Yazar "Cansel, Mehmet" seçeneğine göre listele

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    Abnormal origin of the right coronary artery from the left anterior descending artery
    (2010) Cansel, Mehmet; Kurtoğlu, Ertuğrul; Yağmur, Jülide; Taşolar, Mehmet Hakan; Ermiş, Necip; Açıkgöz, Nusret; Bayramoğlu, Adil
    Abstract: Koroner arter anomalileri seyrek görülmekle birlikte önemli sonuçlara neden olabilmektedir. Bu yüzden bu anomalileri açığa kavuşturmak ve uygun tedaviyi vermek çok önem arz etmektedir. Koroner anomaliler arasında ise sol ön inen arterden köken alan anormal orijinli sağ koroner arter anomalisine daha nadir rastlanmaktadır. Bu vakamızda non-st elevasyonlu miyokard enfarktüsü ile başvuran bir hastada sol ön inen arterden çıkan anormal sağ koroner arter anomalisine sahip bir hastayı sunduk.
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    Akut miyokard enfarktüsünde medikal tedavi: olgu sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Afşin, Abdulmecit; Yağmur, Jülide; Cansel, Mehmet
    Akut ST elevasyonlu miyokard enfarktüsü kardiyak nedenli mortalitenin ve morbiditenin en önemli nedenleri arasında yer almaktadır. 80 yaşında kadın hasta göğüs ağrısı ile acil servisimize sevk edilmişti. Akut ST elevasyonlu inferior ve sağ miyokard enfarktüsü tanısıyla hasta primer şartlarda koroner anjiografiye alındı. Sağ koroner arterde yoğun ve uzun trombüs vardı. Bu nedenle hastaya perkütan koroner girişim düşünülmedi. Rutin antiagregan ve antikoagülan tedaviye bir glikoprotein IIb/IIIa reseptör blokeri olan tirofiban eklendi. 2 gün sonra yapılan kontrol koroner anjiografide rezidü trombüs ve lezyon izlenmedi. Mekanik reperfüzyona gereksinim olmadan, başarılı bir şekilde farmakolojik tedavi ile koroner reperfüzyon sağlandı. Hasta komplikasyonsuz bir şekilde medikal tedavisi düzenlenerek taburcu edildi. İnvaziv girişim yapmadan farmakolojik tedavi ile başarılı şekilde tedavi edilen bir olguyu sunmayı amaçladık.
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    Assessment of atrial conduction time by tissue Doppler echocardiography and P-wave dispersion in patients with mitral annulus calcification
    (Churchill Livingstone Inc Medical Publishers, 2010) Pekdemir, Hasan; Cansel, Mehmet; Yagmur, Julide; Acikgoz, Nusret; Ermis, Necip; Kurtoglu, Ertugrul; Tasolar, Hakan
    The aim of our study was to investigate atrial conduction time in patients with mitral annulus calcification (MAC) using P-wave dispersion (PWD) and electromechanical coupling measured with the surface electrocardiogram and the tissue Doppler echocardiography. Fifty-nine patients with MAC and 43 control subjects underwent resting the surface electrocardiogram and tissue Doppler echocardiography. The difference between the maximum (Pmax) and minimum P-wave durations was calculated and defined as PWD. Interatrial and intraatrial electromechanical delays were measured with tissue Doppler echocardiography. Both Pmax and PWD were higher in patients with MAC compared with controls (111.4 +/- 15.8 vs 97.3 +/- 18.8 milliseconds; P < .0001 and 46.4 +/- 14.6 vs 31.4 +/- 13.1 milliseconds; P < .0001, respectively). Both interatial and intraatrial conduction time were also delayed in patients with MAC compared with controls (29.8 +/- 13.3 vs 17.6 +/- 12.5 milliseconds; P < .0001; 9.4 +/- 5.1 vs 6.8 +/- 4.0 milliseconds; P < .008, respectively). Left atrial (LA) diameter was significantly higher in patients with MAC compared with controls (35.4 +/- 5.0 mm vs 32.3 +/- 4.2 mm; P < .001). The LA diameter correlated significantly with both interatrial conduction times and PWD (r = 0.56; P < .0001 and r = 0.47; P < .0001, respectively). There is a delay in both intraatrial and interatrial electromechanical coupling intervals in patients with MAC. (C) 2010 Elsevier Inc. All rights reserved.
