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Awareness and Knowledge of Pneumococcal Vaccination in Cardiology Outpatient Clinics and the Impact of Physicians' Recommendations on Vaccination Rates
(Mdpi, 2023) Ekin, Tuba; Kis, Mehmet; Gungoren, Fatih; Akhan, Onur; Atici, Adem; Kunak, Aysegul Ulgen; Mutlu, Deniz
Aim: We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physicians' recommendations on vaccination rates. Methods: This was a multicenter, observational, prospective cohort study. Patients over the age of 18 from 40 hospitals in different regions of Turkey who applied to the cardiology outpatient clinic between September 2022 and August 2021 participated. The vaccination rates were calculated within three months of follow-up from the admitting of the patient to cardiology clinics. Results: The 403 (18.2%) patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n = 1808) was 61.9 +/- 12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor, and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The main differences between vaccinated and unvaccinated patients were related to education level and ejection fraction. The physicians' recommendations were positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant correlation between vaccination and female sex [OR = 1.55 (95% CI = 1.25-1.92), p < 0.001], higher education level [OR = 1.49 (95% CI = 1.15-1.92), p = 0.002] patients' knowledge [OR = 1.93 (95% CI = 1.56-2.40), p < 0.001], and their physician's recommendation [OR = 5.12 (95% CI = 1.92-13.68), p = 0.001]. Conclusion: To increase adult immunization rates, especially among those with or at risk of cardiovascular disease (CVD), it is essential to understand each of these factors. Even if during COVID-19 pandemic, there is an increased awareness about vaccination, the vaccine acceptance level is not enough, still. Further studies and interventions are needed to improve public vaccination rates.
Atrial electromechanical delay and p wave dispersion associated with severity of chronic obstructive pulmonary disease
(Makerere Univ, Fac Med, 2021) Çelik, Yunus; Yıldırım, Nesligül; Demir, Vahit; Alp, Çağlar; Şahin, Ömer; Doğru, Mehmet Tolga
Background: The aim of this study was to evaluate atrial electromechanical delay (AEMD) with both electrocardiography (ECG) and echocardiography in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Total of 110 patients were included in this cross-sectional case-control study. P-wave dispersion (PWD) was measured on a 12-lead ECG. Atrial electromechanical intervals (PA) were measured as the time interval between the onset of the P wave on the ECG and the beginning of the late diastolic A wave. Results: PWD was found to be 40.9 +/- 9.2 ms in the healthy control group, 45.6 +/- 8.2 ms in the mild COPD and 44.8 +/- 8.7 ms in the severe COPD group (p<0.05). Intra-right atrial EMD was found to be 10.7 +/- 5.8 ms in mild COPD, 11.0 +/- 7 ms in severe COPD, and it was 16.4 +/- 7.3 ms in healthy control group (p<0.001). Interatrial EMD was detected to be 29.5 +/- 9.1 ms in the control group, 24.1 +/- 9 ms in mild COPD group, and 23.9 +/- 11.1 ms in the severe COPD group (p<0.001). Conclusion: Both mild and severe COPD groups decreased PWD, increased tricuspid PA and significantly decreased inter and right intra-AEMD times in comparison to the control group.
Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality
(2020) Yılmaz, Mehmet Birhan; Aksakal, Emrah; Aksu, Uğur; Altay, Hakan; Yıldırım, Nesligül; Çelik, Ahmet; Akıl, Mehmet Ata
Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7–17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores ?1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 year
The Effects of Metformin, Ethinyl Estradiol/Cyproterone Acetate, and Metformin Ethinyl Estradiol/Cyproterone Acetate Combination Therapy on Carotid Artery Intima-media Thickness in Patients with Polycystic Ovary Syndrome
(2020) Ünal, Derya; Demirci, Hüseyin; Yılmaz, Murat; Kısa, Üçler; Tulmaç, Murat; Güliter, Sefa
Introduction: Patients with polycystic ovary syndrome (PCOS) are in the risk group for early-onset cardiovascular disease. There are few studies evaluating physiological and inflammatory cardiovascular risk factors in PCOS. Our study aimed to measure carotid intima-media thickness (IMT) in PCOS cases and to assess the effects of metformin, ethinyl estradiol/cyproterone acetate (EE/CA) and metformin + EE/ CA combination therapy on carotid IMT, insulin resistance, C-reactive protein (CRP), apelin and adiponectin. Methods: Basal carotid IMT, insulin resistance [Homeostasis model assessment insulin resistance (HOMA-IR)], apelin, adiponectin, and CRP values were evaluated in 60 women with PCOS and 43 healthy volunteers between the ages of 18 and 45. After baseline evaluation, patients were divided into metformin (n=20), EE/CA (n=20) and metformin + EE/CA (n=20) treatment groups. Treatment regimens were administered for six months. At the end of the treatment, the same parameters were reevaluated. Results: Compared with the control group, CRP (p=0.003), HOMA-IR (p=0.004) and IMT (p=0.049) were significantly higher, and adiponectin (p=0.002) and apelin (p=0.031) levels were significantly lower in patients with PCOS. At the end of the six-month treatment, the adiponectin level in the metformin (p=0.012) and metformin + EE/CA groups (p=0.012), and the apelin level in the metformin (p=0.024), EE/CA (p=0.024) and metformin + EE/CA groups (p=0.024) were significantly higher. There was no statistically significant change in CRP level in all treatment groups (p>0.05). There was no statistically significant change in carotid IMT value in all treatment groups (p>0.05). Conclusion: According to these results, we can say that women with PCOS have subclinical atherosclerosis and that metformin treatment has a positive effect on subclinical atherosclerosis.
Monocyte count to high-density lipoprotein ratio predicts occlusion of the infarct-related artery in STEMI
(2017) Zehir, Regayip; Sarak, Taner; Barutçu, Süleyman; Şimşek, Vedat; Karadeniz, Muhammed; Kandemir, Hüseyin
Amaç: ST segment yükselmeli miyokard enfarktüsü (STEMI) olan hastalarda, primer perkütan koroner girişim (pPKI) öncesi enfarktüs ilişkili arter acıklığı daha iyi klinik sonuçlar ile ilişkilidir. Bununla birlikte, STEMI ortamında pPKI öncesinde IRA açıklığının öngördürücüleri ile ilgili sınırlı veri vardır. STEMI'de monosit sayısı /yüksek yoğunluklu lipoprotein oranı (MHR) ile enfarktla ilişkili arterin acıklığı arasındaki ilişkiyi değerlendirmek istedik.Gereç ve Yöntemler: Toplam 726 hasta çalışmaya alındı. IRA açıklığı, miyokard enfarktüsünde tromboliz (TIMI) akım sınıflaması ile belirlendi. PKI öncesi IRA'da TIMI akım derecesine göre çalışma popülasyonu, TIMI 0,1 veya 2 grup (tıkalı IRA, n=624) ve TIMI 3 grubu (patent IRA, n=102) olmak üzere iki gruba ayrıldı. MHR hesaplamak için basvuruda kan örnekleri toplandı. Tüm hastaların 92'sinde (%20,4) IRA'da pre-pPKI TIMI 3 akımı vardı.Bulgular: MHR, tıkanan IRA grubunda anlamlı derecede yüksekti (22,4 ± 5,4'e karşılık 17,8 ± 6,9, P < ,001). Tıkalı IRA grubunda, glikoz, troponin İ ve trombosit/lenfosit oranı (PLR) düzeyleri de yüksekti (P < 0.05). Çok değişkenli regresyon analizinde, başvuru sırasındaki MHR değeri (odds oranı [1,391]; %95 güven aralığı [CI]: 1,116-1,272, P < 0,001) ve prasugrel veya tikagrelorun hastane öncesi kullanımı (OR: 7,045; CI:1,687-29,414, P = 0,007) IRA açıklığının bağımsız öngördürücüleri olarak bulundu.Sonuçlar: IRA açıklığı, pPKI öncesi hızlı etkili antitrombosit tedavi alan hastalarda daha sık görülmektedir ve daha düşük bir MHR değeri IRA açıklığını bağımsız bir şekilde tahmin eder.
