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Article ; Online: Point Shear Wave Elastography Detected Liver Stiffness Increased in Pediatric Patient With Thalassemia Major.

Tuncel, Defne Ay / Pekoz, Burcak Cakir / Koc, Ayse Selcan / Sumbul, Hilmi Erdem

2024 Volume 40, Issue 1, Page(s) 82–86

Abstract: Abstract: Transient elastography (TE) and point shear wave elastography (pSWE) are 2 elastographic ultrasound examinations used in liver stiffness (LS) measurement. It was shown that the LS value detected by TE in pediatric β-thalassemia major patients ... ...

Abstract	Abstract: Transient elastography (TE) and point shear wave elastography (pSWE) are 2 elastographic ultrasound examinations used in liver stiffness (LS) measurement. It was shown that the LS value detected by TE in pediatric β-thalassemia major patients has increased, and there was no LS evaluation obtained with pSWE in literature. Thus, in this study, it was aimed to evaluate LS with pSWE examination in children with thalassemia major and to determine LS-related parameters in these patients. Sixty-three schoolchildren with a diagnosis of β-thalassemia major and 21 healthy controls between the ages of 7 and 18 years were included. In addition to routine anamnesis, physical examination, and laboratory examinations, renal and liver ultrasounds were performed. Liver stiffness values were measured by pSWE examination. Serum levels of urea, aspartate-aminotransferase, alanine-aminotransferase, iron, and ferritin were significantly higher in patients, and serum creatinine, iron binding capacity, and hemoglobin levels were found to be significantly lower (P < 0.05 for each). Liver stiffness values were significantly higher in patients compared with healthy controls. In linear regression analysis, serum iron and iron binding capacity values were found to be closely related with LS (P < 0.001 vs. β = 0.482 and P = 0.047 vs. β = 0.237, respectively). Liver stiffness values obtained by pSWE examination increase significantly in patients. According to the results of our study, in addition to the previously known TE method, we think that the LS evaluation obtained by pSWE, a new method that can make more accurate measurements, can be used in the possible early detection of target organ damage in children with thalassemia major.
MeSH term(s)	Humans ; Child ; Adolescent ; Elasticity Imaging Techniques ; beta-Thalassemia/complications ; beta-Thalassemia/diagnostic imaging ; Iron ; Kidney ; Liver/diagnostic imaging
Chemical Substances	Iron (E1UOL152H7)
Language	English
Publishing date	2024-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	645107-x
ISSN	1536-0253 ; 0894-8771
ISSN (online)	1536-0253
ISSN	0894-8771
DOI	10.1097/RUQ.0000000000000675
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Zs.A 2485: Show issues

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Article ; Online: Age should be considered in cut-off values for increased carotid intima-media thickness.

Koç, Ayşe Selcan / Sümbül, Hilmi Erdem

Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir

2019 Volume 47, Issue 4, Page(s) 301–311

Abstract: Objective: The current guidelines use a cut-off value of 0.9 mm to define abnormally increased carotid intima-media thickness (C-IMT), regardless of age or gender. This study was conducted to examine the effects of age and gender on C-IMT and cut-off ... ...