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    Assessment of atrial conduction time by tissue Doppler echocardiography and P-wave dispersion in smokers
    (Springer, 2012) Akturk, Erdal; Yagmur, Julide; Acikgoz, Nusret; Ermis, Necip; Cansel, Mehmet; Karakus, Yasin; Tasolar, Hakan
    The aim of this study was to evaluate the relationship between cigarette smoking and atrial rhythm disorders with the use of noninvasive methods. The study population consisted of 50 healthy volunteer smokers and 40 healthy volunteer non-smokers who had normal echocardiographic parameters and similar sex and age profiles. P-wave dispersion (PWD) was calculated from the 12-lead surface ECG. Left ventricle (LV) end-systolic and end-diastolic diameters, LV ejection fraction, and interatrial and intraatrial electromechanical delay were measured by tissue Doppler imaging and conventional echocardiography. Isovolumetric relaxation time and deceleration time were significantly higher (91.5 +/- 11 vs. 82.35 +/- 8.6, p < 0.0001; 215.7 +/- 37.1 vs. 175.3 +/- 17.7, p < 0.0001, respectively), and HDL cholesterol was significantly lower in smokers (39.34 +/- 7.5 vs.44.3 +/- 8.07, p = 0.003). There were no significant differences between the groups with respect to Sm and Em values, Am value, and E/A and E/Em ratios. However, the Em/Am ratio was significantly lower in smokers (1.28 +/- 0.21 vs. 1.44 +/- 0.33, p < 0.006). Inter- and intraatrial electromechanical delay were significantly higher in smokers when compared with non-smokers (51.11 +/- 1.54 vs. 27.30 +/- 3.36, p < 0.0001, and 30.63 +/- 3.2 vs. 12.24 +/- 3.26, p < 0.0001, respectively). The amount of smoking was strongly correlated with interatrial electromechanical delay (r = 0.567, p < 0.0001), and a significant correlation was detected between PWD and interatrial electromechanical delay (r = 0.653, p = 0.001). We have demonstrated the relationship between inter- and intraatrial electromechanical delay and PWD. These parameters may be useful predictive markers for the development of AF in the asymptomatic period before cardiac rhythm disturbances occur. This finding may indicate that smokers have an increased risk of developing atrial rhythm disturbances.
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    Assessment of atrial electromechanical delay and influential factors in patients with obstructive sleep apnea
    (Springer Heidelberg, 2012) Yagmur, Julide; Yetkin, Ozkan; Cansel, Mehmet; Acikgoz, Nusret; Ermis, Necip; Karakus, Yasin; Tasolar, Hakan
    The interaction between moderate-to-severe obstructive sleep apnea (OSA) and cardiac arrhythmias, especially atrial fibrillation (AF), is well known. We aimed to determine whether atrial electromechanical parameters assessed by tissue Doppler imaging (TDI) would be affected in moderate-to-severe OSA, and detect the influential factors of atrial electromechanical parameters in these patients. Interatrial and intra-atrial electromechanical delay was measured by TDI in patients with moderate-to-severe OSA (n = 64) and control subjects (n = 39). P-wave dispersion (PWD) was calculated on the 12-lead ECG. Interatrial and intra-atrial electromechanical delay was significantly higher in the OSA group when compared with the controls (52.26 +/- 12.9 vs 29.61 +/- 11.26, P < 0.0001 and 18.90 +/- 8.13 vs 8.71 +/- 5.46, P < 0.0001; respectively). PWD was higher in the OSA group (46.09 +/- 13.40 ms vs 34.10 +/- 10.75 ms, P < 0.0001). Interatrial electromechanical delay had a positive correlation with PWD (r = 0.490, P < 0.0001), left atrial (LA) diameter (r = 0.383, P = 0.002), LA volume index (r = 0.354, P = 0.004), and apnea-hypopnea index (r = 0.365, P = 0.003). In addition, interatrial electromechanical delay was negatively correlated with the magnitude of the lowest oxygen saturation percentage (r = -0.498, P < 0.0001). This study showed that interatrial and intra-atrial electromechanical delay and PWD were prolonged in patients with moderate-to-severe OSA. LA dilatation, hypoxemia, and the severity of the disease may contribute a prolongation in interatrial electromechanical delay via atrial structural and electrical alterations, which may predict the risk of future AF development in patients with moderate-to-severe OSA.
