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Öğe Acil geçici kalp pili takılan hastaların klinik özellikleri ve hastane içi mortalite oranları(2021) Yurdam, Ferhat Siyamed; Erseçgin, Ahmet; Şenöz, Oktay; Yapan Emren, ZeynepGiriş: Geçici kalp pili(GKP) uygulaması birçok bradiaritminin acil tedavisinde hayat kurtarıcı role sahiptir.Özellikle ilaçların etkisiz olduğu infra nodal atriyoventriküler blokların (AVB) acil tedavisi için tek seçenektir.Bu çalışmada,kliniğimizde acil GKP uygulanan hastaların klinik özelliklerini ve hastane içi mortalite oranlarını tespit etmeyi amaçladık. Gereç ve Yöntem:Ekim 2016-Haziran 2021 tarihleri arasında kliniğimizde acil GKP tak ılan 229 hasta çalışmaya dahiledildi. Hastaların klinik ve laboratuvar özellikleri hastane kayıtları vasıtasıyla geriye dönük olarak incelendi. Bulgular: Hastaların 225’ine bradiaritmi nedeniyle, 4’üne ise taşiaritmi nedeniyle (over-drive pacing amaçlı) GKP implante edildi.GKP gerektiren bradiaritmi nedenleri s ırasıyla; idiopatik (%33.3), ilaçlar (%30.6), iskemi (%30.6), hiperpotasemi (%4.9) ve konjenital at riyoventriküler bloktu (%0.4). En s ık bradikardi türü 2. ve 3. derece atriyoventriküler bloklardı (%77.3). Bradiaritmi nedeniyle GKP tak ılan hastaların 110 (%48.9)’una kalıcı kalp pili implantasyonu gerekti. Hastaların 35 (%15.3)’inde hastane içi mortalite gelişti. Mortalite oranı, iskemi ve hiperpotasemi gruplarında diğerlerine göre anlamlı olarak daha yüksekti (p<0.001). Sonuç: Acil GKP implantasyonu gerektiren en sık neden idiopatik ardından iskemi ve ilaçlardı. Hiperpotasemi ve iskeminin neden olduğu ciddibradikardilerde hastane içimortalite oranı oldukça yüksektirÖğe Akut serebrovasküler olay geçiren hastalarda acef risk skoru ile aritmi gelişimi arasındaki ilişki(2022) Güzel, Tuncay; Kış, Mehmet; Şenöz, OktayGiriş: Akut inmeden sonra yüksek riskli hastaların belirlenmesi, uygun kardiyak izlem ve altta yatan aritmilerin tanı ve tedavisi, kardiyak morbidite ve mortaliteyi önlemek için önemlidir. ACEF risk skoru, sadece kısa ve uzun vadeli mortalite açısından değil, aynı zamanda majör advers kardiyovasküler olaylar açısından da tatmin edici prediktif değerler ile ilişkilendirilmiştir. Bu çalışmanın amacı akut iskemik serebrovasküler olay (SVO) geçiren hastalarda ACEF risk skoru ile aritmi gelişimi arasındaki ilişkinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya, akut iskemik SVO geçiren, bazal elektrokardiyografisinde (EKG) aritmi bulunmayan ve aritmi tespiti için Holter EKG takılan ardışık 158 hasta dahil edilmiştir. Hastalar, Holter EKG’de aritmi saptanmayanlar (Grup 1) ve saptananlar (Grup 2) şeklinde iki gruba ayrılarak incelendi. ACEF skoru aşağıdaki formüle göre hesaplandı; ACEF = yaş/sol ventrikül ejeksiyon fraksiyonu+1 (kreatinin>2.0 mg/dL ise). Bulgular: Hastaların yaş ortalaması 71.6±10.6 yıldı ve grup II'deki yaş ortalaması grup I'e göre istatistiksel olarak anlamlı derecede yüksekti (72.8±10.1'e karşı 68.8±11.2 yıl, p=0.025). Hastaların 110'unda (%69.6) Holter EKG'de aritmi saptandı. En sık görülen aritmi tipi ventriküler ekstrasistoller (%32.7) idi. Ortalama ACEF skoru 1.43±0.49 olarak bulundu. ACEF risk skoru grup II'de grup I'e göre istatistiksel olarak anlamlı derecede daha yüksekti (1.497±0.511'e karşı 1.285±0.407, p=0.012). ACEF risk skoru değeri >1.26, %59 duyarlılık ve %56 özgüllük ile akut iskemik inmeli hastalarda aritmi için bir öngördürücü olarak saptandı (eğri altındaki ROC alanı: 0.642, %95 CI: 0.548-0.737, P =0.004 ). Sonuç: Akut iskemik SVO geçiren hastalarda yüksek ACEF risk skoru, holter EKG ile tespit edilen, altta yatan aritmi varlığı ile ilişkilidir. Bu hastalarda aritmi varlığını öngörmek için basit ve kolay ulaşılabilir ACEF risk skoru kullanılabilir.