Gonul Acıksarı - Academia.edu (original) (raw)
Papers by Gonul Acıksarı
International Journal of the Cardiovascular Academy, Sep 1, 2017
доктор педагогічних наук, професор, професор кафедри інформатики, програмної інженерії та економі... more доктор педагогічних наук, професор, професор кафедри інформатики, програмної інженерії та економічної кібернетики Херсонський державний університет orcid.org/0000-0001-5120-620X У статті систематизовані сучасні уявлення щодо дефініції «професійна спрямованість фахівців», визначено складники та критерії рівнів її сформованості і адаптовано загальні концептуальні положення до практики професійної підготовки майбутніх судноводіїв. З цією метою проаналізовано відомості, представлені у фахових джерелах, присвячених професійній підготовці фахівців за різними напрямами, і узагальнено власний досвід формування професійної компетентності, інформаційної культури, іншомовної комунікативної компетентності майбутніх судноводіїв, що дозволило адаптувати загальні теоретичні положення щодо використання інтегративного підходу до втілення принципу професійної спрямованості у систему професійної підготовки майбутніх судноводіїв. З'ясовано, що професійна спрямованість майбутніх судноводіїв є інтегральним особистісним утворенням, зумовленим усвідомленою мотивацією курсанта щодо вибору морської професії, що детермінується переважаючими чинниками потребнісно-мотиваційної сфери до здійснення функціональних обов'язків відповідно до статутних вимог, чинного вітчизняного та міжнародного законодавства, розумінням мети, проміжних цілей та завдань професійної діяльності судноводія, продуктивним та адекватним до ситуації застосуванням набутих у процесі професійної підготовки знань, навичок, вмінь. Структуру професійної спрямованості майбутнього судноводія утворюють мотиваційний, орієнтаційний, ціннісний, когнітивний компоненти. Розуміння професійної спрямованості майбутніх судноводіїв як ядра особистісно-мотиваційного компоненту їх професійної компетентності орієнтують нас на створення інтегрованих курсів з використанням тренажерів, симуляційних технологій на основі доповненої та віртуальної реальності як умов для квазіпрофесійної навчальної діяльності майбутніх судноводіїв. Ключові слова: професійна спрямованість фахівців, структура, критерії сформованості, майбутні судноводії, професійна підготовка.
Koşuyolu heart journal, Apr 26, 2021
Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with ... more Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with refractory heart failure. We aimed to examine the usefulness of N-terminal pro-brain-type natriuretic peptide (NT-proB-NP), mid-regional pro-atrial natriuretic peptide (MR-proANP), and adiponectin in monitoring CRT-induced left ventricular (LV) reverse remodeling, reverse electrical remodeling, and clinical response. Patients and Methods: We prospectively enrolled 46 heart failure patients who underwent clinical, electrocardiographic, echocardiographic evaluation and blood sampling for measurements of NT-proBNP, MR-proANP, and adiponectin before and 12-months after CRT implantation. LV reverse remodeling (LVRR), reverse electrical remodeling (RER) and clinical response were described respectively as a decrease in LV end-systolic volume (LVESV) ≥ 15% or an absolute increase in LV ejection fraction ≥ 5%, a decrease in intrinsic QRS (iQRS) duration by ≥ 20 ms, and an improvement of NYHA ≥ 1 class. Results: At 12 months, LV function, and size, severity of mitral regurgitation (MR), clinical status, and QRS duration were significantly improved by CRT. We detected LVRR, RER, and clinical response in 72%, 54%, and 76% of patients, respectively. Both reductions in MR-proANP and adiponectin levels were correlated with decrease in LVESV (r= 0.51, p< 0.05; r= 0.50, p< 0.05, respectively). Also, there was an association between reduction in MR-proANP levels and decrease in mitral regurgitation grade (r= 0.50, p< 0.05). We observed a relationship between decrease in iQRS duration and reduction in MR-proANP levels after CRT (r= 0.67, p< 0.05). Conclusion: MR-proANP levels after CRT may reflect electrical response and regression in MR. Furthermore, both adiponectin and MR-proANP levels after CRT may reveal decrease in LVESV.
