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Öğe Early detection of ventricular dysfunction in LADA using novel tissue Doppler parameters: A case-control study(SAGE Publications, 2025-05) Dogac Oksen; Muzaffer Aslan; Yunus Emre Yavuz; Cagdas Kaynak; Esra Erturk TekinIntroduction & ObjectiveLatent autoimmune diabetes mellitus (LADA), a heterogeneous disease, is much more common in society than thought. Although it has been claimed that LADA is similar to type 2 diabetes mellitus (T2DM) from a cardiovascular perspective, there is no clear consensus. In this context, the objective of this study is to assess subclinical dysfunction in the left and right ventricles in patients with LADA using novel tissue Doppler imaging (TDI) parameters.Materials &MethodsThe sample of this observational case-control study consisted of 57 consecutive patients aged between 30 and 70 years who applied to the endocrinology and metabolism outpatient clinics, were diagnosed with LADA, and were referred to the cardiology clinic for echocardiographic (ECHO) evaluation. The control group consisted of 60 healthy volunteers. Participants' demographic and clinical characteristics and laboratory findings were recorded. All participants underwent ECHO using conventional ECHO and TDI. Subclinical left ventricular dysfunction was assessed using the myocardial performance index (MPI) and isovolumic myocardial acceleration (IVA).ResultsThere were no significant differences between the patient and control groups in terms of conventional ECHO parameters. The left ventricular (LV) MPI was significantly higher in the patient group than in the control group (0.54 ± 0.11 vs 0.47 ± 0.07, p = 0.008). There was no significant difference between the groups in right ventricular (RV) MPI (0.49 ± 0.10 vs 0.46 ± 0.70, p = 0.217). IVA was decreased in both ventricles (IVA mitral: 3.03 ± 1.44 vs 3.78 ± 1.66, p = 0.008 and IVA tricuspid: 2.67 ± 0.88 vs 3.42 ± 0.97, p = 0.034). Both LV IVA and RV IVA were found to be significantly correlated with glutamic acid decarboxylase antibodies' (GADA) levels in the negative direction (R = -0.290, p = 0.005 and R = -0.340, p = 0.001).ConclusionsIt was observed that LADA negatively affected the systolic and diastolic functions of both ventricles, with its effect being more pronounced in the left ventricle. Glycemic control and autoantibody titers were found to be correlated with TDI parameters, emphasizing their relevance in assessing cardiac dysfunction.Öğe Prognostic Value and Association of Platelet-to-Albumin Ratio with Coronary Artery Ectasia and Severity Classification(Galenos Yayinevi, 2025-04-29) Yunus Emre Yavuz; Hasan Sari; Ahmet Taha Sahin; Serif Ahmet Kandemir; Muzaffer AslanAim: Coronary artery ectasia (CAE) is characterized by abnormal dilation of coronary arteries and is associated with inflammation and thrombotic events. The platelet-to-albumin ratio (PAR) has emerged as a potential biomarker reflecting both inflammatory status and thrombotic activity. This study aimed to evaluate the relationship between PAR and the presence and severity of CAE. Methods: This retrospective, cross-sectional observational study included 80 patients diagnosed with CAE who underwent coronary angiography between April 2022 and January 2024, as well as 73 age-and sex-matched control participants with normal coronary anatomy. We calculated the PAR and assessed CAE using the Markis classification, which categorizes CAE severity based on the number and distribution of ectatic segments. Results: There was no significant difference between the two groups in terms of age and sex. Although the PAR was higher in the coronary ectasia group, the difference was not statistically significant. However, PAR was significantly correlated with the Marquis classification (p=0.014). Conclusion: While PAR values showed no significant difference between patients with CAE and those with normal coronary arteries, there was a notable correlation between PAR values and the Markis classification among patients with CAE, suggesting that PAR could be useful in evaluating the severity of CAE.