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    Angiotensin receptor-neprilysin inhibition by sacubitril/valsartan attenuates doxorubicin induced cardiotoxicity in a pretreatment mice model by interfering with oxidative stress, inflammation, and Caspase 3 apoptotic pathway
    (AVES, 2021) Dindaş, Ferhat; Güngör, Hüseyin; Ekici, Mehmet; Akokay, Pınar; Bayçumendur, Füsun Erhan; Doğduş, Mustafa; Yılmaz, Mehmet Birhan
    Objective: Doxorubicin (DOX) is a well-known cardiotoxic agent, whereas sacubitril/valsartan (Sac/Val) is an effective treatment option in heart failure. In this study, we aimed to evaluate the effect of Sac/Val on DOX-induced cardiotoxicity in pretreatment mice model. Methods: A total of 24 mice were equally classified into 4 groups; control group, DOX (20 mg/kg; fifth day), Sac/Val (80 mg/kg), and Sac/Val+DOX (Sac/Val was given from day one of the study before doxorubicin administration). Electrocardiography parameters, including durations of QRS, ST, QT, PP segment, and QT/PQ index were measured. Total antioxidant status (TAS), total oxidant status (TOS), tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), IL-6, NT-proBNP concentrations, and Caspase 3 activity were evaluated. Results: At the end of the 9-day study duration, QRS, ST, QT intervals, QT/PQ index and TAS, TOS, TNF-α, IL-1β, IL-6 levels were significantly higher in the DOX group than in the control group (p<0.001). Moreover, there were significant differences only in the PP interval when comparing the Sac/Val+DOX and control groups (p<0.001). QRS, ST, QT intervals, and QT/PQ index, TAS, TOS, TNF-α, IL-1β, IL-6 levels were significantly lower in the Sac/Val+ DOX group compared with the DOX group (p<0.001). Furthermore, NT-proBNP levels were lower in the Sac/Val+DOX group compared with the DOX group along with less Caspase 3 apoptosis. Conclusion: Sac/Val seems to be cardioprotective against DOX-induced cardiotoxicity in pretreatment mice model. These findings can be attributed to the antiarrhythmic, anti-inflammatory, antioxidant, and antiapoptotic effects of Sac/Val as shown in this study
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    Angiotensin receptor-neprilysin inhibition by sacubitril/valsartan attenuates doxorubicin-induced cardiotoxicity in a pretreatment mice model by interfering with oxidative stress, inflammation, and Caspase 3 apoptotic pathway
    (2021) Dindaş, Ferhat; Güngör, Hüseyin; Ekici, Mehmet; Akokay, Pınar; Erhan, Füsun; Dogdus, Mustafa; Yılmaz, Mehmet Birhan
    Objective: Doxorubicin (DOX) is a well-known cardiotoxic agent, whereas sacubitril/valsartan (Sac/Val) is an effective treatment option in heart failure. In this study, we aimed to evaluate the effect of Sac/Val on DOX-induced cardiotoxicity in pretreatment mice model. Methods: A total of 24 mice were equally classified into 4 groups; control group, DOX (20 mg/kg; fifth day), Sac/Val (80 mg/kg), and Sac/Val+DOX (Sac/Val was given from day one of the study before doxorubicin administration). Electrocardiography parameters, including durations of QRS, ST, QT, PP segment, and QT/PQ index were measured. Total antioxidant status (TAS), total oxidant status (TOS), tumor necrosis factor-? (TNF-?), interleukin 1? (IL-1?), IL-6, NT-proBNP concentrations, and Caspase 3 activity were evaluated. Results: At the end of the 9-day study duration, QRS, ST, QT intervals, QT/PQ index and TAS, TOS, TNF-?, IL-1?, IL-6 levels were significantly higher in the DOX group than in the control group (p<0.001). Moreover, there were significant differences only in the PP interval when comparing the Sac/Val+DOX and control groups (p<0.001). QRS, ST, QT intervals, and QT/PQ index, TAS, TOS, TNF-?, IL-1?, IL-6 levels were significantly lower in the Sac/Val+ DOX group compared with the DOX group (p<0.001). Furthermore, NT-proBNP levels were lower in the Sac/Val+DOX group compared with the DOX group along with less Caspase 3 apoptosis. Conclusion: Sac/Val seems to be cardioprotective against DOX-induced cardiotoxicity in pretreatment mice model. These findings can be attributed to the antiarrhythmic, anti-inflammatory, antioxidant, and antiapoptotic effects of Sac/Val as shown in this study.
