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A new angiographic finding: primary peripheral slow flow
(Galenos Publishing House, 2021) Akşit, Ercan; Gazi, Emine; Kırılmaz, Bahadır; Aydın, Fatih
In some peripheral angiographies, similar to the coronary slow flow phenomenon (CSFP), we observed a peripheral slow flow (Supplementary Video 1). Although slow flow phenomenon after infrapopliteal balloon angioplasty is mentioned in 2 retrospective studies1, 2, primary peripheral slow flow has been previously reported in only 1 case report.3 Interestingly, it appears that similar to CSFP sometimes occurring in a single coronary artery, there is slow flow only in the left lower extremity artery in the video example (Supplementary Video 1). There is also no severe stenosis that would explain this phenomenon. Moreover, considering that peripheral angiography was performed with the right femoral artery puncture and that the catheter was within the right femoral artery, it could have been expected for the flow to be slower in the right lower extremity artery with the effect of spasm.
A new treatment modality for the treatment of unligated thoracic side branch of left internal mammary artery: Underexpanded stent
(2024) Küçük, Uğur; Kırılmaz, Bahadır; Gazi, Emine; Aşgün, Halil Fatih; Özpınar, Uğur
The left internal mammary artery (LIMA) is often preferred in coronary artery bypass grafting (CABG). LIMA has additional features such as less fenestration in the endothelial layer, less intercellular permeability, anti-thrombotic activity, rapid lipolysis, and less lipid synthesis, resulting in an excellent long-term patency rate. LIMA side branches or anatomical variations that are not ligated intraoperatively may cause coronary ischemia in the postoperative period. Although various treatment modalities such as coiling, vascular plug embolization, and surgical ligation have been described in treating LIMA side branches, no studies show the superiority of one treatment modality over another. In this case, the advantages, disadvantages, and critical points affecting the success of unligated LIMA side branches treatment methods were discussed.
A Rare Arrhythmia Accelerated Junctional Rhythm in Pregnant Without Structural Heart Disease
(Çanakkale Onsekiz Mart Üniversitesi, 2019-03-18) Akşit, Ercan; Gazi, Emine; Kırılmaz, Bahadır; Turgay Yıldırım, Özge; Aydın, Fatih
Changes in the pregnancy, especially with an increase in sympathetic activation, may provide a basis for the development of dysrhythmias. A 27- year old woman within the 26 weeks of her pregnancy with no known cardiac disease admitted to our clinic with palpitation symptoms. Accelerated junctional rhythm with ventricular rate 90/bpm was observed in her electrocardiogram. No structural heart disease was detected during examination. Accelerated junctional rhythm was persisted at first and third month controls after initial examination. After delivery the rhythm was spontaneously converted to sinus rhythm.
A Rare Arrhythmia Accelerated Junctional Rhythm in Pregnant Without Structural Heart Disease
(Çanakkale Onsekiz Mart Üniversitesi, 2019) Akşit, Ercan; Gazi, Emine; Kırılmaz, Bahadır; Yıldırım, Özge Turgay; Aydın, Fatih
Gebelikte özellikle sempatik aktivasyonun artışı ile meydana gelen değişiklikler disritmilerin gelişimine zemin hazırlayabilir. Çarpıntı şikayeti ile kardiyoloji polikliniğine başvuran 27 yaşında 26 haftalık sağlıklı gebede elektrokardiyografide ventriküler hızı 90/dk olan akselere junctional ritim (AJR) görüldü. Yapısal kalp hastalığı saptanmayan gebede bir ay ve üç ay ara ile alınan EKG’lerinde AJR’nin devam ettiği, gebelikten sonra kontrolünde elektrokardiyografide AJR’nin kaybolduğu ve normal sinüs ritmine spontan olarak döndüğü görüldü.
An anchoring technique by looping with the tip of a super-stiff wire: May be a solution in patients with anomaly of the aortic arch and tortuous carotid artery disease?
(2013) Barutcu, Ahmet; Gazi, Emine; Aksu, Feyza; Tatli, Ersan
Vascular anatomy is one of the most important factors for the successful carotid artery interventions, either angioplasty or stenting. We report a new technique for advancing a guiding catheter into the common carotid artery when there is an unfavourable aortic arch anatomy and tortuosity of the carotid artery. Copyright 2013 BMJ Publishing Group. All rights reserved.
Are P-glycoprotein (ABCB1/MDR1) and endothelial nitric oxide synthase (eNOS) polymorphisms related to severity of the coronary artery disease?
