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Öğe Comprehensive Assessment of Heart Failure with Preserved Ejection Fraction Using Cardiac MRI(Elsevier Inc., 2021) Vega-Adauy, Julian; Tok, Özge Özden; Çelik, Ahmet; Barutcu, Ahmet; Vannan, Mani A.Heart failure with preserved ejection fraction (HFpEF) burden is increasing. Its diagnostic process is challenging and imprecise due to absence of a single diagnostic marker, and the multiparametric echocardiography evaluation needed. Left ventricular (LV) ejection fraction (LVEF) is a limited marker of LV function; thus, allocating HF phenotypes based on LVEF can be misleading. HFpEF encompasses a broad spectrum of causes, and its diagnostic criteria give a central role to echocardiography, a first-line technique with inherent limitations related to ultrasound capabilities. Conversely, cardiac magnetic resonance provides superior anatomic and functional assessment, enabling tissue characterization, offering unprecedented diagnostic precision.Öğe Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients(Taylor and Francis Ltd., 2021) Kaya, Hakkı; Şahin, Anıl; Güneş, Hakan; Bekar, Lütfü; Çelik, Ahmet; Çavuşoğlu, Yüksel; Çaldır, VedatBackground Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before. Methods Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea. Results To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 +/- 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2,p < .001- HR:2.8,p = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1,p < .001- HR:3.0,p < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group. Conclusion For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.Öğe Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower?(Istanbul Provincial Directorate of Health, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavuşoğlu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanOBJECTIVE: We aimed to compare the outcomes of chronic heart failure (HF) patients with reduced ejection fraction (CHFrEF) in the Turkish Research Team in HF (TREAT-HF) registry according to marital status with a specific focus on being the widowed (widow/widower) versus the married. METHODS: TREAT-HF is a network, enrolling CHFrEF with a follow up for HF-related hospitalization (HFrH) and all-cause mortality (ACM). In this cohort, the widowed patients were compared with patients who were married before and after propensity score (PS) matching analysis. RESULTS: There were 723 cHFrEF patients with a complete dataset, including reported marital status at baseline for this analysis. Out of 723 patients with HF, 37 “never-married” and “divorced” patients were excluded from the analysis. Then, out of 686 remaining patients with HF, who had at least one reported marriage in the database, widowed patients with HF (n=124) were compared with married patients (n=562). The mean follow up period was 21±12 months up to 48 months. The widowed patients had a higher risk of HFrH (p=0.047), although ACM remained similar compared to married patients (p=0.054). After PS matching, HFrH remained more frequent among the widowed compared with the married (p=0.039) although ACM yielded similar rates. Of note, it was shown that being a widower (p=0.419) was not linked to increased risk of HFrH during follow up contrary to being a widow (p=0.037) despite similar age, ejection fraction, creatinine, NYHA functional class distribution and a similar rate of life-saving medications. CONCLUSION: PS matching analysis yielded that the widowed had increased the risk for HFrH. Of note, widowers did not seem to have an increased risk for HFrH, contrary to widows.