Yazar "Kilci, Hakan" seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim
    Öğe
    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.
  • [ X ]
    Öğe
    Presence of fragmented QRS may be associated with complex ventricular arrhythmias in patients with essential hypertension
    (Churchill Livingstone Inc., 2019) Bekar, Lütfü; Kalçık, Macit; Kilci, Hakan; Çelik, Oğuzhan; Yetim, Mücahit; Doğan, Tolga; Önalan, Orhan
    Background: Ventricular arrhythmias (VAs)are frequent in hypertensive patients. Myocardial fibrosis is one of the components of left ventricular hypertrophy secondary to hypertension. Fragmented QRS (fQRS)on electrocardiography (ECG)has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with essential hypertension. Methods: Two hundreds consecutive patients who were diagnosed with hypertension were included in the study. The control group consisted of 153 age and sex matched healthy individuals. 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. All patients underwent 24-hour Holter monitoring and VAs were classified using Lown's scoring system. Lown class ?3 VAs were considered as complex VAs. Results: There was no significant difference with respect to age (52 ± 8 vs 52 ± 6 years, p = 0.836)and gender distribution (female: 64% vs 63%, p = 0.907)between the groups. As compared to the healthy individuals, prevalence of fQRS (67% vs 9.2%, p < 0.001)and complex VAs (19% vs 0%, p < 0.001)were significantly higher in patients with hypertension. Furthermore, complex VAs (25.4% vs 6.1%, p = 0.001)were significantly higher in hypertensive patients with fQRS. In multiple logistic regression analysis, left ventricular ejection fraction (OR: 1.11, 95%CI: 1.025 to 1.183; p = 0.006), left ventricular mass index (OR: 1.04, 95%CI: 1.021 to 1.107; p = 0.001)and presence of fQRS (OR: 5.605, 95%CI: 1.427 to 22.019; p = 0.014)were independent predictors for complex VAs. Conclusion: The presence of fQRS may be associated with complex VAs in patients with essential hypertension. Therefore, fQRS may be used in risk stratification of complex VAs and sudden cardiac death especially in hypertensive patients with left ventricular hypertrophy. © 2019 Elsevier Inc.