Cem Nazli

Izmir Katip Celebi Universitesi, Temnos, İzmir, Turkey

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Publications (56)102.75 Total impact

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    ABSTRACT: Associations have been recently recognized between psoriasis and an increased incidence of atherosclerotic diseases. However, there are scarce data on the prevalence of coronary lesions in patients with psoriasis. The aim of this study was to identify the calcified and non-calcified atherosclerotic coronary lesions in patients with psoriasis compared to controls. Forty patients with psoriasis and 42 control subjects matched for age, sex, and cardiovascular risk profile were included in this case-control study. Coronary lesions were evaluated by a 128-slice dual source multidetector computed tomography scanner. Coronary calcification scoring was calculated according to the Agatston score. The prevalence of atherosclerotic coronary lesions (psoriasis: 15%, controls: 16.7%; P = 0.83) and the mean coronary calcification scoring (psoriasis: 9.9 ± 35.2 Agatston unit, controls 2.8 ± 12.0 Agatston unit; P = 0.81) did not show a significant difference between the two groups. Multivariate analysis identified age ≥48 years and fasting blood glucose ≥99.0 mg/dl as independent predictors of coronary artery disease in patients with psoriasis (F = 30.9; P = 0.001; adjusted R(2) = 0.49). Patients with psoriasis had the same prevalence of calcified and non-calcified atherosclerotic coronary lesions as compared to controls. Our results demonstrated the necessity of considering the age and fasting blood glucose of patients with psoriasis in a decision for further cardiovascular evaluation. © 2014 The International Society of Dermatology.
    International journal of dermatology 11/2014; DOI:10.1111/ijd.12673 · 1.23 Impact Factor
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    ABSTRACT: The hormone fibroblast growth factor 21 (FGF-21) regulates carbohydrate and lipid homeostasis. FGF-21 represents an attractive novel therapy for obesity since administration of FGF-21 has been shown to improve metabolic abnormalities in obese animal models. We investigated FGF-21 and its relationship with epicardial fat thickness (EFT), metabolic parameters, and inflammatory markers in premenopausal obese women compared to controls with similar Systematic Coronary Risk Evaluation (SCORE) project risk profiles.
    Journal of endocrinological investigation 10/2014; DOI:10.1007/s40618-014-0185-3 · 1.55 Impact Factor
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    ABSTRACT: Introduction: The presence of patent foramen ovale (PFO) is considered a possible cause for cryptogenic stroke. The mechanism underlying the ischaemic neurological events in the presence of PFO has not been firmly established. The purpose of this study was to compare: (1) the mean platelet volume levels in PFO patients with and without a cryptogenic stroke, and (2) pre- and post-procedural mean platelet volumes (MPV) in patients undergoing percutaneous PFO closure. Methods: Sixteen PFO patients undergoing percutaneous closure to prevent recurrent ischaemic events and 15 asymptomatic patients with PFO were enrolled in the study. Mean platelet volume was compared between patients with and without a history of stroke. We also compared pre- and post-procedural MPV levels in patients undergoing percutaneous PFO closure. Results: Mean platelet volume, which is a marker for platelet activity, was similar in PFO patients with and without stroke (9.34 +/- 1.64 vs 9.1 +/- 1.34 fl; p = 0.526). Interestingly, MPV decreased significantly after percutaneous closure compared to pre-procedural levels (9.34 +/- 1.64 vs 8.3 +/- 1.12 fl; p = 0.001). Conclusion: Our findings suggest interatrial communication through a PFO may be related to increased MPV and increased platelet activity.
    Cardiovascular journal of Africa 07/2014; 25(4):165-167. DOI:10.5830/CVJA-2014-027 · 0.79 Impact Factor
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    ABSTRACT: Lipid-lowering therapy (LLT) is a key factor in the prevention of cardiovascular mortality and morbidity in diabetic patients. Current guidelines have expanded the population of patients with diabetes for whom aggressive low-density lipoprotein cholesterol (LDL-C) lowering therapy should be considered. This study evaluated the management of dyslipidemia in patients with type 2 diabetes in real life. Secondary care physicians in a tertiary center recruited 707 patients. The prevalence of statin use along with the achievement of cholesterol targets, predictors for receiving statin, and possible reasons for lack of therapy were investigated. Only 33% of the patients had received statin therapy, and this was significantly higher in those with cardiovascular disease (47% versus 27%; P<0.001). Most of the patients had LDL-C levels of >100 mg/dL (77%), with only 5% having LDL-C levels of <70 mg/dL. Forty-one percent of the patients had never been prescribed LLT previously while 26% had been prescribed this type of therapy in the past but had stopped using it. The most frequent reason for discontinuation of the statin therapy was a physician's advice to stop the medication. The patients taking statins had similar LDL-C levels as those who had never been prescribed statins and those who had discontinued their use of statins on the advice of a physician. The majority of diabetic patients are undertreated with statins and minority of them achieve LDL-C target levels. Our findings suggest that there is a large discrepency between evidence-based recommendations and physicians' treatment attitudes.
