Researcher:
Yurtseven, Ece

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Ece

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Yurtseven

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Yurtseven, Ece

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2017 - 201952020 - 20228

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    Echocardiographic assessment of left ventricular filling pressure in patients with acute ST elevation myocardial infarction: an invasive validation study
    (Springer, 2021) Durmaz, Eser; Ikitimur, Baris; Karadag, Bilgehan; Koca, Damla; Ohtaroglu Tokdil, Kardelen; Raimoglu, Utku; Soysal, Ali Ugur; Incesu, Gunduz; Belpinar, Mehmet Semih; Mutlu, Deniz; Atici, Adem; Ongen, Zeki; Yurtseven, Ece; Teaching Faculty; School of Medicine; 176021
    Backgrounds: Assessment of left ventricular filling pressure (LVFP) is of clinical importance in patients with ST elevation myocardial infarction (STEMI). Although several echocardiographic parameters are recommended for the assessment of LVFP, validation of these parameters in patients with STEMI is missing. We aimed to investigate the clinical utility of these parameters in acute settings. Methods: We prospectively included consecutive patients with STEMI. LV end-diastolic pressure (LVEDP) was measured following primary PCI and echocardiographic examination was performed within 24 hours. Mean left atrial pressure (mLAP) was calculated both invasively using Yamamoto's formula and non-invasively using Naugeh's formula. Mean LAP was considered increased when exceeded 18 mmHg. Results: Patients were grouped according to LVEDP, group 1(41 patients) and group 2(114 patients).There was no significant difference between groups in terms of comorbidities. NT pro-BNP levels (p < 0.001) and peak level of Hs-TnT (p-value: 0.002) were significantly higher in group 2. Average E/e ' ratio was significantly higher in group 2 (10.19 +/- 3.15 vs. 12.04 +/- 4.83, p: 0.046). Isovolumetric relaxation time was longer in group 2 (p < 0.001) and left atrial volume index (LAVI) was also significantly higher in group 2 (p < 0.001). Regression analyses revealed that septal, lateral and average E/e ' ratio, tricuspid regurgitation velocity, LAVI and left ventricular volume are correlated with mLAP. Among group 2 patients only 14 Patients fulfilled the increased LVFP criteria suggested by current guidelines. Conclusions: Echocardiographic parameters indicating increased LVFP require validation and may need to be modified in patients with STEMI. Moreover, current algorithms underestimate the actual number of patients with increased LVFP.
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    Association between lipoprotein (a) level and chronic cardio-renal syndrome in patients with coronary artery disease
    (Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Ural, Dilek; Cünedioğlu, Berkay Ömer; Yurtseven, Ece; Demiray, Atalay; Aytekin, Saide; Aytekin, Vedat; Faculty Member; Undergraduate Student; Teaching Faculty; Master Student; N/A; Doctor; Faculty Member; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; N/A; N/A; School of Medicine; Koç University Hospital; 1057; N/A; 176021; N/A; N/A; 140946
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    The quality of ECG data acquisition, and diagnostic performance of a novel adhesive patch for ambulatory cardiac rhythm monitoring in arrhythmia detection
    (Churchill Livingstone Inc Medical Publishers, 2019) Deliormanli, Bilgen Gulsen; Adiguzel, Omer; Li, Ko-Mai; Yılmaz, Elif Nur; N/A; N/A; N/A; Department of Industrial Engineering; Karaoğuz, Mustafa Remzi; Yurtseven, Ece; Aslan, Gamze; Gönen, Mehmet; Doctor; Teaching Faculty; Doctor; Faculty Member; Department of Industrial Engineering; N/A; School of Medicine; N/A; College of Engineering; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; 176021; N/A; 237468
