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Öğe Can the Glasgow prognostic score predict ischemic stroke in patients with infective endocarditis?(Assoc Medica Brasileira, 2024) Aydin, Cihan; Demirkiran, Aykut; Aykac, Huseyin; Uslu, Nurullah; Alpsoy, SerefOBJECTIVE: The Glasgow prognosis score is a simple parameter calculated using serum levels of albumin and C-reactive protein. The aim of this study was to examine whether this parameter may predict ischemic stroke in patients with infective endocarditis. METHODS: A total of 80 patients who were diagnosed with definitive infective endocarditis according to Duke criteria between 2016 and 2023 were included in the study. Glasgow prognosis score was based on serum levels of albumin and C-reactive protein. In imaging methods, patients were divided into two groups according to whether they had a stroke or not. These two groups were compared in terms of biochemical parameters, and infective endocarditis findings on echocardiography and Glasgow prognosis score. RESULTS: We found that the results were statistically similar except for serum C-reactive protein (Group 1: 54.9 +/- 71.1 and Group 2: 39 +/- 70.7; p=0.03), neutrophil (Group 1: 19.8 +/- 10.8*10(9)/L and Group 2: 13.3 +/- 7.3*109/L; p=0.014), albumin (Group 1: 2.3 +/- 0.6 and Group 2: 2.8 +/- 0.5; p=0.03), and Glasgow prognosis score (Group 1: median 2, min.-max. (1-2) and Group 2: median 1, min.-max. (0-1); p=0.004). In the receiver operating characteristics analysis, Glasgow prognosis score had 82.4% sensitivity and 58.3% specificity in predicting ischemic stroke if the Glasgow prognosis score cutoff was >= 1. In multivariate logistic regression analysis, chronic renal failure [odds ratio (OR): 1.098; 95% confidence interval: 1.054-1.964; p=0.044], age (OR: 1.050; 95%CI 1.006-1.096; p=0.024), and Glasgow prognosis score (OR: 0.695; 95%CI 0.411-0.949; p=0.035) were independent variables in predicting ischemic stroke. CONCLUSION: High Glasgow prognosis score is an independent predictor of ischemic stroke in patients with infective endocarditis. Glasgow prognosis score, determined using albumin and C-reactive protein levels, is a simple and practical index for predicting the prognosis of patients hospitalized with infective endocarditis.Öğe Can the SYNTAX score predict mortality in patients with cardiac arrest?(Assoc Medica Brasileira, 2024) Demirkiran, Aykut; Aydin, Cihan; Orun, Serhat; Kaplangoray, MustafaOBJECTIVE: Sudden cardiac death or arrest describes an unexpected cardiac cause-related death or arrest that occurs rapidly out of the hospital or in the emergency room. This study aimed to reveal the relationship between coronary angiographic findings and cardiac death secondary to acute MATERIALS AND METHODS: Patients presenting with acute ST-elevation myocardial infarction complicated with cardiac arrest were included in the study. The severity of coronary artery disease, coronary chronic total occlusion, coronary collateral circulation, and blood flow in the infarct-related artery were recorded. Patients were divided into two groups, namely, deaths secondary to cardiac arrest and survivors of cardiac arrest. RESULTS: A total of 161 cardiac deaths and 42 survivors of cardiac arrest were included. The most frequent (46.3%) location of the culprit lesion was on the proximal left anterior descending artery. The left-dominant coronary circulation was 59.1%. There was a difference in the SYNTAX score (16.3 +/- 3.8 vs. 13.6 +/- 1.9; p=0.03) and the presence of chronic total occlusion (19.2 vs. 0%; p=0.02) between survivors and cardiac deaths. A high SYNTAX score (OR: 0.38, 95%CI: 0.27-0.53, p<0.01) was determined as an independent predictor of death secondary to cardiac arrest. CONCLUSION: The chronic total occlusion presence and SYNTAX score may predict death after cardiac arrest secondary to ST-elevation myocardial infarction.