Yazar "Duman, Dursun" seçeneğine göre listele
Listeleniyor 1 - 16 / 16
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Agreement between three-dimensional planimetry and mitral navigation method in the assessment of mitral valve area in rheumatic severe mitral stenosis(Taylor and Francis Ltd., 2021) Gök, Gülay; Çınar, Tufan; Duman, Dursun; Nurkelam, ZekeriyaIntroduction:Rheumatic heart disease predisposes to structural changes in the mitral valve including commissural fusion and calcification with subsequent narrowing of the mitral valve orifice resulting in rheumatic mitral stenosis (RMS). To define the best therapeutic strategy, an accurate measurement of mitral valve area (MVA) for RMS is of paramount importance. The propose of the present study was to assess the agreement between the mitral navigation method (MVN) and three-dimensional (3D) planimetry in the assessment of MVA in patients with RMS. Methods:Patients who were diagnosed with a different degree of mitral stenosis with the standard transthoracic echocardiography methods such as the pressure half time and planimetry underwent 3D transesophageal echocardiography (TEE) examination. 3D TEE zoom mitral valve planimetry was measured in the diastolic frame during the mitral valve's largest opening. By using MVN software of the Philips Q-Lab, MVA was measured at its maximum diastolic opening. Both 3D planimetry (3DPL) and MVN were measured at the mid diastole during the mitral valve's largest opening. Results:In this retrospective analysis, we examined consecutive 37 RMS patients (mean age 51.1 +/- 11.6 years, 31 patients were female). MVA measured by the MVN method was found to be highly correlated with the 3D MVA measured by 3DPL (r = 0.937,p<.001). Conclusions:Based on our results, we showed that the MVN method may be additionally used in detecting the severity of RMS.Öğe Attenuated cardiovascular response to sympathetic system activation during exercise in patients with dialysis-induced hypotension(Karger, 2011) Fotbolcu, Hakan; Duman, Dursun; Alışır Ecder, Sebahat; Oduncu, Vecih; Çevik, Cihan; Tigen, Kürşat; Şirin, Gökçe; Özker, Emre; Kıran, Burak; Başaran, YeldaBackground: We wished to investigate potential causes of dialysis-induced hypotension (DIH), including the attenuated cardiovascular response to sympathetic system activation during exercise and myocardial dysfunction. Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (Non-DIH), and 30 control subjects. Each patient was evaluated with echocardiography and a symptom-limited treadmill stress test. The chronotropic index (CRI), heart rate recovery (HRR), systolic blood pressure response to exercise (SBP response), and tissue Doppler systolic myocardial velocities were calculated. Results: The HRR and velocities were reduced in dialysis patients compared to controls; however, they were similar in patients with and without DIH. Patients with DIH had the lowest CRI compared to theNon-DIH group (0.62 ± 0.15 vs. 0.73 ± 0.17, p = 0.020) and controls (0.62 ± 0.15 vs. 0.86 ± 0.11, p < 0.001). Similarly, patients with DIH had the lowest SBP response values compared to the Non-DIH (34.88 ± 15.01 vs. 55.67 ± 25.42, p = 0.002) and controls (34.88 ± 15.01 vs. 59.70 ± 23.04, p < 0.001). Conclusion: Patients with DIH have inadequate sympathetic activity of the cardiovascular system during exercise and impaired left ventricular systolic function. Both factors could contribute to the development of hypotension during hemodialysis.Öğe Comparison of fluoro and cine angiographic modes in coronary stenting procedure: A preliminary feasibility study(Elsevier, 2014) Olcay, Ayhan; Güler, Ekrem; Karaca, İbrahim Oğuz; Kızılırmak, Filiz; Olgun, Fatih Erkam; Yenipınar, Esra; Duman, DursunX-ray exposure of patient during coronary angiography (CA) and percutaneous coronary intervention (PCI) may have some deleterious effects. The radiation dose per frame for digital acquisitions can be 15 times greater than that for fluoroscopy. The number and length of digital acquisition or cine “runs” may be the greatest source of patient radiation dose in interventional cardiology procedures. Last fluoroscopy hold (LFH) is a new advanced feature that dynamically stores only the last current sequence of fluoroscopy images for instant replay, editing and storage in radiography and fluoroscopy systems without the need for operator pre-setting. LFH could reduce the fluoroscopy time to half compared to when it is not used and enables the operator to examine the image as long as necessary for decision making without the use of radiation [1–7].