Publications by authors named "Emrah Aksakal"

15 Publications

  • Page 1 of 1

An investigation into hemodynamically significant coronary artery lesions predictors assessed by fractional flow reserve: A propensity score matching analysis.

North Clin Istanb 2020 10;7(1):35-39. Epub 2019 Mar 10.

Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Objective: Fractional flow reserve (FFR) provides more useful information regarding myocardial metabolism and demand-supply convenience as compared to anatomical measurements. In this study, we aimed to investigate FFR predictors after propensity score matching (PSM) analysis in patients with intermediate coronary lesions.

Methods: Patients who underwent coronary angiography between January 2014 and March 2015 due to suspicion of coronary artery disease were included in this study. Patients were divided into two groups according to the FFR status and predictors of FFR before and after PSM analysis were investigated.

Results: A total of 290 patients (a total of 310 lesions) were included in this study (61±12 years, 75.5% male). In univariate analysis, after PSM analysis, Diameter stenosis (DS) and proximal LAD lesion (PLL) were associated with lower FFR values.

Conclusion: This study indicated that the majority of traditional FFR predictors did not reach the limit of significance after PSM analysis and we suggest that DS and PLL are one step ahead of predicting lesion severity compared to other traditional risk factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/nci.2019.79058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103741PMC
March 2019

Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality.

Anatol J Cardiol 2020 Feb;23(3):160-168

Department of Cardiology, Faculty of Medicine, Hacettepe University; Ankara-Turkey.

Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided.

Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM.

Results: There were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7-17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores ≤1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year.

Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 year.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14744/AnatolJCardiol.2019.87894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222636PMC
February 2020

Assessment of right ventricular dysfunction in patients with mitral stenosis: A speckle tracking study.

J Clin Ultrasound 2020 Jun 3;48(5):269-274. Epub 2019 Dec 3.

Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey.

Purpose: Although it is affected at an early stage, there is a lack of studies investigating right ventricular (RV) function in patients with mitral stenosis (MS). We aimed to investigate the correlation between conventional echocardiographic variables and tricuspid annular plane systolic excursion (TAPSE), used as an indicator of RV dysfunction.

Methods: We enrolled 59 consecutive patients with MS and assigned them in group 1 if TAPSE ≤16, or group 2 if: TAPSE >16.

Results: The mean age of the patients was 42.2 ± 8 years, and 74.6% were females. In univariate analysis, maximal mitral valve gradient, mean mitral valve gradient, systolic pulmonary arterial pressure, RV strain, and RV strain rates were associated with RV dysfunction. In multivariate analysis, both strain variables were found to be independent predictors of RV dysfunction. Kaplan Maier survival analysis showed that patients with lower RV strain had more rehospitalization rate during the one-year follow-up period.

Conclusions: RV dysfunction is common in patients with MS and is associated with higher rehospitalization rate and morbidity. Evaluation of RV strain and strain rate for early detection of RV dysfunction and prediction of rehospitalization may be an appropriate approach in mitral stenosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcu.22798DOI Listing
June 2020

Hemodynamic Stability and Contrast Nephropathy Development in Patients With Acute Myocardial Infarction.

Angiology 2020 03 10;71(3):289. Epub 2019 Sep 10.

Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003319719873805DOI Listing
March 2020

The role of the right atrium in development of postoperative atrial fibrillation: A speckle tracking echocardiography study.

J Clin Ultrasound 2019 Oct 17;47(8):470-476. Epub 2019 May 17.

Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Purpose: Atrial fibrillation (AF) is relatively frequent in the postoperative period, and is associated with an increased frequency of adverse events. The role of right atrial (RA) volume and functions in the development of AF is unknown. In this study, we investigated the effect of RA echocardiographic indices on AF development in the postoperative period.

Method: We enrolled 142 consecutive patients who underwent coronary artery bypass surgery, and assigned them into two groups depending on the occurrence or not of AF development in the postoperative period.

