Ersin Saricam

Bio: Ersin Saricam is an academic researcher from Atılım University. The author has contributed to research in topics: Obstructive sleep apnea & Heart failure. The author has an hindex of 3, co-authored 9 publications receiving 36 citations.

Laboratory and Imaging Evaluation of Cardiac Involvement in Patients with Post-Acute COVID-19

Abstract: Background: In the post-acute COVID-19 syndrome, many patients suffer from palpitations, effort-associated fatigue, and even sudden death. The mechanism of heart involvement in this syndrome is uncertain. The main purpose of the study was to identify possible cardiac involvement causes in patients with post-acute COVID-19 by using biomarkers such as NT-proBNP and nitric oxide (NO) and cardiac imaging modalities. Methods: In this cross-sectional study, a total of 105 participants were included according to the existence of symptoms, and 40 of these participants were asymptomatic patients. The ages of the participants ranged from 20 to 50 years. All patients were healthy before COVID-19. The symptoms were defined as palpitations and/or fatigue association with exercise in post-acute COVID-19 term. The comparison of the two groups was made by using biochemical parameters (NT-proBNP, Troponin I, NO) and imaging techniques (echocardiography, cardiovascular magnetic resonance (CMR) and cardiac positron emission tomography (PET)). Results: The symptomatic patients had higher NT-proBNP levels compared with asymptomatic patients (132.30 +/- 35.15;76.86 +/- 16.79, respectively;p < 0.001). Interestingly, the symptomatic patients had lower NO levels than asymptomatic patients (9.20 +/- 3.08;16.15 +/- 6.02, respectively;p < 0.001). Echocardiography and CMR were normal. However, we found regional increased 18F-FDG uptake on cardiac PET to be compatible with myocardial fatigue. Conclusion: We found elevated NT-proNBP levels, low serum NO levels, and increased 18F-FDG uptake on cardiac PET in post-acute COVID syndrome. Cardiac PET could replace or be added to CMR for detecting subtle subacute/chronic myocarditis. The follow-up of patients with post-acute COVID-19 could target the possibility of risk of heart failure.

Diurnal variation of the P-wave dispersion in chronic ischemic heart diseases.

Abstract: OBJECTIVE: Electrocardiographic indices like maximum P-wave duration (P(max)) and P-wave dispersion (PD) can be used to detect patients with atrial conduction disorders, myocardial ischemia and those at risk for atrial fibrillation. Considering the diurnal variation of ischemia in patients with significant coronary lesions, this study was designed to investigate the diurnal variation of eventual atrial conduction abnormalities. METHODS: Forty-eight patients (31 male) with typical angina were grouped according to coronary angiography results as group 1 - 70% or more luminal reduction in at least one of the coronary arteries (n=28), and group 2 - normal coronary arteries (n=20). The difference between the P(max) and minimum P-wave durations (P(min)) is designated as PD. The diurnal P(max), P(min) and PD values were compared between and within the groups. RESULTS: The morning P(max) value of group 1 was significantly higher than the value of group 2 (112+/-1 vs. 102+/-1 ms, P 0.05). CONCLUSION: This study demonstrated that coronary heart disease patients have higher morning P(max) and PD values that may be important regarding prediction of timing and treatment of atrial conduction disorders in myocardial ischemia.

Assessment of the relationship between functional capacity and right ventricular ultrasound tissue characterization by integrated backscatter in patients with isolated mitral stenosis.