Öğe Comparison of fluoro and cine coronary angiography: Balancing acceptable outcomes with a reduction in radiation dose(HMP Communications, 2015) Olcay, Ayhan; Güler, Ekrem; Karaca, İbrahim Oğuz; Omaygenç, Mehmet Onur; Kızılırmak, Filiz; Olgun, Erkam; Yenipınar, Esra; Çakmak, Hüseyin Altu?; Duman, DursunUse of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques. Methods. We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision. Results. Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 +/- 53542.71 mGy.cm(2) vs 11349.2 +/- 8796.46 mGy.cm(2); P<.001). Mean fluoroscopy times were higher in the cine group vs the LFH group (3.87 +/- 5.08 minutes vs 1.66 +/- 1.51 minutes; P<.01). Mean contrast use was higher in the cine group vs the LFH group (112.07 +/- 43.79 cc vs 88.15 +/- 23.84 cc; P<.001). Mean value of Crombach's alpha was not statistically different between visual estimates of three operators between cine and LFH angiography groups (0.66680 +/- 0.19309 vs 0.54193 +/- 0.31046; P=.20). Conclusion. Radiation doses, contrast use, and fluoroscopy times are lower in fluoroscopic LFH angiography vs cine angiography. Interclass variability of visual stenosis estimation between three operators was not different between cine and LFH groups. Fluoroscopic LFH images conventionally have inferior diagnostic quality when compared with cine coronary angiography, but with new angiographic systems with improved LFH image quality, these images may be adequate for diagnostic coronary angiography.Öğe Coronary calcium score, albuminuria and inflammatory markers in type 2 diabetic patients: Associations and prognostic implications(Elsevier, 2012) Dayan, Akın; Narin, Burcu; Biteker, Murat; Aksoy, Şükrü; Fotbolcu, Hakan; Duman, DursunAims: To investigate the relationship of coronary artery calcium (CAC) scores with common carotid artery intima media thickness (CCA-IMT), albuminuria and inflammatory factors in type 2 diabetes. Methods and results: 128 asymptomatic type 2 diabetic patients, with at least one cardiovascular risk factor in addition to diabetes, were included in the study. CAC scores, carotid arteries plaque formation and CCA-IMT were assessed. The patients were followed for a mean period of 36.6 +/- 3.3 months. Linear regression analysis identified the logarithmically transformed (Ln) albuminuria (beta = 0.32, P = 0.007), age (beta = 0.04, P = 0.001) and the uric acid (beta = 0.13, P = 0.04) as independent determinants of the CAC score. During follow-up period, cardiovascular events occurred in 18 out of 46 patients with CAC score >= 100 compared with 5 out of 82 patients with CAC score <100 (log rank, P < 0.0001). Multivariate Cox proportional hazards analysis identified LnCAC score (P < 0.0001), LnAlbuminuria (P = 0.01) and uric acid (P = 0.03) as independent predictors for cardiovascular events. Conclusions: There was a significant relationship between CAC score, albuminuria and inflammation in patients with type 2 diabetes. LnCAC score together with LnAlbuminuria and uric acid were identified as independent predictors of cardiovascular events in these patients.Öğe Correlation of pulse oximetry oxygen saturation with blood gas arterial oxygen saturation in patients with heart failure reduced ejection fraction: Prospective cohort study(Annals of Medical Research Publishing Inc, 2020) Gök, Gülay; Çınar, Tufan; Nurkalem, Zekeriya; Duman, DursunAbstract Aim: An estimation of accurate oxygen saturation is a critical in the management of patients with heart failure (HF). However, obtaining peripheral arterial blood samples may be technically difficult in some cases. The purpose of this study was to evaluate the correlation of pulse oximetry SO2 with arterial SO2 in patients with HF reduced ejection