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Öğe Allogeneic stem cell transplantation in a blast-phase chronic myeloid leukemia patient with carbapenem-resistant Klebsiella pneumoniae tricuspid valve endocarditis: A case report(Spandidos Publications, 2016) Kantarcıoğlu, Bülent; Beköz, Hüseyin Saffet; Olgun, Fatih Erkam; Çakal, Beytullah; Arkan, Burak; Türkoğlu, Halil; Mert, Ali; Sargın, DenizIn chronic myeloid leukemia (CML), the occurrence of blastic transformation is rare. Treatment outcome is generally poor. Allogeneic stem cell transplantation (allo-SCT) is the only potentially curative treatment option for advanced-phase CML. Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates are associated with high morbidity and mortality rates, particularly in patients with haematological malignancies. Infection and colonization by these multiresistant bacteria may represent a challenge in SCT recipients for the management of post-transplantation complications, as well as for the eligibility to receive a transplant in patients who acquire the pathogen prior to the procedure. We herein report the case of a blast-phase CML patient with a highly resistant, CRKP-associated tricuspid valve endocarditis, who was treated with a combination of systemic antimicrobial therapy and surgical valve repair, and subsequently underwent a successful allo-SCT.Öğe Angiotensin receptor neprilysin inhibitor for patients with heart failure and reduced ejection fraction: Real-world experience from Turkey (ARNi-TR)(Turkish Society of Cardiology, 2021) Ekici, Berkay; Yaman, Mehmet; Küçük, Murathan; Dereli, Seçkin; Yenerçağ, Mustafa; Yiğit, Zerrin; Baş, Mehmet Memduh; Karavelioğlu, Yusuf; Çakmak, Hüseyin Altuğ; Kıvrak, Tarık; Özkan, Hakan; Altın, Cihan; Şabanoğlu, Cengiz; Demirkan, Burcu; Ataş, Ali Ekber; Kılıçaslan, Fethi; Altay, Hakan; Tengiz, İstemihan; Erkan, Aycan Fahri; Kılıçaslan, Barış; Olgun, Fatih Erkam; Durakoğlugil, Murtaza Emre; Alhan, Aslıhan; Zoghi, MehdiObjective: Heart failure (HF) is a growing public health problem with high morbidity and mortality. Recently, angiotensin receptor neprilysin inhibitor (ARNi) has emerged as a promising treatment for HF with reduced ejection fraction (HFrEF). Here, we shared our experience with the use of ARNi in HFrEF from multiple centers in Turkey. Methods: The ARNi-TR is a multicenter, nonintervention al, retrospective, observational study. Overall, 779 patients with HF from 22 centers in Turkey who were prescribed sacubitril/valsartan were examined. Initial clinical status, biochemical and echocardiographic parameters, and New York Heart Association functional class (NYHA-FC) values were compared with follow-up values after 1 year of ARNi use. In addition, the effect of ARNi on number of annual hospitalizations was investigated, and the patients were divided into 2 groups, depending on whether ARNi was initiated at hospitalization or under outpatient clinic control. Results: N-terminal pro-brain natriuretic peptide (NT-proBNP), left-ventricle ejection fraction (LV-EF), and NYHA-FC values improved significantly in both groups (all parameters, p<0.001) within 1-year follow-up. In both groups, a decrease in hemoglobin A1c (HbA1c) values was observed in ARNi use (p<0.001), and a decrease in daily diuretic doses and hospitalizations owing to HF were observed after ARNi use (all comparisons, p<0.001). Hypotension (16.9%) was the most common side effect in patients using ARNi. Conclusion: The ARNi-TR study offers comprehensive real-life data for patients using ARNi in Turkey. The use of ARNi has shown significant improvements in FC, NT-proBNP, HbA1c levels, and LV-EF. Likewise, reductions in the number of annual hospitalizations and daily furosemide doses for HF were seen in this study.