Öğe Clinical features and factors affecting in-hospital mortality of patients who underwent pericardiocentesis due to moderate to severe pericardial effusion(2021) Şenöz, Oktay; Yapan Emren, Zeynep; Erseçgin, Ahmet; Emren, Volkan; Yurdam, Ferhat Siyamend; Nazlı, CemIntroduction: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3 ± 15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p= 0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR= 3.447; 95% CI= 1.266, 9.386; p= 0.015), and receiving antithrombotic therapy (OR= 2.306; 95% CI= 1.078, 4.932; p= 0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality.Öğe Clues on electrocardiography to predict the presence of paroxysmal atrial fibrillation in patients with acute ischemic stroke: A propensity score-matched study(2022) Yurdam, Ferhat Siyamend; Şenöz, OktayObjectives: In this study, we aimed to detect surface electrocardiography (ECG) markers that could be predictive of paroxysmal atrial fibrillation (PAF) attacks in patients with ischemic stroke. Patients and methods: Between November 2017 and April 2021, a total of 112 patients (65 males, 47 females; mean age: 70.5±6.8 years; range, 51 to 84 years) hospitalized for acute ischemic stroke with sinus rhythm on surface ECG who underwent Holter ECG monitoring for PAF were retrospectively analyzed. The patients were divided into two groups of 56 patients in each (Group 1: those with PAF on Holter ECG and Group 2: those without PAF). Both groups were matched according to demographic, clinical, and echocardiographic features using the propensity score matching method. Results: Demographic, clinical, and echocardiographic features were similar between groups (p>0.05). The mean maximum P-wave duration (PWD) and P-wave dispersion (PWDis) were longer in Group 1 than Group 2 (108.4±9.9 vs. 102.5±10.2 ms; p=0.002, 49.4±13.6 vs. 36.8±11.7 ms; p<0.001). Similarly, the mean P-wave terminal force in lead V1 (PTFV 1) was higher in Group 1 than Group 2 (4415±909 vs. 3826±568 ?V·ms; p<0.001). Logistic regression analysis revealed high PWDis (odds ratio [OR]: 1.164; 95% confidence interval [CI]: 1.069-1.268; p<0.001) and PTFV 1 (OR: 1.156; 95% CI: 1.065-1.254; p=0.001) as independent predictors of PAF. Conclusion: PWDis and PTFV1 are independent predictors of PAF in patients with acute ischemic stroke. These simple and easily accessible predictors that can be detected via surface ECG may be used as a guide to identify patients who require longer rhythm monitoring to better detect occult PAF, thereby preventing recurrent strokes.Öğe COVID-19 Salgını döneminde valvüler olmayan atriyal fibrilasyon nedeniyle yeni nesil oral antikoagülan kullanan hastalarda kanama komplikasyonlarının araştırılması(2022) Şenöz, Oktay; Emren, Sadık Volkan; Yapan Emren, Zeynep; Yurdam, Ferhat SiyamendAmaç: COVID?19 pandemisi döneminde hastane başvurularının azalması; yeni oral antikoagülan kullanan hastaların takibini zorlaştır? maktadır. Bu bağlamda COVID?19 pandemisi döneminde yeni oral antikoagülan kullanan hastalarda kanama sıklığının araştırılması amaçlandı. Gereç ve Yöntem: Bu çalışma Mayıs 2020 ve Mayıs 2021 tarihleri arasında yapılmış kesitsel bir çalışmadır. COVID?19 pandemi döne? minde en az bir yıldır yeni oral antikoagülan kullanan 216 hasta dahil edilmiştir. Hastaların majör ve minör kanama oranları ve buna et? ki eden ön gördürücüler araştırılmıştır. Bulgular: Hastaların yaş ortalaması 72±10’du ve 129 (%60) hasta kadındı. 46 (%21) hastada kanama saptandı (%3 majör, %18 minör kanama). Kanama gelişen %12 hastada doz azaltımı yapılırken, %7 hastada ilaç kesilmiştir. Çok değişkenli analizlerde düzensiz ilaç kul? lanımı risk oranı: 14,91 (%95 Güven aralığı: 2,451?90,692, p=0,003), kadın cinsiyet risk oranı: 5,507 (%95 güven aralığı: 2,117?14,327, p<0,001), diyabet risk oranı: 2,319 (%95 güven aralığı: 1,069?5,031, p=0,033), HAS?BLED skoru risk oranı: 1,571 (%95 güven aralığı: 1,035?2,384 p=0,034) kanama ile ilişkili bağımsız değişken olarak bulunmuştur. Sonuç: Yeni oral antikoagülan kullanan hastalarda kanama