19 results on '"Samet Uysal"'
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2. How does severe functional mitral regurgitation redefined by European guidelines affect pulmonary vascular resistance and hemodynamics in heart transplant candidates?
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Zübeyde Bayram, Cem Doğan, Rezzan Deniz Acar, Süleyman Efe, Özgür Yaşar Akbal, Fatih Yılmaz, Büşra Güvendi Şengör, Ahmet Karaduman, Samet Uysal, Ali Karagöz, Çağatay Önal, Mehmet Kaan Kırali, Cihangir Kaymaz, and Nihal Özdemir
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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3. Comparison of 30-Day MACE between Immediate versus Staged Complete Revascularization in Acute Myocardial Infarction with Multivessel Disease, and the Effect of Coronary Lesion Complexity
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Cem Doğan, Zübeyde Bayram, Murat Çap, Flora Özkalaycı, Tuba Unkun, Emrah Erdoğan, Abdulkadir Uslu, Rezzan Deniz Acar, Busra Guvendi, Özgur Yaşar Akbal, Ali Karagöz, Aykun Hakgor, Ahmet Karaduman, Samet Uysal, Ahmet Aykan, Cihangir Kaymaz, and Nihal Özdemir
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acute coronary syndrome ,multivessel coronary artery disease ,Syntax score ,Medicine (General) ,R5-920 - Abstract
Background and objective: In patients with acute myocardial infarction and multivessel disease, the timing of intervention to non-culprit lesions is still a matter of debate, especially in patients without shock. This study aimed to compare the effect of multivessel intervention, performed at index percutaneous coronary intervention (PCI) (MVI-I) or index hospitalization (MVI-S), on the 30-day results of acute myocardial infarction (AMI), and to investigate the effect of coronary lesion complexity assessed by the Syntax (Sx) score on the timing of multivessel intervention. Materials and methods: We enrolled 180 patients with MVI-I, and 425 patients with MVI-S. The major adverse cardiovascular events (MACE) for this study were identified as mortality, nonfatal myocardial infarction, nonfatal stroke, acute heart failure, ischemia driven revascularization, major bleeding, and acute renal failure developed within 30 days. Results: The unadjusted MACE rates at 30 days were 11.2% and 5% among those who underwent MVI-I and MVI-S, respectively (OR 3.02; 95% confidence interval (CI) 1.51⁻6.02; p = 0.002). Associations were statistically significant after adjusting for covariates in the penalized multivariable model (adjusted OR 2.06; 95%CI 1.02⁻4.18; p = 0.043), propensity score adjusted multivariable model (adjusted OR 2.46; 95%CI 1.19⁻5.07; p = 0.015), and IPW (adjusted OR 2.11; 95%CI 1.28⁻3.47; p = 0.041). We found that the Syntax score of lesions did not affect the results. Conclusion: MVI-S was associated with a lower incidence of major adverse cardiovascular events within 30 days after discharge.
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- 2019
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4. The Clinical Course of Infective Endocarditis and Independent Predictors of In-Hospital Mortality
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Hakan Çakır, Samet Uysal, Ali Karagöz, Cüneyt Toprak, Lütfi Öcal, Mehmet Yunus Emiroğlu, and Cihangir Kaymaz
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General Medicine - Abstract
Introduction: Despite advances in prevention, medical, and surgical treatment, the global prevalence of infective endocarditis (IE) has been gradually rising over the last two decades. However, the profile of IE varies by continent, geographic region, and hospital type. In this study, we aimed to investigate the epidemiological and clinical features of IE and to determine the factors predicting in-hospital mortality. Patients and Methods: This retrospective study was carried out at a single tertiary health care hospital in Türkiye. A total of 104 consecutive patients (>18 years old) who were hospitalized with IE between January 2016 and August 2021 were included. Modified Duke criteria were used to diagnose IE. Demographic information (age and gender), underlying heart diseases, comorbidities, causative microorganisms, blood culture results, echocardiographic findings, cardiac and extracardiac complications, surgical requirements, and in-hospital mortality were all examined. Results: The study included 104 IE cases (mean age: 57.2 ± 15.9 years; 59.6% males). Fifty-six patients (53.9%) had native valve IE, 37 patients (35.6%) had prosthetic valve IE, and four patients (3.8%) had devicerelated IE. Blood cultures were negative in 62 cases (59.6%). Staphylococcus aureus was the most common responsible microorganism in 17 patients [methicillin-sensitive Staphylococcus aureus in 13 (12.5%), methicillin-resistant Staphylococcus in four (3.8%)]. The overall in-hospital mortality rate was 30.8%. White blood cell count (OR= 1.002, 95% CI= 1.001-1.003) creatinine (OR= 1.45, 95% CI= 1.08-2.00), acute renal failure (OR= 8.60, 95% CI= 2.27-37.81), and cerebrovascular accidents (OR= 4.58, 95% CI= 1.21-18.85) were independent predictors of in-hospital mortality. Conclusion: In line with developed countries, the epidemiology and causative pathogens of IE in Türkiye have been changing. Investigating these epidemiological and clinical changes may serve as a basis for strategies to be developed for the prevention and treatment of IE.
