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Unkun T, Demirci K, Fidan S, Derebey ST, Sengör BG, Yılmaz C, Efe SC, Alıcı G, Özkan B, Karagöz A. Usability of myocardial work parameters in demonstrating myocardial involvement in INOCA patients. J Clin Ultrasound 2024. [PMID: 38701116 DOI: 10.1002/jcu.23704] [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] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Myocardial work (MW) is a novel echocardiographic modality, which has been shown to have diagnostic and prognostic values in patients with cardiovascular diseases, patients with obstructive coronary artery disease, in particular. However, only a handful of studies have examined the MW analysis in ischemia with nonobstructive coronary artery (INOCA) disease. This study, therefore, aimed to detect the early left ventricular involvement in INOCA patients diagnosed by an invasive coronary angiography performing the MW analysis. METHODS This study included a total of 119 patients with nonobstructive coronary artery disease diagnosed by invasive coronary angiography, who were checked for prior ischemia tests performing myocardial perfusion scintigraphy. Out of these 119 patients, 49 patients developed ischemia (i.e., ischemic group) diagnosed using cardiac single-photon emission computed tomography, whereas 70 patients did not (i.e., nonischemic group). The subjects were divided into three groups based on the global MW tertiles. The groups were compared in terms of the conventional, longitudinal strain, and MW findings by conducting echocardiographic examinations. RESULTS The study subjects were divided into three groups based on the global constrictive work (GCW) value. The three groups were not statistically different in terms of the mean age of the patients (53.0 ± 12 vs. 52.4 ± 13.3 vs. 52.1 ± 12.3; p = 0.96). Furthermore, the three groups were not statistically different regarding the gender, height, weight, and laboratory parameters of the patients except albumin. There was no statistically difference among the tertiles of GCW groups in the measurements of cardiac chambers, LA diameter, interventricular septum, E wave, and A wave. Also, there was no statistical difference in tissue Doppler recordings. The parameters associated with MW were examined, three groups were not statistically different in terms of the global waste work (GWW) (116 ± 92, 122 ± 73, 135 ± 62, p = 0.52, respectively). In contrast, the three groups were different regarding the Global work index (GWI) (1716 ± 300, 1999 ± 130, 2253 ± 195, p < 0.001, respectively), GCW (1888 ± 206, 2298 ± 75, 2614 ± 155, p < 0.001, respectively), and Global work efficiency parameters (92.8 ± 3.6, 94.4 ± 3.2, 95.1 ± 1.8 p = 0.004, respectively). CONCLUSION It was concluded that the MW parameters GCW and GWI may have been used for predicting INOCA in patients.
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Affiliation(s)
- Tuba Unkun
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Koray Demirci
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | | | - Büsra Güvendi Sengör
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Cemalettin Yılmaz
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Süleyman Cagan Efe
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Gokhan Alıcı
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Birol Özkan
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Ali Karagöz
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
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Fidan E, Fidan S, Merev E, Kazaz N. The Relationship between albumin-Bilirubin grade and survival in hepatocelluler carcinoma patients treated with sorefanib. Niger J Clin Pract 2022; 25:173-177. [PMID: 35170443 DOI: 10.4103/njcp.njcp_525_20] [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: 12/09/2022]
Abstract
Background Hepatocellular carcinoma (HCC) is one of the most common hepatic malignancies and the sixth most common cancer worldwide. Prognosis is affected by tumor stage, hepatic disfunction and patient performance. Albumin - bilirubin grade was developed to assess the hepatic function in patient with HCC. Aims: The purpose of this study was to examine the relationship between albumin-bilirubin (ALBI) grade and survival in HCC patients receiving sorafenib. We also planned to investigate whether ALBI scores in advanced stage patients are prognostic and predictive. Patients and Methods Patients presenting to the Karadeniz Technical University Medical Faculty Medical Oncology Clinic and diagnosed with HCC in 2010-2018 were included in the study. Fifty-six patients using sorafenib with Eastern Cooperative Oncology Group (ECOG) performance scores of 0, 1, or 2, who had not previously received systemic therapy were enrolled. Results Patients' median age was 64.8 years (range: 23-86), and 80.4% were men. The highest proportion of patients were infected with hepatitis B virus (46.4%), 37 patients were ECOG 1 (66.1%), and 40 were ALBI grade 2 (71.4%). The change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was found to affect progression-free survival. Prognosis was better in the group with decreasing ALBI scores than in the increasing score group (p: 0.028). Multivariate regression analysis revealed that the change occurring in ALBI scores after sorafenib therapy compared to pre-sorafenib values was predictive of progression-free survival independently of alpha-fetoprotein (AFP) levels. Conclusion This study shows that ALBI grade affects survival independently of AFP, Hand-Foot Syndrome (HFS), and other prognostic factors. ALBI grading can be used as a prognostic parameter in patients using sorafenib.
