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Öğe 2016 ESC and ACC/AHA/HFSA heart failure guideline updates: Changes, similarities, differences, and unresolved isssues(TURKISH SOC CARDIOLOGY, 2016) Sari, Ibrahim; Cavusoglu, Yuksel; Temizhan, Ahmet; Yilmaz, Mehmet Birhan; Eren, Mehmet…Öğe Diagnosis and management of acute heart failure(TURKISH SOC CARDIOLOGY, 2015) Ural, Dilek; Cavusoglu, Yuksel; Eren, Mehmet; Karauzum, Kurtulus; Temizhan, Ahmet; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; Ramassubu, Kumudha; Bozkurt, BiykemAcute heart failure (AHF) is a life threatening clinical syndrome with a progressively increasing incidence in general population. Turkey is a country with a high cardiovascular mortality and recent national statistics show that the population structure has turned to an 'aged' population. As a consequence, AHF has become one of the main reasons of admission to cardiology clinics. This consensus report summarizes clinical and prognostic classification of AHF, its worldwide and national epidemiology, diagnostic work-up, principles of approach in emergency department, intensive care unit and ward, treatment in different clinical scenarios and approach in special conditions and how to plan hospital discharge.Öğe Diagnosis and management of acute heart failure(Turkish Society of Cardiology, 2015) Ural, Dilek; Çavuşoğlu, Yüksel; Eren, Mehmet; Karaüzüm, Kurtuluş; Temizhan, Ahmet; Yılmaz, Mehmet Birhan; Zoghi, MehdiAcute heart failure (AHF) is a life threatening clinical syndrome with a progressively increasing incidence in general population. Turkey is a country with a high cardiovascular mortality and recent national statistics show that the population structure has turned to an 'aged' population. As a consequence, AHF has become one of the main reasons of admission to cardiology clinics. This consensus report summarizes clinical and prognostic classification of AHF, its worldwide and national epidemiology, diagnostic work-up, principles of approach in emergency department, intensive care unit and ward, treatment in different clinical scenarios and approach in special conditions and how to plan hospital discharge. © 2015 by Turkish Society of Cardiology.Öğe Iron deficiency and anemia in heart failure(TURKISH SOC CARDIOLOGY, 2017) Cavusoglu, Yuksel; Altay, Hakan; Cetiner, Mustafa; Guvenc, Tolga Sinan; Temizhan, Ahmet; Ural, Dilek; Yesilbursa, Dilek; Yildirim, Nesligul; Yilmaz, Mehmet BirhanHeart failure is an important community health problem. Prevalence and incidence of heart failure have continued to rise over the years. Despite recent advances in heart failure therapy, prognosis is still poor, rehospitalization rate is very high, and quality of life is worse. Co-morbidities in heart failure have negative impact on clinical course of the disease, further impair prognosis, and add difficulties to treatment of clinical picture. Therefore, successful management of co-morbidities is strongly recommended in addition to conventional therapy for heart failure. One of the most common co-morbidities in heart failure is presence of iron deficiency and anemia. Current evidence suggests that iron deficiency and anemia are more prevalent in patients with heart failure and reduced ejection fraction, as well as those with heart failure and preserved ejection fraction. Moreover, iron deficiency and anemia are referred to as independent predictors for poor prognosis in heart failure. There is strong relationship between iron deficiency or anemia and severity of clinical status of heart failure. Over the last two decades, many clinical investigations have been conducted on clinical effectiveness of treatment of iron deficiency or anemia with oral iron, intravenous iron, and erythropoietin therapies. Studies with oral iron and erythropoietin therapies did not provide any clinical benefit and, in fact, these therapies have been shown to be associated with increase in adverse clinical outcomes. However, clinical trials in patients with iron deficiency in the presence or absence of anemia have demonstrated considerable clinical benefits of intravenous iron therapy, and based on these positive outcomes, iron deficiency has become target of therapy in management of heart failure. The present report assesses current approaches to iron deficiency and anemia in heart failure in light of recent evidence.Öğe Lymphocytopenia is associated with poor NYHA functional class in chronic heart failure patients with reduced ejection fraction(TURKISH SOC CARDIOLOGY, 2015) Yucel, Hasan; Ege, Meltem Refiker; Zorlu, Ali; Kaya, Hakki; Beton, Osman; Gungor, Hasan; Acar, Gurkan; Temizhan, Ahmet; Cavusoglu, Yuksel; Zoghi, Mehdi; Eren, Mehmet; Ural, Dilek; Yilmaz, Mehmet BirhanObjective: In heart failure (HF) patients, functional capacity has been demonstrated to be a marker of poor prognosis, independent of left ventricular ejection fraction (EF). Lymphocyte count is currently recognized in certain risk stratification scores for chronic HF, and severe HF is associated with lymphocytopenia. However, no data exists on the association between lymphocyte count and functional capacity in patients with stable HF. This study aimed to assess the relationship between lymphocyte count and New York Heart Association (NYHA) functional capacity in systolic HF outpatients. Methods: The Turkish Research Team-HF (TREAT-HF) is a network which undertakes multi-center observational studies in HF. Data on 392 HF reduced ejection fraction (HFREF) patients from 8 HF centers are presented here. The patients were divided into two groups and compared: Group 1 comprised stable HFREF patients with mild symptoms NYHA