Browsing by Author "Akdag, S."

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Brucella Endocarditis Caused by Brucella Melitensis
(2013) Akdag, S.; Akyol, A.; Simsek, H.; Şahin, M.; Yaman, M.
We present a rare case of brucella endocarditis, forming a vegetation on the mitral valve. The definitive diagnosis has been made with clinical suspicion, positive serology, the demonstration of the vegetation with the echocardiography and with the production from the multiple blood culture of brucella melitensis and from the excised valve. Our patient has been successfully treated with specific antibiotherapy and the surgery of replacement of mitral valve. Our aim in presenting the case is to remind the infective endocarditis which is due to this factor in the regions like our country which is endemic for brucellosis.
Comparison of Two Patients With Mitral Stenosis and Importance of Sinus Rhythm: Case Report
(2011) Sahin, M.; Simsek, H.; Gumrukcuoglu, H.A.; Akdag, S.; Ekici, B.
We present two woman patients have rheumatic mitral stenosis (MS). They complained of about shortness of breath and palpitation. First patient, she had had two stroke without any sequela (respectively 7 years and 4 years ago). And she has atrial fibrillation (AF) in electrocardiography (ECG). Another woman patient didn't have any complaint before. Latter patient has sinus tachycardia in ECG. Transthoracic echocardiography (TTE) disclosed severe mitral valve stenosis and left atrial dilatation in both patients. But first patient has multiple thrombus in left atrium. Mitral valve surgery was suggested for both patients. In conclusion maintenance of sinus rhythm, in the patients who had MS, is very important for both the protection of left atrial thrombus and the reduction of the development of systemic embolus related to it.
The Correlation Between Red Blood Cell Distribution Width Levels With the Severity of Obstructive Sleep Apnea and Carotid Intima Media Thickness
(International Scientific Literature Inc., 2014) Gunbatar, H.; Sertogullarindan, B.; Ekin, S.; Akdag, S.; Arisoy, A.; Sayhan, H.
Background: Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive collapse of the upper airway during sleep. Red blood cell distribution width (RDW) increases platelet activation and has been reported as an independent predictor of adverse outcomes in the general population and is believed to be associated with cardiovascular morbidity and mortality. We evaluated RDW, mean platelet volume (MPV), and platelet distribution width (PDW) as a severity index in OSAS and the relationship between carotid intima media thickness and pulmonary hypertension.; Material/Methods: The study population consisted of 99 patients who were admitted to the sleep laboratory. Based on the apneahypopnea index, patients were grouped into 3 OSAS severity categories. Morning blood samples were withdrawn from patients after a 12-hour fasting period. MPV, PDW, and RDW were measured in a blood sample. Bilateral common carotid arteries of the patients were scanned.; Results: Ninety-nine patients – 73 with OSAS and 26 simple snoring control cases – were included. Mean values of MPV, PDW, and RDW were similar in patients compared to simple snoring subjects in the control group (p=0.162, p=0.656, p=0.091). RDW showed an inverse correlation with mean desaturation and lowest desaturation (p<0.01). Body mass index, apnea-hypopnea index, pulmonary artery pressure, and desaturation time under 90% were positively correlated with RDW (p<0.05). MPV, PDW, and carotid intima media thickness had no correlation with any other parameters.; Conclusions: The study showed a positive relationship between RDW and the apnea-hypopnea index and systolic pulmonary hypertension in patients with OSAS. © Med Sci Monit, 2014.
The Effect of Low Sodium Dialysate on Ambulatory Blood Pressure Measurement Parameters in Patients Undergoing Hemodialysis
(Oxford Univ Press, 2015) Akdag, S.; Akyol, A.; Cakmak, H. A.; Tosu, A. R.; Asker, M.; Yaman, M.; Gumrukcuoglu, H. A.
Effects of Illness Activity on Electrocardiographic Parameters in Patients With Multiple Sclerosis
(Elsevier Ireland Ltd, 2011) Gumrukcuoglu, H. A.; Tuncer, M.; Simsek, H.; Sahin, M.; Akdag, S.; Gunes, Y.; Tombul, T.
Effects of Lowered Dialysate Sodium on Left Ventricle Function and Brain Natriuretic Peptide in Maintenance of Hemodialysis Patients
(Sage Publications Ltd, 2017) Akyol, A.; Akdag, S.; Asker, M.; Gumrukcuoglu, H. A.; Duz, R.; Demirel, K. C.; Begenik, H.
