Person: SÜNBÜL, MURAT
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SÜNBÜL
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Publication Metadata only The effect of cardiac rehabilitation on blood pressure, and on left atrial and ventricular functions in hypertensive patients(WILEY, 2021) ÇİNÇİN, AHMET ALTUĞ; Sahin, Ahmet Anil; Ozben, Beste; Sunbul, Murat; Yagci, Ilker; Sayar, Nurten; Cincin, Altug; Gurel, Emre; Tigen, Kursat; Basaran, YeldaPurpose Hypertension is associated with left ventricular (LV) hypertrophy, impaired LV relaxation, and left atrial (LA) enlargement. Cardiac rehabilitation (CR) improves clinical outcomes in a broad spectrum of cardiac disease. The aim of our study was to determine the effect of CR on blood pressure (BP), and on LA and LV functions in hypertensive patients. Methods Thirty consecutive hypertensive patients who would undergo CR program, and 38 hypertensive patients who refused to undergo CR program were included. All patients underwent ambulatory BP monitoring and transthoracic echocardiography, which were repeated after completion of the CR program, or 12 weeks later in the control group. LA and LV functions were assessed by both speckle tracking and 3-dimensional echocardiography. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were assessed before and after CR. Results Although initial ambulatory BP values and NT-proBNP levels were similar between the groups, daily, day-time, and night-time BP and NT-proBNP were significantly lower in the CR group after rehabilitation. LA reservoir strain and LV global longitudinal strain of the CR group significantly increased after CR while no significant increase was observed in controls. Conclusion CR improves LA and LV strain while lowering BP and should be encouraged in routine management of hypertensive patients.Publication Metadata only The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients(SPRINGER, 2020) YOLDEMİR, AHMET TEVFİK; Paudel, Ashok; Tigen, Kursat; Yoldemir, Tevfik; Guclu, Mehmet; Yildiz, Ipek; Cincin, Altug; Sunbul, Murat; Gurel, Emre; Sayar, Nurten; Ozben, BestePreeclampsia is a maternal disorder of pregnancy characterized by concomitant increase in preload and afterload with end organ dysfunction. The aim of our study is to evaluate left ventricular (LV) and right ventricular (RV) functions with speckle tracking echocardiography in preeclamptic patients. Fifty-five preeclamptic (mean age: 30.7 +/- 5.9 years) and 35 healthy pregnant women (mean age: 28.8 +/- 5.7 years) of the same race, similar age and gestational week were consecutively included. The diagnosis of preeclampsia was based on the criteria proposed by the American College of Obstetricians and Gynecologists. LV and RV functions were assessed by both conventional and speckle tracking echocardiography after the 30th gestational week and at the postpartum 6th months. The preeclamptic patients had significantly larger left atrium, thicker interventricular septum, higher systolic pulmonary artery pressure and mitral E/e ' ratio compared to controls during pregnancy while LV ejection fraction was similar. Preeclamptic patients had significantly lower LV and RV global longitudinal strain (GLS) during pregnancy compared to controls (- 18.0 +/- 2.6% vs. - 19.8 +/- 2.1% p = 0.001 and - 26.7 +/- 3.3% vs. 28.9 +/- 3.3% p = 0.002, respectively). In the postpartum period, while LVGLS values of preeclamptic patients increased significantly (- 18.0 +/- 2.6% vs. - 20.4 +/- 2.4% p < 0.001) and became similar to those of controls at the sixth month, the RVGLS decreased significantly (- 26.7 +/- 3.3% vs. - 25.8 +/- 2.7% p = 0.003) making the difference in RVGLS between the preeclamptic patients and controls more prominent. Preeclampsia may impair LV and RV function. Long-term follow up with larger sample is needed to determine the clinical relevance of the observed changes in strain.Publication Metadata only Evaluation of right atrial volumes and functions by real-time three-dimensional echocardiography in patients after acute inferior myocardial infarction(WILEY, 2018) SÜNBÜL, MURAT; Kanar, Batur Gonenc; Sunbul, Murat; Sahin, Ahmet Anil; Dogan, Zekeriya; Tigen, Mustafa KursatBackground Methods Right ventricle (RV) involvement causes acute systolic and diastolic functional alterations in the RV in patients after inferior myocardial infarction (IMI), which may result in an increase in left