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    Evaluation of atrial electromechanical coupling times in hemodialysis patients
    (Blackwell Publishing Inc., 2014) Karavelioğlu, Yusuf; Karapınar, Hekim; Özkurt, Sultan; Sarıkaya, Savaş; Küçükdurmaz, Zekeriya; Arısoy, Arif; Kurt, Recep; Yılmaz, Ahmet; Kaya, Mehmet G.
    BackgroundThere are no definite data about the atrial electromechanical coupling times (AEMCT) in patients with end stage renal failure (ESRF). The aim of this study was to investigate the AEMCT in ESRF patients without hypertension (HT) and diabetes mellitus.MethodsThe study population consisted of 47 normotensive, nondiabetic ESRF patients and 41 healthy age/gender-matched control subjects. The time intervals from the onset of P-wave on the surface electrocardiogram to the beginning of late diastolic A-wave (PA) were obtained from the lateral mitral annulus (PA-lateral, maximum AEMCT), septal annulus (PA-septal), and tricuspid lateral annulus (PA-tricuspid). Time intervals were corrected according to the heart rate. The difference between PA-septal and PA-tricuspid (right AEMCT), PA-lateral and PA-septal (left AEMCT), and PA-lateral and PA-tricuspid (inter AEMCT) were calculated. Corrected time intervals were used for calculations.ResultsGroups were similar for age (52 ± 12.3 vs. 49.9 ± 6 years, P > 0.05) and gender. Maximum (61 ± 20 vs. 47 ± 13 ms; P < 0.001) AEMCT was significantly higher in the patients compared with the control group, but septal and tricuspid EMCT were not different (P > 0.05). Both inter-atrial (37 ± 21 vs. 24 ± 16 ms, P = 0.002) and left atrial (25 ± 18 vs. 12 ± 9 ms; P < 0.001) EMCT were significantly higher in patients when compared with the controls but intra-right atrial EMCT was not different.ConclusionsAtrial conduction parameters such as maximal EMCT, left atrial, and inter-atrial EMCTs were prolonged in ESRF patients. This prolongation is seen in ESRF patients even in the absence of factors that affect atrial coupling, such as HT. © 2013, Wiley Periodicals, Inc.
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    Evaluation of left ventricular diastolic function in nonhypertensive nondiabetic hemodialysis patients
    (2013) Karavelioğlu, Yusuf; Özkurt, Sultan; Karapınar, Hekim; Küçükdurmaz, Zekeriya; Arısoy, Arif; Kurt, Recep; Yılmaz, Ahmet; Yarlıoğlueş, Mikail; Akpek, Mahmut; Kaya, Mehmet G.
    AIM: Diastolic dysfunction (DD) is common in hemodialysis (HD) patients. Because diabetes mellitus (DM) and hypertension (HT) are also common in this patient group, the exact reason for DD in HD patients is not clear. The present study evaluated left ventricular (LV) diastolic function in HD patients without DM and HT. METHODS: Fifty patients on HD and 34 age-matched and sex-matched healthy control individuals were enrolled. Echocardiography was performed in all participants. LV systolic and diastolic functions were evaluated by B-mode echocardiography, pulsed wave, and tissue Doppler imaging. The HD patients were divided into two groups according to the presence or absence of left ventricular hypertrophy (LVH) in echocardiography. RESULTS: LV dimensions and systolic function were within normal limits and similar between groups. However, the HD patients had significantly worse diastolic function (E/A: 0.78±0.26 vs. 1.19±0.28, P<0.001, e?/a? septal: 0.77±0.36 vs. 1.04±0.21, P<0.001) and increased filling pressure (E/e?: 8.55±3.2 vs. 5.79±1.93, P<0.001). Thirty-one (62%) patients had LVH, whereas 19 (38%) patients did not have LVH. LV systolic and diastolic functions were similar in HD patients with and without LVH. Seventeen (55%) hypertrophies were concentric and 14 (45%) were eccentric. Diastolic functions were similar in patients with either concentric or eccentric hypertrophy. CONCLUSION: Diastolic function is impaired in HD patients even in the absence of diseases that can cause DD such as HT and DM. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
  • Küçük Resim
    Öğe
    Neutrophil to lymphocyte ratio is predictor of atrial fibrillation recurrence after cardioversion with amiodarone
    (SAGE Publications Inc., 2015) Karavelioğlu, Yusuf; Karapınar, Hekim; Yüksel, Murat; Memiç, Kadriye; Sarak, Taner; Kurt, Recep; Yılmaz, Ahmet
    Background: In this study, our aim is to examine the role of the neutrophil to lymphocyte ratio (NLR) in the predictions of recurrence under long-term follow-up in patients whose sinus rhythms (SRs) were restored with amiodarone in acute atrial fibrillation (AF).Methods: Retrospectively, patients with acute AF, which successfully converted to the SR with amiodarone treatment, were recruited into the study. Patients experiencing the first AF attack were enrolled to the study and followed up for 5 years (median 23 months, 25-75 percentiles 12-24 months). Neutrophil to lymphocyte ratio was computed as absolute neutrophil count divided by lymphocyte count.Results: A total of 218 patients were recruited into the study and followed up for 21.6 ± 13.9 months; 87 (40%) patients had ?1 recurrent AF attack within this period. The follow-up of 131 (60%) patients resulted in persisted SR without any other AF attack. Groups were similar in terms of age nd gender. Left atrium (LA) diameter and NLR were increased, and platelet count and lymphocyte count were decreased in patients with AF recurrence in univariate analysis (P < .05 for all). Only LA diameter (for per mm, 1.077 [1.021-1.136], P .006) and NLR (1.584 [1.197-2.095], P .001) were independent predictors of AF recurrence in the multivariate analysis.Conclusion: Increased NLR is a marker of increased inflammation and may serve as simple, cheap, and readily available predictors of recurrence in the long-term follow-up of patients admitted with acute AF and successfully converted to SR with amiodarone. © The Author(s) 2014.