Öğe Decrease of left ventricular ejection fraction in severe illness patients due to COVID-19 may improve as the disease resolves(Turkiye Klinikleri, 2021) Demirkiran, Aykut; Onar, L. Ç.; Doğan, MustafaBackground/aim: Increase in publications supporting myocardial involvement in the COVID-19 disease has led to need to gain insight into the the global burden of heart failure after pandemic. We examined the course of myocardial systolic function in patients without elevated troponin levels. Materials and methods: We performed a prospective study. Patients with high troponin levels were excluded from the study in order to definitively exclude complications known to cause permanent left ventricular systolic dysfunction, such as acute coronary syndromes. Two echocardiographic examinations were performed. The first evaluation was performed within the days of hospitalization, if possible, on the day when dyspnea is severe. The second evaluation was performed during the outpatient clinic controls one month after the patient was recovered. Left ventricular ejection fraction (LVEF) was measured using the biplane method of disks (modified Simpson’s rule). Results: In the first evaluation, LVEF was found to be significantly lower in the severe illness group than mild/moderate illness group (50 ± 6% and 59 ± 6%; p = 0.03). LVEF decrease (<50%) was found in fifteen patients (43 ± 4%) and detected as global hypokinesia but not segmental. All of these patients were in the severe illness group. In the second evaluation, LVEFs of the fifteen patients with decreased LVEF in the first evaluation were improved and detected in normal limits (first evaluation = 43 ± 4% and second evaluation = 55 ± 2%, p = 0.01). Conclusion: Considering patients without elevated troponin levels during COVID-19 infection, no permanent systolic dysfunction was detected after first month of recovery. We found that transient myocardial dysfunction may develop in the severe illness group with normal troponin levels, LVEF may decrease in the acute phase and improve with the recovery period. © TÜBİTAK.Öğe Do we damage nucleus pulposus tissue while treating cerebrovascular ischemic neurological deficits with nimodipine?(2018) Karaarslan, Numan; Yılmaz, İbrahim; Şirin, Duygu Yaşar; Baykız, Derya; Demirkiran, Aykut; Ateş, ÖzkanAim: Nimodipine is used to prevent cerebrovascular-originated ischemic neurological deficits, yet its effects on nucleus pulposus (NP) cells or annulus fibrosus (AF) cells weren’t studied. This study aimed to examine nimodipine’s effects on vitality and proliferation of chondroadherin (CHAD), type II collagen (COL2A1), and hypoxia-inducible factor 1 alpha (HIF 1?) gene expression in human primary NP/AF cells.Material and Methods: NP/AF cell cultures obtained from 6 patients who underwent microdiscectomy were treated with 100 µMolar nimodipine and analyzed at 0, 24, and 48 h. Data were evaluated using one-way ANOVA and post-hoc Tukey HSD with 95% confidence interval.Results: We observed suppressed cell proliferation and increased necrosis in nimodipine-treated NP/AF cell cultures, especially degenerated tissue. COL2A1 gene expression wasn’t detected in any experimental groups. CHAD and HIF 1? expression had timedependent decreases in control. CHAD and HIF 1? expression were found to decrease at 24h, but increased at 48h in degenerated tissue. In nimodipine-applied intact tissues, CHAD expression was stable at 24h but 1.62 times higher than control at 48h. HIF 1? levels were lower than control.Conclusion: In nimodipine-treated degenerated AF/NP cultures, CHAD and HIF 1? expressions had time-dependent decreases. However, after complete RT-PCR data evaluation, no correlation between nimodipine application and gene expression occurred.