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    Endovascular treatment of proximal venous outflow obstructions in patients with arteriovenous fistula: Our single-center experience
    (Turkish National Vascular and Endovascular Surgery Society, 2022) Ömür, Sefa; Kasımzade, Ferit; Ada, Fatih; Dindaş, Ferhat
    Objectives: In this study, we present our early and mid-term results of percutaneous treatment for proximal venous outflow obstruction (PVOO). Patients and methods: Between January 2017 and July 2019, a total of 40 patients (19 males, 21 females; mean age: 61.9±12.1 years; range, 49 to 74 years) who underwent hemodialysis from the arteriovenous fistula (AVF) were included. All patients had advanced edema due to PVOO in the extremity with AVF. All patients received endovascular treatment for PVOO. Results: Percutaneous transluminal angioplasty (PTA) was performed to all patients. Stent implantation was performed in 20 patients who could not achieve full patency after PTA. A patient whose edema did not regress despite stent implantation underwent surgical AVF recreation. A total of six patients underwent minor/major surgical procedures. In 14 patients, edema completely regressed and the functionality of the fistula increased in the one-month follow-up after the PTA procedure. The patients who underwent percutaneous intervention were evaluated at 3, 6, 12, and 24-months of follow-up, and primary patency rates were found to be 92%, 82%, 67%, and 45%, respectively. Conclusion: Our study results suggest that PVOO should not be overlooked in patients with AVF, edema in the extremity, and no loss of fistula functionality. Percutaneous interventions should be considered primarily in the treatment of PVOO. © 2022 Turkish National Vascular and Endovascular Surgery Society. All rights reserved.
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    Flöroskopi altında vejetasyon imajı: Bir olgu sunumu
    (Sivas Cumhuriyet University, 2020) Dindaş, Ferhat; Ömür, Sefa; Gül, İbrahim
    Enfektif endokardit tanısında vegetasyon varlığının görüntülenmesi kritik önem taşır. Kılavuzlar bu amaçla ekokardiyografi, bilgisayarlı tomografi (BT) ve nükleer görüntüleme yöntemlerini önermektedir. Bu bildiride bir fungal endokardit vakası sunulmuştur. Olgumuz, 45 yaşında endüstriyel bir kaza sonucu mekanik ventilatöre bağlı ve santral venöz kateter ile takip edilen erkek hastaydı. Hastanın daha öncesinde kapak hastalığı öyküsü yoktur. Tekrarlayan ateşleri ve dispnesi olan hastaya ekokardiyografi yapılmıştır. Fungal endokardit tanısı alan hastaya antifungal tedavi başlanmış fakat tedaviye rağmen vejetasyon büyüdüğü için kapak cerrahisi planlanmıştır. Ameliyat öncesi yapılan koroner anjiografi esnasında aort kapak üzerindeki vegetasyon floroskopik olarak da izlenebilmiştir. Hasta tanıdan dört hafta sonra ameliyat edildi ve ameliyattan sekiz hafta sonra tam iyileşme sağlanarak taburcu edildi. Literatür taramamızda floroskopi altında vegetasyon izlenildiğine dair bildirime rastlanmamıştır. Elde ettiğimiz verilere göre bu bildiri bir vegetasyonun floroskopik olarak görüldüğünü gösteren ilk bildiridir.
