SONGÜL USALP | Near East University (original) (raw)

Papers by SONGÜL USALP

Research paper thumbnail of Do sporting activities and using protein supplements change the frontal QRS-T angle?

Minerva Cardiology and Angiology, 2021

BACKGROUND In this study, we investigated whether the frontal QRS-T angle was different between t... more BACKGROUND In this study, we investigated whether the frontal QRS-T angle was different between the athletes and normal healthy people. METHODS The study included 122 healthy athletes (the mean age was 29.7±7.7 years, of them, were 73.8% male) and a control group consisted of 60 healthy people (the mean age was 29.8±7.8 years, of them, were 26% male). Then, the athletes were divided into two groups as who used protein supplements (PS) and those who did not. In the 12-lead ECG, heart rate (HR), P, QRS, QT, corrected QT (QTc) duration, QT and corrected QT dispersion (QTD, QTcD), the sum of V1 or V2S amplitude and V5 or V6R amplitude (V1/2S+V5/6R), frontal QRS-T angle were calculated. RESULTS There was no significant difference between the athletes and control groups regarding age, gender, smoking, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), echocardiographic features, P, PR duration, P, QRS, T axis, QTD and QTcD (p>0.05).HR and QTc were significantly lower (p<0.05) and QRS, QT duration was longer in athletes group (p<0.001). The V1/2S+V5/6R and frontal QRS-T angle values were higher in the athlete's group (p<0.001). There was no significant difference between PS users and non PS users regarding demographic characteristics, duration of sports years, SBP and DBP (p>0.05). However, male gender was dominant in the PS users group (p=0.018). The P axis, PR and QRS duration were longer in the PS users group (p<0.05).It was found that the T axis was negatively correlated (r=-0.431,p<0.001) but the QRS axis was positively correlated (r =0.395,p<0.001) with frontal QRS-T angle. CONCLUSIONS The frontal QRS-T angle, was found to be wider in athletes compared to normal healthy participants. However, there was no significant difference between who used PS and those who didn't.

Research paper thumbnail of Kalp Hızı Değişkenliği ve Serebrovasküler Olaylar

Harran Üniversitesi Tıp Fakültesi Dergisi, 2020

Kalp hızı değişkenliği (KHD), kalbin otonomik fonksiyonlarını yansıtan noninvaziv bir değerlendir... more Kalp hızı değişkenliği (KHD), kalbin otonomik fonksiyonlarını yansıtan noninvaziv bir değerlendirmedir ve sistemik hastalıklarda bozulduğu bilinmektedir. Çalışmamızda, KHD ile akut iskemik inme (Aİİ) arasındaki ilişkiyi araştırmayı amaçladık. Materyal ve metod: Toplam 102 Aİİ hastası ve 66 sağlıklı birey (kontrol grubu) çalışmaya dahil edildi. Aİİ hastaları, iskemik inme (İİ) (n=65) ve geçici iskemik atak (GİA) (n=37) olarak iki gruba ayrıldı. Hasta ve kontrol gruplarına 24 saatlik ritim Holter kaydı yapıldı. Bulgular: Aİİ grubunda hipertansiyon (%60.8'e karşın %33.3, p=0.005) ve diyabetes mellitus (DM) (%39.2'e karşın %15.2, p=0.002) sıklığı ile, serum glukoz (142.4±60.0'a karşı 106.8±20.9, p=0.034) ve kreatinin düzeyleri (0.9±0.3'e karşın 0.8±0.5, p=0.010) anlamlı olarak daha yüksekti, fakat serum yüksek dansiteli lipoprotein düzeyi (44.7±9.7'e karşın 54.6±12.9, p=0.022) ve sol ventrikül ejeksiyon fraksiyonu (SVEF) (53.0 [25-60]'a karşın 58.0 [30-60], p=0.012) daha düşüktü. Ek olarak, KHD parametrelerinden olan SDNN (112.2 [37-1473]'e karşın 134.8 [37-405], p<0.001), SDNN index (44.0 [14-132]'e karşın 55.1 [24-145], p<0.001), üçgen index (1.5 [1-36]'e karşın 2.0 [1-53], p<0.001), HF (22.

Research paper thumbnail of Is there any relationship between frontal QRS-T angle and subclinical hypothyroidism?

Cukurova Medical Journal, 2021

Amac: Bu calismada amacimiz frontal QRS-T acisi ile subklinik hipotiroidizim (SKH) arasinda bir i... more Amac: Bu calismada amacimiz frontal QRS-T acisi ile subklinik hipotiroidizim (SKH) arasinda bir iliski olup olmadigini degerlendirmektir. Gerec ve Yontemler: Calismaya, 41 hasta SKH ve 74 saglikli kontrol grubu olmak uzere toplam 115 kisi dahil edildi. SKH tanisi icin, serum tiroid uyarici hormon (TSH) duzeyi> 4,5 mU / mL olarak belirlendi. Tum hastalarin demografik, elektrokardiyografik ve ekokardiyografik verileri iki grup arasinda karsilastirildi. Bulgular: TSH seviyesi (5.7 [4.5-20]’e karsin 1.2 [0.4-4.3] mlU / L), vucut kitle indeksi (BMI) (30.7 ± 6.4'e karsin 28.1 ± 5.3 kg/m2) ve frontal QRS-T aci degerleri (40 [2-188]’e karsin 15 [1-86] derece) ) SKH'li hastalarda daha yuksekti. Bununla birlikte, sol ventrikul ejeksiyon fraksiyonu (SVEF) degerleri, SKH hastalarinda daha dusuktu (58.9 ± 3.1'e karsin 60.8 ± 2.9) Korelasyon analizlerinde, VKI (r = 0.267, p = 0.007) ve frontal QRS-T acisi arasinda pozitif korelasyon (r = 0,294, p = 0,001), ancak SVEF ile TSH duzeyi...