komplikasyonları COVID?19 döneminde de hala bir sorun olmaya devam et? mektedirÖğe Determinants of coronary angiography in Non-ST-elevation myocardial infarction with low ejection fraction(Coll Physicians & Surgeons Pakistan, 2022) Emren, Sadık Volkan; Emren, Zeynep Yapan; Erseçgin, Ahmet; Şenöz, OktayObjective: To investigate the clinical and demographic factors affecting the selection of angiography in patients with severe left ventricular systolic dysfunction (SLVSD, ejection fraction lower than 30%) developing non-ST-segment elevation (NSTEMI). Study Design: Descriptive study. Place and Duration of Study: This study was conducted at the Department of Cardiology, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey, between March 2018 and March 2021. Methodology: Patients with SLVSD (Ejection fraction <30%) developing Clinical and demographic factors were compared between the patients who were or were not decided for angiography. Associated factors for the decision of angiography were evaluated. Results: Overall, 68 (46%) out of 147 patients underwent coronary angiography. Angiography led to coronary artery bypass grafting (CABG) in 14 (21%), percutaneous coronary intervention (PCI) in 30 (44%), and medical treatment in 24 (35%). Among the patients who decided for CABG, 10 (71%) underwent surgery. In multivariate analysis; Killip score >= 2 [Odds ratio (OR) :33.85, 95% Confidence Interval (CI): 5.03-227.405 p<0.001], lower education level (OR: 17.66, 95% CI: 2.25-138.44, p=0.006), anaemia (OR: 10.60, 95% CI: 2.07-54.28, p=0.005), age >= 65 years (OR: 7.124, 95% CI: 1.33-38.12, p=0.02), and PCI history (OR: 0.132, 95% CI: 0.02-0.84, p=0.032) were associated factors with the decision of only medical treatments instead of angiography. Conclusion: Demographic factors such as age and education level and clinical factors such as decompensation, PCI history, and anaemia significantly affect the decision of angiography in the patients with SLVSD and NSTEMI.Öğe Effect of COVİD-19 pandemic and coronavac vaccine on blood pressure regulation in chronic hypertensive patients(2021) Şenöz, Oktay; Erseçgin, Ahmet; Demir, Yusuf; Yurdam, Ferhat Siyamend; Yapan Emren, Zeynep; Gürses, EcemObjective: The most common comorbidity in patients with Covid-19 infection is hypertension. Apart from the direct effects of the virus on hypertensive patients, the pandemic period also negatively affected these patients. In addition, the effect of the newly discovered CoronaVac vaccine, which has been widely used in our country in recent months for the prevention of covid-19 infection, on blood pressure regulation is unknown. In this study, we aimed to investigate the effects of the pandemic period and the CoronaVac vaccine in patients receiving treatment for essential hypertension.Method: One hundred ninety-six patients who applied to the cardiology outpatient clinic between 4 June - 9 July 2021, were treated for essential hypertension and had at least 1 dose of CoronaVac vaccine were included in the study. In the pre-pandemic, pre-vaccine and post-vaccine period, mean home and office blood pressures of the patients were examined separately. Results: While the mean home blood pressures of the patients differed significantly between the pre-pandemic and pre-vaccine pandemic period (systolic: 125.1±12.6 vs 129.1±14.1 mmhg, p<0.001, diastolic: 75.3±9.7 vs 77.1±9.8 mmhg, p=0.004), there was no significant difference between the pre- and post-vaccination period (systolic: 129.1±14.1 vs 129.7±13.7 mmhg, p=0.229, diastolic: 77.1±9.8 vs 77.9±9.9 mmhg, p=0.091). Similarly, while office blood pressures differed significantly between the pre-pandemic and pre-vaccine pandemic period (systolic: 133.5±16.5 vs 136.1±16.4 mmhg, p=0.015, diastolic: 79.4±10.9 vs 81.2±12.1 mmhg, p=0.036), there was no significant difference between the pre- and post-vaccination period (systolic: 136.1±16.4 vs 135.6±16.9 mmhg, p=0.651, diastolic: 81.2±12.1 vs 81.1±11.2mmhg, p=0.914). Conclusion: While the Covid-19 pandemic increased the blood pressure of chronic hypertensive patients, the CoronaVac vaccine did not affect the blood pressure regulation of these patients.