle training in patients with heart failure: A single-blind randomized controlled trial. Heart Lung 2023; 62:1-8. [PMID: 37285766 DOI: 10.1016/j.hrtlng.2023.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/04/2023] [Accepted: 05/20/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Given the promising effects of inspiratory muscle training (IMT), determining the most appropriate IMT protocol will optimize the training benefits. OBJECTIVES The objective of this study was to determine the effects of high intensity interval-based inspiratory muscle training (H-IMT) on cardiovascular, pulmonary, physical, and psychosocial functions in patients with heart failure and reduced ejection fraction (HFrEF). METHODS Thirty-four patients with HFrEF were randomly assigned to the H-IMT or control group for 3 days/week, 8 weeks training period. The H-IMT group performed IMT at least 70% of the maximal inspiratory pressure, whereas the control group performed unloaded IMT. Each session occurred 7 sets with a total of 21 min consisting of 2-min training and 1-min interval. Heart rate variability (HRV), arterial stiffness, respiratory muscle strength and endurance, diaphragm thickness, quadriceps strength, functional capacity, frailty, dyspnea, fatigue, disease-specific health-related quality of life (HRQoL), and generic HRQoL were evaluated at baseline and after 8 weeks training period by blinded assessors. RESULTS Statistically significant between-group differences were observed in the time domain parameters of HRV, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific HRQoL in favor of the H-IMT group (p<0.05). CONCLUSIONS H-IMT is an effective protocol for improving cardiac autonomic function, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific quality of life in patients with HFrEF. CLINICAL TRIAL REGISTRATION NCT04839211.
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Affiliation(s)
- Aylin Tanriverdi
- Institute of Health Sciences, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey; Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Huseyin Odaman
- Department of Radiology, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Dokuz Eylül University, Izmir, Turkey
| | - Bihter Senturk
- Department of Cardiology, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- Department of Physical Therapy and Rehabilitation, Selcuk University, Konya, Turkey
| | - Agah Baran
- Klinikum Bremerhaven Reinkenheide Diagnostische und Interventionelle Radiologie, Bremerhaven, Germany
| | - Bahri Akdeniz
- Department of Cardiology, Dokuz Eylül University, Izmir, Turkey
| | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ali Balci
- Department of Radiology, Dokuz Eylül University, Izmir, Turkey
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Bora E, Bulut AY, Cankaya T, Cinleti T, Genç HZ, Ozcan EE, Ozpelit E, Ulgenalp A, Caglayan AO. Clinical Heterogeneity in Patients with Long QT Syndrome and Segregation of Single Nucleotide Variants and Clinical Symptoms in 17 Affected Families. Mol Syndromol 2023; 14:363-374. [PMID: 37901857 PMCID: PMC10601819 DOI: 10.1159/000530513] [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: 07/04/2022] [Accepted: 03/28/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Long QT syndrome (LQTS) is a disorder of ventricular myocardial repolarization characterized by a prolonged QT interval on the electrocardiogram. It increases the risk of ventricular arrhythmias, which can cause syncope or sudden cardiac death. In this study, we study the genotype-phenotype relationships of patients referred to us with suspected arrhythmia syndrome. Methods Seventeen cases and their twenty relatives were evaluated. Next-generation sequencing analysis was performed for 17 LQTS-related genes. Results We detected seventeen single nucleotide variants (SNVs) with potential pathogenic significance in 26 of the 36 subjects analyzed. KCNH2 c.172G>A, KCNQ1 c.1768G>A, ANK2 c.4666A>T, c.1484_1485delCT, KCNH2 c.1888G>A were reported as pathogenic or likely pathogenic in HGMD variant classification database. Conclusion Current study pointed out that early diagnosis can be life-saving for patients and their families by taking family history and detailed examination. Also, we highlight the clinical heterogeneity of arrhythmia syndrome through a patient with a dual phenotype.
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Affiliation(s)
- Elcin Bora
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ayca Yıldız Bulut
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Tufan Cankaya
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Tayfun Cinleti
- Division of Medical Genetics, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Halise Zeynep Genç
- Division of Cardiology, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Emin Evren Ozcan
- Department of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ayfer Ulgenalp
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ahmet Okay Caglayan
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Ozcan Kahraman B, Tanriverdi A, Savci S, Odaman H, Akdeniz B, Sevinc C, Ozsoy I, Acar S, Balci A, Baran A, Ozpelit E. Effects of Inspiratory Muscle Training in Patients With Pulmonary Hypertension. Am J Cardiol 2023; 203:406-413. [PMID: 37523937 DOI: 10.1016/j.amjcard.2023.06.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
The study aimed to examine the effects of inspiratory muscle training (IMT) in patients with pulmonary hypertension (PH). A total of 24 patients with PH were included in the randomized controlled evaluator-blind study. IMT was performed at 40% to 60% of the maximal inspiratory pressure for 30 min/d, 7 d/wk (1 day supervised) for 8 weeks. Respiratory muscle strength, dyspnea, diaphragm thickness (DT), pulmonary functions, 24-hour ambulatory blood pressure (BP), arterial stiffness, exercise capacity, upper extremity functional exercise capacity, physical activity levels, fatigue, anxiety-depression levels, activities of daily living (ADL), and quality of life were evaluated. A total of 24 patients (treatment = 12, control = 12) completed the 8-week follow-up. There was no significant difference between the patient groups in terms of demographic and clinical characteristics (p >0.05). Considering the change between the groups in the treatment and control groups, brachial and central BP, dyspnea, respiratory muscle strength, DT in total lung capacity, knee extension muscle strength, functional exercise capacity, upper extremity functional exercise capacity, physical activity, ADL, fatigue, anxiety, and quality of life improved in favor of the IMT group (p <0.05). In conclusion, IMT has improved brachial and central BP, dyspnea, respiratory muscle strength, DT in total lung capacity, knee extension muscle strength, functional exercise capacity, upper extremity functional exercise capacity, physical activity, ADL, fatigue, anxiety, and quality of life compared with the control group. IMT is an effective method in cardiopulmonary rehabilitation for patients with PH.
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Affiliation(s)
- Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Aylin Tanriverdi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cankırı Karatekin University, Cankırı, Turkey
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Hüseyin Odaman
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Can Sevinc
- Department of Chest Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Konya, Turkey
| | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ali Balci
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Agah Baran
- Klinikum Bremerhaven Reinkenheide Diagnostic and Interventional Radiology, Bremerhaven, Germany
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Tanriverdi A, Kahraman BO, Ozpelit E, Savci S. Test Retest Reliability and Validity of 1-Minute Sit-to-Stand Test in Patients With Chronic Heart Failure. Heart Lung Circ 2023; 32:518-524. [PMID: 36774200 DOI: 10.1016/j.hlc.2023.01.008] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 02/11/2023]
Abstract
AIM The psychometric properties of the 1-minute sit-to-stand (1STS) test have not been investigated in patients with chronic heart failure (CHF). The aim of this study was to evaluate test-retest reliability, construct validity, and minimal detectable change of the 1STS test and to investigate the physiological response to the 1STS test in patients with CHF. METHOD Forty-three (43) patients with CHF were included. Demographic and clinical features were recorded. To investigate test-retest reliability, participants performed two 1STS tests on the same day. The correlations between the 1STS test and the 6-minute walk test (6MWT), functional class, pulmonary function, quadriceps muscle strength, and physical activity were investigated for validity. The physiological responses and symptom perception were assessed before and after both the 1STS test and 6MWT. RESULTS Excellent test-retest reliability was found for the 1STS test, with an intraclass correlation of 0.932 (95% confidence interval 0.874-0.963). The minimal detectable change of the 1STST test was 3.7 repetitions. The 1STS test was correlated with 6MWT distance, age, functional class, pulmonary function, quadriceps muscle strength, and physical activity (p<0.05). The 1STS test showed similar changes to the 6MWT in physiological responses and symptom perception (p>0.05), except for leg fatigue (p=0.02). CONCLUSIONS The 1STS test is reliable and valid in evaluating functional exercise capacity in patients with CHF. The 1STS test reveals similar cardiac demand to the 6MWT. The 1STS test may be considered an option when traditional tests are impractical in terms of space and time.
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Affiliation(s)
- Aylin Tanriverdi
- Institute of Health Scieces, Dokuz Eylül University, Izmir, Turkey; Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Ergene O, Aras D, Kaymaz C, Arsava EM, Gonen C, Gurkas E, Arslan U, Cagirici G, Cay S, Kilickap M, Kanat S, Ozpelit E, Vatansever F, Kilickesmez K. The Role of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation: Treatment Management Based on Patient and Drug Characteristics. Turk Kardiyol Dern Ars 2022; 50:356-370. [DOI: 10.5543/tkda.2022.21191] [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: 11/04/2022] Open
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Turk UO, Alioglu E, Mavioglu Z, Diker E, Ozpelit E, De Caterina R. Evaluation of Treatment Safety in Patients with Atrial Fibrillation on Edoxaban Therapy in Real-Life in Turkey Study: Design and Rationale. Turk Kardiyol Dern Ars 2022; 50:117-123. [DOI: 10.5543/tkda.2022.21065] [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: 11/04/2022] Open
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Uzumcu H, Ozpelit E, Ozpelit M, Ercan E, Sahinoglu B, Yilmaz M. The role of coronary CT angiography and person"s lifestyle habits in assessment of risk for primer protection from cardiovascular diseases. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.349] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Prevention of atherosclerotic coronary artery disease (CAD), is primarily based on risk assesment. SCORE risk model is the most widely used risk assesment tool which is a comprehensive model of classical risk factors for CAD . However this model does not include several important risk factors such as socioeconomic level, education status, social support , sedantary life style, systemic inflammation and etc.. SCORE model also does not have any component about imaging findings. Actually high Agatston score, which measures coronary artery calcium (CAC) in cardiac computed tomography angiography (CCTA) is an important risk estimator for CAD.
