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Öğe A new index for the prediction of in-hospital mortality in patients with acute pulmonary embolism: The modified shock index(NLM (Medline), 2023) Türkday Derebey, Sevim; Tokgöz, Hacer Ceren; Keskin, Berhan; Tosun, Ayhan; Hakgör, Aykun; Karagöz, Ali; Akbal, Özgür Yaşar; Bayram, Zübeyde; Efe, Süleyman; Doğan, Cem; Tanboğa, İbrahim Halil; Özdemir, Nihal; Kaymaz, CihangirBACKGROUND: Pulmonary embolism severity index, its simplified version, and shock index have been used for risk stratification in acute pulmonary embolism. In this study, we proposed a modification in severity index and evaluated the correlates and prognostic value of modification in severity index in this setting. METHODS: The study group comprised retrospectively evaluated 181 patients with acute pulmonary embolism. Systematic workup including pulmonary embolism severity index, its simplified version, shock index, biomarkers, and echocardiographic and multidetector computed tomography assessments was performed in all patients. Moreover, we calculated modification in severity index by multiplying original shock index (heart rate/systolic blood pressure ratio) and a third component, 1/pulse oxymetric saturation (pSat O2%) ratio. The primary endpoint was defined as all-cause mortality and hemodynamic collapse during the hospital stay. RESULTS: On the basis of initial risk stratification, ultrasound-assisted thrombolysis, systemic tissue-type plasminogen activator, and unfractionated heparin therapies were utilized in 83 (45.9%), 37 (20.4%), and 61 (33.7%) patients, respectively. The primary end-point occurred in 13 (7.2%) patients. Receiver-operating curve analysis revealed that modification in severity index had the highest area under the curve of 0.739 (0.588-0.890, P =.002) compared with shock index, pulmonary embolism severity index, or its simplified version. The modification in severity index > 0.989 predicted primary endpoint with 73% sensitivity and 54% specificity. CONCLUSIONS: The modification in severity index seems to be a simple, quick, and compre-hensive risk assessment tool for bedside evaluation at initial stratification, in monitoring the clinical benefit from therapies, and decision-making for escalation to other reperfusion strategies in patients with acute pulmonary embolism. However, the prognostic value of modification in severity index needs to be validated with further studies.Öğe A novel composed index to evaluate the right ventricle free-wall adaptation against ventricular wall stress in acute pulmonary embolism(NLM (Medline), 2023) Hakgör, Aykun; Tokgöz Demircan, Hacer Ceren; Keskin, Berhan; Tanyeri, Seda; Kültürsay, Barkın; Tosun, Ayhan; Akbal, Özgür Yaşar; Külahçıoğlu, Şeyhmus; Karagöz, Ali; Türkday Derebey, Sevim; Bayram, Zübeyde; Efe, Süleyman; Doğan, Cem; Tanboğa, İbrahim Halil; Özdemir, Nihal; Kaymaz, CihangirBackground: Pulmonary embolism severity index and simplified pulmonary embolism severity index have been utilized in initial risk evaluation in patients with acute pulmonary embolism. However, these models do not include any imaging measure of right ventricle function. In this study, we proposed a novel index and aimed to evaluate the clinical impact. Methods: Our study population comprised retrospectively evaluated 502 patients with acute pulmonary embolism managed with different treatment modalities. Echocardiographic and computed tomographic pulmonary angiography evaluations were performed at admission to the emergency room within maximally 30 minutes. The formula of our index was as follows: (right ventricle diameter × systolic pulmonary arterial pressure-echo)/(right ventricle free-wall diameter × tricuspid annular plane systolic excursion). Results: This index value showed significant correlations to clinical and hemodynamic severity measures. Only pulmonary embolism severity index, but not our index value, independently predicted in-hospital mortality. However, an index value higher than 17.8 predicted the long-term mortality with a sensitivity of 70% and specificity of 40% (areas under the curve = 0.652, 