Fethi Yavuz

Dicle University, Amida, Diyarbakır, Turkey

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Publications (14)8.45 Total impact

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    ABSTRACT: In-stent restonosis is an important limitation for coronary stenting. The cause of in-stent restenosis is neointimal hyperplasia developed from smooth muscle and matrix. We aimed to investigate the association between urotensin II (U-II) and in-stent restenosis after coronary stenting, which causes endothelial and muscle proliferation and accumulation of collagen. Total 153 patient was enrolled to the study who meet criteria for angiographic indication underwent coronary artery angiography. All patients have history undergone for coronary stent implantation 3 to 9 months ago. In-stent restenosis is identified as ≥50% narrowing inside the stent. In-stent restenosis was observed in 73 and remaining of 80 patients revealed no critical lesion in stent on angiographic evaluation. Plasma level measurement of U-II was performed in all subjects. Urotensin II levels were found to be significantly higher in Group I compared to Group II (1.44±0.74 ng/mL and 1.21±0.59 ng/mL, respectively, P=0.03). In a subgroup analysis, U-II levels were significantly higher in group I than group II in patients treated with bare metal stent (BMS) (1.50±0.76 ng/mL and 1.18±0.56 ng/mL, P=0.016); however, there was not significant change in patients treated with drug-eluted stent (1.26±0.64 ng/mL and 1.27±0.63 ng/mL, P=0.9). Multivariate statistical significance: negative correlation was found between in-stent restenosis and renin-angiotensin-system (RAS) blocker usage (P=0.040) and right coronary artery (RCA) lesion interventions (P=0.018). This study revealed high plasma U-II level might be accepted as a risk factors for in-stent restenosis with BMS. In-stent restenosis is less developed after RCA interventions and taking drug of RAS blockages. Our study findings need to be confirmed in further studies.
    Minerva cardioangiologica. 06/2014; 62(3):297-303.
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    ABSTRACT: Although mitral stenosis has profound effects on the circulation and hemodynamics, few data exist regarding its impact on aortic elastic properties. The study aim was to determine the association between mitral stenosis and aortic elastic properties by using strain and distensibility as a surrogate. Sixty-six patients with echocardiographic documentation of rheumatic mitral stenosis, and 25 age- and gender-matched healthy control subjects were enrolled in the study. Aortic elasticity parameters including strain and distensibility were measured by means of echocardiography. The mean age of the patient and control groups were 41.8 +/- 12.0 and 38.9 +/- 5.0 years, respectively (p = 0.12). There was a significant impairment in distensibility and strain in the patient group compared to controls (0.276 +/- 0.167 versus 0.491 +/- 0.260 cm2 x dyn(-1), p = 0.001; 6.54 +/- 3.18% versus 9.19 +/- 4.78%, p = 0.015). There was a strong correlation between distensibility and left atrial diameter (p < 0.001; r = -0.39), left atrial volume index (p < 0.001; r = -0.56), mitral valve area (p < 0.001; r = 0.40), and mean transmitral gradient (p = 0.022; r = -0.18). Strain was also associated with left atrial diameter (p = 0.002; r = -0.32), left atrial volume index (p < 0.001; r = -0.41), mitral valve area (p = 0.002; r = 0.31), and mean transmitral gradient (p = 0.035; r = -0.18). Mitral stenosis was shown to be associated with impaired aortic elasticity, but further studies are required to clarify the clinical significance of this finding.
