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Öğe Akut pulmoner emboli tanısı alan hastalarda çözünebilir CD40 ligand düzeyi ve ekokardiyografik parametreler(Selçuk Üniversitesi Tıp Fakültesi, 2010) Kaya, Zeynettin; Özdemir, KurtuluşAmaç: Bu çalışmamızda, hayatı tehdit edici ve görece sık karşılaşılan acil bir kardiyovaskuler patoloji olan akut PE'nin patogenezini daha fazla aydınlatabilmek, erken tanı ve risk sınıflamasına katkıda bulunabilmek amacıyla özellikle enflamasyon ve tromboz ile ilişkili çCD40L düzeylerinin akut PE hastalarında benzer demografik özelliklere sahip olan kontrol grubu ile kıyaslanması hedeflenmiştir. Bunun yanında Akut PE hastalarında konvansiyonel ve doku Doppler ekokardiyografik parametrelerindeki farklılıklar ve bunların çCD40L değerleri ile ilişkisi araştırılmıştır. Metod: Tanımlayıcı ve kesitsel çalışmamıza, Ocak 2010 ve Temmuz 2010 tarihleri arasında Selçuk Üniversitesi Meram Tıp Fakültesi Hastanesi'nde akut PE tanısı konan 65 hasta ve hastalar ile benzer demografik özellikleri ve komorbiditeleri olan sağlıklı 29 gönüllü dâhil edildi. Hastaların tümünün, kontrol grubunun 21'nin çCD40L değerleri ELİSA yöntemi ile eBioscience (BenderMed Systems, Avusturya) kiti kullanılarak çalışıldı. Hasta ve kontrol grubunun geleneksel iki boyutlu ve Doppler ekokardiyografik verileri yanında doku Doppler ekokardiyografik parametreleri kaydedildi. Hasta ve kontol grubunda elde edilen değişkenler karşılaştırıldı. Bulgular: Hasta ve kontrol grupları arasında demografik özellikler ve komorbiditeler açısından istatiksel farklılık yoktu. çCD40L düzeyinin akut PE hastalarında (5.3 ng/ml), kontrol grubuna(1.4 ng/ml) göre istatiksel olarak anlamlı düzeyde artmış olduğu görüldü (P<0.001). çCD40L kestirim değeri 0.7 ng/ml olarak alındığında PE olgularını tanıma yönünden duyarlılık 0.71, özgüllük 0.52, pozitif tahmin değeri 0.82, negatif tahmin değeri 0.37 ve tanısal doğruluğu 0.65 olarak hesaplandı. çCD40L değerleri ile akut PE ciddiyetinin göstergesi olan ekokardiyografi parametreler arasında istatiksel anlamlı ilişki izlenmedi. Hasta grubunda SğV EF belirgin düşük (46.2 karşı 60.5 P<0.001), PAB anlamlı yükek (45 mmHg karşı 24.7 mmHg P<0.001) ve İVC kollaps indeksi istatiksel anlamlı düzeyde düşük (0.36 karşı 0.62 P<0.001) tespit edildi. Pulsed wave doku Doppler tekniği ile değerlendirilen SğV MPİ'nin akut PE hastalarında kontrol grubuna göre alamlı düzeyde arttığı (0.53 karşı 0.43 P<0.001), SğV E/Em oranının anlamlı olarak daha yüksek olduğu (6.5 karşı 5,0 P: 0.04) ve SğV İVRZ'nin anlamlı şekilde uzadığı(67msn karşı 57msn P<0.001) tespit edildi. Sonuç: çCD40L daha önce yapılan çalışmalarda aterotromboz ve enflamasyonda gösterilmiş olan rolü yanında venöz tromboz patogezinde de rolü olduğu, ilk olarak gösterilmiştir. Prediktif ve prognostik değeri açısından ileri çalışmalara ihtiyaç duyulmaktadır. Bunun yanında özellikle SğV EF, İVC kollpaps indeksi, Sm, MPİ, E/Em gibi ekokardiyografik parametreler PE olgularının tanısında kullanılabilecek değişkenler olarak tespit edilmiştir.Öğe Arterial Stiffness and Carotid Intima-Media Thickness in Diabetic Peripheral Neuropathy(INT SCIENTIFIC LITERATURE, INC, 2014) Avci, Ahmet; Demir, Kenan; Kaya, Zeynettin; Marakoglu, Kamile; Ceylan, Esra; Ekmekci, Ahmet Hakan; Yilmaz, AhmetBackground: We investigated the relationship between peripheral neuropathy and parameters of arterial stiffness and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Material/Methods: The study included 161 patients (80 females and 81 males), 69 of whom had peripheral neuropathy. All patients underwent 24-h blood pressure monitoring, and arterial stiffness parameters were measured. The CIMT was measured using B- mode ultrasonography and patients also underwent transthoracic echocardiographic