fraction (HFrEF). Material and Methods: In total, 29 consecutive patients who were admitted to cardiology clinics with HFrEF were prospectively enrolled in this study. We enrolled all patients if the chief physician ordered an atrial blood gas analysis. Simultaneous atrial blood gas sample and pulse oximetry measurements were collected and compared. The strength of association between atrial blood gas and pulse oximetry measurements was determined by Pearson correlation and Bland and Altman analysis. Results: We evaluated 29 heart failure patients (the mean age was; 70.7±10.9, 44.8 % of patients were male) with a mean EF of 29.6 ± 5.5. We observed that the mean pulse oximetry SO2 and arterial SO2 in the study were 92.8 ± 4.4 and 93 ± 5.2, respectively. We found significantly positive linear correlation between two methods according to Pearson analysis (r = 0.683, p < 0.001). A low bias was found between two methods according to Bland and Altman method (-0.2296, p = 0.23). Conclusion: The present data may suggest that pulse oximetry oxygen saturation is an acceptable substitute for the arterial oxygen saturation in patients with HFrEF.Öğe Echocardiographic epicardial fat thickness is related to altered blood pressure responses to exercise stress testing(Taylor & Francis, 2011) Şengül, Cihan; Özveren, Olcay; Duman, Dursun; Eroğlu, Elif; Oduncu, Vecih; Tanboğa, Halil İbrahim; Can, Mehmet Mustafa; Akgün, Taylan; Dindar, İsmetObjective. Hypertensive response at peak exercise and blunted blood pressure (BP) recovery, altered BP responses obtained from exercise stress testing, have been suggested as risk factors for future onset of hypertension in previous studies. Epicardial fat, a new cardiometabolic risk factor, has been linked to hypertension in some recent studies. In this study, we tested the primary hypothesis suggesting that the epicardial fat thickness (EFT) is related to altered BP responses to treadmill exercise testing. We also evaluated the sensitivity and specificity of the EFT as a predictor of hypertensive response to peak exercise. Methods. Normotensive subjects underwent to treadmill stress testing and transthoracic echocardiography. Hypertensive response to peak treadmill exercise testing was defined as ? 210/105 mmHg and ?190/105 mmHg at peak exercise in males and females, respectively. BP recovery index (BPRI) was defined as the ratio of the BP at the 3rd minute of the recovery phase to BP at peak exercise. EFT was measured by echocardiography. Thirty-two subjects with hypertensive response to peak exercise constituted Group 1 and 48 subjects with normal response constituted Group 2. Results. The mean EFT of subjects in Group 1 was significantly higher (8.2 ± 1.1 mm vs 5.1 ± 1.5 mm; p = 0.0001) than subjects in Group 2. In correlation analysis performed in Group 1, EFT was found to be significantly correlated with BPRI (r = 0.51, p < 0.003). An EFT of ?6.5 mm predicted the hypertensive response to peak exercise test with 68.8% sensitivity and 87.5% specificity (receiving operator characteristic area under curve: 0.879, 95% CI 0.7930.965, p < 0.001). Patients with EFT ?6.5 mm showed a significantly increased BPRI (0.89 ± 0.07 vs 0.74 ± 0.09, p < 0.0001) and peak systolic BP (198.4 ± 15.3 mmHg vs 169.4 ± 19.8 mmHg, p < 0.0001). There were significant differences in metabolic equivalents, maximum heart rate, homeostatic model assessment of insulin resistance, high-density lipoprotein-cholesterol, waist circumference and age values between two patients groups dichotomized according to the cut-off value of EFT. BPRI was the only independent variable related to EFT in the multivariate analysis (odds ratio = 1.4, 95% CI 2.757.16, p = 0.001). Conclusions. EFT was found to be related to altered BP responses to exercise stress testing. The echocardiographic measurement of EFT may serve as a useful non-invasive indicator of heightened risk of future hypertension.