International Journal of Cardiovascular Imaging, Oct 8, 2021
Cardiac complications such as heart failure and arrhythmias caused by "iron-induced" cardiomyopat... more Cardiac complications such as heart failure and arrhythmias caused by "iron-induced" cardiomyopathy are considered as the primary cause of death in the patients with β-thalassemia major. The aim of this study was to evaluate electrocardiography, echocardiography according cardiac T2* and ferritin ndings of patients followed-up for β-thalassemia major, and to investigate the importance of these ndings for early detection of cardiac complications. The study included 41 patients and 25 healthy individuals with matched age and gender. The cardiac T2* results revealed a cardiac iron load below 20 msec in 12 (29.27%) patients, and above 20 msec in 29 (70.73%) patients. All electrocardiography parameters except JTc interval signi cantly increased in the patient group when compared to the control group (p < 0.05). All parameters except P wave segment in electrocardiography and T peak-end/QT ratio were signi cantly higher in the group with cardiac T2* <20 msec than the group with cardiac T2* >20 msec (p < 0.05). Intraventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index detected by echocardiography were signi cantly higher in the group with T2* <20 msec (p < 0.05). Electrocardiography, echocardiography, cardiac T2* and ferritin ndings should be carefully evaluated in these patients in order to detect early signs of cardiac complications.
Bagcilar Medical Bulletin
Objective: Sexual dysfunction after acute coronary syndrome (ACS), is a frequently encountered pr... more Objective: Sexual dysfunction after acute coronary syndrome (ACS), is a frequently encountered problem in clinical practice. The aim of our study is to determine the time it takes for patients to switch to a healthy sexual life, which is one of the basic elements of a healthy social life, after a cardiovascular event in Turkish society and investigation of the effect of drugs related to ACS on sexual activity. Method: In our study, volunteer women and men who had a cardiovascular event at least 3 months before and were sexually active before the ACS between January 2017-December 2019 were evaluated using a closed questionnaire. The demographic characteristics of the patients, their comorbidities and medications, and their sexual activity levels before and after the ACS were compared. Results: After ACS, sexual dysfunction developed in 36% (n=117) of the patients. In the group with sexual dysfunction, heart failure [21% (n=25)-9% (n=18)-p=0.001], chronic renal failure [9% (n=11)-0% (n=0) p<0.001], and BPH presence [34% (n=40)-(11% (n=23) p<0.001] were higher. Similarly, beta-blocker use [95% (n=111)-84% (n=172) p=0.001] and ACE-I/ARB use [62% (n=73)-54% (n=111) p=0.05] were also higher in participants with sexual dysfunction. Conclusion: In our study, an increase in the prevalence of sexual dysfunction was observed in patients with multiple comorbidities, especially heart failure. Sexual dysfunction was found to be higher in patients using beta-blockers.
The Eurasian Journal of Medicine, 2018
Medicine Science | International Medical Journal, 2017
Drug adherence to novel oral anticoagulants (NOAC) varied by countries and popuplations. As a res... more Drug adherence to novel oral anticoagulants (NOAC) varied by countries and popuplations. As a result of NOAC-TR study, in Turkey, drug adhrence to NOACs is poor comparing to other real world studies. However it is not known whether there is a difference between geographic regions of Turkey in terms of NOAC adherence. In this study we aim to investigate the NOAC adherence in patients with non-valvular atrial fibrillation according to the geographic regions in Turkey Method: This cros-sectional study was designed as a subgroup study of NOAC-TR (Drug Adherence in patients with non valvular atrial fibrillation taking non-vitamin K antagonist oral anticoagulants in Turkey). A total of 2802 patients (59% female) taking NOAC (Dabigatran, apixaban, rivaroxaban) due to NVAF at least 3 months, were included. Morisky-8 item drug adherence scale was used. Patients were divided in 3 groups (high, moderate and low adherent) based on drug adherence Results: Of the patients 24% were adherent, 26% were moderate adhererent and 50% were low adherent to NOAC treatment. Drug adhrence was different between geographic regions (p<0,001). In post-hoc analysis low adherent rate was highest in Blacksea region (72% low adherent, 21% moderate adherent, 7% low adherent). Adherence rate was highest in Aegean (36% adherent, 26% moderate adherent 38%) and Marmara region (38% adherent, 28% moderate adherent 34% low adherent). Conclusion: NOAC adherence was different between geographic regions in Turkey.
Balkan Medical Journal, 2017
Background: The time in therapeutic range values may vary between different geographical regions ... more Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy. Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey. Study Design: Cross-sectional study. Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of the effect of warfarin and fooddrug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5%±22.9 in the WARFARIN-TR study. There were statistically significant differences between
Clinical and Applied Thrombosis/Hemostasis, 2017
Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensu... more Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016. To measure the adherence level, an 8-item Morisky Medication Adherence Scale was used. The mean age of the patients was 70 ± 10 years. Of the 2738 patients, 44% were receiving dabigatran, 38% rivaroxaban, and 18% apixaban. A total of 630 (23%) patients had high medication adheren...
