Browsing by Author "Gullu, Hakan"

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Assessment Of P Wave/Qt Interval Dispersion, Tp-E Interval, Tp-E/Qt Ratio After Transcatheter Aortic Valve Implantation In Geriatric Patients With Aortic Stenosis
(2018) Yilmaz, Mustafa; Gullu, Hakan; Demircan, Senol; Sezgin, Alpay Turan; Bilgel, Ziya Gokalp; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0002-9635-6313; S-6973-2016; AAG-8233-2020
Introduction: One of the most important reasons for a high mortality and morbidity rate in geriatric patients with calcific aortic stenosis is arrhythmias. Transcatheter aortic valve implantation is an alternative to conventional aortic valve surgery for high-risk patients because of its less-invasive nature. Although hemodynamic and functional recoveries are established after transcatheter aortic valve implantation, whether it leads to a decrease in the risk of atrial fibrillation, ventricular arrhythmia and sudden cardiac death remains unclear. Thus, this study aimed to evaluate the risks associated with aortic stenosis by assessing the rates of P wave dispersion for estimating the atrial fibrillation risk and QT interval dispersion, Tp-e interval, and Tp-e/QT ratio for ventricular arrhythmia and assessing sudden cardiac death risk before and after implantation. Materials and Method: In a retrospective study, a total of 39 subjects [14 males (35.89%) and 25 females (64.11%); mean age=81.51 +/- 8.79 years] were enrolled. P wave/QT interval dispersion, Tp-e interval and Tp-e/QT ratio values before and 3rd months after implantation were calculated and compared. Results: There was a statistically significant decline in P wave/QT interval dispersion, Tp-e interval, Tp-e/QT ratio values between preoperative, and 3rd, months (43.72 +/- 7.78 vs. 35.15 +/- 8.92, 61.64 +/- 17.36 vs. 49.41 +/- 12.64, 84.59 +/- 7.64 vs. 73.21 +/- 6.46, 0.21 +/- 0.01 vs. 0.18 +/- 0.01, respectively, p<0.001 for all comparisons). Conclusion: P wave/QT interval dispersion, Tp-e interval and Tp-e/QT ratio were shown to be attenuated after transcatheter aortic valve implantation. These results indirectly offer that there may be a reduction in risk of atrial fibrillation, ventricular arrhythmias and sudden cardiac death.
Could there be an association between chronic brucellosis and endothelial damage?
(2015) Togan, Turhan; Ciftci, Ozgur; Turan, Hale; Narci, Huseyin; Gullu, Hakan; Arslan, Hande; 25596571
Introduction: In this study, we examined the effects of Brucella infection on endothelial dysfunction. Flow-mediated dilatation (FMD) measurement is indicator of the endothelial function, and abnormal values indicating endothelial dysfunction are accepted as the first stage of atherosclerosis. Methodology: Twenty-four patients who had been treated for acute brucellosis two years before, and who had had no relapses in the follow-up, were prospectively included in the study, along with 30 healthy individuals in the control group. Results: While the highly sensitive Creactive protein (hs-CRP) value was 2.42 +/- 1.45 in the patient group, it was 1.72 +/- 0.61 in the control group (p = 0.025). While the FMD value was 3.50 +/- 1.58 in the patient group, it was 5.88 +/- 1.88 in the control group (p < 0.001). While the percentage increase in FMD was 9.88 +/- 4.92 in the patient group, it was 17.49 +/- 6.3 in the control group (p < 0.001). It was observed that FMD value, the percentage increase in FMD, and basal radius were correlated with hs-CRP (r = -0.644, p < 0.001; r = -0.558, p = 0.002; r = 0.444, p = 0.018, respectively). The carotid artery intima media thickness (IMT) value was found to be 0.61 +/- 0.17 in the patient group and 0.49 +/- 0.12 in the control group (p = 0.004). Conclusions: The abnormal FMD and IMT values observed in brucellosis patients might be an indicator of more frequent arterial dysfunction, increased cardiovascular risk, and atherosclerosis.
Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?
(2014) Citfci, Faika Ceylan; Ciftci, Ozgur; Gullu, Hakan; Caliskan, Mustafa; Uckuyu, Ayla; Ozcimen, Ebru Emel; 25669058
Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75 +/- 7.95) and 27 healthy volunteers (27 women; mean age 36.44 +/- 10.45) Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43 +/- 1.91 vs. 3.80 +/- 2.06, p=0.007; 3.09 +/- 2.41 vs. 7.32 +/- 6.89, p=0.001; 2.89 +/- 2.11 vs. 7.00 +/- 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35 +/- 15.99 vs. 12.24 +/- 9.22, p=0.005; 11.17 +/- 9.68 vs. 6.13 +/- 4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55 +/- 0.16 vs. 0.53 +/- 0.19, p=0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation.
