Browsing by Author "Akdag, Serkan"

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Association of Epicardial Adipose Tissue Thickness and Inflammation Parameters With Cha2ds2-Vasasc Score in Patients With Nonvalvular Atrial Fibrillation
(Dove Medical Press Ltd, 2015) Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Akyol, Aytac; Duz, Ramazan; Babat, Naci
Background: Epicardial adipose tissue (EAT), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) have been shown to be helpful in predicting adverse cardiovascular events. However, to date, in the literature, there have been no studies demonstrating the relationship between EAT, MPV, PLR, NLR, and thromboembolism risk in atrial fibrillation (AF). Therefore, we examined the relationship between EAT, MPV, PLR, NLR, and CHA(2)DS(2)-VASc score used for the evaluation of thromboembolism risk in patients with AF. Methods: The study included 96 consecutive patients with AF and 52 age-and sex-matched control subjects. We calculated CHA2DS2-VASc risk score for each patient and measured baseline EAT thickness, MPV, PLR, NLR, left atrial volume index, and left ventricular ejection fraction. Results: The group with high CHA2DS2-VASc score had higher EAT (7.2 +/- 1.5 vs 5.9 +/- 1.2 mm, P<0.001), MPV (9.1 +/- 1.1 vs 8.4 +/- 1.0 fL, P=0.004), PLR (152.3 +/- 28.4 vs 126.7 +/- 25.4, P=0.001), and NLR (4.0 +/- 1.6 vs 3.2 +/- 1.3, P<0.001) compared to group with low-intermediate CHA2DS2-VASc score. Moreover, CHA2DS2-VASc score was found to be positively correlated with EAT (r=0.623, P<0.001), MPV (r=0.350, P=0.004), PLR (r=0.398, P=0.001), and NLR (r=0.518, P<0.001). Conclusion: Our study results demonstrated that EAT thickness, MPV, PLR, and NLR were associated with the thromboembolic risk exhibited by CHA2DS2-VASc score in patients with nonvalvular AF.
Association of P Wave Dispersion and Left Ventricular Diastolic Dysfunction in Non-Dipper and Dipper Hypertensive Patients
(Turkish Soc Cardiology, 2014) Tosu, Aydin Rodi; Demir, Serafettin; Kaya, Yuksel; Selcuk, Murat; Akdag, Serkan; Isik, Turay; Akkus, Oguz
Objective: Objective of this study was to investigate the correlation between P wave dispersion and left ventricular diastolic function, which are associated with the increased cardiovascular events in patients with dipper and non-dipper hypertensive (HT). Methods: Eighty sex and age matched patients with dipper and non-dipper HT, and 40 control subject were included in this observational cross-sectional study. P wave dispersion was measured through electrocardiography obtained during the admission. The left ventricular ejection fraction was measured using the modified Simpson's rule by echocardiography. In addition, diastolic parameters including E/A rate, deceleration time (DT) and isovolumetric relaxation time (IVRT) were recorded. Independent samples Bonferroni, Scheffe and Tamhane tests and correlation test (Spearman and Pearson) were used for statistical analysis. Results: P wave dispersion was found to be significantly increased in the non-dipper than in the dipper group (56.0 +/- 5.6 vs. 49.1 +/- 5.3, p<0.001). P-max duration was found significantly higher (115.1 +/- 5.6 vs. 111.1 +/- 5.8, p=0.003) and P-min duration significantly lower (59.0 +/- 5.6 vs. 62.3 +/- 5.3, p=0.009) in the non-dippers. Correlation analysis demonstrated presence of moderate but significant correlation between P-wave dispersion and left ventricular mass index (r=0.412, p=0.011), IVRT (r=0.290 p=0.009), DT (r=0.210, p=0.052) and interventricular septum thickness (r=0.230 p=0.04). Conclusion: P wave dispersion and P Max were found to be significantly increased and P min significantly decreased in the non-dipper HT patients compared to the dipper HT patients. P-wave dispersion is associated with left ventricular dysfunction in non-dipper and dipper HT.
