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    A rare cause of dysphagia and weight loss in a nonagenarian with hypertension: Dysphagia aortica
    (Blackwell Publishing Inc., 2015) Karavelioğlu, Yusuf; Kalçık, Macit; Yetim, Mücahit; Sarak, Taner; Bekar, Lütfü; Doğan, Tolga
    To the Editor: Dysphagia is a subjective awareness of difficulty in swallowing caused by impaired progression of food from the oropharynx to the stomach. An unusual mechanical cause of dysphagia occurs from extrinsic compression of the esophagus by the aorta. This was first described in 1932 as dysphagia aortica, which develops primarily in women and is associated with short stature, old age, hypertension, and kyphosis.1 A 98?year?old woman with dysphagia aortica caused by a dilated archus aorta and uncontrolled hypertension is reported.
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    A rare complication of percutaneous coronary intervention: Coronary pseudoaneurysm formation
    (Akademiai Kiado Rt., 2017) Çelik, Oğuzhan; Bekar, Lütfü; Yetim, Mücahit; Doğan, Tolga; Çağlar, Alp; Kalçık, Macit; Karavelioğlu, Yusuf
    Coronary pseudoaneurysms (CPAs) are rare complications developed after percutaneous coronary interventions. They may cause stent thrombosis, distal embolization, and coronary rupture leading to cardiac tamponade. Therefore, high-risk CPA should be promptly treated after diagnosis. They can be managed with percutaneous or surgical intervention. Herein, we aimed to present a patient who developed CPA 3 weeks after percutaneous coronary intervention and successfully treated with percutaneous intervention using a covered stent. © 2017 The Author(s)
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    Anafilaktik Reaksiyonda Epinefrin Aşırı Dozuna Bağlı Miyokard Enfarktüsü
    (2016) Bekar, Lütfü; Sarak, Taner; Yetim, Mücahit; Doğan, Tolga; Çelik, Oğuzhan; Çamkıran, Volkan; Karavelioğlu, Yusuf
    Epinefrin anafilaktik reaksiyonun tedavisinde sıklıkla kullanılan bir ajandır. Anafilaktik reaksiyonlarda epinefrin kullanımına bağlı göğüs ağrısı, miyokardiyal enfarktüs ve aritmi olabileceği bildirilmiştir. Biz bu makalede ciddi anafilaksisi olan bir hastada, subkutan olarak order edilen ancak yanlışlıkla intravenöz olarak uygulalan epinefrinin neden olduğu miyokardiyal enfarktüsü sunduk.
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    Clinical features of heart failure with mid-range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study
    (Blackwell Publishing Ltd, 2019) Özlek, Bülent; Özlek, Eda; Tekinalp, Mehmet; Kahraman, Serkan; Zencirkıran Ağuş, Hicaz; Çelik, Oğuzhan; Çil, Cem; Bekar, Lütfü
    Objectives: To compare real-world characteristics and management of individuals aged 80 and older with heart failure (HF) and mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) derived from a large cohort of survey and to compare them with those younger than 80 from the same survey.Methods: This is an observational, multicentre and cross-sectional study conducted in Turkey (NCT03026114). Consecutive 1065 (mean age of 67.1 +/- 10.6 years) patients admitted to the cardiology outpatient units with HFmrEF and HFpEF were included.Results: Participants aged 80 and older (n = 123, 11.5%) were more likely to be female (66.7% vs 52.5%, P = 0.003), had a higher prevalence of atrial fibrillation (49.6% vs 34%, P = 0.001), and anaemia (46.3% vs 33.4%, P = 0.005) than those who were younger than 80. N-terminal pro B-type natriuretic peptide levels were higher in those aged 80 and older than in those younger than 80 (1037 vs 550 pg/ml, P < 0.001). The prescription rates of HF medications (including in ACE-Is/ARBs, beta-blockers, MRAs, digoxin, ivabradine and diuretics) were similar (P > 0.05) in both groups. Octogenarians did not significantly differ from younger patients in the prevalence of HFmrEF (24.4% vs 22.9%) and HFpEF (75.6% vs 77.1%). Coronary artery disease was associated with HFmrEF (P < 0.05), whereas atrial fibrillation was associated with HFpEF (P < 0.05) in octogenarians.Conclusions: This study revealed that nearly 12% of the individuals with HFmrEF and HFpEF in this real-world sample were aged 80 and older. Participants aged 80 and older are more likely to be female and have more comorbidities than those who were younger than 80. However, HF medication profiles were similar in both groups. This study also showed that associated factors with HFmrEF and HFpEF were differ in octogenarians.
