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Öğe Impact of empagliflozin on left atrial mechanical and conduction functions in patients with type 2 diabetes mellitus(2022) Aslan, Muzaffer; Okşen, Doğaç; Kaynak, Çağdaş; Özüdoğru, OsmanObjective: Empagliflozin, an oral anti-diabetic drug that inhibits the sodium-dependent glucose co-transporter 2 (SGLT2), has pleiotropic effects on the myocardium. The aim of the study is to investigate the effect of empagliflozin on atrial electromechanical delay (AEMD) and the left atrial (LA) mechanical functions in patients with type 2 diabetes mellitus (DM). Method: In total 62 patients (40.3% female, mean age 50.5 ± 8.6 years old) with type 2 DM were enrolled to the study. Participants were used a SGLT2 inhibitor (empagliflozin 10-25 mg/daily) for 6 months. Patients were examined initially and after 6 months with echocardiography. LA volume was recorded, atrial conduction times were measured using tissue Doppler imaging (TDI). Results: No significant change was observed in LA volumes (maximal, minimal, and presystolic), total emptying and passive emptying volume at the end of 6 months; however, there was a significant decrease in active emptying volume (8.3 ± 2.9 ml/m2 vs. 7.9 ± 2.9 ml/m2 , p = 0.04). The posteroanterior lateral, septal, and tricuspid conduction times significantly decreased after the empagliflozin treatment. The decrease in right inter-AEMD was statistically significant (13.25 ± 10.21 ms vs. 10.85 ± 9.14 ms, p = 0.011). The changes in inter-AEMD were found to be correlated with the changes in LA active emptying volume (r = 0.408). Conclusion: Empagliflozin may enhance the structure and electrical conductions of the atrium and may prevent DM patients from DM-2-related functional disorder and arrhythmia.Öğe Impact of oxidative stress on myocardial performance in patients with diabetes: a focus on subclinical left ventricular dysfunction(2024) Okşen, Doğaç; Aslan, MuzafferIntroduction: Oxidative stress is known to affect left ventricular functions negatively. There is a strong bidirectional connection between diabetes mellitus (DM) and oxidative stress. In parallel, left ventricular dysfunction is observed more frequently, even in patients with DM without other risk factors. In this context, the objective of this study is to comparatively investigate the potential relationship between oxidative stress and subclinical left ventricular dysfunction (SCLVD) assessed by Myocardial Performance Index (MPI) in patients with and without DM. Research design and methods: The sample of this observational cross-sectional single-center study consisted of 151 patients who were evaluated for oxidative stress and SCLVD by tissue Doppler echocardiography. Patients' total oxidant status (TOS), total antioxidant status (TAS), and Oxidative Stress Index (OSI) values were calculated. The effects of oxidative stress and DM on MPI were analyzed. Results: There were 81 patients with DM (mean age: 46.17±10.33 years) and 70 healthy individuals (mean age: 45.72±9.04 years). Mean TOS and OSI values of the DM group were higher than healthy individuals (5.72±0.55 vs 5.31±0.50, p = <0.001; and 4.92±1.93 vs 1.79±0.39, p = <0.001; respectively). The mean TAS value of the DM group was significantly lower than the healthy group (1.21±0.40 vs 3.23±0.51, p = <0.001). There was a significant correlation between OSI and MPI mitral in the DM group (R 0.554, p = <0.001) but not in the healthy group (R -0.069, p=0.249). Conclusions: Both oxidative stress and myocardial dysfunction were found to be more common in patients with DM. The study's findings indicated the negative effect of oxidative stress on myocardial functions. Accordingly, increased oxidative stress caused more significant deterioration in MPI in patients with DM compared with healthy individuals.