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    A Rare Coronary Anomaly: Single Coronary Artery; Two Cases
    (2025) Ayhan, Selçuk; Köseoğlu, Cemal; Öncel, Can Ramazan
    We present two cases of a rare coronary anomaly—single coronary artery—identified incidentally during routine coronary angiography. Both patients presented with symptoms of chest pain and exertional angina. In both cases, the anomaly is located in the right sinus of Valsalva (R-1-A) and crosses the heart anterior to the right ventricle. (Figure 3) The first patient experienced significant stenosis in the proximal left anterior descending artery, which was successfully treated with percutaneous stent implantation. The second patient's chest pain was managed effectively with medical therapy alone. These cases highlight that a single coronary artery, often asymptomatic, can exist as a congenital anomaly in patients experiencing myocardial ischemia due to atherosclerotic coronary artery disease. Furthermore, they demonstrate that percutaneous coronary intervention, including stent placement, offers a promising treatment approach. In the literature, coronary artery bypass surgery should particularly be considered as a treatment option for these coronary anomalies. However, it has also been shown that in selected cases, percutaneous intervention or medical therapy can be viable alternatives.
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    An under-diagnosed caused of myocardial infarction: Coronary embolism
    (2025) Öncel, Can Ramazan; Türk, Recep; Köseoğlu, Cemal
    The coronary embolism (CE) is a rare cause of acute coronary syndrome (ACS). The most common cardiovascular disease linked to coronary embolism is atrial fibrillation (AF). Despite the acknowledgment of the entity, it is regarded an under-diagnosed cause of ACS, and there is uncertainty over the short and long term prognosis of these patients. In this case report, we aimed to provide information about the diagnosis and treatment process of a patient who presented with acute inferior myocardial infarction caused by coronary embolism.
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    Can Diastolic Dysfunction Develop as a Result of Premature Ventricular Complex?
    (2023) Köseoğlu, Cemal; Öncel, Can Ramazan
    To the Editor, We have read the article by Keleş et al1 entitled “Does premature ventricular com- plex impair left ventricular diastolic functions?’’ with great interest which was published in Anatol J Cardiol 2023; 27: 217-222. In the present study, the authors reported that patients with premature ventricular complex exhibited a lower early diastolic strain rate than the normal population and this parameter can be used to predict left ventricular diastolic dysfunction in the study population. Also, the authors reported that patients with premature ventricular complex may have a higher risk of left ventricular diastolic dysfunction than healthy individuals.1 We would like to emphasize some important points about this well-written study...
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    Clinical Importance of P Wave Dispersion in Mitral Valve Prolapse
    (2024) Öncel, Can Ramazan; Köseoğlu, Cemal; Çoner, Ali
    Objective: Mitral valve prolapse (MVP) is a widespread valvulopathy present in 2–6% of the population, affecting more than 170 million people globally. The objective of this study was to assess P wave dispersion (PWD) in patients with MVP to identify the presence of cardiovascular autonomic dysfunction and the potential risk of developing atrial arrhythmias in these patients. Materials and Methods: The study included 40 healthy control participants (Group 1), 41 patients with non-classic MVP (Group 2), and 36 patients with classic MVP (Group 3). Demographic and clinical characteristics were documented upon admission. An electrocardiographic assessment was conducted to quantify PWD values for both patients and the control group. Results: The minimum P wave duration was lower in classic MVP patients than in controls and non-classic MVP patients (63±3.6 vs. 70±2.0, p<0.001; 63±3.6 vs. 63±3.6, p<0.001, respectively). P wave dispersion was higher in classic MVP patients than in non-classic MVP patients (47.3±3.2 vs. 39.0±2.3, p=0.001). A significant positive correlation was detected between PWD and maximum P wave duration (Pmax), minimum P wave duration (Pmin), maximal leaflet displacement, maximal leaflet thickness, and left atrial diameter (LAD) (r=0.723, p<0.001; r=- 0.771, p<0.001; r=0.557, p<0.001; r=0.770, p<0.001; r=0.517, p<0.001, respectively). Maximum leaflet thickness and maximum leaflet displacement were independent predictors of increased PWD in linear regression analysis (?=1.456, p<0.001, ?=-0.851, p<0.001). Conclusion: Patients with classic MVP exhibited prolonged PWD values compared with non-classic MVP patients and normal controls.