Aim
The aim of this study is to investigate the importance of CCTA findings together with sociocultural and lifestyle characteristics of individuals on top of SCORE risk assesment
Methods
565 patients who applied to the Izmir Medical Park Hospital cardiology outpatient clinic between 15.01.2019-20.01.2020 and underwent CCTA were screened. Patients with known CAD were excluded,497 people were included in the study.Cardiovascular risk factors, socioeconomic and lifestyle characteristics of the person were learned and SCORE risk calculated. Agatston CAC score (CACS), presence of hepatosteatosis, paracardial adipose tissue thickness (PATT) measured in CCTA.Data of individuals were analyzed in terms of presence of Agatston CACS. Parameters that were significant in univariate analysis were included in multivariate analysis. Independent predictors of atherosclerosis were investigated.
Results
Patients were divided into 2 groups according to CAC score: group 1 with an CCS = 0 and group 2 as CCS > 0 . Among several lifestyle and sociocultural characteristics assesed, only having an active working life was found to be significantly associated with CCS = 0 (table 1) However in multivariate analysis, significance was lost for active working ; the only significant predictors of CCS = 0 were SCORE value of <5 and PATT < 5mm. (table 2) The PATT value was a more powerful predictor of atherosclerosis compared to the all other well known metabolic parameters such as BMI, blood glucose and lipid levels
Conclusion
Although SCORE risk model does not include components about lifestyle characteristics of individuals and imaging findings , it was the most powerful estimator of presence of atherosclerosis. No single lifestyle characteristics was able to predict CAD independently. However the PATT which is a marker of visseral obesity with inflamatory roles on heart and coronary arteries, was found to be an independent predictor of atherosclerosis on top of SCORE risk. So we think that The measurement of PATT can be useful to predict an individual"s risk of atherosclerosis. We can use it in our routine practice to make the risk assessment of people more effective. Abstract Figure. Independent Predictors of Being Agatston Abstract Figure. Independent Predictors of Being Agatsto2
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Affiliation(s)
- H Uzumcu
- Sivas Public Hospital, Sivas, Turkey
| | - E Ozpelit
- Dokuz Eylul University, cardiology, Izmir, Turkey
| | - M Ozpelit
- Medical Park Izmir Hospital, cardiology, Izmir, Turkey
| | - E Ercan
- Medical Park Izmir Hospital, cardiology, Izmir, Turkey
| | - B Sahinoglu
- Dokuz Eylul University, cardiology, Izmir, Turkey
| | - M Yilmaz
- Dokuz Eylul University, cardiology, Izmir, Turkey
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Alak C, Ozpelit E, Cirgamis D, Abusharekh M, Baris N. Relationship of PRECISE-DAPT and DAPT scores with mortality in patients admitted with acute coronary syndrome who undergo coronary stent implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1417] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
International guidelines recommend using risk score tools that allow us to assess the risk of bleeding and ischemia when deciding on DAPT. In our research, we aimed to examine the mortality relationship of new risk scores, DAPT and PRECISE-DAPT scores.
Method
Between 2013–2014, 948 patients admitted to our clinic with ACS were included in our study. We excluded 688 patient (no contact number,CABG, medical treatment, use of oral anticoagulation, active malignant cancer). 260 patients admitted with acute coronary syndrome (58%, 8 STEMI, 35%, 4 non-STEMI, 5%, 4 Unstable angina pectoris) who undergo coronary stent implantation were included in the study. We aimed to focus on the patients who undergo percutaneous coronary intervention and their risk of mortality. The patients' records were retrospectively analyzed through the hospital information system and archive records. Laboratory results, echocardiography and CAG reports of the patients, disease histories were obtained from the information recorded through the system. With these data, PRECISE-DAPT and DAPT scores of patients were calculated.
Results
The number of patients with a PRECISE-DAPT Score ≥25 was 62 (23.8%). The number of patients with DAPT Score ≥2 was 193 (74.2%). Mortality occurred in 49 (18.8%) patients. Patients with PRECISE-DAPT ≥25 and those with PRECISE-DAPT <25 were compared in terms of mortality and mortality was significantly higher in the high-scoring group [P <0.001 OR 6.94 C (3.53–13.62)]. The patients were divided into 4 groups (PRECISE-DAPT 25 and DAPT ≥2, PRECISE-DAPT ≥25 and DAPT ≥2, PRECISE-DAPT 25 and DAPT 2, PRECISE-DAPT ≥25 and DAPT 2) according to PRECISE-DAPT and DAPT score. Mortality was significantly higher regardless of DAPT score in patients with high PRECISE-DAPT scores (p<0.001). We evaluated the relationship between PRECISE-DAPT score and major bleeding and all bleeding. Compared to the group there was no significant difference in all bleeding events (P=0.56) and major bleeding events (P=0.23). The relationship between bleeding events and mortality was evaluated. There was no significant difference in mortality (p=0.689) with all bleeding events; but mortality was significantly increased in patients with major bleeding [P=0.025 OR 6.16 (1,33–28,49)].
Conclusion
In our study, we observed that the patient group with a high PRECISE-DAPT score had a high mortality rate regardless of the DAPT score. The PRECISE-DAPT score is a useful tool in determining the group with high long-term mortality in patients who present with acute coronary syndrome and undergo percutaneous coronary intervention. The clinician should use the PRECISE-DAPT score when deciding on the duration of dual antiplatelet therapy in this patient group and these patients with high scores need to be monitored more closely. The data we have obtained from our study is retrospective and these results need to be supported by prospective and large studies.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Alak
- Dokuz Eylul University, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Izmir, Turkey
| | - D Cirgamis
- Agri State Hospital, Cardiology, Agri, Turkey
| | - M Abusharekh
- Medical Park Hospital, Cardiology, izmir, Turkey
| | - N Baris
- Dokuz Eylul University, Izmir, Turkey
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Tanriverdi A, Savci S, Kahraman BO, Ozpelit E. Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality. Ir J Med Sci 2021; 191:969-975. [PMID: 34080125 PMCID: PMC8172250 DOI: 10.1007/s11845-021-02667-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Received: 04/26/2021] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) represents a wide range of clinical manifestations, even if mild disease severity. It has been known that pulmonary function is affected by COVID-19 during infection and mid-to-long term. However, there is inadequate evidence about extrapulmonary features in post-COVID-19 patients. Aims This study aimed to investigate extrapulmonary features in post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Methods This cross-sectional study was carried out after at least 12 weeks from the COVID-19 diagnosis. Disease severity was defined using criteria for clinical severity of confirmed COVID-19 pneumonia. The peripheral muscle strength was measured using the dynamometer. Physical performance was assessed with five times sit-to-stand and 4-m gait speed. Physical activity level (PAL), mood, and sleep quality were assessed with the International Physical Activity Questionnaire, Hospital Anxiety, and Depression Scale, and Pittsburgh Sleep Quality Index, respectively. Results A total of 48 participants with post-COVID-19 (39.2 ± 7.9 years, 54.2% women) were included in the study. Handgrip and quadriceps weakness was observed in 39.6% and 35.4% of the participants, respectively. PAL was low in 39.6%, moderate in 33.3%, and high in 27.1% of the participants. Anxiety, depression, and poor sleep quality were observed in 33.3%, 29.2%, and 50% of the participants, respectively. Conclusions Extrapulmonary features are adversely affected in a substantial proportion of post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Comprehensive assessment and appropriate intervention strategies should also be considered for non-severe post-COVID-19 patients.
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Affiliation(s)
- Aylin Tanriverdi
- Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey. .,School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Eldin AJ, Akinci B, da Rocha AM, Meral R, Simsir IY, Adiyaman SC, Ozpelit E, Bhave N, Gen R, Yurekli B, Kutbay NO, Siklar Z, Neidert AH, Hench R, Tayeh MK, Innis JW, Jalife J, Oral H, Oral EA. Cardiac phenotype in familial partial lipodystrophy. Clin Endocrinol (Oxf) 2021; 94:1043-1053. [PMID: 33502018 PMCID: PMC9003538 DOI: 10.1111/cen.14426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES LMNA variants have been previously associated with cardiac abnormalities independent of lipodystrophy. We aimed to assess cardiac impact of familial partial lipodystrophy (FPLD) to understand the role of laminopathy in cardiac manifestations. STUDY DESIGN Retrospective cohort study. METHODS Clinical data from 122 patients (age range: 13-77, 101 females) with FPLD were analysed. Mature human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from a patient with an LMNA variant were studied as proof-of-concept for future studies. RESULTS Subjects with LMNA variants had a higher prevalence of overall cardiac events than others. The likelihood of having an arrhythmia was significantly higher in patients with LMNA variants (OR: 3.77, 95% CI: 1.45-9.83). These patients were at higher risk for atrial fibrillation or flutter (OR: 5.78, 95% CI: 1.04-32.16). The time to the first arrhythmia was significantly shorter in the LMNA group, with a higher HR of 3.52 (95% CI: 1.34-9.27). Non-codon 482 LMNA variants were more likely to be associated with cardiac events (vs. 482 LMNA: OR: 4.74, 95% CI: 1.41-15.98 for arrhythmia; OR: 17.67, 95% CI: 2.45-127.68 for atrial fibrillation or flutter; OR: 5.71, 95% CI: 1.37-23.76 for conduction disease). LMNA mutant hiPSC-CMs showed a higher frequency of spontaneous activity and shorter action potential duration. Functional syncytia of hiPSC-CMs displayed several rhythm alterations such as early afterdepolarizations, spontaneous quiescence and spontaneous tachyarrhythmia, and significantly slower recovery in chronotropic changes induced by isoproterenol exposure. CONCLUSIONS Our results highlight the need for vigilant cardiac monitoring in FPLD, especially in patients with LMNA variants who have an increased risk of developing cardiac arrhythmias. In addition, hiPSC-CMs can be studied to understand the basic mechanisms for the arrhythmias in patients with lipodystrophy to understand the impact of specific mutations.
