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    Evaluation of aortic stiffness parameters in premenopausal migraine patients
    (Cukurova Univ, Fac Medicine, 2020) Gunturk, Ertugrul Emre; Dogan, Selcuk; Topuz, Ayse Nur
    Purpose: Migraine is an episodic primary headache disorder, which affects approximately 10% of the adult population, predominantly females. Based on the changes detected in migraine and previous findings, arterial stiffness can be considered to be an important contributor to vascular events in patients with migraine. The aim of this study was to investigate the associations between atherosclerosis and migraine through the evaluation of aortic stiffness in premenopausal migraine patients. Materials and Methods: The study included 68 female patients with migraine, and a control group of 39 healthy females. To reveal the association between migraine and arterial stiffness, echocardiography was applied and aortic stiffness was evaluated. Blood pressure measurements, basic biochemical tests and the 12 derivation-ECG recordings of each patient were taken simultaneously. Results: Basic echocardiographic findings were similar in patients and the control group. Systolic and diastolic diameters of the aorta, and the change in aortic diameter were also similar in both groups. Aortic distensibility, aortic strain and beta indices were also similar in both groups. No significant differences were determined between patients with and without aura migraine and the control group in respect of systolic blood pressure, diastolic blood pressure and pulse pressure. Conclusion: As a marker of atherosclerosis, the aortic stiffness parameters didn't differ between migraine and control group.
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    Investigation of Left Atrial Spontaneous Echo Contrast as a Marker Indicating Ineffective Anticoagulation in Patients with Mitral Valve Replacement Receiving Warfarin
    (2019) Gunturk, Ertugrul Emre; Demirbas, Melih; Dogan, Yasemin; Dogan, Selcuk; Gunturk, Inayet
    Objectives: This study aimed to evaluate predictive role of left atrial (LA) spontaneous echo contrast (SEC) for ineffec-tive anticoagulation by assessing time in therapeutic range (TTR) via international normalized ratio (INR) monitoring in patients with mitral valve replacement (MVR) and to determine its relationship with increased thromboembolic events.Methods: The study included patients with mechanical MVR. TTR was estimated using serial INR measurements. On transthoracic echocardiography, left ventricular end-systolic/end-diastolic diameters, LA diameter, ejection fraction were measured, and the presence of SEC was determined.Results: The study included 65 patients with MVR (30 with LA SEC) and 35 without LA SEC. There was a trend for higher rates of cerebrovascular event in the patients with SEC than in those without (30% vs. 14.3%, p=0.046). The LA diameter was higher and the TTR was lower in the patients with SEC than in those without. There was a significant negative cor-relation between TTR and thromboembolic events. Multivariable logistic regression analysis revealed the TTR and LA diameter as independent factors affecting SEC.Conclusion: In patients with MVR, low TTR and enlarged left atrium were independent predictors for future throm-boembolic events. Monitoring INR is important to achieve higher TTR in the presence of LA SEC.