    06/2014; 62(3):287-95.
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    ABSTRACT: There are various instruments to assess quality of life (QoL) in patients with atrial fibrillation (AF). The aim of this study is to determine the reliability and validity of the Turkish version of the University of Toronto Atrial Fibrillation Severity Scale (AFSS). The AFSS and Short Form-36 (SF-36) were completed by 130 patients with documented AF. The Canadian Cardiovascular Society Severity in Atrial Fibrillation (SAF) scale and European Heart Rhythm Association (EHRA) scale were also utilized by the attending physicians. To assess test-retest reliability, the AFSS was readministered to 47 clinically stable patients at a 1-month follow-up visit. Internal consistency reliability, test-retest reproducibility, and construct validity were evaluated. The mean age of the patients was 63.1 + 10.9 years and 58.5% of patients were male. The outcome scores of the Turkish version of the AFSS showed good correlations with theoretically related SF-36 domains. Additionally, AFSS outcome scores showed a linear correlation with the SAF and EHRA scores. Cronbach's alpha values for internal consistency were consistent and similar with the English language version of the AFSS. Intraclass correlation coefficients for reproducibility exceeded 0.80 for every item. Convergent-divergent and known-groups validity and reliability were established for the Turkish version of the University of Toronto AFSS.
    Turkish Journal of Medical Sciences 01/2014; 44(6):996-1001. DOI:10.3906/sag-1304-104 · 0.84 Impact Factor
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    ABSTRACT: Introduction Quality of life has become an important outcome measure in addition to mortality and morbidity in patients with congenital heart disease. Atrial septal defect is a common congenital heart disease, and transcatheter atrial septal defect closure has become an accepted treatment modality. The aim of this study is to assess the quality of life of patients with atrial septal defect who underwent percutaneous closure. Materials and methods We examined the quality of life of 69 patients with atrial septal defect and 69 healthy controls matched according to age, sex, educational level, and economic, marital, and employment status. Quality of life was investigated using the Turkish version of Short Form-36. The mean age of the patients was 39.7 ± 14.2 and 26% were male. The quality of life assessment was performed at a mean follow-up time of 18.0 ± 13.8 months after the intervention. The mean scores of the domains of the Short Form-36, namely, physical functioning, role functioning, social functioning, mental health, vitality, pain, and general health, were similar in patients with atrial septal defect who underwent percutaneous closure and the control group. Adult patients who underwent percutaneous atrial septal defect closure perceive their quality of life to be as good as their healthy counterparts.
    Cardiology in the Young 09/2013; DOI:10.1017/S1047951113001479 · 0.86 Impact Factor
  • Southern medical journal 10/2010; 103(10):1072-3. DOI:10.1097/SMJ.0b013e3181efa30c · 1.12 Impact Factor
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    ABSTRACT: (Echocardiography 2010;27:E55-E56)
    Echocardiography 05/2010; 27(5):E55-6. DOI:10.1111/j.1540-8175.2010.01174.x · 1.25 Impact Factor
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    ABSTRACT: We report a case of percutaneous dual atrial septal defect closure with two Amplatzer septal occluder devices.
    Clinical Research in Cardiology 05/2010; 99(5):329-31. DOI:10.1007/s00392-010-0124-z · 4.17 Impact Factor
  • Cardiovascular revascularization medicine: including molecular interventions 04/2010; 11(2):137-8. DOI:10.1016/j.carrev.2009.09.003
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    ABSTRACT: We report a case of the giant thrombus on atrial lead of a patient who has a DDD dual-chamber permanent pacemaker.
    Clinical and Applied Thrombosis/Hemostasis 03/2010; 17(4):346-7. DOI:10.1177/1076029610363131 · 1.58 Impact Factor
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    ABSTRACT: In this article we report an unusual case of dextrocardia patient with perimembranous ventricular septal defect (VSD) whose defect is closed by percutaneous method with Amplatzer Duct Occluder-II device. To our best knowledge, this was the first time this device has been used to close a membranous defect in a patient with dextrocardia. Our case demonstrates the feasibility of percutaneous VSD closure in challenging patients by using appropiate techniques and devices for particular patients.
    International journal of cardiology 12/2009; 150(2):e77-80. DOI:10.1016/j.ijcard.2009.11.016 · 6.18 Impact Factor
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    ABSTRACT: We report an asymptomatic embolization of an Amplatzer atrial septal closure device into the main pulmonary artery detected by routine postinterventional transthoracic echocardiography 24h after implantation.
