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Öğe Association of Angiotensin II Type 1 Receptor A1166C Gene Polymorphisms with Coronary Artery Disease in Thrace Region of Turkey(Erciyes Univ Sch Medicine, 2021) Taylan, Gokay; Palabiyik, Orkide; Ozkalayci, Flora; Yilmaztepe, Mustafa Adem; Sivri, Nasir; Aksoy, YukselObjective: Although the risk factors for coronary artery disease (CAD) are well established, a significant gap still exists in understanding the pathology of atherosclerotic heart disease evolving without conventional risk factors. Therefore, genetic factors are considered to play a significant role in this setting. The present study aimed to assess the relationship between angiotensin 2 type 1 receptor (AT1R) A1166C gene polymorphism and CAD. Materials and Methods: Patients with documented CAD (n=121) were compared with controls with normal coronary arteries (n=121). CAD was diagnosed using a coronary angiography. The median age of participants was 59 +/- 12 years with an equal sex distribution. A comparison between the two groups with regard to the AT1R A1166C gene polymorphism was made through the amplification of DNA using polymerase chain reaction. Results: This study demonstrated that adenine-adenine and cytosine-cytosine (CC) genotypes were more frequent, yet adenine-cytosine genotype was less frequent among patients with CAD compared with controls [p=0.003), 95% confidence interval (CI)]. The AT1R A1166C gene polymorphism along with the CC genotype and C allele was found to be associated with CAD. Further, gender, hypertension, family history, age, and low levels of serum high-density lipoprotein also had a significant relationship with AT1R A1166C gene polymorphism. Conclusion: The present study suggested AT1R A1166C gene polymorphism, CC genotype, and C allele as potential risk factors for atherosclerotic CAD. Patients harboring these genetic variants should be under close supervision for the development of CAD.Öğe Autonomic and diastolic dysfunction association with quality of life impairment in cirrhotic patients(Elsevier, 2020) Baysal, Mehmet; Ortaburun, Yildiz; Soylu, Ali Riza; Yilmaztepe, Mustafa Adem; Baysal, Serap; Umit, Elif; Umit, HasanBackground and study aims: Cirrhosis is a multisystem disorder characterized by hyperdynamic circulation which can progress to multiple organ dysfunctions. Recent studies have demonstrated autonomic dysfunction and cirrhotic cardiomyopathy including diastolic dysfunction, systolic dysfunction with electrophysiologic abnormalities in patients with cirrhosis. Due to the long and complicated course of the disease, health related quality of life is affected. We aimed to evaluate the frequency of diastolic dysfunction and autonomic dysfunction in cirrhosis, and the effects on health-related quality of life. Patients and methods: Hundred cirrhotic patients were enrolled in the study. According to the Child-Pugh classification 35 patients were of Child A, 36 of Child B and 29 of Child C. The proportion of autonomic dysfunction was 52%, and diastolic dysfunction 51%. Autonomic dysfunction was diagnosed using bedside maneuvers and tests; diastolic dysfunction was diagnosed using the E/A ratio in echocardiographic findings. Health-related quality of life measurements was obtained from an SF-36 questionnaire. Results: Patients with advanced Child-Pugh classifications were found to have significantly lower health-related quality of life values (p < 0.05). Likewise, health-related quality of life values were observed to be significantly lower in patients with autonomic dysfunction (p < 0.05). No significant difference was found in health related quality of life measurements between patients with and without diastolic dysfunction. Conclusion: Our study showed that autonomic dysfunction and diastolic dysfunction are found in patients with cirrhosis. Further studies are needed to assess the effects of autonomic dysfunction and diastolic dysfunction on health-related quality of life. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.Öğe Comparison of Five QT Correction Methods in Patients with Hypoxic Brain Injury(Elsevier Science Inc, 2013) Samsa, Murat; Aksit, Ercan; Aydin, Fatih; Yilmaztepe, Mustafa Adem; Altun, Armagan[Abstract Not Available]Öğe Comparison of the TIMI Frame Count in Dipper and Non-Dipper Hypertensive Patients with Normal Coronary Arteries(Elsevier Science Inc, 2013) Aksir, Ercan; Samsa, Murat; Aydin, Fatih; Yilmaztepe, Mustafa Adem; Ozcelik, Fatih[Abstract Not Available]Öğe Cutaneous analgesia before transradial access for coronary intervention to prevent radial artery spasm(Sage Publications Ltd, 2018) Tatli, Ersan; Yilmaztepe, Mustafa Adem; Vural, Mustafa Gokhan; Tokatli, Alptug; Aksoy, Murat; Agac, Mustafa Tarik; Cakar, Mehmet AkifAim: Transradial access (TRA) for coronary intervention is increasingly used in current