Kudret Aytemir

Dışkapı Yıldırım Beyazıt Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (431)861.72 Total impact

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    ABSTRACT: BACKGROUND: In addition to the diagnostic performance, coronary computed tomography angiography (CTA) can give important data regarding the prognosis of coronary artery disease (CAD). In this study we aimed to evaluate the prognostic role of coronary CTA in patients with suspected CAD and mild-moderate coronary stenosis. METHODS: A total of 1115 patients (602 male, 54%; age 58.4±11.4) without previous CAD were enrolled. Patients underwent coronary CTA imaging using dual-source 64-slice CT scanner. For categorization of the coronary atherosclerotic plaques (CAP), the coronary system was divided into 16 separate segments. For each segment, CAPs were categorized as: calcified, noncalcified and mixed. RESULTS: During follow-up of 29.7±13.2months, cardiovascular events defined as ST segment elevation myocardial infarction (4 patients), non-ST segment elevation myocardial infarction (5 patients) and unstable angina pectoris (20 patients) requiring revascularization or hospital admission were recorded. Cox hazard regression analysis revealed an association between the severity of luminal stenosis (HR: 4.73, 95% CI: 1.36-16.47, p<0.05) and extent (HR: 1.10, 95% CI: 1.00-1.22, p=0.051) and the adverse coronary events in the follow-up. Multivariate Cox hazard regression analysis revealed that nonobstructive (≤50%) lesions were the only factor causing increased probability of coronary events in the follow-up (HR: 4.77, 95% CI: 1.36-16.74, p<0.05). CONCLUSION: The presence and severity of luminal stenosis shown by coronary CTA were associated with prognosis of coronary events in the follow-up. These results may improve the risk stratification in patients evaluated by coronary CTA and provide strategies for the individualized prevention programs.
    International journal of cardiology 11/2012; · 6.18 Impact Factor
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    ABSTRACT: Background: Contrast-induced nephropathy (CIN) is one of the most frequent causes of acute renal failure in hospitalized patients with the incremental use of contrast media. We aimed to investigate whether proteinuria may act as a risk factor for CIN in patients with chronic kidney disease. Methods: Seventy hospitalized patients (37 men, 33 women) with chronic kidney disease, proteinuria, and/or estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m(2), who were exposed to contrast media were investigated prospectively. Thirty patients were diabetic. All patients received prophylaxis against CIN with acetylcysteine and 0.9% intravenous saline. CIN is defined as either a 25% higher increase in serum creatinine (sCr) from the baseline levels or a 0.5 mg/dL increase in sCr at 72 h after contrast media exposure. Results: CIN was detected in 26 (37.1%) patients. Advanced age, diabetes, heart failure, anemia, baseline sCr of >1.5 mg/dL, baseline eGFR of <60 mL/min/1.73 m(2), proteinuria of ≥1 g/day, hypoalbuminemia, and the volume of contrast media of ≥100 mL correlated significantly with CIN. The frequency of CIN was significantly higher in patients with proteinuria of ≥1 g/day compared to patients with proteinuria of <1 g/day (p = 0.009). Conclusion: Proteinuria may be a new risk factor for the development of CIN in patients with chronic kidney disease.