Research paper thumbnail of The predictive value of the Patient Health Questionnaire-9 score for measuring the severity of coronary artery disease

Annals of Clinical and Analytical Medicine, 2021

Aim: It is known that the prevalence of depression increases in patients with coronary artery dis... more Aim: It is known that the prevalence of depression increases in patients with coronary artery disease (CAD). However, it is not clear whether patients' symptoms of depression worsen as the severity of CAD increases. The aim of this study is to investigate whether there is a relationship between the Patient Health Questionnaire-9 (PHQ) score and the severity of CAD. Material and Methods: A total of 168 patients, diagnosed with stable and unstable angina, acute myocardial infarction, were included in the study. The patients were divided into two groups as mild (n=133) and severe CAD (n=35) according to the SYNTAX score (SS) results. All patients completed PHQ-9 questionnaires, reflecting their mood up to 2 weeks before the heart attack. Patients with a previous diagnosis of depression, coronary artery disease, using psychiatric drugs, severe heart and kidney failure were excluded from the study. Results: The PHQ-9 score was higher in severe CAD (6.7±4.5 vs 12.5±15.0 p<0.000). Correlation analyses showed a strong association between PHQ-9 and SS (r=0.724, p<0.000) and heart rate (r=0.381, p<0.000). However, regression analysis showed that only SS [OR: 7.8, 95% CI (0.214-0.358), p<0.000] significantly increased the risk of depression. Receiver operating characteristics curve analyses presented that the optimal cutoff PHQ-9 score was ≥ 8 with 71.4 % sensitivity, 68.4 % specificity, and the area under the curve of 0.79, p < 0.000. Discussion: PHQ-9 was higher in patients with severe CAD, and there was a strong link between PHQ-9 score and heart rate.

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 Is there any link between vitamin D deficiency and vasovagal syncope?

Journal of Arrhythmia, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of P667 Protein supplementation improves left ventricular systolic functions in athletes by 2D speckle tracking echocardiography

European Heart Journal - Cardiovascular Imaging, 2020

Funding Acknowledgements none Background Exercise induced left ventricular remodelling is known f... more Funding Acknowledgements none Background Exercise induced left ventricular remodelling is known for many years. Left ventricular enlargement, hypertrophy, left atrial dilatation are adaptive responsive mechanisms of myocardial tissue to increased physiological demand by exercise. In recent years, strain and strain rate have been used for the assessment of myocardial adaptation in athletes’. In literature, left ventricular and right ventricular deformation is decreased in athletes’, compared to normal healthy individuals. Also left atrial reservoir and contractile functions, which can be measured by speckle tracking echocardiography, decrease in endurance athletes with atrial fibrillation. Athletes have been using protein supplementation frequently in recent years however cardiac effects are largely unknown. There is limited data in the literature about cardiac effects of protein supplementation. Purpose In our study, we aim to evaluate the effects of protein supplementation on cardi...

Research paper thumbnail of Development of Frog Neck After Coronary Angiography: Contrast-Induced Sialadenitis

Kosuyolu Heart Journal, 2019

Iodine-related submandibular sialadenitis is a rare complication among the causes of sialadenitis... more Iodine-related submandibular sialadenitis is a rare complication among the causes of sialadenitis. To date, the pathogenesis of iodide mumps has not yet been ascertained. This situation is a late reaction to iodinecontaining contrast agents and can manifest in any patient receiving iodinated contrast agents and repeated exposure. Fortunately, this condition does not require specific treatment and resolution can be expected within one or two weeks. We report an 82-year-old man suffering from iodide-induced sialadenitis following coronary angiography with the use of non-ionic low osmolar contrast media.

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. Results: 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). Conclusion: 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 Improvement of abnormal systolic motion of the interventricular septum with cardiac resynchronization therapy