Öğe In-hospital and short-term predictors of mortality in patients with intermediate-high risk pulmonary embolism(Tabriz University of Medical Sciences and Health Services, 2020) Gök, Gülay; Karadağ, Mehmet; Çınar, Tufan; Nurkalem, Zekeriya; Duman, DursunIntroduction: The aim of this study was to evaluate the in-hospital and short-term predictive factors of mortality in intermediate-high risk acute pulmonary embolism (PE) patients with right ventricle (RV) dysfunction and myocardial injury.Methods: In this retrospective study, the medical records of 187 patients with a diagnosis of intermediatehigh risk acute PE were evaluated. A contrast-enhanced multi-detector pulmonary angiography was used to confirm diagnosis in all cases. All-cause mortality was determined by obtaining both in-hospital and 30 days follow-up data of patients from medical records.Results: During the in-hospital stay (9.5 +/- 4.72 days), 7 patients died, resulting in an acute PE related in-hospital mortality of 3.2%. Admission heart rate (HR), (Odds ratio (OR), 1.028 95% Confidence interval (CI), 0.002-1.121; P = 0.048) and blood urea nitrogen (BUN) (OR, 1.028 95% CI, 0.002-1.016; P = 0.044) were found to be independent predictors for in-hospital mortality in a multivariate logistic regression analysis. In total, 32 patients (20.9%) died during 30 days follow-up.The presence of congestive heart failure (OR, 0.015, 95%CI, 0.001-0.211; P = 0.002) and dementia (OR, 0.029, 95%CI, 0.002-0.516; P = 0.016) as well as low albumin level (OR, 0.049 95%CI, 0.006-0.383; P = 0.049) were associated with 30 days mortality.Conclusion: HR and BUN were independent predictors of in-hospital mortality and the presence of congestive heart failure, dementia, and low albumin levels were associated with higher 30 days mortality.Öğe Is increased epicardial fat thickness a marker of the presence of severe coronary artery disease?(AVES, 2012) Duman, DursunFat is mainly deposited in subcutaneous tissue, but it also accumulates in the abdominal or thoracal region (1). Other major sites of fat accumulation are visceral and cardiac areas; Cardiac fat deposition is now recognized as a new cardiometabolic risk marker, as it is associated with increased insulin resistance, cardiovascular risk factors, as their measurement is practical (2). Fat accumulation in the heart appears in three different types: intracellular, epicardial and pericardial. Intracellular fat is the microscopic lipid accumulation within the cytoplasm of cardiac muscle and can be the result of myocardial ischemia, cell damage or cell death. Epicardial fat is located between the outer wall of the myocardium and the visceral layer of pericardium (3). Pericardial fat exists anterior to the epicardial fat layer and therefore located between visceral and parietal pericardium. Due to the close anatomic relation between myocardium and the epicardial fat, the two tissues share the same microcirculation (4). In previous studies have been reported that epicardial fat is metabolically active and is the source for several adipokines. Potential interactions through paracrine or vasocrine mechanisms between epicardial fat and myocardium are strongly suggested (4).Öğe Is left ventricular diastolic dysfunction independent from presence of hypertension in metabolic syndrome? An echocardiographic study(Elsevier, 2014) Aksoy, Şükrü; Durmuş, Gündüz; Özcan, Serhan; Toprak, Ercan; Gürkan, Ufuk; Öz, Dilaver; Canga, Yiğit; Karataş, Baran; Duman, DursunBackground: It has been shown that left ventricular diastolic dysfunction (LVDD) develops in patients with metabolic syndrome (MetS). However, there is not sufficient evidence in the literature to determine whether this condition is due to increase in blood pressure, which is frequently encountered in MetS. The purpose of this study was to test the hypothesis whether LVDD in MetS is independent from the presence of hypertension. Methods: A total of 60 patients diagnosed with MetS and 30 healthy people, who were age- and gender-matched with the patient group, were included in the study as the control group. In the study group, 30 of the patients were normotensive whereas the other 30 had hypertension. Conventional echocardiographic examinations and tissue Doppler imaging were performed besides measurements of demographic and biochemical parameters. Results: In the hypertensive MetS group, early diastolic filling flow (E), early