Browsing by Author "Cap, Murat"

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Acute Mitral Valve Endocarditis Complicated by Complete Atrioventricular Block, Junctional Escape Rhythm, and Skin Manifestations
(Turkish Soc Cardiology, 2019) Cap, Murat; Erdogan, Emrah
The Association of Left Ventricular End-Diastolic Pressure With Global Longitudinal Strain and Scintigraphic Infarct Size in St-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention
(Springer, 2021) Cap, Murat; Erdogan, Emrah; Karagoz, Ali; Den Hartigh, Ozden Savas; Acar, Rezzan Deniz; Gecmen, Cetin; Ozdemir, Nihal
Left ventricular end-diastolic pressure (LVEDP) is an independent predictor for prognosis in ST-elevation myocardial infarction (STEMI) patients. We aimed to investigate the relationship of admission LVEDP measured after a successful primary percutaneous coronary intervention (pPCI) with scintigraphic infarct size (IS) and global longitudinal strain (GLS), a strong predictor of IS, in STEMI patients. A total of 62 consecutive patients with STEMI were enrolled in the study. LVEDP measurements were performed after pPCI in patients who had TIMI-3 flow. Echocardiography was performed 24 h after pPCI and repeated 3 months later. GLS was calculated as an average peak strain from the 3 apical projections. IS was evaluated at the third month by technetium 99m sestamibi. The mean age was 56 +/- 8 years in the study population. The mean LVEDP was found 19.4 +/- 4.4 mmHg. Median IS was 4% (0-11.7 IQR).The mean GLS at the 24th hour and the third month were found to be - 15.4 +/- 2.8 and - 16.7 +/- 2.5 respectively. There was a moderate negative correlation between LVEDP and GLS (24th-hour p < 0.001 r = - 0.485 and third-month p < 0.001 r = - 0.489). LVEDP had a moderate positive correlation with scintigraphic IS (p < 0.001 r = 0.545). In the multivariable model, we found that LVEDP was significantly associated with scintigraphic IS (beta coefficient = 0.570, p = 0.008) but was not associated with the 24th hour (beta coefficient = 0.092, p = 0.171) and third month GLS (beta coefficient = 0.037, p = 0.531). This study demonstrated that there was a statistically significant relationship between LVEDP and scintigraphic IS, and IS was increased with high LVEDP values. However, there was not a relationship between LVEDP and GLS.
Early Systolic Lengthening Is Associated With Syntax Score in Patients With Non-St Acute Coronary Syndrome
(Kare Publ, 2024) Unkun, Tuba; Gecmen, Cetin; Cap, Murat; Izci, Servet; Erdogan, Emrah; Onal, Cagatay; Ozdemir, Nihal
Background: Early systolic lengthening is a echocardiographic strain parameter previously used to determine the lesion severity in patients with stable coronary artery disease. In the present study, we aimed to evaluate the relationship between early systolic lengthening and anatomic SYNTAX score in troponin (-) and (+) groups among patients with non-ST-elevation acute coronary syndrome (ACS). Methods: A total of 95 patients diagnosed with non-ST-elevation ACS were included in the prospective, non-randomized, single-center study. The patients were categorized into 2 groups as troponin (+) and troponin (-). The patients were evaluated in terms of echocardiographic, clinical, and angiographic parameters. Results: The baseline characteristics, including age (58 +/- 13 vs. 60 +/- 10 respectively, P=.340), a history of hypertension (67.1% vs. 64%, respectively, P=.479), diabetes (28.6% vs. 32%, respectively, P=.467), global longitudinal strain (-14.37 +/- 5.11 vs. -16.42 +/- 3.93, respectively, P=.095), left ventricular ejection fraction (58.71 +/- 8.73 vs. 57.20 +/- 8.70, respectively, P=.263), and E/e' (8.44 +/- 2.13 vs. 8.33 +/- 1.99, respectively, P=.785), were similar between troponin (+) and troponin (-) groups. Left ventricle end-systolic diameter (3.2 +/- 0.78; 3.50 +/- 0.74 vs. 3.2 +/- 0.78, respectively, P=.031), left ventricle end-systolic volume (55.57 +/- 32.17 vs. 38.28 +/- 13.63, respectively, P=.013), left ventricle end-diastolic volume (115.31 +/- 49.54 vs. 91.23 +/- 20.57, respectively, P=.042), the rate of early systolic lengthening (65.7% vs. 28%, respectively, P=.001), the duration of early systolic lengthening (24.02 +/- 31 ms vs. 15.56 +/- 30.19 ms, respectively, P=.009), and the SYNTAX score (16 +/- 11 vs. 10 +/- 10, respectively, P=.023) were higher in the troponin (+) group. Furthermore, a significant correlation was found between early systolic lengthening and SYNTAX score (r = 0.43, P < .001). Conclusion: The rate and duration of early systolic lengthening were higher in patients in the troponin (+) group. Early systolic lengthening is related to SYNTAX score in patients with non-ST-elevation ACS.
