Browsing by Author "Cetin, N"
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Item Association between uterine leiomyoma and fragmented QRS waves: a prospective case-control studyTatlici, TK; Cetin, N; Korpe, B; Kose, C; Korkmaz, VOBJECTIVE: The aim of this study was to evaluate the relationship between uterine leiomyoma and fragmented QRS, a non-invasive indicator of cardiovascular risk and myocardial ischemia, in women with uterine leiomyoma. METHODS: In this prospective case-control study, a total of 47 patients diagnosed with uterine leiomyoma (case group) and 47 healthy individuals without uterine leiomyoma (control group) who had undergone bilateral tubal ligation surgery were included. Various demographic, clinical, and laboratory parameters and the presence of fragmented QRS were recorded. RESULTS: The leiomyoma group showed significantly higher body mass index (27.46 +/- 2.18 vs. 25.9 +/- 2.87 kg/m(2), p=0.005) and waist circumference (91.34 +/- 9.30 vs. 84.97 +/- 9.3 cm, p=0.001) compared with the control group. Uterine volumes were also significantly higher in the leiomyoma group (235.75 +/- 323.48 vs. 53.24 +/- 12.81 mm3, p<0.001). The presence of fragmented QRS was detected in 18.1% of the patients. Multiple regression analysis identified age, fasting blood glucose value, and the presence of fragmented QRS as independent risk factors for the presence of leiomyoma. CONCLUSION: This study provides valuable insights into the relationship between uterine leiomyoma and fragmented QRS. The presence of fragmented QRS was identified as an independent risk factor for the presence of leiomyoma. Further research is needed to better understand the underlying mechanisms connecting uterine leiomyoma and cardiovascular health.Item Case report: Coexistence of takotsubo syndrome and severe mononeuritis multiplex in rheumatoid vasculitisAcar, EA; Uslu, S; Gemici, YI; Cetin, N; Temiz, P; Gündüz, OSItem Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patientsYavuz, V; Ozyurtlu, F; Cetin, NBackground: Hydroxychloroquine (HCQ) alone or with some antibiotic and antiviral agents is used off label in the treatment of Coronavirus Disease 2019 (COVID-19). It seems that the most important safety problem about these medications are their cardiac side effects. Although there are data on arrhythmogenic events associated with the use of HCQ alone, such as corrected QT (QTc) prolongation, Torsade de pointes (TdP) or bradycardia, there are insufficient data on its combination with moxifloxacin (MOX). Objective: The aim of our study is to analyze the effect of HCQ alone or in combination with the use of MOX on QTc interval, heart rate, and arrhythmic events in patients with a diagnosis of COVID-19. Methods: This is a single center cohort study of non-intensive care unit (ICU) patients hospitalized with clinical signs consistent with pneumonia and at least one positive COVID-19 nasopharyngeal polymerase chain reaction test result. QTc intervals and heart rates in patients whose treatment consisted of HCQ alone or its separate combination with MOX at baseline and post-treatment were calculated and compared. Results: 312 patients were included (median age of 42 [IQR: 31.25-57.75] years, 54.16% male). Patients were divided into two groups based on their in-hospital treatment strategy as follows: HCQ alone (n: 166, 53.20%) or HCQ + MOX (n: 146, 46.79%). As compared to baseline, QTc intervals were significantly increased in all patients after treatment (406.00 [388.00-422.00] ms vs 418.00 [401.00-435.00] ms, p<0.001). When the baseline QTc intervals were evaluated, there was no statistically significant difference between HCQ alone and HCQ + MOX groups (403.00 [384.50-419.00] ms vs. 409.50 [390.00-425.00] ms, p: 0.086). After treatment period, QTc intervals were significantly higher in HCQ + MOX group compared to the group in which patients only used HCQ (413.00 [398.00-430.00] ms vs. 426.50 [405.00-441.00] ms, p<0.001). We found a significant decrease in heart rate in both groups after treatment period. From 79.00 (70.00-88.00) bpm to 70.00 (63.00-79.00) bpm in HCQ alone group (p<0.001) and from 80.00 (70.00-88.00) bpm to 70.50 (63.00-78.75) bpm in HCQ + MOX group (p<0.001). On the other hand, no statistically significant difference was observed between the groups in terms of heart rates either before or after