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Öğe Comparison of the TIMI Frame Count in Dipper and Non-Dipper Hypertensive Patients with Normal Coronary Arteries(Elsevier Science Inc, 2013) Aksir, Ercan; Samsa, Murat; Aydin, Fatih; Yilmaztepe, Mustafa Adem; Ozcelik, Fatih[Abstract Not Available]Öğe Diagnostic value of plasma fibronectin level in predicting the presence and severity of coronary artery disease(Springer, 2009) Ozcelik, Fatih; Erdogan, Okan; Aktoz, Meryem; Ekuklu, Galip; Tatli, Ersan; Demir, MuzafferThe relation between fibronectin and coronary artery disease (CAD) according to previous study results is controversial. The aim of the present study is to investigate the predictive value of fibronectin in determining the presence and severity of CAD. Patients with stable angina (n = 62) who had angiographically documented CAD, and control patients (n = 31) who had normal coronary angiograms, were included in the study. Plasma fibronectin levels were determined in all patients. Plasma fibronectin level (milligrams per liter) in patients with CAD was higher than normal controls (364.2 +/- 171 vs 265.1 +/- 135.5, p = 0.006). The severity of CAD determined according to Gensini score and fibronectin level did not show any correlation (r = 0.13, p = 0.311). If fibronectin level 240 mg/l was determined as cutoff, it showed 76% sensitivity, 46% specificity, 46% negative predictive value, and 72.3% positive predictive value for predicting CAD. The present study showed that plasma fibronectin level in CAD is significantly higher than normal control subjects. However, it has no role in predicting the severity of CAD.Öğe Effects of coronary collateral vessels in left ventricular segmental motions and myocardial viability using color kinesis dobutamine stress echocardiography(Saudi Med J, 2006) Tatli, Ersan; Surucu, Huseyin; Oztekin, Erkan; Ulucay, Abdullah; Ozcelik, Fatih; Ozer, Orhan; Aktoz, MeryemObjective: To detect the functional importance of coronary collaterals, which develop after acute myocardial infarctions (AMI). Methods: Forty patients with acute AMI whose coronary angiography demonstrated a total occlusion of the left anterior descendant (LAD) artery were included in the study, between January 2003 and June 2004. All of the study patients underwent coronary angiography and left ventriculography using standard Judkins techniques (Phillips Integris-3000). Left ventricular (LV) free walls were divided into 5 segments, and all of these segments motions were evaluated then LV free wall motion score index (WMSI) was calculated. The study patients were divided into 2 groups: good (Rentrop 3; group I; n = 14) and poor coronary collateral circulation (Rentrop 0-2; group II; n = 26) according to the Rentrop grading. Then, color kinesis dobutamine stress echocardiography (CK-DSE) was performed to all patients with standard techniques 6 weeks after AMI. Results: There were no significant differences for age, gender, risk factors for the coronary artery disease and use of the fibrinolytic therapy between the groups. There were no significant statistical differences for angiographic WMSI, left ventricular ejection fraction (LVEF), end-diastolic volume, end-systolic volume and end-diastolic pressures between the 2 groups. No difference was detected between Group I and II for initial EF, WMSI and peak dose WMSI in CK-DSE procedure. Viability was determined in all of the 14 patients in group I (100%) and 12 of 26 patients in group II (46%) (p=0.03). Conclusion: In early periods of an AMI genesis of the coronary collateral circulation does not affect left ventricular global and regional systolic functions, but increase viability quite significantly. According to our findings early revascularization could be carried out in patients with good coronary collateral circulation without doing any test for viability.