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    Comparison of aortic pressures and aortic elastic properties between patients with end-stage renal disease and healthy controls
    (Akademiai Kiado Zrt, 2019) Kalçık, Macit; Yetim, Mücahit; Doğan, Tolga; Doğan, İbrahim; Eser, Barış; Bekar, Lütfü; Karavelioğlu, Yusuf
    Background: Current evidence indicates that vascular calcification plays an essential role in the development of cardiovascular diseases in end-stage renal disease (ESRD) patients. Arterial stiffness is a marker of increased cardiovascular risk in various populations. The aim of this study is to evaluate the elastic properties of ascending aorta in patients with ESRD. Methods: This single-center study enrolled 96 patients (45 females, age: 57.2 +/- 12.8 years) with ESRD and 96 healthy controls (52 females, age: 55.3 +/- 10.1 years). Aortic pressures and aortic elastic parameters including aortic strain, aortic distensibility, aortic stiffness index, and aortic compliance were calculated using accepted formulae. Results: The hemodynamic parameters including aortic pulse pressure, aortic mean pressure, aortic fractional pulse pressure, and aortic pulsatility index were significantly higher in patients with ESRD. Systolic and diastolic aortic diameters were similar between the groups. However, pulsatile aortic diameter change, aortic strain, aortic distensibility, and aortic compliance were significantly lower, whereas aortic stiffness index was significantly higher in ESRD group. Conclusions: The results demonstrated that a significant difference was present in terms of aortic blood pressures between patients with ESRD and controls. In addition, the elastic properties of ascending aorta were decreased in patients with ESRD.
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    Comparison of ischemic and non-ischemic heart failure outpatients in a Turkish cohort
    (Wiley, 2017) Altin, C. Cihan; Kaya, H.; Bekar, Lütfü; Altay, H.; Yilmaz, M. B.
    [Abstract Not Available]
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    Comparison of the bioelectrical impedance analyses of body composition before and after cardiac rehabilitation in patients with ischemic heart disease
    (Wiley, 2019) Kalçık, Macit; Yetim, Mücahit; Doğan, Tolga; Bekar, Lütfü; Karaarslan, Osman; Ekinözu, İsmail; Gölbaşı, Zehra
    [Abstract Not Available]
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    Design and rationale for the ASSOS study: appropriateness of aspirin use in medical outpatients a multicenter and observational study
    (Turkish Society of Cardiology, 2018) Çelik, Oğuzhan; Çil, Cem; Özlek, Bülent; Özlek, Eda; Doğan, Volkan; Başaran, Özcan; Demirci, Erkan; Bekar, Lütfü; Kalçık, Macit; Karaarslan, Osman; Yetim, Mücahit; Doğan, Tolga; Demir, Vahit; Kalkan, Sedat; Özkan, Buğra; Hidayet, Şıho; Taylan, Gökhan; Küçüksu, Zafer; Çelik, Yunus; Efe, Süleyman Çağan; Aslan, Onur; Biteker, Murat
    Objective: The aim of this study was to describe the current status of aspirin use and the demographic characteristics of patients on aspirin for primary and secondary prevention of cardiovascular diseases. Methods: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) trial was a multicenter, cross-sectional, and observational study conducted in Turkey. The study was planned to include 5000 patients from 14 cities in Turkey. The data were collected at one visit, and the current clinical practice regarding aspirin use was evaluated (ClinicalTrials.gov number NCT03387384). Results: The study enrolled all consecutive patients who were admitted to the outpatient cardiology clinics from March 2018 until June 2018. Patients should be at least 18 years old, have signed written informed consent, and on aspirin (80–325 mg) therapy within the last 30 days. Cardiologists from the hospital participates in the study. Patients were divided into 2 categories according to presence or absence of atherosclerotic cardiovascular disease, namely secondary prevention group and primary prevention group, respectively. The appropriate use of aspirin in the primary and secondary prevention groups was assessed according to the European Society of Cardiology guidelines and US Preventive Services Task Force. The patients’ gastrointestinal bleeding risk factors and colorectal cancer risk were evaluated. Conclusion: The ASSOS registry will be the most comprehensive and largest study in Turkey evaluating the appropriateness of aspirin use. The results of this study help understand the potential misuse of aspirin in a real-world setting. © 2018 by Turkish Society of Cardiology.
