Person: SÜNBÜL, MURAT
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
SÜNBÜL
First Name
MURAT
Name
10 results
Search Results
Now showing 1 - 10 of 10
Publication Metadata only Right ventricular and atrial functions in systemic sclerosis patients without pulmonary hypertension Speckle-tracking echocardiographic study(URBAN & VOGEL, 2015) SÜNBÜL, MURAT; Durmus, E.; Sunbul, M.; Tigen, K.; Kivrak, T.; Ozen, G.; Sari, I.; Direskeneli, H.; Basaran, Y.Background. Systemic sclerosis (SSc) is a systemic connective tissue disease and cardiac involvement is one of the most important causes of death. Right ventricular (RV) systolic dysfunction is a poor prognostic finding in SSc patients. Assessment of RV function has some difficulties because of its crescent shape and extensive trabeculations. Two-dimensional (2D) speckle-tracking echocardiography (STE) is an angle-independent quantitative technique to evaluate myocardial function. The aim of this study was to assess the RV and right atrial (RA) functions of SSc patients without pulmonary hypertension by using 2D STE. Patients and methods. A total of 40 patients with SSc (mean age 48.5 +/- 11.4 years, 28 female) and 40 healthy volunteers (mean age 45.9 +/- 7.6 years, 21 female) were included in the study. All subjects underwent transthoracic echocardiography for evaluation of RV and RA functions with 2D STE. Results. Although left ventricular systolic and diastolic functions, systolic pulmonary artery pressure (PAP), and RA measurements were similar in both groups, tricuspid annular plane systolic excursion (TAPSE) and maximum systolic myocardial velocity (S') were decreased in SSc patients. The RV free wall global longitudinal strain (GLS) of SSc patients was lower than the controls (-18.5 +/- 4.9% vs. -21.8 +/- 2.4%, p< 0.001) and the RA reservoir and conduit functions were also decreased in SSc patients compared with controls (34.4 +/- 9.9% vs. 39.7 +/- 11.2%, p= 0.027 and 15.0 +/- 5.7% vs. 18.7 +/- 6.4%, p= 0.009, respectively). Disease duration was inversely correlated with RVGLS and TAPSE (r: -0.416, p= 0.018 and r: -0.383, p= 0.031, respectively). Conclusion. The use of 2D STE can be helpful in the detection of impairment in RV and RA functions in SSc patients with normal PAP.Publication Metadata only Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension(TAYLOR & FRANCIS INC, 2014) ÇİNÇİN, AHMET ALTUĞ; Sunbul, Murat; Gerin, Fethullah; Durmus, Erdal; Kivrak, Tarik; Sari, Ibrahim; Tigen, Kursat; Cincin, AltugBackground: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are associated with worse outcome in various diseases. Non-dipping blood pressure pattern is associated with higher cardiovascular mortality. The aim of this study was to explore the association between NLR and PLR in patients with dipper versus non-dipper hypertension. Methods: The study included 166 patients with hypertension. Eighty-three patients (40 male, mean age: 49.1 +/- 10.5 years) had dipper hypertension, while 83 patients (41 male, mean age: 52.3 +/- 12.7 years) had non-dipper hypertension. Results: Baseline demographic characteristics were similar in both groups. Patients with non-dipper hypertension had significantly higher NLR compared to dipper hypertension (2.3 +/- 0.9 versus 1.8 +/- 0.5, p < 0.001). Patients with non-dipper hypertension had significantly higher PLR compared to dipper hypertension (117.7 +/- 35.2 versus 100.9 +/- 30.5, p = 0.001). In univariate analysis, hyperlipidemia, smoking, presence of diabetes, PLR more than 107 and NLR more than 1.89 were among predictors of dipper and non-dipper status. In logistic regression analyses, only hyperlipidemia (odds ratio: 2.96, CI: 1.22-7.13) and PLR more than 107 (odds ratio: 2.62, Cl: 1.13-6.06) were independent predictors of dipper and non-dipper status. A PLR of 107 or higher predicted non-dipper status with a sensitivity of 66.3% and specificity of 68.7%. Conclusion: We demonstrated that patients with non-dipper hypertension had significantly higher NLR and PLR compared to dipper hypertension, which has not been reported previously. Moreover PLR more than 107 but not NLR was independent predictor of non-dipper status.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 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 Anxiety and Depression in Patients with Coronary Artery Disease(KURE ILETISIM GRUBU A S, 2013) SARI, İBRAHİM; Sunbul, Murat; Zincir, Selma Bozkurt; Durmus, Erdal; Sunbul, Esra Aydin; Cengiz, Fatma Fariha; Kivrak, Tarik; Samadov, Fuad; Sari, IbrahimObjective: Previous prospective studies have reported depression as an independent risk factor for myocardial infarction and cardiovascular mortality. Anxiety disorders are also known to be associated with coronary artery disease (CAD. Psychological factors may also affect the course and outcome of CAD through behavioral mechanisms such as smoking, decreased physical activity, poor diet, and reduced compliance to treatment. The aim of this study was to explore the anxiety and depression levels and to determine the atherosclerotic risk factors in patients admitted for elective coronary angiography due to suspected CAD. Methods: The study population