İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner... more İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak çalışılmış, fakat ideal kriter veya kriterler tanımlanamamıştır. Biz bu çalışmada akut inferior miyokard infaktüsünde yüzey EKG'sini kullanarak erken dönemde infarktüsten sorumlu arteri tespit etmeyi amaçladık. Pratik olarak kullanılabilecek 2 kriter tek tek ve kombine olarak değerlendirildi. Bu kriterler şöyle idi: A) DIII'te ST elevasyonu > DII'de ST elevasyonu ise ve B) aVL'de ST depresyonu > DI'de ST depresyonu. Çalışmaya 41 akut inferior miyokard infarktüslü hasta dahil edildi. Kriter A ve kriter B'nin sağ koroner arter lezyonunu belirlemedeki sensitivite ve spesifisitesi yüksek saptanmasada her iki kriter beraber kullanıldığında yüksek spesifisite gösterdi. Sonuç olarak, bu çalışmamızda EKG kriterleri ile akut inferior miyokard infarktüsünde infarkttan sorumlu arterin tahmin edilebileceğini gösterdik. İnfarktüsten sorumlu arterin erken ve doğru tanımlanabilmesi risk altındaki miyokard miktarını öngörebilmemize, klinik riski tahmin edebilmemize ve acil revaskülarizasyon için harekete geçmemize yardımcı olur.
Early cessation of dual antiplatelet therapy (DAPT) is related to stent thrombosis (ST). The use ... more Early cessation of dual antiplatelet therapy (DAPT) is related to stent thrombosis (ST). The use of second-generation everolimus- and zotarolimus-eluting stents is associated with low restenosis rates and short duration of clopidogrel usage. Non-cardiac surgery in recently stent-implanted patients is associated with major adverse cardiac events (MACEs). Chronic renal failure patients awaiting renal transplantation may also undergo coronary stent implantation prior to surgery. Here we aimed to investigate the safety of early (3 months) DAPT interruption in second-generation drug-eluting stent (DES)-implanted renal transplant recipients. In total, 106 previously stent-implanted chronic renal failure patients who underwent renal transplantation were retrospectively enrolled. Three groups were formed according to stent type and the duration of DAPT: early-interruption (3 months from DES implantation), lateinterruption (3-12 months from DES implantation), and bare-metal stent (BMS; at le...
Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentra... more Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentrations and additional pleiotropic effects. However, less is known about the pleotropic effect of fibrates. To investigate the effects of fenofibrate therapy on inflammatory markers and serum paraoxonase activity in patients with combined hyperlipidemia in addition to their lipid lowering effects. Fifty patients (18 women, 32 men, mean age 50+/-8.7 years) with a history of combined hyperlipidemia and coronary artery disease were enrolled into the study. Serum lipids, inflammatory markers (high sensitivity C-reactive protein (hs-CRP) and fibrinogen levels) and paraoxonase levels were determined before and after two months of 250 mg per day of fenofibrate treatment. Fenofibrate decreased plasma fibrinogen level by 41% (from 3.9+/-0.9 mg/dl to 2.3+/-0.48 mg/dl, p<0.0001) and hs-CRP level by 71% (from 1.28 mg/dl to 0.36 mg/dl; p<0.0001). Changes in hs-CRP levels were not correlated with ...
ÖZET İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık% 99 olguda ko... more ÖZET İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık% 99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak ...
Catheterization and Cardiovascular Interventions, 2014
Aims: We report the first experience of transcatheter aortic valve implantation through a transca... more Aims: We report the first experience of transcatheter aortic valve implantation through a transcarotid approach under local anesthesia. Methods and Results: An 81‐year‐old gentleman with severe symptomatic aortic stenosis was referred for TAVI. He was not suitable for transfemoral, transapical, subclavian, or direct aortic approach. He had severe lung disease and was considered unsuitable for general anesthesia. We, therefore, performed the procedure under local anesthesia though the right common carotid artery (CCA) approach. Superficial cervical block was achieved with Levobupivacaine, and in addition, he also had a target controlled infusion of Remifentanil. Cerebral oximetry was monitored throughout the procedure. The CCA was accessed through surgical cut‐down. Aortic valvuloplasty was performed through a 12‐F sheath, and the CoreValve was deployed successfully through an 18‐F sheath. Conclusion: TAVI is commonly performed through femoral access under local anesthesia. The right...
