Person: ÖZBEN SADIÇ, BESTE
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ÖZBEN SADIÇ
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BESTE
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Publication Open Access Evaluation of Biventricular Functions With Tissue Doppler Imaging in Patients With Myotonic Dystrophy(WILEY, 2010-03) ÖZBEN SADIÇ, BESTE; Ozyigit, Tolga; Ozben, Beste; Oflaz, Huseyin; Serdaroglu, PirayeBackground: Myotonic dystrophy (MD) is characterized by myotonia with dystrophic involvement of the muscles. Cardiac involvement is usually not evident in the early stages of MD. Hypothesis: We investigated biventricular functions by tissue Doppler imaging (TDI) in MD patients with no overt cardiac involvement to explore the value of TDI in the early detection of myocardial dysfunction. Methods: A total of 21 MD patients (15 male, age: 32.2 +/- 12.3 yrs) and 21 healthy controls (13 male, age: 32.2 +/- 7.8 yrs) were included. In addition to conventional echocardiography, pulsed Doppler and TDI were performed including measurement of myocardial performance index (MPI); peak systolic (Sm) and early (Em) and atrial (Am) diastolic myocardial velocities at the basal mitral and tricuspid annulus. Results: All patients and controls had normal ejection fraction. Transmitral E peak velocity was significantly lower while both deceleration time of E velocity and isovolumic relaxation time were significantly longer in MD patients (P = 0.007, P = 0.001, and P < 0.001, respectively). Sm, Em and Am peak velocities were significantly lower in MD patients in all segments except for Em of the mitral anterior annulus and Am of the tricuspid lateral annulus. Both left and right ventricular MPI were significantly higher in MD patients (P < 0.001. and P = 0.013, respectively). Conclusion: There are changes in myocardial systolic and diastolic functions in MD patients although they have no overt heart failure. Myocardial tissue velocities and MPI are useful in identifying subclinical biventricular involvement in these patients.Publication Metadata only Blood pressure profile is associated with microalbuminuria and retinopathy in hypertensive nondiabetic patients(SPRINGER WIEN, 2018) ÖZBEN SADIÇ, BESTE; Karadag, Berrin; Ozyigit, Tolga; Serindag, Zeliha; Ilhan, Aysegul; Ozben, BesteTarget organ damage is important for global cardiovascular risk assessment. The aim of this study was to explore the association between the blood pressure profile and end-organ damage in a hypertensive non-diabetic cohort. A total of 560 consecutive hypertensive nondiabetic patients (mean age: 58.2 +/- 13.3 years, 221 men) were included in the study. All patients underwent thorough physical examination including fundoscopic examination. First morning urine samples were obtained from each patient and measurement of the albumin-to-creatinine ratio in first morning urine collection samples was used for diagnosis of microalbuminuria. All patients underwent a 24-h ambulatory blood pressure monitoring and were grouped as dippers and non-dippers according to the presence or absence of > 10% decrease in blood pressure during the night, respectively. The non-dipper group consisted of 247 patients with a non-dipper blood pressure profile, 31 patients with reverse dipping and 4 patients with extreme dipping. Non-dipper patients were significantly older. Coronary artery disease, cerebrovascular disease, hypertensive retinopathy and microalbuminuria were significantly more prevalent in the non-dipper patients. Non-dipping hypertension increased the risk of hypertensive retinopathy by 1.89 times (95% confidence interval, CI:1.35-2.65, p < 0.001) and the risk of microalbuminuria by 2.23 times (95% CI:1.49-3.33, p < 0.001). Non-dipping hypertension was still significantly associated with hypertensive retinopathy and microalbuminuria when adjusted by age and sex. Non-dipping hypertension was associated with increased risk of hypertensive retinopathy and microalbuminuria. Blood pressure profiles should also be considered in assessing the risk for hypertensive patients.Publication Metadata only The role of inflammation and allergy in acute coronary syndromes(2008) ÖZBEN SADIÇ, BESTE; Ozben B., Erdogan O.It is well known that inflammatory mechanisms play a crucial role in the pathogenesis of atherosclerosis and coronary artery disease. In recent years, allergic episodes have been shown to be associated with acute coronary syndromes. Mast cells release certain inflammatory mediators including