95% CI, 0.557-0.747, P = .001). According to the adjusted variable plot, the risk of long-term mortality increased until an index level of 30 but remained unchanged thereafter. The cumulative hazard curve also showed a higher mortality with high-index value versus low-index value. Conclusions: Our index composed from measures of computed tomographic pulmonary angiography and transthoracic echocardiography may provide important insights regarding the adaptation status of right ventricle against pressure/wall stress in acute pulmonary embolism, and a higher value seems to be associated with severity of the clinical and hemodynamic status and long-term mortality but not with in-hospital mortality. However, the pulmonary embolism severity index remained as the only independent predictor for in-hospital mortality.Öğe A simple and reliable computed tomographic measure for the evaluation of right ventricle remodelling in acute pe: right ventricle apical angle(2024) Kültürsay, B.; Erkuş, Yiğit Cengiz; Öcal, Bahadır Erdem; Keskin, Bengisu; Tokgöz, Hacer Ceren; Hakgör, Aykun; Kaymaz, Cihangir...Öğe Baseline characteristics, management patterns and outcome in patients with pulmonary embolism and malignancy: insights from a single-centre study(2025) Hakgör, Aykun; Kültürsay, Barkın; Keskin, Berhan; Sekban, Ahmet; Tokgöz, Hacer Ceren; Tanyeri, Seda; Kaymaz, CihangirBackground and aim: Acute pulmonary embolism (PE) is one of the main causes of death in patients with active cancer. In this study, we evaluated the impact of malignancy on the treatment choices, and short- and long-term clinical outcomes in patients with acute PE. Methods: In this study, 872 acute PE patients (age 61.6 ± 16.8 years, female 57.5 %) from different risk and treatment categories were retrospectively analyzed and divided into two groups according to the presence of active malignancy. Results: Active malignancy was documented in 129 (14.8 %) out of the 872 patients. Ultrasound-assisted-thrombolysis (USAT), rheolytic-thrombectomy (RT), systemic-thrombolysis (ST) and anticoagulation-alone therapies were noted in 27.3 %, 6.4 %, 16.6 % and 49.7 % of overall PE patients. RT and anticoagulation therapies were more frequent in patients with malignancy whereas ST and USAT were more frequently used in the other group. Regardless of the presence of malignancy and the treatment modality chosen, significant improvements were achieved in all treatment targets (p < 0.001 for all). Bleeding rates were similar in both groups, while in-hospital and long-term mortality was higher in the malignancy cohort. Active malignancy was found to be an independent predictor for composite of 60-day mortality and PE-related rehospitalization (adjusted OR: 2.43; 95 % CI: 1.32–4.47, p = 0.04) and long-term mortality (adjusted HR: 2.25, 95 % CI: 1.29–3.91, p = 0.004). Conclusion: Concomitant malignancy adversely affects both short- and long-term outcomes in patients with acute PE. Although these patients are more vulnerable, it is possible to achieve satisfactory treatment success with acceptable bleeding rates with the inclusion of catheter-based methods as treatment option.Öğe Changing patterns in clinical, echocardiographic and haemodynamic characteristics, and management strategies that may be translated to improved survival in pulmonary hypertension(2024) Kaymaz, Cihangir; Tokgöz, Hacer Ceren; Hakgör, Aykun; Kültürsay, B.; Sekban, Ahmet; Tanyeri, S.; Özdemir, Nihal...Öğe Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study(Baycinar Medical Publishing, 2022) Keskin, Berhan; Tokgöz, Hacer Ceren; Akbal, Özgür Yaşar; Hakgör, Aykun; Karagöz, Ali; Kültürsay, Barkın; Tanyeri, Seda; Külahçıoğlu, Şeyhmuş; Tanboğa, İbrahim Halil; Özdemir, Nihal; Kaymaz, CihangirBackground: We aimed to determine the clinical, echocardiographic and hemodynamic correlates of syncope as a presenting symptom in pulmonary embolism and its impact on in-hospital and long-term outcomes. Methods: Between July 2012 and October 2019, a total of 641 patients with PE (277 males, 364 females; median age: 65 years; range, 51 to 74 years) in whom the diagnostic work-up