examination. Results: Patients with peripheral neuropathy, compared with those without it, were older (54.68 +/- 8.35 years vs. 51.04 +/- 7.89 years; p= 0.005) and had T2DM for longer periods (60 vs. 36 months; p= 0.004). Glycated hemoglobin (HbA1c) values (8.55 +/- 1.85 mg/dL vs. 7.30 +/- 1.51 mg/dL; p<0.001), pulse wave velocity (PWV) (7.74 +/- 1.14 m/s vs. 7.15 +/- 1.10 m/s; p= 0.001), CIMT (anterior 0.74 +/- 0.15 mm vs. 0.67 +/- 0.13 mm; p= 0.01), and left ventricular mass (LVM) index (98.68 +/- 26.28 g/m(2) vs. 89.71 +/- 19.70 g/m(2); p= 0.02) were all significantly increased in the group with peripheral neuropathy compared to the group without peripheral neuropathy. We determined that duration of diabetes, HbA1c, and LVM index were predictors of peripheral neuropathy. Conclusions: A significant relationship was found between diabetic neuropathy and increased PWV, a parameter of arterial stiffness, as well as CIMT, a marker of systemic atherosclerosis. Diabetic peripheral neuropathy may be a determinant of subclinical atherosclerosis in T2DM.Öğe Assessment of atrial electromechanical delay and P-wave dispersion in patients with type 2 diabetes mellitus(ELSEVIER, 2016) Demir, Kenan; Avci, Ahmet; Kaya, Zeynettin; Marakoglu, Kamile; Ceylan, Esra; Yilmaz, Ahmet; Ersecgin, AhmetObjectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24 hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 +/- 10.2 ms vs. 102.2 +/- 7.5 ms, p = 0.02; 40.6 +/- 7.6 ms vs. 33.6 +/- 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 +/- 7.8 ms vs.11.2 +/- 4.4 ms, p < 0.001; 9.0 +/- 7.3 ms vs. 6.0 +/- 3.8 ms, p = 0.002, and 7.4 +/- 5.2 ms vs. 5.1 +/- 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428,p < 0.001). Conclusions: In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera(WILEY-BLACKWELL, 2011) Kayrak, Mehmet; Acar, Kadir; Gul, Enes Elvin; Baglicaklioglu, Murat; Kaya, Zeynettin; Sonmez, Osman; Aydogdu, IsmetAims: The aim of this study was to evaluate myocardial performance index (MPI) which reflects the combined systolic and diastolic performance of the ventricles by tissue Doppler imaging (TDI) in patients with polycythemia vera (PV). Method and Materials: Twenty-eight patients with PV (17 men; mean age 60 +/- 9 years) and 30 age-matched healthy subjects were prospectively evaluated. The diagnosis of PV was performed according to the World Health Organization (WHO) criteria. Left ventricular (LV) systolic and diastolic functions were assessed by conventional echocardiography and TDI. MPI of both the LV and right ventricles (RV) were measured by TDI method. Results: The LV MPI was significantly higher in PV group than in the controls (0.61 +/- 0.16 vs. 0.49 +/- 0.05; P = 0.001). Also, the RV MPI was impaired in patients with PV compared to the control subjects (0.51 +/- 0.11 vs. 0.43 +/- 0.09; P = 0.005). RV late A filling velocity (Am) and RV isovolumetric relaxation time were significantly higher in the PV group compared to healthy subjects (P = 0.03 and 0.05, respectively). In logistic regression models, PV was determined as an independent predictor of impaired MPI (odds ratio: 3.7; CI 95%, 1.2-7.5). In addition, pulmonary arterial pressure was significantly elevated in patients with PV compared to the controls (P = 0.02). Conclusion: This study demonstrated that biventricular MPI is impaired in patients with PV. (Echocardiography 2011;28:948-954)Öğe The Association Among Lipoprotein-associated Phospholipase A2 Levels, Total Antioxidant Capacity and Arousal in Male Patients with OSA(IVYSPRING INT PUBL, 2011) Bekci, Taha T.; Kayrak, Mehmet; Kiyici, Aysel; Maden, Emin; Ari, Hatem; Kaya, Zeynettin; Teke, TurgutBackground: The mechanisms of the increased cardiac and vascular events in patients with OSA