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Öğe Apical aneurysm or transient apical ballooning? Potential dilemma in risk stratification of hypertrophic cardiomyopathy(Bmj Publishing Group, 2020) Yalta, Kenan; Gurdogan, Muhammet; Palabiyik, Orkide[Abstract Not Available]Öğe The assessment of coronary microvascular dysfunction: An integral part of risk-stratification in Takotsubo cardiomyopathy(Elsevier Espana Slu, 2020) Yalta, Kenan; Gurdogan, Muhammet; Taylan, Gokay[Abstract Not Available]Öğe Atypical 'de Winter pattern' mimicking acute left main coronary artery lesion(Kare Publ, 2020) Gurdogan, Muhammet; Yalta, Kenan; Altay, Servet; Zeybey, Utku; Akkus, Omer Ferudun[Abstract Not Available]Öğe Cancer Therapy-Related Pulmonary Hypertension: A Review of Mechanisms and Implications for Clinical Practice(Kare Publ, 2023) Gurdogan, Muhammet; Demir, Melik; Yalta, Kenan; Gurlertop, YektaCancer therapy-related pulmonary hypertension is a rare yet potentially fatal cardiotoxicity. However, it is a reversible cause of pulmonary hypertension if detected in its early stages. Cancer therapy-related pulmonary hypertension has been encountered in patients using tyrosine kinase inhibitors, particularly dasatinib. However, it is also well known that many agents used in cancer treatment such as alkylating agents, proteasome inhibitors, thoracic radiation exposure, and immune checkpoint inhibitors are particularly associated with pulmonary hypertension evolution. In case that history, symptoms, and clinical findings suggest a potential cancer therapy-related pulmonary hypertension, echocardiography is considered as the initial tool to detect pulmonary hypertension. If the possibility of pulmonary hypertension is high based on echocardiographic data, cancer treatment, as the initial step, should be discontinued due to its potential risks and other causes for pulmonary hypertension should be investigated thoroughly. Right heart catheterization should be the next step to establish the final diagnosis, and medical management, where appropriate, should be started without delay in these patients according to their pulmonary hypertension subgroup. There exists limited information regarding the diagnostic and management strategies of cancer therapy-related pulmonary hypertension in the current guidelines. In this review article, we aim to present current literature data on the mechanisms and management of cancer therapy-related pulmonary hypertension along with its follow-up algorithm in the setting of cardio-oncology practice.Öğe Cardiac Biomarkers in the Setting of Asthma Exacerbations: a Review of Clinical Implications and Practical Considerations(Current Medicine Group, 2020) Yalta, Kenan; Yalta, Tulin; Gurdogan, Muhammet; Palabiyik, Orkide; Yetkin, ErtanPurpose of Review The present paper aims to highlight clinical implications of elevated cardiac biomarkers and associated myocardial dysfunction in a variety of cardiac and non-cardiac scenarios in patients with an asthma exacerbation, and to propose a basic algorithm for cardiovascular evaluation and triage (and hence, for further management) of these patients primarily based on evaluation of cardiac biomarkers along with basic diagnostic modalities and specific cardiac symptoms in the hospital setting. Recent Findings Elevation of cardiac biomarkers in the setting of an asthma exacerbation mostly signifies a new-onset subclinical myocardial dysfunction/injury generally associated with certain asthma-related factors including acute hypoxemia and bronchodilator therapy, and usually has a limited prognostic value in these patients. On the other hand, elevation of these biomarkers in patients with an asthma exacerbation might also denote a variety of certain life-threatening cardiac or non-cardiac conditions associated with significant myocardial dysfunction (acute coronary syndromes (ACSs), sepsis, etc.) that might be masked by the rampant course of the asthma exacerbation, and hence, might possibly go undetected potentially aggravating the prognosis in a portion of these patients. In patients with an asthma exacerbation, it seems imperative to timely diagnose and manage emerging diverse clinical conditions particularly through the guidance of cardiac biomarkers and associated myocardial dysfunction patterns in an effort to improve overall prognosis in these patients.