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SÜNBÜL, MURAT

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2015 - 201932020 - 20221
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    PublicationOpen Access
    The Effect of Synthetic Cannabinoids on P-Wave Dispersion: An Observational Study
    (KARGER, 2016) SÜNBÜL, MURAT; Sunbul, Esra Aydin; Sunbul, Murat; Terzi, Ayse; Calli, Sumeyye; Koca, Esra; Bilici, Rabia; Citak, Serhat
    Objective: The aim of this study was to investigate the effect of synthetic cannabinoids (SC) on P-wave dispersion (PD) in patients who consume SC. Materials and Methods: The study population included 72 patients who consumed SC and 36 age-and sex-matched healthy controls. The severity of addiction was detected using the addiction profile index (BAPI). The PD was measured by 12-lead ECG obtained upon admission to hospital. Statistical analyses were performed using the SPSS v20.0 statistical software package. Results: The mean age of the patients and controls was 26.9 +/- 7.0 and 26.3 +/- 6.5 years, respectively. Mean duration of SC consumption was 1.7 +/- 0.7 years. Mean BAPI score of patients who consumed SC was 12.8 +/- 3.4. Patients who consumed SC had a significantly higher PD value than controls (37.7 +/- 11.5 vs. 30.6 +/- 6.4 ms, p < 0.001). The BAPI score was significantly correlated with PD value (r = 0.675, p < 0.001). In the linear regression model that included PD value, age and heart rate, PD value was significantly and independently correlated with BAPI score (r(2) of the model = 0.339; p < 0.001). Conclusions: In this study, patients who consumed SC had significantly higher PD values than controls, and the BAPI score correlated with the PD value. Hence SC consumption could lead to an increased risk of cardiovascular disease through prolonged PD. We recommend the use of the simple and inexpensive ECG to assess cardiovascular risk in patients who consume SC. (C) 2016 S. Karger AG, Basel.
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    PublicationOpen Access
    Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Predictors of Heart Failure
    (ARQUIVOS BRASILEIROS CARDIOLOGIA, 2015) SARI, İBRAHİM; Durmus, Erdal; Kivrak, Tarik; Gerin, Fethullah; Sunbul, Murat; Sari, Ibrahim; Erdogan, Okan
    Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inflammatory markers used as prognostic factors in various diseases. Objectives: To compare the PLR and the NLR of heart failure (HF) patients with those of age-sex matched controls, to evaluate the predictive value of those markers in detecting HF, and to demonstrate the effect of NLR and PLR on mortality in HF patients during follow-up. Methods: This study included 56 HF patients and 40 controls without HF. All subjects underwent transthoracic echocardiography to evaluate cardiac functions. The NLR and the PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively. All HF patients were followed after their discharge from the hospital to evaluate mortality, cerebrovascular events, and re-hospitalization. Results: The NLR and the PLR of HF patients were significantly higher compared to those of the controls (p < 0.01). There was an inverse correlation between the NLR and the left ventricular ejection fraction of the study population (r: -0.409, p < 0.001). The best cut-off value of NLR to predict HF was 3.0, with 86.3% sensitivity and 77.5% specificity, and the best cut-off value of PLR to predict HF was 137.3, with 70% sensitivity and 60% specificity. Only NLR was an independent predictor of mortality in HF patients. A cut-off value of 5.1 for NLR can predict death in HF patients with 75% sensitivity and 62% specificity during a 12.8-month follow-up period on average. Conclusions: NLR and PLR were higher in HF patients than in age-sex matched controls. However, NLR and PLR were not sufficient to establish a diagnosis of HF. NLR can be used to predict mortality during the follow-up of HF patients.
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    PublicationOpen Access
    Increased Neutrophil/Lymphocyte Ratio in Patients with Depression is Correlated with the Severity of Depression and Cardiovascular Risk Factors
    (KOREAN NEUROPSYCHIATRIC ASSOC, 2016) SARI, İBRAHİM; Sunbul, Esra Aydin; Sunbul, Murat; Yanartas, Omer; Cengiz, Fatma; Bozbay, Mehmet; Sari, Ibrahim; Gulec, Huseyin
    Objective Chronic inflammation is associated with cardiovascular (CV) risk factors and psychiatric disorders. The neutrophil to lymphocyte ratio (NLR) has been investigated as a new biomarker for systemic inflammatory response. The aim of the study is to investigate the relation of NLR with severity of depression and CV risk factors. Methods The study population consisted of 256 patients with depressive disorder. Patients were evaluated with the Hamilton Rating Scale for Depression (HAM-D). Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Patients were also evaluated in terms of CV risk factors. Results Patients with higher HAM-D score had significantly higher NLR levels compared to patients with lower HAM-D score. Correlation analysis revealed that severity of depression was associated with NLR in depressive patients (r=0.333, p<0.001). Patients with one or more CV risk factors have significantly higher NLR levels. Correlation analysis revealed that CV risk factors were associated with NLR in depressive patients (r=0.132, p=0.034). In logistic regression analyses, NLR levels were an independent predictor of severe or very severe depression (odds ratio: 3.02, 95% confidence interval: 1.867-4.884, p<0.001). A NLR of 1.57 or higher predicted severe or very severe depression with a sensitivity of 61.4% and specificity of 61.2%. Conclusion Higher HAM-D scores are associated with higher NLR levels in depressive patients. NLR more than 1.57 was an independent predictor of severe or very severe depression. A simple, cheap white blood cell count may give an idea about the severity of depression.
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    PublicationOpen Access
    Is there any relation between arterial stiffness and insomnia? A challenging question
    (SPRINGER HEIDELBERG, 2022-03) ÖZBEN SADIÇ, BESTE; Sunbul, Esra Aydin; Sunbul, Murat; Tastekin, Nihal; Ozben, Beste; Sayar, Nurten; Gulec, Huseyin
    Purpose Insomnia is a common sleep disorder which has high comorbidity with a number of cardiovascular diseases (CVD). As a possible risk factor for the CVDs, arterial stiffness may be assessed non-invasively by pulse wave velocity (PWV) and augmentation index (AI). The aim of this study was to evaluate any relation between insomnia and arterial stiffness. Methods Patients with insomnia were included in the study after the exclusion of other sleep disorders by polysomnography. Sleep quality and the degree of insomnia symptoms were evaluated by the Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI), respectively. PWV and AI were assessed by Mobil-O-Graph arteriograph system. Results Consecutive patients with insomnia (n = 72, 56 women, mean age 55.8 +/- 9.1 years) were included. Patients were grouped as those with severe ISI scores (22-28) and those with mild to moderate ISI scores (8-21). Despite no significant difference in characteristics and clinical data, patients with severe ISI scores had significantly higher total PSQI scores and NREM-2 with significantly lower REM duration. They also had significantly higher systolic blood pressure, mean blood pressure, pulse pressure, PWV, and AI compared to patients with mild and moderate ISI scores. Correlation analysis revealed that PWV and AI were significantly correlated with the ISI score and PSQI score. Conclusion There is a close relation between arterial stiffness and insomnia suggesting a risk for CVD in patients with insomnia.