    The Journal of heart valve disease 07/2013; 22(4):550-5. · 1.07 Impact Factor
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    ABSTRACT: AIM: Although it is known that ankylosing spondylitis (AS) is associated with cardiovascular complications, the extent of these complications has not been clearly demonstrated in young adult patients. We have therefore investigated myocardial diastolic functions, carotid intima-media thickness (CIMT), and aortic elastic properties of young adult patients diagnosed with AS. METHOD: Sixty-six AS patients and 21 age/gender-matched healthy subjects were enrolled in the study. Spectral and tissue Doppler echocardiography, CIMT, aortic strain and distensibility, and serum B-type natriuretic peptide values were compared with disease activity indexes of AS, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the role of other variables, such as anti-tumor necrosis factor-alpha (anti-TNF-α) treatment, lipid parameters, erythrocyte sedimentation rate, and C-reactive protein. RESULTS: Both mitral early diastolic flow speed (mE) and late diastolic flow speed (mA) scores were lower among patients than among the control subjects (p = 0.015 and p = 0.035, respectively). The Em ratio of the patients was remarkably lower than that of the control subjects (p = 0.044). BASDAI scores of >4 were used to identify patients with more active disease. The mA and mE/mA ratios were significantly different between patients with a BASDAI score of >4 and those with a BASDAI score of <4 (p = 0.026 and p = 0.021, respectively). While aortic elasticity were not significantly different between the groups, AS patients treated with anti-TNF-α had significantly improved aortic strain and distensibility values (p = 0.022 and p = 0.014, respectively) compared to those treated with non-steroidal anti-inflammatory drugs (NSAIDs). CONCLUSION: Myocardial diastolic functions were significantly deteriorated in the AS patients, and disease activity and myocardial diastolic functions were associated. An interesting finding was that patients receiving anti-TNF-α had better aortic elasticity than those treated with NSAIDs.
    Modern Rheumatology 11/2012; · 1.72 Impact Factor
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    ABSTRACT: In the presence of resistance to circumferential expansion of atherosclerotic plaques due to mechanical dilation high shear stresses between stiff plaques and normal vessel segments may occur and thus may result in coronary dissection. Limited data are available on the clinical and angiographic outcome of severe (type E, type F) coronary dissections. Herein, we report a case of type F dissection (causing total occlusion) of proximal right coronary artery during balon angioplasty which healed spontaneously. In conclusion, although the type F dissection has worse prognosis due to complete cessation of distal vessel perfusion, the possibility of spontaneous healing should be kept in mind after unsuccessful intervention.
    European review for medical and pharmacological sciences 08/2012; 16(8):1130-2. · 1.09 Impact Factor
  • European heart journal cardiovascular Imaging. 06/2012; 13(11):964.
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    ABSTRACT: Cardiac cystic echinococcosis is a rarely encountered parasitic infestation caused by Echinococcus granulasus larvae. Cystic echinococcosis hydatid composes 0.5-2% of all human cystic echinococcosis cases. Isolated cardiac involvement is very rare. Cardiac cystic echinococcosis hydatid generally accompanies another organ involvement, however, it might be isolated as in the present case and although rare and it can cause heart failure. We present a case of isolated apical cardiac cystic echinococcosis hydatid which leads to heart failure.
    Case Reports in Medicine 01/2012; 2012:603087.
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    ABSTRACT: The mean platelet volume (MPV) values reflect platelet size and are accepted as marker of platelet activation. We sought to test the hypothesis that platelet activation occurs independently from presence or absence of thrombus in prosthetic mitral valve. A total of 168 patients were included in the study. Study participants were divided in three groups: group 1 (n = 62) - patients with normal prosthetic mitral valve; group 2 (n = 37) - patients with prosthetic mitral valve thrombosis; and group 3 (n = 69) - healthy individuals. MPV values were significantly higher in normal and thrombotic prosthetic mitral valve patients than in healthy individuals (P = 0.008 and P = 0.01, respectively). MPV values were not different between normal prosthetic mitral valve and thrombotic prosthetic mitral valve. This is the first study indicating that increased MPV is present in normal and thrombotic prosthetic mitral valve, implying that platelet reactivity occurs in prosthetic mitral valve irrespective of development of thrombus formation.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 01/2012; 23(1):91-3. · 1.25 Impact Factor
  • Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 11/2011; 17(11):887-8.