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    Assessment of Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Obese Subjects
    (Wiley, 2011) Yagmur, Julide; Cansel, Mehmet; Acikgoz, Nusret; Ermis, Necip; Yagmur, Murat; Atas, Halil; Tasolar, Hakan
    Our aim was to evaluate whether atrial electromechanical delay measured by tissue Doppler imaging (TDI), which is an early predictor of atrial fibrillation (AF) development, is prolonged in obese subjects. A total of 40 obese and 40 normal-weight subjects with normal coronary angiograms were included in this study. P-wave dispersion (PWD) was calculated on the 12-lead electrocardiogram (ECG). Systolic and diastolic left ventricular (LV) functions, inter-and intra-atrial electromechanical delay were measured by TDI and conventional echocardiography. Inter-and intra-atrial electromechanical delay were significantly longer in the obese subjects compared with the controls (44.08 +/- 10.06 vs. 19.35 +/- 5.94 ms and 23.63 +/- 6.41 vs. 5.13 +/- 2.67 ms, P < 0.0001 for both, respectively). PWD was higher in obese subjects (53.40 +/- 5.49 vs. 35.95 +/- 5.93 ms, P < 0.0001). Left atrial (LA) diameter, LA volume index and LV diastolic parameters were significantly different between the groups. Interatrial electromechanical delay was correlated with PWD (r = 0.409, P = 0.009), high-sensitivity C-reactive protein (hsCRP) levels (r = 0.588, P < 0.0001). Interatrial electromechanical delay was positively correlated with LA diameter, LA volume index, and LV diastolic function parameters consisting of mitral early wave (E) deceleration time (DT) and isovolumetric relaxation time (IVRT; r = 0.323, P = 0.042; r = 0.387, P = 0.014; r = 0.339, P = 0.033; r = 0.325, P = 0.041; respectively) and, negatively correlated with mitral early (E) to late (A) wave ratio (E/A) (r = -0.380, P = 0.016) and myocardial early-to-late diastolic wave ratio (E-m/A(m)) (r = -0.326, P = 0.040). This study showed that atrial electromechanical delay is prolonged in obese subjects. Prolonged atrial electromechanical delay is due to provoked low-grade inflammation as well as LA enlargement and early LV diastolic dysfunction in obese subjects.
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    Assessment of left atrial volume and function by real time three-dimensional echocardiography in obese patients
    (Wiley, 2017) Yagmur, Julide; Cansel, Mehmet; Kurtoglu, Ertugrul; Hidayet, Siho; Acikgoz, Nusret; Ermis, Necip; Ozyalin, Fatma
    Objective: To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). Methods: This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function. Plasma NT-proANP was determined by ELISA method. Results: There was no significant difference between groups in left ventricular (LV) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume (LAVmax), LAVmax index (LAVI), LA minimal volume (LAVmin), before atrial contraction volume (LAVpreA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT-proANP levels were similar between groups. There were positive correlations between NT-proANP level and LAVI, LAVmax, LAVmin, LAVpreA, and LA total and active emptying volumes. Conclusions: Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.
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    Assessment of left atrial volume and function by real time three-dimensional echocardiography inobese patients
    (Wıley, 111 rıver st, hoboken 07030-5774, nj usa, 2017) Yağmur, Julide; Cansel, Mehmet; Kurtoğlu, Ertuğrul; Hidayet, Siho; Açıkgöz, Nusret; Ermis, Necip; Ozyalin, Fatma
    Objective: To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). Methods: This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function. Plasma NT-proANP was determined by ELISA method. Results: There was no significant difference between groups in left ventricular (LV) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume (LAVmax), LAVmax index (LAVI), LA minimal volume (LAVmin), before atrial contraction volume (LAVpreA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT-proANP levels were similar between groups. There were positive correlations between NT-proANP level and LAVI, LAVmax, LAVmin, LAVpreA, and LA total and active emptying volumes. Conclusions: Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.
