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Öğe 3D STRESS ECHOCARDIOGRAPHY EASIER TO USE COMPARED TO CONVENTIONAL METHOD PROVIDES HIGH PREDICTION RATE OF CORONARY ARTERY DISEASE(Elsevier Ireland Ltd, 2010) Kirilmaz, Bahadir; Turk, Ugur Onsel; Saygi, Serkan; Dogan, Huseyin; Tengiz, Istemihan; Ercan, Ertugrul[Anstract Not Available]Öğe A Floating Thrombus in Sinus of Valsalva Complicated with Cardiogenic Shock in a Patient with Plasminogen Activator Inhibitor 1 4G/5G Polymorphism(Wiley-Blackwell, 2011) Saygi, Serkan; Alioglu, Emin; Karabulut, Mehmet Nuri; Turk, Ugur Onsel; Kirilmaz, Bahadir; Tuzun, Nurullah; Sahin, FahriThrombus in sinus of Valsalva is unusual reason for acute myocardial infarction. We demonstrated a case with floating thrombus in sinus of Valsalva obstructing the right coronary ostium intermittently, and causing cardiogenic shock. The patient was diagnosed with multiplane transesophageal echocardiography and treated successfully with surgical removal of mass. A homozygote polymorphism of plasminogen activator inhibitor (PAI) 1 4G/5G was found. This is the first report demonstrating a patient with PAI 1 polymorphism and thrombus of Valsalva complicated with cardiogenic shock. (Echocardiography 2011;28:E64-E167)Öğe Association Between Inherited Thrombophilia and Impaired Right Ventricular Function in Deep Vein Thrombosis Without Symptomatic Pulmonary Embolism(Sage Publications Inc, 2014) Asgun, Halil Fatih; Kirilmaz, Bahadir; Saygi, Serkan; Ozturk, Okan; Sılan, Fatma; Karatag, Ozan; Kosar, SuleThe aim was to evaluate the right ventricular function in patients with inherited thrombophilia and deep vein thrombosis (DVT) without pulmonary embolism. A total of 38 patients with DVT without symptomatic pulmonary embolism and 30 patients with varicose veins were enrolled. Clinical data, echocardiography, and 2 thrombophilic mutations were analyzed. Factor V Leiden (FVL) polymorphism was significantly frequent in the study group (P = .007). The difference in prothrombin G20210A polymorphism between the study and control groups was at a near-significant level (P = .058). There was statistically significant decrease in tricuspid annular plane systolic excursion values in patients with FVL and prothrombin G20210A polymorphism. Combined FVL and prothrombin G20210A polymorphisms were more closely related to the decrease in this value (P = .006). Deep vein thrombosis had no additional adverse effects on right ventricle. Impaired right ventricular systolic function occurs in FVL and prothrombin G20210A polymorphisms.Öğe Atrial fibrillation and the role of LAA in pathophysiology and clinical outcomes?(2012) Saygi, SerkanLeft atrial appendage (LAA) is a source of thromboembolism especially in patients with non valvular atrial fibrillation (AF). It is reasonable to accept LAA as a distinct part of left atrium (LA) with unique anatomical and physiological properties. Advances in imaging modalities increased the knowledge about anatomical and physiological characteristics of LAA. It is important to prevent the AF patients from systemic thromboembolic events, and new pharmacological and non pharmacological management approaches demonstrate encouraging results. Also pulmonary vein isolation which has been accepted as a curative and useful treatment option for the treatment of drug resistant AF has been helpful in understanding the electrophysiological properties of LAA. Accumulating data revealed that LAA continues to be the one of the most important structure of heart during AF because of its distinctive anatomical, mechanical, and electrophysiological properties.Öğe Digoxin intoxication: An old enemy in modern era(Science Press, 2012) Kirilmaz, Bahadir; Saygi, Serkan; Gungor, Hasan; Turk, Ugur Onsel; Alioglu, Emin; Akyuz, Serdar; Asgun, FatihObjectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era. Methods We analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph (ECG) findings, and serum digoxin levels > 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxin use, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients. Results Thirty-eight of 71 patients (53.5%) had symptoms of heart failure during admission or later. Sixty-four percent of patients were older than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequent in the females (64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008, respectively). The mortality rate during the hospital course was 7%. Conclusions This report demonstrated the reduced mortality rates in patients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.