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    ABSTRACT: Percutaneous closure of secundum atrial septal defects (ASD) has become an important alternative treatment to surgery. We evaluated our clinical experience with, and short-term results of transcatheter closure of ASDs with the Amplatzer septal occluder in adult patients. The study included 52 patients (36 women, 16 men; mean age 33±14 years; range 14 to 69 years) who underwent transcatheter ASD closure with the Amplatzer occluder device. The mean ASD diameter measured by transesophageal echocardiography was 19.5±5.7 mm and the mean device diameter was 24.5±5.7 mm. All the patients were assessed clinically and echocardiographically one month after the procedure. Transcatheter ASD closure was successfully performed in 48 patients (92.3%) and failed in four patients (7.7%). Echocardiographic controls showed significant decreases in tricuspid regurgitation, right ventricular dilatation, and pulmonary artery pressure (p=0.003, p=0.026, and p=0.0001, respectively). Functional capacity of the patients also showed significant improvements (p=0.0001). After implantation, residual shunts were detected in four patients, all of which disappeared one month after the procedure. Major complications were seen in two patients. One patient developed ventricular fibrillation immediately after the procedure due to device embolization. One patient with left ventricular dysfunction developed device thrombosis due to cessation of dual antiplatelet therapy, which was successfully treated by anticoagulation therapy. Arrhythmia was not observed in any patient. Percutaneous closure of secundum ASDs with the Amplatzer occluder device is a safe and effective procedure with a high success rate.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2011; 39(1):35-40.
  • International Journal of Cardiology - INT J CARDIOL. 01/2011; 147.
  • International Journal of Cardiology - INT J CARDIOL. 01/2011; 147.
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 11/2010; 10(6):550-2. · 0.72 Impact Factor
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    ABSTRACT: Platelets and clotting cascade play a major role in development of atrial thrombus in patients with atrial fibrillation. The mean platelet volume (MPV) reflects platelet size and is considered a marker and determinant of platelet function because larger platelets are hemostatically more reactive than platelets of normal size, increasing the propensity to thrombosis. We have investigated the relationship between MPV and left atrial thrombus in patients with persistent atrial fibrillation. A total of 205 consecutive patients (men: 67.3%, women: 32.7%; mean age: 62.3 ± 12.8) who had persistent atrial fibrillation, undergone transesophageal and transthoracic echocardiography. Study individuals were divided into two groups. Group 1 (n: 96, 46.8%): atrial fibrillation complicated with atrial thrombus and group 2 (n: 109, 53.2%): atrial fibrillation free of thrombus, which was identified by means of transesophageal echocardiogram. The MPV, platelet distribution weight, and platelet count were measured. There was no difference in terms of MPV, platelet distribution weight, and platelet count in two groups. MPV was not correlated with thrombus and spontaneous echo contrast. Left atrial thrombus was included in multivariate logistic regression analysis and only low ejection fraction was a predictor of left atrial thrombus (P = 0.04). This is first report showing that MPV is not related with left atrial thrombus in patients with atrial fibrillation. According to our result, MPV cannot be considered as an index of left atrial thrombus in patients with atrial fibrillation.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 09/2010; 21(8):722-5. · 1.25 Impact Factor
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    ABSTRACT: Reliable non-invasive new indices reflecting severity of rheumatic valve disease would be highly beneficial. Recently, presence of fragmented QRS (fQRS) in ECG was accepted as a marker of myocardial fibrosis. fQRS is defined as the presence of RSR' patterns such as additional R wave (R'), notching in the R wave or the S wave in 2 contiguous leads. Purpose of our study was to establish frequency of fQRS in isolated rheumatic mitral stenosis compared with control group. We studied 193 patients with mitral stenosis and age/gender matched 97 healthy subjects. Patients were categorized according to the New York Heart Association (NYHA) functional class. Severity of mitral stenosis, left ventricular ejection fraction, and pulmonary artery pressure were obtained by means of echocardiography. fQRS was defined on routine 12-lead ECG. fQRS was more frequent in subjects with mitral stenosis than in control group (p < 0.001). fQRS was associated with low ejection fraction, pulmonary hypertension, poor functional NYHA class, increased mean mitral valve gradient and decreased mitral valve area (R = 0.1, p = 0.02; R = 0.1, p = 0.001; R = 0.1, p = 0.01; R = 0.1, p = 0.04; and R = -0.1, p = 0.009, respectively). Mitral valve area was the only independent predictor of fQRS in multiple logistic regression analysis. In conclusion, fQRS is predictive of severe mitral stenosis, lower ejection fraction, increased pulmonary artery pressure, and poor functional class. fQRS might be considered as a novel indicator of mitral stenosis severity and associated complications.
    The Tohoku Journal of Experimental Medicine 01/2010; 220(4):279-83. · 1.37 Impact Factor