Yazar "Akin, Yesim" seçeneğine göre listele
Listeleniyor 1 - 11 / 11
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Clinical characteristics of atrial fibrillation in nonagenarian population and relationship with mortality(Edizioni Minerva Medica, 2024) Cakan, Fahri; Onalan, Orhan; Adar, Adem; Akbay, Ertan; Colluoglu, Inci T.; Kokturk, Ugur; Akin, YesimBACKGROUND: There is a considerable amount of literature available on well-known risk factors for atrial fibrillation (AF); however, available data specifically focused on the ninth decade are scarce. The main objective of this study was to assess the demographic and clinical characteristics of AF and sinus rhythm in a nonagenarian population. METHODS: All individuals aged >90 years who were admitted to the Cardiology outpatient clinic between April 2018 and January 2019 were enrolled in the study. The demographic and clinical characteristics of all patients were recorded. All deaths that occurred during the two-year follow-up period were recorded. RESULTS: In total, 112 nonagenarian individuals were included in the study. Of these patients, 50 (44.6%) had AF. The groups showed similarities in demographic and clinical characteristics. During a mean follow-up period of 596 +/- 44 days, 39 patients (78%) in the AF group and 35 patients (56.5%) in the sinus group died. Patients with AF showed a lower overall survival distribution than those with sinus rhythm (P=0.005, log-rank test chi 2=7.734). 2 =7.734). AF was associated with an increased risk of mortality (P=0.002, hazard ratio [HR] =2.104, 95% confidence interval [CI] = 1.326-3.339) in multivariate Cox regression analysis, while waist circumference and total cholesterol (P=0.003, HR=0.969, 95% CI=0.949-0.989 and P=0.046, HR=0.993, 95% CI=0.986-1.000, respectively) showed a decreased risk of mortality. CONCLUSIONS: Atrial fibrillation is very common in individuals over the age of 90 years (44.6%). Well-known risk factors do not appear to be effective in this age group, and AF is associated with a 2.1-fold increase in the risk of mortality.Öğe Combined use of frontal plane QRS-T angle and platelet-to-lymphocyte ratio in the risk prediction of ischemic cardiomyopathy in STEMI(Wiley, 2024) Colluoglu, Tugce; Aksu, Melahat Hicran; Akin, Yesim; Onalan, OrhanBackgroundFrontal plane QRS-T angle (fQRS-T) and platelet-to-lymphocyte ratio (PLR) are highly important parameters that well-predict unfavorable outcomes in patients with ST-elevated myocardial infarction (STEMI).There are limited data on the predictive significance of ischemic cardiomyopathy (I-CMP) from the combination of fQRS-T and PLR in STEMI, compared to using fQRS-T and PLR alone.AimWe aimed to evaluate the ability of the combination of fQRS-T and PLR routinely obtained on admission to identify STEMI patients at risk of I-CMP.MethodSix hundred and thirty-eight consecutive patients with STEMI who underwent primary percutaneous coronary intervention between 2018 and 2021 were included. The assessment of I-CMP was conducted through two-dimentional (2D)-echocardiography 6 weeks post-STEMI and I-CMP was defined as a left ventricular ejection fraction (LVEF) of 50% or less. Multivariate logistic regression analysis and receiver operating curve (ROC) analysis were performed to predict the development of I-CMP.ResultsIn ROC analysis, the cut-off values of fQRS-T and PLR for best predicting I-CMP were 66.72 degrees and 101.23, respectively. The model using the combination of two markers was the most powerful predictor of I-CMP risk (OR: 3.183, 95% CI: 1.971-5.139, p = .001) when included in a single variable such as high fQRS-T or high PLR (OR: 1.422, 95% CI: 0.870-0.232, p = .160). Additionally, the concomitant presence of high fQRS-T and high PLR exhibited the highest specificity (77%) for I-CMP relative to the individual presence of high fQRS-T (66%) or PLR (49%).ConclusionThe combination of fQRS-T and PLR, which is a simple and cost-effective risk assessment, may serve as a more reliable prognosticator for I-CMP as opposed to the use of fQRS-T and PLR alone for STEMI. The concurrent presence of a high frontal