Öğe The effect of hemodialysis on left ventricular global longitudinal strain in chronic hemodialysis patients with preserved left ventricular ejection fraction(2022) Emren, Zeynep Yapan; Yurdam, Ferhat Siyamend; Erseçgin, Ahmet; Atay, Gökhan; Arda, Hayri Üstün; Şenöz, OktayObjectives: In the present study, we aimed to evaluate the acute effects of hemodialysis (HD) on left ventricular functions with left ventricular (LV) global longitudinal strain (GLS). Patients and methods: This prospective study included a total of 38 patients (24 males, 14 females; mean age: 60.8±13.8 years; range, 31 to 82 years) who were on chronic HD for at least six months and had a LV ejection fraction of ?50% between December 2021 and January 2022. The clinical and echocardiographic features of the patients were recorded before and after HD. The GLS was calculated using two-dimensional speckle-tracking method. Results: The mean dialysis time of the patients was 6.3±3.9 years. The left atrial volume index was significantly lower after HD than before (30.1±10.0 vs. 27.5±8.2 mL/m 2 , p=0.005). Pulsed Doppler echocardiography showed significantly decreased E and A wave peak velocity after HD (99.3±38.2 vs. 80.4±27.8 cm/s, p=0.001 and 99.4±23.2 vs. 90.4±25.5 cm/s, p=0.022), but no significant change in the E/A ratio (1.1±0.5 vs. 1±0.6, p=0.660). There was no significant change on the LV GLS between before and after HD (-17.3±2.6 vs. -16.9±2.6%, p=0.088). Conclusion: Hemodialysis has no significant effect on LV GLS in the acute phase in patients with end-stage chronic renal disease.Öğe The effect of right conventional radial artery access site and left distal radial artery access site on quality of life in coronary angiography: Which route is more appropriate?(2022) Duygu, Hamza; Şenöz, Oktay; Kış, MehmetObjectives: There are not many studies comparing the right conventional and left distal radial (anatomical snuffbox) access in coronary angiography (CAG) or percutaneous coronary intervention (PCI) in terms of patient satisfaction and complications; therefore, in this study, we planned to compare these two approaches and determine the ideal radial access site for the patients. Patients and methods: A total of 120 patients (80 males, 40 females; mean age: 59.2±11.7 years; range, 18 to 90 years) who underwent CAG or PCI via the radial artery between February 2022 and April 2022 were included in the prospective observational study. The patients were divided into right conventional radial artery access (Group 1; n=68) and left distal radial artery (access (Group 2; n=52) groups. Results: The rate of minor bleeding was higher in the right conventional access group compared to the left distal access group (16.2% vs. 3.8%; p=0.031). Major bleeding, hand ischemia, and radial artery occlusion were not observed in the study population. The rate of patients who had pain that disrupts daily activities was statistically higher in Group 1 than in Group 2 (17.6% vs. 5.8%). The patients in Group 2 were more satisfied with the transradial CAG/PCI compared to Group 1 (94.3% vs. 66.2%; p=0.001). Conclusion: Left distal radial artery access from the anatomic snuffbox was a safer method than right conventional radial artery access for CAG or PCI. Patients were more satisfied with the left distal radial access than the right conventional radial access.