Ugur Coskun - Academia.edu (original) (raw)

Papers by Ugur Coskun

Research paper thumbnail of The association of neutrophil to lymphocyte ratio and TIMI frame count in primary percutaneous coronary intervention

Minerva Cardioangiologica, Dec 1, 2019

BACKGROUND This study was sought to evaluate the relationship between admission neutrophil lympho... more BACKGROUND This study was sought to evaluate the relationship between admission neutrophil lymphocyte ratio (NLR) and estimated coronary flow by the TIMI frame count (TFC) method in patients with ST--segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS TFC of 262 consecutive STEMI patients were evaluated after PPCI. Admission NLR were calculated and TFC was determined after PPCI. According to admission NLR value, patients were divided in to two groups. NLR levels higher than 3.5 were defined "higher NLR" whereas lower than 3.5 were accepted as "lower NLR". RESULTS TFC was significantly higher in patients with higher NLR (56.6± 41.1 vs 37.9± 36.1, p <0.001). No--reflow phenomenon was more frequent in higher NLR group compared to lower NLR group (10.1% vs 5.2% , P=0.001). In multivariate linear regression analysis admission NLR was an independent predictor of high TIMI frame count (B = 2.24 95 % CI (1.17--3.31), p < 0.001). CONCLUSION Our findings suggest that admission NLR predicts coronary blood flow in means of TFC.

Research paper thumbnail of Kararlı koroner arter hastalarında kalp hızı türbülansı ile koroner arter hastalığının ciddiyeti arasındaki ilişki

Türk kardiyoloji derneği arşivi, Oct 1, 2015

Research paper thumbnail of Isolated Right Ventricular Infarction Mimicking Anterior ST-Segment Elevation

Journal of Clinical and Diagnostic Research, 2016

The initial standard 12lead electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4 [T... more The initial standard 12lead electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4 [Table/Fig-1]. On physical examination general health situation was moderate. His heart rate was 98 bpm and blood pressure was 160/80 mmHg. First and second heart sounds were normal. There was no additional heart sound or murmur. Other systemic examinations were unremarkable. The patient was given 5500 U of unfractionated heparin IV, 600 mg clopidogrel oral loading dose and 300 mg oral aspirin, and was transferred to catheterization lab. Coronary angiography showed patent LMCA, CX and LAD [Table/Fig-2]. Proximal occlusion of a nondominant right coronary was detected [Table/Fig-3]. Primer percutaneus coronary intervention was performed to proximal segment of the RCA using a Judkins right (7F JR 4 Cordis Europe, Roden, Holland) guiding catheter and the lession crossed with a balanced middle weight wire. After thrombus aspiration (Diver C.E.MAX), followed by implantation of 3,5 x 12 mm (Ephesos) at 20 atm with exellent angiographic result [Table/Fig-4], the patient's chest pain resolved and transthoracic echocardiogram showed RV dilation and paradoxical interventricular septal wall motion (tapse : 1.1mm), but no wall-motion abnormalities in the left ventricle. Two days later control transthoracic echocardiogram was performed and RV function was found to be recovered. (tapse: 1.8 mm). The patient was discharged 5 days after coronary stenting in good

Research paper thumbnail of PP-427 a Case of Successful Surgical Resection of Left Ventricular Pseudoaneurysm After Aortic Valve Replacement

International Journal of Cardiology, Mar 1, 2012

Research paper thumbnail of OP-113 Strain Analysis during Exercise in Patients with Asymptomatic Atrial Septal Defect

American Journal of Cardiology, Apr 1, 2014

Research paper thumbnail of Kounis syndrome: myocardial infarction secondary to an allergic insult – a rare clinical entity

Acta Cardiologica, Aug 1, 2011

The association of an acute coronary syndrome with mast cell activation secondary to allergen exp... more The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the fi rst incident.

Research paper thumbnail of Is there any Link Between Vitamin D and Recurrence of Atrial Fibrillation after Cardioversion?