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    Assessment of the left ventricular systolic function in cardiac syndrome X using speckle tracking echocardiography
    (Turkish Soc Cardiology, 2016) Yagmur, Julide; Acikgoz, Nusret; Cansel, Mehmet; Ermis, Necip; Karakus, Yasin; Kurtoglu, Ertugrul
    Objective: The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX). Methods: We compared 34 patients with CSX (18 females, mean age 47.9 +/- 10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6 +/- 9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann-Whitney U test, and chi-square test were used to statistically analyze data. Results: LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7 +/- 2.5% vs. -19.8 +/- 1.8%; p<0.0001) was significantly lower in patients with CSX than in healthy control patients. However, regional mean circumferential strain values (-22.0 +/- 1.6% vs. -22.2 +/- 2.3%; p=0.78) did not differ significantly between the two groups. Conclusion: Significant impairment of LV longitudinal myocardial systolic function was detected with STE in patients with CSX, although normal 3-D EF and tissue Doppler imaging systolic parameters were observed. Arteriosclerosis of small coronary arteries and microvascular dysfunction may affect myocardial longitudinal strain.
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    Atriyoventriküler nodal reentrant taşikardili hastaların klinik ve ekokardiyografik özelliklerinin değerlendirilmesi
    (MN Kardiyoloji, 2010) Açıkgöz, Nusret; Ermiş, Necip; Yağmur, Julide; Karakuş, Yasin; Müezzinoğlu, Kübra; Cansel, Mehmet; Pekdemir, Hasan; Özdemir, Ramazan
    Öz: Amaç: Atriyoventriküler nodal reentrant taşikardi (AVNRT) klinikte en sık görülen düzenli ritim bozukluğudur. Bu çalışmada AVNRT’li hastaların klinik ve ekokardiyografik yönden değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya elektrofizyolojik çalışması (EFÇ) yapılan ve AVNRT tanısı konulan 30 hasta ile EFÇ’si yapılan ve normal saptanan 30 kontrol birey alındı. Çalışmaya tüm katılanların klinik ve ekokardiyografik değerlendirilmesi yapıldı. Bulgular: Her iki grup arasında yaş, cinsiyet ve diğer demografik özellikler açısından fark saptanmadı (p>0.05). Ancak vücut kitle indeksi (VKİ) AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek bulundu (28,7 ± 2,7’e karşın 24,6 ± 3,5 kg/m2; p<0,0001). Ekokardiyografik olarak değerlendirilen sol ventrikül duvar kalınlıkları, sol atriyum çapı, sol ventrikül çapları ve sol ventrikül ejeksiyon fraksiyonu her iki grupta benzerdi (p>0,05). Ancak Doppler mitral akım parametrelerinden geç diyastolik akım velositesi (A) (p=0,012), deselerasyon zamanı (p=0,002) ve izovolümetrik gevşeme (p=0,001) zamanı AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek bulundu. Ayrıca E/A oranı AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha düşük bulundu (p<0,0001). Sonuç: AVNRT’li hastalarda diyastolik fonksiyonlar kontrol grubuna göre bozulmuştur. Artmış VKİ AVNRT gelişiminde önemli bir faktör olabilir.