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Affiliation(s)
- E Fidan
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
| | - S Fidan
- Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - E Merev
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
| | - N Kazaz
- Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
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Güneş A, Fidan S, Dulkadir R, Ünlü E. Evaluation of risk factors associated with first episode febrile seizure. Eur Rev Med Pharmacol Sci 2021; 25:7089-7092. [PMID: 34859873 DOI: 10.26355/eurrev_202111_27261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Febrile convulsion (FC) is one of the most common neurological findings in children. This study was aimed to investigate the difference in laboratory parameters between Febrile Seizure and control groups. PATIENTS AND METHODS In this study, 169 children admitted to the pediatric emergency department with their first episode of FS and 189 control groups were retrospectively analyzed. The demographic characteristics and laboratory parameters of children were obtained from their files. RESULTS Upper respiratory tract infection (URTI) was determined the most common disease (81.6%) in the FC group followed by acute gastroenteritis (AGE) (15.4%) and urinary tract infection (UTI) (3%), respectively. Similarly, URTI was detected as the most common disease (81.8%) in control groups. It was determined that there was no statistically significant difference between the two groups in terms of diseases. The leukocyte and neutrophil counts of the children with FC were significantly higher but the mean corpuscular volume of lenfosit and lenfosit/neutrophil ratio was significantly lower than the control groups (p= 0.009, <0.001, 0.001, <0.001, <0.001, respectively). Children with FC had significantly higher blood glucose, urea, creatinine, creatine kinase, alkaline phosphatase and albumin levels compared with the control groups (p<0.001, in all parameters). On the other hand, the potassium, sodium and chlorine levels of the Children with FCs were significantly lower than control groups (p=0.017, <0.001, p <0.001, respectively). CONCLUSIONS To conclude, febrile patients with high leukocyte counts, high neutrophil counts, and several biochemical parameters should be carefully monitored for FCs due to the increasing seizure risk.
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Affiliation(s)
- A Güneş
- Department of Pediatrics, Medical School, Ahi Evran University, Kırşehir, Turkey.
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Sarı M, Çakmak EÖ, Karagöz A, Yılmaz F, Aytürk M, Fidan S, Alizade E, Arslantaş U, Tokgöz HC, Güner ZE, Alıcı G, Özkan B, Pala S. Subacute lower extremity arterial thrombosis; early outcomes of catheter directed thrombolysis with alteplase and importance of malnutrition assessed by CONUT score. Turk Kardiyol Dern Ars 2021; 49:568-578. [PMID: 34623300 DOI: 10.5543/tkda.2021.21140] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In this study, we aimed to report early outcomes of catheter-directed thrombolysis (CDT) with alteplase in patients with subacute limb ischemia and to assess whether there is a link between malnutrition (determined by Controlling Nutritional Status [CONUT] score) and response to thrombolysis and bleeding. METHODS This was a retrospective study conducted between 2007 and 2020 with 118 patients with Rutherford class 3 (34.7%), class 4 (40.7%), and class 5 (24.6%) symptoms owing to infraaortic subacute thrombotic occlusion who were treated with catheter-directed thrombolysis. RESULTS Immediate technical success (Thrombolysis in Myocardial Infarction [TIMI] grade 2/3) was achieved in 56%, overall technical success after all adjunctive procedures was seen in 83.9%. Clinical success was obtained in 74.5% within 30 days. Major bleeding occurred in 11.8%. When we excluded access site hematomas, the rate of major bleeding was 5.1%. In-hospital mortality rate was 5.1%, and the amputation rate within 30 days was 12.7%. Any-degree malnutrition was detected in 48.3% according to CONUT score (≥2). Any-degree malnutrition was associated with failed thrombolysis and bleeding. The CONUT score predicted insufficient lytic response even after adjustment for confounding factors; however, serum C-reactive protein or neutrophil/lenfosit ratio did not. Other predictors of immediate technical failure after thrombolysis were symptom duration, Rutherford class 4/5 symptoms, and worsened distal runoff. CONCLUSION In patients with subacute limb ischemia, CDT combined with adjunctive interventions was effective in many patients at the expense of a substantial risk of bleeding and death. Malnutrition was associated with insufficient lytic response and bleeding. Physicians should be aware of malnutrition and consider the nutritional status of patients with limb ischemia when selecting appropriate treatment.
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Affiliation(s)
- Münevver Sarı
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Ender Özgün Çakmak
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Ali Karagöz
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Fatih Yılmaz
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Mehmet Aytürk
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Elnur Alizade
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Uğur Arslantaş
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Hacer Ceren Tokgöz
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Zeynep Esra Güner
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Gökhan Alıcı
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Birol Özkan
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
| | - Selçuk Pala
- Department of Cardiology, University of Health Sciences Kartal Koşuyolu High Specialization Health Application and Research Center, İstanbul, Turkey
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Yılmaz F, Keskin B, Bayram Z, Fidan S, Karagöz A. Endovascular treatment of upper extremity ischemia due to radiation-induced arteritis. Turk Kardiyol Dern Ars 2021; 49:506-508. [PMID: 34523599 DOI: 10.5543/tkda.2021.49139] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Symptomatic occlusion of the peripheral arteries due to radiation-induced arteritis (RIA) is an extremely rare condition. Patients generally present with the symptoms of ischemic claudication months or years after radiotherapy. Treatment options for symptomatic patients include surgical or endovascular interventions. Although success rate of percutaneous angioplasty in RIA is lower than in atherosclerotic disease, there are several case reports in the literature to demonstrate successful percutaneous angioplasty for RIA. In this report, we presented a case with right upper extremity occlusion due to RIA treated by percutaneous angioplasty successfully.
