Publications by authors named "Sefa Unal"

79 Publications

Severe COVID-19 and Retina: Are There Any Retinal Manifestations?

Klin Monbl Augenheilkd 2021 Sep 15. Epub 2021 Sep 15.

Infectious Diseases and Clinical Microbiology, Kayseri City Education and Research Hospital, Kayseri, Turkey.

Purpose: To investigate whether there are retinal lesions associated with severe COVID-19.

Methods: We studied 232 symptomatic subjects aged 18 - 65 years who had severe COVID-19 and had received treatment. The evaluations included ophthalmological examinations, optical coherence tomography (OCT), imaging modalities with near infrared reflectance (NIR), fundus autofluorescence (FAF), and fundus photography (FP).

Results: The mean age of the patients was 49 years, and 67.6% of them were men. There were no findings of microhemorrhage, cotton wool spots (CWS), vitritis, or retinitis in the examination and imaging.

Conclusions: This study indicates that retinal involvement as a complication associated with COVID-19 is questionable, although some reports have demonstrated a relationship that may occur secondary to existing systemic diseases.
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http://dx.doi.org/10.1055/a-1525-2420DOI Listing
September 2021

Monocyte-to-HDL-cholesterol ratio is associated with Ascending Aorta Dilatation in Patients with Bicuspid Aortic Valve.

Afr Health Sci 2021 Mar;21(1):96-104

Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara/Turkey.

Background: The importance of monocyte count-to-HDL-cholesterol ratio (MHR) in cardio- vascular diseases has been shown in various studies. Ascending aortic dilatation (AAD) is a common complication in the patients with bicuspid aortic valve. In this study, we aimed to investigate the relationship between MHR and the presence of aortic dilatation in the patients with bicuspid aortic valve.

Methods: The study population included totally 347 patients with bicuspid aortic valve.169 patients with aortic dilatation (ascending aorta diameter ≥ 4.0 cm) and 178 patients with no aortic dilatation. Echocardiographic and laboratory measurement was done and compared between groups.

Results: The mean age of the participants was 44.7 ± 15.4 years and average ascending aorta diameter was 3.2 ± 0.3 cm in dilatation negative group and 4.4 ± 0.4 cm in positive group. MHR was significantly increased in in patients with aortic dilatation. MHR and uric acid level was independently associated with the presence of aortic dilatation in the patients with bicuspid aortic valve.

Conclusion: We found a significant relationship between MHR and aortic dilatation in the patients with bicuspid aortic valve.
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http://dx.doi.org/10.4314/ahs.v21i1.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356613PMC
March 2021

Effect of chelation therapy on arrhythmogenic and basal ECG parameters of lead exposed workers.

Arch Environ Occup Health 2021 Apr 10:1-7. Epub 2021 Apr 10.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

Lead exposure has etiological role on cardiovascular system diseases as hypertension, atherosclerosis, stroke, and arrhythmic events. In this study, we aimed to compare the basal and arrhythmogenic ECG parameters of lead exposed workers before and after chelation therapy and to evaluate the effect of acute change of blood lead levels on ECG. Fourty consecutive occupationally lead exposed workers were enrolled, demographic, blood, echocardiographic, and electrocardiographic data's were analyzed before and after chelation therapy. Pmax, P min, P Wave Dispersion, and QT Dispersion values which are arrhythmia predictors were significantly lower after chelation therapy compared to values before chelation therapy. Lead exposed workers are under the risk of ventricular and atrial arrythmias and chelation treatment has a positive effect on these parameters.
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http://dx.doi.org/10.1080/19338244.2021.1910116DOI Listing
April 2021

CAR and SYNTAX Scores in Patients With STEMI.

Angiology 2021 08 2;72(7):696. Epub 2021 Feb 2.

Department of Cardiology, 536164Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319721991734DOI Listing
August 2021

Is Ventricular Arrhythmias the End for All Conditions?

Med Princ Pract 2021 13;30(3):297-298. Epub 2021 Jan 13.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1159/000514379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280432PMC
July 2021

Glypican-6 Level and Ejection Fraction.

Angiology 2021 07 11;72(6):589. Epub 2020 Dec 11.

Department of Cardiology, 146995Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319720979237DOI Listing
July 2021

Relationship between CHA2DS2-VASc and CHADS2 scores with pulmonary hypertension in patients with acute pulmonary embolism.

Adv Respir Med 2019 ;87(6):203-208

Saglik Bilimleri Universitesi Bilkent Şehir Hastanesi, Ankara, Turkey.

Introduction: Pulmonary hypertension (PH) is the most important prognostic factor after acute pulmonary embolism (PE). Therefore, determination of patients who will develop PH after acute PE is crucial. The aim of the present study was to evaluate the predictive value of the CHADS2 and CHA2DS2-VASc scores for PH in patients with acute PE.