ABSTRACT ISBN: 9786054649099
Atherosclerosis, 2014
Microvascular dysfunction has been reported in cardiac syndrome X (CSX), even though the underlyi... more Microvascular dysfunction has been reported in cardiac syndrome X (CSX), even though the underlying mechanisms still remain uncertain. Galectin-3 has been recently recognized as a biomarker of cardiovascular fibrosis and inflammation. We sought to investigate the role of galectin-3 in the CSX. We studied 115 consecutive CSX patients (mean age 55.43 ± 8.71 years, 36 men) and 74 healthy controls (mean age 54.53 ± 10.07 years, 31 men). Serum concentrations of galectin-3 and high-sensitive C-reactive protein (hs-CRP) were measured on the blood samples. Galectin-3 concentrations were significantly higher in patients with CSX compared to controls (0.90 ng/ml; IQR, 0.40-1.70 ng/ml vs 0.40 ng/ml; IQR, 0.36-0.44 ng/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Although, the prevalence of diabetes mellitus, hypertension and family history of coronary artery disease (CAD) were significantly higher among patients with CSX, following adjustment for diabetes mellitus, hypertension, and family history of CAD, serum galectin-3 concentrations were still found significantly increased in patients with CSX. Galectin-3 concentrations correlated positively with hs-CRP (r = 0.16, p = 0.03). In addition, concentrations of galectin-3, hs-CRP, fasting glucose, uric acid and family history of CAD were determined as independent predictors of the CSX. It was found that galectin-3 serum concentrations are higher in patients with CSX compared to healthy controls. Further studies on larger population are needed to confirm the relation between the fibrosis and the CSX, as well as to explore the potential role of galectin-3 in the CSX.
Northern clinics of Istanbul, 2016
The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that in... more The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that includes Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF). The incidence of adverse cardiovascular events is greater among patients with CID, though they may not have conventional atherosclerotic risk factors. Endothelial dysfunction is one of the underlying fundamental mechanisms that trigger development of atherosclerotic alterations in arteries, and flow-mediated dilatation (FMD) is a noninvasive method to determine endothelial dysfunction. Recent studies have shown a relationship between high triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio and coronary atherosclerosis. Many studies have demonstrated that patients with CID have lower FMD values compared to healthy population, indicating endothelial dysfunction. However TG/HDL ratio and its relationship to FMD in patients with CID has not been investigated. The present study investigated whether TG/HD...
Northern clinics of Istanbul, 2016
The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that in... more The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that includes Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF). The incidence of adverse cardiovascular events is greater among patients with CID, though they may not have conventional atherosclerotic risk factors. Endothelial dysfunction is one of the underlying fundamental mechanisms that trigger development of atherosclerotic alterations in arteries, and flow-mediated dilatation (FMD) is a noninvasive method to determine endothelial dysfunction. Recent studies have shown a relationship between high triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio and coronary atherosclerosis. Many studies have demonstrated that patients with CID have lower FMD values compared to healthy population, indicating endothelial dysfunction. However TG/HDL ratio and its relationship to FMD in patients with CID has not been investigated. The present study investigated whether TG/HD...
Angiology, 2015
We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro... more We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro- and anti-inflammatory cytokine levels, as well as the single-nucleotide polymorphisms located in the promoter regions of their related genes. This study included 111 consecutive patients angiographically diagnosed with CSX and 111 healthy controls with similar demographic characteristics. Serum interleukin (IL) 6, tumor necrosis factor α (TNF-α), and IL-10 levels were measured, and the genotypes of the patients and controls were determined using standard methods. Serum IL-6 and IL-10 levels were significantly higher in the CSX group than in the control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .01, respectively). Serum TNF-α level was lower in the CSX group than in the control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). On the other hand, participants with CSX and healthy controls were not significantly different with respect to the genotype distributions of IL-6, TNF-α, and IL-10 genes. As a result of our study, both pro-inflammatory and anti-inflammatory cytokines may play a role in the pathogenesis of CSX. In contrast, the studied gene polymorphisms did not influence CSX pathogenesis.
International Journal of Cardiology, 2012
The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the ... more The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the patient population with metabolic syndrome (MeS). The present study aimed to investigate the association between the epicardial adipose tissue thickness (EATT) and the oxidative stress parameters in MeS patients. The study included 181 patients as a patient group of 92 consecutive patients with MeS and a control group of 89 consecutive patients with similar age and gender. EATT was evaluated by transthoracic echocardiography. Serum levels of total oxidant status (TOS), total antioxidative capacity (TAS), paraoxonase-1 (PON-1), and arylesterase activities were measured. EATT was higher in the MeS group compared to the control group (6.0 ± 2.0 mm and 4.0 ± 1.0 mm, resp.; < 0.001). The level of TOS was higher in the MeS group compared to the control group ( < 0.001). Additionally, the TAS level was higher in the MeS group compared to the control group ( < 0.001). Furthermore, the serum levels of PON-1 and arylesterase were lower in the MeS group compared to the control group ( < 0.001). EAT may cause an increased risk of cardiovascular diseases by leading to increased oxidative stress in patients with MeS.