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    Hastanede yatış sırasında ölen düşük ve sınırda ejeksiyon fraksiyonlu kalp yetersizliği hastalarının klinik özellikleri ve yaşam beklentisinin tek merkezli retrospektif değerlendirilmesi
    (Sivas Cumhuriyet Üniversitesi, 2020) Dindaş, Ferhat; Turgut, Okan Onur
    Amaç: Günümüzde, medikal gelişmelere rağmen kalp yetersizliği (KY) sıklığı artmaktadır. Mevcut kılavuzlar kalp yetersizliği hastalarını daha iyi açıklamak için fenotiplerine göre sınıflandırmıştır. Biz çalışmamızda, hastanede ölen KY fenotiplerinin temel klinik özelliklerini, ilaç tedavilerini ve yaşam sürelerini kıyaslamayı hedefledik. Gereç ve Yöntemler: 2011-2018 yılları arasında kalp yetersizliği ile başvuran ve son hastaneye yatışı sırasında kardiyak nedenden ölen 100 ardışık hasta değerlendirildi. Çalışmada EF% 41-49 ve N-terminal pro-B tipi natriüretik peptit (NT-proBNP) düzeyi > 125 pg / mL olan hastalar SEF-KY olarak sınıflandırıldı. Çalışmada EF% ? 40 ve NT-proBNP düzeyi > 125 pg / mL olan hastalar DEF-KY olarak sınıflandırıldı. Her iki KY grubunda 50 hasta vardı. Retrospektif analizimizde hastaların demografik özellikleri, başlıca laboratuvar parametreleri, ilaç tedavileri ve tahmini yaşam süreleri değerlendirildi. İstatistiksel incelemede SPSS versiyon 17.0 programı kullanıldı. p<0,05 istatiksel olarak anlamlı kabul edildi. Bulgular: DEF-KY ve SEF-KY hastalarının EF değerleri sırasıyla % 30 (15-38) ve % 45 (40-49) idi. İlaç tedavilerinde gruplar arasında anlamlı bir fark yoktu. Grupların yaşam sürelerinin değerleri SEF-KY grubunda 15 (1-61) ay ve DEF-KY grubunda 11 (1-49) ay olarak saptandı (p=0.043). Sonuçlar: Çalışmamızda DEF-KY ve SEF-KY hastalarının demografik özelliklerinin farklı olduğu sonucuna varıldı. SEF-KY grubundaki yaşam süresi DEF-KY grubuna göre daha uzundu.
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    Koroner Arter Hastalığı Varlığında Periferik Arter Hastalığının Prediktörleri: Plazma Aterojenik İndeks ve Trigliserit Glikoz İndeksi
    (2023) Koyun, Emin; Şahin, Anıl; Dindaş, Ferhat; Çerik, İdris Buğra; Kanal, Yücel; Karabey, Ercan
    Amaç: Koroner arter hastalığı olan hastalarda periferik arter hastalığını öngörebilecek basit uygulanabilir parametrelere ihtiyaç va rdır. Aterojenik plazma indeksi ve trigliserit glikoz indeksi ateroskleroz ile ilişkili parametreler olup bu parametrelerin koroner a rter hastalğı olanlarda periferik arter hastalığı öngördürebileceği hipotezi ile çalışmaya başladık. Gereç ve Yöntem: Geriye dönük bir çalışma olup çalışmaya 96 hasta dahil edildi. Hastalar; sadece koroner arter hastalığı olanlar ile ko roner ve periferik arter hastalığı birlikte bulunan hastalar olmak üzere iki gruba ayrıldı. Her iki grup arasındaki değişkenler incelendi. Bulgular: Plazma aterojenik indeks ve trigliserit glikoz indeksi her iki grupta karşılaştırıldı. Yapılan regresyon analizinde AIP ve trigliserit glikoz indeksinın periferik arter hastalığı öngörebilen parametreler olduğu sonucu bulundu. Sonuç: Plazma aterojenik indeks ve trigliserit glikoz indeksi, koroner arter hastalığında periferik arter hastalığını öngörebilen para met relerdir. Koroner arter hastalarında bu indeksler rutin olarak kullanılması önerilebilir. Böylelikle koroner arter hastalarında periferik ar ter hastalığının erken tanı ve tedavisi hızlıca yapılabilecektir.
