Wos Açık Erişimli Yayınlar

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Author: search.filters.author.Bozbas, Huseyin

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    Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease
    (2019) Akinci Ozyurek, Berna; Savas Bozbas, Serife; Aydinalp, Alp; Bozbas, Huseyin; Ulubay, Gaye; 31414640
    Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), maximum work rate (WR), Delta VO2/Delta WR and O-2 pulse (VO2/HR) values were calculated. Significant CAD was defined as >= 50% narrowing in at least one of the coronary arteries. Results: The mean age was 60.4 +/- 8.9 years ve 21 (65.6%) of subjects were male. On CAG, CAD was detected in 19 (59.4%) patients. Maximum heart rate, heart rate reserve (HRR), VE/VCO2 measured at anaerobic threshold AT) and VO2 (mL/kg/min) were significantly differed in patients with CAD than those without (p= 0.031; p= 0.041; p= 0.028; p= 0.03 respectively). Peak VO2, VO2/WR and O-2 pulse values were higher in patients with normal angiographic results than those with CAD but the difference did not reach to statistical significance. Conclusion: The findings of our study indicate that among CPET parameters AT VE/VCO2, ATVO(2) (mL/kg/dk) and HRR can have predictive value in the diagnosis of CAD. We think that these parameters might be used in the evaluation of patients with angina and dyspnea suspected of CAD. In conclusion parameters obtained during the test that are not influenced by patient's effort might increase the value of CPET in the diagnosis CAD.
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    Portopulmonary hypertension in liver transplant candidates
    (2016) Bozbas, Serife Savas; Bozbas, Huseyin; 26877607
    Pulmonary vascular disorders including portopulmonary hypertension (PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure (PAP) and liver transplant surgery, survival of patients with PoPHT and advanced liver disease is significantly improved. Because of the prognostic significance of PoPHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild PoPHT can safely undergo liver transplant surgery. In cases of moderate to severe PoPHT, right heart catheterization (RHC) should be performed. In patients with moderate to severe PoPHT on RHC (mean PAP 35-45 mmHg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri-and post-operative periods as needed.