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2014
This study aimed to evaluate the serum gamma-glutamyltransferase (GGT) levels as an indirect mark... more This study aimed to evaluate the serum gamma-glutamyltransferase (GGT) levels as an indirect marker of elevated oxidative stress in patients with dilated ascending aorta. The study was designed as an observational cross-sectional controlled study. One hundred consecutive patients with dilated ascending aorta and 50 consecutive controls with normal ascending aorta diameter were selected for the study by comprehensive transthoracic echocardiography (TTE). The aortic dilatation group was divided into two subgroups, according to the literature as the ectasia group (3.8-4.3 cm, 53 patients, 24 male and 29 female, mean age: 62.9±10.9 years) and the aneurysm group (≥4.4 cm, 47 patients, 18 male and 29 female, mean age: 65.5±11.1 years). The control group consisted of patients demonstrating no ascending aorta dilatation (≤3.7 cm, 50 patients, 24 male and 26 female, mean age: 62.7±9.2 years). ANOVA, Mann-Whitney U test, Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s correlation analysis, multivariate logistic regression analysis, and receiver-operator curve analysis were used for statistical analysis. Regarding the comparison of laboratory parameters between the patient and control groups, serum gamma-glutamyltransferase (GGT) levels were found to be statistically significantly higher in both of the aortic dilatation subgroups than in the control group (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). In the correlation analysis between the ascending aorta diameter and GGT, a statistically significant positive correlation was found (r=0.282, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The multivariate regression analysis revealed a significant relationship between GGT and the proximal ascending aorta diameter (β=0.131, odds ratio: 1.140, 95% CI: 1.060-1.225, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). GGT as a marker of oxidative stress may play a role in the pathogenesis of aneurysm of the ascending aorta.
Conference Presentations by Gonul Acıksarı
In this study, blood volume pulse and galvanic skin response (GSR) of patients with ST elevation ... more In this study, blood volume pulse and galvanic skin response (GSR) of patients with ST elevation myocardial infarction before angiography and before discharged periods from hospital were acquired and investigated. The purpose of this study was to investigate discriminating features for markers of acute cardiac pain. The recordings were lasted in 5 minutes. We found that Welch PSD and mean GSR values were different in MI patients during this two measurement periods. Further studies are needed to increase our understanding of the causes of these differences in relation to clinical state.
Bu çalışmada, şiddetli göğüs ağrısı ile hastaneye başvurup EKG analizi sonucu ST elevasyonlu kalp... more Bu çalışmada, şiddetli göğüs ağrısı ile hastaneye başvurup EKG analizi sonucu ST elevasyonlu kalp krizi tanısı alan ve hemen anjiyoya alınan hastalardan fotopletismograf aracılığı ile kan hacmi sinyalleri 5 dakika boyunca kaydedilmiştir. Ayrıca hastalardan taburcu edilmeden önce de kan hacmi sinyalleri aynı süre kaydedilerek kalp hızı değişkenliği frekans ekseninde incelenmiştir. Welch güç spektral analizi sonucu alçak frekans (AF), yüksek frekans (YF) güç bileşenleri ve AF/YF oranı ile bulunan sempatovagal denge özniteliklerindeki değişim iki farklı kayıt zamanı arasında karşılaştırılmıştır. Anjiyo öncesi kalp hızı değişkenliğinin AF güç bileşeni ve AF/YF oranı parametrelerinin hasta krizi atlattıktan sonra taburcu öncesi değerlerine göre oldukça yüksek olduğu gözlenmiştir. Kriz sırasındaki artmış sempatik aktivasyonun istatistiki olarak anlamlı olduğu bulunmuştur.
Bu çalışmada, ST segment elevasyonlu enfarktüs tanısı alan hastalardan koroner girişim öncesi ve ... more Bu çalışmada, ST segment elevasyonlu enfarktüs tanısı alan hastalardan koroner girişim öncesi ve kriz sonrası hasta taburcu edilmeden önce olmak üzere iki farklı zaman diliminde 5 dakika boyunca EEG sinyalleri kaydedilmiştir. Kalp krizi sırası ve sonrasında beyin sinyallerindeki kaotik dinamikleri incelemek amacıyla sol parietal ve sol temporal bölgelerden kaydedilen sinyallerin en büyük Lyapunov üsteli hesaplanarak değerlerdeki farklılık karşılaştırılmıştır. Sonuçta, hastalarda enfarktüs sırasında parietal bölgede bulunan azalmış Lyapunov üstelinin o bölgede azalmış kaotik davranışı yansıttığı bulunmuştur.
