Kayan, Fethullah

Kayan, Fethullah

Job Title

Dr. Öğr. Üyesi

Main Affiliation

Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü

Status

Former Staff

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Scholarly Output

18

Articles

13

Citation Count

0

Supervised Theses

0 Scholarly Output Search Results

Now showing 1 - 10 of 18

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.
Atriyal Fibrilasyonda Kanama Riski Belirleme
(2023) Kayan, Fethullah
GİRİŞ risk faktörlerinin modifikasyonu ile AF’nin ve kullanılan ilaçlarının(özellikle de antikoagülan- ların) komplikasyonlarının azaltılması önem arz etmektedir. Persistan ve Permanent AF’li olgularda eş- lik eden komorbiditelerin daha fazla olması ve yaşın daha ileri olması gibi nedenlerle, Parok- sismal AF’li olgulara göre, AF nin komplikas- yonları ve özellikle de antikoaülasyon tedavinse bağlı kanama riski daha yüksektir. AF tedavisinde, tromboembolik olayların önlenmesi için kullanılan Vitamin K Antago- nisti (VKA) ve Yeni Nesil Oral Antikoagülan- ların (YOAK) faydası; iskemik inme riskinde azalma ile major kanama olaylarındaki artma arasındaki dengeye bağlıdır. AF’nin tromboembolik riskinin önlenmesi için kullanılan oral antikoagülan tedavilere bağ- lı meydana gelebilecek kanamalar için gelişti- rilmiş olan Kanama Risk Skorlamaları; ORBİT, ATRİA, HAS-BLED, HEMORR2HAGES, ABC Skorlamalarıdır. Kullanılan bu skorlamalar ve risk grupları tablolar halinde gösterilmiştir. HAS-BLED Skoru: 0-2 puan alanlar düşük kanama risk grubunda bulunurken, HAS-BLED Atriyal Fibrilasyon (AF), dünya çapında erişkin- lerde en sık görülen aritmidir. AF, populasyon- da morbidite ve mortalitenin önemli bir nedeni olduğundan dolayı, hastalara, toplum sağlığına ve sağlık ekonomisine önemli bir yüktür. AF’ nin prevalansı, erişkinlerde yaklaşık ola- rak %2 ile %4 arasındadır. Yapılan çalışmalarda daha uzun yaşam süresi ile genel populasyonda tanı konmamış AF oranının 2,3 kat daha yüksek olduğu tahmin edilmektedir. İlerleyen yaş, AF nin önemli bir risk faktörü olmakla birlikte, Diyabetüs Mellitüs (DM), Hi- pertansiyon (HT), Kronik Böbrek Hastalığı(K- BH), Kalp Yetmezliği(KY), Koroner Arter Has- talığı (KAH), Obezite, Obstrüktif Sleep Apne Sendromu (OSAS) gibi bazı risk faktörleri de AF gelişiminde önemli rol oynar. Avrupa kökenli index yaşı 55 olanlarda, ya- şam boyu AF risk tahmini 4 kişiden 1 kişiyken, son yapılan revizyon ile 3 kişiden 1 kişi olmuş- tur. AF’ nin artan bu sayısı ile AF’ nin kendisi- ne ve kullanılan ilaçlara bağlı komplikasyonları da artmıştır. Değiştirilebilir ve kontrol edilebilir
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
METABOLİK SENDROM VE KARDİYO-ELEKTROFİZYOLOJİK DENGE
(2023) Kayan, Fethullah
Amaç: Kardiyovasküler morbidite ve ölüm, metabolik sendromun daha yüksek prevalansıyla ilişkilidir. Kardiyak elektrofizyolojik denge indeksi (iCE), QT aralığı/QRS süresi olarak tanımlanır ve yükselmiş Tp-e/QT oranı kötücül ventriküler aritmilere ilişkin öngörücüdür. Bu araştırmanın amacı, metabolik sendrom (MS) ile iCE ve Tp-e/QT oranı arasındaki ilişkiyi belirlemektir. Yöntem: Bu araştırma, 40 ila 70 yaş arasındaki 90 hastadan oluşmaktadır ve iki gruba ayrılmıştır: metabolik sendromlu 45 hasta (21 erkek, ortalama yaş 58.7±1.4 yıl) ve kontrol grubu (24 erkek, ortalama yaş 55.1±2.3 yıl). Tüm hastalara standart 12 derivasyonlu elektrokardiyogram kaydı yapıldı. Tp-e aralığı, QT aralığı, QRS süresi, Tp-e/QT oranı ve QT/QRS oranı belirlendi. Sonuçlar: İki grup arasında temel özellikler açısından istatistiksel olarak anlamlı bir farklılık bulunmadı (Tablo 1).
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.
Mİ YOK A RDİT
(2023) Kayan, Fethullah
