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Öğe Assessment of atrial electromechanical delay in patients with polycystic ovary syndrome in both lean and obese subjects(Wiley, 2014) Tasolar, Hakan; Mete, Turkan; Balli, Mehmet; Altun, Burak; Cetin, Mustafa; Yuce, Tuncay; Tasolar, SevgiAimEven though polycystic ovary syndrome (PCOS) is characterized by increased inflammatory activity and insulin resistance, there is no clinical data about whether risk of atrial fibrillation are increased in these patients. We aimed to evaluate atrial conduction parameters predicting atrial involvement in this patient group. MethodsThe study population comprised 50 women 18-40 years of age who had been diagnosed with PCOS. The patients were divided into two groups: lean women (L-PCOS) with a body mass index (BMI) under 25kg/m(2) and obese women (O-PCOS) with a BMI greater than 30kg/m(2). Twenty-five age-matched lean healthy women were enrolled voluntarily as the control group. Difference between maximum and minimum P-wave duration was calculated and was defined as P-wave dispersion (Pd). Inter- and intra-atrial electromechanical delays (inter-AED, intra-AED, respectively) were measured with tissue Doppler imaging. ResultsInter- and intra-AED parameters were higher in the L-PCOS group when compared with control subjects (anova, P=0.004 and P=0.013, respectively), and were also significantly higher in the O-PCOS group compared with other groups (anova, P<0.001 for both). The regression analyses indicated that Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR) (=0.603, P<0.001) and BMI (=0.379, P<0.001) were the independent predictors of inter-AED, HOMA-IR (=0.835, P<0.001) was an independent predictor of intra-AED, and BMI (=0.457, P=0.006) and the left atrial diameter (=0.350, P<0.034) were independent predictors of Pd. ConclusionConsequently, our findings provide data regarding prolonged atrial conduction parameters in PCOS patients, especially when accompanied by obesity.Öğe Assessment of Diastolic Function with Mitral Annular Plane Systolic Excursion in Obese Adults(Elsevier Science Inc, 2013) Tasolar, Hakan; Mete, Turkan; Cetin, Mustafa; Altun, Burak; Balli, Mehmet; Bayramoglu, Adil; Otlu, Omur[Anstract Not Available]Öğe Assessment of serum hepcidin levels in patients with non-ST elevation myocardial infarction(Turkish Soc Cardiology, 2014) Altun, Burak; Altun, Mehzat; Acar, Gurkan; Kilinc, Metin; Tasolar, Hakan; Kucuk, Ahmet; Temiz, AhmetObjective: Hepcidin is an acute-phase reactant produced in the liver displaying intrinsic antimicrobial activity. There are few studies about hepcidin considered to be acute and chronic inflammatory marker in acute coronary syndromes patients. We investigated in our study whether the level of hepcidin has increased in the acute phase of non-ST elevation myocardial infarction patients (NSTEMI) known as acute inflammatory aggravation of chronic atherosclerotic process. Methods: Seventy patients with NSTEMI and twenty healthy people were recruited as controls in this observational cross-sectional study. Serum hepcidin levels were determined by ELISA, and troponin levels were measured by standard laboratory methods. Levels of hepcidin and troponin were measured at admission and 6 hours later. Mean values of continuous variables were compared between groups using the Student t-test or Mann-Whitney U test, according to whether normally distributed or not, as tested by the Kolmogorov-Smirnov test. Serum troponin and hepcidin levels measured at admission and after 6th hours were compared using paired t-test. Results: Hepcidin level was similar between NSTEMI and controls at admission (24.55 +/- 32.13, 23.67 +/- 33.62 ng/mL, p>0.05, respectively). Also, serum hepcidin levels did not change significantly from baseline in blood samples taken after 6 hour from admission in NSTEMI patients (24.55 +/- 32.13 ng/mL, 29.75 +/- 31.48 ng/mL, p=0.62, respectively). However, serum troponin levels were increased significantly compared to baseline (0.29 +/- 3.56, 2.92 +/- 7.2 ng/mL, p<0.01). Conclusion: Our findings suggest that hepcidin could not be use as a marker of myocardial necrosis in acute phase such as troponin in patients with NSTEMI.Öğe Assessment of serum hepcidin levels in patients with non-ST elevation myocardial infarction Reply(Turkish Soc Cardiology, 2015) Altun, Burak; Tasolar, Hakan; Altun, Mehzat[Anstract Not Available]Öğe 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, AhmetObjective: 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.