Person: SARI, İBRAHİM
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SARI
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İBRAHİM
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Publication Metadata only Left Ventricular and Atrial Functions in Hypertrophic Cardiomyopathy Patients with Very High LVOT Gradient: A Speckle Tracking Echocardiographic Study(WILEY-BLACKWELL, 2014) ÇİNÇİN, AHMET ALTUĞ; Tigen, Kursat; Sunbul, Murat; Karaahmet, Tansu; Dundar, Cihan; Ozben, Beste; Guler, Ahmet; Cincin, Altug; Bulut, Mustafa; Sari, Ibrahim; Basaran, YeldaBackgroundDetermination of myocardial deformation (strain) by two-dimensional (2D) speckle tracking echocardiography (STE) is a new method for evaluating left ventricular (LV) regional function in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to assess LV and left atrial (LA) functions with 2DSTE in HCM patients and to investigate relation between strain analysis and LV outflow tract (LVOT) gradient. MethodsForty consecutive HCM patients (26 male, mean age: 47.715.2years), and 40 healthy volunteers (22 male, mean age: 46.611.2years) were included in the study. All subjects underwent a transthoracic echocardiography for evaluation of LV and LA functions with 2DSTE. The HCM patients were divided into 2 groups according to the presence of resting LVOT gradient >100mmHg. ResultsLeft ventricular global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) were significantly lower in patients with HCM compared with controls (-20.3 +/- 3.6% vs. -24.1 +/- 3.4% P<0.001, 38.1 +/- 12.8% vs. 44.8 +/- 10.2% P=0.012, and -22.0 +/- 4.4% vs. -23.9 +/- 4.0% P=0.045, respectively). Although basal and apical rotation were similar between the groups, mid-rotation was significantly clockwise in HCM patients (-1.53 +/- 2.06 degrees vs. 0.05 +/- 1.7 degrees P<0.001). Both LA reservoir functions and LA conduit functions were significantly lower in HCM patients (21.6 +/- 9.1% vs. 39.4 +/- 10.6% P<0.001, and 10.5 +/- 4.3% vs. 15.7 +/- 5.3%, P<0.001). Fifteen patients had a resting LVOT gradient of >100mmHg and they had significantly decreased GLS, twist and untwist compared to the HCM patients with lower resting LVOT gradient (-18.7 +/- 2.3% vs. -21.2 +/- 3.9% P=0.016, 19.4 +/- 4.3 degrees vs. 23.5 +/- 7.4 degrees P=0.038 and -94.0 +/- 29.1 degrees/sec vs. -134.9 +/- 55.8 degrees/sec, 0.005, respectively). Although basal and apical rotation were similar between the 2 groups, mid-rotation was significantly clockwise in HCM patients with higher LVOT gradient (-2.52 +/- 1.76 degrees vs. -0.96 +/- 2.03 degrees, P=0.018). Correlation analysis revealed that LVOT peak velocity was associated with GLS (r=-0.358, P=0.023), LV mid-rotation (r=-0.366, P=0.024), and LV untwist (r=-0.401, P=0.013). ConclusionsLeft ventricular and LA functions are impaired in patients with HCM. 2DSTE is useful in determining patients with impaired myocardial mechanics. High LVOT gradient may be one of the responsible factors that trigger deterioration of LV longitudinal strain and twist mechanics in patients with HCM. Further studies are required to clarify the preliminary results of this study.Publication Metadata only Effect of acute sleep deprivation on left atrial mechanics assessed by three-dimensional echocardiography(SPRINGER HEIDELBERG, 2016) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Sari, Ibrahim; Sunbul, Murat; Kepez, Alper; Oguz, Mustafa; Sert, Sena; Sahin, Anil; Ozben, Beste; Tigen, Kursat; Basaran, YeldaAlthough sleep deprivation (SD) affects cardiovascular system in many ways, physio-pathological changes in cardiac chamber volume and function have not been described well. The aim of the present study was to investigate the effect of SD on left atrial (LA) and ventricular function with three-dimensional (3D) echocardiography. Thirty-two healthy individuals (12 females, mean age 33.25 +/- 8.18) were evaluated. Echocardiographic examination was performed once after a night of regular sleep and a night of sleep debt. Beside conventional parameters, 3D phasic volumes and function were measured using a commercially available 3D echocardiography system and offline analysis software. Mean sleep duration of the study group was 8.15 +/- 2.19 h in the day of regular sleep and 2.56 +/- 2.25 h in the day of sleep deprivation. There was a significant prolongation in deceleration time (180.83 +/- 15.34 vs. 166.44 +/- 26.12; p = 0.044) and increase in E/e' (6.95 +/- 1.26 vs. 6.38 +/- 0.85; p = 0.005). Among 3D measurements, the difference in left ventricular ejection fraction (EF), LA EF, LA reservoir function and LA active EF were not significant. Mean LA passive EF of the individuals was significantly lower after night shift (24.10 +/- 7.66 vs. 31.49 +/- 7.75; p = 0.006). Acute SD is associated with a reduction in LA passive emptying function in healthy adults. 