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Affiliation(s)
- Fatih Yılmaz
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
| | - Berhan Keskin
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
| | - Zübeyde Bayram
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
| | - Ali Karagöz
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
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Çakmak EÖ, Öcal L, Erdoğan E, Cerşit S, Efe SÇ, Karagöz A, Yılmaz F, Fidan S, Alizade E, Zehir R, Kırma C. Prognostic Value of 3 Nutritional Screening Tools to Predict 30-Day Outcome in Patients Undergoing Carotid Artery Stenting. Angiology 2021; 73:225-233. [PMID: 34463144 DOI: 10.1177/00033197211040365] [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] [Indexed: 11/16/2022]
Abstract
The effect of malnutrition on outcomes after carotid artery stenting (CAS) is not well known. This study reports the relationship between malnutrition and post-procedure 30-day major adverse events (MAEs). A total of 978 patients hospitalized for CAS were enrolled in the study. Controlling nutritional status (CONUT) score, the nutritional risk index (NRI), and the prognostic nutritional index (PNI) were calculated. MAEs (myocardial infarction, stroke/transient ischemic attack and mortality) were compared. According to the CONUT score, NRI, and PNI, 9.4%, 41%, and 11.4% patients were moderately or severely malnourished, respectively; 74.8% were at least mildly malnourished by at least 1 score. Forty-seven patients (4.8%) had a post-procedure 30-day MAE. Continuous classifications of the indexes were independently associated with higher MAE. CONUT showed the highest predictive ability, whereas NRI had the lowest (C-index: CONUT, 0.701; NRI, 0.681; PNI, 0.688). According to categorical classification of indexes, only CONUT and PNI showed predictive ability for MAE. Malnutrition assessment could identify patients with CAS at elevated risk for MAE. CONUT, NRI, and PNI continuous scores were independent prognostic factors for the post-procedure 30-day MAE. According to our study, CONUT showed the highest predictive ability.
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Affiliation(s)
- Ender Ö Çakmak
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Lütfi Öcal
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Emrah Erdoğan
- Department of Cardiology, 53000Van Yüzüncü Yıl University, Van, Turkey
| | - Sinan Cerşit
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Süleyman Çağan Efe
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagöz
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Fatih Yılmaz
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Elnur Alizade
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Regayip Zehir
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Cevat Kırma
- Department of Cardiology, 111350University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
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Sari M, Yazar H, Kocayigit I, Karagoz A, Ayturk M, Fidan S, Arslantas U, Cakmak EO, Alici G, Ozkan B. Alteration of serum biomarkers in patients with hypertrophic cardiomyopathy with and without atrial fibrillation. Biomark Med 2021; 15:1131-1142. [PMID: 34402630 DOI: 10.2217/bmm-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We sought to determine the relationship between presence of atrial fibrillation (AF) and serum biomarkers, including native thiol (antioxidant), disulphide/native thiol ratio, Hs-CRP and high-sensitivity Troponin-I (Hs-TnI) in hypertrophic cardiomyopathy (HCM). Materials & methods: We enrolled consecutive 121 HCM outpatients without AF and 40 HCM outpatients with AF. A 12-lead electrocardiogram, transthoracic echocardiography and 24/48-h ambulatory rhythm monitoring were performed for all patients. Fasting venous blood samples were taken from all study patients to measure serum thiol-disulphide homeostasis, Hs-CRP and Hs-TnI. Results: Serum-native thiol was lower and disulphide/native thiol ratio was more oxidized in HCM patients with AF (p < 0.001). Also, HCM patients with AF had higher Hs-TnI and Hs-CRP than no-AF HCM patients. Disulphide/native thiol ratio, serum-native thiol, age, NYHA functional class≥III, and advanced diastolic dysfunction were independently associated with the presence of AF in HCM. Conclusion: In addition to clinical and echocardiographic findings, oxidative stress is also associated with AF in HCM patients.
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Affiliation(s)
- Munevver Sari
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Hayrullah Yazar
- Department of Biochemistry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ibrahim Kocayigit
- Department of Cardiology, Sakarya University Education & Research Hospital, Sakarya, Turkey
| | - Ali Karagoz
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Mehmet Ayturk
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Ugur Arslantas
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Ender O Cakmak
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Gokhan Alici
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Birol Ozkan
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
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Fidan S, Fidan E, Karaman E, Erkut M, Cosar AM. Hepatitis B Reactivation in HBsAg-negative Anti-HBc-positive patients receiving cytotoxic chemotherapy for solid tumors. Acta Gastroenterol Belg 2020; 83:426-431. [PMID: 33094590] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.