Öğe The Importance of Monocyte-to-High Density Lipoprotein-Cholesterol Ratio in Predicting Severity of Coronary Artery Disease in Acute Coronary Syndrome(Ovid Technologies (Wolters Kluwer Health), 2025-03) C Kaynak; E Ozmen; M AslanBackground: Evaluating the association between coronary artery disease (CAD) severity and new inflammatory markers in acute coronary syndrome (ACS) is critical for managing the therapy procedure as well. Aim: The primary goal of this study was to investigate the association between the monocyte-to-high density lipoprotein-cholesterol ratio (MHR), a novel inflammation marker, and the severity of CAD in patients with ACS. Methods: The study was performed on ACS patients who were hospitalized for coronary angiography (CAG) in the coronary intensive care unit and was conducted with a retrospective design. The study comprised 344 patients (mean age 60.49 ± 12.23 years) with ACS who had CAG and laboratory testing. There were 212 patients with mild CAD according to the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score (SYNTAX score ≤22) and 132 patients with severe CAD (SYNTAX score >22). The association between SYNTAX score, MHR, uric acid, the neutrophil-to-lymphocyte ratio (NLR), and other markers were assessed. All analyses were performed using SPSS 26.0. Results: A modestly linear association was observed between MHR and SYNTAX score (r = 0.522, P < 0.001). Multivariate logistic regression analysis found male gender, high uric acid, high MHR, and NLR as possible individual predictors of SYNTAX score >22 in ACS. The receiver operating characteristic (ROC) analysis revealed that MHR 15.64 (AUC = 0.794; P < 0.001) could predict SYNTAX score >22 with higher sensitivity (81.8%) and specificity (78.3%). Conclusions: The higher MHR independently predicts the severity of CAD in ACS. It may be a better parameter than the higher NLR and uric acid levels to predict CAD severity in ACS patients.Öğe Evaluation of Subclinical Left Ventricular Dysfunction in HIV Patients Receiving Abacavir, Dolutegravir, and Lamivudine Therapy with Novel Tissue Doppler Imaging Techniques(MDPI AG, 2025-02-25) Dogac Oksen; Muzaffer Aslan; Ebru Serin; Muhammed Heja Gecit; Yunus Emre Yavuz; Esra Yerlikaya Zerdali; Veysel OktayBackground/Objectives: Highly active antiretroviral therapy (HAART) effectively suppresses viral load and aids immunological recovery in HIV patients, but may still lead to subclinical myocardial dysfunction. This study assesses left and right ventricular functions in patients on HAART containing abacavir, dolutegravir, and lamivudine using Tissue Doppler Imaging (TDI). Methods: This observational cross-sectional study involved 118 HIV-positive adults on HAART and 80 age- and gender-matched healthy controls. Comprehensive echocardiographic assessments, including TDI, were conducted to evaluate myocardial performance index (MPI) and isovolumic acceleration (IVA). Results: Conventional echocardiographic parameters showed no significant differences; however, TDI indicated significant impairments in ventricular functions in the HAART group, with increased MPI and decreased IVA (p < 0.001). Pulmonary artery pressures were also higher in the HIV group (p = 0.012). There was a strong positive correlation between MPI and HAART duration (r = 0.675, p = 0.002), and a negative correlation with CD4 count (r = −0.545, p = 0.006). Conclusions: TDI reveals significant subclinical ventricular dysfunction in HIV patients on HAART, correlating with therapy duration and immune status. These findings underscore the utility of TDI in detecting myocardial deterioration before clinical symptoms appear.Öğe Machine Learning and Shock Indices-Derived Score for Predicting Contrast-Induced Nephropathy in ACS Patients(Ovid Technologies (Wolters Kluwer Health), 2025-02-13) Yunus Emre Yavuz; Sefa Tatar; Hakan Akıllı; Muzaffer Aslan; Abdullah İçliBackground Contrast-induced nephropathy (CIN) is a serious complication following acute coronary syndrome (ACS), leading to increased morbidity and mortality. Machine learning (ML), combined with parameters such as shock indices, can potentially improve CIN risk prediction by analyzing complex variable interactions and creating accessible, clinically applicable models. Methods This retrospective case-control study included 719 ACS patients who underwent percutaneous coronary intervention (PCI). Patients were divided into two groups (CIN and non-CIN), and clinical, procedural, and hemodynamic parameters, including shock indices, were analyzed using machine learning algorithms. A new predictive model, CIN-Predict 5, was developed using the Gradient Boosting Machine (GBM) algorithm, incorporating clinically relevant and statistically significant variables. Correlations between model predictions and secondary outcomes, including