Browsing by Author "Kaya, Yuksel"

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Accelerated Atherosclerosis in Haemodialysis Patients; Correlation of Endothelial Function With Oxidative Dna Damage
(Oxford Univ Press, 2012) Kaya, Yuksel; Ari, Elif; Demir, Halit; Soylemez, Nihat; Cebi, Aysegul; Alp, Hakan; Beytur, Ali
Background. Accelerated atherosclerosis is the major cause of mortality in patients on chronic haemodialysis (HD). The aim of this study was to evaluate the relationship between oxidative DNA damage [8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio)], oxidative stress biomarkers and endothelial function in HD patients as an indicator of atherosclerosis. Methods. Forty-four chronic HD patients without known atherosclerotic disease and 55 age- and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. Endothelial function was assessed by ultrasonography. Results. 8-OHdG/dG ratio and MDA levels were higher in HD patients than controls while SOD and GPx activities were lower in HD patients compared to controls. Flow-mediated dilatation FMD% in HD patients were lower than the control group (7.28 +/- 0.79 versus 11.18 +/- 0.82, P < 0.001). There was a significant negative correlation between FMD% and 8-OHdG/dG ratio (r = -0.678, P < 0.01) and MDA levels (r = 0.517, P < 0.01), while there was a significant positive correlation between FMD% and SOD (r = 0.538, P < 0.01) and GPx levels (r = 0.720, P < 0.01). Conclusions. Our data have demonstrated that HD patients exhibit increased oxidative DNA damage and decreased antioxidant activity. We propose that endothelial function is negatively correlated with 8-OHdG/dG ratio and positively correlated with antioxidant enzymes. To our knowledge, this is the first study to demonstrate the inverse relationship between endothelial function and plasma oxidative DNA damage in HD patients.
Association of Coronary Sinus Diameter With Pulmonary Hypertension
(Blackwell Publishing, 2008) Gunes, Yilmaz; Guntekin, Unal; Tuncer, Mustafa; Kaya, Yuksel; Akyol, Aytac
Background: Impaired venous drainage secondary to increased right atrial pressure (RAP) may result in coronary sinus (CS) dilatation. Methods: Two hundred fifteen patients referred for transthoracic echocardiography were included in the study. CS diameters were measured from apical four-chamber view with the transducer being slightly tilted posteriorly to the level of the dorsum of the heart. Pulmonary artery systolic pressure (PASP) is estimated by measurement of tricuspid regurgitation velocity (v) and estimate RAP based on size and collapsibility of inferior vena cava (VCI) with the formula PASP: 4v(2)+ RAP. Patients with PASP > 35 mmHg were considered to have pulmonary hypertension (PH). Results: CS diameter was measured in 80.3% of the patients with normal PASP (8.1 +/- 2.4 mm) and 93.1% of the patients having PH (12.3 +/- 2.5 mm). PASP was significantly correlated with CS diameter (r = 0.647, P < 0.001), RA volume index ( r = 0.631, P < 0.001), RV volume index (r = 0.475, P < 0.001), VCI diameter (r = 0.365, P < 0.001), and left ventricular ejection fraction (LVEF) (r = - 0.270, P < 0.001). CS diameter was also correlated significantly with estimated RAP (r = 0.557, P < 0.001), RA volume index (r = 0.520, P < 0.001), RV volume index (r = 0.386, P < 0.001), LVEF (r = - 0.327, P < 0.001), and VCI diameter (r = 0.313, P < 0.001). Multivariate analyses, testing for independent predictive information of CS size, VCI diameter, RA and RV volume indexes, and estimated RAP for the presence of PH revealed that estimated RAP (beta = 0.465, P < 0.001) and CS size (beta = 0.402, P = 0.003) were the significant predictors. Conclusions: Coronary sinus is dilated in patients with pulmonary hypertension. Coronary sinus diameter significantly correlates with PASP, RAP, right heart chamber volumes, LVEF, and VCI diameter.
