Dr. MERAL KAYIKÇIOĞLU
Kardiyoloji Uzmanı
Adres: Ege Üniversitesi Tıp Fakültesi Kardiyoloji Ana bilim Dalı /İZMİR
Telefon iş: 0 232 3905448
E-posta: meral.kayikcioglu@ege.edu.tr
Kişisel Bilgiler
Doğum Yeri/Tarihi: İzmir / 20.07.1970
Medeni Hali: Evli ve iki çocuklu
Yabancı Dil: İngilizce
Öğrenim ve Mesleki Hayatı
Ortaokul
Üsküdar Amerikan Kız Koleji ve Nişantaşı Anadolu Lisesi, İstanbul
Lise
Bornova Anadolu Lisesi, İzmir
Üniversite
Ege Üniversitesi Tıp Fakültesi, İzmir
1988-1994
Tıpta Uzmanlık
Ege Üniversitesi Tıp Fakültesi Kardiyoloji AD, İzmir
1995-1999
Uzman Dr.
Doç. Dr.
Prof. Dr.
Mesleki Çalışmaları
Ege Üniversitesi Tıp Fakültesi Kardiyoloji AD, İzmir
Ege Üniversitesi Tıp Fakültesi Kardiyoloji AD, İzmir
Ege Üniversitesi Tıp Fakültesi Kardiyoloji AD, İzmir
1999-2004
2004-2011
2011-Halen
- 1996’dan beri EÜTF Kardiyoloji Anabilim dalı’nda haftada 2 gün Lipid polikliniğini
yürütmektedir.
- Uzmanlık döneminden itibaren EÜTF Kardiyoloji Anabilim Dalı Ekokardiyografi
laboratuarında da aktif olarak çalışmaktadır.
- 2004’de ABD’da (San Diego) UCSD Thornton Hastanesi Pulmoner hipertansiyon
merkezi’nde gözlemci olarak bulunmuştur. 2008’de de EÜTF PAH Merkezi kurulmuştur
ve burada da görevine devam etmektedir. Bu alanda 2012 yılında kurulan TKD Pulmoner
vasküler proje grubunda halen çalışmaktadır.
-2009-2014 döneminde Avrupa Kardiyoloji Derneği’nin Kardiyovasküler Hastalıklardan
Korunma amaçlı projesinde Ulusal Koordinatör (National Coordinator) olarak görev
yapmıştır
-Türk Kardiyoloji Derneği tarafından, Avrupa Kardiyoloji Derneği’nin öncülük ettiği
“Kadın Kalbinde Kırmızı Alarm (Red Alert for Women’s Hearts)” projesinde araştırıcı
olarak görevlendirilmiştir ve bu amaçla 2009’da kurulan Kadın kalp sağlığı grubunda
TKD bünyesinde halen çalışmaktadır.
-2013’de kurulan ‘Kadın kalbine Hanım Eli’ platformu kurucu üyesidir. Halkımızda kadın
kalp sağlığı farkındalığını hedefleyen bu projede aktif olarak görev yapmaktadır.
Araştırma alanları:
KV korunma, dislipidemiler, ailesel hiperkolesterolemi, prematüre miyokard infarktüsü,
herediter trombofililer, hemodializ hastalarında KV tutulum, pulmoner hipertansiyon, eko
Yayınları (pubmed)
1: Kayıkçıoğlu M, Kısmalı E, Can L, Payzin S. Long-term follow-up in patients with homozygous
familial hypercholesterolemia; 13-year experience of a university hospital lipid clinic. Turk Kardiyol Dern
Ars. 2014 Oct;42(7):599-611. doi: 10.5543/tkda.2014.09633.
2: Kayıkçıoğlu M. Management of adult patients with Eisenmenger syndrome. Turk Kardiyol Dern Ars.
2014 Sep;42(6):542-4. doi: 10.5543/tkda.2014.37539.
3: Kayıkçıoğlu M, Yavuzgil O, Eroğlu Z, Onay H, Ergenoğlu M, Can L. Hereditary thrombophilia (factor
V R2-mutation) as a contributing factor in premature myocardial infarction associated with pregnancy.
Anadolu Kardiyol Derg. 2014 Nov;14(7):652-4. doi: 10.5152/akd.2014.5506.