Öğe Bir aile sağlığı merkezine kayıtlı yaşlılarda atriyal fibrilasyon sıklığının değerlendirilmesi(İstanbul Medipol Üniversitesi, Sağlık Bilimleri Enstitüsü, 2022) Aktura, Nilüfer; Olgun, Fatih ErkamAmaç: İstanbul Güngören Güneştepe Aile Sağlığı Merkezi'ne(ASM) kayıtlı 65 yaş ve üzeri popülasyonda atriyal fibrilasyon(AF) sıklığının taranması, tanılı ve tanısız AF tespiti ile birlikte, AF ile ilişkili olabilecek komorbiditeler ve inme riski yüksek olan AF'lilerin antikoagülan tedavi altında olup olmadıklarının araştırılması amaçlanmaktadır. Materyal-Metod: ASM'ye kayıtlı olan 699 yaşlıyı temsil eden örneklemle 357 kişi çalışmaya dâhil edildi. Gönüllülere hasta bilgi ve anamnez formu uygulandı. AF taraması EKG ile yapıldı. İnme riski değerlendirmesi CHA2DS2VASc skoru ile yapıldı. Gönüllülerin boy, kilo ve tansiyonları ölçülüp kaydedildi. Bulgular: 65 yaş ve üzeri AF sıklığı %11,8, kadınlarda %11,3 iken erkeklerde %12,3 idi. AF'liler arasında tanısız AF sıklığı %52,4 idi. 65 yaş ve üzeri tanısız AF sıklığı %6,2 idi. Gönüllüler arasında AF'ye %66,7 oranı ile hipertansiyon, %38,1 oranları ile diyabet, koroner hastalığı ve vasküler hastalık %35,7 oranı ile kronik akciğer hastalığı eşlik etmekte idi. AF'si olanların %88,1'inin inme riski yüksekti ve antikoagülan endikasyonu mevcuttu. CHA2DS2VASc skoruna göre yapılan risk değerlendirmesinde skor ortalaması 3,74±1,52, medyanı 4 idi. Tanılı AF'lilerin %95'i inme açısından yüksek riskli iken, bu vakaların %94,7'si antikoagülan kullanmakta idi. Tüm popülasyonda antikagülasyon endikasyonu olanların %51.4'ü antikoagülan kullanmıyordu. Antikoagülan tedavi gerektiği halde tedavisiz kalan AF sıklığı tüm popülasyonda %5,3 idi. EHRA semptom skalasına göre daha ciddi semptomatik olanlarda ve kadınlarda tanılı AF sıklığı daha fazla idi. Sonuç: AF sıklığı, tanısız AF sıklığı ve antikoagülan tedavisiz AF sıklığı ülkemizde yapılan çalışma sonuçlarına göre daha yüksek idi. Bu durum AF taranması için ciddi bir kanıt ortaya koymaktadır. Birinci basamakta AF taranması neticesinde tespit edilebilecek tanısız ve tedavisiz AF vakaları ile iskemik inme vakaları da önlenebilir.Öğe Changes in electrocardiographic p wave parameters after cryoballoon ablation and their association with atrial fibrillation recurrence(Wiley-Blackwell, 2016) Kızılırmak, Filiz; Günhan Demir, Gültekin; Gökdeniz, Tayyar; Güneş, Hacı Murat; Çakal, Beytullah; Güler, Ekrem; Karaca, İbrahim Oğuz; Omaygenç, Mehmet Onur; Yılmaz, Fatih; Olgun, Fatih Erkam; Kılıçaslan, FethiBackground: Changes in P wave parameters after circumferential pulmonary vein isolation (CPVI) have been previously identified. In this study, we aimed to determine the changes in P wave parameters surface electrocardiogram (ECG) after cryoballoon ablation (CBA) for atrial fibrillation (AF) and evaluate their relationship with AF recurrence. Methods: Sixty-one patients (mean age 53 ± 11 years, 50.8% male) with paroxysmal AF who underwent CBA were enrolled. A surface ECG was obtained from all patients immediately before the procedure, and repeated 12 hours after the procedure. P wave amplitude (Pamp), P wave duration (Pwd), and P wave dispersion (Pdis) values in preprocedural and postprocedural ECGs were measured and compared. Recurrence rates of AF in 3, 6, and 9 months following ablation were recorded for all patients. Changes in P wave parameters were compared between patients with and without AF recurrence. Results: Compared to preprocedural measurements, Pamp (from 0.58 ± 0.18 mV at baseline to 0.48 ± 0.17 mV, P < 0.001), Pwd (from 109.72 ± 18.43 ms at baseline to 91.36 ± 22.53 ms, P < 0.001), and Pdis (from 55.44 ± 20.45 ms at baseline to 45.30 ± 15.31 ms, P < 0.001) were significantly decreased after CBA. The difference in Pamp between pre- and postprocedural values (?Pamp) was significantly higher in patients without AF recurrence compared to those with recurrence (0.10 ± 0.06 mV vs 0.04 ± 0.01 mV, P = 0.002). There was no difference in Pwd difference (?Pwd) and Pdis difference (?Pdis) between patients with and without AF recurrence (P > 0.05). Conclusion: Pamp, Pwd, and Pdis parameters exhibited significant decrease after CBA compared to preprocedural measurements. Decreased Pamp was shown to be a predictor for good clinical outcomes following CBA.