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KEPEZ, ALPER

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Author: KEPEZ, ALPER × Subject: Klinik Tıp ×

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Now showing 1 - 5 of 5
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    PublicationOpen Access
    Effects of balloon pulmonary angioplasty procedure on electrocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension
    (2023-03-01) KOL, AYHAN; KEPEZ, ALPER; ATAŞ, HALİL; MUTLU, BÜLENT; KOL A., KEPEZ A., Akaslan D., Kanar B., ATAŞ H., MUTLU B.
    Aim: The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting post-operative hemodynamic improvement in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).Material and methods: A total of 32 patients were included in the study. During ECG analysis, parameters that have been suggested to be related to right ventricular hypertrophy and/or dilatation were evaluated. The sig-nificance of the change in each parameter obtained at the pre-BPA visit and at the scheduled control visit 6 months after BPA was tested. In addition to ECG analysis, data related to right heart catheterization (RHC) and echocardiography, B-type natriuretic peptide (BNP) levels and World Health Organization (WHO) functional classifications of all patients were also recorded. The relationship between the amount of possible change in ECG parameters and the amount of possible change in hemodynamic parameters was investigated.Results: The Daniel score, which has been suggested to have prognostic value in acute pulmonary embolism, decreased from 8.22 +/- 5.68 to 6.56 +/- 5.55 after the BPA procedure (p: 0.035). Among all parameters studied, only T wave height (V2 t) in V2 derivation changed significantly from-0.77 +/- 2.39 to 1.27 +/- 2.58 mm (p: 0.036). The amount of change in V2 T was found to significantly correlate with the amount of change in systolic right ventricular pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and systemic vascular resistance.Conclusion: Postprocedural T wave changes in lead V2 might serve as a marker of hemodynamic improvement in patients with CTEPH who undergo BPA.
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    PublicationOpen Access
    Belirgin kardiyovasküler hastalığı olmayan hastalarda COVID-19 mRNA aşısının elektrokar-diyografik parametreler üzerinde herhangi bir etkisi var mı?
    (2022-09-01) KEPEZ, ALPER; TİGEN, ELİF; Küp A., Çelik M., Uslu A., Külahçıoğlu Ş., Tükenmez Tigen E., Demir S., Gülşen K., İzci S., Uygun Kızmaz Y., Kepez A.
    Objective: Electrocardiographic alterations were investigated following the second dosage of COVID-19 mRNA vaccination. Methods: A total of 260 individuals after two doses of COVID-19 vaccine with Pfizer-BioNTech were included in the study. The electrocardiographic parameters recorded at baseline and approximately one week later after two doses of Pfizer-BioNTech vaccine were compared for all patients. Results: PR interval was increased and QTc maximum interval was decreased significantly after second dose COVID-19 mRNA vaccination. Baseline and post-second dose vaccination states regarding P wave dispersion and QT dispersion/Tp-e interval which have been recognized to imply inhomogeneous atrial conduction and heterogeneity in ventricular repolarization were similar between groups. Conclusion: Our findings suggest that there should be no concern related to asymptomatic involvement of the myocardium subsequent the second dose of COVID-19 mRNA vaccination.
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    Mekanik trisküpit kapağı bulunan hastada kalıcı pacemaker implantasyonunun zorlukları
    (2022-11-10) KEPEZ, ALPER; Yazıcı S., Çakır S. B. , Güçtekin M. Y. , Güçtekin T., Kepez A.
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    PublicationOpen Access
    Efficacy of high-versus moderate-dose statin therapy on lower extremity artery disease after revascularization
    (2022-01-01) KEPEZ, ALPER; Kup A., Kanar B., Uslu A., Zehir R., Akaslan D., KEPEZ A.
    Aim: Statins are one of the most important agents in the treatment of atherosclerotic peripheral arterial disease. We aim to compare high – and moderate-dose statin therapy in patients with lower extremity artery disease (LEAD) who have undergone percutaneous transluminal angioplasty (PTA). Patients and Methods: Ninety-four patients treated with PTA were selected consecutively and retrospectively and were divided into two groups according to the high – or moderate-dose statin treatments they were given. Groups were compared for the absence of restenosis and occlusion as primary patency and the need for reintervention in the treated arterial segment as secondary patency. All patients underwent computed tomography (CT) angiography or duplex scan one year after receiving PTA. Results: Coronary revascularization (p<0.001) and prior statin usage (p:0.02) were more common in the high-dose statin group when compared to the moderate-dose statin group. Lesion characteristics did not differ between the two groups. Primary patency rate was significantly higher (36.1% vs. 27.6%, p 0.01) in the high-dose statin group. Major amputation (4.2% vs. 10.6%, p:0.03) and minor amputation (12.7% vs. 19.1%, p:0.03) rates were significantly lower in the high-dose statin group. Regression analysis revealed that the usage of high-dose statin therapy was an independent predictor of higher primary patency in patients who were treated with prior PTA(Odds ratio:2.208, p<0.001) Conclusion: High-dose long-term statin treatment might have better outcomes on primary patency in patients who underwent prior PTA for infrapopliteal lesions as a subgroup of peripheral artery disease. The administration of the high-dose long-term statin therapy might be important in the prognosis of peripheral arterial disease, especially for those with infrapopliteal lesions