Pacing and Clinical Electrophysiology, 2019

Background: There is no consensus in the literature regarding what the responsible mechanism of l... more Background: There is no consensus in the literature regarding what the responsible mechanism of left ventricular dyssynchrony is; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler Imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB). 2 This article is protected by copyright. All rights reserved. Methods: 26 patients undergoing CRT implantation with LBBB, wide QRS duration (≥120 ms), low ejection fraction (EF) (<35%) were included. Pulsed TDI was taken from apical 4-chamber view and parasternal short axis view (PSAX). All echocardiographic parameters were measured when CRT is on and off. Results: PSAX anteroseptal and posterolateral systolic ET was statistically significantly longer in CRT on group (321.6±62.7 vs 237.5±59.3, p<0.001; 323.9±58.0 vs 289.4±43.7, p=0.015; respectively). In apical 4-chamber view, septal annulus systolic ET is significantly longer in CRT on group than CRT off group (315.8±57.2 vs 287.3±42.2, p=0.014). Also, there was a strong correlation between systolic ET of the septum in PSAX with aortic velocity time integral (VTI), QRS duration in electrocardiography (ECG) and EF (r=0.587, p=0.002; r=0.479, p=0.013; r=0.440, p=0.025; respectively). Conclusion: Circumferential contraction of septal myocardial fibers is improved with CRT and it is strongly correlated with increase of aortic VTI and shortening of QRS duration. These findings predict the deterioration of septal contraction as the main mechanism in patients with LBBB pattern and, CRT may improves myocardial contraction by correcting septal systolic motion.

Research paper thumbnail of Unusual involvement of right ventricle in patient with Rosai-Dorfman Disease

The Anatolian Journal of Cardiology, 2019

Research paper thumbnail of The Importance of Intra-aortic Pulse Pressure After Anterior ST-segment Elevation Myocardial Infarction

Brazilian Journal of Cardiovascular Surgery, 2018

Objective: To evaluate the association of pulse pressure (PP) with mortality and major adverse ca... more Objective: To evaluate the association of pulse pressure (PP) with mortality and major adverse cardiac events (MACE) in one-year period after anterior ST-elevation myocardial infarction (A-STEMI). Methods: A total of 261 consecutive patients whose blood pressure was measured with the aid of a catheter before primary percutaneous coronary intervention (PPCI) between August 2016 and February 2017 were included in the study. The patients were divided into three groups according to pulse pressure (PP) (Group 1, PP<35 mmHg; Group 2, 35≤PP≤50 mmHg; Group 3, PP>50 mmHg). Results: The mean age of the patients was 63.4±14.1 years, and 206 of them were male. The groups were similar in terms of age and diastolic blood pressure (DBP). The ratio of female patients in Group 1 was higher, and their systolic blood pressure (SBP) was lower than those from the other groups (P=0.005 vs. P=0.042). The rates of MACE and mortality were higher in Group 1. The predictive PP values were calculated to be 42.5 mmHg for development of MACE and 41.5 mmHg for mortality. One-year survival ratio was worse in Group 1 than in the others according to Kaplan-Meier analysis (P<0.001). Conclusion: The values of PP which was measured intraaortically in patients with A-STEMI were associated with mortality and MACE in the one-year follow-up period.

Research paper thumbnail of The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

Brazilian Journal of Cardiovascular Surgery, 2018

Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development o... more Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI). Methods: One hundred and forty seven consecutive patients with aortic stenosis (AS) were evaluated for this study and 133 of them were included. Mean arterial pressure (mAP) and central venous pressure (CVP) were used to calculate mPP before TAVI procedure (mPP = mAP-CVP). The occurrence of AKIN was evaluated with AKIN classification according to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups according to the receiver operating characteristic (ROC) analysis of their mPP levels (high-risk group and low-risk group). Results: The AKIN prevalence was 22.6% in this study population. Baseline serum creatinine level, glomerular filtration rate, amount of contrast medium, and the level of mPP were determined as predictive factors for the development of AKIN. Conclusion: The occurrence of AKIN is associated with increased morbidity and mortality rates in patients with TAVI. In addition to the amount of contrast medium and basal kidney functions, our study showed that lower mPP was strongly associated with development of AKIN after TAVI.

Research paper thumbnail of Kalp Hastalıklarında Cinsiyetin Rolü

International Journal of Current Medical and Biological Sciences, 2021

Amaç: Çalışmamızda, kardiyovasküler hastalıkların kadın ve erkeklerdeki seyrini, sıklığını, bu ha... more Amaç: Çalışmamızda, kardiyovasküler hastalıkların kadın ve erkeklerdeki seyrini, sıklığını, bu hastaların takiplerinde kalp fonksiyonlarında değişiklik olup olmadığını araştırmayı hedefledik.Materiyal ve metod: Hastanemiz kardiyoloji polikliniğine çeşitli kalp rahatsızlıkları nedeniyle başvuran hastaların dosyaları geriye dönük tarandı, erkek ve kadın olarak iki gruba ayrılan hastaların koroner an-jiografileri, geçirmiş oldukları kalp ameliyatları, başvuru ve sonrasındaki ekokardiyografik bulguları karşılaştırıldı.Bulgular: Çalışmaya 270 bayan (ortalama yaş 63.8 yıl) ve 271 erkek (ortalama yaş 62.4 yıl) hasta alındı. Koroner arter hastalığı (KAH), kalp yetersizliği, dejeneratif mitral kapak hastalığı (MKH) oranı ve serum kreatinin düzeyleri erkeklerde fazlaydı (p<0.05). Diyabetes mellitus, kronik obstrüktif akciğer hastalığı, diyaliz tedavisi, serebrovasküler hastalıklar, hipertrofik kardiyomiyopati, kalp pili uygulaması açısından her iki grup arasında fark yoktu (p>0.05). Kad...

Research paper thumbnail of Diyete protein eklenmesi sporcuların kardiyovasküler sistemini etkiler mi?