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Affiliation(s)
- Abdelwahab Jalal Eldin
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Baris Akinci
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Division of Endocrinology, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Andre Monteiro da Rocha
- Center for Arrhythmia Research, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Rasimcan Meral
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Ilgin Yildirim Simsir
- Division of Endocrinology, Department of Internal Medicine, Ege University, Izmir, Turkey
| | - Suleyman Cem Adiyaman
- Division of Endocrinology, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ebru Ozpelit
- Division of Cardiology, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Nicole Bhave
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Ramazan Gen
- Division of Endocrinology, Department of Internal Medicine, Mersin University, Mersin, Turkey
| | - Banu Yurekli
- Division of Endocrinology, Department of Internal Medicine, Ege University, Izmir, Turkey
| | - Nilufer Ozdemir Kutbay
- Division of Endocrinology, Department of Internal Medicine, Celal Bayar University, Manisa, Turkey
| | - Zeynep Siklar
- Division of Endocrinology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Adam H. Neidert
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Rita Hench
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Marwan K. Tayeh
- Departments of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey W. Innis
- Departments of Pediatrics, University of Michigan, Ann Arbor, MI, USA
- Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Jose Jalife
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Cardiac Arrhythmia Section, Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Madrid, Spain
| | - Hakan Oral
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elif A. Oral
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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Tanriverdi A, Kahraman BO, Ozsoy I, Ozpelit E, Savci S. Correction to: Acute effects of inspiratory muscle training at different intensities in healthy young people. Ir J Med Sci 2020; 190:859-860. [PMID: 32902790 DOI: 10.1007/s11845-020-02363-8] [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: 11/30/2022]
Affiliation(s)
- Aylin Tanriverdi
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Selcuk University, Konya, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Tanriverdi A, Kahraman BO, Ozsoy I, Ozpelit E, Savci S. Acute effects of inspiratory muscle training at different intensities in healthy young people. Ir J Med Sci 2020; 190:577-585. [PMID: 32851483 DOI: 10.1007/s11845-020-02353-w] [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: 07/14/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Understanding the acute effects of inspiratory muscle training (IMT) at different intensities on the autonomic nervous system, arterial stiffness, and blood pressure in healthy young people will be important in the constitution of appropriate IMT prescriptions. AIMS To investigate the acute effects of IMT at different intensities on autonomic function, arterial stiffness, and blood pressure in healthy young people METHODS: Thirty-six healthy participants were enrolled in this crossover study. All participants randomly performed IMT sessions, which consisted of diaphragmatic breathing exercise (DBE), 10%, 30%, and 60% of maximal inspiratory pressure (MIP) on consecutive days. Autonomic function and arterial stiffness were assessed by measuring heart rate variability (HRV) and aortic pulse wave velocity (AoPWV), respectively. HRV, AoPWV, and blood pressure were recorded before and immediately after each IMT session. RESULTS There was no significant difference in the baseline measurements between IMT sessions (p > 0.05). Heart rate (HR) significantly decreased after DBE and IMT at 10% of MIP (p < 0.05). All time domain parameters of HRV significantly improved after DBE compared with the baseline (p < 0.05). There was no difference in the frequency domain of HRV after the IMT sessions (p > 0.05). AoPWV significantly increased after IMT at 60% of MIP (p < 0.05). Mean arterial pressure significantly changed after DBE and IMT at 60% of MIP (p < 0.05). CONCLUSIONS A single session of DBE positively affects autonomic function and blood pressure, while IMT at 60% of MIP increases arterial stiffness. The different intensities of IMT have various impacts on autonomic function, arterial stiffness, and blood pressure. TRIAL REGISTRATION NCT03788356.
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Affiliation(s)
- Aylin Tanriverdi
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey. .,School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Selcuk University, Konya, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Tanriverdi A, Kahraman BO, Ozsoy I, Acar S, Senturk B, Ozpelit E, Akdeniz B, Savci S. Balance performance in patients with heart failure. Heart Lung 2020; 49:458-462. [PMID: 32434700 DOI: 10.1016/j.hrtlng.2020.04.004] [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: 01/30/2020] [Revised: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND It has been suggested that patients with heart failure (HF) have an increased fall rate. Although balance is one of the most important risk factors for fall, there is not sufficient information about balance in HF. OBJECTIVE To compare static, dynamic and functional balance between patients with HF and healthy controls. METHODS Twenty-seven patients with HF and 22 healthy controls were recruited in this study. The Unilateral Stance (US) and Limits of Stability (LOS) tests were used to measure static and dynamic balance, respectively. Functional balance was assessed with Berg Balance Scale. RESULTS There was no significant difference in age, gender and body mass index between the groups (p > 0.05). There was a significant difference in US with open eyes between the groups (p < 0.05). Reaction time (backward and left), endpoint excursion (backward), maximum excursion (forward and backward) and directional control (forward and right) variables of LOS were significantly different between the groups (p < 0.05). CONCLUSIONS Patients with HF have impaired static, dynamic and functional balance. Considering the balance impairment, a comprehensive balance assessment performed and balance training should be included in the management of HF as a part of the cardiac rehabilitation program.
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Affiliation(s)
- Aylin Tanriverdi
- Graduate School of Health Sciences, School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kirsehir, Turkey
| | - Serap Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Bihter Senturk
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Eldin AJ, Akinci B, da Rocha AM, Meral R, Simsir IY, Adiyaman SC, Ozpelit E, Bhave N, Gen R, Yurekli BS, Kutbay NO, Siklar Z, Neidert A, Swaidan M, Rus D, Hench R, Jalife J, Oral H, Oral EA. SUN-556 Cardiac Phenotype in Familial Partial Lipodystrophy. J Endocr Soc 2020. [PMCID: PMC7207313 DOI: 10.1210/jendso/bvaa046.1116] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Pathogenic variants in Lamin A/C (LMNA) gene are the most common monogenic etiology in Familial Partial Lipodystrophy (FPLD) causing FPLD2. LMNA pathogenic variants have been previously associated with cardiomyopathy, familial arrhythmias or conduction system abnormalities independent of lipodystrophy. We aimed to assess cardiac impacts of FPLD, and to explore the extent of overlap between cardiolaminopathies and FPLD. Methods We conducted a retrospective review of an established cohort of 122 patients (age range: 13-77, M/F 21/101) with FPLD from Michigan (n = 83) and Turkey (n = 39) with an accessible cardiac evaluation. Also, functional syncytia of mature human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from a FLPD2 patient was studied for assessment of autonomous rhythm and action potential duration with optical mapping using a voltage sensitive dye. Results In the whole study cohort, 95 (78%) patients had cardiac alterations (25% ischemic heart disease, 36% arrhythmia, 16% conduction abnormality, 20% prolonged QT interval, 11% cardiomyopathy, and 15% congestive heart failure). The likelihood of having an arrhythmia (OR; 3.95, 95% CI: 1.49-10.49) and conduction disease (OR: 3.324, 95% CI: 1.33-8.31) was significantly higher in patients with LMNA pathogenic variants. Patients with LMNA pathogenic variants were at high risk for atrial fibrillation/flutter (OR: 6.77, 95% CI: 1.27- 39.18). The time to first arrhythmia was significantly shorter in the LMNA group with a higher hazard rate of 3.04 (95% CI: 1.29-7.17, p = 0.032). Non-482 LMNA pathogenic variants were more likely to be associated with cardiac events (vs. 482 LMNA: OR: 4.74, 95% CI: 1.41- 15.98 for arrhythmia; OR: 17.67, 95% CI: 2.44- 127.68 for atrial fibrillation/flutter; OR: 5.71, 95% CI: 1.37- 23.76 for conduction disease. hiPSC-CMs from a FPLD2 patient had higher frequency of autonomous activity, and shorter Fridericia corrected action potential duration at 80% repolarization compared to control cardiomyocytes. Furthermore, FPLD2 functional syncytia of mature hiPSC-CMs presented several rhythm alterations such as early after-depolarizations, spontaneous quiescence and spontaneous tachyarrhythmia; none of those were observed in the control cell lines. Finally, FPLD2 hiPSC-CMs presented significantly slower recovery in chronotropic changes induced by isoproterenol exposure; which indicates disrupted beta-adrenergic response. Conclusion Our results suggest the need for vigilant cardiac monitoring in FPLD, especially in patients with FPLD2 who have an increased risk to develop cardiac arrhythmias and conduction system diseases. In addition, study of human induced pluripotent stem cell-derived cardiomyocytes may prove useful to understand the mechanism of cardiac disease and arrhythmias and to create precision therapy opportunities in the future.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Diana Rus
- UNIVERSITY OF MICHIGAN, Ann Arbor, MI, USA
| | - Rita Hench
- UNIVERSITY OF MICHIGAN, Ann Arbor, MI, USA
| | | | - Hakan Oral
- UNIVERSITY OF MICHIGAN, Ann Arbor, MI, USA
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Kahraman BO, Savci S, Ozsoy I, Baran A, Acar S, Ozpelit E, Balci A, Sevinc C, Akdeniz B. Effects of neuromuscular electrical stimulation in patients with pulmonary arterial hypertension: a randomized controlled pilot study. J Cardiol 2020; 75:702-708. [PMID: 32001075 DOI: 10.1016/j.jjcc.2019.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/25/2019] [Revised: 12/01/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with pulmonary arterial hypertension (PAH) present impairments in muscle strength and exercise capacity. There is growing evidence about the benefits of neuromuscular electrical stimulation (NMES) in patients with respiratory diseases, except in patients with PAH. The aim of this study was to investigate the effects of NMES on muscle strength, and other physical and psychosocial variables in patients with PAH. METHODS Patients with PAH were randomly divided into two groups as NMES and control. The NMES was applied to the bilateral deltoid and quadriceps femoris muscles with 50 Hz for 3 days/week, 8 weeks for the NMES group. Muscle strength, muscle cross-sectional area and thickness, arterial stiffness, exercise capacity, functional mobility and balance, balance confidence, fatigue, physical activity, and quality of life were assessed at baseline and after 8 weeks by blinded assessors. RESULTS There was no significant difference in the demographic and clinical characteristics between the patient groups (p > 0.05). The improvements in muscle strength, muscle cross-sectional area and thickness, pulse wave velocity, exercise capacity, functional mobility and balance, balance confidence, fatigue, physical activity, and quality of life were significantly higher in the NMES group compared to the control group (p < 0.05). CONCLUSIONS This study suggests that NMES intervention is safe and effective for patients with PAH.
