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    Comparison of the echocardiographic and pulmonary function test findings in orderly treated and untreated essential hypertensive patients
    (Taylor & Francis Ltd, 2003) Guven, A; Koksal, N; Sokmen, G; Özdemir, R
    Objective: Although it has been well established that hypertension effects pulmonary functions negatively, the effect of regular antihypertensive therapy on pulmonary functions is not known. In this study, we aimed to compare the pulmonary function tests of the hypertensive patients taking regular antihypertensive therapy with those of the ones not taking any antihypertensive medicine, to document the differences in pulmonary functions of both hypertensive groups. Materials and Methods: Patients who had received antihypertensive treatment (Group I: 29 males, 24 females, mean age 42.3 +/- 8.2 years), and untreated cases (Group II: 28 males, 22 females, mean age 43.4 +/- 6.4 years) were included in the study. Patients with a history of coronary heart disease, respiratory diseases, smokers and those who were obese were excluded from the study. Results: Forced vital capacity (FVC) and forced expiratory volume at the first second (FEV1) levels were found significantly lower in Group II ( p < 0.05). In echocardiographic evaluation, the mitral E/A ratio of Group II was lower than that of Group I ( p < 0.05). Isovolumetric relaxation time and deceleration time was higher in Group II than in Group I ( p < 0.05). There was a significant association between pulmonary function tests and impaired left ventricular diastolic parameters; especially, mitral E/A ratio was significantly associated with decreased FVC and FEV1 in Group II (respectively r = -0.695, p = 0.01 and r = -0.591, p = 0.03). Conclusion: FVC and FEV1 levels in untreated hypertensive cases were lower than in those of treated hypertensive cases, and this may be caused by diastolic function rather than the systolic function. In the evaluation of dyspnea in hypertensive patients, it would be useful to examine respiratory function in addition to echocardiographic investigation.
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    Effects of the sibutramine therapy on pulmonary artery pressure in obese patients
    (Blackwell Publishing Ltd, 2004) Guven, A; Koksal, N; Cetinkaya, A; Sokmen, G; Ozdemir, R
    Aim: Obesity is a major global public health problem. Previous drugs (dexfenfluramine and fenfluramine) used for the treatment of obesity have been withdrawn due to various cardiac side effects. Sibutramine is an anti-obesity agent. The purpose of this study was to assess cardiac valve disease and pulmonary artery pressure (PAP) of the patients who used once daily doses of sibutramine. Methods: One hundred and six obese patients (51 men and 55 women) determined to have minimal tricuspid regurgitation (TR) on echocardiographic examination were included in the study. All patients had a complete physical examination, complete blood count and measurement of lipid parameters, and echocardiography was performed by which cardiac valves and PAP were evaluated. After the mean duration of 24-week of follow up, all examinations were repeated for each patient. Results: The drug was well tolerated by all patients for the follow-up period. A significant weight loss was recorded in all patients compared to the baseline values (93.1 +/- 9.6 kg vs. 85.8 +/- 7.7 kg, p < 0.001). Blood pressures and heart rate of the patients increased compared to the baseline measurements (systolic 122.3 +/- 8.5 vs. 124 +/- 10.2 mmHg, p = 0.128, diastolic 79.3 +/- 4.7 vs. 80 +/- 5.7 mmHg, p = 0.42 and heart rate 79.5 +/- 6.5 vs. 85 +/- 5.7 beats/min, p < 0.001). Echocardiographically determined aortic or mitral valve dysfunction appeared in none of the patients. PAP lightly increased after the treatment but the difference between pre and post-treatment values was not found statistically significant (14.7 +/- 1.8 vs. 16.3 +/- 1.6 mmHg, p = 0.06). Conclusions: A 24-week treatment with sibutramine does not affect heart valves and pulmonary artery pressure.