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    Determining ECG Parameters for Electrical Risk Score in Patients with Non-ST Elevation Myocardial Infarction
    (2025) Öncel, Can Ramazan; Çoner, Ali; Köseoğlu, Cemal
    [Abstract Not Available]
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    Effect of astaxanthin in imatinib mesylate-induced cardiotoxicity
    (Alanya Alaaddin Keykubat Üniversitesi, 2020) Övey, İshak Suat; Öncel, Can Ramazan
    Aim: Imatinib mesylate is a tyrosine kinase inhibitor and is approved as a standard first-line therapy of chronic myeloid leukemia. Oxidative stress, as well as intracellular calcium overload and mitochondrial dysfunction, play an important role in chemotherapy-induced cardiotoxicity. The underlying pathophysiological mechanism associated with imatinib-induced cardiotoxicity is not well understood. In the present study, we investigated alterations in calcium influx, oxidative stress and apoptosis through transient receptor potential melastatin 2 (TRPM2) channels. Also, we aimed to investigate if there is a modulator role of astaxanthin in cardiomyocytes during imatinib mesylate-induced cardiotoxicity. Materials and methods: The cells were divided into seven main control groups: imatinib, imatinib+antranilic acid, imatinib+astaxanthin, imatinib+antranilic acid+astaxanthin, astaxanthin and astaxanthin+antranilic acid groups. Cells in the groups were stimulated with cumene hydroperoxide and inhibited with antranilic acid in related experiments for activation and inactivation of TRPM2 channels, respectively. We measured cytosolic calcium, intracellular reactive oxygene, mitochondrial depolarization, caspase 3 and caspase 9 levels.Results: The apoptosis values were significantly lower in the astaxanthin and the imatinib+astaxanthin group than in the imatinib group of cardiomyocytes (p&lt; 0.001). The cell viability values were significantly higher in the imatinib+astaxanthin+antranilic acid (p&lt;0.001) and the imatinib+astaxanthin (p&lt;0.05) groups, than in the imatinib group.Conclusions: As a result, we found that TRPM2 channels were found in cardiomyocyte cells and they were activated by reactive oxygen species. Also, we showed that overactivated TRPM2 channels are associated with increased cytosolic free calcium, oxidative stress and apoptotic cell injury in imatinib mesylate-induced cardiotoxicity, whereas astaxanthin could have a modulator role in this instance.
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    Evaluation of the novel electrocardiographic parameters in patients with acute cholecystitis
    (Alanya Alaaddin Keykubat Üniversitesi, 2019) Öncel, Can Ramazan; Çalış, Hasan
    Aim: Acute cholecystitis (AC) can display electrocardiographic changes mim-icking cardiovascular disorders. The aim of this study is to evaluate electrocardiographic changes with novel parameters in patients with AC. Methods: This study included 34 patients with AC and 30 controls. Control group was consisted of age and gender matched individuals without any cardiovascular and systemic disease. Demographic and clinical data were recorded. The electrocardiographic measurements were done in order to calculate QT interval , corrected QT (QTc) interval, peak and the end of the T wave (Tp-e), Tp-e/QT ratio and p wave durations. Results: In our study there was no significant difference b etween two g roups in terms of demographic data and clinical features. QT interval , corrected QT (QTc) interval, peak and the end of the T wave (Tp-e), and p wave durations were similiar in the two groups. No statistically significant difference was found between two groups in terms of p wave dispersion and Tp-e/QT ratio. ( 38.0±3.9 vs 37.9±4.4, p:0.93; 0.21±0.07 vs 0.20±0.09, p:0.26 respectively) Conclusion: Patients with acute cholecystitis have similiar electrophysiological properties of myocardium and atrium on electrocardiography as compared with healthy controls.
