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Öğe Akut miyokard infarktüsü ile başvuran bir COVID-19 hastasına yaklaşım(Çanakkale Onsekiz Mart Üniversitesi, 2021) Duygu, Ali; Küçük, Uğur; Arslan, MehmetKoroner arter hastalığı sıklıkla, şiddetli koroner arter daralmasına neden olan ve miyokardiyuma yetersiz kan akışına yol açan koroner aterosklerotik hastalığı ifade eder. COVID-19 pnömonisinin şiddetli endotelyal inflamasyon, mikrovasküler tromboz ve multiorgan yetmezliği ile birlikte sitokin fırtınası ile karakterizedir. COVID-19'un hem tromboz hem de miyokard hasarı üzerindeki etkileri sonucunda bu hastalarda miyokard infarktüsü sıklıkla görülmektedir. 68 yaşında erkek hasta 3-4 gün önce başlayan göğüste baskı hissi, nefes darlığı, el ve kollarda uyuşma şikayetleri ile acil servise başvurdu. Kardiyak troponin değerleri sırasıyla 560 ve 680 ng/L (üst sınır: 14 ng/L) idi. Toraks bilgisayarlı tomografi görüntüleri viral pnömoni ile uyumlu olduğu için hasta akut koroner sendrom ve COVID-19 pnömonisi ön tanılarıyla yoğun bakım ünitesine yatırıldı. Medikal tedavi sonrası aynı gün kardiyojenik şok gelişince hasta koroner anjiyografi laboratuvarına alındı. Kardiyojenik şoklu hastada ilişkili tüm arterlere girişim düşüncesiyle lezyonlarına stent implante edildi. Şu anda, miyokardiyal hasarın sadece hastalık şiddetinin bir belirteci olup olmadığı veya COVID-19 morbidite ve mortalitesine doğrudan katkıda bulunup bulunmadığı belirsizliğini korumaktadır. Olgumuzda olduğu gibi troponin birçok COVID-19 hastasında limit değerleri aşmaktadır. Bu artış; miyokardit, akut koroner sendrom ve enfeksiyon gibi nedenlere sekonder olabilir ve bu nedenle ihmal edilebilir. Troponin yükselmesi olan ve akut klinik instabilite belirtileri olmayan hastalar (EKG değişiklikleri, ağrının tekrarlaması) öncelikle konservatif bir yaklaşımla tedavi edilebilir. COVID19 ve akut koroner sendrom tanısıyla kardiyojenik şok birlikteliğinde primer perkütan girişim yaptığımız hastamızda ekokardiyografi, EKG, klinik ve kardiyak enzim kombinasyonu ile merkezimizin multidisipliner yaklaşımından bahsederek bu sunumla başvuran hastaların tedavi uygulamalarına katkı sağlamaya çalıştıkÖğe Assessment of Awareness Levels About Anticoagulants in Patients With Atrial Fibrillation Presenting to Emergency Department(Springer, 2021) Akman, Canan; Kırılmaz, Bahadır; Balcı, Serdal; Akşit, Ercan; Yurtseven, Ersan; Duygu, AliAtrial fibrillation (AF) is a rhythm disorder observed mostly amongst adults. AF has been regarded as one of the most important medical problems because it leads to thromboembolism and paralysis risks. Although warfarin has been used in the past to cope with this health problem, new oral anticoagulant medicines have replaced it in the last few years. The new oral anticoagulants, namely, dabigatran etexilate, rivaroxaban, and apixaban, are currently being used in daily clinical practice and treatment guidelines. Since AF patients are supposed to receive long-term oral anticoagulant therapy, it is extremely important to provide them with accurate information and appropriate training regarding the treatment to decrease oncoming complications. This is a prospective study involving 168 patients who were admitted to the emergency department with AF and who were using oral anticoagulants. Findings indicate a lack of awareness in the patients regarding the effects and side effects of the drugs they take despite having been informed by the prescribing physician. We believe that informed action by patients with regard to the oral anticoagulants and their side effects will have an impact on the reduction in hospitalization observed. It will also make a substantial contribution to the quality of life of AF patients and to their use of medical services.