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.
Changes in Serum Natriuretic Peptide Levels After Percutaneous Closure of Small To Moderate Ventricular Septal Defects
(Hindawi Publishing Corporation, 2012) Kaya, Yuksel; Akdemir, Ramazan; Gunduz, Huseyin; Murat, Sani; Bulut, Orhan; Kocayigit, Ibrahim; Acar, Zeydin
Background. B-type natriuretic peptide has been shown to be a very sensitive and specific marker of heart failure. In this study, we aimed to investigate the effect of percutaneous closure of ventricular septal defects with Amplatzer septal occluders on brain natriuretic peptide levels. Methods. Between 2008 and 2011, 23 patients underwent successfully percutaneous ventricular septal defect closure in 4 cardiology centers. Brain natriuretic peptide levels were measured in nine patients (4 male, mean ages were 25.3 +/- 14.3) who underwent percutaneous closure with Amplatzer occluders for membranous or muscular ventricular septal defects were enrolled in the study. Brain natriuretic peptide levels were measured one day before and one month after the closure. Patients were evaluated clinically and by echocardiography one month after the procedure. Results. Percutaneous closures of ventricular septal defects were successfully performed in all patients. There was not any significant adverse event in patients group during followup. Decrease in brain natriuretic peptide levels after closure were statistically significant (97.3 +/- 78.6 versus 26.8 +/- 15.6, P = 0.013). Conclusion. Brain Natriuretic Peptide levels are elevated in patients with ventricular septal defects as compared to controls. Percutaneous closure of Ventricular Septal Defect with Amplatzer occluders decreases the BNP levels.
Characteristics and Transcatheter Closure of Patent Ductus Arteriosus in Patients Living at Moderate To High Altitude in Eastern Anatolia
(Turkish Soc Cardiology, 2019) Epcacan, Serdar; Bulut, Mustafa Orhan; Kaya, Yuksel; Yucel, Ilker Kemal; Cakir, Cayan; Sisli, Emrah; Celebi, Ahmet
Objective: The incidence of patent ductus arteriosus (PDA) is greater among patients living at high altitude. In this population, the ductal diameter is often larger and pulmonary hypertension is more frequent. The aim of this study was to evaluate the hemodynamic and morphological features of PDA and transcatheter closure procedures performed with various devices in a group of patients living at high altitude in Turkey. Methods: The data of 327 patients who lived at an altitude of at least 1600 m above sea level and who had undergone cardiac catheterization for isolated PDA between May 2010 and July 2018 were retrospectively analyzed. Results: The mean age was 7.33 +/- 7.67 years, and 62.4% of the patients were female. The mean ductal diameter was 3.74 +/- 2.14 mm. Pulmonary hypertension was present in 57.8%. Transcatheter closure was performed in 322 patients, with a 97.3% success rate. The Amplatzer duct occluder I (ADO I) was used most often, as well as off-label use of the Amplatzer vascular plug II (AVP) and the Amplatzer muscular ventricular septal defect occluder (AMVSDO). Pulmonary artery pressure decreased immediately in the vast majority after percutaneous closure. Transient left ventricular systolic dysfunction after ductal closure was seen only rarely. Follow-up was uneventful. Conclusion: Transcatheter PDA closure can be performed with high success rate in highlanders. Off-label devices may be required for these procedures. Pulmonary hypertension is frequent but regresses after ductal closure. Transient left ventricular dysfunction after transcatheter closure is rarely seen in these patients and resolves without any medication.