Class (I-II), while Group 2 consisted of patients with NYHA Class III-IV symptoms. Results: Patient mean age was 60 +/- 14 years. Lymphocyte count was lower in patients with NYHA functional classes III and IV than in patients with NYHA functional classes I and II, 0.9 [0.6-1.5] x1000 versus 1.5 [0.7-2.2] x1000, p<0.001). In multivariate logistic regression analysis, lymphocyte count OR: 0.602, 95% CI: 0.375-0.967, p=0.036), advanced age, male gender, presence of hypertension, EF, left atrium size, systolic pulmonary artery pressure, neutrophil and basophil counts, creatinine level, and diuretic usage were associated with poor NYHA functional class in systolic HF outpatients. Conclusion: The present study demonstrated that in stable HFREF outpatients, lymphocytopenia was strongly associated with poor NYHA function, independent of coronary heart disease risk factors.Öğe Right Ventricular Dysfunction Complicates Time in Therapeutic Range in Heart Failure Patients Receiving Warfarin(KARGER, 2017) Beton, Osman; Asarcikli, Lale Dinc; Sen, Taner; Ipek, Esra Gucuk; Kafes, Habibe; Yaman, Mehmet; Efe, Tolga Han; Kaya, Hakki; Temizhan, Ahmet; Yilmaz, Mehmet BirhanAim: We aimed to evaluate the effect of echocardiographically demonstrated right ventricular dysfunction (RVD) on time in therapeutic range (TTR) in heart failure (HF) patients receiving warfarin therapy. Methods:A total of 893 consecutive HF patients were included and classified into 4 different subgroups: HF with preserved ejection fraction (HFpEF) without RVD (n = 373), HF with reduced EF (HFrEF) without RVD (n = 215), HFpEF with RVD (n = 106) and HFrEF with RVD (n = 199). Groups were compared according to baseline, demographic and clinical data and the characteristics of warfarin therapy. Results: Presence of RVD yielded lower median TTR values both in HFpEF and HFrEF patients. RVD, current smoking, New York Heart Association functional class III/IV, hypertension, diabetes mellitus, pulmonary disease, prior transient ischemic attack or stroke, chronic kidney disease (CKD) stage 4/5 and CKD stage 3 were found to be independent predictors of poor anticoagulation control in multivariate logistic regression analysis. Conclusions: The present study demonstrated that presence of RVD in HF increases the risk for poor anticoagulation. (C) 2016 S. Karger AG, BaselÖğe Vaccination of adults with heart failure and chronic heart conditions: Expert opinion(TURKISH SOC CARDIOLOGY, 2018) Celik, Ahmet; Altay, Hakan; Azap, Alpay; Cavusoglu, Yuksel; Nalbantgil, Sanem; Senol, Esin; Temizhan, Ahmet; Yilmaz, Mehmet Birhan…Öğe What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?(ELSEVIER IRELAND LTD, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Dogan, Volkan; Ceyhan, Ceyhun; Tuncez, Abdullah; Kutlu, Merih; Onrat, Ersel; Alici, Gokhan; Akbulut, Mehmet; Celik, Ahmet; Yesilbursa, Dilek; Sahin, Tayfun; Sonmez, Alper; Ozdogan, Oner; Temizhan, Ahmet; Kilic, Salih; Bayram, Fahri; Sabuncu, Tevfik; Coskun, Fatma Yilmaz; Ildizli, Muge; Durakoglugil, Emre; Kirilmaz, Bahadir; Yilmaz, Mehmet Birhan; Yigit, Zerrin; Yildirim, Aytul Belgi; Gedikli, Omer; Topcu, Selim; Oguz, Aytekin; Demir, Mesut; Yenercag, Mustafa; Yildirir, Aylin; Demircan, Sabri; Yilmaz, Mehmet; Kaynar, Leyla Gul; Aktan, Melih; Durmus, Rana Berru; Gokce, Cumali; Ozcebe, Osman Ilhami; Akyol, Tulay Karaagac; Okutan, Harika; Sag, Saim; Gul, Ozen Oz; Salcioglu, Zafer; Altunkeser, Bulent Behlul; Kuku, Irfan; Yasar, Hurriyet Yilmaz; Kurtoglu, Erdal; Kose, Melis Demir; Demircioglu, Sinan; Pekkolay, Zafer; Ilhan, Osman; Can, Levent H.Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.Öğe Which is the best for the warfarin monitoring: Following up by fixed or variable physician?(Kare Publ, 2022) Asarcikli, Lale Dinc; Kafes, Habibe; Sen, Taner; Ipek, Esra Gucuk; Beton, Osman; Temizhan, Ahmet; Yilmaz, Mehmet BirhanOBJECTIVE: Warfarin therapy has some difficulties in terms of close monitoring and dosage. This study aims to evaluate the effect of same-fixed versus different-variable physician-based monitoring of warfarin therapy on treatment quality and clinical end-points. METHODS: A total of 625 consecutive patients requiring warfarin treatment were enrolled at seven centers. INR values of the patients measured at each visit and registered to hospital database were recorded. Time in therapeutic range (TTR) was calculated using linear interpolation method (Rosendaal's method). A TTR value of >= 65% was considered as effective warfarin treatment. If a patient was evaluated by the same-fixed physician at each INR visit, was categorized into the same-physician (SP) group. In contrast, if a patient was evaluated by different-variable physicians at each INR visit, was categorized into variable physician (VP) group. Enrolled patients were followed up for bleeding and embolic events. RESULTS: One hundred and fifty-six patients (24.9%) were followed by SP group, 469 (75.1%) patients were followed by VP group. Median TTR value of the VP group was lower than that of SP group (56.2% vs. 65.1%, respectively, p=0.009). During median 25.5 months (9-36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p<0.001, p=0.023, p<0.001, respectively). In multivariate analysis, INR monitoring by VP group was found to be an independent predictor of increased risk of bleeding events (OR 2.55, 95% CI 1.64-3.96, p<0.001) and embolism (OR 3.42, 95% CI 1.66-7.04, p=0.001). CONCLUSION: INR monitoring by same physician was associated with better TTR and lower rates of adverse events during followup. Hence, it is worth encouraging an SP-based outpatient follow-up system at least for where warfarin therapy is the only choice.