Nazire Aladağ - Academia.edu (original) (raw)

Papers by Nazire Aladağ

DergiPark (Istanbul University), Mar 1, 2013

Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Nov 21, 2012

Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and h... more Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two-dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic-hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemichypomagnesemic (63%) and normokalemic-normomagnesemic (after potassium and magnesium therapy, 67%) hearts. However, decreased left ventricular apical 4-chamber peak systolic longitudinal strain, left ventricle global peak systolic strain, and global torsion values increased after potassium chloride and magnesium replacement therapy. (Echocardiography 2013;30:E47-E50)

Herz, Oct 21, 2021

Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality... more Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality rates. Ischemia, autonomic nervous system dysfunction, impaired cardiac ionic currents, and genetic predisposition may be the underlying mechanisms. Proarrhythmic ventricular electrophysiological remodeling detected on the basis of Tp‑e interval, Tp-e/QT, and Tp-e/QTc ratios plays a key role in the prognosis. Our aim was to assess proarrhythmic ventricular electrophysiological remodeling in patients with RA, a well-known chronic inflammatory disorder. A total of 163 patients with RA and 47 patients as a control group were included in this retrospective study. Proarrhythmic ventricular electrophysiological remodeling markers were evaluated in both groups along with baseline demographic and clinical variables. Patients using medication or with chronic disorders that can affect ventricular repolarization markers were excluded. The patients with RA had prolonged Tp‑e interval (66 ms [44–80]; 80 ms [78–96], p < 0.001) and increased Tp-e/QT ratio (0.18 [0.12–0.22]; 0.22 [0.20–0.24], p < 0.001) and Tp-e/QTc ratio (0.16 [0.11–0.19]; 0.20 [0.17–0.22], p < 0.001) compared to the control group. The Tp‑e interval and Tp-e/QT ratio, which may help to clarify the pathophysiological mechanisms of ventricular arrhythmias, were increased in patients with RA.

Advances in Clinical and Experimental Medicine, 2015

Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated... more Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated with cardiovascular disease, such as coronary artery disease. Melatonin plays a role as a direct free radical scavenger and indirect antioxidant. No study has examined the relationships between endogenous melatonin and uric acid in order to predict the risk of future cardiovascular disease in male so far. To better characterize a possible relationship, we studied the association of endogenous melatonin with uric acid and traditional cardiovascular risk factors such as plasma lipids, and glucose in healthy young male. Material and Methods. Twenty-one male participants [mean age: 22.6 2.5 (18-26) year], non-smoking; their medication or alcohol consumption history were studied. Blood samples for measuring melatonin concentrations were collected in the supine position between 13:30-14:30 hours. After centrifugation, plasma samples were immediately frozen at-20°C until analysis. Results. Although we found a significant negative correlation between the levels of endogeneous melatonin and uric acid (p = 0.01, r =-0.51), we did not find any correlation among the melatonin and other antropometric, hemodynamic and biochemical parameters in male subjects (p > 0.41). Conclusions. The present study demonstrated that a significant negative correlation between the levels of endogeneous melatonin and uric acid in healthy young male (Adv Clin Exp Med 2015, 24, 2, 233-237).