Title translation	Artmış karotis intima-media kalınlığı için sınır değerleri belirlemede yaş göz önünde bulundurulmalıdır.
Abstract	Objective: The current guidelines use a cut-off value of 0.9 mm to define abnormally increased carotid intima-media thickness (C-IMT), regardless of age or gender. This study was conducted to examine the effects of age and gender on C-IMT and cut-off values for C-IMT in different age groups. Methods: A total of 644 patients with a recorded C-IMT measurement, at least 1 cardiovascular risk factor, and aged between 20 and 90 years were included in the study. Common and internal C-IMT (CC-IMT and IC-IMT) measurements were obtained using carotid ultrasonography (USG). The patients were divided into 5 groups based on age: Group I (20-40 years), Group II (41-50 years), Group III (51-60 years), Group IV (61-70 years), and Group V (>70 years). Results: The CC-IMT and IC-IMT values were significantly greater as the age of the group increased. Group I to Group V had a median CC-IMT value of 0.70 mm, 0.70 mm, 0.75 mm, 0.75 mm, and 0.85 mm, respectively. The median IC-IMT value for each group was 0.60 mm, 0.65 mm, 0.70 mm, 0.70 mm, and 0.80 mm, respectively. The median CC-IMT value was 50 μm greater than the median IC-IMT value in all groups. Only the CC-IMT value was significantly different in males (0.80+-0.20 mm vs. 0.76+-0.19 mm; p=0.020). Age, hypertension (HT), smoking, hyperlipidemia, systolic-diastolic blood pressure, and body mass index measures were associated with increased C-IMT. Regression analysis revealed that increased C-IMT was independently associated with age and HT presence. Each decade of life and the presence of HT revealed an incidence of increased C-IMT by 44% and 53%, respectively. Conclusion: C-IMT significantly increased with age. New, age-appropriate cut-off values are needed for C-IMT assessment. In addition, it was observed that the CC-IMT value was approximately 50 μm greater than the IC-IMT measurement in all age groups. CC-IMT measurements should be included in USG reports.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aging/pathology ; Carotid Intima-Media Thickness/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Regression Analysis ; Retrospective Studies ; Sex Factors ; Young Adult
Language	English
Publishing date	2019-07-12
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	1215217-1
ISSN	1308-4488 ; 1016-5169
ISSN (online)	1308-4488
ISSN	1016-5169
DOI	10.5543/tkda.2018.94770
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Zs.A 4156: Show issues

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Article ; Online: Prediabetes Is Associated With Increased Liver Stiffness Identified by Noninvasive Liver Fibrosis Assessment: ElastPQ Ultrasound Shear Wave Elastography Study.

Koc, Ayse Selcan / Sumbul, Hilmi Erdem

Ultrasound quarterly

2019 Volume 35, Issue 4, Page(s) 330–338

Abstract: Patients with type 2 diabetes mellitus (DM) have been shown to have increased liver fibrosis (LF) as determined by liver elastography. However, the data on LF incidence in patients with prediabetes are scarce. This study was undertaken to determine the ... ...

Abstract	Patients with type 2 diabetes mellitus (DM) have been shown to have increased liver fibrosis (LF) as determined by liver elastography. However, the data on LF incidence in patients with prediabetes are scarce. This study was undertaken to determine the incidence of LF and associated parameters in prediabetic patients. Three study groups with equal number of participants defined on the basis of glucose metabolism status were included the following: normal glucose metabolism (NGM), prediabetes, and newly diagnosed type 2 DM (55 patients in each group). Liver stiffness measurements were carried out using liver elastography point quantification, and 7 kPa or greater was considered to denote the presence of LF. Patients were subdivided into 2 groups as those with or without LF. Of the NGM, prediabetes, and type 2 DM subjects involved in the study 3.6%, 27%, and 38% were found to have LF (P < 0.001), respectively. Glycated hemoglobin (HbA1c), triglycerides, and alkaline phosphatase levels independently correlated with liver stiffness measurements (P < 0.05, for each). In addition, presence of mild or moderate-severe liver steatosis, hypertension, waist circumference, and HbA1c were independent predictors of the LF status. Presence of mild or moderate-severe liver steatosis, hypertension, waist circumference (each 1-cm increment), and HbA1c (each 1% increment) were associated with a 2.78-fold, 7.16-fold, 68%, and 36.7% increased likelihood of LF, respectively. As compared with subjects with NGM, patients with impaired glucose metabolism were more likely to have LF. As in patients with type 2 DM, a significant proportion of patients with prediabetes (27%) have LF, which is closely or independently associated with markers of metabolic syndrome.
MeSH term(s)	Blood Glucose/metabolism ; Cross-Sectional Studies ; Elasticity ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Liver/diagnostic imaging ; Liver/physiopathology ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/physiopathology ; Male ; Middle Aged ; Prediabetic State/blood ; Prediabetic State/complications ; Reproducibility of Results ; Retrospective Studies ; Ultrasonography/methods
Chemical Substances	Blood Glucose ; Glycated Hemoglobin A
Language	English
Publishing date	2019-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	645107-x
ISSN	1536-0253 ; 0894-8771
ISSN (online)	1536-0253
ISSN	0894-8771
DOI	10.1097/RUQ.0000000000000419
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Zs.A 2485: Show issues

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Article ; Online: The Abdominal Aortic Intima-Media Thickness Increases in Patients with Primary Hyperparathyroidism.