    International journal of cardiology 11/2009; 148(2):235-7. DOI:10.1016/j.ijcard.2009.09.532 · 6.18 Impact Factor
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    ABSTRACT: We report a case of isolated pericardial hydatidosis as a cause of chest pain.
    International journal of cardiology 09/2009; 150(1):e28-9. DOI:10.1016/j.ijcard.2009.08.033 · 6.18 Impact Factor
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    ABSTRACT: We aimed to evaluate the success and safety of percutaneous mitral balloon valvuloplasty (PMBV) and its mid-term clinical and echocardiographic results in patients with symptomatic mitral stenosis, including those having a high echo score (9 to 11). This prospective study included 57 consecutive patients (9 men, 48 women; mean age 41+/-9 years) who underwent PMBV with the Inoue technique for symptomatic (NYHA class II-IV) mitral stenosis (valve area <1.5 cm2). The patients were divided into two groups according to the echo scores of <or=8 (group 1, n=25) and >8 (group 2, n=32). Clinical and echocardiographic evaluations were performed before and after 24-48 hours of PMBV and during the follow-up period, including restenosis and major cardiovascular events. Patients in group 2 had significantly higher rates of atrial fibrillation (53.1% vs. 16%; p=0.006) and functional capacity of NYHA class III-IV (90.7% vs. 56%; p=0.01). Procedural success rates were 96% (n=24) and 90.6% (n=29) in group 1 and 2, respectively. Failure occurred in one patient (4%) in group 1, and in three patients (9.4%) in group 2. One patient in group 1 developed severe mitral stenosis resulting in valve replacement. In group 2, two patients developed hemopericardium. After the procedure, there was a two-fold increase from 1.0+/-0.1 cm2 to 2.0+/-0.2 cm2 in the mean valve area, being more prominent in group 1 (group 1: from 1.1+/-0.1 cm2 to 2.1+/-0.1 cm2; group 2: from 0.9+/-0.1 cm2 to 1.8+/-0.1 cm2; p<0.001). In-hospital mortality or embolic events did not occur, nor did restenosis or major cardiovascular events during a mean follow-up of 21+/-13 months. Our results show that PMBV can be performed successfully in patients having a low (<or=8) or higher (9-11) echo score, with satisfactory hemodynamic and symptomatic improvements.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2009; 37(8):531-7.
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    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 01/2009; 36(6):624-5. · 0.63 Impact Factor
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    ABSTRACT: We evaluated the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for further risk stratification of intermediate-risk patients with non-ST elevation acute coronary syndromes (NSTE-ACS). The study included 137 intermediate-risk patients (85 men, 52 women; mean age 62+/-11 years) with ACS, based on the TIMI risk score (scores 3 to 5). Serum NT-proBNP levels were measured 12 hours after the last anginal episode. The patients were divided into four groups according to the following NT-proBNP quartiles: 17-310 pg/ml (n=34), 313-688 pg/ml (n=35), 724-2,407 pg/ml (n=34), and 2,575-24,737 pg/ml (n=34). Primary endpoint of the study was mortality. The mean follow-up was 21.8+/-7.1 months. There were 27 deaths (19.7%), 14 of which were in the 4th quartile (4th vs 1st, 2nd, and 3rd quartiles: p=0.02, p=0.01, and p<0.01, respectively). The first three quartiles did not differ significantly in this respect. In Kaplan-Meier analysis, patients in the 4th quartile had the lowest cumulative survival (log rank test, 4th vs 1st, 2nd, and 3rd quartiles: p=0.041, p=0.026, and p=0.009, respectively). NT-proBNP level was significantly higher in nonsurvivors than in survivors (p=0.01). In univariate analysis, mortality was also associated with the TIMI risk score, ejection fraction, and age. Patients who died were older (65.6+/-11.9 years vs 60.7+/-11.0 years; p=0.048) and had a lower ejection fraction (46.3+/-11% vs 54.1+/-9.8%; p<0.001) than patients who survived. Mortality rates corresponding to TIMI risk scores of 3, 4, and 5 were 25.9%, 29.6%, and 44.4%, respectively (p=0.58 for TIMI 3 vs 4; p=0.001 for TIMI 3 vs 5; p=0.013 for TIMI 4 vs 5). Cox proportional hazards regression analysis showed that only TIMI risk score was an independent predictor of mortality (hazard ratio 2.3, 95% confidence interval 1.4-3.8, p=0.001). NT-proBNP has an additive predictive value over TIMI risk score in predicting long-term mortality in intermediate-risk patients with ACS.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2009; 37(1):1-8.
