Papers by Recep Demirbağ
Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, Jan 13, 2014
We aimed to assess the impact of meteorological variables on coronary blood flow (CBF). Coronary ... more We aimed to assess the impact of meteorological variables on coronary blood flow (CBF). Coronary blood flow was evaluated using the thrombolysis in myocardial infarction frame count (TFC). The association of CBF with meteorological parameters such as temperature, relative humidity, total solar radiation, atmospheric pressure, wind velocity, and total sunshine duration were investigated as well as demographic, clinical, and laboratory characteristics. Assessment of 1206 patients (median age = 53 years, 723 females) revealed the presence of slow coronary flow (SCF) in 196 patients. Daily maximum temperature [odds ratio = 0.951, 95% confidence interval = 0.916-0.986, P = .007] was the only independent predictor of the presence of SCF, whereas systolic blood pressure (β = -0.139, P = .026), hematocrit level (β = 0.128, P = .044), and daily maximum temperature (β = -1.479, P = .049) were independent predictors of log10 (mean TFC). Findings of the present study suggest a role of meteorolo...
International Journal of Cardiology, 2009
Congenital coronary fistula is consisted of a communication between a coronary artery and a cardi... more Congenital coronary fistula is consisted of a communication between a coronary artery and a cardiac chamber or pulmonary vessel. Congenital left coronary artery-left ventricle fistula is uncommon. A 41-year-old female patient admitted to our institution for evaluation of heart murmur etiology. A loud continuous murmur heard at the apex area was detected at auscultation. Echocardiography showed a large fistula draining into the left ventricle apex. Coronary angiography revealed fistula from left circumflex coronary artery to left ventricular cavity. Since the patient was asymptomatic and no concomitant cardiac pathology was detected, we advised endocarditis prophylaxis and medical follow-up.
tkd-online.org
... Dr. Niyazi GÜLER*, Doç. Dr: lieylian ERYONUCU*, Dr. Ayhan SÍNCÍ*, Dr. Ahmet GÜNE§* Van Yüksek... more ... Dr. Niyazi GÜLER*, Doç. Dr: lieylian ERYONUCU*, Dr. Ayhan SÍNCÍ*, Dr. Ahmet GÜNE§* Van Yüksek ihüsas Egitim ve Araçtirma Hastanesi, Kardiyoloji Klinigi, * Yüziincü Yil Tip Fakiiltesi, Kardiyoloji Anabilim Dali, ÖZET Atriyum biiyiimesi ve kalp debisinin azaimasma bagli ...
The American Journal of Cardiology, 2015
Introduction: Heart murmurs in children are the most common reason for specialist cardiac treatme... more Introduction: Heart murmurs in children are the most common reason for specialist cardiac treatment. Evaluation of heart murmur represents exclusion or existence of congenital anomalies of the heart. Normal anatomical and functional findings of heart must be proven with clinical examination, electrocardiography (ECG), as well as X-ray diagnostics, laboratory diagnostics, less often with echocardiography, and other noninvasive and invasive methods. There are organic, functional, and innocent murmurs. Objectives: The main objective was to show the frequency and significance of innocent heart murmurs in children. Study was made in order to show the wrong trend in modern medicine, the neglect of classical detection methods, primarily auscultation. Material-Methods: The study included 1827 patients who were treated at the Health Centre "Dom zdravlja Breza", in Breza (primary health care), Bosnia and Herzegovina, from January till 20th December 2014. This study had prospective and analytical character. Results: Heart murmurs were registered in 251 (13,7%) patients, in 203 (80,8%) that was an accidental finding, while 48 (19,2%) had symptoms that could be linked to the cardiovascular disorder. In 63 (25%) patients ECG was done (doctor/ parent request), in 19 complete X-ray of the heart and lungs, and 11 patients underwent additional laboratory tests. Ultrasound evaluation was performed in 50 (19,9%) patients, and on 8 (3,1%) patients abnormal findings have been observed (mainly for monitoring). Two patients had indication for cardiovascular/ interventional procedure (ostium secundum atrial septal defect 10.6 mm and ductus arteriosus persistens 2.8 mm). Conclusion: In everyday practice, clinical diagnosis and differential diagnosis of heart murmurs in children are based mainly on the use of auscultation of the heart. Echocardiography should not be routine, initial method. It is necessary to adjust the treatment of heart murmurs, with assessment of whether it is innocent heart murmur, suspected congenital heart defect or probable congenital heart defect. Given that most of the heart murmurs are innocent, family doctors and paediatricians, should be trained to recognize heart murmurs, so knowledge could rationalize sole use of expensive diagnostic methods.
