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MUTLU, BÜLENT

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2014 - 20162
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Author: SÜNBÜL, MURAT × Subject: pulmonary endarterectomy ×

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    PublicationOpen Access
    Effect of pulmonary endarterectomy on six-minute walking test and echocardiography in the early stage
    (TURKISH SOC CARDIOLOGY, 2016) YILDIZELİ, BEDRETTİN; Kivrak, Tarik; Durmus, Erdal; Sunbul, Murat; Yildizeli, Bedrettin; Mutlu, Bulent
    Objective: Pre- and postoperative changes in echocardiographic parameters and results of 6-minute walking test (6-MWT) were investigated in the present study. Methods: Seventy-six patients (32 males, 44 females; mean age 45.9 +/- 15.1 years) were included. Before and after surgery, 6-MWT and echocardiography were performed. Changes in postoperative parameters were compared to basal walking test and other basal parameters. Results: Distance covered in 6-MWT significantly increased after surgery (p<0.001). Significant decrease in right ventricular diameter and pressure, and significant increase in left ventricular diameter were also observed. While changes in ejection fraction (EF) were not significant, significant reduction in systolic pulmonary artery pressure (sPAP) and tricuspid regurgitation were observed. No statistically significant correlation was observed between baseline 6-MWT results and echocardiographic parameters. Conclusion: The present study was the first to investigate the correlation between baseline 6-MWT results and right ventricular echocardiographic parameters. Myocardial performance index (MPI) and TAPSE were important parameters in follow-up after pulmonary endarterectomy. Improvement in quality of life parameters was also important.
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    Evaluation of Improvement in Exercise Capacity after Pulmonary Endarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension: Correlation with Echocardiographic Parameters
    (GEORG THIEME VERLAG KG, 2014) KEPEZ, ALPER; Kepez, Alper; Sunbul, Murat; Kivrak, Tarik; Eroglu, Elif; Ozben, Beste; Yildizeli, Bedrettin; Mutlu, Bulent
    BackgroundThe study evaluates the alterations in exercise capacity of chronic thromboembolic pulmonary hypertension (CTEPH) patients after pulmonary endarterectomy (PEA) and investigates the echocardiographic parameters associated with the degree of functional recovery. MethodsThirty consecutive patients with the diagnosis of CTEPH (17 males; mean age, 45.915.1 years) who had been referred for PEA operation were included in the study. Each patient underwent transthoracic echocardiography and 6-minute walk test (6-MWT) before and 6 months after PEA. ResultsAfter PEA, 6-MWT distances significantly increased (242.8 +/- 112.8 m vs. 423.6 +/- 89.1 m, p<0.001), whereas systolic pulmonary artery pressures and right ventricular dimensions significantly decreased (86 +/- 25.1mm Hg vs. 41.9 +/- 15.6mm Hg, p<0.001 and 42.1 +/- 10.1mm vs. 35.3 +/- 5.6mm, p<0.001, respectively). Magnitude of change in 6-MWT distance (-6-MWT) was found to be correlated with concomitant change in tricuspid annular plane systolic excursion and left ventricular myocardial performance index (r: 0.518, p: 0.004 and r: -0.385, p: 0.043, respectively). Linear regression analysis revealed preoperative 6-MWT distance as an independent negative predictor of delta-6-MWT (beta: -0.89, t: -3.97, p: 0.001). ConclusionCTEPH patients with more severely depressed exercise capacity at baseline displayed relatively greater degree of functional recovery after PEA in our study. Improvement in functional capacity was found to be correlated with improvement in parameters reflecting right ventricular functions rather than improvement in pulmonary artery pressure after PEA operation.