Öğe The impact of a single episode of remote ischemic preconditioning on myocardial injury after elective percutaneous coronary intervention(Termedia Publishing House Ltd, 2017) Yilmaztepe, Mustafa A.; Taylan, Gokay; Aktoz, Meryem; Gurlertop, Hanefi Y.; Aksoy, Yuksel; Ozcelik, Fatih; Yalta, KenanIntroduction: Myocardial injury after percutaneous coronary intervention (PCI) occurs in approximately 30% of procedures, and is related to worse prognosis. Effects of remote ischemic preconditioning (RIPC) on reperfusion injury have been investigated before, yielding conflicting results. Aim: To assess the impact of a single episode of RIPC on myocardial injury after elective PCI. Material and methods: One hundred and four patients undergoing elective PCI, with normal baseline cardiac troponin-I (cTn-I) values, were randomized to two groups. Two patients were excluded due to data loss, and 102 patients were analyzed. Five minutes of ischemic preconditioning was delivered just before the intervention to the preconditioning group, by inflating the blood pressure cuff up to 200 mm Hg on the non-dominant arm. Postprocedural 16th hour cTn-I, Delta cTn-I (difference between the 16th h and baseline cTn-I values) and the prevalence of type 4a myocardial infarction were compared between the two groups. Results: Median cTn-I values after the procedure were compared. 16th hour cTn-I was insignificantly lower in the preconditioning arm (0.026 mu g/l vs. 0.045 mu g/l, p = 0.186). The incidence of cTn-I elevation 5-fold above the upper reference limit (URL) (> 0.115 mu g/l) was lower in the preconditioning group, but it was also not significant (21.6% vs. 11.8%, p = 0.184). Conclusions: A single episode of RIPC before elective PCI demonstrated less troponin elevation but failed to show a significant effect.Öğe Lipoprotein(a) Gene Polymorphism Increases a Risk Factor for Aortic Valve Calcification(Mdpi, 2019) Ozkan, Ugur; Ozcelik, Fatih; Yildiz, Mustafa; Budak, MetinCalcific aortic valve disease (CAVD) is a multifactorial condition. Both environmental and genetic factors play an important role in its etiology. CAVD exhibits a broad spectrum, varying from mild valve thickening to severe valve calcification and stenosis. Progression of the disease consists of chronic inflammation, lipoprotein deposition, and active leaflet calcification. It is a process similar to coronary artery disease. In this study, we investigated Lp(a) levels and gene polymorphisms associated with calcific aortic stenosis from blood samples after echocardiography in the evaluation of 75 patients diagnosed with CAVD and 77 controls. Blood tests were run in our laboratory to rule out certain risk factors before echocardiography examination. A significant association among smoking, elevated LDL level and creatinine, low albumin levels, Lp(a) level, rs10455872, and rs3798220 polymorphisms may be considered genetic risk factors for the development of calcific aortic stenosis.Öğe Non-dipper hypertension is associated with slow coronary flow among hypertensives with normal coronary angiogram(Clinics Cardive Publ Pty Ltd, 2017) Aksit, Ercan; Gursul, Erdal; Aydin, Fatih; Samsa, Murat; Ozcelik, FatihAim: A person with a drop of more than 10% in nocturnal arterial blood pressure during the circadian rhythm is referred to as a dipper and one with a smaller decrease is referred to as a non-dipper. In our study, we aimed to compare the thrombolysis in myocardial infarction (TIMI) frame count in non-dipper and dipper hypertensive patient groups who had normal coronary artery angiography. Methods: Patients with normal coronary arteries and with ambulatory blood pressure monitoring follow ups were retrospectively investigated and 60 patients (35%, female) were included in our study. The patients were grouped as dipper (n = 30) and non-dipper (n = 30) hypertensives. Results: The TIMI frame counts in all three coronary arteries and the mean TIMI frame count in the dipper hypertensive patient group were significantly lower than those of the non-dipper hypertensives (right coronary artery TIMI frame count: 16.83 +/- 3.70; 21.63 +/- 3.44, p < 0.001; circumflex artery TIMI frame count: 21.28 +/- 3.52; 25.65 +/- 3.61, p < 0.001; left anterior descending artery TIMI frame count: 34.20 +/- 2.80; 37.05 +/- 