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Öğe Accessory mitral valve tissue: anatomical and clinical perspectives(Elsevier Science Inc, 2021) Yetkin, Ertan; Cuglan, Bilal; Turhan, Hasan; Yalta, KenanMitral valve is a complex cardiac structure composed of several components to work in synchrony to allow blood flow into left ventricle during diastole and not to allow blood flow into left atrium during systole. Accessory mitral valve tissue (AMVT) was defined as existence of any additional part and parcel of valvular structure which has an attachment to normal mitral valve apparatus in left-sided cardiac chambers. AMVT may present itself in different clinical circumstances ranging from a silent clinical course to thromboembolic events, heart failure, left ventricular outflow tract obstruction, and severe arrhythmia. This article reviews the clinical perspectives of AMVT in terms of symptoms, diagnosis, and treatment, providing a new anatomical classification regarding the location of AMVT. Briefly type I refers to AMVT having attachments on the supra leaflets level, type II refers to attachments on the mitral leaflets, and type III refers to attachment below the mitral leaflets. Increased awareness and widespread use of echocardiographic techniques would increase recognition of AMVT in patients with heart murmurs but otherwise healthy and in those with left ventricular outflow tract obstruction or tissue which causes subaortic stenosis and with unexplained cerebrovascular events. (C) 2020 Elsevier Inc. All rights reserved.Öğe Atrial septal aneurysm and cryptogenic stroke: an arrhythmic approach to pathophysiology(Hygeia Press Corridori Marinella, 2023) Yetkin, Ertan; Atmaca, Hasan; Cuglan, Bilal; Yalta, KenanIn patients with cryptogenic strokes, more attention should be paid to the possible existence of paroxysmal atrial fibrillation, especially in those with atrial septal aneurysm with or without patent foramen ovale.Öğe Ignored Role of Paroxysmal Atrial Fibrillation in the Pathophysiology of Cryptogenic Stroke in Patients with Patent Foramen Ovale and Atrial Septal Aneurysm(Bentham Science Publ Ltd, 2024) Yetkin, Ertan; Atmaca, Hasan; Cuglan, Bilal; Yalta, KenanThe association between cryptogenic stroke (CS) and patent foramen ovale (PFO) with or without atrial septal aneurysm (ASA) has been a debate for decades in terms of pathophysiologic processes and clinical courses. This issue has become more interesting and complex, because of the concerns associating the CS with so-called normal variant pathologies of interatrial septum, namely ASA and PFO. While there is an anatomical pathology in the interatrial septum, namely PFO and ASA, the embolic source of stroke is not clearly defined. Moreover, in patients with PFO and CS, the risk of recurrent stroke has also been associated with other PFO-unrelated factors, such as hyperlipidemia, body mass index, diabetes mellitus, and hypertension, leading to the difficulty in understanding the pathophysiologic mechanism of CS in patients with PFO and/or ASA. Theoretically, the embolic source of cryptogenic stroke in which PFO and/or ASA has been involved can be categorized into three different anatomical locations, namely PFO tissue and/or ASA tissue itself, right or left atrial chambers, and venous vascular territory distal to the right atrium, i.e., inferior vena cava and lower extremity venous system. However, the possible role of paroxysmal atrial fibrillation associated with PFO and/or ASA as a source of cryptogenic stroke has never been mentioned clearly in the literature. This review aims to explain the association of cryptogenic stroke with PFO and/or ASA in a comprehensive manner, including anatomical, clinical, and mechanistic aspects.The potential role of paroxysmal atrial fibrillation and its contribution to clinical course have been also discussed in a hypothetical manner to elucidate the pathophysiology of CS and support further treatment modalities.Öğe Pelvic congestion syndrome, migraine and dilating venous disease: Interesting but not surprising(Sage Publications Inc, 2023) Yetkin, Ertan; Atmaca, Hasan; Cuglan, Bilal; Yalta, Kenan[Abstract Not Available]Öğe Pigmented purpuric dermatosis-ecchymosis and chronic venous disease(Sage Publications Inc, 2023) Yetkin, Ertan; Atmaca, Hasan; Cuglan, Bilal; Yalta, Kenan[Abstract Not Available]Öğe Systolic Blood Pressure to Diastolic Blood Pressure Ratios in Diabetic and Non-diabetic Patients: Deviation from Golden Ratio(Adis Int Ltd, 2022) Atmaca, Hasan; Cuglan, Bilal; Yalta, Kenan; Yetkin, ErtanIntroduction Cardiovascular measures like, systolic to diastolic time intervals on ECG recordings, end-diastolic to end-systolic diameters of the left ventricle on echocardiography, pulmonary and systemic hemodynamic measures have gained an interest in terms of Golden ratio or Golden proportions. Ratio of SBP to DBP as a reflection of GR has been recently evaluated in patients who have undergone ABPM to assess the presence of hypertension. Aim To assess and compare the ratios of SBP to DBP as a reflection of GR in 24 h ABPM recordings in patients with and without DM who were not on medical treatment. Methods Six hundred and thirty two patients who underwent ABPM were retrospectively screened and enrolled in the study population in between October 2020 and March 2021. After exclusion of 378 who did not meet the inclusion criteria, 254 patients were enrolled in statistical analysis. Systolic blood pressure and diastolic blood pressure measurements were also averaged for the day and the night spans according to the patients' reported time of waking up and going to bed. The ABPM was programmed to measure blood pressure every 45 min during both the day time and night time periods Results Among those 254 patients included in statistical analysis, 212 patients were classified as non-diabetic and 42 patients as diabetic. SBP/DBP ratios were significantly higher in diabetics compared to those of non-diabetics in all time spans (1.698 vs 1.631, p = 0.041 for 24 h; 1.689 vs 1.618 p = 0.032 for day-time; 1.74 vs 1.66 p = 0.037 for night time). In non-diabetic patients interestingly day time SBP/DBP gave almost the same value of GR i.e 1.618, likewise the 24 h value of SBP/DBP gave the value of 1.631 which was so close to GR. On the other hand SBP/DBP ratios for all time spans were deviated far from the 1.618 in diabetic patients Conclusion We have shown that systolic to diastolic blood pressure ratios of patients with DM are significantly higher than those without DM. These differences are mainly to due to the lower DBP of diabetic patients compared to non-diabetic patients. Beyond these differences SBP/DBP ratio of non-diabetic patients has shown close proximity to 1.618 known as golden ratio.Öğe Uterine fibroids in hypertension and pregnancy(Lippincott Williams & Wilkins, 2021) Cuglan, Bilal; Atmaca, Hasan; Yalta, Kenan; Yetkin, Ertan[Abstract Not Available]Öğe Where cystatin C acts: inside or outside of the plaque(Springer-Verlag Italia Srl, 2020) Yetkin, Ertan; Cuglan, Bilal; Turhan, Hasan; Yalta, Kenan[Abstract Not Available]