Öğe G protein ?3 subunit gene polymorphism in Turkish hypertensives(Turkish Soc Cardiology, 2008) Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Yildiz, Ahmet; Tuerk, Ugur Oensel; Saygi, Serkan; Cam, F. SirriObjective: G protein is one of the most important regulators of intracellular signaling pathways. C825T polymorphism of G protein (33 subunit is associated with increased intracellular signal transduction. The 825T allele has been found associated with a variety of cardiovascular risk factors, including hypertension. The aim of the present study was to investigate the association between the C825T polymorphism of the G protein beta 3 subunit and essential hypertension in Turkish population. Methods: This cross-sectional, case-controlled study included 209 patients with essential hypertension (Patient group) and 82 subjects with normal blood pressure (Control group). The G protein 133 subunit C825T gene polymorphism was determined by polymerase chain reaction. Hypertension was defined according to JNC VII criteria. Statistical analysis was performed using Chi square and unpaired t tests. Logistic regression analysis was used to study association between hypertension and genotypes. Results: We found that the frequencies of the G protein 133 subunit C825T polymorphism in hypertensive and control groups were 17.7%, 59.3%, 23.0% and 32.9%, 48.8%, 18.3%, (CC, CT, TT) respectively (chi(2)=7.963, p=0.019). In the multivariate logistic regression analysis CT genotype had 2.2 (OR=2.262, 95% CI 1.228-4.167, p=0.009), and TT genotype had 2.3 times (OR=2.335, 95% CI 1.089-5.008, p=0.029) greater risk of hypertension compared to CC genotype. Conclusion: It seems that the G protein (33 subunit C825T gene polymorphism is associated with systolic and diastolic blood pressure. Furthermore, the study indicates that the G protein 133 subunit may be a susceptible gene to essential hypertension. (Anadolu Kardiyol Derg 2008; 8: 337-5)Öğe High Inflammatory Activity Related to the Number of Metabolic Syndrome Components(Wiley, 2010) Kirilmaz, Bahadir; Asgun, Fatih; Alioglu, Emin; Ercan, Ertugrul; Tengiz, Istemihan; Turk, Ugur; Saygi, SerkanIt has been known that each component of the metabolic syndrome (MS) has an atherogenic potential and increases the risk of cardiovascular events. Therefore, patients who have MS are candidates for the development of atherosclerosis and accompanying complications. In this study, the authors assessed the levels of acute phase reactants as an indicator of inflammation in patients with MS. Twenty-five patients with recently diagnosed MS and not treated before who had at least 3 of 5 diagnostic criteria of MS listed in the Third Report of the Adult Treatment Panel National Cholesterol Education Program (NCEP-ATP III) guidelines were included in the study. Twenty healthy patients constituted the control group. Inflammatory parameters were compared between the groups. There was no significant difference between the MS and control group with regard to age and sex. White blood cell count (/mm(3)), high-sensitivity C-reactive protein (hs-CRP), uric acid, interleukin (IL) 6, and fibrinogen levels were found to be significantly higher in the MS group. Number of MS components was strongly correlated with serum levels of hs-CRP (r=0.688, P=.0001), IL-6 (r=0.546, P=.0001), fibrinogen (r=0.551, P=.0001), uric acid (r=0.517, P=.0001), and leucocyte count (/mmr3) (r=0.456, P=.002). Inflammation plays an important role in atherosclerotic complications, which is activated in MS. Increased number of MS components are strongly associated with elevated inflammatory and metabolic markers. Measurement of serum inflammatory parameters in patients with MS may be beneficial in detection and management of cardiovascular events and in the assessment of efficacy of treatment. J Clin Hypertens (Greenwich). 2010;12:136-144. (C)2009 Wiley Periodicals, Inc.Öğe Left atrial appendage function in mitral stenosis: Is it determined by cardiac rhythm?