(Selçuk BAŞAK, 2022) Öztürk, Ufuk; Gazi, Emine; Özdemir, Öztürk
Background/Aim: Atherosclerotic cardiovascular disease is one of the most common causes of morbidity and mortality in developed countries. Genetic and environmental factors are associated with atherosclerosis development. Some single nucleotide polymorphisms have also been directly related to atherosclerosis, for example, polymorphisms that reduce nitric oxide (NO) levels and/or activity have been linked to atherosclerotic diseases. However, the multidrug resistance gene 1 (MDR-1) polymorphism is related to repeated cardiovascular events. This study aimed to investigate the relationship between MDR-1 and endothelial NO synthase (e-NOS) polymorphism and severe coronary artery disease (CAD). Methods: In total, 90 patients presenting with acute coronary syndrome were included in this cross-sectional study. Patients with at least > 70% stenosis in ≥ 2 coronary vessels were defined as severe CAD (Group 1), while those with this same level of involvement in < 2 vessels were diagnosed with single-vessel disease (Group 2). MDR 3435C-T and eNOS T-786C were determined by polymerase chain reaction (PCR) amplification. Comparison of parametric and nonparametric values between the two groups was performed using the Student’s t- or Mann–Whitney U test. Categorical variables were analyzed using the χ2 test. Risk estimations for the association of severe CAD with the polymorphisms were calculated using odds ratio (OR) and 95% confidence intervals by comparing the genotypic combinations. Results: Baseline demographic parameters were similar in both groups, except for the presence of DM and glucose level. T allele of MDR was 42% and 40% in groups 1 and 2, respectively (OR = 1.12). The C allele of eNOS was 34% and 30% in groups 1 and 2, respectively (OR = 1.16). Fourteen and 15 patients (40% and 27%, respectively) had both T and C alleles in patients in groups 1 and 2, respectively (OR = 1.77). All P-values were > 0.05. Conclusion: This study is the first one that shows that MDR1 and e-NOS polymorphisms are frequent in patients with ≥ 2 vessel disease and may be associated with severe CAD.
Are patients, who were previously diagnosed with coronary artery disease by coronary angiography, on optimal medical treatment?
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Temiz, Ahmet; Yener, Ali Umit; Barutcu, Ahmet; Gazi, Emine; Altun, Burak; Bekler, Adem; Vural, Ahmet
Background: This study aims to detect the drug usage rate of patients who had coronary artery disease (CAD) diagnosis by coronary angiogram (CAG). Methods: Reports of 1,549 patients (993 males, 556 females; mean age 62.9 +/- 10.9 years; range 20 to 87 years) (184 normal CAG, 1,365 CAD) who were performed CAG between October 2009 and February 2012 were retrospectively analyzed. Medication data were collected between August 2013 and November 2013 from patients' pharmacy refill data. Usage of aspirin, tienopiridine, statin, angiotensin converting enzyme inhibitor, beta blocker (BB), warfarin, angiotensinogen receptor blocker, nitrate, trimetazidine, calcium channel blocker, and diuretic were recorded. Results: Usage rates of angiotensinogen receptor blocker, trimetazidine, calcium channel blocker, warfarin, diuretic, and fibrate were not statistically different between patients with CAD and normal CAG. Rates of using aspirin (50.3% vs. 39.1%, p=0.005), tienopiridine (25.6% vs. 9.8%, p<0.001), angiotensin converting enzyme inhibitor (38.0% vs. 21.7%, p<0.001), statin (48.5% vs. 30.6%, p<0.001), BB (56.8% vs. 40.2%, p<0.001) and nitrate (15.1% vs. 6.0%, p<0.001) were higher in patients with CAD. Rate of patients using all four drugs, antiplatelet agent, statin, angiotensin converting enzyme inhibitor, and BB was only 13.1% in CAD group. Only 25.8% of patients with CAD used all three of antiplatelet agent, statin, and BB. Conclusion: Patients with CAD are not on optimal medical treatment. These patients should be questioned in every visit in terms of the status of their treatment to administer the optimum medications to reduce cardiovascular mortality and morbidity.