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- 2022
5. Effect of Group 2 Pulmonary Hypertension Subgroups on Outcomes: Impact of the Updated Definition of Pulmonary Hypertension
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Özgür Yaşar Akbal, Cem Doğan, Samet Uysal, Hacer Ceren Tokgoz, Zübeyde Bayram, Süleyman Çağan Efe, Cihangir Kaymaz, Busra Guvendi, Ravza Betul Aktas, Ali Karagöz, Fatih Yilmaz, Mehmet Kaan Kırali, and Nihal Özdemir
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hypertension, Pulmonary ,medicine.medical_treatment ,Hemodynamics ,Ventricular Function, Left ,Internal medicine ,medicine ,Humans ,Retrospective Studies ,Heart Failure ,Heart transplantation ,Ejection fraction ,business.industry ,Hazard ratio ,Stroke Volume ,medicine.disease ,Pulmonary hypertension ,medicine.anatomical_structure ,Ventricle ,Heart failure ,Ventricular assist device ,Cardiology ,Heart-Assist Devices ,Cardiology and Cardiovascular Medicine ,business - Abstract
Pulmonary hypertension (PH) is a common complication of end-stage heart failure (ESHF) and associated with increased mortality. The definition of PH has recently been changed from a mean pulmonary arterial pressure (PAPm) ≥25 mmHg to a PAPm20 mmHg. Since this change, there are no data evaluating group 2 PH subgroups on outcomes. The purpose of this study was to determine the impact of updated group 2 PH subgroups on outcomes, as well as to evaluate the clinical, echocardiographic, and haemodynamic characteristics of subgroups, and determine predictors of PH in patients with ESHF.A total of 416 patients with ESHF with left ventricular ejection fraction (LVEF) ≤25% were divided into three groups. Pulmonary hypertension was defined as PAPm20 mmHg. Primary outcome was defined as left ventricular assist device (LVAD) implantation, urgent heart transplantation (HT), or death. Secondary outcome was defined as LVAD implantation and HT.Over a median follow-up of 503.5 days, combined pre- and postcapillary PH (Cpc-PH) displayed greater risk of primary outcome than those with isolated postcapillary (Ipc-PH) (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.29-1.91; p0.001) and those with no PH (HR, 2.47; 95% CI, 1.68-3.63; p0.001). Patients with Ipc-PH demonstrated greater risk than those with no PH (HR, 1.57; 95% CI, 1.57-1.90; p0.001). Likelihood ratios of updated PH criteria and old PH criteria (PAPm ≥25 mmHg) in identifying primary outcome were 75.6 (RPulmonary hypertension increases the risk of LVAD, urgent HT, or death, and Cpc-PH further increases risk in patients with ESHF. Compared to the previous definition, a new PH definition better discriminates death, going to urgent HT, or LVAD implantation for PH subgroups.
