Browsing by Author "Saylik, Faysal"

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The Association Between Whole Blood Viscosity and High Thrombus Burden in Patients With Non-St Elevation Myocardial Infarction
(Polish Cardiac Soc, 2022) Cinar, Tufan; Saylik, Faysal; Akbulut, Tayyar; Asal, Suha; Selcuk, Murat; Cicek, Vedat; Orhan, Ahmet Lutfullah
Background: Prior studies showed that patients with elevated whole blood viscosity (WBV) had a higher risk of arterial thrombosis, acute stent thrombosis, and left ventricular apical thrombus presence after acute coronary syndrome. This investigation aimed to determine the association between WBV and high thrombus burden (HTB) in non-ST elevation myocardial infarction (NSTEMI) patients treated with percutaneous coronary intervention (PCI). Methods: This retrospective cohort investigation included data from consecutive 290 NSTEMI patients who received PCI at a tertiary institution. Patients with grade 1-3 thrombus burden were categorized as having low thrombus burden (LTB) (n = 178), whereas those with grade 4-5 thrombus burden were classified as having HTB (n = 112). WBV at high shear rate (HSR) and low shear rate (LSR) were estimated using hematocrit (HTC) and total protein levels. Results: Patients with HTB had higher WBV at both LSR and HSR. In HTB patients, the frequency of infarct-related artery (IRA) reference vessel diameter, distal embolization, and no-reflow was also higher. Multivariable logistic regression models indicated that WBV at LSR (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.014-1.043; P < 0.001) and HSR (OR, 1.606; 95% CI, 1.334-1.953; P < 0.001) were independent predictors of HTB in NSTEMI patients. Notably, the area under the curve value of WBV at both shear rates was greater than that of its components, including total protein and HTC. Conclusion: This is the first study showing that WBV at both shear rates is a significant predictor of HTB in NSTEMI patients.
The Association of a Precise-Dapt Score With No-Reflow in Patients With St-Segment Elevation Myocardial Infarction
(Sage Publications inc, 2022) Selcuk, Murat; Cinar, Tufan; Saylik, Faysal; Demiroz, Onder; Yildirim, Ersin
This study aimed to evaluate the association of admission PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score with the development of no-reflow (NR) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). In this observational, retrospective study, 335 consecutive STEMI patients who were treated with primary PCI were included. We classified the study population into 2 groups: patients with a PRECISE-DAPT score <25 and those with a PRECISE-DAPT score >= 25. Overall, 30 (8.9%) patients developed NR. The mean PRECISE-DAPT score (20.03 +/- 15.32 vs 11.33 +/- 12.18; P = .005) was significantly higher in cases who developed NR. Moreover, arrhythmic complications, in-hospital shock, and in-hospital mortality rates were significantly higher in patients with a PRECISE-DAPT score >= 25 compared to those with a PRECISE-DAPT score <25. According to a multivariable analysis, the PRECISE-DAPT score was found to be independently linked with NR (odds ratio: 2.87, with P = .015). To our knowledge, these data are the first in major medical science databases to determine the relationship between the PRECISE-DAPT score and the NR phenomenon in patients with STEMI undergoing primary PCI.
Association of Coronary Artery Severity and Late In-Stent Restenosis: an Angiographic Imaging Study
(Sage Publications inc, 2024) Oguz, Mustafa; Akbulut, Tayyar; Saylik, Faysal; Sipal, Abdulcabbar; Erdal, Emrah
Coronary in-stent restenosis (ISR) remains a challenge in interventional cardiology. We investigated the relationship between angiographic pre-interventional grade of lesion stenosis (LS) and the prognosis of late ISR. After exclusions, 110 patients with ISR and 109 patients without ISR were compared. In the ISR group, the grade of LS was greater (P < .001) and the length of the critical segment (LCS) was longer (P < .001). Stent length was longer in the ISR group (P = .008). Compared with the LCS, the grade of LS above 87.5% is 6.9 times more predictive of ISR than the LCS >10.5 mm. Kaplan-Meier curve analysis showed that the grade of initial LS >87.5% had a higher ISR rate than the grade of LS <87.5% (log-rank test P < .001) and critical lesion length over 10.5 mm had a higher ISR rate than critical lesion length under 10.5 mm (log-rank test P < .001). The present study found that the angiographic pre-interventional grades of LS and LCS were important predictors of ISR. Pre-interventional angiographic stenosis >87.5% was significantly predictive of late ISR.