ventricle (LV) end-diastolic and right atrial (RA) pressure. In our study, we sought to evaluate RA volumes and mechanical functions using real-time three-dimensional echocardiography (RT3DE) in IMI patients with or without RV involvement. Ninety-six consecutive patients with IMI (mean age: 59.7 +/- 10.2 years, 60 female) were included. RV myocardial involvement (RVMI) was defined as the presence of a culprit lesion at the proximal portion of the first RV marginal branch in coronary angiography. The study population was divided into two groups: IMI (58.3%) and IMI + RVMI (41.7%). Patients were evaluated using conventional two-dimensional echocardiography (2DE) and RT3DE. Results Conclusions In RT3DE measurements, IMI + RVMI patients had significantly higher RA phasic volumes and worse conduit mechanical function. A receiver operating characteristic (ROC) curve analysis revealed that an RT3DE RA maximum volume (Vmax) index > 27.9 mL/m(2) was an independent predictor of RV involvement in patients after acute IMI, with a sensitivity of 80.0% and a specificity of 89.3%. Right ventricle involvement may cause an increase in RA phasic volumes and deterioration of conduit function in patients with acute IMI.Publication Open Access Right Ventricular Functional Improvement after Pulmonary Rehabilitation Program in Patients with COPD Determined by Speckle Tracking Echocardioga araphy(ARQUIVOS BRASILEIROS CARDIOLOGIA, 2018) SÜNBÜL, MURAT; Kanar, Batur Gonenc; Ozmen, Ipek; Yildirim, Elif Ozari; Ozturk, Murat; Sunbul, MuratBackground: Although right ventricular (RV) dysfunction in pulmonary diseases has been associated with increased morbidity, tools for RV dysfunction identification are not well defined. Objective: The aim of this study was to evaluate the magnitude of RV dysfunction by means of speckle tracking echocardiography (STE) in patients with chronic obstructive pulmonary disease (COPD) and to investigate whether STE could be used as an index of RV improvement after a pulmonary rehabilitation (PR) program. Methods: Forty-six patients with COPD undergoing PR program and 32 age-sex matched healthy subjects were enrolled. RV function was evaluated at admission and after PR program by conventional two-dimensional echocardiography (2DE) and STE. In addition, exercise tolerance of subjects was evaluated using the six-minute walk test (6MWT). Results: COPD patients had worse RV function according to STE and 2DE as well. STE was more sensitive than conventional 2DE in determining RV improvement after PR program - RV global longitudinal strain (LS): 20.4 +/- 2.4% vs. 21.9 +/- 2.9% p < 0.001 and RV free wall LS: 18.1 +/- 3.4% vs. 22.9 +/- 3.7%, p < 0.001). RV free wall IS was directly related to distance walked at baseline 6MWT (r = 0.58, p < 0.001) and to the change in the 6MWT distance (6MWTD Delta) (r = 0.41, p = 0.04). Conclusions: We conclude that STE might be as effective as 2DE for evaluation of global and regional RV functions. STE may become an important tool for assessment and follow-up of COPD patients undergoing PR program to determine the relationship between RV function and exercise tolerance.Publication Metadata only Androgen-deprivation therapy impairs left ventricle functions in prostate cancer patients(SPRINGER, 2019) ÖZBEN SADIÇ, BESTE; Kanar, Batur Gonenc; Ozben, Beste; Sunbul, Murat; Sener, Emre; Ozkan, Onur; Tinay, Ilker; Tigen, Mustafa KursatBackgroundAndrogen-deprivation therapy (ADT) is a treatment option for locally advanced and metastatic prostate cancer (PCA). The aim of the study was to evaluate the effect of ADT on left ventricular (LV) functions assessed by speckle-tracking echocardiography (STE) in prostate cancer (PCA) patients.MethodsForty-nine consecutive PCA patients (mean age 71.56.7years) who would be treated with radiotherapy and ADT and 32 consecutive PCA patients (mean age 71.97.0years) who would be treated with radical or partial prostatectomy and 42 age-matched healthy men (mean age 70.5 +/- 9.1years) were included in our study. The left ventricular functions were assessed by both conventional echocardiography and STE at baseline and 6months later.ResultsThere were not any significant difference in characteristics of the patients and controls. There were not any significant differences in conventional echocardiographic measures at baseline and at 6th month among the PCA patients and controls. Although there were