Akut Koroner Sendromda Serum Fibrinojen Düzeyi İle Stent Restenozu Arasındaki İlişki
(2020) Karadeniz, Muhammed; Sarak, Taner
Amaç: İn-stent restenoz, koroner arterlere stent implantasyonu sonrası stentli bölgenin aşamalı olarak yeniden daralmasıdır. İlaç salınımlı stentlerin kullanılmaya başlanmasıyla restenoz oranları azalmış olsa da hala majör problem olmaya devam etmektedir. Bu çalışmada akut koroner sendrom nedeniyle koroner anjiyografi yapılan hastalarda in-stent restenozu ile fibrinojen düzeyi arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: İki grup arasında yaş, hipertansiyon, diyabetes mellitus, sigara içimi ve sol ventrikül ejeksiyon fraksiyonu açısından fark yoktu (p>0.005, hepsi için). İSR grubunda erkek cinsiyet ve hiperlipidemi oranı İSR olmayan gruba göre daha yüksekti (sırasıyla, p=0.04; 0.007). Biyokimyasal parametrelerden homosistein ve fibrinojen dışında iki grup arasında fark izlenmedi. Serum homosistein ve fibrinojen seviyesi İSR olan grupta İSR olmayan gruba göre istatistiksel olarak anlamlı derecede yüksek saptandı (sırasıyla, p=0.009; 0.032). Dislipidemi, homosistein ve fibrinojen İSR'nin bağımsız prediktörleri olarak saptandı. Bulgular: Tedavi sonrası WOMAC ağrı, WOMAC tutukluk, WOMAC fonksiyonel durum ve WOMAC toplam skorlarında tedavi öncesi değerlere göre her iki grupta da istatistiksel olarak anlamlı gelişme saptandı (p<0.001). Ancak tedavi sonuçları arasında gruplar arası istatistiki olarak anlamlı fark saptanmadı. Sonuç: Koroner arter hastalığı nedeniyle çıplak metal stent implante edilmiş hastalarda plazma fibrinojen düzeyi İSR riskini öngörmede yardımcı olabilecek önemli bir biyokimyasal parametre olabilir.
Akut Koroner Sendromlu Hastalarda Çok Damar Hastalığı İle Kardiyovasküler Risk Faktörleri Arasındaki İlişki
(2019) Alp, Çağlar; Karadeniz, Muhammed; Sarak, Taner; Demir, Vahit
Amaç: Akut koroner sendrom olgularında ciddi darlık olan koroner arter sayısı ile kardiyovasküler risk faktörleri arasındaki ilişki değerlendirildi. Yöntemler: Bu çalışma retrospektif olarak dizayn edildi. 2016–2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiografi yapılan 904 hasta çalışmaya dahil edildi. Ciddi koroner arter darlığı olmayan ve koroner operasyon geçiren hastalar çalışma dışı bırakıldı. Hastalar kritik koroner arter darlıklarına göre tek damar hastalığı (TDH) ve çok damar hastalığı (ÇDH) olacak şekilde iki gruba ayrıldı. ÇDH ile TDH olanlar klasik kardiyovasküler risk faktörleri açısından karşılaştırıldı. Bulgular: Hastaların 544’ünde (%60) ÇDH 365’inde (%40) TDH saptandı. ÇDH olan grupta yaş, hipertansiyon ve diyabet mellitus istatistiksel olarak daha fazla saptandı (sırasıyla p<0.001, p=0.003, p=0.005). TDH olan grupta ise erkek cinsiyet, aile öyküsü ve sigara içiciliği istatistiksel olarak daha fazla saptandı (sırasıyla p=0.006, p<0.001, p<0.001). Sonuç: Diyabet ve hipertansiyon ÇDH grubunda yüksek saptanırken aile öyküsü ve sigara içiciliği TDH grubunda yüksek saptandı. Akut koroner sendrom hastalarında bu risk faktörlerin göz önünde bulundurulması önemlidir.