Brazilian Journal of Cardiovascular Surgery, 2020

Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly popul... more Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly population. In symptomatic patients, restoration and maintenance of sinus rhythm improve quality of life. Unfortunately, AF recurrence still occurs in a considerable number of patients after cardioversion (CV). In this study, we aimed to evaluate the association between vitamin D (VitD) and AF recurrence after electrical or medical CV. Method: A total of 51 patients who underwent CV for symptomatic AF were included in the study. AF recurrence was defined as an AF pattern in 12-lead electrocardiography (ECG) recording after CV within 6 months or ECG Holter recording of AF lasting more than 30 seconds at 6-month follow-up. Results: Mean vitD level was 21.4 ng/ml in our study population. VitD level was lower in the AF recurrence group than in the non-recurrence group (18 ng/ml vs. 26.3 ng/ml, respectively; P=0.001). Additionally, left atrial diameter was larger in the AF recurrence group compared to the non-recurrence group (4.4 vs. 4.1, P=0.025). Patients with AF recurrence were older than patients without AF recurrence, and, although the prevalence of hypertension is higher in the AF recurrence group, there was no statistically significant difference (P=0.107, P=0.867). Conclusion: In our study, there is a strong association between vitD level and AF recurrence after CV. VitD deficiency might be a predictor of high risk of AF recurrence after CV and vitD supplementation during the follow-up might help the maintenance of sinus rhythm.

Research paper thumbnail of Effects of chronic cigarette smoking on myocardial deformation parameters by two‐dimensional speckle tracking echocardiography

Echocardiography, 2019

Background: Cigarette smoking causes myocardial damage with several mechanisms such as sympatheti... more Background: Cigarette smoking causes myocardial damage with several mechanisms such as sympathetic nervous system activation, oxidative stress, and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with cardiac events. We aimed to compare the myocardial deformation parameters between chronic smokers and nonsmoker healthy population. Method: Forty-two healthy participants (mean age 33.48 ± 10.00 years) without smoking history, 40 participants (mean age 33.98 ± 9.27 years) who had been smoking were prospectively included. In addition to conventional echocardiographic measurements, global longitudinal strain (GLS) of left ventricle (LV), GLS of right ventricle (RV), left atrial strain, and strain rate were analyzed. Smokers had lower peak early diastolic velocity (E) and E/a (early diastolic velocity/late diastolic velocity) ratio in mitral inflow (70.0 ± 13.9 cm/sec vs 77.1 ± 13.3 cm/sec, P = .023; 1.4 ± 0.4 vs 1.7 ± 0.4, P = .011; respectively). Peak early diastolic velocity of mitral valve septal annulus (Em) and Em/Am ratio (peak early diastolic velocity of mitral valve/late diastolic velocity of mitral valve) (11.0 ± 2.1 cm/ sec vs 12.1 ± 2.4 cm/sec, P = .023; 1.2 ± 0.3 vs 1.4 ± 0.4, P = .039; respectively) were lower in smokers. LV GLS and RV GLS were significantly lower in smokers (-17.6% ± 3.01 vs -19.2% ± 2.5; P = .013, -18.9% ± 4.4 vs -21.0% ± 4.5; P = .039; respectively). Impaired LV and RV deformation were found in chronic smokers in our study. Although there was no statistically significant difference with left ventricular ejection fraction, LV GLS which is the early indicator of LV systolic dysfunction was lower in chronic smokers. The assessment of early harmful effects of smoking on left and right ventricle might be evaluated with speckle tracking echocardiography.

Research paper thumbnail of Coronary Arteries Arising from Single Coronary Ostium: A Case Report

The Heart Surgery Forum, 2019

Advanced diagnostic systems and healthcare screening programs enabled increased diagnosis of cong... more Advanced diagnostic systems and healthcare screening programs enabled increased diagnosis of congenital cardiovascular anomalies, including variations in coronary arteries. Single coronary artery is a rare congenital cardiovascular malformation in which all three main coronary arteries originate from a single coronary trunk. In this report, we present a patient with single coronary ostium giving rise to the left and right coronary artery systems, which was diagnosed incidentally with coronary computerized tomography and confirmed with conventional angiography. INTRODUCTION

Research paper thumbnail of Comparison of Long-Term Outcomes in Real-World Patients Between Resolute Zotarilumus-Eluting and Paclitaxel-Eluting Stents in Small Vessel