are not well understood. Arousal which is an important component of OSA was associated with increased sympathetic activation and electrocardiographic changes which prone to arrhythmias. We planned to examine the association among arousal, circulating Lp-PLA2 and total antioxidant capacity in male patients with OSA. Methods: Fifty male patients with newly diagnosed OSA were enrolled the study. A full-night polysomnography was performed and arousal index was obtained. Lp-PLA2 concentrations were measured in serum samples with the PLAC Test. Total antioxidant capacity in patients was determined with Antioxidant Assay Kit. Results: Arousal was positively correlated with LP-PLA2 levels (r=0.43, p=0.002) and was negatively correlated with total antioxidant capacity (r= -0.29, p=0.04). Elevated LP-PLA2 levels and decreased total antioxidant activities were found in the highest arousal quartile compared with the lowest and 2nd quartiles (p=0.02, p=0.05, respectively). LP-PLA2 was an independently predictor of arousal index in regression model (beta=0.357, p=0.002) Conclusions: This study demonstrated a moderate linear relationship between arousal and LP-PLA2 levels. Also, total antioxidant capacities were decreased in the higher arousal index. Based on the study result, the patients with higher arousal index may be prone to vascular events.Öğe Association of paraoxonase-1 activity and major depressive disorder in patients with metabolic syndrome(SPRINGER INDIA, 2015) Ari, Hatem; Kayrak, Mehmet; Gunduz, Mehmet; Kayhan, Fatih; Kaya, Zeynettin; Kiyici, Aysel; Uguz, FarukAssociations between metabolic syndrome (MS) and major depressive disorder (MDD) are well documented although the underlying biological mechanisms for this relationship are less studied. Paraoxonase (PON1) is a high-density lipoprotein (HDL)-associated enzyme, with demonstrated evidence of strong antioxidant activity. Oxidative stress has been implicated in the pathophysiology of MS and MDD. PON1 activity has been studied to some extent in patients with MS and less in MDD. The aim of this study was to compare serum PON1 activity in patients with MS and MDD, MS without MDD, and normal control groups in the context of the biological mechanism of the association between MS and MDD. In this case-control study, 67 patients with MS and 25 healthy controls from the hospital-university staff were recruited. All patients and healthy controls were assessed by a semi-structured psychiatric interview. Patients with MDD were diagnosed according to the DSM-IV criteria for MDD. Serum PON1 activity was determined with a spectrophotometric method, and the activity was compared between patients with MS and MDD, with MS but without MDD, and control groups. Serum PON1 activity levels were lower in patients with MS and MDD group compared to those in the patients with MS and without MDD group and control group (69.5+/-24.2, 84.3+/-34.6, and 97.1+/-40.8 U/ml, p=0.03, respectively). Post hoc analysis showed that PON1 activity was statically significantly lower in the MS with MDD group than in the control group (p=0.02). Impaired PON1 activity, in the context of enhanced oxidative stress, could be one of the possible underlying biological mechanisms of the MS-MDD association.Öğe A Bizarre Electrocardiographic Pattern Due to Chronic Lithium Therapy(Wiley, 2010) Kayrak, Mehmet; Duman, Çetin; Gül, Enes Elvin; Sönmez, Osman; Kaya, Zeynettin; Arı, HatemCardiotoxicity that results from lithium overdose is uncommon and electrocardiographic (ECG) changes are rarely reported. However, some authors have specifically reported the occurrence of ischemic ECG changes due to a lithium overdose. This article describes a case that is demonstrating ECG changes that mimic inferior myocardial infarction during the course of chronic lithium treatment and showing QTc prolongation in this patient. The patients’ ECG changes were partially recovered after hemodialysi.