clinical practice. The aim of the present study was to evaluate the hypothesis that cutaneous analgesia before TRA for coronary intervention at a puncture site 30 minutes before puncture can reduce patient discomfort and the incidence of radial artery spasm (RAS). Methods: Patients (n=104) undergoing planned coronary interventions using TRA were prospectively randomized to receive either 1 mL of 1% lidocaine subcutaneously (n=52) (control group) or subcutaneous lidocaine plus 5% lidocaine cream (n=52) cutaneously 30 minutes before puncture (treatment group). The primary endpoint was angiographically or clinically confirmed RAS. Secondary endpoints were the occurrence of patient discomfort in the forearm during the procedure and access-site crossover to the femoral artery. Patient discomfort was quantified with a visual analogue scale (VAS) score. Results: Fifty-two patients in the treatment group (60.5 +/- 9.4 years of age and 16 female) and 52 patients in the control group (60.4 +/- 9.7 years of age and 16 female) were included in the final analysis. Radial artery spasm occurrence decreased in the treatment group compared to the control group (26.9% vs 9.6%; p=0.04) accompanied by a VAS score of 3.7 +/- 1.8 in the treatment group and 4.9 +/- 2.0 in the control group; p=0.02. The access site crossover rate did not differ between the groups (7.6% vs 21.1%; p=0.09). Conclusion: Cutaneous analgesia before TRA for coronary interventions is associated with a substantial reduction in the RAS and the procedure-related level of patient discomfort.Öğe EFFECT OF COLD STRES ON THE RIGHT VENTRICULAR FUNCTIONS IN PATIENTS WITH SCLERODERMA(Elsevier Ireland Ltd, 2010) Yilmaztepe, Mustafa Adem; Aktoz, Meryem; Tatli, Ersan; Altun, Armagan[Abstract Not Available]Öğe Effect of transient ulnar artery compression on radial artery diameter(SPANDIDOS PUBL LTD, 2018) Yilmaztepe, Mustafa Adem; Yilmaz, ErdemThe transradial approach is widely preferred in coronary procedures. A small radial artery diameter (RAD) is the most important factor affecting successful access. Various maneuvers and medications have been used to increase the RAD and thereby facilitate RA cannulation. Ulnar artery compression (UAC) for 30 min has been indicated to be effective in increasing the RAD and facilitating RA access. The aim of the present preliminary study was to assess the effect of transient UAC for 1 min on the RAD. A total of 151 patients were included in the present study. RA ultrasonography was performed at the level of the wrist. The UA was compressed for 1 min. The RAD was measured at baseline, at the end of UAC and at 1 min thereafter. The results indicated that the RAD was significantly smaller in diabetic vs. non-diabetic patients (2.35 +/- 0.43 vs. 2.50 +/- 0.39 mm, P=0.024) and in women vs. men (2.25 +/- 0.38 vs. 2.56 +/- 0.38 mm, P<0.001). At the end of UAC, the RAD was increased compared with that at baseline (2.45 +/- 0.41 vs. 2.62 +/- 0.41 mm, P<0.001), but it started to decrease thereafter, and the RAD measured at 1 min after stopping UAC was significantly smaller (2.62 +/- 0.41 vs. 2.55 +/- 0.40 mm, P<0.001), while remaining significantly larger than that at baseline (P<0.001). The RA peak systolic flow velocity also increased significantly during UAC (35.3 +/- 8.9 vs. 60.3 +/- 19.2 cm/sec; P<0.001). In conclusion, Transient UAC for 1 min significantly increased the RAD and the peak systolic flow velocity. Further studies with clinical endpoints are required for further exploration of the feasibility of this approach.Öğe Evaluation of Index of Cardio-Electrophysiological Balance (iCEB) in Patients with Rheumatoid Arthritis.(Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Faith Mehmet; Yilmaztepe, Mustafa Adem[Abstract Not Available]Öğe Evaluation of Index of Cardioelectrophysiological Balance (iCEB) in Patients with Rheumatoid Arthritis(Aves, 2018) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem; Taylan, GokayObjective: Index of cardioelectrophysiological balance (iCEB), measured as QT interval divided by QRS duration, is defined recently as a new risk marker for arrhythmias. Increased or decreased iCEB is associated with malignant ventricular arrhythmias. We aimed to investigate the ventricular balance between the depolarization (changes in QRS duration) and depolarization (changes in the QT interval) of the cardiac action potential in rheumatoid arthritis (RA) patients by using iCEB. Materials and Methods: In total, 60 patients (mean age was 49.4 +/- 11.7 y and 61% of the patients were female) with RA and 60 control subjects (45.3 +/- 12.6 y and 60% of the patients were female) were enrolled. iCEB (QT/QRS) and iCEBc (heart rate-corrected QT (QTc)/QRS) rates were calculated from the 12-lead electrocardiogram. Results: iCEB and iCEBc were significantly higher in patients with RA than in control subjects (p<0.001 and p<0.001, respectively), and they were correlated with high-sensitivity C-reactive protein (hsCRP) levels (r=0.467, p<0.001 and r=0.479, p<0.001, respectively) Conclusions: Our results indicate that iCEB was increased in patients with RA. It is known that high iCEB is associated with torsade de Pointes (TdP) ventricular tachycardia. The increased frequency of ventricular arrhythmias in patients with RA may be TdP-related and can be clarified by the new index of balance between depolarization and repolarization (iCEB).