    Renal Failure 11/2012; · 0.94 Impact Factor
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    Internal and Emergency Medicine 11/2012; · 2.35 Impact Factor
  • U Canpolat, L Sahiner, K Aytemir
    Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 11/2012; · 1.41 Impact Factor
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    ABSTRACT: Background. Recent studies have shown a strong relationship between testosterone levels and vasomotor actions. The aim of this study is to compare the elastic properties of the aorta in male patients with hypogonadism and eugonadal healthy control subjects. Method. A total of 22 male with hypogonadism (mean age: 35.2 ± 9.5 years, mean disease duration: 5.3 ± 1.8 years) and 25 age-, sex- and weight-matched eugonadal healthy subjects (mean age: 34.5 ± 8.2 years) were enrolled in the study. Aortic stiffness (β) index, aortic strain (AoS) and aortic distensibility (AoD) were calculated from the aortic diameters measured by transthoracic echocardiography and blood pressure obtained by sphygmomanometer. Results. The routinely performed echocardiographic parameters were similar between patient and control groups. There were significant differences between the control and patient groups in β index (1.75 ± 0.44 vs 2.68 ± 1.72, p < 0.001), AoS (18.52 ± 6.44 vs 12.35 ± 3.88%, p < 0.001) and AoD (7.56 ± 2.86 vs 3.96 ± 1.24, 10(-6) cm(2)/dyn, p < 0.001). There were statistically significant positive correlations between the serum total testosterone level and AoD (r = 0.539, p < 0.001) and AoS (r = 0.372, p = 0.036); moreover, there was a negative correlation between the serum total testosterone level and β index (r = - 0.462, p = 0.001). In multivariate analysis, serum total testosterone level was significantly related with AoD, AoS and β index (respectively, RR = 2.88, p = 0.004; RR = 3.45, p = 0.001; RR = 2.64, p = 0.01). Conclusion. The study results showed that aortic elasticity was impaired in patients with hypogonadism. We also have demonstrated a statistically significant correlation between aortic elastic properties and the serum total testosterone level.
    Blood pressure 11/2012; · 1.26 Impact Factor
  • Indian Journal of Gastroenterology 10/2012;
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    ABSTRACT: BACKGROUND: The aim of this study was to compare the diagnostic accuracy of 64-slice multidetector computed tomography (MDCT) with conventional coronary angiography to detect graft patency and stenosis. METHODS: In this retrospective analysis, we included a total of 284 subjects (210 men, 73.9%; mean ± SD age, 62.6 ± 9.9) and evaluated 684 bypass grafts using a dual-source 64-slice MDCT scanner The mean ± SD time interval between coronary artery bypass grafting operation and MDCT was 30.8 ± 6.2 months. The mean ± SD interval between MDCT angiography and conventional coronary angiography was 14.2 ± 3.6 days. Significant stenosis was defined as lesions causing 50% or greater luminal narrowing. All atherosclerotic lesion components were assessed on per-segment basis. RESULTS: All of the 684 grafts (420 venous and 264 arterial grafts) were evaluable and included in the analysis. For the detection of 50% or greater graft stenosis, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT was 98.3%, 99.3%, 98.3%, and 99.3% for venous grafts and 100%, 99.5%, 98.0%, and 100% for arterial grafts. In detection of graft patency, the sensitivity, specificity, positive predictive value, and negative predictive value of MDCT was 99.6%, 97.2%, 99.0%, and 99.0% for venous grafts and 99.5%, 97.5%, 99.5%, and 97.5% for arterial grafts. Diagnostic accuracy for the detection of graft patency was 99% (416/420) and 99.2% (262/264) for venous and arterial grafts, respectively. CONCLUSION: The diagnostic accuracy of dual-source 64-slice MDCT angiography for evaluating coronary artery bypass grafts patency and stenosis was high. Dual-source 64-slice MDCT can be used for the evaluation of patients after coronary artery bypass grafting.
    Journal of Investigative Medicine 10/2012; · 1.75 Impact Factor
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    ABSTRACT: BACKGROUND: Previous studies have shown that cardiovascular risk is increased in premature ovarian failure (POF). To determine the effects of POF on different parameters of cardiovascular health, we investigated the relationship between POF and circulating endothelial progenitor cells (EPC), endothelial function, carotid intima media thickness (CIMT) and left ventricular diastolic function. METHODS: We compared 23 female POF patients (mean age; 37.8±10.8years) with 20 gender and age-matched healthy controls. Circulating CD133(+)/34(+) and CD34(+)/KDR(+) EPCs were determined by using flow-cytometry. Ultrasound assessment of endothelial function by brachial artery flow-mediated dilatation (FMD) and CIMT was made. Left ventricular systolic and diastolic function was assessed by standard 2D and M-mode echocardiography and tissue Doppler velocities. RESULTS: Brachial artery FMD was significantly impaired in patients with POF compared with CG (6.3±1.9% vs 10.4±3.7%, p<0.05). Furthermore, circulating EPCs were lower among patients with POF compared to controls for CD133(+)/34(+) and CD34(+)/KDR(+) cells (p<0.05). There was a significant correlation between serum estradiol levels and EPC number (CD 133+/34+) (r=0.329, p<0.05). POF patients had increased CIMT compared to controls (0.67±0.17 vs 0.43±0.10, p<0.05). When diastolic functions were assessed, patients with POF had lower E(peak), A(peak) and mitral CP and higher DT and IVRT (p<0.05, respectively). CONCLUSION: Our findings indicate that endothelial function as well as circulating EPCs, CIMT and diastolic function are significantly affected in young women with POF which may have an adverse long-term effect on cardiovascular prognosis.
