Person: MUTLU, BÜLENT
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MUTLU
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BÜLENT
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Publication Open Access Characteristics, management, and outcomes of patients with left-sided infective endocarditis complicated by heart failure: a substudy of the ESC-EORP EURO-ENDO (European infective endocarditis) registry(2022-07-01) MUTLU, BÜLENT; Bohbot Y., Habib G., Laroche C., Stohr E., Chirouze C., Hernandez-Meneses M., Melissopoulou M., Mutlu B., Scheggi V., Branco L., et al.Aims To evaluate the current management and survival of patients with left-sided infective endocarditis (IE) complicated by congestive heart failure (CHF) in the ESC-EORP European Endocarditis (EURO-ENDO) registry. Methods and results Among the 3116 patients enrolled in this prospective registry, 2449 (mean age: 60years, 69% male) with left-sided (native or prosthetic) IE were included in this study. Patients with CHF (n = 698, 28.5%) were older, with more comorbidity and more severe valvular damage (mitro-aortic involvement, vegetations >10 mm and severe regurgitation/new prosthesis dehiscence) than those without CHF (all p 10 mm, severe valvular regurgitation and/or new prosthetic dehiscence, perivalvular complication, and prosthetic IE (OR 0.22, 95% CI 0.12-0.38; p < 0.001) and in 1-year mortality (HR 0.29, 95% CI 0.20-0.41; p < 0.001). Conclusion Congestive heart failure is common in left-sided IE and is associated with older age, greater comorbidity, more advanced lesions, and markedly higher 30-day and 1-year mortality. Early surgery is strongly associated with lower mortality but is performed on only approximately half of patients with CHF, mainly because of a surgical risk considered prohibitive.Publication Metadata only Left Ventricular Strain and Strain Rate by Two-Dimensional Speckle Tracking Echocardiography in Patients with Subclinical Hypothyroidism(2012-11-01) SÜNBÜL, MURAT; MUTLU, BÜLENT; SÜNBÜL M., Kivrak T., Yildiz H., Durmus E., Kanar B., Ozben B., MUTLU B.Publication Open Access The angiogenic gene profile of pulmonary endarterectomy specimens: Initial study(2023-01-01) ERMERAK, NEZİH ONUR; YILMAZ, BETÜL; BATIREL, SAİME; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; ERMERAK N. O., YILMAZ B., BATIREL S., OLGUN YILDIZELİ Ş., KOCAKAYA D., MUTLU B., Tas S., YILDIZELİ B.© 2023 The Author(s)Objectives: The underlying mechanisms for the development of chronic thromboembolic pulmonary hypertension and prognostic biomarkers are not clear yet. Thus, our aim is to assess and identify new biomarkers for the expression of 84 key genes linked to angiogenesis. Methods: Patients who had levels more than 1000 dynes·sec·cm−5 were included in the test group, and the other patients were included in the control group. Twelve specimens were taken from the patients. RT2 Profiler PCR Array (Qiagen) was used to quantify the expression of the 84 key genes. Results: Eight patients (6 male, 2 female, median age 54.4 ± 13.1 years) who underwent pulmonary endarterectomy were included. Pulmonary vascular resistance improved significantly from 811 ± 390 dyn/s/cm−5 to 413.3 ± 144.9 dyn/s/cm−5 (P .005) after surgery. Median length of hospital stay was 11.62 ± 2.97 days. The test group had a distinct pattern of impaired angiogenic and antiangiogenic genes. The expression levels of TGFA, TGFB1, THBS2, THBS1, TGFBR1, SERPINE1, SERPINF1, TGFB2, TIMP2, VEGFC, IFNA1, TNF, CXCL10, NOS3, IGF1, and MMP14 were downregulated in the specimens from the patients who had higher pulmonary vascular resistance values, whereas some genes, including PDGFA, showed upregulation that was statistically nonsignificant in the same group. Conclusions: These results can lead to the development of new markers that could predict adverse outcomes of patients with CTEPH. Identification of new markers that are related to worse outcomes would enable screening patients for early diagnosis and treatment.Publication Metadata only The effects of iron replacement on functional capacity in patients with group 1 and group 4 pulmonary hypertension(2022-10-01) ATAŞ, HALİL; KOCAKAYA, DERYA; YILDIZELİ, BEDRETTİN; MUTLU, BÜLENT; Akaslan D., Aslanger E., ATAŞ H., Kanar B. G. , KOCAKAYA D., YILDIZELİ B., MUTLU B.Objective: Abnormal iron handling complicates pulmonary hypertension and causes functional limitation and poor outcomes. Although preliminary results in group 1 pulmonary hypertension patients support the use of iron replacement, whether this applies to other PH subgroups is not known.Publication Open Access Effects of balloon pulmonary angioplasty procedure on electrocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension(2023-03-01) KOL, AYHAN; KEPEZ, ALPER; ATAŞ, HALİL; MUTLU, BÜLENT; KOL A., KEPEZ A., Akaslan D., Kanar B., ATAŞ H., MUTLU B.Aim: The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting post-operative hemodynamic improvement in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).Material and methods: A total of 32 patients were