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Öğe Akut miyokard enfarktüsü geçiren bir hastada multi koroner arter trombozu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Afşin, Abdulmecit; Otlu, Yılmaz Ömür; Yılmaz, Mahmut; Ulutaş, Zeynep; Açıkgöz, NusretAkut ST segment elevasyonlu miyokard enfarktüsü (STEMI) ile eş zamanlı çoklu koroner arter trombozisi nadir görülen durumdur ve kötü prognoz ile ilişkilidir. 63 yaşındaki erkek hasta 3 saat önce başlayan ani göğüs ağrısı şikayetiyle acil servise başvurdu. Hastaya akut inferior STEMI tanısı konuldu. Yapılan acil koroner anjiografi de sol ön inen (LAD), sol sirkümfleks (LCx) ve sol sirkümfleks arterin ilk dalı (obtüs marjin) arterde akut tromboz saptandı. Obtüs marjin lezyonuna stent uygulandı, LAD ve LCx deki trombüs için tirofiban (glikoprotein 2b/3a inhibitörü) infüzyonu kararı verildi. Tirofiban infüzyonu sonrası yapılan koroner anjiografide koroner arterlerde trombüs izlenmedi. Hasta komplikasyonsuz taburcu edildi.Öğe Atrial fibrillation due to blunt cardiac ınjury: Case report(AVES, BUYUKDERE CAD 105-9, MECIDIYEKOY, SISLI, ISTANBUL 34394, TURKEY, 2018) Yücel, Neslihan; Oğuztürk, Hakan; Ulutaş, Zeynep; Afşin, AbdulmecitIntroduction: Blunt cardiac injury secondary to chest trauma is an important cause of emergency department admissions. It can range from asymptomatic myocardial contusion to significant dysrhythmia, acute heart failure, valvular injury, or cardiac rupture. Case Report A 38-years-old patient was admitted to the emergency department with atrial fibrillation (AF) that occurred after a car accident. The patient had chest trauma caused by striking the steering wheel during the accident. The AF rhythm of the patient reverted to the normal sinus rhythm at the 3rd hour after trauma. Conclusion: Emergency medicine professionals should keep in mind arrhythmias due to blunt chest trauma and take electrocardiograms of patients to be able to provide treatment in time.Öğe 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, YakupAbstract 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.Öğe The effect of lactate levels on prognosis in patients with ST-segment elevation myocardial infarction(2020) Gür, Ali; Ulutaş, Zeynep; Turgut, Kasım; Güven, Taner; Yücel, Neslihan; Ermiş, NecipAbstract: Aim: The prognostic role of lactate for early mortality in patients with ST-segment elevation myocardial infarction (STEMI) submitted to primary percutaneous transluminal coronary angiography (PTCA) is not elucidated clearly. This study was conducted with patients that presented to the emergency department (ED) with STEMI and underwent PTCA to investigate whether the changes in lactate values from ED admission to 24 hours after PTCA affected mortality. Material and Methods: This prospective observational study on 143 patients with STEMI was conducted at emergency service and tertiary-level cardiology clinic in a public university hospital. The documentation for each patient included detailed information on demographics, type of myocardial infarction according to electrocardiography and PTCA results, duration of hospital stay, vital signs, laboratory fidings on admission, lactate levels 24 hours after PTCA, and outcome (hospital discharge or death). Results: The lactate values are higher in non-surviving groups measured 24 hours after PTCA (P < 0.001). The differences in the lactate levels from the time of admission to 24 hours after PTCA were signifiantly lower in the non-surviving group (P < 0.001). Conclusion: Among patients presenting to the ED with STEMI, a high lactate level is associated with mortality. Also, the difference between lactate values of the patients after PTCA is associated with the risk of mortality. Therefore, we consider that fist lactate levels in ED and last lactate levels after PTCA in patients with STEMI can provide physicians with an insight into the possibility of mortalityÖğe Effects of mirtazapine on cisplatin cardiotoxicity in rats(2023) Özhan, Onural; Ulutaş, Zeynep; Serduman, Seray; Büyükkorkmaz, Leyla Şahin; Yıldız, Azibe; Ulu, Ahmet; Vardı, NigarAtypical antidepressant mirtazapine (MIR) is primarily used to treat major depressive disorder. It has not been clarified whether cardiovascular uncertainties and mechanisms of action emerge as problems during the use of mirtazapine. Cisplatin (CIS) is an effective anti-cancer medication used to treat a variety of human malignancies. There were four groups of 32 Wistar albino male rats in all. Rats were split into 4 groups at random. 1. Control Group, 2. CIS Group, 3. MIR Group, 4. MIR+CIS Group. On the 15th day of the study, ECG, heart rate, and blood pressure were determined. Histopathological and biochemical analyses were carried out on cardiac and vascular tissue samples. Comparing the CIS group to the other groups, blood pressure was considerably lower in the CIS group (p<0.05). In vascular tissue examination, catalase and superoxide dismutase levels were substantially higher in the control, MIR, and MIR+CIS groups, similar to those of the myocardium, compared to the CIS group (p<0.05). While the CIS group had the highest malondialdehyde level, it was much lower in all other groups in both myocardial and vascular tissue (p<0.05). It was observed that the congestion persisted, but the interstitial edema's intensity was much less severe in the MIR+CIS group than in the CIS group (p=0.009). We sought to clarify the function of the oxidative system, tissue-level histological alterations, the possibility that mirtazapine protects against CIS cardiotoxicity, and the role of MIR in cardio-oncology in this study. In this study, we demonstrated the possible protective effect of MIR in CIS-mediated cardiotoxicity and its antioxidant effect mechanism.