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    Comparison of atrial electromechanical coupling interval and P-wave dispersion in non-dipper versus dipper hypertensive subjects
    (Taylor & Francis Ltd, 2011) Ermis, Necip; Acikgoz, Nusret; Cuglan, Bilal; Cansel, Mehmet; Yagmur, Julide; Tasolar, Hakan; Barutcu, Irfan
    Background. The lack of nocturnal BP fall less than 10% of the daytime, called non-dipper hypertension, is associated with increased cardiovascular morbidity and mortality. The aim of our study was to investigate atrial conduction time in patients with non-dipper hypertension using electromechanical coupling interval and P-wave dispersion (PWD), measured with the surface electrocardiogram and tissue Doppler echocardiographic imaging (TDI). Methods. Age-and sex-matched 43 dipper hypertensive patients (19 male, 24 female, mean age: 53.9 +/- 10.5 years), 40 non-dipper patients (18 male, 22 female, mean age 54.3 +/- 9.6 years) and 46 healthy subjects (22 male, 24 female, mean age: 52.8 +/- 9.6 years) were included in the study. The difference between the maximum and minimum P-wave durations was calculated and defined as PWD. Atrial electromechanical coupling (PA), inter-atrial and intra-atrial electromechanical delays were measured with TDI. Results. PWD was significantly higher in patients with non-dippers compared with dippers (p < 0.02) and controls (p < 0.001). The inter-atrial conduction time was delayed in non-dippers compared with dippers (p < 0.01) and controls (p < 0.001). There was a positive correlation between left atrial (LA) diameter and inter-atrial conduction times (r = 0.46, p < 0.001). LA diameter was also correlated with PWD (r = 0.44, p < 0.001). Conclusion. The patients with non-dipper hypertension have higher P-wave duration, PWD and delayed inter-atrial electromechanical coupling intervals compared with those of dippers and controls. This indicates that these subjects may be more prone to atrial rhythm disturbances.
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    Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time three-dimensional echocardiography study
    (Kare Publ, 2016) Ermis, Necip; Otlu, Yilmaz Omur; Afsin, Abdulmecit; Hidayet, Siho; Acikgoz, Nusret; Cansel, Mehmet; Yagmur, Julide
    Objective: Non-dipper hypertension is associated with an increased cardiovascular morbidity and mortality. Besides this, the left atrial (LA) size and functions are accepted to be prognostic factors in various cardiovascular diseases. In this study, we aimed to evaluate the effect of nondipper hypertension on LA volume and functions using real-time three-dimensional echocardiography (RT3-DE). Methods: Forty dipper and 52 non-dipper hypertensives enrolled in this prospective cross-sectional study. Patients with any comorbidities that have a potential for causing structural cardiac alterations were excluded. Two-dimensional echocardiography (2-DE) and RT3-DE were performed to assess LA volumes and functions. The statistical tests used in this study were Shapiro-Wilk's test, Student's t-test, Mann-Whitney U test, chi-square test, Spearman's test, and Pearson's correlation test. Results: LA minimal volume, LA volume before LA contraction, and LA total systolic volume were higher in non-dipper hypertensives than in dipper hypertensives (p<0.001, p=0.003, and p=0.03, respectively). Only, the 2-DE measurements of interventricular septal thickness and E/Em ratio were higher in non-dipper hypertensives (p=0.001 and p=0.03, respectively). There was a moderate correlation between LA minimal volume and LA volume before LA contraction with E/Em (r=0.31, p=0.007 and r=0.32, p=0.005, respectively). Conclusion: Although LA volume and passive LA systolic functions measured by RT3-DE are significantly increased in non-dipper hypertensives, the alterations in active LA systolic functions are not prominent. RT-3DE may be used to define LA volume and function alterations in conditions that have capabilities of adverse cardiac remodeling such as systemic hypertension.
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    Dose-dependent subacute cardiovascular effects of modafinil in rats
    (Taylor & Francis Ltd, 2022) Canyurt, Dilan; Tanriverdi, Lokman Hekim; Ozhan, Onural; Cansel, Mehmet; Parlakpinar, Hakan; Vardi, Nigar; Cigremis, Yilmaz
    Modafinil is used for the treatment of various sleep disorders; however, its usage among healthy individuals is also increasing. There are a limited number of cardiovascular side effects, including ischemic T-wave changes, dyspnea, hypertension, and tachycardia in the literature. Our research aimed to investigate the dose-dependent subacute cardiovascular effects of modafinil in rats. Thirty-two rats were randomly and equally assigned to a control group (vehicle-treated for 14 days), a subacute low-dose group (SALD, 10 mg/kg for 14 days), a subacute moderate-dose group (SAMD, 100 mg/kg for 14 days), and a subacute high-dose group (SHD, 600 mg/kg for 14 days). The cardiovascular effects of modafinil were evaluated using hemodynamic, biochemical, electrocardiographic, electrophysiologic, and histopathologic parameters. In terms of hemodynamic parameters, heart rate, and systolic/diastolic/mean blood pressure levels, electrophysiological parameters did not reach statistical significance among the groups (p > 0.05). The incidence of T-wave negativity in SAMD and SAHD groups was 25 and 37.5%, respectively. Moreover, one rat per group was affected by an atrioventricular blockage. Malondialdehyde, superoxide dismutase, catalase, and reduced glutathione levels in the heart and vascular tissues, serum troponin-I, and creatine kinase levels were similar between the modafinil-administered groups and the control group (p > 0.05); this indicates that modafinil activated neither oxidative stress nor antioxidant pathway. Also, there was no difference in histopathological parameters between groups (p > 0.05). Supratherapeutic doses of modafinil may have the potential to cause ischemic cardiac damage and atrioventricular blockage, despite inconsistency with literature findings; however, this does not pertain to hemodynamic changes.