Introduction: Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients. Materials and Methods: The study included 49 chronic hemodialysis patients. Left atrium (LA) diameter and LV ejection fraction, LV systolic and diastolic diameter, deceleration time (DT), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), early diastolic transmitral flow (E) and late diastolic transmitral flow (A) velocities, E/A ratio, isovolumic relaxation time, peak early diastolic velocity (E), late diastolic velocity (A) of tissue Doppler mitral annulus, and flow propagation velocity of mitral inflow (V-p) were measured before and 6 months after hemodialysis with low Na dialysate. Results: Six months after low Na hemodialysis, a decrease was observed in echocardiographic parameters such as PAP and IVCD (p < 0.05, p < 0.001, and p < 0.001, respectively). However, a significant difference was not observed in LA diameter. In LV diastolic measurement of E and A waves, E/A ratio, DT, V-p, septal E and A, and lateral E and A exhibited significant improvement by low Na HD. BNP level was significantly reduced (p < 0.001). Conclusions: Lowered dialysate Na concentration improves PAP, IVCD, and LV diastolic properties assessed by mitral inflow filling, tissue Doppler velocity, and mitral inflow velocity propagation.
Maintenance of Sinus Rhythm and Treatment of Atrial Fibrillation in Mitral Stenosis
(2011) Sahin, M.; Simsek, H.; Ekici, B.; Akdag, S.; Tuncer, M.
Rheumatic fever is the most common cause of mitral stenosis. The most common complication of mitral stenosis is atrial fibrillation (AF). AF precipitates symptoms, greatly increases the risk of systemic embolisation, and reduces cardiac output and exercise capacity. Systemic embolization most often occurs in patients with both AF and mitral stenosis. Maintenance of the sinus rhythm in patients with mitral stenosis is very important because of reduce the risk of cerebral embolism, conservation of cardiac output and exercise capacity, and reduction of symptoms.
Maternal, Fetal Outcome, and Anticoagulant Management in Pregnant Women With Prosthetic Heart Valves
(Imr Press, 2018) Akyol, A.; Yuman, M.; Sabin, M.; Simsek, H.; Akdag, S.; Gumrukcuoglu, H. A.; Tuncer, M.
Introduction: Cardiac disease in maternity is a great problem particularly in developing countries. Pregnant patients with prosthetic heart valves (PHV) may suffer therapeutic difficulty, as the need for anticoagulation is fraught with risk of hemorrhagic or thromboembolic complications and structural valve deterioration. The present study aimed to evaluate the maternal, fetal outcome, and anticoagulant management in pregnant women with PHV. Materials and Methods: This study is prospective observational research. The medical archives of pregnant patients with PHV from September 2010 to January 2015 were scanned. Data collected from Yuzuncu Yil University Hospital Cardiology clinics archives included demographic characteristics, anticoagulant, presence or absence of obstructive or non-obstructive thrombus, and maternal-fetal outcome. Results: The authors evaluated the outcomes of 56 pregnant patients with PHV. The age at the time of pregnancy ranged between 19 and 37 (mean 28.7 +/- 8.4) years. Most common preferred anticoagulation therapy was heparin during the first trimester, followed by oral anticoagulation up to the 36th week, with subsequent replacement by heparin until delivery. Most common encountered complication was preterm birth. Death occurred in one patient due to obstructive valve thrombosis. Conclusion: Ideal PHV is not accessible for women during childbearing age. The risk of adverse event during pregnancy depends on valve position, symptoms, valve type, cardiac function, and functional capacity in patients with PHV. The active collaboration among an obstetrician, a cardiologist, and a cardiothoracic surgeon is required for optimal outcome patient with PHV.
Movable Thrombus Attached on Mitral Anterior Leaflet
(Elsevier Ireland Ltd, 2011) Gumrukcuoglu, H. A.; Odabasi, D.; Ekim, H.; Akdag, S.; Ozdemir, M.
A New Echocardiographic Parameter of Arterial Stiffness in End-Stage Renal Disease
(Urban & Vogel, 2014) Sahin, M.; Simsek, H.; Akyol, A.; Akdag, S.; Yaman, M.; Aydin, C.; Gumrukcuoglu, H. A.