Results: A propensity score matching analysis was performed to balance the groups, and 37 pairs were eventually included in the analysis. The median age was 67.5 (63-75) years and 73.3% of them were males. In the univariate analysis, right atrial volume index (RAVi), right atrial strain during reservoir phase (RASr), left ventricular global longitudinal strain, right ventricular strain, left atrial volume index, left atrial strain during reservoir phase, and systolic pulmonary artery pressure were associated with AF development. In the regression analysis, we found that RAVi (OR: 3.1, 95% CI: 2.2-6.3, P: .033) and RASr (OR: 0.82, 95% CI: 0.67-0.93, P: .048) were independent predictors of AF development.

Conclusions: RA structure and functions are closely associated with AF development in the postoperative period, and screening of RA functions prior to surgery may be useful for preventing AF development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcu.22736DOI Listing
October 2019

Acute cardiac effects of high dose steroid treatment: A speckle tracking echocardiography study.

J Clin Ultrasound 2019 Jul 20;47(6):351-355. Epub 2019 Feb 20.

Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Purpose: High-dose steroid therapy (HDST) has frequent side-effects that appear at its cessation and depend on its dose. However, there is a lack of studies about the acute effects of HDST on cardiac function in adult patients.

Methods: We included in this study 30 patients who underwent HDST (intravenously at doses ranging from 250 to 1000 mg) and 30 healthy control subjects with similar demographic and clinical characteristics, between September and December 2016. Echocardiographic measurements were made before and during the first 3 hours after the end of treatment, and results were compared between patients and controls.

Results: There was no difference in baseline biochemical and echocardiographic characteristics between the patient and control groups. While left ventricular global longitudinal strain (LVGLS) and strain rate E were higher after treatment, no significant change was observed in conventional echocardiographic variables.

Conclusions: LVGLS, but not conventional echocardiographic variables, showed an increase in cardiac systolic function at the acute phase of HDST.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcu.22716DOI Listing
July 2019

Endocan and Major Adverse Cardiovascular Events: Understanding Regression Methods.

Angiology 2019 11 10;70(10):982. Epub 2019 Feb 10.

1 Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003319719828911DOI Listing
November 2019

The association between CRP / Albumin ratio and in-stent restenosis development in patients with ST-segment elevation myocardial infarction.

J Clin Lab Anal 2019 May 8;33(4):e22848. Epub 2019 Feb 8.

Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey.

Background: Although interventional methods are the first-line treatment options in ST-segment elevation myocardial infarction (STEMI), the incidence of stent restenosis (SR) is frequent. We investigated the relationship between CRP/albumin ratio (CAR), a novel indicator of inflammatory response, and SR in this study.

Method: This study was carried out on the patients who underwent coronary angiography in our clinic between January 2017 and September 2017. Two groups were generated according to restenosis status (group 1: restenosis (-), group 2: restenosis (+)), and clinical biochemical and angiographical features were compared. As baseline demographic and angiographic characteristics are slightly different in two groups, propensity score matching analysis was performed to reduce bias. 45 SR patients were matched on a 1:1 basis were enrolled final cohort.

Results: The mean age of the patients was 55 ± 5.1 and 80% were male; Cox regression model was performed to demonstrate independent predictor of restenosis development; and during the one-year follow-up period, CAR (P < 0.001) was found an independent predictor of SR CONCLUSION: In this study, we demonstrate that there may be a strong relationship between SR development and CAR. We implied that inflammatory reaction may be an important diagnostic tool for prediction of SR development in STEMI patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jcla.22848DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6528603PMC
May 2019

Evaluation of ventricular repolarization parameters during migraine attacks.

J Electrocardiol 2019 Mar - Apr;53:66-70. Epub 2018 Dec 21.

Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey.

