Browsing by Author "Karapinar, Hekim"

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Dynamic Circle Image in Left Ventricle Outflow Tract
(Wiley, 2011) Karapinar, Hekim; Kaya, Zekeriya; Aung, Soe Moe; Karavelioglu, Yusuf; Kaya, Hasan; Kirma, Cevat; Esen, Ali Metin
A 46-year-old man presented with a complaint of effort dyspnea. On transthoracic echocardiography a circle appeared in LVOT. It was seen freely floating, disappearing in every systole and appearing again in diastole. Turbulence was seen inside the circle with color Doppler. Transesophageal echocardiography showed aortic cusps and their coaptation to be normal. Aortic root diameters were normal at the annulus, sinus of Valsalva, and sinotubular junction. There were no signs of dissection, infective endocarditis or abscess. But as the probe was advanced, left sinus of Valsalva was found to be prolapsed, and ruptured into LVOT. (Echocardiography 2011;28:E9-E11).
External Iliac Artery Pseudo-Stenosis Associated With Catheterization: Report of Two Cases
(Termedia Publishing House Ltd, 2012) Karapinar, Hekim; Gul, Ibrahim; Kucukdurmaz, Zekeriya; Gumrukcuoglu, Hasan Ali; Yilmaz, Ahmet
In invasive cardiology practices, the most commonly used vascular access site is the femoral artery. Atherosclerotic stenoses on the femoral and iliac arteries create difficulties in these practices. Vasospasm rarely occurs on large arteries like these. This paper reports stenosis encountered during coronary angiography on iliac arteries in 2 patients. The stenoses caused difficulties for guidewire and catheter insertion in catheterization. In the revisualization of these arteries at the next session, the stenoses had disappeared, but the arteries were tortuous. The patients did not have peripheral ischemia signs previously, nor did they appear after the procedure. These transient stenoses might have occurred due to vasospasm and the accordion effects caused by the guidewire and/or catheter.
Gamma Glutamyltransferase Levels and Its Association With High Sensitive C-Reactive Protein in Patients With Acute Coronary Syndromes
(Medknow Publications & Media Pvt Ltd, 2010) Emiroglu, Mehmet Yunus; Esen, Ozlem Batukan; Bulut, Mustafa; Karapinar, Hekim; Kaya, Zekeriya; Akcakoyun, Mustafa; Esen, Ali Metin
Background: Elevated Gamma-glutamyltransferase (GGT) level is independently correlated with conditions associatedwith increased atherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure and myocardial infarction. It is also demonstrated that serum gamma-glutamyltransferase activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Although the relationship between gamma-glutamyltransferase and coronary artery disease has been reported, not many studies have shown the relationship between changes ofgamma-glutamyltransferase in acute coronary syndromes and a well established coronary risk factor high sensitive C-reactive protein. (hs-CRP). Aims: In this study, how gamma-glutamyltransferase levels changed in acute coronary syndromes and its relationship with high sensitive C-reactive protein if any were studied. Patients & Methods: This trial was carried out at Kosuyolu Cardiovascular Training and Research Hospital and Van Yuksek Ihtisas Hospital, Turkey. 219 patients (177 males and 42 females) presenting with acute coronary syndrome, and 51 control subjects between September 2007 and September 2008 were included in the study. Serum gamma-glutamyltransferase, high sensitive C-reactive protein, serum lipoprotein levels and troponin I were determined. Results: Serum gamma-glutamyltransferase and high sensitive C-reactive protein levels were higher in acute coronary syndrome patients compared to control. There was also correlation between gamma-glutamyltransferase and high sensitive C-reactive protein levels. Conclusion: Serum gamma-glutamyltransferase and high sensitive C-reactive protein levels were higher in acute coronary syndrome patients. In subgroup analyses, the higher difference with Non-ST elevation myocardial infarction and ST elevation myocardial infarction groups than unstable angina oectoris group proposes a relationship between gamma-glutamyltransferase and severity of acute coronary syndromes.
