Browsing by Author "Yumurtas, Ahmet Cagdas"

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Investigation of Predictive Parameters for Recurrence in Patients Undergoing Electrical Cardioversion for Atrial Fibrillation
(Wiley, 2025) Pay, Levent; Tezen, Ozan; Cetin, Tugba; Yumurtas, Ahmet Cagdas; Keskin, Kivanc; Dereli, Seyda; Hayiroglu, Mert Ilker
Background Electrical cardioversion (ECV) is a technique used to restore sinus rhythm in atrial fibrillation (AF), aiming to reduce AF-related symptoms. Various recurrence predictors, such as non-paroxysmal pattern, prolonged duration, chronic obstructive pulmonary disease, advanced age, or left atrial dilation, have been identified. Hence, the aim of our study was to determine the parameters that could predict AF recurrence in the long term in patients who underwent ECV. Methods One hundred seventy-two patients who underwent electrical cardioversion due to AF at our tertiary center were included in the study. Patients with recurrent AF after cardioversion were defined as the AF recurrence (+) group, and those with normal sinus rhythm were defined as the AF recurrence (-) group. Parameters that would predict AF recurrence were investigated between these two groups. Results AF recurrence was observed in 91 patients, while 81 patients did not experience any recurrence. The prediction model, constructed using multivariate Cox regression analysis, included six variables: non- high-density lipoprotein (HDL) cholesterol, free T3, mean corpuscular volume (MCV), left atrium anterior-posterior diameter, number of cardioversions, and oral anticoagulant use. ROC curve analysis demonstrated that our prediction model effectively distinguished between patients with arrhythmia relapse and those without, with an AUC value of 0.719 (p < .05). Conclusions This study revealed that AF recurrence after ECV can be predicted by our prediction model consisting of patient characteristics, disease factors, and various biochemical parameters. The current study demonstrated a statistically significant association between the number of cardioversions and non-HDL cholesterol levels in patients with recurrent AF.
Prognostic Value of Pulmonary Artery Diameter/Aorta Diameter Ratio in Patients With Acute Pulmonary Embolism
(Urban & Vogel, 2024) Pay, Levent; Cetin, Tugba; Keskin, Kivanc; Dereli, Seyda; Tezen, Ozan; Yumurtas, Ahmet Cagdas; Hayiroglu, Mert Ilker
BackgroundThe ratio of pulmonary artery diameter (PAD) to ascending aortic diameter (AoD) has been reported to be a prognostic marker in several lung diseases; however, the usefulness of this tool in patients with acute pulmonary embolism (APE) is unknown. Here, we aimed to determine the long-term prognostic value of the PAD/AoD ratio in patients with APE.MethodsA total of 275 patients diagnosed with APE at our tertiary care center between November 2016 and February 2022 were included in the study. The patients were divided into two groups according to the presence of long-term mortality and their PAD/AoD ratios were compared.ResultsLong-term mortality was observed in 48 patients during the median follow-up of 59 (39-73) months. The patients were divided into two groups for analysis: group 1, consisting of 227 patients without recorded mortality, and group 2, consisting of 48 patients with documented mortality. A multivariate Cox regression model indicated that the PAD/AoD ratio has the potential to predict long-term mortality (HR: 2.9116, 95% CI: 1.1544-7.3436, p = 0.023). Analysis of the receiver operating characteristic curve revealed that there was no discernible difference in discriminative ability between the simplified pulmonary embolism severity index (sPESI) and PAD/AoD ratio (area under the curve [AUC] = 0.679 vs. 0.684, respectively, p = 0.937). The long-term predictive ability of the PAD/AoD ratio was not inferior to the sPESI score.ConclusionsThe PAD/AoD ratio, which can be easily calculated from pulmonary computed tomography, may be a useful parameter for determining the prognosis of APE patients. HintergrundDas Verh & auml;ltnis zwischen dem Pulmonalarteriendurchmesser (PAD) und dem Durchmesser der Aorta ascendens (AoD) wurde als prognostischer Marker f & uuml;r verschiedene Lungenerkrankungen beschrieben; sein Nutzen bei Patienten mit akuter Lungenembolie (LE) ist jedoch nicht bekannt. Ziel der vorliegenden Arbeit war es, den prognostischen Langzeitwert des PAD-AoD-Quotienten bei Patienten mit LE zu ermitteln.MethodenZwischen November 2016 und Februar 2022 wurden 275 Patienten mit der Diagnose einer LE im Terti & auml;rversorgungszentrum der Autoren in die Studie eingeschlossen. Dabei wurden die Patienten entsprechend dem Vorliegen von Langzeitmortalit & auml;t in 2 Gruppen eingeteilt und ihre PAD-AoD-Quotienten verglichen.ErgebnisseLangzeitmortalit & auml;t wurde bei 48 Patienten w & auml;hrend des mittleren Follow-up von 59 (39-73) Monaten festgestellt. Zur Auswertung wurden die Patienten in 2 Gruppen unterteilt: Gruppe 1, bestehend aus 227 Patienten ohne dokumentierte Mortalit & auml;t, und Gruppe 2, bestehend aus 48 Patienten mit dokumentierter Mortalit & auml;t. Ein multivariates Cox-Regressions-Modell ergab, dass der PAD-AoD-Quotient das Potenzial aufweist, die Langzeitmortalit & auml;t vorherzusagen (Hazard Ratio, HR: 2,9116; 95%-Konfidenzintervall, 95%-KI: 1,1544-7,3436; p = 0,023). Die Analyse der Receiver-Operating-Characteristic-Kurve zeigte, dass es keinen erkennbaren Unterschied in der Unterscheidungsf & auml;higkeit zwischen dem Simplified Pulmonary Embolism Severity Index (sPESI) und dem PAD-AoD-Quotienten gab (,,area under the curve" [AUC] = 0,679 vs. 0,684; p = 0,937). Die langfristige Vorhersagekraft des PAD-AoD-Quotienten war dem sPESI-Score nicht unterlegen.SchlussfolgerungDer PAD-AoD-Quotient, der einfach anhand der Computertomographie der Lunge errechnet werden kann, ist m & ouml;glicherweise ein n & uuml;tzlicher Parameter zur Ermittlung der Prognose von Patienten mit LE.