diastolic mitral annular velocity (E'), and E/A ratio were significantly lower compared to the control group. Late diastolic filling flow (A), deceleration time (DT), late diastolic mitral annular velocity (A'), and E/E' ratio were higher in the hypertensive MetS group than the control group. In the normotensive MetS group, E, E', and E/A ratio were also lower compared to the control group whereas DT, A', and E/E' ratio were higher. Conclusion: These findings support the idea that LVDD may develop in patients with MetS even in the absence of hypertension. In addition, co-existence of hypertension with MetS contributes to further worsening of diastolic functions. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe Peripartum cardiomyopathy: Current state of knowledge, new developments and future directions(Bentham Science Publishers, 2014) Biteker, Murat; Kayataş, Kadir; Duman, Dursun; Türkmen, Muhsin; Bozkurt, BiykemPeripartum cardiomyopathy (PPCM) is a form of idiopathic dilated cardiomyopathy affecting women in late pregnancy or early puerperium. Although initially described in the late 1800s, it has only recently been recognized as a distinct cardiac condition. The reported incidence and prognosis varies according to geography. The clinical course varies between complete recovery to rapid progression to chronic heart failure, heart transplantation or death. In spite of significant improvements in understanding the pathophysiology and management of the PPCM many features of this unique disease are poorly understood, including incidence, etiology, epidemiology, pathophysiology, predictors of prognosis and optimal therapy. The present article revisits these concepts and recent advances in PPCM.Öğe Preprocedural red blood cell distribution width predicts bare metal stent restenosis(Lippincott Williams & Wilkins, 2014) Yıldız, Abdülmelik; Tekiner, Fatih; Karakurt, Ahmet; Şirin, Gökçe; Duman, DursunBACKGROUND: It has been shown that increased red blood cell distribution width (RDW) predicts adverse outcomes in cardiovascular disease and in patients undergoing a percutaneous coronary intervention. The aim of the present study was to assess the predictive value of preinterventional RDW on the development of in-stent restenosis (ISR) in patients undergoing stent implantation. MATERIALS AND METHODS: In this retrospective study, we compared 131 patients with ISR and 138 patients without ISR who had undergone bare metal stent implantation. RESULTS: Preprocedural RDW was significantly higher in patients with ISR than those without restenosis (14.6±3.2 vs. 13.4±1.6%, P<0.001). Stent length was significantly longer in patients with than those without restenosis (17.9±5.6 vs. 16.2±5.2 mm, respectively, P=0.03). Compared with patients with restenosis, patients without restenosis had a lower rate of diabetes (28 vs. 61 patients, P=0.001), a significantly short period between two coronary angiographies (9.8±9.3 vs. 12.9±11.6 months, respectively, P=0.02), and lower triglyceride levels (133±53 vs. 198±121 mg/dl, respectively, P=0.05). In multivariate logistic regression analysis, diabetes mellitus, stent length, preprocedural RDW, and current smoking independently predicted ISR. CONCLUSION: Increased preinterventional RDW significantly predicts bare metal stent restenosis and might represent a useful screening tool to stratify patients according to a higher or a lower risk of ISR after stent implantation in patients with stable and unstable angina pectoris.Öğe Relationship between coronary calcium, markers of inflammation and albuminuria in diabetic patients without known coronary artery disease(Oxford University Press, 2011) Dayan, Akın; Duman, Dursun; Anıl, B. N.; Aksoy, Sercan; Biteker, Murat[Abstract Not Available]Öğe Romatoid Artritli hastalarda aortik sertleşme(2011) Masatlıoğlu, Seval; Ayaydın, Semiha; Demirtunç, Refik; Yılmaz, Güven; Yolcu, Nilcihan; Kayataş, Kadir; Duman, DursunRomatoid Artirit (RA) de mortalitenin en önemli sebebi kardiyovasküler sistem (KVS) tutulumudur. Aortun mekanik özelliklerinin invaziv olmayan yöntemlerle değerlendirilmesi aterosk-lerozun erken tanısında oldukça yararlıdır. Bu çalışmada; ateroskleroz