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Affiliation(s)
- S Fidan
- Department of Internal Medicine, Divisions of Gastroenterology
| | - E Fidan
- Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - E Karaman
- Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - M Erkut
- Department of Internal Medicine, Divisions of Gastroenterology
| | - A M Cosar
- Department of Internal Medicine, Divisions of Gastroenterology
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Atıcı A, Barman HA, Erturk E, Baycan OF, Fidan S, Demirel KC, Asoglu R, Demir K, Ozturk F, Elitok A, Okuyan E, Sahin I. Multilayer longitudinal strain can help predict the development of no-reflow in patients with acute coronary syndrome without ST elevation. Int J Cardiovasc Imaging 2019; 35:1811-1821. [PMID: 31093895 DOI: 10.1007/s10554-019-01623-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/06/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022]
Abstract
No-reflow (NR) is one of the major complications of primary percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aim to assess the value of multilayer longitudinal strain parameter to predict NR in patients with NSTEMI and preserved ejection fraction. 230 consecutive patients who were admitted to the emergency department and diagnosed with NSTEMI were prospectively included in this study. Echocardiography was performed 1 h before angiography. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer longitudinal strain. NR was described as flow grade of ≤ TIMI 2 when mechanical occlusions like dissection, intimal tear, arterial spasm and thromboembolism during angiography were excluded. 49 of 168 patients admitted to the study had NR. No significant differences were observed between the groups regarding age and gender. Multilayer longitudinal strain imaging (endocard, midmyocard and epicard) revealed lower strain values particularly in endocardial layer in patients with NR (GLS-endocard: - 14.14 ± 1.39/- 17.41 ± 2.34, p < 0.001; GLS-midmyocard: - 14.81 ± 1.40/17.81 ± 2.22, p < 0.001; GLS-epicard: - 16.14 ± 1.38/18.22 ± 2.00, p < 0.001). GLS-endocard, GLS-midmyocard, GLS-epicard and ST depression were found to be statistically significant independents parameters respectively to predict NR phenomenon (GLS-endocard: OR: 2.193, p < 0.001; GLS-midmyocard: OR: 1.510, p: 0.016; GLS-epicard: OR: 1.372, p: 0.035; ST depression: OR: 3.694, p: 0.014). We revealed that left ventricular strain study with speckle tracking echocardiography predicts NR formation. This noninvasive method may be useful for detecting NR formation in patients with NSTEMI.
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Affiliation(s)
- Adem Atıcı
- Cardiology Department, İstanbul Gaziosmanpasa Taksim Training and Research Hospital, Osmanbey Caddesi, 621 Sokak, Gaziosmanpaşa, Istanbul, Turkey
| | - Hasan Ali Barman
- Cardiology Department, Okmeydani Training Ve Research Hospital, Darulaceze street No:25, Okmeydani, 34384, Istanbul, Turkey.
| | - Emre Erturk
- Cardiology Department, Medical Park İzmir Hospital, İmbatlı Mahallesi, 1825. Sk., 35575, Karşıyaka/Izmir, Turkey
| | - Omer Faruk Baycan
- Cardiology Department, Istanbul Medeniyet University, Dr. Erkin street, 34722, Istanbul, Turkey
| | - Serdar Fidan
- Cardiology Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, Cevizli Mah. Denizer Cad. Cevizli Kavşağı No:2, 34865, Kartal/Istanbul, Turkey
| | - Koray Celal Demirel
- Cardiology Department, 29 Mayıs State Hospital, Aydınlar Mah. Dikmen Cad. No: 312 PK, 06105, Çankaya/Ankara, Turkey
| | - Ramazan Asoglu
- Cardiology Department, Adiyaman Training Ve Research Hospital, Yunus Emre Mahallesi, 1164 Sokak No:13, Merkez/Adıyaman, Turkey
| | - Koray Demir
- Cardiology Department, Mus State Hospital, Saray, Mus Center, 49200, Mus, Turkey
| | - Fatih Ozturk
- Cardiology Department, Mus State Hospital, Saray, Mus Center, 49200, Mus, Turkey
| | - Ali Elitok
- Cardiology Department, Istanbul University Istanbul School of Medicine, Turgut Ozal street No: 118, Fatih, 34093, Istanbul, Turkey
| | - Erugrul Okuyan
- Cardiology Department, Bagcilar Training Ve Research Hospital, Bagcilar Center, Mimar Sinan street, Bagcilar, 34100, Istanbul, Turkey
| | - Irfan Sahin
- Cardiology Department, Bagcilar Training Ve Research Hospital, Bagcilar Center, Mimar Sinan street, Bagcilar, 34100, Istanbul, Turkey
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Fidan S, Muhaffel F, Riool M, Cempura G, de Boer L, Zaat S, Filemonowicz AC, Cimenoglu H. Fabrication of oxide layer on zirconium by micro-arc oxidation: Structural and antimicrobial characteristics. Materials Science and Engineering: C 2017; 71:565-569. [DOI: 10.1016/j.msec.2016.11.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/02/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
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Avci A, Fidan S, Tabakçı MM, Toprak C, Alizade E, Acar E, Bayam E, Tellice M, Naser A, Kargın R. Association between the Gensini Score and Carotid Artery Stenosis. Korean Circ J 2016; 46:639-645. [PMID: 27721854 PMCID: PMC5054175 DOI: 10.4070/kcj.2016.46.5.639] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 11/09/2015] [Revised: 12/28/2015] [Accepted: 01/12/2016] [Indexed: 12/25/2022] Open
Abstract
Background and Objectives The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG). Subjects and Methods A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s. Results The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001). Conclusion The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG.