Ggt Levels in Type Ii Diabetic Patients With Acute Coronary Syndrome (Does Diabetes Have Any Effect on Ggt Levels in Acute Coronary Syndrome?)
(Springer-verlag Italia Srl, 2013) Emiroglu, Mehmet Yunus; Esen, Ozlem Batukan; Bulut, Mustafa; Karapinar, Hekim; Kaya, Zekeriya; Akcakoyun, Mustafa; Esen, Ali Metin
Elevated gamma-glutamyltransferase (GGT) level is independently correlated with conditions associated with increased atherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure and myocardial infarction. It is demonstrated that serum GGT activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Diabetes is also a well-known cardiovascular risk factor and an equivalent of coronary artery disease. Although the relationship between GGT and coronary artery disease has been reported, there are limited data exploring the changes of GGT in acute coronary syndromes, especially in patients with diabetes. So, this study aimed to determine changes in GGT level in diabetic and non-diabetic acute coronary syndromes. This trial was carried out at Kosuyolu Cardiovascular Training and Research Hospital and Van Yuksek Ihtisas Hospital, Turkey. A total of 219 patients (177 men and 42 women) presenting with acute coronary syndrome) and 51 control subjects between September 2007 and September 2008 were included in the study. Serum gamma-glutamyltransferase and serum lipoprotein levels were determined. The resuls indicated that serum GGT levels were higher in acute coronary syndrome patients compared with control. In subgroup analyses, there was no difference between diabetic and non-diabetic subgroups. There was also weak correlation between GGT and blood glucose levels. There was no correlation between GGT and serum lipoprotein levels. In conclusion, serum GGT levels were higher in acute coronary syndrome patients. In subgroup analyses, There was no difference between diabetic and non diabetic subgroup.
Is Atrial Electromechanical Coupling Delayed in Patients With Secundum Atrial Septal Defect
(Wiley-blackwell, 2013) Oflaz, Mehmet Burhan; Karapinar, Hekim; Kucukdurmaz, Zekeriya; Guven, Ahmet Sami; Gumrukcuoglu, Hasan Ali; Sarikaya, Savas; Yilmaz, Ahmet
Background: There is no available published information about the atrial electromechanical coupling time (AEMCT) in patients with atrial septal defect (ASD). The aim of this study was to investigate the relationship between ASD and AEMCT obtained by tissue Doppler imaging (TDI). Methods: A total of 35 patients with ASD and 22 healthy controls were included in the study. The time intervals from the onset of the P-wave on the surface electrocardiogram to the beginning of the late diastolic A-wave (PA) representing AEMCT were obtained from the lateral mitral annulus, septal mitral annulus, and right ventricular (RV) tricuspid annulus, and named PA-lateral, PA-septal, and PA-tricuspid, respectively. The difference between PA-septal and PA-tricuspid, PA-lateral and PA-septal, and PA-lateral and PA-tricuspid were defined as intra-right AEMCT, intra-left AEMCT, and inter-AEMCT, respectively. Results: PA-tricuspid, PA-septal, and PA-lateral values were longer in patients with ASD when compared with the controls, but did not reach statistical significance (39.9 +/- 19.1 vs. 37.2 +/- 15.5, P = 0.952; 49.6 +/- 14.0 vs. 45.4 +/- 11.1, P = 0.826 and 60.3 +/- 16.3 vs. 59.7 +/- 12.5, P = 0.437, respectively). There were no significant differences between the ASD and control groups in terms of inter-atrial, intra-right atrial, and intra-left AEMCT (21.3 +/- 2.3 vs. 20.8 +/- 4.6, P = 0.957; 9.7 +/- 3.3 vs. 6.9 +/- 1.3, P = 0.723 and 13.6 +/- 4.7 vs. 10.9 +/- 4.5, P = 0.518, respectively). Furthermore, ASD diameter and total septum length did not correlate with AEMCT. Conclusion: Both intra-and inter-AEMCT were not increased in patients with ASD than control subjects. In addition, we found no association between the ASD diameter and indices of AEMCT in patients with ASD.
