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    Assessment of Inhomogeneities of Repolarization in Patients with Systemic Lupus Erythematosus
    (WILEY, 2014) Avcı, Ahmet; Demir, Kenan; Altunkeser, Bülent Behlül; Yılmaz, Sema; Yılmaz, Ahmet; Erseçgin, Ahmet; Demir, Tarık
    Objectives: Systemic lupus erythematosus (SLE) is a chronic disease that affects many organ systems and manifests a broad spectrum of laboratory and clinical features. SLE patients have an increased risk of developing cardiovascular disease. The aim of this study was to evaluate inhomogeneities of repolarization by using T-peak-T-end (Tp-e) interval and Tp-e/QT ratio were measured from the 12-lead surface electrocardiogram (ECG) in patients with SLE. Material and method: This study included 69 SLE patients (69 females; mean age 35.8 +/- 10.2) and 57 control subjects (57 females; mean age 34.5 +/- 8.9). Transthoracic echocardiographic examination was done in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead ECG. These parameters were compared between groups. Results: No statistically significant difference was found between two groups in terms of basic characteristics. Diastolic function parameters were similar between the two groups (P > 0.05). In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QT dispersion (cQTd) were significantly increased in SLE patients compared the control group (49.5 +/- 16.4 ms vs. 32.8 +/- 11.7 ms and 56.7 +/- 19.5 ms vs. 36.4 +/- 13.1 ms, all P value < 0.001). Tp-e interval and Tp-e/QT ratio were also significantly higher in SLE patients (82.8 +/- 18.9 vs. 72.4 +/- 17.6 and 0.22 +/- 0.05 vs. 0.19 +/- 0.05, P = 0.002 and P = 0.001, respectively). Tp-e interval and Tp-e/QT were positively correlated with disease duration (r = 0.29, P = 0.01 and r = 0.24, P = 0.04, respectively). Conclusion: Our study revealed that QTd, cQTd, Tp-e interval and Tp-e/QT ratio increased in patients with SLE. Also, Tp-e interval and Tp-e/QT were positively correlated with disease duration.
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    Fragmented QRS in patients with systemic lupus erythematosus
    (TAYLOR & FRANCIS LTD, 2014) Demir, Kenan; Avcı, Ahmet; Yılmaz, Sema; Demir, Tarık; Erseçgin, Ahmet; Altunkeser, Bülent Behlül
    Introduction. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Cardiac involvement is present in more than half of the patients with SLE. Fragmentation of QRS (fQRS) is presumed marker of cardiovascular risk and has not been previously evaluated in SLE. Methods. A total of 56 women previously diagnosed with SLE were recruited. In addition, a control group consisting of 51 healthy people was formed. QRS complexes were also evaluated in terms of fragmentations. All patients with SLE and control subjects underwent transthoracic echocardiographic examination. Erythrocyte sedimentation rate and C-reactive protein levels were also obtained. Results. Frequency of fQRS was higher in patients with SLE (41% vs. 21%, p = 0.03). Left ventricular posterior wall thickness and mass index were higher in the patients with SLE. CRP levels and age were significantly higher, and disease duration was significantly longer in the fQRS(+) group (p = 0.02, 0.01, and 0.006, respectively). Conclusion. A careful cardiovascular evaluation and follow-up is essential to continuously improve survival in SLE. For this purpose, fQRS may be used for the early detection in patients with SLE.
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    The relation between neutrophil-to-lymphocyte ratio and coronary chronic total occlusions
    (BIOMED CENTRAL LTD, 2014) Demir, Kenan; Avcı, Ahmet; Altunkeser, Bülent Behlül; Yılmaz, Ahmet; Keleş, Fikret; Erseçgin, Ahmet
    Background: Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that correlates with cardiac events. This study assessed the association between NLR and the presence of chronic coronary total occlusion (CTO). Methods: The study population included 225 patients, a control group (n = 75), a coronary artery disease group (n = 75), and a CTO group (n = 75). NLR was compared in the three groups. Results: NLR levels were significantly higher in the CTO than in the other two groups (p < 0.001). Bivariate correlation analysis showed a positive correlation between NLR and SYNTAX Score, and multivariate logistic regression analysis found that NLR was an independent predictor of CTO. ROC analysis showed that an NLR cut-off of 2.09 could distinguish between patients with and without CTO (AUC = 0.74; 95% CI, 0.68-0.81), with a specificity of 69.3% and a sensitivity of 61%. Conclusion: NLR may be useful as a marker of CTO.