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    Drug Adherence in Patients With Nonvalvular Atrial Fibrillation Taking Non-Vitamin K Antagonist Oral Anticoagulants in Turkey: NOAC-TR
    (SAGE Publications Inc., 2018) Emren, Sadık Volkan; Şenöz, Oktay; Bilgin, Murat; Beton, Osman; Aslan, Abdullah; Taşkın, Uğur; Açıksarı, Gönül; Bekar, Lütfü
    Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016. To measure the adherence level, an 8-item Morisky Medication Adherence Scale was used. The mean age of the patients was 70 ± 10 years. Of the 2738 patients, 44% were receiving dabigatran, 38% rivaroxaban, and 18% apixaban. A total of 630 (23%) patients had high medication adherence, 712 (26%) moderate adherence, and 1396 (51%) low adherence. Nonadherence had related to stroke (5.6% vs 2.5%, P <.001) and minor (21.2% vs 11.1%, P <.001) and major (6.1% vs 3.7%, P =.004) bleeding rates. The adherence to NOAC was found to be quite low in Turkey. Nonadherence is associated with bleeding and thromboembolic cardiovascular events. Age, taking NOAC twice a day, and the additional noncardiac diseases, depression, and dementia were the independent factors affecting poor medication adherence. © 2017, © The Author(s) 2017.
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    Echocardiographic predictors of interatrial block in patients with severe chronic kidney disease
    (Springer, 2020) Kalçık, Macit; Yetim, Mücahit; Doğan, Tolga; Eser, Barış; Doğan, İbrahim; Bekar, Lütfü; Karavelioğlu, Yusuf
    Background Interatrial block (IAB), defined as a conduction delay between the right and left atrium, is manifested on the electrocardiogram as a prolonged P-wave duration. Large number of studies recently have been published regarding the prevalence of IAB and its associations with the risk of atrial fibrillation and ischemic stroke. Cardiovascular diseases are the leading causes of mortality in chronic kidney disease (CKD). In this study, we aimed to investigate echocardiographic predictors of IAB in patients with severe CKD. Methods This study enrolled a total of 155 patients [male: 95 (61.3%), mean age: 56.3 +/- 12.8 years] with severe CKD (glomerular filtration rate < 30 mL/min). All patients were evaluated by electrocardiography and transthoracic echocardiography. IAB was defined as P wave duration of >= 120 ms on electrocardiography. Results Electrocardiography revealed IAB in 54 patients. The baseline demographic characteristics of the patients were similar in both groups with and without IAB. Left atrial diameter (LAD), left ventricular end-systolic and end-diastolic diameters, interventricular septal thickness, posterior wall thickness, left ventricular mass, left ventricular mass index (LVMI), and the prevalence of left ventricular hypertrophy were found to be significantly increased in patients with IAB. Increased LAD (OR = 1.119; 95% CI 1.019-1.228; p = 0.019) and LVMI (OR = 1.036; 95% CI 1.003-1.070; p = 0.031) were found to be independent predictors of IAB. Conclusion A significant association exists between the presence of IAB and echocardiographic parameters related to left ventricular hypertrophy and left atrial dilatation. Presence of IAB may be an additional and easy diagnostic marker for risk stratification of patients with severe CKD.