Left Circumflex Artery Originating From the Pulmonary Artery in an Adult
(Turkish Soc Cardiology, 2011) Karapinar, Hekim; Gumrukcuoglu, Hasan Ali; Asker, Muntecep; Goktekin, Omer
Long Coronary Artery Aneurysm Treated by Two Graft Stents on a Single Bare Metal Stent Scaffold
(Termedia Publishing House Ltd, 2012) Karapinar, Hekim; Kucukdurmaz, Zekeriya; Gumrukcuoglu, Hasan Ali; Yilmaz, Ahmet
We report a case of a 61-year-old male who presented with symptoms of stable angina The coronary angiography revealed a long aneurysm and significant stenosis after the aneurysmatic segment on the circumflex artery. The length of the aneurysm was 21 mm with the largest diameter 9 mm. We thought that single graft stent placement was not possible due to the angled circumflex artery, length of the aneurysm and inflexible nature of graft stents. Distal stenosis was stented as usual. A bare metal stent was implanted over the aneurysm from normal to normal segments. Two graft stents were implanted sequentially in the aneurysm over the bare metal stent scaffold. Stent grafts covered the aneurysm without any main side branch occlusion. The patient was discharged the next day without any complications. The patient was asymptomatic after two years of follow-up with usual medications.
A Multicenter Study on Experience of 13 Tertiary Hospitals in Turkey in Patients With Infective Endocarditis
(Turkish Soc Cardiology, 2013) Elbey, Mehmet Ali; Akdag, Serkan; Kalkan, Mehmet Emin; Kaya, Mehmet G.; Sayin, M. Rasit; Karapinar, Hekim; Akyuz, Abdurrahman
Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.
Serum Levels of Angiopoietin-1 in Patients With Pulmonary Hypertension Due To Mitral Stenosis
(Springer, 2011) Karapinar, Hekim; Esen, Ozlem; Emiroglu, Yunus; Akcakoyun, Mustafa; Pala, Selcuk; Kargin, Ramazan; Esen, Ali Metin
The molecular basis and pathophysiology of pulmonary hypertension (PH) are rapidly evolving areas. Recently discovered angiopoietins (Ang) constitute a family of growth factors, and whether they play a causal or protective role in pulmonary hypertension has not been fully elucidated. Since left heart disease probably represents the most frequent cause of PH, we sought to determine whether there was a relationship between serum Ang-1 levels and pulmonary hypertension caused by mitral stenosis (MS). The study population was composed of 49 patients with isolated MS. These patients were then divided into group 1 [31 patients with severe MS: mitral valve area (MVA) <= 1.1 cm(2)] and group 2 (18 patients with mild-moderate MS: MVA 1.2-2.0 cm(2)). Twenty-one healthy volunteers comprised the control group (group 3). All of the subjects underwent complete transthoracic echocardiography with determination of systolic pulmonary artery pressure (PAPs). Ang-1 levels were determined in serum. Serum levels of Ang-1 were significantly higher in the control group compared to patients with severe (group 1) and mild-moderate (group 2) MS (p < 0.001). Ang-1 levels were found to have moderate inverse correlation with PAPs and left atrial (LA) diameter (r: -0.620, p < 0.001 and r: -0.489, p < 0.001, respectively). The AUC for the ROC curve for predicting PAPs < 50 mmHg by serum Ang-1 level was 0.824 (95% CI 0.722-0.926, p < 0.001). A serum level of Ang-1 above 34,656 pg/ml has 74% sensitivity and 80% specificity for predicting that PH is not severe (PAPs < 50 mmHg). In conclusion, the findings of this study are distinctive in the sense that they clearly demonstrate a negative correlation between serum Ang-1 levels and the degree of PH.
Volume Dependence of Blood Pool and Tissue Doppler Parameters: Confirmation by Blood Donor Model
(Elsevier Ireland Ltd, 2010) Karapinar, Hekim; Karavelioglu, Yusuf; Kaya, Zekeriya; Kaya, Hasan; Esen, Ozlem Batukan; Zehir, Regayip; Kirma, Cevat