Cinacalcet May Improve Oxidative Dna Damage in Maintenance Hemodialysis Patients: an Observational Study
(Springer, 2014) Ari, Elif; Kaya, Yuksel; Demir, Halit; Asicioglu, Ebru; Eren, Zehra; Celik, Eray; Arikan, Hakki
Oxidative stress is accepted as a non-classical cardiovascular risk factor in patients on maintenance hemodialysis (HD). The aim of this study was to evaluate the impact of cinacalcet on oxidative stress biomarkers, oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine), endothelial function (FMD %) and carotid artery intima-media thickness (CIMT) in HD patients. Forty-two chronic HD patients with secondary hyperparathyroidism undergoing 60 mg/day cinacalcet treatment with a follow-up of 6 months and 38 age- and sex-matched healthy individuals were included in this prospective study. Plasma malondialdehyde (MDA) levels and 8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG) were determined as oxidative stress markers. Superoxide dismutase (SOD), paraoxonase (PON), catalase (CAT), carbonic anhydrase (CAN) and glutathione peroxidase (GPx) activities were measured as antioxidants. FMD % and CIMT were assessed by ultrasonography. MDA levels were decreased; SOD, PON, CAT, CAN and GPx activities were increased after 6 months of cinacalcet treatment in HD patients. Although CIMT remained stabile, there was a significant improvement in FMD % as well as a notable reduction trend in 8-OHdG/dG ratio after 6 months of treatment. Our data have demonstrated that cinacalcet improves oxidative stress, genomic damage, endothelial function and increases antioxidant protection in HD patients after 6 months of treatment.
Comparison of Inflammatory Markers in Non-Dipper Hypertension Vs. Dipper Hypertension and in Normotensive Individuals: Uric Acid, C-Reactive Protein and Red Blood Cell Distribution Width Readings
(Termedia Publishing House Ltd, 2014) Tosu, Aydin Rodi; Demir, Serafettin; Selcuk, Murat; Kaya, Yuksel; Akyol, Aytac; Ozdemir, Mahmut; Tenekecioglu, Erhan
Aim: In this study, we investigated the relationship of increased inflammatory parameters (C-reactive protein - CRP), oxidative stress markers (serum uric acid -SUA) and red blood cell distribution width (RDW) with non-dipper hypertension (NDHT). Material and methods: Among the individuals who presented to the cardiology clinic, 40 patients (32.5% male, 67.5% female; mean age: 54.4+/-7.1) who had hypertension and were diagnosed with NDHT through ambulatory blood pressure monitoring, 40 age- and sex-matched dipper hypertension (DHT) patients (25% male, 75% female, mean age: 54.2+/-7.0), and 40 normotensive individuals (42.5% male, 57.5% female, mean age: 51.9+/-9.0) were enrolled in the study. Peripheral venous blood samples were collected from all the patients in order to evaluate the hematological and biochemical parameters. All the assessed parameters were compared among the groups. Results: The CRP, RDW and uric acid levels were observed to be significantly higher in the non-dipper hypertension group in comparison to the dipper hypertension patients and the normotensive population (p < 0.05). These parameters were also significantly higher in the dipper HT group compared to the normotensive population (p < 0.05). Conclusions: We found in our study that increased CRP, uric acid and RDW levels, which are indicators of increased inflammation and oxidative stress, are significantly higher in the non-dipper HT patients in comparison to the dipper HT patients and control group.
Correlation Ima With Timi Frame Count in Slow Coronary Flow: Can It Be a Guide for Treatment
(Taylor & Francis Ltd, 2020) Babat, Naci; Kaya, Yuksel; Demir, Halit
Aim Coronary slow flow (CSF) is defined as late opacification in epicardial coronary arteries with no significant stenosis. The aim of this study is to evaluate the relationship between ischemia-modified albumin (IMA) by using Spectrophotometer in CSF. Methods Level of IMA was measured by spectrophotometer. CSF patients were chosen for the determination of IMA level. All obtained data were compared with control groups. Results Serum IMA levels increased in the CSF group. It was observed that there was a significant increase in IMA levels in patients with CSF when compared to controls (p < 0.05). Conclusion IMA may play a role in the pathogenesis of CSF. IMA levels in the serum can be considered as a marker to predict coronary slow flow. IMA level can be used as a guide for coronary slow flow. Also, as increases number square frame, value IMA Increases similarly. It was found that the severity of impotence was correlated with CSF. Therefore, the IMA level may be predictive of the course of treatment. This study is the first one to show the relationships of IMA in CSF. In addition, further studies should be performed on IMA in CSF patients.