(2011) Saygi, Serkan; Turk, Ugur Onsel; Alioglu, Emin; Kirilmaz, Bahadir; Tengiz, Istemihan; Tuzun, Nurullah; Ercan, ErtugrulBackground and aim of the study: The left atrial appendage (LAA) is a common source of cardiac thrombus formation associated with systemic embolism in patients with mitral stenosis (MS). Low flow velocities in the LAA are important factors in the development of thrombosis. Whilst oral anticoagulant therapy is used routinely in MS with atrial fibrillation (AF), the characteristics of LAA contractile functions and the protective role of oral anticoagulant treatment in patients with MS in sinus rhythm (SR) are unclear. The study aim was to compare LAA contractile functions in patients with MS who were either in SR or had AF. Methods: The study population comprised 51 patients with MS, who had undergone both standard transthoracic and transesophageal echocardiography. The patients were allocated to two groups, according to the presence of AF or SR. Ten healthy, gendermatched subjects were included in the study as a control group. Results: Except for age, the characteristics of the groups were similar. In patients with SR and AF, the LAA contractile functions were significantly lower than in controls. While the LAA contractile functions of the SR group were significantly lower than the AF group (LAA emptying/filling velocity: 26 ± 7/24 ± 8 versus 19 ± 5/17 ± 5 cm/s; p = 0.002 and p = 0.001, respectively, LAA maximum/minimum area: 5.4 ± 1.2/3.2 ± 0.9 versus 6.2 ± 1.1/3.7 ± 0.8 cm2, p = 0.02 and p =0.02, respectively), no statistically significant differences were observed between patients in SR with mitral valve area (MVA) ?1.5 cm 2 and patients in AF. Four SR patients (13%) and six AF patients (27%) had LAA thrombus. A strong correlation was observed between the MVA and LAA peak emptying/filling velocity in patients with MS in SR (r = 0.739, p = 0.0001 and r = 0.728, p = 0.0001, respectively). Conclusion: The study results showed that LAA contractile function is diminished in patients with mod-erate- severe MS in SR, and to a similar degree as patients in AF. It was concluded that patients with moderate-severe MS in SR have a higher risk for thromboembolic events than MS patients in AF. © Copyright by ICR Publishers 2011.Öğe Left Atrial Appendage Function in Mitral Stenosis: Is It Determined by Cardiac Rhythm?(I C R Publishers, 2011) Saygi, Serkan; Turk, Ugur Onsel; Alioglu, Emin; Kirilmaz, Bahadir; Tengiz, Istemihan; Tuzun, Nurullah; Ercan, ErtugrulBackground and aim of the study: The left atrial appendage (LAA) is a common source of cardiac thrombus formation associated with systemic embolism in patients with mitral stenosis (MS). Low flow velocities in the LAA are important factors in the development of thrombosis. Whilst oral anticoagulant therapy is used routinely in MS with atrial fibrillation (AF), the characteristics of LAA contractile functions and the protective role of oral anticoagulant treatment in patients with MS in sinus rhythm (SR) are unclear. The study aim was to compare LAA contractile functions in patients with MS who were either in SR or had AF. Methods: The study population comprised 51 patients with MS, who had undergone both standard transthoracic and transesophageal echocardiography. The patients were allocated to two groups, according to the presence of AF or SR. Ten healthy, gender-matched subjects were included in the study as a control group. Results: Except for age, the characteristics of the groups were similar. In patients with SR and AF, the LAA contractile functions were significantly lower than in controls. While the LAA contractile functions of the SR group were significantly lower than the AF group (LAA emptying/filling velocity: 26 +/- 7/24 +/- 8 versus 19 +/- 5/17 +/- 5 cm/s; p = 0.002 and p = 0.001, respectively, LAA maximum/minimum area: 5.4 +/- 1.2/3.2 +/- 0.9 versus 6.2 +/- 1.1/3.7 +/- 0.8 cm(2), p = 0.02 and p =0.02, respectively), no statistically significant differences were observed between patients in SR with mitral valve area (MVA) <= 1.5 cm(2) and patients in AF. Four SR patients (13%) and six AF patients (27%) had LAA thrombus. A strong correlation was observed between the MVA and LAA peak emptying/filling velocity in patients with MS in SR (r = 0.739, p = 0.0001 and r = 0.728, p = 0.0001, respectively). Conclusion: The study results showed that LAA contractile function is diminished in patients with moderate-severe MS in SR, and to a similar degree as patients in AF. It was concluded that patients with moderate-severe MS in SR have a higher risk for thromboembolic events than MS patients in AF.