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 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 Open 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, OkanBackground: 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.Publication Open 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, HuseyinObjective 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.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 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.