Taliha Oner

Dr. Behcet Uz Children's Hospital, Nikfer, Denizli, Turkey

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Publications (26)49.77 Total impact

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    ABSTRACT: Background: Coarctation of the aorta (CoA) is a chronic vascular disease characterized by a persistence ofmyocardial and vascular alterations. We aimed to evaluate children who have had successful coarctation surgery or balloon dilatation to evaluate the elasticity of the aorta, left atrial ejection force (AEF) and myocardial performance collectively at midterm follow-up. Methods: Nineteen patients (7.15 ± 0.9 years of age) and 21 age-sex matched healthy children were included in this study. Left AEF index is defined as the product ofmass and acceleration of blood expelled fromthe left atrium. Aortic stiffness and distensibility were estimated using ascending and descending aorta diameters. Results: The left atrial force index [(g•cm/s2 )/m 2] in the patient group was found to be significantly higher (12.69 ± 7.29, 5.74 ± 2.59, respectively, p = 0.001). Distensibility of the ascending aorta (cm2 /dynes 10-6) was significantly lower in the patient group than in the control group (42.13 ± 24.02, 78.79 ± 20.49, respectively, p < 0.001). The stiffness index of the ascending aortawas significantly higher in the patient group (p < 0.001).We also documented that atrial force index is associated with peak E velocity, right arm systolic blood pressure and left ventricular mass index. Conclusions: Our investigation showed that AEF is higher in children who have had successful coarctation surgery or balloon dilatation, and AEF is associated with systolic blood pressure, peak E velocity and left ventricular mass index. Distensibility of the ascending aortawas lower, and stiffness indexwas higher in children with corrected CoA than in healthy subjects.
    Acta Cardiologica Sinica 05/2015; 31(3):183-192. DOI:10.6515/ACS20150127A · 0.33 Impact Factor
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    ABSTRACT: Objective: An arterial switch operation converts the left ventricle (LV) into the systemic ventricle, replacing the right ventricle (RV), which is the systemic ventricle during the prenatal period. The procedure is performed in patients with arterial transposition and those in whom a coronary reimplantation procedure is performed. Therefore, the adaptation of LV and RV to the arterial switch operations is an interesting issue. This study aimed to evaluate systolic and diastolic functions in the LV and RV myocardium using echocardiography in pediatric patients with transposed great arteries after an arterial switch operation. Methods: This observational case control study included 28 patients and 20 gender-and age-matched healthy controls. A group study was performed using patients who were followed for at least 6 months after the operation and who visited the pediatric cardiology outpatient between October 2009 and May 2011. Systolic and diastolic parameters, LV and RV myocardial performance index (MPI) values, and left atrium (LA) volume index were assessed in both groups. Results: The LV MPI and tricuspid valve (TV) E/Ea ratio measured using pulsed-wave Doppler were higher in the patient group than in the control group. The TV E/A ratio and late velocity of lateral mitral annulus (Aa) and systolic velocity (Sa)-early diastolic velocity (Ea)-late velocity (Aa) of the septal mitral annulus and systolic velocity (Sa)-early diastolic velocity (Ea)-late velocity (Aa) of the lateral tricuspid annulus were lower in the patient group than in the control group. Conclusion: Considering the present study's findings obtained during short-to mid-term follow-up, the RV tissue Doppler flows and the LV MPI were found impaired.
    Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 02/2015; DOI:10.5152/akd.2015.5692 · 0.93 Impact Factor
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    ABSTRACT: Fetal tachyarrhythmia is a well-recognized cause of non-immune hydrops fetalis. Without treatment, it may progress to hydrops fetalis and in utero fetal death. The prognosis of hydrops fetalis is highly dependent on rapid response to antiarrhythmic therapy, gestational age, fetal well being and high cardiovascular profile score (CVPS). We report here a case of severe hydrops secondary to supraventricular tachycardia (SVT) detected in 28 weeks of gestation. We presented this case to discuss CVPS. Maternally administered drug combinations including digoxin and sotalol successfully converted the disordered cardiac rhythm to sinus rhythm within 1 day. However, the fetal health failed to improve, hydrops fetalis worsened and the fetus died in utero after 21 days of treatment. The fetal CVPS was 7/10 (2 points deducted for skin edema, 1 for ductus venosus atrial reversal). It was a score, which is considered compatible with life. However, the fetus died despite an acceptable average CVPS score of 7. CVPS score could be misleading in determination of prognosis in hydrops fetalis secondary to SVT.