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    Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with acute pancreatitis
    (Alanya Alaaddin Keykubat Üniversitesi, 2020) Güler, Yılmaz; Öncel, Can Ramazan
    Aim: Acute pancreatitis may affect cardiovascular system regardless of etiology. Electrocardiographic parameters such as QT interval, corrected QT interval (QTc), Tp-e interval and Tp-e/QT, Tp-e/QTc ratio can be used to evaluate myocardial repolarization. We aimed to investigate the effects of acute pancreatitis on the cardiovascular system and the relationship between ventricular repolarization parameters and the severity of the disease.Methods: Ventricular repolarization parameters (QT interval, QTc interval, Tp-e/QT, Tp-e/QTc ratio) of the patients who were included in the study and diagnosed with acute pancreatitis were compared with the control group patients. In addition, these parameters and Ranson, APACHE II and amylase values were taken into account in all patients in the pancreatitis group and the relationship between the severity of the disease and cardiac parameters was investigated.Results: 60 patients (30 acute pancreatitis and 30 control) were examined. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were significantly higher in the acute pancreatitis group compared to the control. In addition, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios showed a positive correlation with the Ranson and APACHE II scores and Tp-e interval displayed a positive correlation with amylase levels.Conclusions: Tp-e interval, Tp-e/QT and Tp-e/QTc ratios can be used as a marker for the detection of ventricular arrhythmia risk in acute pancreatitis patients and Tp-e/QT and Tp-e/QTc ratios increased depending on the severity of AP and Tp-e interval increased in parallel with higher levels of amylase. Amylase level alone could be an indicator for increased risk of ventricular arrhythmia in patients with acute pancreatitis.
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    Factors Associated with Aortic Stiffness Index, Aortic Velocity Propagation, and Epicardial Fat Thickness in Pregnancy
    (Kare Publications, 2025) Köseoğlu, Cemal; Öncel, Can Ramazan; Çoner, Ali
    I found the study titled “The Effect of Number of Pregnancies on Aortic Stiffness Index, Aortic Velocity Propagation, and Epicardial Fat Thickness” by Şaylık et al.,1 published in the Archives of the Turkish Society of Cardiology, to be highly interesting. We would like to highlight several important aspects of this well-written study.
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    Management of Ventricular Pseudoaneurysms
    (2024) Köseoğlu, Cemal; Öncel, Can Ramazan
    [Abstract Not Available]
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    P wave dispersion in patients with erectile dysfunction
    (Akademiai Kiado Zrt, 2019) Öncel, Can Ramazan; Akkoç, Ali
    Background and aims: P wave dispersion (PWD) has been reported to be a non-invasive electrocardiographic predictor for atrial fibrillation. The aim of this study is to evaluate PWD between men with erectile dysfunction (ED) and healthy controls in order to investigate whether PWD was prolonged in patients with ED and related to severity of the disease. Methods: This study included a total of 72 men (42 patients with ED and 30 healthy controls). Demographic data and clinical features were recorded on admission. An electrocardiographic evaluation was obtained to measure PWD values for both patients and controls. Results: Maximum P wave duration was 108.5 +/- 4.7 and 108.3 +/- 4.3 in ED group and control group, respectively (p = 0.748). Minumum P wave duration was significantly higher in the control group than in the ED group. PWD was 48.1 +/- 5.9 in the ED group. As a result, PWD was prolonged in patients with ED (48.1 +/- 5.9 vs. 38.0 +/- 3.9, p < 0.05). A significant negative correlation was observed between IIEF score and PWD values (p < 0.05, r = -0.662). Conclusions: Patients with ED exhibited prolonged PWD values compared with normal controls. In addition, PWD was found to be associated with severity of the disease.
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    Predicting Postoperative Atrial Fibrillation Using HARMS2-AF Score
    (2024) Öncel, Can Ramazan; Köseoğlu, Cemal; Dagasan, Goksel; Çoner, Ali; Ayhan, Selçuk; Akkaya, Özgür; Karahan, Oğuz
    Background: Postoperative atrial fibrillation (POAF) remains a common complication after cardiac surgery. The ability to accurately identify patients at risk through previous risk scores is limited. This study aimed to evaluate the new HARMS2-AF risk score to pre- dict POAF after coronary artery bypass grafting (CABG) surgery. Methods: In this retrospective cohort study, we included 265 patients undergoing CABG surgery from 2022-2023. Data were obtained from the medical files of the patients and hospital records. Each patient was assigned a HARMS2-AF risk score. A univariate and multivariate regression analyses were done to analyze independent predictors of POAF. Results: Of 265 patients, 49 had postoperative atrial fibrillation. HARMS2-AF score was significantly higher in patients with POAF. Age, sleep apnea, left atrial diameter (LAd), and HARMS2-AF score were independently associated with POAF. A HARMS2-AF score ? 4.5 predicted POAF with 91% sensitivity and 64% specificity (AUC = 0.787, 95% CI = 0.731- 0.842, P < .001). Conclusion: The HARMS2-AF score is a strong predictor of atrial fibrillation (AF) develop- ment after isolated CABG surgery. It can be used as a novel stratification tool to estimate AF after cardiac surgery.