Angiology, Jan 18, 2015

To compare the long-term clinical outcomes between Resolute zotarolimus-eluting stent (R-ZES) and... more To compare the long-term clinical outcomes between Resolute zotarolimus-eluting stent (R-ZES) and paclitaxel-eluting stent (PES) in patients with small coronary artery disease. Patients with a small vessel diameter are independently associated with increased risk of adverse cardiac events after drug-eluting stent implantation. A cohort of 265 patients treated with R-ZES (185 patients with 211 lesions) or PES (80 patients with 100 lesions) in small vessel (≤2.5 mm) lesions were retrospectively analyzed. The primary end point of the study was the composite of major adverse cardiac events. The secondary end points included target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis at 3 years. The baseline characteristics were similar between the 2 groups. In the R-ZES group, the mean stent diameter was smaller and the total stent length per lesion was longer. Major adverse cardiac events occurred in 8 (10%) patients who had received PES and in 7 ...

Research paper thumbnail of Acute Myocardial Infarction After the Use of Amoxicillin/Clavulanic Acid: Type I Kounis Syndrome

Yeditepe Medical Journal, 2013

Research paper thumbnail of Journal of Echocardi̇ography MVR Posteri̇or Obstructi̇on

Research paper thumbnail of Herz LV apical wall thrombus case

Research paper thumbnail of Kounis syndrome: myocardial infarction secondary to an allergic insult--a rare clinical entity

Acta cardiologica, 2011

The association of an acute coronary syndrome with mast cell activation secondary to allergen exp... more The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the first incident.

Research paper thumbnail of Four‐Dimensional Speckle Tracking Echocardiography in Patients with Hypertrophic Cardiomyopathy

Echocardiography, 2015

ObjectiveAbnormal left ventricular (LV) deformational mechanics have been demonstrated in patient... more ObjectiveAbnormal left ventricular (LV) deformational mechanics have been demonstrated in patients with hypertrophic cardiomyopathy (HCM) using two‐dimensional (2D) speckle tracking echocardiography, but there is not enough information about the four‐dimensional speckle tracking echocardiography (4DSTE) in these patients. The objective of the study was to identify and quantify the left ventricular contractility in patients with HCM using 4DSTE.MethodsThirty patients [age, 54.6 ± 12.1 years; 12 (40%) women] with diagnosis of nonobstructive HCM and 20 healthy controls [age, 47.42 ± 11.43 years; 8 (40%) women] underwent 4DSTE measurement of longitudinal, radial, circumferential, and area strains.ResultsPatients with HCM showed lower longitudinal (−13.5% vs. −20.3%, P < 0.001) and radial (33.4% vs. 43.6%, P < 0.001) strain, but higher circumferential (−22.7% vs. −15.9%, P < 0.001) and area (−30.7% vs. −22.1%, P < 0.001) strain than control subjects. Peak LV twist showed sign...

Research paper thumbnail of Admission Hyperglycemia Is Associated with Failed Reperfusion Following Fibrinolytic Therapy in Patients with STEMI: Results of a Retrospective Study

American Journal of Cardiovascular Drugs, 2014

Hyperglycemia on admission is associated with increased mortality rates in patients with ST-eleva... more Hyperglycemia on admission is associated with increased mortality rates in patients with ST-elevation myocardial infarction (STEMI) who are treated with either fibrinolytic therapy (FT) or primary percutaneous coronary intervention (PCI). However, data regarding the relationship between hyperglycemia and the success of FT are lacking. The aim of this study was to investigate the value of admission blood glucose for the prediction of failed reperfusion following FT. This is a retrospective study of 304 STEMI patients who received FT and whose admission glucose levels were recorded. The main outcome measure was ST segment resolution ≥50 %. The median (interquartile range [IQR]) blood glucose level in the entire study group was 112 (95-153). In 92 (30.2 %) patients, FT was unsuccessful and rescue PCI was performed. Admission glucose (126 [99-192] vs. 110 [94-144] mg/dL, 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;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;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;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), time from symptom onset to FT (180 [120-270] vs. 150 [120-180] min, p = 0.009), and maximum ST elevation amplitude (3 [2-7] vs. 3 [2-6] mm, p = 0.05) were higher in the failed reperfusion group than in the reperfusion group. Admission hyperglycemia was an independent predictive factor for failed reperfusion (hazard ratio 4.79 [1.80-12.76], p = 0.002), along with time from symptom onset to fibrinolysis and anterior wall myocardial infarction. In patients with STEMI who undergo FT, admission hyperglycemia is an independent predictor of the failure of fibrinolysis.