Assessment of left-atrial strain parameters in patients with frequent ventricular ectopic beats without structural heart disease
(Springer, 2014) Barutcu, Ahmet; Gazi, Emine; Temiz, Ahmet; Bekler, Adem; Altun, Burak; Kirilmaz, Bahadir; Kucuk, Ugur
Ventricular ectopic beats (VEBs) are often encountered in daily clinical practice. Clinical significance of VEBs seen in patients without structural cardiovascular diseases is controversial. We aimed to investigate the effects of VEBs on left atrium (LA) function using speckle tracking echocardiography with LA strain parameters. Patients with frequent VEBs (more than 30 times in 1 h, according to the Lown classification) were identified. Identified patients were evaluated by speckle tracking methods. There were 40 patients with frequent VEBs and 40 controls in our study. The general characteristics were similar of the study population. The LA global longitudinal strain parameters were significantly different. Global Peak atrial longitudinal strain (PALS) (38.39 +/- A 7.93 vs. 44.15 +/- A 6.71, p = 0.001) and peak atrial contraction strain (PACS) (16.37 +/- A 4.58 vs. 20.49 +/- A 3.65, p = 0.000) were revealed significantly lower in the VEBs group. Time to peak longitudinal strain (TPLS) was found significantly longer in the VEBs group [485.5 (352-641) vs. 435 (339-516.5) p = 0.000]. Number of VEBS was correlated with TPLS (r = 0.499, p = 0.000). PALS and PACS were negatively correlated with number of VEBs (r = -0.348, p = 0.002 and r = -0.444, p = 0.000, respectively). We described that in this study, The LA functions are affected by VEBs adversely. This deterioration is increasing as the number of VEBs.
Assessment of the effects of frequent ventricular extrasystoles on the left ventricle using speckle tracking echocardiography in apparently normal hearts
(Turkish Soc Cardiology, 2016) Barutcu, Ahmet; Bekler, Adem; Temiz, Ahmet; Kirilmaz, Bahadir; Gazi, Emine; Altun, Burak; Ozdemir, Semra
Objective: Impairment in left ventricular (LV) function due to excessive ventricular extrasystoles (VESs) occurs during long-time follow-up. Speckle tracking echocardiography (STE) has been shown to be superior to conventional methods for evaluating cardiac functions. We aimed to use STE for early detection of LV dysfunction in patients with apparently normal hearts who have frequent VESs. Methods: Fifty-five patients with frequent VESs were identified according to the Lown classification (Grade 2; unifocal more than 30 times in 1 h). Subjects aged 22-60 years with frequent VESs that had been detected for at least 1 year were included in the study according to the inclusion criteria. Forty-five subjects with similar demographic characteristics, but without VESs, were included as the control group. All participants were evaluated by STE. Results: Fifty-five patients with frequent VESs (mean age 47 years, range 22-60 years; 42.2% male) and 45 control subjects (mean age 46 years, range 22-60 years; 37.8% male) were enrolled in the study. Global LV longitudinal strain (GLS) was decreased in patients with frequent VESs (-18.41 +/- 3.37 and -21.82 +/- 2.43; p<0.001). In addition, global LV circumferential strain was decreased in patients with frequent VESs (-16.83 +/- 6.06, -20.51 +/- 6.02; p<0.001). The frequency and exposure time of VESs were negatively correlated with GLS (r=-0.398, p<0.001; r=-0.191, p=0.001, respectively). Conclusion: STE revealed that LV functions were decreased in patients with VESs. This deterioration increased with the frequency and exposure time of VESs. Impairment of LV function due to excessive VESs occurs during long-time follow-up. STE may be used for early detection of LV dysfunction.
Assessment of the relationship between red cell distribution width and fragmented QRS in patients with non-ST elevated acute coronary syndrome
(Int Scientific Literature, Inc, 2014) Bekler, Adem; Gazi, Emine; Tenekecioglu, Erhan; Karaagac, Kemal; Altun, Burak; Temiz, Ahmet; Barutcu, Ahmet
Background: Red cell distribution width (RDW) and fragmented QRS (fQRS) complexes have also been reported to be predictors of cardiac events and all-cause mortality in coronary artery disease (CAD). We aimed to investigate the association of serum red cell distribution width (RDW) levels and fQRS in patients with non-ST elevated acute coronary syndrome (NST-ACS). Material/Methods: We retrospectively evaluated a total of 251 patients (191 men and 60 women) with NST-ACS. The NST-ACS consisted of unstable angina (UA) and non-ST elevated myocardial infarction (NSTEMI). The fQRS pattern was defined as the presence of an additional R' or crochetage wave, notching in the nadir of the S wave or fragmentation of the RS or QS complexes in 2 contiguous leads corresponding to a major coronary artery territory. The relationships between the RDW and fQRS were assessed. Results: The patients in the fQRS group were older, left ventricular ejection fraction (LVEF) levels were significantly lower, and baseline RDW and troponin levels were significantly higher than in the group without fQRS. There were positive correlations between age, number of coronary arteries narrowed, and RDW, and negative correlations between triglyceride, LVEF, and RDW in study patients. There were positive correlations between number of fQRS leads, age, and RDW, and negative correlations between triglyceride, LVEF, and RDW in NSTEMI patients. Conclusions: Our results indicate that an elevated RDW values is associated with fQRS in NST-ACS. Elevated RDW values and fQRS together may be useful for identifying NSTEMI patients in NST-ACS.