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    ABSTRACT: We evaluated our initial experience with percutaneous closure of ventricular septal defects (VSD) in adult patients. Percutaneous closure of VSDs in adult patients was launched in 2007 in our center. This study included the first five patients (3 women, 2 men; mean age 32.6 years; range 17 to 44 years) with a perimembranous (n=4) or muscular (n=1) VSD. Before percutaneous intervention, all the patients were assessed by transthoracic (TTE) and, when necessary, transesophageal (TEE) echocardiography, heart catheterization, and ventriculography. Percutaneous closure was performed under fluoroscopy and TEE or TTE guidance using the Amplatzer device (perimembranous asymmetric VSD occluder in perimembranous VSDs and muscular VSD occluder in muscular VSD). The mean VSD diameter was 7.4 mm (range 5 to 11 mm) by echocardiography, and 8.2 mm (range 6 to 11 mm) by ventriculography. The mean left ventricular end-diastolic diameter was 47.2 mm, and the mean distance between the VSD and the aorta was 5.6 mm. Percutaneous closure was successful in all the patients. Ventriculography obtained immediately after the procedure showed minimal passage from the interventricular septum in three patients, but there was no passage on control TTE examination on the first day after the procedure. Aortic, tricuspid, and mitral valves showed normal function. No rhythm problems were seen. All the patients were discharged within one or two days after the procedure. Percutaneous closure of VSDs has become a good alternative to surgical repair in recent years, with high success rates and low morbidity. The results of percutaneous closure of VSDs are also successful in adult patients.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2009; 37(5):312-6.
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    ABSTRACT: Oral anticoagulant therapy has been shown to decrease the risk for vascular complications in patients with atrial fibrillation (AF). We evaluated the frequency of oral anticoagulant use in patients with AF, whether oral anticoagulant use was associated with effective INR values, and the reasons for not including an anticoagulant in the treatment. The study included 426 consecutive patients (256 women, 170 men; mean age 66+/-11 years) who presented with a diagnosis of AF between October 2007 and November 2008. The patients were inquired about whether they were using warfarin and/or aspirin and the reasons for not taking an oral anticoagulant. The INR levels were measured in those receiving warfarin. Permanent AF was present in 72.8%, and paroxysmal AF was present in 27.2%. Patients = or >75 years of age accounted for 32.4%. The risk for stroke was high in 69.3%, moderate in 21.8%, and low in 8.9%, hypertension being the most frequent risk factor (66.7%). Inquiry about medications showed that 107 patients (25.1%) were taking aspirin and warfarin, 21 patients (4.9%) and 237 patients (55.6%) were taking warfarin and aspirin alone, respectively, while 61 patients (14.3%) used none. The incidence of oral anticoagulant use was 30.1%, being significantly low in patients = or >75 years of age (p=0.0001), and having hypertension (p=0.023) or coronary artery disease (p=0.004). Effective INR values recommended by the guidelines were attained in 47.7% (n=61) of patients receiving warfarin. Sex, age, clinical risk factors, and socioeconomic parameters were not associated with achievement of target INR values. The most frequent reason for not starting anticoagulant treatment was the low tendency of physicians to prescribe the drug (74.3%), followed by the presence of contraindications (9.8%). The most important factor for inadequate oral anticoagulant use especially in patients having a high risk for stroke is the low incidence of prescription of the drug by the physicians, suggesting low influence of the guidelines on the clinical practice.
    Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2009; 37(3):161-7.
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    ABSTRACT: Pulmonary embolus and right atrial thrombus trapped in a patent foramen ovale is an unusual, rare condition. We report a case of impending paradoxical embolism with pulmonary embolism, in which a thrombus entrapped in a patent foramen ovale was detected. To our knowledge, this is the first case in the literature in which 'thrombus-in-transit' was detected in the right atrium both before and after entrapment in a patent foramen ovale. J Cardiovasc Med 9:1166-1168 (C) 2008 Italian Federation of Cardiology.
    Journal of Cardiovascular Medicine 12/2008; 9(11):1166-8. DOI:10.2459/JCM.0b013e328311eed8 · 1.41 Impact Factor

Publication Stats

284 Citations
102.75 Total Impact Points


  • 2013–2014
    • Izmir Katip Celebi Universitesi
      Temnos, İzmir, Turkey
  • 2004–2010
    • Izmir Bozkaya Research and Training Hospital
      Ismir, İzmir, Turkey
  • 2009
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2008–2009
    • İzmir Atatürk Eğitim ve Araştırma Hastanesi
      Ismir, İzmir, Turkey
  • 2001–2008
    • T.C. Süleyman Demirel Üniversitesi
      • Department of Cardiology
      Hamitabat, Isparta, Turkey
  • 2007
    • Ege University
      Ismir, İzmir, Turkey
  • 1999
    • Dokuz Eylul University
      Ismir, İzmir, Turkey