International Journal of the Cardiovascular Academy, Sep 1, 2017
доктор педагогічних наук, професор, професор кафедри інформатики, програмної інженерії та економі... more доктор педагогічних наук, професор, професор кафедри інформатики, програмної інженерії та економічної кібернетики Херсонський державний університет orcid.org/0000-0001-5120-620X У статті систематизовані сучасні уявлення щодо дефініції «професійна спрямованість фахівців», визначено складники та критерії рівнів її сформованості і адаптовано загальні концептуальні положення до практики професійної підготовки майбутніх судноводіїв. З цією метою проаналізовано відомості, представлені у фахових джерелах, присвячених професійній підготовці фахівців за різними напрямами, і узагальнено власний досвід формування професійної компетентності, інформаційної культури, іншомовної комунікативної компетентності майбутніх судноводіїв, що дозволило адаптувати загальні теоретичні положення щодо використання інтегративного підходу до втілення принципу професійної спрямованості у систему професійної підготовки майбутніх судноводіїв. З'ясовано, що професійна спрямованість майбутніх судноводіїв є інтегральним особистісним утворенням, зумовленим усвідомленою мотивацією курсанта щодо вибору морської професії, що детермінується переважаючими чинниками потребнісно-мотиваційної сфери до здійснення функціональних обов'язків відповідно до статутних вимог, чинного вітчизняного та міжнародного законодавства, розумінням мети, проміжних цілей та завдань професійної діяльності судноводія, продуктивним та адекватним до ситуації застосуванням набутих у процесі професійної підготовки знань, навичок, вмінь. Структуру професійної спрямованості майбутнього судноводія утворюють мотиваційний, орієнтаційний, ціннісний, когнітивний компоненти. Розуміння професійної спрямованості майбутніх судноводіїв як ядра особистісно-мотиваційного компоненту їх професійної компетентності орієнтують нас на створення інтегрованих курсів з використанням тренажерів, симуляційних технологій на основі доповненої та віртуальної реальності як умов для квазіпрофесійної навчальної діяльності майбутніх судноводіїв. Ключові слова: професійна спрямованість фахівців, структура, критерії сформованості, майбутні судноводії, професійна підготовка.
Koşuyolu heart journal, Apr 26, 2021
Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with ... more Introduction: Cardiac resynchronization therapy (CRT), is a therapeutic option for patients with refractory heart failure. We aimed to examine the usefulness of N-terminal pro-brain-type natriuretic peptide (NT-proB-NP), mid-regional pro-atrial natriuretic peptide (MR-proANP), and adiponectin in monitoring CRT-induced left ventricular (LV) reverse remodeling, reverse electrical remodeling, and clinical response. Patients and Methods: We prospectively enrolled 46 heart failure patients who underwent clinical, electrocardiographic, echocardiographic evaluation and blood sampling for measurements of NT-proBNP, MR-proANP, and adiponectin before and 12-months after CRT implantation. LV reverse remodeling (LVRR), reverse electrical remodeling (RER) and clinical response were described respectively as a decrease in LV end-systolic volume (LVESV) ≥ 15% or an absolute increase in LV ejection fraction ≥ 5%, a decrease in intrinsic QRS (iQRS) duration by ≥ 20 ms, and an improvement of NYHA ≥ 1 class. Results: At 12 months, LV function, and size, severity of mitral regurgitation (MR), clinical status, and QRS duration were significantly improved by CRT. We detected LVRR, RER, and clinical response in 72%, 54%, and 76% of patients, respectively. Both reductions in MR-proANP and adiponectin levels were correlated with decrease in LVESV (r= 0.51, p< 0.05; r= 0.50, p< 0.05, respectively). Also, there was an association between reduction in MR-proANP levels and decrease in mitral regurgitation grade (r= 0.50, p< 0.05). We observed a relationship between decrease in iQRS duration and reduction in MR-proANP levels after CRT (r= 0.67, p< 0.05). Conclusion: MR-proANP levels after CRT may reflect electrical response and regression in MR. Furthermore, both adiponectin and MR-proANP levels after CRT may reveal decrease in LVESV.
