Browsing by Author "Ekmekci, Ahmet"

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Citation Count: 2
The Impact of the Neutrophil-to-Lymphocyte Ratio on In-Hospital Outcomes in Patients With Acute ST-Segment Elevation Myocardial Infarction
(Springernature, 2024) Karaca, Guerkan; Ekmekci, Ahmet; Kimiaei, Ali; Safaei, Seyedehtina; Oezer, Nihat; Tayyareci, Guelsah
Introduction The neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of cardiovascular diseases, influencing their progression and prognosis. The exact role of the NLR in acute ST -segment elevation myocardial infarction (STEMI) is unclear. We investigated the possible association between peak NLR values within the first three days after STEMI onset and in -hospital outcomes in patients undergoing primary percutaneous coronary intervention (PCI). Methods This retrospective study included 641 patients who were diagnosed with acute STEMI and treated with primary PCI for 18 months at Dr. Siyami Ersek Hospital. The NLR was calculated using the maximum values obtained during the first three days after admission. The patients were divided into quartiles according to their NLR values for further analysis of potential complications during and after hospitalization, up to a follow-up period of three months. Results Significant differences were found in factors such as age, body mass index (BMI), and length of hospital stay among these groups. Specifically, we found that in -hospital mortality rates were significantly higher in the Q4 group, and there were variations in target vessel revascularization (TVR) rates, major adverse cardiac events (MACE) rates, and other clinical outcomes. Some parameters, such as reinfarction rates and certain procedural outcomes, did not show significant differences among the groups. However, despite the differences, most of the patients achieved successful outcomes after PCI, with the best results in the low NLR group and the worst results in the high NLR group. Conclusion Higher NLR values were associated with a higher risk of unfavorable outcomes during hospitalization.
Citation Count: 0
Lack of right ventricular hypertrophy is associated with right heart failure in patients with left ventricular failure
(Springer, 2022) Naser, Abdulrahman; Guvenc, Tolga Sinan; Isgandarov, Khagani; Ekmekci, Ahmet; Gunduz, Sabahattin; Cetin Guvenc, Rengin; Sahin, Muslum
Presence of right heart failure (RHF) is associated with a worse prognosis in patients with left ventricular failure (LVF). While the cause of RHF secondary to LVF is multifactorial, an increased right ventricular (RV) afterload is believed as the major cause of RHF. However, data are scarce on the adaptive responses of the RV in patients with LVF. Our aim was to understand the relationship of right ventricular hypertrophy (RVH) with RHF and RV systolic and diastolic properties in patients with LVF. 55 patients with a left ventricular ejection fraction of 40% or less were included in the present study. A comprehensive two-dimensional transthoracic echocardiographic examination was done to all participants. 12 patients (21.8%) had RHF, and patients with RHF had a significantly lower right ventricular free wall thickness (RVFWT) as compared to patients without RHF (5.3 +/- 1.7 mm vs. 6.6 +/- 0.9 mm, p = 0.02) and the difference remained statistically significant after adjusting for confounders (Delta x:1.34 mm, p = 0.002). RVFWT had a statistically significant correlation with tricuspid annular plane systolic excursion (r = 0.479, p < 0.001) and tricuspid annular lateral systolic velocity (r = 0.360, p = 0.007), but not with the indices of the RV diastolic function. None of the patients with concentric RVH had RHF, while 22.2% of patients with eccentric RVH and 66.7% of patients without RVH had RHF (p < 0.01 as compared to patients with concentric RVH). In patients with left ventricular systolic dysfunction, absence of RVH was associated with worse RV systolic performance and a significantly higher incidence of RHF.
Citation Count: 0
A "Periodic Table" approach to understand the pathophysiology of heart failure with preserved ejection fraction
(Elsevier, 2024) Guvenc, Tolga Sinan; Guvenc, Rengin Cetin; Demir, Gizem; Nikzad, Mohammad Tahir; Ekmekci, Ahmet
Heart failure with preserved ejection fraction is a complex syndrome that is characterized by symptoms and signs of heart failure without an apparent reduction in left ventricular ejection fraction. Although the main pathophysiologic pathways related to HFpEF are grossly understood, whether all or a specific number of mechanisms are related to the genesis of HFpEF for a given patient remains elusive. Moreover, it has been recently understood that HFpEF is a diverse disease with many phenotypes that have overlapping features, suggesting that a "oneway-fits-all" approach to understand the pathophysiology of this complex syndrome might not be appropriate. In this manuscript, we introduce a "periodic table" approach that incorporates both individual pathophysiologic pathways with consequent hemodynamic alterations, in which combinations of such pathophysiologic "elements" may explain the pathogenetic basis of HFpEF in each phenotype. This approach may held promise for understanding the basis of HFpEF syndrome and may contribute to the personalization of treatment approaches for each individual patient, but further evidence is needed to ascertain whether HFpEF patients have diverse pathogenetic mechanisms as suggested in the periodic table approach.