1
|
Aliyeva N, Yozgat Y, Bakhshaliyev N, Afshord TZ, Yozgat CY, Kilicoglu AG. Evaluation of executive functions in children with rheumatic heart diseases. Pediatr Int 2022; 64:e15035. [PMID: 34674348 DOI: 10.1111/ped.15035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/30/2021] [Accepted: 10/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute rheumatic fever (ARF) is a multisystemic inflammatory disease in children and young adults. The most notable complications of ARF are rheumatic heart disease (RHD) and Sydenham's chorea (SC). There have been many reports about executive dysfunctions with children who have SC. "Executive function" is an umbrella term that is used to describe higher level cognitive functions. The aim of this study is to determine the executive functions of children with RHD. We evaluated executive functions in healthy children with the same sociodemographic characteristics as children with RHD. METHODS Our study was designed as a cross-sectional randomized study, including children with RHD aged between 12 and 18, and healthy controls. The difference between the patient and control group participants in terms of age, gender, education level, education level of the parents, family income level, and executive functions were investigated. Executive functions composed of Digit Sequence Test, Verbal Fluency Test, Trail-Making Test, Stroop Test, Wisconsin Card Sorting Test. RESULTS In our study, a total of 30 children with RHD were followed up at the pediatric cardiology outpatient clinic of Bezmialem Vakif University Hospital composed the patient group. The control group was made up of 30 healthy children of the same sex and age group as the patient group. The mean age of the case group was 14.73 ± 1.84 years. The Digit Span Test, Verbal Fluency Test, Trail-Making Test, Wisconsin Card Sorting Test, and Stroop Test produced no statistically significant differences between the RHD patients and the controls. CONCLUSIONS No statistically significant difference was found between the RHD patients and control patients in any executive function test. It was suggested that executive dysfunction might not develop in RHD patients before developing SC.
Collapse
Affiliation(s)
- Nigar Aliyeva
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Yilmaz Yozgat
- Department of Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
| | | | - Telli Zadehgan Afshord
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Ali Guven Kilicoglu
- Department of Child and Adolescent Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
2
|
Bakhshaliyev N, Ozdemir R. The impact of atrial flow regulator implantation on hemodynamic parameters in patients with heart failure. Kardiologiia 2021; 61:71-80. [PMID: 34763641 DOI: 10.18087/cardio.2021.10.n1612] [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] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
Background Left atrial decompression has emerged a new option to treat patients with heart failure and dyspnea at rest or during exercise. Here we report the impact of atrial flow regulator (AFR) implantation on hemodynamic parameters in patients at our center with heart failure and with reduced (HFrEF) or with preserved left ventricular ejection fraction (HFpEF).Material and methods The PRELIEVE trial is designed to assess the safety and efficacy of the AFR in patients with HFrEF or HFpEF. Patients with left ventricular end-diastolic pressure ≥15 mmHg at rest or ≥25 mmHg during exercise and with an ejection fraction ≥15 % were enrolled. Echocardiographic data, 6‑min walking distance, Kansas City Cardiomyopathy Questionnaire, and brain natriuretic peptide levels were assessed pre- and post-AFR implantation and at 3 mos. Invasive hemodynamic assessments were also performed pre- and post-AFR implantation and at 3 mos.Results 27 (69.2 %) patients with HFrEF and 12 (30.8 %) patients with HFpEF at our center were enrolled in this study. A significant decrease was observed in pulmonary arterial wedge pressure regardless of EF (p=0.007 for HFrEF and p=0.03 for HFpEF). No significant difference of mean pulmonary arterial pressure, right arterial pressure and cardiac output (CO) existed at 3 months compared with pre-implantation baseline values.Conclusion AFR implantation led to decrease in left ventricle filling pressure without the deleterious impact on CO and right heart function regardless of ejection fraction.