    International journal of cardiology 10/2012; · 6.18 Impact Factor
  • Herz 10/2012; · 0.78 Impact Factor
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    ABSTRACT: Background: The main purpose of this study is to determine the correlation of inter- and intraatrial conduction times between the electrophysiological and tissue Doppler echocardiographic measurements, and to evaluate the appropriateness of tissue Doppler echocardiography for this measurement. Methods: One-hundred and one patients were included in the study who underwent electrophysiological study for clinical arrhythmias. Inter- and intraatrial conduction times were measured from intracardiac electrograms. Atrial conduction times were also measured by tissue Doppler echocardiography by evaluating atrial electromechanical delay between lateral mitral annulus, septal mitral annulus, and right ventricular tricuspid annulus. The correlation between electrophysiological and echocardiographic atrial conduction times were analyzed. Results: We found a weak correlation between the measurements of interatrial conduction times with the electrophysiological and tissue Doppler techniques (r = 0.308; p = 0.002). The correlation for intraleft atrial conduction times was moderate (r = 0.652; p 〈 0.001). There was no correlation between the measurements of intra-right atrial conduction times. Conclusions: We concluded that tissue Doppler echocardiography can be used for the measurement of interatrial and intra-left atrial conduction times. Tissue Doppler echocardiography can be a suitable technique to evaluate atrial substrate. (Cardiol J 2012; 19, 5: 487-493).
    Cardiology journal 10/2012; 19(5):487-93. · 1.15 Impact Factor
  • Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 10/2012; 40(6):559.
  • International journal of cardiology 09/2012; · 6.18 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 09/2012; · 0.72 Impact Factor
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    ABSTRACT: Background/Aims: We tested the hypothesis that adding an ultrafiltration session per week may improve brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels and left ventricular function in hypervolemic hemodialysis patients. Methods: Twenty-six patients (18 male, 8 female; mean age 57.2 ± 12.7 years) who had high BNP and CRP levels and interdialytic weight gain (IDWG) were recruited for the study. Patients were randomly allocated to one of two groups, namely the supplementary ultrafiltration (sUF) group (n = 13), who had additional ultrafiltrations for 8 weeks, and the regular hemodialysis (rHD) group (n = 13), who continued regular dialysis treatments. Results: There were significant decreases in mean CRP and BNP levels and mean arterial blood pressure and significant improvements in left ventricular function in the sUF group, with no changes in the rHD group. Higher IDWG was observed in the rHD group compared to the sUF group after 8 weeks. Conclusion: sUF may be effective in reducing inflammatory burden and improving cardiac function.