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Affiliation(s)
- Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kirsehir, Turkey
| | - Agah Baran
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Serap Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ali Balci
- Department of Radiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Can Sevinc
- Department of Chest Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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Ozcan Kahraman B, Ozsoy I, Akdeniz B, Ozpelit E, Sevinc C, Acar S, Savci S. Test-retest reliability and validity of the timed up and go test and 30-second sit to stand test in patients with pulmonary hypertension. Int J Cardiol 2020; 304:159-163. [PMID: 31980271 DOI: 10.1016/j.ijcard.2020.01.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Received: 12/02/2019] [Revised: 12/25/2019] [Accepted: 01/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Timed up and go (TUG) and sit to stand (STS) tests that required less space and easier to be performed in respiratory and cardiac diseases for assessing functionality. Aim was to test the reliability of TUG and 30-second STS (30STS) tests and determine the validity of TUG and 30STS tests in patients with Pulmonary Hypertension (PH). METHODS Thirty-eight patients with diagnosed PH were included. We collected TUG, 30STS, quadriceps muscle strength, physical activity level, and 6MWT. Intra-class correlation coefficient (ICC) was used to determine test-retest reliability and correlations with quadriceps muscle strength, physical activity level and 6MWT for validity of the TUG and 30STS tests. RESULTS The TUG and 30STS tests were associated with age, functional class, muscle strength, physical activity and functional exercise capacity in patients with PAH (p < 0.05). 6MWT was associated with age, functional class, muscle strength, physical activity and functional exercise capacity (p < 0.05). ICC (95%) for TUG test and 30STS were 0.96 (0.93-0.98) and 0.95 (0.90-0.97), respectively. CONCLUSIONS The TUG and 30STS tests were reliable and valid tests for measuring physical performance in PH. This study supports using the TUG and 30STS tests as practical assessment tools in patients with PH.
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Affiliation(s)
- Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Can Sevinc
- Department of Chest Disease, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Serap Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Baskurt AA, Ozpelit E, Kumral Z, Akdeniz B. P1474 Right or left; which sided the infective endocarditis is? Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.900] [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: 11/15/2022] Open
Abstract
Abstract
ABSTRACT
Treatment and management of infective endocarditis (IE) depends on the side of involvement. Involvement of both sides of heart is rarely encountered. We describe one case of both sided infective endocarditis caused by staphylococcus auerus. In this case, the vegetation is thought to be on the right side of the heart at first examination by transthrorasic echocardiography (TTE). However; when examined more carefully with transoesophageal echocardiography (TEE), nothing was as it seemed.
CASE PRESENTATİON
A 86-year-old woman, who underwent mechanic aortic valve replacement surgery 11 years before, was admitted to emergency room with fever, dispnea and cough. Physical examination showed a temperature of 38.6. Electrocardiography showed a atrial fibrillation of 112 beats/min. Laboratory tests revealed an elevated C reactive protein of 211 mg/l. The patient was empirically treated with intravenous piperacillin-tazobactam and teicoplanin, by the recommendation of infection disease unit. Staphylococcus aureus grew in both bottles of blood cultures.
A TTE showed severe tricuspid regurgitation with vegetation, mild aortic regurgitation and moderate mitral regurgitation with no clear vegetation. We decided perform TEE and realised the vegetation in the right atrium was originated from the right atrial wall not from the tricuspid valve. Then we also noticed a thickening in the walls of aortic root with systolic expansion. This finding was consistent with paraaortic abscess formation. The 3D TEE examination helped us to understand the origin of the vegetation in the right atrium. Because the wall of the right atrium which the vegetation arised from was in direct continuity with the infected aortic root. We conclude that the paraortic abscess was spread to the right atrium by neighborhood. After one week of IV antibiotics treatment, the patient undergone open heart surgery. The surgical inspection confirmed the echocardiographic diagnosis.
DISCUSSION
Echocardiography helps us in diagnosis, determination of side of involvement, and complications of infective endocarditis. Usually the endocarditis invole only one side of the heart: left or right. We have found only four cases of double-sided endocarditis in literature. Our case is the first one , in which we describe a direct extension of aortic root abscess to the right atrium.
Abstract P1474 figure 1
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Affiliation(s)
| | - E Ozpelit
- Dokuz Eylul University, Izmir, Turkey
| | - Z Kumral
- Dokuz Eylul University, Izmir, Turkey
| | - B Akdeniz
- Dokuz Eylul University, Izmir, Turkey
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Alak C, Cirgamis D, Badak O, Ozpelit E. P1734 Surprising image in the aortic root, is it zebra ? Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1095] [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: 11/13/2022] Open
Abstract
Abstract
CASE
80 year old-man patient was admitted our emergency department with dyspnea and chest pain. Transthoracic echocardiography (TTE) was performed.Ejection fraction was %60.Severe tricuspid regurtation was observed and pulmonary artery pressure was 55 mmHg.TTE showed mobile, hyperdense, flap-like appearance (Figure 1-A) Thorax computerized tomography (CT) angiography scan was performed with the suspicion of aortic dissection.CT angiography showed that there is no aortic dissection.(Figure 1-B) Transesophageal echocardiography (TEE) was planned. TEE showed an appearance consistent with the prosthetic material extending from the ascending aorta to the left main coronary artery.(Figure 1-C,D) When the patient"s history was investigated in detail, it was learned that the patient underwent coronary angiography six months ago.The patient was recommended bypass surgery, but he refused bypass surgery. Due to his rejection of bypass surgery, percutaneous intervention was attempted to the left anterior descending artery. Percutaneous coronary intervention was unsuccessful due to the severely calcified lesions. After learning this information, it was decided to perform imaging with fluoroscopy and chest CT without contrast.Because the image mimicking aortic dissection was thought to be the material related to previous unsuccesfull percutaneous coronary intervention. CT showed linear, hyperdense metallic densities that mimicked aortic dissection,extending form the left main coronary artery orifice to the ascending aorta. (Figure 1-E) The patient underwent imaging under fluoroscopy. In the imaging of the patient under fluoroscopy, it was observed that the image was consistent with the stent extending from the aorta to the left main coronary. (Figure 1-F) The mystery was solved and it was understood that during the unsuccessfull percutaneous coronary intervention the stent was removed from the balloon in the ascending aorta.
CONCLUSİON
In patients presenting with shortness of breath and chest pain, differantial diagnoses should always be life-threatening conditions such as aortic dissection, myocardial infarction and pulmonary embolism. When you hear hoofbeats, think of horses not zebras as taught in the early years of medical schools. Everything is never as it seems.Sometimes the sound of hoofbeats may also belong to the zebras.It is very important to evaluate the patient and medical history together with different perspectives.
Abstract P1734 Figure.
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Affiliation(s)
- C Alak
- Dokuz Eylul University, Izmir, Turkey
| | | | - O Badak
- Dokuz Eylul University, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Izmir, Turkey
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21
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Alak C, Ozpelit E, Cirgamis D, Badak O, Goldeli O. P699 Atrial septum tearing due to balloon sizing in percutaneous closure of ASD. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.372] [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: 11/13/2022] Open
Abstract
Abstract
INTRODUCTION
Percutanous closure of atrial septal defect (ASD) has become an accepted ,reliable procedure and alternative to surgical treatment.Various complications associated with this procedure have been identified but tear of atrial septal rim is a very rare complication.We report a case of atrial septal rim tear due to balloon sizing and diagnosed at the same time by transesophageal echocardiography (TEE).
