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SARI, İBRAHİM

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SARI

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İBRAHİM

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Now showing 1 - 10 of 40
  • PublicationOpen Access
    Asymptomatic ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow
    (TERMEDIA PUBLISHING HOUSE LTD, 2014) SARI, İBRAHİM; Sunbul, Murat; Erdogan, Okan; Sari, Ibrahim
    Exercise-induced ST segment elevation without Q wave formation is rarely observed. Frequent causes are significant coronary stenosis, myocardial bridge and coronary vasospasm. Both exercise-induced ST segment elevation due to stow coronary flow and ST segment elevation in the recovery phase of the exercise stress test are very rare. We present a 49-year-old man with asymptomatic inferolateral ST segment elevation in the recovery phase of the exercise stress test due to slow coronary flow, which has not been reported previously. The learning points of the present paper are as follows: a) although significant coronary stenosis, myocardial bridge and coronary vasospasm are frequent causes of exercise-induced ST segment elevation, slow coronary flow might also cause it; b) one should keep in mind that ST segment elevation might also occur in the recovery phase; and c) ST segment elevation might be asymptomatic, as in the present case.
  • Publication
    Acute sleep deprivation in healthy adults is associated with a reduction in left atrial early diastolic strain rate
    (SPRINGER HEIDELBERG, 2013) SARI, İBRAHİM; Acar, Goksel; Akcakoyun, Mustafa; Sari, Ibrahim; Bulut, Mustafa; Alizade, Elnur; Ozkan, Birol; Yazicioglu, Mehmet Vefik; Alici, Gokhan; Avci, Anil; Kargin, Ramazan; Esen, Ali Metin
    Sleep deprivation (SD) is known to be associated with adverse cardiovascular events. Strain and strain rate measure the local deformation of the myocardium and have been used to evaluate atrial phasic function in various disease states. The aim of the study was to investigate whether strain rate imaging enables the identification of left atrial dysfunction in otherwise healthy young adults with acute SD which has not been studied previously. Adequate echocardiographic images of 27 healthy volunteers were obtained both after a night with regular sleep and after a night with SD. Tissue Doppler-derived strain and strain rate were measured from the apical four- and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate (S-Sr), early diastolic (E-Sr) and late diastolic (A-Sr) strain rate. Phasic left atrial (LA) volumes and fractions were also calculated. There was no significant difference in the traditional parameters of atrial function and LA volumes. Subjects had similar S-Sr, A-Sr and global atrial strain values after the night of sleep debt when compared after regular sleep, whereas they had significantly reduced E-Sr values (mean (SD) 3.2 (0.7) s(-1) vs 3.7 (0.6) s(-1), p < 0.001). Moreover, global E-Sr showed a significant correlation with sleep time (r = 0.554, p < 0.001). Acute SD in healthy adults is associated with a reduction in LA early diastolic strain rate in the absence of geometric alterations or functional impairment of the left atrium, raising the possibility that chronic SD may more profoundly affect LA function and thereby promote the occurrence of atrial fibrillation.
  • PublicationOpen Access
    Utility of Speckle Tracking Echocardiography in Asymptomatic Mild to Moderate Aortic Stenosis at Rest and During Supine Bicycle Exercise Test
    (ELSEVIER SCIENCE INC, 2013-10) MUTLU, BÜLENT; Sunbul, Murat; Akhundova, Aysel; Sari, Ibrahim; Erdogan, Okan; Mutlu, Bulent
  • Publication
    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, Altug
    Background: 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
    Recurrent gastrointestinal bleeding in a patient with Eisenmenger syndrome using bosentan
    (Bentham Science Publishers, 2013) SARI, İBRAHİM; Sari I., Cam H., Sait Dag M., Durmus E., Kivrak T., Tigen K., Davutoglu V.
    Eisenmenger syndrome is associated with irreversible increase in pulmonary vascular resistance causing reduced survival. Bosentan, a non-selective endothelin receptor antagonist is the commonly used specific pulmonary arterial hypertension drug in Eisenmenger syndrome. In this paper, we present a case of recurrent gastrointestinal bleeding in a 23-year-old female with Eisenmenger syndrome who was only under bosentan treatment, which has not been reported previously. Most common adverse effect of bosentan is elevation in the liver enzymes however, bleeding complication is very rare. On the contrary, it was proposed that bosentan might be a potential protector against hyperacidity and mucosal erosion that occur as a consequence of stress. Although the mechanistic relationship of bleeding tendency and role of Eisenmenger syndrome concomitant with bosentan treatment is far from conclusive statement for now, this association warrants and should draw attention of clinicians and researches in this field. © 2013 Bentham Science Publishers.
  • Publication