Abstract: AIM The aim of the present study was to investigate right ventricular (RV) myocardial textural properties in asymptomatic and symptomatic mitral stenosis (MS) patients with normal RV systolic function using integrated backscatter (IBS). METHODS The study included 40 patients with MS of moderate or severe degree. Patients were classified into 2 groups according to NYHA class (asymptomatic group, NYHA class I, symptomatic group, NYHA class II-III). RV pulsed-wave tissue Doppler imaging (TDI) and IBS analyses were performed in all patients. Isovolumic contraction time (IVCT), systolic wave velocity (S), isovolumic relaxation time (IVRT), early diastolic wave velocity (E), and late diastolic wave velocity (A) were measured by TDI. IBS amplitude (IB) and cyclic variation (CV) of the RV lateral wall in the parasternal long-axis view were measured by IBS. CV was calculated by subtracting systolic IB from diastolic IB. RESULTS IVRT (54.2 +/- 11.9 ms versus 86.2 +/- 16.2 ms, P < 0.001) and A wave amplitude (10.2 +/- 2.1 cm/s versus 13.6 +/- 1.8 cm/s, P < 0.05) were higher whereas E wave amplitude (11.7 +/- 1.6 cm/s and 10.3 +/- 1.5 cm/s, P < 0.05) and E/A ratio (1.3 +/- 0.3 versus 0.7 +/- 0.1, P < 0.001) were lower in group 2. Symptomatic patients had a lower CV value of RV (9.5 +/- 3.4 dB versus 6.7 +/- 1.9 dB, P = 0.004). There was a positive correlation between CV and E/A (r = 0.964, P < 0.001) CONCLUSION Symptomatic isolated MS patients had RV echo texture changes and diastolic dysfunction in comparison to asymptomatic ones with similar mitral valve areas in the presence of normal RV systolic function. In isolated MS, both pulsed-wave TDI and IBS may aid in the detection of RV diastolic pathology.

Right bundle branch block: a new parameter revealing the progression rate of mitral stenosis.

Abstract: Background: Mitral stenosis has a generally slow but often variable clinical course. However, the factors that influence the rate of stenosis progression have not been completely id

Bedside approach in the diagnosis obstructive sleep apnea using postprandial oximetry testing: A comparative study with polysomnography

Abstract: Introduction Due to the availability and cost issues in developing countries of polysomnography (PSG), there is a need for outpatient test for an initial assessment of the patients with suspected obstructive sleep apnea (OSA). Objectives Epworth sleepiness scale (ESS) is a widely used and best-validated scale for assessing daytime sleepiness, including dozing when sitting quietly after a lunch (no alcohol). This study introduces a novel screen test called postprandial oximetry test (POT) used during daytime. Methods This single-center prospective study included 101 patients (80 patients with suspected OSA and 21 patients without OSA suspicion). Berlin Questionnaire was used to determine the score/pretest probability of OSA patients, all chosen randomly. First, all the patients underwent POT in laboratory. Then we performed PSG. After lunch, while sleeping, the patients were monitored for 1 hour with pulse oximetry and standard electroencephalographic system. The oximetry saturation classification events with SpO2 was divided into two groups as normal or mild obstructive sleep apnea syndrome (OSAS), and moderate-to-severe OSAS. Below 90% SpO2 drops in a postprandial oximetry recordings were accepted as moderate-to-severe. Results The mean lowest oxygen saturation in PSG was 82.34 ± 5.99, while it in POT were 87.42 ± 1.39. A positive correlation was found between POT- and PSG-derived Apnoea-Hypopnoea Index (AHIs). The sensitivity and specificity in postprandial oximetry were 85% and 85.7%, respectively. The accuracy was 0.903 for POT. Conclusion POT may be useful as an outpatient test in the initial assessment of the patients with suspected OSA, serving as a gatekeeper for PSG.

Valvular heart disease

Abstract: This unique text covers all aspects of valvular heart disease, including normal valve anatomy and physiology, pathophysiology, modes of investigation, assessment and treatment of specific valve lesions, valve surgery (both medical and surgical aspects), treatment in pregnancy or during non-cardiac surgery, and the devastating complication of infective endocarditis, in an easy-to-read, accessible format.

P-wave dispersion: What we know till now?

Abstract: P-wave dispersion is defined as the difference between the maximum and the minimum P-wave duration recorded from multiple different-surface ECG leads. It has been known that increased P-wave duration and P-wave dispersion reflect prolongation of intraatrial and interatrial conduction time and the inhomogeneous propagation of sinus impulses, which are well-known electrophysiologic characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation. Extensive clinical evaluation of P-wave dispersion has been performed in the assessment of the risk for atrial fibrillation in patients without apparent heart disease, in hypertensives, in patients with coronary artery disease, in patients undergoing coronary artery bypass surgery, in patients with congenital heart diseases, as well as in other groups of patients suffering from various cardiac or non-cardiac diseases. In this paper, we aimed to summarize the measurement methods, current use in different clinical situations, strengths and limitations of the of P-wave dispersion.