The Correlation of Serum Trace Elements and Heavy Metals With Carotid Artery Atherosclerosis in Maintenance Hemodialysis Patients
(Springernature, 2011) Ari, Elif; Kaya, Yuksel; Demir, Halit; Asicioglu, Ebru; Keskin, Siddik
Changes in essential trace elements and heavy metals may affect the atherosclerotic state of patients on maintenance hemodialysis (HD). The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio) and carotid artery intima-media thickness (CIMT) in HD patients. Fifty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM-929). CIMT was assessed by carotid artery ultrasonography. The serum levels of iron, zinc, and manganese were lower; levels of copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio were higher in HD patients compared to controls. CIMT in HD patients were higher than the control group (0.64 +/- 0.11 vs 0.42 +/- 0.05, p < 0.001). There was a significant negative correlation between CIMT and serum levels of zinc (r = -0.70, p < 0.01), iron (r = -0.71, p < 0.01), and manganese (r = -0.47, p < 0.01), while there was a significant positive correlation between CIMT and serum levels of copper (r = 0.63, p < 0.01), magnesium (r = 0.77, p < 0.01), cobalt (r = 0.63, p < 0.01), cadmium (r = 0.48, p < 0.01), lead (r = 0.38, p < 0.01), and copper/zinc ratio (r = 0.68, p < 0.01). A linear regression analysis showed that serum levels of magnesium, cadmium, lead, and copper/zinc ratio were still significantly and positively correlated with CIMT. We propose that copper/zinc ratio, magnesium and toxic metals cadmium and lead are independent determinants of CIMT in maintenance HD patients without known atherosclerotic disease.
Correlations Between Oxidative Dna Damage, Oxidative Stress and Coenzyme Q10 in Patients With Coronary Artery Disease
(Ivyspring int Publ, 2012) Kaya, Yuksel; Cebi, Aysegul; Soylemez, Nihat; Demir, Halit; Hakan, Hamit A. L. P.; Bakan, Ebubekir
The correlation of coronary artery disease ( CAD) with pro-oxidant/antioxidant balance and oxidative DNA damage was investigated. Seventy-seven patients with CAD and 44 healthy individuals as control were included in this study. The comparative ratios of ubiquinol-10/ubiquinone-10, 8-hydroxy-2'-deoxyguanosine/ deoxyguanosine and the level of MDA measured by HPLC and the activities of GPX and SOD by colorimetric approach in blood samples obtained from patients with CAD were unraveled. 8-OHdG/dG ratios, serum MDA level and GPX activity were found significantly elevated level in serum of CAD patients compared to control group. The SOD activity was observed in stable levels in CAD patients. Ubiquinol-10/ubiquinone-10 ratio was significantly lower in patients with CAD than the controls. The positive correlation was observed between 8-OHdG/dG ratios in both MDA levels and GPX activity, while the significant negative correlation was seemed between the ratio of 8-OHdG/dG and ubiquinol-10/ ubiquinone-10 as well as MDA levels and ubiquinol-10/ubiquinone-10 ratio. We conclude that, both the disruption of pro-oxidant/antioxidant balance and oxidative stress in DNA may play an important role in the pathogenesis of coronary artery disease.
