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 Effects of diabetes mellitus on left atrial volume and functions in normotensive patients without symptomatic cardiovascular disease(ELSEVIER SCIENCE INC, 2014) KEPEZ, ALPER; Atas, Halil; Kepez, Alper; Atas, Dilek Barutcu; Kanar, Batur Gonenc; Dervisova, Ramile; Kivrak, Tarik; Tigen, Mustafa KursatPurpose: Left atrial (LA) size has been shown to be a predictor of adverse cardiovascular outcomes. The aim of the study was to evaluate the direct effect of diabetes mellitus (DM) on left atrial volume and phasic functions by using real-time three-dimensional echocardiography (RT3DE) in a population of patients free of symptomatic cardiovascular disease and hypertension. Methods: Comprehensive transthoracic echocardiographic examination was performed on 40 consecutive patients with DM (20 male, age: 50.5 +/- 7.3 years) and 40 healthy controls (20 male, age: 48.4 +/- 6.7 years). In addition to conventional 2D echocardiographic measurements RT3DE was performed to assess LA volumes and phasic functions. Results: There were no significant difference between groups regarding parameters reflecting LV systolic function as LV diameters and ejection fraction. However, regarding parameters reflecting LV diastolic function; transmitral deceleration time and E/E' ratio values were significantly higher and majority of early diastolic tissue Doppler velocity values were significantly lower in diabetic patients compared with controls. RT3DE demonstrated significantly higher LA maximum and minimum volumes for diabetic patients compared with controls (40.9 +/- 11.9 vs 34.6 +/- 9.3 mL, p: 0.009 and 15.6 +/- 5.9 vs 11.9 +/- 4.6 mL, p: 0.002, consecutively). LA total emptying fraction (TEF), expansion index (El) and active emptying fraction (AEF) were found to be significantly lower in diabetics reflecting depressed LA reservoir and pump functions. There was no significant difference between groups regarding passive emptying fraction (PEF) which is assumed to be a marker of left atrial conduit function. Conclusion: Patients with type 2 diabetes mellitus were found to have increased LA volume and impaired atrial compliance and contractility. Evaluation of asymptomatic diabetic patients by using RT3DE atrial volume analysis may facilitate recognition of subtle myocardial alterations related with type 2 diabetes. (C) 2014 Elsevier Inc. All rights reserved.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 Open Access Short and Long Term Mortality Predictors in Octogenarians with Acute Coronary Syndromes(2018-06-30) ÖZBEN SADIÇ, BESTE; Atas, Halil; Tigen, Kursat; Ozben, Beste; Kartal, Fatih; Gurel, Emre; Atas, Dilek B; Sari, İbrahim; Basaran, YeldaPurpose: Octogenarians with acute coronary syndromes have higher mortality and morbidity due to higher prevalence of comorbidities and frailty. The aim of this study was to explore the predictors of short and long term mortality in octogenarians with ACS. Methods: Ninety-eight consecutive octogenarians presenting with acute coronary syndrome (mean age:84±3 years, 56 male) were included. All patients underwent coronary angiography and were given optimal medical treatment. The primary end point was cardiovascular mortality in hospital and at one year. Results: Fifteen patients died during hospitalization and 20 patients died after discharge within the first year. ST-segment-elevation myocardial infarction and hypotension were significantly more prevalent in the in-hospital mortality group while atrial fibrillation and hyponatremia were more prevalent in the long-term mortality group. All deceased patients had significantly lower left ventricular ejection fraction and glomerular filtration rate. Cox analysis revealed ST-segment-elevation myocardial infarction, hypotension and left ventricular ejection fraction as independent predictors of in-hospital mortality while hyponatremia, atrial fibrillation and renal dysfunction as independent predictors of long term mortality. Conclusion: It would be reasonable to pay further attention to octogenarians with acute coronary syndrome if they are presenting with ST-segment-elevation myocardial infarction, and have hypotension, impaired left ventricular function, hyponatremia, atrial fibrillation or renal dysfunction, which are associated with increased mortality.