Karahan, Mehmet Zülkif

Karahan, Mehmet Zülkif

Job Title

Prof. Dr.

Main Affiliation

Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü

Status

Current Staff

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Scholarly Output

23

Articles

21

Citation Count

0

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Now showing 1 - 10 of 23

Prevalence of Hypertension in Military Personnel: A Study Conducted in Türkiye
(2023) Günlü, Serhat; Karahan, Mehmet Zülkif
Abstract: Hypertension is a major global public health concern. There is a paucity of studies describing military populations with hypertension. We aimed to demonstrate Turkish military personnel with hypertension and review associated factors in a garrison of Diyarbakır City. This retrospective cross-sectional study comprised 22,141 individuals referred to an outpatient cardiology clinic between August 2016 and June 2022 with complaints of early morning headaches, abnormal heart rhythms, nosebleeds, visual problems, and buzzing in the ears. Sociodemographic characteristics were collected. Analyses of laboratory test findings and blood pressure measurements were conducted. The study comprised a total of 174 patients with an average age of 32.68±6.51 years. 94.8 percent of the patients were not drug users, and 68.3 percent had no strong family history. The prevalence of hydration habits (29.4%) and sleep disturbances (22.5%) were lower. According to body mass index (BMI), the rate of overweight was higher (56.8%). Most patients' educational status was bachelor’s degrees (46.5%). The smoking rate was high (73%). Body mass index was a statistically significant predictive factor of hypertension (OR [95% CI], 2.69 [1.0-7.17], p= 0.048). Physical exercise rate in the past three months was a statistically significant predictive factor for hypertension (OR [95%CI], 2.98 [1.42-6.23], P= 0.021). Hypertension was detected in 0.78 percent of all participants and was associated with being overweight and a lower frequency of physical exercise.
Effect of cardio-gastric interaction on atrial fibrillation in GERD patients
(2023) Günlü, Serhat; Aktan, Adem; Kayan, Fethullah; Karahan, Mehmet Zülkif; Bernas, Altıntaş; Karahan, Mehmet Zülkif
Objective: Atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) are very common in daily clinical practice. Post-prandial AF episodes have been reported in GERD patients. Although it was reported in previous studies that it was caused by sympathovagal imbalance, there are no studies on cardiac conduction system involvement. In this study, we aimed to evaluate whether the risk of developing AF increases in untreated GERD patients with non-invasive electrophysiological tests. Methods: The research was prospectively performed. Endoscopy was performed on the individuals due to reflux complaints. ECG was recorded at 25mm/s and 10 mm/mV amplitude, and 24-hour Holter ECG (three-channel; V1, V2, and V5) was performed. ECG parameters were measured and Holter ECG results were analyzed. Results: A total of 120 individuals, 60 patients and 60 controls, were included. No significant statistically differences existed between groups for hypertension, diabetes, smoking, or dyslipidemia (p>0.05). In terms of heart rate, Pmax, Pmin, QTd, and QTcd, there were no significant differences across the two groups (p>0.05). P-wave dispersion (Pd) was substantially higher in the study group (p=0.014). Comparing the heart rate variabilities of 24-hour Holter ECG recordings across the groups, the standard deviation of R-R intervals (SDNN) was substantially higher in the study group (p<0.001). Low Frequency (LF) and LF/HF were significantly higher in the control group (p<0.001 and p=0.003, respectively). AF was detected in nine individuals on Holter ECG. Conclusion: Pd duration and risk of developing AF were higher in GERD patients.
Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia
(Sociedade Brasileira de Cardiologia, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Kayan, Fethullah; Günlü, Serhat; Günlü, Serhat
Background: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE
Comparison of Diagnostic Values of Monocyte-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, Red Cell Distribution Width-Lymphocyte Ratio, and Systemic Inflammatory Index in Predicting Patients With Non-Dipper Hypertension
(2024) Günlü, Serhat; Kayan, Fethullah; Karahan, Mehmet Zülkif
Objective: Hypertension is related to myocardial ischemia, malignant arrhythmias, and cardiovascular mortality. However, inflammatory biomarkers are an important predictor of cardiovascular events. This study aimed to examine the diagnostic utility of inflammatory biomarkers in determining non-dipper hypertensive individuals and the relative superiority of the biomarkers. Method: The research was carried out as a retrospective observational study. The patients with hypertension were classified into two groups: non-dipper (n=54) and dipper (n=143). The cut-off value of MLR (monocyte-lymphocyte ratio), NLR (neutrophil-lymphocyte ratio), SII (systemic inflammatory index), and RLR (red cell distribution width-lymphocyte ratio) for predicting non-dipper hypertension was determined using a receiver operating characteristic (ROC) analysis. Results: A total of 197 patients, comprising 84 females (42.6%) and, 113 males (57.4%) with a median age of 62 (54-69) years, participated in the research. Age, FPG, CRP, WBC, NEU, LYM, MONO, RDW, NLR, MLR, RLR, and SII were higher in the non-dipper group (p<0.05). MLR, NLR, RLR, and SII were found to have acceptable diagnostic capabilities in identifying non-dipper hypertension patients (AUC: 0.70-0.76). When ROC analysis was performed to determine the main similarities, it was found that there were no differences between inflammatory indicators (p>0.05).When the odds ratios of putative variables were evaluated, it was found that increasing MLR (OR: 7.22; 95%CI: 3.52 14.78; p<0.001), NLR (OR: 8.63; 95%CI: 4.19-17.68; p<0.001), RLR (OR: 4.29; 95%CI: 2.18-8.54; p<0.001), and SII (OR: 6.31; 95%CI: 3.09 12.85; p<0.001) were independent predictors for non-dipper positivity. Conclusion: In hypertensive patients, hematological inflammatory biomarkers MLR, NLR, RLR, and SII are valuable in determining non dipper hypertension.
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(Sage Journals, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(SAGE, 2023) Günlü, Serhat; Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Local Against General Anesthesia For Transcatheter Aortic Valve Replacement
(Bandırma Onyedi Eylül Üniversitesi Tıp Fakültesi, 2023) Günlü, Serhat; Kayan, Fethullah; Aktan, Adem; Karahan, Mehmet Zülkif; Tanırcan, Muhammed Raşid; Karahan, Mehmet Zülkif
Background/Aims: Transcatheter aortic valve replacement (TAVR) poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation (LAS) against general anesthesia (GA). Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization. Results: 115 patients were included, of whom 62 (53.9%) received LAS and 53 received GA (46.1%). 59 female (48.8%) patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 (86.9%) of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA (p=0.001). There were no differences among the groups including fluoroscopy time, contrast, and radiation dose (p>0.05). In 2 patients (3.2%), significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups (GA 7.5% vs. LAS 3.2%, p =0.28). GA had substantially longer ICU and total hospitalization stays than LAS (p=0.009 and p =0.004, respectively). Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA.
Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia
(Sociedade Brasileira de Cardiologia – SBC, 2023) Günlü, Serhat; Karahan, Mehmet Zülkif; Aktan, Adem; Kayan, Fethullah; Günlü, Serhat
Background: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE.
