Person: MUTLU, BÜLENT
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MUTLU
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BÜLENT
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Publication Metadata only Predictors of health related quality of life in patients wi̇th pulmonary hypertension(2022-02-07) KOCAKAYA, DERYA; ATAŞ, HALİL; YILDIZELİ, BEDRETTİN; MUTLU, BÜLENT; KOCAKAYA D., ŞİŞMAN A., AKASLAN D., ATAŞ H., YILDIZELİ B., MUTLU B.Publication Metadata only Prevalence of Coronary Artery to Pulmonary Artery Collaterals in Patients with Chronic Thromboembolic Pulmonary Hypertension: Retrospective Analysis from a Single Center(GEORG THIEME VERLAG KG, 2018) KEPEZ, ALPER; Kepez, Alper; Mutlu, Bulent; Paudel, Ashok; Ileri, Cigdem; Atas, Halil; Yildizeli, BedrettinBackground Our aim was to determine the prevalence of coronary artery-pulmonary artery collaterals in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by retrospectively evaluating coronary angiograms of eligible consecutive patients who had undergone pulmonary endarterectomy (PEA). We also aimed to evaluate predictors and potential clinical associates of these collaterals. Methods Coronary angiograms of 83 consecutive CTEPH patients who had undergone coronary angiography before PEA operation between January 1, 2012 and June 1, 2015 were retrospectively evaluated for presence of coronary artery-pulmonary artery collaterals. Medical records of all patients were also retrospectively reviewed for demographic information, cardiovascular risk factors, preoperative right heart catheterization reports, operation reports, and follow-up data. Data of CTEPH patients with coronary artery-pulmonary artery collaterals were compared with data of CTEPH patients without such collaterals. Results There were 15 patients (18.1%) with definite and 4 patients (4.8%) with probable coronary artery-pulmonary artery collaterals among the study population. CTEPH patients with collaterals had higher preoperative pulmonary artery pressures, higher pulmonary vascular resistance (PVR) and lower cardiac index values compared with CTEPH patients without collaterals. However, CTEPH patients with collaterals displayed higher amount of reduction in PVR after PEA compared with patients without collaterals. There were no significant differences between groups regarding incidence of reperfusion injury or mortality. Conclusion Prevalence of coronary artery-pulmonary artery collaterals seems to be increased in our CTEPH patients compared with the general population. The presence of coronary artery-pulmonary artery collaterals is often combined with proximal disease with the possibility of increased reduction of PVR after PEA operation.Publication Metadata only The anatomical relationship between the axillary artery and vein investigated by radial coronary angiography(WILEY, 2018) KEPEZ, ALPER; Sert, Sena; Kepez, Alper; Atas, Halil; Mutlu, Bulent; Erdogan, OkanAimsTo reduce the risk of inadvertent arterial puncture and bleeding, we aimed to define a safe puncture site by demonstrating the relation of the axillary artery and vein. MethodsThe anatomical course and relation as well as crossover sites of the axillary artery and vein, the presence of small arterial bridges over the axillary vein, and validation of commonly preferred axillary venous puncture sites were determined by simultaneous ipsilateral venography in patients (n=111; 80 men, age 60 10 years) who underwent coronary angiography by radial artery access. ResultsThe axillary vein was detected at the first costa-clavicular intersection in 62% and at the second anterior and third posterior costal intersection in 60% of the patients. Small arterial bridges over the axillary vein were observed in 77% of the patients and more frequently in females and body mass index 25kg/m(2) (P=0.034 and P=0.03, respectively). The axillary artery crossed the vein in 24% of the patients and almost always within the region close to the first costa-clavicular intersection site. ConclusionOur study demonstrated a high crossover rate (24%) of axillary artery and vein and a high degree of variation in the course of axillary vein. Small arterial bridges over the axillary vein were observed in 77% of the patients.Publication Metadata only The effects of iron replacement on functional capacity in patients with group 1 and group 4 pulmonary hypertension(2022-10-01) ATAŞ, HALİL; KOCAKAYA, DERYA; YILDIZELİ, BEDRETTİN; MUTLU, BÜLENT; Akaslan D., Aslanger E., ATAŞ H., Kanar B. G. , KOCAKAYA D., YILDIZELİ B., MUTLU B.Objective: Abnormal iron handling complicates pulmonary hypertension and causes functional limitation and poor outcomes. Although preliminary results in group 1 pulmonary hypertension patients support the use of iron replacement, whether this applies to other PH subgroups is not known.Publication Open Access Effects of balloon pulmonary angioplasty procedure on electrocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension(2023-03-01) KOL, AYHAN; KEPEZ, ALPER; ATAŞ, HALİL; MUTLU, BÜLENT; KOL A., KEPEZ A., Akaslan D., Kanar B., ATAŞ H., MUTLU B.Aim: The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting post-operative hemodynamic improvement in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).Material