Echocardiography, 2006
It is known that antioxidants have an important role in the prevention of coronary artery disease... more It is known that antioxidants have an important role in the prevention of coronary artery disease (CAD). Low total antioxidant capacity (TAC) is a risk factor for ischemic heart disease. However, no data are available concerning the relationship between TAC and severity of thoracic aortic atherosclerosis. This study using multiplane transesophageal echocardiography (TEE) examined the relationship between atherosclerotic thoracic aortic intima-media thickness (TAIMT) and TAC. Twenty-nine patients (17 male, 12 female; mean age 36 ± 8 years) without a history of atherosclerotic cardiovascular disease referred for TEE were included. The patients with obesity, hypertension, diabetes, and CAD were excluded. The TAC was measured for each patient using a more recently developed method. TAIMT and grade of thoracic aortic atherosclerosis were evaluated in each patient by using TEE.
Atherosclerosis, 2008
Background: Paraoxonase (PON) is a high-density lipoprotein-bound anti-oxidant enzyme that inhibi... more Background: Paraoxonase (PON) is a high-density lipoprotein-bound anti-oxidant enzyme that inhibits atherosclerosis and endothelial dysfunction. Slow coronary flow (SCF) has long been identified and endothelial dysfunction and atherosclerosis of epicardial coronary arteries and microvasculature were reported to be associated with SCF. Consequently, we aimed to investigate the association between coronary blood flow by means of Thrombolysis in Myocardial Infarction frame count (TFC) and serum PON activity and other laboratory parameters in patients with SCF compared to control cases. Methods: Twenty-four patients with SCF and 110 control cases with normal coronary flow were studied after quantifying coronary blood flow according to TFC. Serum PON activity was evaluated by measuring the rate of paraoxon hydrolysis. The association between TFC and serum PON activity and other clinical and laboratory parameters were evaluated. Results: There were statistically significant differences between SCF and control groups in respect to serum uric acid (p = 0.001), high sensitive C-reactive protein (p = 0.03) levels and serum PON activity (p < 0.001). The mean TFC was correlated with male gender (r = 0.263, p = 0.002), serum uric acid level (r = 0.287, p = 0.001), hemoglobin concentration (r = 0.192, p = 0.032) and serum PON activity (r = −0.306, p < 0.001). Serum uric acid level (χ 2 = 10.08, β = 0.362, p = 0.009) and serum PON activity (χ 2 = 16.73, β = −0.005, p = 0.001) were independent predictors of SCF whereas the only independent predictor of mean TFC was serum PON activity (β = −0.318, p < 0.001). Conclusion: These findings suggest that serum PON activity is independently associated with mean TFC and reduced serum PON activity might represent a biochemical marker of SCF.
Journal of Electrocardiology, 2005
P-wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous pr... more P-wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The purpose of this study was to investigate the PD in patients with stable coronary artery disease (CAD) and to determine its relationship with severity of the disease. We prospectively analyzed 66 subjects with normal coronary angiogram (group 1) and 68 patients with significant (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =50%) coronary stenosis; 25 had 1-vessel disease (group 2), 27 had 2-vessel disease (group 3), and 16 had 3-vessel disease (group 4). The maximum and minimum P-wave duration (Pmax and Pmin) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed. Angiographic vessel score and Gensini score were used to evaluate the severity of CAD. Pmax was longer in groups 3 and 4 compared with group 1 (P = .001 for both comparison). PD was greater in groups 2, 3, and 4 compared with group 1 ( P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001 for all comparison), and also in group 4 compared with group 2 (P = .001). However, there was no statistically significant difference among the groups regarding Pmin. In bivariate correlation, increased PD was correlated with presence of hypertension (r = 0.278, P = .013), left ventricular ejection fraction (r = -0.231, P = .044), left atrial diameter (r = 0.223, P = .032), presence of moderate to severe mitral regurgitation (r = 0.284, P = .017), vessel score (r = 0.465, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), and Gensini score (r = 0.338, P = .005). Multiple linear regression analysis showed that only vessel score was independently associated with PD (beta = .471, P = .01). PD was found to be greater in patients with stable CAD than in controls and to be associated with severity of the disease.