and risk-based management were performed according to the current pulmonary embolism guidelines were retrospectively analyzed. Clinical, laboratory and imaging data of the patients were obtained from hospital database system. Results: Syncope was noted in 193 (30.2%) of patients on admission, and was associated with a significantly higher-risk status manifested by elevated troponin and D-dimer levels, a higher Pulmonary Embolism Severity Index scores, deterioration of right-to-left ventricular diameter ratio, right ventricular longitudinal contraction measures, the higher Qanadli score, and higher rates of thrombolytic therapies (p<0.001) and rheolytic– thrombectomy (p=0.037) therapies. In-hospital mortality (p=0.007) and minor bleeding (p<0.001) were significantly higher in syncope subgroup. Multivariate logistic regression analysis showed that higher Pulmonary Embolism Severity Index scores and right-to-left ventricular diameter ratio were independently associated with syncope, while aging and increased heart rate predicted in-hospital mortality. Malignancy and right-to-left ventricular diameter ratio at discharge, but not syncope, were independent predictors of cumulative mortality during follow-up. Conclusion: Syncope as the presenting symptom is associated with a higher risk due to more severe obstructive pressure load and right ventricular dysfunction requiring more proactive strategies in patients with pulmonary embolism. However, with appropriate risk-based therapies, neither in-hospital mortality nor long-term mortality can be predicted by syncope.Öğe Current insights for catheter-directed therapies in acute pulmonary embolism: Systematic review and our single-center experience(NLM (Medline), 2023) Kaymaz, Cihangir; Tokgöz, Hacer Ceren; Kültürsay, Barkın; Hakgör, Aykun; Keskin, Berhan; Sekban, Ahmet; Karagöz, AliIn this review, the current status of the worldwide experience on different catheter-directed treatment systems utilized as alternative reperfusion methods in acute pulmonary-embolism was evaluated, and the risk stratification algorithms in which catheter-directed treatments may be implemented, source of evidence in this setting, adjudication of benefits and risks of available techniques, and innovative multidisciplinary frameworks for referral patterns and care delivery were discussed. Moreover, our perspectives on risk-based catheter-directed treatment utilization strategies in acute pulmonary embolism were summarized.Öğe Efficacy and safety of reduced-dose and slow-infusion intravenous alteplase regimen in patients with acute pulmonary embolism at intermediate-high-risk(2024) Kültürsay, B.; Keskin Meriç, Bengisu; Sekban, Ahmet; Hakgör, Aykun; Tokgöz, Hacer Ceren; Tanyeri, S.; Kaymaz, Cihangir...Öğe Hoarseness as a predictor for pulmonary arterial aneurysm and extrinsic left main coronary artery compression in patients with severe pulmonary hypertension(Turkish Society of Cardiology, 2023) Tokgöz, Hacer Ceren; Tanyeri, Seda; Sekban, Ahmet; Hakgör, Aykun; Kültürsay, Barkın; Keskin, Berhan; Karagöz, Ali; Tosun, Ayhan; Buluş, Çağdaş; Külahçıoğlu, Şeyhmus; Tanboğa, İbrahim Halil; Özdemir, Nihal; Kaymaz, CihangirOBJECTIVE: Pulmonary artery (PA) enlargement is a common finding in patients with severe pulmonary hypertension (PH) and may be associated with extrinsic compression of the left main coronary artery (LMCA-Co) and/or compression of the left recurrent laryngeal nerve resulting in hoarseness named as Ortner syndrome (OS). In this study, we evaluated the diagnostic impact of OS in predicting the PA aneurysm and significant LMCA-Co in patients with PH. METHODS: Our study population comprised retrospectively evaluated 865 with PH confirmed with the right heart catheterization between 2006 and 2022. Patients underwent coronary angiography due to several indications, including the presence of a PA aneurysm on echocardiography, angina symptoms, or the incidental discovery of LMCA-Co on multidetector computed tomography. The LMCA-Co is defined as diameter stenosis ³ 50% in reference distal LMCA segment on two consecutive angiographic planes. RESULTS: The