4: Atay S, Tetik A, Bozok Çetintaş V, Yakar Tülüce S, Tülüce K, Kayıkçıoğlu M, Eroğlu Z. Beta-myosin
heavy-chain mutations R403QLW, V606M, K615N and R663H in patients with hypertrophic
cardiomyopathy. Anadolu Kardiyol Derg. 2014 May;14(3):244-50. doi: 10.5152/akd.2014.4730.
5: Prugger C, Wellmann J, Heidrich J, De Bacquer D, Perier MC, Empana JP, Reiner Ž, Fras Z,
Jennings C, Kotseva K, Wood D, Keil U; EUROASPIRE Study Group. Passive smoking and smoking
cessation among patients with coronary heart disease across Europe: results from the EUROASPIRE
III survey. Eur Heart J. 2014 Mar;35(9):590-8. doi: 10.1093/eurheartj/eht538.
6: Terek D, Kayikcioglu M, Kultursay H, Ergenoglu M, Yalaz M, Musayev O, Mogulkoc N, Gunusen I,
Akisu M, Kultursay N. Pulmonary arterial hypertension and pregnancy. J Res Med Sci. 2013
Jan;18(1):73-6.
7: Asci G, Tz H, Ozkahya M, Duman S, Demirci MS, Cirit M, Sipahi S, Dheir H, Bozkurt D, Kircelli F, Ok
ES, Erten S, Ertilav M, Kose T, Basci A, Raimann JG, Levin NW, Ok E; EGE Study Group. The impact
of membrane permeability and dialysate purity on cardiovascular outcomes. J Am Soc Nephrol. 2013
May;24(6):1014-23. doi: 10.1681/ASN.2012090908.
8: Hur E, Usta M, Toz H, Asci G, Wabel P, Kahvecioglu S, Kayikcioglu M, Demirci MS, Ozkahya M,
Duman S, Ok E. Effect of fluid management guided by bioimpedance spectroscopy on cardiovascular
parameters in hemodialysis patients: a randomized controlled trial. Am J Kidney Dis. 2013
Jun;61(6):957-65. doi: 10.1053/j.ajkd.2012.12.017.
9: ORIGIN Trial Investigators, Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP,
Pogue J, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S. Basal insulin and
cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012 Jul 26;367(4):319-28. doi:
10.1056/NEJMoa1203858.
10: ORIGIN Trial Investigators, Bosch J, Gerstein HC, Dagenais GR, Díaz R, Dyal L, Jung H, Maggiono
AP, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S. n-3 fatty acids and cardiovascular
outcomes in patients with dysglycemia. N Engl J Med. 2012 Jul 26;367(4):309-18. doi:
10.1056/NEJMoa1203859.
11: Kozan O, Ozcan EE, Sancaktar O, Kabakcı G; Turkish investigators of the i-SEARCH study. The
prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive
patients. Turk Kardiyol Dern Ars. 2011 Dec;39(8):635-45. doi: 10.5543/tkda.2011.01477.
12: Demirci MS, Gungor O, Kircelli F, Carrero JJ, Tatar E, Demirci C, Kayikcioglu M, Asci G, Toz H,
Ozkahya M, Ok E. Impact of mean arterial pressure on progression of arterial stiffness in peritoneal
dialysis patients under strict volume control strategy. Clin Nephrol. 2012 Feb;77(2):105-13.
doi:10.5414/CN107223.
13: Demirci MS, Celik G, Ozkahya M, Tumuklu M, Toz H, Asci G, Duman S, Basci A, Kircelli F,
Ozdogan O, Demirci C, Can L, Isik IO, Ok E; Long Dialysis Group. Effects of thrice weekly nocturnal
hemodialysis on arterial stiffness. Atherosclerosis. 2012 Feb;220(2):477-85.
doi:10.1016/j.atherosclerosis.2011.11.015.
14: Kozan O; RiskMan Study Group. An observational study to evaluate the clinical practice of
cardiovascular risk management among hypertensive patients in Turkey. Turk Kardiyol Dern Ars. 2011
Sep;39(6):445-55. doi: 10.5543/tkda.2011.01592.