Öğe Can we medically follow coronary artery aneurysms?; A case report(2024) Duygu, Ali; Küçük, UğurCoronary artery aneurysm (CAA) is an enlargement of the coronary vascular lumen that can’t be fixed and is at least 1.5 times the diameter of the normal coronary segment next to or connected to it. They are usually asymptomatic; their clinical presentation ranges from incidental findings on cardiac imaging to myocardial infarction (MI), and they may result in angina, MI, and sudden death, especially when they are very large. An aneurysm was seen in the middle segment of the left anterior descending artery (LAD) in the images obtained from the patient. After the council, coronary artery bypass grafting (CABG) was decided due to the risk of rupture, but the patient and his relatives did not accept the operation. In outpatient clinic visits every 3 months for 9 months, it was observed that her complaints regressed with medical treatment. There is still no clear treatment approach for CAAs and CABG, and percutaneous coronary intervention (PCI) may be preferred or medical therapy may be used.Öğe Contradictory Effect of Coronary Collateral Circulation on Regional Myocardial Perfusion That Assessed by Quantitative Myocardial Perfusion Scintigraphy(Elmer Press, 2021) Özdemir, Semra; Barutçu, Ahmet; Akşit, Ercan; Duygu, Ali; Koç Öztürk, FulyaBackground: Previous studies showed conflicting results about the contribution of coronary collateral circulation (CCC) to myocardial perfusion and function. The aim of this study was to investigate these contradictory problems by gated myocardial perfusion scintigraphy (gated MPS) for the first time. Methods: The current cohort was retrospectively selected among patients who underwent gated MPS and coronary angiography within 2 months. Two different groups including 96 patients were assessed by gated MPS to detect the understanding of the miscellaneous effect of CCC on myocardial perfusion. Group 1 consisted of those who had collateral arteries that were not-well-developed (Rentrop grade 0 - 1) (n = 58), while group 2 consisted of those who had collateral arteries that were well-developed (Rentrop grade 2 - 3) (n = 38). Results: There was no statistically significant difference between groups 1 and 2 in terms of perfusion and functional parameters obtained from gated MPS. Furthermore, no statistically significant difference was found in the phase analysis parameters which is a novel technique to evaluate left ventricular synchronization. On the other hand the left ventricular mass index values were high and quite close to the statistically significant value (P = 0.059) in group 2. Conclusions: The current results that obtained by using the gated MPS technique for the first time in the evaluation of CCC showed that the well-developed collateral circulation has a positive effect on myocardial perfusion and function, but this effect was not statistically significant. Results need to be supported by large scale of patients' size.Öğe Could ARNI have an Effect on LV Fibrosis and Inflammatory Parameters in an Experimental Autoimmune Myocarditis Model?(2022) Duygu, Ali; Gazi, Emine; Deveci, Bülent; Arslan, Mehmet; Öztopuz, Özlem; Adalı, YasemenObjectives: The aim of this study is to investigate the efficacy of sacubitril-valsartan treatment in the early period of\rExperimental Autoimmune Myocarditis (EAM) model, under the perspective of fibrosis and inflammatory cytokines.\rMethods: The study was performed using 18 rats in three groups of EAM (n=6), EAM treatment (n=6) and control (n=6).\rEAM was induced by footpad injections of porcine cardiac myosin and Complete Freund’s Adjuvant (CFA). The EAM group\rwas not given any medical care. 20 mg/kg sacubitril-valsartan was given to EAM treatment (marked as treatment) group\rtwice a day beginning from the 21st day to the 42nd day. No procedure was applied to the control group. Histopathological,\rbiochemical and RT-PCR analyses were performed on the heart tissues taken after the 42nd day of sacrificing.\rResults: Significant congestion, fibrosis, and cellular changes were observed in the EAM and treatment groups. There was\r50% less severe fibrosis,which is 3rd degree, in the Treatment group compared to EAM. Severe congestion rate was lower\rin the treatment group compared to EAM; with the percentage of 16,6% to 50%. Though the average values of treatment\rgroup were lower than EAM group, there was obvious difference in TNF ?, TGF ?1 and NT-proBNP levels (p>0.05) between\rthe EAM and the treatment groups. There was no significant difference in IL-6 levels between the three groups.