Person: ATAŞ, HALİL
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ATAŞ
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HALİL
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Publication Metadata only Evaluation of arterial stiffness and hemodynamics by oscillometric method in patients with systemic sclerosis(SPRINGER WIEN, 2013) ÇİNÇİN, AHMET ALTUĞ; Sunbul, Murat; Tigen, Kursat; Ozen, Gulsen; Durmus, Erdal; Kivrak, Tarik; Cincin, Altug; Kepez, Alper; Atas, Halil; Direskeneli, Haner; Basaran, YeldaArterial stiffness and its hemodynamic consequences are associated with adverse cardiovascular events. Pulse wave velocity (PWV) and augmentation index (AIx) are noninvasive markers of arterial stiffness. Systemic sclerosis (SSc) is a systemic, autoimmune disease affecting mainly the small vessels. The aim of this study was to evaluate the arterial stiffness parameters and hemodynamics by oscillometric method in patients with SSc. Thirty-five consecutive patients with diagnosed SSc and 35 age- and sex-matched healthy controls were included in the study. Measurements of arterial stiffness were carried out by using a Mobil-O-Graph arteriograph system that detected signals from the brachial artery. While hemodynamic parameters were not statistically significant between SSc and control groups, heart rate was significantly higher in SSc group (84 +/- 12 and 72 +/- 7 bpm, p = 0.001). SSc patients had significantly higher AIx and PWV values compared with controls (27.9 +/- 12.4 versus 21.0 +/- 11.4 %, p = 0.019 and 6.56 +/- 1.5 versus 5.04 +/- 0.17 m/s, p < 0.001, respectively). PWV was significantly associated with SSc when adjusted by heart rate (p = 0.001, Odds ratio (OR): 17.304, 95 % confidence interval (CI): 3.225-92.832). PWV and AIx were significantly higher in patients with SSc. Measurement of arterial stiffness parameters using oscillometric method was reliable, reproducible and easy in patients with SSc.Publication Metadata only Successful Treatment of a Giant Left Atrial Mass Stemming from Pulmonary Vein after Chemotherapy-radiotherapy Combination in a Patient with Lung Adenocarcinoma(ELSEVIER SCIENCE INC, 2016) ATAŞ, HALİL; Besiroglu, Fatih; Atas, Halil; Sunbul, Murat; Samadov, Fuad; Oguz, Mustafa; Sari, IbrahimPublication Metadata only Assessment of left atrial volume and function in patients with psoriasis by using real time three-dimensional echocardiography(SPRINGER WIEN, 2015) ÇİNÇİN, AHMET ALTUĞ; Atas, Halil; Kepez, Alper; Bozbay, Mehmet; Gencosmanoglu, Dilek Seckin; Cincin, Altug; Sunbul, Murat; Bozbay, Ayfer Yildiz; Darvishova, Ramila; Ergun, TulinBackground Left atrial (LA) volume has been identified as a predictor of adverse cardiovascular outcomes, both in the general population and in selected clinical conditions. The aim of this study was to evaluate the effect of psoriasis on LA volume and mechanical function. Methods A total of 40 consecutive normotensive psoriasis patients free of any cardiovascular disease and 39 healthy volunteers were included. All participants underwent comprehensive transthoracic echocardiographic examination. LA volume and mechanical function were evaluated using real-time three-dimensional echocardiography (RT3DE). Results There were no significant differences between psoriasis and control groups with regard to conventional echocardiographic parameters. Individuals with psoriasis had a higher incidence of left ventricular diastolic dysfunction (LVDD) than the controls; nine people with psoriasis (23 %) and three control individuals (8 %) had LVDD (p = 0.06). With regard to the parameters obtained from RT3DE, LA maximum, LA minimum, passive stroke volume, and passive emptying fraction were significantly higher; whereas LA active emptying fraction, LA total emptying fraction, LA expansion index, and active stroke volume values were significantly lower in individuals with psoriasis compared with controls. Disease duration and Psoriasis Area of Severity Index (PASI) score correlated with the majority of volume parameters. Conclusion Individuals with psoriasis had higher LA phasic volumes and impaired LA mechanical function compared with healthy controls. LA volume and functional analysis with RT3DE may facilitate recognition of subtle LA dysfunction in patients with psoriasis.Publication Metadata only Regional myocardial dysfunction assessed by two-dimensional speckle tracking echocardiography in systemic sclerosis patients with fragmented QRS complexes(CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2014) ÇİNÇİN, AHMET