Association of Echocardiographic Parameters With Chest Computed Tomography Score in Patients With Covid-19 Disease
(Elsevier Urban & Partner Sp Z O O, 2021) Saylik, Faysal; Akbulut, Tayyar; Oguz, Mustafa; Sipal, Abdulcabbar; Ormeci, Tolgahan
Purpose: Although coronavirus disease 2019 (COVID-19) primarily affects the pulmonary system, the involvement of the heart has become a well-known issue. Pulmonary CT plays an additive role in the diagnosis and prognosis of the disease. We aimed to investigate the association of echocardiographic indices with pulmonary CT scores and mortality in COVID-19 patients. Materials and methods: A total of 123 patients diagnosed with COVID-19 were included in this study. The British Society of Thoracic Imaging (BSTI) score and echocardiographic parameters were calculated, and echocardio-graphic indices were compared between BSTI score grades. Results: During in-hospital follow-up, 36 of 123 patients (29.3%) had died. BSTI score, IVS, LVPWd, RV mid-diameter, RV basal diameter, RV longitudinal diameter, sPAP, and RVMPI were higher, and RVFAC, TAPSE, and RVS were lower in the non-survivor group than in the survivor group. There were statistically significant changes between BSTI scores in terms of LVPWd, RV mid diameter, RV basal diameter, RV longitudinal diameter, sPAP, RVFAC, RVMPI, and TAPSE. BSTI score was positively correlated with sPAP and RV basal diameter and negatively correlated with TAPSE and RVFAC. Multivariate logistic regression analysis demonstrated that sPAP (OR = 1.071, p = 0.002) and RV basal diameter (OR = 1.184, p = 0.005) were independent predictors of high BSTI scores (grade 4 and 5). Furthermore, age, sPAP, and a high BSTI score (grade 5) were independent predictors of in-hospital mortality in COVID-19 patients. Conclusion: Echocardiographic indices were correlated with BSTI scores, and patients with higher BSTI scores had more cardiac involvement in COVID-19.
The Association of Galectin-3 Level With Ventricular Arrhythmias and Left Ventricular Strain in Heart Failure Patients With Implantable Cardioverter Defibrillator
(Taylor & Francis Ltd, 2022) Akbulut, Tayyar; Saylik, Faysal; Sipal, Abdulcabbar
Background Ventricular arrhythmias are life-threatening complications of heart failure (HF). Galectin-3, an indicator of fibrosis, is associated with incident HF and was found to be related to poor prognosis in these patients. We aimed to investigate the association of galectin-3 level with left ventricular (LV) arrhythmias in HF. Methods A total of 92 non-ischaemic HF patients who had implantable cardioverter-defibrillator were included in this study. Patients were divided into two groups based on the galectin-3 level. Ventricular arrhythmic events and LV strain indices were compared between the two groups. Negative binomial regression was used to detect the independent predictors of total arrhythmic events in HF patients. Results The median age was 65 (54-71) in the high galectin-3 group (HGAL) and 62 (52-68) in the low galectin-3 group (LGAL). Ventricular arrhythmic events were more frequent in HGAL than in LGAL, including non-sustained ventricular tachycardia (VTnon), sustained-VT (VTs), and ventricular fibrillation (VF) (p < 0.0001, p = 0.002, and p = 0.026, respectively). There were no statistically significant differences between HGAL and LGAL in terms of LV strain measurements. Galectin-3 level was positively significantly correlated with total arrhythmic events (r = 0.58, p < 0.001), but no correlation was found between galectin-3 and LV global longitudinal strain (r = 0.15, p = 0.16). Galectin-3 was an independent predictor of total ventricular arrhythmic events in HF patients (p < 0.0001). Conclusion VTnon, VTs, and VF events were higher in HGAL compared to LGAL. Galectin-3 was an independent predictor of total ventricular arrhythmic events in HF patients and might be used to detect high-risk HF patients for arrhythmic events.
