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Öğe Blood pressure, autonomic stress, and inflammatory markers during sleep deprivation and recovery in healthy men(Turkish Soc Cardiology, 2021) Bozer, Ozge; Kaya, Oktay; Ozturk, Gulnur; Bulut, Erdogan; Zorkun, Cafer; Ozturk, LeventObjective: Recent community-based studies have identified sleep deprivation (SD) as an important modifiable risk factor for hypertension However, the underlying mechanisms linking SD to hypertension remain elusive. Thus, this study investigates blood pressure (BP) responses to cardiac autonomic stress tests in the presence of SD. Furthermore, we analyzed vascular inflammatory biomarkers as a possible underlying factor linking SD to increased BP. Methods: Ten healthy male volunteers (age, 21.6 +/- 1.2 years) underwent repeated autonomic stress tests for three consecutive days (baseline, SD, and recovery). The autonomic stress tests included the Valsalva maneuver, mental arithmetic, isometric handgrip, and cold pressor tests. Each day, resting BPs were measured, venous blood samples were collected for intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and E-selectin measurements, and stress tests were performed between 0900 and 1100. Ambulatory BP was recorded during the entire SD period (24 h). Results: One-night SD abolished BP reactivity to the Valsalva maneuver, isometric hand grip, and cold pressor tests, which returned after recovery sleep. Ambulatory BP monitoring showed that the mean systolic and diastolic BPs were 121.1 +/- 8.5 mm Hg and 72.8 +/- 6.3 mm Hg, respectively, between 0700 and 2300 and 120.3 +/- 9.6 mm Hg and 74.1 +/- 6.1 mm Hg, respectively, between 2300 and 0700 during the SD day (p>0.05 for both). Vascular inflammatory markers seemed unrelated to BP changes. Conclusion: Acute SD altered BP responses to cardiac autonomic stress tests in healthy men without affecting resting BP levels. SD led to a non-dipping pattern in BP oscillation. Collectively, these findings highlight the importance of sleep in regulating BP.Öğe The Correlation between Elevated HDL-Cholesterol, Body Mass Index, and Presence of Thyroid Nodules: A Retrospective Analysis(Mdpi, 2023) Zorkun, Cafer; Yalta, Kenan; Eren, Alara; Yetkin, ErtanBackground: Elevated high-density lipoprotein-cholesterol (HDL-cholesterol) levels have been linked to unfavorable outcomes in various clinical settings, but the association with thyroid nodules remains unclear. We aimed to analyze the correlation between elevated HDL-cholesterol and the presence of thyroid nodules along with certain demographic and clinical findings. Methods: In this retrospective study, the patients were divided into three groups based on their body mass index (BMI): <25, 25-29, and >30 and evaluated. Data of 677 patients aged between 15 and 95 years (52.6 +/- 15.6) were evaluated. The entire study population comprised 516 females (76.2%). Results: Thyroid nodules (67.1%) and left ventricle diastolic dysfunction (LVDD) (58.1%) were the two most frequent findings in the overall cohort. In the multivariate regression model, BMI, heart rate, and HDL-cholesterol values were significant and independent predictors (p = 0.000 for all) of the presence of thyroid nodules. The presence of thyroid nodules is higher in females, particularly within the higher BMI groups [odds ratio (OR) = 1.048 (CI = 1.02-1.08) for BMI < 25, p = 0.003; OR = 1.094 (CI = 1.05-1.14) for BMI 25-29, p = 0.000; OR = 1.115 (CI = 1.05-1.19) for BMI >= 30]. This higher incidence is not observed in males. Conclusion: While the precise mechanisms underlying this association are yet to be fully elucidated, elevated HDL-cholesterol may serve as an indicator of thyroid nodules rather than a marker of cardiovascular protection.Öğe Late coronary ischemic syndromes associated with transcatheter aortic valve implantation: A review of mechanistic and clinical aspects(Elsevier, 2018) Yalta, Kenan; Zorkun, Cafer; Yilmaztepe, Mustafa; Gurlertop, YektaIn the past years, transcatheter aortic valve implantation (TAVI) has emerged as a promising option for the treatment of aortic valve pathologies particularly in the the presence of surgically high-risk situations. Importantly, a variety of specific procedural complications including acute coronary osteal occlusion, though very rare, has been reported in major clinical studies. However, little is known about the late impact of TAVI on coronary system at the macro and microvascular levels. On the other hand, clinical studies as well as real life experiences have shown variable rates of acute coronary syndrome (ACS) readmissions among TAVI recipients in the short and long terms. Within this context, it may be suggested that even though late coronary ischemic events arising after TAVI, to some extent, appears to be spontaneous or attributable to certain stressors, TAVI may also have the potential to directly account for, accelerate or contribute to the evolution of these ischemic events on follow-up. Accordingly, the present review primarily focuses on potential association of TAVI with late coronary ischemic syndromes along with a particular emphasis on its mechanistic basis and clinical implications among TAVI recipients. (C) 2018 Published by Elsevier B.V. on behalf of Cardiological Society of India.