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 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 A Case of Decompensated Heart Failure Due to Prosthetic Valve Dysfunction: Quick Diagnosis with Fluoroscopy(AVES, 2015-07-23) ÇİNÇİN, AHMET ALTUĞ; Cincin, Ahmet Altug; Ozben, Beste; Atas, Halil; Tigen, KursatIntroduction: Patients with decompensated heart failure due to prosthetic heart valves consists of a challenging group in emergency clinics for both diagnosis and treatment. Despite the important role in diagnosis, transthoracic echocardiography (TTE) remains unsatisfactory in many cases. Case Report: A 65-year-old female patient with decompensated heart failure and a history of valve replacement surgery 6 years ago for both mitral and aortic valves was admitted. The diagnosis of prosthetic valve dysfunction was successfully fixed using fluoroscopy, despite the fact that initial TTE was not adequate enough to assess valve function. Conclusion: In cases that TTE is not accessible or inadequate enough to assess valve function, fluoroscopy is a practical and quick method to rule out prosthetic valve dysfunction.Publication Metadata only Subacute aortic prosthetic mechanical valve thrombosis complicated with acute coronary syndrome(W B SAUNDERS CO-ELSEVIER INC, 2018) ÇİNÇİN, AHMET ALTUĞ; Kanar, Batur Gonenc; Tigen, Kursat; Atas, Halil; Cincin, Altug; Ozben, BesteA prosthetic valve thrombosis (PVT), which is a potentially fatal complication, refers to the presence of non-infective thrombotic material on a prosthetic valve apparatus, interfering with its function. Possible complications of a PVT include transient neurologic embolic events, cardiac arrest due to a stuck valve prosthesis, and cardio-embolic myocardial infarction (MI). The choice of treatments, including a redo surgery, a percutaneous coronary intervention (PCI), and a fibrinolysis with PVT or MI dosages, depends on the patient's dinical and hemodynamic status and thrombotic burden involving the prosthetic valve and surrounding tissues. An early post-operative mechanical valve thrombosis is associated with increased risks due to the need for unforeseen early redo surgery complications and excessive bleeding risk in case of thrombolytic therapy usage. Here, we present a fifty-seven-year old female patient who was admitted to the emergency department with the complaint of acute chest pain seven days after an aortic prosthetic mechanical valve implantation. The clinical presentation was consistent with ST segment elevated MI and echocardiography revealed a large mass on the recently implanted prosthetic aortic valve. Valvular thrombotic complications after heart valve replacement operations are associated with high morbidity and mortality rates. Efficient and urgent treatment is necessary. Considering the clinical status of the patient, we preferred fibrinolytic therapy rather than PC1 or surgery. The aim of this case report was to show the efficiency and safety of low-dose slow-infusion fibrinolytic therapy in PVT complicated with acute coronary syndrome. (C) 2018 Elsevier Inc. All rights reserved.Publication Open Access Percutaneous and surgical removal of two cases of embolized totally implantable venous access devices that were implanted a long time ago(2015-03-06) ÇİNÇİN, AHMET ALTUĞ; Atas, Halil; Sari, Ibrahim; Cincin, Altug; Tigen, KursatPublication Metadata only Effect of acute sleep deprivation on heart rate recovery in healthy young adults(SPRINGER HEIDELBERG, 2015) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Sari, Ibrahim; Oguz, Mustafa; Sert, Sena; Bozbay, Mehmet; Atas, Halil; Ozben, Beste; Tigen, Kursat; Basaran, YeldaSleep deprivation (SD) is known to be associated with increased incidence of adverse cardiovascular events, but underlying pathophysiological mechanism has not been clearly demonstrated. Autonomic nervous system plays an important role in the regulation of cardiovascular function, and impairment in this system is associated with increased cardiovascular mortality. The aim of the current study was to investigate the effect of acute SD on autonomic regulation of cardiac function by determining heart rate recovery (HRR). Twenty-one healthy security officers and nine nurses (mean age 33.25 +/- 8.18) were evaluated. Treadmill exercise test was applied once after a night with regular sleep and once after a night shift in hospital. The HRR was calculated as the reduction in heart rate from peak exercise to the 30th second (HRR30), 1st minute (HRR1), 2nd minute (HRR2), 3rd minute (HRR3), and 5th minute (HRR5). The change in blood pressure (BP) measurements was also determined. Exercise capacity of individuals with SD was significantly lower (10.96 +/- 1.01 vs. 11.71 +/- 1.30 metabolic equivalent task (MET)s; p = 0.002), and peak systolic BP was significantly higher (173.8 +/- 16.3 vs. 166.2 +/- 9.9; p = 0.019). There was a signicant difference in HRR30 (12.74 +/- 6.19 vs. 17.66 +/- 5.46; p = 0.003) and HRR1 (31 +/- 6.49 vs. 36.10 +/- 7.78; p = 0.004). The ratio of these indices to peak HR was also significantly lower with SD (HRR%(30) 8.04 +/- 4.26 vs. 10.19 +/- 3.21; p = 0.025 and HRR%(1): 18.66 +/- 4.43 vs. 20.98 +/- 4.72; p = 0.013). The difference in other indices of HRR was not significant. Our findings suggest that SD blunts cardiovascular autonomic response, and consequences of this relation might be more pronounced in subjects who are exposed to sleeplessness regularly or in subjects with baseline cardiovascular disease.