GİRİŞ Miyokardit, öncelikle çocukları ve genç yetişkin- leri etkileyen, nadir görülen, potansiyel olarak ölümcül ve genellikle yetersiz teşhis edilen bir kalp yetmezliği nedenidir. Akut miyokardit insidansı küresel olarak yılda yaklaşık 1,5 milyon vaka olarak tahmin edilmek- tedir (1). Miyokardit, asemptomatik olabileceği gibi kalp nakli gerektirebilecek kadar ileri derecede kalp yetmezliğine neden olabilen çok geniş bir klinik yelpazeye sahiptir. Bu sebeple miyokardit, klinik prezentasyonunun heterojenliği nedeniyle zor bir tanıdır. Miyokarditin kalp yetmezliği (Heart Failu- re-HF) nedeni olarak katkısı, yaşa ve bölgeye göre yaklaşık olarak % 0.5 ila % 4.0 arasında değişir (2). Açıklanamayan non-iskemik dilate kardiyomi- yopatisi (DKM) olan yetişkin hastaların %9-16’sın- dan sorumlu olduğu düşünülmektedir. (3) The Global Burden of Disease çalışmasına göre, 1990 ile 2013 yılları arasında hastaneden taburcu olma belgelerindeki Uluslararası Hasta- lık Sınıflandırması (ICD) kodlarına dayalı olarak Fethullah KAYAN 1 100.000 hasta başına 22 miyokardit vakası in- sidansı bildirmiştir.(4) Hastaların yaklaşık üçte ikisi erkekti ve ortalama yaş erkeklerde 33, kadın- larda 46’dır. Hafif semptomlar ve minimal ventriküler disfonksiyonla başvuran hastalarda miyokardit genellikle özel tedavi olmaksızın spontan olarak iyileşir.(5)
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.
The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
(ELSEVIER, 2023) Günlü, Serhat; Kayan, Fethullah; Kılıç, Raif; Aktan, Adem; Kılıç, Raif; Aktan, Adem; Bernas, Altıntaş; Karahan, Mehmet Zülkif
Background: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02–5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45–0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01–1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61–3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69–5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
The predictive effect of shock index on mortality in patients with acute heart failure
(AME Publishing, 2023) Günlü, Serhat; Kayan, Fethullah; Karahan, Mehmet Zülkif
Background: The predictive usefulness of the shock index (SI), which is determined as a proportion of heart rate (HR) to systolic blood pressure (SBP), and age-adjusted SI (SI × age) for clinical outcomes other than mortality in acute heart failure (AHF) is not well established. This research aimed to examine whether SI and SI × age measured non-invasively at a patient’s bedside can identify mortality risk in patients admitted to the coronary care unit (CCU) with AHF. Methods: This research was carried out as a retrospective case-control study. Indices were calculated. The receiving operating characteristic (ROC) and Youden index were applied to calculate the optimal SI and SI × age cut-off for estimating mortality. Using multivariate analysis to determine independent indicators of mortality in patients with AHF. Results: A total of 1,468 patients who were hospitalized at the CCU with AHF were included. The population’s median age was 81 (73–91) years and 53.7% were male. In the survivor group, the median SI was 0.6 (0.5–0.75), and the median SI × age was 46 (38–58). In the non-survivor group, the median SI was 0.62 (0.55–0.81) and the median SI × age was 53 (44–66). According to the Youden index, the best value of SI was 0.56 with a specificity of 46% and a sensitivity of 70%, and the best value of SI × age was 44.8 with a specificity of 48% and a sensitivity of 76%. In the multivariate analysis, the power of SI × age to predict mortality was 2.39 times greater than other independent predictors. Conclusions: SI and SI × age calculated in the CCU may be valuable prognostic markers for identifying AHF patients at high risk for adverse outcomes.