Endothelial and Autonomic Functions in Patients with Migraine
(OXFORD UNIV PRESS, 2020) Dogru, Mehmet Tolga; Dilekoz, Ergin; Alpua, Murat; Eroglu, Oguz; Kandemir, Hilseyin; Alp, Caglar; Bolay, Hayrunnisa
Objective It has been shown that patients with migraine have endothelial dysfunction. Migraine patients with aura, especially, have more clinical manifestations of autonomic nervous system dysfunction. We aimed to evaluate the endothelial and autonomic functions in migraine patients during both migraine headache attack and headache-free periods. Design This was a cross-sectional, randomized study. Subjects and Methods A total of 130 participants (67 male and 63 female patients, minimum age = 19 years, maximum age = 71 years, mean age = 38.812.2years) were enrolled into the study. For the statistical evaluation of data, we classified the participants of the study as follows: group 1: headache (+) aura (+); group 2: headache (+) aura (-); group 3: headache (-) aura (+); group 4: headache (-) aura (-). Noninvasive evaluation of endothelial function was performed by flow-mediated dilation (FMD) and pulse wave analysis methods. Heart rate variability measurements were used for noninvasive evaluation of autonomic functions. Results Group 1 had a higher FMD ratio than the control group, group 3, or group 4 (P<0.001, P<0.001, and P=0.003, respectively). Group 4 had lower FMD ratio levels than the other migraine groups and or the control group (P<0.001). Group 3 had the highest high-frequency (HF) power levels among all migraine groups (P<0.001). Group 2 had higher low-frequency/HF ratio values than other migraineurs (P<0.001). Conclusions We concluded that endothelial dysfunction and headache are closely related. Additionally, higher parasympathetic tonus might be associated with the presence of aura.
Investigation of heart rate variability and heart rate turbulence in chronic hypotensive hemodialysis patients
(SPRINGER, 2020) Yalim, Zafer; Demir, Mehmet Emin; Yalim, Sumeyra Alan; Alp, Caglar
Background Sudden cardiac death is the leading cause of cardiac-related death in hemodialysis patients. Hypotensive episodes in pre-, intra-, and post-dialytic periods can present serious clinical challenges that affect a patient's quality of life and prognosis. The aim of the present study was to evaluate cardiac autonomic control and arrhythmogenic risk by analyzing 24-h heart rate variability (HRV) and heart rate turbulence (HRT) in hypotensive hemodialysis patients. Methods A total of 79 patients on maintenance hemodialysis treatment, 39 normotensive and 40 with frequent hypotension episodes during non-dialysis periods, were included in the study. Dialysis-free periods were recorded with a 24-h Holter rhythm and ambulatory blood pressure monitor device. The time-domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope (TS), were calculated. Results Values for SDNN (105.5 +/- 7.02, 127.6 +/- 6.2 p < 0.001), SDANN (95.1 +/- 5.9, 111.8 +/- 5.01 p < 0.001), and SDNN index (50.04 +/- 2.7, 55.6 +/- 3.7 p = 0.03), in the hypotensive group were significantly lower than in the normotensive group, respectively. Values for RMSSD (26.5 +/- 2.5, 27.3 +/- 2.7 p = 0.178), pNN50 (17 +/- 1.7, 55.6 +/- 3.7 p = 0.03), and TI (35.1 +/- 3.1, 34.7 +/- 2.6 p = 0.542) in both groups were not significantly different; however, there was a significant difference between HRT parameters, TO (- 1.8 +/- 0.37, - 2.4 +/- 0.39 p < 0.001) and TS (6.9 +/- 0.71, 8.2 +/- 0.97 p < 0.001), respectively, hypotensive and normotensive group. Conclusion Dialysis patients that experience frequent hypotensive episodes may also undergo significant changes in HRT and HRV which may be indicative of serious cardiac sequela. Thus, in such cases, a complete cardiologic evaluation is warranted.
Author's Reply to the Letter to the Editor "Hyperhomocysteinemia Predicts the Severity of Coronary Artery Disease as Determined by the SYNTAX Score in Patients with Acute Coronary Syndrome"
(TAIWAN SOC CARDIOLOGY, 2020) Karadeniz, Muhammed; Celik, Ibrahim Etem
[Özet Yok]
Effects of mesenchymal stem cell and amnion membrane transfer on prevention of pericardial adhesions
(WALTER DE GRUYTER GMBH, 2020) Kabalci, Mehmet; Sahin, Mustafa; Pekcan, Zeynep; Zengin, Mehmet; Dogru, Mehmet Tolga; Kisa, Ucler
Background: To investigate and compare the antiadhesive/antifibrotic effects of mesenchymal stem cells (MSC) and amnion membrane transfer (AMT) in a rat model. Material and methods: Three experimental and sham groups were formed using 30 Wistar-Albino rats. AMT and MSC were applied to the related groups. The control group was not treated. After 12 weeks follow-up, intracardiac blood and cardiac-pericardiac tissue samples were taken. The severity of adhesions and fibrosis were scored macroscopically and microscopically with Hematoxylin/ Eosin and Masson's trichrome staining. TNF-alpha, TGF-beta, IL-1, PDGF, FGF, VEGF and Caspase-3 levels were measured with the ELISA method. Results: Severe adhesions were observed in the AMT and control groups, but no adhesion was present in the MSC group. Pericardial thickness, increased vascularity, fibrosis, and collagen accumulation were similar between control and AMT groups, but were less in Sham and MSC groups. Between MSC and AMT groups, only Caspase-3 level was different, which is an apoptosis marker. Conclusion: The positive effects of MSC on adhesion, which we achieved in our study, suggest that it may prevent adhesion. AMT did not provide a positive effect. The correlation of Caspase-3 with postoperative adhesion/fibrosis should be examined in more detail.