Cukurova Medical Journal

Öz Purpose: Arrhythmias are reproached for most of the sudden cardiac deaths in professional athl... more Öz Purpose: Arrhythmias are reproached for most of the sudden cardiac deaths in professional athletes. Also, performance-enhancing dietary supplements have been blamed in recent years. In this study, we aimed to investigate the effect of protein supplements (PS) on regular training athletes. Materials and Methods: 70 male sportsmen (30.0 ± 7.3 year) who regularly train in the gym, were included in the study; 35 used approximately 40 grams of PS daily, while the other half regularly trained without additional PS. All participants underwent ECG, exercise test and results were evaluated by two independent cardiologists. Results: There were no differences between two groups in terms of age, smoking and alcohol use, body mass index, baseline ECG results, effort capacity, heart rate, and blood pressure values. Correlation analyses showed a negative correlation between the age and maximum HR in an effort test. Conclusion: This study showed that using PS in certain does not have any effect on ECG findings, heart rate at both rest and during exercise, effort capacity evaluated by a treadmill test, and blood pressure values of sportsmen. Amaç: Profesyonel sporcularda aritmiler, ani kardiyak ölümlerin çoğundan sorumlu tutulmaktadır. Aynı zamanda, performansı artıran diyet takviyeleri de son yıllarda suçlanmaktadır. Bu çalışmada, protein takviyelerinin (PT) düzenli antreman yapan sporcular üzerindeki etkisini araştırmayı amaçladık. Gereç ve Yöntem: Düzenli olarak antrenman yapan 70 (30.0 ± 7.3 yıl) erkek sporcu çalışmaya dahil edildi; 35 sporcu günde yaklaşık 40 gram PT kullanan, diğer yarısı PT kullanmadan egzersiz yapanlardı. Tüm katılımcılara EKG çekildi, efor testi yapıldı ve sonuçları iki bağımsız kardiyolog tarafından değerlendirildi. Bulgular: İki grup arasında yaş, sigara ve alkol kullanımı, vücut kitle indeksi, başlangıç EKG sonuçları, efor kapasitesi, kalp atım hızı ve kan basıncı değerleri açısından fark yoktu. Korelasyon analizinde, yaş ile efordaki en yüksek kalp hızı arasında negative korelasyon görüldü. Sonuç: Bu çalışma, sporcuların protein tozlarını belirli dozlarda kullandıklarında, kalp atış hızı, hem dinlenme hem egzersiz esnasındaki EKG bulguları, kan basıncı ve egzersiz kapasitesi üzerinde hiç bir etkiye sahip olmadıklarını göstermiştir.

Research paper thumbnail of Could T-wave and T peak-end interval be a new prognostic marker for patients receiving after cardiac resynchronization therapy?

Background:In this study, we investigated predictors of favourable responses to CRT using electro... more Background:In this study, we investigated predictors of favourable responses to CRT using electrocardiography parameters in heart failure patients. Methods : Seventy-two patients with heart failure, sinus rhythm, left bundle branch block and receiving CRT were included in the study. Patients were classified as “responders” with an improvement in ejection fraction of 10% and “non-responders” as any patient not meeting this definition. Electrocardiograms were evaluated before and after 6 months CRT implantation. Results: There was no difference between responder and non-responder groups in terms of age, co-morbidities, medications, pre-implantation ECG parameters (p>0.05). A number of women CRT-responders higher than non-responder (25.4 % vs 6 %, p=0.026), and NYHA Class III patients dominantly in CRT-responder groups (36.9 % vs 29.2 %, p=0.014, respectively).Post–implantation QRS duration (143.3± 18.6 vs 160.1 ± 29.2 ms), cQT interval (474.8 ± 43.4 vs 502.7 ± 49.6 ms), T-wave (165...

Research paper thumbnail of Hiperlipidemi ve Yönetimi

Research paper thumbnail of Use of T-wave duration and Tpeak-Tend interval as new prognostic markers for patients treated with cardiac resynchronization therapy

BACKGROUND The use of electrocardiography (ECG) is a practical method to evaluate the response to... more BACKGROUND The use of electrocardiography (ECG) is a practical method to evaluate the response to cardiac resynchronization therapy (CRT) implantation, as it is easily performed and saves time. AIMS In this study, it was aimed to assess the predictive value of the T-wave duration and Tpeak-Tend (Tp-e) interval following the CRT implantation administered to heart failure patients. METHODS Sixty-seven patients with left ventricular ejection fraction ≤ 35, New York Heart Association (NYHA) II-III, ambulatory class-IV, normal sinus rhythm, who have complete left bundle branch block on ECG and treated with CRT were included in this study. Patients, who have manifested a ≥ 10% improvement in ejection fraction following CRT implantation, were categorized as "responders", and the remaining patients were categorized as "non-responders". ECGs and echocardiograms were evaluated both six months before and after CRT implantation. RESULTS The post-CRT QRS duration (P = 0.01), ...

Research paper thumbnail of Predictive value of frontal QRS-T angle after cardiac resynchronization therapy

Journal of Electrocardiology

Research paper thumbnail of Is there any link between blood brain barrier and coronary arteries?

