Browsing by Author "Yavuz, V"

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    Why fear can be fatal?
    Tuncer, E; Yavuz, V; Turk, UO; Alioglu, E
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    Comparison of Access Site Complications After Early or Late Sheath Removal in Patients with PCI, Regardless of ACT Levels
    Özyurtlu, F; Özdemir, IH; Çetin, N; Yavuz, V
    Background: Despite the lack of supporting data, many clinics perform sheath removal 4-6 hours after femoral percutaneous coronary intervention to reduce the risk of possible access site complications. This study aims to examine the effects of sheath removal immediately after the procedure on access site complications and patient comfort. Methods: This prospective study included 349 patients who underwent percutaneous coronary intervention via the femoral site and 6 French guiding catheters. The sheath in the early group was removed immediately after the procedure without checking the activated clotting time levels but after 4 hours in the late group. Access site complications were recorded and patient comfort was evaluated using the Visual Analog Scale. Results: Patients were divided into 2 groups: patients in the early removal group (n = 171) and in the late removal group (n = 178). There was no statistically significant difference between the 2 groups in terms of access site complications. Three patients in the early removal group and 4 patients in the late removal group developed a hematoma. Six patients in the early removal group and 10 patients in the late removal group showed ecchymosis. The Visual Analog Scale score was statistically significantly lower in the early removal group compared with that in the late removal group [2 (1-3) vs. 3 (2-4), P < .001]. Conclusion: This study shows that immediate sheath removal is safe and more comfortable for patients with percutaneous coronary intervention who received weight-adjusted dose of heparin, regardless of the percutaneous coronary intervention levels after the procedure.
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    Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients
    Yavuz, V; Ozyurtlu, F; Cetin, N
    Background: 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.
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    Comparison of Framingham risk score and atherogenic indices as a predictor of atherosclerosis in patients with myocardial bridge in left anterior descending artery
    Çetin, N; Özlek, B; Özdemir, IH; Yildiz, BS; Yavuz, V; Tikiz, H
    Background Myocardial bridge (MB) is generally considered as a benign condition, but it may trigger atherosclerosis, especially in the adjacent proximal coronary artery segment. In this study, we aimed to investigate whether the Framingham risk score (FRS) or atherogenic indices are risk factors for coronary atherosclerosis in patients with MB in the left anterior descending coronary artery (LAD). Methods We performed a retrospective study evaluating 155 patients who have MB in LAD. The patients were evaluated in two groups according to the presence of atherosclerosis (74 patients in atherosclerotic group vs. 81 patients in non-atherosclerotic group). Baseline characteristics, FRS and atherogenic indices were reviewed between groups. Significant independent risk factors for coronary atherosclerosis were investigated by logistic regression analysis. Results Patients in atherosclerotic group were significantly older (58.15 +/- 10.04 vs. 50.22 +/- 9.27 years, p < .001) and 74.3% of the patients were male. While the mean FRS in the atherosclerotic group was 21.20 +/- 8.81, it was 12.79 +/- 8.61 in the non-atherosclerotic group (p < .001). Among the atherogenic indices, only LDL-c/HDL-c ratio was significantly higher in the atherosclerotic group (3.49 +/- 1.2 vs. 3.11 +/- 0.98, p:.033). Multivariable analysis showed that age (OR: 1.08, 95% CI 1.03-1.13, p < .001) and FRS (OR: 1.06, 95% CI 1.01-1.11, p:.012) were independently associated with the presence of atherosclerotic lesion. Conclusions FRS is an easily applicable predictor in clinical practice that indicates the presence of coronary atherosclerosis in patients with MB in LAD.
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    The Echocardiographic Evaluation of Right Ventricular Function in Patients with Non-Dipper Hypertension
    Akçay, S; Bilge, AR; Turker, Y; Yavuz, V; Çetin, N; Dalgic, O
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    The effect of long-term continuous positive airway pressure treatment on systolic and diastolic function in patients with obstructive sleep apnoea syndrome: A five year observational study
    Bilge, AR; Yavuz, V; Çetin, N; Dalgiç, O; Kum, G; Yilmaz, H; Tikiz, H
    Objective: Evaluation of the long-term effects of continuous positive airway presure (CPAP) on mean heart rate and left ventricular systolic and diastolic parameters in obstructive sleep apnea syndrome (OSAS) using conventional and tissue Doppler techniques. Methods: This prospective cohort study is designed to evaluate the long-term effects of CPAP treatments in normotensive OSAS patients. Initially 40 patients aged from eighteen to fifty five with documented OSAS syndrome were evaluated within one month of CPAP treatment. All had high self-reported compliance with treatment. From the latter, 21 patients with uninterrupted CPAP therapy (for at least 5 years, 5 hours per day) were included in the study and further evaluated with treatment. The left ventricular systolic function was assessed on apical four-chamber view using modified Simpson method and diastolic function was evaluated with classic transmitral pulsed and tissue Doppler techniques. Paired t test and Wilcoxon signed rank test had been used to compare the clinical and echocardiography data before and after treatment period. Results: A comparison of values assessed after one month and after 5 years of CPAP therapy, revealed a significant increase in the acceleration time(AT) Em/Am ratio and ejection time (ET) (AT: p=0.04; Em/Am ratio p=0.03 ET: p=0.04) while a significant decrease was observed on deceleration time (DT), isovolumetric relaxation time (IRT), myocardial performance index (MPI), mitral regurgitation (MR) and 24 hour mean heart rate (HR) in all subjects (DT: p=0.02; IVRT: p=0,04; MPI: p=0,01; MR: p=0.001; HR: p=0.004). Conclusion: We observed a significant improvement in the left ventricular systolic and diastolic function and a significant decrease of 24-hour heart rate and mitral regurgitation with unchanged ejection fraction of the left ventricle with long-term CPAP treatment similar to short-term treatment studies. The long-term maintenance of the beneficial effect of CPAP throughout the 5 year long-term treatment can be one of the pathophysiologic mechanisms that may explain the decrease of cardiovascular mortality observed with long-term CPAP therapy in OSAS patients.
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    TAKOTSUBO CARDIOMYOPATHY IN A MALE PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
    Bayturan, Ö; Çetin, N; Yavuz, V; Yurdam, F; Uludag, Ö; Tezcan, UK
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    The Evaluation of Galectin-3 Levels in Non-dipper Hypertensive Patients
    Akçay, S; Cakin, O; Ilhan, N; Kalayci, H; Kobat, MA; Gulger, M; Yavuz, V; Dalgic, O; Bilge, AR
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    Strenuous Exercise Induced Syncope Due to Coronary Artery Anomaly
    Yavuz, V; Cetin, N; Tuncer, E; Dalgic, O; Taskin, U; Bilge, AR; Tikiz, H
    Coronary 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.0
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    Drug-induced QTc interval prolongation in PCR-positive non-ICU COVID-19 patients with diverse findings on chest computed tomography
    Ozyurtlu, F; Cetin, N; Yavuz, V
    Background 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.