CASE
A 64-year-old female patient was admitted to our clinic with dyspnea.Transthoracic echocardiography (TTE) was performed.Ejection fraction was %60 .Moderate tricuspit regurgitation was observed and pulmonary artery pressure was 45 mmHg. TTE revealed a left to right shunt and TEE was planned.2D and 3D-TEE was performed.Two separate secundum type ASD were observed and diameters of defects were measured as 15 mm and 14 mm.Measurement of rim between two defects was 7 mm.(Figure 1 A-B-C) It was observed that the aortic rim was absent but the other rims were sufficient for percutaneous closure.Percutaneous closure was planned .Balloon sizing with a 34-mm AGA balloon resulted in a stretched defect diameter of 26 mm using the stop-flow technique.After the measurement of ASD with sizing balloon flail structure was observed in atrial septal rim.We evaluate this image from various echocardiographic window and we diagnosed the atrial septal rupture. (Figure 1-E ) The patient was hemodynamically stable during the intervention and the atrial septal rupture diameter did not increase. Therefore it was decided to continue the process.ASD diameter was measured again after the rupture of the atrial septum and it was measured 26 mm by TEE and sizing balloon. A 28-mm Amplatzer septal occluder (ASO) was selected.In the same session 28 mm ASO device was successfully placed in the defect.In the TEE examination, it was found that the device was in correct place, there was no shunt from left to right and the torn was between the two discs of the device.(Figure 1-F) The procedure was successfully completed without complications.
DISCUSSION
Rupture of the interatrial septum or rim during percutaneous ASD closure is a very rare complication. Possible causes of rupture in the interatrial septum when using sizing balloon may be the manipulation of the sizing balloon, passing the guide wire through a small atrial septum fenestration , and the over-stretching of the sizing balloon.There are very rare case reports in the literature about this subject. The rupture of the atrial septum can be enlarged, and therefore surgical treatment has to be performed in these cases in the literature.
CONCLUSION
In this case, we tried to present the rupture of the interatrial septum, which is a rare complication that may develop when using sizing balloon, and successful percutaneous closure of ASD in the same session.
Abstract P699 Figure.
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Affiliation(s)
- C Alak
- Dokuz Eylul University, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Izmir, Turkey
| | | | - O Badak
- Dokuz Eylul University, Izmir, Turkey
| | - O Goldeli
- Dokuz Eylul University, Izmir, Turkey
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Altin C, Ozpelit E, Gezmis E, Ozpelit ME. 498 A missed and misdiagnosed case of pericardial agenesis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.262] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Pericardium is a fibroserous sac surrounding the heart and the roots of the great vessels. Pericardial agenesis which is a rare condition can be complete or partial and the most common form is absence of left hemipericardium. Pericardial agenesis is often an incidental finding, as it is usually asymptomatic. Moreover patients presenting with symptoms can be missed diagnosed, because it can be difficult to visualise the pericardium clearly with imaging modalities. Herein we present a misdiagnosed pericardial agenesis case.
Case Report
A 49 years old male was admit to our cardiology clinic for confirmation, and follow-up of a previous diagnosis of right ventricular cardiomyopathy (CMP). He had been previously diagnosed based on transthoracic and transesophageal echocardiography findings 13 years ago. Since then he had been attending routine follow-ups, he had also underwent several imagining modalities even cardiac magnetic resonance (CMR) to confirm the diagnosis of right ventricular CMP. No arrhythmia had been detected in Holter monitoring. He had no dyspnea, or other specific signs and symptoms. His medical and family histories were otherwise unremarkable. A 12-lead electrocardiogram (ECG) showed normal sinus rhythm without having specific abnormalities. The chest X-ray revealed laevorotation of the heart (Fig A). The transthoracic echocardiography showed a laterally displaced left ventricle (LV) apex, and an enlarged right ventricle (RV) with normal systolic function (Fig B). Coronary computed tomography angiography (CCTA) revealed normal coronary arteries, leftward displacement of the heart with mild RV dilatation. The pericardium was only visible around right atrium (Fig C). CMR demonstrated mild RV dilatation (end-diastolic volume 167ml) with reasonable systolic function (EF 50%), normal LV dimensions with normal systolic function (Fig D). The absence of pericardium at both left and right sides, except around right atrium, was confirmed, whereas there was no additional finding such as wall motion abnormality. Therefore the patient was diagnosed with partial pericardial agenesis and scheduled for follow-ups.
Conclusion
The pericardial agenesis which is a rare disorder is generally benign. Although MRI is believed to be the gold standard technique, it might not be able to delineate entire pericardium, because of various artefacts or paucity of surrounding fat. Therefore physicians should be aware of the indirect signs on various imaging modalities like excessive laevorotation of the heart, as direct recognition can be tricky, and the patient can be easily missed and/or misdiagnosed. Our patient was asymptomatic. His pericardial defect was almost total and this abnormality hadn’t been recognized in his previous CMR or echocardiograpy, leading to a misdiagnosis of CMP. Complete or unilateral absence of the pericardium is considered to be benign, surgical pericardioplasty may only be considered for highly symptomatic patients.
Abstract 498 Figure.
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Affiliation(s)
- C Altin
- Baskent University Zubeyde Hanim Hospital, Cardiology, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | - E Gezmis
- Baskent University Zubeyde Hanim Hospital, Radiology, Izmir, Turkey
| | - M E Ozpelit
- Medical Park Hospital, Cardiology, Izmir, Turkey
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Coner A, Saracoglu E, Akdeniz A, Ozkan H, Tuluce K, Gul M, Coskun FY, Kurt D, Karagoz A, Karaarslan O, Gok G, Ozdogan O, Ozpelit E, Ozer SF, Zoghi M. P3622Demographic and clinical characteristics of atrial fibrillation patients suffering from an ACS without prior revascularization history. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0480] [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: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of atrial fibrillation in acute coronary syndromes (ACS) ranges from 3% to 25%. The purpose of the current study was to investigate the demographic and baseline clinical characteristics, cardiovascular risk factors and comorbid conditions between patients (pts) with concomitant atrial fibrillation (AF) to those without AF in patients suffering from ACS without previous coronary artery bypass graft (CABG) and/or percutaneous coronary intervention.
Methods
The MINOCA-TR study has a cross-sectional, multicenter, observational design and was conducted with 32 interventional cardiology centers in our country. Heart rhythm at emergency admission, demographical, clinical and angiographic data was recorded for each patient. Patients with stable coronary artery disease, unstable angina pectoris and with type 4/5 myocardial infarction were excluded from study population.
Results
A total of 1626 patients (male: 70.7%, mean age: 61.4±12.5 years) were classified according to the presence of AF. The rate of AF was 3.1% in study population. This group was older (73.4 vs. 61.0 years, p<0.001) and AF was more common among females (43.1% vs. 28.7%, p=0.027). The frequency of AF was slightly higher (7.8%) in MINOCA group (p=ns).
STEMI presentation was more common in patients without AF (31.3% vs. 46.9%, p=0.028). LVEF was significantly lower in ACS patients with AF (44.1% vs. 49.4%, p=0.039). The frequency of AF was significantly higher (3.7%) in MINOCA group.
AF vs. non-AF ACS pts w/o prior revasc Parameter ACS with AF ACS without AF p value Age (years) 73.4 (±9.4) 61.0 (±12.4) <0.001 Female (%) 43.1 28.7 0.027 cTnT levels (pg/dL) median (IQR) 15.2 (96) 15.3 (428) 0.421 STEMI (%) 31.3 46.9 0.028 LVEF (%) 44.1 (±12.2) 49.4 (±10.4) 0.039 MINOCA (%) 7.8 6.6 0.743 STEMI: ST-segment elevation MI; NSTEMI: Non-ST-segment elevation myocardial infarction; LVEF: left ventricular ejection fraction; MINOCA: Myocardial Infarction with Non-Obstructive Coronary Arteries.
Conclusions
The frequency of AF was relatively lower in patients suffering from an ACS without prior revascularization history. They were older than patients without AF and were common in females. Non-ST-segment elevation myocardial infarction was significantly higher in the AF. The presence of MINOCA was similar between 2 groups.