Gazzetta Medica Italiana Archivio per le Scienze Mediche

Research paper thumbnail of Do sporting activities and using protein supplements change the frontal QRS-T angle?

Minerva Cardiology and Angiology, 2021

BACKGROUND In this study, we investigated whether the frontal QRS-T angle was different between t... more BACKGROUND In this study, we investigated whether the frontal QRS-T angle was different between the athletes and normal healthy people. METHODS The study included 122 healthy athletes (the mean age was 29.7±7.7 years, of them, were 73.8% male) and a control group consisted of 60 healthy people (the mean age was 29.8±7.8 years, of them, were 26% male). Then, the athletes were divided into two groups as who used protein supplements (PS) and those who did not. In the 12-lead ECG, heart rate (HR), P, QRS, QT, corrected QT (QTc) duration, QT and corrected QT dispersion (QTD, QTcD), the sum of V1 or V2S amplitude and V5 or V6R amplitude (V1/2S+V5/6R), frontal QRS-T angle were calculated. RESULTS There was no significant difference between the athletes and control groups regarding age, gender, smoking, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), echocardiographic features, P, PR duration, P, QRS, T axis, QTD and QTcD (p>0.05).HR and QTc were significantly lower (p<0.05) and QRS, QT duration was longer in athletes group (p<0.001). The V1/2S+V5/6R and frontal QRS-T angle values were higher in the athlete's group (p<0.001). There was no significant difference between PS users and non PS users regarding demographic characteristics, duration of sports years, SBP and DBP (p>0.05). However, male gender was dominant in the PS users group (p=0.018). The P axis, PR and QRS duration were longer in the PS users group (p<0.05).It was found that the T axis was negatively correlated (r=-0.431,p<0.001) but the QRS axis was positively correlated (r =0.395,p<0.001) with frontal QRS-T angle. CONCLUSIONS The frontal QRS-T angle, was found to be wider in athletes compared to normal healthy participants. However, there was no significant difference between who used PS and those who didn't.

Research paper thumbnail of Kalp Hızı Değişkenliği ve Serebrovasküler Olaylar

Harran Üniversitesi Tıp Fakültesi Dergisi, 2020

Kalp hızı değişkenliği (KHD), kalbin otonomik fonksiyonlarını yansıtan noninvaziv bir değerlendir... more Kalp hızı değişkenliği (KHD), kalbin otonomik fonksiyonlarını yansıtan noninvaziv bir değerlendirmedir ve sistemik hastalıklarda bozulduğu bilinmektedir. Çalışmamızda, KHD ile akut iskemik inme (Aİİ) arasındaki ilişkiyi araştırmayı amaçladık. Materyal ve metod: Toplam 102 Aİİ hastası ve 66 sağlıklı birey (kontrol grubu) çalışmaya dahil edildi. Aİİ hastaları, iskemik inme (İİ) (n=65) ve geçici iskemik atak (GİA) (n=37) olarak iki gruba ayrıldı. Hasta ve kontrol gruplarına 24 saatlik ritim Holter kaydı yapıldı. Bulgular: Aİİ grubunda hipertansiyon (%60.8'e karşın %33.3, p=0.005) ve diyabetes mellitus (DM) (%39.2'e karşın %15.2, p=0.002) sıklığı ile, serum glukoz (142.4±60.0'a karşı 106.8±20.9, p=0.034) ve kreatinin düzeyleri (0.9±0.3'e karşın 0.8±0.5, p=0.010) anlamlı olarak daha yüksekti, fakat serum yüksek dansiteli lipoprotein düzeyi (44.7±9.7'e karşın 54.6±12.9, p=0.022) ve sol ventrikül ejeksiyon fraksiyonu (SVEF) (53.0 [25-60]'a karşın 58.0 [30-60], p=0.012) daha düşüktü. Ek olarak, KHD parametrelerinden olan SDNN (112.2 [37-1473]'e karşın 134.8 [37-405], p<0.001), SDNN index (44.0 [14-132]'e karşın 55.1 [24-145], p<0.001), üçgen index (1.5 [1-36]'e karşın 2.0 [1-53], p<0.001), HF (22.

Research paper thumbnail of Is there any relationship between frontal QRS-T angle and subclinical hypothyroidism?

Cukurova Medical Journal, 2021

Amac: Bu calismada amacimiz frontal QRS-T acisi ile subklinik hipotiroidizim (SKH) arasinda bir i... more Amac: Bu calismada amacimiz frontal QRS-T acisi ile subklinik hipotiroidizim (SKH) arasinda bir iliski olup olmadigini degerlendirmektir. Gerec ve Yontemler: Calismaya, 41 hasta SKH ve 74 saglikli kontrol grubu olmak uzere toplam 115 kisi dahil edildi. SKH tanisi icin, serum tiroid uyarici hormon (TSH) duzeyi> 4,5 mU / mL olarak belirlendi. Tum hastalarin demografik, elektrokardiyografik ve ekokardiyografik verileri iki grup arasinda karsilastirildi. Bulgular: TSH seviyesi (5.7 [4.5-20]’e karsin 1.2 [0.4-4.3] mlU / L), vucut kitle indeksi (BMI) (30.7 ± 6.4'e karsin 28.1 ± 5.3 kg/m2) ve frontal QRS-T aci degerleri (40 [2-188]’e karsin 15 [1-86] derece) ) SKH'li hastalarda daha yuksekti. Bununla birlikte, sol ventrikul ejeksiyon fraksiyonu (SVEF) degerleri, SKH hastalarinda daha dusuktu (58.9 ± 3.1'e karsin 60.8 ± 2.9) Korelasyon analizlerinde, VKI (r = 0.267, p = 0.007) ve frontal QRS-T acisi arasinda pozitif korelasyon (r = 0,294, p = 0,001), ancak SVEF ile TSH duzeyi...