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    Estimated plasma volume as a determinant of heart failure hospitalization: TREAT-HF data
    (Wiley-Blackwell, 2016) Sarı, İbrahim; Kaya, Hakkı; Acar, Gürkan; Çavuşoğlu, Yüksel; Demir, Mihriban; Güngör, Hasan; Oğuz, Doğaç; Bekar, Lütfü; Şahin, Ahmet Anıl; Yılmaz, Mehmet Birhan
    [Abstract Not Available]
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    Evaluation of echocardiographic determinants of interatrial block in patients with essential hypertension
    (Oxford Univ Press, 2019) Kalçık, Macit; Bekar, Lütfü; Çelik, Oğuzhan; Yetim, Mücahit; Doğan, Tolga; Karaarslan, Osman; Karavelioğlu, Yusuf
    [Abstract Not Available]
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    Evaluation of homocystein and asymmetric dimethyl arginine levels in patients with coronary slow flow phenomenon
    (Akademiai Kiado Zrt, 2019) Demirci, Erkan; Çelik, Oğuzhan; Kalçık, Macit; Bekar, Lütfü; Yetim, Mücahit; Doğan, Tolga
    Background: Previous studies have demonstrated that homocysteine and asymmetric dimethyl arginine (ADMA) levels were strongly associated with cardiovascular diseases including coronary artery disease. The aim of this study was to investigate the role of plasma homocysteine and ADMA levels in the pathogenesis of coronary slow flow (CSF) phenomenon. Methods: Twenty-three patients with CSF and 25 controls with normal coronary flow were included in this study. The quantitative measurement of coronary blood flow was performed using the thrombolysis in myocardial infarction frame count method. Plasma homocysteine and ADMA levels were determined using enzymatic assays from venous blood samples. Results: The patients with CSF had significantly higher plasma homocysteine levels than controls (16.2 +/- 7.6 vs. 12.2 +/- 2.2 mu M/L; p = 0.023). The uric acid levels were significantly higher in CSF group than controls (5.4 +/- 1.1 vs. 4.6 +/- 0.9 mg/dl; p = 0.011). Plasma ADMA levels were also higher in the CSF group; however, this was not statistically significant (0.6 +/- 0.1 vs. 0.5 +/- 0.2 mu M/L; p = 0.475). Conclusions: Increased homocysteine and uric acid levels may play an important role in the pathogenesis of CSF. Further large scale studies are required to determine the relationship between ADMA levels and CSF.
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    Fragmented QRS complexes are a marker of myocardial fibrosis in hypertensive heart disease
    (Turkish Society of Cardiology, 2016) Bekar, Lütfü; Katar, Muzaffer; Yetim, Mücahit; Çelik, Oğuzhan; Kilci, Hakan; Önalan, Orhan
    Objective: Carboxy-terminal propeptide of type 1 procollagen (PICP) is a marker of extracellular collagen synthesis. Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) has been demonstrated as a marker of myocardial fibrosis. The present objective was to investigate the association between serum PICP concentration and presence of fQRS on ECG in hypertensive patients. Methods: Consecutive patients with previously or newly diagnosed hypertension were included. fQRS was defined as the presence of additional R-wave (R?), or notching of R- or Swaves, or the presence of fragmentation in 2 contiguous ECG leads. Serum PICP levels were measured by ELISA method. Results: The study group consisted of 90 hypertensive patients (74% females, with a mean age of 54.7±8.5 years). Of these patients, 47 (52.2%) had fQRS on ECG. Age (p=0.121) and gender distribution (p=0.625) were similar in patients with or without fQRS. Receiver operating characteristic curve analysis yielded a strong predictive ability of PICP levels for the presence of fQRS (area under the curve: 0.850; 95% CI: 0.772-0.929; p<0.0001). In multivariate logistic regression analysis, PICP levels were strongly and independently associated with the presence of fQRS (OR: 1.938; 95% CI: 1.398-2.688). Conclusion: Serum PICP level is a strong and independent predictor of fQRS. Discriminative performance of serum PICP levels for the presence of fQRS is high. The present results are the first to demonstrate that fQRS may indicate myocardial fibrosis in patients with hypertension. © 2016 Turkish Society of Cardiology.