and methods: A total of 32 patients were included in the study. During ECG analysis, parameters that have been suggested to be related to right ventricular hypertrophy and/or dilatation were evaluated. The sig-nificance of the change in each parameter obtained at the pre-BPA visit and at the scheduled control visit 6 months after BPA was tested. In addition to ECG analysis, data related to right heart catheterization (RHC) and echocardiography, B-type natriuretic peptide (BNP) levels and World Health Organization (WHO) functional classifications of all patients were also recorded. The relationship between the amount of possible change in ECG parameters and the amount of possible change in hemodynamic parameters was investigated.Results: The Daniel score, which has been suggested to have prognostic value in acute pulmonary embolism, decreased from 8.22 +/- 5.68 to 6.56 +/- 5.55 after the BPA procedure (p: 0.035). Among all parameters studied, only T wave height (V2 t) in V2 derivation changed significantly from-0.77 +/- 2.39 to 1.27 +/- 2.58 mm (p: 0.036). The amount of change in V2 T was found to significantly correlate with the amount of change in systolic right ventricular pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and systemic vascular resistance.Conclusion: Postprocedural T wave changes in lead V2 might serve as a marker of hemodynamic improvement in patients with CTEPH who undergo BPA.Publication Open Access A case of heart failure mimicking COVID-19 pneumonia: The role of clinical and chest computed tomography findings in the differential diagnosis(AVES, 2020) MUTLU, BÜLENT; Dogan, Zekeriya; Ileri, Cigdem; Yildrim, Cagan; Atas, Halil; Cincin, Altus; Ozben, Beste; Mutlu, BulentAcute heart failure (HF) is one of the most common cardiac emergencies. Pulmonary edema caused by HF may mimic an exudative disease on chest computed tomography scans. Coronavirus disease 2019 (COVID-19) emerged in China in December 2019 and quickly spread around the world. During this pandemic period, the need to exclude the possibility of COVID-19 pneumonia in patients with acute dyspnea may cause a delay in the diagnosis and treatment of patients with acutely decompensated HF who have similar symptoms. This case report describes a diabetic patient admitted with dyspnea one week after she suffered an acute myocardial infarction. The objective of this report is to draw attention to the differential diagnosis of HF and COVID-19 pneumonia.Publication Open Access Intra-aortic balloon occlusion for refractory cardiac arrest in a patient with anterior myocardial infarction(2022-12-01) YILDIRIM, ÇAĞAN; UYSALER, EREN; NİZAM, AHMET CEM; ATAŞ, HALİL; TİGEN, MUSTAFA KÜRŞAT; MUTLU, BÜLENT; Aslanger E., Akaslan D., Yıldırım Ç., Uysaler E., Nizam A. C., Jafarov E., ATAŞ H., TİGEN M. K., MUTLU B.Despite recent advances in its management, the outcome of cardiac arrest is often poor despite appropriate cardiopulmonary resuscitation. The arteriovenous perfusion gradient achieved dur ing cardiopulmonary resuscitation is associated with the successful return of spontaneous cir culation. Continuous balloon occlusion of the descending aorta is an experimental method that can occlude the \"unnecessary\" part of the circulation, thus diverting generated pressure and blood flow to the heart and brain. In this study, we present a case report of a patient unre sponsive to standard cardiopulmonary resuscitation, in whom constant intra-aortic balloon occlusion achieved a return of spontaneous circulation and successful survival.Publication Open Access Bendopnea predicts right ventricular energy failure in patients with pulmonary hypertension(2023-10-01) ATAŞ, HALİL; MUTLU, BÜLENT; Akaslan D., Aslanger E., Basa C. İ., Öztürk R. K., ATAŞ H., MUTLU B.OBJECTIVE: The development of right ventricular failure has a significant adverse prognostic impact on the course of pulmonary hypertension. Right ventricular energy failure has been shown to double the mortality of pulmonary hypertension even after correction for many established risk predictors. We hypothesize that bendopnea may indicate right ventricular energy failure in patients with pulmonary hypertension. METHODS: We prospectively enrolled patients with pulmonary hypertension who were admitted to our pulmonary hypertension outpatient clinic between January 2021 and June 2021. Bendopnea was assessed by asking patients to bend forward and report any shortness of breath within 30 seconds. Routine physical examination, laboratory tests, echocardiography, and right heart catheterization parameters were collected. RESULTS: A total of 167 patients were enrolled into the study. Bendopnea and right ventricular energy failure was present in 79 (47.3%) and 43 (25.7%) patients, respectively. Bendopnea accurately predicted the presence of right ventricular energy failure (area under the curve, 0.667; 95% CI, 0.574-0.760; P < 0.001) and had a significantly superior diagnostic power compared with many other symptoms and signs. CONCLUSIONS: Our study shows that bendopnea predicts right ventricular energy failure in patients with pulmonary hypertension and can be added to our physical examination armamentarium as an easy, rapid, and noninvasive prognostic tool.