Vatanından Uzakta Ölmek” Palyatif Bakım Kliniğinde Ölen 7 Suriye Uyruklu Hasta ve Ülkemizin Sığınmacıların Sağlık İhtiyaçlarını Karşılamadaki Rolü
(2022) Akelma, Hakan; Karahan, Mehmet Zülkif
Savaşlar, iç çatışmalar telafisi mümkün olmayan yıkımlara neden olup, en çok da sivilleri etkilemektedir. Yıkımın etkisi başta ikincil şahıslara ihtiyaç duyan çocuk, yaşlı ve kadınlar için daha belirgindir. Şu anda dünyadaki sığınmacıların yarısından fazlası Suriye’de hayatlarını kurtarmak için ülkelerinden ayrılmak zorunda kalan sığınmacılardan oluşmaktadır. Siyasal, sosyal, kültürel ve ekonomik açıdan toplumu ve bireyleri etkileyen yurdundan edilme durumu sağlık sorunlarını da beraberinde getirmektedir. Sığınmacılar zor yaşam koşulları, barınma, beslenme, şiddet ve psikolojik travmalar gibi birçok neden ile sağlık bakım sisteminde en kırılgan ve savunmasız gruplardandır. Kendi yaşam alanlarından zorunlu olarak ayrılan bireylerin yaşam konforlarının azalması ve yaşadıkları psikolojik yıkım, beraberinde bulaşıcı hastalıklar, kardiyovasküler hastalıklar, diyabet, kanser ve akciğer hastalıkları gibi kronik hastalıkların riskini artırmaktadır. Bu hastalıklara bağlı palyatif bakım ünitelerine yatışlar artmakta ve bu kliniklerde yaşam koşullarından daha iyi şartlarda sağlık hizmeti almakta ancak hastalıklarının şiddetine göre ölümler gerçekleşmektedir. Türkiye, sığınmacılara mümkün olan en iyi yaşam koşullarını ve kapsamlı insani yardımı sağlamaktadır. Sığınmacılar hem kamplarda hem de barındıkları iskânlarda tüm sağlık hizmetlerini sürdürmektedir. Bu sığınmacılar aynı şekilde gerekli durumlarda palyatif bakım hizmetlerinden faydalanmaktadır. Bu çalışmanın amacı palyatif bakım kliniklerde özellikle kanser, diyabet ve diğer kronik hastalıklar sonucu hayatını kaybeden sığınmacı hastaların değerlendirilmesi ve bunun yanında ülkemiz sağlık bakımındaki desteğini vurgulamaktır.
Relationship Between Atrial Fibrillation Recurrence and Frontal QRS-T Angle After Effective Cardioversion
(Cureus, 2023) Karahan, Mehmet Zülkif; Karahan, Mehmet Zülkif
Objective: Maintaining sinus rhythm is important in the management of atrial fibrillation (AF). After cardioversion, there is a significant probability of AF recurrence. There is limited research on the relationship between AF recurrence and ECG parameters. This study aimed to evaluate whether the frontal plane QRS-T angle (fQRS-T), a predictor of ventricular heterogeneity, could be used to predict AF recurrence following cardioversion. Methods: The study was conducted as a retrospective observational study. Patients diagnosed with acuteonset AF for the first time were included in the study. All patients underwent an ECG after cardioversion, and ECG parameters were evaluated. The patients were separated into two groups based on the presence of AF recurrence during hospitalization after cardioversion. The relationship between the fQRS-T and AF recurrence was also examined. Results: A total of 162 patients, comprising 68 women (41.9%) and 94 men (58.1%) with an average age of 59.4±6.5 years, were enrolled in the research. Based on the patient monitoring device findings, patients were separated into two groups: non-recurrent AF (n=118) and recurrent AF (n=44). P-wave duration was significantly longer in the recurrence group (p=0.009). The recurrence group's mean fQRS-T was significantly higher (p<0.001). AF recurrence was substantially higher in patients with fQRS-T >90 ̊compared to those with fQRS-T ≤90 ̊(56.1% vs. 14.2%, p <0.001). Increased fQRS-T >93.7 ̊indicated AF recurrence with 78.3% sensitivity and 83.4% specificity (AUC {area under curve}:0.748, p < 0.001). In multivariate analysis, fQRS-T was revealed to be an early indicator of recurrent AF (OR: 1.882, 95%CI: 1.358-2.881, p<0.001). Conclusion: The fQRS-T, an easily determinable parameter from automatic identification ECG recordings, may be useful for predicting the early return of AF after successful cardioversion.