    Background: Short and long ambulatory electrocardiographic monitoring with different systems is a widely used method to detect cardiac arrhythmias. In this study, we aimed to evaluate the effectiveness of a novel monitoring device on cardiac arrhythmia detection. Methods: We used two different protocols to evaluate device performance. For the first one, 36 healthy subjects were enrolled. The standard 12-lead, 24-h Holter monitoring and the novel single lead electrocardiogram (ECG) Patch Monitor (EPM) device (BeyondCare (R), Rooti Labs Ltd., Taipei, Taiwan) were simultaneously applied to all subjects for 24 h. The quality of ECG data acquisition of novel system was compared to that of standard Holter. The second phase included 73 patients that were referred from our outpatient arrhythmia clinic for evaluation of their symptoms relevant to the cardiac arrhythmias. Advanced algorithms, statistical methods (cross-correlation method, Pearson's correlation coefficient, Bland-Altman plots) were used to process and verify the acquired data. Results: The overall average beat per minute correlation between BeyondCare (R) and standard 12-lead Holter was found 98% in 33 healthy subjects. The mean percentage of invalid measurements in BeyondCare (R) was 1.6% while the Holter's was 1.7%. In the second protocol of the study, prospective data from 67 patients who were referred for evaluation of their symptoms relevant to cardiac arrhythmias, showed that the mean BeyondCare (R) wear time was 4.7 +/- 0.5 days out of five total days per protocol. The mean analyzable wear time was 93.6%. The water-resistant design enabled 73.5% of the participants to take a shower. 7.3% of participants had minor skin irritations related to the electrodes. Among the patients with detected arrhythmia (40.2% of all patients), 29.6% had their first arrhythmia after the initial two days period. A clinically significant pause was detected in one patient, ventricular tachycardia was detected in four patients, and supraventricular tachycardia was detected in 15 patients. Paroxysmal atrial fibrillation was identified in seven patients. Three of them had their first episodes after the second day of monitoring. Conclusion: BeyondCare (R) Patch was well-tolerated and allowed prolonged time periods for continuous ECG monitoring, may result in an improvement in clinical accuracy and detection of arrhythmias by cloud-based artificial intelligence operating system. (C) 2019 Elsevier Inc. .
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    Nonsustained atrial fibrillation in ambulatory ECG recording and thromboembolic events in long-term follow-up
    (Oxford University Press (OUP), 2017) Karaüzüm, Kurtuluş; Karaüzüm, İrem Yilmaz; Çelikyurt, Yengi Umut; Hancı, Kaan; Aktaş, Müjdat; Sinan, Ümit Yaşar; Küçükoğlu, Mehmet Serdar; Fıratlı, İnci; Ağır, Ayşen Ağaçdiken; Ural, Dilek; Yurtseven, Ece; Faculty Member; Teaching Faculty; School of Medicine; School of Medicine; 1057; 176021
    Background: Short-lasting (<30 s), nonsustained episodes of atrial fibrillation (NS-AF) are frequently observed in ambulatory ECG monitoring. Although they are considered as a risk factor for future persistent/permanent AF and stroke, real-life data on the indence of thromboembolic events in these patients are limited. This study aimed to examine whether NS-AF detected in Holter monitoing increases the risk of thromboembolic events. Methods: A total of 6,117 Holter monitorings were evaluated after excluding patients with paroxysmal/persistant/permenant atrial fibrillation, valvular heart diseases and known thrombembolic events. The control group consisted of 114 patients without any detected arrhythmia. Both groups were followed-up for a mean of 5.5 years, and new onset thromboembolic events were recorded. Results: NS-AF episodes were detected in 134 patients (2.2%). Twenty-one subjects (15.7%) in NS-AF group experienced stroke and 9 (6.7%) deceased during the follow-up period, whereas the corresponding numbers were 5 (4.4%) and 2 (1.8%) in controls respectively (p=0.004 and p=0.069). After adjusting for baseline risk factors, both NS-AF and CHADS-VASc were associated with stroke (HR: 3.58; 95% confidence interval [CI]: 1.26 to 10.16) and HR: 1.77; 95% CI: 1.34 to 2.24). In ROC analysis of the NS-AF group, a CHADs-VASc score ≥2 had a sensitivity of 91%, a specificity of 38%, a postive predictivity of 21% and a negative predictivity of 95% to predict stroke (AUC 0.74; 95% CI 0.63–0.85; p=0.001). Conclusions: NS-AF is associated with an increased risk of stroke, and especially in NS-AF patients with a CHADS-VASc ≥2 oral anticoagulation should be considered.