A 75 year old female patient with chest pain was admitted to our clinic. The angiography showed m... more A 75 year old female patient with chest pain was admitted to our clinic. The angiography showed multiple coronary micro fistulas from left intermediate artery drained into left ventricle and critical coronary stenoses. Contrast agent injected through left main coronary artery caused an interesting image mimicking optimal ventriculography with normal ejection fraction. The patient has been followed up with health after coronary artery bypass grafting operation with subsequent endocarditis prophylaxis and guideline directed medical therapy. Coronary fistulas to left ventricle are rarely encountered than the others, and they should be considered in terms of treatment if the fistulas cause functional disorder of the heart
Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, 2018
Önceki çalışmalarda sol ventrikül hipertrofisi (SVH) bulunan hipertansif hastalarda, SVH bulunmay... more Önceki çalışmalarda sol ventrikül hipertrofisi (SVH) bulunan hipertansif hastalarda, SVH bulunmayan hastalara göre miyokardiyal repolarizasyon belirteçlerinin uzamış olduğu gösterilmiştir. Ortalama QRS ve T dalgası eksenleri arasındaki açı olarak tanımlanan frontal QRS-T açısı da miyokard repolarizasyonunun yeni bir göstergesidir. Çalışmamızın amacı, hipertansif hastalarda frontal QRS-T açısı ile SVH arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Çalışmamıza toplam 187 hipertansif hasta dâhil edildi. Frontal QRS-T açısı, EKG cihazının otomatik raporlarından elde edildi. Sol ventrikül kitle indeksinin (SVKİ) erkeklerde > 115 g/m 2 , kadınlarda > 95 g/m 2 olması SVH olarak tanımlandı. Bulgular: SVH bulunan hastalarda, SVH bulunmayan hastalara göre QT dispersiyonu (p = 0,028), düzeltilmiş QT dispersiyonu (p = 0,010) ve Tp-e aralığı (p = 0,045) daha uzun, frontal QRS-T açısı (p < 0,001) ise daha genişti. Korelasyon analizinde, SVKİ QT dispersiyonu (r= 0,150, p= 0,041), düzeltilmiş QT dispersiyonu (r= 0,167, p= 0,022), Tp-e aralığı (r= 0,160, p= 0,046) ve frontal QRS-T açısı (r= 0,360, p < 0,001) ile pozitif bir şekilde korele idi. Çok değişkenli analizle, frontal QRS-T açısı SVH'nin tek bağımsız prediktörü olarak bulundu (OR: 1,04, 95% CI: 1,02-1,06, p < 0,001). ROC curve analizinde frontal QRS-T açısının SVH'yi göstermedeki en iyi kesme değeri 28 o idi. Bu kesme değer, SVH'yi %70,5 sensitivite ve %54,5 spesifite ile öngördü. Sonuç: Frontal QRS-T açısı, basit, ucuz ve 12 derivasyonlu yüzey elektrokardiyografiden kolaylıkla elde edilebilen bir parametredir. Bu açı, hipertansif hastalarda SVH'nin basit bir göstergesi olarak kullanılabilir.