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 Early atherosclerosis and conduction defect in a rare case of dunnigan type familial partial lipodystrophy(Turkish Society of Cardiology, 2024) Olgun, Fatih Erkam; Güler, Ekrem; Çeleğen, Muhammed Furkan; Demirçelik, Bora; Kılıçaslan, Fethi; Boztosun, BilalA 45-year-old female patient was admitted to the emergency department with syncope. Her medical history revealed a diagnosis of Familial Partial Lipodystrophy 2 (FPLD2). The patient's electrocardiogram showed a complete atrioventricular (A-V) block, and she had a history of insulin-dependent diabetes mellitus and coronary artery bypass surgery. A severe stenosis was observed in the aortic right coronary artery saphenous vein graft during coronary angiography, which was successfully revascularized. Subsequently, due to persistant syncope attacks, a permanent pacemaker was implanted after an electrophysiological study. This case highlights that serious cardiac conduction defects in patients with FPLD2 may not only be related to coronary artery disease but can also present as direct conduction defects.Öğe Early hemoptysis following cryoballoon pulmonary vein isolation: A single centre experience(Wiley, 2023) Olgun, Fatih Erkam; Kılıçaslan, Fethi[Abstract Not Available]Öğe Evaluation of changes in ventricular repolarization parameters in morbidly obese patients undergoing bariatric surgery(Springer, 2021) İbişoğlu, Ersin; Naki Tekin, Deniz Dilan; Kızılırmak, Filiz; Turgut Güneş, Saime; Boyraz, Bedrettin; Özdenkaya, Yaşar; Çakal, Sinem; Çakal, Beytullah; Savur, Ümeyir; Erdoğan, Aslan; Olgun, Fatih Erkam; Güneş, Hacı MuratBackground Weight loss after bariatric surgery has been associated with reduced cardiovascular mortality and overall mortality in obese patients. In this study, we aimed to analyze the changes between pre-operation and post-operation ventricular arrhythmia predictors in patients who underwent bariatric surgery. Materials and Methods The study included 58 patients who underwent bariatric surgery. We measured QT max, QT min, QRS, JT, and Tp-e intervals, and we estimated Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc rates, QTc max, QTc min, cQTd, and JTc intervals both pre-op and 6 months post-op. Results Heart rate, PR, QT max, QTc max, QTc min, cQTd, JTc, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, and Tp-e/JTc values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months post-op. Conclusion The results of our study showed that bariatric surgery had positive effects on the regression of ventricular repolarization parameters and the possible development of ventricular arrhythmia.Öğe Evans syndrome with non-ST segment elevation myocardial infarction complicated by hemopericardium(Elsevier B.V., 2016) Kızılırmak, Filiz; Demir, Gültekin Günhan; Çakal, Beytullah; Beköz, Hüseyin Saffet; Olgun, Fatih ErkamEvans syndrome (ES) is a rare hematological disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and/or neutropenia, all of which may be seen simultaneously or subsequently. Thrombotic events in ES are uncommon. Furthermore, non-ST segment-elevation myocardial infarction (NSTEMI) during ES is a very rare condition. Here, we describe a case of a 69-year-old female patient presenting with NSTEMI and ES. Revascularization via percutaneous coronary intervention (PCI) was scheduled and performed. Hemopericardium and cardiac tamponade occurred 5 h after PCI, and urgent pericardiocentesis was performed. Follow-up was uneventful, and the patient was safely discharged. Early recognition and appropriate management of NSTEMI is crucial to prevent morbidity and mortality. Coexistence of NSTEMI and ES, which is associated with increased bleeding risk, is a challenging scenario and these patients should be closely monitored in order to achieve early recognition and treatment of complications.