Öğe 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, AhmetAimThe 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.Öğe Effect of smoking on Tp-e interval, Tp-e/QT and Tp-e/QTc ratios as indices of ventricular arrhythmogenesis(Elsevier Science Inc, 2013) Tasolar, Hakan; Balli, Mehmet; Cetin, Mustafa; Altun, Burak; Cakici, Musa; Bayramoglu, Adil; Otlu, Omur[Anstract Not Available]Öğe Effect of Smoking on Tp-e Interval, Tp-e/QT and Tp-e/QTc Ratios as Indices of Ventricular Arrhythmogenesis(Elsevier Science Inc, 2014) Tasolar, Hakan; Balli, Mehmet; Bayramoglu, Adil; Otlu, Yilmaz Omur; Cetin, Mustafa; Altun, Burak; Cakici, MusaBackground Smoking may lead to ventricular arrhythmias and sudden cardiac death via altering ventricular recovery time dispersion indices such as QT interval and QT dispersion (QTd). The Tp-e/QT and Tp-e/QTc ratios are also known as predictors of ventricular arrhythmogenesis. The aim of this study was to evaluate the relationship between cigarette smoking and ventricular repolarisation dispersion using these novel electrocardiographic parameters. Methods One hundred and twenty-one chronic smokers and 70 age- and sex-matched non-smoker controls were included in our study. The Tp-e interval and Tp-e/QT ratio were measured by 12-lead electrocardiogram, and corrected for heart rate. Results QTd (34.2 +/- 8.4, 27.2 +/- 10.4, P < 0.001) and corrected QTd (37.3 +/- 8.9, 29.8 +/- 11.2, P < 0.001) were significantly increased in the smokers compared to the non-smoker control group. The Tp-e interval (76.5 +/- 6.3, 70.3 +/- 6.8, P < 0.001), cTp-e interval (83.5 +/- 8.0, 77.1 +/- 8.7, P <0.001), Tp-e/QT (0.20 +/- 0.03, 0.19 +/- 0.02, P < 0.001) and Tp-e/QTc ratios (0.19 +/- 0.02, 0.17 +/- 0.02, P < 0.001) were increased in the patient group when compared to the controls. Significant positive correlations were also found between the level of smoking with the cTp-e interval (r = 0.836, P <0.001), and Tp-e/QT (r = 0.714, P <0.001) and Tp-e/QTc ratios (r = 0.448, P < 0.001). Conclusion We found in our study that cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in smokers and significantly correlated to the amount of smoking.Öğe Effects of Coronary Collateral Circulation on Tp-e interval, Tp-e/QT and Tp-e/QTc Ratios in Coronary Artery Disease Patients(Elsevier Science Inc, 2013) Tasolar, Hakan; Otlu, Omur; Bayramoglu, Adil; Balli, Mehmet; Cetin, Mustafa; Altun, Burak; Pekdemir, Hasan[Anstract Not Available]Öğe Effects of the Coronary Collateral Circulation on the Tp-e Interval and Tp-e/QT Ratio in Patients with Stable Coronary Artery Disease(Wiley, 2015) Tasolar, Hakan; Balli, Mehmet; Cetin, Mustafa; Otlu, Yilmaz Omur; Altun, Burak; Bayramoglu, AdilBackgroundThe clinical utility of the Tp-e interval and Tp-e/QT ratio in the risk stratification of ventricular arrhythmic events is controversial. Therefore, we investigated the impact of CCC on these electrocardiographic indexes in the course of stable CAD. MethodsTwo hundred three consecutive patients with stable CAD who underwent coronary angiography and had documented total occlusion of one of the major coronary arteries were enrolled in this prospective cross-sectional study. The Tp-e interval and Tp-e/QT ratio were measured by 12-lead electrocardiogram. ResultsThe Tp-e interval, cTp-e interval, Tp-e/QT ratio, and cTp-e/QT ratio were lower in the grade 3 CCC group compared with the others in all leads. Multivariate linear regression analyses was performed to identify the clinical factors affecting the cTp-e interval and was indicated that age ( = 0.261, P < 0.001), male sex ( = 0.334, P < 0.001), poor Rentrop grade ( = -0.228, P < 0.001), and NLR ( = 0.137, P = 0.027) were independent predictors of a prolonged cTp-e interval. ConclusionIt could be concluded that the decreased dispersion of ventricular repolarization might contribute to the lower incidence of ventricular arrhythmias and SCD in CAD patients with a good CCC.Öğe Endothelial nitric oxide synthase levels and their response to exercise in patients with slow coronary flow(Clinics Cardive Publ Pty Ltd, 2013) Tasolar, Hakan; Eyyupkoca, Ferhat; Akturk, Erdal; Karakus, Yasin; Cansel, Mehmet; Yagmur, Julide; Ozyalin, FatmaBackground: Endothelial dysfunction plays a key role in the aetiopathogenesis of slow coronary flow (SCF) even if there is no obstructive epicardial lesion. Reduced plasma levels of endothelial nitric oxide synthase (eNOS) are an important indicator of endothelial dysfunction. We aimed to determine plasma levels of eNOS and their relationship with exercise in patients with SCF. Methods: Twenty-two patients with SCF in at least one coronary