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 Ozden
Background: 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.
Atrial conduction time, and left atrial mechanical and electromechanical functions in patients with polycystic ovary syndrome: interatrial conduction delay
(Clinics Cardive Publ Pty Ltd, 2015) Gazi, Emine; Gencer, Meryem; Hanci, Volkan; Temiz, Ahmet; Altun, Burak; Barutcu, Ahmet; Gungor, Ayse Nur
Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of women during the reproductive period. Cardiovascular risk factors are more frequent in patients with PCOS. We aimed to investigate the P-wave dispersion (Pd), inter-and intra-atrial conduction time and mechanical functions of the left atrium (LA) in patients with PCOS. Methods: Forty-eight patients with PCOS and 38 normal healthy women were enrolled in this study. A 12-lead surface electrocardiogram was used to evaluate Pd. Left ventricular (LV) functions were measured using conventional and tissue Doppler imaging (TDI) methods. Inter-and intra-atrial conduction times were measured by TDI. LA volumes were measured echocardiographically with the biplane area-length method from the apical four-chamber view. Results: Heart rate (82.02 +/- 13.15 vs 74.24 +/- 11.02 bpm, p = 0.014) and Pd were significantly increased in the PCOS patients [ 27 +/- 5 vs 24 +/- 6 ms, p = 0.035]. Transmitral E/A ratio was significantly lower in the PCOS patients than in the controls (1.5 +/- 0.3 vs 1.7 +/- 0.4 m/s, p = 0.023). Passive emptying volume (12.54 +/- 4.39 vs 15.28 +/- 3.85 ml/m(2), p = 0.004) and passive emptying fraction [54.4 (21-69) vs 59.1% (28-74), p = 0.008] were significantly decreased in PCOS patients. Total emptying volume was significantly decreased (17.9 +/- 5.49 vs 20.67 +/- 4.29 ml/m(2), p = 0.018) in PCOS patients. Interatrial (19 +/- 7.4 vs 15 +/- 6.4 ms, p = 0.035) and intra-atrial [8.5 (1-19) vs 5 ms (1-20), p = 0.026] electromechanical delays were found to be significantly higher in PCOS patients. Conclusion: This study showed that patients with PCOS had increased inter-and intra-atrial conduction delays, and decreased LA passive emptying volumes and fractions.
Atrial electromechanical coupling intervals in pregnant subjects
(Clinics Cardive Publ Pty Ltd, 2014) Altun, Burak; Tasolar, Hakan; Gazi, Emine; Gungor, Aysenur Cakir; Uysal, Ahmet; Temiz, Ahmet; Barutcu, Ahmet
Objective: The aim of this study was to evaluate atrial conduction abnormalities obtained by tissue Doppler imaging (TDI) and electrocardiogram analysis in pregnant subjects. Methods: A total of 30 pregnant subjects (28 +/- 4 years) and 30 controls (28 +/- 3 years) were included. Systolic and diastolic left ventricular (LV) function was measured using conventional echocardiography and TDI. Inter-atrial, intra-atrial and intra-left atrial electromechanical coupling (PA) intervals were measured with TDI. P-wave dispersion (PD) was calculated from a 12-lead electrocardiogram. Results: Atrial electromechanical coupling at the septal and left lateral mitral annulus (PA septal, PA lateral) was significantly prolonged in pregnant subjects (62.1 +/- 2.7 vs 55.3 +/- 3.2 ms, p < 0.001; 45.7 +/- 2.5 vs 43.1 +/- 2.7 ms, p < 0.001, respectively). Inter-atrial (PA lateral - PA tricuspid), intra-atrial (PA septum - PA tricuspid) and intra-left atrial (PA lateral - PA septum) electromechanical coupling intervals, maximum P-wave (P-max) duration and PD were significantly longer in the pregnant subjects (26.4 +/- 4.0 vs 20.2 +/- 3.6 ms, p < 0.001; 10.0 +/- 2.0 vs 8.0 +/- 2.6 ms, p = 0.002; 16.4 +/- 3.3 vs 12.2 +/- 3.0 ms, p < 0.001; 103.1 +/- 5.4 vs 96.8 +/- 7.4 ms, p < 0.001; 50.7 +/- 6.8 vs 41.6 +/- 5.5 ms, p < 0.001, respectively). We found a significant positive correlation between inter-atrial and intra-left atrial electromechanical coupling intervals and P-max (r = 0.282, p = 0.029, r = 0.378, p = 0.003, respectively). Conclusion: This study showed that atrial electromechanical coupling intervals and PD, which are predictors of AF, were longer in pregnant subjects and this may cause an increased risk of AF in pregnancy.