\rConclusion: In view of findings, the treatment of ARNI in acute autoimmune myocarditis may be promising on cardiac\rrisk markers (cytokine, BNP values) and fibrosis parameters. Studies to be conducted in high-numbered groups will\rreveal more statistical significance.Öğe Deneysel otoimmün miyokardit modelinde erken dönemde verilen sakubitril-valsartan tedavisinin mortalite, morbidite ve miyokardiyal fibrozis parametreleri üzerine etkisi, hayvan çalışması(Çanakkale Onsekiz Mart Üniversitesi, 2020) Duygu, Ali; Gazi, EmineAmaç: Gençlerde non iskemik dilate kardiyomiyopatinin sık nedeni olan miyokarditin yol açtığı kalp yetmezliğinde erken dönemde verilen sakubitril-valsartan tedavisinin etkinliğini; deneysel otoimmün miyokardit modeli oluşturarak görmektir. Gereç ve Yöntem: Çalışma her grupta altı wistar cinsi sıçan olan toplamda 18 sıçan kullanılarak; DOM, DOM + Tedavi, Kontrol olarak belirlenen üç grupla yapıldı. DOM modeli ayak tabanından eşit miktar domuz kardiyak miyozini ve Complete Freund's Adjuvant (CFA) verilerek oluşturuldu. DOM grubuna tedavi verilmedi. DOM + Tedavi grubuna 21. günden itibaren 42. güne kadar günde iki defa 20 mg/kg sakubitril-valsartan verildi. Kontrol grubuna ise herhangi bir işlem uygulanmadı. 42. gün sakrifikasyon ardından alınan kalp dokularında histopatolojik, biyokimyasal ve PCR analizleri yapıldı. Bulgular: Konjesyon, fibrozis ve hücresel değişikliklerde DOM ve DOM + Tedavi grubu arasında anlamlı fark izlenmedi (p>0.05). TNF ?, TGF ?1 seviyelerinde DOM ve DOM + Tedavi grubu arasında anlamlı fark izlenmedi (p>0.05). IL 6 seviyelerinde üç grup arasında da anlamlı fark izlenmedi (p>0.05). pro BNP düzeylerinde ise DOM ve DOM + Tedavi grubu arasında arasında anlamlı fark izlenmemiştir (p:0.052). IL 6 hariç diğer analiz sonuçlarında ise hem DOM grubu hemde DOM + Tedavi grubu, kontrol grubu ile karşılaştırıldığında anlamlı fark izlenmiştir (p<0.05). Sonuç: Tedavi grubu ile hasta grubu arasında yapılan tetkik analizi sonucunda, tedavi grubunda değerler daha düşük olmasına rağmen, hasta grubuyla karşılaştırıldığında fibroz, sitokin, BNP değerleri arasında anlamlı bir fark gözlenmemiştir. Gelecekte oluşturulacak deneysel modellerde ilaç dozunun yüksek verilmesi, daha çok sayıda hayvan kullanılması veya tedavinin daha erken dönemde başlanması ile anlamlı sonuçlar elde edilebileceği düşünülmektedir. Anahtar Sözcükler: Deneysel otoimmün miyokardit, dilate kardiyomiyopati, kalp yetmezliği, sakubitril-valsartan, fibrozis, ARNİÖğe Effect of Treatment Regimen on Long-Term Mortality of Geriatric Patients Diagnosed With Stable Coronary Artery Disease(Springer, 2021) Küçük, Uğur; Duygu, Ali; Kırılmaz, BahadırBackground: Increased life expectancy across the world has resulted in an increase in the proportion of the elderly population who are lost to heart diseases. Advanced age and comorbidities are believed to change the response to treatments. In this study, we aimed to investigate the effects of surgical and medical treatments on the mortality of stable coronary diseases. Methods : A total of 150 geriatric patients who underwent coronary angiography (CAG) were followed up in our cardiology clinic. Patients who decided to undergo coronary artery bypass graft (CABG) surgery after CAG and were willing to undergo the operation were assigned to group 1, whereas those who were unwilling to undergo the operation were not eligible for percutaneous coronary intervention and were followed up medically, and were assigned to group 2. Keeping the primary goal as mortality rates, both the groups were compared using medical records for three years after the treatment. Results : After three years, the overall mortality rate included six patients (16%) in the CABG group versus 63 patients (55%) in the medical therapy group (p < 0.001). The CABG therapy was found to be significantly and independently associated with first- and third-year mortality (risk ratio: 0.064, 95% confidence interval: 0.009-0.467, p = 0.007; risk ratio: 0.305, 95% confidence interval: 0.151-0.615, p < 0.001, respectively). Kaplan-Meier analysis for first- and third-year all-cause mortality rates led to significant results and curves between the groups. Conclusion : Our study revealed that compared to CABG surgery in the treatment of coronary artery disease in geriatric patients, medical treatment is associated with poor outcomes in terms of mortality in long-term follow-up.