Atriyoventriküller Tam Bloğa Bağlı Arrest
(2011) Katı, İsmail; Göktaş, Uğur; Akdag, Serkan; Gümrükcüoğlu, Hasan Ali; Işık, Yasemin
Yetişkinlerde ilaç toksisitesi, koroner arter hastalığı ve dejeneratif bozukluk atriyoventriküler tam bloğun en sık nedenleridir. Bu sunu da poliklinikte bebeğini muayene ettirmek için sıra beklerken ani kardiyak arrest geçiren atriyovenriküler tam bloklu bir olgu irdelendi, iki ay önce normal yolla doğum yapmış 29 yaşında olgu çocuğunu muayene ettirmek için sıra beklerken ani kardiyak arrest geçirmiş. Yaklaşık 14 dakika resüste edilen olgu hastanemize gönderilmiş. Acil servisteki ilk değerlendirmede; şuur kapalı, pupiller dilate, ışık refleksi: +/+, entübe, kalp atım hızı: 30 atım dk1, arteriyal kan basıncı 90160 mmHg ve Glaskow Koma Skoru: 7 idi. Elektrokardiografide atriyoventriküler tam kalp bloğu saptandı ve kardiyoloji kliniği tarafından tek odacıklı geçici kardiyak pacemaker takıldı ve ritmi 80 atım dk'1 olarak ayarlandı. Olgu bu haliyle anestezi yoğun bakım ünitesine alındı ve mekanik ventilatöre bağlandı. İntoksikasyon düşünülen hastada ilaç seviyeleri normal bulundu. Şuuru açılan olgu bir gün sonra ekstübe edilip kardiyoloji kliniğine gönderildi. Takipleri sırasında geçici kalp pilinin hızı kademeli olarak azaltılmasına karşın kalp atım hızı 35 atım dk'1 civarın idi ve atriyoventriküler tam bloğun devam ettiği görüldü. Olgunun pacemaker bağımlı olduğuna karar verildi. Çift odacıklı kalıcı kalp pili takıldı. Olgu kalıcı kalp pili takıldıktan 72 saat sonra taburcu edildi. Peripartum kardiyomyopatiye bağlı yaşamı tehdit eden klinik bulgularla karşımıza çıkan atriyoventriküler tam bloğun; hızlı, usulüne uygun yapılan resüsitatif işlemlerle sekelsiz iyileşebileceğini düşünmekteyiz.
Bicuspit Aorta, Aneurysm of Ascendan Aorta, Significant Aort and Mitral Insufficiency in Patient With Marfan Syndrome
(Elsevier Ireland Ltd, 2010) Tuncer, Mustafa; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Gunes, Yilmaz
Clinical and Echocardiographic Follow-Up in Pregnant Patients With Valvular Heart Disease
(Turkish Soc Cardiology, 2013) Gumrukcuoglu, Hasan Ali; Guler, Ayse; Odabasi, Dolunay; Simsek, Hakki; Sahin, Musa; Akdag, Serkan; Tuncer, Mustafa
Objectives: Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD). Study design: The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S. Results: We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively). Conclusion: Valvular heart disease is associated with fetal/maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.
Clinical and Laboratory Aspects of Our Patients Have Pericardial Effusion
(Elsevier Ireland Ltd, 2010) Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Tuncer, Mustafa; Gunes, Yilmaz; Akdag, Serkan; Begenik, Huseyin; Simsek, Hakki
Clinical Characteristics and Outcome of Brucella Endocarditis
(Royal Soc Medicine Press Ltd, 2009) Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Karahocagil, Mustafa; Ekim, Hasan
Brucella endocarditis, a rare complication of brucellosis, is the main cause of death attributable to this disease. There are difficulties in the diagnosis and uncertainty regarding many aspects of the treatment of Brucella endocarditis. We retrospectively examined the clinical characteristics and outcome of patients diagnosed with Brucella endocarditis. Of the six patients diagnosed as having Brucella endocarditis, four had valvular disease, one had aortic and mitral mechanic valve prosthesis (AVR + MVR) and one had secundum type atrial septal defect. Transesophageal echocardiography showed vegetations in four patients. Blood culture grew Brucella mellitensis only in two patients. Standard agglutination tests were elevated in all patients (range 1/320-1/10240). Four patients were managed with combined antibiotherapy and surgery. One refused further treatment and one refused an operation and follow-up was lost for that patient. Two patients died during follow-up; one having had a previous AVR + MVR operation refused further treatment and the other suffering renal failure. Due to the fulminant course of the disease, treatment should be initiated when there is a clinical suspicion, even if the culture results are unknown or negative. Agglutination titres aid in the diagnosis. A combination of antibiotherapy and surgery seems to be preferable treatment modality.