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    Heart Failure Awareness Survey in a Turkish Population: HFAS-TR
    (KARE PUBL, 2024) Karabulut, Dilay; Günay, Şeyda; Sert Şekerci, Sena; Bekar, Lütfü
    Objective: Heart failure is a leading cause of death and the most common diagnosis leading to hospitalization. Its awareness is lower than that of other cardiovascular diseases, both in the general population and among patients with heart failure (HF). This study aimed to establish the current level of knowledge about HF in patients with HF with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) in Türkiye. Methods: This questionnaire-based survey study is multicenter, conducted across 34 centers from December 2021 to July 2022. We performed a survey consisting of two sets of questions focusing on individual characteristics of the patients and HF-related knowledge. Results: The study included a total of 2,307 outpatient HF patients, comprising 70.5% males and 29.5% females with a mean age of 64.58 ± 13 (56-74) years and a mean body mass index value of 32.5 ± 10 kg/m2. HFrEF and HFmrEF were determined in 74.7% and 25.3% of patients, respectively. Thirty percent of the patients were unaware that they had HF. While 28.7% of the patients thought that they had sufficient information about HF, 71.3% believed they lacked adequate knowledge. In the study, 25.2% of the participants identified dyspnea, 22% identified tiredness, and 25.4% identified leg edema as the most common symptoms of HF. Only 27.4% of patients recognized all three typical symptoms of HF. Conclusion: We found that the study population’s knowledge about HF symptoms and the nature of the disease was poor. Educational and awareness activities are necessary to optimize outcomes and benefits.
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    How Did the Updated 2019 European Society of Cardiology/European Atherosclerosis Society Risk Categorization for Patients with Diabetes Affect the Risk Perception and Lipid Goals? A Simulated Analysis of Real-life Data from EPHESUS Study
    (KARE PUBL, 2023) Başaran, Özcan; Doğan, Volkan; Mert, Kadir Uğur; Bekar, Lütfü; Kalçık, Macit; ...
    Background: The recent 2019 European Society of Cardiology/European Atherosclerosis Society practice guidelines introduced a new risk categorization for patients with diabetes. We aimed to compare the implications of the 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines with regard to the lipid-lowering treatment use, low-density lipoprotein cholesterol goal attainment rates, and the estimated proportion of patients who would be at goal in an ideal setting. Methods: Patients with diabetes were classified into 4 risk categories according to 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidemia guidelines from the database of EPHESUS (cross-sectional, observational, countrywide registry of cardiology outpatient clinics) study. The use of lipid-lowering treatment and low-density lipoprotein cholesterol goal attainment rates were then compared according to previous and new guidelines. Results: This analysis included a total of 873 diabetic adults. Half of the study population (53.8%) were on lipid-lowering treatment and almost one-fifth (19.1%) were on highintensity statins. While low-density lipoprotein cholesterol goal was achieved in 19.5% and 7.5% of patients, 87.4% and 69.6% would be on target if their lipid-lowering treatment was intensified according to 2016 and 2019 European Society of Cardiology/European Atherosclerosis Society lipid guidelines, respectively. The new target <55 mg/dL could only be achieved in 2.2% and 8.1% of very high-risk primary prevention and secondary prevention patients, respectively. Conclusion: The control of dyslipidemia was extremely poor among patients with diabetes. The use of lipid-lowering treatment was not at the desired level, and high-intensity lipid-lowering treatment use was even lower. Our simulation model showed that the highdose statin plus ezetimibe therapy would improve goal attainment; however, it would not be possible to get goals with this treatment in more than one-third of the patients.