LMCA-Co and hoarseness were documented in 3.8% and 4.3% of patients with PH, respectively. Increasing PA diameter was significantly associated with worse clinical, hemodynamic, laboratory, and echocardiographic parameters. The receiver operating curves revealed that the PA diameter >41 mm was cutoff for hoarseness (AUC: 0.834; sensitivity 69%, specificity 84%, and negative predictive value 98%), and PA diameter >35 mm was cutoff for LMCA-Co >50% (AUC: 0.794; sensitivity 89%, specificity 58 %, and negative predictive value 99%). An odds ratio of hoarseness for LMCA-Co was 83.3 (95% confidence interval; 36.5-190, P < 0.001) with 3.2% sensitivity, 98.7% specificity, and 59% positive and 98% negative predictive values. CONCLUSION: In this study, a close relationship was found between the presence of hoarseness and the probability of extrinsic LMCA-Co by enlarged PA in patients with severe PH. Therefore, the risk of LMCA-Co should be taken into account in patients with PH suffering from hoarseness.Öğe Impedance cardiography for demonstrating procedural efficacy of percutaneous mitral balloon valvuloplasty(Türkiye Klinikleri, 2015) Omaygenç, Mehmet Onur; Do?an, Cem; Bakal, Ruken Bengi; Candan, Özkan; Hatipoğlu Akpınar, Suzan; Babür Güler, Gamze; Kaymaz, Cihangir; Özdemir, NihalObjective: Impedance Cardiography (ICG) method, facilitates measuring hemodynamic parameters indirectly by recording thoracic impedance variations induced by cyclic changes in blood flow. The aim of this study is to evaluate alterations in hemodynamic parameters obtained by impedance cardiography (ICG) in addition to conventional echocardiographic and catheterization data after percutaneous mitral balloon valvuloplasty (PMBV). Material and Methods: 18 patients with severe rheumatic mitral stenosis to whom PMBV had been performed were included in this study. Impedance cardiographic measurements were performed in addition to routine echocardiographic examination and invasive left atrial and pulmonary arterial pressure recordings before and after the procedure. Cardiac output was calculated with direct Fick method before PMBV. Average values of several measurements were used to obtain the most accurate results for atrial fibrillation patients in the study group. Results: Following successful PMBV, in impedance cardiographic evaluation an increase in cardiac output (4.69±1.46 and 5.68±1.3 l/min, before and after PMBV, respectively, p<0.001) and cardiac index (2.72±0.81 and 3.29±0.73 l/min/m2, before and after PMBV, respectively, p<0.001) an evident prolongation in ejection period (246.8±40.3 and 275.2±32.1 msec, before and after PMBV, respectively, p<0.001); and a statistically significant reduction in pre-ejection period (103.7±41.8 and 82.7±16.8 msec, before and after PMBV, respectively, p=0.033), and thoracic fluid content (34.3±11.2 and 27.7±5.31/k?, before and after PMBV, respectively, p=0.037) was observed. There was a strong correlation between preprocedural cardiac output calculations of ICG and direct Fick method (r:0.89, p<0.001). onclusion: In addition to the conventional methods, serial recordings of impedance cardiographic outputs may yield beneficial information for the assessment of PMBV efficacy.As a non-invasive and easily applicable method, it might be utilized during in-hospital follow-up.Öğe Is it time to reappraise for black-box warning on angiojet rheolytic thrombectomy in patients with pulmonary embolism: a systematic review and meta-analysis(2024) Kaymaz, Cihangir; Kültürsay, Barkın; Tokgöz, Hacer Ceren; Hakgör, Aykun; Keskin, Berhan; Tanyeri, Seda; Karagöz, AliBackground: AngioJet rheolytic thrombectomy (ART) system has been widely used as a catheter-directed treatment (CDT) method in acute pulmonary embolism (PE), however, there has been a controversy regarding the safety of its use. In this systematic review and meta-analysis, we evaluated the efficacy and safety outcomes of ART in patients with PE. Methods: Our meta-analysis have been based on search in the MEDLINE, EMBASE, and Cochrane Library for studies published up to August 2022. The primary outcomes were overall pooled