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Affiliation(s)
- A Coner
- Baskent University Hospital Alanya Application and Research Center, Cardiology, Antalya, Turkey
| | - E Saracoglu
- Doctor Ersin Arslan Research and Training Hospital, Cardiology, Gaziantep, Turkey
| | - A Akdeniz
- Bursa Yuksek Ihtisas Research and Training Hospital, Cardiology, Bursa, Turkey
| | - H Ozkan
- Medical Park Hospital, Cardiology, Bursa, Turkey
| | - K Tuluce
- Cigli Research and Training Hospital, Cardiology, Izmir, Turkey
| | - M Gul
- Aksaray University, Cardiology, Aksaray, Turkey
| | - F Y Coskun
- Gaziantep University, Cardiology, Gaziantep, Turkey
| | - D Kurt
- Giresun University, Cardiology, Giresun, Turkey
| | - A Karagoz
- Giresun University, Cardiology, Giresun, Turkey
| | - O Karaarslan
- Hitit University Erol Olcok Research and Training Center, Cardiology, Corum, Turkey
| | - G Gok
- Mardin State Hospital, Cardiology, Mardin, Turkey
| | - O Ozdogan
- Tepecik Training and Research Hospital, Cardiology, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | - S F Ozer
- Necmettin Erbakan University, Cardiology, Konya, Turkey
| | - M Zoghi
- Ege University, Cardiology, Izmir, Turkey
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Tanriverdi A, Ozcan Kahraman B, Acar S, Ozsoy I, Senturk B, Ozpelit E, Akdeniz B, Savci S. Factors Associated with Inspiratory Muscle Strength in Patients with Heart Failure. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.418] [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: 11/22/2022]
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Ozcan Kahraman B, Ozsoy I, Tanriverdi A, Ozpelit E, Akdeniz B, Acar S, Savci S, Sevic C. Role of Respiratory Muscle Strength and Functional Exercise Capacity in Static and Dynamic Balance Assessments in Pulmonary Hypertension. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.148] [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: 11/22/2022]
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26
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Tanriverdi A, Ozcan Kahraman B, Ozsoy I, Bayraktar F, Ozgen Saydam B, Acar S, Ozpelit E, Akdeniz B, Savci S. Physical activity in women with subclinical hypothyroidism. J Endocrinol Invest 2019; 42:779-785. [PMID: 30456624 DOI: 10.1007/s40618-018-0981-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 08/10/2018] [Accepted: 11/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Physical activity is associated with many health-related benefits. However, there is a shift towards inactive lifestyles around the world. Subclinical hypothyroidism (SCH) may have adverse effects similar to hypothyroidism. The presence of symptoms and reduced physical performance in SCH may contribute to an inactive lifestyle. Therefore, the present study aimed to compare physical activity levels (PALs) between women with subclinical hypothyroidism and healthy controls. METHODS Thirty-two women with newly diagnosed SCH and 28 healthy women were enrolled in this cross-sectional study. Arterial stiffness was evaluated by pulse wave velocity (PWV). Neuromuscular symptoms were questioned. Participants wore a physical activity monitor (SenseWear® Armband) for 4 consecutive days. Handgrip and quadriceps muscle strength were assessed by dynamometer. Functional exercise capacity was assessed by 6-minute walk test (6MWT). RESULTS There was no significant difference in sociodemographic variables between the groups. PWV was significantly higher in the SCH group (P = 0.006). Physical activity duration and number of steps were significantly lower in the SCH group (P < 0.05). There was significant difference in neuromuscular symptoms, handgrip and quadriceps muscle strength, and 6MWT distance between the groups (P < 0.05). CONCLUSIONS This study demonstrates that women with SCH had lower PALs compared to healthy controls. Women with SCH should participate in exercise programs to increase physical activity and muscle strength to achieve adequate PALs.
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Affiliation(s)
- A Tanriverdi
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
| | - B Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - I Ozsoy
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kirsehir, Turkey
| | - F Bayraktar
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - B Ozgen Saydam
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - S Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - E Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - B Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - S Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Ozcan Kahraman B, Ozsoy I, Kahraman T, Tanriverdi A, Acar S, Ozpelit E, Akdeniz B, Hiser S, Guimaraes FS, Needham DM, Savci S. Turkish translation, cross-cultural adaptation, and assessment of psychometric properties of the Functional Status Score for the Intensive Care Unit. Disabil Rehabil 2019; 42:3092-3097. [PMID: 31020855 DOI: 10.1080/09638288.2019.1602852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/27/2022]
Abstract
Purpose: To translate and cross-culturally adapt the Functional Status Score for the Intensive Care Unit instrument to Turkish and investigate its psychometric properties.Methods: An expert committee supervised forward and backward translation. Thirteen participants reviewed the pre-final version of Turkish Functional Status Score for the Intensive Care Unit instrument providing minor revisions to improve its readability. Two physiotherapists assessed patients (N = 50) from a coronary intensive care unit using the Turkish Functional Status Score for the Intensive Care Unit instrument.Results: Internal consistency was excellent (Cronbach's α = 0.949). Inter-rater reliability and intra-rater reliability were excellent for each of five functional tasks and total scores (intra-class correlation coefficient = 0.955-0.996). The Turkish Functional Status Score for the Intensive Care Unit score had moderate to high correlations with other functional measures as follows: Perme Intensive Care Unit Mobility Score (Spearman's r = 0.92), Katz Activities of Daily Living (r = 0.80), handgrip strength (r = 0.76-0.77), and knee extension strength (r = 0.70-0.71).Conclusion: The Functional Status Score for the Intensive Care Unit instrument was translated and culturally adapted to Turkish and demonstrated strong psychometric properties, including internal consistency, intra-rater and inter-rater reliability, construct validity, and floor and ceiling effects.Implications for rehabilitationRehabilitation professionals strive to assess and document patient status using validated and reliable outcome measures as part of good clinical practice.Longitudinal evaluation of physical function in the intensive care units is important.The Functional Status Score for the Intensive Care Unit is a validated and reliable physical functioning measurement instrument suitable for the intensive care units.The Functional Status Score for the Intensive Care Unit was translated and culturally adapted to Turkish, and demonstrated strong psychometric properties, including internal consistency, intra-rater reliability, inter-rater reliability, construct validity, and floor and ceiling effects.
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Affiliation(s)
- Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Aylin Tanriverdi
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Serap Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Stephanie Hiser
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Dale M Needham
- Division of Pulmonary & Critical Care Medicine and Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Ozpelit ME, Ozpelit E. How we eat may be as important as what we eat: eating behaviour and heart rate variability. Acta Cardiol 2017. [PMID: 28636519 DOI: 10.1080/00015385.2017.1304749] [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: 10/19/2022]
Abstract
Objective Diet exerts a crucial role on cardiovascular health. Evidence is mainly based on the content and the amount of dietary intakes. Some recent reports demonstrated that eating behaviour may also be of significant importance in cardiovascular health. In this study we aimed to investigate the effects of eating behaviour on heart rate variability (HRV) in healthy subjects. Methods and results In total, 521 healthy subjects with 24-hour Holter ECG recordings filled out a special questionnaire about their eating behaviour and lifestyles. From these patients, 425 subjects were healthy and had recordings suitable for analysis. Five types of eating behaviour were assessed in the questionnaire: (1) adherence to the Mediterranean diet (using the MedDietScore), (2) skipping breakfast, (3) late night eating, (4) having snacks, and (5) rapid eating. Physical exercise level and active working status of the subjects were also assessed. The root mean square of successive differences (RMSSD) was used for assessment of HRV. RMSSD values were lower in subjects skipping breakfast compared to subjects having breakfast regularly (26.32 vs 31.52 P = 0.02). Other behavioural patterns did not have any effect on the HRV parameters. Ageing, male sex, sedentary lifestyle and no active working were also found to be associated with reduced HRV in univariate analysis. In multivariate regression analysis, age and skipping breakfast were the only parameters significantly associated with a lower RMSSD (β: -0.222, P: 0.008 and β: -0.191, P: 0.020, respectively) Conclusions The findings of this study showed that skipping breakfast may be a cause of cardiac autonomic dysfunction.
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Affiliation(s)
| | - Ebru Ozpelit
- Department of Cardiology, Dokuz Eylul University Izmir, Turkey
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Ozpelit ME, Ercan E, Ozpelit E, Pekel N, Tengiz I, Ozyurtlu F, Yilmaz A. OPERATOR DEPENDENCY OF THE RADIATION EXPOSURE IN CARDIAC INTERVENTIONS: FEASIBILITY OF ULTRA LOW DOSE LEVELS. Radiat Prot Dosimetry 2017; 173:383-388. [PMID: 26940438 DOI: 10.1093/rpd/ncw028] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Mean radiation exposure in invasive cardiology varies greatly between different centres and interventionists. The International Commission on Radiological Protection and the EURATOM Council stipulate that, despite reference values, 'All medical exposure for radiodiagnostic purposes shall be kept as low as reasonably achievable' (ALARA). The purpose of this study is to establish the effects of the routine application of ALARA principles and to determine operator and procedure impact on radiation exposure in interventional cardiology. MATERIALS AND METHODS A total of 240 consecutive cardiac interventional procedures were analysed. Five operators performed the procedures, two of whom were working in accordance with ALARA principles (Group 1 operators) with the remaining three working in a standard manner (Group 2 operators). Radiation exposure levels of these two groups were compared. RESULTS Total fluoroscopy time and the number of radiographic runs were similar between groups. However, dose area product and cumulative dose were significantly lower in Group 1 when compared with Group 2. Radiation levels of Group 1 were far below even the reference levels in the literature, thus representing an ultra-low-dose radiation exposure in interventional cardiology. CONCLUSION By use of simple radiation reducing techniques, ultra-low-dose radiation exposure is feasible in interventional cardiology. Achievability of such levels depends greatly on operator awareness, desire, knowledge and experience of radiation protection.
