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Öğe C-reactive protein to albumin ratio predicts for severity of coronary artery disease and ischemia(Verduci Publisher, 2022) Sabanoglu, C.; Inanc, I. H.OBJECTIVE: Myocardial perfu-sion scintigraphy (MPS) has prognostic importance in demonstrating myocardial ischemia, and the Syntax score (SS) in coronary angiogra-phy has prognostic importance in demonstrat-ing the extent of coronary artery disease (CAD). C-reactive protein (CRP) and albumin are prognostic markers for both atherosclerosis and inflammation. In this study, we aimed at investigating the relationship of CRP/albumin ratio (CAR) with the severity of myocardial ischemia and SS in patients with stable CAD. PATIENTS AND METHODS: We retrospec-tively evaluated 355 patients between January 2018 and January 2020. Patients were divided into normal, mild-moderate, and severe ischemia groups according to MPS. SS was classi-fied as low risk (< 32) and high risk (>= 32) groups. The association between CAR, SS, and MPS findings were analyzed. RESULTS: The median CAR level was high-er in the high-risk group compared to the low -risk group (20.7 vs. 13.8, p < 0.05), and higher in the low-risk group compared to the normal group (13.8 vs. 7.4, p < 0.05). The increase in CAR level was associated with increased ischemia severity (p < 0.001). Increased CAR level was found to be an independent predictor of both high-risk and severe ischemia (OR = 1.04, p = 0.006; OR = 1.05, p = 0.001, respectively). The cut-off value of CAR > 10.2 was a common point in predicting both low -risk and mild-moderate ischemia (AUC: 0.736, p < 0.001; AUC: 0.741, p < 0.001, respectively). CONCLUSIONS: High CAR level was an inde-pendent predictor of both the severity of ischemia and the extent of CAD. Therefore, CAR can be a potential screening tool in patients with suspected CAD and in risk stratification.Öğe Long-term predictive value of cardiac biomarkers in patients with COVID-19 infection(Verduci Publisher, 2022) Sabanoglu, C.; Inanc, I. H.; Polat, E.; Peker, S. A.OBJECTIVE: Several studies have investigated the association between cardiac biomarkers and short-term prognosis in the COVID-19 infection. However, the data on the pre-dictive value of cardiac biomarkers to predict long-term prognosis in COVID-19 infection are limited. We aimed at determining the relationship between N-terminal brain-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-TnI) as cardiac biomarkers and in-hospital/ long-term outcomes in COVID-19 infection.PATIENTS AND METHODS: The study included a total of 916 patients with confirmed COVID-19 infection. The primary outcome was in-hospital and 1-year mortality. The secondary outcome was intensive care need at admission or the need to be transferred to the intensive care unit later on.RESULTS: The study included 498 (54.4%) males and 418 (45.6%) females with a mean age of 55.1 & PLUSMN;18.5 years. The patients with known heart failure (HF), COVID-19-related HF, acute renal failure (ARF), chronic kidney disease (CKD), diabetes mellitus, hypertension, coronary artery dis-ease (CAD), chronic obstructive pulmonary dis-ease (COPD)/asthma, high CO-RADS score (& GE; 4), lower EF, higher hs-TnI, and NT-proBNP levels had increased in-hospital and 1-year mortality. After multivariate analysis, NT-proBNP, hs-TnI, CKD, ARF, diabetes mellitus, and CAD were independent predictors of in-hospital and 1-year mortali-ty. After ROC analysis, NT-proBNP cut-off levels of 1022.50 (sensitivity 87.5%, specificity 87.1%) and 1008 (sensitivity 88.6%, specificity 88.0%) were found to predict in-hospital and 1-year mortality, respectively. Hs-TnI cut-off levels of 49.6 (sensitivity 88.6%, specificity 88.9%) and 34.10 (sensitivity 83.8%, specificity 84.1%) were found to predict in-hospital and 1-year mortality, respectively.CONCLUSIONS: The current study suggests that NT-proBNP and hs-TnI can be used as valuable cardiac biomarkers to predict short-term and long-term parameters in COVID-19 infection.Öğe Predictive value of Tp-e interval, Tp-e/QT, and Tp-e/QTc for disease severity in patients with liver cirrhosis(Verduci Publisher, 2023) Barutcu, S.; Inanc, I.; Sabanoglu, C.; Polat, E.OBJECTIVE: The cardiovascular system is one of the most affected systems in the liver cirrhosis (LC) process, especially due to the tendency to arrhythmia. Since the data about the relationship between LC and novel electrocardiography (ECG) indexes are lacking, we aimed to investigate the association between LC and Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio.PATIENTS AND METHODS: The study included 100 patients in the study group (56 male, median age 60) and 100 in the control group (52 female, 60 median age) between January 2021 and January 2022. ECG indexes and laboratory findings were analyzed. RESULTS: The patient group had significant-ly higher heart rate (HR), Tp-e, Tp-e/QT, and