Background. Cardiovascular disease is the leading cause of death among patients with end-stage renal disease (ESRD). Arterial stiffness is an independent predictive parameter of overall and cardiovascular mortality in these patients. However, the defined procedures for the measurement of arterial stiffness are time consuming and not practical in daily practice. Methods. The study population included 50 patients with ESRD who were treated with hemodialysis (HD; n=23) or peritoneal dialysis (PD; n=27) and 70 age-and sex-matched control subjects. Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and color M-mode propagation velocity of the descending aorta (aortic propagation velocity, APV) were measured. Results. Compared to the control group, the patients with ESRD had significantly lower APV (46.4 +/- 12.4 vs. 58.5 +/- 8.5, p<0.01) and higher PWV (10.5 +/- 2.5 vs. 9.2 +/- 1.2, p<0.01) and CIMT (0.66 +/- 0.15 vs. 0.43 +/- 0.06, p<0.01) measurements. There were significant correlations between APV and CIMT (r=-0.769, p<0.001), APV and PWV (r=-0.682, p<0.001), and PWV and CIMT (r=0.564, p<0.001). There were no significant differences in APV and PWV between the PD and HD patients. Conclusion. Arterial stiffness is an important indicator of atherosclerosis and arterial aging in patients with ESRD. The measurement of APV is an easy and practical new echocardiographic method and may be used to identify arterial stiffness in these patients.
A Novel Echocardiographic Method as an Indicator of Endothelial Dysfunction in Patients With Coronary Slow Flow
(verduci Publisher, 2013) Simsek, H.; Sahin, M.; Gunes, Y.; Akdag, S.; Akil, M. A.; Akyol, A.; Yaman, M.
BACKGROUND: To improve clinical outcomes, noninvasive imaging modalities have been proposed to measure and monitor atherosclerosis. Endothelial dysfunction is considered the first stage in the development of atherosclerosis. Brachial artery flow-mediated dilatation (FMD) has been impaired in patients with coronary slow flow (CSF). Recently, color M-mode derived propagation velocity of descending thoracic aorta (aortic propagation velocity-AVP) was shown to be an ultrasonographic marker for atherosclerosis. AIM: To assess endothelial function in patients with CSF and the correlation of AVP with FMD. MATERIALS AND METHODS: FMD and AVP were measured in 90 patients with CSF and 39 patients having normal coronary arteries (NCA) detected by coronary angiography. RESULTS: Compared to patients with normal coronary arteries patients having CSF had significantly lower AVP (39.1 +/- 8.4 vs. 53.7 +/- 12.7 cm/s, p < 0.001) and FMD (5.6 +/- 3.2 vs. 17.6 +/- 4.4 %, p < 0.001) measurements. There were significant correlations between AVP and FMD (r = 0.524, p < 0.001). CONCLUSIONS: Transthoracic echocardio-graphic determination of color M-mode propagation velocity of descending aorta is a simple practical method and correlates well with coronary slow flow and brachial endothelial function.
A Novel Echocardiographic Method for Assessing Arterial Stiffness in Obstructive Sleep Apnea Syndrome
(Oxford Univ Press, 2015) Akdag, S.; Akyol, A.; Cakmak, H. A.; Gunbatar, H.; Asker, M.; Babat, N.; Gumrukcuoglu, H. A.
Papillary Muscle Rupture Due To Myocardial Infarction in a Patient Presenting With Clinical Features of Acute Pulmonary Oedema
(Elsevier Ireland Ltd, 2011) Simsek, H.; Sahin, M.; Gumrukcuglu, H. A.; Caglayan, C. E.; Akdag, S.; Dogan, A.
Percutaneous Transluminal Angioplasty in Haemodialysis Patients With Central or Peripheral Venous Stenosis
(Ondokuz Mayis Universitesi, 2016) Yaman, M.; Sahin, M.; Simsek, H.; Gumrukcuoglu, H.A.; Tuncer, M.; Gunes, Y.; Akdag, S.
Dysfunction of arteriovenous fistulae (AVF), which result from peripheral or central venous occlusive illness, occurs very often in haemodialysis patients. In therapy, endovascular open procedures are prefered. Our study illustrated the clinical success of percutaneous transluminal angioplasty (PTA) for the treatment of these patient. A retrospective analysis was applied on patients presenting during a 2-years term with haemodialysis failure and ipsilateral arm swelling coherant with peripheral and/or central venous stenosis. PTA was performed as clinically and angiografically indicated. Technical success of PTA was defined less than 30% residual stenosis and clinical success was illustrated by resolution of pain and edema along with preservation of the AVF. Our study shows a subgroup of 26 patients that presented with symptomatic peripheral or central venous occlusive disease. Mean follow-up was 12.4 months (range, 3-24 months). PTA was successful in 26 patients 11 of whom were with central lesions and 15 of whom were with peripheral lesions. We were stated for central lesions PTA had a priority patency rates of 81.8%, 60%, 37.5% and supported primary patency rates of 90.9%, 70%, 62.5% at 3, 6, 12 months. For peripheral lesions, primary patency rates of 86.7%, 78.5%, 66.6% at 3, 6 and 12 months and assisted primary patency rates of 93.3%, 85.7% and 75%, separately. PTA for central and peripheral venous stenosis is be a successful and safe procedure in hemodialysis patients. In patients with lesions that are responsible for dilation, continuous functional access in the affected extremity is sustained, especially for patients with peripheral venous stenosis. © 2016 OMU.