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- 2022
6. Prognostic impact of nutritional indices in candidates for heart transplantation
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Zübeyde, Bayram, Süleyman Çağan, Efe, Ali, Karagöz, Cem, Doğan, Büşra, Güvendi, Samet, Uysal, Özgür Yaşar, Akbal, Fatih, Yılmaz, Hacer Ceren, Tokgöz, Rezzan Deniz, Acar, Mehmet Kaan, Kirali, Cihangir, Kaymaz, and Nihal, Özdemir
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Nutrition Assessment ,Malnutrition ,Heart Transplantation ,Humans ,Nutritional Status ,Prognosis ,Retrospective Studies - Abstract
No study has thus far evaluated the association of controlling nutritional status (CO NUT) score and prognostic nutritional index (PNI) with prognosis in candidates listed for heart transplantation (HT). Therefore, in this study, we aimed to investigate the impact of these nutritional indices on prognosis in these candidates.In this retrospective study, a total of 195 candidates for HT were included. Over a median follow-up period of 503.5 days, the patients were grouped as survivors (n=121) and non-survivors (n = 74). Malnutrition was defined as CONUT score ≥2 (CONUT-defined malnu trition) and PNI ≤38 (PNI-defined malnutrition).The CONUT-defined malnutrition was observed in 19.8% and 39.2% of the survivors and non-survivors (P = .003), and the PNI-defined malnutrition was observed in 7.4% and 16.2% of the survivors and non-survivors (P = .032). The univariate analysis revealed that the CONUT score from 0 to 2 (hazard ratio [HR]: 1.41, 95% confidence interval [CI]: 1.11-1.79, P =.004) and PNI from 45.5 to 54.5 (HR: 0.78, 95% CI: 0.64-0.95, P = .001), the CONUT-defined malnutrition (HR: 2.48, 95% CI: 1.55-3.97, P.001) and the PNI-defined malnutrition (HR: 1.97, 95% CI: 1.01-3.86, P = .04) were associated with mortality. In the multivariate adjusted models, the CO NUT-defined malnutrition was an independent predictor of mortality, whereas the PNI-defined malnutrition was not a predictor of mortality (HR: 1.92, 95% CI: 1.12-3.27, P = .001 and HR: 1.64, 95% CI: 0.80-3.40, P = .18). The log-rank test revealed that the CONUT-defined malnutri tion and the PNI-defined malnutrition were associated with decrease in survival rate.Although both the CONUT score and the PNI score were associated with prognosis in candidates for HT, the CONUT score was superior to the PNI score in predicting mortality.
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- 2022
7. Prognostic Importance of Pulmonary Artery Pulsatility Index and Right Ventricular Stroke Work Index in End-Stage Heart Failure Patients
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Zubeyde Bayram, Cem Dogan, Suleyman Cagan Efe, Ali Karagoz, Busra Guvendi, Samet Uysal, Ravza Betul Akbas, Rezzan Deniz Acar, Ozgur Yasar Akbal, Fatih Yilmaz, Hacer Ceren Tokgoz, Mehmet Kaan Kirali, Cihangir Kaymaz, and Nihal Ozdemir
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Heart Failure ,Stroke ,Ventricular Dysfunction, Right ,Ventricular Function, Right ,Humans ,Stroke Volume ,Pharmacology (medical) ,Heart-Assist Devices ,Pulmonary Artery ,Prognosis ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Background: Right ventricular (RV) failure is an important cause of morbidity and mortality in patients with left ventricular (LV) end-stage heart failure (ESHF). Pulmonary artery pulsatility index (PAPi) and RV stroke work index (RVSWI) are invasive parameters related to RV function. This study aimed to investigate the prognostic impact of PAPi and RVSWI in these patients. Methods and Results: In this study, 416 patients with ESHF were included. The adverse cardiac event (ACE) was defined as LV assist device implantation, urgent heart transplantation, or cardiac mortality. There were 218 ACE cases and 198 non-ACE cases over a median follow-up of 503.50 days. Patients with ACE had lower PAPi and similar RVSWI compared to those without ACE (3.1 ± 1.9 vs. 3.7 ± 2.3, p = 0.003 and 7.3 ± 4.9 vs. 6.9 ± 4.4, p = 0.422, respectively). According to the results of multivariate analysis, while PAPi (from 2 to 5.65) was associated with ACE, RVSWI (from 3.62 to 9.75) was not associated with ACE (hazard ratio [HR]: 0.75, 95% confidence interval [CI] [0.55–0.95], p = 0.031; HR: 0.79, 95% CI: [0.58–1.09], p = 0.081, respectively). Survival analysis revealed that PAPi ≤2.56 was associated with a higher ACE risk compared to PAPi >2.56 (HR: 1.46, 95% CI: 1.11–1.92, p = 0.006). PAPi ≤2.56 could predict ACE with 56.7% sensitivity and 51.3% specificity at 1 year. Furthermore, the association between RVSWI and ACE was nonlinear (J-curve pattern). Low and high values seem to be associated with higher ACE risk compared to intermediate values. Conclusion: The low PAPi was an independent risk for ACE and it had a linear association with it. However, RVSWI seems to be have a nonlinear association with ACE (J-curve pattern).