Öğe Endocan may predict the presence of coronary slow flow and coronary artery disease(Assoc Medica Brasileira, 2024) Efe, Muhammet Mucip; Akyuz, Aydin; Aydin, Cihan; Demirkiran, Aykut; Alpsoy, SerefOBJECTIVE: Coronary artery disease (CAD) is frequent, but coronary slow flow (CSF) is a less common cardiovascular disease with a significant risk of mortality and morbidity. Endocan is a proinflammatory glycopeptide that has been investigated in cardiovascular diseases as well as some inflammatory diseases in recent years. We planned to compare the levels of endocan in both CAD and CSF in a similar population and examine the relationship of endocan with additional clinical variables. MATERIALS AND METHODS: In the trial, we included 169 consecutive subjects having a coronary angiography indication. According to the results of coronary angiography, 58 people were included in the CAD group, 52 were in the CSF group, and 59 people were in the control group. The control group includes those who did not have any lesions in their epicardial coronary arteries. Thrombolysis in myocardial infarction (TIMI)-frame counts (TFC) were calculated for all patients. RESULTS: Notably, 2.6% of the population in our study had CSF. Both the CAD (555 +/- 223 pg/mL) and CSF (559 +/- 234 pg/mL) groups had higher endocan levels than the control group (331 +/- 252 pg/mL) (p<0.001). There were similar endocan levels between the CAD and CSF groups. Endocan levels were shown to be favorably associated with mean TFC (r=0.267; p0.001). Serum endocan levels (particularly those above 450 pg/mL) and the presence of hyperlipidemia were the most important predictors of both CAD and CSF. CONCLUSION: Endocan levels are higher in CAD and CSF patients than in those with normal coronary arteries.Öğe Evaluation of Tp-e/QTc Ratio in Obesity(Galenos Publ House, 2024) Uyan, Umut; Aydin, Cihan; Demirkiran, Aykut; Karadeniz, Muhammed; Alpsoy, SerefAim: We aimed to detect simple findings that might predict sudden cardiac death in electrocardiography recordings in obese patients. Materials and Methods: Patients were included in our study retrospectively. Two groups with body mass index (BMI) >= 30 kg/m(2) (Group 1) and BMI <30 kg/m(2) (Group 2) were sampled from the study population with similar baseline characteristics, biochemical and echocardiographic features. Ventricular repolarization parameters were compared between the two groups. The Tp-e interval was defined as the period of time between the T waves' peak and their end. Tp-e/QTc ratio was calculated. Results: This study included 190 participants. There were no differences between the two groups in terms of age (p=0.42), diabetes (p=0.238), hypertension (p=0.877), smoking (p=1.000), medical treatment used, laboratory parameters, left ventricular ejection fraction (p=0.673), and left ventricular mass index (p=0.089). The QTc interval was similar between the groups (416.4 +/- 11.6 ms, and 422.1 +/- 14.8 ms; p=0.081). Tp-e, and Tp-e/QTc ratio were greater in Group 1 (93.1 +/- 6.2 ms, and 67.7 +/- 2.5 ms; p=0.00; 0.22 +/- 0.02, and 0.15 +/- 0.01; p=0.001). Twelve months after the first examinations, six deaths were noted in the obese group (p=0.001). Conclusion: Our study results showed that the Tp-e interval and Tp-e/QTc ratio were significantly increased, and sudden cardiac death was more common in patients with BMI >= 30 kg/m(2).Öğe Investigation of the Relationship Between Triglycerides-Glucose Index and Coronary Slow Flow: A Retrospective Case-Control Study(Arquivos Brasileiros Cardiologia, 2023) Kaplangoray, Mustafa; Toprak, Kenan; Basanalan, Fuat; Palice, Ali; Aydin, Cihan; Demirkiran, Aykut; Cekici, YusufBackground: Coronary slow flow (CSF) refers to delayed distal vessel opacification in the absence of epicardial coronary artery stenosis. The etiopathogenic mechanism of CSF is still unclear.Objectives: This study investigates the relationship between CSF and the triglyceride-glucose (TyG) index.Methods: The study sample consisted of 118 CSF patients and 105 patients with normal coronary flow (NCF). The coronary flow rate was measured via the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method