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Affiliation(s)
| | - Ertugrul Ercan
- Department of Cardiology, Izmir University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Dokuz Eylul University, Izmir, Turkey
| | - Nihat Pekel
- Department of Cardiology, Izmir University, Izmir, Turkey
| | | | - Ferhat Ozyurtlu
- Department of Cardiology, Grand Medical Hospital, Manisa, Turkey
| | - Akar Yilmaz
- Department of Cardiology, Izmir University, Izmir, Turkey
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Ozpelit E, Ozpelit ME, Albayrak G, Karabay O, Nesli Sahin B, Gonencer JZ, Badak O. Arterial stiffness and cardiac functions in patients with chronic venous disease. INT ANGIOL 2015; 34:582-588. [PMID: 25719398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Although the venous system is in direct continuity with the heart and the arterial system, it is not known whether chronic venous disease (CVD) has any impact on either of these. The aims of this study were to investigate the global functions of the left and right heart, and also arterial stiffness parameters in patients with CVD. METHODS Forty-eight patients with primary stage C4-C6 CVD were enrolled into the study. The control group consisted of 39 age/sex and Body Mass Index matched healthy volunteers. All of the patients underwent detailed echocardiographic examination with further focus on Doppler and tissue Doppler (TD) parameters of the left and right ventricle. Arterial stiffness was evaluated via applanation tonometry in each patient. RESULTS The left atrial area (LAA) and interventricular septum thickness were slightly increased in patients with CVD. Regarding Doppler and tissue Doppler measurements of the LV, all of the parameters were similar among the groups, while RV tissue Doppler systolic velocity and TAPSE were higher in patients with CVD. Among the arterial stiffness parameters, central aortic pressure, augmentation index, and pulse wave velocity were slightly higher in patients with CVD. CONCLUSION The results of this study indicated that CVD may be associated with a subclinical disease state in the arterial system and also in the heart. Further studies are needed to confirm this association and to describe the possible mechanisms.
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Affiliation(s)
- E Ozpelit
- Department of Cardiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey -
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31
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Dogan NB, Ozpelit E, Akdeniz S, Bilgin M, Baris N. Simple clinical risk score for no-reflow prediction in patients undergoing primary Percutaneous Coronary Intervention with acute STEMI. Pak J Med Sci 2015; 31:576-81. [PMID: 26150847 PMCID: PMC4485274 DOI: 10.12669/pjms.313.7484] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Received: 02/11/2015] [Accepted: 03/28/2015] [Indexed: 11/28/2022] Open
Abstract
Objectives: To identify the STEMI patients at high risk in terms of no-reflow during percutaneous coronary intervention (PCI) with a simple risk score system that can be used before reperfusion. Methods: Total 173 patients who had undergone primary or rescue percutaneous coronary intervention following the diagnosis of STEMI, were classified as “no-reflow” developers and “no-reflow” non-developers, during the procedure. The pre-procedural ECGs, laboratory parameters, demographic data, time for the treatment, and the treatment methods were evaluated with univariate analysis. The independent predictors were identified by multivariate logistic regression analysis among the no-reflow risk factors. Using the independent predictors, we developed a simple risk score system proportional to area under the ROC (AUROC) curves. Results: The independent predictors of “no-reflow” phenomenon were identified as follows: high values of blood glucose at reference; long symptom-onset-to-balloon-time; and low lymphocyte count. The incidence rates of “no-reflow” in patients with low (0-1), moderate (2-3) and high (4-6) risk factors were 13.3%, 40.0%, and 46.7%, respectively. The risk score system demonstrated a good risk prediction between patients with various risk levels of the development of “no-reflow” with a c-statistics of 0.734 (95% CI 0.654-0.814). Conclusion: The development of “no-reflow” which is an adverse event in STEMI treatment can be predicted efficiently by simple clinical risk scoring method.
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Affiliation(s)
- Nazile Bilgin Dogan
- Nazile Bilgin Dogan, MD. Department of Cardiology, Menemen State Hospital, Izmir, Turkey
| | - Ebru Ozpelit
- Ebru Ozpelit, MD. Department of Cardiology, DokuzEylul University Hospital, Izmir, Turkey
| | - Selma Akdeniz
- Selma Akdeniz, MD. Department of Cardiology, AKUT Cardiovascular Hospital, Izmir, Turkey
| | - Muzaffer Bilgin
- Muzaffer Bilgin, M.Sc. Department of Biostatistics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Nezihi Baris
- Prof. Dr. Nezihi Baris, Professor, Department of Cardiology, DokuzEylul University Hospital, Izmir, Turkey
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Ozkan Duman O, Goldeli O, Gursul E, Baris N, Ozpelit E, Aytek Simsek M. The value of aortic pulse wave velocity in predicting coronary artery disease diagnosis and severity. Acta Cardiol 2015; 70:315-22. [PMID: 26226705 DOI: 10.1080/ac.70.3.3080636] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Aortic pulse wave velocity (AoPWV), one of the parameters showing arterial stiffness, has been investigated in different patient groups as a predictor of cardiovascular diseases. The purpose of our study is to investigate the correlation between AoPWV and coronary artery disease (CAD) and its severity. METHODS AND RESULTS One hundred and three patients who were not diagnosed with CAD but who were scheduled to have coronary angiography (CAG) with CAD suspicion were included in the study. PWV was measured with tonometry device before CAG. Patients were divided into two groups: with or without CAD. The Gensini score of each patient was calculated in the CAD group by several independent specialists. The average age of the patients was 55.2 +/- 8.5 (range 33-73 years). CAD was confirmed in 59 patients (49%). Average PWV in the CAD group was statistically more significant than in the non-CAD group (8.6 +/- 2.0, 5.0 +/- 1.8; P < 0.001). A highly positive correlation was observed between CAD severity and PWV (r = 0.838, P = 0.001). In the CAD diagnosis, for an AoPWV cut-off value of 7.3 m/sec, the sensitivity was 83.1% and the specificity 86.4%. CONCLUSIONS Various non-invasive techniques are used in CAD prognosis. Besides being simple, these techniques are also required to show a high rate of accuracy in CAD prognosis. In this respect, AoPWV gains importance as being a non-invasive method that can be performed with a tonometry device at low cost in policlinic conditions.
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Affiliation(s)
- Omer Ozkan Duman
- Dept. of Cardiology, Buca Seyfi demirsoy State Hospital, Izmir, Turkey
| | - Ozhan Goldeli
- Dept. of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Erdal Gursul
- Dept. of Cardiology, Biga State Hospital, Canakkale, Turkey
| | - Nezihi Baris
- Dept. of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ebru Ozpelit
- Dept. of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Yilmaz B, Yilmaz A, Sari F, Sarikaya AM, Ellidag HY, Kucukseymen S, Ozpelit E. Decrease of Urotensin II activity can impact on the volume status in predialysis chronic kidney disease. Ren Fail 2015; 37:476-81. [PMID: 25608453 DOI: 10.3109/0886022x.2015.1006083] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Urotensin II (U-II) was thought to be one of the mediators of primary renal sodium retention due to effects on renal sodium excretion. For this purpose, the relationship between U-II and overhydration was investigated. A total of 107 patients were enrolled in the study. According to body compositor monitor analysis, fluid overload up to 1.1 L, was considered normohydration. Patients were divided according to hydration status; overhydrate (n = 42) and normohydrate (n = 65) were studied in both groups. Pulse waveform velocity propagation for arterial stiffness and blood pressure analysis and echocardiographic left ventricular and left atrial indices were performed with known fluid overload-related parameters. U-II levels were measured by using Human ELISA kit. In overhydrated group, U-II levels were significantly lower. All parameters (blood pressure, arterial stiffness parameters, echocardiographic data, age, gender, diabetes, U-II, hemoglobin) correlated with overhydration, were determined by linear regression model (method = enter), when considered together, U-II was found to be an independent predictor from other conventional overhydration-related parameters. Male sex, left ventricular mass index, left atrial volume index, hemoglobin value were found to be independent predictors for overhydration. Considering the association of low U-II levels with adverse cardiovascular events and its role in sodium retention, we think that low U-II levels can be accepted as a potential therapeutic target in patients with hypervolemic cardio-renal syndrome.