Öğe Cardiac Magnetic Resonance Imaging and Transthoracic Echocardiography: Investigation of Concordance between the Two Methods for Measurement of the Cardiac Chamber(Mdpi, 2019) Gurdogan, Muhammet; Ustabasioglu, Fethi Emre; Kula, Osman; Korkmaz, SelcukBackground and objectives: Cardiac magnetic resonance (CMR) imaging is the gold standard method for the detection of ventricular volumes and myocardial edema/scar. Transthoracic echocardiography (TTE) imaging is primarily used in the evaluation of cardiac functions and chamber dimensions. This study aims to investigate whether the chamber diameter measurements are concordant with each other in the same patient group who underwent TTE and CMR. Materials and Methods: The study included 41 patients who underwent TTE and CMR imaging. Ventricular and atrial diameter measurements from TTE-derived standard parasternal long axis and apical four-chamber views and CMR-derived three- and four-chamber views were recorded. The concordance between the two methods was compared using intra-class correlation coefficients (ICC) and Bland-Altman plots. Results: Of the patients, 25 (61%) were male and the mean age was 48.12 +/- 16.79. The mean ICC for LVDD between CMR observers was 0.957 (95% CI: 0.918-0.978), while the mean ICC between CMR and TTE measurements were 0.849 (95% CI: 0.709-0.922) and 0.836 (95% CI: 0.684-0.915), respectively. The mean ICC for the right ventricle between CMR observers was 0.985 (95% CI: 0.971-0.992), while the mean ICC between CMR and TTE measurements were 0.869 (95% CI: 0.755-0.930) and 0.892 (95% CI: 0.799-0.942), respectively. Passing-Bablok Regression and Bland-Altman plots indicated high concordance between the two methods. Conclusions: TTE and CMR indicated high concordance in chamber diameter measurements for which the CMR should be considered in patients for whom optimal evaluation with TTE could not be performed due to their limitations.Öğe Cardiac pacing in patients with Fontan circulation: Further considerations(Polish Cardiac Soc-Polskie Towarzystwo Kardiologiczne, 2022) Yalta, Kenan; Gurdogan, Muhammet; Yalta, Tulin[Abstract Not Available]Öğe Coexistence of Anti-PD1-Induced Immune Myocarditis and Complete Atrioventricular Block: A Case Report(Excerpta Medica Inc-Elsevier Science Inc, 2023) Gurdogan, Muhammet; Yalta, Kenan; Gurlertop, Yekta; Karahan, Furkan; Bulburu, Irem Bilge; Kocyogot, Beliz; Ustabasioglu, Fethi EmreThe present report describes the late recovery of an emerging complete atrioventricular (AV block) in a patient with immune check point inhibitor-related myocarditis following a period of immunosuppresive therapy. Therefore, decision-making for permanent pace-maker implantation should be implemented after a substantial period of time owing to the potential recovery of bradyarrhythmic complications in similar cases. (c) 2023 Elsevier Inc. All rights reserved.Öğe Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results in Breast Cancer Patients Treated with Radiotherapy(Mdpi, 2023) Ozkan, Ugur; Gurdogan, MuhammetBreast cancer is the most common type of malignancy in women and radiotherapy (RT) is an important part of treatment. Although it reduces cancer recurrence, it has been shown to cause accerelerated athnerosclerosis. This study aimed to compare the results of myocardial perfusion scintigraphy (MPS) for ischemia investigation with coronary angiography (CAG) findings and to investigate the effect of RT on the development of coronary artery disease in breast cancer patients who underwent RT. The results of 660 patients were analyzed and compared with each other in terms of clinical, demographic, laboratory parameters and MPS results. The mean age was 57.5 years and all of them were female. When the groups were compared, the Gensini score and marking of the left anterior descending artery (LAD) area as ischemic area localization were found more, but angiographically, the rate of severe stenosis in the area indicated by MPS was found to be lower in the RT group (p < 0.001). While the sensitivity of MPS in the RT group was 67.5% and non-RT group was 88.5% (p < 0.001), the result of our study shows that the sensitivity of the MPS test is significantly lower in the patient group receiving RT.