gelişimine yol açabilecek başka hastalığı ve risk faktörleri olmayan RA'lı hastalarda aortun elastisite parametreleri ile hastalığın aktivite ölçümleri arasında etkileşim olup olmadığı araştırılmıştır. Yöntem: Çalışmaya 46 RA'li hasta ve 20 sağlıklı birey alındı. Hastaların hastalık süresi, DAS-28 skorları, eritrosit sedimentasyon hızı (ESH), C-reaktif proteinleri (CRP) ve lipid düzeyleri kaydedildi. Ekokardiyografik değerlendirme ile aortun elastik parametreleri hesaplandı ve gruplar arasında karşılaştırma yapıldı. RA'lı hastaların aktivite ölçümleri ile aortun elastik parametreleri arasındaki ilişki araştırıldı. Bulgular: RA'lı hastaların aortik strain ve distensibilite düzeyi; kontrol grubuna göre daha düşük bulundu (p<0.002). Aortik strain ile ESH arasında istatistiksel olarak ileri düzeyde anlamlı bir ilişki saptanmıştır (p<0.01). Distensibilite ile DAS28 ve ESH arasında istatistiksel olarak anlamlı bir ilişki bulundu (p<0.05). Sonuç: Ekokardiyografi ile noninvaziv metod olarak ölçülen aortik elastisite parametreleri hastalığın erken döneminde kardiyovasküler riski tahmin etmede faydalı olabilir.Öğe The association of epicardial fat thickness with blunted heart rate recovery in patients with metabolic syndrome(Tohoku University Medical Press, 2011) Şengül, Cihan; Duman, DursunEpicardial fat tissue has unique endocrine and paracrine functions that affect the cardiac autonomic system. Epicardial fat thickness (EFT) and blunted heart rate recovery (HRR) are newly identified cardiovascular risk factors in patients with metabolic syndrome (MS). The objective of this study is to evaluate the association between EFT and HRR in patients with MS. Forty patients with MS and 36 healthy controls were included in the study. Echocardiographic EFT and HRR at 1min after exercise termination (HRR-1) are measured and compared between the two groups. HRR-1 equal to or lower than 18 beats is considered as blunted HRR. EFT was increased (7.2 +/- 2 vs. 5.6 +/- 1.8 mm; p = 0.001) and HRR-1 was significantly reduced in patients with MS compared to control group (21 +/- 8 vs. 26 +/- 9; p = 0.006). Among the MS patients, subjects with blunted HRR had increased EFT compared to patients without blunted HRR (8.5 +/- 2.0 vs. 5.9 +/- 1.1 mm, p < 0.001). In multivariate analysis, EFT was the only independent predictor of blunted HRR in patients with MS (95% confidence interval = 1.42-3.87, OR = 2.34, p = 0.001). Furthermore, EFT of equal to or thicker than 5.5 mm was associated with the blunted HRR with 84% sensitivity and 52% specificity (ROC area under curve: 0.84, 95% confidence interval = 0.70-0.96, p < 0.001). In conclusion, EFT is an independent predictor of blunted HRR, a novel cardiovascular risk factor, in patients with MS.Öğe The evaluation of aortic elasticity in subclinical hypothyroidism(Marmara University, 2015) Özkan, Sevil; Duman, Dursun; Tarım, Mehmet Ali; Demirtunç, RefikObjective: In this study we evaluated the elastic properties of the aorta in patients with subclinical hypothyroidism and their relation with left ventricular diastolic function by transthoracic echocardiography. Patients and Methods: Aortic transthoracic echocardiography was performed and the aortic elasticity was evaluated using the following parameters; strain, the beta index and distensibility. results: There was significant difference in terms of aortic strain (5.79% vs. 9.45% p <0.001) and distensibility (4.64 versus 3.02 10-3.cm2. dyn-1, p <0.005) between the control group and patients with subclinical hypothyroidism group. In the subclinical hypothyroidism group the average mitral early diastolic velocity (E), (p <0.05) were significantly lower than the mean mitral diastolic flow velocity / mitral late diastolic flow velocity (E / A) (p <0.01) observed in the control group, and higher than the mean mitral late diastolic flow velocity (A) and isovolumetric relaxation time (IVRT) (P <0.05) in the control group. conclusions: In patients with subclinical hypothyroidism an increase in the aortic stiffness was observed. The diastolic dysfunction observed in subclinical hypothyroidism is mainly responsible for the increase in the aortic stiffness.