consisted of 116 patients, who were consecutively admitted for elective coronary angiography. Findings were classified into two major groups: normal or abnormal coronary angiography. Abnormal coronary angiography was suggested in patients with atherosclerotic disease (equal to or greater than 50% stenosis) and/or slow blood flow in coronary arteries. Anxiety and depression symptom severities were assessed by self-reported scales, including the Beck Depression Inventory, Beck Anxiety Inventory and Spielberger's State-Trait Anxiety Inventory. Results: Sixty-three patients (44 male, mean age: 52.2 +/- 11.1 years) had abnormal coronary angiography while fifty-three patients (40 male, mean age: 54.5 +/- 10.5 years) had normal findings. Sociodemographic characteristics and atherosclerotic risk factors were similar for both groups. Patients with abnormal coronary angiography had significantly higher depression and anxiety scores compared to patients with normal coronary angiography. In logistic regression analyses, only a Beck Anxiety Inventory score over 15 (odds ratio: 13.2, CI: 3.8-46.4) and State-Trait Anxiety Inventory score over 42 (odds ratio: 4.9, CI: 1.7-14.2) were independent predictors of coronary artery disease. Conclusions: We have demonstrated a significant relationship between depression and anxiety scores and coronary artery disease while cardiovascular risk factors were similar for both groups.Publication Metadata only The impact of major depression on heart rate variability and endothelial dysfunction in patients with stable coronary artery disease(ELSEVIER SCIENCE INC, 2017) SÜNBÜL, MURAT; Sunbul, Esra Aydin; Sunbul, Murat; Gulec, HuseyinBackground: Depression is an independent risk factor in cardiovascular diseases. Changes in the cardiac autonomic functions and pro-inflammatory processes are potential biological factors. Endothelial dysfunction plays an important role in the etiopathogenesis of atherosclerosis. Our objective was to evaluate the impact of major depression on heart rate variability and endothelial dysfunction in patients with stable CAD. Methods: The study group included 65 CAD patients with a diagnosis of major depression and 54 CAD patients without major depression. All study population underwent transthoracic echocardiography, measurement of flow mediated dilatation (FMD) and 24-h holter recording for heart rate variability (HRV). Blood samples were drawn to determine the inflammatory parameters. Severity of depressive episode was assessed by Montgomery-Asberg Depression Scale (MADRS). Results: The distribution of age and sex was similar in the patient and control groups (P = 0.715, 0.354, respectively). There was no significant difference in medications used between the groups. Echocardiographic parameters were similar between the groups. Inflammatory parameters were also similar between the groups. HRV parameters were significantly lower in the patient group than controls. The absolute FMD value and percentage FMD were significantly lower in the patient group than controls (P < 0.001). The MADRS score correlated with pNN50 in both groups (P < 0.05), and with FMD in the control group (P < 0.001), even after adjusting for age and gender (P < 0.001). Conclusions: MADRS score was an independent predictor of pNN50 level, percentage and absolute FMD values regardless of age and gender. Clinician should pay more attention for evaluation of depressive patients with CAD. (C) 2016 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 Metadata only Il-6 and UGT1A1 variations may related to furosemide resistance in heart failure patients(2023-01-01) GÜNEY, AHMET İLTER; SÜNBÜL, MURAT; Koprululu Kucuk G., GÜNEY A. İ., SÜNBÜL M., Guctekin T., Koç G., Kirac D.Furosemide is a diuretic and is used for the treatment of patients with heart failure (HF). It has been found that in some HF patients, the drug does not treat patients efficiently. This condition is named as furosemide resistance. In this study, it is aimed to investigate the relationship between UDP-glucuronosyltransferase 1 (UGT1A1) and interleukine-6 (IL-6) variations with furosemide resistance in HF patients. Sixty HF patients using furosemide (patient group) and 30 healthy individuals (control group) were enrolled in this study. Patients were divided into two subgroups as non-responders (furosemide resistant) group (n = 30) and the responders (non-resistant) group (n = 30) according to the presence of furosemide resistance (n = 30). Variations in the first exon of UGT1A1 and rs1800795 and rs1800796 variations in IL-6 were analyzed by direct sequencing and real-time polymerase chain reaction (RT-PCR), respectively. The effects of newly detected mutations on 3-D protein structure were analyzed by in silico analysis. At the end of the study, 11 variations were detected in UGT1A1, of which nine of them are novel and eight of them cause amino acid change. Also, rs1800795 and rs1800796 variations were detected in all the groups. When patient and control groups were compared with each other, rs1800796 mutation in IL-6 was found statistically high in the patient group (p = 0.027). When the three groups were compared with each