Comparison of Two Patients With Mitral Stenosis Which Do Not Have Diagnosis Up To Advanged Age
(Elsevier Ireland Ltd, 2010) Sahin, Musa; Tuncer, Mustafa; Akdag, Serkan; Gumrukcuoglu, Hasan Ali; Simsek, Hakki
Decreased Risk of Ventricular Arrhythmias With Treatment of Nebivolol in Patients With Coronary Slow Flow
(Via Medica, 2016) Simsek, Hakki; Yaman, Mehmet; Babat, Naci; Akdag, Serkan; Akyol, Aytac; Demirel, Koray Celal; Gunes, Yilmaz
Background: Coronary slow-flow (CSF) is an angiographic phenomenon characterised by delayed opacification of vessels in the absence of any evidence of obstructive epicardial coronary disease. QT interval dispersion (QTD) reflects regional variations in ventricular repolarisation and cardiac electrical instability and has been reported to be longer in patients with CSF. Aim: To examine QT duration and dispersion in patients with CSF and the effects of nebivolol on these parameters. Methods: The study population included 67 patients with angiographically proven normal coronary arteries and CSF, and 38 patients with angiographically proven normal coronary arteries without associated CSF. The patients were evaluated with 12-lead electrocardiography, and echocardiography before and three months after treatment with nebivolol. Results: Compared to the control group QTcmax and QTcD were significantly longer in patients with CSF (p = 0.036, p = 0.019, respectively). QTcD significantly correlated with the presence of CSF (r = 0.496, p < 0.001). QTcmax (p = 0.027), QTcD (p = 0.002), blood pressure (p = 0.001), and heart rate (p < 0.001) values significantly decreased after treatment with nebivolol. Conclusions: Coronary slow flow is associated with increased QTD. Nebivolol reduced increased QTD in patients with CSF after three months.
Demographical Data and Outcomes of Surgically Treated Patients With the Diagnosis of Infective Endocarditis: a Multi-Center Retrospective Study
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2014) Oylumlu, Mustafa; Elbey, Mehmet Ali; Kalkan, Emin; Akdag, Serkan; Ozbek, Kerem; Eren, Nihan Kahya; Yuksel, Murat
Background: This study aims to investigate the demographic and clinical characteristics and echocardiographic and microbiological findings of the patients as well as the outcomes of surgery undergoing surgical treatment with the diagnosis of infective endocarditis in Turkey. Methods: Between January 2005 and August 2012 116 patients (65 males, 51 females; mean age 43 +/- 16 years; range 14 to 80 years) with the diagnosis of infective endocarditis who underwent surgery in 13 tertiary university/research and education hospitals were included in this multi-center study. Demographic and clinical characteristics of the patients, and echocardiographic and microbiological findings, surgical indications and outcomes of surgery were retrospectively analyzed. Results: The most common symptom on admission and physical finding was fever. Blood cultures were negative in 35 patients (30%). Staphylococci were the most common microbiological pathogens (22%). Congestive heart failure was the most common indication for surgery in 56 patients (48%). Valve repair was performed in 12 patients (10%), valve replacement was the procedure of choice in 104 patients (90%). Thirty-three patients undergoing surgical treatment died in the postoperative period. The mortality rate was 28%. Independent predictors of surgical mortality were Class 3-4 functional capacity, elevated C-reactive protein, and renal dysfunction. Conclusion: Although complicated cases of infective endocarditis can be treated through surgery, surgical morbidity and mortality is still high.