histamine and neutral proteases during an allergic episode and these inflammatory mediators are implied to induce coronary artery spasm and/or atheromatous plaque erosion or rupture. As the inflammatory component of acute coronary syndromes is a potential therapeutic target, drugs that stabilize mast cell membrane and monoclonal antibodies that protect mast cell surface may be effective in preventing allergy associated acute coronary syndromes. In this review, we will mention the role of inflammation and allergy and anti-inflammatory therapeutic modalities in acute coronary syndromes. © 2008 Bentham Science Publishers Ltd.Publication Metadata only Right ventricular longitudinal deformation parameters and exercise capacity Prognosis of patients with chronic thromboembolic pulmonary hypertension(URBAN & VOGEL, 2014) KEPEZ, ALPER; Sunbul, M.; Kepez, A.; Kivrak, T.; Eroglu, E.; Ozben, B.; Yildizeli, B.; Mutlu, B.Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease characterized by increased pulmonary vascular resistance resulting in pulmonary hypertension and right heart failure. The six-minute walk test (6MWT) distance is associated with the prognosis of CTEPH patients. Speckle tracking echocardiography (STE) is a reliable method for determining ventricular function. The aim of this study was to assess and compare the right ventricular (RV) function of CTEPH patients according to their 6MWT distances. Forty-nine consecutive CTEPH patients (mean age, 50 +/- 16 years; 22 male) who were referred to our center for pulmonary thromboendarterectomy (PTE) were included in the study. All patients underwent the 6MWT and right heart catheterization (RHC). Standard echocardiography and STE were performed on all patients before PTE. Patients were divided into two groups based on their 6MWT distance being less or more than 300 m. Patients with a shorter 6MWT distance had a significantly larger RV, while they had a significantly lower RV fractional area change and higher myocardial performance index suggesting impaired RV function. Both RV basal-lateral strain and strain rate measures were significantly lower in patients with shorter 6MWT distances than those with longer 6MWT distances. Similarly, they had lower RV basal-septal, mid-lateral, and global strain measures. 6MWT distances were correlated with RV basal-lateral and mid-lateral strain measures (r = 0.349, p = 0.025 and r = 0.415, p = 0.008, respectively). Our data suggest that RV myocardial deformation parameters are associated with 6MWT distances. Determination of RV dysfunction by STE may be helpful in identifying patients with a poor prognosis.Publication Metadata only The effect of cardiac rehabilitation on blood pressure, and on left atrial and ventricular functions in hypertensive patients(WILEY, 2021) ÇİNÇİN, AHMET ALTUĞ; Sahin, Ahmet Anil; Ozben, Beste; Sunbul, Murat; Yagci, Ilker; Sayar, Nurten; Cincin, Altug; Gurel, Emre; Tigen, Kursat; Basaran, YeldaPurpose Hypertension is associated with left ventricular (LV) hypertrophy, impaired LV relaxation, and left atrial (LA) enlargement. Cardiac rehabilitation (CR) improves clinical outcomes in a broad spectrum of cardiac disease. The aim of our study was to determine the effect of CR on blood pressure (BP), and on LA and LV functions in hypertensive patients. Methods Thirty consecutive hypertensive patients who would undergo CR program, and 38 hypertensive patients who refused to undergo CR program were included. All patients underwent ambulatory BP monitoring and transthoracic echocardiography, which were repeated after completion of the CR program, or 12 weeks later in the control group. LA and LV functions were assessed by both speckle tracking and 3-dimensional echocardiography. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were assessed before and after CR. Results Although initial ambulatory BP values and NT-proBNP levels were similar between the groups, daily, day-time, and night-time BP and NT-proBNP were significantly lower in the CR group after rehabilitation. LA reservoir strain and LV global longitudinal strain of the CR group significantly increased after CR while no significant increase was observed in controls. Conclusion CR improves LA and LV strain while lowering BP and should be encouraged in routine management of hypertensive patients.Publication Metadata only Effect of Increased Severity of Mitral Regurgitation and Preprocedural Right Ventricular Systolic Dysfunction on Biventricular and Left Atrial Mechanical Functions