the treatment. Conclusion: In this cohort study, patients who received HCQ for the treatment of COVID-19 were at high risk of QTc prolongation, and concurrent treatment with MOX was associated with greater changes in QTc. However, none of patients experienced malignant ventricular arrhythmia or death during treatment. Clinicians should carefully weigh risks and benefits with close monitoring of QTc if considering treatment with HCQ especially concomitant use with MOX. Further prospective studies are needed to determine the exact implications of these drugs on arrhythmias in patients with COVID-19.Item Effect of Coronary Thrombus Aspiration in Non ST Elevation Acute Coronary Syndrome Patients on Three-Year Survival- Does it add any Benefit?Yildiz, BS; Cetin, N; Gunduz, R; Bilge, A; Ozgur, S; Orman, MNWe assessed the effect of thrombus aspiration (TA) during percutaneous coronary intervention (PCI) on in-hospital and 3-year mortality in consecutive non-ST segment elevation myocardial infarction (n = 189) and unstable angina pectoris (n = 148) patients (n = 337) between 2011 and 2016. In total, 153 patients (45.4%) underwent TA. The number of patients with postoperative thrombolysis in terms of myocardial infarction grade 3 blood flow (P < .001) and myocardial blush grade 3 (P < .001) were significantly higher in all TA groups. At 6-, 12- and 24-month post-PCI, the mean left ventricular ejection fraction was significantly higher in the all TA groups versus the stand alone PCI group (P < .001). Thrombus aspiration was associated with a significant improvement both in epicardial flow, myocardial perfusion and left ventricular ejection fraction. Thrombus aspiration during PCI in all acute coronary syndrome (except ST segment elevation) patients was associated with better survival compared with stand alone PCI group at 3-year follow-up (P = .019).Item Evaluation of coronary sinus strain in patients with dipper and nondipper hypertensionAkcay, S; Turker, Y; Kobat, MA; Cetin, N; Bilge, AR; Tezcan, UKObjective Hypertension has been reported to affect both the left and the right ventricular functions, but its effect on the coronary sinus has not been investigated. The aim of this study was to investigate the effect of systemic hypertension on the cardiac venous system by evaluating the coronary sinus strain (CSS). Methods One-hundred and twelve hypertensive patients without diabetes and 44 healthy individuals (the control group) were evaluated consecutively at the outpatient clinic and enrolled in the study. CSS was evaluated by echocardiography in all the participants before blood pressure evaluations. Twenty-four-hour ambulatory blood pressure monitoring enabled the study population to be divided into two groups: 52 patients with dipper pattern hypertension and 60 with nondipper pattern hypertension. Results Nondipper pattern patients had significantly lower values of CSS compared with the participants in the control group (140.8 +/- 54.2 and 193.9 +/- 48.1, P < 0.001). Similarly, dipper pattern patients had significantly lower values of CSS values compared with the controls (164 +/- 68.4 and 193.9 +/- 48.1, P = 0.036). On comparing the three groups, the CSS values showed a progressive decrease from normal individuals to dipper and nondipper hypertension patients. Correlation analysis indicated a positive correlation between the aortic strain and the CSS (r = 0.247, P = 0.002). There was a weak correlation between left ventricular mass and CSS (r = -164, P = 0.041). Conclusion Our study suggests that systemic hypertension may affect the cardiac venous system as well as the arterial system, which has been reported in many papers. The effect on the venous system may be more pronounced in nondipper pattern hypertension. Blood Press Monit 19: 320-326 (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Item Frontal QRS/T angle can predict mortality in COVID-19 patientsGunduz, R; Yildiz, BS; Ozgur, S; Ozen, MB; Bakir, EO; Ozdemir, IH; Cetin, N; Usalp, S; Duman, SAims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and nonischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation.Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90 degrees versus an fQRS angle <_90 degrees. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90 degrees group and 26.1% and 29.9% in the fQRS <_90 degrees group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90 degrees patient group versus the fQRS <_90 degrees group.Conclusion: In conclusion, a wide fQRS angle >90 degrees was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients.(c) 2022 Elsevier Inc. All rights reserved.Item HbA1c Levels Increase in Patients with Non-Dipper Hypertension without Diabetes MellitusAkçay, S; Kobat, MA; Inci, F; Birkan, Z; Yildiz, M; Dagli, N; Cetin, N; Bilge, ARItem Stress and workload impact of the COVID-19 pandemic on pulmonology residentsInam, MG; Cetin, N; Terzi, OE; Teke, NH; Parlak, M; Ozkul, A; Ugurlu, AOItem Utilization of different aspects of digital health among pulmonology residents in Turkey during the pandemicCetin, N; Inam, MG; Terzi, OE; Ozkul, A; Teke, NH; Parlak, M; Ugurlu, AO; Ugurlu, AÖItem Strenuous Exercise Induced Syncope Due to Coronary Artery AnomalyYavuz, V; Cetin, N; Tuncer, E; Dalgic, O; Taskin, U; Bilge, AR; Tikiz, HCoronary artery anomalies are among the neglected topics in cardiology. Anomalous origin of the left main coronary artery from the right sinus of valsalva is a rare coronary anomaly observed in 0.15% of patients. During exercise, the distended aorta and pulmonary artery with increased blood flow may squeeze the Left Main Coronary Artery (LMCA) between them. Even though arrhythmias are common causes of syncope, one should also think about aberrant coronary artery in the patients with syncope of unexplained origin. Patients experiencing exercise induced syncope accompanied by symptoms of coronary ischemia (typically: chest pain, ischemic findings on ECG, and raised cardiac markers) should be referred to diagnostic coronary angiography.0Item Turkish Thoracic Society Early Career Members Task Force Group's Virtual Congress Notes: European Respiratory Society International Congress 2020Kizilirmak, D; Karadogan, D; Yildirim, H; Akyil, FT; Eyüboglu, TS; Emiralioglu, N; Sertçelik, ÜÖ; Günaydin, FE; Ataoglu, Ö; Oguz, MS; Çakmakci, S; Özçelik, N; Öncel, A; Firincioglulari, A; Kara, BY; Ömer, D; Karaoglanoglu, S; Cetin, N; Karakas, FG; Gurkan, CG; Marim, F; Önyilmaz, T; Yulug, DP; Öztürk, NAA; Güçlü, ÖA; Küsbeci, TÇ; Serifoglu, I; Arikan, H; Töreyin, ZN; Çelik, P; Akgün, MIn this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers.Item Drug-induced QTc interval prolongation in PCR-positive non-ICU COVID-19 patients with diverse findings on chest computed tomographyOzyurtlu, F; Cetin, N; Yavuz, VBackground Some of the drugs used for the treatment of coronavirus disease (COVID-19) can increase the risk of corrected QT (QTc) interval prolongation, which may trigger arrhythmia or even death. Due to the low sensitivity of the reverse transcriptase-polymerase chain reaction (RT-PCR) test, chest computed tomography (CT) imaging is being used for COVID-19 diagnostic correlation and to evaluate whether there is pneumonic involvement in the lung. Objective In this study, we aimed to investigate the correlation between lung changes on CT and QTc interval changes on ECG in non-ICU patients with COVID-19 who have a positive PCR test when using drugs that can prolong the QTc interval. Methods This was a single-centre retrospective cohort study of hospitalized non-ICU patients. The study included 344 patients (56.1% men) with a mean age of 46.34 +/- 17.68 years. The patients were divided into four groups according to their chest CT results: those having typical, atypical, indeterminate, or no pneumonic involvement. The mean QTc intervals and heart rates calculated from electrocardiograms (ECG) during admission to the hospital and after the treatment were compared. Results No significant differences were found between the groups' age, gender, and body mass index (BMI). In addition, no significant differences were found between the groups' mean QTc interval values at admission (P:.127) or after the treatment (P:.205). The groups' heart rate values were also similar, with no significant differences in the mean heart rate on admission (P:.648) and post-treatment (P:.229) ECGs. Conclusion This study has demonstrated findings of COVID-19 infection based on chest CT does not correlate with QT interval prolongation in non-ICU COVID-19 patients. There is a need for additional larger studies investigating the effect of chest CT findings on QT interval prolongation and bradycardia in COVID-19 patients.