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Öğe Association of abnormal coronary sinus reflux with coronary slow flow and importance of the Thebesian valve(Elsevier Ireland Ltd, 2020) Aksit, Ercan; Barutcu, Ahmet; Sehitoglu, Muserref Hilal; Kirilmaz, Bahadir; Arslan, Mehmet; Gazi, Emine; Tok, Ozge OzdenBackground: The relationship between coronary slow flow (CSF) and coronary sinus (CS) reflux has not been previously studied. This study aimed to investigate the relationship between CSF and CS reflux and Thebesian valve presence as well as the relationship between CS reflux and serum annexin-V and ICAM-1 levels. Methods: In this case-control study, patients were divided into two groups: CSF (n = 13) and control (n = 7) groups. CS flow parameters and Thebesian valve presence were evaluated by cardiac magnetic resonance (CMR). Moreover, serum ICAM-1 and annexin-V levels were measured. Results: Regurgitation volume and regurgitation fraction, indicators of reflux flow in CS, were higher in the CSF group than in the control group (p = 0.039 and p = 0.019). Fewer Thebesian valves were observed in the CSF group than in the control group (p = 0.022). Furthermore, a positive correlation was found between regurgitation volume and regurgitation fraction and serum annexin-V and ICAM-1 levels (r = 0.813, p < 0.001 and r = 0.996, p < 0.001; r = 0.817, p < 0.001 and r = 0.993, p < 0.001, respectively). Conclusions: This study revealed the significant relationship between CSF and reflux flow in CS. The fact that the patients in the CSF group have fewer Thebesian valves suggests the importance of the valve in preventing backward flow from the coronary vein. A positive correlation between serum ICAM-1 and annexin-V levels with regurgitation volume and regurgitation fraction indicates that after a certain threshold, CS reflux should be considered an abnormal condition. (C) 2020 Elsevier B.V. All rights reserved.Öğe Chest pain score: a novel and practical approach to angina pectoris. A diagnostic accuracy study(Associacao Paulista Medicina, 2019) Aydin, Fatih; Aksit, Ercan; Yildirim, Ozge Turgay; Aydin, Ayse Huseyinoglu; Dagtekin, Evrin; Samsa, MuratBACKGROUND: The chest pain classifications that are currently in use are based on studies that are several decades old. Various studies have indicated that these classifications are not sufficient for determining the origin of chest pain without additional diagnostic tests or tools. We describe a new chest pain scoring system that examines the relationship between chest pain and ischemic heart disease (IHD). DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level university hospital and two public hospitals. METHODS: Chest pain scores were assigned to 484 patients. These patients then underwent a treadmill stress test, followed by myocardial perfusion scintigraphy if necessary. Coronary angiography was then carried out on the patients whose tests had been interpreted as positive for ischemia. Afterwards, the relationship between myocardial ischemia and the test score results was investigated. RESULTS: The median chest pain score was 2 (range: 0-7) among the patients without IHD and 6 (1-8) among those with IHD. The median score of patients with IHD was significantly higher than that of patients without IHD (P = 0.001). Receiver operating characteristic analysis showed that the score had sensitivity of 97% and specificity of 87.5% for detecting IHD. CONCLUSION: We developed a pre-test chest pain score that uses a digital scoring system to assess whether or not the pain was caused by IHD. This scoring system can be applied easily and swiftly by healthcare professionals and can prevent the confusion that is caused by other classification and scoring systems.