Öğe Clinical Characteristics and Outcome of Cardiovascular Implantable Electronic Device Infections in Turkey(SAGE PUBLICATIONS INC, 2016) Aydin, Mesut; Yildiz, Abdulkadir; Kaya, Zeynettin; Kaya, Zekeriya; Basarir, Ahmet Ozgur; Cakmak, Nazmiye; Donmez, IbrahimInfection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality.Öğe The effects of spironolactone on atrial remodeling in patients with preserved left ventricular function after an acute myocardial infarction: a randomized follow-up study(LIPPINCOTT WILLIAMS & WILKINS, 2010) Kayrak, Mehmet; Bacaksiz, Ahmet; Vatankulu, Mehmet A.; Ayhan, Selim S.; Ari, Hatem; Kaya, Zeynettin; Ozdemir, KurtulusObjectives Atrial remodeling is an important part of cardiac remodeling after acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of spironolactone on atria in patients with preserved left ventricular (LV) functions after AMI by using two-dimensional and tissue Doppler imaging techniques (TDI). Methods The study consisted of 110 patients with AMI, successfully revascularized with percutaneous coronary intervention, ejection fraction greater than or equal to 40%, and Killip class I-II. Patients were randomized into two groups: conventional therapy (n=55) and additional spironolactone of 25 mg/day with standard conventional therapy (n=55). Echocardiography was performed in the first 48-72 h of AMI and during 6 months of follow-up. Left atrial volume index and emptying fraction were obtained. The peak regional atrial contraction velocity, the time between the onset of p-wave on the monitor ECG and the onset, peak, and the end (TE) of the atrial contraction wave on the tissue Doppler technique curve were measured. Results The left atrial volume index and left atrium (LA) dimensions did not significantly change in either group. In the spironolactone group, left atrial emptying fraction increased compared with both baseline value ( from 53.0 +/- 0.16 to 57.0 +/- 0.13 P = 0.011) and conventional therapy group (from 50.0 +/- 0.17 to 47.0 +/- 0.16, P = 0.013). The atrial contraction velocity did not change but the LA-TE, interatrial septum-TE, and right atrium-TE were prolonged in the conventional therapy group. Conclusion Additional spironolactone therapy provided a little benefit on LA remodeling and atrial electromechanic properties in patients with AMI and preserved LV functions. Coron Artery Dis 21:477-485 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.Öğe Electrocardiographic Findings in Patients with Polycythemia Vera(IVYSPRING INT PUBL, 2012) Kayrak, Mehmet; Acar, Kadir; Gul, Enes Elvin; Abdulhalikov, Turyan; Baglicaklioglu, Murat; Sonmez, Osman; Kaya, ZeynettinBackground: The 12-lead surface electrocardiogram (ECG) is a useful tool to predict both atrial and ventricular arrhythmias via P-wave and QT measurements and its derivatives. Polycythemia vera (PV) is a chronic myeloproliferative disorder associated with cardiovascular events. The aim of this study was to assess ECG findings of patients with PV. Method and materials: Sixty patients with PV (34 male, mean age 58 +/- 11 years) and 60 age and gender-matched healthy volunteers were enrolled into the study. From the 12-lead surface ECG, P-wave and both conventional QT measurements and transmyocardial repolarization parameters (T-peak-T-end interval (T-p-T-e) and derivatives) were evaluated digitally by two experienced cardiologists. In addition, a novel parameter, Pi was calculated digitally as the standard deviation of the P-wave duration across the 12 ECG leads. Results: QT duration and corrected QT interval were significantly longer in