Turkish Journal of Clinics and Laboratory, 2020
Aim: The aim of the present study is to evaluate the levels of these biomarkers in decompensated ... more Aim: The aim of the present study is to evaluate the levels of these biomarkers in decompensated heart failure (HF) patients. Material and Methods: 44 decompensated HF patients and 32 healthy individuals were enrolled in the study as patient and control groups. Transthoracic echocardiography and serum troponin I, vaspin, apelin, and PTX-3 levels besides routine laboratory analysis were performed for both groups. Results: Troponin I and vaspin were higher, apelin was lower in patient group (for all, p<0.05).PTX-3 levels were higher in patient group, but it was not statistically significant (p=0.133). Troponin I and PTX-3 levels were significantly decreased (for both, p<0.05) with in-hospital-HF treatment. Vaspinand apelin levels did not show any significant change (p=0.938, p=0.121, respectively). Vaspin had an independent relationship with troponin, apelin had an independent relationship with PTX-3, troponin and apelin had independent relationship with vaspin, and finally troponin,PTX-3, and vaspin had independent relationship with apelin in decompensated HF patients. Conclusion: Troponin I and vaspin levels were elevated,and serum apelin levels were reduced in decompensated HF patients. PTX-3 levels were higher in HF patients, but it was not statistically significant. Vaspin and apelin levels did not change with HF stabilization in HF patients, but troponin I and PTX-3 levels were significantly decreased.
Kosuyolu Heart Journal, 2016
's work is the bearer of a magic function, revealing the marvellous through mystification. Švankm... more 's work is the bearer of a magic function, revealing the marvellous through mystification. Švankmajer, like the alchemists of old, is continually distilling the water of his experiences so that through this process, the heavy water of knowledge, essential for the transmutation of life, begins to flow. In his work, Švankmajer constantly explores and analyses his concern with power, freedom, human desire, fear and anxiety, his interest in confrontation, alienation and destruction, his fascination with experiment, alchemy, magic, transformation, reality and unreality, his obsession with games and breaking rules, as well as his attraction in the surface materiality of things, the texture and the physical properties of objects, creating films that are highly visual and strikingly theatrical, saturated by cruel melancholy and black humour. His oeuvre is a poetic and dynamic work that operates by means of close interactions with literature, theatre, and the visual arts. This approach consistently rejects conventional critical categorisation, spilling over forcibly into various forms of representation; it ruptures dominant cinematic conventions, and it rejects and exceeds normative barriers in filmic expression. Although in many ways recognisably included in the rich tradition of East European animation, Švankmajer tends to distance himself from the Czech animation school, refusing to limit himself to the generic idea of 'animation' and standing apart by virtue of his eclecticism and passionate commitment to 'militant Surrealism'. Švankmajer's work remains unique as a result of the way he combines, blends and transforms disparate elements, as 'an alchemist of the Surreal'. Various elements of his work are deployed in the service of fantasia, such as stop-frame animation, trick photography, the manipulation
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2017
K alp kapak hastalıkları sık görülme ve yüksek girişim yapılma oranları ile kardiyovasküler hasta... more K alp kapak hastalıkları sık görülme ve yüksek girişim yapılma oranları ile kardiyovasküler hastalıklar arasında önemli bir yer tutmaktadır. [1,2] Görüntüleme teknolojisindeki ilerlemeler, aort darlığı ve mitral yetersizliğinde başarılı kateter bazlı teknik giri
Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 2016
The goal of this study was to develop a national database of patients hospitalized in Turkey with... more The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches. Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country. Mean age was 62±13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%. Coronary heart disease and hypertension were found in 61% and 53% of the patients, respectively. Valvular heart disease was the underlying cause in 46% of heart failure patients. The most frequent factor associated with decompensation was noncompliance with treatment, observed in 34% of patients. Systolic blood pressure was 125±28 mmHg and heart rate was 93±22 beats/minute in the cohort. The most common findings on physical examination were inspiratory fine crackles (84%), peripheral edema (64%), and cold extremities in 34%. Mean ejection frac...