Öğe Comment on: Direct oral anticoagulants in adults with congenital heart disease - A single centre study(Elsevier Ireland Ltd, 2020) Yildirim, Ozge Turgay; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, Ercan[Anstract Not Available]Öğe Drug-eluting Vein Graft with Acetylsalicylic Acid-Ticagrelor- Unfractionated Heparin Complex Inhibits Early Graft Thrombosis(Galenos Publ House, 2020) Aksit, Ercan; Kurt, Tolga; Buyuk, Basak; Cokkalender, OmerBackground: Bypass graft surgery remains to be an important treatment option for left main and multivessel coronary artery disease. Approximately 2% of saphenous vein grafts are lost immediately after the coronary artery bypass graft operations and 12% in the first month due to thrombosis. Aims: To administer one anticoagulant and two antiplatelet agents in a way that locally affects the vein graft before the bypass operation and to thereby analyse their effects on early graft thrombosis. Study Design: Animal experimentation. Methods: Since ticagrelor was used locally for the first time in this study; its efficacy in combination with other drugs (acetylsalicylic acid, acetylsalicylic acid and ticagrelor, and acetylsalicylic acid + ticagrelor unfractionated heparin) was examined on rats including control (untreated) and sham (pluronic gel) group (n=14 for each group). Before the tunica adventitia layer of the femoral veins was bypassed to the femoral artery, it was coated with the drug-eluting pluronic F-127 gel. The presence or absence of thrombus in the vein graft samples was recorded under light microscopy. In vein graft preparations where thrombus was detected, the thrombus area (mu m(2)) was calculated using the Axiovision software. Immunohistochemical staining was performed with the anti-rat von Willebrand factor polyclonal antibody kit. Results: The number of preparations containing thrombus was significantly lower in the acetylsalicylic acid + ticagrelor + unfractionated heparin group than in the acetylsalicylic acid, control, and sham groups, according to the comparisons made on the Is/ and 3rd days (p=0.00I and 0.02. respectively). von Willebrand factor staining was significantly lower in the acetylsalicylic acid + ticagrelor + unfractionated heparin group than in the other groups on the 3rd day (p=0.005). Conclusion: Locally effective acetylsalicylic acid-ticagrelor-unfractionated heparin complex has been shown to significantly reduce thrombus formation in vein grafts in this experimental model. Local administration of these drugs, which are routinely administered orally just before stent implantations, on the vein graft before the bypass is performed can prevent the loss of vein grafts due to thrombus, thereby reducing the mortality and morbidity of these patients.Öğe Efficacy of direct oral anticoagulants on left ventricular thrombus(Lippincott Williams & Wilkins, 2019) Yildirim, Ozge Turgay; Aksit, Ercan; Aydin, Fatih; Aydin, Ayse HuseyinogluLeft ventricular thrombus (LVT) is a commonly seen complication of myocardial infarction and it also can be seen because of hypertrophic cardiomyopathies, nonischemic dilated cardiomyopathies, malignancies, and so on. Guidelines suggest the use of warfarin for left ventricular thrombi, but recent case reports show that direct oral anticoagulants (DOACs) are beginning to be used for this complication. DOACs are strong alternatives for warfarin because of their efficacy and safety even though there is no randomized controlled trial that proves the effect of DOACs against LVT. In this article, we gather the case reports of DOACs against left ventricular thrombi in various conditions. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.Öğe Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging(Karger, 2022) Kucuk, Ugur; Gazi, Emine; Duygu, Ali; Aksit, ErcanObjective: While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects lung tissue, it may cause direct or indirect damage to the cardiovascular system, and permanent damage may occur. Arterial stiffness is an early indicator of cardiovascular disease risk. The aim of our study was to establish the potential effects of SARS-CoV-2 on the vascular system evaluated by transthoracic echocardiographic examination. Subjects and Methods: This study compared arterial stiffness between the survivors of COVID-19 and those without a history of COVID-19 infection. The difference in aortic diameter was examined using echocardiography. Results: The study included 50 patients who survived COVID-19 in the last 3-6 months and 50 age- and gender-matched healthy volunteers. In surviving COVID-19 patients, aortic diastolic diameter in cm ([3.1 +/- 0.2] vs. [2.9 +/- 0.1], p < 0.001), pulse pressure (PP) ([43.02 +/- 14.05] vs. [35.74 +/- 9.86], p = 0.004), aortic distensibility ([5.61 +/- 3.57] vs. [8.31 +/- 3.82], p < 0.001), aortic strain ([10.56 +/- 4.91] vs. [13.88 +/- 5.86], p = 0.003), PP/stroke volume index ([1.25 +/- 0.47] vs. [0.98 +/- 0.28], p = 0.001), and aortic stiffness index ([2.82 +/- 0.47] vs. [2.46 +/- 0.45], p < 0.001) were statistically significant compared to the control group. Conclusion: SARS-CoV-2 may cause reduced or impaired aortic elasticity parameters linked to impaired arterial wall function in COVID-19 survivors compared with controls.