Person: BAKHSALIYEV, NIJAD
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Publication Open Access Assessment of the Relationship between Monocyte to High-Density Lipoprotein Ratio and Myocardial Bridge.(2019-01-01T00:00:00Z) Bakshaliyev, N; Karacop, E; Cosansu, K; Huyut, MA; Turna, F; Enhos, A; Nadir, A; Ozdemir, R; Uluganyan, MAHMUT; ENHOŞ, ASIM; KARAÇÖP, ERDEM; BAKHSALIYEV, NIJAD; NADİR, AYDIN; ÖZDEMİR, RAMAZAN; ULUGANYAN, MAHMUTBackground: Assessing the monocyte to high-density lipoprotein ratio (MHR) is a new tool for predicting inflamation, which plays a major role in atherosclerosis. Myocardial bridge (MB) is thought to be a benign condition with development of atherosclerosis, particularly at the proximal segment of the brigde. Objective: To evaluate the relationhip between MHR and the presence of MB. Methods: We consecutively scanned patients referred for coronary angiography between January 2013- December 2016, and a total of 160 patients who had a MB and normal coronary artery were enrolled in the study. The patients’ angiographic, demographic and clinic characteristics of the patients were reviewed from medical records. Monocytes and HDL-cholesterols were measured via complete blood count. MHR was calculated as the ratio of the absolute monocyte count to the HDL-cholesterol value. MHR values were divided into three tertiles as follows: lower (8.25 ± 1.61), moderate (13.11 ± 1.46), and higher (21.21 ± 4.30) tertile. A p-value of < 0.05 was considered significant. Results: MHR was significantly higher in the MB group compared to the control group with normal coronary arteries. We found the frequency of MB (p = 0.002) to increase as the MHR tertiles rose. The Monocyte-HDL ratio with a cut-point of 13.35 had 59% sensitivity and 65.0% specificity (ROC area under curve: 0.687, 95% CI: 0.606-0.769, p < 0.001) in accurately predicting a MB diagnosis. In the multivariate analysis, MHR (p = 0.013) was found to be a significant independent predictor of the presence of MB, after adjusting for other risk factors. Conclusion: The present study revealed a significant correlation between MHR and MB.Publication Open Access P Wave Duration/P Wave Voltage Ratio Plays a Promising Role in the Prediction of Atrial Fibrillation: A New Player in the Game(2021-05-01T00:00:00Z) KARAÇÖP, ERDEM; ENHOŞ, Asim; BAKHSALIYEV, NIJAD; ÖZDEMİR, Ramazan; KARAÇÖP, ERDEM; ENHOŞ, ASIM; BAKHSALIYEV, NIJAD; ÖZDEMİR, RAMAZANBackground. Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. Identification of patients at risk for developing AF and the opportunity for early targeted intervention might have a significant impact on morbidity and mortality. Prolonged P wave duration and decreased P wave voltage have been shown to be independent predictors of AF. The present study aimed to investigate the role of P wave duration/P wave voltage in predicting new-onset AF. Methods. We screened a total of 640 consecutive patients who admitted to cardiology outpatient clinic with a complaint of palpitation between 2012 and 2014. 24-h Holter monitoring, echocardiography, and electrocardiography (ECG) recordings were reviewed to identify new-onset AF. Patients were assigned into two groups based on presence (n = 150) and absence (n = 490) of new-onset AF. Previous ECGs with sinus rhythm were analyzed. P wave duration was measured in inferior leads, and P wave voltage was measured in lead one. P wave duration/P wave voltage was also calculated for each patient. Results. One hundred fifty subjects (23.4%) had new-onset AF among 640 patients. P wave duration (123.27 +/- 12.87 vs. 119.33 +/- 17.39 ms, p=0.024) and P wave duration/P wave voltage (1284.70 +/- 508.03 vs. 924.14 +/- 462.06 ms/mV, p<0.001) were higher, and P wave voltage (0.12 +/- 0.04 vs. 0.13 +/- 0.04 mV, p<0.001) was significantly lower in the new-onset AF group compared with non-AFs. P wave duration/P wave voltage, with a cut off of 854.5 ms/mV, had 83.3% sensitivity and 62.0% specificity in a receiver operating characteristic curve (AUC 0.728, 95% CI 0.687-0.769; p<0.001). Their negative and positive predictive values were 78.7% and 68.6%, respectively. In a univariate regression analysis, age, smoking, C-reactive protein, brain natriuretic peptide, left atrial diameter, left atrial volume index, P wave duration, P wave voltage, and P wave duration/P wave voltage were significantly associated with the development of new-onset AF. Moreover, smoking (OR 4.008, 95% CI 1.707-9.409; p=0.001), left atrial volume index (OR 7.108, 95% CI 4.400-11.483; p<0.001), and P wave duration/P wave voltage (OR 1.002, 95% CI 1.000-1.003; p=0.044) were found to be significant independent predictors of new-onset AF in a multivariate analysis, after adjusting for other risk parameters. Conclusion. The P wave duration/P wave voltage ratio is a practical, easy-to-use, cheap, and reliable