Research paper thumbnail of Long-Term Follow-Up of Patients at High Risk for Nephropathy After Contrast Exposure

Angiology, 2014

Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, ... more Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, but the long-term outcomes of patients who do not develop CI-AKI remain unknown. We assessed clinical end points during long-term follow-up in patients at high risk for nephropathy who did not develop CI-AKI. Patients (n = 135) with impaired renal function (estimated glomerular filtration rate: 30-60 mL/min/1.73 m2) were divided into 2 groups according to contrast media (CM) exposure. The primary end point of this study was a composite outcome measure of death or renal failure requiring dialysis. Multivariate analyses identified CM exposure to be independently associated with major adverse long-term outcomes (hazard ratio: 2.3; 95% confidence interval, 1.34-6.52; P = .018). Even when CM exposure does not cause CI-AKI in patients with impaired renal function, in the long term, primary end points occur more frequently in patients exposed to CM than in those with no CM exposure.

Research paper thumbnail of Comparison of Rosuvastatin versus Atorvastatin for Preventing Postoperative Atrial Fibrillation

The Heart Surgery Forum, 2013

Background: Postoperative atrial fibrillation (AF) following cardiac surgery is associated with a... more Background: Postoperative atrial fibrillation (AF) following cardiac surgery is associated with an increased risk of stroke, prolonged hospitalization, and increased costs. Statin therapy is associated with a lower incidence of postoperative AF. We aimed to compare the preventive effects of rosuvastatin and atorvastatin on postoperative AF.Methods: This study included 168 patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were divided into 2 groups according to treatment of statin. Group 1 (n = 96) was patients receiving atorvastatin, and group 2 (n = 72) was patients receiving rosuvastatin. Postoperative electrocardiographs (ECGs) and telemetry strips were examined for AF within postoperative period during hospitalization.Results: The incidences of postoperative AF were 17.9% (n = 17) in group 1 and 22.2% (n = 16) in group 2 (P = .48). Left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF) were not different between groups. Incide...

Research paper thumbnail of Percutaneous coronary intervention vs. optimal medical therapy - the other side of the coin: medication adherence

Journal of Clinical Pharmacy and Therapeutics, 2013

Although many studies have examined medication adherence in patients with coronary artery disease... more Although many studies have examined medication adherence in patients with coronary artery disease (CAD), no prospective trial has compared medication adherence between patients treated with percutaneous coronary intervention (PCI) or with optimal medical therapy (OMT) in real life. This study sought to compare the adherence to evidence-based secondary preventive medications in patients with documented CAD treated with PCI and OMT, or OMT alone. We evaluated adherence to statins, beta-blockers, and angiotensin converting enzyme inhibitors (ACEI) during a 6-month follow-up in 232 patients with documented CAD, comparing patients treated with PCI and those receiving medical therapy alone. Medication adherence was measured with reference to national reimbursement database records. Of the 232 patients who survived the 6-month follow-up, the percentages of adherent patients according to prescription records (prespecified primary endpoint) were 53·6% (n = 82) in the PCI group and 33·8% (n = 27) in the OMT group (P = 0·004). Analysis of the individual medication classes revealed similar results for beta-blockers (86·0% in PCI group vs. 72·5% in OMT group, P = 0·006) and statins (64·5% in PCI group vs. 44·0% in OMT group, P = 0·003). Adherence to ACEI was also higher in the PCI group, but the difference was not statistically significant (77·6% vs. 69·3%, P = 0·17). By logistic regression analysis, belonging to the PCI group was an independent predictor of medication adherence [B = 2·20 (1·06-4·50), P = 0·03)]. In the present study we demonstrated that adherence to evidence-based medication therapies in patients treated with PCI is significantly higher than in patients treated with OMT alone. Medication adherence should be followed carefully in CAD patients treated with OMT.

