Person: SARI, İBRAHİM
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SARI
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İBRAHİM
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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 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 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 Evaluation of Cardiac Function by Two-Dimensional Speckle Tracking Echocardiography in Ulcerative Colitis Patients(SPRINGER, 2014) ÇİNÇİN, AHMET ALTUĞ; Cincin, Altug; Sunbul, Murat; Kivrak, Tarik; Atas, Halil; Sari, Ibrahim; Tigen, Kursat; Kani, Tarik; Akin, Hakan; Imeryuz, Nese; Basaran, YeldaPurpose Although ulcerative colitis (UC) shows obvious similarities with other autoimmune diseases, cardiac consequences have not adequately introduced. The aim of our study was to evaluate left ventricular (LV) function in UC patients by using novel echocardiographic parameters. Results Forty-five UC patients (mean age 37, 18 female) and 90 age-and sex-matched healthy volunteers (mean age 40, 38 female) included in the study. The mean disease activity score according to partial Mayo score was 2.16 +/- 2.13. Mean global longitudinal strain (GLS) and global longitudinal strain rate (GLSR) measurements were significantly lower (-21.16 +/- 2.71 vs. -23.36 +/- 3.34; p < 0.001 and -1.33 +/- 0.24 vs. -1.43 +/- 0.24; p = 0.037, respectively), whereas global circumferential (-22.67 +/- 3.66 vs. -23.37 +/- 3.99; p = 0.140) and global radial strain (43.07 +/- 8.58 vs. 44.12 +/- 9.32; p = 0.545) measurements of the LV were similar in patients with UC compared with controls. The correlation coefficient (r) between GLS and partial Mayo score was -0.578 (p < 0.001). Conclusion Our study suggests that systolic cardiac deformation values are impaired in UC patients. Reduced GLS and GLSR might be an early indicator of cardiac involvement in this population.Publication Open Access Thrombus Entrapment in the Hemostasis Valve during Thrombus Aspiration: An Octogenarian with Inferior Myocardial Infarction and Complete Flow Restoration without Any Additional Angioplasty(2013-08-11) SARI, İBRAHİM; Topal, Nurdan; Cincin, Altug; Sunbul, Murat; Tigen, Kursat; Sari, IbrahimPublication 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 Open Access Percutaneous and surgical removal of two cases of embolized totally implantable venous access devices that were implanted a long time ago(2015-03-06) ÇİNÇİN, AHMET ALTUĞ; Atas, Halil; Sari, Ibrahim; Cincin, Altug; Tigen, KursatPublication Metadata only Acute proximal left anterior descending artery occlusion with de Winter sign(W B SAUNDERS CO-ELSEVIER INC, 2014) ÇİNÇİN, AHMET ALTUĞ; Samadov, Fuad; Akaslan, Dursun; Cincin, Altug; Tigen, Kursat; Sari, IbrahimPrompt recognition of electrocardiographic signs of acute coronary occlusion is essential for timely restoration of flow. ST-segment elevation or new onset left bundle-branch block are the most common electrocardiographic changes seen in acute phase of coronary occlusion. However, some patients may present with atypical electrocardiographic signs, and early diagnosis of these patients may constitute a clinical challenge. Here, we report a 41-year-old man presenting with an atypical electrocardiographic manifestation despite angiographically confirmed acute thrombotic occlusion of proximal left anterior descending artery.Publication Metadata only Pericardiocentesis in patients with thrombocytopenia and high international normalized ratio: case report and review of the literature(2014) ÇİNÇİN, AHMET ALTUĞ; Kepez, Alper; Sari, Ibrahim; Cincin, Altug; Tigen, KursatPublication 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.