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    Impact of gender and diabetes on the relationship between lipoprotein (a) and coronary artery disease
    (Elsevier Ireland Ltd, 2021) Yurtseven, Ece; Ural, Dilek; Cünedioğlu, Berkay Ömer; Gürsoy, Erol; Güler, Orhan Ulaş; Aytekin, Saide; Aytekin, Vedat; Baysal, Kemal; Teaching Faculty; Faculty Member; Undergraduate Student; Doctor; Undergraduate Student; Doctor; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; N/A; School of Medicine; School of Medicine; 176021; 1057; N/A; N/A; N/A; N/A; 140946; 119184
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    Relationship between lipoprotein (a) and coronary artery disease in patients with very high ldl level
    (Elsevier Ireland Ltd, 2022) Yurtseven, Ece; Ural, Dilek; Cünedioğlu, Berkay Ömer; Gürsoy, Erol; Aytekin, Saide; Aytekin, Vedat; Baysal, Kemal; Teaching Faculty; Faculty Member; Undergraduate Student; Doctor; Doctor; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; 176021; 1057; N/A; N/A; N/A; 140946; 119184
    Background and Aims : Adults who have low density lipoprotein (LDL) cholesterol levels of more than 190 mg/dl are classified in very high-risk group for major cardiovascular events. The data about the impact of Lp(a) on coronary artery disease (CAD) in patients with very high LDL levels is insufficient. We aimed to investigate the relationship of Lp(a) level with CAD in patients with very high LDL levels. Methods: We retrospectively analyzed the data of 247 patients whose LDL levels were equal to or higher than 190mg/dl and who had Lp(a) measurements. Lipid profile, co-morbidities, cardiovascular diseases, blood pressure, body mass index, eGFR and smoking status were assessed. The relationship between Lp(a) levels and CAD was analyzed. Results: A total of 247 patients whose 50.4% were female, 22.6% diabetic and 36.7% hypertensive, 19% had coronary artery disease were included in the analysis. Patients with CAD had higher levels of Lp (a) (median 16 mg/dl vs 23 mg/dl p= 0.024). Age [odds ratio (OR), 1.060; 95% confidence interval (CI): 1.020-1.101; p = 0.003], sex (OR, 6.29; 95% CI:2.604-15.198; p = 0.000) and Lp(a) level (OR, 1.011; 95% CI: 1.001-1.021; p = 0.035) were independently related with CAD. ROC curve analyses demonstrated that Lp(a) level of 19.5mg/dl was the cut-off value for CAD in patients with very high LDL level (AUC:0.6, p=0.023). Conclusions: In our study, we found increased Lp(a) level as a risk factor for CAD in patients with very high LDL levels. Furthermore, our results demonstrate that Lp(a) is the independent predictor of CAD in this patient group.
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    Brain-derived neurotrophic factor as biomarker reply
    (Kare Yayıncılık, 2020) Barman, Hasan Ali; Sahin, Irfan; Atici, Adem; Durmaz, Eser; Ikitimur, Baris; Okuyan, Ertugrul; Keles, Ibrahim; N/A; Yurtseven, Ece; Teaching Faculty; School of Medicine; Koç University Hospital; 176021
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    Gender difference in the relation of serum lipoprotein (a) to reduced renal function in diabetic and non-diabetic patients
    (Elsevier, 2021) Aytekin, Saide; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Ural, Dilek; Yurtseven, Ece; Cünedioğlu, Berkay Ömer; Güler, Orhan Ulaş; Aytekin, Saide; Aytekin, Vedat; Baysal, Kemal; Faculty Member; Teaching Faculty; Undergraduate Student; N/A; Undergraduate Student; NA; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; 1057; 176021; N/A; N/A; N/A; N/A; 140946; 119184
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    PublicationOpen Access
    Predictors of complex aortic plaques in patients undergoing transeusophageal echocardiographic study
    (Oxford University Press (OUP), 2018) Durmaz, E.; Karadağ, B.; İkitimur, B.; Avcı, B. Kılıçkıran; Koçak, B.; Koca, D.; Tokdil, H.; Raimoğlu, U.; Belpınar, M. S.; Öngen, Z.; N/A; Yurtseven, Ece; Teaching Faculty; School of Medicine
