Browsing by Author "Kaya, Hasan"

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Abnormal Left Ventricular Longitudinal Functional Reserve Assessed by Exercise Pulsed Wave Tissue Doppler Imaging in Patients With Subclinical Hypothyroidism
(Endocrine Soc, 2009) Akcakoyun, Mustafa; Kaya, Hasan; Kargin, Ramazan; Pala, Selcuk; Emiroglu, Yunus; Esen, Ozlem; Esen, Ali Metin
Background: Response of systolic and diastolic velocities of mitral annulus to exercise in patients with subclinical hypothyroidism (SCH) has not been explored previously. We sought to investigate whether SCH is associated with abnormal left ventricular (LV) longitudinal function reserve to exercise. Methods: Mitral annular systolic (S') and early diastolic (E') velocities were measured at rest and during supine bicycle exercise using tissue Doppler echocardiography (TDE) in 23 patients with newly diagnosed SCH and 25 controls. LV diastolic and systolic longitudinal function reserve indices were calculated. Results: There were no significant differences in mitral inflow velocities at rest between groups except for LV end-diastolic dimension and LV end-systolic dimension, which were higher in the control group. E' and S' at rest were also similar between the groups. However, S' (9.8 +/- 1.5 vs. 11.3 +/- 1.5 cm/sec at 25 W, P = 0.001; and 11.3 +/- 1.8 vs. 13.1 +/- 1.8 cm/sec at 50 W, P = 0.001) and E' (13.8 +/- 1.4 vs. 15.7 +/- 1.6 cm/sec at 25 W, P = 0.001; and 15.6 +/- 1.6 vs. 18.2 +/- 1.5 cm/sec at 50 W, P < 0.001) during exercise were significantly lower in patients with SCH. Longitudinal systolic and diastolic function reserve indices were significantly lower in patients with SCH (systolic index, 1.4 +/- 0.9 vs. 2.5 +/- 0.9 cm/sec at 25 W, P = 0.001; and 2.7 +/- 1.3 vs. 4.1 +/- 1.2 cm/sec at 50 W, P = 0.001; diastolic index, 2.3 +/- 1.3 vs. 3.6 +/- 1.5 cm/sec at 25 W, P = 0.003; and 3.9 +/- 1.6 vs. 5.9 +/- 1.3 cm/sec at 50 W, P < 0.001). Conclusion: Assessment of LV longitudinal functional reserve with exercise using TDE appears to be helpful in identifying early myocardial dysfunction in SCH. (J Clin Endocrinol Metab 94: 2979-2983, 2009)
Age at Death in the Turkish Adult Risk Factor Study: Temporal Trend and Regional Distribution at 56.700 Person-years' Follow-Up
(Turkish Soc Cardiology, 2009) Onat, Altan; Ugur, Murat; Tuncer, Mustafa; Ayhan, Erkan; Kaya, Zekeriya; Kucukdurmaz, Zekeriya; Kaya, Hasan
Objectives: We analyzed the temporal trend and regional distribution of age at death due to all-causes and the sex-specific and age range defined by coronary mortality in the 18-year follow-up of the Turkish Adult Risk Factor Study. Study Design: The participants of the Turkish Adult Risk Factor Study who have been examined in even years were last surveyed in August 2008. A total of 1,582 individuals were surveyed, which constituted half of the surviving participants of the overall cohort. Information on death was obtained from first-degree relatives and/or health personnel of local health offices. Survivors were evaluated by history, physical examination, and 12-lead electrocardiography. The cumulative follow-up was 56,700 person-years. Results: Of 1582 participants, 868 (431 men, 437 women) were examined, in 604 subjects information was gathered, and 47 participants (26 men, 21 women) were ascertained to have died. Twenty-two deaths were classified as being of coronary origin. Cumulative assessment of the entire cohort in the age range of 45-74 years disclosed coronary mortality to be 7.64 per 1000 person-years in men and 3.84 in women and persisted to be the highest among 30 European countries, whereas overall mortality declined at a greater proportion. Overall mean ages at death were deferred within a 12-year period by 7.4 years in men and 6 years in women, to 71.9 and 74.8 years, respectively. The extension of this mean survival was similar among urban-rural areas and geographic regions. Conclusion: Coronary mortality declined modestly, but life expectancy of Turkish adults rose by a mean of nearly seven years in the 12 years to 2003-08 without showing major differences in sex, urban-rural dwelling or geographic regions.