Research paper thumbnail of The predictive value of the Patient Health Questionnaire-9 score for measuring the severity of coronary artery disease

Annals of Clinical and Analytical Medicine, 2021

Aim: It is known that the prevalence of depression increases in patients with coronary artery dis... more Aim: It is known that the prevalence of depression increases in patients with coronary artery disease (CAD). However, it is not clear whether patients' symptoms of depression worsen as the severity of CAD increases. The aim of this study is to investigate whether there is a relationship between the Patient Health Questionnaire-9 (PHQ) score and the severity of CAD. Material and Methods: A total of 168 patients, diagnosed with stable and unstable angina, acute myocardial infarction, were included in the study. The patients were divided into two groups as mild (n=133) and severe CAD (n=35) according to the SYNTAX score (SS) results. All patients completed PHQ-9 questionnaires, reflecting their mood up to 2 weeks before the heart attack. Patients with a previous diagnosis of depression, coronary artery disease, using psychiatric drugs, severe heart and kidney failure were excluded from the study. Results: The PHQ-9 score was higher in severe CAD (6.7±4.5 vs 12.5±15.0 p<0.000). Correlation analyses showed a strong association between PHQ-9 and SS (r=0.724, p<0.000) and heart rate (r=0.381, p<0.000). However, regression analysis showed that only SS [OR: 7.8, 95% CI (0.214-0.358), p<0.000] significantly increased the risk of depression. Receiver operating characteristics curve analyses presented that the optimal cutoff PHQ-9 score was ≥ 8 with 71.4 % sensitivity, 68.4 % specificity, and the area under the curve of 0.79, p < 0.000. Discussion: PHQ-9 was higher in patients with severe CAD, and there was a strong link between PHQ-9 score and heart rate.

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 Is there any link between vitamin D deficiency and vasovagal syncope?

Journal of Arrhythmia, 2020

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Research paper thumbnail of P667 Protein supplementation improves left ventricular systolic functions in athletes by 2D speckle tracking echocardiography

European Heart Journal - Cardiovascular Imaging, 2020

Funding Acknowledgements none Background Exercise induced left ventricular remodelling is known f... more Funding Acknowledgements none Background Exercise induced left ventricular remodelling is known for many years. Left ventricular enlargement, hypertrophy, left atrial dilatation are adaptive responsive mechanisms of myocardial tissue to increased physiological demand by exercise. In recent years, strain and strain rate have been used for the assessment of myocardial adaptation in athletes’. In literature, left ventricular and right ventricular deformation is decreased in athletes’, compared to normal healthy individuals. Also left atrial reservoir and contractile functions, which can be measured by speckle tracking echocardiography, decrease in endurance athletes with atrial fibrillation. Athletes have been using protein supplementation frequently in recent years however cardiac effects are largely unknown. There is limited data in the literature about cardiac effects of protein supplementation. Purpose In our study, we aim to evaluate the effects of protein supplementation on cardi...

Research paper thumbnail of Development of Frog Neck After Coronary Angiography: Contrast-Induced Sialadenitis

Kosuyolu Heart Journal, 2019

Iodine-related submandibular sialadenitis is a rare complication among the causes of sialadenitis... more Iodine-related submandibular sialadenitis is a rare complication among the causes of sialadenitis. To date, the pathogenesis of iodide mumps has not yet been ascertained. This situation is a late reaction to iodinecontaining contrast agents and can manifest in any patient receiving iodinated contrast agents and repeated exposure. Fortunately, this condition does not require specific treatment and resolution can be expected within one or two weeks. We report an 82-year-old man suffering from iodide-induced sialadenitis following coronary angiography with the use of non-ionic low osmolar contrast media.

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. Results: 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). Conclusion: 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 Improvement of abnormal systolic motion of the interventricular septum with cardiac resynchronization therapy

Pacing and Clinical Electrophysiology, 2019

Background: There is no consensus in the literature regarding what the responsible mechanism of l... more Background: There is no consensus in the literature regarding what the responsible mechanism of left ventricular dyssynchrony is; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler Imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB). 2 This article is protected by copyright. All rights reserved. Methods: 26 patients undergoing CRT implantation with LBBB, wide QRS duration (≥120 ms), low ejection fraction (EF) (<35%) were included. Pulsed TDI was taken from apical 4-chamber view and parasternal short axis view (PSAX). All echocardiographic parameters were measured when CRT is on and off. Results: PSAX anteroseptal and posterolateral systolic ET was statistically significantly longer in CRT on group (321.6±62.7 vs 237.5±59.3, p<0.001; 323.9±58.0 vs 289.4±43.7, p=0.015; respectively). In apical 4-chamber view, septal annulus systolic ET is significantly longer in CRT on group than CRT off group (315.8±57.2 vs 287.3±42.2, p=0.014). Also, there was a strong correlation between systolic ET of the septum in PSAX with aortic velocity time integral (VTI), QRS duration in electrocardiography (ECG) and EF (r=0.587, p=0.002; r=0.479, p=0.013; r=0.440, p=0.025; respectively). Conclusion: Circumferential contraction of septal myocardial fibers is improved with CRT and it is strongly correlated with increase of aortic VTI and shortening of QRS duration. These findings predict the deterioration of septal contraction as the main mechanism in patients with LBBB pattern and, CRT may improves myocardial contraction by correcting septal systolic motion.

