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Author: search.filters.author.Kocabas, Umutsearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    Effect of Aortic Valve Opening Pattern on Endothelial Function After Continuous-Flow Left Ventricular Assist Device Implantation
    (2023) Kaya, Ersin; Kocabas, Umut; Simsek, Evrim; Nalbantgil, Sanem; Engin, Cagatay; Ozbaran, Mustafa; Akilli, Azem; 0000-0001-6424-9399; 37773149; GXG-7709-2022
    This study aimed to evaluate the effects of aortic valve opening patterns on endothelial functions in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation. This study included 43 patients who underwent CF-LVAD implantation and 35 patients with heart failure reduced ejection fraction (HFrEF; control group). The CF-LVAD group was divided into three subgroups based on aortic valve opening patterns: open with each beat, intermittently opening, and not opening groups. Flow-mediated dilatation (FMD) and pulsatility index (PI) were compared before and 3 months after CF-LVAD implantation. Cardiopulmonary exercise test (CPET) and 6 minute walk test (6-MWT) scores were measured at baseline and follow-up in the CF-LVAD group. The mean FMD and PI of patients in the CF-LVAD group reduced 3 months after implantation. Patients with intermittently opening and not opening aortic valves had worse endothelial function at follow-up. Before and 3 months after implantation FMD% did not significantly differ in patients whose aortic valves were open with each beat (4.72 +/- 1.06% vs. 4.67 +/- 1.16%, p = 0.135). Pulsatility index changes paralleled FMD changes. Cardiopulmonary exercise test and 6-MWT scores improved after implantation but without significant differences between subgroups. Maintaining normal aortic valve function after CF-LVAD implantation may reduce endothelial dysfunction; however, larger studies are needed for long-term clinical effects.
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    Successful Thrombolysis of A Subacute Prosthetic Valve Thrombosis With Modified Ultra-Slow Thrombolytic Therapy
    (2018) Altay, Hakan; Kocabas, Umut; Yildirimturk, Ozlem; Ozkalayci, Flora; Saritas, Bulent; Pehlivanoglu, Seckin; https://orcid.org/0000-0001-6424-9399; 29943853; AAE-1392-2021; AAG-5856-2020; ABC-9264-2021
    Prosthetic valve thrombosis is a serious complication of heart valve surgery. According to the recent studies, thrombolytic therapy is an important alternative therapy to the open heart surgery with successful outcomes. We present a case of a prosthetic mitral valve thrombosis who was successfully treated with modified ultra-slow thrombolytic therapy.
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    Reply to The Letter to The Editor: Successful Thrombolysis of A Subacute Prosthetic Valve Thrombosis with Modified Ultra-Slow Thrombolytic Therapy
    (2018) Altay, Hakan; Kocabas, Umut; Yildirimturk, Ozlem; Ozkalayci, Flora; Saritas, Bulent; Pehlivanoglu, Seckin; 30079510
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    Effects of Continuous-Flow Left Ventricular Assist Device Therapy on Peripheral Vascular Function
    (2022) Kaya, Ersin; Kocabas, Umut; Simsek, Evrim; Nalbantgil, Sanem; Kahraman, Umit; Engin, Cagatay; Yagdi, Tahir; Ozbaran, Mustafa; Akilli, Azem; 35089263; GXG-7709-2022
    The peripheral vascular effects of continuous-flow left ventricular assist device (CF-LVAD) implantation are still unclear. The aim of the current study was to determine peripheral vascular function before and after implantation of CF-LVAD in patients with end-stage heart failure (HF), and to compare this data to age- and sex-matched chronic heart failure with reduced ejection fraction (HFrEF) patients. Forty-three consecutive end-stage HF patients (New York Heart Association [NYHA] class III/IV; three women and 40 men; mean age 53 +/- 11 years) who planned to receive CF-LVAD implantation comprised the LVAD patient population, and their clinical characteristics, preoperative and third postoperative month peripheral vascular function assessment data including flow-mediated dilation (FMD) and pulsatility index (PI) assessed by ultrasound Doppler in brachial artery were compared to age- and sex-matched chronic, stable HFrEF patients (NYHA class II; five women and 30 men; mean age 51 +/- 10 years). After CF-LVAD implantation, median FMD decreased from 5.4 to 3.7% (p < 0.001), and median PI decreased from 6.9 to 1.4 (p < 0.001). In patients with end-stage HF before CF-LVAD implantation, FMD and PI were significantly lower compared to the chronic HFrEF patients (FMD: 5.4% +/- 0.9% vs. 7.6% +/- 1.1%; p < 0.001, respectively) and (PI: 6.9 +/- 1.3 vs. 7.4 +/- 1.2; p = 0.023, respectively). The current study revealed impaired peripheral vascular function in the end-stage HF patients compared to stable HFrEF patients, and documented the deterioration of peripheral vascular function after CF-LVAD implantation. These results suggest that impaired peripheral vascular function in the CF-LVAD patients compared to preoperative assessment is a consequence of the nonpulsatile blood flow due to the continuous-flow mechanical support.
