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    Can Glypican-6 Levels Be Used to Determine Right Ventricular Remodeling After Non-ST Segment Elevation Myocardial Infarction?
    (Kare Publ, 2024) Kucuk, Ugur; Volina, Emir; Arslan, Kadir
    Objective: Myocardial infarction is associated with right ventricular (RV) remodeling. Glypican-6 (GPC6), a member of the membrane proteoglycan family, plays a significant role in cardiac remodeling. This study aims to determine if GPC6 can predict RV remodeling after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation myocardial infarction (NSTEMI). Methods: The study enrolled 164 consecutive patients with NSTEMI and controls. It compared baseline plasma GPC6 levels, echocardiography, and laboratory parameters between the RV remodeling and non-RV remodeling groups with NSTEMI. Echocardiographic data were measured at baseline and at six months. Results: GPC6 levels were higher in the NSTEMI group 11.06 ng/mL (4.61-18.17) vs. 5.98 ng/ mL (3.81-9.83) compared to the control group in the initial phase. RV remodeling, defined as a >= 20% increase in RV end-diastolic area (RV EDA), was observed in 23 patients (30%). After six months, RV EDA increased significantly from baseline 18.68 +/- 1.20 cm2 2 vs. 24.91 +/- 1.08 cm(2),P < 0.001. GPC6 was a significant independent predictor of RV remodeling (hazard ratio [HR]: 1.546, 95% confidence interval [CI]: 1.056-2.245, P < 0.001). Receiver operating characteristic curve (ROC) analyses showed that GPC6 values > 15.5 ng/mL (area under the curve [AUC] = 0.828, sensitivity: 70%, specificity: 74%, P < 0.001) were strong predictors of RV remodeling. Conclusion: NSTEMI patients should be closely monitored for RV remodeling. GPC6 appears useful in detecting RV remodeling following NSTEMI in patients undergoing PCI.
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    Öğe
    Collateral development from vertebral artery to axil-lary artery in left subclavian artery agenesis
    (Çanakkale Onsekiz Mart Üniversitesi, 2021) Arslan, Kadir; Küçük, Uğur; Kırılmaz, Bahadır
    Subclavian artery agenesis is the congenital underdevel-opment of the artery supplying the head, neck and upper extremity directly originating from the aorta. This rare benign condition is usually asymptomatic. But it can be symptomatic in 20% of cases. The decrease/absence of flow caused by agenesis may cause weakening in pulses, neurological events (presyncope, syncope) and ischemic changes in upper extremity. These symptoms can be caused by many inflammatory diseases, especially Taka-yasu's arteritis
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    Öğe
    Relationship of Frontal QRS-T Angle with Coronary Flow Grade and Adverse Events Before Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Myocardial Infarction
    (Turkish Society of Cardiology, 2023) Küçük, Uğur; Arslan, Kadir; Özpınar, Uğur; Altun, Burak
    Objective: Electrocardiography is used in the initial risk assessment of patients with non-ST elevation myocardial infarction. The frontal QRS-T angle is an electrocardiography paramete that may be affected by the alterations in the coronary blood flow. This study aimed to explor the relationship of the frontal QRS-T angle with coronary flow grade and adverse events i non-ST-elevation myocardial infarction patients. Methods: A total of 191 non-ST-elevation myocardial infarction patients were divided int 2 groups based on the thrombolysis in myocardial infarction (TIMI) flow level on coronar angiography before revascularization, namely TIMI 0/1 and TIMI 2/3. The frontal QRS-T angl obtained before revascularization was compared between the groups and its relationship wit adverse events was examined. In-hospital all-cause mortality, repeat target lesion revascular ization, new-onset heart failure, ventricular arrhythmias, and atrial fibrillation were defined a adverse events. Results: Frontal QRS-T angle was wider in the patients with TIMI 0/1 flow compared to th patients with TIMI 2/3 flow (P < 0.001). The frontal QRS-T angle was determined to be predictor of TIMI flow grade 0/1 before revascularization in patients with non-ST-elevatio myocardial infarction (odds ratio: 1.51; 95% CI: 1.30-1.75; P < 0.001). The frontal QRS-angle was a predictor of the adverse events during hospitalization in the patients with non-ST elevation myocardial infarction (odds ratio: 1.11; 95% CI: 1.04-1.19; P = 0.002). The cut-o values of the frontal QRS-T angle for TIMI flow grade and adverse events were determined t be 73.5°, based on receiver operating characteristic curve analysis. Conclusion: Increased frontal QRS-T angle may be a useful electrocardiography parameter fo determining TIMI flow grade and the need for an early invasive strategy in patients with non ST-elevation myocardial infarction.