3.30, p = 0.001; corrected left anterior descending artery TIMI frame count: 20.05 +/- 1.63; 21.74 +/- 1.95, p = 0.001; mean TIMI frame count: 19.31 +/- 2.3; 22.94 +/- 2.61, p < 0.001). The body mass index (BMI) was 23.79 +/- 2.81 kg/m(2) in the dipper patient group, while it was 25.47 +/- 2.92 in the non-dippers. BMI was found to be significantly higher in the non-dipper group than in the dipper group (p = 0.027). Conclusion: In this study, TIMI frame count, which is a simple, productive, objective and reproducible method for determination of microvascular changes, was found to be higher in non-dipper hypertensive patients than in the dipper patients.Öğe Plasma fibrinogen level may predict critical coronary artery stenosis in young adults with myocardial infarction(Via Medica, 2009) Tatli, Ersan; Ozcelik, Fatih; Aktoz, MeryemBackground: This study aims to determine the role of hematological variables in determining critical coronary artery stenosis in young adults with myocardial infarction. Methods: This study includes 76 of 1,804 patients who applied to our hospital between January 2001 and December 2005. All were under 35 years old, diagnosed as acute myocardial infarction with clinical and laboratory findings, and had coronary angiography. Study patients were divided into two groups: those having critical coronary artery lesions (group I) and those having normal coronary arteries (group II). Then we compared these groups for age, sex, body mass index, risk factors, plasma protein C, protein S, antithrombine III and fibrinogen. Student t test, the chi(2) test, Fisher's exact test and Mann Whitney U test were used. Results: There were no differences between the two groups in terms of hypertension (p = 0.70), smoking (p = 0.50), hyperlipidemia (p = 0.09), body mass index (p = 0.14), family history (p = 0.10), plasma protein C (p = 0.08), protein S (p = 0.35) or antithrombine III (p = 0.60). Plasma fibrinogen levels were significantly higher in group I than in group II (p = 0.001). Conclusions: Our study shows that high plasma fibrinogen levels may be used as a predictor of critical coronary artery lesions in young patients with acute myocardial infarction.Öğe The relation between the levels of osteoprotegerin and the degree of coronary artery disease in patients with acute coronary syndrome and stable angina pectoris(Via Medica, 2014) Aksu, Feyza; Ozcelik, Fatih; Kunduracilar, Hakan; Barutcu, Ahmet; Yel, Mesih; Umit, Elif Gulsum; Altun, ArmaganBackground: Osteoprotegerin (OPG), an inhibitor of osteoclastogenesis, has recently been under the spotlight in studies regarding the pathophysiology of atherosclerosis. Aim: To evaluate the value of serum OPG in the diagnosis and severity in patients with stable angina pectoris (SA) and unstable angina pectoris/non ST elevation myocardial infarction. Methods: This study involved 160 patients, SA (n = 65), acute coronary syndrome (NSTE-ACS; n = 65), and a control group (n = 30). Blood samples were collected in the first hour, after 24 hours and on the fifth day. The prevalence of coronary artery atherosclerotic lesions was determined using the Gensini scoring system. Results: A statistically significant difference was observed in the first hour OPG levels between the control group and both the SA and NSTE-ACS group (p < 0.001). When the cut-off value was determined as 247.71 pg/mL, the sensitivity and specificity of the first hour OPG levels indicating coronary artery disease were 91.54% and 46.67%, respectively, while the positive predictive value was 88.1% and the negative predictive value was 56%. No correlations were observed between the first, 24th hour and the fifth day OPG levels and the Gensini scores. No relation was denoted between the OPG levels and number of diseased coronary arteries. Conclusions: In our study, serum OPG level seemed to be unrelated to the severity or the degree of coronary artery disease in patients with SA and unstable angina pectoris/non ST elevation myocardial infarction. OPG may only be accepted as an indicator of coronary artherosclerosis.