The Effect of Low-Sodium Dialysate on Ambulatory Blood Pressure Measurement Parameters in Patients Undergoing Hemodialysis
(Dove Medical Press Ltd, 2015) Akdag, Serkan; Akyol, Aytac; Cakmak, Huseyin Altug; Tosu, Aydin Rodi; Asker, Muntecep; Yaman, Mehmet; Gumrukcuoglu, Hasan Ali
Background: End stage renal disease is related to increased cardiovascular mortality and morbidity. Hypertension is an important risk factor for cardiovascular disorder among hemodialysis (HD) patients. The aim of this study was to investigate the effect of low-sodium dialysate on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels detected by ambulatory BP monitoring (ABPM) and interdialytic weight gain (IDWG) in patients undergoing sustained HD treatment. Patients and methods: The study included 46 patients who had creatinine clearance levels less than 10 mL/min/1.73 m(2) and had been on chronic HD treatment for at least 1 year. After the enrollment stage, the patients were allocated low-sodium dialysate or standard sodium dialysate for 6 months via computer-generated randomization. Results: Twenty-four hour SBP, daytime SBP, nighttime SBP, and nighttime DBP were significantly decreased in the low-sodium dialysate group (P<0.05). No significant reduction was observed in both groups in terms of 24-hour DBP and daytime DBP (P=NS). No difference was found in the standard sodium dialysate group in terms of ABPM. Furthermore, IDWG was found to be significantly decreased in the low-sodium dialysate group after 6 months (P<0.001). Conclusion: The study revealed that low-sodium dialysate leads to a decrease in ABPM parameters including 24-hour SBP, daytime SBP, nighttime SBP, and nighttime DBP and it also reduces the number of antihypertensive drugs used and IDWG.
Effects of Illness Activity on Electrocardiographic Parameters in Patient With Multiple Sclerosis
(Drunpp-sarajevo, 2012) Gumrukcuoglu, Hasan Ali; Akyol, Aytac; Akdag, Serkan; Simsek, Hakki; Tombul, Temel
Background: Multiple sclerosis (MS) has been reported to be associated with autonomic dysfunction. QT and P wave duration are clearly related to autonomic nervous system. We compared P wave dispersion (PWD) and corrected QT dispersion (QTcD) in stable phase and active phase MS patients to healthy control subjects. Method: 76 MS patients and44 healthy control subjects were included. Twelve-lead surface ECG recording was performed all participants. The P and QT wave parameters were measured manually Results: Maximum P wave and QTc duration were higher in MS patients than control groups. The average PWD and QTcD value of MS patients was also found to be higher than control groups. According to illness activity, statistically differences weren't observed at ECG parameters in patients with MS. Conclusion: P wave and QTc duration were found to be statistically different in patients with MS and control subjects. But illness activity didn't affect these electrocardiographic parameters as significantly.
Effects of Lowering Dialysate Sodium on Carotid Artery Atherosclerosis and Endothelial Dysfunction in Maintenance Hemodialysis Patients
(Springer, 2012) Gumrukcuoglu, Hasan Ali; Ari, Elif; Akyol, Aytac; Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Tuncer, Mustafa
Purpose Our aim in this study was to examine the effects of low-sodium dialysate on carotid artery atherosclerosis, endothelial dysfunction, and blood pressure (BP) in maintenance hemodialysis (HD) patients. Methods After baseline measurements were obtained, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Carotid artery intima-media thickness (CIMT) and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low-sodium dialysate. Interdialytic weight gain (IDWG), pre- and post-dialysis BP, and dialysis-related symptoms were monitored during the study. Results Fifty-two patients were enrolled, and 41 patients completed the study. Twenty-one patients had hypertension and were receiving antihypertensive medications. The average number of antihypertensive drugs per patient was 1.9 +/- 0.8. There was no significant reduction in BP at the end of the study, but the average number of antihypertensive drugs was reduced to 1.2 +/- 0.4 (P < 0.001). There were significant improvements in CIMT (P = 0.003) and FMD (P < 0.001) with low-sodium HD. The IDWG decreased significantly during the low-sodium dialysate treatment (P < 0.001). However, hypotensive episodes and cramps were more frequent during the study period. Conclusions Our study demonstrated that the lowering of dialysate sodium concentration reduced CIMT, improved FMD, and provided better control of IDWG and BP, but increased the incidence of dialysis-related symptoms.