    Blood Purification 08/2012; 34(1):67-74. · 2.06 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 08/2012; 12(7):E36-7. · 0.72 Impact Factor
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    ABSTRACT: OBJECTIVES Multidetector computed tomography (MDCT) angiography, which is used for native coronary vessels and bypass graft (CABG) imaging is a non-invasive test. Here, we aimed to compare the diagnostic accuracy of 16- and 64-slice MDCT for graft patency and stenosis. METHODS A total of 129 consecutive patients with CABG who underwent both MDCT (58 patients with 16-slice, 71 patients with 64-slice) and invasive angiography were included. Median time interval between the two procedures was 12 days (range 3-28 days). Bypass grafts were evaluated concerning patency and presence of stenosis ≥50%. Both 16- and 64-slice MDCT results were compared with invasive angiography. RESULTS Overall diagnostic accuracy for the detection of graft patency was 95% for 64-slice vs 92% for 16-slice MDCT. By analyzing the 173 grafts by 64-slice vs 153 grafts by 16-slice MDCT that could be evaluated, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of the MDCT for visualization of graft patency were 90, 98, 90 and 98% vs 87, 97, 94 and 93%, respectively. The accuracy of MDCT for the detection of significant graft stenosis was relatively low (sensitivity, specificity, PPV and NPV were 67, 98.6, 50 and 98.6% with 16-slice vs 80, 98.1, 72.7 and 98.7% with 64-slice). CONCLUSIONS This study showed that the 16-slice has a diagnostic accuracy comparable with the 64-slice system for graft patency and can still be used for this purpose if newer systems with improved performance are not available on-site. On the other hand, by the virtue of better image quality, the 64-slice MDCT demonstrates significant graft lesions with higher sensitivity.
    Interactive Cardiovascular and Thoracic Surgery 07/2012; 15(5):847-53. · 1.11 Impact Factor
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    ABSTRACT: Renal artery stenosis (RAS) and coronary artery disease share common risk factors. We investigated the frequency and predictors of RAS among hypertensive patients who underwent elective coronary angiography. A total of 832 hypertensive patients underwent coronary and renal angiography at the same session. Renal artery stenosis was classified as mild, moderate, or severe. The study population consisted of 4 groups; 71.1% with normal renal arteries, 12.5% with mild, 8.9% with moderate, and 7.5% with severe RAS. The prevalence of significant (≥50%) RAS was 16.3%. The Gensini score showed a stepwise rise with increasing severity of RAS. Age, duration of hypertension, estimated glomerular filtration rate, Gensini score, and multivessel disease were independent predictors for the presence of RAS. Hypertensive patients with those risk factors might need detailed investigation for RAS which may affect their prognosis.
    Angiology 07/2012; · 2.37 Impact Factor
  • Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2012; 12(6):E30-1. · 0.72 Impact Factor
  • Uğur Canpolat, Hamza Sunman, Kudret Aytemir, Ali Oto
    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2012; 12(6):528-9. · 0.72 Impact Factor
  • Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 06/2012; 40(4):391.

Publication Stats

2k Citations
861.72 Total Impact Points

Institutions

  • 2013
    • Dışkapı Yıldırım Beyazıt Training and Research Hospital
      Engüri, Ankara, Turkey
  • 1998–2013
    • Hacettepe University
      • • Department of Cardiology
      • • Department of Internal Medicine
      • • Department of Radiology
      • • Faculty of Medicine
      Ankara, Ankara, Turkey
  • 2011–2012
    • State Hospital of Ercis, Turkey
      Arcis, Van, Turkey
    • Gazi University
      • Faculty of Health Sciences
      Ankara, Ankara, Turkey
    • Kahramanmaras State Hospital
      Marache, Kahramanmaraş, Turkey
  • 2010
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2009
    • Ulus State Hospital
      Engüri, Ankara, Turkey
  • 2002–2009
    • Gulhane Military Medical Academy
      • Department of Cardiology
      Ankara, Ankara, Turkey
  • 2008
    • Yunus Emre State Hospital
      Dorylaeum, Eskişehir, Turkey
  • 2007
    • University of Gaziantep
      • Division of Rheumatology
      Ayıntap, Gaziantep, Turkey
    • Ankara University
      • Department of Internal Medicine
      Ankara, Ankara, Turkey
  • 2004
    • Celal Bayar Üniversitesi
      • Department of Cardiology
      Saruhan, Manisa, Turkey
  • 1999
    • St. George's School
      • Department of Cardiological Sciences
      Middletown, Rhode Island, United States