The Effect of Prior Covid-19 Infection on Coronary Microvascular Dysfunction
(Taylor & Francis Ltd, 2022) Bilge, Onder; Cap, Murat; Kepenek, Ferat; Erdogan, Emrah; Tatli, Ismail; Ozturk, Cansu; Tanboga, Ibrahim Halil
Background Thrombolysis in Myocardial Infarction Frame Count (TFC) is an index that provides a quantitative evaluation of coronary microvascular dysfunction. In this study, we aimed to examine the effect of COVID-19 infection on TFC in patients admitted with chest pain and dyspnoea after COVID-19 disease and had abnormal findings in myocardial perfusion scintigraphy. Methods For this single-center retrospective study, patients with and without a history of COVID-19 who were underwent coronary angiography for abnormal findings in myocardial perfusion scintigraphy between January 1, 2021 and June 30, 2021 were analysed. Patients were divided into two groups as patients with COVID-19 history and those without. After exclusion criteria, patients with adequate angiographic monitoring and data were included in the study. Results A total of 210 patients, 48 with a history of COVID-19, were included in the study. The mean age was +/- 55 10 years, and 122 (58%) patients were women. In patients with a history of COVID-19, TFC was significantly higher in the LAD (p < 0.001) and LCx (p < 0.001) arteries and RCA TFC (p = 0.223) was similar in both groups. In the linear mix model, male gender (beta = 2.38, 95% CI = 1.26-3.51, p < 0.001) and history of COVID-19 (beta = 1.51, 95% CI = 0.49-2.53, p = 0.004) were significantly associated with TFC. Conclusion TFC may be elevated due to coronary microvascular dysfunction in patients with a history of COVID-19.
Implications of Coronary Calcification on the Assessment of Plaque Pathology: a Comparison of Computed Tomography and Multimodality Intravascular Imaging
(Springer, 2025) Yap, Nathan Angelo Lecaros; Ramasamy, Anantharaman; Tanboga, Ibrahim Halil; He, Xingwei; Cap, Murat; Bajaj, Retesh; Bourantas, Christos V.
Objectives This study aimed to investigate the impact of calcific (Ca) on the efficacy of coronary computed coronary angiography (CTA) in evaluating plaque burden (PB) and composition with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) serving as the reference standard. Materials and methods Sixty-four patients (186 vessels) were recruited and underwent CTA and 3-vessel NIRS-IVUS imaging (NCT03556644). Expert analysts matched and annotated NIRS-IVUS and CTA frames, identifying lumen and vessel wall borders. Tissue distribution was estimated using NIRS chemograms and the arc of Ca on IVUS, while in CTA Hounsfield unit cut-offs were utilized to establish plaque composition. Plaque distribution plots were compared at segment-, lesion-, and cross-sectional-levels. Results Segment- and lesion-level analysis showed no effect of Ca on the correlation of NIRS-IVUS and CTA estimations. However, at the cross-sectional level, Ca influenced the agreement between NIRS-IVUS and CTA for the lipid and Ca components (p-heterogeneity < 0.001). Proportional odds model analysis revealed that Ca had an impact on the per cent atheroma volume quantification on CTA compared to NIRS-IVUS at the segment level (p-interaction < 0.001). At lesion level, Ca affected differences between the modalities for maximum PB, remodelling index, and Ca burden (p-interaction < 0.001, 0.029, and 0.002, respectively). Cross-sectional-level modelling demonstrated Ca's effect on differences between modalities for all studied variables (p-interaction <= 0.002). Conclusion Ca burden influences agreement between NIRS-IVUS and CTA at the cross-sectional level and causes discrepancies between the predictions for per cent atheroma volume at the segment level and maximum PB, remodelling index, and Ca burden at lesion-level analysis. Clinical relevance statement Coronary calcification affects the quantification of lumen and plaque dimensions and the characterization of plaque composition coronary CTA. This should be considered in the analysis and interpretation of CTAs performed in patients with extensive Ca burden. Key Points Coronary CT Angiography is limited in assessing coronary plaques by resolution and blooming artefacts. Agreement between dual-source CT angiography and NIRS-IVUS is affected by a Ca burden for the per cent atheroma volume. Advanced CT imaging systems that eliminate blooming artefacts enable more accurate quantification of coronary artery disease and characterisation of plaque morphology.