Sumbul, Hilmi Erdem / Koc, Ayse Selcan

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association

2018 Volume 127, Issue 6, Page(s) 387–395

Abstract: Background: We aimed to determine whether there is an increase in aortic intima-media thickness values measured from the abdominal aorta in addition to the traditional carotid intima-media thickness in patients with primary hyperparathyroidism and to ... ...

Abstract	Background: We aimed to determine whether there is an increase in aortic intima-media thickness values measured from the abdominal aorta in addition to the traditional carotid intima-media thickness in patients with primary hyperparathyroidism and to determine the parameters closely related to aortic intima-media thickness. Methods: This perspective study included 65 primary hyperparathyroidism patients and 30 healthy-controls. Routine laboratory tests for the diagnosis of hyperparathyroidism and vascular ultrasound examinations were performed. Common carotid, internal carotid, and abdominal aortic intima media thickness were measured. The participants of the study was divided into 3 groups as the control (Group-I), the medical treatment (Group-II) due to primary hyperparathyroidism, and the planned surgery (group-III). Results: Aortic intima-media thickness, serum urea, creatinine, glucose, uric acid, hs-CRP, parathyroid hormone, calcium and urine calcium levels increased significantly from Group-I to Group-III and T-scores and serum phosphorus in levels decreased significantly. Carotid intima-media thicknesses were not significantly different between the groups. Serum and urinary calcium levels were independently associated with aortic intima-media thickness. Aortic intima-media thickness, serum phosphorus, parathyroid hormone, T-scores, serum and urinary calcium levels are independent indicators for Group-III. When the cut-off value of aortic intima-media thickness was taken as 1.5 mm, 80.6% sensitivity and 89.1% specificity were determined for patients who would go to surgery. Conclusion: Serum and urine calcium levels were independently associated with aortic intima-media thickness. Aortic intima-media thickness is more useful than carotid intima-media thickness in showing vascular organ involvement in patients with primary hyperparathyroidism.
MeSH term(s)	Adult ; Aged ; Aorta, Abdominal/diagnostic imaging ; Blood Glucose/metabolism ; Calcium/blood ; Calcium/urine ; Female ; Humans ; Hyperparathyroidism, Primary/blood ; Hyperparathyroidism, Primary/diagnostic imaging ; Hyperparathyroidism, Primary/urine ; Male ; Middle Aged ; Parathyroid Hormone/blood ; Tunica Media/diagnostic imaging ; Ultrasonography ; Urea/blood ; Uric Acid/blood
Chemical Substances	Blood Glucose ; Parathyroid Hormone ; Uric Acid (268B43MJ25) ; Urea (8W8T17847W) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2018-08-14
Publishing country	Germany
Document type	Clinical Trial ; Journal Article
ZDB-ID	1225416-2
ISSN	1439-3646 ; 0947-7349
ISSN (online)	1439-3646
ISSN	0947-7349
DOI	10.1055/a-0664-7820
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Article ; Online: Correction: The Abdominal Aortic Intima-Media Thickness Increases in Patients with Primary Hyperparathyroidism.

Sumbul, Hilmi Erdem / Koc, Ayse Selcan

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association

2018 Volume 130, Issue 6, Page(s) e6

Language	English
Publishing date	2018-08-22
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	1225416-2
ISSN	1439-3646 ; 0947-7349
ISSN (online)	1439-3646
ISSN	0947-7349
DOI	10.1055/a-0697-6549
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Article: Silent ischemic brain lesions detected by multi-slice computed tomography are associated with subclinical atrial fibrillation in patients with cardiac resynchronization therapy.

Icen, Yahya Kemal / Koc, Ayse Selcan

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

2018 Volume 14, Issue 3, Page(s) 285–290

Abstract: Introduction: There is insufficient research on the relationship between subclinical atrial fibrillation (SCAF) and silent ischemic brain lesions (IBLs).: Aim: To investigate the relationship between SCAF and silent IBLs in patients with cardiac ... ...