plane QRS-T angle (fQRS-T) and a high platelet-to-lymphocyte ratio (PLR) poses the highest risk for the development of ischemic cardiomyopathy 6 weeks after ST-elevation myocardial infarction, in comparison to solely high fQRS-T or high PLR alone.imageÖğe The Effect of Early Administration of Hypertonic Saline Solution İn Acute Decompensated Heart Failure(Arquivos Brasileiros Cardiologia, 2024) Colluoglu, Tugce; Kapansahin, Tugba; Aksu, Melahat Hicran; Oenalan, Orhan; Akin, YesimBackground: There was no scientific evidence about the initial treatment of hypertonic saline solution (HSS) in acutely decompensated heart failure (ADHF). Objectives: This study assessed the impact of using HSS along with a loop diuretic (LD) as the first diuretic treatment for ADHF, focusing on renal function, electrolyte levels, and clinical outcomes. Methods: In this retrospective case-control study, 171 adult patients (93 females/78 males) with ADHF were included between January 1, 2022, and December 31, 2022. Patients were allocated into two groups: upfront combo HSS+LD and standardized LD. The primary endpoint was worsening renal function (WRF). Hospitalization for HF and all-cause mortality were evaluated during 6 months of follow-up. The significance level adopted in the statistical analysis was 5%. Results: The groups exhibited similarities in baseline characteristics.A significantly higher diuresis on the 1(st) day (3975 [3000-5150] vs. 2583 [2000-3250], p=0.001) and natriuresis on the 2(nd) hour (116.00 [82.75-126.00] vs. 68.50 [54.00-89.75], p=0.001) in the initial upfront combo HSS+LD were found in comparison with the standardized LD.When compared to the standardized LD, the utilization of HSS led to an increase in serum Na+ (137.00 [131.75-140.00] vs. 140.00 [136.00-142.25], p=0.001 for upfront combo HSS, 139.00 [137.00-141.00] vs. 139.00 [136.00-140.00], p=.0470 for standardized LD), while chloride (99.00 [94.00-103.25] vs. 99.00[96.00-103.00], p=0.295), GFR (48.50 [29.75-72.50 vs. 50.00 [35.50-63.50, p=0.616), and creatinine (1.20 [0.90-1.70] vs. 1.20 [1.00-1.50], p=0.218) remained stable in the upfront combo HSS group when compared to standardized LD group (Cl-: 102.00 [99.00-106.00] vs. 98.00 [95.00-103.00], p=0.001, eGFR: 56.00 [41.00-71.00] vs. 55.00 [35.00-71.00], p=0.050, creatinine:1.10 [0.90-1.40] vs. 1.20 [0.90-1.70], p=0.009). Worsening renal function (16.1% vs 35.5%, p=0.007), and length of stay in the hospital (4 days [3-7] vs. 5 days [4-7], p=0.004) were lower in the upfront combo HSS+LD in comparison with the standardized LD. In-hospital mortality, hospitalization for HF, and all-cause mortality were similar between the two groups. Conclusion: HSS as an initial therapy, when combined with LD, may provide a safe and effective diuresis without impairing renal function in ADHF. Therefore, HSS may lead to a shorter length of stay in the hospital for these patients.Öğe Exercise Prevents Glucocorticoid-Induced Myocardial 4-Hydroxynonenal Production(Springer, 2023) Hayta, Umit; Akin, Senay; Gungor, Irem; Colluoglu, Inci Tugce; Guray, Umit; Akin, Yesim; Demirel, Haydar A.Purpose Long-term administration of glucocorticoids (GCs) increases myocardial oxidative stress. 4-Hydroxynonenal (4-HNE) protein adducts, a marker of oxidative damage, have been associated with several cardiovascular diseases, including atherosclerosis, cardiac hypertrophy, cardiomyopathy, and ischemia-reperfusion injury. Exercise training has been shown to have a protective effect on the heart by lowering the level of oxidative stress in cardiomyocytes. Therefore, we aimed to investigate the effect of long-term dexamethasone treatment and exercise training on myocardial 4-HNE levels.Methods Twenty-four female Wistar albino rats were assigned to sedentary control-saline treated (C, n = 8), sedentary-dexamethasone treated (D, n = 8), and exercise training-dexamethasone treated (DE, n = 8) groups. Daily dexamethasone was injected for 28 days at a 1 mg kg(-1) dose, while C animals were injected with the same volume of saline subcutaneously. DE animals underwent an exercise training protocol of 60 