First case of cardiac amyloidosis presenting as right atrial mass
(2019) Acibuca, Aynur; Okar, Sefa; Canpolat, Tuba; Koc, Zafer; Gullu, Hakan; 0000-0003-1413-7393; 0000-0002-3444-8845; 31475954; AAF-2872-2020; ABG-4047-2020
Impaired Coronary Microvascular and Left Ventricular Diastolic Function in Patients with Inflammatory Bowel Disease
(2015) Caliskan, Zuhal; Gokturk, Huseyin Savas; Caliskan, Mustafa; Gullu, Hakan; Ciftci, Ozgur; Ozgur, Gulsum Teke; Guven, Aytekin; Selcuk, Haldun; 0000-0003-2579-9755; 0000-0002-8445-6413; 0000-0002-6463-6070; 25128749; AAJ-8546-2021; JYO-9455-2024; IXD-5147-2023; AAJ-6976-2021; A-7318-2017
Background and aim: Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Methods: Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Results: Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1 +/- 3.9 vs. 22.4 +/- 2.9, p < 0.05), and hyperemic DPFV (56.1 +/- 12.5 vs. 70.6 +/- 15.3, p < 0.05) and CFR (2.34 +/- 0.44 vs. 3.14 +/- 0.54, p < 0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. Conclusion: CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP. (C) 2014 Published by Elsevier Inc.
Impaired Coronary Microvascular Function and Increased Intima-Media Thickness in Preeclampsia
(2014) Ciftci, Faika C.; Caliskan, Mustafa; Ciftci, Ozgur; Gullu, Hakan; Uckuyu, Ayla; Toprak, Erzat; Yanik, Filiz; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-2877-1232; 25455007; A-7318-2017; IXD-5147-2023; GRR-9885-2022
There is an association between preeclampsia (PE) and excessive morbidity and mortality. Some recent studies have revealed the presence of endothelial dysfunction in PE patients with inflammatory activity. Moreover, it has been argued that the chronic inflammatory state involved in PE leads to an acceleration in atherosclerosis. Accordingly, our goal in this study is to determine whether there is any coronary microvascular dysfunction and increase in the intima-media thickness in patients who had mild PE 5 years before, without the presence of any traditional cardiovascular risk factors. The study included 33 mild PE patients (mild preeclampsia is classified as a blood pressure (BP) of 140/90 mm Hg or higher with proteinuria of 0.3 to 3 g/d) whose mean age was 33.7 years old, and 29 healthy women volunteers whose mean age was 36.1 years old. Each subject was examined using transthoracic echocardiography 5 years after their deliveries. During the echocardiographic examination, coronary flow reserve (CFR) and carotid intima-media thickness (IMT) were measured. There was a statistically. lower CFR value in PE patients as compared with controls (2.39 +/- 0.48 vs. 2.90 +/- 0.49; P < .001). On the other hand, there was a significant increase in their IMT and high-sensitivity C-reactive protein (hs-CRP) values (respectively, 0.59 +/- 0.15 vs. 0.46 +/- 0.10; P < .001 and 3.80 +/- 2.10 vs. 2.33 +/- 1.79; P = .004). There was a negative correlation between the CFR values of the PE patients and hs-CRP (r = -0.568; P = .001) and IMT (r = -0.683, P < .001) results. We deteinfined in the study that there was impaired CFR and increased carotid IMT in patients with PE, and, moreover, that these adverse effects were significantly correlated with hs-CRP. (C) 2014 American Society of Hypertension. All rights reserved.
Increased Morning Blood Pressure Surge and Coronary Microvascular Dysfunction in Patient with Early Stage Hypertension
(2014) Caliskan, Mustafa; Caliskan, Zuhal; Gullu, Hakan; Keles, Nursen; Bulur, Serkan; Turan, Yasar; Kostek, Osman; Ciftci, Ozgur; Guven, Aytekin; Aung, Soe Moe; Muderrisoglu, Haldun; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0002-9635-6313; 25224866; IXD-5147-2023; A-7318-2017; AAJ-8546-2021; AAG-8233-2020
Morning blood pressure surge (MBPS) is defined as an excessive increase in blood pressure (BP) in the morning from the lowest systolic BP during sleep, and it has been reported as a risk factor for cardiovascular events in current clinical studies. In this study, we evaluated the association between the rate of BP variation derived from ambulatory BP monitoring data analysis and coronary microvascular function in patients with early stage hypertension. One hundred seventy patients with prehypertension and Stage 1 hypertension who fulfilled the inclusion and exclusion criteria were included in the study. We divided our study population into two subgroups according to the median value of coronary flow reserve (CFR). Patients with CFR values <2.5 were defined as the impaired CFR group, and patients with CFR values >= 2.5 were defined as the preserved CFR group, and we compared the MBPS measurements of these two subgroups. CFR was measured using transthoracic Doppler echocardiography (TTDE). Ambulatory 24-hour systolic and diastolic BP, uric acid, systolic MBPS amplitude, diastolic MBPS amplitude, high-sensitivity C-reactive protein, and mitral flow E/A ratio were statistically significant. These predictors were included in age- and gender-adjusted multivariate analysis; ambulatory 24-hour systolic BP (beta = 0.077, P <.001; odds ratio [OR] = 1.080; 95% confidence interval [CI] [1.037-1.1241) and systolic MBPS amplitude (beta = 0.043, P =.022; OR = 1.044; 95% CI [1.006-1.0841) were determined to be independent predictors of impaired CFR (Hosmer-Lemeshow test, P=.165, Nagelkerke's R-2 = 0.320). We found that increased changes in MBPS values in patients with prehypertension and Stage 1 hypertension seemed to cause microvascular dysfunction in the absence of obstructive coronary artery disease. (C) 2014 American Society of Hypertension. All rights reserved.
