Araştırma Çıktıları
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Item Assessment of cardiovascular risk in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report(OXFORD UNIV PRESS, 2009-01-01) Bakkaloglu, Sevcan A.; Saygili, Arda; Sever, Lale; Noyan, Aytul; Akman, Sema; Ekim, Mesiha; Aksu, Nejat; Doganay, Beyza; Yildiz, Nurdan; Duzova, Ali; Soylu, Alper; Alpay, Harika; Sonmez, Ferah; Civilibal, Mahmut; Erdem, Sevcan; Kardelen, FiratMethods. We aimed to clarify arteriosclerotic risk and to document possible relationships between cardiovascular risk factors and echocardiographic parameters in paediatric peritoneal dialysis (PD) patients. M-mode/Doppler/tissue Doppler echocardiographic studies and lipid/lipoproteins, homocysteine, high-sensitivity C-reactive protein (HS-CRP) levels and carotid intima-media thickness (CIMT) were determined in 59 patients (age: 14.2 +/- 4.5 years) and in 36 healthy subjects. Results. Structural and functional cardiac abnormalities were observed in patients on maintenance dialysis. Increased left ventricular mass index (LVMI, P = 0.000), relative wall thickness (P = 0.000), myocardial performance index (MPI, P = 0.000) were documented in the patients. Lipoprotein (a) (P = 0.000), homocysteine (P = 0.001), HS-CRP (P = 0.000) and CIMT (P = 0.000) were significantly elevated in the patients. Left ventricular hypertrophy (LVH) was prevalent in 68\% of the patients. Patients with LVH had higher levels of HS-CRP (P = 0.001) and CIMT (P = 0.028) than those without LVH. Haemoglobin was an independent predictor of LVMI (beta: -8.9, P = 0.001), while residual diuresis and CIMT were independent predictors of diastolic dysfunction (beta: -0.45, P = 0.034 and beta: 5.90, P = 0.008, respectively). Albumin (beta: -0.72, P = 0.018) and Kt/V urea (beta: -0.48, P = 0.012) were significant predictors of CIMT. There were positive correlations between LVMI and CIMT. HS-CRP was positively correlated with LVMI as well as CIMT. Conclusions. Elevated levels of atherosclerotic/inflammatory risk factors, low haemoglobin levels and loss of residual renal function and their negative effects on heart are of remarkable importance in paediatric patients on maintenance peritoneal dialysis. Achieving recommended targets for haemoglobin, blood pressure and Kt/V urea, preserving residual renal function as well as managing inflammation and subsequent arteriosclerosis is obviously essential to improve the patients' prognosis.Item Impact of peritoneal transport characteristics on cardiac function in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report(OXFORD UNIV PRESS, 2010-01-01) Bakkaloglu, Sevcan A.; Saygili, Arda; Sever, Lale; Aksu, Nejat; Noyan, Aytul; Akman, Sema; Ekim, Mesiha; Doganay, Beyza; Yildiz, Nurdan; Akalin, Figen; Caliskan, Salim; Kara, Orhan D.; Duzova, Ali; Soylu, Alper; Atalay, SemraMethods. One hundred and ten PD patients (13 +/- 5 years, PD vintage: 31 +/- 27 months) were enrolled into the study. Four-hour dialysate/plasma creatinine ratio was used for differentiating PET groups. Thirty-eight patients were high transporters, 29 were high-average transporters and 43 were low-average/low transporters. Echocardiography was performed in all subjects. Results. Age, PD vintage, dialysate glucose concentration, ultrafiltration volume, urine volume and blood pressure levels were similar in all PET groups. No biochemical or echocardiographic data (ejection fraction, fractional shortening, left ventricular mass index, myocardial performance index, power Doppler E/tissue Doppler E ratio reflecting diastolic function) were different among PET groups except lower albumin (P = 0.025) levels in high transporters and higher high-sensitivity C-reactive protein (P = 0.026) levels in high and high-average transporters compared to other transport groups. Conclusions. Cardiac structural and functional abnormalities are highly prevalent among paediatric PD patients. Transport rates did not have a significant effect on biochemical parameters or