Kombine Hiperlipidemili Olgularda Fibrat Tedavisinin Lipid Dışı Parametrelere Etkisi Dr. Yelda SA... more Kombine Hiperlipidemili Olgularda Fibrat Tedavisinin Lipid Dışı Parametrelere Etkisi Dr. Yelda SALTAN*, Dr. Sevil GÜÇLÜ*, Doç.Dr. Dilek YEŞİLBURSA*, Doç.Dr. Zehra SERDAR**, Dr. Davran ÇİÇEK*, Dr. Yasemin HEPER***, Dr. Neslihan ŞENGEZER*, Prof.Dr. Osman Akın ...
A 65-year-old woman was referred to our outpatient clinic for further evaluation of a chronic pri... more A 65-year-old woman was referred to our outpatient clinic for further evaluation of a chronic primary mitral regurgitation, seen in 2D transthoracic echocardiography (TTE) 10 years before.
Aerobic exercise training has an important role within the cardiac rehabilitation program. An exe... more Aerobic exercise training has an important role within the cardiac rehabilitation program. An exercise test performed in the early period after myocardial infarction (MI) allows determining early the functional status and the risk factors of the patients and can accelerate their return to their occupational life. Patients can get back faster and safely to their active lifestyle following MI with exercises carried out at least 3 days per week, for 20 to 60 minutes and at intensities between 40% to 85% of VO2max. These exercises may concern the lower extremity like walking or running, upper extremity like arm cycle ergometer or combinations of these like rowing or swimming. Regular aerobic exercises increase the functional capacity and parasympathetic tone, and these together lead to an improvement in cardiovascular autonomic control. As a result, frequency of coronary artery disease and other cardiovascular diseases declines to an important extent. Studies conducted in humans and animals have shown contradictory outcomes about left ventricular remodelling. General opinion is that aerobic exercise has no favourable effect on ventricular remodelling.
The Anatolian Journal of Cardiology is an international monthly periodical on cardiology publishe... more The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peerreview principles. The journal's publication language is English however titles of articles, abstracts and Keywords are also published in Turkish on the journal's web site. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal's scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
Journal of Thrombosis and Thrombolysis, May 29, 2009
The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.
The Journal of Heart and Lung Transplantation, 2018
Conclusion: In this sample of end-stage HF patients ≥ 65y, VAD recipients were sicker than those ... more Conclusion: In this sample of end-stage HF patients ≥ 65y, VAD recipients were sicker than those with OHT, which may explain poorer survival and longer LOS. These results imply that age alone should not be exclusionary for transplant consideration.
Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parki... more Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe e...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2004
Aerobic exercise training has an important role within the cardiac rehabilitation program. An exe... more Aerobic exercise training has an important role within the cardiac rehabilitation program. An exercise test performed in the early period after myocardial infarction (MI) allows determining early the functional status and the risk factors of the patients and can accelerate their return to their occupational life. Patients can get back faster and safely to their active lifestyle following MI with exercises carried out at least 3 days per week, for 20 to 60 minutes and at intensities between 40% to 85% of VO2max. These exercises may concern the lower extremity like walking or running, upper extremity like arm cycle ergometer or combinations of these like rowing or swimming. Regular aerobic exercises increase the functional capacity and parasympathetic tone, and these together lead to an improvement in cardiovascular autonomic control. As a result, frequency of coronary artery disease and other cardiovascular diseases declines to an important extent. Studies conducted in humans and ani...
The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.
İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner... more İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık %99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak çalışılmış, fakat ideal kriter veya kriterler tanımlanamamıştır. Biz bu çalışmada akut inferior miyokard infaktüsünde yüzey EKG'sini kullanarak erken dönemde infarktüsten sorumlu arteri tespit etmeyi amaçladık. Pratik olarak kullanılabilecek 2 kriter tek tek ve kombine olarak değerlendirildi. Bu kriterler şöyle idi: A) DIII'te ST elevasyonu > DII'de ST elevasyonu ise ve B) aVL'de ST depresyonu > DI'de ST depresyonu. Çalışmaya 41 akut inferior miyokard infarktüslü hasta dahil edildi. Kriter A ve kriter B'nin sağ koroner arter lezyonunu belirlemedeki sensitivite ve spesifisitesi yüksek saptanmasada her iki kriter beraber kullanıldığında yüksek spesifisite gösterdi. Sonuç olarak, bu çalışmamızda EKG kriterleri ile akut inferior miyokard infarktüsünde infarkttan sorumlu arterin tahmin edilebileceğini gösterdik. İnfarktüsten sorumlu arterin erken ve doğru tanımlanabilmesi risk altındaki miyokard miktarını öngörebilmemize, klinik riski tahmin edebilmemize ve acil revaskülarizasyon için harekete geçmemize yardımcı olur.
Early cessation of dual antiplatelet therapy (DAPT) is related to stent thrombosis (ST). The use ... more Early cessation of dual antiplatelet therapy (DAPT) is related to stent thrombosis (ST). The use of second-generation everolimus- and zotarolimus-eluting stents is associated with low restenosis rates and short duration of clopidogrel usage. Non-cardiac surgery in recently stent-implanted patients is associated with major adverse cardiac events (MACEs). Chronic renal failure patients awaiting renal transplantation may also undergo coronary stent implantation prior to surgery. Here we aimed to investigate the safety of early (3 months) DAPT interruption in second-generation drug-eluting stent (DES)-implanted renal transplant recipients. In total, 106 previously stent-implanted chronic renal failure patients who underwent renal transplantation were retrospectively enrolled. Three groups were formed according to stent type and the duration of DAPT: early-interruption (3 months from DES implantation), lateinterruption (3-12 months from DES implantation), and bare-metal stent (BMS; at le...
Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentra... more Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentrations and additional pleiotropic effects. However, less is known about the pleotropic effect of fibrates. To investigate the effects of fenofibrate therapy on inflammatory markers and serum paraoxonase activity in patients with combined hyperlipidemia in addition to their lipid lowering effects. Fifty patients (18 women, 32 men, mean age 50+/-8.7 years) with a history of combined hyperlipidemia and coronary artery disease were enrolled into the study. Serum lipids, inflammatory markers (high sensitivity C-reactive protein (hs-CRP) and fibrinogen levels) and paraoxonase levels were determined before and after two months of 250 mg per day of fenofibrate treatment. Fenofibrate decreased plasma fibrinogen level by 41% (from 3.9+/-0.9 mg/dl to 2.3+/-0.48 mg/dl, p<0.0001) and hs-CRP level by 71% (from 1.28 mg/dl to 0.36 mg/dl; p<0.0001). Changes in hs-CRP levels were not correlated with ...
ÖZET İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık% 99 olguda ko... more ÖZET İskemik kalp hastalığı önemli bir morbidite ve mortalite nedeni olup, yaklaşık% 99 olguda koroner ateroskleroza bağlıdır. Akut miyokard infarktüsünde yüzey EKG ile sorumlu arterin tespiti birçok çalışmada araştırılmış, EKG kriterleri tek tek ve kombine olarak ...