in all patients. The TyG index was calculated as the logarithm of the [fasting triglyceride (mg/dL)xfasting glucose (mg/dL)]/2 value. A significance level of < 0.05 was adopted as statistically significant.Results: The TyG index, low-density lipoprotein (LDL), body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR) and TFC values, male ratio, and the ratio of smokers were higher, whereas high-density lipoprotein (HDL) levels were significantly lower in the CSF group compared to the NCF group (p<0,05). The correlation analysis revealed that CSF was significantly correlated with TyG index, BMI, NLR, and HDL values. The strongest of these correlations was between CSF and TyG index (r= 0.57, p<0.001). Additionally, the multivariate analysis revealed that TyG index, BMI, NLR ratio, and male gender were independent predictors for CSF (p<0.05). Receiver operating characteristic (ROC) curve analysis indicated that a cut-off value of >= 9.28 for the TyG index predicted CSF with a sensitivity of 78% and a specificity of 78.1% [Area under the curve (AUC): 0.868 and 95% Confidence Interval (CI): 0.823-0.914].Conclusion: The findings of this study revealed a very strong relationship between CSF and TyG index.Öğe Letter: Inflammatory Markers and Coronary Collateral Circulation(Sage Publications Inc, 2024) Demirkiran, Aykut; Aydin, Cihan; Engin, Mesut[Abstract Not Available]Öğe NATRIURETIC PEPTIDE CONCENTRATIONS AND ECHOCARDIOGRAPHY FINDINGS IN PATIENTS WITH MICRO-ATRIAL FIBRILLATION(Russian Heart Failure Soc, 2024) Aykac, Huseyin; Aydin, Cihan; Demirkiran, Aykut; Uslu, Nurullah; Alpsoy, SerefAim Atrial fibrillation (AF) is a rhythm disorder characterized by very rapid and disorganized atrial-derived electrical activations with uncoordinated atrial contractions. Very short periods of AF-like activity (micro-AF) may be precursors of undetected, silent episodes of atrial fibrillation. Here, we examined the relationship between natriuretic peptide concentrations and echocardiography findings in patients with micro-AF. Material and methods The electrocardiograms (ECGs) of patients complaining of palpitations were recorded with a 24-hour Holter monitor, and the patients were consecutively included in the study. Micro-AF was defined as sudden, irregular atrial tachycardia lasting less than 30 sec with episodes of >= 5 consecutive supraventricular depolarizations with the absolute absence of p-waves. After a G-power test, patients were consecutively included in the study: 45 patients in the micro-AF group and 45 patients in the control group. Laboratory parameters, ECG and echocardiographic findings of the two groups were compared. Results N-terminal pro B-type natriuretic peptide (Pro-BNP) and serum troponin T concentrations were higher in the micro-AF group, (375.5 +/- 63.6 pg / ml vs. 63.1 +/- 56.8 pg / ml, p<0.001; 13 +/- 11.4 ng / dl vs. 4.4 +/- 2.4 ng / dl, p<0.001 respectively.) Each 1 pg / ml increase in serum Pro-BNP increased the risk of micro-AF by 1.8 %. In the ROC analysis, the cut-off value of Pro-BNP for the diagnosis of micro-AF was 63.4 pg / ml, with a sensitivity of 91.1 % and a specificity of 73.3 %. Atrial electro-mechanical delay durations were significantly higher in the micro-AF group. To predict micro-AF, the inter-annulus plane electromechanical delay time (inter-annulus plane AEMD) had a cut-off value of 18.5 sec, with a sensitivity of 93.3 % and a specificity of 91.1 %. Left intra-annulus plane electro-mechanical delay time (intra-annulus AEMD LEFT) had a cut-off value of 11.5 sec with a 95.6 % sensitivity and 75.6 % specificity. In the ECG evaluation, maximum P wave duration (Pmax) (113.+/- 10.2 ms vs. 98 +/- 10.4 ms; p<0.001), minimum P wave duration (Pmin) (73.8 +/- 5.5 ms vs.70 +/- 6.3 ms; p<0.001) and P wave dispersion (PWD) (39.1 +/- 7.9 ms vs.28 +/- 7.6 ms; p<0.001) were longer in the micro-AF group. Conclusions Micro-AF in patients may be predicted by evaluating ECG, echocardiographic, and serum natriuretic peptide data.