International Journal of Cardiovascular Imaging, Oct 8, 2021
Cardiac complications such as heart failure and arrhythmias caused by "iron-induced" cardiomyopat... more Cardiac complications such as heart failure and arrhythmias caused by "iron-induced" cardiomyopathy are considered as the primary cause of death in the patients with β-thalassemia major. The aim of this study was to evaluate electrocardiography, echocardiography according cardiac T2* and ferritin ndings of patients followed-up for β-thalassemia major, and to investigate the importance of these ndings for early detection of cardiac complications. The study included 41 patients and 25 healthy individuals with matched age and gender. The cardiac T2* results revealed a cardiac iron load below 20 msec in 12 (29.27%) patients, and above 20 msec in 29 (70.73%) patients. All electrocardiography parameters except JTc interval signi cantly increased in the patient group when compared to the control group (p < 0.05). All parameters except P wave segment in electrocardiography and T peak-end/QT ratio were signi cantly higher in the group with cardiac T2* <20 msec than the group with cardiac T2* >20 msec (p < 0.05). Intraventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index detected by echocardiography were signi cantly higher in the group with T2* <20 msec (p < 0.05). Electrocardiography, echocardiography, cardiac T2* and ferritin ndings should be carefully evaluated in these patients in order to detect early signs of cardiac complications.
Bagcilar Medical Bulletin
Objective: Sexual dysfunction after acute coronary syndrome (ACS), is a frequently encountered pr... more Objective: Sexual dysfunction after acute coronary syndrome (ACS), is a frequently encountered problem in clinical practice. The aim of our study is to determine the time it takes for patients to switch to a healthy sexual life, which is one of the basic elements of a healthy social life, after a cardiovascular event in Turkish society and investigation of the effect of drugs related to ACS on sexual activity. Method: In our study, volunteer women and men who had a cardiovascular event at least 3 months before and were sexually active before the ACS between January 2017-December 2019 were evaluated using a closed questionnaire. The demographic characteristics of the patients, their comorbidities and medications, and their sexual activity levels before and after the ACS were compared. Results: After ACS, sexual dysfunction developed in 36% (n=117) of the patients. In the group with sexual dysfunction, heart failure [21% (n=25)-9% (n=18)-p=0.001], chronic renal failure [9% (n=11)-0% (n=0) p<0.001], and BPH presence [34% (n=40)-(11% (n=23) p<0.001] were higher. Similarly, beta-blocker use [95% (n=111)-84% (n=172) p=0.001] and ACE-I/ARB use [62% (n=73)-54% (n=111) p=0.05] were also higher in participants with sexual dysfunction. Conclusion: In our study, an increase in the prevalence of sexual dysfunction was observed in patients with multiple comorbidities, especially heart failure. Sexual dysfunction was found to be higher in patients using beta-blockers.
The Eurasian Journal of Medicine, 2018
Medicine Science | International Medical Journal, 2017
Drug adherence to novel oral anticoagulants (NOAC) varied by countries and popuplations. As a res... more Drug adherence to novel oral anticoagulants (NOAC) varied by countries and popuplations. As a result of NOAC-TR study, in Turkey, drug adhrence to NOACs is poor comparing to other real world studies. However it is not known whether there is a difference between geographic regions of Turkey in terms of NOAC adherence. In this study we aim to investigate the NOAC adherence in patients with non-valvular atrial fibrillation according to the geographic regions in Turkey Method: This cros-sectional study was designed as a subgroup study of NOAC-TR (Drug Adherence in patients with non valvular atrial fibrillation taking non-vitamin K antagonist oral anticoagulants in Turkey). A total of 2802 patients (59% female) taking NOAC (Dabigatran, apixaban, rivaroxaban) due to NVAF at least 3 months, were included. Morisky-8 item drug adherence scale was used. Patients were divided in 3 groups (high, moderate and low adherent) based on drug adherence Results: Of the patients 24% were adherent, 26% were moderate adhererent and 50% were low adherent to NOAC treatment. Drug adhrence was different between geographic regions (p<0,001). In post-hoc analysis low adherent rate was highest in Blacksea region (72% low adherent, 21% moderate adherent, 7% low adherent). Adherence rate was highest in Aegean (36% adherent, 26% moderate adherent 38%) and Marmara region (38% adherent, 28% moderate adherent 34% low adherent). Conclusion: NOAC adherence was different between geographic regions in Turkey.
Balkan Medical Journal, 2017
Background: The time in therapeutic range values may vary between different geographical regions ... more Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy. Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey. Study Design: Cross-sectional study. Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of the effect of warfarin and fooddrug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5%±22.9 in the WARFARIN-TR study. There were statistically significant differences between
Clinical and Applied Thrombosis/Hemostasis, 2017
Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensu... more Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016. To measure the adherence level, an 8-item Morisky Medication Adherence Scale was used. The mean age of the patients was 70 ± 10 years. Of the 2738 patients, 44% were receiving dabigatran, 38% rivaroxaban, and 18% apixaban. A total of 630 (23%) patients had high medication adheren...