The Influence of On-pump Versus Off-pump Surgery on Short- and Medium-term Postoperative Coronary Flow Reserve After Coronary Artery Bypass Grafting
(2016) Ozulku, Mehmet; Caliskan, Mustafa; Saba, Tonguc; Aksu, Feyza; Ciftci, Ozgur; Gullu, Hakan; Guven, Aytekin; Kostek, Osman; Caklili, Ozge Telci; Aslamaci, Sait; 0000-0001-7566-5427; 0000-0002-9635-6313; 0000-0002-1901-5603; 27269474; AAT-7733-2020; AAG-8233-2020; AAA-3604-2019; AAJ-8546-2021
Background Although several clinical trials have compared surgical outcomes between off-pump and on-pump coronary artery bypass grafting (CABG), whether there is a difference in the early- and medium-term postoperative coronary microvascular functions is not fully understood. We compared short- and medium-term coronary microvascular function after off-pump and on-pump CABG. Methods A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery. Each participant's coronary flow reserve (CFR) and diastolic function were measured with transthoracic Doppler echocardiography six and 12 months after surgery. Results Baseline and hyperaemic diastolic peak flow velocity in the left anterior descending artery were similar in both groups, as was CFR (2.22 +/- 0.66) in the off-pump group compared with (2.13 +/- 0.61) in the on-pump group, (P = 0.54). Coronary flow reserve was significantly and inversely correlated with high sensitivity C-reactive protein concentration (r = -0.416; P < 0.001) and positively correlated with mitral E/ A-wave velocity ratio (r = 0.247; P = 0.02). Stepwise linear regression analysis revealed that only high sensitivity C-reactive protein concentration was independently correlated with CFR (beta = -0.272, P = 0.02). Conclusions Heart-lung bypass technique had no medium-term influence on the coronary microcirculation, despite a possible initial unfavourable effect. Serum hs-CRP concentration was an independent predictor of medium-term coronary microvascular dysfunction.
Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy
(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, Haldun
Objective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.
Previous Gestational Diabetes History is Associated with Impaired Coronary Flow Reserve
(2015) Caliskan, Mustafa; Turan, Yasar; Caliskan, Zuhal; Gullu, Hakan; Ciftci, Faika Ceylan; Avci, Enver; Duran, Cevdet; Kostek, Osman; Caklili, Ozge Telci; Koca, Harun; Kulaksizoglu, Mustafa; 0000-0003-2579-9755; 26555575; IXD-5147-2023
Background Gestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM). Methods Ninety-three women with GDM history and 95 healthy women without GDM history were recruited. We used transthoracic Doppler echocardiography to assess CFVR, EFT, and left ventricular diastolic function. Insulin resistance of each subject was assessed with homeostasis model assessment insulin resistance (HOMA-IR). Hemoglobin A1c and high-sensitivity C-reactive protein (hsCRP) were also measured in all patients. Results CFVR values were significantly lower (2.34 +/- 0.39 versus 2.80 +/- 0.24, p<0.001) and EFT values were significantly higher in patients with p-GDM than the control group (5.5 +/- 1.3 versus 4.3 +/- 1.1, p<0.001). E/E' ratio (7.21 +/- 1.77 versus 6.53 +/- 1.38, p = 0.003), hemoglobin A1c (5.2 +/- 0.4 and 5.0 +/- 0.3, p = 0.001), HOMA-IR (2.8 +/- 1.4 versus 1.7 +/- 0.9, p = 0.04), and hsCRP levels were significantly higher in the p-GDM group than the control group. Multivariate analysis revealed that gestational diabetes history is independently associated with CFVR. Conclusion Women with a GDM history may be at more risk regarding coronary microvascular dysfunction compared to the healthy ones.
A Rare Cause of Left Ventricular Mass: Cardiac Hemangioma
(2018) Altin, Cihan; Gullu, Hakan; Bilgel, Ziya Gokalp; Yilmaz, Mustafa; Canpolat, Tuba; Gulcan, Omer; 29588260
Relapsed acute myeloid leukemia presenting with myocardial hypertrophy and constrictive pericardial physiology
(2019) Acibuca, Aynur; Yeral, Mahmut; Kocer, Nazim Emrah; Koc, Zafer; Gullu, Hakan; 0000-0002-3444-8845; 31062759; ABG-4047-2020; ABC-4148-2020