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    Predictive factors for longer length of hospital stay in patients with heart failure
    (Turkish Soc Cardiology, 2019) Öncel, Can Ramazan
    [No abstract available]
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    Protective effects of N-acetyl cysteine against paclitaxel-induced cardiotoxicity through modulation of transient receptor potential melastatin 2 channels
    (Gazi Univ, Fac Med, 2019) Öncel, Can Ramazan; Övey, İshak Suat
    Aim : In our study, we investigated the paclitaxel induced cardiotoxicity and alterations in Ca2+ influx, oxidative stress and apoptosis through transient receptor potential melastatin 2 (TRPM2) channels and modulator role of N-acetyl cysteine (NAC) in cardiomyocytes. Material and Methods : All cells were cultured at 37 degrees C. The cells were divided into seven main groups. Cells in the paclitaxel group were incubated with 2.5 mu M Paclitaxel for 12 hours and cells in the NAC+Paclitaxel group were incubated with 2.5 mu M Paclitaxel for 12 hours and then incubated with 10 mu M NAC for 24 hours. Intracellular free calcium concentration, reactive oxygen species (ROS) production measurements and cell viability analyses were done according to the study protocol. Results : Cytosolic calcium levels, apoptosis levels, intracellular ROS production levels were lower in paclitaxel+NAC group than in the paclitaxel group of cardiomyocytes. Also values were markedly lower in the paclitaxel+NAC+antranilic acid group when compared to the paclitaxel+ NAC group. Conclusion : We found that TRPM2 channels are overactivated during paclitaxel induced cardiotoxicity and NAC could show a cardioprotective effect through TRPM2 channel modulation.
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    Red cell distribution width and subclinical left ventricular dysfunction in patients with ankylosing spondylitis
    (Alanya Alaaddin Keykubat Üniversitesi, 2018) Kocabaş, Hilal; Küçük, Murathan; Öncel, Can Ramazan; Yıldırım, Aytul Belgi; Kaçar, Cahit
    Aim: The aim of this study is to investigate the relationship between left ventricular function and red cell distribution width (RDW) measured by myocardial performance index in patients with Ankylosing Spondylitis (AS). Patients and Methods: The study included 35 patients with AS and 38 controls. Control group was consisted of age and gender matched individuals without any cardiologic complaint and systemic disease. Laboratory parameters including RDW tests and transthoracic echocardiographic evaluation were conducted consecutively on the entire cohort of ankylosing spondylitis patients and healthy individuals. Results: In our study, no statistically significant difference was found between two groups, in terms of general properties such as age, gender, Body Mass Index (BMI), body surface area, systolic and diastolic blood pressure, smoking, serum lipid levels and blood glucose levels. ESR and CRP levels of AS group were found to be significantly higher compared to that of control group. EF and FS, which are among the parameters of systolic function, were normal in all individuals of both groups and there was no significant difference between two groups. However, myocardial performance index (MPI ) was higher in patients with AS than in controls. In addition, we showed a significant positive correlation between RDW and MPI (r: 0.372 , p: 0.001). Conclusion: Myocardial performance index may be useful for the early diagnosis of potential heart failure, by providing an earlier diagnosis of left ventricular dysfunction in patients with ankylosing spondylitis. Also , red cell distribution width was significantly correlated with myocardial performance index in these patients.
