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Öğe Effect of cardiac resynchronization therapy on mitral valve geometry: A novel aspect as "reversed mitral remodeling"(Springer, 2018) Karaca, Oğuz; Çakal, Beytullah; Omaygenç, Mehmet Onur; Güneş, Hacı Murat; Kızılırmak, Filiz; Çakal, Sinem Deniz; Naki, Deniz Dilan; Barutçu, İrfan; Boztosun, Bilal; Kılıçaslan, FethiAmelioration of the valvular geometry is a possible mechanism for mitral regurgitation (MR) improvement in patients receiving cardiac resynchronization therapy (CRT). We aimed to establish the precise definition, incidence, and predictors of reversed mitral remodeling (RMR), as well as the association with MR improvement and short-term CRT outcome. Ninety-five CRT recipients were retrospectively evaluated for the end-point of "MR response" defined as the absolute reduction in regurgitant volume (RegV) at 6 months. To identify RMR, changes in mitral deformation indices were tested for correlation with MR response and further analyzed for functional and echocardiographic CRT outcomes. Overall, MR response was observed in 50 patients (53%). Among the echocardiographic indices, the change in tenting area (TA) had the highest correlation with the change in RegV (r = 0.653, p < 0.001). The mean TA significantly decreased in MR responders (4.15 +/- 1.05 to 3.67 +/- 1.01 cm(2) at 6 months, p < 0.001) and increased in non-responders (3.68 +/- 1.04 to 3.98 +/- 0.97 cm(2), p = 0.014). The absolute TA reduction was used to identify patients with RMR (47%) which was found to be associated with higher rates of functional improvement (p = 0.03) and volumetric CRT response (p = 0.036) compared to those without RMR. Non-ischemic etiology and the presence of LBBB independently predicted RMR at multivariate analysis. In conclusion, reduction in TA is a reliable index of RMR, which relates to MR response, and functional and echocardiographic improvement with CRT. LBBB and non-ischemic etiology are independent predictors of RMR.Öğe Isolated subclinical right ventricle systolic dysfunction in patients after liver transplantation(MDPI, 2023) Çeliker Güler, Emel; Omaygenç, Mehmet Onur; Naki, Deniz Dilan; Yazar, Arzu; Karaca, İbrahim Oğuz; Korkut, EsinAlthough hemodynamic alterations in end-stage liver disease (ESLD) and its association with porto-pulmonary hypertension have been well-established, the long-term effects of ESLD on RV systolic function in patients without porto-pulmonary hypertension remain disregarded. Here we aimed to assess the long-term effect of ESLD on RV function and its relationship with the use of NSBBs and clinical, laboratory and imaging parameters in end-stage liver disease. The use of NSBBs is still controversial due to concerns about reduced cardiac contractility and the possibility of increased mortality. Thirty-four liver transplant recipients were included. Demographic characteristics, laboratory and baseline echocardiography measures were obtained. Patients were recalled for transthoracic echocardiographic evaluation after transplantation. Right ventricle dysfunction was identified by having at least one value below the reference levels of RV S', or TAPSE. Isolated subclinical RV dysfunction was observed at 20.6% of the sample population. The present study demonstrates hemodynamic circulation in cirrhosis and increased preload and afterload might have long-term effects on RV function, even the lack of porto-pulmonary hypertension. These findings underline the significance of cardiac function follow-up in cirrhotic patients after transplantation. In this study, patients treated with propranolol seemed to have better RV function and less gastrointestinal bleeding. We speculated that preoperative propranolol treatment might help preserve RV function by providing RAS suppression, improving endothelial function and hyperdynamic circulation seen in ESLD. This potential protective relationship between the use of propranolol and RV function might improve mortality or graft-failure during OLT and after liver transplantation in patients with cirrhosis.Öğe Long-term outcomes of patients presenting with acute coronary syndrome and implanted with bioresorbable scaffold(Yuzuncu Yıl University Faculty of Medicine, 2022) İbişoğlu, Ersin; Güneş, Hacı Murat; Kızılırmak, Filiz; Çakal, Beytullah; Karaca, Oğuz; Omaygenç, Mehmet Onur; Güler, Ekrem; Demir, Gültekin Günhan; Olgun, Fatih Erkam; Savur, Ümeyir; Naki, Deniz Dilan; Boztosun, BilalA bioresorbable scaffold (BRS) has been used in the latest stages of stent technology and is a less-known material than drug-eluting stents (DES). In this study, we aimed to evaluate the long-term clinical outcomes of BRS in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), a type of acute coronary syndrome (ACS). 39 patients and 53 lesions who applied to Istanbul Medipol University Faculty of Medicine Hospital between June 2015 and April 2016 with a diagnosis of NSTEMI and were treated with BRS were included in the study. The 4-year follow-up of the patients between 2016 and 2020 was recorded. Endpoints for the study were device success, treatment success, stent thrombosis, restenosis, and major adverse cardiac events (MACE). Operations were performed with a device success rate of 98.1% and a treatment success rate of 98.1%. No death or stent thrombosis was detected in any patient, and target lesion revascularization (TLR) occurred in one patient. The total rate of MACE was found to be 1.9%. Complications developed in two patients during the procedure and hospitalization and in four patients during the 4-year follow-up. If BRS are implanted by experienced surgeons in NSTEMI patients, it has been observed that the complication rate in the early period is low, and the complication rate increases depending on the type of stent chosen in the late period. To obtain better results, a BRS with good radial strength, thinner strut thickness, and rapid deployment should be achieved.Öğe Olanzapine associated acute peripheral edema and pericardial effusion: A case report(Aves, 2019) Arslan, Mehmet; Bulut, Ümit; Naki, Deniz DilanOlanzapine is a potent atypical antipsychotic drug used for the treatment of schizophrenia and bipolar disorder with approved efficiency. Olanzapine is superior to the typical antipsychotic drugs with low incidence of extrapyramidal side effects, especially tardive dyskinesia. The most common side effects associated with olanzapine are constipation, dyspepsia, weight gain, somnolence, asthenia, dry mouth and dizziness. Peripheral edema associated with olanzapine is rarely reported and as far as we know there is no report in the literature about peripheral edema concomitant with pericardial effusion related to olanzapine. The mechanism of these side effects associated with olanzapine is still unclear and there are different hypotheses in the literature. Herein we report the first case that developed both peripheral edema and pericardial effusion after olanzapine administration. Although very rarely encountered, clinicians should be aware of these possible side-effects.Öğe The effect of CRT on mitral valve geometry: Incidence and predictors of reversed mitral remodeling(Wiley, 2017) Karaca, Oğuz; Çakal, Beytullah; Omaygenç, Mehmet Onur; Güneş, Hacı Murat; Çakal, Sinem Deniz; Kızılırmak, Filiz; İbişoğlu, Ersin; Savur, Umeyr; Çelebi, Fener; Naki, Deniz Dilan; Kılıçaslan, Fethi[Abstract Not Available]