Evaluation of the relationship between erectile dysfunction and epicardial fat tissue thickness and carotid intima-media thickness in patients with newly diagnosed hypertension
(TURKISH SOC CARDIOLOGY, 2020) Karakurt, Davut; Ede, Huseyin; Turan, Yasar; Gurel, Abdullah; Ardahanli, Isa; Sarak, Taner
Objective: This study is an investigation of the relationship between erectile dysfunction and epicardial adipose tissue and carotid intima-media thickness, which are indicators of endothelial dysfunction and subclinical atherosclerosis, in patients with newly diagnosed hypertension. Methods: The epicardial adipose tissue and carotid intima-media thickness of 101 male patients with newly diagnosed hypertension were measured using echocardiography between May 1, 2018 and May 31, 2019. Evaluation of erectile dysfunction was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) in a face-toface interview in the urology outpatient clinic. The data of patients with and without erectile dysfunction were compared. Results: There was a significant relationship between the presence and severity of erectile dysfunction and epicardial fat tissue and carotid intima-media thickness in patients with newly diagnosed hypertension. Left ventricular diastolic function was found to be more impaired in patients with erectile dysfunction. Conclusion: Erectile dysfunction was determined to be related to increased epicardial fat tissue and carotid intima-media thicknesses in patients with newly-diagnosed hypertension.
Is ionizing radiation a risk factor for anxiety in employees?
(ASSOC MEDICA BRASILEIRA, 2020) Mansiroglu, Asli Kurtar; Erer, Murat; Cosgun, Mehmet; Sincer, Isa; Gunes, Yilmaz
OBJECTIVE: Workers describe many physical and mental symptoms when working in radiation areas. This study aimed to assess these symptoms in radiation workers using the Beck Anxiety Inventory (BAI). METHODS: A total of 42 radiation workers (22 males and 20 females, mean age 34 +/- 7 years) and 47 control subjects (22 males and 27 females, mean age 31 +/- 8 years) who work in non-radiation areas in the hospital were included in the study. All participants anonymously filled out the Beck Anxiety Inventory (BAI) questionnaire. RESULTS: The demographic data of workers were not significantly different between groups. In the BAI, the dizzy or lightheaded (p =0.01), terrified (p= 0.01), unsteady (p=0.02), heart-pounding and racing (p=0.02) items were significantly higher in the radiation-exposed group compared to the control group. vertical bar The BAI score was also significantly higher in the radiation-exposed group (11.1 +/- 6.8 vs. 8.7 +/- 3.8, p =0.04) CONCLUSION: These results suggest the possibility that radiation may play a role in the psychometric properties of workers. The effects of radiation on the health of employees need to be further investigated and understood.
Influence of circadian blood pressure alterations on serum SCUBE-1 and soluble CD40 ligand levels in patients with essential hypertension
(E-Century Publishing Corp, 2019) Guzel, Murat; Dogru, Mehmet Tolga; Simsek, Vedat; Demir, Vahit; Alp, Caglar; Kandemir, Huseyin; Kisa, Ucler
Background: Dipper and non-dipper hypertension are different clinical forms of essential hypertension. In this study, the effect of circadian blood pressure changes on serum SCUBE-1 and soluble CD40 ligand (sCD40L) levels was investigated in patients with hypertension. Methods: A total of 100 participants aged 23-89 years were included in the study. Patients with essential hypertension were followed up by ambulatory blood pressure measurement. Results: Serum SCUBE1 levels were significantly higher in the non-dipper group than in the normal group (P < 0.001). Dipper and non-dipper patients had significantly higher serum sCD40L levels when compared to the normal group (P = 0.048 and P = 0.035, respectively). We also found a positive correlation between SCUBE1, sCD40L levels and 24-hour mean systolic blood pressure levels (r: 0.232, p: 0.034 and r: 0.241, p: 0.027, respectively). Conclusion: Serum SCUBE1 and sCD40L levels were higher in hypertensive patients than normal participants. Serum SCUBE1 levels were higher in patients with non-dipper compared to other participants.