Russian Journal of Cardiology, Dec 30, 2020

Koşuyolu heart journal, Aug 3, 2015

Oral direkt trombin inhibitörü bir ilaç olan dabigatran eteksilat, günümüzde warfarin alamayan at... more Oral direkt trombin inhibitörü bir ilaç olan dabigatran eteksilat, günümüzde warfarin alamayan atriyal fi brilasyonlu hastalarda tromboemboli riskinin azaltılması için yaygın olarak kullanılmaya başlanmıştır. En önemli yan etkisi kanama olup; daha çok gastrointestinal kanama şeklindedir. Cilt içine kanama nadir olarak görülmekte ve özellikle yaşlı hastalarda kullanımını kısıtlayabilmektedir. Kliniğimize yorgunluk ve Class II efor dispnesi ile başvuran seksen yedi yaşındaki erkek hastanın yaklaşık 5 yıldır atriyal fi brilasyon nedeni ile klopidogrel 75 mg aldığı öğrenildi. Özgeçmişinden warfarin kullanamadığı ve bir kez transient iskemik atak geçirdiği tespit edildi. Yüzey elektrokardiyogramında ritim atriyal fi brilasyon, kalp hızı ortalama 70/dak idi. Transtorasik ekokardiyografi de ejeksiyon fraksiyon %50 civarında, sol ventrikül diyastol sonu çapı 52 mm, sol ventrikül sistol sonu çapı 37 mm, sol atriyum 44 mm idi. Hematolojik ve biyokimyasal bulguları normal olan hastaya dabigatran 110 mg 2x1 başlandı. Yaklaşık 3 hafta sonra yaygın cilt içi kanamalar tespit edilmesi üzerine ilaca ara verildi ve tekrar klopidogrel 75 mg başlandı (Resim 1). Takiplerinde lezyonlarında gerileme izlendi (Resim 1). Günümüzde, ülkemizde de atriyal fi brilasyon tedavisinde sık olarak kullanılmaya başlanan dabigatrana bağlı cilt içi kanamaların gelişebileceği ve bunun özellikle yaşlı hastalarda daha büyük kanamaların habercisi olabileceği unutulmamalıdır.

DergiPark (Istanbul University), Oct 17, 2022

Hippocrates Medical Journal

Introduction: MAFLD is a new diagnosis that has been brought to the terminology in the last 2 yea... more Introduction: MAFLD is a new diagnosis that has been brought to the terminology in the last 2 years, and it is thought that the main mechanism underlying its development is Insulin Resistance (IR). In our study, it is planned to research the role of IR level in the etiology of patients with MAFLD. Method: 265 individuals with MAFLD are included in the study by examining their sub-parameters of case diagnosis. While 85 patients have T2DM, 180 patients are found to be Prediabetic. IR is calculated with HOMA-IR. The value of 2.5 and above is considered as high, and below 2.5 is considered as normal. The ratios of HOMA-IR levels and their relationship between waist circumference and BMI were examined. Findings: The value of HOMA-IR was found high in 60.6% of prediabetic MAFLDs, while it was normal in 39.4% of them. Age ((p=0.001; p<0.01) and waist circumference (p=0.028; p<0.05) in the T2DM group were found to be higher than the prediabetic group. Very weak positive correlation wa...

Journal of Investigative Medicine

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrat... more COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=...

A 61-year-old female was admitted because of chest pain on exertion. She had a long history of hy... more A 61-year-old female was admitted because of chest pain on exertion. She had a long history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and aspirin 100 mg once daily. Her electrocardiography and echocardiography were normal. Myocardial perfusion scintigraphy revealed inferior hypoperfusion suggestive of ischemia. We planned multislice coronary computed tomography because of the patient refused the coronary angiography. Significant circumflex coronary artery lesion (70%) was found at tomography. We planned percutaneous transluminal coronary angioplasty and stent implantation of the circumflex coronary artery after 2 weeks. She was prescribed clopidogrel which is irreversibly inhibiting P2Y12 and adenosine diphosphate receptor on platelet cell membranes 75 mg once daily(1). One weeks later she presented to our hospital with severe pain of his left knee. The knee was tender and hot. His erythrocyte sedimentation rate (42 mm/hour) and C-reactive ...

Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies w... more Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies widely depending on underlying causes, spe-cially, cardiac ones. We sought to determine the abnormal Electrophysiolgic (EP) study results as predictors of prognosis in syncope patients with suspected cardiac cause and risk factors associated with mortality. Methods: A total of 227 consecutive patients with unexplained syncope were prospectively enrolled in this study. EP study was performed in 177 patients in base of inclusion criteria. These patients, in whom a cardiac cause of syncope was suspected, underwent EP study and if negative, head-up tilts test (HUTT). Complete follow-up was obtained for 132 patients for 20.0±10.8 months. Results: A cardiac cause of syncope was established in 35%, a neurally mediated syncope in 35.6%, and in the rest 29.4 % the cause of syn-cope remained unexplained despite a throughout neurologic and cardiologic evaluation. Logistic analysis revealed that the ...