Material And Methods: Seventy-nine adults who presented with acute PE, had an admission systolic pulmonary artery pressure (sPAP) measured on echocardiogram and no previous history of PE, were retrospectively identified from the computerized database. 31 patients who had sPAP ≤ 40 mm Hg were categorized as a "normal pulmonary pressure" group, whereas 48 patients who had sPAP > 40 mm Hg were categorized as a "PH" group.

Results: SPAP was > 40 mm Hg in 48 patients (60.8%), with a mean sPAP of 60.9 ± 16.1 mm Hg (median = 60, min-max = 41-100 mm Hg). In multivariate logistic regression models adjusted for CHADS2 and CHA2DS2-VASc score components, only age was found to be related with the development of PH. SPAP was weakly positively correlated with CHADS2 (p = 0.047; r = 0.224) and CHA2DS2-VASc (p = 0.023; r = 0.256) scores. SPAP values were increasing with the severity of the scores.

Conclusions: Both CHADS2 and CHA2DS2-VASc scores could be useful in the determination of which patients should be closely followed up in order to prevent the development of PH after acute PE.
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http://dx.doi.org/10.5603/ARM.2019.0057DOI Listing
July 2020

Diurnal rhythm of blood pressure in patients with polycythemia vera.

Blood Press Monit 2020 Apr;25(2):69-74

Hematology, Ankara City Hospital, Ankara, Turkey.

Aims: Polycythemia vera increases the risk of hypertension, but there is limited information about the effect on daily blood pressure fluctuations. This study aimed to demonstrate how diurnal blood pressure rhythm is affected in polycythemia vera patients.

Methods: Fifty (50) patients (33 men; mean age 48 ± 15 years) with a diagnosis of polycythemia vera and 51 age and sex-matched healthy subjects for the control group were prospectively evaluated. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated by ambulatory blood pressure monitoring (ABPM) as average 24-hour, daytime and nighttime measures.

Results: Average 24-hour SBP and DBP, daytime SBP and DBP were similar in both groups. However, nighttime SBP and DBP were significantly higher in the polycythemia vera group compared with the control group (125.3 ± 17.2 and 73.7 ± 12.2 vs. 118.9 ± 12.2 and 69.5 ± 8.5; P = 0.034 and P = 0.044). Both nocturnal SBP fall and nocturnal DBP fall were blunted in the polycythemia vera group compared with the control group (-6.9 ± 8.9 and -11.3 ± 12.2 vs. -11.6 ± 7.7 and -16.3 ± 12.0, respectively). Both hemoglobin and hematocrit levels were positively correlated with nocturnal SBP fall (r = 0.306, P = 0.002 and r = 0.355, P < 0.001; respectively) in all patients.

Conclusion: We found that the polycythemia vera group had significantly decreased nocturnal dipping compared with healthy controls. The SBP fall was also positively correlated with hemoglobin and hematocrit levels.
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http://dx.doi.org/10.1097/MBP.0000000000000427DOI Listing
April 2020

Gender and age differences in patients with atrial fibrillation referred for catheter ablation.

Pacing Clin Electrophysiol 2020 01 22;43(1):158. Epub 2019 Dec 22.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1111/pace.13851DOI Listing
January 2020

Anticoagulants and No-Reflow.

Angiology 2020 02 17;71(2):192. Epub 2019 Jul 17.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319719863996DOI Listing
February 2020

γ-Glutamyltransferase Subtype and Major Adverse Cardiac Events.

Angiology 2020 03 15;71(3):292. Epub 2019 Jul 15.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319719862961DOI Listing
March 2020

Nicorandil and Contrast-Induced Nephropathy.

Angiology 2020 02 11;71(2):189. Epub 2019 Jun 11.

Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319719855156DOI Listing
February 2020

Atherosclerosis and Arrhythmias in Patients With HIV.

Angiology 2019 05 18;70(5):469. Epub 2018 Nov 18.

1 Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718812741DOI Listing
May 2019

The Relationship between Nesfatin-1 Levels and SYNTAX Score in Patients with Non-ST Segment Elevation Myocardial Infarction.

Acta Cardiol Sin 2018 Sep;34(5):386-393

Department of Nutrition and Dietetics, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.

Objective: Nesfatin-1 is a novel anorectic neuropeptide with potent metabolic regulatory effects. It regulates blood pressure, heart rate, cardiomyocyte metabolism and permeability. SYNTAX score, which is an angiographic scoring system, defines the grade and complexity of coronary artery disease (CAD). We aimed to evaluate the relationship between nesfatin-1 level and severity of CAD according to the SYNTAX score in patients with non-ST segment elevation myocardial infarction (NSTEMI).