Collapse
|
3
|
Ertaş G, Ekmekçi A, Şahin S, Murat A, Bakhshaliyev N, Erer HB, Güvenç TS, Eren M. Epicardial fat thickness assessment by multi-slice computed tomography for predicting cardiac outcomes in patients undergoing transcatheter aortic valve implantation. Cardiovasc J Afr 2021; 33:108-111. [PMID: 34704590 DOI: 10.5830/cvja-2021-043] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 09/13/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Chronic inflammation promotes aortic valve calcification. It is known that epicardial fat is a source of inflammation. The aim of this study was to investigate the relationship between epicardial fat thickness, cardiac conduction disorders and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS During a three-year period, 45 patients with severe aortic stenosis who underwent TAVI were recruited to the study. Data were collected retrospectively. Epicardial fat was defined as the adipose tissue between the epicardium and the visceral pericardium. Mean epicardial fat thickness was determined by multi-slice computed tomography, which was performed before the procedure. RESULTS The average thickness of epicardial fat was 13.06 ± 3.29 mm. This study failed to reveal a significant correlation between epicardial fat thickness and post-procedural left bundle branch block, right bundle branch block, paravalvular aortic regurgitation and pacemaker implantation rates (p > 0.05). CONCLUSIONS The results of this study failed to show a significant relationship between epicardial fat thickness, cardiac conduction disorders and outcomes, however further studies with larger sample numbers are required to explore the relationship.
Collapse
Affiliation(s)
- Gökhan Ertaş
- Department of Cardiology, Memorial Sisli Hospital, Istanbul, Turkey.
| | - Ahmet Ekmekçi
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Murat
- Department of Cardiology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hatice Betül Erer
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Tolga Sinan Güvenç
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Mehmet Eren
- Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
4
|
Bakhshaliyev N, Çelikkale İ, Enhoş A, Karaçöp E, Uluganyan M, Özdemir R. Impact of atrial flow regulator (AFR) implantation on 12-month mortality in heart failure : Insights from a single site in the PRELIEVE study. Herz 2021; 47:366-373. [PMID: 34459929 DOI: 10.1007/s00059-021-05063-w] [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: 06/06/2021] [Revised: 07/10/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Implantation of the atrial flow regulator (AFR) to create an interatrial left-to-right shunt has been shown to be safe and feasible to reduce intracardiac filling pressures in patients with heart failure (HF). OBJECTIVES We aimed to assess the effect of AFR implantation on 12-month mortality and hospitalization rates in patients with reduced (HFrEF) or preserved HF (HFpEF). METHODS One-year follow-up data from 34 subjects enrolled at a single PRELIEVE center were analyzed. The 12-month predicted mortality was calculated using the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score. Patients were divided into two groups, according to their history of hospitalizations for HF. RESULTS Study data of 34 patients (HFrEF: 24 [70.6%]; HFpEF: 10 [29.4%]) were assessed. Median follow-up duration was 355 days. In total, 14 (41.2%) patients were hospitalized during the follow-up period and 6 (17.6%) of these patients were hospitalization for HF (HHF). A total of 24 hospitalizations occurred in this period and 8 (33%) hospitalizations were for HHF. The median baseline MAGGIC score was 23 and the median predicted mortality was 13.4/100 patient years. Observed mortality was 3.1/100 patient years. The observed survival (97%) was 10.3% (95% confidence interval 3.6-17.5%, p = 0.004) better than the predicted survival (86.6%). CONCLUSION Our results suggest that AFR implantation has favorable effects on mortality in patients with heart failure, regardless of ejection fraction. Furthermore, compared to baseline, left ventricular filling pressure (assessed by echocardiography) decreased significantly without right side volume overload at the 1‑year follow-up.