The relationship between serum NT-proBNP levels and severity of coronary artery disease assessed by SYNTAX score in patients with acute myocardial infarction
(Tubitak Scientific & Technical Research Council Turkey, 2019) Sarak, Taner; Karadeniz, Muhammed
Background/aim: In the present study, we aimed to investigate the relationship between NT-proBNP and SYNTAX score, which is a measure of the complexity of coronary artery disease. Materials and methods: We enrolled 405 consecutive patients with myocardial infarction who underwent coronary angiographic examination. Patients were divided into 3 groups according to their SYNTAX scores. Those with SYNTAX score <= 22 were included in the low SYNTAX score group (LSTX), those with a score of 23-32 were included in the intermediate SYNTAX score group (ISTX), and those with a score of >= 33 were included in the high SYNTAX score group (HSTX). Results: NT-proBNP levels were found to be significantly higher in the HSTX group compared to the other groups (P < 0.001) and in the ISTX group compared to the LSTX group (P < 0.001). The NT-proBNP levels demonstrated an increase from low SYNTAX score to high SYNTAX score tertiles. Conclusions: NT-ProBNP levels in patients with myocardial infarction on admission were independently associated with extent, severity, and complexity of coronary atherosclerosis as assessed by SYNTAX score.
Serum pentraxin-3 levels and flow-mediated dilation in dipper and non-dipper hypertension
(Wiley, 2019) Alp, Caglar; Dogru, Mehmet Tolga; Karadeniz, Muhammed; Sarak, Taner; Demir, Vahit; Celik, Yunus; Kisa, Ucler
Background Endothelial dysfunction is one of the main pathological processes of hypertension. The association of serum pentraxin-3 (PTX3) levels and endothelial dysfunction becomes a more interesting scientific research issue due to high potential of PTX3 as a diagnostic and prognostic biomarker. We aimed to investigate the relationship between serum PTX3 levels and flow-mediated dilation results in patients with dipper and non-dipper hypertension. Methods This study included 90 hypertensive patients were divided into two groups based on 24 hours ambulatory blood pressure monitoring (ABPM): 38 patients with a dipper pattern and 52 patients with non-dipper pattern. Noninvasive evaluation of the endothelial functions was performed using flow-mediated dilation (FMD) method. Results Serum pentraxin-3 levels were higher in patients with non-dipper HT compared to dipper hypertension (P = 0.028). In addition, we found negative correlation between serum PTX3 and FMD basal/FMD hyperemia ratio (r = -0.297, P = 0.05 for FMD basal/FMD hyperemia ratio, respectively). Conclusions Serum PTX3 levels are closely related with the measures of indirect noninvasive evaluation methods (FMD) in both DH and NDH patients.
The Effects of Nocturnal Blood Pressure Patterns and Autonomic Alterations on Erectile Functions in Patients with Hypertension
(Urol & Nephrol Res Ctr-Unrc, 2019) Yuvanc, Ercan; Dogru, Mehmet Tolga; Simsek, Vedat; Kandemir, Huseyin; Tuglu, Devrim
Purpose: Hypertension (HT) is known to be of the main risk factors for erectile dysfunction (ED). But non-dipping (<%10 drop in the night) of HT is not investigated truly. The aim of this study was to test the hypothesis that the non-dipper hypertensive patients are more prone to develop erectile dysfunction. Materials and Methods: This was a cross-sectional clinical study. 70 HT patients diagnosed by Ambulatory blood pressure monitoring (ABPM) were classified into 3 groups (No ED, mild to moderate and severe) according to their International Index of Erectile Function (IIEF) scores. All three groups were compared for their dipping status by ABPM, heart rate variability (HRV) by holter monitoring. Results: In our study non-dipper hypertensives had statistically more erectile dysfunction (P = 0.004). Also severe ED patients with non-dipping pattern had decreased dipping blood pressure levels then those of ED(-) patients with non-dipping HT (P = .003) Conclusion: Autonomic dysfunction especially sympathetic overactivity is associated with both non dipping pattern of HT and erectile dysfunction as a common pathologic pathway, besides there might be an association between ED and non dipping HT.