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Affiliation(s)
- Anil Avci
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Serdar Fidan
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Mehmet Mustafa Tabakçı
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Cuneyt Toprak
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Elnur Alizade
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Emrah Acar
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Emrah Bayam
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Muhammet Tellice
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Abdurrahman Naser
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
| | - Ramazan Kargın
- Deparment of Cardiology, 1-Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
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Acar RD, Bulut M, Acar Ş, Izci S, Fidan S, Yesin M, Efe SC. Evaluation of the P Wave Axis in Patients With Systemic Lupus Erythematosus. J Cardiovasc Thorac Res 2015; 7:154-7. [PMID: 26702344 PMCID: PMC4685281 DOI: 10.15171/jcvtr.2015.33] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 11/23/2015] [Indexed: 11/09/2022] Open
Abstract
Introduction: P wave axis is one of the most practical clinical tool for evaluation of cardiovascular disease. The aim of our study was to evaluate the P wave axis in electrocardiogram (ECG), left atrial function and association between the disease activity score in patients with systemic lupus erythematosus (SLE).
Methods: Standard 12-lead surface ECGs were recorded by at a paper speed of 25 m/s and an amplifier gain of 10 mm/mV. The heart rate (HR), the duration of PR, QRS, QTd (dispersion), the axis of P wave were measured by ECG machine automatically.
Results: The P wave axis was significantly increased in patients with SLE (49 ± 20 vs. 40 ± 18, P = 0.037) and the disease activity score was found positively correlated with P wave axis (r: 0.382, P = 0.011). The LA volume and the peak systolic strain of the left atrium (LA) were statistically different between the groups (P = 0.024 and P = 0.000). The parameters of the diastolic function; E/A and E/e’ were better in the control group than the patients with SLE (1.1 ± 0.3 vs. 1.3 ± 0.3, P = 0.041 and 6.6 ± 2.8 vs. 5.4 ± 1.4, P = 0.036, respectively).
Conclusion: P wave axis was found significantly increased in patients with SLE and positively correlated with SELENA-SLEDAI score. As the risk score increases in patients with SLE, P wave axis changes which may predict the risk of all-cause and cardiovascular mortality.
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Affiliation(s)
- Rezzan Deniz Acar
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mustafa Bulut
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Şencan Acar
- Department of Internal Medicine, Bilim University, Istanbul, Turkey
| | - Servet Izci
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Serdar Fidan
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mahmut Yesin
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Suleyman Cagan Efe
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
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Bulut M, Acar RD, Acar Ş, Fidan S, Yesin M, İzci S, Efe SC, Çakır H. Evaluation of torsion and twist mechanics of the left ventricle in patients with systemic lupus erythematosus. Anatol J Cardiol 2015; 16:434-9. [PMID: 26680549 PMCID: PMC5331377 DOI: 10.5152/anatoljcardiol.2015.6324] [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] [Indexed: 11/22/2022] Open
Abstract
Objective: Myocardial involvement in systemic lupus erythematosus (SLE) has great importance. The aim of this study is to evaluate the rotation and twisting mechanics of the left ventricle (LV) in patients with SLE. Methods: Forty-three patients fulfilled at least four of the American College of Rheumatology criteria for SLE and 30 individuals as controls were included in the study. SLE disease activity was assessed using the SELENA–SLEDAI score. Echocardiography was performed for all subjects. The patients fulfilled at least four of the American College of Rheumatology criteria for SLE were enrolled in the study. SLE disease activity was assessed using the SELENA-SLEDAI score. Echocardiography was performed for all individuals. Comparisons between groups were made using independent samples t-test with the standard statistical software (SPSS, version 15.0; SPSS Inc., Chicago, IL, USA). Each image was digitally stored for offline analysis. Measurement of global strain assessed by 17-segment model and rotational parameters were performed. LV ejection fraction was calculated by the biplane Simpson's method. Comparisons between groups were made using the independent samples t-test with the standard statistical software. A p value of 0.05 was considered statistically significant. Results: The values of mean global longitudinal strain, basal global circumferential strain (GCS), mean basal radial strain, and apical GCS were significantly lower in SLE patients. The difference between basal rotation, apical rotation, twist of the LV, and torsion of the LV in the SLE patients and controls were not significant (8.8±5.5 vs. 10.6±5.8, p=0.183;-4.7±3.0 vs. -4.8±3.2, p=0.947; 11.7±6.4 vs. 13.2±6.4, p=0.366; and 1.8±0.8 vs. 1.9±2.3, p=0.725, respectively). Although there was not any significant relationship between SELENA–SLEDAI score and myocardial strain analyses of the LV, the basal rotation and the torsion of the LV were lower in patients with SLE having a SLEDAI score of ≥17 (p=0.024 for basal rotation and p=0.032 for torsion). Conclusion: The number of segmental and global strain analyses were decreased in SLE patients with globally normal LVEF. The twist and torsion mechanics of the LV were preserved according to the control group, and the left ventricular torsion and basal rotation were found to be significantly decreased in those with an activity score of ≥17.
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Affiliation(s)
- Mustafa Bulut
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital; İstanbul-Turkey.