Öğe Relationship between the infarct localization and left ventricular rotation parameters following acute ST-segment elevation myocardial infarction(Turkish Soc Cardiology, 2020) Demirkiran, Aykut; Zorkun, Cafer Sadık; Demir, Hasan Deniz; Topçu, Birol; Emre, Ender; Özdemir, NihalOjective: This study was an investigation of the role of left ventricular (LV) apical rotation seen in the early period after myocardial infarction (MI) in predicting infarct localization. Methods: A total of 124 patients with a ST-Segment elevation myocardial infarction (STEMI) diagnosis who underwent primary percutaneous coronary intervention (PCI) and 50 healthy volunteers with similar demographic characteristics were included in the study. The relationship between 2-dimenstional speckle tracking echocardiography (STE)-guided LV apical rotation angle measurements and technetium-99m sestamibi-single-photon emission computed tomography (SPECT)-guided infarct localization was evaluated. Conventional echocardiography and STE were performed on average 2 days after PCI, and gated SPECT myocardial perfusion imaging (MPI) was performed within an average of 60 days. Results: The apical rotation angle was lower in patients with an anterior MI compared with those who had an inferior MI and the control group (AntMl-InfMl: 6.51 +/- 2.4 degrees, AntMI-Control: 13.20 +/- 2.5 degrees, InfMI-Control: 14.3 +/- 2.1 degrees, p value: 0.00, 0.00, 0.15, respectively). SPECT MPI analysis revealed the presence of an LV apical scar in all patients with acute anterior MI, but only 14 of those with inferior MI group (usually the inferoapical wall). The apical rotation angle recorded in patients with apical scar was lower than that of the patients without apical scar (7.6 +/- 2.8 degrees and 14.5 +/- 2 degrees, respectively; p=0.00). Receiver operating characteristic curve analysis yielded an area under the curve for apical rotation of 0.799 (p<0.01). The optimal cutoff value of 12.1 degrees had a sensitivity of 78.3% and a specificity of 68.2% for predicting LV apical scar following STEMI. Conclusion: Detection of apical rotation angle decrease in the early period after STEMI may be useful in predicting extension of infarct scarring to the LV apex.Öğe Role of simple inflammatory parameters in predicting the severity of coronary artery disease(Assoc Medica Brasileira, 2023) Aydin, Cihan; Uyan, Umut; Karadeniz, Muhammed; Demirkiran, AykutOBJECTIVE: In our study, we aimed to find simple, useful biomarkers in patients with non-ST elevation myocardial infarction to predict coronary artery severity.METHODS: Between May 2022 and December 2022, patients diagnosed with non-ST elevation myocardial infarction according to the European cardiology guidelines were included in our study. The Synergy between PCI with Taxus and Cardiac Surgery score was calculated to determine the severity of coronary artery disease. These patients were classified into two groups according to Synergy between PCI with Taxus and Cardiac Surgery >= 23 and Synergy between PCI with Taxus and Cardiac Surgery<23 scores. Biochemical markers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio were studied in blood tests taken before coronary angiography in patients diagnosed with non-ST elevation myocardial infarction according to current guidelines. These two groups were compared in terms of the data obtained.RESULTS: There were 281 patients in group 1 and 67 patients in group 2. There was no significant difference between the two groups in terms of demographic data such as age and gender. Platelet-to-lymphocyte ratio [group 1=125 (26-134) and group 2=156 (73-293); p=0.001] and neutrophil-to-lymphocyte ratio [group 1=2.71 (1.3-30.2) and group 2=3.2 (2.1-32.1); p=0.002] were higher in the group of patients with a Synergy between PCI with Taxus and Cardiac Surgery score of <23, while lymphocyte-to-monocyte ratio [group 1=3.6 (0.56-11) and group 2=3.4 (0.64-5.75); p=0.017] was lower in group 2.CONCLUSION: We observed that elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios showed coronary artery severity. Multivessel disease and chronic total occlusion rates were observed to be higher in patients with high platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios.Öğe Serum chromogranin A levels are associated with the SYNTAX score in coronary artery disease(Assoc Medica Brasileira, 2023) Celikkol, Aliye; Demirkiran, Aykut; Aydin, Cihan; Akyuz, Aydin; Kaplangoray, Mustafa; Yilmaz, Ahsen; Efe, Muhammed MucipOBJECTIVE: In this article, we investigated the association of chromogranin A with coronary artery disease.METHODS: Biochemical parameters and chromogranin A levels obtained from peripheral blood samples during coronary angiography were analyzed in 90 patients. Patients were classified into two groups, namely, SYNergy between PCI with TAXUS and Cardiac Surgery score >= 1 (n=45) and SYNergy between PCI with TAXUS and Cardiac Surgery score=0 (n=45). This is a cross-sectional, prospective study. RESULTS: Serum chromogranin A levels were significantly higher in the group with SYNergy between PCI with TAXUS and Cardiac Surgery score >= 1 compared to the group with SYNergy between PCI with TAXUS and Cardiac Surgery score=0 (1381.5 +/- 418.9 ng/mL and 1121.2 +/- 290.7 ng/mL, respectively; p=0.002). Serum chromogranin A levels were correlated with SYNergy between PCI with TAXUS and Cardiac Surgery score (r=0.556, p<0.04). ROC analysis showed that the area under the curve for serum chromogranin A levels was 0.687 (p=0.007), and the best cutoff value of 1,131 ng/mL had a sensitivity of 67% and a specificity of 65% for the prediction of coronary artery disease.CONCLUSION: Serum chromogranin A levels were increased in coronary artery disease patients with SYNergy between PCI with TAXUS and Cardiac Surgery score >= 1. Increasing serum chromogranin A levels are proportional to the SYNergy between PCI with TAXUS and Cardiac Surgery score.KEYWORDS: Chromogranin A. Coronary artery disease. Hypertension.Öğe Speckle-tracking strain assessment of left ventricular dysfunction in synthetic cannabinoid and heroin users(Turkish Soc Cardiology, 2018) Demirkiran, Aykut; Albayrak, Neslihan; Albayrak, Yakup; Zorkun, Cafer SadikObjective: There is growing evidence regarding the numerous adverse effects of synthetic cannabinoids (SCBs) on the cardiovascular system; however, no studies have shown the cardiovascular effects of opioids using strain echocardiography. This study examines the cardiac structure and function using echocardiographic strain imaging in heroin and synthetic cannabinoid users. Methods: This double-blind study included patients who were admitted or referred to a rehabilitation center for heroin (n=31) and synthetic cannabinoid users (n=30). Heroin users and synthetic cannabinoid users were compared with healthy volunteers (n=32) using two-dimensional (2D) speckle-tracking (ST) echocardiography. Results: No differences were found in the baseline characteristics and 2D echocardiography values. The mean global longitudinal strain value was -20.5%+/- 2.4% for SCB users, -22.3%+/- 2.4% for opioid users, and -22.5%+/- 2.2% for healthy volunteers (p=0.024). The mean apical 2-chamber (AP2C) L-strain values were -20.1%+/- 3.1%, -22.4%+/- 3.0%, and -22.3%+/- 2.8% for SCB users, opioid users, and healthy volunteers, respectively (p=0.032). The mean apical 4-chamber (AP4C) L-strain values were -20.7%+/- 2.5% for SCB users, -23.2%+/- 3.2% for opioid users, and -23.8%+/- 3.1% for healthy volunteers (p<0.001). Conclusion: SCBs are potential causes of subclinical left ventricular dysfunction.Öğe Strain can hide some states Reply(Turkish Soc Cardiology, 2018) Demirkiran, Aykut; Albayrak, Neslihan; Albayrak, Yakup; Zorkun, Cafer Sadik[No Abstract Available]