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Affiliation(s)
- Banu Yilmaz
- Clinic of Nephrology, Antalya Training and Research Hospital , Antalya , Turkey
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Ozpelit E, Akdeniz B, Ozpelit ME, Göldeli O. Severe tricuspid regurgitation mimicking constrictive pericarditis. Am J Case Rep 2014; 15:271-4. [PMID: 24995118 PMCID: PMC4079647 DOI: 10.12659/ajcr.890092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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] [Received: 11/27/2013] [Accepted: 02/06/2014] [Indexed: 11/09/2022]
Abstract
Patient: Female, 62 Final Diagnosis: Tricuspid regurgitation Symptoms: Dyspnea exertional • fatigue • leg edema Medication: — Clinical Procedure: — Specialty: Cardiology
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Affiliation(s)
- Ebru Ozpelit
- Department of Cardiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - Mehmet Emre Ozpelit
- Department of Cardiology, Izmir University, School of Medicine, Medicalpark Hospital, Izmir, Turkey
| | - Ozhan Göldeli
- Department of Cardiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
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Akdeniz B, Birlik M, Bariş M, Tertemiz K, Ozpelit E, Sevinc C. PP-356 A Rare Cause of Pulmonary Hypertension: Distal Pulmonary Artery Stenosis Due To Takayasu Arteritis. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.386] [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: 11/25/2022]
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Uzel H, Ozpelit E, Badak O, Akdeniz B, Barış N, Aytemiz F, Göldeli O. Diagnostic accuracy of mean platelet volume in prediction of clopidogrel resistance in patients with acute coronary syndrome. ACTA ACUST UNITED AC 2014; 14:134-9. [PMID: 24449625 DOI: 10.5152/akd.2014.4433] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Clopidogrel therapy is the standard of care in patients with acute coronary syndrome (ACS) and stent implantation. However, concern arises because 25% of subjects are nonresponders to clopidogrel. As this nonresponsiveness is associated with increased adverse outcome, detection of these subjects in daily practice is important in order to withhold a more aggressive therapy and closer follow up. In this study we aimed to evaluate the relation between mean platelet volume (MPV) which is an indicator of platelet activation and clopidogrel nonresponsiveness. METHODS The study was planned as a prospective cohort study. A total of 185 patients who had been on clopidogrel therapy for any acute coronary syndrome were enrolled in this study. Clopidogrel responsiveness was analyzed by Multiplate MP-0120 device by using the method of whole blood aggregometry. Blood samples were drawn 3.5 days after clopidogrel loading dose. The amount of ADP induced platelet aggregation was assessed as area under curve (AUC), and a cut-off value of 500, above which the patient is considered as clopidogrel nonresponder, was used. MPV was analyzed from the blood which were sampled at the admission of the patient by using automatic hemocounter. Independent sample t-test, ROC analyses and logistic regression analsis were used in statistical analysis. RESULTS Among the 185 patients analyzed 41 were found to be clopidogrel nonresponder (22.1%). Mean MPV was found to be significantly higher in nonresponders compared to responders (8.7±0.82 fL vs. 8.1±0.83 fL, p<0.001). A cut-off value of 8.3 fL for MPV was detected in prediction of clopidogrel nonresponsiveness with a sensitivity of 76.6% and specificity of 68.3% (OR: 6.4; 95% CI 2.9-14.1, AUC: 0.70, p<0.001). CONCLUSION This study showed that MPV can be used as a predictor of clopidogrel resistance in patients with ACS.
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Affiliation(s)
- Hazel Uzel
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University; İzmir-Turkey.
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Oto O, Albayrak G, Ugurlu B, Kuserli Y, Ozpelit E, Guneri S. A mandatory modification in extracorporeal biventricular assist device (BIVAD) implantation: intercostal tunnel application: a case report. J Cardiothorac Surg 2013; 8:229. [PMID: 24330814 PMCID: PMC3878676 DOI: 10.1186/1749-8090-8-229] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 12/06/2013] [Indexed: 11/11/2022] Open
Abstract
In this case, our patient was a heart transplant candidate connected to a respiratory system. An extracorporeal biventricular assist device (BIVAD) was the only option in order to bridge to transplantation. In routine procedures, it is recommended that Berlin Heart Excor cannulas be removed through the subfascial subcostal tunnel. As the severely dilated right ventricle compressed the apex of the left ventricle, which was also dilated to the mid-back zone of the left hemithorax, the whole length of the Extracorporeal BIVAD apical cannula had to remain within the thorax; however, the cannula was removed from the body by creating a tunnel at the 7th intercostal space. In the long-term follow-up, this compulsory modification has proven to be safe and effective.
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Affiliation(s)
| | - Gokhan Albayrak
- Department of Cardiovascular Surgery, Izmir University, Yeni Girne Bulvari, 1825 sok, No: 12 Karsiyaka, Izmir, Turkey.
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Metin K, Maltepe F, Bal M, Bilen Ç, Ozpelit E, Kızıltan G, Ozkan G, Tahta N, Keleş E, Kanpalta A, Oto O, Ugurlu B. OP-185 ARE BOVINE PERICARDIAL BIOPROSTHESES APPROPRIATE SUBSTITUTES FOR TRICUSPID VALVE REPLACEMENT? Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70186-4] [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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Edem E, Aslan Ö, Göldeli Ö, Güneri S, Ozpelit E, Aytemiz F. PP-309 MORTALITY DETERMINANTS IN ICD (IMPLANTABLE CARDIOVERTER DEFIBRILLATOR) IMPLANTED PATIENTS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70513-8] [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: 11/27/2022]
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Ozpelit E, Badak O, Ozpelit M, Taş S, Göldeli Ö. PP-038 RAPID RETRACTION OF A POST-INFARCTION INTRAMYOCARDIAL DISSECTING HEMATOMA. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70242-0] [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: 11/28/2022]
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Ozpelit E, Akdeniz B, Aytemiz F, Barış N, Göldeli Ö. PP-039 SEVERE TRICUSPID REGURGITATION MIMICKING CONSTRICTIVE PERICARDITIS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70243-2] [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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Ekinci M, Ozpelit E, Badak O, Ünal B, Göldeli Ö. OP-153 WHAT ARE THE BEST ECHOCARDIOGRAPHIC CORRELATES OF BNP CHANGE IN MEDICALLY MANAGED DECOMPENSATED HEART FAILURE PATIENTS? Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70154-2] [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: 11/26/2022]
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Akdeniz B, Gedik A, Turan O, Ozpelit E, Ikiz AO, Itil O, Badak O, Baris N, Çömlekçi A. Evaluation of Left Ventricular Diastolic Function According to New Criteria and Determinants in Acromegaly. Int Heart J 2012; 53:299-305. [DOI: 10.1536/ihj.53.299] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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: 11/18/2022]
Affiliation(s)
- Bahri Akdeniz
- Department of Cardiology, Dokuz Eylül University Hospital
| | - Arzu Gedik
- Department of Endocrinology, Dokuz Eylül University Hospital
| | - Onur Turan
- Department of Chest Medicine, Dokuz Eylül University Hospital
| | - Ebru Ozpelit
- Department of Cardiology, Dokuz Eylül University Hospital
| | - Ahmet Omer Ikiz
- Department of Otolaryngology, Dokuz Eylül University Hospital
| | - Oya Itil
- Department of Chest Medicine, Dokuz Eylül University Hospital
| | - Ozer Badak
- Department of Cardiology, Dokuz Eylül University Hospital
| | - Nezihi Baris
- Department of Cardiology, Dokuz Eylül University Hospital
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Abstract
OBJECTIVES With growing awareness of arterial stiffness (AS) in the past 10 years, it was realized that resistant hypertension (RH) and AS share the same associated conditions such as older age, isolated systolic hypertension (HT), obesity, chronic kidney disease (CKD), and so on. Until now, there is no study investigating the role of AS in RH. In our study we aimed to determine whether there is an association between RH and AS. METHODS Among 87 patients enrolled in this study, 30 were resistant hypertensives (Group 1), 29 were controlled hypertensives (Group 2), and 28 were normotensives (Group 3). Arterial stiffness was measured by both applanation tonometry and echocardiography; augmentation index, pulse wave velocity (PWV), aortic strain, and aortic distensibility were recorded in each patient. Diastolic function parameters were also assessed. RESULTS In resistant hypertensive group, augmentation index and PWV were significantly higher than Group 2 and Group 3 (P = .03 and P < .01). Aortic strain and aortic distensibility parameters were significantly lower in RH group (P < .01 and P < .01). Arterial stiffness parameters were similar among Group 2 and Group 3. Among diastolic function parameters, left atrial volume index and left ventricular mass index significantly differ between groups. These two parameters were significantly lower in control group (P < .01 and P = .02) whereas similar in Group 1 and Group 2. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels were significantly different between groups as expected. When the correlation between two methods of AS was analyzed, a significant strong inverse correlation was found between echocardiographic and tonometric parameters. CONCLUSION Arterial stiffness was found to be associated with RH. The inconsistency of this association in controlled hypertensives suggests a possible role of AS in RH pathogenesis. This study also showed that aortic strain and distensibility correlate well with the PWV which is the gold standard in the assessment of AS. This finding is important for the evaluation of AS more commonly in daily practice as echocardiography is a more feasible device than applanation tonometry.
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Affiliation(s)
- Turker Pabuccu
- Department of Cardiology, Dokuz Eylul University Hospital, Izmir, Turkey
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Affiliation(s)
- Dilek Solmaz
- Department of Rheumatology, Dokuz Eylul University School of Medicine, Turkey
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Güneri S, Ozpelit E. [Coronary invasive procedures in women]. Turk Kardiyol Dern Ars 2010; 38 Suppl 1:50-56. [PMID: 21491716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Cardiovascular diseases are the most common etiology in women deaths worldwide. Despite this fact, coronary artery disease is usually known as a disease of men, and its importance in women health is not emphasized so much. In many registries, it has been shown that, female patients are opposed to less coronary invasive procedures than men. The reasons of this conservative strategy in women are, the older age, the more advanced coronary atherosclerosis at the time of diagnosis and smaller coronary arteries. Because of these factors, female patients are also prone to more complication rates than men. Until a few years ago, there had been little knowledge about gender related differences in diagnosis and management of coronary artery disease. In many of the large angiographic trials, most of the female patients were excluded from the studies, because of age and small coronary vessels. But now, with growing awareness of gender related differences in management of coronary artery disease, more female patients are included in trials, and more post-hoc analysis about gender factor are made.
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Affiliation(s)
- Sema Güneri
- Dokuz Eylül Universitesi Tip Fakültesi, Kardiyoloji Anabilim Dali, Izmir.
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Bariş N, Kirimli O, Ozpelit E, Akdeniz B. Right coronary artery intervention with mirror image in a patient with dextrocardia. Anadolu Kardiyol Derg 2005; 5:340-1. [PMID: 16330413] [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] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Nezihi Bariş
- Department of Cardiology, School of Medicine, Dokuz Eylul University, 35340 Inciralti, Izmir, Turkey.
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