Research paper thumbnail of PP-087 a Rare Case Report of Noncoronary Sinus of Valsalva Aneurysm Rupture Into the Left Atrium Detected with 2D and Real Time 3D Echocardiography

International Journal of Cardiology, 2013

Research paper thumbnail of The association of neutrophil to lymphocyte ratio and TIMI frame count in primary percutaneous coronary intervention

Minerva Cardioangiologica, Dec 1, 2019

BACKGROUND This study was sought to evaluate the relationship between admission neutrophil lympho... more BACKGROUND This study was sought to evaluate the relationship between admission neutrophil lymphocyte ratio (NLR) and estimated coronary flow by the TIMI frame count (TFC) method in patients with ST--segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS TFC of 262 consecutive STEMI patients were evaluated after PPCI. Admission NLR were calculated and TFC was determined after PPCI. According to admission NLR value, patients were divided in to two groups. NLR levels higher than 3.5 were defined "higher NLR" whereas lower than 3.5 were accepted as "lower NLR". RESULTS TFC was significantly higher in patients with higher NLR (56.6± 41.1 vs 37.9± 36.1, p <0.001). No--reflow phenomenon was more frequent in higher NLR group compared to lower NLR group (10.1% vs 5.2% , P=0.001). In multivariate linear regression analysis admission NLR was an independent predictor of high TIMI frame count (B = 2.24 95 % CI (1.17--3.31), p < 0.001). CONCLUSION Our findings suggest that admission NLR predicts coronary blood flow in means of TFC.

Research paper thumbnail of Kararlı koroner arter hastalarında kalp hızı türbülansı ile koroner arter hastalığının ciddiyeti arasındaki ilişki

Türk kardiyoloji derneği arşivi, Oct 1, 2015

Research paper thumbnail of Isolated Right Ventricular Infarction Mimicking Anterior ST-Segment Elevation

Journal of Clinical and Diagnostic Research, 2016

The initial standard 12lead electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4 [T... more The initial standard 12lead electrocardiogram (ECG) showed ST-segment elevation in leads V1-V4 [Table/Fig-1]. On physical examination general health situation was moderate. His heart rate was 98 bpm and blood pressure was 160/80 mmHg. First and second heart sounds were normal. There was no additional heart sound or murmur. Other systemic examinations were unremarkable. The patient was given 5500 U of unfractionated heparin IV, 600 mg clopidogrel oral loading dose and 300 mg oral aspirin, and was transferred to catheterization lab. Coronary angiography showed patent LMCA, CX and LAD [Table/Fig-2]. Proximal occlusion of a nondominant right coronary was detected [Table/Fig-3]. Primer percutaneus coronary intervention was performed to proximal segment of the RCA using a Judkins right (7F JR 4 Cordis Europe, Roden, Holland) guiding catheter and the lession crossed with a balanced middle weight wire. After thrombus aspiration (Diver C.E.MAX), followed by implantation of 3,5 x 12 mm (Ephesos) at 20 atm with exellent angiographic result [Table/Fig-4], the patient's chest pain resolved and transthoracic echocardiogram showed RV dilation and paradoxical interventricular septal wall motion (tapse : 1.1mm), but no wall-motion abnormalities in the left ventricle. Two days later control transthoracic echocardiogram was performed and RV function was found to be recovered. (tapse: 1.8 mm). The patient was discharged 5 days after coronary stenting in good

Research paper thumbnail of PP-427 a Case of Successful Surgical Resection of Left Ventricular Pseudoaneurysm After Aortic Valve Replacement

International Journal of Cardiology, Mar 1, 2012

Research paper thumbnail of OP-113 Strain Analysis during Exercise in Patients with Asymptomatic Atrial Septal Defect

American Journal of Cardiology, Apr 1, 2014

Research paper thumbnail of Kounis syndrome: myocardial infarction secondary to an allergic insult – a rare clinical entity

Acta Cardiologica, Aug 1, 2011

The association of an acute coronary syndrome with mast cell activation secondary to allergen exp... more The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the fi rst incident.

Research paper thumbnail of Is there any Link Between Vitamin D and Recurrence of Atrial Fibrillation after Cardioversion?