Decreased Serum Selenium Levels Are Correlated With Diminished Coronary Flow Reserve Among Hemodialysis Patients
(Humana Press inc, 2013) Atakan, Aydin; Macunluoglu, Beyza; Kaya, Yuksel; Ari, Elif; Demir, Halit; Asicioglu, Ebru; Kaspar, Cigdem
Cardiovascular diseases are the main reason of high mortality among hemodialysis patients. Decreased serum selenium levels may have a role in accelerated atherosclerosis in this patient group. The hypothesis of this study was to show a correlation between decreased serum selenium levels and coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in HD patients. Seventy-one chronic hemodialysis patients and age 65 and sex-matched healthy controls were included in the study. Plasma selenium levels were measured by spectrophotometry, and coronary flow reserve was assessed by transthoracic Doppler echocardiography. Serum selenium levels (34.16 +/- 6.15 ng/ml vs. 52.4 +/- 5.51 ng/ml, P < 0.001) and coronary flow reserve values (1.73 +/- 0.11 vs. 2.32 +/- 0.28, P < 0.001) were significantly lower in hemodialysis patients compared with controls, respectively. There was a significant positive correlation between coronary flow reserve and serum levels of selenium (r = 0.676, P < 0.001). A linear regression analysis showed that serum levels of selenium were independently and positively correlated with coronary flow reserve (regression coefficient = 0.650, P < 0.05). This study was the first to show a positive and independent correlation between decreased selenium levels and diminished coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in hemodialysis patients. Our data suggest that decreased serum selenium levels may facilitate the development of endothelial dysfunction and disruption of coronary flow reserve which occur before the development of overt atherosclerosis.
The Effect of Altitude on P-Wave and Qt Duration and Dispersion
(Wiley, 2008) Guntekin, Unal; Gunes, Yilmaz; Tuncer, Mustafa; Gumrukcuoglu, Hasan Ali; Kaya, Yuksel
Background: Short-term and long-term exposure to high altitude has been reported to change the surface electrocardiogram. We aimed to compare P-wave and QT parameters between healthy people living at high altitude and sea level. Methods: Twelve-lead electrocardiographies of 38 healthy people living at sea level (Antalya,Turkey) and 38 healthy people living at high altitude (Van, Turkey; 1,700-1,800 m) were obtained. Minimum and maximum P-wave durations, P-wave dispersion, minimum and maximum corrected QT intervals, and corrected QT dispersion were calculated. Results: There was no significant difference between the two groups in respect to heart rate and QT variables. Mean Pminimum values were slightly but significantly lower in the high altitude group (P = 0.029). Mean Pmaximum values tended to be lower at high altitude but did not reach statistical significance (P = 0.085). However, there was no significant difference in respect to P-wave dispersion values. Conclusions: In a sample of men and women living at high altitude in Turkey, significant reduction of Pminimum and borderline reduction of Pmaximum duration, but no significant change of P-wave and QT dispersion, were observed.
Epicardial Fat Thickness Is Associated With Impaired Coronary Flow Reserve in Hemodialysis Patients
(Wiley, 2014) Atakan, Aydin; Macunluoglu, Beyza; Kaya, Yuksel; Ari, Elif; Demir, Halit; Asicioglu, Ebru; Kaspar, Cigdem
Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross-sectional study including 71 chronic HD patients and 65 age- and sex-matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53 +/- 1.01 mm vs. 5.79 +/- 1.06 mm, respectively, P < 0.001). On transthoracic Doppler echocardiography, CFR values were significantly lower in HD patients when compared to healthy controls (1.73 +/- 0.11 vs. 2.32 +/- 0.28, P < 0.001). Correlation analysis showed CFR values to be inversely correlated with EFT (r = -0.287, P < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. Artery flow reserve, age, body mass index and total cholesterol levels were independently correlated with EFT thickness. This study demonstrated that EFT was significantly higher among HD patients compared to healthy controls. In addition, this study was the first to demonstrate an inverse correlation between EFT and CFR in this patient population.