min/day, 5 days a week, at 25 m/min(-1) (0% grade) for 28 days. Left ventricular 4-HNE, Hsp72 levels, and pHsp25/Hsp25 ratio were determined by Western blot.Results The administration of dexamethasone led to a significant elevation in 4-HNE levels in the myocardium of adult rats (p < 0.05; D vs. C). The concurrent implementation of exercise training impeded this increase (p > 0.05; DE vs. C). Exercise training induced a threefold increase in myocardial Hsp72 expression (p < 0.001; DE vs. C and D) and attenuated the dexamethasone-induced increase in Hsp25 phosphorylation (p < 0.05; C vs. D) (p < 0.001; DE vs. D).Conclusion Our results indicate that long-term administration of dexamethasone is associated with an increase in cardiac 4-HNE levels, which is hindered by the addition of exercise training.Öğe Increased vitamin B12 in heart failure with reduced ejection fraction: A novel marker of disease severity and mortality(Bayrakol Medical Publisher, 2024) Erbay, Ilke; Demirkan, Burcu; Akin, Yesim; Balci, Gulcihan KevserAim: The relationship between elevated vitamin B12 levels and liver damage is well -established, but its association with the severity of heart failure (HF) remains unclear. This study aimed to investigate the prognostic importance of vitamin B12 levels according to disease severity in HF patients with reduced left ventricular ejection fraction (HFrEF). Material and Methods: Two hundred and three consecutive patients with HFrEF were enrolled in this study. Patients were divided into advanced and nonadvanced HF groups based on specific criteria and the primary endpoint was all -cause mortality, which was prospectively assessed. Cox proportional hazards regression analyses were conducted to identify independent predictors of mortality. Results: Of the study patients, 75 (36.9%) had advanced, while 128 (63.1%) had non -advanced HF. The advanced group had significantly higher serum vitamin B12 levels compared to the non -advanced group (p<0.001). Serum vitamin B12 level of > 707.8 pg/mL had a sensitivity of 78.3% and specificity of 76.1% in predicting all -cause mortality (area under the curve=0.863, 95% CI 0.806-0.920, p<0.001). Kaplan -Meier analysis demonstrated that patients with vitamin B12 levels > 707.8 pg/mL had significantly lower survival rates (p < 0.001). In Cox regression analysis, vitamin B12 emerged as an independent predictor of death. Discussion: Elevated serum vitamin B12 levels in HFrEF patients are associated with advanced HF, increased ALT and GGT levels, indicating a cardiohepatic syndrome, and independently predict higher all -cause mortality risk.Öğe An interesting observation: prolonged green urine can be a combined effect of decreased liver and renal function in a patient with heart failure-a case report(Oxford Univ Press, 2023) Coellueoglu, Tugce; Aksu, Melahat Hicran; Oenalan, Orhan; Akin, YesimBackground The administration of propofol and methylene blue (MB) can be associated with the appearance of prolonged green urine discoloration, particularly in patients with heart failure (HF) concomitant with renal and liver dysfunction. Understanding the reasons behind this phenomenon is of clinical significance.Case summary A 79-year-old woman with a history of HF experienced dyspnoea and persistent green urine discoloration for a week, leading to her hospitalization for acutely decompensated HF. A recent dual-chamber rate-modulated-pacemaker implantation had necessitated propofol sedation and the administration of 100 mg of MB due to methaemoglobinaemia. Upon admission, the patient exhibited elevated levels of brain natriuretic peptide (BNP) and liver function tests, as well as a significant decrease in glomerular filtration rate (GFR). Initial therapy with intravenous furosemide yielded an inadequate response, requiring the initiation of combined diuretic therapy (CDT). The patient's condition improved with CDT, resulting in the normalization of BNP, liver function tests, and GFR, along with the restoration of normal urine colour lasting 12 days.Discussion Our case report sheds light on the complex interaction between drug metabolic pathways and their potential for prolonged side effects, particularly in patients with multiorgan dysfunction. The association between propofol, MB, and green urine discoloration in the context of HF warrants further investigation, emphasizing the need for increased awareness of drug interactions and their implications in complex clinical scenarios.