Öğe The Effect of SGLT2 Inhibitors on the Development of Contrast-Induced Nephropathy in Diabetic Patients with Non-ST Segment Elevation Myocardial Infarction(Mdpi, 2023) Ozkan, Ugur; Gurdogan, MuhammetBackground and Objectives: Percutaneous procedures using contrast agents are modern diagnosis and treatment methods for cardiovascular diseases. Contrast use may cause nephropathy, especially in diabetic patients. SGLT2 inhibitors have strong cardioprotective and renal protective effects. In our study, we investigated the effectiveness of this drug group in preventing the development of Contrast-Induced Nephropathy (CIN). Materials and Methods: The results of 312 diabetic patients who underwent CAG were analyzed. The study group included 104 DM patients using SGLT2 and the control group did not use SGLT2. These groups were compared with each other in terms of clinical, demographic, and laboratory parameters. Results: The groups were similar characteristics. However, post-CAG creatinine values compared with before the procedure, the development of CIN was observed to be significantly less in the group using SGLT2 inhibitor (p = 0.03). When the results of the multivariate analysis were examined, it was seen that the use of SGLT2 inhibitors significantly reduced the risk of CIN (odds ratio (OR): 0.41, 95% confidence interval (CI): 0,142-0.966, p = 0.004). Conclusions: Our study showed that SGLT2 inhibitors may be protective against the development of CIN, especially in patients with comorbid conditions such as diabetes.Öğe The effect of thyroid functions on contrast-induced nephropathy in patients undergoing coronary angiography and percutaneous coronary intervention(Pakistan Medical Assoc, 2019) Gurdogan, Muhammet; Ari, HasanObjective: To investigate the effects of thyroidism on the development of contrast-induced nephropathy in patients undergoing coronary angiography and percutaneous coronary intervention. Methods: The prospective, observational study was conducted at Trakya University Faculty of Medicine, Edirne, Turkey, from October 1, 2016, to October 1, 2017, and comprised patients with hypothyroidism, hyperthyroidism and euthyroid patients. Thyroid and renal functions were evaluated from blood samples taken before the procedure. The definition of contrast-induced nephropathy included absolute (0.5 mg/dL) or relative increase (25%) in serum creatinine 48-72 h after exposure to a contrast agent compared with baseline serum creatinine values. SPSS 10 was used for data analysis. Results: Of the 162 patients, 58(35.8%) had hypothyroidism, 47(29%) hyperthyroidism and 57(35.2%) euthyroid. Contrast-induced nephropathy was significantly higher in hypothyroid and hyperthyroid subjects compared to euthyroid group (p<0.001 each). Univariate analysis showed contrast volume, procedure, albumin value, hypothyroidism and hyperthyroidism to be independent predictors of contrast-induced nephropathy (p<0.05 each), but multivariate analysis only showed hypothyroidism and the hyperthyroidism as the independent predictors (p<0.01 each). Conclusion: Contrast-induced nephropathy rate was increased in patients with malfunctioning thyroid, Hypothyroidism and hyperthyroidism were found to be independent predictors of contrast-induced nephropathy.Öğe The Effect of Thyroid Stimulating Hormone Level Within the Reference Range on In-Hospital and Short-Term Prognosis in Acute Coronary Syndrome Patients(Mdpi, 2019) Gurdogan, Muhammet; Altay, Servet; Korkmaz, Selcuk; Kaya, Caglar; Zeybey, Utku; Ebik, Mustafa; Demir, MelikBackground and objectives: Despite being within the normal reference range, changes in thyroid stimulating hormone (TSH) levels have negative effects on the cardiovascular system. The majority of patients admitted to hospital with acute coronary syndrome (ACS) are euthyroid. The aim of this study was to investigate the effect of TSH level on the prognosis of in-hospital and follow-up periods of euthyroid ACS patients. Materials and Methods: A total of 629 patients with acute coronary syndrome without thyroid dysfunction were included in the study. TSH levels of patients were 0.3-5.33 uIU/mL. Patients were divided into three TSH tertiles: TSH level between (1) 0.3 uIU/mL and <0.90 uIU/mL (n = 209), (2) 0.90 uIU/mL and <1.60 uIU/mL (n = 210), and (3) 1.60 uIU/mL and 5.33 uIU/mL (n = 210). Demographic, clinical laboratory, and angiographic characteristics were compared between groups in terms of in-hospital and follow-up prognosis. Results: Mean age was 63.42 +/- 12.5, and 73.9% were male. There was significant difference between tertiles in terms of TSH level at admission (p < 0.001), the severity of coronary artery disease (p = 0.024), in-hospital mortality (p < 0.001), in-hospital major hemorrhage (p = 0.005), total adverse clinical event (p = 0.03), follow-up mortality (p = 0.022), and total mortality (p < 0.001). In multivariate logistic regression analysis, the high-normal TSH tertile was found to be cumulative mortality increasing factor (OR = 6.307, 95%; CI: 1.769-22.480; p = 0.005) during the 6-month follow-up period after hospitalization and discharge. Conclusions: High-normal TSH tertile during hospital admission in euthyroid ACS patients is an independent predictor of total mortality during the 6-month follow-up period after hospitalization and discharge.