Öğe Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with acute myocarditis(Bmc, 2019) Ucar, Fatih Mehmet; Ozturk, Cihan; Yilmaztepe, Mustafa AdemBackground Acute myocarditis (AM) can be defined as an inflammatory disease of the myocardium and characterized by large heterogeneity of clinical presentation. Myocarditis is becoming increasingly recognized as a contributor to unexplained mortality, and is thought to be a major cause of sudden cardiac death in the first two decades of life. The present study aimed to search the assessment of repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT and Tp-e/QTc ratios) in AM patients. Methods Totally 56 patients (mean age was 22 +/- 3.7 years and 67% of the patients were male) with AM and 56 control subjects (23 +/- 4.7 years and 64% of the patients were male) were enrolled. Tp-e intervals, Tp-e/QT and Tp-e/corrected QT (QTc) ratios were calculated from 12-lead electrocardiogram. Results Heart rate, QT and QTc values were similar between groups. QRS interval was lower in AM group compared to the control group (p < 0.001). Tp-e, Tp-e/QT and Tp-e/ QTc were significantly higher in AM group (p < 0.001, p < 0.001, p = 0.03 respectively) and they were significantly correlated with high troponin and high sensitive C reactive protein levels. In hospital follow-up time was 6 +/- 2 days. Four patients have non sustained ventricular tachyarrhythmias and 1 patient dead because of cardiac arrest. Conclusions Our study demonstrated that Tp-e intervals, Tp-e/QT and Tp-e/QTc ratios were higher in patients with AM than control subjects. The increased frequency of ventricular arrhythmias can be clarified by increased indexes of ventricular repolarization parameters in patients with AM.Öğe ICD Detected Non Sustained Ventricular Tachycardia Episodes are Associated with Hospitalization(Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem; Taylan, Gokay; Aktoz, Meryem[Abstract Not Available]Öğe ICD Detected Patient Activity is Associated with Arrhythmic Events in Heart Failure Patients [Meeting Abstract](Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem[Abstract Not Available]Öğe The Importance and Safety of Contrast Venography before Procedure in Patients with Permanent(Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem[Abstract Not Available]Öğe Layer-specific strain analysis in patients with suspected stable angina pectoris and apparently normal left ventricular wall motion(BMC, 2018) Yilmaztepe, Mustafa Adem; Ucar, Fatih MehmetBackground: Non-invasive imaging tests are widely used in the evaluation of stable angina pectoris (SAP). Despite these tests, non-significant coronary lesions are not a rare finding in patients undergoing elective coronary angiography (CAG). Two-dimensional (2D) speckle tracking global longitudinal strain (GLS) imaging is a more sensitive and accurate technique for measuring LV function than conventional 2D methods. Layer-specific strain analysis is a relatively new method that provides endocardial and epicardial myocardial layer assessment. The aim of the present study was to evaluate longitudinal layer-specific strain (LSS) imaging in patients with suspected SAP. Methods: Patients who underwent CAG for SAP were retrospectively screened. A total of 79 patients with no history of heart disease and wall motion abnormalities were included in the study. Forty-three patients with coronary lesions > 70% constituted the coronary artery disease (CAD) group and 36 patients without significant CAD constituted the control group. Layer-specific GLS transmural, endocardium, and epicardium values (GLS-trans, GLS-endo, and GLS-epi, respectively) were compared between the groups. Results: Patients in the CAD group had significantly lower GLS values in all layers (GLS-trans: -18.2 + 2.4% vs -22.2 + 2.2% p <.001; GLS-endo: -20.8 + 2.8% vs -25.3 + 2.6%, p < .001; GLS-epi: 15.9 + 2.4% vs -19.5 + 1.9%, p < .001). Multivariate adjustment demonstrated GLS-trans as the only independent predictor of CAD (OR:0.472, CI (0.326-0.684), p < .001]. Additionally, the GLS values were all lower in myocardial perfusion scintigraphy (MPS) true-positive patients compared with MPS false-positive patients (GLS-trans: -17.7 +/- 2.4 vs. -21.9 +/- 2.4%, p < .001; GLS-endo: -20.2 +/- 2.9% vs -24.9 +/- 2.9%, P < .001; GLS-epi: 15.4 +/- 2.6% vs. -19.2 +/- 1.8%, P < .001). Conclusion: Resting layer-specific strain as assessed by 2D speckle tracking analysis demonstrated that GLS values were reduced in all layers of myocardium with SAP and with no wall motion abnormalities. LSS analysis can improve the identification of patients with significant CAD but further prospective larger scale studies are needed to put forth the incremental value of LSS analysis over transmural GLS.