Herz, 2021

Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality... more Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality rates. Ischemia, autonomic nervous system dysfunction, impaired cardiac ionic currents, and genetic predisposition may be the underlying mechanisms. Proarrhythmic ventricular electrophysiological remodeling detected on the basis of Tp‑e interval, Tp-e/QT, and Tp-e/QTc ratios plays a key role in the prognosis. Our aim was to assess proarrhythmic ventricular electrophysiological remodeling in patients with RA, a well-known chronic inflammatory disorder. A total of 163 patients with RA and 47 patients as a control group were included in this retrospective study. Proarrhythmic ventricular electrophysiological remodeling markers were evaluated in both groups along with baseline demographic and clinical variables. Patients using medication or with chronic disorders that can affect ventricular repolarization markers were excluded. The patients with RA had prolonged Tp‑e interval (66 ms [44–80]; 80 ms [78–96], p < 0.001) and increased Tp-e/QT ratio (0.18 [0.12–0.22]; 0.22 [0.20–0.24], p < 0.001) and Tp-e/QTc ratio (0.16 [0.11–0.19]; 0.20 [0.17–0.22], p < 0.001) compared to the control group. The Tp‑e interval and Tp-e/QT ratio, which may help to clarify the pathophysiological mechanisms of ventricular arrhythmias, were increased in patients with RA.

Kosuyolu Kalp Dergisi, 2014

history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and ... more history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and aspirin 100 mg once daily. Her electrocardiography and echocardiography were normal. Myocardial perfusion scintigraphy revealed inferior hypoperfusion suggestive of ischemia. We planned multislice coronary computed tomography because of the patient refused the coronary angiography. Significant circumflex coronary artery lesion (70%) was found at tomography. We planned percutaneous transluminal coronary angioplasty and stent implantation of the circumflex coronary artery after 2 weeks. She was prescribed clopidogrel which is irreversibly inhibiting P2Y12 and adenosine diphosphate receptor on platelet cell membranes 75 mg once daily(1). One weeks later she presented to our hospital with severe pain of his left knee. The knee was tender and hot. His erythrocyte sedimentation rate (42 mm/hour) and C-reactive protein (17 mg/dL) were increased. Other hematological, biochemical and rheumatological findings such as glucose, urea, creatinin, uric acide, sodium, potassium, calcium, thyroid function tests, romatoid factor, and antinuclear antibody were normal. Knee X ray films and magnetic resonance imaging showed signs of soft tissue swelling. Clopidogrel was discontinued. One week later the joint pain and inflammatory tests had improved. After recovery, clopidogrel 75 mg/day was re-initiated, but the same complaints were re-induced. The patient refused the percutaneous intervention and medical therapy without clopidogrel was started. Finally, according to this findings, clopidogrel may be a cause of acute arthritis(2)

Turkiye Klinikleri Cardiovascular Sciences, 2013

Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombophilia is ... more Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombophilia is usually categorized into two types, acquired and genetic. The factor V Leiden (F-VL) and methylenetetrahydrofolate reductase (MTHFR) gene mutations are genetic conditions which associated with the recurrent fetal loss. In this case, the patient who has heterozigot F-VL 1691G>A and MTHFR-677C>T gene mutations with the recurrent fetal loss is presented. The present of both FVL and MTHFR gene mutations increase the risk of thrombosis seriously. In conclusion, the pregnant who has two gene mutations must be observed carefully for recurrent fetal loss and thrombosis. Moreover, they should be investigated for the purposes of the antiagregan and anticoagulant (low molecular weight heparin) theraphy. In similar cases, the cardiologist, internal medicine specialist and gynecologist should be work in cooperation.