Öğe Evaluation of arrhythmia frequency with Holter electrocardiography in pregnants with palpitation complaints(2021) Şenöz, Oktay; Kış, MehmetObjectives: The aim of this study was to investigate the underlying etiology and the frequency of arrhythmia by Holter electrocardiography (ECG) in pregnant women with palpitations. Patients and methods: Between January 2019 and March 2021, a total of 64 pregnant women (mean age: 29.1±5.3 years; range, 20 to 46 years) who were admitted to the cardiology outpatient clinic with the complaint of palpitations and had a Holter ECG were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, Holter ECG records, imaging findings, and biochemical data were recorded. Results: The mean systolic blood pressure was 118.7±16.4 mmHg and the mean heart rate was 96.2±18.2 bpm. There was an arrhythmia on Holter ECG in 32 (50%) of the patients. The most common arrhythmias were ventricular extrasystoles in 21.9% and supraventricular tachycardia in 14.1% of the patients. The frequency of paroxysmal atrial fibrillation was 4.7%. Non-sustained ventricular tachycardia (VT) was detected in two (3.1%) patients. Conclusion: Identifying underlying arrhythmias in pregnant women with palpitation is of utmost importance for both the maternal and fetal health. The incidence of arrhythmias that should be treated in this patient group is too high to be ignored.Öğe Evaluation of bleeding rate and time in therapeutic range in patients using warfarin before and during the COVID-19 pandemic-warfarin treatment in COVID-19(Sage Publications Inc, 2021) Emren, Zeynep Yapan; Şenöz, Oktay; Ersecgin, Ahmet; Emren, Sadık VolkanThe treatment process of patients using warfarin is expected to be hindered during the COVID-19 pandemic. Therefore we investigated whether the time in therapeutic range (TTR) and bleeding complications were affected during the COVID-19 pandemic. 355 patients using warfarin were included between March 2019 to March 2021. Demographic parameters, INR (international normalized ratio), and bleeding rates were recorded retrospectively. The TTR value was calculated using Rosendaal's method. The mean age of the patients was 61 +/- 12 years and 55% of them were female. The mean TTR value during the COVID-19 pandemic was lower than the pre-COVID-19 period (56 +/- 21 vs 68 +/- 21, P < 0.001). Among the patients, 41% had a lack of outpatient INR control. During the COVID-19 pandemic, 71 (20%) patients using VKA suffered bleeding. Among patients with bleeding, approximately 60% did not seek medical help and 6% of patients performed self-reduction of the VKA dose. During the COVID-19 pandemic, TTR values have decreased with the lack of monitoring. Furthermore, the majority of patients did not seek medical help even in case of bleeding.Öğe Investigation of left ventricular systolic and diastolic functions before and after levosimendan administration in patients with heart failure(2021) Yurdam, Ferhat; Emren, Zeynep Yapan; Şenöz, OktayBackground: we aimed to investigate effect of levosimendan treatment on left ventricle systolic and diastolic parameters with transthoracic echocardiography in patients with heart failure Method: Patients over 18 years old with lower than %35 of ejection fraction and New York Heart Association (NYHA) class III-IV were included. Left ventricle systolic and diastolic parameters before and after levosimendan treatment were compared. Approval was obtained from the local ethics committee of Celal Bayar University Medical Faculty for our study. Results: With levosimendan treatment; E/A ratio(2,25±0,76 vs 1,67±0,75 , p:0,03 ) and E/E’ ratio (23,03±13,60 vs 15,96±8,43 , p:0,01) decreased significantly. Furthermore there was an increase in ejection fraction(20,60±5,65 vs 27,00±7,11 , p:0,01) and A velocity( 0,45±0,14 vs 0,61±0,30 , p:0,03). Conclusion: Levosimendan treatment has an acute favoruble effect in ejection fraction and diyastolic mitral inflow parameters that showed ventricle overloadÖğe Is coronary artery tortuosity a predisposing factor for drug-eluting stent restenosis?