rates of major bleeding (MB) and minor bleeding (mB), worsening renal function (WRF), bradycardia/conduction disturbance (BCD), and PE-related and all-cause mortality in patients who underwent ART. Results: Among the 233 studies documented at initial search, 24 studies were eligible for meta-analysis, and a total of 427 PE patients who underwent ART were evaluated. Overall pooled rates of MB and mB were 9.6% (95% CI 5.9%-15.2%) and 9.2% (95% CI 6.1%-13.6%), transient BCD and WRF were 18.2% (95% CI 12.4%-26%) and 15% (95% CI 10%-21.8%), and PE-related death and all-cause death were 12.7% (95% CI 9.1%-17.3%) and 15% (95% CI 11%-20%), respectively. However, significant heterogeneity and some evidence of funnel plot asymmetry and publication bias were noted for MB, BCD and WRF, but not for PE-related death and all-cause death. Conclusion: Overall pooled rates of bleeding events, BCD and WRF episodes, PE-related death and all-cause death may be considered as encouraging results for efficacy and safety issues of ART utilization in specific scenarios of acute PE, and a reappraisal for black-box warning on ART seems to be necessary.Öğe Left atrial expansion index is an independent predictor of diastolic dysfunction in patients with preserved left ventricular systolic function: A three dimensional echocardiography study(Springer, 2014) Hatipoğlu, Suzan; Özdemir, Nihal; Babür Güler, Gamze; Omaygenç, Mehmet Onur; Bakal, Ruken Bengi; Kahveci, Gökhan; Unkun, Tuba; Şahin, Gülsüm; Kaymaz, CihangirIn the absence of mitral valve disease left atrial (LA) volume is a marker of diastolic dysfunction and its severity. This study investigated the relationship between left ventricular (LV) end diastolic pressure (LVEDP) and LA volumes and phasic atrial functions detected by real-time full volume three-dimensional echocardiography (RT3DE), in a patient population with preserved LV systolic function. Seventy-two (39 female and 33 male; mean age 56.1 +/- A 9.0 years) stable patients with normal LV ejection fraction (EF) undergoing cardiac catheterization were studied. All patients underwent comprehensive echocardiographic examination just before catheterization and LVEDP was obtained. In addition to conventional echocardiographic measurements and Doppler indices; by using RT3DE LA maximum, minimum and pre-a-wave volumes were measured; LA total, passive and active emptying volumes and fractions were calculated. LV systolic function was assessed by EF and global longitudinal strain by speckle tracking. RT3DE minimum LA volume index, RT3DE active LAEF and LA expansion index (EI) were statistically significant univariate predictors of LVEDP a parts per thousand yen 16 mmHg. When age and hypertension adjusted multivariate analysis was performed EI [beta = -1.741, p = 0.015; OR 0.175; 95 % CI (0.043-0.717)] was an independent predictor of elevated LVEDP. RT3DE evaluation of LA function during entire cardiac cycle has incremental value for the diagnosis of diastolic dysfunction in patients with preserved EF. We suggest that RT3DE evaluation of LA may find clinical application in this field.Öğe Prediction of infarct size using two-dimensional speckle tracking echocardiography in acute myocardial infarction(Wiley, 2017) Doğan, Cem; Bayram, Zübeyde; Candan, Özkan; Omaygenç, Mehmet Onur; Yılmaz, Fatih; Acar, Rezzan Deniz; Akbal, Özgür Yaşar; Kaymaz, Cihangir; Özdemir, NihalBackground: This study aimed to determine the myocardial damage (infarct size provided by cardiac single-photon emission tomography) in early stages of the infarction using longitudinal strain and rotational parameters of the left ventricle. Methods: The study included 66 patients with anterior myocardial infarction (AMI) and 62 patients with inferior myocardial infarction (IMI) who underwent primary percutaneous intervention as well as a control group consisting of 50 healthy subjects. LV rotational parameters based on parasternal short-axis views in basal and apical planes and global longitudinal strain were measured with apical four-chamber, apical two-chamber, and apical long-axis views. Results: There was a significant positive