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- 2022
8. Ischaemic versus non-ischaemic: how does heart failure aetiology affect pulmonary arterial capacitance and pulmonary artery pulsatility index in end-stage heart failure?
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Zubeyde Bayram, Cem Dogan, Suleyman C. Efe, Busra Guvendi, Ali Karagoz, Rezzan Deniz Acar, Samet Uysal, Ravza Betul Akbas, Fatih Yilmaz, Ozgur Y. Akbal, Hacer Ceren Tokgoz, Mehmet Kaan Kirali, Cihangir Kaymaz, and Nihal Ozdemir
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Heart Failure ,Hypertension, Pulmonary ,Ventricular Dysfunction, Right ,Ventricular Function, Right ,Humans ,Stroke Volume ,General Medicine ,Pulmonary Artery ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine - Abstract
The aetiology of heart failure may have different effects on right ventricular (RV) function, pulmonary pressures and RV afterload. Pulmonary arterial capacitance (PAC) and pulmonary artery pulsatility index (PAPi) are novel haemodynamic indices used in determining RV afterload and RV function, respectively. We aimed to investigate whether there was a difference in PAC and PAPi between ischaemic cardiomyopathy (ICMP) and non-ischaemic cardiomyopathy (NICMP) in patients with end-stage heart failure.A total of 215 subjects undergoing evaluation for heart transplantation or left ventricular (LV) assist device were classified into two groups: ICMP (ICMP was associated with lower PAC and higher PAPi. These results indicated that an ischaemic aetiology is associated with higher RV afterload and better RV function in the end-stage heart failure.
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- 2021
9. Effect of non‐dipper pattern on echocardiographic myocardial work parameters in normotensive individuals
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Ali Karagöz, Nihal Özdemir, Cem Doğan, Özgür Yaşar Akbal, Süleyman Çağan Efe, Busra Guvendi, Cihangir Kaymaz, Hacer Ceren Tokgoz, Samet Uysal, Turgut Karabag, Mahmut Bugrahan Cicek, and Zübeyde Bayram
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medicine.medical_specialty ,Ambulatory blood pressure ,Longitudinal strain ,biology ,Adverse outcomes ,business.industry ,Dipper ,Statistical difference ,Blood Pressure ,Stroke Volume ,Work efficiency ,Regression analysis ,Blood Pressure Monitoring, Ambulatory ,biology.organism_classification ,Ventricular Function, Left ,Examination method ,Echocardiography ,Internal medicine ,Hypertension ,medicine ,Cardiology ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND It is known that non-dipper pattern (NDP) is associated with adverse outcomes in hypertensive patients. However, there is insufficient data on the outcome of NDP in normotensive individuals. Using myocardial work (MW) analysis, as a new echocardiographic examination method, this study aimed to determine the early myocardial effects of NDP in normotensive individuals. METHODS This study included 70 normotensive individuals who were followed by ambulatory blood pressure monitoring (ABPM). The subjects were divided into two groups according to dipper pattern (DP) and NDP. Conventional, strain, and MW findings were compared between the groups by making echocardiographic evaluations. RESULTS The demographic characteristics, laboratory parameters, and measurements of cardiac chambers, and left ventricular (LV) walls were similar between the groups. There was no statistical difference between the groups in terms of LV 3-2-4 chambers strains and global longitudinal strain (GLS) values. LVMW parameters, global work index (GWI), and global constrictive work (GCW) were not statistically different between groups (2012 ± 127, 2069 ± 137, p = 0.16; 2327 ± 173, 2418 ± 296, p = 0.18, respectively). However, global waste work (GWW) and global work efficiency (GWE) parameters were different between the groups (144 ± 63.9, 104 ± 24.8, p
