Publications by authors named "Mutlu Bulent"

Background:  We retrospectively analyzed patients who underwent prone positioning (PP) for acute respiratory failure after pulmonary endarterectomy (PEA).

Methods:  A total of 125 patients underwent PEA and the outcome related to patients who underwent PP for acute respiratory failure after surgery was analyzed.

Results:  In all 13 patients (10%) underwent PP at the mean duration of 28.

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Pulmonary hypertension (PH) is a progressive vascular disease characterized by elevated pulmonary arterial pressure and resistance in the pulmonary vascular bed. It is associated with high morbidity and mortality. Although right heart catheterization (RHC) is the gold standard for diagnosis, noninvasive methods, such as echocardiography, are essential for early detection and management.

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Background: Unilateral chronic thromboembolism pulmonary disease (CTEPD) is very rare. There is limited information on the safety and efficacy of pulmonary endarterectomy (PEA) in this population. This study investigated the effectiveness of PEA in this unique disease.

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Article Synopsis
  • Pulmonary endarterectomy is a surgical option for chronic thromboembolic pulmonary hypertension (CTEPH) that can potentially cure the condition, and this study looked at factors influencing patient outcomes post-surgery.
  • The study analyzed data from 834 patients who underwent surgery between March 2014 and January 2024, revealing a 7.8% in-hospital mortality rate and highlighting that older patients (≥70 years) had a significantly higher mortality rate compared to younger patients (<70 years).
  • Key predictors of mortality included age, length of ICU stay, the Charlson Comorbidity Index, and six-minute walk distance, with the findings indicating that while elderly patients faced higher risks, the surgery could still lead
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Background: Patients with chronic thromboembolic pulmonary hypertension (CTEPH) in countries with limited resources have, to date, been poorly represented in registries.

Objective: This work assesses the epidemiology, diagnosis, hemodynamic and functional parameters, and treatment of CTEPH in Russia, Kazakhstan, Turkey, Lebanon, and Saudi Arabia.

Methods: A prospective, cohort, phase IV, observational registry with 3-year follow-up (n = 212) in patients aged ≥ 18 years diagnosed with CTEPH was created.

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Background: Although high left ventricular filling pressures [left ventricular (LV) end-diastolic pressure or pulmonary capillary wedge pressure (PCWP)] are widely taken as surrogates for LV diastolic dysfunction, the actual distending pressure that governs LV diastolic stretch is transmural pressure difference (∆PTM). Clinically, preferring ∆PTM over PCWP may improve diagnostic and therapeutic decision-making. We aimed to compare the clinical implications of diastolic function characterization based on PCWP or ∆PTM.

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Objective: The relationship between oral health and general health has gained increased attention in recent years. This study sought to assess the knowledge, attitudes, and practices of cardiologists in Türkiye concerning the link between periodontal disease and cardiovascular disease (CVD).

Methods: After a pilot test, a modified survey was dispatched to 1,894 practicing cardiologists in Türkiye.

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Although current pulmonary hypertension (PH) guidelines recommend a pulmonary capillary wedge pressure (PCWP) >15 mm Hg for the detection of a postcapillary component, the rationale of this recommendation may not be quite compatible with the peculiar hemodynamics of PH. We hypothesize that a high PCWP alone does not necessarily indicate left-sided disease, and this diagnosis can be improved using left ventricle transmural pressure difference (∆ P). In this 2-center, retrospective, observational study, we enrolled 1,070 patients with PH who underwent heart catheterization, with the final study population comprising 961 cases.

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Cor triatriatum sinister (CTS) is a rare adult congenital heart disease. The usual presentation may vary according to the size of the hole in the membrane in the left atrium and the pressure gradient. In addition to acute clinical presentations including acute pulmonary edema and sudden cardiac death, patients may present with chronic findings such as right heart failure due to pulmonary hypertension.

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Article Synopsis
  • Right ventricular failure significantly worsens the prognosis of pulmonary hypertension, doubling the mortality rate.
  • In a study involving 167 patients, 47.3% exhibited bendopnea, a symptom that may indicate right ventricular energy failure.
  • Bendopnea effectively predicted right ventricular energy failure with notable accuracy, suggesting it could be a valuable, easy-to-use tool in clinical assessments of patients with pulmonary hypertension.
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Background: In this study, we aimed to describe our experience with primary pulmonary artery sarcoma in patients who underwent pulmonary endarterectomy and to evaluate clinical features, treatment, outcomes, and survival rates according to the histological subtypes of this malignant disease.

Methods: Between March 2011 and May 2022, a total of 13 patients (7 males, 6 females; mean age: 52.6±13.