the PV group compared to healthy controls (p<0.01 and p<0.01, respectively). The T-p-T-e was longer and the T-p-T-e/QT ratio was significantly higher in the PV group compared to the controls. P-wave analyses showed that all P-wave parameters including Pmax, Pmin, P dispersion, and Pi were significantly prolonged in PV patients compared to the controls. The increase of both T-p-T-e and P max in the PV group was independent of age, BMI, diabetes and hypertension, gender, systolic blood pressure, hemoglobin, hematocrit, left atrial dimension, left ventricular end-diastolic diameter and early deceleration time in a univariate analysis of co-variance model (F= 11.097, p= 0.001 and F= 31.537, p= 0.0001, respectively). Conclusion: The present study demonstrated that PV may be associated with electrocardiographic abnormalities of both atrium and ventricle.Öğe Epicardial Fat Tissue Predicts Increased Long-Term Major Adverse Cardiac Event in Patients With Moderate Cardiovascular Risk(SAGE PUBLICATIONS INC, 2015) Ulucan, Seref; Kaya, Zeynettin; Efe, Duran; Keser, Ahmet; Katlandur, Huseyin; Aygun, Fatih; Ulgen, Mehmet SiddikWe investigated the relationship between epicardial fat volume (EFV) measured by multislice computed tomography (MDCT) and long-term major adverse cardiac events (MACEs). Consecutive patients (n = 564) were enrolled in this retrospective study. Patients were divided into tertiles according to EFV. Patients were followed up for an average of 18 months. Patients in each tertile were similar in terms of gender and risk factors. Patients with greater EFV in the third group were more likely to be overweight (P = .001) and older (P = .001). High-density lipoprotein cholesterol levels were relatively lower in the third tertile (45 +/- 9, 45 +/- 11, and 43 +/- 9 mg/dL, respectively; P = .018). The third group had a significantly higher rate of myocardial infarction (0.6%, 1.1%, and 3.7%, respectively; P = .043). The incidence of MACEs during the follow-up period was highest in the third group 15.9% (4.1%, 7.7%, and 15.9%, respectively; P = .001). Epicardial fat volume measured by MDCT was associated with increased long-term cardiovascular risk.Öğe Exaggerated Blood Pressure Response to Exercise - A New Portent of Masked Hypertension(Taylor & Francis Inc, 2010) Kayrak, Mehmet; Bacaksız, Ahmet; Vatankulu, Mehmet Akif; Ayhan, Selim S.; Kaya, Zeynettin; Ari, Hatem; Sönmez, Osman; Gök, HasanMasked hypertension (MHT) is a popular entity with increased risk of developing sustained hypertension, heart attack, stroke, and death. Subjects have normal blood pressure (BP) at office but elevated values at night so it is difficult to diagnose. Exaggerated blood pressure response to exercise (EBPR) is also a predictor of future hypertension. To investigate the relationship between these two entities, we evaluated 61 normotensive subjects with EBPR. The subjects underwent 24-h ambulatory blood pressure monitoring (ABPM). The prevalence of masked hypertension among subjects with EBPR was 41%. Body mass index (BMI), non-high density lipoprotein (HDL) cholesterol, diastolic blood pressure (DBP) at peak exercise and recovery, nondipping DBP pattern, and elevated early morning average BPs were associated with masked hypertension. In multivariate logistic regression analysis, the DBP measured at peak exercise was detected as an independent predictor of MHT in subjects with EBPR. Subjects with abnormally elevated BP during exercise are prone to MHT, necessitate medical assessment and close follow-up for hypertension.