(Urban & Vogel, 2021) Levent, Fatih; Şenöz, Oktay; Emren, Sadık Volkan; Emren, Zeynep Yapan; Gediz, Rahman BilalBackground Coronary artery tortuosity (CAT) is a relatively common finding on coronary angiography and may be associated with impaired left ventricular relaxation and coronary ischemia However, the significance of CAT remains unknown. This study aimed to investigate whether the severity of tortuosity in the targeted coronary segment is a predictor of stent restenosis. Methods The study included a total of 637 patients undergoing drug-eluting stent implantation due to stable or unstable angina and who had no native coronary artery stenosis on their last coronary angiogram. The patients were separated into two groups: 312 patients with in-stent restenosis and 325 patients without in-stent restenosis. All patients underwent computed tomography (CT) coronary angiography after invasive angiography and CAT was calculated using the computer software. Results Patients with in-stent restenosis had higher CAT than those without restenosis (1.25 +/- 0.11 vs. 1.11 + 0.07, p < 0.001). Multivariate Cox regression analysis showed that the tortuosity index (hazard ratio [HR]: 1.246 95% confidence interval [CI]: 1.127-1.376 p < 0.001) and the circumflex lesion (HR: 1.437 95% CI: 1.062-1.942 p = 0.019) were independently associated with in-stent restenosis. With the threshold value of severe tortuosity set at 1.15, the prediction of could be made with 81% sensitivity and 80% specificity. Conclusion The severity of tortuosity is proportional to coronary in-stent stenosis in patients with stable and unstable angina pectoris undergoing drug-eluting stent implantation for a severe single coronary artery.Öğe Is myocardial bridge more frequently detected on radial access coronary angiography?(BMC, 2021) Şenöz, Oktay; Emren, Zeynep YapanBackground: Although the incidence of myocardial bridge (MB) has been defined in different femoral access conventional coronary angiography (FACCA) studies, the frequency of MB on radial access coronary angiography (RACA) is unknown. The aim of this study was to determine the difference in the incidence of MB between patients undergoing RACA and FACCA. Method: A total of 2500 consecutive patients who underwent RACA and a total of 1455 consecutive patients who underwent FACCA were retrospectively investigated to detect the presence of MB. The incidences of the groups were calculated separately and compared. The clinical and angiographic features of the patients with MB were analyzed. Results: MB was detected at an incidence of 10.2%, in 255/2500 patients who underwent RACA, and 1.8% in 27/1455 patients who underwent FACCA (p < 0.001). In both RACA and FACCA patients, the most involved coronary artery was the left anterior descending artery (LAD) (86.9% and 93.1%) and the mid-segment (84.9% and 88.9%) was the most affected section. Co-involvement of multiple coronary arteries by MB was 7.8% in patients who underwent RACA and 7.4% in patients who underwent FACCA. Coronary artery disease (CAD) was determined in 111 (35.7%) of the coronary arteries with MB, of which 81.9% were proximal to the MB. No significant CAD was detected in any of the vessels of 69.8% (178/255) of the patients who underwent RACA for different clinical indications. Conclusion: These data demonstrated that the incidence of myocardial bridge able to be detected on RACA was much higher than FACCA.