ABSTRACT ISBN: 9786054649099
Atherosclerosis, 2014
Microvascular dysfunction has been reported in cardiac syndrome X (CSX), even though the underlyi... more Microvascular dysfunction has been reported in cardiac syndrome X (CSX), even though the underlying mechanisms still remain uncertain. Galectin-3 has been recently recognized as a biomarker of cardiovascular fibrosis and inflammation. We sought to investigate the role of galectin-3 in the CSX. We studied 115 consecutive CSX patients (mean age 55.43 ± 8.71 years, 36 men) and 74 healthy controls (mean age 54.53 ± 10.07 years, 31 men). Serum concentrations of galectin-3 and high-sensitive C-reactive protein (hs-CRP) were measured on the blood samples. Galectin-3 concentrations were significantly higher in patients with CSX compared to controls (0.90 ng/ml; IQR, 0.40-1.70 ng/ml vs 0.40 ng/ml; IQR, 0.36-0.44 ng/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Although, the prevalence of diabetes mellitus, hypertension and family history of coronary artery disease (CAD) were significantly higher among patients with CSX, following adjustment for diabetes mellitus, hypertension, and family history of CAD, serum galectin-3 concentrations were still found significantly increased in patients with CSX. Galectin-3 concentrations correlated positively with hs-CRP (r = 0.16, p = 0.03). In addition, concentrations of galectin-3, hs-CRP, fasting glucose, uric acid and family history of CAD were determined as independent predictors of the CSX. It was found that galectin-3 serum concentrations are higher in patients with CSX compared to healthy controls. Further studies on larger population are needed to confirm the relation between the fibrosis and the CSX, as well as to explore the potential role of galectin-3 in the CSX.
Northern clinics of Istanbul, 2016
The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that in... more The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that includes Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF). The incidence of adverse cardiovascular events is greater among patients with CID, though they may not have conventional atherosclerotic risk factors. Endothelial dysfunction is one of the underlying fundamental mechanisms that trigger development of atherosclerotic alterations in arteries, and flow-mediated dilatation (FMD) is a noninvasive method to determine endothelial dysfunction. Recent studies have shown a relationship between high triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio and coronary atherosclerosis. Many studies have demonstrated that patients with CID have lower FMD values compared to healthy population, indicating endothelial dysfunction. However TG/HDL ratio and its relationship to FMD in patients with CID has not been investigated. The present study investigated whether TG/HD...
Northern clinics of Istanbul, 2016
The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that in... more The term chronic inflammatory disease (CID) refers to a category of inflammatory diseases that includes Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF). The incidence of adverse cardiovascular events is greater among patients with CID, though they may not have conventional atherosclerotic risk factors. Endothelial dysfunction is one of the underlying fundamental mechanisms that trigger development of atherosclerotic alterations in arteries, and flow-mediated dilatation (FMD) is a noninvasive method to determine endothelial dysfunction. Recent studies have shown a relationship between high triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio and coronary atherosclerosis. Many studies have demonstrated that patients with CID have lower FMD values compared to healthy population, indicating endothelial dysfunction. However TG/HDL ratio and its relationship to FMD in patients with CID has not been investigated. The present study investigated whether TG/HD...
Angiology, 2015
We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro... more We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro- and anti-inflammatory cytokine levels, as well as the single-nucleotide polymorphisms located in the promoter regions of their related genes. This study included 111 consecutive patients angiographically diagnosed with CSX and 111 healthy controls with similar demographic characteristics. Serum interleukin (IL) 6, tumor necrosis factor α (TNF-α), and IL-10 levels were measured, and the genotypes of the patients and controls were determined using standard methods. Serum IL-6 and IL-10 levels were significantly higher in the CSX group than in the control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .01, respectively). Serum TNF-α level was lower in the CSX group than in the control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). On the other hand, participants with CSX and healthy controls were not significantly different with respect to the genotype distributions of IL-6, TNF-α, and IL-10 genes. As a result of our study, both pro-inflammatory and anti-inflammatory cytokines may play a role in the pathogenesis of CSX. In contrast, the studied gene polymorphisms did not influence CSX pathogenesis.
International Journal of Cardiology, 2012
The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the ... more The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the patient population with metabolic syndrome (MeS). The present study aimed to investigate the association between the epicardial adipose tissue thickness (EATT) and the oxidative stress parameters in MeS patients. The study included 181 patients as a patient group of 92 consecutive patients with MeS and a control group of 89 consecutive patients with similar age and gender. EATT was evaluated by transthoracic echocardiography. Serum levels of total oxidant status (TOS), total antioxidative capacity (TAS), paraoxonase-1 (PON-1), and arylesterase activities were measured. EATT was higher in the MeS group compared to the control group (6.0 ± 2.0 mm and 4.0 ± 1.0 mm, resp.; < 0.001). The level of TOS was higher in the MeS group compared to the control group ( < 0.001). Additionally, the TAS level was higher in the MeS group compared to the control group ( < 0.001). Furthermore, the serum levels of PON-1 and arylesterase were lower in the MeS group compared to the control group ( < 0.001). EAT may cause an increased risk of cardiovascular diseases by leading to increased oxidative stress in patients with MeS.
Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology, 2014
This study aimed to evaluate the serum gamma-glutamyltransferase (GGT) levels as an indirect mark... more This study aimed to evaluate the serum gamma-glutamyltransferase (GGT) levels as an indirect marker of elevated oxidative stress in patients with dilated ascending aorta. The study was designed as an observational cross-sectional controlled study. One hundred consecutive patients with dilated ascending aorta and 50 consecutive controls with normal ascending aorta diameter were selected for the study by comprehensive transthoracic echocardiography (TTE). The aortic dilatation group was divided into two subgroups, according to the literature as the ectasia group (3.8-4.3 cm, 53 patients, 24 male and 29 female, mean age: 62.9±10.9 years) and the aneurysm group (≥4.4 cm, 47 patients, 18 male and 29 female, mean age: 65.5±11.1 years). The control group consisted of patients demonstrating no ascending aorta dilatation (≤3.7 cm, 50 patients, 24 male and 26 female, mean age: 62.7±9.2 years). ANOVA, Mann-Whitney U test, Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s correlation analysis, multivariate logistic regression analysis, and receiver-operator curve analysis were used for statistical analysis. Regarding the comparison of laboratory parameters between the patient and control groups, serum gamma-glutamyltransferase (GGT) levels were found to be statistically significantly higher in both of the aortic dilatation subgroups than in the control group (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). In the correlation analysis between the ascending aorta diameter and GGT, a statistically significant positive correlation was found (r=0.282, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The multivariate regression analysis revealed a significant relationship between GGT and the proximal ascending aorta diameter (β=0.131, odds ratio: 1.140, 95% CI: 1.060-1.225, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). GGT as a marker of oxidative stress may play a role in the pathogenesis of aneurysm of the ascending aorta.
In this study, blood volume pulse and galvanic skin response (GSR) of patients with ST elevation ... more In this study, blood volume pulse and galvanic skin response (GSR) of patients with ST elevation myocardial infarction before angiography and before discharged periods from hospital were acquired and investigated. The purpose of this study was to investigate discriminating features for markers of acute cardiac pain. The recordings were lasted in 5 minutes. We found that Welch PSD and mean GSR values were different in MI patients during this two measurement periods. Further studies are needed to increase our understanding of the causes of these differences in relation to clinical state.
Bu çalışmada, şiddetli göğüs ağrısı ile hastaneye başvurup EKG analizi sonucu ST elevasyonlu kalp... more Bu çalışmada, şiddetli göğüs ağrısı ile hastaneye başvurup EKG analizi sonucu ST elevasyonlu kalp krizi tanısı alan ve hemen anjiyoya alınan hastalardan fotopletismograf aracılığı ile kan hacmi sinyalleri 5 dakika boyunca kaydedilmiştir. Ayrıca hastalardan taburcu edilmeden önce de kan hacmi sinyalleri aynı süre kaydedilerek kalp hızı değişkenliği frekans ekseninde incelenmiştir. Welch güç spektral analizi sonucu alçak frekans (AF), yüksek frekans (YF) güç bileşenleri ve AF/YF oranı ile bulunan sempatovagal denge özniteliklerindeki değişim iki farklı kayıt zamanı arasında karşılaştırılmıştır. Anjiyo öncesi kalp hızı değişkenliğinin AF güç bileşeni ve AF/YF oranı parametrelerinin hasta krizi atlattıktan sonra taburcu öncesi değerlerine göre oldukça yüksek olduğu gözlenmiştir. Kriz sırasındaki artmış sempatik aktivasyonun istatistiki olarak anlamlı olduğu bulunmuştur.
Bu çalışmada, ST segment elevasyonlu enfarktüs tanısı alan hastalardan koroner girişim öncesi ve ... more Bu çalışmada, ST segment elevasyonlu enfarktüs tanısı alan hastalardan koroner girişim öncesi ve kriz sonrası hasta taburcu edilmeden önce olmak üzere iki farklı zaman diliminde 5 dakika boyunca EEG sinyalleri kaydedilmiştir. Kalp krizi sırası ve sonrasında beyin sinyallerindeki kaotik dinamikleri incelemek amacıyla sol parietal ve sol temporal bölgelerden kaydedilen sinyallerin en büyük Lyapunov üsteli hesaplanarak değerlerdeki farklılık karşılaştırılmıştır. Sonuçta, hastalarda enfarktüs sırasında parietal bölgede bulunan azalmış Lyapunov üstelinin o bölgede azalmış kaotik davranışı yansıttığı bulunmuştur.