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ŞAYLAN ÇEVİK, BERNA

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ŞAYLAN ÇEVİK

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BERNA

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2017 - 201912020 - 20221
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Subject: CHILDREN ×

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    The association between obesity, hypertension and left ventricular mass in adolescents
    (WALTER DE GRUYTER GMBH, 2017) ŞAYLAN ÇEVİK, BERNA; Dibeklioglu, Saime Ergen; Cevik, Berna Saylan; Acar, Banu; Ozcakar, Zeynep Birsin; Uncu, Nermin; Kara, Nazli; Cayci, Semsa; Cakar, Nilgun
    Background: Obesity and hypertension (HT) are well known cardiac risk factors. Our goal was to show that even if arterial blood pressure (BP) measurements of obese adolescents are normal during clinical examination, ambulatory blood pressure monitoring (ABPM) can be high, may include cardiac involvement and can also detect left ventricular mass indices (LVMI) value for obese adolescents to diagnose left ventricular hypertrophy (LVH). Methods: This study included 130 children (57 obese hypertensive, 36 obese normotensive, 14 normal weight hypertensive and 23 normal weight normotensive). Adolescents whose BP was measured during clinical examination, after 24-h BP was detected using ABPM, were examined with echocardiography for calculation of LVMI to determine cardiac risk factors for LVH. Results: There was a significant difference between the LVMI of obese-normotensive and obese-hypertensive adolescents, which showed the effect of obesity on LVMI independent of HT. Twenty (35.7%) of 56 obese adolescents with HT detected with ABPM had normal BP measurements during clinical examination. Dipper and nondipper features of obese adolescents were significantly higher in ABPM than those with normal body mass index. When the cutoff LVMI value for LVH was set at >= 38 g/m(2.7), 38.9% of obese-normotensive and 50.9% of obese-hypertensive subjects had LVH; however, when the cutoff value was set at >= 51 g/m(2.7), the rates were 2.8% and 19.3%, respectively. Conclusions: Obesity is a risk factor for LVH independent of HT. To identify masked HT, 24-h ABPM and cardiac examination should be routinely performed in obese adolescents. Using a limit of LVMI >= 38 g/m(2.7) in evaluating LVH secondary to HT in obese individuals may lead to an overestimated diagnosis rate of LVH.
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    PublicationOpen Access
    Paediatric and adult congenital cardiology education and training in Europe
    (2022-03-01) ŞAYLAN ÇEVİK, BERNA; McMahon C. J., Heying R., Budts W., Cavigelli-Brunner A., Shkolnikova M., Michel-Behnke I., Kozlik-Feldmann R., Wahlander H., DeWolf D., Difilippo S., et al.
    Background: Limited data exist on training of European paediatric and adult congenital cardiologists. Methods: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. Results: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87-9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63-10.72 million), and one training centre per 4.29 million population (range 1.63-10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1-17), and duration of training was 3 years (range 2-5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R-2 = 0.41). Conclusion: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.