The Association of Serum Uric Acid/Albumin Ratio With No-Reflow in Patients With St Elevation Myocardial Infarction
(Sage Publications inc, 2023) Cinar, Tufan; Saylik, Faysal; Hayiroglu, Mert Ilker; Asal, Suha; Selcuk, Murat; Cicek, Vedat; Tanboga, Ibrahim Halil
The goal of this investigation was to explore the relationship between serum uric acid/albumin ratio (UAR) and no-reflow (NR) in ST elevation myocardial infarction (STEMI) patients (n = 838) who underwent primary percutaneous coronary intervention (pPCI). Angiographic NR was defined as thrombolysis in myocardial infarction (TIMI) flows 0, 1, and 2 in the absence of coronary spasm or dissection. NR developed in 91 (10.9%) STEMI patients. Patients with NR had higher UAR and according to multivariable logistic regression models, a high UAR was an independent risk factor for NR. The area under the curve (AUC) value of the UAR was .760 (95%CI: .720-.801) in a receiver-operating characteristics curve (ROC) assessment. Notably, the UAR AUC value was greater than that of its components: albumin (AUC: .642) and serum uric acid (AUC: .637) (P < .05 for both comparisons). The optimum UAR value in detecting NR in STEMI patients was >1.21 with a sensitivity of 82% and a specificity of 67%. This was the first study to report that the UAR was independently associated with NR in STEMI patients who underwent pPCI.
The Association of Serum Uric Acid/Albumin Ratio With the Development of Coronary Collateral Circulation in Patients With Chronic Total Occluded Coronary Arteries
(Tabriz Univ Medical Sciences & Health Services, 2023) Saylik, Faysal; Cinar, Tufan; Sarikaya, Remzi; Akbulut, Tayyar; Selcuk, Murat; Ozbek, Emrah; Tanboga, Ibrahim Halil
Introduction: Coronary collateral circulation (CCC) develops in chronic total occluded (CTO) vessels and protects the myocardium against ischemia in addition to the improvement of cardiac functions. Poor CCC is related to adverse cardiac events as well as poor prognosis. Serum uric acid/albumin ratio (UAR) has emerged as a novel marker associated with poor cardiovascular outcomes. We aimed to investigate whether there was an association between UAR and poor CCC in CTO patients. Methods: This study was comprised of 212 patients with CTO (92 with poor CCC and 120 with good CCC). All patients were graded based on Rentrop scores to poor CCC (Rentrop scores 0 and 1) and good CCC (Rentrop scores 2 and 3). Results: Poor CCC patients had higher frequencies of diabetes mellitus, triglyceride levels, Syntax and Gensini scores, uric acid, and UAR and lower lymphocyte, high-density lipoprotein cholesterol, and ejection fraction when compared to good CCC patients. UAR was an independent predictor of poor CCC in CTO patients. Furthermore, UAR had a better discriminative ability for patients with poor CCC from good CCC compared to serum uric acid and albumin. Conclusion: Based on the results of the study, the UAR could be used to detect poor CCC in CTO patients.
Association of Tp-e/Qt Ratio With Syntax Score Ii in Patients With Coronary Artery Disease
(Taylor & Francis Ltd, 2022) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Akbulut, Tayyar
Background. The SYNTAX score II (SS) is an angiographic tool, which grades the complexity of coronary artery lesions and predicts short- and long-term events. Tp-e/QT ratio is a novel electrocardiographic marker for the risk of ventricular arrhythmias. We aimed to investigate whether there was a correlation between SS and Tp-e/QT ratio.Methods. A total of 227 consecutive patients who underwent elective coronary angiography were enrolled in this study. Patients who had a lumen diameter >1.5 mm and at least % 50 diameter stenosis on coronary angiogram were determined as coronary artery disease (CAD) group, and others were identified as a control group. The SS was calculated for the CAD group, and SS >= 23 was defined as a high SS group, and SS < 23 was identified as a low SS group. Electrocardiographic indices, such as Tp-e and Tp-e/QT, were measured for all patients. A multivariable logistic regression analysis was performed with variables age, interventricular septum thickness (IVS), hypertension, and Tp-e/QT. Results. Tp-e interval and Tp-e/QT ratio were higher in the CAD group compared with the control group. Tp-e, corrected Tp-e (cTP-e) and Tp-e/QT were higher in the high SS group than in the low SS group. The cTp-e and Tp-e/QT were correlated with SS score. Age, IVS and Tp-e/QT ratio were independent predictors of high SS in the logistic regression analysis. Conclusions. Tp-e/QT ratio was an independent predictor of high SS and might be used for risk stratification in CAD patients.