Öğe Mitral valve obstruction caused by heart-shaped large left atrial myxoma(2021) Şenöz, Oktay; Yurdam, Ferhat; Emren, Zeynep Yapan; Emren, Volkan; Tomakin, Fatma NurMyxoma is one of the most common benign primary cardiac tumors, usually detected at ages between 30 and 60 years. It accounts for 50% of the primary cardiac tumors. The most common location of a myxoma is the left atrium. Myxomas are more prevalent in females. The clinical outcomes can differ depending on the tumor’s size, location, and architecture. The clinical picture can mimic mitral stenosis, which causes mitral valve obstruction. Syncope is a rare but life-threatening symptom and requires early surgical treatment. This paper describes a patient with a large left atrial myxoma, causing mitral valve obstructionÖğe Platelet-Lymphocyte ratio is a predictor for the development of no-reflow phenomenon in patients with ST-segment elevation myocardial infarction after thrombus aspiration(Wiley, 2021) Şenöz, Oktay; Emren, Sadık Volkan; Ersecgin, Ahmet; Yapan Emren, Zeynep; Gül, İlkerBackround We aimed to evaluate the utility of the preprocedural platelet-lymphocyte ratio (PLR) for predicting the no-reflow phenomenon after thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Method We retrospectively analyzed postprocedural thrombolysis in myocardial infarction (TIMI) flow grades and myocardial blush grades (MBG) of 247 patients who underwent a PCI procedure with thrombus aspiration.We divided these patients into two groups according to whether they had no-reflow (TIMI < 3, MBG < 2) or not (TIMI 3, MBG >= 2). Results No-reflow developed in 43 (17%) patients.Preprocedural PLR was significantly higher in the no-reflow group (183.76 +/- 56.65 vs 118.32 +/- 50.42 p < 0.001).Independent predictors of no-reflow were as follows: higher preprocedural platelet-lymphocyte ratio (PLR) (OR = 1.018; 95% CI = 1.004, 1.033; p = 0.013),mean corpuscular volume (MCV) (OR = 1.118; 95% CI = 1.024, 1.220; p = 0.012) and SYNTAX Score-2 (OR = 1.073; 95% CI = 1.005, 1.146; p = 0.036). PLR of 144 had 79% sensitivity and 75% specificity for the prediction of no-reflow. Conclusion PLR is a reliable predictor for no-reflow in STEMI patients undergoing thrombus aspiration.Öğe A rare complication of pericardiocentesis: Pneumopericardium(2022) Şenöz, OktayPneumopericardium is a rare complication of pericardiocentesis and defined as the presence of air in the pericardial space. Pneumopericardium usually occurs after trauma. However, pneumopericardium due to iatrogenic procedures, such as pericardiocentesis, is extremely rare. It can be caused by either direct pleuropericardial connection development or reverse air leakage in the drainage system. Herein, we report the case of a 39-year-old female with cardiac tamponade who developed pneumopericardium after pericardiocentesis.Öğe The relationship between good collateral development and magnesium/phosphate ratios in chronic total occlusion(2022) Kış, Mehmet; Şenöz, Oktay; Güzel, TuncayObjective: Coronary collateral formation can be triggered by many acquired factors such as ischemia and growth factors, which ultimately manifests as differences in the quality of the coronary collateral circulation (CCC) in patients. Low magnesium (Mg) levels can increase endothelial cell dysfunction and potentially increase the risk of thrombosis and atherosclerosis. However, it has been reported that high serum phosphate (P) levels are correlated with the development of atherosclerosis and mortality. In this article, we aimed to reveal the relationship between CCC quality and Mg/P ratio in chronic total occlusion (CTO). Methods: A total of 269 patients with detected CTO in coronary angiography between March 2014 and June 2018 were included in the study. The patients were divided into two groups as group I (127 patients) and group II (142 patients) according to the Rentrop classification. The study is a retrospective, observational study. Results: In the multivariable regression analysis; smoking (p=0.004), triglyceride (p<0.001) and Mg/P ratio (p<0.001) parameters were independent predictors affecting CCC in CTO. Mg/P value was statistically lower in the group I (0.49±0.17) than group II (0.62±0.12) (p<0.001). The ideal Mg/P cut-off value was 0.56 that calculated by the Youden index had 69% sensitivity, and 64% specificity for collateral development of CTO. Conclusion: Mg/P is a parameter that affects coronary collateral development. High Mg/P ratio level is associated with good collateral development in patients who had CTO.