Aims: Migraine is a chronic neurovascular disorder characterized by intermittent episodes of severe headache. Abnormalities in the autonomic nervous system (sympathetic and parasympathetic nervous systems) have been detected during migraine-free periods in patients with migraine. In these patients, disrupted autonomic innervations of the heart and coronary arteries may lead to electrocardiographic changes during a migraine attack. T-wave peak-to-end interval (Tp-e interval) and Tp-e/QT ratio are relatively new markers of ventricular arrhythmogenesis and repolarization heterogeneity. In the present observational study, we investigated the changes in ventricular repolarization during migraine attacks and attack-free periods by performing 12‑lead electrocardiography (ECG).

Methods: This study included 63 patients (54 [86%] women; mean age: 33.3 ± 9.9 years) with migraine. The QT and corrected QT (QTc) intervals, Tp-e interval, and Tp-e/QT ratio of the patients during migraine attacks and attack-free periods were measured by performing 12‑lead ECG.

Results: The QT and QTc intervals, Tp-e interval, and Tp-e/QT ratio were higher during migraine attacks than during attack-free periods (P < 0.001 for all).

Conclusion: These results indicate that migraine attacks are associated with an increase in ventricular repolarization parameters compared with attack-free periods possibly because of the dysregulation of the autonomic nervous system.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jelectrocard.2018.12.014DOI Listing
July 2020

Long-Term Mortality and Contrast-Induced Nephropathy.

Angiology 2019 09 7;70(8):783. Epub 2019 Jan 7.

2 Department of Cardiology, Atatürk University, Erzurum, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003319718823628DOI Listing
September 2019

Evaluating the Association Between the Three Different Ejection Fraction Measurement Techniques and Left Ventricle Global Strain.

Eurasian J Med 2018 Oct;50(3):173-177

Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey.

Objective: The prognosis of cardiovascular diseases (CVDs) is directly associated with systolic function based on the measurement of ejection fraction (EF), and many studies have indicated that the left ventricular global strain (LVGS) provides better predictivity than the EF measurement in the diagnosis, prognosis, survival, and CVD staging. However, these studies did not investigate the correlation between the EF measurement and the LVGS parameters, or which parameters are better correlated with LVGS, but we analyzed the association between three EF measurement methods and LVGS.

Materials And Methods: This study included 62 patients that applied to the clinic between October 2015 and March 2016. An echocardiography examination of these patients was performed. The exclusion criteria were atrial fibrillation and suboptimal image quality.

Results: Sixty-two patients (the average age 61.0±12.6 years; 56% male and 44% female) were enrolled in the study. A statistically significant association was found between the visual EF and Simpson EF measurements and the LVGS parameters (p<0.001). While the visual EF was moderately correlated with the LVGS parameters (r=0.44), there was a good correlation between the Simpson EF and the LVGS parameters (r=0.710).

Conclusion: In this study, we demonstrate that the Simpson's rule LVEF correlates better with LVGS than the Teicholtz method or visual EF and that it has a better area under the curve value for determining an abnormal LVGS. Therefore, we recommend the use of the Simpson EF for the EF measurement that has a better correlation with the LVGS values in the patients whose ventricle functions should be evaluated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/eurasianjmed.2018.17409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263235PMC
October 2018

The effect of dialysis type on left atrial functions in patients with end-stage renal failure: A propensity score-matched analysis.

Echocardiography 2018 03 11;35(3):308-313. Epub 2017 Dec 11.

Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey.

Introduction: Despite the widespread use of both hemodialysis (HD) and peritoneal dialysis (PD), there is no study comparing the effects of these dialysis methods on the left atrial (LA) volume and functions. In this study, we investigated the impact of different dialysis methods on the LA volume and function in the patients exposed to chronic pressure overload and volume overload.

Method: This study was carried out on the patients who received dialysis treatment at our healthcare center between March, 2015 and January, 2016. Twenty-eight patients receiving hemodialysis (HD) treatment and 24 patients under PD treatment were enrolled into the study. Patients were divided into 2 groups according to the dialysis therapy, and the atrial volumetric and mechanical functions were investigated.