Methods: A total of 109 subjects were enrolled into the study, of whom 80 underwent coronary angiography (CA) with the diagnosis of NSTEMI and 29 had normal coronary arteries detected in CA. NSTEMI patients were divided into 2 groups: low SYNTAX score (< 32) (45 patients) and high SYNTAX score (≥ 32) (35 patients).

Results: The NSTEMI patients with a high SYNTAX score (score ≥ 32) had a lower serum nesfatin-1 level (62 pg/ml; 39-98) compared to the NSTEMI patients with a low SYNTAX score (score < 32) (138 pg/ml; 65-286) and the control group (392 pg/ml; 178-1320). There was also a negative correlation between serum nesfatin-1 level and SYNTAX score (r = -0.594, p < 0.001). A lower serum level of nesfatin-1 (odds ratio = 0.116; 95% confidence interval: 0.138- 0.094; p < 0.001) was an independent predictor for high SYNTAX score in the NSTEMI patients after multiple linear regression analysis.

Conclusions: Serum nesfatin-1 level was lower in the high SYNTAX group than in the low SYNTAX group in patients with NSTEMI. Nesfatin-1could have a role in the pathogenesis of atherosclerotic burden in patients with NSTEMI.
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http://dx.doi.org/10.6515/ACS.201809_34(5).20180423ADOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160508PMC
September 2018

Advantages and Pitfalls of the Glycated Hemoglobin A1c Measurement in Acute Coronary Syndrome: Start Simple, Evolve to More Sophisticated.

Angiology 2019 02 19;70(2):182-184. Epub 2018 Sep 19.

1 Department of Cardiology, Health Sciences University, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718800570DOI Listing
February 2019

Cerebrovascular Events in Stenting for Carotid Artery Stenosis.

Angiology 2019 02 19;70(2):187. Epub 2018 Sep 19.

1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718801086DOI Listing
February 2019

SYNTAX Score and Severity of Atherosclerosis.

Angiology 2019 07 19;70(6):567. Epub 2018 Sep 19.

1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718802051DOI Listing
July 2019

The association between cardiac resynchronization therapy response and sexual activity in patients with heart failure.

Hellenic J Cardiol 2020 Jan - Feb;61(1):34-39. Epub 2018 Aug 28.

Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey. Electronic address:

Background: Sexual activity is an important indicator of quality of life and is significantly impaired in patients with heart failure (HF). Cardiac resynchronization therapy (CRT) has positive effects on cardiac dysfunction and endothelial dysfunction that lead to erectile dysfunction (ED). We aimed to evaluate whether CRT may improve sexual activity in patients with HF.

Methods: In total, 136 patients (mean age 61.8 ± 12.8 years) were evaluated for the study. All patients filled the Sexual Health Inventory for Men (SHIM) questionnaire for evaluation of their erectile functions before CRT device implantation. One hundred eighty days after CRT device implantation, the patients were re-evaluated with SHIM questionnaire.

Results: In the whole study population, SHIM test scores were significantly increased after CRT (12.99 ± 3.22 vs. 18.03 ± 5.00; p<0.001). The patients were divided into two groups according to the CRT response. The increase in SHIM test scores was significantly more in the response (+) group than in the response (-) group [response (+) group: 6.94 ± 3.36; p<0.001 vs. response (-) group: 0.81 ± 1.77; p = 0.465]. A positive CRT response was found to be an independent predictor of SHIM score (p<0.001).

Conclusion: Our study showed that CRT had positive effects on ED of patients with HF.
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http://dx.doi.org/10.1016/j.hjc.2018.08.005DOI Listing
April 2021

Inflammation Parameters in Aortic Aneurysm.

Angiology 2019 03 22;70(3):280. Epub 2018 Jul 22.

Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718789324DOI Listing
March 2019

Giant Aneurysm of the Left Main Coronary Artery: A Case Report.

J Tehran Heart Cent 2018 Jan;13(1):35-37

Department of Cardiology, Yuksek Ihtisas Heart-Research and Education Hospital, Ankara, Turkey.

Coronary artery aneurysms are rare findings in patients referred for coronary angiography. Their prevalence ranges between 0.2% and 6% in different case series. We describe a male patient with a huge left main coronary artery aneurysm causing exertional angina, which was diagnosed with coronary angiography. All of the left coronary system arose from the aneurysm. He underwent coronary angiography again, followed by multislice computed tomography with a three-dimensional reconstruction. Although there is no known standard treatment modality for such aneurysms, we planned medical therapy after consultation with the cardiovascular surgery department. The patient's first visit was in March 2013, and he was thereafter followed up until September 2016.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037631PMC
January 2018

Infection Status Can Affect White Blood Cell Parameters.

Angiology 2019 08 26;70(7):676. Epub 2018 Jun 26.

1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.

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http://dx.doi.org/10.1177/0003319718784412DOI Listing
August 2019
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