Anterior myocardial infarction in a patient with isolated left ventricular non-compaction
(Cambridge Univ Press, 2019) Celik, Ibrahim Etem; Kilic, Alparslan; Karadeniz, Muhammed
We presented a 55-year-old male patient with isolated left ventricular non-compaction who was admitted to our emergency department for chest pain and exertional dyspnoea. He was hospitalised due to anterior myocardial infarction, and during his assessment, isolated left ventricular non-compaction was diagnosed.
The comparison of the relationships about the presence of branch retinal vein occlusion and endothelial functions between diabetic and non-diabetic patients
(Lippincott Williams & Wilkins, 2019) Demir, Vahit; Dogru, Mehmet Tolga; Onaran, Zafer; Kandemir, Huseyin; Alp, Caglar
Objectives The aim of this study was to investigate the endothelial functions in both patients with diabetics and non-diabetics with branch retinal vein occlusion by using pulse wave analysis and flow-mediated dilatation methods. Patients and methods This cross-sectional study included a total of 136 participants (47 diabetic patients with branch retinal vein occlusion, 43 non-diabetic patients with branch retinal vein occlusion, and 46 otherwise healthy subjects). Evaluation of endothelial functions was performed by flow-mediated dilatation and pulse wave analysis methods. Stiffness index, reflection index (RI), and pulse propagation time were calculated. Results The mean stiffness index and RI were significantly higher in the diabetic branch retinal vein occlusion group compared with the non-diabetic branch retinal vein occlusion and the healthy controls (for stiffness index: 11.5 +/- 2.8 vs. 10.1 +/- 2.5 and 8.3 +/- 2.0, P < 0.001; and for RI: 75.1 +/- 11.7 vs. 65.4 +/- 8.4 and 60.2 +/- 18.8, P < 0.001, respectively), whereas the pulse propagation time was significantly lower in the diabetic group (156.4 +/- 32.3 vs. 174.4 +/- 46.5 and 205.0 +/- 58.5, P < 0.001, respectively). There was a significant negative correlation between visual acuity and stiffness index (r = -0.512, P < 0.001). Besides, there was also a significant positive correlation between visual acuity and pulse propagation time (r = 0.398, P < 0.001). Conclusion This study demonstrated that the stiffness index and RI values were higher in patients with branch retinal vein occlusion compared to the healthy subjects. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.
The effects of treatment with atorvastatin versus rosuvastatin on endothelial dysfunction in patients with hyperlipidaemia
(Clinics Cardive Publ Pty Ltd, 2018) Demir, Vahit; Dogru, Mehmet Tolga; Ede, Huseyin; Yilmaz, Samet; Alp, Caglar; Celik, Yunus; Yidirim, Nesligul
Introduction: Statins can reduce cardiovascular events and improve endothelial function, However. differences in the effect of statins on endothelial dysfunction have not been researched sufficiently. Here. we aimed to compare the effects of atorvastatin Versus rosuvastatin on endothelial function via flow-mediated ',aid endothelial-independent dilation. Methods: Hyperlipidaemic subjects on treatment with statins for one year (either 20 mg/day atorvastatin or 10 mg/day rosuvastatin) were enrolled in the study. In accordance with the literature, flow-mediated dilation (FMD) and nitrate-mediated endothelium-independent dilation (EID) were measured by ultrasonography on the right brachial artery of each subject. Baseline and final measurements were compa red to each group and between the groups. Results: One hundred and four subjects (50 atorvastatin and 54 rosuvastatin users) were enrolled in the study. Fifty-eight subjects were female. The groups were statistically similar in terms of age and body mass index, and haemoglobin, creatinine, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein cholesterol levels. In each group, the mean final FMD and LID values were higher compared to their respective baseline values. but the mean changes in FMD and EID were statistically similar in both groups (p = 0.958 for FMD and 0.827 for EID). There was no statistically significant difference between the atorvastatin and rosuvastatin groups in terms of final FMD and EID values (p = 0.122 and 0.115. respectively). Conclusion: This study demonstrated that both one-year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and FAD and measured by ultrasonography. However, the amount of improvement in endothelial dysfunction was similar in the two treatments.

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