Collapse
Affiliation(s)
- Nijad Bakhshaliyev
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey.
| | - İlke Çelikkale
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey
| | - Asım Enhoş
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey
| | - Erdem Karaçöp
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey
| | - Mahmut Uluganyan
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey
| | - Ramazan Özdemir
- Cardiology Department, Bezmialem Vakif University, Adnan Menderes bulvari, Fatih/Istanbul, Turkey
| |
Collapse
|
5
|
Bakhshaliyev N, Özdemir R. The impact of hydroxychloroquine-azithromycin combination on Tpeak-to-end and Tpeak-to-end/QT ratio during a short treatment course. Ann Noninvasive Electrocardiol 2021; 26:e12846. [PMID: 33956361 PMCID: PMC8293593 DOI: 10.1111/anec.12846] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Since there was no proven treatment of coronavirus disease 2019 (COVID-19), hydroxychloroquine-azithromycin (HCQ-AZM) combination is being used in different countries as a treatment option. Many controversies exist related to the safety and effectiveness of this combination, and questions about how HCQ-AZM combination affects the ventricular repolarization are still unknown. OBJECTIVE The aim of the study was to show whether the hydroxychloroquine-azithromycin (HCQ-AZM) combination prolonged Tpeak-to-end (TpTe) duration and TpTe/QT interval ratio or not. METHODS One hundred and twenty-six consequent COVID-19(+) patients meeting the study criteria were enrolled in this study. Baseline ECGs were obtained immediately after hospitalization and before commencing the HCQ-AZM combination. On-treatment ECG was obtained 24-48 hr after the loading dose of HCQ/AZM. ECG parameters including PR interval, QRS duration, QT interval, QTc interval, TpTe duration, and TpTe/QT interval ratio were assessed. Demographic and laboratory findings were collected from an electronic recording system. RESULTS ECGs of 126 COVID-19(+) patients who received HCQ-AZM combination were assessed. Mean baseline QTc (by Fridericia formula), TpTe, and TpTe/QT ratio were 420.0 ± 26.5 ms, 82.43 ± 9.77 ms, and 0.22 ± 0.02, respectively. On-treatment QTc, TpTe and TpTe/QT ratio were 425.7 ± 27.18 ms, 85.17 ± 11.17 ms, and 0.22 ± 0.03, respectively. No statistically significant acute impacts of HCQ-AZM combination on TpTe duration and TpTe/QT interval ratio were observed compared with baseline values. No ventricular tachycardia/fibrillation and the significant conduction delays were seen during in-hospital follow-up. CONCLUSION HCQ-AZM combination increased TpTe duration. However, no significant impact on TpTe/QT interval ratio was observed.
Collapse
|
6
|
Bakhshaliyev N, Acikgoz N. EuroSCORE II and STS score as a predictor of acute kidney injury following transcatheter aortic valve replacement: Two birds with one stone? Med-Science 2021. [DOI: 10.5455/medscience.2021.01.015] [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: 11/03/2022] Open
|
7
|
Karacop E, Enhos A, Bakhshaliyev N. Impact of postdischarge care fragmentation on clinical outcomes and survival following transcatheter aortic valve replacement. Herz 2020; 46:180-186. [PMID: 32902687 DOI: 10.1007/s00059-020-04976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/17/2020] [Accepted: 08/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The study aimed to evaluate the prognostic impact of postdischarge care fragmentation in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS A total of 266 patients undergoing TAVR due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned to one of two groups based on presence (n = 104) and absence (n = 162) of postdischarge care fragmentation. Fragmented care was defined as at least one readmission to a site other than the implanting TAVR center within 90 days. Prognostic impact of care fragmentation on clinical outcomes and predictors of long-term mortality were investigated. RESULTS Increased major vascular complication (16.3 vs 8.0%, p = 0.037), permanent pacemaker implantation (14.4 vs 6.2%, p = 0.025), and acute kidney injury (22.1 vs 14.2%, p < 0.001) were reported in the fragmented care group. Although early mortality (6.7 vs 4.3%, p = 0.152) was similar between groups, there was a significant difference in 5‑year mortality (66.3 vs 45.7%, p < 0.001). In a univariate regression analysis fragmented care, age, chronic obstructive pulmonary disease, pulmonary artery systolic pressure, and paravalvular leakage were significantly associated with 5‑year mortality. Fragmented care (hazard ratio [HR] 1.510, 95% confidence interval [CI] 1.080-2.111; p = 0.016), age (HR 1.024, 95% CI 1.001-1.048; p = 0.045), paravalvular leakage (HR 1.863, 95% CI 1.076-3.228; p = 0.026), and chronic obstructive pulmonary disease (HR 1.616, 95% CI 1.114-2.344; p = 0.012) were found to be significant independent predictors of 5‑year mortality in a multivariate analysis, after adjusting for other risks. CONCLUSION Fragmented care has a significant prognostic impact on clinical outcomes and survival.