electrocardiographic parameter, which can play a promising role for both in predicting and elucidating a mechanism of new-onset AF.Publication Open Access The prognostic value of fragmented QRS in patients undergoing transcatheter aortic valve implantation(2018-11-01) Ay, Nuray Kahraman; ENHOŞ, ASİM; AY, YASİN; Ozdemir, Razaman; NADİR, AYDIN; KARAÇÖP, ERDEM; ÇELİKKALE, İLKE; ULUGANYAN, MAHMUT; Goktekin, Omer; KAHRAMAN AY, NURAY; ENHOŞ, ASIM; AY, YASİN; BAKHSALIYEV, NIJAD; NADİR, AYDIN; KARAÇÖP, ERDEM; ÇELİKKALE, İLKE; ULUGANYAN, MAHMUT; ÖZDEMİR, RAMAZANBackground Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis. Methods A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n = 36) or absence (n = 81) of fQRS. Predictors of long-term survival were estimated. Results In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p = 0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29–7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07–6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05–5.60, p: 0.03) emerged as significant independent predictors of short survival. Conclusion Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted.Publication Metadata only Impact of atrial flow regulator (AFR) implantation on 12-month mortality in heart failure Insights from a single site in the PRELIEVE study(2021-08-01T00:00:00Z) BAKHSALIYEV, NIJAD; ÇELİKKALE, İLKE; ENHOŞ, Asim; KARAÇÖP, ERDEM; ULUGANYAN, Mahmut; ÖZDEMİR, Ramazan; BAKHSALIYEV, NIJAD; ÇELİKKALE, İLKE; ENHOŞ, ASIM; KARAÇÖP, ERDEM; ULUGANYAN, MAHMUT; ÖZDEMİR, RAMAZANBackground Implantation of the atrial flow regulator (AFR) to create an interatrial left-to-right shunt has been shown to be safe and feasible to reduce intracardiac filling pressures in patients with heart failure (HF). Objectives We aimed to assess the effect of AFR implantation on 12-month mortality and hospitalization rates in patients with reduced (HFrEF) or preserved HF (HFpEF). Methods One-year follow-up data from 34 subjects enrolled at a single PRELIEVE center were analyzed. The 12-month predicted mortality was calculated using the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score. Patients were divided into two groups, according to their history of hospitalizations for HF. Results Study data of 34 patients (HFrEF: 24 [70.6%]; HFpEF: 10 [29.4%]) were assessed. Median follow-up duration was 355 days. In total, 14 (41.2%) patients were hospitalized during the follow-up period and 6 (17.6%) of these patients were hospitalization for HF (HHF). A total of 24 hospitalizations occurred in this period and 8 (33%) hospitalizations were for HHF. The median baseline MAGGIC score was 23 and the median predicted mortality was 13.4/100 patient years. Observed mortality was 3.1/100 patient years. The observed survival (97%) was 10.3% (95% confidence interval 3.6-17.5%, p = 0.004) better than the predicted survival (86.6%). Conclusion Our results suggest that AFR implantation has favorable effects on mortality in patients with heart failure, regardless of ejection fraction. Furthermore, compared to baseline, left ventricular filling pressure (assessed by echocardiography) decreased significantly without right side volume overload at the 1-year follow-up.Publication Metadata only Impact of postdischarge care fragmentation on clinical outcomes and survival following transcatheter aortic valve replacement(2020-09-01T00:00:00Z) KARAÇÖP, ERDEM; ENHOŞ, Asim; Bakhshaliyev, NIJAD; KARAÇÖP, ERDEM; ENHOŞ, ASIM; BAKHSALIYEV, NIJADBackground. The study aimed to evaluate the prognostic impact of postdischarge care fragmentation in patients undergoing transcatheter aortic valve replacement (TAVR). Methods. A total of 266 patients undergoing TAVR due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned to one of two groups based on presence (n= 104) and absence (n= 162) of postdischarge care fragmentation. Fragmented care was defined as at least one readmission to a site other than the implanting TAVR center within 90 days. Prognostic impact of care fragmentation on clinical outcomes and predictors of long-term mortality were investigated.Publication Open Access The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patients(2020-09-01T00:00:00Z) Bakhshaliyev, Nijad; ULUGANYAN, Mahmut; ENHOŞ, Asim; KARAÇÖP, ERDEM; ÖZDEMİR, Ramazan; BAKHSALIYEV, NIJAD; ULUGANYAN, MAHMUT; ENHOŞ, ASIM; KARAÇÖP, ERDEM; ÖZDEMİR, RAMAZANBackground: The combination of Hydroxychloroquine (HCQ) and azithromycin showed effectiveness as a treat-ment for COVID-19 and is being used widely all around the world. Despite that those drugs are known to cause prolonged QT interval individually there is no study assessing the impact of this combination on electrocardiography (ECG). This study aimed to assess the impact of a 5-day course of HCQ and azithromycin combination on ECG in non-ICU COVID19(+) patients.