Öğe Music Therapy may Decrease Radial Artery Spasm Rates and Increase Satisfaction during Coronary Angiography(2025) Aslan, Muzaffer; Okşen, Doğaç; Yavuz, Yunus Emre; Kaynak, ÇağdaşIntroduction: With the widespread use of the radial artery in catheterization procedures, radial artery spasm (RAS) is frequently considered an undesirable event. It is known that anxiety increases RAS, and listening to music helps individuals control anxiety during the procedure. This study aimed to investigate the effects of music concerts on RAS. Methods: In this prospective study, imaging and interventional coronary catheterization procedures using the radial artery were included. One group listened to a musical recital during the procedure, while the other group was treated in a quiet environment. The demographics, procedural parameters, and complications of both groups were compared. Results: The study included a total of 147 patients, with an average age of 51.6 ± 11.1 years. Of these, 78 patients (53%) listened to music, while 69 patients (46.9%) underwent catheterization in a quiet environment. The impact of music therapy on the RAS was found to be significant (11.5% vs. 20.3%; p=0.035). While music therapy showed a potential to reduce RAS rates, its effect was not statistically significant in multivariate analysis (p=0.055). Conclusion: Music is a feasible, simple, and inexpensive method for reducing anxiety levels in patients. Listening to music during catheterization can reduce procedural discomfort and the frequency of undesirable events by helping people control their anxiety.Öğe Ranolazine improved left ventricular diastolic functions and ventricular repolarization indexes in patients with coronary slow flow(2023) Okşen, Doğaç; Aslan, Muzaffer; Özmen, Emre; Yavuz, Yunus EmreIntroduction: Coronary slow flow (CSF) is a condition commonly encountered during angiography. Recent studies have shown the adverse effects of CSF on left ventricular diastolic functions. CSF reportedly increases the novel ventricular repolarization parameters. Ranolazine is a preparation with a prominent anti-anginal activity that has positive effects on anti-arrhythmic and diastolic parameters. In this context, this study was carried out to investigate the effects of ranolazine on left ventricular diastolic functions and repolarization in patients with CSF. Material and methods: Forty-six patients with CSF and 29 control subjects were included in the patient and control groups, respectively. Both groups received ranolazine for one month and were evaluated using 12-lead electrocardiography, conventional echocardiography, and tissue Doppler imaging at the baseline and after one month of ranolazine treatment. Results: Corrected P, QT dispersion, and Tp-e interval values were significantly higher in the patient group than in the control group. There was a significant decrease in isovolumic relaxation time (IVRT) and deceleration time (DT) values after the ranolazine treatment compared to the baseline values in the patient group but not the control group. A significant increase was observed in the mean E and A velocities and the mean E/A ratio after the ranolazine treatment compared to the baseline values in the patient group. Additionally, there was a significant difference between the Tp-e interval and corrected P dispersion values measured after the ranolazine treatment compared to the baseline values in the patient group but not in the control group. Conclusion: This study's findings demonstrated that ranolazine positively affected impaired diastolic functions and repolarization parameters, particularly in patients with CSF.Öğe The relationship of erectile dysfunction severity with nocturnal blood pressure pattern and RDW(2024) Aslan, Muzaffer; Yavuz, Yunus Emre; Okşen, Dogac; Bal, ErdemAims: The study aimed to investigate the relationship between the severity of erectile dysfunction (ED), nocturnal blood pressure patterns, and red blood cell width distribution (RDW) in hypertensive patients. Methods: The study involved 106 hypertensive patients, categorized into non-dippers and dippers based on their nocturnal blood pressure patterns. Key parameters including smoking status, RDW, and International Index of Erectile Function (IIEF) scores, were compared between the groups. Results: The demographic data of the patients were similar. RDW was significantly higher in patients with non-dipper hypertension (HT) compared to the dipper group. Moderate and severe ED was seen more frequently in the non-dipper HT group (40.4% vs 20.4%; p=0.025). IIEF score was higher in the dipper HT group (17.6±6.9 vs 21.0±4.5; p=0.004). According to logistic regression analysis, age and smoking habit were significant predictors for moderate or severe ED. Conclusion: The study highlights the significant association between non-dipping blood pressure patterns, elevated RDW, and the severity of ED in hypertensive patients. The findings underscore the importance of monitoring nocturnal blood pressure patterns and RDW in understanding and managing ED in this population.