Öğe NOISE EXPOSURE LEVELS IN OLIVE OIL EXTRACTION PLANTS AND ITS EFFECTS ON EMPLOYEES(2020) Çelik, Ahmet; Sümer, Sarp KorkutThe aim of this study is to determine noise levels in continuous olive oil extraction plants and to evaluate their effects on worker health. The study was conducted in 17 continuous system plants. The sound pressure level (dBA) measurements were carried out at the ear levels of operators working in all units used in olive oil production. In the study, considering A weighted equivalent sound pressure levels and working durations, personal daily noise exposure levels were calculated. It was determined that the daily personal noise exposure levels in the loading units located outside the plants ranged from 65 to 85 dBA, and these values were found to be between 72 and 99 dBA in all other indoor units. As a result, it was observed that the upper daily noise exposure action value (85 dBA) was exceeded in all indoor units.Öğe Noncompliance with Dietary Salt Restriction and Outcomes in Chronic Heart Failure: A Propensity Score Matching Analysis from TREAT-HF Registry(University of Health Sciences Turkey, Istanbul Haseki Training and Research Hospital, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavusoglu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanAim: To compare chronic heart failure patients with reduced ejection fraction (cHFrEF) who stated to comply with salt restriction in their diets versus those who did not. Methods: Patients without salt restriction were compared to those with salt restriction regarding HF-related hospitalization (HFrH) and all-cause mortality (ACM) before and after propensity score (PS) matching analysis. Results: The study included a total of 723 patients. 136 of them stated not to comply with salt restriction, 587 of them stated to comply with salt restriction. More frequent HFrH were observed in patients without salt restriction compared to those with salt restriction (75% vs. 62.9%, p=0.007), though, ACM was similar in both groups (29.4% vs 27.6%, p=0.672). After PS matching, HFrH during follow-up remained more frequent in those without salt restriction compared to those with salt restriction (73.7% vs 59.3%, p=0.019) but ACM was not different in both groups (30.5% vs 29.7%, p=0.887). Noncompliance to dietary salt restriction was found as one of the independent predictors of HFrH. Conclusion: In cHFrEF outpatients, noncompliance to dietary salt restriction does not seem to increase the risk for ACM but it poses an increased risk for HFrH.Öğe Zeytinyağı üretim tesislerinde gürültü düzeylerinin belirlenmesi ve çalışanlar üzerindeki etkilerinin değerlendirilmesi(Çanakkale Onsekiz Mart Üniversitesi, 2019) Çelik, Ahmet; Sümer, Sarp KorkutSon yıllarda zeytinyağı üretiminde, nitelik ve niceliğin artırılması, işçiye bağımlılığın azaltılması, zamanın verimli kullanımı gibi gereksinimler nedeniyle, klasik sistemler yerini gelişen teknolojik yenilikler içeren modern (kontinü) sistemlere bırakılmaktadır. Kontinü sistemler, iş gücü, zaman ve üretim miktarında klasik sistemlere üstünlükler sağlamasına karşın bazı olumsuz koşullara da neden olabilmektedir. Çalışanın sağlığını ve iş verimini etkileyen olumsuz koşulları oluşturan tehlikelerden birisi gürültüdür. Bu çalışmada, kontinü zeytinyağı fabrikalarında gürültü düzeylerinin belirlenmesi, çalışan sağlığı üzerine etkilerinin değerlendirilmesi amaçlanmıştır. Çalışma, Marmara ve Ege Bölgelerinde faaliyet gösteren 17 farklı kontinü zeytinyağı fabrikalarında yürütülmüştür. Ses düzeyi ölçümleri, zeytinyağının eldesinde kullanılan yükleme, temizleme, kırma-yoğurma, santrifüj ve ayırma ünitelerinde, çalışanların kulak seviyelerinde gerçekleştirilmiştir. Ölçümlerde, IEC 61672-1:2002'ye uygun Tip-2 sınıfında ses düzeyi ölçer kullanılmıştır. TS EN ISO 9612 standardı dikkate alınarak, üç tekerrürlü olarak beşer dakikalık sürelerde yapılan ölçümlerde elde edilen veriler, standartta belirtilen eşitlikler kullanılarak A ağırlıklı eşdeğer ses basınç düzeyleri belirlenmiş ve sonuçlar ilgili yönetmeliklere göre değerlendirilmiştir. Çalışmada, fabrikanın dışında bulunan yükleme ünitelerinde günlük gürültü maruziyet seviyelerinin, 65-85 dB(A) arasında değiştiği, diğer kapalı alanda bulunan tüm ünitelerde bu değerlerin 72-99 dB(A) arasında olduğu belirlenmiştir. İlgili yönetmeliklerde belirtilen en yüksek maruziyet eylem değeri olan 85 dB(A)'dan yüksekte ki işletme ortamlarında çalışanların kulak koruyucu kullanmaları gerekmektedir.