Abstract	Introduction: There is insufficient research on the relationship between subclinical atrial fibrillation (SCAF) and silent ischemic brain lesions (IBLs). Aim: To investigate the relationship between SCAF and silent IBLs in patients with cardiac resynchronization therapy (CRT). Material and methods: Of 720 CRT implanted patients in our department between 2012 and 2018, 121 patients who underwent elective cranial multi-slice computed tomography (MSCT) during their follow-up were included in our study. Atrial high-rate episodes (AHRE) were detected by the CRT device. Subclinical atrial fibrillation was defined as asymptomatic AHRE longer than 6 min and shorter than 24 h. A cranial MSCT scan was performed using a 128-section scanner with contiguous 2-5 mm axial images. Patients were divided into two groups - with and without silent IBL. Results: Silent IBLs were detected in 21 (17.4%) of 121 patients with CRT. Ischemic brain lesion presence was found to be associated with age, CHA2DS2-VASc score, left ventricular (LV) ejection fraction (EF), hypertension and SCAF in univariate analysis ( Conclusions: Subclinical atrial fibrillation is independently associated with silent IBL presence. Patients with CRT should be closely monitored for SCAF. Patients diagnosed with SCAF should be evaluated for IBL development and treated with the appropriate oral anticoagulant.
Language	English
Publishing date	2018-09-21
Publishing country	Poland
Document type	Journal Article
ISSN	1734-9338
ISSN	1734-9338
DOI	10.5114/aic.2018.78332
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Article ; Online: Increased aortic intima-media thickness may be used to detect macrovascular complications in adult type II diabetes mellitus patients.

Koc, Ayse Selcan / Sumbul, Hilmi Erdem

Cardiovascular ultrasound

2018 Volume 16, Issue 1, Page(s) 8

Abstract: Background: Carotid intima media thickness (C-IMT) and aortic IMT (A-IMT) increase in adult and pediatric patients with diabetes mellitus (DM), respectively. In both age groups IMT is used for early detection of macrovascular complications. In adult DM ... ...

Abstract	Background: Carotid intima media thickness (C-IMT) and aortic IMT (A-IMT) increase in adult and pediatric patients with diabetes mellitus (DM), respectively. In both age groups IMT is used for early detection of macrovascular complications. In adult DM patients, A-IMT is still not a routine examination and is not used frequently. We aimed to determine whether there is an increase in A-IMT values measured from abdominal aorta besides traditional C-IMT in patients with type II DM and to determine parameters closely related to A-IMT in the same patient group. Methods: We included 114 type II DM patients and 100 healthy control subjects similar in age and sex in our study. Bilateral C-IMT and A-IMT values were measured by B-mode ultrasonography (USG) in addition to anamnesis, physical examination and routine examinations of all patients. Results: When the clinical, demographic and laboratory data of patients with and without DM were compared, there was a high level of glucose and HbA1c and low hemoglobin levels in the DM patient group. All other parameters were found to be similar between the two groups. When the B-mode USG findings were examined, it was found that C-IMT and A-IMT were increased in patients with DM, with the A-IMT increase being more prominent. A-IMT values were found to be strongly and positively correlated with age, systolic blood pressure, blood urea nitrogen, DM onset time and HbA1c levels, and a negatively and significantly correlated with hemoglobin levels (p < 0.05, for each). In the regression model, the parameters correlating most closely with A-IMT were DM diagnosis onset time, HbA1c and hemoglobin levels (p = 0.001 and β = 0.353, p = 0.014 and β = 0.247 and p < 0.001 and β = - 0.406). Conclusions: As in pediatric DM patients also in adult DM patients A-IMT can easily be measured with new model USG devices. A-IMT must be measured during abdominal USG which is routine in adult DM patients. A-IMT is an easy, reproducible and non-invasive parameter that may be used in the diagnosis of macrovascular complications of adult type II DM.
MeSH term(s)	Adult ; Aorta, Abdominal/diagnostic imaging ; Atherosclerosis/diagnostic imaging ; Atherosclerosis/etiology ; Carotid Arteries/diagnostic imaging ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2/complications ; Diabetic Angiopathies/diagnostic imaging ; Diabetic Angiopathies/etiology ; Female ; Humans ; Male ; Middle Aged ; Tunica Intima/diagnostic imaging ; Tunica Media/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2018-06-12
Publishing country	England
Document type	Journal Article
ISSN	1476-7120
ISSN (online)	1476-7120
DOI	10.1186/s12947-018-0127-x
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Article: Rare coexistence: type A aortic interruption and left ventricular non-compaction.