Bendopnea Predicts High Syntax Score in Patients With Coronary Artery Disease: a Bayesian Approach
(Sage Publications inc, 2024) Saylik, Faysal; Kumet, Omer; Sarikaya, Remzi; Akbulut, Tayyar
Coronary artery disease (CAD) is one of the major health problems worldwide. CAD severity, as calculated by SYNTAX score (SS), is associated with higher morbidity and mortality. A new symptom of shortness of breath within 30 s while bending forward is described as bendopnea and is related to elevated cardiac filling pressure. It is also known that a high SS is associated with left ventricular (LV) dysfunction which leads to higher LV filling pressure. We aimed to investigate whether there was an association between bendopnea and high SS in CAD patients. A high SS was defined >= 22. Of 374 stable angina pectoris patients, 238 (64%) patients had bendopnea and 136 (36%) patients had no bendopnea in this study. The bendopnea (+) group had higher SS and Gensini scores than the bendopnea (-) group (posterior probabilities >0.999 and 0.995, respectively). The presence of bendopnea was independently associated with a higher SS (odds ratio [OR] = 3.82, 95% credible intervals [CrI] = 1.93-8.17). When different priors were used in the context of meta-analysis, there was only 18% heterogeneity among the results, indicating that the results of our study were robust. This is the first study to report that bendopnea was independently associated with CAD severity.
Can Systemic Immune-Inflammation Index Detect the Presence of Exxaggerated Morning Blood Pressure Surge in Newly Diagnosed Treatment-Naive Hypertensive Patients
(Taylor & Francis inc, 2021) Saylik, Faysal; Sarikaya, Remzi
Background: The exaggerated morning blood pressure surge (MS) is associated with target organ damage and cardiovascular events. Systemic immune-inflammation index (SII) has been detected as a useful marker in tumors and cardiovascular diseases. The role of inflammation in the pathogenesis of hypertension is a well-known issue. We aimed to investigate whether there is an association between SII and exaggerated MS in newly diagnosed treatment-naive hypertensive patients. Material and Methods: In total, 343 newly diagnosed in clinical and 24-h ambulatory blood pressure (BP) monitoring treatment-naive hypertensive patients were included in this study. Morning surge was defined as the difference between morning BP, which was the mean of BP during 2 h after wake-up, and the lowest BP, which was the mean of three lowest BP during nighttime. A cutoff value of 52.1 mmHg was used to discriminate the high- and low value MS groups. SII was calculated based on neutrophil, platelet, and lymphocyte counts. Results: Neutrophil, platelet, SII, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) were higher, whereas lymphocyte counts were lower in the high-value MS than the low-value MS. These indices were all independently associated with exaggerated MS and SII was superior to all other indices for detecting the presence of exaggerated MS. SII was moderately correlated with morning BP surge (r: 0.489, p < 0.0001). Conclusion: SII was higher in patients with exaggerated MS and was independently associated with exaggerated MS. Furthermore, SII might be a better indicator than platelet, neutrophil, lymphocyte, NLR, and PLR for the presence of exaggerated MS.
Comparison of Continuous Loop Diuretic Versus Bolus Injection Regimens in Patients With Heart Failure: a Comprehensive Meta-Analysis of the Literature
(Assoc Medica Brasileira, 2022) Saylik, Faysal; Cinar, Tufan
Comparison of Long-Term Outcomes Between Intravascular Ultrasound-, Optical Coherence Tomography- and Angiography-Guided Stent Implantation: a Meta-Analysis
(Sage Publications inc, 2024) Saylik, Faysal; Hayiroglu, Mert Ilker; Akbulut, Tayyar; Cinar, Tufan
Intravascular ultrasonography (IVUS) and optical coherence tomography (OCT) guided percutaneous coronary interventions (PCI) are alternative techniques to angiography-guided (ANG-g) PCI in patients with coronary artery disease (CAD), especially for optimal stent deployment in coronary arteries. We conducted a network meta-analysis including studies comparing those three techniques. We searched databases for studies that compared IVUS, OCT, and ANG-g PCI in patients with CAD. Overall, 52 studies with 231,137 patients were included in this meta-analysis. ANG-g PCI had higher major adverse cardiovascular events (MACEs), all-cause death, cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis (ST) than IVUS-guided PCI. Of note, both OCT-guided and IVUS-guided PCI had similar outcomes. The frequency of MACEs, cardiac death, and MI were higher in ANG-g PCI than in OCT-guided PCI. The highest benefit was established with OCT for MACEs (P-score=.973), MI (P-score=.823), and cardiac death (P-score=.921) and with IVUS for all-cause death (P-score=.792), TLR (P -score=.865), and ST (P-score=.930). This network meta-analysis indicated that using OCT or IVUS for optimal stent implantation provides better outcomes in comparison with ANG-g in patients with CAD undergoing PCI.