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 Hidden enemy of pulmonary arteries: COVID-19(2024) Duygu, Ali; Küçük, UğurIt has been reported that COVID-19 may cause severe endothelial damage. Pulmonary Artery Stiffness (PAS) is a strong predictor of right ventricular function. PAS can reveal important information about the endothelial functions of the pulmonary bed. In this study, we aimed to elucidate the possible effect of COVID-19 on PAS. The study was performed by measuring PAS values with transthoracic echocardiography in 130 patients, 60 of whom had COVID-19 and 70 were controls. COVID-19 patients with positive polymerase chain reaction (PCR) test results were included in the study 3-6 months after their positivity. When the Maximal frequency shift (MFS) (Hz) results were examined, no significant difference was observed between the patient and control groups (2764±279.24 and 2664.8±673.91 p=0.340, respectively). There was a significant difference between the patient and control groups in favor of the patient group in pulmonary acceleration time (PAT) (msec) results (93.18±14.99 and 126.1±17.58, respectively, p<0.001). There was a significant difference between the patient and control groups in favor of the patient group in PAS (Hz/msec) results (30.28±5.07 and 21.57±7.04, respectively, p<0.001). It is possible that COVID-19 may have adverse effects on the pulmonary artery wall and bed. As a result of endothelial damage due to COVID-19, an increase in PAS values can be observed.Öğe Hybrid Approach to Coronary Artery Disease During the COVID-19 Pandemic Period(Çanakkale Onsekiz Mart Üniversitesi, 2021) Duygu, Ali; Kırılmaz, Bahadır; Reşorlu, MustafaCoronary artery disease (CAD) is a common cause of morbidity and mortality worldwide. CAD is an atherosclerotic disease manifested by stable angina, unstable angina, myocardial infarction (MI) or sudden cardiac death. In the COVID 19 pandemic, coronary angiography, which is used for the diagnosis and interventional treatment of coronary artery disease for diagnostic purposes all over the world, is less preferred due to the risk of infection. A 42-year-old male patient was admitted to our outpatient clinic with chest pain for 15 days. Considering that the most effective and beneficial method for our patient was coronary CT angiography, it was decided to perform coronary CT angiography in our center on the patient with a known family history. Although catheter coronary angiography is the gold standard, coronary CT angiography is increasingly used as a non-invasive diagnostic test that can easily identify the type of plaque and the severity of coronary occlusion and provides direct visualization of the plaque in the coronary arteries. According to the 2019 ESC Chronic Coronary Artery Disease Guidelines, coronary CT angiography is the test of choice in patients with a lower clinical probability of CAD, no previous diagnosis of CAD, and features associated with a higher likelihood of image quality.Although it has side effects, the accurate diagnostic feature of coronary CT angiography maintains its usefulness as it reduces the risk of contact during the pandemic period and helps to reduce the amount of contrast agent administeredÖğe Non-obstruktif Koroner Arter Hasta Grubunda Miyokardiyal İskeminin Miyokard Perfüzyon Sintigrafisi ve Speckle Tracking Ekokardiyografi ile Değerlendirilmesi(Eskişehir Şehir Hastanesi, 2022) Arslan, Mehmet; Barutçu, Ahmet; Arslan, Şeyda Ferah; Duygu, AliGiriş: 2D speckle tracking ekokardiyografi ile yapılan strain analizinin ciddi koroner arter hastalığı tanısında kullanılabileceği diğer çalışmalarla gösterilmiştir. Bu çalışmada amaç, miyokard Perfüzyon Sintigrafisi (MPS) pozitif olan fakat ciddi koroner arter hastalığı (KAH) olmayan hasta grubunda, 2D speckle tracking ekokardiyografinin etkinliği değerlendirmektir. Yöntemler: Çalışmaya kararlı anjina pektoris ön tanısıyla tetkik edilip MPS‟de iskemi saptanan ve yapılan koroner anjiografide non-obsrüktif KAH (<%50 darlık) izlenen 40 (25‟i kadın, yaş:58,85±9,73) hasta dahil edildi. Tüm hastalarda 2D speckle tracking ekokardiyografi yöntemiyle strain analizi yapıldı. 