correlation between infarct size and GLPSavg (r=-.55 <.001), GTOR angle (r=-.52, P<.001), apical rotation angle (r=-.40 <.001, and EF (r=-.43, <.001). While cutoff values were GLPSavg: 11.9 (AUC=0.78), GTOR angle: 11.4 degrees(AUC=0.77), apical rotation angle: 7.1 degrees (AUC=0.76) for patients with an infarct size greater than 20%, the cutoff values were GLPSavg: 10.7 (AUC=0.75), GTOR angle: 8.7 degrees (AUC=0.86), apical rotation angle: 4.35 degrees (AUC-0.87) for those with an infarct size greater than 40%. Conclusion: GLPSavg, GTOR angle, and apical rotation angle values may be used to determine the extent of infarction in early post-MI period, thereby allowing precautions to be taken for remodeling in early stages.Öğe Prognostic impact of the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio in acute pulmonary embolism(2024) Kültürsay, Barkın; Keskin, Berhan; Tanyeri, Seda; Külahçıoğlu, Şeyhmus; Hakgör, Aykun; Mutlu, Deniz; Kaymaz, CihangirBackground: Currently available risk stratification models for acute pulmonary embolism (PE) include hemodynamic status, cardiac biomarkers, right ventricle (RV) dysfunction on imaging, and clinical scores. Focusing on the length–tension relationship of the ventricle might have a superior predictive capability over RV dysfunction in terms of mortality and classification of patients with acute PE. In this study, our hypothesis suggests that the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio has superior predictive capability for in-hospital mortality in patients with acute PE compared to TAPSE or sPAP as distinct measures. Methods: This single-center study comprised retrospectively evaluated 703 patients referred to our tertiary cardiovascular center with acute PE. We divided patients into quartiles based on the TAPSE/sPAP ratio. Different models were developed to quantify the predictive relationship between in-hospital death and echocardiographic measurements. A base model was created with variables including risk status and RV/LV ratio >1. Then, to evaluate the predictive contribution of each measurement; TAPSE/sPAP, TAPSE, and sPAP were sequentially added to the base model. After that, the performance of each model was evaluated. Results: Predictive and discriminative power was the highest in model containing TAPSE/ sPAP. There was still a significant inverse association between TAPSE/sPAP and the risk of in-hospital death even after adjusting for risk status and RV/LV ratio >1. Receiver operating characteristic curve analysis for TAPSE/sPAP revealed the best cut-off value as 0.34. Conclusion: The outcomes of our study reveal that the ratio of TAPSE/sPAP serves as a more potent predictor of mortality than either of the 2 measurements taken separately. The interpretation and utilization of the TAPSE/sPAP cut-off value in acute PE can assist in identifying patients at risk of deterioration and guide the consideration of more intensive treatment options across all risk groups.Öğe Reappraisal of echocardiographic algorithm in predicting the pulmonary hypertension redefined by updated pulmonary artery mean pressure treshold(Oxford University Press, 2022) Tanyeri, Seda; Tokgöz, Hacer Ceren; Karagöz, Ali; Yaşar Akbal, Özgür; Keskin, Başak; Kültürsay, Barkın; Hakgör, Aykun; Külahcıoğlu, Şeyhmus; Çeneli, Doğancan; Tosun, Ayhan; Efe, Süleyman Çağan; Bayram, Zübeyde; Tanboğa, İbrahim Halil; Özdemir, Nihal; Kaymaz, Cihangir[Abstract Not Available]Öğe Relationship between histopathological features of aspirated thrombi and long-term left ventricular function in patients with ST-segment elevation myocardial infarction(Turkish Society of Cardiology, 2020) Omaygenç, Mehmet Onur; Doğan, Cem; Somay, Adnan; Karaca, Oğuz; Bakal, Ruken Bengi; Teber, Mehmet Kamil; Hatipoğlu, Suzan; Bayram, Zübeyde; Kaymaz, Cihangir; Özdemir, NihalObjective: This study was an investigation of the severity ofinflammation (SOI) in aspirated material and thrombus age toexamine any association with pre-discharge and long-term leftventricular (LV) function after ST-elevation myocardial infarction (STEMI).Methods: The study group comprised 25 patients