Öğe Impact of aortic stiffness on the frequency of paroxysmal atrial fibrillation recurrences(Taylor & Francis, 2015) Kızılırmak, Filiz; Babür Güler, Gamze; Güler, Ekrem; Güneş, Hacı Murat; Demir, Gültekin Günhan; Omaygenç, Mehmet Onur; Çakal, Beytullah; Olgun, Fatih Erkam; Köklü, Erkan; Kılıçaslan, FethiBackground The relationship between arterial stiff ness (AS) and atrial fi brillation (AF) incidence is well-known. In this study we aimed to investigate the relationship between AS parameters and AF occurence as well as AF recurrence post catheter ablation (CA) in patients with paroxysmal AF (PAF). Methods We enrolled 103 patients with PAF diagnosis and 103 control subjects with similar demographic characteristics. We measured AS parameters and central aortic pressure (CAP) parameters by an oscillometric device in both groups. In the patient group 51 patients underwent CA for AF and recurrence rates at 3 and 6 months postprocedurally were recorded. AS parameters were compared between patients with and without AF recurrence. Results In the PAF patient group central systolic pressure, central diastolic pressure, central pulse pressure, augmentation pressure, augmentation index, and pulse wave velocity were signifi cantly higher than in the control group (for each listed parameter P < 0.05). AS parameters were not associated with AF recurrence post CA. Left atrial size (LAS) was found as an independent predictor for recurrence in multivariate analysis (?: 2.30; P = 0.02; OR: 9.97; 95% CI [1.28-77.48]). Conclusion Increased AS is associated with PAF occurence. Nevertheless, LAS, a traditional risk factor, was the most powerful predictor for recurrence post CA; whereas AS or CAP were not associated with recurrence.Öğe Impact of surgical weight loss on novel P-wave-related variables which are nominated as predictors of atrial arrhythmias(Wiley, 2021) İbişoğlu, Ersin; Boyraz, Bedrettin; Turgut Güneş, Saime; Savur, Ümeyir; Naki Tekin, Deniz Dilan; Erdoğan, Aslan; Özdenkaya, Yaşar; Erdoğan, Emrah; Çeğilli, Ercan; Olgun, Fatih Erkam; Güneş, Hacı MuratBackground Bariatric surgery has been associated with reduced cardiovascular mortality and morbidity in obese patients. In this study, we aimed to evaluate the alterations of novel P-wave related atrial arrhythmia predictors in patients who achieved effective weight loss with bariatric surgery. Methods The study included 58 patients who underwent bariatric surgery. We measured heart rate, PR, P wave (PW) max, PW min, Average P axis, P wave peak time (PWPT) in lead D2 and lead V1, terminal force in lead V1 (V1TF), and we estimated P wave dispersion (PWdis) interval both pre-operation and 6 months after operation. Results Heart rate, PR, PW max, PW min, PWdis, Average P axis, PWPTD2, PWPTV1 and V1TF values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months after the operation. The most prominent changes were observed in PW dis (51.15 +/- 9.70 ms vs. 48.79 +/- 9.50 ms, p = .010), PWPTD2 (55.75 +/- 6.91 ms vs. 50.59 +/- 7.67 ms, p < .001), PWPTV1 (54.10 +/- 7.06 ms vs. 48.05 +/- 7.64 ms, p < .001) and V1TF (25 [43.1%] vs. 12 [20.7%], p < .001). Conclusions The results of our study indicated that bariatric surgery has positive effects on the regression of ECG parameters which are predictors of atrial arrhythmias, particularly atrial fibrillation (AF).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 Miyokart iskemisi olan kararlı koroner arter hastalarında lezyon lokalizasyonunun ve iskemik miyokart kitlesi büyüklüğünün aritmi parametreleri ile değerlendirilmesi(İstanbul Medipol Üniversitesi Tıp Fakültesi, 2016) Olgun, Fatih Erkam; Boztosun, BilalAmaç: Kararlı koroner arter hastalığında, hangi koroner arterdeki kritik darlığın daha aritmik olduğunu ve darlık bulunan arterin mi yoksa darlığa bağlı iskemi altında kalan miyokart dokusunun büyüklüğünün mü aritmi açısından daha önemli olduğunu elektrokardiyografi (EKG) üzerinde hesaplanan aritmi öngördürücüleri yardımıyla değerlendirmektir. Yöntem: Ocak 2013-2016 tarihleri arasında koroner anjiyografisinde tek damar hastalığı saptanmış ve bu damara perkütan koroner girişim uygulanmış 183 