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    Single-Center Retrospective Evaluation of Clinical Features and Life Expectancy in Mid-Range/Reduced Left Ventricular Ejection Fraction Heart Failure Patients Who Died During Hospitalization
    (2020) Dindaş, Ferhat; Turgut, Okan Onur; Yılmaz, Mehmet Birhan
    Objective: Today, despite medical developments the frequency of heart failure is increasing. The current guidelines have categorized patients with heart failure (HF) by their phenotypes to betterexplain them. In our study, we aimed to compare the basic clinical features, drug treatment and the life expectancy in HF phenotypes who diedduring hospitalization. Material and Methods: 100 consecutive patientswho admitted with HF between 2011 and 2018 and died of cardiac causeduring last hospitalization were evaluated. Patients with left ventricleejection fraction (LVEF) 41-49% and N-terminal pro-B type natriureticpeptide (NT-proBNP) level >125 pg/mL were classified in the study asHFmrEF. Patients with EF% ?40 NT-proBNP level >125 pg/mL wereclassified in the study as HFrEF. There were 50 patients from each HFgroup. Patients' demographic features, major laboratory parameters, drugtreatments and life expectancy were evaluated in retrospective analysis.SPSS version 17.0 program was used for statistical analysis. p<0.05 wasconsidered statistically significant. Results: The LVEF values of HFrEFand HFmrEF patients were 30% (15-38) and 45% (40-49), respectively.There was no significant difference between groups in drug treatment.The life expectancy values of the groups were 15 (1-61) months in theHFmrEF group and 11 (1-49) months in the HFrEF group (p=0.043).Conclusion: In our study, it was concluded that the demographic characteristics of HFrEF and HFmrEF patients were different. The life expectancy in HFmrEF group was longer than in HFrEF group.
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    The Relationship of Inflammation Parameters with Obstruction in Coronary Artery Ectasia
    (2021) Çerik, İdris Buğra; Dindaş, Ferhat; Ömür, Sefa; Yenerçağ, Mustafa
    Background: Coronary artery ectasia (CAE) is a coronary artery disease that can progress in a wide clinical spectrum, from asymptomatic cases to stable angina pectoris or acute coronary syndrome. CAE can present with an acute coronary syndrome without an obstructive lesion. Although many studies comparing isolated CAE with normal coronary arteries and coronary artery disease, CAE patients with obstructive type lesions (obstructive CAE) have never been evaluated. In this study, we aimed to compare obstructive CAE patients and isolated CAE patients in terms of various inflammatory parameters. Materials and Methods: A total of 190 patients were enrolled, including 95 obstructive CAE patients and 95 age and sex-matched isolated CAE patients. All participants were evaluated in the study consisted of patients admitted to the emergency department and diagnosed with NSTE-ACS. Systemic inflammatory parameters such as Platelet/lymphocyte ratio (PLR), Neutrophil/lymphocyte ratio (NLR), Monocyte/HDL ratio, CRP and sedimentation of the patients, were compared between two groups. Results: CRP value was found significantly higher in obstructive CAE, compared to isolated CAE [5.5 (3.0- 9.0) mg/L, 4.0 (3.0-6.0) mg/L (P=0.003) respectively]. PLR value was found significantly higher in obstructive CAE compared to isolated CAE [143±76, 120±45 (p=0.015) respectively]. In multivariable logistic regression analysis, only CRP was an independent predictor of obstruction in CAE [OR:1.075 (1.011-1.142), p=0.021]. Conclusions: To the best of our knowledge, this study is the first to evaluate the effects of obstructive lesions on inflammatory parameters in patients with CAE presenting with acute coronary syndrome. We have shown that systemic inflammation is increased in the presence of obstructive coronary artery disease in CAE patients.