ALTUĞ; Tigen, Kursat; Sunbul, Murat; Ozen, Gulsen; Durmus, Erdal; Kivrak, Tarik; Cincin, Altug; Ozben, Beste; Atas, Halil; Direskeneli, Haner; Basaran, YeldaBackground: The aim of the study was to explore the relation between regional myocardial dysfunction and fragmented QRS (fQRS) complexes in systemic sclerosis (SSc). Methods: Fifty-three SSc patients and 26 controls were included. All subjects underwent speckle tracking echocardiography for evaluation of left ventricular (LV) function and ECG to check for fQRS complexes. Results: SSc patients had significantly lower LV global longitudinal, radial and circumferential strain and twist compared to controls. Thirteen SSc patients had fQRS (DII, DIII, aVF leads in eleven patients and V1 to V5 leads in two patients) and they had significantly lower global longitudinal and circumferencial strain compared to SSc patients with normal QRS. The SSc patients with fQRS in DII, DIII, and aVF leads had impaired longitudinal strain and delay in time to peak longitudinal strain in inferior LV segments compared to those with normal QRS. Conclusion: fQRS is associated with lower strain measures in SSc patients indicating impairment in LV function. (C) 2014 Elsevier Inc. All rights reserved.Publication Metadata only Heart Failure and Mortality in Patients With Nonvalvular Atrial Fibrillation Started on Novel Oral Anticoagulant Therapy: A Single-Center Experience(SAGE PUBLICATIONS INC, 2017) ÇİNÇİN, AHMET ALTUĞ; Sunbul, Murat; Oguz, Mustafa; Dogan, Zekeriya; Atas, Halil; Bozbay, Mehmet; Cincin, Altug; Agirbasli, MehmetHeart failure (HF) is the leading cause of in-hospital morbidity and mortality in the elderly population. Coexistence of HF and atrial fibrillation (AF) increases the risk of thromboembolic events. Oral anticoagulant therapy reduces the risk of thromboembolic events in patients with AF. Novel oral anticoagulants (NOACs) have been introduced as an alternative drug for prevention from thromboembolic events in patients with nonvalvular AF. The primary aim of this study is to investigate the clinical effects of warfarin, dabigatran, and rivaroxaban in patients with nonvalvular AF. The secondary aim of this study is to reveal the predictors of all-cause mortality in patients with nonvalvular AF undergoing NOACs therapy. The study population consisted of 171 patients with nonvalvular AF. Patients were divided into 3 groups according to the usage of oral anticoagulant therapy including coumadin (51 patients), dabigatran (52 patients), and rivaroxaban (68 patients). Although CHA2DS2-VASc score was similar between groups, HAS-BLED score was significantly higher in patients using rivaroxaban. Dyspepsia and itching were more common in patients using dabigatran. Heart failure and vascular disease were more common in the nonsurviving group (10 patients) than in the surviving group (110 patients) in patients using NOACs. Among age, sex, HF, hypertension, vascular disease, and CHA2DS2-VASc, which were included in the regression model, only the presence of HF was an independent predictor of all-cause mortality in patients using NOACs. In conclusion, the mortality rate is significantly higher in patients with HF using NOACs. Moreover, HF is an independent predictor of all-cause mortality in patients using NOACs.Publication Open Access The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction(WILEY, 2018-03) ÇİNÇİN, AHMET ALTUĞ; Kanar, Batur G.; Tigen, Mustafa K.; Sunbul, Murat; Cincin, Altug; Atas, Halil; Kepez, Alper; Ozben, BesteBackgroundRight ventricular (RV) involvement in inferior myocardial infarction (MI) increases in-hospital morbidity and mortality. HypothesisRV systolic dysfunction assessed by 2-dimensional speckle tracking echocardiography (STE) might be a predictor of early mortality in patients with acute inferior MI. MethodsEighty-one consecutive patients with acute inferior MI (mean age, 60.812.7years; 18 females) were included. RV myocardial involvement was defined as an elevation >1mm in V-1 or V4R within 12hours of symptom onset. RV function was assessed by STE. Patients were followed for 30days for all-cause mortality. ResultsThirty-eight patients had RV myocardial involvement, and they had significantly lower tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (RVS), and left ventricular (LV) and RV global longitudinal strain (GLS). Nine patients (11%) died within 30days. The mean age of mortality group was higher with more female frequency. They had significantly higher pro-BNP, hs-troponin T, and creatinine