ertan akbay - Academia.edu (original) (raw)

Papers by ertan akbay

PubMed, May 1, 2019

Background: Coronary artery disease continues to be the most important cause of morbidity and mor... more Background: Coronary artery disease continues to be the most important cause of morbidity and mortality. Obstructive sleep apnea (OSA) is independently associated with subclinical atherosclerosis. In this study, we aimed to assess the relationship between the presence of coronary plaques and OSA and between coronary plaque burden and the severity of OSA according to plaque type. Methods: In this cross-sectional study, we enrolled 214 consecutive patients who were divided into four groups of 43 patients (age: 52.3 ± 6.4 years) without OSA, 51 patients (age: 53.9 ± 6.7 years) with mild OSA, 40 patients (age: 55.2 ± 5.9 years) with moderate OSA, and 80 patients (age: 54.9 ± 7.2 years) with severe OSA according to the apnea-hypopnea index (AHI). We performed coronary computed tomographic angiography (CCTA) and evaluated plaque positivity, the presence of non-calcified/mixed plaques, and total stenosis score for each group. Results: The prevalence of non-calcified/mixed plaques was three times higher in the severe OSA (41.3%) group and two times higher in the moderate OSA (30.0%) group compared to the patients without OSA (14.0%). When the four groups were examined in terms of plaque burden, the total stenosis score was found to increase with the presence and severity of OSA (0.27 ± 0.85, 1.07 ± 2.44, 1.75 ± 2.85, and 2.55 ± 3.96 respectively, p = 0.001). In addition, AHI and age were independent predictors of the presence of non-calcified/mixed plaques (p < 0.001 and p = 0.007, respectively). Conclusions: The presence of coronary artery plaques, especially non-calcified/mixed plaques, and coronary artery stenosis as measured by CCTA was significantly associated with the severity of sleep-disordered breathing in symptomatic patients at low to intermediate risk of coronary artery disease. Prospective studies are needed to establish the relationship between plaque burden and OSA.

Sakarya Medical Journal

Objective: It is very important to identify individuals at high risk of atherosclerotic cardiovas... more Objective: It is very important to identify individuals at high risk of atherosclerotic cardiovascular diseases (ASCVD) and for this purpose, many risk calculation tools and parameters are used. In this study, we aimed to investigate the correlation between the ACC/AHA cardiovascular risk and serum lipid indices and high sensitivity C-reactive protein (hs-CRP) in a healthy population. Methods: Our study was conducted retrospectively on individuals aged between 40 and 79 years and with sufficient data, using the hospital database. Patients with a history of any chronic disease and active infection were excluded. Individuals were analyzed by grouping them into low (5%) estimated 10-year risk of ASCVD. Results: 184 individuals with a median age of 46 and 37.5% women were included in the study. The median 10-year estimated risk of ASCVD in the study population was 3% (1.3/5.98). The low-risk group had a significantly lower atherogenic index of plasma (AIP), Castelli I risk index (CR-I),...

Blood Pressure Monitoring, Dec 23, 2022

Journal of Experimental and Clinical Medicine

Periaortic adipose tissue (PAT) is associated with atherosclerosis. The severity of coronary sten... more Periaortic adipose tissue (PAT) is associated with atherosclerosis. The severity of coronary stenosis with PAT has not been evaluated with conventional coronary angiography (CAG). The aim of the study is to determine the relationship between PAT and coronary stenosis severity/ complexity, and to evaluate it with the periaortic adipose tissue index (PATI), a new index derived from PAT. Patients who underwent CAG and thoracic computed tomography (CT) between January 2017 and January 2022 were included in the study. PAT volume was calculated by evaluating CT images, and PATI was calculated by dividing the PAT volume by the circumference of the descending aorta. Patients were divided into two groups according to the presence of ≥50% stenosis on CAG. The correlation of PAT and PATI with the SYNTAX score was evaluated. In our study, 263 patients [mean age 64.5(54/72), male 164 (62.4%)] were evaluated. Severe coronary artery disease (CAD) was observed in 181 patients (68.8%). PAT volume an...

Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology

High Blood Pressure & Cardiovascular Prevention, 2022

Metabolic Syndrome and Related Disorders

Heart & Lung

PURPOSE Acute pulmonary edema is characterized by increased levels of fluid in the interstitial a... more PURPOSE Acute pulmonary edema is characterized by increased levels of fluid in the interstitial and alveolar space of the lung and requires emergency treatment. In acute pulmonary edema, the amount of fluid in the intra-alveolar, interstitial space, and pleural space vary considerably and this fluid will evaporate in different amounts compared to the physiological fluid. The aim of this study was to compare the humidity rates of expiratory air measured before and after pulmonary edema induced by α-naphthylthiourea (ANTU) in rats. METHODS The study included twenty healthy adult rats divided equally into a healthy control group and a pulmonary edema group. Pulmonary edema was induced by administering ANTU intraperitoneally in the rats in the study group. Humidity, temperature, lung weight, pleural effusion, and histopathological changes in the respiratory system due to pulmonary edema were examined in the ANTU group. Control measurments were taken before administration of ANTU and again 4 h after administration of ANTU when lung damage was considred to be at maximum levels. RESULTS Mean expiratory air humidity was 71.22±3.59% before ANTU and 56.28±3.94% after administration of ANTU. The mean humidity difference of -14.94±5.96% was considered statistically different (p = 0.01). CONCLUSION Humidity rate in expiratory air was significantly lower in rats with acute pulmonary edema compared to healthy rats. This result supports the hypothesis that humidity in expiratory air can be considered an important parameter in patients during clinical are follow-up for pulmonary edema.

Purpose: Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds t... more Purpose: Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds the aorta. It contributes significantly to aortic atherosclerosis and enlargement. Studies conducted with computed tomography and magnetic resonance have shown that individuals with aortic aneurysm had more PAT than healthy individuals. In this study, we measured PAT for the first time using transthoracic echocardiography (TTE).The aim of this study is to investigate the possible relationship of TTE measured PAT with ascending aortic width.Methods: PAT was defined as the hypoechoic space in front of ascending aortic 2 cm above the sinotubular junction at the end of the systole. Patients were divided into 2 groups according to the presence of dilatation in the ascending aorta using Roman's classification (aortic size index, ASI). ASI of less than 21 was considered no aortic dilation and an ASI of 21mm/m2 or greater was considered to have aortic dilation.Results: A total of 321 unselect...

Purpose: The relationship between diastolic dysfunction and fatigue in hemodialysis patients with... more Purpose: The relationship between diastolic dysfunction and fatigue in hemodialysis patients with preserved ejection fraction is unknown. In this context, the objective of this study is to assess fatigue using the relevant scales and to demonstrate its relationship with diastolic dysfunction.Methods: The patients who underwent hemodialysis were evaluated prospectively. Patients' fatigue was assessed using the Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F). The echocardiographic works were performed as recommended in the American Society of Echocardiography guidelines.Results: A total of 94 patients [mean age 64.7±13.5 years, 54 males (57.4%)] were included in the study. The median VAS-F score of these patients was 68.5 (33.25-91.25), and they were divided into two groups according to this value. Peak myocardial velocities during early diastole (e') and tricuspid annular plane systolic excursion (TAPSE) values were found to be significantly lower in the group with...

Acta Cardiologica Sinica, 2019

Background Coronary artery disease continues to be the most important cause of morbidity and mort... more Background Coronary artery disease continues to be the most important cause of morbidity and mortality. Obstructive sleep apnea (OSA) is independently associated with subclinical atherosclerosis. In this study, we aimed to assess the relationship between the presence of coronary plaques and OSA and between coronary plaque burden and the severity of OSA according to plaque type. Methods In this cross-sectional study, we enrolled 214 consecutive patients who were divided into four groups of 43 patients (age: 52.3 ± 6.4 years) without OSA, 51 patients (age: 53.9 ± 6.7 years) with mild OSA, 40 patients (age: 55.2 ± 5.9 years) with moderate OSA, and 80 patients (age: 54.9 ± 7.2 years) with severe OSA according to the apnea-hypopnea index (AHI). We performed coronary computed tomographic angiography (CCTA) and evaluated plaque positivity, the presence of non-calcified/mixed plaques, and total stenosis score for each group. Results The prevalence of non-calcified/mixed plaques was three ti...