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ACAR RDENIZ, Bulut M, Acar Ş, Fidan S, Izci S, Yesin M, Efe SÇ, Akçakoyun M. OP-173 Evaluation of the Torsion and Twist Mechanics of the Left Ventricle in Patients with Systemic Lupus Erythematosus. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.324] [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: 10/23/2022]
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Acar RD, Kalkan ME, Bulut M, Ergün S, Fidan S, Izci S, Akçakoyun M. PP-106 QT Dispersion İmproves with Cardiac Rehabilitation in Patients with Acute Myocardial Infarction. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.463] [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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Alizade E, Avcı A, Fidan S, Tabakçı M, Bulut M, Zehir R, Simsek Z, Evlice M, Arslantaş U, Çakır H, Emiroglu MY, Akçakoyun M. The Effect of Chronic Anabolic-Androgenic Steroid Use on Tp-E Interval, Tp-E/Qt Ratio, and Tp-E/Qtc Ratio in Male Bodybuilders. Ann Noninvasive Electrocardiol 2015; 20:592-600. [PMID: 25631523 DOI: 10.1111/anec.12256] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The chronic consumption of androgenic anabolic steroids has shown to cause atrial arrhythmias. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT ratio, and Tp-e/cQT ratio) in bodybuilders who are using anabolic androgenic steroids (AAS). METHODS We selected a population of 33 competitive bodybuilders, including 15 actively using AAS for ≥ 2 years (users) and 18 who had never used AAS (nonusers), all men. RESULTS QT, cQT, QTd, cQTd, JT, and cJT were significantly increased in AAS users bodybulders compared to the nonusers (all P < 0.001). Tp-e interval, Tp-e/QT ratio, and Tp-e/cQT ratio were also significantly higher in AAS user group compared to the nonuser group (all P < 0.001). QRS duration was not different between the groups. There were negative correlation between E(m) and Tp-e, Tp-e/QT ratio, Tp-e/cQT ration (r = -0.657, P < 0.01; r = -0.607, P = 0.02; r = -0.583, P = 0.02; respectively).There were also negative correlation between S(m) and Tp-e, Tp-e/QT ratio, Tp-e/cQT ration (r = -0.681, P < 0.01; r = -0.549, P = 0.03; r = -0.544, P = 0.023; respectively). CONCLUSION In conclusion, we have presented a strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in AAS users, which suggest that there might be a link between AAS use and ventricular arrthymias and sudden death.
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Affiliation(s)
- Elnur Alizade
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Anıl Avcı
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Serdar Fidan
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Tabakçı
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Bulut
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Regayip Zehir
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Zeki Simsek
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mert Evlice
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Uğur Arslantaş
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Hakan Çakır
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mehmet Yunus Emiroglu
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
| | - Mustafa Akçakoyun
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Turkey
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Acar G, Fidan S, İzci S, Avcı A. Severe coronary vasospasm complicated with ventricular tachycardia. Arq Bras Cardiol 2015; 103:e81-6. [PMID: 25590937 PMCID: PMC4290748 DOI: 10.5935/abc.20140166] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/27/2013] [Indexed: 11/20/2022] Open
Affiliation(s)
- Göksel Acar
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital, Istambul, Turkey
| | - Serdar Fidan
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital, Istambul, Turkey
| | - Servet İzci
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital, Istambul, Turkey
| | - Anıl Avcı
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital, Istambul, Turkey
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Tabakci MM, Durmuş Hİ, Avci A, Toprak C, Demir S, Arslantaş U, Cerşit S, Fidan S, Kulahçioğlu Ş, Batgerel U, Kargin R. Relation of epicardial fat thickness to the severity of heart failure in patients with nonischemic dilated cardiomyopathy. Echocardiography 2014; 32:740-8. [PMID: 25418427 DOI: 10.1111/echo.12796] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study was to assess whether epicardial fat thickness (EFT) is associated with the severity of heart failure in patients with nonischemic dilated cardiomyopathy (NICMP). METHODS The study group was composed of 93 patients with NICMP and38 age- and sex-matched healty individuals as the control group. The EFT was identified during end-systole at the point on the free wall of the right ventricle. RESULTS Patients with NICMP had significantly lower mean EFT than those in the control group (4.1 ± 0.8 vs. 6.1 ± 1.8 mm, P < 0.001). EFT was thinnest in patients with New York Heart Association (NYHA) functional class III or IV (3.5 ± 0.5, P < 0.001). There was a significant correlation between EFT, left ventricle EF (r = 0.540 P < 0.001), and B-type natriuretic peptide (BNP) (r = -0.695, P < 0.001) values in patients with NICMP. In addition, when EFT was corrected for BMI, EFT/BMI was lower in patients with NYHA functional class III-IV than patients with NYHA class I-II and control group (0.13 ± 0.01, 0.16 ± 0.02, 0.23 ± 0.04, respectively; P < 0.001). There was a significant correlation between EFT/BMI, left ventricle EF (r = 0.489, P < 0.001), and BNP (r = -0.549, P < 0.001) in patients with NICMP. In multivariate regression analysis, EFT (P = 0.009), BNP (P = 0.039), and left atrium volume index (P = 0.039) were independently associated with impaired functional status. CONCLUSION Echocardiographic EFT is an inexpensive, simple, and readily available marker that may be used to asses the severity of chronic heart failure in patients with NICMP.