Collapse
Affiliation(s)
- E Karacop
- Faculty of Medicine, Department of Cardiology, Bezmialem Foundation University, Adnan Menderes Avenue, Vatan Street, 34093, Fatih/Istanbul, Turkey.
| | - A Enhos
- Faculty of Medicine, Department of Cardiology, Bezmialem Foundation University, Adnan Menderes Avenue, Vatan Street, 34093, Fatih/Istanbul, Turkey
| | - N Bakhshaliyev
- Faculty of Medicine, Department of Cardiology, Bezmialem Foundation University, Adnan Menderes Avenue, Vatan Street, 34093, Fatih/Istanbul, Turkey
| |
Collapse
|
8
|
Bakhshaliyev N, Uluganyan M, Enhos A, Karacop E, Ozdemir R. The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patients. J Electrocardiol 2020; 62:59-64. [PMID: 32827987 PMCID: PMC7417268 DOI: 10.1016/j.jelectrocard.2020.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/19/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The combination of Hydroxychloroquine (HCQ) and azithromycin showed effectiveness as a treatment for COVID-19 and is being used widely all around the world. Despite that those drugs are known to cause prolonged QT interval individually there is no study assessing the impact of this combination on electrocardiography (ECG). This study aimed to assess the impact of a 5-day course of HCQ and azithromycin combination on ECG in non-ICU COVID19(+) patients. METHODS In this retrospective observational study, we enrolled 109 COVID19(+) patients who required non-ICU hospitalization. All patients received 5-day protocol of HCQ and azithromycin combination. On-treatment ECGs were repeated 3-6 h after the second HCQ loading dose and 48-72 h after the first dose of the combination. ECGs were assessed in terms of rhythm, PR interval, QRS duration, QT and QTc intervals. Baseline and on-treatment ECG findings were compared. Demographic characteristics, laboratory results were recorded. Daily phone call-visit or bed-side visit were performed by attending physician. RESULTS Of the 109 patients included in the study, the mean age was 57.3 ± 14.4 years and 48 (44%) were male. Mean baseline PR interval was 158.47 ± 25.10 ms, QRS duration was 94.00 ± 20.55 ms, QTc interval was 435.28 ± 32.78 ms, 415.67 ± 28.51, 412.07 ± 25.65 according to Bazett's, Fridericia's and Framingham Heart Study formulas respectively. ∆PR was -2.94 ± 19.93 ms (p = .55), ∆QRS duration was 5.18 ± 8.94 ms (p = .03). ∆QTc interval was 6.64 ± 9.60 ms (p = .5), 10.67 ± 9.9 ms (p = .19), 14.14 ± 9.68 ms (p = .16) according to Bazett's, Fridericia's and Framingham Heart Study formulas respectively. There were no statistically significant differences between QTc intervals. No ventricular tachycardia, ventricular fibrillation or significant conduction delay was seen during follow-up. There was no death or worsening heart function. CONCLUSION The 5-day course of HCQ- AZM combination did not lead to clinically significant QT prolongation and other conduction delays compared to baseline ECG in non-ICU COVID19(+) patients.