Öğe THE ETIOLOGY AND AGE-RELATED PROPERTIES OF PATIENTS WITH DELIRIUM IN CORONARY INTENSIVE CARE UNIT AND ITS EFFECTS ON INHOSPITAL AND FOLLOW UP PROGNOSIS(Literatura Medica, 2020) Altay, Servet; Gurdogan, Muhammet; Kaya, Caglar; Kardas, Fatih; Zeybey, Utku; Cakir, Burcu; Ebik, MustafaObjective - Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. Methods - This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. Results - A total of 1108 patients (mean age: 64.4 +/- 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Conclusion - Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.Öğe The first septal perforating artery in the setting of percutaneous coronary interventions: More than just a side branch(Polish Cardiac Soc, 2024) Yalta, Kenan; Gok, Murat; Gurdogan, Muhammet[Abstract Not Available]Öğe Hyponatremia and takotsubo syndrome: a review of pathogenetic and clinical implications(Springer, 2024) Yalta, Kenan; Palabiyik, Orkide; Gurdogan, Muhammet; Yetkin, ErtanHyponatremia is a common electrolyte abnormality with important prognostic and therapeutic implications. It might exert detrimental effects on various organ systems including the central nervous system (CNS), bone, and heart along with its potential association with poor quality of life. These adverse effects might be largely mediated through a variety of mechanisms including osmotic stress, dysfunctional transmembrane exchangers, and enhanced oxidative stress.Interestingly, hyponatremia might also have an important association with takotsubo syndrome (TTS) that has been universally considered as a reversible form of cardiomyopathy usually emerging in response to various stressors. In this context, severe hyponatremia was previously reported to serve as a direct trigger of TTS evolution largely through its potential impact on CNS and heart. However, pathogenetic and clinical implications of hyponatremia still need to be thoroughly evaluated in patients with TTS. This paper aims to analyze the clinical features of published cases with TTS primarily triggered by hyponatremia and also aims to discuss the association between hyponatremia and TTS from a broader perspective.Öğe The importance of speckle tracking echocardiography in the evaluation of cardiac functions in patients with rheumatoid arthritis(Turkish League Against Rheumatism, 2024) Ebik, Muserref; Tastekin, Nurettin; Gurdogan, Muhammet; Ebik, Mustafa; Birtane, Murat; Emmungil, Hakan; Yilmazer, BarisObjectives: In this study, we aimed to analyze the layer-specific strain values obtained by speckle tracking echocardiography (STE) method in the determination of subclinical cardiac dysfunction in rheumatoid arthritis (RA) patients. Patients and methods: Between February 2019 and October 2019, a total of 63 female RA patients (mean age: 51.82 +/- 6.07 years; range, 40 and 65 years) who had a confirmed diagnosis were included. Thirty-one age-matched female healthy individuals (mean age: 50.71 +/- 5.37 years; range, 40 and 65 years) were selected as the control group. The patients were divided into three groups according to the duration of disease as <5 years, 5-10 years and >10 years. The Disease Activity Score in 28 joint - C-reactive protein (CRP) was used to determine disease activation. The standard assessment included complete serum CRP, anti-cyclic citrullinated peptide, rheumatoid factor, N-terminal pro B-type natriuretic peptide (NT-proBNP), and homocysteine. Global longitudinal strain (GLS) analysis was performed with STE. Results: The NT-proBNP values were found to be higher in RA patients compared to the control group (p=0.044). In terms of conventional echocardiographic parameters, a significant difference between E/A and E/E' ratios was observed (p<0.001 and p=0.015). Endocardium, transmural, and epicardium GLS values obtained by STE were found to be lower in RA patients (p<0.05). The left ventricular (LV) GLS values worsened, as the duration of disease increased (p<0.05). There was a significant correlation between RA disease activity and LV GLS values, showing that increasing levels of disease activity was associated with worse LV GLS (r=0.583, p<0.01 and r=0.681, p<0.01 and r=0.689, p<0.01 for endocardium, transmural and epicardium, respectively). Conclusion: Our study results suggest that the layer-specific GLS values obtained by STE decrease in RA patients.