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 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]Öğe Non-Sustained Ventricular Tachycardia Episodes Predict Future Hospitalization in ICD Recipients with Heart Failure(Arquivos Brasileiros Cardiologia, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem; Taylan, Gokay; Aktoz, MeryemBackground: Implantable cardioverter-defibrillator (ICD) therapy is well known to reduce mortality in selected patients with heart failure (HF). Objective: To investigate whether monitored episodes of non-sustained ventricular tachycardia (NSVT) might predict future HF hospitalizations in ICD recipients with HF. Methods: We examined 104 ICD recipients (mean age: 60 +/- 10.1 years, 80.8 % male) with HF who were referred to our outpatient clinic for device follow-up. After device interrogation, patients were divided into NSVT positive and negative groups. The primary endpoint was the rate of hospitalization within the next 6 months after initial ICD evaluation. Results: Device evaluation demonstrated at least one episode of monitored NSVT in 50 out of 104 patients. As expected, no device therapy (shock or anti-tachycardia) was needed for such episodes. At 6 months, 24 patients were hospitalized due to acute decompensated HF. Hospitalization rate was significantly lower in the NSVT negative as compared with positive groups (38% versus 62%; adjusted hazard ratio [HR] 0.166 ; 95% CI 0.056 to 0.492; p = 0.01). Conclusions: Monitored NSVT bouts in ICD recordings may serve as a predictor of future HF hospitalizations in ICD recipients with HF suggesting optimization of therapeutic modalities in these patients along with a close supervision in the clinical setting.Öğe Periprocedural cardiac troponin elevation: a potential indicator of enhanced ventricular threshold in permanent pacemaker recipients.(Scientific Publishers India, 2017) Ucar, Fatih Mehmet; Taylan, Gokay; Yilmaztepe, Mustafa Adem; Aktoz, MeryemBackground and aim: Permanent cardiac pacing is the most efficient treatment for patients with symptomatic bradycardia and high-degree atrioventricular (AV) block. For effective pacing, sensing and pacemaker battery longevity; ventricular pacing threshold (VPT) levels, lead impedance levels and Rwave amplitude levels must be desirable. We aimed to search the association between elevated serum troponin levels and VPT values in patients who has implanted single chamber permanent pacemaker. Materials and methods: We retrospectively analyzed a total of 109 patients (mean age: 78 +/- 7.1 years, 53.6% male) who underwent single chamber permanent pacemaker implantation for indications such high-degree atrioventricular block and sick sinus syndrome. Hematological and biochemical parameters were measured prior to pacemaker implantation. Additionally troponin I and high-sensitivity C-reactive protein (hs-CRP) were sampled about 12 hours after pacemaker implantation. Results: Over a median follow-up period of 17.3 months, 32 (29.3%) patients has positive troponin I levels after implantation. Troponin positive group has higher VPT values at the time of implantation (0.94 +/- 0.33 vs. 0.71 +/- 0.19, p<0.001) and at 30th day of implantation (0.69 +/- 0.16 V vs. 0.91 +/- 0.31 V, p<0.001). To identify in dependent risk factors for ventricular threshold values, a multivariate linear regression model was conducted and after implantation having positive troponin value (beta= 0.337, p= 0.01) and troponin elevation ratio (beta= 0.365, p<0.001) were found to be independent risk factors for ventricular threshold. Conclusion: Our results indicate that troponin I elevation after pacemaker implantation is associated with higher VPT values at the time of and the 30th day of implantation. For longevity of pacemaker batteries, low threshold values are preferable. To further extend the life of pacemakers, we recommend following patients more closely who has high troponin levels after permanent pace replacement.Öğe Periprocedural Cardiac Troponin Elevation: A Potential Marker of Enhanced Ventricular Threshold in Permanent Pacemaker Recipients(Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem; Taylan, Gokay; Aktoz, Meryem[Abstract Not Available]Öğe A Rare Case of Lead Revision With Subclavian Vein Stenosis: Transport Lead From Opposite Side to Generator.(Excerpta Medica Inc-Elsevier Science Inc, 2017) Ucar, Fatih Mehmet; Yilmaztepe, Mustafa Adem[Abstract Not Available]