Browsing by Author "Tuner, Hasim"

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Effect of Empagliflozin Treatment on Ventricular Repolarization Parameters
(Imr Press, 2024) Ozturk, Fatih; Tuner, Hasim; Atici, Adem; Barman, Hasan Ali
Background: An example of a sodium-glucose cotransporter-2 (SGLT-2) inhibitor is Empagliflozin. It is a new medicine for treating type 2 diabetes mellitus (T2DM), but there is increasing interest in how empagliflozin affects the heart. This study aims to examine the impact of empagliflozin treatment on ventricular repolarization parameters in T2DM patients. Methods: T2DM patients were included in a prospective study. Measurements of ventricular repolarization parameters, including QT interval, corrected QT interval (QTc), QT dispersion (QTd), Tpeak-to-Tend interval (Tp-e), and Tpeak-to-Tend interval corrected for QTc (Tp-e/QTc), were obtained before initiating empagliflozin treatment and six months following treatment initiation. Statistical analysis was performed to assess changes in these parameters. Results: In this study, 95 patients were diagnosed with T2DM out of 177 patients. Among T2DM patients, 40 were male (42%) compared to 48% males in controls (p = 0.152). The average age of the T2DM patients was 60.2 +/- 9.0 years, compared to 58.2 +/- 9.2 years in the control group (p = 0.374). When comparing pre- and post-treatment measurements of parameters representing ventricular repolarization (QT 408.5 +/- 22.9/378.8 +/- 14.1, p < 0.001; QTc 427.0 +/- 20.5/404.7 +/- 13.8, p < 0.001; QTd 52.1 +/- 1.2/47.8 +/- 1.7, p < 0.001; Tp-e 82.3 +/- 8.7/67.1 +/- 5.1, p < 0.001; Tp-e/QTc 0.19 +/- 0.01/0.17 +/- 0.01, p < 0.001 (respectively)), statistically significant improvements were observed. A statistically significant dose-dependent decline in the magnitude of change in the QTc parameter (19.4/29.6, p = 0.038) was also observed. Conclusions: According to these results, empagliflozin may decrease the risk of potential ventricular arrhythmias.
Effectiveness of Cardiac Rehabilitation in Enhancing Adherence and Improving Clinical Outcomes Post-Acute Coronary Syndrome: a Randomized Controlled Trial
(Wiley, 2025) Tuner, Hasim; Polat, Fuat; Alic, Enes; Kaya, Ali Nail; Cakmak, Cigdem Bahar; Coskun, Ferhat; Ozbek, Emrah
Background:Acute coronary syndrome (ACS) remains a major contributor to cardiovascular morbidity and mortality. Cardiacrehabilitation programs have shown promise in improving adherence to lifestyle and medical recommendations, yet theirimpact on clinical outcomes and complications requires further investigation. Methods:This prospective, randomized, single-center study evaluated the effects of cardiac rehabilitation on adherence andclinical outcomes in ACS patients. A total of 340 patients were randomized into a Cardiac Rehabilitation Group or ControlGroup. The Cardiac Rehabilitation Group underwent supervised exercise, dietary counseling, and education, while the ControlGroup received standard recommendations. Outcomes, including adherence rates and complications, were assessed over 1 year,with additional interim analyses to evaluate early sustainability of behavioral changes. Results:Patients in the Cardiac Rehabilitation Group demonstrated significant improvements in adherence to dietary rec-ommendations (73.5% vs. 52.4%,p< 0.01) and physical activity (85.3% vs. 68.2%,p< 0.01). Cardiac Rehabilitation Grouppatients also experienced fewer instances of weight gain (22.9% vs. 34.7%,p= 0.017) and access site complications (21.2% vs.40%,p< 0.01). Hospital readmissions were reduced in the Cardiac Rehabilitation Group compared to the Control Group (18.8%vs. 31.2%,p= 0.015). Non-adherence to dietary recommendations (HR: 2.42, 95% CI: 1.08-5.41,p= 0.032) and medical treat-ments (HR: 2.84, 95% CI: 1.32-6.11,p= 0.007) were significantly associated with increased risk of revascularization. Conclusion:Cardiac rehabilitation significantly enhances adherence to medical and lifestyle recommendations, reducescomplications, and improves outcomes in ACS patients. These findings emphasize the critical role of structured rehabilitation inpost-ACS management.
Flow-Mediated Dilatation Facilitates Transradial Coronary Angiography: a Comparative Study
(Termedia Publishing House Ltd, 2024) Tuner, Hasim; Kaya, Yuksel; Bingol, Gulsuem; Ozden, Ozge; Unlu, Serkan; Ozmen, Emre; Ozturk, Fatih
Introduction: Radial artery (RA) spasm is demonstrated to be one of the most common complications of transradial approach (TRA). Aim: We hypothesised that radial flow-mediated dilation (FMD) can be used as a preprocedural method to assess the likelihood of arterial spasm. Material and methods: The patients were divided into 2 groups: those with and without flow-mediated RA dilatation. A blood pressure cuff was placed on the upper part of the antecubital region of the patients in the FMD group and inflated for 10 min, allowing the pressure to rise to 30 mm Hg above the systolic blood pressure. RA diameters of the patients in both groups were measured via quantitive coronary angiography method before transradial coronary angiography. Results: A total of 165 patients were included in the study, of whom 64 (38.8%) were women. The median age of the patients was 56 years (48-63). The mean RA diameter was significantly larger in the FMD group (3.44 +/- 0.48 vs. 2.96 +/- 0.46 mm, p < 0.001), and the number of punctures required for successful transradial cannulation was found to be significantly higher in the group without FMD (1.55 +/- 0.7 vs. 1.20 +/- 0.64; p < 0.001). Linear regression analysis revealed diabetes and FMD as independent predictors of RA diameter. In the diabetic subgroup, RA diameter remained larger in the FMD group (3.00 +/- 0.35 vs. 2.78 +/- 0.26, p = 0.036). Radial puncture attempts were significantly higher in the control group compared to the FMD group (1.55 +/- 0.7 vs. 1.20 +/- 0.64; p < 0.001). Conclusions: In our study, we demonstrated that FMD created by pressure application significantly increased RA diameter and reduced puncture attempt during TRA.