Comparison of Monocyte With High Density Lipoprotein Cholesterol Ratio in Dipper and Nondipper Hypertensive Patients
(Future Medicine Ltd, 2019) Selcuk, Murat; Yildirim, Ersin; Saylik, Faysal
Aim: We aimed to compare the monocyte to HDL-cholesterol ratio (MHR) of nondipper hypertension (NDHT) and dipper hypertension patients. Patients & methods: A total of 162 patients were included in the study. Patients were grouped as dipper and nondipper according to 24-h ambulatory blood pressure recordings. Results: The MHR was significantly higher in nondipper hypertension group compared with control (p < 0.001) and dipper hypertension groups (p = 0.03). MHR, hs-CRP and red-cell distribution width (RDW) were independent predictors of nondipper hypertension. Area under the curve was 0.62 (p = 0.034) for MHR and 0.61 (p = 0.012) for hs-CRP in the ROC analysis. Conclusion: MHR has elevated levels in NDHT patients. Increased levels of MHR may evaluate as increased risk of cardiovascular events in NDHT patients.
Comparison of Outcomes Between Single Long Stent and Overlapping Stents: a Meta-Analysis of the Literature
(Urban & Vogel, 2023) Saylik, Faysal; Cinar, Tufan; Selcuk, Murat; Cicek, Vedat; Hayiroglu, Mert Ilker; Orhan, Ahmet Lutfullah
ObjectivesThere is no consensus on whether to treat diffuse coronary artery lesions with a single long stent (SLS) or by overlapping two or more stents (OLS). The goal of this review was to compare the outcomes of these two approaches through a meta-analysis of the literature.MethodsWe searched for relevant studies in MEDLINE, Scopus, EMBASE, Google Scholar, and the Cochrane Library. Our meta-analysis included 12 studies (n = 6414) that reported outcomes during the follow-up period.ResultsIndividuals who received OLS had a greater risk of cardiac mortality and target lesion revascularization (TLR) than those who received SLS (RR: 1.51, CI: 1.03-2.21, p = 0.03, I-2 = 0% and RR: 1.64, CI: 1.02-2.65, p = 0.04, I-2 = 38%, respectively). The fluoroscopy period in the OLS group was longer than in the SLS group (SMD: 0.35, CI: 0.25-0.46, p < 0.01, I-2 = 0%). more contrast volume was sued for the OLS group; however, there was substantial variability in the pooled analysis (I-2 = 95%). In terms of all outcomes, there were no differences between stent generation types.ConclusionIn the first meta-analysis of mainly observational data comparing OLS vs. SLS for long coronary lesions, OLS had higher rates of cardiac mortality and TLR as well as longer fluoroscopy times compared to SLS.
Development and Validation of Nomogram Based on the Systemic-Immune Inflammation Response Index for Predicting Contrast-Induced Nephropathy in St-Elevation Myocardial Infarction Patients
(Sage Publications inc, 2024) Saylik, Faysal; Cinar, Tufan; Sarikaya, Remzi; Tanboga, Ibrahim Halil
Contrast-induced nephropathy (CIN) is a prominent complication of ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI). The systemic immune inflammation response index (SIIRI) is a novel inflammatory marker developed by multiplying the monocyte count by the systemic immune inflammation index (SII) and is associated with coronary artery disease severity. We investigated the predictive ability of SIIRI for detecting CIN in STEMI patients (n = 2289) following pPCI and developed a nomogram based on SIIRI for risk stratifying. CIN was diagnosed based on an elevation in baseline creatinine levels >.5 mg/dL or 25% within 72 h after pPCI; 219 CIN (+) and 2070 CIN (-) patients were included. CIN (+) patients had higher SIIRI than CIN (-) patients and SIIRI was an independent predictor of CIN. A nomogram based on SIIRI had good calibration and discrimination abilities for predicting CIN development. SIIRI was superior to SII in discriminating CIN (+) patients. Adding SIIRI to the baseline model, which consists of age, hypertension, hemoglobin, estimated glomerular filtration rate, albumin, ejection fraction, lesion length, and pain-to-balloon time, had a higher discriminative ability and benefit in detecting CIN (+) patients than baseline model as assessed by decision curve analysis.