with STEMIfrom whom an occlusive thrombus was aspirated from the infarct-related artery with a 7-F catheter. The SOI in the aspirate was determined according to the mean leukocyte countin 5 high-power magnification fields and graded as mild in thepresence of ?100 leukocytes per field or significant if therewere >100 leukocytes per field. The thrombi were categorizedas fresh or lytic/organized (L/O) using predefined criteria.Echocardiographic assessment was performed prior to discharge and at 1 year. Adverse left ventricular remodeling (LVR)was defined as a 20% increase in LV end-diastolic volume incomparison with baseline values.Results: LVR was observed in 8 patients. The mean leukocytecount of the aspirate (127.5±86.0 vs 227.2±120.7; p=0.026)and frequency of significant inflammation (35% vs 75%;p=0.046) were significantly higher in the group with LVR. Theserum high-sensitivity C-reactive protein (hsCRP) level wassignificantly correlated with the leukocyte count of the aspirate (r=0.532; p=0.006). An L/O thrombus was related to betterpre-discharge and long-term LV volumes and ejection fractionvalues compared with a fresh thrombus.Conclusion: A significant increase in the leukocyte count inthe aspirate and a fresh thrombus might predict long-term LVfunctional deterioration irrespective of the clinical and procedure-related characteristics. In addition, serum markers of inflammation, like hsCRP, might also reflect the intensity of thelocal inflammatory response at the site of occlusion.Öğe Remembering the Occam’s Razor: Could simple electrocardiographic findings provide relevant predictions for current hemodynamic criteria of pulmonary hypertension?(Turkish Society of Cardiology, 2023) Tokgöz, Hacer Ceren; Öcal, Bahadır Erdem; Erkuş, Yiğit Cengiz; Tanyeri Üzel, Seda; Kültürsay, Barkın; Tosun, Ayhan; Keskin, Berhan; Hakgör, Aykun; Sırma, Dicle; Buluş, Çağdaş; Karagöz, Ali; Tanboğa, İbrahim Halil; Külahçıoğlu, Şeyhmus; Bayram, Zübeyde; Sekban, Ahmet; Özdemir, Nihal; Kaymaz, CihangirBackground: We evaluated the predictive value of electrocardiographic (ECG) findings for pulmonary hemodynamics assessed by right heart catheterization (RHC). Methods: Our study population comprised 562 retrospectively evaluated patients who underwent RHC between 2006 and 2022. Correlations between ECG measures and pulmonary arterial systolic and mean pressures (PASP and PAMP) and pulmonary vascular resistance (PVR) were investigated. Moreover, receiver operating characteristic (ROC) curve analysis assessed the predictive value of ECG for pulmonary hypertension (PH) and precapillary PH. Results: The P-wave amplitude (Pwa) and R/S ratio (r) in V1 and V2, Ra in augmented voltage right (aVR), right or indeterminate axis, but not P wave duration (Pwd) or right bundle branch block (RBBB) significantly correlated with PASP, PAMP, and PVR (P < .001 for all). The partial R2 analysis revealed that amplitude of R wave (Ra) in aVR, R/Sr in V1 and V2, QRS axis, and Pwa added to the base model provided significant contributions to variance for PASP, PAMP, and PVR, respectively. The Pwa > 0.16 mV, Ra in aVR > 0.05 mV, QRS axis > 100° and R/Sr in V1 > 0.9 showed the highest area under curve (AUC) values for PAMP > 20 mm Hg. Using the same cutoff value, Ra in aVR, Pwa, QRS axis, and R/Sr in V1 showed highest predictions for PVR > 2 Wood Units (WU). Conclusion: In this study, Pwa, Ra in aVR, right or indeterminate axis deviations, and R/Sr in V1 and V2 showed statistically significant correlations with pulmonary hemodynamics, and Ra in aVR, R/Sr in V2 and V1, QRS axis, and Pwa contributed to variance for PASP, PAMP, and PVR, respectively. Moreover, Pwa, Ra in aVR, QRS axis, and R/Sr in V1 seem to provide relevant predictions for PH and precapillary PH.Öğe Right ventricular global work efficiency provides the highest prediction for improvements in right ventricle to left ventricle diameter ratio with acute pulmonary embolism treatments(Oxford University Press, 2023) Keskin, Berhan; Tokgöz, Hacer Ceren; Kültürsay, Barkın; Hakgör, Aykun; Tanyeri, Seda; Tosun, Ayhan; Kaymaz, Cihangir[Abstract Not Available]