Öğe Late Versus Early Myocardial Remodeling After Acute Myocardial Infarction: A Comparative Review on Mechanistic Insights and Clinical Implications(Sage Publications Inc, 2020) Yalta, Kenan; Yilmaz, Mehmet Birhan; Yalta, Tulin; Palabiyik, Orkide; Taylan, Gokay; Zorkun, CaferIn the setting of acute myocardial infarction (AMI), adverse myocardial remodeling (AMR) has been universally regarded as an early-onset phenomenon generally arising within the first few weeks (usually within days in the infarct zone) following myocardial injury. On the other hand, onset of cardiac morphological changes in this setting may potentially extend far beyond this time frame (usually beyond several months after the index AMI), suggesting a prolonged latent period in certain cases. In clinical practice, this delayed form of post-AMI remodeling, namely late AMR, has emerged as an interesting and underrecognized phenomenon with poorly understood mechanisms. Notably, systemic inflammation and associated growth factors seem to play a pivotal role in this setting. Accordingly, the present article primarily aims to discuss potential mechanisms and clinical implications of late AMR (in a comparative manner with its classical early counterpart) among AMI survivors along with a particular emphasis on potential benefits of certain anti-inflammatory strategies in this setting.Öğe Mechanically expanding transcatheter aortic valves: pros and cons of a unique device technology(Ame Publishing Company, 2018) Yalta, Kenan; Gurdogan, Muhammet; Zorkun, Cafer; Gurlertop, Yekta[Abstract Not Available]Öğe Pentraxin-3 and its further clinical implications in women with preeclampsia(Elsevier Ireland Ltd, 2017) Yalta, Kenan; Ucar, Fatih; Yilmaztepe, Mustafa; Zorkun, Cafer[Abstract Not Available]Öğe Relationship between the infarct localization and left ventricular rotation parameters following acute ST-segment elevation myocardial infarction(Turkish Soc Cardiology, 2020) Demirkiran, Aykut; Zorkun, Cafer; Demir, Hasan Deniz; Topcu, Birol; Emre, Ender; Ozdemir, NihalOjective: This study was an investigation of the role of left ventricular (LV) apical rotation seen in the early period after myocardial infarction (MI) in predicting infarct localization. Methods: A total of 124 patients with a ST-Segment elevation myocardial infarction (STEMI) diagnosis who underwent primary percutaneous coronary intervention (PCI) and 50 healthy volunteers with similar demographic characteristics were included in the study. The relationship between 2-dimenstional speckle tracking echocardiography (STE)-guided LV apical rotation angle measurements and technetium-99m sestamibi-single-photon emission computed tomography (SPECT)-guided infarct localization was evaluated. Conventional echocardiography and STE were performed on average 2 days after PCI, and gated SPECT myocardial perfusion imaging (MPI) was performed within an average of 60 days. Results: The apical rotation angle was lower in patients with an anterior MI compared with those who had an inferior MI and the control group (AntMl-InfMl: 6.51 +/- 2.4 degrees, AntMI-Control: 13.20 +/- 2.5 degrees, InfMI-Control: 14.3 +/- 2.1 degrees, p value: 0.00, 0.00, 0.15, respectively). SPECT MPI analysis revealed the presence of an LV apical scar in all patients with acute anterior MI, but only 14 of those with inferior MI group (usually the inferoapical wall). The apical rotation angle recorded in patients with apical scar was lower than that of the patients without apical scar (7.6 +/- 2.8 degrees and 14.5 +/- 2 degrees, respectively; p=0.00). Receiver operating characteristic curve analysis yielded an area under the curve for apical rotation of 0.799 (p<0.01). The optimal cutoff value of 12.1 degrees had a sensitivity of 78.3% and a specificity of 68.2% for predicting LV apical scar following STEMI. Conclusion: Detection of apical rotation angle decrease in the early period after STEMI may be useful in predicting extension of infarct scarring to the LV apex.Öğe Soluble ST2 biomarker and reverse remodelling in patients with systolic heart failure(Elsevier, 2018) Yalta, Kenan; Zorkun, Cafer[Abstract Not Available]Öğe Takotsubo cardiomyopathy and acute coronary syndromes: Are they always mutually exclusive?(Elsevier, 2018) Yalta, Kenan; Ucar, Fatih; Yilmaztepe, Mustafa; Zorkun, Cafer[Abstract Not Available]