Collapse
Affiliation(s)
| | | | - Asim Enhos
- Bezmialem Vakif University, Department of Cardiology, Turkey
| | - Erdem Karacop
- Bezmialem Vakif University, Department of Cardiology, Turkey
| | - Ramazan Ozdemir
- Bezmialem Vakif University, Department of Cardiology, Turkey
| |
Collapse
|
9
|
Ay NK, Enhos A, Ay Y, Bakhshaliyev N, Nadir A, Karacop E, Celikkale I, Uluganyan M, Ozdemir R, Goktekin O. The prognostic value of fragmented QRS in patients undergoing transcatheter aortic valve implantation. J Electrocardiol 2018; 51:923-927. [PMID: 30497748 DOI: 10.1016/j.jelectrocard.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/24/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis. METHODS A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n = 36) or absence (n = 81) of fQRS. Predictors of long-term survival were estimated. RESULTS In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p = 0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29-7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07-6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05-5.60, p: 0.03) emerged as significant independent predictors of short survival. CONCLUSION Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted.
Collapse
Affiliation(s)
- Nuray Kahraman Ay
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey.
| | - Asim Enhos
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Yasin Ay
- Department of Cardiovascular Surgery, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Aydin Nadir
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Erdem Karacop
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Ilke Celikkale
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Mahmut Uluganyan
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Razaman Ozdemir
- Department of Cardiology, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Omer Goktekin
- Department of Cardiology, Bahcelievler Memorial Hospital, Bahcelievler, 34344 Istanbul, Turkey
| |
Collapse
|
10
|
Yamac AH, Huyut MA, Yilmaz E, Celikkale I, Bacaksiz A, Demir Y, Demir AR, Erturk M, Bakhshaliyev N, Ozdemir R, Kilic U. MicroRNA 199a Is Downregulated in Patients After Coronary Artery Bypass Graft Surgery and Is Associated with Increased Levels of Sirtuin 1 (SIRT 1) Protein and Major Adverse Cardiovascular Events at 3-Year Follow-Up. Med Sci Monit 2018; 24:6245-6254. [PMID: 30192743 PMCID: PMC6139112 DOI: 10.12659/msm.912065] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 01/21/2023] Open
Abstract
Background The cardioprotective protein SIRT1 is elevated in patients with coronary artery disease (CAD) to compensate for the disease-related adverse effects, but less is known about the prognostic role of SIRT 1 regulating microRNAs in patients after coronary artery bypass graft (CABG) surgery. Material/Methods The expression of the SIRT 1-specific microRNAs miR-199a and miR-195 was analyzed using real-time PCR in 68 patients referred for CABG surgery and 34 control patients undergoing heart valve surgery. In CABG patients, major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, myocardial infarction (MI), re-vascularization, heart failure symptoms ≥NYHA II, re-hospitalization for any cardiovascular reason, and stroke, were analyzed at a median follow-up (FU) of 3.2 years (range: 3.0–3.6). Results The level of miR-199a in patients with CAD was significantly reduced compared to the control group (relative expression: 0.89±0.49 vs. 1.90±0.90, p=0.001), while SIRT 1 protein was markedly enhanced (p<0.001). In patients undergoing CABG who had MACCEs, miR-199a was significantly lower compared to patients with an uneventful FU (0.71±0.25 vs. 0.98±0.53, p=0.007). Heart failure status, death, and total MACCEs rate were inversely correlated with the amount of miR-199a (p=0.039) at 3-year FU. Conclusions Altered expression of miR-199a in myocardial tissue was found to be associated with SIRT 1 upregulation in patients with CAD undergoing CABG and was associated with an increased MACCEs rate at mid-term follow-up.