The Effects of Nebivolol on Qt Duration and Dispersion in Patients With Coronary Slow Flow
(Elsevier Science inc, 2013) Sahin, Musa; Simsek, Hakki; Akyol, Aytac; Akdag, Serkan; Akil, Mehmet Ata; Aksoy, Hakan; Gumrukcuoglu, Hasan Ali
The Effects of Trimetazidine on P-Wave Duration and Dispersion in Heart Failure Patients
(Wiley, 2009) Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Akdag, Serkan; Gumrukcuoglu, Hasan Ali
Background: P-wave duration and dispersion (PWD) have been shown to be noninvasive predictors for development of atrial fibrillation. Thus, it may be possible to attenuate atrial fibrillation risk through normalization of P-wave duration and dispersion. Trimetazidine, a metabolic modulator, has been reported to improve cardiac function in heart failure (HF) patients. Methods: Thirty-six HF patients being treated with angiotensin inhibitors, carvedilol, spironolactone, and furosemide were prescribed trimetazidine, 20 mg three times a day. Electrocardiographic and echocardiographic examinations were obtained before and 6 months after addition of trimetazidine in HF patients and 36 healthy control group patients having normal echocardiographic examination. Results: Maximum P-wave duration (Pmax) (106.7 +/- 15.8 vs. 91.7 +/- 12.7 ms) and PWD (57.2 +/- 15.4 vs. 37.9 +/- 16.7 ms) were significantly longer in HF patients compared to the control group. There were significant correlations of Pmax and PWD with left atrial diameter (r = 0.508, P = < 0.001 and r = 0.315, P = 0.029), left ventricular ejection fraction (LVEF) (r = 0.401, p = 0.005 and r = 0.396, P = 0.005), deceleration time (r = 0.296, P = 0.032 and r = 0.312, P = 0.035), and isovolumetric relaxation time (r = 0.265, P = 0.038 and r = 0.322, P = 0.015). There were significant improvements in LVEF (32.7 +/- 6.5% to 37.2 +/- 5.5%, P = 0.036), left atrial diameter (41.5 +/- 6.7 to 40.3 +/- 6.1 mm, P < 0.001), and Pmax (106.7 +/- 15.8 to 102.2 +/- 11.5 ms, P = 0.006) and PWD (57.2 +/- 15.4 to 48.9 +/- 10.1 ms, P < 0.001) during follow-up. Conclusions: Trimetazidine added to optimal medical therapy in HF may improve Pmax and PWD in association with improved left ventricular function. Longer-term and larger studies are necessary to evaluate whether these findings may have clinical implications on prevention of atrial fibrillation. (PACE 2009; 32:239-244).
Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease
(Korean Soc Cardiology, 2016) Yaman, Mehmet; Arslan, Ugur; Gumrukcuoglu, Hasan Ali; Sahin, Musa; Simsek, Hakki; Akdag, Serkan
Background and Objectives: Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value for arrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects of trimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease. Subjects and Methods: One hundred patients (23 females, mean age 55.6 +/- 9.2 years) with stable ischemic heart disease were included in the study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patients were stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for a minimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWA values were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography. Results: After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63 +/- 8 mu V vs. 53 +/- 7 mu V, p<0.001). Abnormal MTWA was present in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001). Conclusion: Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parameters related with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmic complications and improve myocardial functions in patients with stable coronary artery disease.