İçen, Yahya Kemal / Koç, Ayşe Selcan

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

2018 Volume 14, Issue 2, Page(s) 212–213

Language	English
Publishing date	2018-06-19
Publishing country	Poland
Document type	Journal Article
ISSN	1734-9338
ISSN	1734-9338
DOI	10.5114/aic.2018.76420
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Article ; Online: Renal resistive index significantly increased in hypertensive children and it is independently related to the pulse pressure and left ventricular mass index.

Cilsal, Erman / Koc, Ayse Selcan

Clinical and experimental hypertension (New York, N.Y. : 1993)

2018 Volume 41, Issue 7, Page(s) 607–614

Abstract: ... ...

Abstract	Background
MeSH term(s)	Adolescent ; Blood Pressure ; Child ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Diastole ; Echocardiography ; Female ; Heart Septum/diagnostic imaging ; Humans ; Hypertension/blood ; Hypertension/physiopathology ; Hypertrophy, Left Ventricular/diagnostic imaging ; Kidney/diagnostic imaging ; Male ; Renal Artery/physiopathology ; Systole ; Triglycerides/blood ; Ultrasonography, Doppler, Color ; Vascular Resistance
Chemical Substances	Cholesterol, HDL ; Cholesterol, LDL ; Triglycerides
Language	English
Publishing date	2018-10-04
Publishing country	England
Document type	Journal Article
ZDB-ID	604757-9
ISSN	1525-6006 ; 0730-0077
ISSN (online)	1525-6006
ISSN	0730-0077
DOI	10.1080/10641963.2018.1523920
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Article ; Online: Hypertension is Common in Patients with Newly Diagnosed Acromegaly and is Independently Associated with Renal Resistive Index.

Sumbul, Hilmi Erdem / Koc, Ayse Selcan

High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension

2018 Volume 26, Issue 1, Page(s) 69–75

Abstract: Introduction: There are conflicting results regarding the frequency of hypertension (HT) and values of related parameters in patients with acromegaly.: Aim: We aimed to determine the frequency of HT and values of its associated parameters in patients ...

Abstract	Introduction: There are conflicting results regarding the frequency of hypertension (HT) and values of related parameters in patients with acromegaly. Aim: We aimed to determine the frequency of HT and values of its associated parameters in patients with acromegaly. Methods: 57 patients with newly diagnosed acromegaly were included in this study. Renal ultrasonography (US) was performed in addition to routine evaluation of acromegaly. Renal resistive index (RRI), renal pulsatility index (RPI), and accelerated time were measured using Doppler US. Results: Hypertension was detected in 16 patients (28.1%) with newly diagnosed acromegaly. Serum triglyceride, TSH, growth hormone, and insulin growth factor 1 levels were higher and HDL levels were lower in acromegaly patients with HT. RRI and RPI values were found to be higher in acromegaly patients with HT. In logistic regression analysis, only the RRI value was found to be independently related to the presence of HT. Based on this analysis, it was determined that the frequency of HT increases 2.99 times for each increase in RRI of 0.05 units. When ROC analysis was performed, it was found that the area under the ROC curve was 0.781. In the same analysis, when the cutoff value for RRI was taken to be 0.70, the development of HT in acromegaly patients was determined with 75% sensitivity and 78% specificity. Conclusions: In patients with newly diagnosed acromegaly, HT frequency was significantly increased and it was independently associated with the RRI value. Therefore, these patients should be closely monitored for HT-the most frequent and important cardiovascular risk factor-and treated before they develop target organ damage.
MeSH term(s)	Acromegaly/blood ; Acromegaly/complications ; Acromegaly/diagnostic imaging ; Acromegaly/physiopathology ; Adult ; Biomarkers/blood ; Blood Pressure ; Female ; Humans ; Hypertension/diagnosis ; Hypertension/etiology ; Hypertension/physiopathology ; Kidney/blood supply ; Kidney/diagnostic imaging ; Male ; Middle Aged ; Prognosis ; Renal Circulation ; Risk Factors ; Ultrasonography, Doppler ; Vascular Resistance
Chemical Substances	Biomarkers
Language	English
Publishing date	2018-12-07
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	1236337-6
ISSN	1179-1985 ; 1120-9879
ISSN (online)	1179-1985
ISSN	1120-9879
DOI	10.1007/s40292-018-0293-9
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