Öğe Evaluation of Heart Functions With Detailed Echocardiogram in Patients With Septum Deviation(Lippincott Williams & Wilkins, 2018) Caglar, Ozge; Aksit, ErcanBackground: One of the most important reasons for nasal congestion is septum deviation. Nasal septal deviation increases airway resistance and can cause systemic problems. In this study, echocardiographic findings were compared with the normal population to see how cardiac function was affected in patients with obstructive nasal septum deviation. Methods: This study included a young patient group with 44 obstructive septum deviation patients and 30 healthy individuals with no nasal-related problems. Echocardiography was performed by the same cardiologist and results were compared with normal patients. The authors got permission from the ethics committee of faculty for the study (E. 116795). Results: In the patient group with septum deviation, pulmonary artery pressure was high. In addition, the size of the right heart chambers was also increased. TAPSE, pulmonary acceleration time, ejection fraction, and right ventricular outflow tractfractional shortening were found to be lower than the normal group. Conclusion: Patients with obstructive septum deviations should be evaluated early for cardiologic functions.Öğe Evaluation of the effect of coronary slow flow phenomenon on cardiac functions(Bayrakol Medical Publisher, 2022) Barutcu, Ahmet; Aksit, Ercan; Arslan, Mehmet; Tok, Oezge Oezden; Kuecuek, UgurAim: Although coronary slow flow phenomenon (CSFP) is seen in 2% of patients undergoing coronary angiography, its clinical significance and impact on ventricular function remain controversial. Cardiac magnetic resonance imaging (CMR) is the gold standard for evaluating ventricular function and volumes. In this study, we aimed to assess the impact of CSF on ventricular function using CMR-based deformation imaging.Material and Methods: This is a cross-sectional study. Twenty-two people were included in the study. Patients with structural heart disease and secondary coronary slow flow were excluded. Twelve subjects with CSFP and 10 subjects with normal flow and normal cardiac function were compared by CMR and CMR strain.Results: Left ventricle (LV) and right ventricle (RV) functions and volumes were similar. There was no difference between CMR strains in both groups. Furthermore, there was no correlation between age and heart function in patients with CSF.Discussion: CSF has no or limited impact on cardiac functions. Further long-term prospective studies should be carried out to establish the impact and significance of CSF in patients with CSF.Öğe Is Rivaroxaban a Safe Choice for Apical Thrombus in Atrial Fibrillation Patients? A Case Report(Elsevier Science Bv, 2018) Aydin, Fatih; Yildirim, Ozge Turgay; Aydin, Ayse Huseyinoglu; Dagtekin, Evrin; Aksit, ErcanLeft ventricular thrombi are mostly seen in the akinetic segments of left ventricle and warfarin is the golden standard treatment. In our case, a 67-year-old male patient with ischemic dilated cardiomyopathy and atrial fibrillation was under warfarin treatment, but due to fluctuations in international normalized ratio, warfarin was discontinued and changed to rivaroxaban (20 mg once a day). He had a fixed thrombus measuring 1.80 x 1.12 cm(2) in the left ventricle under warfarin treatment before rivaroxaban use. After 6 months of rivaroxaban treatment, the thrombus regressed to 1.54 x 1.06 cm(2) without any embolic episode or bleeding. This case supports the finding that rivaroxaban can be a safe alternative to warfarin when warfarin cannot be used.