Digital Health Interventions in Patient Management Following Acute Coronary Syndrome: a Meta-Analysis of the Literature
(Kare Publ, 2023) Saylik, Faysal; Cinar, Tufan; Hayiroglu, Mert Ilker; Tekkesin, Ahmet Ilker
Objective: Acute coronary syndrome patients should be closely followed-up to maintain optimal adherence to medical treatments and to reduce adverse events. Digital health interventions might provide improved outcomes for patient care by providing closer follow-up, compared to standard care. Thus, in this meta-analysis, we aimed to evaluate the effect of digital health interventions on follow-up in acute coronary syndrome patients. Methods: We searched medical databases to obtain all relevant studies comparing digital health interventions with standard care in acute coronary syndrome patients. After reviewing all eligible studies, a meta-analysis was conducted with the remaining 11 randomized controlled studies and 2 non-randomized controlled studies. A modified Jadad scale and Newcastle-Ottawa scale were used to assess the quality of the publications for randomized controlled studies and non-randomized controlled studies, respectively. Results: This meta-analysis consisted of 7657 patients. The all-cause mortality rate was 49% lower in the digital health intervention cases, compared to those who received standard care [relative risk (RR) = 0.51 (0.37; 0.70), P <.01]. There was a significant decrease in systolic blood pressure in the digital health interventions group, compared to the standard care group [mean difference = -5.28 (-9.47; -1.08), P =.01]. The rate of nonadherence to anti-aggregant drugs was 69% lower in the digital health interventions than in the standard care group [RR = 0.31 (0.20; 0.46), P <.01]. Also, nonadherence rates for statin and beta-blockers were lower in the digital health interventions group. The risk of rehospitalization was observed to be 55% less in the digital health interventions patients, compared to the standard care group [RR = 0.45 (0.30; 0.67), P <.01]. Conclusion: Digital health interventions can be effective in follow-up for secondary prevention in acute coronary syndrome patients.
Double Orifice Mitral Valve and Bicuspid Aortic Valve: Pieces of the Same Single Puzzle
(Hindawi Ltd, 2015) Saylik, Faysal; Mutluer, Ferit Onur; Tosu, Aydin; Selcuk, Murat
Double orifice mitral valve is a very rare congenital abnormality. Well known associations of this pathology with other congenital lesions point to a complex and central pathophysiological mechanism leading to a sequence of pathologies. These associations have long been realized and arbitrarily defined as Shone complex. We would like to present a 21-year-old patient with double orifice mitral valve associated with bicuspid aortic valve, with a brief review of the literature on possible central mechanisms leading to different subsets of congenital abnormalities involving these two.
Effect of Heroin on Right Ventricular Cardiac Performance
(Clinics Cardive Publ Pty Ltd, 2020) Selcuk, Murat; Yildirim, Ersin; Saylik, Faysal; Deniz, Ozgur; Mutluer, Ferit Onur
Objective: The aim of this study was to investigate the effects of heroin addiction. which is an important social and health problem, on right cardiac function. Methods: A total of 85 individuals were included in the study The study group comprised 45 patients smoking heroin and the control group was 40 healthy individuals with no drug addiction. Patients injecting heroin were excluded. Echocardiographic evaluation of patients using heroin was performed and compared with those in the control group. Results: The right ventricle and pulmonary artery diameters in the heroin group were found to be higher compared to the control group. The myocardial performance index (WI) was higher and more abnormal in the heroin group (0.48 +/- 0.22 vs 0.39 +/- 0.11, p < 0.05) whereas isovolumic acceleration d VA) of the right ventricle was significantly lower in the heroin group (2.92 +/- 0.69 vs 3.4 +/- 0.68 m/s(2), p < 0.01). No significant difference was observed between the groups with regard to the right ventricular ejection fraction (RVEF) (59.6 +/- 2.5 vs 60.6 +/- p = 0.08), tricuspid annular plain systolic excursion (TAPSE) (24.1 +/- 4.2 vs 24.5 +/- 2.4 mm,p = 0.7), tissue Doppler imaging S wave (TDI-S) (13.7 +/- 2.1 vs 13.8 +/- 2.1 cm/s, p = 0.86) and right ventricular fractional area change (RVFAC) (42.7 +/- 8.3 vs 43.9 +/- 3.5%, p = 0.4). Multivariate and univariate regression analyses revealed independent correlation between the pulmonary artery diameter and RVIVA, and heroin addiction. Conclusion: Heroin addiction negatively affected right ventricular function and more attention should be paid to the cardiac function of these patients.
