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Article Citation - WoS: 1Citation - Scopus: 2The Detailed Transseptal Puncture Technique for Optimal Closure in Patients With a Patent Foramen Ovale(Frontiers Media Sa, 2024) Ilkay, Erdogan; Saricam, Ersin; Kacmaz, Fehmi; Yakici, Aysel; Koca, Cigdem; Ozeke, Ozcan; Onal, Mehmet ZulkufBackground The closure of a patent foramen ovale (PFO) using transseptal puncture has particular advantages and disadvantages. Thus, transseptal puncture should be re-evaluated in detail. Aims We aimed to assess the effectiveness of the detailed transseptal puncture technique in patients who underwent PFO closure due to cryptogenic stroke or transient ischemic attack in terms of residual shunts and atrial fibrillation. Methods We prospectively analyzed 144 consecutive patients who underwent PFO closure by the detailed transseptal puncture technique between February 2013 and April 2023 in two centers. All of the patients had a >10 mm long-tunnel PFO. Results The procedural success rate was 100%. However, after the procedure, moderate pericardial effusion developed in one patient (0.7%) and an acute pulmonary embolism related to femoral vein thrombosis was observed in one patient (0.7%) during the first month. Complications related to the procedure were noted in two patients (1.4%) during the first month of follow-up. Residual shunts were observed in 1.4% of cases after PFO closure. Conclusion We demonstrated that the detailed transseptal technique is safe and effective for PFO closure. The detailed transseptal PFO closure technique significantly reduced the risk of atrial fibrillation, and the occurrence of residual shunts was significantly low following the closure.Article Citation - WoS: 9Citation - Scopus: 13The Evaluation of Oxidative Stress in the Young Adults With Covid-19 Mrna Vaccines Induced Acute Pericarditis- Myopericarditis(Dove Medical Press Ltd, 2022) Dursun, Ali Dogan; Saricam, Ersin; Sariyildiz, Gulcin Turkmen; Iscanli, Murat Dogan; Cantekin, Omer FarukBackground: During COVID-19 pandemic, several vaccines have been developed such as mRNA vaccines. However, acute pericarditis and myocarditis/myopericarditis cases have been described after mRNA vaccination. The mechanism for the development of cardiac involvement is unknown. Potential mechanism for oxidative stress associated with vaccine-induced heart involvement is unidentified. This study aimed to examine the role of oxidative stress and the heart involvement in young adults vaccinated with COVID-19 mRNA vaccines. Methods: In this cross-sectional study, a total of 23 participants were included and 10 of these participants were asymptomatic patients (control group). Comparison of the cardiac involvement and control group was made by using troponin I, C-reactive protein (hsCRP), D-dimer levels, and oxidative stress tests including nitric oxide, and imaging techniques (ECG, echocardiography, cardiovascular magnetic resonance). Results: The median age of acute pericarditis group (10 patients) was 22 years (Q1-Q3: 18.5-31), and the mean age was 24.4 +/- 7.5 years. The median age of myopericarditis group (3 patients) was 22 years (Q1-Q3 18.0-25.0), and the mean age was 21.6 +/- 3.5 years. All the myopericarditis cases were male. The patients with myopericarditis had higher troponin I level, hsCRP, and D-dimer levels (troponin I level; 1600.00 ng/mL; D-dimer; 1.20 mu g/mL, hsCRP; 3.0 mg/L, respectively; p < 0.05). Serum nitric oxide levels and OSI (total oxidant status, H2O2/total antioxidant status) were lower in myopericarditis group than the control and acute pericarditis group (p < 0.05). This shows inflammatory and procoagulant state. Conclusion: Vaccine-induced myopericarditis cases are associated with oxidative stress test abnormality (abnormal NO, OSI levels). However, there is no relationship between NO levels and other oxidative stress tests difference in vaccine-induced acute pericarditis. It is thought that vaccine-induced pericarditis and myopericarditis could have different pathogenesis. This could make it necessary to reassess the second dose of vaccination for vaccine-induced cardiac involvement cases.Article New Ecg Algorithm for the Prediction of Culprit Vessel in Acute Myocardial Infarction Involving Lateral Part of the Ventricle: Ilkay Classification(Dove Medical Press Ltd, 2023) Saricam, Ersin; Erdol, Mehmet Akif; Bozkurt, Engin; Ilkay, Erdogan; Cantekin, Omer FarukBackground: Isolated lateral myocardial infarction sometimes does not meet ST-segment elevation myocardial infarction (STEMI) criteria according to contiguous leads. This condition could cause late diagnosis and the need for revascularization therapy.Aim: To accurately predict the occlusion of lateral surface of the left ventricle, we defined a new electrocardiogram (ECG) algorithm by using angiographic and electrocardiographic correlations.Methods: This was a retrospective, multicenter observational study. The study population consisted of 200 patients with STEMI affecting lateral surface of myocardium, between 2021 and 2022. According to the coronary angiography results, we identified 74 eligible patients for study protocol. The study patients were divided into two groups: isolated DB (14 patients) or circumflex obtuse marginal group (60 patients).Results: ST depression in lead V2 had high positive predictive values for the prediction of obtuse marginal occlusion (positive predictive values (PPV), 100%; negative predictive value (NPV), 90%). ST elevation in V2 in ECG, in conjunction with ST depression in lead III had high positive predictive values for prediction of diagonal branch of LAD. Moreover, the presence of hyperacute T wave (& GE;10 mm) in lead V2 and & GE;2 mm ST depression in lead III had large diagonal branch of LAD (PPV, 98%; NPV, 100%). However, <10 mm T wave in lead V2 and <2 mm ST depression in lead III had small diagonal branch of LAD.Conclusion: We comprehensively classified the lateral STEMI definition through new electrocardiographic scheme as Ilkay classification, whereby we could accurately predict infarct-related artery and its occlusion level in lateral myocardial infarction.Article Citation - WoS: 2Citation - Scopus: 2Association Between the Degree of Nonalcoholic Fatty Liver Disease and Nocturnal Hypertension(Lippincott Williams & Wilkins, 2025) Astan, Ramazan; Kacmaz, Fehmi; Saricam, Ersin; Ozyer, Esref Umut; Ilkay, ErdoganNighttime blood pressure (BP) decreases have prognostic significance owing to circadian patterns. The prevalence of nonalcoholic fatty liver disease (NAFLD) has rapidly increased in recent years. We aimed to investigate circadian blood pressure changes in patients with NAFLD. The present study included 114 patients diagnosed with nonalcoholic fatty liver disease and no previous hypertension diagnosis. Thirty patients comprised the control group (no hepatosteatosis and no hypertension). The patients were divided into 3 groups based on nocturnal BP dipping. Blood pressure patterns using night-day ratios were classified as dipper (ratio <= 0, 9), nondipper (0, 9 < ratio <= 1, 0), or nocturnal hypertension (ratio > 1, 0). There were no significant differences in sex, age, presence of diabetes, or biochemical test results between the groups. According to the blood pressure pattern, the nondipper rate in the hepatosteatosis group was significantly higher than that in the control group. Patients were compared in terms of the presence and severity of hepatosteatosis according to night blood pressure patterns. A significant difference was observed between the groups (P < .001 and P = .001, respectively). We found an association between hepatosteatosis severity and night blood pressure patterns. Patients with nonalcoholic fatty liver disease have a higher incidence of nocturnal hypertension. We observed impaired circadian blood pressure changes in patients with nonalcoholic fatty liver disease.