ÖZ Amaç: Koroner arter bypas greftleme (KABG) cerrahisi hastalarının postoperatif klinik takibind... more ÖZ Amaç: Koroner arter bypas greftleme (KABG) cerrahisi hastalarının postoperatif klinik takibinde preoperatif olarak tam tıkalı olmayan nativ koroner arterlerin kronik total oklüde (KTO) hale gelmesi sık görülse de, seyriyle ilgili veriler kısıtlıdır. Çalışmamızın amacı postoperatif dönemde nativ koroner arterlerde yeni KTO gelişim sıklığını ve bu konuda rol oynayan faktörleri araştırmaktır. Yöntem: Başkent Üniversitesi Hastanesi Alanya Uygulama ve Araştırma Merkezi'nde gerçekleştirilen tüm KABG operasyonları bilgisayar sisteminden tarandı ve postoperatif ilk 6 aylık dönemden sonra rekürren koroner anjiyografi (KAG) prosedürü uygulanan hastalar çalışma grubuna alındı. Rekürren KAG görüntüleri yeni KTO gelişimi açısından değerlendirildi ve nativ koroner arterlerde yeni KTO gelişimine yol açan demografik ve anjiyografik özellikler lojistik regresyon analizi kullanılarak test edildi. Bulgular: Rekürren KAG yapılmış olan 73 KABG hastası istatistiksel analize dahil edildi (Ortalama yaş 65.2 ± 9.8 yıl; erkek cinsiyet %76.7). Preoperatif olarak tam tıkalı olmayan ve greftlenmiş olan 218 nativ koroner arter incelendi ve 119'unda (%54.5) yeni KTO saptandı. Preoperatif proksimal darlığın ≥%90 olması 3 kat daha fazla yeni KTO gelişimi ile ilişkili bulundu (%67.8 vs. %22.2) (p<0.001). İkili antiplatelet tedavisinin nativ koroner arterlerin açıklığını koruyucu rolü olduğu tespit edildi (HR:-0.259; %95 CI:-0.475'den-0.017'ye; p=0.036). Sonuç: Nativ koroner arterlerde postoperatif yeni KTO gelişimi CABG hastalarında sık görülmektedir. Preoperatif darlığın daha ciddi olması ve ikili antiplatelet tedavinin yokluğu yeni KTO gelişimi için temel faktörler olarak bulundu.

Düzce Tıp Fakültesi Dergisi

Aim: Tissue Doppler-derived isovolumic acceleration (IVA) is a parameter that evaluates the systo... more Aim: Tissue Doppler-derived isovolumic acceleration (IVA) is a parameter that evaluates the systolic function of both ventricles, without being affected by pre-load and post-load. We aimed to detect left ventricular systolic dysfunction at an early stage with IVA in patients with asymptomatic aortic stenosis (AS). Material and Methods: A total of 105 patients were included in the study, 75 of which had isolated AS and 30 were free of any valve disease. Patients with AS were divided into three groups (mild, moderate and severe) according to their aortic valve area (AVA) and aortic peak velocities, as determined by means of a transthoracic echocardiography. Conventional echocardiography, systolic and diastolic Tissue Doppler parameters [peak myocardial velocity during isovolumic contraction (IVV), myocardial velocity during ejection phase (Sm), early diastolic myocardial velocity (e'), late diastolic myocardial velocity (a'), and acceleration time (AT)] were calculated in all ...

Clinical and Experimental Hypertension, 2021

Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims... more Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population. Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis. Results: A total of 233 participants were involved in the study population (median age 45 years [40–50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin...

Arquivos Brasileiros de Cardiologia, 2019

Background Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-relate... more Background Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. Objectives The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern. Methods All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant. Results A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the pre...

Clinical and Experimental Hypertension

ABSTRACT Objective Masked hypertension (MH) and non-dipping pattern are conditions associated wit... more ABSTRACT Objective Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern. Methods Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP ≥135/85 mmHg and night BP ≥120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage. Results 289 patients [mean age 46.6 ± 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives (p < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI (p < .05, for both). Conclusion Target organ damage seen in MH may be due to the deterioration of the dipping pattern.

Kardiologiia

Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal sync... more Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope.Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24 hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured.Res...

Acta Medica Alanya

Heparin ilişkili trombositopeni (HİT) başa çıkılması zor bir klinik tablodur ve bu hastaların yön... more Heparin ilişkili trombositopeni (HİT) başa çıkılması zor bir klinik tablodur ve bu hastaların yönetimiyle ilgili bilgimiz sınırlıdır. Heparin'in kesilmesi tedavinin esasıdır ancak bu hastaların bir kısmında antikoagülan kullanım ihtiyacı doğabilir ve takibinde antikoagülan ihtiyacı olan hastalarla ilgili net bir veri bulunmamaktadır. Bu yazımızda anfraksiyone heparin sonrasında tip I HİT gelişen ve aynı zamanda antikoagülan kullanım ihtiyacı bulunan miyokart enfarktüsü hastamızın sunumunu yapmayı amaçladık.