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Affiliation(s)
- Mehmet Mustafa Tabakci
- Cardiology Department, Kartal Koşuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey
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Açar G, Fidan S, Kaynar Topal Y, Alnur Uslu Z, Kalçık M. Case images: A case of isomerism with infracardiac total abnormal pulmonary venous connection: demonstration of extracardiac venous anomalies by CT angiography. Turk Kardiyol Dern Ars 2014; 42:495. [PMID: 25080962 DOI: 10.5543/tkda.2014.70740] [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: 11/04/2022] Open
Affiliation(s)
- Göksel Açar
- Department of Cardiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Yaşa Kaynar Topal
- Department of Radiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Zülal Alnur Uslu
- Department of Radiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Macit Kalçık
- Department of Cardiology, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
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Abstract
OBJECTIVES The aim of this study was to assess whether NLR levels are associated with echocardiographic parameters, New York Heart Association (NYHA) functional class, or B- type natriuretic peptide (BNP) levels in patients with idiopathic dilated cardiomyopathy (DCM). DESIGN Eighty-seven patients with idiopathic DCM were included prospectively from 2009 to 2014. Patients with acute decompensated heart failure and conditions that alter the total or differential white blood cell counts were excluded. Blood samples were collected before echocardiographic investigation on admission. RESULTS There was a statistically significant correlation between neutrophil/lymphocyte ratio (NLR) and NYHA functional class (r = 0.68, p < 0.001), BNP levels (r = 0.61, p < 0.001) and various echocardiographic parameters. NLR was significantly higher in patients in NYHA functional class III or IV (n = 39) than among those categorized as NYHA class I or II (n = 48), (3.3 ± 1.0 vs 2.1 ± 0.6; p < 0.001). The NLR cutoff value predicting severe chronic HF was 2.25 with 82% sensitivity and 65% specificity (p < 0.001). On multivariate linear regression analysis NLR (p = 0.025), left ventricular end-diastolic volume (p = 0.041) and left atrial volume index (LAVI) (p = 0.001) were found to be independent positive predictors of BNP levels. CONCLUSION Neutrophil/Lymphocyte ratio is associated with the severity of chronic heart failure in patients with idiopathic DCM.
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Affiliation(s)
- Anil Avci
- Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital , Kartal, Istanbul , Turkey
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Avci A, Fidan S, Alıcı G, Acar G, Toprak C, Izci S, Esen AM. Coronary artery perforation after crush technique for stent compression. Herz 2014; 40:554-7. [PMID: 24737403 DOI: 10.1007/s00059-014-4052-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 01/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A Avci
- Cardiology Department, Kartal Koşuyolu High Specialty Education and Research Hospital Kartal/Istanbul, Denizer Cad., 34846, Kartal/Istanbul, Turkey,
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Açar G, Fidan S, Topal YK, Uslu Z, Avci A, Alizade E, Esen A. PP-225 Unusual Case of Isomerism: Demonstration of Extracardiac Venous Anomalies by CT Angiography. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.246] [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: 10/25/2022]
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Açar G, Fidan S, Uslu ZA, Turkday S, Avci A, Alizade E, Kalkan ME, Tabakci ON, Tanboğa IH, Esen AM. Relationship of neutrophil-lymphocyte ratio with the presence, severity, and extent of coronary atherosclerosis detected by coronary computed tomography angiography. Angiology 2014; 66:174-9. [PMID: 24554426 DOI: 10.1177/0003319714520954] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 11/17/2022]
Abstract
We evaluated whether the neutrophil-lymphocyte ratio (NLR) was associated with the presence, severity, and extent of coronary atherosclerotic plaques detected by computed tomography angiography (CTA). We studied 238 patients who underwent dual-source 64-slice CTA for the assessment of coronary artery disease. Coronary arteries were evaluated on 16-segment basis and critical plaque was described as luminal narrowing >50%. In regression analysis, being in the third NLR tertile increased the risk of coronary atherosclerosis (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.15-4.43; P = .023). When the severity of coronary atherosclerosis was assessed, being in the third NLR tertile increased the risk of critical luminal stenosis (OR, 2.60; 95% CI, 1.19-5.69; P = .017). Although plaque morphology was not associated with NLR, the extent of coronary atherosclerosis was increased with higher NLR tertiles (P = .001). Our results suggest that a higher NLR may be a useful additional measure to assess cardiovascular risk in clinical practice.
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Affiliation(s)
- Göksel Açar
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Zulal Alnur Uslu
- Department of Radiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Sevim Turkday
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Anıl Avci
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Elnur Alizade
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Emin Kalkan
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Omer Naci Tabakci
- Department of Radiology, Sisli Etfal Educational and Research Hospital, Istanbul, Turkey
| | | | - Ali Metin Esen
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
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Açar G, Fidan S, Alici G, Tabakci MM, Avci A, Pala S. Retrieval of a malpositioned left subclavian artery stent from the ascending aorta: combined percutaneous and surgical management. Herz 2013; 40:325-8. [PMID: 24297399 DOI: 10.1007/s00059-013-4005-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/12/2013] [Accepted: 10/15/2013] [Indexed: 11/29/2022]
Abstract
Chronic upper limb ischemia is an uncommon clinical condition and is most often caused by subclavian artery stenosis. Surgical and percutaneous treatment modalities have been shown to be effective for the management of subclavian artery occlusion. Because of lower mortality and morbidity rates, percutaneous interventions for subclavian arterial occlusions are more acceptable than surgery. Chronic total occlusions of the subclavian artery are challenging to treat percutaneously because of the structure and complexity of the lesion. The complexity of the lesion causes its own complications. In this paper, we report a case of a completely occluded left subclavian artery that was complicated by a malpositioned stent hanging into the aortic arch and the ascending aorta during percutaneous intervention, which was successfully managed by our heart team.