3D-derived indices were sufficient to show subclinical diastolic dysfunction according to impairment in passive phase of LA ejection. Prospective large-scale studies are needed to enlighten this issue.Publication Metadata only Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Two-dimensional Speckle Tracking Echocardiography Study(ELSEVIER SCIENCE INC, 2016) ÖZBEN SADIÇ, BESTE; Ozben, Beste; Akaslan, Dursun; Sunbul, Murat; Filinte, Deniz; Ak, Koray; Sari, Ibrahim; Tigen, Kursat; Basaran, YeldaBackground Postoperative atrial fibrillation (POAF) may develop after coronary artery bypass grafting (CABG). The aim of the study was to explore the relationship between preoperative left atrial function and atrial fibrosis and POAF after CABG. Methods Forty-eight consecutive patients undergoing CABG (mean age: 61.6 +/- 8.9 years, 39 male) were included. All patients were in sinus rhythm during surgery. Patients were followed by continuous electrocardiography monitoring and daily electrocardiogram. Left atrial function was assessed by both conventional and speckle tracking echocardiography. Atrial fibrosis was determined by samples taken from right atrium. Results Postoperative atrial fibrillation was detected in 13 patients. Female sex and number of bypassed vessels were significantly higher and cardiopulmonary bypass time was significantly longer in patients with POAF. Left atrial volume index (LAVI) was significantly higher while left atrial reservoir strain was significantly lower in POAF patients. The percentage of patients with severe fibrosis was higher in the POAF group. Regression analysis revealed fibrosis and LAVI as independent predictors of POAF. Left atrial volume index >= 36 mL/m(2) predicted POAF with a sensitivity of 84.6% and specificity of 68.6% in our cohort. Conclusion Patients who developed POAF after CABG had more fibrosis, increased LAVI and lower left atrial reservoir strain. Preoperative echocardiography might be helpful in discriminating these patients.Publication Open Access Left Ventricular and Atrial Functions in Hypertrophic Cardiomyopathy Patients with Very High LVOT Gradient: A Speckle-Tracking Echocardiographic Study(ELSEVIER SCIENCE INC, 2013-10) ÖZBEN SADIÇ, BESTE; Sunbul, Murat; Tigen, Kursat; Karaahmet, Tansu; Dundar, Cihan; Ozben, Beste; Guler, Ahmet; Cincin, Altug; Bulut, Mustafa; Sari, Ibrahim; Basaran, YeldaPublication Metadata only Effect of acute sleep deprivation on heart rate recovery in healthy young adults(SPRINGER HEIDELBERG, 2015) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Sari, Ibrahim; Oguz, Mustafa; Sert, Sena; Bozbay, Mehmet; Atas, Halil; Ozben, Beste; Tigen, Kursat; Basaran, YeldaSleep deprivation (SD) is known to be associated with increased incidence of adverse cardiovascular events, but underlying pathophysiological mechanism has not been clearly demonstrated. Autonomic nervous system plays an important role in the regulation of cardiovascular function, and impairment in this system is associated with increased cardiovascular mortality. The aim of the current study was to investigate the effect of acute SD on autonomic regulation of cardiac function by determining heart rate recovery (HRR). Twenty-one healthy security officers and nine nurses (mean age 33.25 +/- 8.18) were evaluated. Treadmill exercise test was applied once after a night with regular sleep and once after a night shift in hospital. The HRR was calculated as the reduction in heart rate from peak exercise to the 30th second (HRR30), 1st minute (HRR1), 2nd minute (HRR2), 3rd minute (HRR3), and 5th minute (HRR5). The change in blood pressure (BP) measurements was also determined. Exercise capacity of individuals with SD was significantly lower (10.96 +/- 1.01 vs. 11.71 +/- 1.30 metabolic equivalent task (MET)s; p = 0.002), and peak systolic BP was significantly higher (173.8 +/- 16.3 vs. 166.2 +/- 9.9; p = 0.019). There was a signicant difference in HRR30 (12.74 +/- 6.19 vs. 17.66 +/- 5.46; p = 0.003) and HRR1 (31 +/- 6.49 vs. 36.10 +/- 7.78; p = 0.004). The ratio of these indices to peak HR was also significantly lower with SD (HRR%(30) 8.04 +/- 4.26 vs. 10.19 +/- 3.21; p = 0.025 and HRR%(1): 18.66 +/- 4.43 vs. 20.98 +/- 4.72; p = 0.013). The difference in other indices of HRR was not significant. Our findings suggest that SD blunts cardiovascular autonomic response, and consequences of this relation might be more pronounced in subjects who are exposed to sleeplessness regularly or in subjects with baseline cardiovascular disease.