15: Prugger C, Keil U, Wellmann J, de Bacquer D, de Backer G, Ambrosio GB, Reiner Z, Gaita D,
Wood D, Kotseva K, Heidrich J; EUROASPIRE III Study Group. Blood pressure control and knowledge
of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey.
J Hypertens. 2011 Aug;29(8):1641-8. doi: 10.1097/HJH.0b013e328348efa7.
16: Karaca E, Kayıkçıoğlu M, Onay H, Gündüz C, Ozkınay F. The effect of interleukin-10 gene
promoter polymorphisms on early-onset coronary artery disease. Anadolu Kardiyol Derg. 2011
Jun;11(4):285-9. doi: 10.5152/akd.2011.077.
17: Kayikçioğlu M. Ischemic heart disease in women. Turk Kardiyol Dern Ars. 2010 Mar;38 Suppl
1:41-9. Review. Turkish. PubMed PMID: 21491715.
18: Saygi S, Asci G, Dheir H, Duman S, Kayikcioglu M, Yilmaz M, Ozkahya M, Ok E. Ventricular
arrhythmia in dialysis patients: a link with higher hemoglobin levels? Hemodial Int. 2011 Apr;15(2):2505. doi: 10.1111/j.1542-4758.2011.00532.x.
19: Hasdemir C, Ulucan C, Yavuzgil O, Yuksel A, Kartal Y, Simsek E, Musayev O, Kayikcioglu M,
Payzin S, Kultursay H, Aydin M, Can LH. Tachycardia-induced cardiomyopathy in patients with
idiopathic ventricular arrhythmias: the incidence, clinical and electrophysiologic characteristics, and the
predictors. J Cardiovasc Electrophysiol. 2011 Jun;22(6):663-8. doi: 10.1111/j.1540-8167.2010.01986.x.
20: Can LH, Kayıkçıoğlu M, Yavuzgil O, Kültürsay H, Soydan I. [Evaluation of hospitalization period
and five-year follow-up of patients admitted with acute coronary syndrome following coronary artery
bypass graft surgery]. Turk Kardiyol Dern Ars. 2010 Sep;38(6):387-92.
21: Ok E, Duman S, Asci G, Tumuklu M, Onen Sertoz O, Kayikcioglu M, Toz H, Adam SM, Yilmaz M,
Tonbul HZ, Ozkahya M; Long Dialysis Study Group. Comparison of 4-and 8-h dialysis sessions in
thrice-weekly in-centre haemodialysis: a prospective, case-controlled study. Nephrol Dial Transplant.
2011 Apr;26(4):1287-96. doi: 10.1093/ndt/gfq724.
22: Yakar Tuluce S, Kayikcioglu M, Tuluce K, Yilmaz MG, Ozdogan O, Aydın M, Hasdemir C.
Assessment of left atrial appendage function during sinus rhythm in patients with hypertrophic
cardiomyopathy: transesophageal echocardiography and tissue doppler study. J Am Soc Echocardiogr.
2010 Nov;23(11):1207-16. doi:10.1016/j.echo.2010.08.016
23: Kayikçioğlu M. The etiopathogenesis of pulmonary hypertension: inflammation, vascular
remodeling. Anadolu Kardiyol Derg. 2010 Aug;10 Suppl 1:5-8. doi:10.5152/akd.2010.113.
24: Asci G, Ok E, Savas R, Ozkahya M, Duman S, Toz H, Kayikcioglu M, Branscum AJ, MonierFaugere MC, Herberth J, Malluche HH. The link between bone and coronary calcifications in CKD-5
patients on haemodialysis. Nephrol Dial Transplant. 2011 Mar;26(3):1010-5. doi: 10.1093/ndt/gfq491.
25: Ozdogan O, Yuksel A, Gurgun C, Kayikcioglu M, Yavuzgil O, Cinar CS. Assessment of cardiac
remodeling in asymptomatic mitral regurgitation for surgery timing: a comparative study of
echocardiography and magnetic resonance imaging. Cardiovasc Ultrasound. 2010 Aug 13;8:32. doi:
10.1186/1476-7120-8-32.
26: Tokgözoğlu L, Kaya EB, Erol C, Ergene O; EUROASPIRE III Turkey Study Group. [EUROASPIRE
III: a comparison between Turkey and Europe]. Turk Kardiyol Dern Ars. 2010 Apr;38(3):164-72.