Öğe The relationship between left ventricular diastolic dysfunction and hemoglobin A1c levels in the type 2 diabetes mellitus patient population(2022) Şenöz, Oktay; Güzel, Tuncay; Kış, MehmetObjectives: This study aimed to investigate the relationship between hemoglobin A1c (HbA1c) levels, which is a good marker for determining glycemic levels, and left ventricular diastolic dysfunction (LVDD) in the type 2 diabetes mellitus (DM) patient population. Patients and methods: This retrospective study was conducted with 116 type 2 DM patients (62 males, 54 females; mean age: 58.4±9.5 years; range, 18 to 65 years) between July 2019 and November 2021. The patients were divided into two groups as those without LVDD (n=55, Group 1) and those with LVDD (n=61, Group 2). Early to late diastolic transmural flow velocity (E/A) ratio, the mean ratio (E/e') of mitral inflow (E) and mitral annular (e'), HbA1c levels, other hemogram and biochemical parameters, and demographic data were recorded. Results: The HbA1c level was significantly higher in the group with LVDD (6.96±1.23 vs. 9.00±2.19, p<0.001). While the mean E/e' ratio was 9.69±2.73 in the group without LVDD, it was 16.00±1.69 in the group with LVDD, and there was a significant difference between the two groups (p<0.001). The mean E/A ratio was significantly higher in the group without LVDD (1.25±0.51 vs. 1.02±0.53, p=0.021). In regression operating characteristics analysis, a HbA1c cut-off value of 7.35 and was found to be a predictor of LVDD in the type 2 DM patient group with a sensitivity of 80% and specificity of 80% (AUC: 0.805; 95% confidence interval: 0.718-0.892; p<0.001). Conclusion: Providing close glycemic follow-up and monitoring the HbA1c level can reduce heart failure and other comorbid conditions that may develop, particularly after LVDD.Öğe Systemic immune-inflammation index as a tool for predicting the need for a permanent pacemaker in patients with drug-induced atrioventricular block(Wiley, 2021) Şenöz, Oktay; Ersecgin, AhmetBackground Drug-induced atrioventricular block (AVB) is generally considered reversible and does not require a permanent pacemaker implantation (PPM). However, some studies have demonstrated a failure of AVB cessation even when the inducing agent has been discontinued. This study has investigated the use of systemic immune-inflammation index (SII) to predict irreversible drug-induced AVB after drug discontinuation. Method Files of patients with high-degree AVB that required a temporary pacemaker (TPM) were retrospectively analyzed. Sixty-three patients in which AVB was drug-induced were included in the study. The patients were divided into the following two groups: (1) those whose AVB reversed after discontinuation of the related drug, and (2) those in which AVB did not reverse. Results AVB reversed in 24 patients (38%) after the inducing agent was discontinued while in the remaining 39 patients (62%) PPM was required. The most common drugs to induce AVB were beta-blockers (n = 46, 73%). Follow-up time with TPM was significantly longer in the irreversible group (2.91 +/- 1.05 days vs. 4.94 +/- 2.15 days, p < .001). Multivariate logistic regression analysis showed that SII (odds ratio [OR] = 1.002; 95% confidence interval [CI] = 1.000-1.003; p = .01) was an independent predictor of the requirement for a PPM. An SII > 752.05 was found to be a predictor of irreversible AVB requiring PPM with a sensitivity of 64% and specificity of 75% (receiving-operating characteristics [ROC] area under the ROC curve [AUC]: 0.704, 95% CI = 0.570-0.838, p = .007). Conclusion Approximately 2/3 of drug-induced high-degree AVBs are irreversible. SII is an easily available and cheap inflammatory biomarker that can be used to predict irreversible AVB.