Advances in Clinical and Experimental Medicine, 2015

Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated... more Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated with cardiovascular disease, such as coronary artery disease. Melatonin plays a role as a direct free radical scavenger and indirect antioxidant. No study has examined the relationships between endogenous melatonin and uric acid in order to predict the risk of future cardiovascular disease in male so far. To better characterize a possible relationship, we studied the association of endogenous melatonin with uric acid and traditional cardiovascular risk factors such as plasma lipids, and glucose in healthy young male. Material and Methods. Twenty-one male participants [mean age: 22.6 2.5 (18-26) year], non-smoking; their medication or alcohol consumption history were studied. Blood samples for measuring melatonin concentrations were collected in the supine position between 13:30-14:30 hours. After centrifugation, plasma samples were immediately frozen at-20°C until analysis. Results. Although we found a significant negative correlation between the levels of endogeneous melatonin and uric acid (p = 0.01, r =-0.51), we did not find any correlation among the melatonin and other antropometric, hemodynamic and biochemical parameters in male subjects (p > 0.41). Conclusions. The present study demonstrated that a significant negative correlation between the levels of endogeneous melatonin and uric acid in healthy young male (Adv Clin Exp Med 2015, 24, 2, 233-237).

Echocardiography, 2012

Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia a... more Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two‐dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic–hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemic–hypomagnesemic (63%) and normokalemic–normomagnesemic (after potassium and magnesium therapy, 67%) hear...

The European Research Journal

Objectives: There are publications showing sleep quality is impacted in type 2 diabetes mellitus ... more Objectives: There are publications showing sleep quality is impacted in type 2 diabetes mellitus (T2DM) cases. In our study, we planned to assess the prevalence of sleep disorder in these patients compared to society, and investigate whether poor glycemic regulation and increased body mass index (BMI) caused disruption of sleep quality or not. Methods: Sleep quality was compared between patients followed in our clinic with T2DM (n = 534) for minimum 5 years and a control group (n = 269). Assessment was performed for whether increased glycated haemoglobin (HbA1c) and increased BMI caused an increase in Pittsburgh Sleep Quality Index (PSQI) score or not. Cases with any comorbid disease or drug use affecting sleep quality were excluded from the study. Results: T2DM patients had higher PSQI points compared to the control group. A statistically significant, very low-level positive correlation was identified between BMI measurements and PSQI scores (as BMI increased, PSQI increased). A st...

Koşuyolu heart journal, Dec 18, 2013

Introduction: Atrial fi brillation is the most common type of arrhythmia. The prevalence of atria... more Introduction: Atrial fi brillation is the most common type of arrhythmia. The prevalence of atrial : fi brillation is increased in hemodialysis patients. The aim of the present study was to investigate the prevalence of atrial fi brillation and related factors including anthropometric, hemodynamic and echocardiographic parameters in hemodialysis patients. Patients and Methods: We recruited 154 [72 (46.8%) woman, 82 (53.2%) man] hemodialysis : patients in this study. Atrial fi brillation was determined electrocardiographically (the P waves was absent and RR intervals were irregular) and the patients were divided into two groups depending on the presence or absence of atrial fi brillation. Transthoracic echocardiography was performed in all patients. Results: There were 7 (4.5%) patients with atrial fi brillation. Although we found that the age, left ventricle end-diastolic diameter, left ventricle end-systolic diameter and left atrial diameter were increased in hemodialysis patients with atrial fi brillation, ejection fraction increased in hemodialysis patients with no atrial fi brillation. Left atrial diameter and left ventricle end-systolic diameter were shown to be independent predictors of atrial fi brillation in hemodialysis patients (p< 0.05). Conclusion: Left atrial diameter and end-systolic left ventricle diameter were independent pre-: dictors of atrial fi brillation in hemodialysis patients.

Kardiologiya, May 4, 2020

Повышение артериальной жесткости у пациентов с субклинической формой болезни Бехчета на основании... more Повышение артериальной жесткости у пациентов с субклинической формой болезни Бехчета на основании оценки каротидно-феморальной скорости распространения пульсовой волны. Кардиология. 2020;60(5):123-127]

DergiPark (Istanbul University), Mar 1, 2013

Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Nov 21, 2012

Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and h... more Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two-dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic-hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemichypomagnesemic (63%) and normokalemic-normomagnesemic (after potassium and magnesium therapy, 67%) hearts. However, decreased left ventricular apical 4-chamber peak systolic longitudinal strain, left ventricle global peak systolic strain, and global torsion values increased after potassium chloride and magnesium replacement therapy. (Echocardiography 2013;30:E47-E50)