Öğe The Inflammation-Based Glasgow Prognostic Score as a Prognostic Factor in Patients with Intensive Cardiovascular Care Unit(Mdpi, 2019) Altay, Servet; Gurdogan, Muhammet; Keskin, Muhammed; Kardas, Fatih; Cakir, BurcuBackground: The Glasgow prognostic score (GPS), which is obtained from a combination of C-reactive protein (CRP) and serum albumin level, predicts poor prognoses in many cancer types. Systemic inflammation also plays an important role in pathogenesis of cardiovascular diseases. In this study, we aimed to investigate the effect of inflammation-based GPS on in-hospital and long-term outcomes in patients hospitalized in intensive cardiovascular care unit (ICCU). Methods: A total of 1004 consecutive patients admitted to ICCU were included in the study, and patients were divided into three groups based on albumin and CRP values as GPS 0, 1, and 2. Patients' demographic, clinic, and laboratory findings were recorded. In-hospital and one-year mortality rates were compared between groups. Results: Mortality occurred in 109 (10.8%) patients in in-hospital period, 82 (8.1%) patients during follow-up period, and thus, cumulative mortality occurred in 191 (19.0%) patients. Patients with a high GPS score had a higher rate of comorbidities and represented increased inflammatory evidence. In the multivariate regression model there was independent association with in-hospital mortality in GPS 1 patients compared to GPS 0 patients (Odds ratio, (OR); 5.52, 95% CI: 1.2-16.91, p = 0.025) and in GPS 2 patients compared to GPS 0 patients (OR; 7.01, 95% CI: 1.39-35.15, p = 0.018). A higher GPS score was also associated with a prolonged ICCU and hospital stay, and increased re-hospitalization in the follow-up period. Conclusion: Inflammation based GPS is a practical tool in the prediction of worse prognosis both in in-hospital and one-year follow-up periods in ICCU patients.Öğe Left ventricle pseudoaneurysm detected eight months after myocardial infarction(Turkish Soc Cardiology, 2019) Yilmaztepe, Mustafa Adem; Ozturk, Cihan; Ucar, Fatih Mehmet; Kaya, Caglar; Gurdogan, Muhammet[Abstract Not Available]Öğe Levels of awareness of occupational and general cardiovascular risk factors among metal industry employees(Turkish Soc Cardiology, 2015) Gurdogan, Muhammet; Gurdogan, Eylem Pasli; Ari, Hasan; Erturk, Mehmet; Genc, Ahmet; Ucar, Mehmet FatihObjective: Long-term exposure to physical, chemical, ergonomic and psychosocial environmental factors may lead to occupational cardiovascular disease in metal industry employees. This study aimed to determine levels of knowledge levels regarding occupational and cardiovascular risk factors among metal industry employees. Methods: The study was conducted between 2nd and 6th June 2014 with the participation of 82 employees. All were working in a medium-sized workplace in the metal industry. Data were collected by means of a questionnaire, which included sociodemographic characteristics and occupational cardiovascular risk factors, and a scale developed by Arikan et al. to measure awareness levels of risk factors for cardiovascular diseases (CARRF-KL). Results: The mean age of employees was 39.97 +/- 8.44. Of the participants, 58.5% stated that they had knowledge on cardiac disease risk factors. The mean CARRF-KL score was found to be 18.65 +/- 4.04. The percentage of employees stating that they had no knowledge on the occupational risks for such diseases was 79.3%, while 19.5% stated that job stress caused cardiac diseases. One individual (1.2%) stated that one of the chemical solvents used in the working environment was a risk factor. Conclusion: Although awareness among metal industry employees of cardiovascular risk factors was above average, it was determined that they do not have adequate information on occupational risk factors. Prolonged and unprotected levels exposure to environmental factors constitute a risk for cardiovascular disease. This information is important for the development of preventive cardiology.Öğe A Liver Transplant Patient on Everolimus Treatment Presented with Acute Anterior Myocardial Infarction: Does the Type of Drug-eluting Stent Matter?(Galenos Publ House, 2020) Gurdogan, Muhammet; Yalta, Kenan; Yilmaztepe, Mustafa Adem; Altay, Servet; Akkus, Omer Ferudun[Abstract Not Available]