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Öğe Cardiac Involvement is the Reason for Persistent Dyspnea in Post COVID-19 Patients without Pulmonary Sequelae: A Retrospective Study(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2022) Çöllüoglu, T.; Acat, M.; Özsaraç, Ö.; Akin, Y.; Önalan, O.Objective: Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019 (COVID-19) infection and also it has been shown that acute infection is responsible for cardiac symptoms. However, the data on cardiac involvement and associated symptoms in chronic phase remains unclear. Recent evidence have shown that the reason for persistent dyspnea can be persistent cardiac dysfunction in post COVID-19 infection. The aim of our study was to investigate the relationship between persistent dyspnea and cardiac involvement in post COVID-19 patients without pulmonary sequelae. Material and Methods: In our study, we recruited 30 post COVID-19 patients with dyspnea between January 2021 and July 2021. In all patients, the absence of pulmonary sequelae was detected with PFT and chest- CT. 2D-TTE, 2D-STE and MPS were performed for each case. Results: Left ventricular dysfunction was detected in 63.3% of patients and also 93.3% of patients had extensive abnormal GLS at 3 month follow-up. Of the patients, 33.3% had myocardial perfusion defect (MPD) and all MPDs were observed to be reversible defects. MPD was obviously seen in anterior wall (60%) and mid (20%) to apical (70%) segments. As compared with patients without MPD, patients with MPD had higher CK-MB (p: 0.016) and troponin I (p: 0.011), lesser PW thickness (p:0.020) and lower peak systolic strain rate at A2C view (p:0.031). Patients with NYHA III had more impaired GLS than patients with NYHA II (p:0.035). Conclusion: Our study suggests ischemic or non-ischemic cardiac dysfunction may be associated with persistent dyspnea in post- COVID- 19 patients without lung sequelae. © 2022 by Türkiye Klinikleri.Öğe Development of pacemaker lead thrombosis in a patient with atrial fibrillation during apixaban treatment(Tehran Heart Center, 2019) Adar, A.; Önalan, O.; Cakan, F.Apixaban was introduced in clinical use for nonvalvular atrial fibrillation as an alternative to warfarin. There is a dearth of information regarding apixaban use in patients suffering from atrial fibrillation with intracardiac foreign bodies such as pacemaker leads. In this report, we describe a 72-year-old female patient with a complaint of weakness in both legs of a few days’ duration. She was detected to have a thrombus over the pacemaker lead and inside the left atrial appendage during apixaban treatment. After the discontinuation of apixaban and the commencement of warfarin, the thrombus was resolved. Our case is the first report to show that apixaban treatment (5 mg, twice daily) may not prevent the development of pacemaker lead thrombosis in patients with atrial fibrillation. © 2019, Tehran Heart Center. All rights reserved.Öğe Extensive, Idiopathic, Recurrent, Spontaneous Coronary Artery Dissection Healed With Medical Treatment(Duzce University Medical School, 2021) Akbay, E.; Önalan, O.; Adar, A.; Çakan, F.Spontaneous coronary artery dissection is a rare cause of sudden cardiac death and acute coronary syndrome, and mainly affects young female. Treatment of this condition depends on the clinical features, hemodynamic and angiographic findings of the patient, but due to the rarity of the disease, guideline support was insufficient until the last period. Depending on the condition of the patient and the coronary blood flow, medical observation, percutaneous coronary intervention or coronary artery bypass graft surgery are used in the treatment. We present a young female patient who underwent emergency coronary artery bypass graft surgery after spontaneous left main coronary artery dissection four years ago and was recently diagnosed with extensive spontaneous coronary artery dissection in her right coronary artery. After the diagnosis, the patient was given medical treatment and recovered completely. © 2021, Duzce University Medical School. All rights reserved.Öğe A strong clue on chest radiography for metabolic syndrome in patients with obstructive sleep apnea: Aortic arch calcification(Duzce University Medical School, 2019) Adar, A.; Önalan, O.; Casim, H.; Çakan, F.; Köktürk, U.; Çetin, E.; Özçalik, E.Aim: Obstructive sleep apnea (OSA) is associated with increased atherosclerosis and metabolic syndrome (MetS). Vascular calcification plays a pivotal role in the development of atherosclerosis. However, data regarding vascular calcification and MetS is insufficient. The aim of the present study was to investigate the association between MetS and aortic arch calcification in patients with OSA. Material and Methods: Patients who underwent an overnight polysomnography and diagnosed with OSA were enrolled into the study. Patients were classified into two groups based on the presence of MetS. Two examiners who were unaware of the results of polysomnographic assessment reviewed the chest radiograms. Results: A total of 314 patients with OSA were included in the study. 33.1% of the patients were female and mean age was 51.2±10.9. Of these, 43.6% had mild OSA, 30.9% had moderate OSA, and 25.5% had severe OSA. Aortic arch calcification was detected in 56.4% (n=177) and MetS was detected in 58.6% (n=184) of the patients. Prevalence of aortic arch calcification was higher in patients with MetS than in those without MetS (p<0.001). By multiple logistic regression analysis found that body mass index (1.148, 95% CI, 1.089-1.210), apnea hypnea index (1.039, 95% CI, 1.016-1.062), and aortic arch calcification (4.986, 95% CI, 2.887-8.610) were found to be predictors of MetS. Conclusion: Aortic arch calcification seen in chest radiography is strongly associated with MetS in patients with OSA. Aortic arch calcification may be an alerting finding for clinicians regarding the development of MetS in patients with OSA. © 2019, Duzce University Medical School. All rights reserved.