Following Percutaneous Mitral Balloon Valvuloplasty(WILEY-BLACKWELL, 2014) ÖZBEN SADIÇ, BESTE; Tigen, Kursat; Pala, Selcuk; Sadic, Beste Ozben; Karaahmet, Tansu; Dundar, Cihan; Bulut, Mustafa; Izgi, Akin; Esen, Ali Metin; Kirma, CevatBackgroundSevere mitral stenosis (MS) may impair left atrial (LA) pump function, and increase LA and pulmonary venous pressure resulting in right ventricular (RV) systolic dysfunction. The aim of this study was to evaluate biventricular and LA function after percutaneous mitral balloon valvuloplasty (PMBV) by tissue Doppler (TDI) and speckletracking echocardiography (STE).MethodsTwenty-eight consecutive patients with severe symptomatic rheumatic MS (11 men, mean age: 397years) who were referred for PMBV were included in the study. In addition to conventional echocardiography, all patients underwent TDI and two-dimensional (2D) (STE) to assess left ventricular (LV), LA, and RV function before and 3months after PMBV. Severity of mitral regurgitation (MR) was graded by the ratio of MR jet area to LA area (JA/LAA) method and any postprocedural progression of the JA/LAA ratio was defined as worsening of MR. Peak systolic velocity of tricuspid lateral annulus (RVs) <11.5cm/sec was accepted as RV dysfunction.ResultsLeft atrial diameter and area were decreased, while LV dimensions were unchanged following the valvuloplasty. PMBV improved STE-based LV mechanical indices, LA reservoir and conduit function, and RV free wall basal longitudinal strain (LS) and displacement. Increased severity of MR was detected in 6 patients, and PMBV did not improve the STE-based RV or LV function in these patients, while LA reservoir and conduit function were both improved independent of MR worsening. There was significant improvement in RVs and RV basal LS in the 15 patients with preprocedural RV systolic dysfunction, while the improvement in patients with normal preprocedural RV function was not significant.ConclusionPercutaneous mitral balloon valvuloplasty may improve both LA and biventricular function in patients with severe symptomatic MS. Both TDI and STE are useful to determine biventricular and LA function after PMBV. Although the number of patients was insufficient, worsening of MR after PMBV may limit the improvement in RV and LV function, while preprocedural RV dysfunction does not seem to limit the improvement in RV function and pulmonary artery systolic pressure. Large scale follow-up studies are required to see whether the changes observed in cardiac mechanics are persistent.Publication Metadata only Left atrial volume changes are an early marker of end-organ damage in essential hypertension: A multidisciplinary approach to an old problem(WILEY, 2017) ÖZBEN SADIÇ, BESTE; Kanar, Batur; Ozben, Beste; Kanar, Hatice Selen; Arsan, Aysu; Tigen, KursatPurposeLeft atrial (LA) volume has been shown to be a predictor of adverse cardiovascular outcomes. The aim of this study was to evaluate the relation between LA phasic volumes and hypertensive end-organ damage (EOD), by using real time three-dimensional echocardiography (RT3DE) in patients with essential hypertension (HT). MethodsThe study included 95 essential hypertensive patients (6010years, 37 males). The patients were divided into three according to the presence of EOD, namely microalbuminuria and retinal vascular changes detected by direct ophthalmoscopy. The first group had no EOD. The second group (EOD+ group) had either microalbuminuria or retinal vascular changes while the third group (EOD++ group) had both renal and retinal damage. ResultsThe three groups did not differ with regard to age, sex, or metabolic profile. In RT3DE measurements, there were significant differences in LA phasic volumes (LA maximal volume index, LA minimal volume index, LA pre-atrial contraction volume index, LA total stroke volume index, and LA active stroke volume index, P<.001) among the groups. Moreover, patients with more extended EOD had significantly worse LA reservoir and conduit functions. In the logistic regression analysis, the LA active stroke volume index was an independent predictor of EOD (82% sensitivity and 92% specificity, area under the curve=0.96, P<.001). ConclusionRT3DE measured LA phasic volumes and mechanical functions are associated with hypertensive EOD, which might serve as a surrogate endpoint for determining cardiovascular mortality and morbidity rates in patients with essential HT.Publication Open Access Effect of Vitamin D Deficiency and Replacement on Endothelial Function