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Objectives: We aimed to investigate the occurrence of sleep-related breathing disorders (SRBDs) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and addressed the effect of pulmonary hemodynamics and SRBD indices on the severity of nocturnal hypoxemia (NH).

Methods: An overnight polysomnography (PSG) was conducted in patients with CTEPH, who were eligible for pulmonary endarterectomy. Pulmonary hemodynamics (mean pulmonary arterial pressure (mPAP), pulmonary arterial wedge pressure (PAWP), pulmonary vascular resistance (PVR) measured with right heart catheterization (RHC)), PSG variables (apnea-hypopnea index (AHI)), lung function and carbon monoxide diffusion capacity (DLCO) values, as well as demographics and comorbidities were entered into a logistic regression model to address the determinants of severe NH (nocturnal oxyhemoglobin saturation (SpO) < 90% under >20% of total sleep time (TST)).

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Objectives: The underlying mechanisms for the development of chronic thromboembolic pulmonary hypertension and prognostic biomarkers are not clear yet. Thus, our aim is to assess and identify new biomarkers for the expression of 84 key genes linked to angiogenesis.

Methods: Patients who had levels more than 1000 dynes·sec·cm were included in the test group, and the other patients were included in the control group.

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Background: Pulmonary hypertension is a complex syndrome that encompasses a diverse group of pathophysiologies predisposed by different environmental and genetic factors. It is not clear to which extent the universal risk classification schemes can be applied to cohorts in individual pulmonary hypertension centers with differing environmental backgrounds, genetic pools, referral networks.

Aims: To explore whether the recommended risk classification schemes could reliably be used for mortality prediction in an unselected pulmonary hypertension population of a tertiary pulmonary hypertension center.

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Objectives: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension (CTEPH) is not well known. Our goal was to investigate the matrix metalloproteinase (MMP)-2 and -9 protein levels in patients with CTETH.

Methods: This is a prospective, cross-sectional study.

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Background: Coronavirus disease 2019 (COVID-19) is still an ongoing entity and every day we face new sequalae of the disease. We hereby present surgical results of patients who are treated for post-COVID chronic thromboembolic pulmonary hypertension.

Methods: Data were collected among patients who underwent pulmonary endarterectomy and had a diagnosis of post-COVID chronic thromboembolic pulmonary hypertension.

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Right ventricular (RV) failure has a significant adverse impact on pulmonary hypertension (PH) prognosis. None of the currently used parameters directly assess whether RV fails to provide enough energy output to propel the blood through diseased pulmonary vascular system. Furthermore, most of the current parameters are affected by the volume status of the patient.

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Aim: The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting postoperative 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.

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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.

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Objective: Abnormal iron handling complicates pulmonary hypertension (PH), causes functional limitation and poor outcomes. Although preliminary results in group 1 PH patients support the use of iron replacement, whether this applies to other PH subgroups is not known.

Methods: A total of 58 patients with an established diagnosis of group 1 or 4 PH, who had a serum ferritin of <100 ng/mL or 100 to 300 ng/mL in combination with a transferrin saturation (TSAT) <20% and received 500 to 1000 mg of ferric carboxymaltose (FCM) were included in the study.

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Background: Antiphospholipid syndrome is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis. Chronic thromboembolism is one of the known established pathogenesis of pulmonary hypertension, known as chronic thrombo-embolic pulmonary hypertension. Pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension.

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Aims: To evaluate the current management and survival of patients with left-sided infective endocarditis (IE) complicated by congestive heart failure (CHF) in the ESC-EORP European Endocarditis (EURO-ENDO) registry.

Methods And Results: Among the 3116 patients enrolled in this prospective registry, 2449 (mean age: 60 years, 69% male) with left-sided (native or prosthetic) IE were included in this study. Patients with CHF (n = 698, 28.

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Article Synopsis
  • Older patients (≥80 years) with infective endocarditis (IE) face higher mortality rates and lower rates of both surgery indication and performance compared to younger patients (<80 years).
  • Despite these disparities, the mortality rates for those who do undergo surgery are similar across both age groups, suggesting surgical treatment is beneficial.
  • There is a need for better identification of surgical candidates and more frequent surgeries in older patients to improve their outcomes in IE.
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Objective: Although the underlying pathology of chronic thromboembolic pulmonary hypertension (CTEPH) is mechanical obliteration of the major pulmonary vessels, high pulsatile stress penetrating into the normal distal pulmonary microvasculature resulting from reduced pulmonary arterial compliance (CPA) may cause progressive deterioration in pulmonary hemodynamics. Hypothetically, balloon pulmonary angioplasty (BPA) may be beneficial in reducing CPA and pulsatile stress in patients with CTEPH.

Methods: In total, 26 patients with available pre- and post-BPA right heart catheterization results were included in the study.

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