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    Association of dipping pattern of blood pressure and atherosclerotic burden of coronary arteries in hypertensive patients
    (Russian Heart Failure Soc., 2022) Taşbulak, Ömer; Aktemur, Tuğba; Şahin, Ahmet Anıl; Demir, Ali Rıza; Güler, Arda; Topel, Çağdaş; Türkvatan, Aysel; Pusuroğlu, Hamdi; Ertürk, Mehmet
    Aim The aim of this study was to determine the association between the dipping pattern of BP and coronary artery disease in hypertensive patients.Material and methods A total of 356 hypertensive patients were included in the study. The results of ambulatory BP monitoring, echocardiography, and coronary computerised tomographic angiography were evaluated retrospectively. The patients were divided into two groups on the basis of their ambulatory BP monitoring: 1) patients with the dipping pattern of BP; 2) patients with the non-dipping pattern (NDP).Results Among the 356 patients, 145 were male (40.7?%). The smoking status was higher in patients with NDP (p=0.023). The statin usage in patients with the dipping pattern was higher in patients with NDP (p=0.027). There were no significant differences in the echocardiographic findings. 58.6?% of the patients without plaque formation had the dipping pattern of BP (p<0.05), however 84.4?% of patients with >50?% plaque formation had the NDP of BP (p<0.001).Conclusion The NDP of BP might be related to the increased atherosclerotic process in coronary arteries, and pa-tients with NDP might have an increased atherosclerotic burden for coronary arteries when compared with patients with a dipping pattern.
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    A joint convolutional?recurrent neural network with an attention mechanism for detecting intracranial hemorrhage on noncontrast head CT
    (Nature, 2022) Aliş, Deniz; Aliş, Ceren; Yergin, Mert; Topel, Çağdaş; Asmakutlu, Ozan; Bağcılar, Ömer; Deniz Şenli, Yeşeren; Üstündağ, Ahmet; Salt, Vefa; Nacar Doğan, Sebahat; Velioğlu, Murat; Selçuk, Hakan Hatem; Kara, Batuhan; Özer, Caner; Öksüz, İlkay; Kızılkılıç, Osman; Karaarslan, Ercan
    To investigate the performance of a joint convolutional neural networks-recurrent neural networks (CNN-RNN) using an attention mechanism in identifying and classifying intracranial hemorrhage (ICH) on a large multi-center dataset; to test its performance in a prospective independent sample consisting of consecutive real-world patients. All consecutive patients who underwent emergency non-contrast-enhanced head CT in five different centers were retrospectively gathered. Five neuroradiologists created the ground-truth labels. The development dataset was divided into the training and validation set. After the development phase, we integrated the deep learning model into an independent center's PACS environment for over six months for assessing the performance in a real clinical setting. Three radiologists created the ground-truth labels of the testing set with a majority voting. A total of 55,179 head CT scans of 48,070 patients, 28,253 men (58.77%), with a mean age of 53.84 ± 17.64 years (range 18-89) were enrolled in the study. The validation sample comprised 5211 head CT scans, with 991 being annotated as ICH-positive. The model's binary accuracy, sensitivity, and specificity on the validation set were 99.41%, 99.70%, and 98.91, respectively. During the prospective implementation, the model yielded an accuracy of 96.02% on 452 head CT scans with an average prediction time of 45 ± 8 s. The joint CNN-RNN model with an attention mechanism yielded excellent diagnostic accuracy in assessing ICH and its subtypes on a large-scale sample. The model was seamlessly integrated into the radiology workflow. Though slightly decreased performance, it provided decisions on the sample of consecutive real-world patients within a minute.
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    Persistent right heart dilatation after percutaneous mitral balloon valvuloplasty: A weird coexistence of iatrogenic and congenital shunts
    (John Wiley and Sons Inc, 2022) Güler, Arda; Topel, Çağdaş; Memiç Sancar, Kadriye; Kahveci, Gökhan; Onan, Burak; Güler, Gamze Babur
    We present an interesting case of concomitant congenital anomalies with an iatrogenic defect. The female patient underwent a percutaneous mitral balloon valvuloplasty due to rheumatic mitral stenosis. Unfortunately, an iatrogenic atrial septal defect (ASD) transpired during the procedure. Upon post-procedure examination, partial anomalous pulmonary venous (PAPVR) return was observed. The patient was symptomatic; on imaging, dilatation of the right heart chambers were detected. In addition, another crucial point was that the patient was planning a pregnancy, thus robotic surgery for iatrogenic ASD and PAPVR return was recommended. After a successful operation, the patient was asymptomatic and the size of right heart chambers were normalized. © 2022 Wiley Periodicals LLC.