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    Assessment of atrial functional remodeling in patients with atrioventricular nodal reentrant tachycardia with and without drug-induced type 1 Brugada pattern: A case-control study
    (2021) Kocabas, Umut; Payzin, Serdar; Hasdemir, Can; 33599988
    Purpose The time interval between the onset of the P-wave on electrocardiogram (ECG) and peak A ' velocity of the lateral left atrial wall assessed by tissue Doppler imaging (PA-TDI interval) determine total atrial conduction time (TACT) which reflects atrial remodeling and arrhythmic substrate. In this retrospective study, we aimed to assess TACT in patients with atrioventricular nodal reentrant tachycardia (AVNRT) with and without drug-induced type 1 Brugada electrocardiogram ECG pattern (DI-Type 1 BrP) and control subjects. Methods Study population consisted of 62 consecutive patients (46 women; mean age 44 +/- 12 years) undergoing electrophysiological study and ablation for symptomatic, drug-resistant AVNRT, and 42 age-matched and sex-matched control subjects. All patients and control subjects underwent ajmaline challenge test and tissue Doppler imaging. Results A DI-Type 1 BrP was uncovered in 24 of 62 patients with AVNRT (38.7%). PA-TDI interval was similar among AVNRT patients with and without DI-Type 1 BrP (124 +/- 12 ms vs 119 +/- 14 ms, respectively, P = .32), but significantly longer in patients with AVNRT with as well as without DI-Type 1 BrP than in control subjects (124 +/- 12 ms and 119 +/- 14 ms vs 105 +/- 11 ms, respectively, P < .001). Conclusion The TACT assessed by PA-TDI interval is longer in patients with AVNRT with and without DI-Type 1 BrP than in age-matched and sex-matched healthy control subjects.
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    ADHERENCE TO GUIDELINE-DIRECTED MEDICAL AND DEVICE THERAPY IN HEART FAILURE WITH REDUCED EJECTION FRACTION
    (2020) Kocabas, Umut; Kivrak, Tarik; Oztekin, Gulsum Meral Yilmaz; Tanik, Veysel Ozan; Ozdemir, Ibrahim; Kaya, Ersin; Yuce, Elif Ilkay; Demir, Fulya Avci; Dogdus, Mustafa; Pehlivanoglu, Seckin; ABA-3670-2020
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    Recognition and clinical implications of high prevalence of migraine in patients with Brugada syndrome and drug-induced type 1 Brugada pattern
    (2020) Hasdemir, Can; Gokcay, Figen; Orman, Mehmet N.; Kocabas, Umut; Payzin, Serdar; Sahin, Hatice; Nyholt, Dale R.; Antzelevitch, Charles; 33058326
    Introduction We have previously reported high 1-year prevalence of migraine in patients with atrial arrhythmias associated with DI-type 1 BrP. The present study was designed to determine the lifetime prevalence of migraine in patients with Brugada syndrome (BrS) or drug-induced type 1 Brugada pattern (DI-type 1 BrP) and control group, to investigate the demographic and clinical characteristics, and to identify clinical variables to predict underlying BrS/DI-type 1 BrP among migraineurs. Methods and Results Lifetime prevalence of migraine and migraine characteristics were compared between probands with BrS/DI-type 1 BrP (n = 257) and control group (n = 370). Lifetime prevalence of migraine was 60.7% in patients with BrS/DI-type 1 BrP and 30.3% in control group (p = 3.6 x 10(-14)). On stepwise regression analysis, familial migraine (odds ratio [OR] of 4.4; 95% confidence interval [CI]: 2.0-9.8; p = 1.3 x 10(-4)), vestibular migraine (OR of 5.4; 95% CI: 