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    Early Left Atrial Mechanics and Volume Abnormalities in Subjects with Prehypertension: A Real Time Three-Dimensional Echocardiography Study
    (Wiley, 2012) Akturk, Erdal; Ermis, Necip; Yagmur, Julide; Acikgoz, Nusret; Kurtoglu, Ertugrul; Cansel, Mehmet; Eyupkoca, Ferhat
    The aim of this study was to evaluate left atrial (LA) volume and mechanical functions by real time three-dimensional echocardiography (RT3DE) in prehypertensive subjects. The study included 54 (34 male and 20 female) prehypertensive subjects and 36 (14 male and 22 female) healthy control subjects. Transthoracic echocardiography and RT3DE were performed in all patients. Interventricular septum thickness and isovolumetric relaxation time were significantly higher in prehypertensives than in controls (10.7 +/- 0.7 vs. 10.1 +/- 0.8 P = 0.001 and 89.9 +/- 10 vs. 82.4 +/- 11 P = 0.002, respectively). LA maximum volume, volume before atrial contraction, total and active stroke volume, total and active emptying fractions, expansion index, and LA max volume index were significantly higher in prehypertensives when compared with controls (P < 0.0001 for all). However, the passive emptying fraction was significantly lower in prehypertensives than controls (45.7 +/- 5.6 vs. 48.6 +/- 4.1, P = 0.006), and the minimum LA volume between the two groups was similar. The main finding of this study was that although LA volume and LA active systolic functions were significantly increased in prehypertensive people, there was a reduction in passive LA systolic functions. These parameters may be important in showing hemodynamic and structural changes in cardiac tissue caused by prehypertension. (Echocardiography 2012;29:1211-1217)
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    Early single clinical experience with the new Figulla ASD Occluder for transcatheter closure of atrial septal defect in adults
    (Elsevier Masson, 2011) Cansel, Mehmet; Pekdemir, Hasan; Yagmur, Julide; Tasolar, Hakan; Ermis, Necip; Kurtoglu, Ertugrul; Acikgoz, Nusret
    Background. Recently, the Occlutech Figulla ASD Occluder (FSO) has been introduced for transcatheter closure of atrial septal defects. This device can be used for transcatheter closure of small as well as large atrial septal defects. Aims. To evaluate the feasibility and short-term results of transcatheter closure of secundum type atrial septal defects using the FSO device in adult patients. Methods. Seventy-four consecutive adult patients were referred for transcatheter closure of secundum large atrial septal defects (stretched diameter > 20 mm and/or invasive pulmonary/systemic flow [Qp/Qs] ratio > 1.5) using the FSO device. Results. The FSO device was successfully implanted in 68 patients (mean +/- SD [range] age: 31.8 +/- 12.3 [17-64] years; weight: 71.5 +/- 18.4 [49-98] kg). All patients had right atrial and ventricular volume overload with a mean Qp/Qs ratio of 2.5 +/- 0.6 (range 1.5-3.8). Mean atrial septal defect diameter was 22.3 +/- 4.8 (range 12-33) mm and the size of the implanted FSO was 24.1 +/- 4.9 (range 12-36) mm. Two patients had trivial (jet width <1 mm in diameter) residual shunts and one patient had a small (1-2 mm) residual shunt. There were no moderate or severe residual shunts. No device embolization or other serious complication occurred during either the procedure or the follow-up. Conclusion. The present study found that transcatheter closure of isolated secundum atrial septal defects using the novel design of the FSO device was safe, effective, and had an excellent outcome during the 6 month follow-up period. (C) 2011 Elsevier Masson SAS. All rights reserved.