other, similarly, rs1800796 mutation in IL-6 was found statistically high in the non-responders group (p = 0.043). When allele distributions were compared between the patient and control groups, the C allele of rs1800795 mutation in IL-6 was found statistically high in the patient group (p = 0.032). When allele distributions were compared between the three groups, 55T-insertion in UGT1A1 was found statistically high in the non-responders group (p = 0.017). According to in silico analysis results, two variations were found deleterious and six variations were detected as probably damaging to protein functions. Our study may contribute to the elucidation of pharmacogenetic features (drug response–gene relationship) and the development of individual-specific treatment strategies in HF patients using furosemide.Publication Metadata only Circulating endothelial cell number and markers of endothelial dysfunction in previously preeclamptic women(MOSBY-ELSEVIER, 2015) ÖZBEN SADIÇ, BESTE; Tuzcu, Zeyneb Baspehlivan; Asicioglu, Ebru; Sunbul, Murat; Ozben, Beste; Arikan, Hakki; Koc, MehmetOBJECTIVE: Patients with preeclampsia (PE) have endothelial dysfunction and an increased future risk of cardiovascular (CV) mortality. The number of circulating endothelial cells (CECs) is markedly increased in conditions associated with a high degree of endothelial cell activation/injury including PE. We hypothesized that the number of CECs continues to be increased in women with a history of PE, reflecting ongoing endothelial cell activation/injury. STUDY DESIGN: CECs, flow-mediated vasodilation, levels of adhesion molecules and soluble vascular endothelial growth factor receptor-1 (sVEGFR1), and urine albumin/creatinine ratio were determined in 21 healthy women with ongoing normal pregnancy, 24 healthy currently nonpregnant women with a history of normal pregnancy, a total of 17 women with currently active mild (n = 11) or severe (n = 6) PE without hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and 16 currently nonpregnant women with a history of mild (n = 10) or severe (n = 6) PE. RESULTS: Blood samples from women with active preeclampsia had higher CECs (9.9 +/- 7.9 cells/mL) than healthy pregnant women (3.0 +/- 4.1 cells/mL; P <.001), healthy nonpregnant women with a history of normal pregnancy (3.4 +/- 4.0 cells/mL; P<. 001), or women with a history of preeclampsia (2.4 +/- 2.0 cells/mL; P <.001). The number of CECs were similar between women with a history of preeclampsia and healthy nonpregnant women with a history of normal pregnancy. Patients with active preeclampsia had significantly higher soluble vascular cell adhesion molecule-1, soluble E-selectin, sVEGFR1, and urinary albumin/creatinine ratio than healthy pregnant women. However, soluble vascular cell adhesion molecule-1, soluble E-selectin, urinary albumin/creatinine ratio were similar in women with a history of preeclampsia and healthy nonpregnant women with a history of normal pregnancy. However, women with a history of preeclampsia had higher sVEGFR1 levels than women with a history of normal pregnancy (P <.05). CONCLUSION: Markers of endothelial activation, dysfunction, and damage were increased in patients with PE. After the delivery, this activation status is similar to the age-matched nonpregnant women with a history of normal pregnancy. However, sVEGFR-1 levels remain higher in women with a history of preeclampsia compared with women without a history of preeclampsia.Publication Metadata only Warfarin pharmacogenetics in patients with heart valve replacement(ELSEVIER, 2020) KARAALP, ATİLA; Bezci, Kivanc; Cevik, Mehtap; Akdeniz, Cansu Selcan; Canbolat, Ismail Polat; Yurdakul, Selen; Sunbul, Murat; Atas, Halil; Cagatay, Penbe; Ciftci, Cavlan; Karaalp, Atila; Susleyici, BelginBackground: Warfarin treatment is crucial to prevent thrombolytic complications after the heart valve replacement (HVR) operation. Our purpose was to investigate the prevalence of CYP2C9 *2 and *3 gene polymorphisms, which are essential in warfarin metabolism in patients with and without HVR surgery prescribed with warfarin. Material and method: 47 patients with and without HVR were genotyped for the CYP2C9*2 (rs1799853, 430 C> T), CYP2C9*3 (rs1057910, 1075 A> C) polymorphisms by PCR-RFLP assay. Results: Homozygous wild (CC), heterozygous and homozygous polymorphic (CT+TT) genotype frequencies of CYP2C9 *2 were determined respectively as 69.6% and 30.4% for patients with HVR; 79.2% and 20.8% for patients without HVR. Homozygous wild (AA) and heterozygous (AC) genotype frequencies of CYP2C9 *3 polymorphism were determined respectively as 73.9% and 26.1%f for patients with HVR; 79.2% and 20.8% for patients without HVR. CYP2C9 *2 and *3 genotype frequencies did not show any statistically significant difference between with and without HVR groups. Conclusion: In the present study, no significant difference was observed between patients with and without HVR with respect to CYP 2C9 *2 and *3 gene polymorphisms in Turkish subjects. Further studies with higher number of patients are needed to evaluate the importance of CYP 2C9 *2 and *3 pharmacogenetic testing in patients with HVR using warfarin.