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Affiliation(s)
- G Açar
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Denizer Street, Cevizli Kavsagi, No: 2, 34846, Kartal/Istanbul, Turkey,
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Koyuncu A, Eroglu E, Kahveci G, Toprak C, Kilicgedik A, Acar G, Avci A, Fidan S, Tellice M, Alici G, Ozkan B, Pala S, Esen AM. Epicardial and Endocardial Deformations in Discrimination of Nonobstructive Hypertrophic Cardiomyopathy from Hypertensive Left Ventricular Hypertrophy. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.476] [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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Fidan S, Izci S, Tellice M, Alizade E, Açar G. ST elevation myocardial infarction after use of pseudoephedrine : which is more dangerous, the common cold itself or the medication used for it? Herz 2013; 40:144-6. [PMID: 23999667 DOI: 10.1007/s00059-013-3952-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/04/2013] [Accepted: 08/11/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S Fidan
- Cardiology Clinic, Kartal Kosuyolu High Speciality Education and Research Hospital, Denizer Street, 34846, Kartal/Istanbul, Turkey,
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Fidan E, Mentese A, Kavgaci H, Orem A, Fidan S, Uzun A, Ozdemir F, Aydin F. Increased ischemia-modified albumin levels in patients with gastric cancer. Neoplasma 2012; 59:393-7. [PMID: 22489694 DOI: 10.4149/neo_2012_051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reactive oxygen species (ROS) are found in the development stages of carcinogenesis. Fifty two patients with gastric cancer and 35 controls were enrolled in this trial. IMA, MDA, Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were evaluated. There was a significant increase in IMA and MDA levels in the patient group (0.405±0.111, 0.271±0.066; p= 0.0001 and 0.207±0.251, 0.077±0.103; p= 0.004 respectively). TOS was also higher in the patient group but it was not statistically different. TAS was statistically lower and there was significant difference in OSI (0.621±0.394, 0.996±0.37; p=0.0001 and 9.68±18.2, 2.9±3.85; p=0.001 respectively). The areas under receiver operating characteristics curves for the determination of gastric cancer were 0.842 for IMA and 0.708 for MDA. Increased levels of IMA, MDA and oxidative stress index were detected and this condition is associated with the impairment of oxidant-antioxidant balance.
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Affiliation(s)
- E Fidan
- Division of Medical Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
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Fidan E, Fidan S, Yildiz B, Durmus I, Kavgaci H, Ozdemir F, Aydin F. Bolus fluorouracil induced syncope and pulseless ventricular tachycardia: a case report. Hippokratia 2011; 15:93-95. [PMID: 21607046 PMCID: PMC3093156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
5-fluorouracil is an anti-cancer drug commonly used in oncology practice. Typical side effects are myelosupression, nausea, vomiting, diarrhea and stomatitis. Cardiotoxicity is the other toxicity. Cardiac side effects are ST segment changes, rhythm abnormalities, supraventricular and ventricular dysrhytmias. Pulseless ventricular tachycardia and ventricular fibrillation releated with bolus fluorouracil were not detected in the literature. Here we discussed a 46 year-old male patient that has no known cardiac history. After bolus fluorouracil administration, syncope and pulseless ventricular tachycardia developed in this patient. There are a few explanations about the cardiotoxicity of fluorouracil. One of these is the effect on nitric oxide. It causes a reduction in the levels of endothelial NO and this leads coronary vasospasm. Another explanation is protein kinase C mediated vasospasm. In animal studies toxic myocarditis like lesions were detected with fluorouracil infusions. Finally both myocardit and vasospasm may lead cardiac problems like sudden cardiac deaths. Bolus 5-fluorouracil is as cardiotoxic as 5-fluorouracil infusion and we must be careful about the arrhytmia after the bolus administration.
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Pommier J, Laurent-Beq A, Beurrier B, Fidan S, Guilhem L, Jeandel L, Ligoure V, Thomas V. [Hospital nurses' perception of public health]. Sante Publique 2004; 16:383-92. [PMID: 15360195 DOI: 10.3917/spub.042.0383] [Citation(s) in RCA: 2] [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] [Indexed: 11/14/2022]
Abstract
The objective of this work was to study hospital nurses' perceptions of public health based on a pedagogical exercise. A qualitative study, lead by students of a training institute for nursing care (IFSI), was conducted using semi-directed interviews of hospital nurses from different departments of a provincial hospital. The main results show that for one-third of the nurses interviewed, the hospital is not a setting for public health practice. In terms of their definition of public health, it is closely linked to the concept of prevention, with primarily individual approaches. This definition is very close to the public health activities that they conduct at the hospital and which are centred on information and disease prevention, on education related to pathologies and the relationship between the provision of care and listening to the patients and their families. Few nurses place their public health activities within the scope of the areas of hospital cleanliness, the welcoming of the patients, the organisation of services, and the improvement of the quality of care. The potential tracks which have emerged from this work lead to the need for the strengthening of training in patient education, in the hospital's work networking with external partners, and in better development of public health activities undertaken in the hospital setting.
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McLaughlin W, Miller A, Fidan S, Pejtersen K, Batsberg Pedersen W. Radiochromic plastic films for accurate measurement of radiation absorbed dose and dose distributions. ACTA ACUST UNITED AC 1977. [DOI: 10.1016/0146-5724(77)90017-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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