Platelet-To Ratio May Predict the Severity of Calcific Aortic Stenosis
(International Scientific Literature Inc., 2015) Akdag, S.; Akyol, A.; Asker, M.; Duz, R.; Gumrukcuoglu, H.A.
Background: Platelet-to-lymphocyte ratio (PLR) is an emerging inflammatory indicator which is closely associated with adverse cardiovascular events. Therefore, we aimed to investigate the relationship between PLR and the severity of calcific aortic stenosis (AS). Material/Methods: The study was designed as a retrospective study. A total of 86 consecutive patients with calcific AS were divided into two groups as mild-to-moderate AS and severe AS according to the transaortic mean pressure gradient. PLR levels were calculated from the complete blood count (CBC). Results: Platelet to lymphocyte ratio was significantly higher in severe and mild-to-moderate AS groups when compared to the control subjects (151±31.2, p<0.001, 138±28.8 vs. 126±26.5, p=0.008, respectively). In the subgroup analysis of AS patients, PLR was found to be higher in the severe AS group compared to mild-to-moderate group (p<0.001). A significant correlation was found between PLR and transaortic mean pressure gradient in patients with AS (r=0.421, p<0.001). Conclusions: Our study results demonstrated that increased PLR correlates with the severity of calcific AS. © Med Sci Monit, 2015.
Resolution of Atrial Thrombus With Adjusted Dose Warfarin Therapy in Patient With Nonvalvular Atrial Fibrillation
(Elsevier Ireland Ltd, 2011) Simsek, H.; Dogan, A.; Sahin, M.; Gumrukcuoglu, H. A.; Akdag, S.
Severe Mitral and Aorta Insufficiency in Patient With Acute Rheumatismal Fever
(Elsevier Ireland Ltd, 2011) Akdag, S.; Sahin, M.; Simsek, H.; Gumrukcuoglu, H. A.; Tuncer, M.
Treatment of Gigantic Left Ventricular Thrombus: Case Report
(Elsevier Ireland Ltd, 2011) Sahin, M.; Simsek, H.; Gumrukcuoglu, H. A.; Akdag, S.; Ekici, B.
Two Markers in Predicting the Cardiovascular Events in Patients With Polycystic Ovary Syndrome: Increased P-Wave and Qt Dispersion
(verduci Publisher, 2015) Akdag, S.; Cim, N.; Yildizhan, R.; Akyol, A.; Ozturk, F.; Babat, N.
OBJECTIVE: Polycystic ovary syndrome (PCOS) is a prevalent disease with many potential long-term cardiovascular risks. P-wave dispersion (Pdis) and QT dispersion (QTdis) have been shown to be noninvasive electrocardiographic predictors for development of cardiac arrhythmias. In this study we aimed to search Pdis and QTdis parameters in patients with PCOS. PATIENTS AND METHODS: The study included 82 patients with PCOS and 74 age-and sex-matched healthy controls. Baseline 12-lead electrocardiographic and transthoracic echocardiographic measurements were evaluated. P-wave maximum duration (Pmax), P-wave minimum duration (Pmin), Pdis, QT interval, heart rate-corrected QT dispersion and QTdis were calculated by two cardiologists. RESULTS: Patients wirh PCOS had significantly higher QT dispersion (49.5 +/- 14.1 vs. 37.9 +/- 12.6 ms, p < 0.001), and P wave dispersion (54.2 +/- 11.4 vs. 45.9 +/- 10.1 ms, p < 0.001) than the controls. Serum testosterone and estradiol levels was correlated with the Pdis (r = 0.677, p < 0.001 and r = 0.415, p < 0.001 respectively) and QTdis (r = 0.326, p < 0.001 and r = 0.321, p < 0.001 respectively). CONCLUSIONS: Pdis and QTdis are simple and useful electrocardiographic markers which may be used in the prediction of the risk of adverse cardiovascular events in PCOS patients.
Vascular Endothelial Function in Patients With Coronary Slow Flow and the Effects of Nebivolol
(Elsevier Ireland Ltd, 2011) Gunes, Y.; Gumrukcuoglu, H. A.; Akdag, S.; Simsek, H.; Sahin, M.; Tuncer, M.