Catheterization and Cardiovascular Interventions, 2014
Aims: We report the first experience of transcatheter aortic valve implantation through a transca... more Aims: We report the first experience of transcatheter aortic valve implantation through a transcarotid approach under local anesthesia. Methods and Results: An 81‐year‐old gentleman with severe symptomatic aortic stenosis was referred for TAVI. He was not suitable for transfemoral, transapical, subclavian, or direct aortic approach. He had severe lung disease and was considered unsuitable for general anesthesia. We, therefore, performed the procedure under local anesthesia though the right common carotid artery (CCA) approach. Superficial cervical block was achieved with Levobupivacaine, and in addition, he also had a target controlled infusion of Remifentanil. Cerebral oximetry was monitored throughout the procedure. The CCA was accessed through surgical cut‐down. Aortic valvuloplasty was performed through a 12‐F sheath, and the CoreValve was deployed successfully through an 18‐F sheath. Conclusion: TAVI is commonly performed through femoral access under local anesthesia. The right...
Kombine Hiperlipidemili Olgularda Fibrat Tedavisinin Lipid Dışı Parametrelere Etkisi Dr. Yelda SA... more Kombine Hiperlipidemili Olgularda Fibrat Tedavisinin Lipid Dışı Parametrelere Etkisi Dr. Yelda SALTAN*, Dr. Sevil GÜÇLÜ*, Doç.Dr. Dilek YEŞİLBURSA*, Doç.Dr. Zehra SERDAR**, Dr. Davran ÇİÇEK*, Dr. Yasemin HEPER***, Dr. Neslihan ŞENGEZER*, Prof.Dr. Osman Akın ...
A 65-year-old woman was referred to our outpatient clinic for further evaluation of a chronic pri... more A 65-year-old woman was referred to our outpatient clinic for further evaluation of a chronic primary mitral regurgitation, seen in 2D transthoracic echocardiography (TTE) 10 years before.
Aerobic exercise training has an important role within the cardiac rehabilitation program. An exe... more Aerobic exercise training has an important role within the cardiac rehabilitation program. An exercise test performed in the early period after myocardial infarction (MI) allows determining early the functional status and the risk factors of the patients and can accelerate their return to their occupational life. Patients can get back faster and safely to their active lifestyle following MI with exercises carried out at least 3 days per week, for 20 to 60 minutes and at intensities between 40% to 85% of VO2max. These exercises may concern the lower extremity like walking or running, upper extremity like arm cycle ergometer or combinations of these like rowing or swimming. Regular aerobic exercises increase the functional capacity and parasympathetic tone, and these together lead to an improvement in cardiovascular autonomic control. As a result, frequency of coronary artery disease and other cardiovascular diseases declines to an important extent. Studies conducted in humans and animals have shown contradictory outcomes about left ventricular remodelling. General opinion is that aerobic exercise has no favourable effect on ventricular remodelling.
The Anatolian Journal of Cardiology is an international monthly periodical on cardiology publishe... more The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peerreview principles. The journal's publication language is English however titles of articles, abstracts and Keywords are also published in Turkish on the journal's web site. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal's scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
Journal of Thrombosis and Thrombolysis, May 29, 2009
The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.
The Journal of Heart and Lung Transplantation, 2018
Conclusion: In this sample of end-stage HF patients ≥ 65y, VAD recipients were sicker than those ... more Conclusion: In this sample of end-stage HF patients ≥ 65y, VAD recipients were sicker than those with OHT, which may explain poorer survival and longer LOS. These results imply that age alone should not be exclusionary for transplant consideration.
Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parki... more Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe e...
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2004
Aerobic exercise training has an important role within the cardiac rehabilitation program. An exe... more Aerobic exercise training has an important role within the cardiac rehabilitation program. An exercise test performed in the early period after myocardial infarction (MI) allows determining early the functional status and the risk factors of the patients and can accelerate their return to their occupational life. Patients can get back faster and safely to their active lifestyle following MI with exercises carried out at least 3 days per week, for 20 to 60 minutes and at intensities between 40% to 85% of VO2max. These exercises may concern the lower extremity like walking or running, upper extremity like arm cycle ergometer or combinations of these like rowing or swimming. Regular aerobic exercises increase the functional capacity and parasympathetic tone, and these together lead to an improvement in cardiovascular autonomic control. As a result, frequency of coronary artery disease and other cardiovascular diseases declines to an important extent. Studies conducted in humans and ani...
The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (R... more The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin.
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