levels, but lower hemoglobin levels. TIMI 3 flow was significantly less achieved in mortality group. RV myocardial involvement was more frequent in the mortality group, and they had significantly lower TAPSE, RVS, and LV and RV GLS. Multivariate analysis revealed that age and RV GLS were independent predictors of early mortality. RV GLS -14% predicted early mortality in patients with acute inferior MI with a sensitivity of 88.9% and a specificity of 62.5% (AUC: 0.817, P =0.002). ConclusionsRV GLS may be useful in predicting early mortality in patients with acute inferior MI.Publication Open Access Subclinical Regional Myocardial Dysfunction Assessed by Two-Dimensional Speckle Tracking Echocardiography in Systemic Sclerosis Patients with Fragmented QRS Complexes(ELSEVIER SCIENCE INC, 2013-10) ÇİNÇİN, AHMET ALTUĞ; Sunbul, Murat; Tigen, Kursat; Ozen, Gulsen; Durmus, Erdal; Kivrak, Tarik; Cincin, Altug; Ozben, Beste; Atas, Halil; Direskeneli, Haner; Basaran, YeldaPublication Metadata only Evaluation of Cardiac Function by Two-Dimensional Speckle Tracking Echocardiography in Ulcerative Colitis Patients(SPRINGER, 2014) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Sunbul, Murat; Kivrak, Tarik; Atas, Halil; Sari, Ibrahim; Tigen, Kursat; Kani, Tarik; Akin, Hakan; Imeryuz, Nese; Basaran, YeldaPurpose Although ulcerative colitis (UC) shows obvious similarities with other autoimmune diseases, cardiac consequences have not adequately introduced. The aim of our study was to evaluate left ventricular (LV) function in UC patients by using novel echocardiographic parameters. Results Forty-five UC patients (mean age 37, 18 female) and 90 age-and sex-matched healthy volunteers (mean age 40, 38 female) included in the study. The mean disease activity score according to partial Mayo score was 2.16 +/- 2.13. Mean global longitudinal strain (GLS) and global longitudinal strain rate (GLSR) measurements were significantly lower (-21.16 +/- 2.71 vs. -23.36 +/- 3.34; p < 0.001 and -1.33 +/- 0.24 vs. -1.43 +/- 0.24; p = 0.037, respectively), whereas global circumferential (-22.67 +/- 3.66 vs. -23.37 +/- 3.99; p = 0.140) and global radial strain (43.07 +/- 8.58 vs. 44.12 +/- 9.32; p = 0.545) measurements of the LV were similar in patients with UC compared with controls. The correlation coefficient (r) between GLS and partial Mayo score was -0.578 (p < 0.001). Conclusion Our study suggests that systolic cardiac deformation values are impaired in UC patients. Reduced GLS and GLSR might be an early indicator of cardiac involvement in this population.Publication Open Access Potential Causes and Implications of Low Target Therapeutic Ratio in Warfarin-Treated Patients for Thrombosis Prophylaxis: A Single-Center Experience(SAGE PUBLICATIONS INC, 2018-04) KEPEZ, ALPER; Atas, Halil; Sahin, Ahmet Anil; Atas, Dilek Barutcu; Sunbul, Murat; Kepez, Alper; Agirbasli, MehmetTime in therapeutic range (TTR) of international normalized ratio is crucial for the safety and efficacy of anticoagulation with warfarin and it is influenced by many factors. There are limited data about the quality of warfarin therapy and its effects on clinical outcomes in Turkey. The aim of this study is to demonstrate the quality of anticoagulant therapy with warfarin and evaluate the parameters that affect the quality of warfarin therapy. A total of 170 patients with atrial fibrillation (AF; mean age: 62.2 +/- 13.3; 69.2% female) treated with warfarin were included in this study. The mean follow-up period was 20 +/- 8.4 months. The mean TTR levels of all patients were found to be 54.2% +/- 21.4%. The TTR levels were similar in patients with valvular AF (VAF) and nonvalvular AF (NVAF). Logistic regression analysis revealed that elderly, heart failure (HF), and renal dysfunction were independent predictors of lower TTR. There were no significant differences between the VAF and NVAF subgroups regarding the incidence of mortality, stroke, and myocardial infarction. Cox regression analysis revealed that HF, coronary artery disease, and renal dysfunction were independent predictors of clinical outcomes in addition to lower TTR. Our results provide data regarding the quality of anticoagulation with warfarin from a single tertiary center in Istanbul, Turkey. The questions remain in seeking quality improvement in anticoagulation.Publication Open Access A Rare Case of Acute Pulmonary Embolism after Coronary Angiography due to Sand Bag Compression(2013-06-27) ATAŞ, HALİL; Kivrak, Tarik; Durmus, Erdal; Atas, Halil; Sunbul, Murat; Sari, Ibrahim