Öğe Long pentraxin-3 measured at late phase associated with GRACE risk scores in patients with non-ST elevation acute coronary syndrome and coronary stenting(Aves, 2012) Saygi, Serkan; Kirilmaz, Bahadir; Tengiz, Istemihan; Turk, Ugur Onsel; Yildiz, Hicran; Tuzun, Nurullah; Alioglu, EminObjectives: We analyzed pentraxin 3 (PTX3) levels and the relation of PTX3 levels with GRACE risk scores in 39 patients with non-ST elevation acute coronary syndrome (ACS) and stabile angina after stenting. Study design: Seventeen patients with ACS and 22 patients with stabile angina who underwent coronary stenting were included in the study. PTX3 levels were measured serially at admission, at the 8th hour and at the 24th hour after stenting. Results: While diabetes and hypertension were more frequent in the stabile angina group, leukocyte counts were significantly higher in the ACS group. PTX3 levels measured at the 8th hour were significantly higher in the ACS group compared to the stabile angina group (p=0.003). Strong correlations were observed between 24th hour PTX3 levels and GRACE scores calculated for risk of death and death/MI at admission (in-hospital/to 6 months), and for risk of death/MI at discharge to 6 months (R=0.571, p=0.01, R=0.564, p=0.01; R=0.558, p=0.02, R=0.512, p=0.03; R=0.653, p=0.004, respectively). Conclusion: The serum PTX3 levels may provide important information for the early risk stratification of patients with ACS who underwent coronary stenting.Öğe N-Acetylcysteine in Preventing Contrast-Induced Nephropathy Assessed by Cystatin C(Wiley-Hindawi, 2013) Alioglu, Emin; Saygi, Serkan; Turk, Ugur; Kirilmaz, Bahadir; Tuzun, Nurullah; Duman, Can; Tengiz, IstemihanAims: Prophylactic oral N-acetylcysteine (NAC) has been widely used for prevention of contrast-induced nephropathy (CIN). However, clinical studies have not been demonstrating this effect consistently because of evidence that NAC can alter serum creatinine levels without affecting glomerular filtration rate (GFR). We investigated NAC for the prevention of CIN by monitoring creatinine and cystatin C. Methods: We enrolled 113 patients (49 patients in NAC group and 64 patients in control group) with normal to subnormal GFR who were scheduled for cardiovascular procedures. Patients in NAC group receive acetylcysteine 600 mg twice a day, on the day before and on the day of cardiovascular procedure. All patients received a periprocedural intravenous infusion (volume expansion) of 1 ml/kg/h with 0.45% saline for 24 h (12 h before and 12 h after exposure to contrast medium). Serum cystatin C and creatinine levels were measured before and at 12, 24, and 48 h after procedure. Results: The incidence of cystatin C-based CIN was 28.5% (n = 14) in NAC and 23.4% (n = 15) in control group (p = 0.663) and serum creatinine-based CIN was 12.2% (n = 6) in NAC and 17.2% (n = 11) in control group (P= 0.468). In this study, oral NAC had no effect on the prevention of CIN in patients undergoing cardiovascular procedures. Conclusion: In this study, oral NAC administration does not reduce neither the incidence of cystatin C-based CIN nor serum creatinine-based CIN in patients undergoing cardiovascular procedures.Öğe Non ST-segment elevation myocardial infarction in patient with essential thrombocythemia(BMC, 2009) Alioglu, Emin; Tuzun, Nurullah; Sahin, Fahri; Kosova, Buket; Saygi, Serkan; Tengiz, Istemihan; Turk, UgurA 68-year-old woman presented with acute chest pain and a greatly increased platelet count. Cardiac catheterization revealed subtotal occlusion and a thrombus-like filling defect in the right coronary artery. The patient was successfully treated with intravenous tirofiban. Essential thrombocythemia was diagnosed based on bone marrow findings, clinical presentation and laboratory analysis. The relationship between intracoronary thrombus and essential thrombocythemia is discussed.Öğe Reel syndrome: dislodgement of an active fixation lead(Turkish Soc Cardiology, 2013) Saygi, Serkan; Kirilmaz, Bahadir; Yildiz, Hicran; Ercan, Ertugrul[Anstract Not Available]Öğe Thrombotic occlusion of a left main coronary artery in a patient with prosthetic mitral valve(Turkish Soc Cardiology, 2010) Saygi, Serkan; Alioglu, Emin; Turk, Ugur; Tuzun, Nurullah; Kirilmaz, Bahadir; Tengiz, Istemihan; Ercan, Ertugrul[Anstract Not Available]
