Browsing by Author "Tas, S"

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    The Relationship between Serum Neuropeptide FFR2, Serum Smoothelin and Pregnancy Outcomes in Pregnant Women with Gestational Hypertension
    Tas, S; Sarsmaz, K; Sarsmaz, HY; Gürgen, SG; Tas, U; Eyüboglu, M; Ari, Z
    Objective: Gestational hypetension is a major public health concern due to its links with cardiovascular disease, stroke and neonatal morbidity and mortality. Timely diagnosis and effective management of gestational hypertension are essential for both maternal and neonatal health. Neuropeptide FF Receptor 2 (NPFFR2) is a protein secreted by the brain and placenta, involved in pain regulation, water balance, and the modulation of cardiovascular effects. This study aims to conduct a comparative analysis of NPFFR2, smoothelin (SMTH), echocardiographic results and pregnancy outcomes in pregnant women with and without gestational hypertension. Method: This study included 78 pregnant participants, which were grouped into women with gestational hypertension (n = 39) and those without gestational hypetension (n = 39). The gestational hypertension population was classified into two groups, i.e., dipper and non-dipper groups, based on the 24-hour ambulatory blood pressure monitoring results. Smoothelin and NPFFR2 analyses were performed using the blood samples and placental tissue samples collected from all participants, along with echocardiography and 24-hour ambulatory blood pressure monitoring. Results: The study group comprised 78 pregnant women with a mean age of 28.8 years and mean gestational age of 27.7 weeks. The gestational hypertension group had a significantly higher NPFFR2 levels, lower SMTH levels and gestational age at birth and higher all 24-hour ambulatory blood pressure monitoring findings. The left atrial-to-aortic ratio and Tricuspid annular plane systolic excursion (TAPSE) were significantly higher in G & Idot;H group than in the control group. NPFFR2 and gestational age at birth were found to be independently associated with neonatal intensive care unit admission. Conclusion: Serum NPFFR2 levels were increased in women with gestational hypertension, SMTH levels were decreased, and pregnancy prognosis was found to be associated with NPFFR2 levels.
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    Time to Reconsidering the Potential Role of Leech Salivary Proteins in Medicine: Type-II Kounis Syndrome Triggered by Leech Bite
    Tas, S; Yildiz, BS; Ersin, A; Tas, U
    Kounis syndrome also known as allergic myocardial infarction, represents the simultaneous occurrence of acute coronary syndromes with allergic or hypersensitivity reactions. We present a case of a 58-years-old male who developed anaphylaxis following a leech bite, leading to myocardial infarction despite the absence of prior allergic history. He was entubated and cardiopulmonary resusciation had been performed for 10 minutes. The patient was successfully resuscitated and Intravenous antihistamine, prednisolone and adrenaline were given. The patient was stabilized and transferred to the intensive care unit and coronary angiography was performed, which revealed a 90% stenosis in the circumflex coronary artery. A stent was successfully implanted in the affected artery. This report emphasizes the complexity of diagnosing and managing Type-II Kounis syndrome and highlights the need for increased clinical awareness.
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    Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs. non-dipper hypertensive patients
    Tas, S; Altinisik, M; Tas, Ü
    Purpose To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT). Methods Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased >= 10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 mu m nasal and temporal to the fovea. Results Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 +/- 3.39 vs. 4.96 +/- 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender. Conclusion Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels.
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    Comparison of Serum Spexin Level and its Relationship with Echocardiographic Findings in Prediabetic Patients with and without Hypertension
    Tas, S; Tas, U; Küme, T
    Objective: Prediabetes mellitus, hypertension, and their frequent coexistence are risk factors for macrovascular and cardiovascular complications. In this study we aimed to determine the relationship between spexin levels and echocardiographic findings and hypertension in prediabetic patients. Methods: This study included 118 adult patients diagnosed with prediabetes mellitus who presented to outpatient clinics between April 2021 and January 2022. The patients were grouped into prediabetic patients with hypertension (n = 58) and those without hypertension (n = 60). The hypertension group was further divided into dipper and non-dipper groups according to the 24-hour ambulatory blood pressure monitoring. Blood samples were collected from all patients and echocardiography was performed. Spexin levels were measured by ELISA. Serum spexin levels, echocardiographic and ambulatory blood pressure monitoring findings were compared between the groups. Results: The hypertension and non-dipper groups had significantly lower spexin levels and higher left atrial volume index, E/Em index, and interventricular septum and posterior wall thicknesses. Spexin levels were negatively correlated with body mass index (r = -0.298, P < 0.001), nighttime systolic blood pressure (r = -0.264, P = 0.006), nighttime diastolic blood pressure (r =-.255, P = 0.005), left atrial volume index (r =-.238, P = 0.009), E/Em (r =-.214,P = 0.020), and low-density lipoprotein cholesterol (r = -.243, P = 0.008). Obesity, overweight and spexin <780 pg/mL were independently associated with hypertension. Conclusion: Circulating spexin levels were lower in prediabetic patients with overall hypertension and in non-dipper patients, and were associated with echocardiographic and lipid parameters. The cut-off value of spexin identified in our study may be a useful indicator for hypertension detection and raise clinicians' awareness about evaluating prediabetic patients for hypertension.