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    PublicationOpen Access
    Predictors of complex aortic plaques in patients undergoing transoesophageal echocardiography
    (Galenos Yayınevi, 2020) Durmaz, Eser; Karadağ, Bilgehan; İkitimur, Barış; Avcı, Burcak Kılıçkıran; Koçak, Burak; Koca, Damla; Raimoğlu, Utku; Belpınar, Mehmet Semih; Öngen, Zeki; Yurtseven, Ece; Teaching Faculty; School of Medicine; Koç University Hospital
    Introduction: atrial fibrillation (AF) is one of the most important causes of ischaemic stroke according to the TOAST classification. The CHA(2)DS(2)-VASc score is a widely used scoring system for estimating systemic thromboembolism in patients with non-valvular AF. TOAST classification indicates that an ischaemic stroke may also be due to large artery atherosclerosis. Since some of the atherosclerotic risk factors also occur in the CHA(2)DS(2)-VASc scoring system, we hypothesised that this scoring system can also predict the presence of complex aortic plaques and their stroke risk. Methods: we retrospectively investigated 551 patients who underwent transthoracic echocardiography and subsequent transoesophageal echocardiography (TEE). Baseline characteristics of the patients were recorded, and the CHA(2)DS(2)-VASc score was calculated before the TEE examination. Aortic plaques are classified as complex when they are protruding more than 4 mm, mobile or have irregular boundaries. Results: among 551 patients, 110 complex aortic plaques (CAPs) were detected. Considering all the patients, higher CHA(2)DS(2)-VASc score [odds ratio (OR): 2.905], increasing age (OR: 1.056), and male (OR: 3.008) were significantly associated with CAP. CHA(2)DS(2)-VASc score was even more significantly associated with CAP in patients with a previous stroke [p<0.001, OR: 16.754 (4.196-66.894), confidence interval (CI): 95%]. After excluding complicated aortic plaques from the calculation, higher CHA(2)DS(2)-VASc score in patients with AF was also associated with the presence of CAPs (p<0.001, OR: 3.379 1.848-6.179, CI: 95%). Conclusion: although the CHA(2)DS(2)-VASc score has been validated to estimate thromboembolic risk in patients with non-valvular AF, the results of this study show that a high CHA(2)DS(2)-VASc score may also indicate an increased risk for CAP in patients with both sinus and non-valvular-AF rhythm. / Amaç: atriyal fibrilasyon (AF) TOAST sınıflamasına göre iskemik inmenin önemli bir nedenidir. CHA2 DS2 -VASc skor non-valvüler AF’li hastalarda iskemik stroke ve tromboemboli riskini belirlemek için sıklıkla kullanılan bir skorlama sistemidir. Bunun yanı sıra TOAST sınıflamasında, büyük arter aterosklerozu kardiyoembolizm gibi iskemik inmenin ayrı bir sınıfıdır. Biz bu çalışmamızda CHA2 DS2 -VASc skorunun kompleks aortik plaklar (KAP) ile olan ilişkisini incelemeyi amaçladık. Yöntemler: retrospektif olarak transtorasik ve sonrasında transözefajiyal ekokardiyografi (TÖE) uygulanmış 551 hasta analiz edildi. Hastaların demografik ve klinik özellikleri kaydedildi. CHA2 DS2 -VASc skoru TÖE incelemesi öncesinde hesaplandı. 4 mm’den büyük, hareket eden veya düzensiz sınırları olan plaklar KAP olarak kabul edildi. Bulgular: beş yüz elli bir hasta dahil edildi ve 110 KAP saptandı. Tüm hastalar göz önüne alındığında CHA2 DS2 -VASc skoru [olasılık oranı (OR): 2,905], yaş (OR: 1,056) ve ve erkek cinsiyet (OR: 3,008) anlamlı bir şekilde KAP ile ilişkili saptandı. Buna ek olarak daha önce iskemik inme geçiren [p<0,001, OR: 16,754 (4,196-66,894), güven aralığı (GA) %95] veya AF’li hastalarda da (p<0,001, OR: 3,379 1,848-6,179, GA: %95) KAP CHA2DS2-VASc skoru ile ilişkili saptandı. Sonuç: her ne kadar CHA2DS2-VASc skoru non-valvüler AF hastalarında tromboembolik riski hesaplamak için geliştirilmiş olsa da, bu çalışmanın sonucu CHA2DS2-VASc skorunun hem sinüs hem de AF ritmindeki hastalarda artmış KAP riskine işaret edeceğini de göstermiştir.