27: Ozdogan O, Kayikcioglu M, Asci G, Ozkahya M, Toz H, Sezis M, Can LH, Ok E. Left atrial volume
predicts mortality in low-risk dialysis population on long-term low-salt diet. Am Heart J. 2010
Jun;159(6):1089-94.
28: Hasdemir C, Aydin HH, Celik HA, Simsek E, Payzin S, Kayikcioglu M, Aydin M, Kultursay H, Can
LH. Transcriptional profiling of septal wall of the right ventricular outflow tract in patients with idiopathic
ventricular arrhythmias. Pacing Clin Electrophysiol. 2010 Feb;33(2):159-67. doi:
10.1111/j.1540-8159.2009.02606.x.
29: Kayikçioğlu M, Soydan I. Egg consumption and cardiovascular health. Turk Kardiyol Dern Ars.
2009 Jul;37(5):353-7.
30: Ozdogan O, Yuksel A, Gurgun C, Kayikcioglu M, Yavuzgil O, Cinar CS. Evaluation of the severity
of mitral regurgitation by the use of signal void in magnetic resonance imaging. Echocardiography.
2009 Nov;26(10):1127-35. doi:10.1111/j.1540-8175.2009.00968.x.
31: Kayikçioğlu M, Kültürsay H. Current approach to the treatment of pulmonary arterial hypertension
and our experience in the Cardiology Department of Medicine Faculty of Ege University]. Turk Kardiyol
Dern Ars. 2009 Dec;37(8):580-90. Review.
32: Ozdogan O, Yilmaz GM, Gurgun C, Kayikcioglu M, Cinar CS. Right ventricular adaptations along
with left ventricular remodeling in older athletes. Echocardiography. 2009 Mar;26(3):237-45. doi:
10.1111/j.1540-8175.2008.00810.x.
33: Kayikcioglu M, Tumuklu M, Ozkahya M, Ozdogan O, Asci G, Duman S, Toz H, Can LH, Basci A,
Ok E. The benefit of salt restriction in the treatment of end-stage renal disease by haemodialysis.
Nephrol Dial Transplant. 2009 Mar;24(3):956-62. doi: 10.1093/ndt/gfn599.
34: Bozkaya YT, Aydin HH, Celik HA, Kayikcioglu M, Payzin S, Kultursay H, Aydin M, Yesil M, Can
LH, Hasdemir C. Increased myocardial collagen turnover in patients with progressive cardiac
conduction disease. Pacing Clin Electrophysiol. 2008 Oct;31(10):1284-90. doi: 10.1111/j.15408159.2008.01179.x.
35: Kayikçioğlu M, Kültürsay H. [Seven years of experience in patients with pulmonary arterial
hypertension in Ege University Hospital: diagnostic approach of a single center . Anadolu Kardiyol
Derg. 2008 Aug;8(4):279-85. Turkish.
36: Mominadam S, Ozkahya M, Kayikcioglu M, Toz H, Asci G, Duman S, Ergin P, Kirbiyik S, Ok E,
Basci A. Interdialytic blood pressure obtained by ambulatory blood pressure measurement and left
ventricular structure in hypertensive hemodialysis patients. Hemodial Int. 2008 Jul;12(3):322-7.
doi:10.1111/j.1542-4758.2008.00275.x.
37: Ulucan C, Cetintas V, Tetik A, Eroglu Z, Kayikcioglu M, Can LH, Payzin S, Aydin M, Hasdemir C.
Beta1 and beta2-adrenergic receptor polymorphisms and idiopathic ventricular arrhythmias. J
Cardiovasc Electrophysiol. 2008 Oct;19(10):1053-8. doi: 10.1111/j.1540-8167.2008.01202.x.
38: Eroğlu Z, Selvi N, Kosova B, Biray C, Kumral E, Topçuoğlu N, Kayikçioğlu M. Absence of
apolipoprotein B-3500 mutation in Turkish patients with coronary and cerebrovascular atherosclerosis.
Anadolu Kardiyol Derg. 2008 Feb;8(1):7-9.
39: Tumuklu MM, Etikan I, Kisacik B, Kayikcioglu M. Effect of obesity on left ventricular structure and
myocardial systolic function: assessment by tissue Doppler imaging and strain/strain rate imaging.