Öğe Percutaneous Transcatheter Closure of Double Atrial Septal Defects with Double Amplatzer Septal Occluder Devices(Elsevier Ireland Ltd, 2010) Kaya, Zeynettin; Ülgen, Mehmet Sıddık; Kayrak, Mehmet; Göktekin, ÖmerA 19-year-old female college student was admitted to hospital with effort dyspnea and palpitations. On physical examination her arterial blood pressure was normal. There was normal S1, fixed splitting S2 and no systolic ejection murmur on auscultation. The electrocardiogram showed sinus tachycardia at a rate of 87 bpm and incomplete right bundle branch block. Right atrial and ventricular enlargements were noted as well as suspected interatrial flow on transthoracic echocardiographic (TTE) evaluation. Transesophageal echocardiography (TEE) was performed and revealed a left to right interatrial shunt via 2 Atrial Septal Defects (ASD): the defects sizes were 12mm and 17mm respectively.Öğe Prevalence and Pattern of Cardiovascular Symptoms and Diseases in Pediatric Patients: Insights from a Single-Center Observational Study with a Focus on Age and Gender(Selçuk Üniversitesi, 2024 Şubat) Polat, Fuat; Kaya, ZeynettinABSTRACT Background/Aims: This single-center, cross-sectional study aimed to investigate the prevalence and patterns of cardiovascular symptoms and findings among pediatric patients aged 1-18 years, focusing on age and gender as potential influencing factors. Methods: Pediatric patients aged 1-18 years with cardiovascular symptoms grouped as murmur, dyspnea, chest pain, palpitation, syncope and cyanosis were examined, categorized by age (1-6, 7-12, 13-18) and gender (male and female) using electronic medical records, undergoing comprehensive clinical assessments including examinations, ECGs, and echocardiograms. Statistical analyses unveiled prevalence trends. Results: 720 patients were included in the study and 53.9% of them were female. The prevalence of symptoms and diseases varied by age. Chest pain was more common in 13-18 group; cardiac murmurs linked to congenital defects were more common in 1-6 group; valve and pericardial/ myocardial diseases were more common in the 7-12 age group. Gender had no significant effect on disease patterns. Conclusion: The study emphasizes the importance of age-appropriate management and personalized management in cardiovascular diseases. Gender did not have a significant role in terms of cardiovascular diseases.Öğe The relationship between white coat hypertension and sleep quality(SPRINGER JAPAN KK, 2014) Kaya, Zeynettin; Kayrak, Mehmet; Demir, Kenan; Gunduz, Mehmet; Alibasic, Hayruddin; Karanfil, Mustafa; Akilli, HakanImpaired sleep quality is frequently associated with hypertension. The present study aims to examine self-reported sleep quality of patients with white coat hypertension. A total of 74 subjects who were evaluated in a cardiology outpatient clinic, including 39 normotensive subjects and 35 patients with white coat hypertension between the ages of 20 and 65 were included in this study. Patients with elevated office blood pressure (>= 140/90 mm Hg) and normal 24-h and daytime ambulatory blood pressure (<125/80 mm Hg and <130/85 mm Hg, respectively) were defined as white coat hypertension. Patient's sleep quality was evaluated using the Pittsburgh sleep quality index. Global Pittsburgh sleep quality index score was significantly higher in patients with white coat hypertension than normotensive subjects (7.2 +/- 3.7 vs. 5.1 +/- 3.8, P = 0.01). Poor sleep quality was present in 65% of patients with white coat hypertension, and in 30% of the normotensive group (P = 0.003). A multiple logistic regression analysis showed that white coat hypertension (odds: 6.7 (95% confidence interval [CI] 1.22-36.64), P = 0.03) and female gender (odds: 10.1(95% CI 1.35-76.32), P = 0.02) were independent predictors of poor sleep quality. In conclusion, white coat hypertension seems to be associated with impaired sleep quality.