    Successful Treatment of a Giant Left Atrial Mass Stemming from Pulmonary Vein after Chemotherapy-radiotherapy Combination in a Patient with Lung Adenocarcinoma
    (ELSEVIER SCIENCE INC, 2016) ATAŞ, HALİL; Besiroglu, Fatih; Atas, Halil; Sunbul, Murat; Samadov, Fuad; Oguz, Mustafa; Sari, Ibrahim
  • PublicationOpen Access
    Acute Sleep Deprivation is Associated with Increased Arterial Stiffness in Healthy Young Adults
    (ELSEVIER SCIENCE INC, 2013-10) SARI, İBRAHİM; Sunbul, Murat; Kanar, Batur Gonenc; Durmus, Erdal; Kivrak, Tarik; Sari, Ibrahim
  • Publication
    Depression and anxiety are associated with abnormal nocturnal blood pressure fall in hypertensive patients
    (INFORMA HEALTHCARE, 2014) SARI, İBRAHİM; Sunbul, Murat; Sunbul, Esra Aydin; Kosker, Selcen Dogru; Durmus, Erdal; Kivrak, Tarik; Ileri, Cigdem; Oguz, Mustafa; Sari, Ibrahim
    Background: Previous studies have shown that depression and anxiety were independent risk factors for hypertension. Non-dipper hypertension is associated with higher cardiovascular mortality. The aim of this study was to evaluate the anxiety and depression scores in patients with dipper and non-dipper hypertension. Methods: The study sample consisted of 153 hypertensive patients. All patients underwent 24-h blood pressure monitoring. Patients were classified into two groups according to their dipper or non-dipper hypertension status. We evaluated results of the Hospital Anxiety and Depression Scale between groups. Results: Seventy-eight patients (38 male, mean age: 51.6 +/- 12.5 years) had dipper hypertension while 75 patients (27 male, mean age: 55.4 +/- 14.1 years) had non-dipper hypertension (p = 0.141, 0.072, respectively). Clinical characteristics were similar for both groups. Patients with non-dipper hypertension had significantly higher depression and anxiety scores compared to patients with dipper hypertension. Dipper and non-dipper status significantly correlated with anxiety (p: 0.025, r: 0.181) and depression score (p: 0.001, r: 0.255). In univariate analysis, smoking, alcohol usage, presence of diabetes, hyperlipidemia, anxiety score >8 and depression score >7 were predictors of dipper versus non-dipper status. In multivariate logistic regression analyses only depression score 47 was independent predictor of dipper versus non-dipper status (odds ratio: 2.74, confidence intervals: 1.41-5.37). A depression score of 7 or higher predicted non-dipper status with a sensitivity of 62.7% and specificity of 62.8%. Conclusion: Non-dipper patients have significantly higher anxiety and depression scores compared to dipper patients. Evaluation of anxiety and depression in patients with hypertension might help to detect non-dipper group and hence guide for better management.
  • Publication
    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, Ibrahim
    Objective: 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.
  • PublicationOpen Access
    Severity of Depression and Anxiety Symptoms is Associated with Increased Arterial Stiffness in Depressive Disorder Patients Undergoing Psychiatric Treatment
    (KURE ILETISIM GRUBU A S, 2016-09) SARI, İBRAHİM; Yanartas, Omer; Sunbul, Murat; Durmus, Erdal; Kivrak, Tarik; Senkal, Zeynep; Subasi, Nilufer; Karaer, Gulhan; Ergun, Serhat; Sari, Ibrahim; Sayar, Kemal
    Objective: Depression and anxiety are associated with both subdinical and clinical cardiovascular disease. Endothelial dysfunction, atherosclerosis, and inflammation are some of the underlying mechanisms. Pulse wave velocity (PWV) and augmentation index (Alx) are noninvasive markers for evaluation of arterial stiffness. The aim of this study was to examine the association between arterial stiffness parameters and depression/anxiety scores in depressive patients undergoing psychiatric treatment. Methods: The study population consisted of 30 patients with depression undergoing psychiatric treatment at least 4 weeks, and 25 age and gender matched healthy controls. Depression and anxiety were assessed by self-reported scales, including the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Measurements of arterial stiffness parameters were performed by using a Mobil-O-Graph arteriograph system, which detects signals from the brachial artery. Results: Baseline characteristics and clinical data were similar between the two groups. BDI and BAI scores were statistically significantly higher in patients with depression (p<0.001, p<0.01). PWV and Alx were statistically significantly higher in patients with depression compared to controls (6.40 +/- 1.31 m/s vs 5.51 +/- 0.41 m/s and 26.9 +/- 12.1 % vs 17.4 +/- 11.3 %, p=0.001, p=0.004, respectively). PWV and Alx positively, mildly and statistically significantly correlated with BDI and BAI scores. Conclusion: Arterial stiffness parameters were statistically significantly higher in depressive patients receiving antidepressant treatment. Moreover, arterial stiffness parameters statistically significantly correlated with BDI and BAI. Assessment of arterial stiffness parameters may be useful for early detection of cardiovascular deterioration in depressive patients undergoing antidepressant treatment.