Brazilian Journal of Cardiovascular Surgery, 2020

Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly popul... more Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly population. In symptomatic patients, restoration and maintenance of sinus rhythm improve quality of life. Unfortunately, AF recurrence still occurs in a considerable number of patients after cardioversion (CV). In this study, we aimed to evaluate the association between vitamin D (VitD) and AF recurrence after electrical or medical CV. Method: A total of 51 patients who underwent CV for symptomatic AF were included in the study. AF recurrence was defined as an AF pattern in 12-lead electrocardiography (ECG) recording after CV within 6 months or ECG Holter recording of AF lasting more than 30 seconds at 6-month follow-up. Results: Mean vitD level was 21.4 ng/ml in our study population. VitD level was lower in the AF recurrence group than in the non-recurrence group (18 ng/ml vs. 26.3 ng/ml, respectively; P=0.001). Additionally, left atrial diameter was larger in the AF recurrence group compared to the non-recurrence group (4.4 vs. 4.1, P=0.025). Patients with AF recurrence were older than patients without AF recurrence, and, although the prevalence of hypertension is higher in the AF recurrence group, there was no statistically significant difference (P=0.107, P=0.867). Conclusion: In our study, there is a strong association between vitD level and AF recurrence after CV. VitD deficiency might be a predictor of high risk of AF recurrence after CV and vitD supplementation during the follow-up might help the maintenance of sinus rhythm.

Research paper thumbnail of Effects of chronic cigarette smoking on myocardial deformation parameters by two‐dimensional speckle tracking echocardiography

Echocardiography, 2019

Background: Cigarette smoking causes myocardial damage with several mechanisms such as sympatheti... more Background: Cigarette smoking causes myocardial damage with several mechanisms such as sympathetic nervous system activation, oxidative stress, and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with cardiac events. We aimed to compare the myocardial deformation parameters between chronic smokers and nonsmoker healthy population. Method: Forty-two healthy participants (mean age 33.48 ± 10.00 years) without smoking history, 40 participants (mean age 33.98 ± 9.27 years) who had been smoking were prospectively included. In addition to conventional echocardiographic measurements, global longitudinal strain (GLS) of left ventricle (LV), GLS of right ventricle (RV), left atrial strain, and strain rate were analyzed. Smokers had lower peak early diastolic velocity (E) and E/a (early diastolic velocity/late diastolic velocity) ratio in mitral inflow (70.0 ± 13.9 cm/sec vs 77.1 ± 13.3 cm/sec, P = .023; 1.4 ± 0.4 vs 1.7 ± 0.4, P = .011; respectively). Peak early diastolic velocity of mitral valve septal annulus (Em) and Em/Am ratio (peak early diastolic velocity of mitral valve/late diastolic velocity of mitral valve) (11.0 ± 2.1 cm/ sec vs 12.1 ± 2.4 cm/sec, P = .023; 1.2 ± 0.3 vs 1.4 ± 0.4, P = .039; respectively) were lower in smokers. LV GLS and RV GLS were significantly lower in smokers (-17.6% ± 3.01 vs -19.2% ± 2.5; P = .013, -18.9% ± 4.4 vs -21.0% ± 4.5; P = .039; respectively). Impaired LV and RV deformation were found in chronic smokers in our study. Although there was no statistically significant difference with left ventricular ejection fraction, LV GLS which is the early indicator of LV systolic dysfunction was lower in chronic smokers. The assessment of early harmful effects of smoking on left and right ventricle might be evaluated with speckle tracking echocardiography.

Research paper thumbnail of Coronary Arteries Arising from Single Coronary Ostium: A Case Report

The Heart Surgery Forum, 2019

Advanced diagnostic systems and healthcare screening programs enabled increased diagnosis of cong... more Advanced diagnostic systems and healthcare screening programs enabled increased diagnosis of congenital cardiovascular anomalies, including variations in coronary arteries. Single coronary artery is a rare congenital cardiovascular malformation in which all three main coronary arteries originate from a single coronary trunk. In this report, we present a patient with single coronary ostium giving rise to the left and right coronary artery systems, which was diagnosed incidentally with coronary computerized tomography and confirmed with conventional angiography. INTRODUCTION

Research paper thumbnail of Comparison of Long-Term Outcomes in Real-World Patients Between Resolute Zotarilumus-Eluting and Paclitaxel-Eluting Stents in Small Vessel

Angiology, Jan 18, 2015

To compare the long-term clinical outcomes between Resolute zotarolimus-eluting stent (R-ZES) and... more To compare the long-term clinical outcomes between Resolute zotarolimus-eluting stent (R-ZES) and paclitaxel-eluting stent (PES) in patients with small coronary artery disease. Patients with a small vessel diameter are independently associated with increased risk of adverse cardiac events after drug-eluting stent implantation. A cohort of 265 patients treated with R-ZES (185 patients with 211 lesions) or PES (80 patients with 100 lesions) in small vessel (≤2.5 mm) lesions were retrospectively analyzed. The primary end point of the study was the composite of major adverse cardiac events. The secondary end points included target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis at 3 years. The baseline characteristics were similar between the 2 groups. In the R-ZES group, the mean stent diameter was smaller and the total stent length per lesion was longer. Major adverse cardiac events occurred in 8 (10%) patients who had received PES and in 7 ...