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    Effect of Heart Rate-Oriented Therapy on Diastolic Functions in Patients with Heart Failure with Reduced Ejection Fraction
    Tas, S; Tas, Ü; Özpelit, E; Edem, E; Akdeniz, B
    Background: Resting heart rate (HR) is a strong predictor of cardiovascular mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). However, the effects of HR-lowering therapy on diastolic function in HFrEF patients are not well described. In this study, we aimed to investigate the effect of lowering HR on diastolic function in HFrEF patients with sinus rhythm. Methods: Fifty patients with HFrEF with coexisting diastolic dysfunction and sinus rhythm with resting HR > 70 bpm were prospectively included in the study. All patients were treated with intended HR-lowering therapy, which targeted a HR below 70 bpm. We divided the whole population according to the resting HR achieved with strict rate control (group 1) and to that achieved without strict rate control (group 2; HR > 70 bpm) at the end of the study. Left ventricular diastolic function and B-type natriuretic peptide (BNP) values at baseline and at the end of the study were compared in both groups. Results: No significant differences were found between the groups in terms of baseline parameters except for lower diastolic blood pressure in group 2. At the end of follow-up, E/Em ratio, E/A ratio and left atrial area significantly decreased with an increased deceleration time in group 1. The changes in HR (delta HR) were correlated with E/Em (r = 0.67, p < 0.001) and delta BNP level (r = 0.49, p < 0.001). Conclusions: This study showed that an effective HR lowering in patients with HFrEF can lead to improvements in diastolic function.
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    The Relationship between Nocturnal Dipping Status, Morning Blood Pressure Surge, and Hospital Admissions in Patients with Systolic Heart Failure
    Tas, U; Tas, S; Edem, E
    Background: Hypertension is a known risk factor for developing heart failure. However, there is limited data to investigate the association between morning blood pressure surge (MBPS), dipping status, echocardiographic parameters, and hospital admissions in patients with systolic heart failure. Objectives: To evaluate the relationship between morning blood pressure surge, non-dipper blood pressure pattern, echocardiographic parameters, and hospital admissions in patients with systolic heart failure. Methods: We retrospectively analyzed data from 206 consecutive patients with hypertension and a left ventricular ejection fraction below 40%. We divided the patients into two groups according to 24-hour ambulatory blood pressure monitoring (ABPM) results: dippers (n=110) and non-dippers (n=96). Morning blood pressure surge was calculated. Echocardiographic findings and hospital admissions during follow-up were noted. Statistical significance was defined as p < 0.05. Results: The study group comprised 206 patients with a male predominance and mean age of 63.5 +/- 16.1 years. The non-dipper group had significantly more hospital admissions compared to dippers. There was a positive correlation between MBPS and left atrial volume index (r=0.331, p=0.001), the ratio between early mitral inflow velocity and flow propagation velocity (r= 0.326, p=0.001), and the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/Em) (r= 0.314, p=0.001). Non-dipper BP, MBPS, and E/Em pattern were found to be independently associated with increased hospital admissions. Conclusion: MBPS is associated with diastolic dysfunction and may be a sensitive predictor of hospital admission in patients with systolic heart failure.
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    Serum Neuropeptide FFR2 is increased in pregnant women with pre-eclampsia and associated with pregnancy outcomes
    Tas, U; Tas, S; Kume, T; Yilmaz, O
    Objectives: NPFFR2 is a biomarker produced by the placenta during pregnancy and is thought to be associated with in various physiological processes, including pain modulation, opioid receptor regulation, and cardiovascular function. Pre-eclampsia (PE) is a major public health concern due to its links with cardiovascular disease (CVD), stroke and neonatal morbidity and mortality. Consequently, timely diagnosis and efficient management of PE are essential for both maternal and neonatal health. This study aimed to conduct a comparative analysis of neuropeptide FFR2 (NPFFR2), echocardiographic evaluation results, and pregnancy outcomes in pregnant women with and without PE. Methods: This is a prospective case-control study. It included 94 pregnant participants who applied to Manisa City Hospital between October 2021 to January 2023 and were grouped into women with PE (n = 47) and those without PE (n = 47). Biochemical and NPFFR2 analyses were performed using the blood samples collected from all participants, along with echocardiography and 24 hours. Ambulatory blood pressure monitoring (ABPM). A p-value <0.05 was considered statistically significant Results: The study group comprised 94 pregnant women with a mean age of 29.2 years and mean gestational age of 27.6 weeks. The preeclampsia group had a significantly higher NPFFR2 levels, lower gestational age at birth and higher all 24-hours ABPM findings. The left atrial-to-aortic ratio and right ventricle myocardial performance index were significantly higher and EA ratio was significantly lower in the preeclampsia group than in the control group. NPFFR2, gestational age at birth, LDL cholesterol, and body mass index were found to be independently associated with neonatal intensive care unit admission. Conclusions: The women with PE presented with increased serum NPFFR2 levels and the prognosis of pregnancy was associated with NPFFR2 levels.