Herz, Oct 21, 2021

Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality... more Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality rates. Ischemia, autonomic nervous system dysfunction, impaired cardiac ionic currents, and genetic predisposition may be the underlying mechanisms. Proarrhythmic ventricular electrophysiological remodeling detected on the basis of Tp‑e interval, Tp-e/QT, and Tp-e/QTc ratios plays a key role in the prognosis. Our aim was to assess proarrhythmic ventricular electrophysiological remodeling in patients with RA, a well-known chronic inflammatory disorder. A total of 163 patients with RA and 47 patients as a control group were included in this retrospective study. Proarrhythmic ventricular electrophysiological remodeling markers were evaluated in both groups along with baseline demographic and clinical variables. Patients using medication or with chronic disorders that can affect ventricular repolarization markers were excluded. The patients with RA had prolonged Tp‑e interval (66 ms [44–80]; 80 ms [78–96], p < 0.001) and increased Tp-e/QT ratio (0.18 [0.12–0.22]; 0.22 [0.20–0.24], p < 0.001) and Tp-e/QTc ratio (0.16 [0.11–0.19]; 0.20 [0.17–0.22], p < 0.001) compared to the control group. The Tp‑e interval and Tp-e/QT ratio, which may help to clarify the pathophysiological mechanisms of ventricular arrhythmias, were increased in patients with RA.

Advances in Clinical and Experimental Medicine, 2015

Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated... more Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated with cardiovascular disease, such as coronary artery disease. Melatonin plays a role as a direct free radical scavenger and indirect antioxidant. No study has examined the relationships between endogenous melatonin and uric acid in order to predict the risk of future cardiovascular disease in male so far. To better characterize a possible relationship, we studied the association of endogenous melatonin with uric acid and traditional cardiovascular risk factors such as plasma lipids, and glucose in healthy young male. Material and Methods. Twenty-one male participants [mean age: 22.6 2.5 (18-26) year], non-smoking; their medication or alcohol consumption history were studied. Blood samples for measuring melatonin concentrations were collected in the supine position between 13:30-14:30 hours. After centrifugation, plasma samples were immediately frozen at-20°C until analysis. Results. Although we found a significant negative correlation between the levels of endogeneous melatonin and uric acid (p = 0.01, r =-0.51), we did not find any correlation among the melatonin and other antropometric, hemodynamic and biochemical parameters in male subjects (p > 0.41). Conclusions. The present study demonstrated that a significant negative correlation between the levels of endogeneous melatonin and uric acid in healthy young male (Adv Clin Exp Med 2015, 24, 2, 233-237).

Russian Journal of Cardiology, Dec 30, 2020

Koşuyolu heart journal, Aug 3, 2015

Oral direkt trombin inhibitörü bir ilaç olan dabigatran eteksilat, günümüzde warfarin alamayan at... more Oral direkt trombin inhibitörü bir ilaç olan dabigatran eteksilat, günümüzde warfarin alamayan atriyal fi brilasyonlu hastalarda tromboemboli riskinin azaltılması için yaygın olarak kullanılmaya başlanmıştır. En önemli yan etkisi kanama olup; daha çok gastrointestinal kanama şeklindedir. Cilt içine kanama nadir olarak görülmekte ve özellikle yaşlı hastalarda kullanımını kısıtlayabilmektedir. Kliniğimize yorgunluk ve Class II efor dispnesi ile başvuran seksen yedi yaşındaki erkek hastanın yaklaşık 5 yıldır atriyal fi brilasyon nedeni ile klopidogrel 75 mg aldığı öğrenildi. Özgeçmişinden warfarin kullanamadığı ve bir kez transient iskemik atak geçirdiği tespit edildi. Yüzey elektrokardiyogramında ritim atriyal fi brilasyon, kalp hızı ortalama 70/dak idi. Transtorasik ekokardiyografi de ejeksiyon fraksiyon %50 civarında, sol ventrikül diyastol sonu çapı 52 mm, sol ventrikül sistol sonu çapı 37 mm, sol atriyum 44 mm idi. Hematolojik ve biyokimyasal bulguları normal olan hastaya dabigatran 110 mg 2x1 başlandı. Yaklaşık 3 hafta sonra yaygın cilt içi kanamalar tespit edilmesi üzerine ilaca ara verildi ve tekrar klopidogrel 75 mg başlandı (Resim 1). Takiplerinde lezyonlarında gerileme izlendi (Resim 1). Günümüzde, ülkemizde de atriyal fi brilasyon tedavisinde sık olarak kullanılmaya başlanan dabigatrana bağlı cilt içi kanamaların gelişebileceği ve bunun özellikle yaşlı hastalarda daha büyük kanamaların habercisi olabileceği unutulmamalıdır.