Research paper thumbnail of Unusual involvement of right ventricle in patient with Rosai-Dorfman Disease

The Anatolian Journal of Cardiology, 2019

Research paper thumbnail of The Importance of Intra-aortic Pulse Pressure After Anterior ST-segment Elevation Myocardial Infarction

Brazilian Journal of Cardiovascular Surgery, 2018

Objective: To evaluate the association of pulse pressure (PP) with mortality and major adverse ca... more Objective: To evaluate the association of pulse pressure (PP) with mortality and major adverse cardiac events (MACE) in one-year period after anterior ST-elevation myocardial infarction (A-STEMI). Methods: A total of 261 consecutive patients whose blood pressure was measured with the aid of a catheter before primary percutaneous coronary intervention (PPCI) between August 2016 and February 2017 were included in the study. The patients were divided into three groups according to pulse pressure (PP) (Group 1, PP<35 mmHg; Group 2, 35≤PP≤50 mmHg; Group 3, PP>50 mmHg). Results: The mean age of the patients was 63.4±14.1 years, and 206 of them were male. The groups were similar in terms of age and diastolic blood pressure (DBP). The ratio of female patients in Group 1 was higher, and their systolic blood pressure (SBP) was lower than those from the other groups (P=0.005 vs. P=0.042). The rates of MACE and mortality were higher in Group 1. The predictive PP values were calculated to be 42.5 mmHg for development of MACE and 41.5 mmHg for mortality. One-year survival ratio was worse in Group 1 than in the others according to Kaplan-Meier analysis (P<0.001). Conclusion: The values of PP which was measured intraaortically in patients with A-STEMI were associated with mortality and MACE in the one-year follow-up period.

Research paper thumbnail of The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation

Brazilian Journal of Cardiovascular Surgery, 2018

Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development o... more Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI). Methods: One hundred and forty seven consecutive patients with aortic stenosis (AS) were evaluated for this study and 133 of them were included. Mean arterial pressure (mAP) and central venous pressure (CVP) were used to calculate mPP before TAVI procedure (mPP = mAP-CVP). The occurrence of AKIN was evaluated with AKIN classification according to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups according to the receiver operating characteristic (ROC) analysis of their mPP levels (high-risk group and low-risk group). Results: The AKIN prevalence was 22.6% in this study population. Baseline serum creatinine level, glomerular filtration rate, amount of contrast medium, and the level of mPP were determined as predictive factors for the development of AKIN. Conclusion: The occurrence of AKIN is associated with increased morbidity and mortality rates in patients with TAVI. In addition to the amount of contrast medium and basal kidney functions, our study showed that lower mPP was strongly associated with development of AKIN after TAVI.

Research paper thumbnail of Kalp Hastalıklarında Cinsiyetin Rolü

International Journal of Current Medical and Biological Sciences, 2021

Amaç: Çalışmamızda, kardiyovasküler hastalıkların kadın ve erkeklerdeki seyrini, sıklığını, bu ha... more Amaç: Çalışmamızda, kardiyovasküler hastalıkların kadın ve erkeklerdeki seyrini, sıklığını, bu hastaların takiplerinde kalp fonksiyonlarında değişiklik olup olmadığını araştırmayı hedefledik.Materiyal ve metod: Hastanemiz kardiyoloji polikliniğine çeşitli kalp rahatsızlıkları nedeniyle başvuran hastaların dosyaları geriye dönük tarandı, erkek ve kadın olarak iki gruba ayrılan hastaların koroner an-jiografileri, geçirmiş oldukları kalp ameliyatları, başvuru ve sonrasındaki ekokardiyografik bulguları karşılaştırıldı.Bulgular: Çalışmaya 270 bayan (ortalama yaş 63.8 yıl) ve 271 erkek (ortalama yaş 62.4 yıl) hasta alındı. Koroner arter hastalığı (KAH), kalp yetersizliği, dejeneratif mitral kapak hastalığı (MKH) oranı ve serum kreatinin düzeyleri erkeklerde fazlaydı (p<0.05). Diyabetes mellitus, kronik obstrüktif akciğer hastalığı, diyaliz tedavisi, serebrovasküler hastalıklar, hipertrofik kardiyomiyopati, kalp pili uygulaması açısından her iki grup arasında fark yoktu (p>0.05). Kad...

Research paper thumbnail of Diyete protein eklenmesi sporcuların kardiyovasküler sistemini etkiler mi?