Öğe Myocardial Venous Bridge: Images of the First Cases Detected by Conventional Angiography and Venography(Galenos Publ House, 2025) Aksit, Ercan; Taylan, Gokay; Kucuk, Ugur; Kirilmaz, Bahadir[No abstract available]Öğe Olfactory Dysfunction in Patients with Ischemic Heart Failure(Taiwan Soc Cardiology, 2020) Aksit, Ercan; Cil, Ozge CaglarBackground: Heart failure (HF) is one of the leading causes of morbidity and mortality in the elderly. Early recognition, treatment, and elimination of potentially modifiable risk factors for HF are crucial for improving both survival and health-related life quality in those with HF. We aimed to investigate whether or not there is an association between olfactory function and the presence and severity of ischemic HF. Methods: The study included 40 patients with ischemic HF and 40 controls with coronary artery disease but without HF. All patients and controls underwent detailed physical and echocardiographic examinations. The Sniffin' Stick test was used to evaluate olfactory function. Results: Threshold-discrimination-identification (TDI) score was significantly lower in the patients with HF than in the controls (16.4 +/- 7.8 vs. 33.3 +/- 5.2, p < 0.001). When patients with ischemic HF were categorized according to New York Heart Association (NYHA) class, the TDI scores were significantly higher in the patients with NYHA class 1 HF compared to those with NYHA class 3 HF (23.4 +/- 0.9 vs. 8.8 +/- 7.0, p <0.001). We also found a significant negative correlation between the TDI score and NYHA class (r = -0.769, p < 0.001) and a positive correlation between the TDI score and left ventricular ejection fraction (r = 0.902, p < 0.001). Conclusions: Olfactory function was severely impaired in the patients with ischemic HF in this study. In addition, olfactory dysfunction in the patients with ischemic HF was significantly correlated with the severity of HF.Öğe Olfactory dysfunction may predict myocardial injury in COVID-19 patients(Churchill Livingstone, 2020) Aksit, Ercan; Cil, Ozge Caglar; Kaya, Hakki[Anstract Not Available]Öğe Percutaneous Closure of the Atrial Septal Defect in a Patient with Dextrocardia and Situs Inversus Totalis(2021) Gazi, Emine; Barutçu, Ahmet; Aksit, Ercan; Volina, Emir; Demir, CengizSitus inversus totalis with dextrocardia and atrial septal defect is extremely rare. Different position and inversion types are required different closure techniques. We present a dextrocardia patient whose atrial septal defect was closed percutaneously. A 47-year-old female patient was referred for cardiological evaluation due to the diagnosis of situs inversus totalis and dextrocardia while preparing for gall bladder surgery. The patient’s heart was located on the right side, right heart chambers were dilated and a secundum-type atrial septal defect of 15 mm in width was detected. A 20 mm atrial septal defect closure device (Occlutech, GmbH) was placed and the defect was completely covered. In this case report, we defined technical differences and issues that should be considered when planning interventions in dextrocardia patients.Öğe Red cell distribution width and its prediction value of mortality(Mosby-Elsevier, 2020) Yildirim, Ozge Turgay; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, Ercan[Anstract Not Available]Öğe Short term follow-up of a patient with uncomplicated type B aortic dissection under dabigatran treatment(Turkish Soc Cardiology, 2019) Yildirim, Ozge Turgay; Canakci, Mustafa Emin; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, ErcanThis case report illustrates the follow-up of a 57-year-old female with a type B aortic dissection (AD) under dabigatran treatment. The patient had been operated on 8 years earlier due to type A AD. The aortic valve was repaired and a 26-mm polyester fiber graft was applied to the ascending aorta and the aortic arch. In computerized tomography scans taken after the procedure, a dissection flap extending from the descending aorta to the iliac arteries was seen, but the patient was asymptomatic and no further surgery was performed. The patient was subsequently diagnosed with atrial fibrillation. A CHA(2)DS(2)VASc score of 3 was recorded and dabigatran treatment was initiated. The aortic aneurysm and dissection were followed up via computed tomography and echocardiography at regular intervals, and at 6 months no progression was seen. No thromboembolic or hemorrhagic events were observed. To our knowledge, this is the first case report of dabigatran treatment for a patient with a type B AD. Based on this case, the use of dabigatran would appear to be safe in a patient with an uncomplicated type B AD, but the results of this case need to be confirmed with extended follow-up and additional patients.