DergiPark (Istanbul University), Oct 17, 2022

Hippocrates Medical Journal

Introduction: MAFLD is a new diagnosis that has been brought to the terminology in the last 2 yea... more Introduction: MAFLD is a new diagnosis that has been brought to the terminology in the last 2 years, and it is thought that the main mechanism underlying its development is Insulin Resistance (IR). In our study, it is planned to research the role of IR level in the etiology of patients with MAFLD. Method: 265 individuals with MAFLD are included in the study by examining their sub-parameters of case diagnosis. While 85 patients have T2DM, 180 patients are found to be Prediabetic. IR is calculated with HOMA-IR. The value of 2.5 and above is considered as high, and below 2.5 is considered as normal. The ratios of HOMA-IR levels and their relationship between waist circumference and BMI were examined. Findings: The value of HOMA-IR was found high in 60.6% of prediabetic MAFLDs, while it was normal in 39.4% of them. Age ((p=0.001; p<0.01) and waist circumference (p=0.028; p<0.05) in the T2DM group were found to be higher than the prediabetic group. Very weak positive correlation wa...

Journal of Investigative Medicine

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrat... more COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=...

A 61-year-old female was admitted because of chest pain on exertion. She had a long history of hy... more A 61-year-old female was admitted because of chest pain on exertion. She had a long history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and aspirin 100 mg once daily. Her electrocardiography and echocardiography were normal. Myocardial perfusion scintigraphy revealed inferior hypoperfusion suggestive of ischemia. We planned multislice coronary computed tomography because of the patient refused the coronary angiography. Significant circumflex coronary artery lesion (70%) was found at tomography. We planned percutaneous transluminal coronary angioplasty and stent implantation of the circumflex coronary artery after 2 weeks. She was prescribed clopidogrel which is irreversibly inhibiting P2Y12 and adenosine diphosphate receptor on platelet cell membranes 75 mg once daily(1). One weeks later she presented to our hospital with severe pain of his left knee. The knee was tender and hot. His erythrocyte sedimentation rate (42 mm/hour) and C-reactive ...

Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies w... more Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies widely depending on underlying causes, spe-cially, cardiac ones. We sought to determine the abnormal Electrophysiolgic (EP) study results as predictors of prognosis in syncope patients with suspected cardiac cause and risk factors associated with mortality. Methods: A total of 227 consecutive patients with unexplained syncope were prospectively enrolled in this study. EP study was performed in 177 patients in base of inclusion criteria. These patients, in whom a cardiac cause of syncope was suspected, underwent EP study and if negative, head-up tilts test (HUTT). Complete follow-up was obtained for 132 patients for 20.0±10.8 months. Results: A cardiac cause of syncope was established in 35%, a neurally mediated syncope in 35.6%, and in the rest 29.4 % the cause of syn-cope remained unexplained despite a throughout neurologic and cardiologic evaluation. Logistic analysis revealed that the ...

