Person: SARI, İBRAHİM
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SARI
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İBRAHİM
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Publication Metadata only 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 MetinSleep 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.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 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, IbrahimPublication Metadata only 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, IbrahimBackground: 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 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 Acute sleep deprivation is associated with increased arterial stiffness in healthy young adults(SPRINGER HEIDELBERG, 2014) SARI, İBRAHİM; Sunbul, Murat; Kanar, Batur Gonenc; Durmus, Erdal; Kivrak, Tarik; Sari, IbrahimBackground Arterial stiffness and its hemodynamic consequences are known to be associated with increased cardiovascular morbidity and mortality. Pulse wave velocity (PWV) and augmentation index (AIx) are noninvasive indicators of the arterial stiffness and wave reflection. Sleep deprivation (SD) is known to be associated with increased incidence of adverse cardiovascular events. The aim of this study was to investigate whether there is an association between acute SD and arterial stiffness parameters in healthy adults, which has not been studied previously. Methods The study population consisted of 42 healthy volunteers (18 males, mean age 30.0 +/- 4.5 years). Measurements of arterial stiffness were carried out by using a Mobil-O-Graph arteriograph system. Arterial stiffness measurements were obtained both after a night with regular sleep (RS) and after a night with SD. Results Mean sleep time was significantly lower after the night of SD when compared after RS (0.73 +/- 1.39 versus 7.33 +/- 0.52 h, p < 0.001). Peripheral systolic blood pressure, peripheral pulse pressure, and cardiac output were significantly higher after SD when compared after RS (p = 0.032, 0.007, and 0.003, respectively). PWVwas significantly higher (5.33 +/- 0.46 versus 5.15 +/- 0.26 m/s, p = 0.001), and AIx was significantly lower (20.5 +/- 11.9 versus 26.0 +/- 8.4 %, p = 0.008) after the night of SD when compared after the RS. While PWV was significantly higher (p= 0.008), and AIx was significantly lower (p = 0.039) in male subjects, only PWVwas significantly higher (p = 0.009) in female subjects. Sleep time correlated with AIx (p = 0.034; r = 0.233) and inversely correlated with PWV (p = 0.044; r = -0.222). Conclusion In the present study, we demonstrated that even one night of SD is associated with increased arterial stiffness in healthy adults. The present findings suggest that adverse effects of SD on cardiovascular system might be at least in part due to increased arterial stiffness which needs to be tested with large-scale studies and in the chronic SD setting.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 Acute myocardial infarction due to liquid nicotine in a young man(2014) SARI, İBRAHİM; Kivrak T., Durmus E., Dervisova R., Sari I., Yesildag O., Sunbul M.[No abstract available]Publication Metadata only Assessment of arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions(SPRINGER, 2015) SEÇKİN GENÇOSMANOĞLU, DİLEK; Sunbul, Murat; Seckin, Dilek; Durmus, Erdal; Ozgen, Zuleyha; Bozbay, Mehmet; Bozbay, Ayfer; Kivrak, Tarik; Oguz, Mustafa; Sari, Ibrahim; Ergun, Tulin; Agirbasli, MehmetArterial stiffness is associated with increased cardiovascular risk. Pulse wave velocity (PWV) and augmentation index (AIx) are non-invasive markers for assessment of arterial stiffness. Increased arterial stiffness is associated with atherosclerosis in patients with psoriasis. Previous studies have shown that high neutrophil-to-lymphocyte ratio (NLR) predicts poor cardiovascular outcome. The aim of this study was to evaluate arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions. Fifty consecutive patients with the diagnosis of psoriasis and 50 controls were included in the study. NLR was calculated as the ratio of neutrophil count to lymphocyte count. All patients underwent echocardiographic examination. Measurements of arterial stiffness were carried out using a Mobil-O-Graph arteriograph system. Fifty patients with psoriasis (26 male, mean age 43.3 +/- 13.2 years) and 50 controls (33 male, mean age 45.0 +/- 6.1 years) were included into the study. The distribution of cardiovascular risk factors was similar between the two groups, and NLR was significantly higher in patients with psoriasis (2.74 +/- 1.78 versus 1.82 +/- 0.52, p = 0.002). There was a weak correlation between NLR and PASI score without reaching statistical significance (r = 0.300, p = 0.060). While echocardiographic and hemodynamic parameters were comparable between psoriasis and control groups, heart rate was significantly higher in psoriasis group (81.5 +/- 15.1 and 75.2 +/- 11.8 beats/min, p = 0.021). Psoriasis patients had significantly higher AIx and PWV values as compared to controls (25.8 +/- 13.1 versus 17.4 +/- 12.3 %, p = 0.001 and 6.78 +/- 1.42 versus 6.18 +/- 0.80 m/s, p = 0.011, respectively). AI and PWV were significantly associated with psoriasis when adjusted by heart rate (p = 0.005, odds ratio 1.04, 95 % confidence interval 1.01-1.08 and p = 0.035, odds ratio 1.52, 95 % confidence interval 1.02-2.26, respectively). PWV significantly correlated with blood pressure, lipid levels, and several echocardiographic indices. AIx only correlated with left atrial diameter (r = 291, p = 0.040). Linear regression analysis was performed to find predictors of PWV. Central systolic blood pressure, left atrial diameter, and total cholesterol were independent predictors of PWV. PWV and AIx were significantly higher in patients with psoriasis. Assessment of arterial stiffness parameters may be useful for early detection of cardiovascular deterioration in psoriasis patients with normal cardiac functions. Novel inflammatory biomarkers such as NLR may elucidate the mechanism of vascular dysfunction in such patients.
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