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    Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients
    (Taylor & Francis Ltd, 2021) Kaya, Hakki; Sahin, Anil; Gunes, Hakan; Bekar, Lütfü; Celik, Ahmet; Cavusoglu, Yuksel; Yilmaz, Mehmet Birhan
    Background Relationship between the frequency of occurrence of bendopnea during the daily life of heart failure (HF) outpatients and clinical outcomes has never been evaluated before. Methods Turkish Research Team-Heart Failure (TREAT-HF) is a network between HF centres, which undertakes multicentric observational studies in HF. Herein, the data including stable 573 HF patients with reduced ejection fraction out of seven HF centres were presented. A questionnaire was filled by the patients, with the question 'Do you experience shortness of breath while tying your shoelace?', assessing the presence and frequency of bendopnea. Results To the question related to bendopnea, 48% of the patients answered 'yes, every time', 31% answered 'yes, sometimes', and 21% answered 'No'. Patients were followed for an average of 24 +/- 14 months, and the patients who answered 'yes, every time' and 'yes, sometimes' to the bendopnea question were found having increased risk for both HF-related hospitalisations (HR:3.2,p < .001- HR:2.8,p = .005) and composite outcome consisting of 'HF-related hospitalisations and all-cause death in the multi-variate analysis (HR:3.1,p < .001- HR:3.0,p < .001). Kaplan Meier analysis for HF-related hospitalisation, all-cause death, and the composite of these were provided for these three groups, yielding significant and graded divergence curves with the best prognosis in 'no' group, with the moderate prognosis in 'sometimes' group, and with the worst prognosis in the 'every time' group. Conclusion For the first time in the literature, our study shows that the increased frequency of bendopnea occurrence in daily life is associated with poor outcomes in HF outpatients.
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    Increased Ventricular Activation Time in Patients with the Diagnosis of Cardiac Syndrome X
    (2019) Kalçık, Macit; Bayam, Emrah; Güner, Ahmet; Yesin, Mahmut; Yetim, Mücahit; Doğan, Tolga; Karavelioğlu, Yusuf; Bekar, Lütfü
    Introduction: Cardiac syndrome X (CSX) is defined as typical angina with detectable ischaemia on noninvasive stress tests without any evidence of coronary artery stenosis during coronary angiography. Impaired coronary microcirculation, inflammation and endothelial dysfunction are accepted aetiological factors for CSX. The ventricular activation time (VAT) has been reported to be prolonged in myocardial ischaemia due to the conduction delay in the Purkinje fibres and the myocytes. In this study, we aimed to investigate the electrocardiographic parameters including VAT in patients with CSX. Patients and Methods: This study enrolled 120 patients (mean age, 54.7 ± 8.6 years; male, 53) diagnosed with CSX and 130 healthy controls (mean age, 53.3 ± 8.9; male, 66) without ischaemia. All patients underwent electrocardiography and transthoracic echocardiography. VAT was defined as the interval from the beginning of the QRS complex until the peak of the R or R’ wave. Results: There was no significant difference in terms of demographic, laboratory and echocardiographic parameters between CSX patients and controls. Comparison of electrocardiographic parameters yielded that there was no significant difference in terms of the heart rate, P-wave duration, PR interval, QT and corrected QT intervals between the groups. However, the QRS duration (95.1 ± 13.8 vs. 90.4 ± 12.7 msec; p= 0.006) and VAT (34.8 ± 5.7 vs. 29.2 ± 5.6 msec; p< 0.001) were significantly higher in patients with CSX. Conclusion: The present study demonstrated that QRS duration and VAT were prolonged significantly in patients with CSX. This prolongation may be due to the presence of impaired microvascular perfusion and ischaemia-induced conduction delay.