Öğe Important considerations in the echocardiographic assessment of tricuspid regurgitation and right ventricular function(2020) Akaycan, Julide; Hidayet, Siho; Ulutaş, Zeynep; Karaca, YücelAbstract: Tricuspid regurgitation (TR) and right ventricular dysfunction, which have been traditionally underemphasized, are known to be associated with increased morbidity and mortality, particularly in patients undergoing left-sided cardiac valvular surgery. Echocardiographic assessments are of utmost importance in terms of timely management and proper patient selection. In this review, our aim was to assess tricuspid failure as well as right ventricular functions using echocardiography.Öğe Multivessel Coronary Artery Thrombosis Accompanying Acute Myocardial Infarction: A Case Report(2015) Afşin, Abdulmecit; Ömür Otlu, Yılmaz; Yılmaz, Mahmut; Ulutaş, Zeynep; Açıkgöz, NusretAbstract: Akut ST segment elevasyonlu miyokard enfarktüsü (STEMI) ile eş zamanlı çoklu koroner arter trombozisi nadir görülen durumdur ve kötü prognoz ile ilişkilidir. 63 yaşındaki erkek hasta 3 saat önce başlayan ani göğüs ağrısı şikayetiyle acil servise başvurdu. Hastaya akut inferior STEMI tanısı konuldu. Yapılan acil koroner anjiografi de sol ön inen (LAD), sol sirkümfleks (LCx) ve sol sirkümfleks arterin ilk dalı (obtüs marjin) arterde akut tromboz saptandı. Obtüs marjin lezyonuna stent uygulandı, LAD ve LCx deki trombüs için tirofiban (glikoprotein 2b/3a inhibitörü) infüzyonu kararı verildi. Tirofiban infüzyonu sonrası yapılan koroner anjiografide koroner arterlerde trombüs izlenmedi. Hasta komplikasyonsuz taburcu edildi.Öğe The protective effects of glycyrrhizin on doxorubicin-induced cardiotoxicity in rats(2023) Ulutaş, Zeynep; Alıcı, Mustafa; Ozhan, Onural; Colak, Mehmet Cengiz; Arslan, Ahmet Kadir; Tunc, Selahattin; Vardı, NigarAim: Doxorubicin (DOX) is a type of chemotherapy drug frequently used to treat different malignancies. However, one of the most serious adverse effects of DOX usage is the potential of cardiotoxicity. Cardioprotective medications may be used to reduce cardiac damage because of DOX therapy. Glycyrrhizin (GL) is found in high amounts in the roots of the ‘Licorice’ plant from the Glycyrrhiza species. Due to its possible effects on blood pressure (BP) and cardiovascular health, GL has attracted attention concerning the heart. Oxidative stress and inflammatory process have been shown to be responsible for DOX-induced cardiotoxicity (DIC). For this reason, in consequence of its possible pharmacological benefits, such as antiinflammatory and antioxidant GL has been researched in this study. Here in, we aimed to investigate the protective effects of GL on DIC. Materials and Methods: In this study, thirty-two male Wistar albino adult male rats were used. Four groups of rats were assigned at randomly: Control, DOX, GL+DOX, and GL groups. DOX was given 20 mg/kg intraperitoneally (i.p.) and 100 mg/kg GL was administered orally (p.o.) once a day for 14 days. Electrocardiography (ECG) and BP records of the rats were obtained. In addition, malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels in the tissue were measured. Histopathological analyses were performed on the myocardium and descending aorta. Results: In the DOX group, mean and diastolic BP were higher than in the control group (p<0.05). In the GL+DOX group, diastolic BP was lower than in the DOX group (p<0.05). Pathological ECG changes such as ST segment changes and T negativity were observed in DOX-treated groups. MDA, SOD, CAT, and GSH levels studied in heart tissue were similar in all groups (p>0.05). GSH level in descending aorta was significantly lower in the GL+DOX group compared to the other groups (p<0.05). In the DOX group, degenerated cardiomyocyte density, interstitial edema, and severity of congestion-hemorrhage were statistically significantly increased compared to the control group (p<0.05). On the other hand, degenerated cardiomyocyte density was found to be significantly decreased in the GL+DOX group compared to the DOX group (p<0.05). In the DOX group, thinning of elastic lamellae and loss of myofibrils in muscle cells were observed in the descending aorta. Therefore, the histopathological alterations identified in the DOX group exhibited a significant statistical improvement in the GL+DOX group (p<0.05). Conclusion: Based on the study’s findings, GL can regulate high BP caused by DOX and also alleviate the toxic effects of DOX on both the myocardium and descending aorta.Öğe Successful recanalization of previously subintimal stenting of the right coronary artery(2020) Ulutaş, Zeynep; Taşolar, Mehmet Hakan; Hidayet, Siho; Pekdemir, HasanAbstract: Stent placement in the subintimal or false lumen is a rare complication of coronary interventions. Subintimal stenting can cause chronic total occlusion. Angiography images of previously treated CTO cases should be carefully monitored. To avoid placing a stent in the false lumen, it must be absolutely sure that it is inside the lumen. In this case, we presented a successful case of chronic total occlusion in the right coronary artery with a subintimal stent.