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    Echocardiographic evaluation of aortic elasticity parameters in aortic stenosis patients with preserved ejection fractions undergoing transcatheter aortic valve implantation
    (2022) Bayramoğlu, Adil; Tasolar, Hakan; Ulutaş, Zeynep; Akaycan, Julide; Cansel, Mehmet; Ermiş, Necip; Yiğit, Yakup
    Abstract Aim: Aortic stiffness is an important risk factor that reflects the mechanical tension and elasticity of the aorta and predicts cardiovascular mortality and morbidity. However, it has been found that aortic stiffness contributes to both symptom burden and clinical outcomes in patients with aortic stenosis (AS). In our study, we aimed to evaluate the effect of transcatheter aortic valve implantation (TAVI) on aortic elasticity parameters by echocardiography in patients with severe aortic stenosis, especially with preserved ejection fraction. Materials and Methods: A total of 55 consecutive patients with symptomatic severe AS who underwent TAVI were included in the study. Demographic data, echocardiographic and aortic elasticity measurements of all patients were measured before and 6 months after the procedure. To evaluate the elastic properties of the aorta, aortic strain, distensibility and stiffness index were calculated. Results: Left ventricular mass index (LVMI) (p < 0.001) and aortic stiffness (p < 0.001) were decreased, while aortic strain (p < 0.001) and aortic distensibility (p < 0.001) were found to be increased in the measurements performed at 6 months after TAVI. In the regression analysis, age and LVMI were found to be independent predictors for predicting improvement in aortic stiffness; on the other hand, LVMI also independently predicted the increase in aortic distensibility. Conclusion: Improvement in aortic elastic properties and left ventricular functions were found in patients who underwent TAVI. Age and LVMI were observed to predict the improvement in stiffness and distensibility of the aorta in patients undergoing TAVI, especially in AS patients with preserved ejection fraction.
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    Effect of Hemodynamic Changes During Percutaneous Mitral Balloon Valvuloplasty on Short and Long Term Clinical Outcome
    (Drunpp-Sarajevo, 2012) Akurk, Erdal; Kurtoglu, Ertugrul; Eyupkoca, Ferhat; Ermis, Necip; Acikgoz, Nusret; Yagmur, Julide; Cansel, Mehmet
    Aims: We aim of this study is to determine whether hemodynamic changes that occur before and after percutaneous mitral balloon valvuloplasty (PMV) procedure is a predictor in determining the short- and long-term clinical results in patients with mitral stenosis (MS). Methods: The study population consisted of 118 (26 males and 92 females) consecutive patients with symptomatic rheumatic MS, underwent successful PMV. Mean pulmonary artery pressure, pulmonary capillary wedge pressure (PCWP), mean transmitral gradient and mean left atrial was obtained before and immediately after valvuloplasty. Two separate groups were formed on the basis of these measured pressure differences. The first group pressure differences (PD) <= 15 mmHg and the second group PD > 15 mmHg. Results: There was no difference in immediate outcomes between two group. There was no significant difference in between groups in terms of primary endpoints. However, there was a difference in mean left atrial pressure difference (LAPD) between <= 15 mmHg group and > 15mmHg group. MVR and redo PMV rates were significantly lower in LAPD> 15mmHg group (p=0.027 and p=0.03, respectively), the difference between stroke and death rates was not statistically significant (p=0.6). Conclusion: The significant risk factors in determining long-term outcomes in patients undergoing PMV are; mitral valve morphology, atrial fibrillation, advanced age, NYHA class, post-PMV, MR grade, post-PMV MVA, prior surgical commissurotomy, post-PMV pulmonary artery pressure and echocardiographic score. In addition to these parameters we found that LAPD could also be a predictor of long term outcomes patients undergoing PMV.