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    Soluble suppression of tumorigenicity-2 for risk stratification in outpatients with heart failure
    (2018) Öncel, Can Ramazan
    [No abstract available]
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    The cardioprotective role of trimetazidine on cisplatin-induced cardiotoxicity
    (2020) Küçük, Murathan; Öncel, Can Ramazan
    [No abstract available]
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    The effect of melatonin on digoxin-induced cardiac damage in cardiomyocytes
    (Comenius Univ, 2019) Övey, İshak Suat; Öncel, Can Ramazan
    OBJECTIVES: Digoxin is a cardiac glycoside which is widely used in cardiovascular medicine. Oxidative stress, as well as intracellular Ca2+ overload, plays an important role in digoxin toxicity. Transient receptor potential vanilloid 1 (TRPV1) channels are found in cardiomyocyte cells and they are activated by reactive oxygen species. We investigated the effects of digoxin toxicity and alterations in Ca2+ influx, oxidative stress and apoptosis through TRPV1 channels and modulator role of melatonin in cardiomyocytes. METHODS: The cells were divided into seven main groups as control, digoxin, digoxin+capsazepine, digoxin+melatonin, digoxin+capsazepine+melatonin, melatonin and melatonin+capsazepine groups. Cells in the groups were stimulated with capsaicin and inhibited with capsazepine in related experiments for activation and inactivation of TRPV1 channels, respectively. We measured cytosolic calcium, intracellular reactive oxygen, mitochondrial depolarization, caspase 9 and caspase 3 levels. RESULTS: The apoptosis values were significantly lower in the melatonin and digoxin+ melatonin groups than in the digoxin group of cardiomyocytes (p < 0.001). The cell viability values were higher in the digoxin+ capsazepine (p < 0.001), digoxin+melatonin (p < 0.001) and digoxin+melatonin+capsazepine (p < 0.001) groups than in the digoxin group. CONCLUSION: TRPV1 channels are overactivated during digoxin toxicity and melatonin could show a cardioprotective effect through TRPV1 channel modulation (Fig. 5, Ref. 56).
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    The potential of artificial intelligence and machine learning algorithms in the field of cardiovascular diseases
    (2024) Öncel, Can Ramazan; Aslan, Ahmet
    Artificial intelligence (AI) and machine learning (ML) is a form of intelligence that has a wide-reaching impact on various aspects of contemporary life, including the field of medicine. Artificial intelligence tools and technology are utilized for the early identification and diagnosis of severe or intricate heart conditions. The potential of artificial intelligence (AI) in cardiovascular medicine is significant. However, the major challenges hindering the development of AI applications in this field include the scarcity of diverse data and limited availability of huge datasets. These revolutionary digital technologies will play a significant role in shaping the future of cardiology.
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    The role of atrial myocardial deformation parameters in determining cardioversion success in atrial fibrillation patients
    (Gazi Univ, Fac Med, 2019) Öncel, Can Ramazan; Küçük, Murathan; Yıldırım, Aytül Belgi
    Aim: To investigate the role of left atrial myocardial deformation parameters measured by speckle tracking method in predicting cardioversion success in addition to conventional echocardiographic measurements in cardioversion (CV) planned patients with persistent atrial fibrillation (AF). Material and Methods: 60 patients scheduled for cardioversion were evaluated and 40 patients with atrial fibrillation were included in the study. Patients with sinus rhythm continuing after 24 hour monitoring were classified as group 1, and patients with AF were classified as group 2. Group 1 patients are divided into 2 groups according to 1st month ECG, as sinus rhythm maintained group and AF detected group. Results: The global left atrial strain S (LA S-S) and the global left atrial strain rate S (LA SR-S) measured before and after cardioversion were found to be significantly lower in the group with failed cardioversion (group 2) than those with successful group (group 1). The predictive value of LAVI value in cardioversion success was found to be 39 mL/m(2). At first month; LA SR-S measured before and after cardioversion in the maintained sinus rhythm group was significantly higher than the atrial fibrillation recurrence group. Also; the LA S-S, measured after cardioversion, was found to be significantly higher in the maintained sinus rhythm group. Conclusion: We showed that atrial myocardial deformation parameters could play role in determining CV success in patients with persistant atrial fibrillation. In addition; we determined that the LA SR-S value was as sensitive and specific parameter as LAVI in predicting cardioversion success.