Diverging Sex-Specific Long-Term Effects of Cigarette Smoking on Fasting Insulin and Glucose Levels in Non-Diabetic People
(Pergamon-elsevier Science Ltd, 2012) Onat, Altan; Can, Gunay; Cicek, Gokhan; Dogan, Yuksel; Kaya, Hasan; Gumrukcuoglu, Hasan Ali; Yuksel, Husniye
Objectives: We determined in non-diabetic persons the associations of current smoking with future glucose and insulin concentrations. Design and methods: Middle-aged non-diabetic adults (n = 1071) were studied in whom these values were measured at baseline and 5.2-years later. Results: Age-adjusted fasting insulin concentrations in 137 smoking men remained lower than never smokers at both surveys. While age-adjusted fasting glucose values in male never smokers declined at follow-up (p = 0.037), they rose in male smokers. In 94 female smokers, age-adjusted fasting insulin values marginally declined, and fasting glucose was reduced (by 0.09 mmol/L., p = 0.055) during follow-up. In contrast in never-smoking women, insulin and glucose concentrations rose (p < 0.001 in both). Age-adjusted insulin levels in former smokers exhibited similar trends as never smokers. Trends were essentially unchanged when adjustment included body mass index. Current male smokers demonstrated evidence of reduced insulin sensitivity, female smokers of improved one, as assessed by QUICKI. Conclusion: Smoking among Turks induces at long-term lower fasting insulin levels which represent improved insulin sensitivity in women, yet a reduced one in men. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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).
An Epidemiological Study To Evaluate the Use of Vitamin K Antagonists and New Oral Anticoagulants Among Non-Valvular Atrial Fibrillation Patients in Turkey- After-2 Study Design
(Turkish Soc Cardiology, 2015) Ertas, Faruk; Kaya, Hasan; Yildiz, Abdulkadir; Davutoglu, Vedat; Kiris, Abdulkadir; Dinc, Lale; Toprak, Nizamettin
Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials. gov number, NCT02354456.).
Regional Distribution of All-Cause Mortality and Coronary Disease Incidence in Turkey: Findings of Turkish Adult Risk Factor Survey 2010
(Turkish Soc Cardiology, 2011) Onat, Altan; Murat, Sani Namik; Cicek, Gokhan; Ayhan, Erkan; Ornek, Ender; Kaya, Hasan; Can, Gunay
Objectives: We analyzed the distribution of cumulative allcause and cardiovascular mortality and incident coronary heart disease (CHD) across the seven geographic regions of Turkey and presented overall and coronary mortality findings of the 2010 survey of the Turkish Adult Risk Factor Study. Study design: A total of 1406 participants were surveyed. Information on the mode of death was obtained from firstdegree relatives and/or health personnel of local heath offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiography. Results: Of the surveyed participants, 686 were examined; information on health status was obtained in 577 subjects, and 32 participants (14 women, 18 men; mean age 72.3 +/- 15.6 years) were ascertained to have died. The total duration of follow-up was 2,520 person-years. Nineteen deaths were of coronary (n=16) or cerebrovascular (n=3) origin. Cumulative 20-year assessment of the entire cohort for the age bracket of 45-74 years disclosed a high coronary mortality rate, being 7.4 and 4.1 per 1000 person-years in men and women, respectively, and representing a limited decline after year 2000. Ageadjusted Cox regression analysis comprising 433 deaths and 506 incident CHD cases over a 7.3-year follow-up showed similar mortality rates across the regions, and a significantly high CHD incidence in males of the Black Sea and Marmara regions and in females of the Southeast Anatolia. Currently, 480,000 incident CHD cases are estimated yearly in Turkey. Conclusion: The high age-adjusted overall mortality in Turkey shows nonsignificant differences across geographic regions, whereas the age-adjusted CHD incidence is high in the Black Sea and Marmara regions.
Tekharf 2009 Taraması: Kırsal Kesim ve Kentlerde Benzer Kardiyovasküler Ölüm Riski
(2010) Kaya, Hasan; Uğur, Murat; Ayhan, Erkan; Doğan, Yüksel; Çiçek, Gökhan; Onat, Altan; Can, Günay
Amaç: TEKHARF Çalışması’nın 2009 sonbaharında gerçekleştirilen tarama verileri incelenerek koroner/kardiyovasküler ve tüm-nedenli ölümlerde kırsal kesim-kent farklılıkları ve 45-74 yaş kesiminde mortalitenin cinsiyete göre dağılımı değerlendirildi.Çalışma planı: TEKHARF Çalışması kapsamında Marmara ile İç Anadolu bölgeleri tekli yıllarda taranmaktadır. 2009 yılında 1655 kişi bu amaçla tarandı. Ölüm nedeni ve şekli konusunda birinci derece akraba ve/veya sağlık ocağı personelinden bilgi alındı. Örneklemden 960 kişi fizik muayene ve 12-derivasyonlu EKG ile incelendi; 572 kişinin sağlık durumu hakkında bilgi edinildi.Bulgular: Taramada 23 erkek ile 20 kadının öldüğü belirlendi. Ölümlerin 21’i koroner hastalığa, dördü serebrovasküler olaya bağlandı. Tüm kohortun 19 yıllık takibinde, 45-74 yaş kesiminde koroner kalp hastalığı kökenli ölümler erkeklerde 1000 kişi-yılında 7.5, kadınlarda 3.9 düzeyinde bulundu. Toplam 405 ölümü (235 kardiyovasküler ölüm) ve 24 bin kişi-yılını aşan izlemi kapsayan Cox regresyon analizinde, kırsal alanda ve kentlerde oturanlar benzer yaş-ayarlı ölüm oranları sergiledi. Kentli kadınlarda, kırsalda yaşayan hemcinslerine göre genel mortalite daha yüksek bulundu (HR 1.41; %95 GA 1.02-1.96).Sonuç: Kardiyovasküler mortalitenin hem mutlak, hem de genel ölümdeki payı yüksek olmayı sürdürmektedir; bu konuda kır-kent farkı gözlenmedi. Kentte yaşayan kadınlarda yaş-ayarlı tüm nedenli ölüm oranı, kırsal alan hemcinslerine göre daha yüksektir.