Epicardial Fat Tissue Thickness Is Correlated With Diminished Levels of Co-Enzyme Q10, a Major Antioxidant Molecule Among Hemodialysis Patients
(Pergamon-elsevier Science Ltd, 2014) Macunluoglu, Beyza; Atakan, Aydin; Ari, Elif; Kaya, Yuksel; Kaspar, Cigdem; Demir, Halit; Alp, Hamit Hakan
Objectives: Accelerated atherosclerosis is the major cause of mortality in patients on chronic maintenance hemodialysis (HD). Epicardial fat tissue (EFT) is a new risk factor in cardiovascular disease (CVD). The aim of this study was to evaluate the relation between plasma coenzyme Q10 levels (Co-Q10) which is a potent physiologic antioxidant and EFT thickness in HD patients. Design and methods: Seventy one chronic HD patients and 65 age and sex matched healthy individuals were included in the study. Plasma Co-Q10 levels were performed by high-performance liquid chromatography (HPLC) measurements. EFT was measured by transthoracic echocardiograpy (TTE) performed with a VIVID 7 instrument. Results: Plasma Co-Q10 levels (1.36 +/- 0.43 vs 2.53 +/- 0.55, p < 0.001) were significantly lower in HD patients compared to controls. EFT was significantly increased in HD patients compared to healthy controls (6.53 +/- 1.01 vs. 5.79 +/- 1.06 mm respectively, p < 0.001). Correlation analysis showed that plasma Co-Q10 levels were inversely correlated with EFT (r = -0.263, p < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. According to linear regression analysis, age, BMI, total cholesterol and Co-Q10 levels were found to be independent predictors of EFT (adjusted r(2) = 0.38, p < 0.001). Conclusion: This study demonstrated that EFT thickness was significantly higher among HD patients compared to healthy controls. In addition; this study was the first to demonstrate an inverse correlation between EFT thickness and Co-Q10 levels in this patient population. (C) 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Flow-Mediated Dilatation Facilitates Transradial Coronary Angiography: a Comparative Study
(Termedia Publishing House Ltd, 2024) Tuner, Hasim; Kaya, Yuksel; Bingol, Gulsuem; Ozden, Ozge; Unlu, Serkan; Ozmen, Emre; Ozturk, Fatih
Introduction: Radial artery (RA) spasm is demonstrated to be one of the most common complications of transradial approach (TRA). Aim: We hypothesised that radial flow-mediated dilation (FMD) can be used as a preprocedural method to assess the likelihood of arterial spasm. Material and methods: The patients were divided into 2 groups: those with and without flow-mediated RA dilatation. A blood pressure cuff was placed on the upper part of the antecubital region of the patients in the FMD group and inflated for 10 min, allowing the pressure to rise to 30 mm Hg above the systolic blood pressure. RA diameters of the patients in both groups were measured via quantitive coronary angiography method before transradial coronary angiography. Results: A total of 165 patients were included in the study, of whom 64 (38.8%) were women. The median age of the patients was 56 years (48-63). The mean RA diameter was significantly larger in the FMD group (3.44 +/- 0.48 vs. 2.96 +/- 0.46 mm, p < 0.001), and the number of punctures required for successful transradial cannulation was found to be significantly higher in the group without FMD (1.55 +/- 0.7 vs. 1.20 +/- 0.64; p < 0.001). Linear regression analysis revealed diabetes and FMD as independent predictors of RA diameter. In the diabetic subgroup, RA diameter remained larger in the FMD group (3.00 +/- 0.35 vs. 2.78 +/- 0.26, p = 0.036). Radial puncture attempts were significantly higher in the control group compared to the FMD group (1.55 +/- 0.7 vs. 1.20 +/- 0.64; p < 0.001). Conclusions: In our study, we demonstrated that FMD created by pressure application significantly increased RA diameter and reduced puncture attempt during TRA.