not any significant differences in STE measures at baseline among the PCA patients and controls, the strain measures of the PCA patients receiving ADT decreased significantly at the 6th month and were significantly lower compared to strain measures of PCA patients undergoing prostatectomy and controls. There was not any statistically significant difference in baseline and 6th-month strain measures of the PCA patients undergoing prostatectomy.ConclusionsPublication Metadata only Ventricular and atrial functions assessed byspeckle-trackingechocardiography in patients with human immunodeficiency virus(WILEY, 2021) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Ozben, Beste; Tukenmez Tigen, Elif; Sunbul, Murat; Sayar, Nurten; Gurel, Emre; Tigen, Kursat; Korten, VolkanPurpose Antiretroviral therapy (ART) has dramatically changed the clinical manifestation of human immunodeficiency virus (HIV) associated cardiomyopathy from severe left ventricular (LV) systolic dysfunction to a pattern of subclinical cardiac dysfunction. The aim of this study was to evaluate by speckle tracking echocardiography (STE) LV, right ventricular (RV), and biatrial functions in HIV-infected patients under different ART combinations. Methods We consecutively included 128 HIV-infected patients (mean age 44.2 +/- 10.1 years, 110 males) and 100 controls (mean age 42.1 +/- 9.4 years, 83 males). Ventricular and atrial functions were assessed by both conventional and STE. Results Although there was not any significant difference in conventional echocardiographic variables, HIV-infected patients had significantly lower LV global longitudinal strain (GLS), RV GLS, left atrial (LA) reservoir and conduit strain, and right atrial conduit strain. HIV patients receiving integrase strand transfer inhibitors and protease inhibitors (PI) had significantly lower LV GLS and LA conduit strain, while patients receiving non-nucleoside reverse transcriptase inhibitors and PI had significantly lower RV GLS than controls. CD4 count at the time of echocardiography was strongly correlated with LV GLS (r= .619,P< .001) and RV GLS (r = .606,P< .001). Conclusion Biventricular and atrial functions are subclinically impaired in HIV-infected patients. ART regimen may also affect myocardial functions.Publication Metadata only Myocardial involvement in Behcet's disease may be higher in patients with Neuro-Behcet's disease: a speckle tracking echocardiographic study(TAYLOR & FRANCIS LTD) ÖZBEN SADIÇ, BESTE; Sunbul, Murat; Midi, Ipek Gursoy; Agackiran, Seda Kutlug; Engin, Esin; Ucem, Selen; Alibaz-Oner, Fatma; Sayar, Nurten; Direskeneli, Haner; Sadic, Beste OzbenBackground Behcet's disease (BD) may present with life threating complications including neurological and cardiovascular involvement. Neuro-Behcet's disease (NBD) is one of the most important causes of morbidity and mortality in patients with BD. The aim of the present study is to investigate whether patients with NBD are different than BD patients with other manifestations in terms of subclinical myocardial dysfunction. Methods Forty patients with NBD (23 female, mean age: 42.4 +/- 9.4 years), 40 patients with BD (9 female, mean age: 39.7 +/- 9.0 years) and 40 controls (20 male, mean age: 41.8 +/- 6.5 years) were consecutively included in the study. All subjects underwent a transthoracic echocardiography for evaluation of left ventricular (LV) and atrial (LA) functions with two-dimensional (2D) speckle tracking echocardiography (STE). Results Baseline characteristics, clinical data, LV dimensions, systolic and diastolic functions were all in normal range among the groups. LV global longitudinal strain (LV-GLS) was significantly lower in patients with NBD and BD patients without neurologic involvement compared to controls. LA conduit strain was significantly lower in patients with NBD compared to controls. Patients with both parenchymal NBD and vascular NBD manifestations had significantly lower LV-GLS and LA conduit strain compared to controls. Linear regression analysis demonstrated that among cardiovascular risk factors only presence of NBD was the independent predictor of LV-GLS. Conclusions BD is associated with impaired LV and LA functions. LV-GLS and LA conduit strains of the patients with NBD were lower. NBD was an independent predictor of LV-GLS, suggesting a link between neurological manifestations and cardiac dysfunction in BD patients.