Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleYalnız künye2022Serum heparanase levels and left atrial/left atrial appendage thrombus in patients with nonvalvular atrial fibrillation
Yilmaz, Mehmet Fatih; Acar, Emrah; Inanir, Mehmet; Karabay, Can Yucel; Izgi, Ibrahim Akin
Introduction Data regarding the possible role of heparanase (HPA) in the occurrence of left atrial/left atrial appendage (LA/LAA) thrombus in patients with atrial fibrillation (AF) is lacking. The goal of the present study was to assess the association between plasma levels of HPA and LA/LAA thrombus in AF. Methods A total of 687 patients with nonvalvular AF (NVAF) without anticoagulation therapy were included from January 2016 to June 2019. Serum HPA analysis was performed with a commercially available human ELISA kit. Logistic regression models were used to test for association. Results Serum HPA levels were significantly higher in patients with LA/LAA thrombus than in those without LA/LAA thrombus (270.8 [193.4 +/- 353.2] pg/mL vs 150.3 [125.2 +/- 208.4] pg/mL; P < 0.001). In multivariate analysis, serum HPA remained a significantly independent predictor of LA/LAA thrombus (odds ratio 1.674, 95% confidence interval [CI] 1.339-2.289, P < 0.001). In the receiver operating characteristic (ROC) curve analysis, HPA showed a predictive value with an area under the curve (AUC) of 0.757 (95% CI 0.652-0.810, P < 0.001). The optimal cutoff level for HPA predicting LA/LAA thrombus was 210.7 pg/mL, with a sensitivity of 74.3% and a specificity of 64.8%. Conclusion An elevated HPA level was associated with the presence of LA/LAA thrombus in patients with AF. HPA might portend the risk for the prothrombotic state in AF patients.
- MakaleYalnız künye2021The simple right ventricle contraction pressure index: A novel method for echocardiographic assessment of right ventricle dysfunction in acute pulmonary embolism
Acar, Emrah; Ozgul, Neryan; Izci, Servet
Purpose The simple right ventricular contraction pressure index (sRVCPI) is a new echocardiographic variable for estimating the right ventricular systolic function. Our aim was to investigate the association between the sRVCPI, the pulmonary embolism severity index (PESI), and mortality rate in acute pulmonary embolism (APE). Methods We included in this study 116 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy. They were divided into two groups based on the simplified PESI < or >1. Tricuspid regurgitation velocity and TAPSE were measured and used for sRVCPI calculation. Results Mortality was higher in patients with a higher sRVCPI (P < .001). In receiver operating characteristic (ROC) curve analysis using a cut-off level of 312.8 mm Hg mm, sRVCPI predicted mortality with a sensitivity of 86.8% and specificity of 69.5% (ROC area under curve: 0.712; 95%CI 0.597-0.882; P < .001). The sRVCPI was lower in the sPESI >1 than in the sPESI <1 group (364.3 +/- 31.9 vs 511.6 +/- 26.1; P < .001). There was an inverse correlation between sRVCPI and the sPESI score (-0.784; P < .001). Conclusion The sRVCPI correlated with the sPESI score and was associated with mortality in patients with APE. This easily measurable variable may be used to predict short-term mortality in APE patients.
- MakaleYalnız künye2021Time interval between E and E′ waves can predict complicated clinical course in patients with acute pulmonary embolism
Acar, Emrah; Kilicgedik, Alev; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet Fatih; Gokce, Mustafa; Izgi, Ibrahim Akin; Kirma, Cevat
Purpose Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. Material and methods Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group. Results The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A ' wave velocity, E/E ' ratio, and time interval between E and E ' waves (P < .05), but lower values of tricuspid annular plane systolic excursion, A-wave velocity, isovolumetric relaxation time, deceleration time, E ', and E '/A ' (P < .05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r = .564, P < .001), E/E ' (r = .495, P < .001), and TE-E ' (r = .596, P < .001). Receiver operator characteristic curve analysis showed that TE-E ' had the largest area under curve (TE-E ' 0.82, IVRT 0.77, E/E ' 0.72). A cut-off value of TE-E ' = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course. Conclusion The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism.
- MakaleYalnız künye2020Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism
Acar, Emrah; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet F.; Izgi, Ibrahim A.; Gokce, Mustafa; Kirma, Cevat
Purpose Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status. Methods We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows. Result A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI >= 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD. Conclusion HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE.
- MakaleYalnız künye2020Right Ventricular Early Inflow-Outflow Index-A new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism
Acar, Emrah; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet Fatih; Izgi, Ibrahim Akin; Kirma, Cevat
Introduction Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life-threatening. Several risk graduation algorithms may be applied to delineate short-term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow-outflow (RVEIO) index, which is a Doppler-based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. Methods In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI >= 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured. Results There were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581-0.814; P < .001). RVEIO index was higher in the sPESI >= 1(n:72) than in the patients with sPESI < 1(14.27 +/- 2.13 vs 10.63 +/- 2.09; P < .001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P < .001). Conclusion As well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well-correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short-term mortality in APE patients.
- EditoryalAçık Erişim2018A rare coincidence of hypoplasia of the posterior mitral leaflet and the bicuspid aortic valve
Demirel, Muhittin; Acar, Emrah; Sivri, Serkan; Sökmen, Erdogan; Özbek, Sinan Cemgil
- EditoryalAçık Erişim2017A young girl presenting with cardiac thrombus: An unusual complication of inflammatory bowel disease
Demirel, Muhittin; Sökmen, Erdogan; Acar, Emrah; Sivri, Serkan