Echocardiography. 2007 Sep;24(8):802-9.
40: Hasdemir C, Yavuzgil O, Payzin S, Aydin M, Ulucan C, Kayikcioglu M, Can LH, Turkoglu C,
Kultursay H. Angiographic analysis of the anatomic relation of coronary arteries to mitral and tricuspid
annulus and implications for radiofrequency ablation. Am J Cardiol. 2007 Aug 15;100(4):666-71
41: Ulucan C, Yavuzgil O, Kayikçioğlu M, Can L, Payzin S, Kültürsay H, Soydan I, Hasdemir C.
Pseudonormalization: clinical, electrocardiographic, echocardiographic, and angiographic
characteristics. Anadolu Kardiyol Derg. 2007 Jul;7 Suppl 1:175-7.
42: Bozkaya YT, Eroğlu Z, Kayikçioğlu M, Payzin S, Can LH, Kültürsay H, Hasdemir C. Repolarization
characteristics and incidence of Torsades de Pointes in patients with acquired complete atrioventricular
block. Anadolu Kardiyol Derg. 2007 Jul;7 Suppl 1:98-100.
43: Kayikcioglu M, Saygi S, Azarsiz E, Can LH, Kultursay H, Sözmen EY. Serum paraoxonase 1
activity and oxidative markers of LDL in patients with cardiac syndrome X. Acta Cardiol. 2007
Jun;62(3):245-9.
44: Hasdemir C, Aktas S, Govsa F, Aktas EO, Kocak A, Bozkaya YT, Demirbas MI, Ulucan C, Ozdogan
O, Kayikcioglu M, Can LH, Payzin S. Demonstration of ventricular myocardial extensions into the
pulmonary artery and aorta beyond the ventriculo-arterial junction. Pacing Clin Electrophysiol. 2007
Apr;30(4):534-9
45: Kayikcioglu M, Eroglu Z, Kosova B, Olukman M, Karatas A, Can LH, Hasdemir C. Acute
myocardial infarction following an arthropod bite: is hereditary thrombophilia a contributing factor?
Blood Coagul Fibrinolysis. 2006 Oct;17(7):581-3.
46: Briel M, Schwartz GG, Thompson PL, de Lemos JA, Blazing MA, van Es GA, Kayikçioglu M,
Arntz HR, den Hartog FR, Veeger NJ, Colivicchi F, Dupuis J,Okazaki S, Wright RS, Bucher HC,
Nordmann AJ. Effects of early treatment withstatins on short-term clinical outcomes in acute coronary
syndromes: a meta-analysis of randomized controlled trials. JAMA. 2006 May 3;295(17):2046-56
47: Yavuzgil O, Altay B, Zoghi M, Gürgün C, Kayikçioğlu M, Kültürsay H. Endothelial function in
patients with vasculogenic erectile dysfunction. Int J Cardiol. 2005 Aug 3;103(1):19-26.
48: Kayikçioğlu M, Ildizli M, Gürgün C, Soydan I. Cardiac thrombus due to protein C deficiency.
Anadolu Kardiyol Derg. 2005 Jun;5(2):135-7. Turkish.
49: Kayikçioğlu M, Aksu K, Hasdemir C, Keser G, Turgan N, Kültürsay H, Doganavsargil E.
Endothelial functions in Behçet's disease. Rheumatol Int. 2006 Feb;26(4):304-8.
50: Gulpek D, Bayraktar E, Akbay SP, Capaci K, Kayikcioglu M, Aliyev E, Soydas C. Joint
hypermobility syndrome and mitral valve prolapse in panic disorder. Prog Neuropsychopharmacol Biol
Psychiatry. 2004 Sep;28(6):969-73.
51: Gündüz R, Payzin S, Kayikçioğlu M, Hasdemir C. Sinus node deceleration during exercise stress
testing: Bezold-Jarisch reflex versus sinus node ischemia. Anadolu Kardiyol Derg. 2004 Jun;4(2):181-3.