Research paper thumbnail of Acute Myocardial Infarction After the Use of Amoxicillin/Clavulanic Acid: Type I Kounis Syndrome

Yeditepe Medical Journal, 2013

Research paper thumbnail of Journal of Echocardi̇ography MVR Posteri̇or Obstructi̇on

Research paper thumbnail of Herz LV apical wall thrombus case

Research paper thumbnail of Kounis syndrome: myocardial infarction secondary to an allergic insult--a rare clinical entity

Acta cardiologica, 2011

The association of an acute coronary syndrome with mast cell activation secondary to allergen exp... more The association of an acute coronary syndrome with mast cell activation secondary to allergen exposure is known as the Kounis syndrome. We present two cases of the Kounis syndrome: (i) one was misdiagnosed as acute ST elevation myocardial infarction and treated with thrombolytics; (ii) the second diagnosis was made after a recurrence two months after the first incident.

Research paper thumbnail of Four‐Dimensional Speckle Tracking Echocardiography in Patients with Hypertrophic Cardiomyopathy

Echocardiography, 2015

ObjectiveAbnormal left ventricular (LV) deformational mechanics have been demonstrated in patient... more ObjectiveAbnormal left ventricular (LV) deformational mechanics have been demonstrated in patients with hypertrophic cardiomyopathy (HCM) using two‐dimensional (2D) speckle tracking echocardiography, but there is not enough information about the four‐dimensional speckle tracking echocardiography (4DSTE) in these patients. The objective of the study was to identify and quantify the left ventricular contractility in patients with HCM using 4DSTE.MethodsThirty patients [age, 54.6 ± 12.1 years; 12 (40%) women] with diagnosis of nonobstructive HCM and 20 healthy controls [age, 47.42 ± 11.43 years; 8 (40%) women] underwent 4DSTE measurement of longitudinal, radial, circumferential, and area strains.ResultsPatients with HCM showed lower longitudinal (−13.5% vs. −20.3%, P < 0.001) and radial (33.4% vs. 43.6%, P < 0.001) strain, but higher circumferential (−22.7% vs. −15.9%, P < 0.001) and area (−30.7% vs. −22.1%, P < 0.001) strain than control subjects. Peak LV twist showed sign...

Research paper thumbnail of Admission Hyperglycemia Is Associated with Failed Reperfusion Following Fibrinolytic Therapy in Patients with STEMI: Results of a Retrospective Study

American Journal of Cardiovascular Drugs, 2014

Hyperglycemia on admission is associated with increased mortality rates in patients with ST-eleva... more Hyperglycemia on admission is associated with increased mortality rates in patients with ST-elevation myocardial infarction (STEMI) who are treated with either fibrinolytic therapy (FT) or primary percutaneous coronary intervention (PCI). However, data regarding the relationship between hyperglycemia and the success of FT are lacking. The aim of this study was to investigate the value of admission blood glucose for the prediction of failed reperfusion following FT. This is a retrospective study of 304 STEMI patients who received FT and whose admission glucose levels were recorded. The main outcome measure was ST segment resolution ≥50 %. The median (interquartile range [IQR]) blood glucose level in the entire study group was 112 (95-153). In 92 (30.2 %) patients, FT was unsuccessful and rescue PCI was performed. Admission glucose (126 [99-192] vs. 110 [94-144] mg/dL, 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;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;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;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), time from symptom onset to FT (180 [120-270] vs. 150 [120-180] min, p = 0.009), and maximum ST elevation amplitude (3 [2-7] vs. 3 [2-6] mm, p = 0.05) were higher in the failed reperfusion group than in the reperfusion group. Admission hyperglycemia was an independent predictive factor for failed reperfusion (hazard ratio 4.79 [1.80-12.76], p = 0.002), along with time from symptom onset to fibrinolysis and anterior wall myocardial infarction. In patients with STEMI who undergo FT, admission hyperglycemia is an independent predictor of the failure of fibrinolysis.

