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Öğe High Levels of High Sensitivity C-Reactive Protein and Uric Acid can Predict Disease Severity in Patients with Mitral Regurgitation(Elsevier Science Inc, 2013) Türker, Yasin; Ekinözü, İsmail; Aslantaş, Yusuf; Türker, Yasemin; Akkaya, Mehmet; Erkan, Melih Engin…Öğe High levels of high-sensitivity C-reactive protein and uric acid can predict disease severity in patients with mitral regurgitation(Elsevier Doyma Sl, 2014) Türker, Yasin; Ekinözü, İsmail; Türker, Yasemin; Akkaya, MehmetIntroduction: Both high-sensitivity CRP (hs-CRP) and uric acid (UA) levels are known to be increased in heart failure patients and are associated with poorer functional capacity and adverse outcome. The role of these markers in patients with mitral regurgitation (MR) is less clear. The aim of this study was to assess the relationship between hs-CRP, UA and organic MR. We also assessed whether hs-CRP and UA levels are correlated with symptoms of MR, severity of MR, LV remodeling and outcome during follow-up. Methods: A total of 200 consecutive patients (87 men [43.5%]; mean age 61.6 +/- 12.5 years) with moderate or severe isolated and organic MR were included in the study. All the patients were assessed clinically and were managed and treated with standard medical therapy according to evidence-based practice guidelines. Patients were categorized according to New York Heart Association (NYHA) functional class. We assessed and graded the severity of MR using a multiparametric approach. hs-CRP was measured with chemiluminescent immunometric assay using an IMMULITE (R) 1000 autoanalyzer (Siemens, Germany). Serum UA levels were analyzed using a Cobas (R) 6000 autoanalyzer (Roche Diagnostics, Mannheim, Germany). Results: Mean UA levels increased significantly with NYHA class: 4.46 +/- 1.58 mg/dl for patients in NYHA class I, 5.91 +/- 1.69 mg/dl for class II, 6.31 +/- 2.16 mg/dl for class III and 8.86 +/- 3.17 mg/dl for class IV (p<0.001). Mean UA levels also increased significantly with increased severity of MR (moderate 5.62 +/- 1.9 mg/dl, moderate to severe 5.56 +/- 1.2 mg/dl, severe 7.38 +/- 3.4 mg/dl, p<0.001). There was a significant correlation between UA level and left ventricular end-diastolic diameter (r=0.40; p<0.001), left ventricular end-systolic diameter (r=0.297; p=0.001) and left ventricular ejection fraction (LVEF) (r=0.195, p=0.036), whereas hs-CRP was not correlated with these parameters. In multivariate Cox proportional hazards analysis LVEF, NYHA class and UA levels were the only independent predictors of death. Conclusion: UA and hs-CRP levels can help identify patients with asymptomatic moderate or severe mitral regurgitation. UA levels may be useful to assess the extent of left ventricular remodeling and in the optimal timing of mitral valve surgery in certain subsets of patients. (C) 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Mechanical prosthetic valve disease is related with an increase in depression and anxiety disorder(Medical Association of Zenica-Doboj Canton, 2015) Türker, Yasemin; Öngel, Kurtuluş; Özaydın, Mehmet; Türker, Yasin; Baş, Funda Yıldırım; Akkaya, MehmetAim Patients with organic disease can present with psychiatric symptoms. We hypothesized that since patients with prosthetic heart valve require frequent hospital followup and are at higher risk for complications, the incidence of depression and anxiety is higher in these patients. Methods This cross-sectional study prospectively studied 98 consecutive patients with mechanical prosthetic heart valve. All patients fulfilled prosthetic heart valve evaluation form, Beck Depression Inventory (BDI) and Hamilton Anxiety Scale (HAS). Complete blood count, basic metabolic panel and echocardiogram results were collected for all the patients. Results Using the BDI, there were 26 patients (27%) with no depression, 20 (20%) with mild depression, 38 (39%) with moderate, 4 (4%) with severe and 10 (10%) patients with very severe depression. Avarege score was 18.3±11.4 on BDI and 19.1±11.1 on HAS. The depression level was positively associated with prothrombin time (p<0.001) and international normalized ratio (INR) level (p<0.001). Hamilton Anxiety Scale was significantly correlated with comorbidities (r: 0.344; p=0.002), blood transfusion (r: 0.370; p<0.001), obesity (r: 0.319; p=0.007) and Beck Depression Scale was correlated with comorbidities (r: 0.328; p=0.002), in patients with prosthetic heart valve disease. Conlusion Patients with prosthetic heart valve have higher prevalence of depression and higher scores of anxiety and depression. Early recognition and appropriate treatment of depression and anxiety may decrease the morbidity in prosthetic heart valve disease. Besides, use of new oral anticoagulant agents that do not need INR check, could decrease anxiety and depression in the future. © 2015 Medical Association of Zenica-Doboj Canton. All rights reserved.Öğe A Novel Indicator for Assessment of Mitral Regurgitation Severity: Pro-Adrenomedullin(Elsevier Science Inc, 2013) Türker, Yasin; Aslantaş, Yusuf; Türker, Yasemin; Uçgun, Taner; Akkaya, Mehmet; Erkan, Melih Engin…Öğe A novel indicator for assessment of mitral regurgitation severity: Pro-adrenomedullin - [letter](Elsevier Ireland Ltd, 2013) Türker, Yasin; Aslantaş, Yusuf; Türker, Yasemin; Akkaya, Mehmet; Uçgun, Taner; Erkan, Melih Engin…