hastadan, çalışmadan dışlanma kriterlerine sahip olmayan toplam 155 hasta çalışmaya dahil edildi. Çalışma retrospektif olarak hastane kayıtları üzerinden yapıldı. Girişim öncesi ve sonrası çekilen EKG'lerde aritmi öngördürücülerinden TpTe intervali, QTc intervali ve TpTe/QT oranı hesaplandı. İskemi altındaki miyokart dokusu yüzdesi APPROACH skoru kullanılarak, koroner anjiyografi görüntüleri yardımı ile hesaplandı. Bulgular: Hastaların 60 tanesinde izole LAD lezyonuna, 54 tanesinde izole Cx lezyonuna, 41 tanesinde izole RCA lezyonuna perkütan koroner girişim (PKG) uygulanmıştır. LAD lezyonlarının iskemi altında bıraktığı sol ventrikül miyokart dokusu yüzdesinin (34±10); Cx (17±11) ve RCA (21±5)'nın iskemi altında bıraktığı miyokart dokusu yüzdelerinden anlamlı bir şekilde fazla olduğu görüldü (p<0,001). LAD lezyonu olan grupta; Cx ve RCA lezyonları olan gruplara göre preoperatif TpTe intervali, QTc intervali, TpTe/QT oranı yüksek saptandı (p<0,001). Perkütan koroner girişim öncesi ve sonrası TpTe intervali ve TpTe/QT oranı farkı LAD lezyonu olan grupta Cx ve RCA lezyonu olan gruplardan anlamlı bir şekilde yüksek bulundu (p<0,001). Sonuç: Kararlı koroner arter hastalığında EKG üzerinden hesaplanan aritmi öngördürücülerinin, kritik LAD lezyonlarına sahip hastalarda yüksek saptandığı ve bu yüzden kritik LAD lezyonlarının diğer lezyonlardan daha aritmojen olabileceği görüldü. İskemik miyokart büyüklüğü arttıkça aritmojenitenin artabileceği saptandı. PKG öncesi ve sonrası aritmi parametrelerindeki değişim miktarı en fazla LAD lezyonlarında saptandı. EKG üzerinden hesaplanan aritmi parametreleri açısından revaskülarizasyondan en fazla fayda gören grubun kritik LAD darlığına sahip kararlı koroner arter hastaları olduğu gösterildi.Öğe Myocardial injury biomarkers after radiofrequency catheter and cryoballoon ablation for atrial fibrillation and their impact on recurrence(Via Medica, 2017) Kızılırmak, Filiz; Gökdeniz, Tayyar; Güneş, Hacı Murat; Demir, Gültekin Günhan; Çakal, Beytullah; Babur Güler, Gamze; Güler, Ekrem; Olgun, Fatih Erkam; Kılıçaslan, FethiBackground: Myocardial injury induced by catheter ablation (CA) for atrial fibrillation (AF) leads to elevated biomarker levels. Aim: This prospective study examined levels of myocardial injury biomarkers (creatinine kinase [CK], myocardial bound for CK [CK-MB], and troponin I [TnI]) and their impact on AF recurrence following two different ablation strategies, namely: cryoballoon ablation (CBA) and radiofrequency ablation (RFA). We also aimed to evaluate the relationship between AF recurrence after CA and other clinical, echocardiographic and procedural parameters. Methods: We enrolled 98 patients with AF, 21% of whom had persistent AF and 79% had paroxysmal AF. 58% of patients underwent CBA, and 42% underwent RFA. CK, CK-MB, and TnI levels were measured before and 6 h after the procedure. Patients had follow-up visits three, six, and nine months after the index procedure. Biomarker levels were compared between the patients with and without AF recurrence. Results: Post-ablation CK (postCK), post-ablation CK-MB (postCKMB), and post-ablation TnI (postTnI) levels were significantly high in the CBA and RFA groups (p < 0.001 for all). TnI elevation (DTnI) was correlated with age (p = 0.033) and median temperature reached during ablation (p < 0.005) in the CBA group, while it was correlated with application time in the RFA group (p < 0.001). Multivariate analysis in the CBA group revealed age and left atrium diameter as positive independent predictors (p = 0.029 and p = 0.046), and DTnI as a negative independent predictor for AF recurrence (p = 0.001). Elevated cardiac biomarkers were not associated with AF recurrence in the RFA group (p > 0.05). Conclusions: The levels of all cardiac biomarkers were elevated after CBA and RFA. Elevated TnI levels after CBA were independent negative predictors of AF recurrence. Measurement of TnI levels after CBA may be useful for the prediction of better clinical outcome.