Collapse
Affiliation(s)
- Aylin Hatice Yamac
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mustafa Ahmet Huyut
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Emre Yilmaz
- Department of Cardiology, Mehmet Akif Ersoy Heart Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ilke Celikkale
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Bacaksiz
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Yusuf Demir
- Department of Cardiology, Mehmet Akif Ersoy Heart Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali Riza Demir
- Department of Cardiology, Mehmet Akif Ersoy Heart Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Heart Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ramazan Ozdemir
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ulkan Kilic
- Department of Medical Biology, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
11
|
Uluganyan M, Karaca G, Ulutas TK, Ekmekci A, Tusun E, Murat A, Koroglu B, Uyarel H, Bakhshaliyev N, Eren M. The Impact of Admission Serum Creatinine Derived Estimated Glomerular Filtration Rate on Major Adverse Cardiac Events in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention. J Clin Med Res 2016; 8:325-30. [PMID: 26985253 PMCID: PMC4780496 DOI: 10.14740/jocmr2482w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 11/15/2022] Open
Abstract
Background The impact of Cockroft-Gault (C-G) derived estimated glomerular filtration rate (eGFR) on mortality and major adverse cardiac events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) was assessed. Methods A total of 884 patients were classified into four categories according to admission creatine derived eGFR: < 60, 60 - < 90, 90 - < 120, and ≥ 120 mL/min/1.73 m2. Results In-hospital and long-term MACEs were significantly higher in eGFR < 60 mL/min/1.73 m2 subgroup (P < 0.001 and P = 0.028). Multivariate analysis demonstrated 7.78-fold (95% CI: 0.91 - 66.8) higher mortality risk in eGFR < 60 mL/min/1.73 m2 subgroup. Conclusion As an easily applicable bedside method, C-G derived eGFR could be important for prediction of in-hospital and long-term mortality and MACE in STEMI patients undergoing primary PCI.
Collapse
Affiliation(s)
- Mahmut Uluganyan
- Clinic of Cardiology, Kadirli Government Hospital, Osmaniye, Turkey
| | - Gurkan Karaca
- Clinic of Cardiology, Osmancik Government Hospital, Corum, Turkey
| | | | - Ahmet Ekmekci
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Eyup Tusun
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Murat
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Bayram Koroglu
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Uyarel
- Department of Cardiology, Bezmialem Vakif University Medical Hospital, Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Eren
- Clinic of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
12
|
Hayıroğlu Mİ, Bozbeyoğlu E, Akyüz Ş, Yıldırımtürk Ö, Bozbay M, Bakhshaliyev N, Renda E, Gök G, Eren M, Pehlivanoğlu S. Acute myocardial infarction with concomitant pulmonary embolism as a result of patent foramen ovale. Am J Emerg Med 2015; 33:984.e5-7. [PMID: 25656332 DOI: 10.1016/j.ajem.2014.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/14/2014] [Indexed: 02/08/2023] Open
Abstract
Acute myocardial infarction (MI) and pulmonary embolism canal one lead to life-threatening conditions such as sudden cardiac death and congestive heart failure. We discuss a case of a 74-year-old man presented to the emergency department with acute dyspnea and chest pain. Acute anterior MI and pulmonary embolism concomitantly were diagnosed. Primary percutaneous coronary intervention performed because of preliminary acute anterior MI diagnosis. Transthoracic echocardiography was performed to determine further complications caused by acute MI because patient had a continuous tachycardia and dyspnea although hemodynamically stable. Transthoracic echocardiography revealed a thrombus that was stuck into the patent foramen ovale with parts in right and left atria. Anticoagulation therapy was started; neither fibrinolytic therapy nor operation was performed because of low survey expectations of the patient's recently diagnosed primary disease stage IV lung cancer. Patient was discharged on his 20th day with oral anticoagulation and antiagregant therapy.
Collapse
Affiliation(s)
- Mert İlker Hayıroğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
| | - Emrah Bozbeyoğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Şükrü Akyüz
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Özlem Yıldırımtürk
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Bozbay
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Emir Renda
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Gülay Gök
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Eren
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| | - Seçkin Pehlivanoğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|