in Asymptomatic Subjects(ENDOCRINE SOC, 2009-10-01) VELİOĞLU ÖĞÜNÇ, AYLİZ; Tarcin, Ozlem; Yavuz, Dilek Gogas; Ozben, Beste; Telli, Ahu; Ogunc, Ayliz Velioglu; Yuksel, Meral; Toprak, Ahmet; Yazici, Dilek; Sancak, Seda; Deyneli, Oguzhan; Akalin, SemaContext: Vitamin D receptors are present in many tissues. Hypovitaminosis D is considered to be a risk factor for atherosclerosis. Objective: This study explores the effects of vitamin D replacement on insulin sensitivity, endothelial function, inflammation, oxidative stress, and leptin in vitamin D-deficient subjects. Design, Setting, and Patients: Twenty-three asymptomatic vitamin D-deficient subjects with 25-hydroxyvitamin D [25(OH)D] levels below 25 nmol/liter were compared with a control group that had a mean 25(OH)D level of 75 nmol/liter. The vitamin D-deficient group received 300,000 IU im monthly for 3 months. The following parameters were evaluated before and after treatment: vitamin D metabolites, leptin, endothelial function by brachial artery flow mediated dilatation (FMD), insulin sensitivity index based on oral glucose tolerance test, and lipid peroxidation as measures of thiobarbituric acid reactive substances (TBARS). Results: FMD measurements were significantly lower in 25(OH)D-deficient subjects than controls (P = 0.001) and improved after replacement therapy (P = 0.002). Posttreatment values of TBARS were significantly lower than pretreatment levels (P < 0.001). A positive correlation between FMD and 25(OH)D (r = 0.45; P = 0.001) and a negative correlation between FMD and TBARS (r = -0.28; P < 0.05) were observed. There was a significant increase in leptin levels after therapy, and the leptin levels were positively correlated with 25(OH)D levels (r = 0.45; P < 0.05). Conclusions: This study shows that 25(OH)D deficiency is associated with endothelial dysfunction and increased lipid peroxidation. Replacement of vitamin D has favorable effects on endothelial function. Vitamin D deficiency can be seen as an independent risk factor of atherosclerosis. Hypovitaminosis D-associated endothelial dysfunction may predispose to higher rates of cardiovascular disease in the winter. (J Clin Endocrinol Metab 94: 4023-4030, 2009)Publication Metadata only Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclinical hypothyroid patients(HUMANA PRESS INC, 2015) ÖZBEN SADIÇ, BESTE; Yazici, Dilek; Ozben, Beste; Toprak, Ahmet; Yavuz, Dilek; Aydin, Hasan; Tarcin, Ozlem; Deyneli, Oguzhan; Akalin, SemaEpicardial adipose tissue (EAT) thickness is a novel cardiovascular risk indicator, whereas carotid intima media thickness (CIMT) is a known marker of subclinical atherosclerosis. The aim of this study was to measure EAT thickness and CIMT in subclinical hypothyroid (SCH) patients and to determine the effect of restoration of the euthyroid state on these variables. The study included 43 patients with SCH (mean age: 35.2 +/- 10.7 years; F-M ratio: 42: 1) and 30 healthy controls (mean age: 34.5 +/- 8.2 years; F-M ratio: 25: 5). EAT thickness and CIMT were measured via conventional echocardiography and ultrasonography. Among the patients, 23 were followed up with L-thyroxine replacement until restoration of the euthyroid state and re-evaluated 6 months after baseline. Basal EAT thickness was higher in the SCH patients than in the controls (3.2 +/- 0.7 vs. 2.3 +/- 0.3 mm-p < 0.0001), whereas CIMT was similar in both groups (0.50 +/- 0.09 vs. 0.48 +/- 0.04 mm). EAT thickness was correlated with CIMT in the patient group (r = 0.39, p = 0.01), but this correlation was not evident based on multivariate analysis when corrected for age and body mass index (r(2) = 0.47 and p = 0.0001 for the model). In the follow-up patient subgroup, both EAT thickness and CIMT decreased significantly following L-thyroxine treatment, when normal TSH levels were attained (3.4 +/- 0.7 vs. 2.3 +/- 0.5 mm-p = 0.007 and 0.51 +/- 0.09 vs. 0.46 +/- 0.07 mm-p = 0.01, respectively). EAT thickness was greater in the SCH patients than in controls, whereas CIMT was similar in both groups. Restoration of the euthyroid state with L-thyroxine treatment was associated with significant decreases in EAT thickness and CIMT in the group of patients that received L-thyroxine treatment and, as such, might reduce the cardiovascular risk associated with SCH.Publication Open Access Validity and reliability of the turkish version of "cardiac rehabilitation barriers scale"(2019) ÖZBEN SADIÇ, BESTE; Coşkun, Özge Keniş; Yağcı, İlker; Göçmen, Selma; Sağdıç, Beste Özben