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2016
In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, le... more In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, left ventricular diastolic parameters, and left ventricular mass (LVM) index in moderate to severe obstructive sleep apnea syndrome (OSAS) patients without coexisting disorders were investigated. Methods: A total of 66 non-diabetic, non-hypertensive, and non-smoking volunteers were enrolled. Participants were categorized by apnea-hypopnea index (AHI; event/hour). The control group was defined as no OSAS: AHI<5 (n=35), and OSAS group had moderate to severe OSAS: AHI>15 (n=31). Echocardiographic and biochemical tests, including measurement of C-reactive protein (CRP), were performed. PAS (kHz/s) was calculated by dividing the maximal frequency shift of the pulmonary flow by the acceleration time. Results: PAS (kHz/s), obtained by echocardiography, was statistically significantly higher in the OSAS group than the control group (28±5 vs 18±4, p<0.001), and was positively correlated with AHI, CRP, aortic stiffness index, E/E', and LVM index (p=0.034, p=0.039, p<0.001, p=0.040, and p<0.001, respectively), and negatively correlated with aortic strain (AS), aortic distensibility (AD), E/A, E'/A', and E' (p<0.001). Regression analyses indicated that CRP and PAS are independent predictors of aortic stiffness (p<0.05). E/A and LVM index were independent predictors of PAS (p=0.002 and p=0.001, respectively). Conclusion: Increased PAS is associated with aortic stiffness, left ventricular diastolic function, and increased LVM index. PAS may be a more effective indicator of aortic stiffness in OSAS patients than CRP. Amaç: Bu çalışmada, eşlik eden hastalıkları bulunmayan orta ve ciddi derece obstrüktif uyku apne sendromuna (OUAS) sahip hastalarda pulmoner arter sertliğinin (PAS) aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu parametreleri ve sol ventrikül kitle indeksi ile ilişkisi araştırıldı. Yöntemler: Hipertansiyon ve diyabeti bulunmayan ve sigara kullanmayan 66 gönüllü çalışmaya alındı. Katılımcılar apne hipopne indeksine göre sınıflandırıldılar (AHI, olay/saat). Kontrol grubu sağlıklı bireylerden oluştu AHI <5 normal (n=35), OUAS grubu orta veya ciddi OUAS'lı hastaları kapsadı AHI >15 orta/ciddi (n=31). Ekokardiyografi ve C-reaktif proteinin (CRP) dahil olduğu biyokimyasal testler değerlendirildi. PAS (kHz/s) = pulmoner akım maksimal sapma sıklığı/akselerasyon zamanı, formülüyle hesaplandı. Bulgular: Ekokardiyografiyle elde edilen PAS (kHz/s) OUAS grubunda istatistiksel olarak anlamlı derecede daha yüksekti (18±4 ve 28±5, p<0.001) ve AHI, CRP, aort sertlik indeksi, E/E' oranı ve sol ventrikül kitle indeksi ile pozitif (sırasıyla, p=0.034, p=0.039, p<0.001, p=0.040 ve p<0.001) ve aort straini, aortgerilebilirliği, E/A oranı, E'/A' oranı ve E' ile negatif korelasyona sahipti (p<0.001). Regresyon analizi CRP ve PAS'nin aort sertliği için bağımsız öngördürücüler olduğunu gösterdi (p<0.05). E/A oranı ve sol ventrikül kitle indeksi PAS için bağımsız öngördürücülerdi (sırasıyla; p=0.002 ve p=0.001). Sonuç: Artmış PAS aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu ve artmış sol ventrikül kitle indeksiyle ilişkiliydi. OUAS'li hastalarda PAS aort sertliği için CRP'den daha iyi bir belirteç olabilir.
Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır, 2016
While it is known that consumption of licorice may lead to cardiac arrhythmias, there have been n... more While it is known that consumption of licorice may lead to cardiac arrhythmias, there have been no reports of atrial fibrillation resulting from the consumption of licorice root syrup. A 57-year-old male with no prior history of cardiovascular disease was admitted to the emergency department with palpitation. His electrocardiogram showed atrial fibrillation with a moderate to rapid ventricular rate. In laboratory assessment, potassium was 2.0 mmol/L and plasma renin activity and aldosterone level were suppressed (<300 ng/L/hour, 42 ng/L respectively). Volumes of the heart chambers were within normal range and functions and structures of the heart valves were normal in echocardiographic assessment. The arrhythmia was resolved with propafenone infusion.
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Papers by Recep Demirbağ