Cukurova Medical Journal

Öz Purpose: Arrhythmias are reproached for most of the sudden cardiac deaths in professional athl... more Öz Purpose: Arrhythmias are reproached for most of the sudden cardiac deaths in professional athletes. Also, performance-enhancing dietary supplements have been blamed in recent years. In this study, we aimed to investigate the effect of protein supplements (PS) on regular training athletes. Materials and Methods: 70 male sportsmen (30.0 ± 7.3 year) who regularly train in the gym, were included in the study; 35 used approximately 40 grams of PS daily, while the other half regularly trained without additional PS. All participants underwent ECG, exercise test and results were evaluated by two independent cardiologists. Results: There were no differences between two groups in terms of age, smoking and alcohol use, body mass index, baseline ECG results, effort capacity, heart rate, and blood pressure values. Correlation analyses showed a negative correlation between the age and maximum HR in an effort test. Conclusion: This study showed that using PS in certain does not have any effect on ECG findings, heart rate at both rest and during exercise, effort capacity evaluated by a treadmill test, and blood pressure values of sportsmen. Amaç: Profesyonel sporcularda aritmiler, ani kardiyak ölümlerin çoğundan sorumlu tutulmaktadır. Aynı zamanda, performansı artıran diyet takviyeleri de son yıllarda suçlanmaktadır. Bu çalışmada, protein takviyelerinin (PT) düzenli antreman yapan sporcular üzerindeki etkisini araştırmayı amaçladık. Gereç ve Yöntem: Düzenli olarak antrenman yapan 70 (30.0 ± 7.3 yıl) erkek sporcu çalışmaya dahil edildi; 35 sporcu günde yaklaşık 40 gram PT kullanan, diğer yarısı PT kullanmadan egzersiz yapanlardı. Tüm katılımcılara EKG çekildi, efor testi yapıldı ve sonuçları iki bağımsız kardiyolog tarafından değerlendirildi. Bulgular: İki grup arasında yaş, sigara ve alkol kullanımı, vücut kitle indeksi, başlangıç EKG sonuçları, efor kapasitesi, kalp atım hızı ve kan basıncı değerleri açısından fark yoktu. Korelasyon analizinde, yaş ile efordaki en yüksek kalp hızı arasında negative korelasyon görüldü. Sonuç: Bu çalışma, sporcuların protein tozlarını belirli dozlarda kullandıklarında, kalp atış hızı, hem dinlenme hem egzersiz esnasındaki EKG bulguları, kan basıncı ve egzersiz kapasitesi üzerinde hiç bir etkiye sahip olmadıklarını göstermiştir.

Research paper thumbnail of Could T-wave and T peak-end interval be a new prognostic marker for patients receiving after cardiac resynchronization therapy?

Background:In this study, we investigated predictors of favourable responses to CRT using electro... more Background:In this study, we investigated predictors of favourable responses to CRT using electrocardiography parameters in heart failure patients. Methods : Seventy-two patients with heart failure, sinus rhythm, left bundle branch block and receiving CRT were included in the study. Patients were classified as “responders” with an improvement in ejection fraction of 10% and “non-responders” as any patient not meeting this definition. Electrocardiograms were evaluated before and after 6 months CRT implantation. Results: There was no difference between responder and non-responder groups in terms of age, co-morbidities, medications, pre-implantation ECG parameters (p>0.05). A number of women CRT-responders higher than non-responder (25.4 % vs 6 %, p=0.026), and NYHA Class III patients dominantly in CRT-responder groups (36.9 % vs 29.2 %, p=0.014, respectively).Post–implantation QRS duration (143.3± 18.6 vs 160.1 ± 29.2 ms), cQT interval (474.8 ± 43.4 vs 502.7 ± 49.6 ms), T-wave (165...

Research paper thumbnail of Hiperlipidemi ve Yönetimi

Research paper thumbnail of Use of T-wave duration and Tpeak-Tend interval as new prognostic markers for patients treated with cardiac resynchronization therapy

BACKGROUND The use of electrocardiography (ECG) is a practical method to evaluate the response to... more BACKGROUND The use of electrocardiography (ECG) is a practical method to evaluate the response to cardiac resynchronization therapy (CRT) implantation, as it is easily performed and saves time. AIMS In this study, it was aimed to assess the predictive value of the T-wave duration and Tpeak-Tend (Tp-e) interval following the CRT implantation administered to heart failure patients. METHODS Sixty-seven patients with left ventricular ejection fraction ≤ 35, New York Heart Association (NYHA) II-III, ambulatory class-IV, normal sinus rhythm, who have complete left bundle branch block on ECG and treated with CRT were included in this study. Patients, who have manifested a ≥ 10% improvement in ejection fraction following CRT implantation, were categorized as "responders", and the remaining patients were categorized as "non-responders". ECGs and echocardiograms were evaluated both six months before and after CRT implantation. RESULTS The post-CRT QRS duration (P = 0.01), ...

Research paper thumbnail of Predictive value of frontal QRS-T angle after cardiac resynchronization therapy

Journal of Electrocardiology

Research paper thumbnail of Is there any link between blood brain barrier and coronary arteries?

Gazzetta Medica Italiana Archivio per le Scienze Mediche