included in the study. During ECG analysis, parameters that have been suggested to be related to right ventricular hypertrophy and/or dilatation were evaluated. The sig-nificance of the change in each parameter obtained at the pre-BPA visit and at the scheduled control visit 6 months after BPA was tested. In addition to ECG analysis, data related to right heart catheterization (RHC) and echocardiography, B-type natriuretic peptide (BNP) levels and World Health Organization (WHO) functional classifications of all patients were also recorded. The relationship between the amount of possible change in ECG parameters and the amount of possible change in hemodynamic parameters was investigated.Results: The Daniel score, which has been suggested to have prognostic value in acute pulmonary embolism, decreased from 8.22 +/- 5.68 to 6.56 +/- 5.55 after the BPA procedure (p: 0.035). Among all parameters studied, only T wave height (V2 t) in V2 derivation changed significantly from-0.77 +/- 2.39 to 1.27 +/- 2.58 mm (p: 0.036). The amount of change in V2 T was found to significantly correlate with the amount of change in systolic right ventricular pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and systemic vascular resistance.Conclusion: Postprocedural T wave changes in lead V2 might serve as a marker of hemodynamic improvement in patients with CTEPH who undergo BPA.Publication Metadata only Pulmoner arter sarkomanın cerrahi sonuçları: Histoloji sağkalımı etkiler mi(2023-08-01) BOZKURTLAR, EMİNE; OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; KOCAKAYA, DERYA; BEKİROĞLU, GÜLNAZ NURAL; YILDIZELİ, BEDRETTİN; Başar V., Olgun Yıldızeli Ş., Bozkurtlar E., Ercelep ., Mutlu B., Kocakaya D., Bekiroğlu G. N., Taş S., Sunar H., Küçükoğlu M. S., et al.Publication Metadata only Extracellular matrix collagen biomarker levels in patients who underwent pulmonary endarterectomy(2023-04-01) OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; Zengin A., Kalkan R., Aydin K. Y., OLGUN YILDIZELİ Ş., MUTLU B., Karakoc A. Z., Tas S., Sunar H., Kilic U., Yanartas M., et al.OBJECTIVES: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension (CTEPH) is not well known. Our goal was to investigate the matrix metalloproteinase (MMP)-2 and -9 protein levels in patients with CTETH.Publication Open Access Intra-aortic balloon occlusion for refractory cardiac arrest in a patient with anterior myocardial infarction(2022-12-01) YILDIRIM, ÇAĞAN; UYSALER, EREN; NİZAM, AHMET CEM; ATAŞ, HALİL; TİGEN, MUSTAFA KÜRŞAT; MUTLU, BÜLENT; Aslanger E., Akaslan D., Yıldırım Ç., Uysaler E., Nizam A. C., Jafarov E., ATAŞ H., TİGEN M. K., MUTLU B.Despite recent advances in its management, the outcome of cardiac arrest is often poor despite appropriate cardiopulmonary resuscitation. The arteriovenous perfusion gradient achieved dur ing cardiopulmonary resuscitation is associated with the successful return of spontaneous cir culation. Continuous balloon occlusion of the descending aorta is an experimental method that can occlude the \"unnecessary\" part of the circulation, thus diverting generated pressure and blood flow to the heart and brain. In this study, we present a case report of a patient unre sponsive to standard cardiopulmonary resuscitation, in whom constant intra-aortic balloon occlusion achieved a return of spontaneous circulation and successful survival.Publication Open Access Bendopnea predicts right ventricular energy failure in patients with pulmonary hypertension(2023-10-01) ATAŞ, HALİL; MUTLU, BÜLENT; Akaslan D., Aslanger E., Basa C. İ., Öztürk R. K., ATAŞ H., MUTLU B.OBJECTIVE: The development of right ventricular failure has a significant adverse prognostic impact on the course of pulmonary hypertension. Right ventricular energy failure has been shown to double the mortality of pulmonary hypertension even after correction for many established risk predictors. We hypothesize that bendopnea may indicate right ventricular energy failure in patients with pulmonary hypertension. METHODS: We prospectively enrolled patients with pulmonary hypertension who were admitted to our pulmonary hypertension outpatient clinic between January 2021 and June 2021. Bendopnea was assessed by asking patients to bend forward and report any shortness of breath within 30 seconds. Routine physical examination, laboratory tests, echocardiography, and right heart catheterization parameters were collected. RESULTS: A total of 167 patients were enrolled into the study. Bendopnea and right ventricular energy failure was present in 79 (47.3%) and 43 (25.7%) patients, respectively. Bendopnea accurately predicted the presence of right ventricular energy failure (area under the curve, 0.667; 95% CI, 0.574-0.760; P < 0.001) and had a significantly superior diagnostic power compared with many other symptoms and signs. CONCLUSIONS: Our study shows that bendopnea predicts right ventricular energy failure in patients with pulmonary hypertension and can be added to our physical examination armamentarium as an easy, rapid, and noninvasive prognostic tool.