Myocardial Strain Assessment by 2d Speckle-Tracking Echocardiography in Patients With Congenital Myopathy
(Wolters Kluwer Medknow Publications, 2021) Cap, Murat; Akyuz, Abdurrahman; Isik, Ferhat; Turken, Askeri; Erdogan, Emrah; Varsak, Suleyman; Baysal, Erkan
Background: Congenital myopathies (CMs) are a group of rare genetic muscle disorders. Cardiac involvement can be seen in these patients. We aimed to evaluate the myocardial strain parameters by 2D speckle-tracking echocardiography (STE) in patients with CM. Materials and Methods: Twenty-four patients with CM whose diagnosis was confirmed by genetic analysis or muscle biopsy were included in the study, and 48 patients were involved as a control group. Left ventricular ejection fraction (LVEF%) was calculated by biplane Simpson method, and myocardial strain analysis was performed by 2D STE. Results: The median age of the study population was 26 (19-35 interquartile range [IQR]) and 43 (60%) were women. In the analysis performed after the exclusion of two patients with multiminicore disease (MMD) who developed heart failure, although mild, LVEF% (62 [60-65 IQR] vs. 64 [63-66 IQR], P = 0.008) and right ventricular global longitudinal strain (RVGLS) were significantly lower in the CM group (-21.8 [-19.7, -24.9 IQR] vs. -23.9 [-22.4, -25.6 IQR], P = 0.0017). Left ventricular global longitudinal strain (LVGLS) was observed similarly in both groups (-19.9 [-18.7, -20.7 IQR] vs. -20.5 [-19.3, -21.9 IQR], P = 0.069). LVEF% (33 and 46), LVGLS (-7.5 and -10.7), and RVGLS (-14.9 and -16.1) values were low in two siblings with MMD. Conclusion: Although LVEF% and RVGLS were significantly lower in the CM group, LVGLS was similar. The decrease in RVGLS and LVEF% was mild, and heart failure was not observed in any patient except MMD patients who were not included in the analysis.
Progressive Pulmonary Stenosis Due To Huge Mediastinal Thymoma
(Turkish Soc Cardiology, 2021) Cap, Murat; Erdogan, Emrah; Akyuz, Abdurrahman; Cap, Nese Kanbal; Erdur, Erkan
Spect Myocardial Perfusion Imaging Identifies Myocardial Ischemia in Patients With a History of Covid-19 Without Coronary Artery Disease
(Springer, 2022) Cap, Murat; Bilge, Onder; Gundogan, Cihan; Tatli, Ismail; Ozturk, Cansu; Tastan, Ercan; Tanboga, Ibrahim Halil
We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.
Turkish Real Life Atrial Fibrillation in Clinical Practice: Traffic Study
(Kare Publ, 2024) Karabay, Can Yucel; Tasolar, Hakan; Kunak, Aysegul Ulgen; Cap, Murat; Astarcioglu, Mehmet Ali; Sen, Taner; Tanboga, Ibrahim Halil
Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide and is associated with an increased risk of thromboembolism, ischemic stroke, impaired quality of life, and mortality. The latest research that shows the prevalence and incidence of AF patients in Turkiye was the Turkish Adults' Heart Disease and Risk Factors study, which included 3,450 patients and collected data until 2006/07.The Turkish Real Life Atrial Fibrillation in Clinical Practice (TRAFFIC) study is planned to present current prevalence data, reveal the reflection of new treatment and risk approaches in our country, and develop new prediction models in terms of outcomes. Methods: The TRAFFIC study is a national, prospective, multicenter, observational registry. The study aims to collect data from at least 1900 patients diagnosed with atrial fibrillation, with the participation of 40 centers from Turkiye. The following data will be collected from patients: baseline demographic characteristics, medical history, vital signs, symptoms of AF, ECG and echocardiographic findings, CHADS2VASC2 and HAS -BLED (1 -year risk of major bleeding) risk scores, interventional treatments, antithrombotic and antiarrhythmic medications, or other medications used by the patients. For patients who use warfarin, international normalized ratio levels will be monitored. Follow-up data will be collected at 6, 12, 18, and 24 months. Primary endpoints are defined as systemic embolism or major safety endpoints (major bleeding, clinically relevant nonmajor bleeding, and minor bleeding as defined by the International Society on Thrombosis and Hemostasis). The main secondary endpoints include major adverse cardiovascular events (systemic embolism, myocardial infarction, and cardiovascular death), all -cause mortality, and hospitalizations due to all causes or specific reasons. Results: The results of the 12 -month follow-up of the study are planned to be shared by the end of 2023. Conclusion: The TRAFFIC study will reveal the prevalence and incidence, demographic characteristics, and risk profiles of AF patients in Turkiye. Additionally, it will provide insights into how current treatments are reflected in this population. Furthermore, risk prediction modeling and risk scoring can be conducted for patients with AF.
An Unusual Case of Concurrent Kounis Syndrome and Prolonged Qt in a Young Patient
(Cambridge Univ Press, 2022) Erdogan, Emrah; Cap, Murat; Kus, Gorkem; Gokhan, Cem; Kilic, Yakup
Allergic reactions related to drug use is a common entity presenting often from minor urticaria to life-threatening anaphylactoid reactions. A common but easily overlooked diagnosis, Kounis syndrome, is an established hypersensitivity coronary disorder induced by drugs, foods, environmental factors, and coronary stents that can present in the same way as non-allergy-induced acute coronary syndrome. Here within, we present a unique case of dual presentation of Kounis syndrome and prolonged QTc in a young patient after a single dose of Domperidone and Lansoprazole.