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- 2021
10. Renal Artery Embolism: A Salvage Therapy with Catheter-Directed Intra Arterial Ultraslow Thrombolytic Infusion
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Samet Uysal, Zeki Şimşek, Elnur Alizade, and Dogancan Ceneli
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Catheter directed thrombolysis ,Salvage therapy ,Thrombolysis ,Catheter ,Renal artery thrombosis ,Internal medicine ,Renal artery embolism ,Cardiology ,Intra arterial ,Medicine ,business - Published
- 2021
11. Inferior Vena Cava Collapsibility Index in Severe Acute Decompensated Heart Failure as Predictor of In-Hospital Mortality
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Samet Uysal, İbrahim Akın İzgi, Emrah Bayam, Mehmet Celik, Ender Özgün Çakmak, Muzaffer Kahyaoglu, Cevat Kirma, and Elnur Alizade
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medicine.medical_specialty ,Index (economics) ,In hospital mortality ,medicine.vein ,Acute decompensated heart failure ,business.industry ,Heart failure ,Internal medicine ,medicine ,Cardiology ,medicine.disease ,business ,Inferior vena cava - Published
- 2021
12. Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure
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Ali Karagöz, Busra Guvendi, Özgür Yaşar Akbal, Zübeyde Bayram, Rezzan Deniz Acar, Hacer Ceren Tokgoz, Süleyman Çağan Efe, Samet Uysal, Cem Doğan, Mehmet Kaan Kirali, Fatih Yilmaz, Nihal Özdemir, and Cihangir Kaymaz
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medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Non ischemic cardiomyopathy ,Medicine ,Hemodynamics ,End stage heart failure ,business - Abstract
Objectives: The aim of this study was to investigate the effect of heart failure (HF) etiology on clinical, echocardiographic, and hemodynamic findings, right ventricular (RV) function, and outcomes in patients with end-stage HF. Patients and Methods: A total of 470 end-stage HF patients who undergoing evaluation for heart transplantation (HT) were divided into two groups: ischemic cardiomyopathy (ICMP, n=249) and nonischemic cardiomyopathy (NICMP, n=221). RV dysfunction was defined as tricuspid annular plane systolic excursion (TAPSE) ≤1.5 cm (TAPSE-defined RV dysfunction) and right ventricular stroke work index (RVSWI) Results: Patients with ICMP had higher pulmonary vascular resistance, systolic and mean pulmonary artery pressures (PAPs and PAPm) than those with NICMP [3.0 (1.1-6.0) vs. 2.0 (1.0-5.0),P=0.013; 53.5 (42.0-68.0) vs. 46.0 (32.5-64.5),P Conclusion: We that demonstrated patients with end-stage HF, ICMP had greater RV afterload and RVSWI value than NICMP and HF etiology was not predictor of primary outcome. However, we couldn't say for sure whether HF etiology has an effect on RV function because of the conflicting results in TAPSE-defined RV dysfunction and RVSWI-defined RV dysfunction.