Öğe Long-term Dexamethasone Treatment Increases Cardiac Galectin-3 Levels(Springer, 2023) Akin, Senay; Gucuk-Ipek, Esra; Hayta, Umit; Gungor, Irem; Kubat, Gokhan Burcin; Akin, Yesim; Guray, UmitPurpose Glucocorticoids, which are widely prescribed around the world, cause cardiac remodeling in long-term treatment by triggering insulin resistance and increasing blood pressure. However, its role in cardiac remodeling remains unclear. Galectin-3 (gal-3) is a member of a beta-galactoside-binding animal lectins, upregulated as a result of insulin resistance and in the pressure-overloaded myocardium and regulate cardiac remodeling. We hypothesized that gal-3 may be upregulated in the myocardium with prolonged use of glucocorticoids and associated with cardiac hypertrophy. Methods To examine the involvement of glucocorticoids in gal-3 levels in rat myocardium, sixteen female Wistar Albino rats were assigned to control (C; n= 8) and dexamethasone (Dex; n= 8) groups. Daily dexamethasone was injected subcutaneously for 28 days at a dose of 1 mg.kg(-1). Control animals were injected with the same volume of saline. The body weight and heart weights were determined. Gal-3 levels in myocardium were determined by Western blot. Results Our data shows that dexamethasone administration resulted in significant increase in heart weight (p < 0.05) and HW/BW ratios (p < 0.001) and 28 days of dexamethasone administration with the dose of 1 mg.kg(-1) caused a twofold increase in the gal-3 expression in the left ventricle (p < 0.001). Conclusion The finding of the current study is the first to show that dexamethasone causes an increase in gal-3 levels in myocardium. Our study provides an important step in the development of possible therapeutics by determining that dexamethasone causes an increase in gal-3 levels in the myocardium and raises awareness about the follow-up of patients receiving long-term glucocorticoid therapy.Öğe Pacemaker-associated superior vena cava syndrome: Role of contrast echocardiography(Wiley, 2022) Akin, Yesim; Cagli, Kumral; Okten, Riza Sarper; Keles, Telat; Golbasi, ZehraPacemaker-associated superior vena cava (SVC) syndrome is increasingly recognized as a nonmalignant type of SVC syndrome. Computed tomographic (CT) angiography is the first choice of imaging for diagnosis but in some cases there is discrepancy between the clinical findings and CT images. In this report we present the role of contrast study with transesophageal echocardiography in a patient with suspicion of SVC syndrome but inconclusive CT findings.Öğe Possible value of galectin-3 on follow-up of cardiac remodeling during glucocorticoid treatment(Wiley, 2021) Akin, Senay; Kubat, Gokhan B.; Guray, Umit; Akin, Yesim; Demirel, Haydar A.Glucocorticoids are among the most prescribed drugs globally due to their potent anti-inflammatory and immunosuppressive properties. Although they have positive effects on the treatment of various disease states; long-term administration is associated with high blood pressure, insulin resistance, and susceptibility to type 2 diabetes. The heart attempts to cope with increased blood pressure and a decrease in glucose utilization by developing pathological cardiac remodeling. However, in this process, cardiac fibrosis formation and deterioration in heart structure and functions occur. Galectin-3, a member of the beta-galactoside binding lectins, is consistently associated with inflammation and fibrosis in the pathogenesis of various disease states including insulin resistance and heart failure. Galectin-3 expression is markedly increased in activated macrophages and a subset of activated fibroblasts and vascular cells. Also, failing and remodeling myocardium show increased Gal-3 expression and elevated Gal-3 levels are related to heart failure severity and prognosis. Furthermore, Gal-3-related pathways are recently suggested as therapeutic targets both pharmacologically and genetically to increase insulin sensitivity in vivo. The objective of this review is to provide a summary of our current understanding of the role of glucocorticoid-associated insulin resistance, which is important for some cardiac events, and the potential role of galectin in this pathophysiological process.