CARDIOVASCULAR SYSTEM FEATURES OF YOUNG ADULTS BORN BY CESAREAN SECTION
(2020) Akşit, Ercan; Gazi, Emine; Kırılmaz, Bahadır; Bozkurt, Hasan; Edinciklioğlu, Melike; Yıldırım, Özge Turgay
Aim: Currently, the prevalence of caesarean section (CS) has been increasing at an alarming rate across the world. In parallel with theincreasing rate of CS, it is reported that there is an increasing prevalence of obesity, autoimmune and allergic diseases. The purpose ofthe present study is to analyse whether the cardiovascular system characteristics of young adults born by CS are different from those ofyoung adults born by vaginal delivery (VD).Materials and Methods: A total of 112 participants were included in the study (40 CS group vs 82 VD ie control group). Transthoracicechocardiography and carotid Doppler ultrasonography were performed to the participants. In addition, participants were evaluated witha 24-hour ECG recording.Results: Tricuspid E wave, tricuspid A wave and tricuspid E/A ratio were lower in the CS group compared with the control group(57.6±8.6 vs. 72.4±10.3, p<0.001; 46.7±8.8 vs. 50.6±8.9, p=0.04; 1.2±0.14 vs 1.45±0.88, p<0.001). Epicardial fat tissue thickness werehigher in the CS group compared with the control group (4.8±1.3 vs. 3.1±0.8, p<0.001).Conclusion: The results of this study show that cardiovascular system features of the young adults born by CS are different from thoseborn by VD. Further follow-up studies are needed to understand whether these findings will subsequently result in cardiovasculardiseases.
Comparison of the GRACE risk score and the TIMI risk index in predicting the extent and severity of coronary artery disease in patients with acute coronary syndrome
(Kare Publ, 2015) Bekler, Adem; Altun, Burak; Gazi, Emine; Temiz, Ahmet; Barutcu, Ahmet; Gungor, Omer; Ozkan, Muhammed Turgut Alper
Objective: The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) has been reported in coronary artery disease (CAD) patients. We aimed to evaluate the relationship between the GRS, TRI, and severity of CAD evaluated by SYNTAX score (SS) in patients with acute coronary syndrome (ACS). Methods: Patients with ACS who were admitted to the coronary care unit of our institution were retrospectively evaluated in this study. A total of 287 patients with ACS [154 non-ST elevated ACS (NSTE-ACS), 133 ST elevated myocardial infarction (STEMI)] were included in the study. The GRS and TRI were calculated on admission using specified variables. The severity of CAD was evaluated using the SS. The patients were divided into low (GRS<109)-, intermediate (GRS 109-140)-, and high (GRS>140)-risk groups and group 1 (TRI<17), group 2 (TRI 17-26), and group 3 (TRI>26) according to GRS and TRI scores. A Pearson correlation analysis was used for the relation between GRS, TRI, and SS. Results: Patients with a history of coronary artery bypass surgery, those who had missing data for calculating the GRS and TRI, and those whose systolic blood pressure (SBP) was more than 180 mm Hg or whose diastolic blood pressure (DBP) was more than 110 mm Hg were excluded from the study. Were excluded from the study. There were significant differences in mean age (p<0.001), heart rate (p<0.001), SS (p<0.001), TRI (p<0.001), rate of NSTE-ACS (p<0.001), and STEMI (p<0.001) in all patients between the risk groups. There was a positive significant correlation between the GRS and the SS (r=0.427, p<0.001), but there were no significant correlation between the TRI and SS (r=0.121, p=0.135). The area under the ROC curve value for GRS was 0.65 (95% CI: 0.56-0.74, p=0.001) in the prediction of severity of CAD. Conclusion: The GRS is more associated with SS than TRI in predicting the severity of CAD in patients with ACS.