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- 2021
13. A tricuspid mitral valve with severe regurgitation
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Samet Uysal, Sedat Kalkan, and Alev Kılıçgedik
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Published
- 2022
14. Coronary artery thromboembolism: Unexpected presentation of left atrial myxoma covered with thrombus
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Ozkan Candan, Kadir Biyikli, Ayse Zehra Karakoc, Benay Erden, Gonca Gul Gecmen, and Samet Uysal
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Arterial embolism ,business.industry ,Myxoma ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,Internal medicine ,Ventricular fibrillation ,cardiovascular system ,Cardiology ,medicine ,Surgery ,cardiovascular diseases ,Myocardial infarction ,Presentation (obstetrics) ,Left Atrial Myxoma ,Thrombus ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Cardiac myxomas are benign primer cardiac tumors of the heart. They can be fatal with a thromboembolic presentation. Myocardial infarction is one of these unusual thromboembolic presentations. We report a patient who presented with cardiac arrest due to ventricular fibrillation related to myocardial infarction. After successful resuscitation, coronary angiography and transthoracic echocardiography were performed. A left atrial mass was observed and interpreted as a possible cause of coronary embolism leading to myocardial infarction. After surgical excision, the pathological examination confirmed myxoma, which was the essential cause of the tendency to arterial embolism.
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- 2020
15. A Calcified Unicommissural Unicuspid Aortic Valve: is it the trigger to the calcified amorphous tumor?
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Gonca Gecmen, Ender Özgün Çakmak, Samet Uysal, and Çetin Geçmen
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medicine.medical_specialty ,Stenosis ,Valvular calcification ,business.industry ,Amorphous calcification ,Internal medicine ,Unicommissural unicuspid aortic valve ,cardiovascular system ,medicine ,Cardiology ,Regurgitation (circulation) ,business ,medicine.disease - Abstract
Unicommissural unicuspid aortic valve (UAV) is a rare valvular malformation. It may lead to severe aortic stenosis with or without aortic regurgitation. UAVs have many characteristic changes such as premature dysmorphic valvular calcification and premature valvular dysfunction. Transesophageal echocardiography (TEE) was described as the gold standard for the diagnosis of UAVs. We reported the case of a 58 years old man who presented with syncope and dyspnea due to severe aortic stenosis secondary to a heavily calcified unicommissural UAV. After the surgery pathological specimen showed severe amorphous calcification just like a calcified amorphous tumor (CAT).
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- 2020
16. Monocyte to High-Density Lipoprotein Ratio Predicts Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome
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Ahmet Serdar Yilmaz, Ibrahim Vasi, Kamal Isgandarov, Taner Ulus, Fezan Mutlu, Muhammet Dural, and Samet Uysal
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medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Contrast-induced nephropathy ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Nephropathy ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,medicine ,030212 general & internal medicine ,Myocardial infarction ,neoplasms ,business.industry ,virus diseases ,Percutaneous coronary intervention ,Thrombolysis ,medicine.disease ,female genital diseases and pregnancy complications ,surgical procedures, operative ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with acute coronary syndrome (ACS). Early identification and intervention for patients with a high risk of CIN are very important to improve clinical outcomes. Inflammation plays important role in the development of CIN in the setting of ACS. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. Bleeding is also associated with worse prognosis in such patients. We aimed to investigate whether the preprocedural MHR had a predictive role for CIN development in such patients. In addition, using the thrombolysis in myocardial infarction classification, we aimed to assess whether there was any relationship between bleeding and CIN. A total of 647 patients (496 males; age: 63.3 ± 12.7 years) with ACS who underwent percutaneous coronary intervention (PCI) were included in the study. Seventy patients (10.8%) had developed CIN. Age, diabetes mellitus, contrast volume, estimated glomerular filtration rate, and MHR were independent predictors for CIN. Preprocedural MHR may be used as a simple marker of CIN. It may help with the early identification of patients with ACS who underwent PCI who are at high risk of CIN thus allowing the planning of protective measures.