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    The effects of Ramadan fasting on heart rate variability in healthy individuals: A prospective study
    (Aves, 2014) Cansel, Mehmet; Tasolar, Hakan; Yagmur, Julide; Ermis, Necip; Acikgoz, Nusret; Eyupkoca, Ferhat; Pekdemir, Hasan
    Objective: Ramadan fasting is one of the five fundamental rituals of Islam. Heart rate variability (HRV) is an independent predictor of increased mortality of patients with myocardial infarction and congestive heart failure. Although many patients in this region fast once a year, the effects of fasting on the HRV, which has a prognostic significance for patients with myocardial infarction and congestive heart failure, are not known. Therefore, the study on the effects of one month fast of HRV in healthy volunteers seems to be reasonable to address. Methods: Our study is a prospective cohort study that includes a total of 40 healthy volunteers with sinus rhythm between 19 and 40 years of age (16 female and 24 male). HRV was determined twice by ambulatory 24-hour Holter recordings at fasting in the middle of Ramadan and first week after Ramadan month. Mean values of continuous variables were compared by using the Student t-test or Mann-Whitney U test. Paired t-test or Wilcoxon test were used for comparison of variables between groups. Results: When two groups compared, statistically significant differences were found in terms of RR (p=0.049), SDNNI (p=0.010), rMSSD (p=0.009), pNN50 (p=0.015), T power (p=0.009), LF (p=0.008), Lfnu (p=0.002), HF (p=0.022) and Hfnu (p=0.013) values. Conclusion: In our study, HRV parameters were found to be increased in Ramadan month, so we think that Ramadan fasting enhances the activity of the parasympathetic system.
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    Effects of the transcatheter closure of atrial septal defect on electrocardiographic and echocardiographic parameters six months after the closure
    (2017) Ataş, Halil; Cansel, Mehmet; Kurtoğlu, Ertuğrul; Pekdemir, Hasan; Özdemir, Ramazan
    Abstract: Although percutaneous transcatheter atrial septal defect (ASD) closure (TCC) has been performed on adults for a long time there is limited data about the effects of the procedure in the literature and the majority of studies have been performed on children. The study purposed to evaluate the impact of TCC on cardiac remodeling, electrical changes and exercise capacity in adults. Transthoracic echocardiography and electrocardiography were performed one day before and six months after TCC in 27 consecutive patients who underwent successful TCC. Twenty-seven age and sex matched healthy subjects were used as control group. Right ventricular (RV) diameter (had decreased from 44±6.3 to 34±3.9; p<0.001), right atrial (RA) diameter (had decreased from 38±5.6 to 34±4.7; p<0.001), systolic pulmonary artery pressure (sPAP) (had decreased from 38±5.1 to 32±4.3; p<0.001) and P dispersion (Pd) times (had decreased from 59±9.9 to 45.2±16.3; p<0.001) significantly decreased in patients with ASD after TCC. However, these parameters obtained after TCC were still higher compared with parameters of healthy controls. There were not significant differences regarding QT dispersion (QTd) times between ASD patients before and after TCC and healthy controls. New York Heart Association (NYHA) functional class of patients with ASD was significantly improved after TCC. The findings of the present study indicate that although TCC leads to significant improvements regarding right heart dimensions and sPAP and Pd values of ASD patients; residual deterioration still persists up to 6 months after the procedure
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    Elevated Monocyte to High-Density Lipoprotein Cholesterol Ratio and Endothelial Dysfunction in Behcet Disease
    (Sage Publications Inc, 2018) Acikgoz, Nusret; Kurtoglu, Ertugrul; Yagmur, Julide; Kapicioglu, Yelda; Cansel, Mehmet; Ermis, Necip
    Behcet disease (BD) is a multisystemic disorder characterized by endothelial dysfunction and inflammation. Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerged indicator of inflammation and oxidative stress. Sixty patients with BD and 50 control individuals were included to investigate the relationship between MHR and endothelial dysfunction. Endothelial function was assessed by flow- and nitroglycerin-mediated dilatation technique (FMD and NMD, respectively). Serum high-sensitivity C-reactive protein (hsCRP) levels were measured in all study participants. The MHR and hsCRP levels were significantly higher in patients with active BD than in controls. Brachial artery FMD was significantly lower in patients with active BD than in controls. Brachial artery NMD was similar between groups. There was a strong inverse correlation between MHR and FMD and a strong positive correlation between MHR and serum hsCRP levels. Thus, elevated MHR may be a useful marker reflecting impaired endothelial function and systemic inflammation in patients with BD.