artery and 17 healthy individuals were included in this study. The TIMI frame count method was used to determine SCF. Plasma levels of eNOS before and after effort were determined in the patient and control groups. Results: Basal eNOS levels in the patient group were lower than in the control group (p = 0.040), and plasma eNOS levels after exercise decreased more significantly in the patient group compared to the control group (p = 0.002). Median decreases of eNOS in response to exercise were higher in the SCF group than in the control group (p < 0.001), and the decrease observed in the control group was not statistically significant (p = 0.35). There were significantly negative correlations between TIMI frame count and plasma levels of eNOS at baseline and after exercise (r = -0.51, p = 0.015, r = -0.58, p = 0.005, respectively). Moreover, there was also a positive correlation between the rate-pressure product and plasma levels of eNOS after exercise in patients with SCF (r = 0.494, p = 0.019). Conclusion: Our findings indicate an important pathophysiological relationship between the severity of SCF in which endothelial dysfunction plays a role in its pathogenesis and the level of circulating plasma levels of eNOS.Öğe Epicardial Adipose Tissue Thickness in Hemodialysis Patients(Wiley, 2014) Altun, Burak; Tasolar, Hakan; Eren, Necmi; Binnetoglu, Emine; Altun, Mehzat; Temiz, Ahmet; Gazi, EmineAim: Hemodialysis (HD) patients had higher cardiovascular mortality and it is related to atherosclerosis. Epicardial adipose tissue (EAT) thickness is a marker of atherosclerosis and independent predictor of coronary artery disease. The aim of our study was to evaluate the relationship between EAT and carotid intima-media thickness (CIMT) predictors of early atherosclerosis in HD patients. Methods: The study included 62 HD patients and 40 healthy controls. EAT thickness and CIMT were measured by echocardiography in all subjects. Results: Epicardial adipose tissue thickness and CIMT were higher (6.98 +/- 1.67 vs. 3.84 +/- 0.73 mm, P < 0.001, 0.94 +/- 0.17 vs. 0.63 +/- 0.11 mm, P < 0.001, respectively) in HD patients than in control subjects. EAT thickness were correlated with CIMT, HD duration, age, and calcium. In addition, HD duration, CIMT, and age were independent predictors of EAT thickness on HD patients in regression analysis. Conclusion: Epicardial adipose tissue thickness may be a useful indicator of early atherosclerosis in HD patients.Öğe Increased Epicardial Adipose Tissue Thickness in Patients with Behcet's Disease(Elsevier Science Inc, 2013) Tasolar, Hakan; Tasolar, Sevgi; Kurtulus, Duygu; Altun, Burak; Bayramoglu, Adil; Otlu, Omur; Balli, Mehmet[Anstract Not Available]Öğe Increased Epicardial Adipose Tissue Thickness on Transthoracic Echocardiography in Patients With Behget Disease(Wiley, 2014) Tasolar, Hakan; Tasolar, Sevgi; Kurtulus, Duygu; Altun, Burak; Bayramoglu, Adil; Omur, Yilmaz; Balli, MehmetObjectives-Owing to the fact that the potential frequency of endothelial dysfunction and early atherosclerosis might be higher in Behcet disease, characterized by acute and chronic inflammatory attacks, it may lead to impairment in flow-mediated dilatation and an increase in epicardial adipose tissue thickness. Therefore, we aimed to evaluate whether epicardial adipose tissue thickness and brachial artery flow-mediated dilatation as markers of early atherosclerosis and endothelial dysfunction were associated with Behcet disease. Methods-Thirty-five patients with Behcet disease and 35 healthy volunteers were included in this study. Epicardial adipose tissue was identified as an anechoic space between epicardial layers on 2-dimensional images, and its thickness was measured on the free wall of the right ventricle. Right brachial artery flow-mediated dilatation was assessed according to recent guidelines. Results-Serum gamma-glutamyl transferase (GGT) levels and epicardial adipose tissue thickness were significantly higher (P = .001; P < .001 respectively), whereas flow-mediated, endothelium-dependent dilatation was significantly lower in the Behcet disease group than controls. (P < .001). There was a significant negative association between epicardial adipose tissue thickness and flow-mediated dilatation (P < .001). Epicardial adipose tissue thickness was also positively correlated with Behcet disease activity (P < .001), Behcet disease duration (P < .001), and waist circumference (P < .001). Flow-mediated dilatation was negatively correlated with GGT (P < .001), Behcet disease activity (P < .001), and age (P < .001). There was also a significant association between GGT and Behcet disease activity (P < .001). Conclusions-We found that epicardial adipose tissue thickness was significantly higher and flow-mediated dilatation was significantly lower in patients with Behcet disease than in controls. We suggest that identification of increased epicardial adipose tissue might aid in the diagnosis and treatment of possible coronary artery disease in patients with Behcet disease.