Tp-e/ QTc compared to the control group (p < 0.001 for all). There was no difference in terms of QT, QTc, QRS (depolarization of ventricles, involving Q, R, and S waves on ECG) duration, and ejection fraction between the two groups. Kruskal-Wal-lis test results revealed that there was a signifi-cant difference between Child stages in terms of HR, QT, QTc, Tp-e, Tp-e/QT, Tp-e/QTc, and QRS duration. There was also a significant difference between the model for end-stage liver disease (MELD) score groups in terms of all these param-eters except for Tp-e/QTc. In the ROC analyses of Tp-e, Tp-e/QT and Tp-e/QTc to predict the Child C, the AUC values were 0.887; (95% CI: 0.853-0.921), 0.730; (95% CI: 0.680-0.780), and 0.670; (95% CI: 0.614-0.726), respectively. Similarly, AUC values for the MELD score > 20 were 0.877; (95% CI: 0.854-0.900), 0.935; (95% CI: 0.918-0.952), and 0.861; (95% CI: 0.835-0.887); (p < 0.001 for all).CONCLUSIONS: Tp-e, Tp-e/QT, and Tp-e/QTc values were significantly higher in patients with LC. These indexes can be useful for arrhythmia risk stratification and to predict the end-stage of the disease.Öğe The impact of percutaneous left atrial appendage closure on left ventricular diastolic function and natriuretic peptide levels(Verduci Publisher, 2021) Sabanoglu, C.; Okutucu, S.; Cnanc, I. Halil; Yorgun, H.; Aytemir, K.; Oto, A.OBJECTIVE: Although the efficacy and safety of left atrial (LA) appendage (LAA) closure in patients with atrial fibrillation (AF) have been well documented in randomized controlled trials and real-world experience, there are limited data in the literature about the impact of LAA closure on diastolic functions. The study aimed to examine the impact of LAA closure on diastolic function and natriuretic peptide levels in patients with AF. PATIENTS AND METHODS: Twelve non-valvular AF patients with high risk for developing cardioembolic stroke and contraindications to warfarin underwent LAA occlusion with the WATCHMAN device (Atritech Inc., Plymouth, MN, USA). B-type natriuretic peptide levels and detailed diastolic parameters (mitral inflow velocities, deceleration time (DT), flow propagation velocity (Vp), isovolumetric relaxation time (IVRT), mitral annular e', TE-e', IVRT/TE-e', EJVp, E/e', pulmonary vein flow parameters consisting of S. D, and S/D) were evaluated at baseline and 45 days after LAA closure. RESULTS: The median age of the patients was 69 (54-78) years and 75% (n: 9) of them were male. All patients completed forty-five days of follow-up. Compared to the baseline values, E/Vp ratio and BNP levels (1.95 (0.94-3.32) vs. 2.37 (1.09-4.46), p= 0.015: 290.0 (90-1271) pg/mI vs. 322.00 (106-1635) pg/ml, p=0.018. respectively) increased, and pulmonary vein S wave and S/D ratio (0.67 (0.33-0.92) vs. 0.38 (0.23-0.91) m/sec, p=0.048: 1.62 (0.865.75) vs. 1.33 (0.11-3.35), p=0.019. respectively) decreased after LAA closure. CONCLUSIONS: In the present study, we demonstrated that patients with AF have shown impaired diastolic functions and elevated BNP levels after the percutaneous closure of the LAA.Öğe The relationship of masked hypertension with autonomic dysfunction and cardiometabolic parameters: a case-control study(Verduci Publisher, 2022) Inanc, I. H.; Sabanoglu, C.OBJECTIVE: Masked hypertension (MH) is associated with cardiovascular events and mortality. Data on the association between exaggerated blood pressure response (EBPR) to exercise, heart rate recovery (HRR), which are indicators of autonomic dysfunction, and MH are lacking. This study aimed at evaluating the association between EBPR, HRR, and MH. PATIENTS AND METHODS: Between January 2020 and January 2021, 130 MH (57 male, median age = 52.8 years) and 60 healthy (28 male, median age = 40.8 years) subjects were included in this single-center, case-control, and cross-sectional study. Office blood pressure measurement, 24-hour ambulatory blood pressure monitoring, treadmill test, echocardiography, and specific biochemical parameters were evaluated. RESULTS: The frequency of blunted HRR (73 subjects, 56.2%) and EBPR (40 subjects, 30.8%) were significantly higher in patients with MH (p < 0.001). Patients with MH had higher serum uric acid levels and frequency of hyperlipidemia (p < 0.05). Diameters of the left atrium (LA), aortic root, and ascending aorta were significantly higher in MH patients (p < 0.05). Thirty-two (24.6%) patients with MH had left ventricular hypertrophy and 33 (25.4%) had diastolic dysfunction (p < 0.001). Multivariate analysis identified the presence of blunted HRR as an independent predictor factor of MH as well as smoking, hyperlipidemia, GFR, LA diameter, and aortic root diameter were other independent factors. CONCLUSIONS: The frequency of blunted HRR and EBPR were significantly higher in the MH group compared to the control group, suggesting a close relationship between MH and autonomic dysfunction.
