Günlü, Serhat

Günlü, Serhat

Job Title

Dr. Öğr. Üyesi

Main Affiliation

Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü

Status

Current Staff

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Scholarly Output

27

Articles

24

Citation Count

0

Supervised Theses

0 Scholarly Output Search Results

Now showing 1 - 10 of 27

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.
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(ELSEVIER, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
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.
Predicting the mortality in patients with carotid artery stenosis by monocyte to high density lipoprotein ratio
(2023) Günlü, Serhat
Introduction: Background: Monocytes, which produce a variety of cytokines and molecules, interact with platelets and endothelial cells, causing inflammatory and thrombotic pathways to become worse. Macrophage migration and oxidation of low-density lipoprotein cholesterol molecules are both inhibited by high-density lipoprotein cholesterol (HDL-C). HDL-C neutralizes monocytes' pro-inflammatory and pro-oxidant effects through several mechanisms. As a result, characteristics like the monocyte to HDL-C ratio (MHR) may reveal a patient's inflammatory status. Objective: The development of carotid artery stenosis (CAS) is influenced by inflammation, oxidative stress, and endothelial dysfunction. Recent research suggests that inflammatory biomarkers are important for assessing mortality in carotid artery stenosis. This study aims to determine the association between MHR and mortality after carotid artery stenting. Tools and Method: We enrolled 260 patients with CAS who underwent carotid artery stenting between 2019 and 2021. MHR was calculated using the formula: the monocyte value dividing by the high-density lipoprotein cholesterol value. According to 30-day mortality, the patients were divided into two groups; surviving and non-surviving. Monocyte counts, HDL-C, and MHR values were compared between the groups. Results: The patient group had significantly higher monocyte counts and lower HDL levels than the control group, resulting in higher MHR values. In addition, non-surviving patients had a higher monocyte count and MHR value, as well as a lower HDL-C level (p<0.001). In patients with CAS, the MHR value was also found to be a significant independent determinant of 30-day mortality (p<0.001). MHR had the optimum cut-off value of 17.52 with 78.3% sensitivity and 83.4% specificity (AUC:0.724, p<0.001) for predicting 30-day mortality in patients with CAS. Comparison of the monocyte count, HDL level, and MHR value according to the mortality within the 30 days. Non-surviving group n=48 Surviving group n=212 P-values Monocyte (x109 µL) 915.42±53.21 524.03±9.98 <0.001 HDL-C (mg/dL) 37.03±1.16 46.22±0.9 <0.001 MHR 18.86±5.25 12.21±2.21 <0.001 Values are presented as mean ± SD and median [interquartile range]. HDL-C; high-density lipoprotein cholesterol, MHR; monocyte to high-density lipoprotein ratio. Discussion: Conclusion: In patients with CAS, a high MHR value was found to be an independent predictor of 30-day mortality.
Akut Kalp Yetmezliğinde Tedavi Yaklaşımı
(AKADEMİSYEN, 2023) Günlü, Serhat
GIRIŞ Akut Kalp Yetmezliği (AKY) hastanın acil tıb- bi yardım alması için yeterince şiddetli bir kli- nik duruma, plansız bir hastaneye yatışa veya acil servis başvurusuna yol açan kalp yetmezliği semptomlarının ve/veya belirtilerinin hızlı veya aşamalı olarak başlamasını ifade eder (1). AKY’li hastalarının tedavilerinin planlanması için acil değerlendirilmesi gerekir. AKY, 65 yaş üstü kişi- lerde hastaneye yatışların önde gelen nedenidir (2). Yüksek mortalite ve tekrarlayan hastaneye yatış oranları mevcuttur. Hastane içi ölüm oranı %4 ila %10 arasında değişmektedir (3). Tabur- culuk sonrası 1 yıllık ölüm oranı %25-30, ölüm veya tekrar yatış oranları %45’ten fazladır (4). AKY, yeni başlayan KY’nin ilk belirtisi olabilir veya daha sıklıkla kronik KY’nin akut dekom- pansasyonuna bağlı ortaya çıkabilir (5). Akut de- kompanse kronik KY’si olan hastalarla akut pul- moner ödemli hastalar karşılaştırıldığında, akut pulmoner ödemi olanlar daha yüksek hastane içi mortaliteye sahiptirler ancak taburculuk sonra- sı mortalite ve yeniden hastaneye yatış oranları daha düşüktür (6). AKY’nin en sık tetikleyici fak- törleri atriyal fibrilasyon, akut MI veya iskemi, ilaç alımının (diüretik) kesilmesi, artmış sodyum yükü,miyokard fonksiyon bozukluklarına sebep olan ilaçlar ve aşırı fiziki efordur (7). Önceden var olan kardiyak disfonksiyonu olan hastalarda spesifik dış faktörler (anemi, GİS kanama, enfeksiyon vb.) AKY’yi hızlandırabilir (8).
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.