Consensus paper on the evaluation and treatment of resistant hypertension by the Turkish Society of Cardiology
(Kare Publ, 2020) Sahinarslan, Asife; Gazi, Emine; Aktoz, Meryem; Ozkan, Cigdem; Okyay, Gulay Ulusal; Elalmis, Ozgul Ucar; Belen, Erdal
[Anstract Not Available]
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, Yasemen
Objectives: 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.
Could elevated platelet-lymphocyte ratio predict left ventricular systolic dysfunction in patients with non-ST elevated acute coronary syndrome?
(Turkish Soc Cardiology, 2015) Bekler, Adem; Gazi, Emine; Yilmaz, Mustafa; Temiz, Ahmet; Altun, Burak; Barutcu, Ahmet; Peker, Tezcan
Objective: The prognostic value of a high platelet-lymphocyte ratio (PLR) has been reported in patients with non-ST elevated myocardial infarction (NSTEMI) and different oncologic disorders. We aimed to evaluate the predictive value of the PLR for left ventricular systolic dysfunction (LVSD) in patients with non-ST elevated acute coronary syndrome (NST-ACS). Methods: A total of 220 patients with NST-ACS were included in the study. The study population was divided into tertiles based on admission PLR values. High (n=73) and low PLR (n=147) groups were defined as patients having values in the third tertile (>135.6) and lower 2 tertiles (<= 135.6), respectively. Left ventricular dysfunction was defined as ejection fraction <= 40%, and related variables were evaluated by backward conditional binary logistic regression analysis. Results: The patients in the high PLR group were older (p<0.001) and had a higher rate of previous myocardial infarction and NSTEMI (p=0.046, p=0.013, respectively). There were significantly more coronary arteries narrowed (p=0.001) and lower left ventricular ejection fraction (p<0.001) in the high PLR group. Baseline platelet levels were significantly higher (p<0.001) and triglyceride and lymphocyte levels were significantly lower (p=0.009 and p<0.001, respectively) in the high PLR group. PLR >135.6 was found to be an independent predictor of systolic dysfunction in the multivariate analyses (beta: 0.306, 95% confidence interval: 0.151-0.619; p=0.001). Conclusion: A high PLR is a strong and independent predictor for LVSD in patients with NST-ACS.
Could Epicardial Adipose Tissue Thickness by Echocardiography Be Correlated with Acute Coronary Syndrome Risk Scores
(Wiley, 2013) Altun, Burak; Colkesen, Yucel; Gazi, Emine; Tasolar, Hakan; Temiz, Ahmet; Simsek, Hicran Yildiz; Barutcu, Ahmet
AimThe aim of our study was, echocardiographic epicardial adipose tissue (EAT) thickness could show the severity and the prognosis of acute coronary syndromes (ACS). Methods and ResultsSixty-five ACS patients (mean age 57.412.2years) who underwent coronary angiography were studied. EAT thickness on the free wall of right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles. SYNTAX and Global Registry of Acute Coronary Events (GRACE) scoring considered for severity and the prognosis of ACS. The mean value of the EAT thickness were 5.5 +/- 0.5mm (range 1-12mm). EAT thickness had a positive correlation with high sensitive troponin T (r=0.712, P<0.001) and body mass index (r=0.522, P<0.001.) EAT thickness was significantly correlated patients with high SYNTAX score (r=0.690, P<0.001), but not correlated with GRACE score (r=0.224, P=0.072). ConclusionEpicardial adipose tissue thickness was correlated with angiographic severity of ACS, but not correlated with clinical prognosis risk score.
Covered stents may provide extra protection during carotid artery stenting in high risk patients with an excessive thrombus burden
(2013) Tatli, Ersan; Barutcu, Ahmet; Gazi, Emine; Gunduz, Yasemin
Carotid artery disease is an important cause of mortality and morbidity related to atherosclerosis. Recently, percutaneous intervention procedures have been widely used to treat atherosclerotic carotid artery disease. We report the case of a 57-year-old male patient with a history of acute amaurosis fugax. Carotid angiography was performed as blood pressure differed between his left and right arms and there was a pan-systolic murmur on the left common carotid artery. Total occlusion of the proximal right brachiocephalic artery and a thrombus occluding 90-99% of the left internal carotid artery were detected by carotid angiogram. A self-expanding graft-covered stent was successfully implanted and there were no complications. This case shows that graft-covered stents may be a good alternative technique in special situations. Copyright 2013 BMJ Publishing Group. All rights reserved.

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