Increased Plasma High-Sensitivity C-Reactive Protein and Myeloperoxidase Levels May Predict Ischemia During Myocardial Perfusion Imaging in Slow Coronary Flow
(Elsevier Science inc, 2014) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Kaya, Yuksel; Ozdemir, Mahmut
Background and Aims. It is unclear whether changes in plasma levels of inflammatory markers could explain the link between ischemia and slow coronary flow (SCF). The aim of the study was to evaluate the plasma levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, and myeloperoxidase (MPO) during myocardial perfusion imaging (MPI) in SCF patients. Methods. The study population consisted of 53 SCF patients and 30 controls. Coronary flow rates were documented by TEVII frame count (TFC). Plasma levels of hsCRP, IL-6, MPO, and MPI were obtained in all participants. Results. hsCRP, IL-6 and MPO levels of SCF patients were higher than controls (hsCRP: 4.7 +/- 2.5 vs. 1.7 +/- 1.1 mg/L, p <0.001; IL-6: 8.2 +/- 4.3 vs. 5.2 +/- 2.1 pg/mL, p <0.001;. and MPO: 75.9 +/- 59.6 vs. 24.3 +/- 16.7 ng/mL, p <0.001). Twenty-one SCF patients exhibited myocardial perfusion defect (MPD) on MPI. In SCF patients, the highest hsCRP, IL-6 and MPO levels were observed in patients with both MPD and three-vessel slow flow. Mean TFCs were positively correlated with plasma levels of hsCRP (r = 0.424, p = 0.002), IL-6 (r = 0.367, p = 0.007), MPO (r = 0.430, p = 0.001), and reversibility score (r = 0.671, p <0.001) in SCF patients. HsCRP and MPO were the independent variables, which predicted positive MPI results (hsCRP: OR, 2.176; 95% CI, 1.200-3.943; p = 0.010, MPO: OR, 1.026; 95% CI, 1.007-1.046; p = 0.008). Conclusions. Inflammation may play a crucial role in both the pathogenesis and development of ischemia in SCF. Association of increased levels of inflammatory markers and ischemia suggests that endothelial inflammation may be largely responsible for clinical presentation. New combined treatment regimens should target endothelial activation and inflammation in SCF. (C) 2014 IMSS. Published by Elsevier Inc.
Increased Plasma Hscrp and Mpo Levels May Predict Ischemia During Mpi in Slow Coronary Flow
(Elsevier Science inc, 2013) Yurtdas, Mustafa; Yaylali, Yalin Tolga; Ozdemir, Mahmut; Kaya, Yuksel; Arin, Can Baba
Increased Qt Dispersion and P Wave Dispersion in Major Depressive Disorder
(Cardiology Academic Press, 2013) Tosu, Aydin Rodi; Demir, Serafettin; Kaya, Yuksel; Selcuk, Murat; Asker, Muntecep; Ozdemir, Mahmut; Tenekecioglu, Erhan
BACKGROUND: QT and P wave dispersion parameters can indicate abnormalities in autonomic nervous system and cardiac functioning. OBJECTIVES: To determine QT and P wave dispersion in patients with major depressive disorder compared with healthy volunteers. METHODS: Fifty newly diagnosed patients with major depressive disorder and 50 age- and sex-matched healthy volunteers underwent 12-lead electrocardiography. QT interval, QT dispersion, heart rate-corrected QT dispersion and P wave dispersions were calculated manually by a blinded specialist. RESULTS: Groups were comparable in terms of age, sex, body mass index, smoking status, metabolic diseases and left ventricular ejection fraction. The major depressive disorder group had significantly higher QT dispersion (58.5 +/- 9.9 versus 41.7 +/- 3.8; P<0.001), heart rate-corrected QT dispersion (62.5 +/- 10.0 versus 45.2 +/- 4.3; P<0.001) and P wave dispersion (46.9 +/- 4.8 versus 41.5 +/- 5.1; P<0.001). CONCLUSION: Increased QT dispersion, heart-rate corrected QT dispersion and P wave dispersion in major depressive disorder patients may be indicative of autonomic imbalance and increased risk of cardiac morbidity and mortality.
