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 Open 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, KemalObjective: 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.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 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.Publication Open Access Increased arterial stiffness parameters in panic disorder patients in long term treatment period(BMC, 2016-12) SARI, İBRAHİM; Yanartas, Omer; Sunbul, Murat; Senkal, Zeynep; Durmus, Erdal; Kivrak, Tarik; Subasi, Nilufer; Karaer, Gulhan; Ergun, Serhat; Sari, Ibrahim; Sayar, KemalBackground: The relationship between mental stress and cardiovascular disease has been shown in several studies. Panic disorder (PD) is also associated with cardiovascular disease due to increased risk of myocardial infarction. The aim of this study is to evaluate the association between arterial stiffness parameters and depression/anxiety scores in patients with PD. Methods: The study population consisted of 25 patients with PD and 25 age-sex-matched healthy controls. Depression and anxiety levels were evaluated by Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. Determination of arterial stiffness parameters was conducted using a Mobil-O-Graph arteriograph system that detected signals from the brachial artery. Results: While baseline characteristics were similar between two groups, BDI and BAI scores were significantly higher in patients with PD (p < 0.005). The pulse wave velocity (PWV) and Augmentation Index (AIx) were also significantly higher in patients with PD (p = 0.001, p = 0.006). There was a moderate correlation between PWV and AIx with BAI scores (r = 0.442, p = 0.001, r = 0.441, p = 0.001). AIx was also positively correlated with BDI scores (r = 0.415, p = 0.03). Conclusion: We demonstrated a significant relationship between arterial stiffness parameters and anxiety/depression scores in patients with PD who receive antidepressant treatment.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.