Öğe Revitalizing Sexual Function in Heart Failure patients: The Impact of Sodium-Glucose Co-Transporter 2 Inhibitors on Erectile Dysfunction(Galenos Publ House, 2024) Erbay, Ilke; Akin, YesimBACKGROUND/AIMS: The prognosis of heart failure (HF) is closely related to the structural integrity of the endothelium. Endothelial dysfunction is observed as a characteristic feature of HF and it plays an important role in the development of erectile dysfunction (ED) in patients with HF. Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) have been shown to increase microvascular endothelial cell function through their pleiotropic effects. Therefore, we aimed to investigate the effects of SGLT-2i treatment on ED in patients with HF. MATERIALS AND METHODS: Forty sexually active HF patients with reduced left ventricular ejection fraction [(LVEF) <40%] and ED were enrolled in this study. In all patients, their functional status was assessed according to the New York Heart Association functional classification, and erectile function was assessed by the Sexual Health Inventory for Men (SHIM) questionnaire at baseline and after three months of SGLT-2i treatment. RESULTS: SGLT-2i treatment resulted in a significant improvement in the SHIM scores (12.7 +/- 5.6 vs. 15.4 +/- 5.5, p<0.001). Predictors of improved SHIM scores with SGLT-2i were assessed using multivariable regression. Age (p=0.002), baseline SHIM scores (p=0.042), and lower extremity peripheral vascular disease (p=0.002) were identified as negative predictors of improvements in SHIM scores, while changes in brain natriuretic peptide levels (p=0.035) emerged as a significant predictor of improvement in SHIM scores. CONCLUSION: This cross-sectional study suggests that treatment by SGLT-2i could potentially provide advantages to patients with HF who also experience ED, enhancing their functional status.Öğe The Value of Neutrophil-to-Lymphocyte Ratio and Epicardial Adipose Tissue Thickness in Heart Failure With Preserved Ejection Fraction(Springernature, 2023) Colluoglu, Tugce; Akin, YesimBackgroundUsing epicardial adipose tissue thickness (EATt) and neutrophil-to-lymphocyte ratio (NLR) as individual indicators provides beneficial insight into the prognosis of patients suffering from heart failure with preserved ejection fraction (HFpEF).AimIn our study, we aimed to evaluate whether the combined evaluation of NLR and EATt would provide an advantage for identifying high-risk HFpEF patients according to hospitalization for heart failure (HHF) and left ventricular diastolic dysfunction (LVDD).MethodA total of 168 outpatients with HFpEF were retrospectively analyzed. The predictive performance of two inflammatory variables was assessed by the receiver operating characteristic curve and a one-way analysis of variance (ANOVA) test. The patients were stratified into three distinct risk categories based on the established cut-off values for EATt and NLR as follows: Group I, high risk; Group II, middle risk; and Group III, low risk.ResultsPatients in Group I had the highest risk for HHF and the presence of LVDD (p=0.001 for HHF, p=0.011 for LVDD). Patients in Group I also exhibited more symptomatic and a greater number of comorbidities. In Group I, more structural remodeling (enlarged left ventricular end-systolic volume index (LVESVI) and left atrial volume index (LAVI)) and associated signs of increased intracardiac pressure (elevated E/A ratio, medial E/e') were observed.ConclusionThe results of our study indicate that the use of both EATt and NLR among patients with HFpEF may provide better accuracy in predicting HHF and LVDD compared to the use of either EATt or NLR alone.