17 LV miyokard segmenti için longitudinal strain ölçüldü. Sol ventrikül segmentleri MPS sonuçlarına göre iskemik ve iskemik olmayan segmentler olarak gruplandırıldı ve elde edilen 680 segmentin strain parametreleri karşılaştırıldı. Bulgular: İskemi saptanan segmentlerin ortalama longitudinal strain değerleri % -20,24±6,00, iskemi saptanmayan segmentlerin ise %-20,11±6,46 olarak bulundu ve istatistiksel olarak anlamlı fark gözlenmedi (p>0,05). Cinsiyet, hipertansiyon, diabetes mellitus, hiperlipidemi, hipertrigliseridemiye göre yapılan alt grup analizlerinde de iskemik olan ve olmayan segmentler arasında longitudinal strain açısından fark olmadığı izlendi. Sonuç: Ciddi koroner arter hastalığı olmayan hasta grubunda MPS pozitif olan segmentler ile MPS negatif olan segmentler açısından sol ventrikül 2D longitudinal strain analizinde stain parametreleri arasında fark olmadığı izlendi. Daha önceki çalışmalar da göz önüne alındığında 2D strain analizi MPS ile kombine olarak kullanılarak böbrek yetmezliği, şüpheli MPS pozitifliği, gibi özel durumlarda gereksiz koroner anjiografiden kaçınılmasını sağlayabilirizÖğe Sakubitril valsartan’ın deneysel havyan modellerindeki yeri(Çanakkale Onsekiz Mart Üniversitesi, 2023) Duygu, Ali; Gazi, EmineKalp yetersizliği tedavisinde yeni bir molekül olan sakubutril/valsartan’ın (S/V) büyük ve kapsamlı çalışmalarda faydaları ortaya koyulmuş ve günlük pratikte kullanıma sunulmuştur. Bu ilaç kombinasyonu, neprilisin tarafından bozulan potansiyel olarak faydalı endojen vazoaktif peptitlerin seviyelerini arttırırken, renin anjiyotensin aldosteron sistemi (RAAS) aktivasyonunun zararlı etkilerini engellemek için geliştirilmiştir. Son yayınlanan 2022 Avrupa Kardiyoloji Derneği Kalp Yetersizliği Kılavuzu’nda da daha önce kalp yetersizliği tedavisinde sınıf 1 endikasyona sahip olan ACE-İ ve beta blokerler ile birlikte sınıf 1 endikasyonu almıştır. Bunun yanında farklı deneysel hayvan modellerinde de S/V’ın etkileri incelenmiş, böylece etiyolojik farklılıklar da değerlendirilmiş ve incelenmeye, değerlendirilmeye devam etmektedir. Bu derlemede S/V ile yapılmış deneysel hayvan çalışmalarını özetlemeyi amaçladıkÖğe The clinical importance of triglyceride/glucose ratio in the primary prevention of cardiovascular diseases: A retrospective cohort study(Selçuk BAŞAK, 2021) Küçük, Uğur; Duygu, Ali; Gazi, EmineBackground/Aim: Atherosclerosis plays a significant role in cardiovascular diseases. Dyslipidemia, inflammation, genetics, and environmental factors greatly impact the development and progression of atherosclerosis. This study aimed to investigate the importance of triglyceride-glucose ratio in primary cardiovascular event prevention. Methods: Our retrospective cohort study included 56 patients (39 males, 17 females). Coronary computed tomography angiography (CCTA) images of the individuals were examined, and calcium score was calculated using the Agatston score. Those with a score of zero and those with scores>0 were included in Groups 1 and 2, respectively. Triglyceride/glucose (TyG) ratio and atherosclerotic cardiovascular disease (ASCVD) risk were calculated for all individuals. Results: Among all patients, 69.6% had coronary artery calcium scores (CACs) of greater than zero. The TyG ratios were 0.92 (0.33) and 1.77 (0.83) in Groups 1 and 2, respectively (PÖğe The relationship between the amount of edema and functional capacity and annexin V and ICAM 1 in patients with heart failure(Çanakkale Onsekiz Mart Üniversitesi, 2022) Duygu, Ali; Şehitoğlu, Hilal; Kaya, Hakkı; Arslan, Mehmet; Akşit, ErcanObjective: Edema, one of the common findings of