Öğe Relationship between arterial stiffness parameters and the extent and severity of coronary artery disease(Elsevier Science Bv., 2017) Kızılırmak Yılmaz, Filiz; Babur Güler, Gamze; Kaya, Özgür; Güler, Ekrem; Demir, Gültekin Günhan; Güneş, Hacı Murat; Olgun, Fatih Erkam; Barutçu, İrfan; Boztosun, BilalBackground: The association between arterial stiffness (AS) and coronary artery disease (CAD) has been previously demonstrated. In the present study, we aim to investigate the relationship between various AS parameters and the extent and severity of CAD. Methods: The study population consisted of 411 patients with CAD documented by coronary angiography. We measured various AS parameters including augmentation index (AIx), augmentation pressure (AP), pulse wave velocity (PWV), central systolic pressure (cSys), central diastolic pressure (cDia) and central pulse pressure (cPP) with pulse wave analysis. Angiographic images were used to calculate Gensini score and Syntax score. AS parameters were compared using Gensini score and Syntax score. Results: Syntax score is correlated with age, cSys, cPP, PWV, AP, brachial pulse pressure (bPP), hemoglobin, urea, diabetes mellitus, left main coronary artery disease (p < 0.10 for each). However, Gensini score is correlated only with age, diabetes mellitus, left main coronary artery disease and bPP (p < 0.10 for each). Multivariate analysis revealed age, diabetes mellitus, left main coronary artery disease and bPP as significant predictors of Syntax score; however, for Gensini score, age, diabetes mellitus, gender, left main coronary artery disease, and bPP are determined as predictors. Conclusion: AS parameters are not associated with Syntax score or Gensini score. Apart from traditional risk factors, bPP appears to be the only significant predictor for Syntax score and Gensini score.Öğe Relationship between autonomic nervous system activity and recurrence after cryoballoon ablation in patients with paroxysmal atrial fibrillation(University of Health Sciences, Kartal Koşuyolu High Specialization Training and Research Hospital, 2022) Kızılırmak Yılmaz, Filiz; Yılmaz, Fatih; Yıldırım, Arzu; Güneş, Hacı Murat; Gökdeniz, Tayyar; Olgun, Fatih Erkam; Aktemur, Tuğba; Savur, Ümeyir; Kılıçaslan, FethiIntroduction: In this study, we aimed to investigate the relationship between autonomic dysfunction (AD) deter- mined according to the blood pressure (BP) and heart rate (HR) response in exercise treadmill test (ETT) prior to cryoballoon ablation (CBA), and the recurrence of atrial fibrillation (AF) after CBA in patients with paroxysmal AF. Patients and Methods: Seventy-six patients (mean age 53 ± 11 years, 61.8% male) with paroxysmal AF who underwent CBA were enrolled. Before CBA the ETT was performed by all patients. BP and HR responses in ETT were compared between patients with and without AF recurrence. Results: AD rate was significantly higher in the group with recurrence compared to the non-recurrent group (p< 0.001). In addition to AD, age, female gender, and lower exercise capacity were also associated with post-CBA AF recurrence (p> 0.05 for all). Examining AD parameters, systolic blood pressure at peak exercise (SBPpeak) (p< 0.001) and diastolic blood pressure at peak exercise (DBPpeak) (p< 0.001), slow heart rate recovery (HRR) (p< 0.001) were significantly higher in the recurrent group. Conclusion: AD may be associated with AF recurrence after CBA in patients with paroxysmal AF. SBPpeak, DBPpeak, and slow HRR appear to be predictors of AF recurrence after ablation.Öğe The impact of plasmablade on cardiac implantable electronic device generator replacement procedures(AVES, 2022) Olgun, Fatih Erkam; Yıldırım, Ersin; Demir, Gültekin Günhan; Kılıçaslan, Fethi[Abstract Not Available]Öğe The impact of the naples prognostic score on the short- and long-term prognosis of patients undergoing transcatheter aortic valve implantation(2024) Hakgör, Aykun; Dursun, Atakan; Çatalbaş Kahraman, Başak; Yazar, Arzu; Savur, Ümeyir; Akhundova, Aysel; Olgun, Fatih Erkam; Güvendi Şengör, BüşraBACKGROUND: Preoperative systemic inflammation and nutritional status have been shown to affect prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). In this study, we investigated the effect of the Naples Prognostic Score (NPS), which consists of four different parameters including these two components on short- and long-term prognosis in patients undergoing TAVI. METHODS: In 343 patients (mean age 78.1?