Herz, 2021

Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality... more Rheumatoid arthritis (RA) is related to cardiovascular disease and results in increased mortality rates. Ischemia, autonomic nervous system dysfunction, impaired cardiac ionic currents, and genetic predisposition may be the underlying mechanisms. Proarrhythmic ventricular electrophysiological remodeling detected on the basis of Tp‑e interval, Tp-e/QT, and Tp-e/QTc ratios plays a key role in the prognosis. Our aim was to assess proarrhythmic ventricular electrophysiological remodeling in patients with RA, a well-known chronic inflammatory disorder. A total of 163 patients with RA and 47 patients as a control group were included in this retrospective study. Proarrhythmic ventricular electrophysiological remodeling markers were evaluated in both groups along with baseline demographic and clinical variables. Patients using medication or with chronic disorders that can affect ventricular repolarization markers were excluded. The patients with RA had prolonged Tp‑e interval (66 ms [44–80]; 80 ms [78–96], p < 0.001) and increased Tp-e/QT ratio (0.18 [0.12–0.22]; 0.22 [0.20–0.24], p < 0.001) and Tp-e/QTc ratio (0.16 [0.11–0.19]; 0.20 [0.17–0.22], p < 0.001) compared to the control group. The Tp‑e interval and Tp-e/QT ratio, which may help to clarify the pathophysiological mechanisms of ventricular arrhythmias, were increased in patients with RA.

Kosuyolu Kalp Dergisi, 2014

history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and ... more history of hypertension. She took irbesartan 150 mg once daily, diltiazem 90 mg twice daily, and aspirin 100 mg once daily. Her electrocardiography and echocardiography were normal. Myocardial perfusion scintigraphy revealed inferior hypoperfusion suggestive of ischemia. We planned multislice coronary computed tomography because of the patient refused the coronary angiography. Significant circumflex coronary artery lesion (70%) was found at tomography. We planned percutaneous transluminal coronary angioplasty and stent implantation of the circumflex coronary artery after 2 weeks. She was prescribed clopidogrel which is irreversibly inhibiting P2Y12 and adenosine diphosphate receptor on platelet cell membranes 75 mg once daily(1). One weeks later she presented to our hospital with severe pain of his left knee. The knee was tender and hot. His erythrocyte sedimentation rate (42 mm/hour) and C-reactive protein (17 mg/dL) were increased. Other hematological, biochemical and rheumatological findings such as glucose, urea, creatinin, uric acide, sodium, potassium, calcium, thyroid function tests, romatoid factor, and antinuclear antibody were normal. Knee X ray films and magnetic resonance imaging showed signs of soft tissue swelling. Clopidogrel was discontinued. One week later the joint pain and inflammatory tests had improved. After recovery, clopidogrel 75 mg/day was re-initiated, but the same complaints were re-induced. The patient refused the percutaneous intervention and medical therapy without clopidogrel was started. Finally, according to this findings, clopidogrel may be a cause of acute arthritis(2)

Turkiye Klinikleri Cardiovascular Sciences, 2013

Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombophilia is ... more Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombophilia is usually categorized into two types, acquired and genetic. The factor V Leiden (F-VL) and methylenetetrahydrofolate reductase (MTHFR) gene mutations are genetic conditions which associated with the recurrent fetal loss. In this case, the patient who has heterozigot F-VL 1691G>A and MTHFR-677C>T gene mutations with the recurrent fetal loss is presented. The present of both FVL and MTHFR gene mutations increase the risk of thrombosis seriously. In conclusion, the pregnant who has two gene mutations must be observed carefully for recurrent fetal loss and thrombosis. Moreover, they should be investigated for the purposes of the antiagregan and anticoagulant (low molecular weight heparin) theraphy. In similar cases, the cardiologist, internal medicine specialist and gynecologist should be work in cooperation.

Advances in Clinical and Experimental Medicine, 2015

Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated... more Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated with cardiovascular disease, such as coronary artery disease. Melatonin plays a role as a direct free radical scavenger and indirect antioxidant. No study has examined the relationships between endogenous melatonin and uric acid in order to predict the risk of future cardiovascular disease in male so far. To better characterize a possible relationship, we studied the association of endogenous melatonin with uric acid and traditional cardiovascular risk factors such as plasma lipids, and glucose in healthy young male. Material and Methods. Twenty-one male participants [mean age: 22.6 2.5 (18-26) year], non-smoking; their medication or alcohol consumption history were studied. Blood samples for measuring melatonin concentrations were collected in the supine position between 13:30-14:30 hours. After centrifugation, plasma samples were immediately frozen at-20°C until analysis. Results. Although we found a significant negative correlation between the levels of endogeneous melatonin and uric acid (p = 0.01, r =-0.51), we did not find any correlation among the melatonin and other antropometric, hemodynamic and biochemical parameters in male subjects (p > 0.41). Conclusions. The present study demonstrated that a significant negative correlation between the levels of endogeneous melatonin and uric acid in healthy young male (Adv Clin Exp Med 2015, 24, 2, 233-237).

