Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Effects of Carvedilol Compared to Nebivolol on Insulin Resistance and Lipid Profile in Patients With Essential Hypertension(2017) Ozyildiz, Ali Gokhan; Eroglu, Serpil; Bal, Ugur; Atar, Ilyas; Okyay, Kaan; Muderrisoglu, Haldun; 0000-0001-6134-8826; 0000-0002-9635-6313; 0000-0002-9446-2518; 0000-0003-0679-9434; 0000-0003-3055-7953; 27093951; AAK-7355-2020; AAG-8233-2020; AAK-4322-2021; ABG-1582-2021; D-2856-2015Background and aim: Beta-blockers have unfavorable effects on metabolic parameters in hypertensive treatment. New generation beta-blockers with vasodilatory capabilities are superior to traditional beta-blockers, but studies examining their effects on metabolic parameters are still lacking. This study aimed to compare the effects of 2 new generation beta-blockers, carvedilol and nebivolol, on insulin resistance (IR) and lipid profiles in patients with essential hypertension. Methods: This was a prospective, randomized, open-label, single-center clinical trial. A total of 80 patients were randomized into 2 groups: the carvedilol group (n = 40, 25 mg of carvedilol daily) and the nebivolol group (n = 40, 5 mg of nebivolol daily). Follow-up was performed for 4 months. Fasting plasma glucose, insulin levels, and the lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], total cholesterol, triglyceride, apolipoprotein AI, and apolipoprotein B levels) were measured and IR was calculated by the homeostasis model assessment (HOMA) index. These variables were compared before and 4 months after treatment. Results: Blood pressure and heart rate were significantly and similarly reduced in the carvedilol and nebivolol groups after treatment compared to those before treatment (both P < .001). Serum glucose (P < .001), insulin (P < .01), HOMA-IR (P < .01), HDL (P < .001), LDL (P < .001), total cholesterol (P < .001), and apolipoprotein B (P < .05) levels decreased in a similar manner in the carvedilol and nebivolol groups after treatment compared to those before treatment. Serum triglyceride and apolipoprotein AI levels did not change after treatment with both drugs. Conclusion: New generation beta-blockers, carvedilol and nebivolol, efficiently and similarly decrease blood pressure. They have similar favorable effects on glucose, insulin, IR, and the lipid profile.Item Clinical Outcomes of ST Segment Elevated Myocardial Infarction in Nonagenarians(2017) Coner, Ali; Ozyildiz, Ali Gokhan; Muderrisoglu, Haldun; https://orcid.org/0000-0002-9635-6313; https://orcid.org/0000-0002-9635-6313; AAG-8233-2020; AAG-8233-2020Item Role of myocardial strain and rotation for predicting prosthetic aortic valve stenosis(2021) Ozyildiz, Afag; Pirat, Bahar; Ozyildiz, Ali Gokhan; Muderrisoglu, Haldun; 0000-0003-0679-9434; 34626295; D-2856-2015Pressure overload due to aortic stenosis leads to subclinical left ventricular (LV) dysfunction and global longitudinal strain (GLS) impairment even if ejection fraction is preserved. However, little is known about LV mechanics in aortic prosthetic valve (APV) stenosis. The study aimed to determine the role of myocardial strain and rotation in predicting prosthetic valve stenosis in mechanical APV patients. 60 patients with mechanical APV and 30 healthy individuals were evaluated. APV patients were analyzed in two groups; aortic valve mean gradient < 20 mmHg (27 normal gradient patients) and >= 20 mmHg (33 high gradient patients). Strain, rotation, and twist values were assessed using the speckle tracking method, and brain natriuretic peptide (BNP) levels were measured. Four-chamber (p < 0.001) and two-chamber (p = 0.008) longitudinal strain (LS) were higher in the control group. GLS was lower in the high gradient group than control and normal gradient groups (p < 0.001, p = 0.022). LS of lateral wall's basal and mid segments were lower in normal and high gradient groups than the control group (p = 0.003, p = 0.008). While basal rotation was lower in the high gradient group than the control group (p = 0.048), there was no difference between the groups in terms of apical rotation, and twist. BNP levels were significantly different between the groups (p = 0.048). No correlation was found between aortic valve mean gradient and GLS, basal rotation, and BNP. In conclusions, LV GLS and basal rotation are depressed in high APV gradient patients; however, these parameters are not independent predictors of gradient increment.