±?8.4 years, 51.3% female) who underwent TAVI, the NPS score was calculated from the blood tests obtained before the procedure and the study population was divided into three according to the NPS value: those with 0 and 1 were divided into Group-1, those with 2 into Group-2, and those with 3 and 4 into Group-3. The relationship between NPS group and in-hospital adverse events and long-term survival was evaluated. RESULTS: Systolic pulmonary artery pressure, STS score, presence of chronic lung disease and being in NPS Group-3 [adjusted odds ratio (adjOR): 3.93, 95% confidence interval (CI) (1.02-15.17), P ?=?0.047] were found to be independent predictors of in-hospital mortality. According to the multivariate Cox-regression model, both Group-2 NPS [adjusted hazard ratio (adjHR): 4.81, 95% CI (1.09-21.14), P ?=?0.037] and Group-3 NPS [adjHR: 10.1, 95% CI (2.31-43.36), P ?=?0.002] was an independent predictor of 2-year all-cause mortality after TAVI. There was no significant difference in perioperative adverse events between the groups except for postprocedural acute kidney injury. According to receiver-operating characteristic analysis, the optimal predictive value of NPS for in-hospital and long-term mortality was 2.5. CONCLUSION: In patients who will be candidates for TAVI, NPS is a simple and effective tool for determining both short- and long-term prognosis.Öğe Transseptal puncture and cryoballoon ablation of atrial fibrillation in patients with atrial septal occluder or atrial septal defect surgical repair a single center experience(2024) Olgun, Fatih Erkam; Yıldırım, Ersin; Demir, Gültekin Günhan; İbişoǧlu, Ersin; Hakgör, Aykun; Savur, Ümeyir; Yazar, Arzu; Akhundova, Aysel; Dursun, Atakan; Kılıçaslan, FethiBackground: Atrial fibrillation (AF) is a common arrhythmia in patients with atrial septal defect (ASD). Cryoballoon ablation (CA) is a safe and efficient method for pulmonary vein (PV) isolation in the treatment of AF. Achieving left atrial access may be difficult in patients with atrial septal occluders (ASO) or surgical repair of ASD. The aim of this study was to present our experience with the efficacy and safety of transseptal puncture and AF ablation in CA in this subset of patients. Methods: We retrieved our data about patients with ASO or surgical repair of ASD undergoing cryoballoon AF ablation procedures at our center between August 2019 and January 2022. Results: Nine patients (age 43.88 ± 9.73 years) with AF (5 paroxysmal and 4 persistent) and ASO or surgical repair of ASD were enrolled. All three patients had a 28 mm Amplatzer ASO device which occupied the whole septum, and direct puncture through the ASO was performed. Sequential balloon dilatation was performed in 2 patients with surgical ASD repair and all 3 patients with ASO. Four of 6 patients (66.7%) in the surgical repair group required transesophageal echocardiography during transseptal puncture. The endpoint of the procedure, isolation of all PVs, was achieved in all 9 patients. None of the patients had evidence of an interatrial shunt or pericardial effusion at the end of the procedure. Total procedural time (123 ± 28 minutes vs. 63 ± 21 minutes, P = .024) and total fluoroscopy time (41 ± 5 minutes vs. 23 ± 8 minutes, P = .024) were significantly higher in the percutaneous closure group. Conclusions: In patients with ASO or surgical repair of ASD, CA of AF might be feasible, safe, and effective. The balloon dilatation of the interatrial septum (IAS) might assist transseptal access through the ASO or a surgically repaired thickened IAS.