congestive heart failure, can be seen in the form of pretibial, scrotal or pulmonary edema and always undesired changes the quality of life of patients. Some studies have previously demonstrated the correlation of some cytokines and inflammation markers with heart failure. This study purposed to investigate the relevance of the amount of edema and functional capacity with ICAM 1 and annexin V in heart failure patients. Methods: The study included a total of 40 individuals, 20 of whom were diagnosed with heart failure and 20 of whom were enrolled as the control group. Edema grades and functional capacities were scored and noted. All patients underwent transthoracic echocardiography. ICAM 1 and annexin V levels were compared between the patient and control groups. The correlation between the grade of edema and functional capacity and ICAM 1 and annexin V levels was examined. ROC curve analysis was used to determine the cut-off point. Results: There was a significant difference in both ICAM 1 and annexin V levels in the patient group compared to the control group (ICAM 1 58.14±25.65 ng/mL, 36.04±14.14 ng/mL, p [TR] Amaç: Konjestif kalp yetmezliğinin yaygın bulgularından biri olan ödem pretibial, skrotal ya da pulmoner ödem şeklinde görülebilmekte ve hastaların yaşam standartlarını daima olumsuz yönde etkilemektedir. Bazı sitokin ve inflamasyon markerlarının kalp yetmezliği ile korelasyonu daha önce kimi çalışmalarda gösterilmiştir. Amacımız; kalp yetmezliği hastalarında fonksiyonel kapasite ve ödem miktarı ile ICAM 1 ve annexin V arasında ilişkiyi incelemektir. Yöntem: Çalışmaya kalp yetmezliği tanısı almış 20 ve kontrol grubu olarak belirlenmiş 20 olmak üzere toplam 40 kişi alındı. Ödem dereceleri ve fonksiyonel kapasiteleri skorlanarak not edildi. Tüm hastalara transtorasik ekokardiografi yapıldı. Hasta ve kontrol grubu arasında ICAM 1 ve annexin V düzeyleri karşılaştırıldı. Ödem derecesi ve fonksiyonel kapasite ile ICAM 1 ve annexin V düzeyleri arasındaki korelasyona bakıldı. Kesim noktasının belirlenmesi için ROC Curve analizi kullanıldı. Bulgular: Hem ICAM 1 hem de annexin V düzeylerinde hasta grupta kontrol grubuna kıyasla anlamlı fark oluştu (ICAM 1 58.14±25.65 ng/mL, 36.04±14.14 ng/mL, pÖğe Wellens’ Syndrome: Case report(Çanakkale Onsekiz Mart Üniversitesi, 2021) Arslan, Mehmet; Duygu, Ali; Küçük, UğurWellens’ syndrome is a clinical picture characterized by T wave changes mostly observed in painless periods on electrocardiography as a result of the critical narrowing of the left anterior descending artery. In our case, a 57-year-old female was admitted to the emergency department with the complaint of intermittent atypical chest pain for two days. In the electrocardiography, negative T waves were observed in the anterior leads defined as Wellens’ syndrome. Cardiac enzyme markers were slightly elevated. The patient was evaluated as an acute coronary syndrome and was taken to the catheter laboratory. In coronary angiography, 99% critical stenosis was detected in the middle segment of the left anterior descending artery and percutaneous intervention was performedÖğe Zirai ilaç zehirlenmesi ile başvuran stent trombozu(Çanakkale Onsekiz Mart Üniversitesi, 2021) Duygu, Ali; Kırılmaz, Bahadır; Arslan, Mehmet; Küçük, Uğurİnsanların kimyasal maddelere maruz kalması büyüyen bir endişe kaynağıdır. Glifosat bazlı herbisit (GBH) kullanımı da akut zehirlenme sonucu çeşitli hastalıklara neden olur. GBH bazlı ilaçlar sinüs bradikardisi, QT uzaması, torsade de pointes, AV blok gibi elektrokardiyografi değişikliklerine ve nadiren koroner arter trombozu neden olabilir. 2 yıl önce ilaç kaplı stent uygulanmış olan 68 yaşında erkek hasta göğüs ağrısı şikayeti ile acil servise başvurdu. Hastadan alınan anamnezde GBH içeren zirai ilaç kullanarak 2 gündür tarlada maskesiz ilaçlama yaptığı, göğüs ağrısının başladığı ve acil servise başvurduğu anlaşıldı. Akut GBH entoksikasyonu hipotansiyon, solunum sıkıntısı, gastrointestinal semptomlar, bilinç kaybı, oligüri ve nadiren ölüme neden olabilir. GBH'ye kronik maruziyetin koroner arter hastalığına neden olduğu gösterilmiştir