52: Evrengul H, Dursunoglu D, Kayikcioglu M, Can L, Tanriverdi H, Kaftan A, Kilic M. Effects of a beta-
blocker on ventricular late potentials in patients with acute anterior myocardial infarction receiving
successful thrombolytic therapy. Jpn Heart J. 2004 Jan;45(1):11-21.
53: Sekuri C, Kayikcioglu M, Kayikcioglu O. Retinal artery macroaneurysm as initial presentation of
hypertension. Int J Cardiol. 2004 Jan;93(1):87-8.
54: Danaoğlu Z, Kültürsay H, Kayikçioğlu M, Can L, Payzin S. Effect of statin therapy added to ACEinhibitors on blood pressure control and endothelial functions in normolipidemic hypertensive patients.
Anadolu Kardiyol Derg. 2003 Dec;3(4):331-7.
55: Kayikcioglu M, Payzin S, Yavuzgil O, Kultursay H, Can LH, Soydan I. Benefits of statin treatment
in cardiac syndrome-X1. Eur Heart J. 2003 Nov;24(22):1999-2005.
56: Azarsiz E, Kayikcioglu M, Payzin S, Yildirim Sözmen E. PON1 activities and oxidative markers of
LDL in patients with angiographically proven coronary artery disease. Int J Cardiol. 2003 Sep;91(1):4351.
57: Evrengul H, Kayikcioglu M, Can L, Payzin S, Kultursay H. Effect of pre-infarction angina on
ventricular late potentials in patients with acute myocardial infarction and successful thrombolysis. Acta
Cardiol. 2003 Aug;58(4):295-301.
58: Kayikcioglu M, Can L, Evrengul H, Payzin S, Kultursay H. The effect of statin therapy on
ventricular late potentials in acute myocardial infarction. Int J Cardiol. 2003 Jul;90(1):63-72.
59: Tümüklü M, Kayikçioğlu M, Aliyev E, Cinar CS, Soydan I. [Evaluation of early alterations in
transmitral diastolic flow and tissue Doppler findings of the Basal segments of both ventricles in early
period after coronary angioplasty]. Anadolu Kardiyol Derg. 2003 Mar;3(1):16-23, AXVII-AXVIII.
60: Can L, Kayikcioglu M, Evrengul H, Kultursay H, Payzin S, Turkoglu C. Serial analyses of
ventricular late potentials in patients with reciprocal ST segment changes during acute myocardial
infarction. Jpn Heart J. 2003 Jan;44(1):1-10.
61: Kültürsay H, Kayikçioğlu M. [Apoptosis and cardiovascular disease]. Anadolu Kardiyol Derg. 2002
Dec;2(4):323-9.
62: Kayikçioğlu M, Can LH, Payzin S, Kültürsay H, Soydan I. The combined use of sildenafil with
epoprostenol in a patient with primary pulmonary hypertension]. Anadolu Kardiyol Derg. 2002
Sep;2(3):262-4.
63: Kayikçioğlu M, Can L, Kültürsay H, Payzin S, Turkoğlu C. Early use of pravastatin in patients with
acute myocardial infarction undergoing coronary angioplasty. Acta Cardiol. 2002 Aug;57(4):295-302.
PubMed PMID: 12222700.
64: Kayikçioglu M, Can L, Mete-Erdem N, Kültürsay H, Payzin S, Kokuludag A, Türkoglu C. Soluble Pselectin and the success of thrombolysis in acute myocardial infarction. Int J Cardiol. 2001 Jul;79(23):223-9. PubMed PMID: 11461745.
65: Can L, Kayikçioğlu M, Halil H, Kültürsay H, Evrengül H, Kumanlioğlu K, Türkoglu C. The effect of
myocardial surgical revascularization on left ventricular late potentials. Ann Noninvasive Electrocardiol.
2001 Apr;6(2):84-91. PubMed PMID: 11333164.
66: Kayikçioglu O, Kayikçioglu M, Erakgün T, Güler C. Electrocardiographic changes during
subconjunctival injections. Int Ophthalmol. 1999;23(1):37-41. PubMed PMID: 11008897.
67: Kayikçioğlu M, Ozerkan F, Soydan I. Effectiveness and safety of alternate-day simvastatin and
fenofibrate on mixed hyperlipidemia. Am J Cardiol. 1999 Apr 1;83(7):1135-7, A9. PubMed PMID:
10190536.