Echocardiography, 2012

Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia a... more Gitelman's syndrome is a primary renal tubular hypokalemic metabolic alkalosis. Hypokalemia and hypomagnesemia can cause cardiac tissue excitability and conduction. Global ventricular mechanical function is directly related to the contractile properties of cardiac myocytes, which are largely dependent on the flow of ions such as potassium and magnesium. Here, we show that increased levels of potassium, in addition to magnesium, in a patient with Gitelman's syndrome significantly impacts the timing of ventricular wall motion and the pattern of ventricular strain and torsion. Two‐dimensional speckle tracking echocardiography was used for evaluation of the hypokalemic–hypomagnesemic period (first day) and third day after potassium chloride and magnesium replacement therapy. The transthoracic echocardiography showed that the percent ejection fraction was similar in hypokalemic–hypomagnesemic (63%) and normokalemic–normomagnesemic (after potassium and magnesium therapy, 67%) hear...

The European Research Journal

Objectives: There are publications showing sleep quality is impacted in type 2 diabetes mellitus ... more Objectives: There are publications showing sleep quality is impacted in type 2 diabetes mellitus (T2DM) cases. In our study, we planned to assess the prevalence of sleep disorder in these patients compared to society, and investigate whether poor glycemic regulation and increased body mass index (BMI) caused disruption of sleep quality or not. Methods: Sleep quality was compared between patients followed in our clinic with T2DM (n = 534) for minimum 5 years and a control group (n = 269). Assessment was performed for whether increased glycated haemoglobin (HbA1c) and increased BMI caused an increase in Pittsburgh Sleep Quality Index (PSQI) score or not. Cases with any comorbid disease or drug use affecting sleep quality were excluded from the study. Results: T2DM patients had higher PSQI points compared to the control group. A statistically significant, very low-level positive correlation was identified between BMI measurements and PSQI scores (as BMI increased, PSQI increased). A st...

Koşuyolu heart journal, Dec 18, 2013

Introduction: Atrial fi brillation is the most common type of arrhythmia. The prevalence of atria... more Introduction: Atrial fi brillation is the most common type of arrhythmia. The prevalence of atrial : fi brillation is increased in hemodialysis patients. The aim of the present study was to investigate the prevalence of atrial fi brillation and related factors including anthropometric, hemodynamic and echocardiographic parameters in hemodialysis patients. Patients and Methods: We recruited 154 [72 (46.8%) woman, 82 (53.2%) man] hemodialysis : patients in this study. Atrial fi brillation was determined electrocardiographically (the P waves was absent and RR intervals were irregular) and the patients were divided into two groups depending on the presence or absence of atrial fi brillation. Transthoracic echocardiography was performed in all patients. Results: There were 7 (4.5%) patients with atrial fi brillation. Although we found that the age, left ventricle end-diastolic diameter, left ventricle end-systolic diameter and left atrial diameter were increased in hemodialysis patients with atrial fi brillation, ejection fraction increased in hemodialysis patients with no atrial fi brillation. Left atrial diameter and left ventricle end-systolic diameter were shown to be independent predictors of atrial fi brillation in hemodialysis patients (p< 0.05). Conclusion: Left atrial diameter and end-systolic left ventricle diameter were independent pre-: dictors of atrial fi brillation in hemodialysis patients.

Kardiologiya, May 4, 2020

Повышение артериальной жесткости у пациентов с субклинической формой болезни Бехчета на основании... more Повышение артериальной жесткости у пациентов с субклинической формой болезни Бехчета на основании оценки каротидно-феморальной скорости распространения пульсовой волны. Кардиология. 2020;60(5):123-127]