Browsing by Author "Özdogan, Ö"
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Item Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspneaÇolak, A; Çuhadar, S; Gölcük, B; Gölcük, Y; Özdogan, Ö; Çoker, IObjective: Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction in a typical population attended to emergency department with acute dyspnea. Methods: In this cross-sectional study, all consecutive patients with acute dyspnea underwent clinical evaluation, laboratory assessment of NT-proBNP, and echocardiographic examinations. Among subjects, 54.5% were diagnosed as heart failure. Grouping variables according to renal function capacity and ejection fraction, independent variables were compared with Kruskal-Wallis or ANOVA with posthoc tests. Correlation and linear regression analysis were done to analyze the variables associated with NT-proBNP. The diagnostic performance of NT-proBNP was evaluated by receiver-operating characteristic (ROC) curve. Results: Serum median NT-proBNP level in patients with severe renal impairment was significantly higher than moderate and mildly decreased renal functions (p=0.001). In patients with moderate and severe left ventricular failure, NT-proBNP was significantly higher compared with normal subjects (LVEF>50%) (p=0.040, and 0.017, respectively). Renal dysfunction was associated in 56% of patients with heart failure. The area under the ROC curve of NT-proBNP for identifying left ventricular failure in patients with renal failure (eGFR<90 mL/min/1.73 m(2)) was 0.649 and reached significant difference (95% CI:0.548-0.749, p=0.005). Conclusion: In addition to NT-proBNP measurement in clinical judgement of heart failure, renal functions have to be taken into consideration to avoid misdiagnosisItem The Diagnosis of Yo-Yo Reflux with Dynamic Renal Scintigraphy in a Patient with Incomplete Ureteral DuplicationÖzdogan, Ö; Ates, O; Kart, Y; Aras, F; Olguner, M; Akgür, F; Durak, HThe diagnosis of yo-yo reflux in patients with incomplete upper collecting system duplications is difficult. We report a case with recurrent urinary tract infections and ultrasonographically detected duplication in the left collecting system in which the presence of yo-yo reflux is demonstrated with dynamic renal scintigraphy.Item PREDICTORS OF NEW-ONSET ATRIAL FIBRILLATION AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE ELDERLYKartal, E; Elbi, H; Alp, A; Sahin, S; Özbakkaloglu, M; Özdogan, ÖObjective: The predictors and outcomes of new-onset atrial fibrillation (AF) were evaluated among elderly patients with acute ST elevation myocardial infarction (STEMI). Material and Method: Patients with STEMI who are older than 65 years were evaluated for new-onset AF and its complications. Patients with a previous history of AF and those found in AF at the time of admission were excluded. Results: Of the 102 patients with STEMI, AF was not observed in 74 patients (Group I) and was observed in 28 patients (Group II) during hospitalization. Those 28 patients with AF were further divided into two subgroups according to the onset time of AF (early <24 hours and late >24 hours). Anterior MI was observed in 49% of patients in Group I and 71.4% of patients in Group II (p<0.05). In late onset AF group; pulse rate, systolic and diastolic blood pressure were significantly higher than Group I at admission to the hospital (p<0.05). All patients in Group II had higher Killip class and TIMI risk scores than Group I patients (p<0.05). Left ventricular ejection fraction was 30.4 +/- 4.0% in the late onset group and 44.4 +/- 8.8% in Group I (p<0.05). There was a significant difference in mortality rate among groups during hospitalization period; 36% in Group II, 9% in Group I (p<0.05). Conclusion: AF is especially seen in elderly female patients with anterior MI and higher Killip Class. It is associated with higher rates of in-hospital mortality. Particularly, late-onset AFs are associated with lower LVEFs in older patients with STEMI and could be predictors of in hospital mortality.Item Serum N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and homocysteine levels in type 2 diabetic patients with asymptomatic left ventricular diastolic dysfunctionGörmüs, U; Özmen, D; Özmen, B; Parildar, Z; Özdogan, Ö; Mutaf, I; Bayindir, OAims: : The aim of this study was to determine serum NT-proBNP and plasma Hcy levels and to explore the relationship between serum NT-proBNP and plasma Hcy levels in type 2 diabetic patients with and without asymptomatic LVDD. Methods: : NT-proBNP and Hcy levels were measured 31 patients with type 2 diabetes mellitus. According to echocardiographic data, diabetic patients were divided into two groups: normal LV function or LV diastolic dysfunction. Results: : Serum NT-proBNP levels in diabetic patients with LVDD were significantly higher than in diabetic patients with normal LV function and controls. The area under the receiver-operating characteristic (ROC) curve for NT-proBNP to separate normal vs. diastolic dysfunction was 0.96 in type 2 diabetic patients. Plasma Hcy levels were significantly higher in both diabetic groups than in controls. Positive correlation was noted between NT-proBNP and Hcy levels in diabetic patients with LVDD (r = 0.881, p = 0.0001). Conclusions: : The correlation between elevated NT-proBNP and Hcy levels in diabetic patients with LVDD suggest an association between homocysteinemia and increased NT-proBNP secretion. Our data indicate that NT-proBNP may be a simple screening tool to select diabetic patients with LVDD requiring further examination with echocardiography. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Item 33 Questions about Triglycerides and Cardiovascular Effects: Expert AnswersÇetinkalp, S; Koylan, N; Özer, N; Onat, A; Özgen, AG; Koldas, ZL; Güven, GS; Özdogan, Ö; Karsidag, K; Yigit, Z; Kayikçioglu, M; Tokgözoglu, L; Can, LH; Tartan, Z; Kültürsay, H; Karpuz, B; Kirilmaz, B; Ersanli, M; Ural, D; Erbakan, AN; Oguz, A; Kayikçioglu, ÖR; Temizhan, A; Sansoy, V; Ceyhan, C; Öngen, Z; Bayram, F; Örem, C; Sönmez, A; Beyaz, S; Ükinç, K; Yürekli, BS; Çoker, M; Canda, E; Simsir, IY