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    Investigation of ICAM-1 levels in hypertensive patients with fragmented QRS complexes
    (Taylor and Francis Ltd., 2019) Bekar, Lütfü; Kalçık, Macit; Katar, Muzaffer; Yetim, Mücahit; Çelik, Oğuzhan; Doğan, Tolga; Karavelioğlu, Yusuf; Gölbaşı, Zehra
    Objective: Fragmented QRS (fQRS) detected on a 12-lead electrocardiogram (ECG) has been demonstrated to be a marker of myocardial fibrosis. Intercellular adhesion molecule-1 (ICAM-1) is a protein which plays an important role in fibro-inflammatory processes. In this study, we aimed to investigate the relationship between ICAM-1 levels and the presence of fQRS in hypertensive patients. Methods: Ninety consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R’ wave or notching/splitting of S wave in two contiguous ECG leads. Serum ICAM-1 levels were measured using the enzyme-linked immunosorbent assay method. Patients were divided into two groups according to the presence of fQRS. Results: A total of 90 patients (female, 65%; mean age: 54.6 ± 8.5 years) were included in the study. fQRS was detected on ECG recordings of 47 (52.2%) patients. The demographic characteristics were similar between the groups. Left atrial diameter (p =.003), interventricular septal thickness (p =.013), posterior wall thickness (p =.01), left ventricular mass (p =.002), left ventricular mass index (p <.001), left ventricular hypertrophy (p =.001), and ICAM-1 levels (p <.001) were found to be significantly increased in fQRS(+) group. In multivariate analysis, only high ICAM-1 level was observed to be an independent predictor for the presence of fQRS (odds ratio: 1.029; 95%Confidence Interval: 1.013–1.045, p <.001). Conclusion: A significant association exists between serum ICAM-1 levels and the presence of fQRS in hypertensive patients. The presence of fQRS may be used as an indicator of inflammation in hypertensive patients. © 2019, © 2019 Belgian Society of Cardiology.
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    Investigation of mindin levels in hypertensive patients with left ventricular hypertrophy and QRS fragmentation on electrocardiography
    (Taylor and Francis Ltd., 2018) Doğan, Tolga; Yetim, Mücahit; Çelik, Oğuzhan; Kalçık, Macit; Özcan, Oğuzhan; Doğan, İbrahim; Erenler, Ali Kemal; Bekar, Lütfü; Karavelioğlu, Yusuf
    Purpose: Mindin was associated with diabetic nephropathy, podocyte injury, colitis, allergic asthma, liver ischaemia and reperpusion injury and ischaemic brain injury. On the other hand, it was reported as a protective factor against obesity, cardiac hypertrophy, fibrosis and remodelling. Fragmented QRS complexes (fQRS) are markers of altered ventricular depolarisation owing to a prior myocardial scar and fibrosis. In this study, we aimed to investigate mindin levels in hypertensive patients with left ventricular hypertrophy and fQRS on electrocardiography. Methods: This observational case-control study enrolled 70 (36 female) hypertensive patients with fQRS and 38 (23 female) hypertensive control patients. All patients were evaluated by transthoracic echocardiography. Mindin levels were measured by the enzyme-linked immunosorbent assay (ELISA). Clinical, echocardiographic and laboratory data were compared between patient and control groups. Results: There was no significant difference between patient and control groups in terms of clinical, echocardiographic and routine laboratory parameters. The mindin levels were significantly higher in the patient group than controls (11.3 (7.21–19.31) vs 4.15 (2.86–6.34); p <.001). Multiple logistic regression analyses defined increased mindin levels as an independent predictor for the presence of fQRS (Odds ratio: 1.733; p =.034). Mindin levels >6.74 predicted the presence of fQRS with a sensitifity of 84.3% and specificity of 79.9% on receiver operating characteristic (ROC) curve analysis (The area under the curve:0.889; Confidence Interval: 0.827–0.951; p <.001). Conclusion: Mindin expressin is upregulated in hypertensive patients with fQRS complexes. In contrary to previous studies, increased mindin levels may be associated with myocardial fibrosis. © 2017, © 2017 Belgian Society of Cardiology.