Results: As the basal demographical characteristics of patients in the PD and HD groups were significantly different, 44 patients matched on a 1:1 basis were taken for final analysis (22 HD, 22 PD, and the average age of 42.4 ± 4.8; 73% was male). After propensity score matching analysis, it was determined that left atrial volume index (LAVi) was higher in the HD group while peak LA strain and LA contraction strain were higher in the PD group. Additionally, both strain parameters showed a good negative correlation with LAVi.

Conclusion: We demonstrated that the left atrial structure and functions were better in the PD group suggesting that PD may be a relatively better option for the preservation and maintenance of the left atrial functions as compared to HD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/echo.13774DOI Listing
March 2018

Comparison of the three conventional methods for the postoperative atrial fibrillation prediction.

Echocardiography 2017 Jun 6;34(6):831-834. Epub 2017 Apr 6.

Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey.

Introduction: Although various risk factors have been defined for the development of postoperative atrial fibrillation (PAF), these parameters have not been adequately verified and validated. We investigated the atrial fibrillation detection capabilities of echocardiographic parameters in PAF developing and the determination of predictive values for clinical use.

Method: We enrolled 60 consecutive patients with 234 lesions who underwent CABG surgery. All patients underwent preoperative echocardiographic evaluation. Patients were divided into two groups according to PAF development status.

Results: The mean age of the patients was 67, and 73% were male and PAF occurred in 19 patients. In univariate analysis, left atrial volume index (LAVi), left ventricular global strain (LVGS) and ejection fraction were associated with PAF development. Parameters which were significant in univariate analysis were included in a logistic regression model to determine the independent predictors of PAF. LAVi was found to be an independent predictor of PAF.

Conclusion: Although several parameters have been defined for PAF development, LAVi is more advantageous than the other conventional methods in clinical decision making.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/echo.13535DOI Listing
June 2017

The Risk of Atrial Fibrillation With Ivabradine Treatment: A Meta-analysis With Trial Sequential Analysis of More Than 40000 Patients.

Clin Cardiol 2016 Oct 11;39(10):615-620. Epub 2016 Aug 11.

Department of Cardiology, Kosuyolu Heart Hospital, Istanbul, Turkey.

Recent trials reported that risk of atrial fibrillation (AF) is increased in patients using ivabradine compared with controls. We performed this meta-analysis to investigate the risk of AF association with ivabradine treatment on the basis of data obtained from randomized controlled trials (RCTs). We searched PubMed, EMBASE, Scopus, and the Cochrane Library for RCTs that comprised >100 patients. The incidence of AF was assessed. We obtained data from European Medicines Agency (EMA) scientific reports for the RCTs in which the incidence of AF was not reported. We used trial sequential analysis (TSA) to provide information on when we had reached firm evidence of new AF based on a 15% relative risk increase (RRI) in ivabradine treatment. Three RCTs and 1 EMA overall oral safety set (OOSS) pooled analysis (included 5 RCTs) were included in the meta-analysis (N = 40 437). The incidence of AF was 5.34% in patients using ivabradine and 4.56% in placebo. There was significantly higher incidence of AF (24% RRI) in the ivabradine group when compared with placebo before (RR: 1.24, 95% confidence interval: 1.08-1.42, P = 0.003, I 1980 = 53%) and after excluding OOSS (RR: 1.24, 95% confidence interval: 1.06-1.44, P = 0.008). In the TSA, the cumulative z-curve crossed both the traditional boundary (P = 0.05) and the trial sequential monitoring boundary, indicating firm evidence for ≥15% increase in ivabradine treatment when compared with placebo. Study results indicate that AF is more common in the ivabradine group (24% RRI) than in controls.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/clc.22578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490712PMC
October 2016

The paradox of uric acid in cardiovascular diseases.

Angiology 2014 Mar 15;65(3):232-3. Epub 2013 Dec 15.

1Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003319713506515DOI Listing
March 2014