Hiatal hernia presenting like a large left atrial mass

Keskin, Muhammed/0000-0002-4938-0097WOS: 000418481400017PubMed: 29226902

The association of right ventricular dysfunction with in-hospital and 1-year outcomes in anterior myocardial infarction

Keskin, Muhammed/0000-0002-4938-0097; Cinar, Tufan/0000-0001-8188-5020WOS: 000458270500009PubMed: 30109454In anterior ST-segment elevation myocardial infarction (STEMI), attention paid mainly to the left ventricle. The predictive significance of right ventricular (RV) dysfunction in patients with anterior STEMI has been frequently neglected. In this study, we evaluated the prognostic effect of RV dysfunction on in-hospital and long-term outcomes in patients with first anterior STEMI. A total of 350 patients without known coronary artery disease with first anterior STEMI and treated with primary percutaneous coronary intervention were prospectively enrolled in this study. In-hospital and long-term outcomes were compared between two groups of with or without RV dysfunction. In-hospital mortality was significantly higher in the RV dysfunction group (26.7% vs. 1.6%, P<0.001). The RV dysfunction group also had a higher incidence of cardiogenic shock, recurrent myocardial infarction, target lesion revascularization and stent thrombosis. The 1-year overall survival in patients with and without RV dysfunction was 62.2% and 95.0% respectively. After multivariable analysis, RV dysfunction remained as an independent predictor for in-hospital and long-term mortality. RV dysfunction is an independent predictor of cardiogenic shock, recurrent myocardial infarction, and, in-hospital and long-term mortality in anterior STEMI. Therefore, attention should be paid to the function of right ventricle as in the left ventricle after anterior STEMI

Relation of the Number of Parity to Left Ventricular Diastolic Function in Pregnancy

Guvenc, Tolga Sinan/0000-0002-6738-266X; Keskin, Muhammed/0000-0002-4938-0097WOS: 000405144700024PubMed: 28479168Left ventricular diastolic dysfunction (LVDD) has been relatively less studied than other cardiac changes during pregnancy. Previous studies revealed a mild diastolic deterioration during pregnancy. However, these studies did not evaluate the long-term effect of parity on left ventricular diastolic function. A comprehensive study evaluating the long-term effect of parity on diastolic function is required. A total of 710 women with various number of parity were evaluated through echocardiography to reveal the status of diastolic function. Echo cardiographic parameters were compared among the women by parity number and categorized accordingly: none, 0 to 4 and 4 4 parity and that had 21 and 5.8 times higher than nulliparous group, respectively. In conclusion, according to the present study, grand multiparity but not multiparity, severely deteriorates left ventricular diastolic function. Further studies are warranted to evaluate the risk of gradual diastolic dysfunction after each pregnancy. (C) 2017 Elsevier Inc. All rights reserved

A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index

Guvenc, Tolga Sinan/0000-0002-6738-266X; Keskin, Muhammed/0000-0002-4938-0097WOS: 000415210400031PubMed: 28575813Background: Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. Methods: We retrospectively evaluated the in-hospital and long-term(4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. Results: In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. Conclusion: TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. (C) 2017 Elsevier Inc. All rights reserved

A novel and useful predictive indicator of prognosis in ST segment elevation myocardial infarction; prognostic nutritional index

Guvenc, Tolga Sinan/0000-0002-6738-266XWOS: 000440509304675

A Novel Independent Survival Predictor in Pulmonary Embolism: Prognostic Nutritional Index

Keskin, Muhammed/0000-0002-4938-0097; Cinier, Goksel/0000-0001-5064-1816; Guvenc, Tolga Sinan/0000-0002-6738-266XWOS: 000430070500012PubMed: 28401800The prognostic impact of nutritional status in patients with pulmonary embolism (PE) is poorly understood. A well-accepted nutritional status parameter, prognostic nutritional index (PNI), which was first demonstrated to be valuable in patients with cancer and gastrointestinal surgery, was introduced to patients with PE. Our aim was to evaluate the predictive value of PNI in outcomes of patients with PE. We evaluated the in-hospital and long-term (53.8 +/- 5.4 months) prognostic impact of PNI on 251 patients with PE. During a median follow-up of 53.8 +/- 5.4 months, 27 (11.6%) patients died in hospital course and 31 (13.4%) died in out-of-hospital course. The patients with lower PNI had significantly higher in-hospital and long-term mortality. The Cox proportional hazard analyses showed that PNI was associated with an increased risk of all-cause death for both unadjusted model and adjusted for all covariates. Our study demonstrated that PNI, calculated based on serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with PE