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- 2018
17. The TAPSE/PASP ratio and MELD score in patients with advanced heart failure
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Nihal Özdemir, Rezzan Deniz Acar, Cem Doğan, Şencan Acar, Zübeyde Bayram, Aykun Hakgör, Cihangir Kaymaz, Özgür Yaşar Akbal, Ahmet Karaduman, and Samet Uysal
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Male ,medicine.medical_specialty ,Cardiac output ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Pulmonary Artery ,Severity of Illness Index ,End Stage Liver Disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Cyclophosphamide ,Heart transplantation ,Heart Failure ,Ischemic cardiomyopathy ,business.industry ,Central venous pressure ,Mean Aortic Pressure ,Stroke Volume ,Middle Aged ,medicine.disease ,Echocardiography, Doppler ,body regions ,Preload ,Blood pressure ,Heart failure ,Cardiology ,Ventricular Function, Right ,Cardiology and Cardiovascular Medicine ,business - Abstract
The aim of this study was to explore the relationship between the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure (TAPSE/PASP) ratio and model for end-stage liver disease (MELD) score in patients with advanced heart failure.A total of 103 patients with advanced heart failure evaluated for candidacy for heart transplantation were included in this study. TAPSE was measured by M‑mode echocardiography and cardiac catheterization was performed. TAPSE/ PASP ratio and MELD score were calculated.The median age of patients was 49 (40.5-54) years and the majority were male (92%). The percentage of patients with ischemic cardiomyopathy was 40%. The mean value of the group's MELD score was 10 ± 3.3 and the median value of TAPSE/PASP 0.24 (0.18-0.34). There was a moderate negative correlation between TAPSE/PASP and MELD score (r: -0.38, p 0.001). Right atrial pressure (RAP) and left ventricular end-diastolic pressure (LVEDP) were also negatively correlated with TAPSE/PASP (correlation coefficients were r: -0.562 and r: -0.575, respectively). In patients with a lower TAPSE/PASP ratio, MELD score, LVEDP and RAP were higher and tricuspid regurgitation was more severe, but there were no significant differences between cardiac output (CO) and mean aortic pressure (mean BP). The presence of ischemia was found to be an independent predictor for lower values of TAPSE/PASP.The lower TAPSE/PASP obtained on echocardiography may be a sign of the multi-organ failure defined as a high MELD score in patients with advanced heart failure.EINLEITUNG: Ziel dieser Studie war es, die Beziehung zwischen dem TAPSE/PASP-Verhältnis („tricuspid annular plane systolic excursion“/systolischer Pulmonalarteriendruck) und dem Model-for-end-stage-liver-disease(MELD)-Score bei Patienten mit fortgeschrittener Herzinsuffizienz zu untersuchen.Die Studie schloss insgesamt 103 Patienten mit fortgeschrittener Herzinsuffizienz ein, deren Anwartschaft auf eine Herztransplantation geprüft wurde. Die TAPSE wurde mithilfe der M‑Modus-Echokardiographie gemessen, und es erfolgte eine Herzkatheterisierung. Das TAPSE/PASP-Verhältnis und der MELD-Score wurden berechnet.Die Patienten hatten ein medianes Alter von 49 (40,5–54) Jahren und waren mehrheitlich männlich (92 %). Der Anteil der Patienten mit ischämischer Kardiomyopathie betrug 40 %. Der Mittelwert des MELD-Scores lag in der Gruppe bei 10 ± 3,3 und der Mittelwert des TAPSE/PASP-Verhältnisses bei 0,24 (0,18–0,34). Es fand sich eine mäßige negative Korrelation zwischen TAPSE/PASP und MELD-Score (r: −0,38, p 0,001). Der rechtsatriale (RA) Druck und der linksventrikuläre enddiastolische Druck (LVEDP) korrelierten ebenfalls negativ mit TAPSE/PASP (Korrelationskoeffizienten r: −0,562 bzw. r: −0,575). Bei Patienten mit einem niedrigeren TAPSE/PASP-Verhältnis waren MELD-Score, LVEDP und RA-Druck höher und die Trikuspidalklappeninsuffizienz schwerwiegender, es bestanden aber keine signifikanten Unterschiede in Bezug auf Herzzeitvolumen und mittleren Aortendruck (mittlerer Blutdruck). Eine bestehende Ischämie zeigte sich als unabhängiger Prädiktor für niedrige TAPSE/PASP-Werte.Das erniedrigte TAPSE/PASP-Verhältnis, wie es in der Echokardiographie ermittelt wurde, könnte ein Zeichen des Multiorganversagens, definiert als hoher MELD-Score, bei Patienten mit fortgeschrittener Herzinsuffizienz sein.