Research paper thumbnail of Long-Term Follow-Up of Patients at High Risk for Nephropathy After Contrast Exposure

Angiology, 2014

Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, ... more Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, but the long-term outcomes of patients who do not develop CI-AKI remain unknown. We assessed clinical end points during long-term follow-up in patients at high risk for nephropathy who did not develop CI-AKI. Patients (n = 135) with impaired renal function (estimated glomerular filtration rate: 30-60 mL/min/1.73 m2) were divided into 2 groups according to contrast media (CM) exposure. The primary end point of this study was a composite outcome measure of death or renal failure requiring dialysis. Multivariate analyses identified CM exposure to be independently associated with major adverse long-term outcomes (hazard ratio: 2.3; 95% confidence interval, 1.34-6.52; P = .018). Even when CM exposure does not cause CI-AKI in patients with impaired renal function, in the long term, primary end points occur more frequently in patients exposed to CM than in those with no CM exposure.

Research paper thumbnail of Comparison of Rosuvastatin versus Atorvastatin for Preventing Postoperative Atrial Fibrillation

The Heart Surgery Forum, 2013

Background: Postoperative atrial fibrillation (AF) following cardiac surgery is associated with a... more Background: Postoperative atrial fibrillation (AF) following cardiac surgery is associated with an increased risk of stroke, prolonged hospitalization, and increased costs. Statin therapy is associated with a lower incidence of postoperative AF. We aimed to compare the preventive effects of rosuvastatin and atorvastatin on postoperative AF.Methods: This study included 168 patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were divided into 2 groups according to treatment of statin. Group 1 (n = 96) was patients receiving atorvastatin, and group 2 (n = 72) was patients receiving rosuvastatin. Postoperative electrocardiographs (ECGs) and telemetry strips were examined for AF within postoperative period during hospitalization.Results: The incidences of postoperative AF were 17.9% (n = 17) in group 1 and 22.2% (n = 16) in group 2 (P = .48). Left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF) were not different between groups. Incide...

Research paper thumbnail of Percutaneous coronary intervention vs. optimal medical therapy - the other side of the coin: medication adherence

Journal of Clinical Pharmacy and Therapeutics, 2013

Although many studies have examined medication adherence in patients with coronary artery disease... more Although many studies have examined medication adherence in patients with coronary artery disease (CAD), no prospective trial has compared medication adherence between patients treated with percutaneous coronary intervention (PCI) or with optimal medical therapy (OMT) in real life. This study sought to compare the adherence to evidence-based secondary preventive medications in patients with documented CAD treated with PCI and OMT, or OMT alone. We evaluated adherence to statins, beta-blockers, and angiotensin converting enzyme inhibitors (ACEI) during a 6-month follow-up in 232 patients with documented CAD, comparing patients treated with PCI and those receiving medical therapy alone. Medication adherence was measured with reference to national reimbursement database records. Of the 232 patients who survived the 6-month follow-up, the percentages of adherent patients according to prescription records (prespecified primary endpoint) were 53·6% (n = 82) in the PCI group and 33·8% (n = 27) in the OMT group (P = 0·004). Analysis of the individual medication classes revealed similar results for beta-blockers (86·0% in PCI group vs. 72·5% in OMT group, P = 0·006) and statins (64·5% in PCI group vs. 44·0% in OMT group, P = 0·003). Adherence to ACEI was also higher in the PCI group, but the difference was not statistically significant (77·6% vs. 69·3%, P = 0·17). By logistic regression analysis, belonging to the PCI group was an independent predictor of medication adherence [B = 2·20 (1·06-4·50), P = 0·03)]. In the present study we demonstrated that adherence to evidence-based medication therapies in patients treated with PCI is significantly higher than in patients treated with OMT alone. Medication adherence should be followed carefully in CAD patients treated with OMT.

Research paper thumbnail of PP-087 a Rare Case Report of Noncoronary Sinus of Valsalva Aneurysm Rupture Into the Left Atrium Detected with 2D and Real Time 3D Echocardiography

International Journal of Cardiology, 2013