Öğe Is the level of resistin appropriate for predicting atrial fibrillation?(Elsevier Science Bv, 2014) Tasolar, Hakan; Balli, Mehmet; Cetin, Mustafa; Altun, Burak[Anstract Not Available]Öğe Mitral annular plane systolic excursion in the assessment of left ventricular diastolic dysfunction in obese adults(Turkish Soc Cardiology, 2015) Tasolar, Hakan; Mete, Turkan; Cetin, Mustafa; Altun, Burak; Balli, Mehmet; Bayramoglu, Adil; Otlu, Yilmaz OmurObjective: Mitral annular plane systolic excursion (MAPSE) is a simple way to assess left ventricle (LV) function. MAPSE is also correlated to parameters, illustrating the close relation between systolic and diastolic function of LV. In this study, we evaluated whether MAPSE could help us in the determination the LV diastolic dysfunction (DD) in obese adults. Methods: Our study was a prospective cross-sectional study. Obese patients who were referred from the endocrinology clinic were enrolled into this study. The participants included 40 obese patients with early-stage DD (grade I and II) and 40 obese patients with normal diastolic function, with an equal number of males and females. The patients with DD were further divided into Obese DD+I, who had grade I DD, and Obese DD+II, who had grade II DD. Student t-test, Mann-Whitney U test, one-way analysis of variance, ROC curve analysis, and pairwise comparisons of the ROC curves were used for statistical analysis. Results: MAPSE was different in all groups, with the lowest value in the Obese DD+II group (p<0.001). E/Em ratio was also different among all groups and was highest in the Obese DD+II group (p<0.001). Furthermore, MAPSE was negatively correlated with E/Em ratio (r=-0.368, p=0.020). The optimal threshold point of MAPSE in the diagnosis of left ventricle diastolic dysfunction (LVDD) was <= 1.45 cm, with 92.5% sensitivity (95% CI 79.6-98.4) and 77.5% specificity (95% CI 61.5-89.2) in the ROC curve analysis. There was no difference in the pairwise comparisons of the ROC curves of MAPSE and E/Em ratio in the diagnosis of DD [area under the ROC curve 0.902 (0.033) vs. 0.927 (0.027); p=0.54]. Conclusion: Consequently, we found significantly a close relationship between MAPSE with conventional echocardiographic parameters, especially with E/Em, in the detection of left ventricle diastolic dysfunction (LVDD) in obese adults with normal LV ejection fraction. We think that MAPSE is a simple, easily acquired and less time consuming measurement and may help us in the stratification of LVDD in obese adults.Öğe The relationship between high-sensitive troponin T, neutrophil lymphocyte ratio and SYNTAX Score(Informa Healthcare, 2014) Altun, Burak; Turkon, Hakan; Tasolar, Hakan; Beggi, Halil; Altun, Mehzat; Temiz, Ahmet; Gazi, EmineAim. Cardiac troponins are the most preferred biomarkers in the evaluation of acute coronary syndromes (ACS). The aim of our study was to examine the association between high sensitive troponin T (hs-TnT), and neutrophil to lymphocyte ratio (NLR) and the complexity of ACS assessed by SYNTAX Score. Methods and results. 287 patients who underwent coronary angiography were studied (215 male, mean age 62.0 +/- 12.7 years). 133 patients were ST elevation myocardial infarction (STEMI), 154 patients were non-ST elevation (NSTE) ACS. The patients are divided to tertiles according to SYNTAX Score; SYNTAX Score <22 (n = 122) 22 < SYNTAX Score < 32 (n = 120), and SYNTAX Score >32 (n = 45). NLR was significantly correlated with SYNTAX Score in both STEMI and NSTE-ACS groups (r = 0.254, p = 0.003, r = 0.419 p < 0.001). Multiple linear regression analysis showed NLR predicted the angiographic severity of ACS assessed by SYNTAX Score in two groups (beta = 0.231, p = 0.004; beta = 0.232, p = 0.003). Hs-TnT was significantly correlated with SYNTAX Score in two groups (r = 0.327, p < 0.001; r = 0.430, p < 0.001). Multiple linear regression analysis showed hs-TnT was independent predictor of SYNTAX Score in STEMI and NSTE-ACS patients (beta = 0.292, p < 0.001; beta = 0.317, p < 0.001). Conclusion. Hs-TnT and NLR were significantly correlated with angiographic severity of ACS assessed by SYNTAX Score.