1.4-21.0); p = .013), migraine with visual aura (OR of 1.8; 95% CI: 1.0-3.4); p = .04) and younger age-at-onset of migraine (OR of 0.95; 95% CI: 0.93-0.98); p = .004) were predictors of underlying BrS/DI-type 1 BrP among migraineurs. Use of anti-migraine drugs classified as "to be avoided" or "preferably avoided" in patients with BrS and several other anti-migraine drugs with potential cardiac I-Na/I-Ca channel blocking properties was present in 25.6% and 26.9% of migraineurs with BrS/DI-type 1 BrP, respectively. Conclusion Migraine comorbidity is common in patients with BrS/DI-type 1 BrP. We identify several clinical variables that point to an underlying type-1 BrP among migraineurs, necessitating cautious use of certain anti-migraine drugs.
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    Acute Coronary Syndrome Associated with Carfilzomib Treatment
    (2020) Kocabas, Umut; Atalay, Figen; Altay, Hakan; Altun, Armagan; Pehlivanoglu, Seckin; 0000-0003-4384-2913; 0000-0002-8506-7583; 0000-0002-3233-8263; 32647445; AAE-1392-2021; B-5507-2014; ABB-5844-2020
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    Gender-related clinical and management differences in patients with chronic heart failure with reduced ejection fraction
    (2020) Kocabas, Umut; Kivrak, Tarik; Yilmaz Oztekin, Gulsum Meral; Tanik, Veysel O.; Ozdemir, Ibrahim; Kaya, Ersin; Yuce, Elif Ilkay; Avci Demir, Fulya; Dogdus, Mustafa; Altinsoy, Meltem; Ustundag, Songul; Ozyurtlu, Ferhat; Karagoz, Ugur; Karakus, Alper; Urgun, Orsan Deniz; Sinan, Umit Yasar; Mutlu, Inan; Sen, Taner; Astarcioglu, Mehmet Ali; Kinik, Mustafa; Ozden Tok, Ozge; Uygur, Begum; Yeni, Mehtap; Alan, Bahadir; Dalgic, Onur; Altay, Hakan; Pehlivanoglu, Seckin; 33063424; AAE-1392-2021
    Aim Gender-related differences have been described in the clinical characteristics and management of patients with chronic heart failure with reduced ejection fraction (HFrEF). However, published data are conflictive in this regard. Methods We investigated differences in clinical and management variables between male and female patients from the ATA study, a prospective, multicentre, observational study that included 1462 outpatients with chronic HFrEF between January and June 2019. Results Study population was predominantly male (70.1%). In comparison to men, women with chronic HFrEF were older (66 +/- 11 years vs 69 +/- 12 years, P < .001), suffered more hospitalisations and presented more frequently with NYHA class III or IV symptoms. Ischaemic heart disease was more frequent in men, whereas anaemia, thyroid disease and depression were more frequent in women. No difference was seen between genders in the use rate of renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists, or ivabradine, or in the proportion of patients achieving target doses of these drugs. Regarding device therapies, men were more often treated with an implantable cardioverter-defibrillator (ICD) and women received more cardiac resynchronisation therapy. Conclusion In summary, although management seemed to be equivalent between genders, women tended to present with more symptoms, require hospitalisation more frequently and have different comorbidities than men. These results highlight the importance of gender-related differences in HFrEF and call for further research to clarify the causes of these disparities. Gender-specific recommendations should be included in future guidelines in HFrEF.