cardiac structural/functional parameters. It might be suggested that being a high transporter does not provide a disadvantage in terms of atherogenic tendency and cardiac disease in paediatric PD patients. Oligoanuria, anaemia and hypertension were independent predictors of cardiac disease.Item The effect of myocardial fibrosis on left ventricular torsion and twist in patients with non-ischemic dilated cardiomyopathy(VIA MEDICA, 2013-01-01) Karaahmet, Tansu; Gurel, Emre; Tigen, Kursat; Guler, Ahmet; Dundar, Cihan; Fotbolcu, Hakan; Basaran, YeldaBackground: Left ventricular (LV) rotation, twist, and torsion are important aspects of the cardiac performance. Myocardial fibrosis can be identified as the late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). In this study, we investigated the association between myocardial fibrosis and LV rotational parameters in patients with nonischemic dilated cardiomyopathy (NDC). Methods: Twenty-two NDC patients were enrolled. LV dimensions, volumes and ejection fraction (EF) were measured, conventional tissue Doppler imaging data was acquired. Speckle tracking imaging was performed to measure LV deformation, LV rotational parameters. Blood samples were obtained for NT-proBNP. Late gadolinium enhanced cardiac magnetic resonance (LGE-CMR) was used to assess cardiac fibrosis index. Results: Myocardial deformation was similar between LGE+ and LGE-groups. LGE+ patients have significantly higher basal and lower apical systolic rotation, lower twist and torsion when compared to LGE-patients. However, untwisting rate was similar between the groups. Torsion was significantly correlated with LVEF and MR-index. Patients with reversed apical systolic rotation had significantly greater NT-proBNP values, basal systolic rotation and significantly lower apical systolic rotation, torsion, and MR-index. Conclusions: Cardiac fibrosis index is closely related with myocardial torsion and LV systolic function and may be used for the evaluation of cardiac condition. Reversed apical systolic rotation indicated more extensive cardiac fibrosis as it may reflect severe LV dyssynchrony and poor LV performance.Item Is the Nexfin finger cuff method for cardiac output measurement reliable during coronary artery bypass grafting? A prospective comparison with the echocardiography and FloTrac/Vigileo methods(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2016-01-01) Ariturk, Cem; Acil, Meltem; Ulugol, Halim; Ozgen, Zehra Serpil Ustalar; Okten, Eyup Murat; Dagdelen, Sinan; Karabulut, Esref Hasan; Alhan, Huseyin Cem; Toraman, FevziBackground/aim: The aim of the current study was to assess the accuracy of cardiac output (CO) measurements obtained by the Nexfin finger cuff method as compared with the FloTrac/Vigileo and echocardiography methods in coronary artery bypass grafting (CABG) patients. Materials and methods: First-time elective CABG patients were prospectively enrolled in this study and divided into three groups according to CO measurement method. CO measurements were performed simultaneously by three different contributors and were collected by the fourth one 24 h postoperative in the intensive care unit (ICU). Data were statistically analyzed. Results: Seventeen female and 13 male patients between 42 and 78 years of age (with a mean of 56 +/- 4) were the subjects of this study. The mean CO measurements were 5.9 +/- 1.4 L/min, 5.8 +/- 1.1 L/min, and 6.0 +/- 1.1 L/min for the Nexfin, FloTrac/Vigileo, and echocardiography methods, respectively (P > 0.05). The correlation values between Nexfin and FloTrac/Vigileo, Nexfin and echocardiography, and FloTrac/Vigileo and echocardiography were r = 0.445, r = 0.377, and r = 0.384, respectively (P < 0.05). Conclusion: Nexfin yielded results comparable to those obtained with FloTrac/Vigileo and echocardiography for the postoperative CO assessment of CABG patients. Nexfin may be used in uncomplicated, hemodynamically stable patients in ICU as a reliable and totally noninvasive method of CO measurement.