Electrocardiographic Parameters in Coronary Slow Flow
(2010) Şahin, Musa; Tuncer, Mustafa; Gümrükcüoğlu, Hasan Ali; Batyraliev, Talantbek; Akdag, Serkan; Şimşek, Hakkı
Koroner yavaş akım, epikardiyal okluziv hastalıklar yokluğunda, koroner arterlerin gecikmiş görüntülenmesi ile karakterizedir. Uzamış QT dispersiyonu (QTD) genellikle ventriküler repolarizasyon heterojenitesi ile birliktedir ki, çeşitli durumlarda gelişen ciddi ve fatal aritmilerde anahtar rol oynar. P dalga dispersiyonu (PWD) otonomik tonus tarafından etkilendiği son zamanlarda bildirilen elektrokardiyografik bir belirteçdir. Bu çalışmada, P dalga süresi PWD ile düzeltilmiş QT süresini (QTc) mukayese ettik ve CSF ve kontrol grubu arasındaki dispersiyonu kıyasladık. Çalışmaya CSF si olan 50 hastada ve koroner anjiyografide koroner arterleri normal olan 40 kişi alındı. Hastalar 12 derivasyonlu elektrokardiyografi ile değerlendirildi, maksimum, minimum QT süresi manuel olarak ölçüldü, QTc süresi Bazett formülü ile hesaplandı. Koroner yavaş akım, 24 hastada (%48) sol ön inen arterde (LAD), 12 hastada (%24) Cirkumflex (Cx) ve 14 hastada (%28) sağ koroner arterde gözlendi. Bazal klinik özellikler Table 1 de göste¬rilmiştir. Maksimum P dalga süresi ve PWD, CSF grubunda çok yüksekti ((94.7±7.5 msec vs 105.1±10.8 msec, p<0.001, 25.4±6.2 msec vs34.8±9.7 msc p<0.001, herbirisi için). Ayrıca, QTc max ve QTcD CSF grubunda çok uzundu (405.2±24.6 msec vs 435.3±27.1, p<0.001, 36.7+10.4 msec vs 63.7±14.8 msec, p<0.001 her¬birisi için). CSF fenomeni uzun P dalga süresi ve artmış PWD QT süresi ve QTD ile birlikte bulundu. Muhtemelen mekenizma mikrovasküler işlemi ve/veya kardiyovasküler sistemin otonomik kontroluna bağlı olabilir.
Hemopericardium and Cardiac Tamponade in a Patient With an Elevated International Normalized Ratio: Two Case Report
(Elsevier Ireland Ltd, 2010) Gumrukcuoglu, Hasan Ali; Tuncer, Mustafa; Akdag, Serkan; Akyol, Aytac; Gunes, Yilmaz
Hepatosteatosis and Carotid Intima-Media Thickness in Patients With Myocardial Infarction
(Springer Japan Kk, 2016) Ozturk, Hasan; Gumrukcuoglu, Hasan Ali; Yaman, Mehmet; Akyol, Aytac; Ozturk, Senay; Akdag, Serkan; Gunaydin, Zeki Yuksel
The aim of the study was to determine the involvement of non-alcoholic fatty liver disease (NAFLD) in myocardial infarction patients and its relation with carotid intima-media thickness (CIMT). This study consisted of 224 patients divided into three groups: those with myocardial infarction (MI), stable coronary artery disease (CAD), and normal coronary artery. Measurement of CIMT and abdominal ultrasonography for hepatosteatosis was performed in all participants. NAFLD was significantly more frequent among MI patients compared to the other groups. There was a significant difference between CAD and the presence of NAFLD (p < 0.05). Also, we found significant correlations between the severity of CAD and hepatosteatosis grade (r = 0.648, p < 0.001), CAD and CIMT (r = 0.594, p < 0.001), and NAFLD and CIMT (r = 0.233, p = 0.005). NAFLD was also significantly correlated with the severity of CAD (r = 0.607, p < 0.001), and the grade of NAFLD significantly correlated with CIMT (r = 0.606, p < 0.001). Patients with more severe CAD were more likely to have NAFLD. In addition, hepatosteatosis may be associated with coronary plaque instability and high fatty volume. Patients with NAFLD should be screened regularly for other cardiovascular risk factors, and the presence of fatty liver may help better classify these patients.
Increased P-Wave Dispersion in Patients With New Diagnosed Lichen Planus
(Elsevier Science inc, 2013) Sahin, Musa; Bilgili, Serap Gunes; Simsek, Hakki; Akdag, Serkan; Akyol, Aytac; Gumrukcuoglu, Hasan Ali; Karadag, Ayse Serap