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- 2019
18. Comparison of 30-Day MACE between Immediate versus Staged Complete Revascularization in Acute Myocardial Infarction with Multivessel Disease, and the Effect of Coronary Lesion Complexity
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Ali Karagöz, Cem Doğan, Flora Özkalaycı, Ahmet Karaduman, emrah erdogan, Nihal Özdemir, Busra Guvendi, Murat Çap, Samet Uysal, Özgür Yaşar Akbal, Aykun Hakgör, Ahmet Cagri Aykan, Abdulkadir Uslu, Tuba Unkun, Cihangir Kaymaz, Rezzan Deniz Acar, and Zübeyde Bayram
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,Medicine (General) ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,multivessel coronary artery disease ,Coronary Artery Disease ,Postoperative Hemorrhage ,Revascularization ,Article ,Syntax score ,acute coronary syndrome ,Ventricular Dysfunction, Left ,Percutaneous Coronary Intervention ,R5-920 ,Risk Factors ,Internal medicine ,Myocardial Revascularization ,Medicine ,Humans ,Myocardial infarction ,cardiovascular diseases ,Aged ,Retrospective Studies ,Heart Failure ,business.industry ,Incidence ,Percutaneous coronary intervention ,General Medicine ,Coronary Lesion Complexity ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Hospitalization ,Treatment Outcome ,Heart failure ,Conventional PCI ,Multivariate Analysis ,Cardiology ,Regression Analysis ,ST Elevation Myocardial Infarction ,Female ,business ,Mace - Abstract
Background and objective: In patients with acute myocardial infarction and multivessel disease, the timing of intervention to non-culprit lesions is still a matter of debate, especially in patients without shock. This study aimed to compare the effect of multivessel intervention, performed at index percutaneous coronary intervention (PCI) (MVI-I) or index hospitalization (MVI-S), on the 30-day results of acute myocardial infarction (AMI), and to investigate the effect of coronary lesion complexity assessed by the Syntax (Sx) score on the timing of multivessel intervention. Materials and methods: We enrolled 180 patients with MVI-I, and 425 patients with MVI-S. The major adverse cardiovascular events (MACE) for this study were identified as mortality, nonfatal myocardial infarction, nonfatal stroke, acute heart failure, ischemia driven revascularization, major bleeding, and acute renal failure developed within 30 days. Results: The unadjusted MACE rates at 30 days were 11.2% and 5% among those who underwent MVI-I and MVI-S, respectively (OR 3.02, 95% confidence interval (CI) 1.51&ndash, 6.02, p=0.002). Associations were statistically significant after adjusting for covariates in the penalized multivariable model (adjusted OR 2.06, 95%CI 1.02&ndash, 4.18, p=0.043), propensity score adjusted multivariable model (adjusted OR 2.46, 95%CI 1.19&ndash, 5.07, p=0.015), and IPW (adjusted OR 2.11, 95%CI 1.28&ndash, 3.47, p=0.041). We found that the Syntax score of lesions did not affect the results. Conclusion: MVI-S was associated with a lower incidence of major adverse cardiovascular events within 30 days after discharge.
- Published
- 2019
19. Reply to the Letter to the Editor Entitled 'C-Reactive Protein-to-Albumin Ratio and Progression of Abdominal Aortic Aneurysm'
- Author
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Muhammed Keskin, Macit Kalçık, Uğur Arslantaş, Ayhan Kup, Sinan Cerşit, Ahmet Karaduman, Lütfi Öcal, Abdulkadir Uslu, Mustafa Ozan Gürsoy, Seçkin Dereli, Samet Uysal, Mehmet Muhsin Türkmen, and Emrah Bayam
- Subjects
medicine.medical_specialty ,Letter to the editor ,biology ,business.industry ,C-reactive protein ,Albumin ,medicine.disease ,Abdominal aortic aneurysm ,Text mining ,Internal medicine ,medicine ,biology.protein ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
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