Öğe Right coronary artery compression caused by mediastinal hematoma after aortic dissection operation(VIA MEDICA, 2011) Gul, Enes Elvin; Kaya, Zeynettin; Kartin, Mustafa; Ozbek, Orhan; Can, Ilknur[Abstract not Available]Öğe Soluble CD40 Ligand Levels in Acute Pulmonary Embolism: A Prospective, Randomized, Controlled Study(SPRINGER, 2012) Kaya, Zeynettin; Özdemir, Kurtuluş; Kayrak, Mehmet; Gül, Enes Elvin; Altunbaş, Gökhan; Duman, Çetin; Kıyıcı, AyselCD40 ligand is a thromboinflammatory molecule that predicts cardiovascular events. Platelets constitute the major source of soluble CD40 ligands (sCD40L), which has been shown to influence platelet activation. The main aim of this study was to evaluate sCD40L levels in patients with acute pulmonary embolism (PE). Sixty-five PE patients (32 males, mean age 58 +/- A 12 years) and 29 healthy controls (15 males, mean age 56 +/- A 14 years) were enrolled in the study. sCD40L levels were evaluated at the enrollment by ELISA method. Multislice detected pulmonary computed tomography was performed on all patients with a suspected diagnosis of PE. In addition, echocardiography was performed to evaluate right ventricular (RV) dysfunction. There was no statistically significant difference between the two groups regarding demographic features. sCD40L levels were significantly higher in acute PE group compared to healthy controls (5.3 ng/ml and 1.4 ng/ml, respectively; < 0.001). sCD40L levels of patients with and without RV dysfunction were similar. Correlation analysis between echocardiographic findings and sCD40L levels did not show significant difference. The present study demonstrated a role of sCD40L in pathogenesis of PE for the first time. Further studies are needed to clarify a predictive and prognostic value of sCD40L levels in acute PE patients.Öğe A Successful Fibrinolytic Therapy of Trombus Entrapped in a Patent Foramen Ovale with Acute Pulmonary Embolism(Elsevier Ireland Ltd, 2010) Kaya, Zeynettin; Altunbaş, Gökhan; Doğan, Umuttan; Özdemir, Kurtuluş; Gök, HasanA 75-year old male patient without prior history of chronic disease was admitted to hospital with worsening dyspnea for three days. On admission he was hypotensive (90/60 mmHg) and tachycardic (121 beat/pm). Electrocardiogram showed right bundle branch block, deep S waves in DI, Q waves and negative T waves in DIII. Transthoracic echocardiography (TTE) which was performed in emergency service revealed dilated right heart chambers (right ventricle area/left ventricle area: 1.27), depressed right ventricle (RV) systolic functions (RV ejection fraction: 22%, RV lateral wall basal segment tissue doppler Sm: 11.2 cm/s), elevated pulmonary artery pressure (45mmHg). In 2-D images, there was a mobile thrombus entrapped in a patent foramen ovale (PFO) which was also entering RV via tricuspid valve. The condition was considered as having high surgical risk since the patient was hemodynamically unstable with decreased O2 saturation (SaO2: 83%), high creatinine levels (2.6 mg/dl) and advanced age. Slow intravenous. infusion of alteplase (100 mg/2 hours) was administered after carefully ruling out contraindications. Thereafter, blood pressure and SaO2 rapidly improved. Control TTE after infusion showed that the thrombus had been dramatically resolved and disappeared. Pulmonary artery pressure decreased (36 mmHg), RV ejection fraction (36%) and RV systolic wall motion improved (Sm:15.1 cm/s), RV dilatation regressed (RV area/left ventricle area: 0.87) shortly after initial therapy. After full recovery, the patient was discharged with oral anticoagulant therapy.Öğe White Coat Hypertension and Poor Sleep Quality(ELSEVIER SCIENCE INC, 2013) Kaya, Zeynettin; Kayrak, Mehmet; Demir, Kenan; Gunduz, Mehmet; Alibasic, Hayruddin; Karanfil, Mustafa; Akilli, Hakan[Abstract not Available]