The Effect of Number of Pregnancies on Aortic Stiffness Index, Aortic Velocity Propagation, and Epicardial Fat Thickness
(Federal Reserve Bank St Louis, 2024) Saylik, Faysal; Cinar, Tufan; Akbulut, Tayyar; Hayiroglu, Mert Ilker; Selcuk, Murat; Uzuner, Zeynep Sevde Serdaroglu; Tanboga, Ibrahim Halil
Objective: Pregnancy causes physiological, hormonal, and hemodynamic changes that affect the aortic wall dimensions and elastic properties. Multiple pregnancies increase the risk of aortic enlargement and reduce aortic elasticity. The aortic stiffness index (ASI) and aortic velocity propagation (AVP) are markers of elasticity. Additionally, epicardial fat thickness (EFT) is associated with cardiovascular risk factors. The impact of multiparity on ASI, AVP, and EFT has not been previously reported in the literature. Therefore, we aimed to investigate the association of these parameters with the number of live pregnancies in this study. Methods: A total of 410 patients were enrolled in this prospective study. Patients were divided into three groups based on the number of live births: Group 1 (n = 0, 128 patients), Group 2 (4 >= n > 0, 157 patients), and Group 3 (n >= 5, 125 patients). A linear regression analysis was conducted to investigate trend associations of ASI, AVP, and EFT between the study groups. Multiple linear regression analysis was used to evaluate the independent predictors of continuous parameters. Results: There were increasing trends in multiparity with variables such as aortic systolic (ASD) and diastolic diameters, pulmonary artery diameters, ASI, and EFT, and a decreasing trend in AVP. The number of pregnancies was strongly and positively correlated with ASI, moderately and positively correlated with EFT and ASD, and moderately and negatively correlated with AVP. Conclusion: Multiparity was independently associated with ASI, EFT, ASD, and AVP, reflecting decreased elasticity and elevated cardiovascular risk in multiparous women.
The Epicardial Fat Thickness Is Associated With Fragmented Qrs in Patients With Newly Diagnosed Metabolic Syndrome
(Assoc Medica Brasileira, 2022) Akbulut, Tayyar; Saylik, Faysal; Sengul, Cihan
OBJECTIVE: The metabolic syndrome involves both metabolic and cardiovascular risk factors and is associated with cardiovascular mortality. Epicardial fat tissue plays a crucial role in deleterious effects of metabolic syndrome on the heart, including myocardial fibrosis. The fragmented QRS reflects heterogeneous depolarization of the myocardium and occurs as a result of fibrosis. Thus, we aimed to investigate whether there is an association between fragmented QRS and epicardial fat tissue in patients with metabolic syndrome. METHODS: This study enrolled 140 metabolic syndrome patients, of whom 35 patients with fragmented QRS (+) and 105 patients with fragmented QRS (-). The two groups were compared with respect to clinical, laboratory, electrocardiographic, and echocardiographic indexes. RESULTS: Fragmented QRS (+) patients had higher waist circumference, red cell distribution width, creatinine, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, QRS duration, and epicardial fat tissue compared with fragmented QRS (-) patients. Waist circumference, red cell distribution width, QRS duration, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, and epicardial fat tissue were significantly associated with the presence of fragmented QRS. The QRS duration and epicardial fat tissue were independently associated with the presence of fragmented QRS on surface electrocardiographic in metabolic syndrome patients. CONCLUSIONS: Epicardial fat tissue and QRS duration were independently associated with the presence of fragmented QRS. Basic echocardiographic and electrocardiographic parameters might be used for the risk stratification in metabolic syndrome patients.