Browsing by Author "Sipal, Abdulcebbar"

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Cardiovascular Drugs and Analysis of Potential Risk Factors Associated With Mortality in Severe Coronavirus Disease 2019 Patients
(Assoc Medica Brasileira, 2022) Atabey, Rukiye Derin; Aladag, Nesim; Sipal, Abdulcebbar; Akbulut, Tayyar; Dogan, Zeki; Ozdemir, Mahmut
OBJECTIVES: Cardiovascular diseases are also considered to increase the risk of death in COVID-19 patients. However, real-world data concerning the risk factors for death in patients with severe COVID-19 still remain vague. This study aimed to identify the potential risk factors associated with mortality in severe COVID-19 patients. METHODS: All consecutive patients admitted to the intensive care unit (ICU) of our institute for COVID-19 for severe COVID-19 pneumonia from April 1, 2020 to July 20, 2020 were included in the analysis. Patient characteristics, including complete medical history and comorbid diseases, blood test results during admission and on day 7, and clinical characteristics were compared between survivors and nonsurvivors. RESULTS: There was no significant difference between survivors and nonsurvivors regarding age, gender, and preexisting cardiovascular diseases. Moreover, the rate of the medications including angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockers did not differ between survivors and nonsurvivors. The peak C-reactive protein (CRP), procalcitonin, fibrinogen, and D-dimer levels and the rate for chronic renal failure were significantly higher in nonsurvivors compared with survivors. Intubated patients had a higher risk of death than the others had. CONCLUSIONS: This study failed to demonstrate a significant difference in preexisting cardiovascular diseases and cardiovascular medications between survivors and nonsurvivors who were admitted to ICU for severe COVID-19. Our findings indicate that the presence of chronic renal failure, a high peak ferritin concentration, and the need for invasive mechanical ventilation appear predictive for mortality. We propose that these risk factors should be taken into account in defining the risk status of severe COVID-19 patients admitted to the ICU.
Qrs Narrowing and Prediction of Response To Cardiac Resynchronization Therapy Reply
(Turkish Soc Cardiology, 2018) Sipal, Abdulcebbar; Bozyel, Serdar; Aktas, Mujdat; Dervis, Emir; Akbulut, Tayyar; Argan, Onur; Vural, Ahmet
Surface Electrogram-Guided Left Ventricular Lead Placement Improves Response To Cardiac Resynchronization Therapy
(Turkish Soc Cardiology, 2018) Sipal, Abdulcebbar; Bozyel, Serdar; Aktas, Mujdat; Dervis, Emir; Akbulut, Tayyar; Argan, Onur; Vural, Ahmet
Objective: Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins. Methods: We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation. Patients were divided into two groups. In group 1, LV lead was positioned at the site with the shortest biventricular-paced (BiV-paced) QRS duration (QRSd), as intraprocedurally measured using surface ECG. In group 2 (control), we included patients who underwent the standard unguided CRT. ECG, echocardiogram, and functional status were evaluated before and 6 months after CRT implantation in all patients. Results: In group 1, BiV-paced QRSd measurements were successfully performed in 112 of 120 coronary sinus branches during CRT and an LV lead was successfully placed at the optimal site in all patients. Compared with group 2, group 1 had a significantly higher rate (85% vs. 50%, p=0.02) of response (>15% reduction in LV end-systolic volume) to CRT as well as a shorter QRSd (p<0.001) and a greater QRS shortening (Delta QRS) associated with CRT compared with baseline (p<0.001). The mean New York Heart Association functional class was significantly improved in both groups, and no significant differences were found in clinical response to CRT (85% vs. 70%, p=0.181). Conclusion: Surface ECG can be used to guide LV lead placement in patients with multiple target veins for improving response to CRT Thus, it is a safe, feasible, and economic approach for CRT-D implantation.