Tekharf Taramasında Ölüm Yaşı: 56700 Kişi-yıllık İzlemede Dönemsel Eğilim ve Bölgesel Dağılım
(2009) Bulur, Serkan; Küçükdurmaz, Zekeriya; Onat, Altan; Kaya, Hasan; Kaya, Zekeriya; Uğur, Murat; Ayhan, Erkan
Amaç: TEKHARF Çalışması’nın 18 yıllık takibinde tüm-nedenli ölümdeki yaş verilerinin zaman dilimine ve bölgelere bağlı değişimi ve cinsiyete özgü ve belirli yaş kesimindeki koroner mortalite değerlendirildi. Çalışma planı: TEKHARF Çalışması’nın çift yıllarda taranan kohortu 2008 Ağustos ayında yeniden izlendi. Taramaya giren kohortun toplam sayısı 1582 kişi idi ve ülke genelinde hayatta bulunan izlenecek TEKHARF kohortunun yarısını oluşturuyordu. Ölüm konusunda birinci derece akraba ve/veya sağlık ocağı personelinden bilgi alındı; yaşayanlarda bilgi edinmekten başka, fizik muayene ve 12-derivasyonlu EKG kaydı yapıldı. Toplam takip süresi 56700 kişi-yılıydı. Bulgular: Örneklemin 868’i (431 erkek, 437 kadın) muayene edildi, 604 kişi hakkında bilgi edinildi ve 47 kişinin (26 erkek, 21 kadın) öldüğü belirlendi. Ölümlerin 22’si koroner kalp hastalığı (KKH) kökenli sayıldı. Tüm kohortun 18 yıllık takibinde 45-74 yaş kesiminde KKH kökenli ölümler erkeklerde 1000 kişi-yılında 7.64, kadınlarda 3.84 düzeyinde bulundu ve böylece 30 Avrupa ülkesi içinde en yüksek seviyede süregeldiği gözlemlendi; oysa, genel mortalitedeki gerileme daha yüksek orandaydı. Ortalama ölüm yaşı Türkiye genelinde 12 yıl içerisinde erkeklerde 7.4 yıl, kadınlarda altı yıl ertelenerek, 2003-08 döneminde sırasıyla ortalama 71.9 ve 74.8’e ulaştı. Ortalama ömürdeki bu uzama kentsel ve kırsal kesimler ile coğrafi bölgelerde benzerdi. Sonuç: Yetişkinlerimizde koroner mortalite az gerilemiş, ama ömür süresi son 12 yılda yedi yıla varan belirgin uzama göstermiştir; bu uzamanın erkek-kadın, kent-kır sakinleri ve coğrafi bölgelerde önemli farklar sergilemediği gözlenmiştir.
The Turkish Adult Risk Factor Survey 2009: Similar Cardiovascular Mortality in Rural and Urban Areas
(Turkish Soc Cardiology, 2010) Onat, Altan; Ugur, Murat; Cicek, Gokhan; Ayhan, Erkan; Dogan, Yuksel; Kaya, Hasan; Can, Gunay
Objectives: We analyzed the 2009 survey of the Turkish Adult Risk Factor (TARF) Study to assess the distribution of all-cause and cardiovascular mortality in urban and rural areas and gender-specific coronary mortality in the age-range of 45 to 74 years. Study Design: The Marmara and Central Anatolian regions have been surveyed every odd year in the TARF Study. In 2009, 1,655 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office; 960 participants underwent physical examination and ECG recording, and 572 subjects were evaluated on the basis of information obtained regarding health status. Results: In the survey, 23 men and 20 women were ascertained to have died. Twenty-one deaths were attributed to coronary disease and four deaths to cerebrovascular events. Assessment of the entire cohort in the age range of 45-74 years after a 19-year follow-up disclosed a high coronary mortality with 7.5 per 1000 person-years in men and 3.9 in women. In a Cox regression analysis comprising 405 deaths (235 cardiovascular) and over 24,000 person-year follow-up, age- adjusted cardiovascular mortality was similar in rural and urban participants. All- cause mortality was higher in females living in urban areas than those living in rural areas (HR 1.41; 95% CI 1.02-1.96). Conclusion: Cardiovascular mortality both in absolute terms and as a share of overall mortality persists to be high among Turkish adults, with similar rates in urban and rural areas. Age-adjusted all-cause mortality rate is higher among urban versus rural women.
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