Öğe SPONTAN İNTRASEREBRAL HEMORAJİ İLE fQRS KOMPLEKSİ ARASINDAKİ İLİŞKİ(2021) Malçok, Ümit Ali; Çam, Mustafa; Aksit, Ercan; Ocak, ÖzgülAmaç: Spontan intraserebral hemoraji (SİSH) insidansında, son üç dekat boyunca değişim olmadığı ve olguların yaş ortalamalarının arttığı görülmektedir. Günümüzde, hastaların tedavilerindeki başarı oranı artmakta ancak kanamaların tahmin edilmesinde umut verici bir ilerleme sağlanamamıştır. Bu çalışmada, fragmente QRS (fQRS) kompleks varlığı ile SİSH arasında bir ilişki olup olmadığını göstermeyi amaçladık. Materyal ve Metot: Bu çalışma vaka-kontrol çalışması olarak planlanmıştır. Çalışma kriterlere uygun 30 SİSH’li ve 30 sağlıklı kontrol bireye ait veriler kullanıldı. Hemoraji derecelendirme ölçeğine göre 1-5 puan alanlar çalışma dışı bırakıldı ve sıfır puan alan olgular çalışmaya alındı. Tüm olgulara ait elektrokardiyogram (EKG) kayıtlarının yorumlanması ve ekokardiyografi (EKO) işlemleri, kardiyoloji uzmanı tarafından kör olarak gerçekleştirildi ve EKG kayıtlarında fQRS kompleksi varlığı arandı. Bulgular: Hemoraji geçiren hastaların yaş ortalaması 69 ve 19’u (%63) erkekti. Grupların yaşları, diyabet prevalansı ve sigara alışkanlıkları arasında belirgin bir fark yoktu, ancak hipertansiyonun (HT) kanama geçiren olgularda daha fazla bulunduğu görüldü (p<0,05). Ayrıca SİSH hastalarında, kontrol grubuna kıyasla fQRS kompleksi daha sık görüldü (p<0,01). SİSH olgularına ait EKO parametrelerinde ise sol ventrikül ejeksiyon farksiyonunda (SVEF) azalmanın (p<0,05) yanı sıra sol atriyumda (SA) artış olduğu görüldü (p<0,05). Bununla birlikte, EKG kayıtlarında fQRS kompleksi bulunan SİSH olgularının, kontrol grubuna göre 5 kat daha fazla olduğu görüldü (OR 5,2, p<0,01). Sonuç: Bu çalışmada fQRS varlığı ile SİSH arasındaki ilişki değerlendirildi. EKG’sinde fQRS kompleksi bulunan; SVEF’de azalma, SA’da artma olan ve eşlik eden HT’si olan hastalarda, SİSH’nin daha fazla görüldüğü sonucuna ulaşıldı.Öğe The Crucial Importance of Optimal Primary and Secondary Prevention of Cardiovascular Disease during COVID-19 Pandemic(Taiwan Soc Cardiology, 2020) Aksit, Ercan; Gazi, Emine; Kinlmaz, Bahadir; Yildirim, Ozge Turgay; Aydin, Fatih[Anstract Not Available]Öğe The Effect of Direct Oral Anticoagulant Drugs on Platelet Indiceses and Their Relationship with Bleeding Events(2020) Aksit, Ercan; Aydin, Fatih; Yildirim, Ozge Turgay; Dagtekin, Evrin; Aydin, Ayse HuseyinogluAim: Atrial fibrillation is a common disorder and is an important cause of thromboembolic events. Recently, direct oral anticoagulant drugs (DOACs) are being used to reduce the frequency of thromboembolic events among these patients. DOACs have several advantages over oral vitamin K antagonists, such as fixed dosage and fewer side effects. However, since the drugs and their affects cannot be monitored directly, difficulties are encountered in assessing drug efficacy and side effects. For this purpose, platelet indices and their relationship with DOACs may be utilized for the prediction of thromboembolic and hemorrhagic events. Patients and Methods: 301 patients with atrial fibrillation who were using DOACs were included in the study. Platelet indices such as platelet count, platelet distribution volume, plateletcrit, platelet-large cell ratio were evaluated at the first and sixth months. The effect of DOACs on these indices and relationships with bleeding events were investigated.Results: All groups were similar in regard to baseline platelet indices, except for lower P-LCR value among recipients of rivaroxaban. When post-treatment results were compared, all groups were found to have similar values in all parameters. However, time-bound comparisons revealed that apixaban and dabigatran significantly reduced P-LCR value after 6 months of use. Conclusion: This study showed that apixaban, rivoraxaban and dabigatran had no effect on platelet count, MPV, PDW, PCT values in whole blood count of patients with non-valvular AF. All characteristics of those with and without hemorrhagic events were also similar of patients with non-valvular AF.Öğe The importance of anti-fibrotic drugs as first-line therapy in patients with arrhythmogenic right ventricular dysplasia(Elsevier Ireland Ltd, 2022) Aksit, Ercan; Kucuk, Ugur; Taylan, Gokay; Cinier, Goksel; Karabay, Can Yucel; Akgun, Taylan[Anstract Not Available]Öğe The importance of individualized multimodality imaging-guided methods for selected patients in cardiac resynchronization therapy(Oxford Univ Press, 2022) Aksit, Ercan; Kucuk, Ugur; Altay, Servet; Taylan, Gokay; Asgun, Halil Fatih[Anstract Not Available]