Incremental Diagnostic Value of Color M-Mode Propagation Velocity of the Descending Thoracic Aorta To Exercise Electrocardiography
(Turkish Soc Cardiology, 2010) Gunes, Yilmaz; Gumrukcuoglu, Hasan Ali; Kaya, Yuksel; Tuncer, Mustafa
Objectives: Exercise electrocardiography test (EET) has limited sensitivity and specificity. Recently, color M-modederived propagation velocity of the descending thoracic aorta (APV) has been shown to be associated with coronary artery disease (CAD). We evaluated the incremental value of APV for better prediction of CAD in EET-positive patients. Study design: Color M-mode APV was measured in 342 patients undergoing EET for chest pain and an intermediate likelihood of CAD. Coronary angiography was performed in 199 patients having a positive EET. Results: The mean APV was 44.5 +/- 20.8 cm/sec in patients with a positive EET compared to 63.5 +/- 19.6 cm/sec in those with a normal test. Significant CAD was detected in 134 patients (67.3%), involving one vessel (n=41), two vessels (n=52), and three vessels (n=41). Patients with CAD had significantly lower APV values compared to patients with normal coronary arteries (33.8 +/- 13.2 vs. 66.6 +/- 15.6 cm/sec, p<0.001). An APV value of <= 41 cm/sec predicted CAD with 85.1% sensitivity and 93.8% specificity. An APV of >61 cm/sec had 94% specificity for the estimation of normal coronary arteries. A threshold of >41 cm/sec and a threshold of >61 cm/sec would have avoided unnecessary coronary angiography in 30.7% (61/199) and 21.6% (43/199) of patients with a positive EET but high APV values, with negative predictive values of 75.3% and 84.3%, respectively. In correlation analysis, APV was significantly correlated with Duke treadmill score (r=0.587, p<0.001) and the number of coronary vessels involved (r=-0.767, p<0.001), but not with any of the echocardiographic parameters. Conclusion: Measurement of APV may improve diagnostic value of EET and may be specifically valuable to exclude false positive EET results, leading the physician to other noninvasive tests for further evaluation of CAD probability.
Neutrophil-To Ratio May Predict Subclinical Atherosclerosis in Patients With Psoriasis
(Wiley, 2014) Yurtdas, Mustafa; Yaylali, Yalin T.; Kaya, Yuksel; Ozdemir, Mahmut; Ozkan, Ilker; Aladag, Nesim
Background: Systemic inflammation beyond the skin may provide an explanation of the increased cardiovascular risk observed in psoriasis. It was hypothesized that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are potential predictors of subclinical atherosclerosis measured by aortic velocity propagation (AVP) and carotid intima-media thickness (CIMT) in psoriasis. Methods: Fifty-one patients with psoriasis taking no antipsoriatic therapy and 37 age- and sex-matched healthy controls were prospectively enrolled. The Psoriasis Area and Severity Index (PASI) was calculated. Complete blood counts were obtained. Measurements of AVP and CIMT were performed. Results: The baseline clinical and demographic features, and white blood cell, platelet, neutrophil, lymphocyte, monocyte, and PLR were similar in both groups. NLR and high-sensitivity C-reactive protein (hs-CRP) were higher in the psoriasis group than the control group (P = 0.001, P < 0.001; respectively). The psoriasis group had lower AVP and higher CIMT values than those of controls (AVP: 48.9 +/- 18.1 vs. 64.3 +/- 14.5 cm/sec; P < 0.001, CIMT: 0.84 +/- 0.29 vs. 0.63 +/- 0.27 mm; P = 0.001, respectively). PASI was positively correlated with NLR and hs-CRP (r = 0.423, P = 0.002; r = 0.315, P = 0.024, respectively). There was an inverse association between AVP and CIMT (r = -0.749, P < 0.001). Binary logistic regression analysis demonstrated that NLR was the only variable able to predict lower AVP (= 41 cm/sec) and higher CIMT (>0.9 mm) values (P = 0.024 and 0.023; respectively). Conclusion: NLR is potentially an unrecognized predictor of subclinical atherosclerosis in patients with psoriasis. Future studies assessing the prognostic significance of NLR on cardiovascular event rates in psoriasis patients would be of great interest.