in-hospital mortality and hospitalization duration, were evaluated. Results Among the variables used in the GBM algorithm, the Modified Shock Index emerged as the most significant predictor, with an importance score of 0.25. The CIN-Predict 5 model achieved an AUC of 0.87, outperforming the Mehran Risk Score (AUC = 0.75) for predicting CIN. The secondary outcomes showed that CIN-Predict 5 correlated significantly with in hospital mortality (r = 0.16, p < 0.001) and hospitalization duration (r = 0.20, p < 0.001). Conclusions The GBM-based model we developed, utilizing shock indices and derived through ML, provides a practical tool for early identification of high-risk CIN patients post-ACS, enabling timely preventive strategies and improving clinical decision-making. © 2025 Wolters Kluwer Health, Inc. All rights reserved.Öğe Music Therapy may Decrease Radial Artery Spasm Rates and Increase Satisfaction during Coronary Angiography(Bentham Science Publishers Ltd., 2025-02-04) Muzaffer Aslan; Doğaç Okşen; Yunus Emre Yavuz; Çağdaş KaynakIntroduction: With the widespread use of the radial artery in catheterization procedures, radial artery spasm (RAS) is frequently considered an undesirable event. It is known that anxiety increases RAS, and listening to music helps individuals control anxiety during the procedure. This study aimed to investigate the effects of music concerts on RAS. Methods: In this prospective study, imaging and interventional coronary catheterization procedures using the radial artery were included. One group listened to a musical recital during the procedure, while the other group was treated in a quiet environment. The demographics, procedural parameters, and complications of both groups were compared. Results: The study included a total of 147 patients, with an average age of 51.6 ± 11.1 years. Of these, 78 patients (53%) listened to music, while 69 patients (46.9%) underwent catheterization in a quiet environment. The impact of music therapy on the RAS was found to be significant (11.5% vs. 20.3%; p=0.035). While music therapy showed a potential to reduce RAS rates, its effect was not statistically significant in multivariate analysis (p=0.055). Conclusion: Music is a feasible, simple, and inexpensive method for reducing anxiety levels in patients. Listening to music during catheterization can reduce procedural discomfort and the frequency of undesirable events by helping people control their anxiety.Öğe Do current indices predict cardioversion success in patients with atrial fibrillation? A retrospective observational study(Walter de Gruyter GmbH, 2024) Sefa Tatar; Yunus Emre Yavuz; Emirhan Feyzullahoglu; Ahmet Lütfi Sertdemir; Abdullah Icli; Hakan AkilliObjective: Atrial fibrillation (AF) is one of the leading arrhythmias that causes serious complications. Our aim is to investigate the factors predicting the success of cardioversion in patients who underwent the procedure due to AF. Methods: A total of 107 patients who underwent cardioversion were included in the study. Patients were divided into groups based on cardioversion success. Demographic, echocardiographic, and laboratory characteristics were compared between the groups. Results: Hypertension and diabetes mellitus were more frequent in patients with successful cardioversion, but no statistically significant difference was found between the groups (p > 0.05). The pre-procedure leukoglycemic index (LGI) was found to be higher in the successful cardioversion group. However, this difference was not statistically significant between the groups (p > 0.05). Although the fibrosis-4 (FIB-4) index and systemic immune-inflammation index (SII) were numerically higher in the group with unsuccessful cardioversion, no statistically significant difference was observed between the groups (p > 0.05). Echocardiographic parameters such as left atrial diameter and mitral regurgitation rate were higher in patients with successful cardioversion, but no significant difference was detected between the groups (p > 0.05). Conclusion: AF is a significant arrhythmia that may lead to high mortality and morbidity. Various scoring systems have been developed to predict cardioversion success. The LGI, FIB-4 index, and SII are potential predictors of cardioversion success. However, these parameters alone are insufficient to predict cardioversion success. Further large-scale randomized studies are needed to clarify the effectiveness of these parameters.