    Gulhane Medical Journal 01/2015; 57(2):1. DOI:10.5455/gulhane.26379
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    ABSTRACT: Objective: It has been documented that impaired heart rate variability (HRV) is related to life threatening arrhythmias in children with surgically repaired congenital heart disease. We aimed to analyze the balance of the cardiac autonomic functions by assessing HRV in children with arterial switch operation (ASO). Methods: In this observational cohort study, HRV analysis using 24-h Holter electrocardiography recordings was examined in 22 patients (mean age: 59.5±38.7 months, 18 male, 4 female) who had undergone ASO during the newborn period and 22 healthy children (mean age: 65.1±39.4 months, 18 male, 4 female). After Kolmogorov-Smirnov testing for normality, Student t-test and Mann-Whitney U test were used when appropriate. Chi-square was used for categorical data. Results: In 24-h HRV analysis showed that SDANN and VLF were significantly higher in patient group. Awake SDNN, rMSSD, pNN50, TP and VLF levels of patient group were significantly higher than those of control subjects. Awake LF/HF ratio in patient group was significantly higher than their counterpart in asleep group. In the patient group, awake rMSSD, pNN50, TP, LF and HF were significantly lower than their counterpart in the asleep group. Conclusion: Children with transposition of the great arteries (TGA) following ASO have not decreased levels of time and frequency HRV parameters in the mid-term follow-up period. All HRV parameters reflecting vagal tone were increased in the patient group. It is suggested that vagal tone is more predominant than sympathetic tone for children with ASO.
    The American Journal of Cardiology 04/2014; 113(7). DOI:10.5152/akd.2014.5124 · 3.28 Impact Factor
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    ABSTRACT: Objective: Vitamin B12 is involved in the production of adrenaline from noradrenaline. It is the cofactor involved in catecholamine degradation and plays a role in myelin synthesis. The current study aimed to investigate the association between vitamin B12 levels and postural orthostatic tachycardia syndrome (POTS) during adolescence when accelerated myelin synthesis increases the vitamin B12 need. Methods: One hundred twenty-five patients (mean age 11.1 ± 2.3 years; 60% female) reporting short-term loss of consciousness and diagnosed with vasovagal syncope based on anamnesis with a normal distribution and 50 control subjects (mean age 10.94 ± 2.5 years, 62% female) were included in this study. Serum vitamin B12, folic acid, and ferritin levels were measured prospectively in addition to other tests. We defined vitamin B12 deficiency as a serum level <300 pg/mL.(1-4) RESULTS: Vitamin B12 levels were significantly lower in the patient group compared with the control group (47.2% vs 18%, P < .001). In the patient group, children with the POTS pattern had significantly lower vitamin B12 levels compared with children without the POTS response (P = .03). Conclusions: Vitamin B12 deficiency in patients with POTS may lead to sympathetic nervous system baroreceptor dysfunction.
    PEDIATRICS 12/2013; 133(1). DOI:10.1542/peds.2012-3427 · 5.47 Impact Factor
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    ABSTRACT: We sought to assess the effects of transcatheter closure of atrial septal defect (ASD) on right and left ventricular form and functions, as well as atrial volumes and pulmonary venous flows. We enrolled 25 patients (mean age: 9.02) prospectively who underwent successful transcatheter closure of secundum ASD. We performed transthoracic echocardiography, including two-dimensional, pulsed wave Doppler, M-mode echocardiography, and tissue Doppler imaging before the procedure and 1 day, 1 month, 3 months and 6 months after the procedure. Serum brain natriuretic peptide (BNP) levels were measured prior to the procedure, and 1 day, 1 month, and 3 months there after. Mitral inflow early diastolic wave increased significantly, while isovolumetric relaxation time and deceleration time did not change during the follow-up. The E/E was also increased significantly during follow-up. After the closure, right ventricular size and right atrial volume reduced, while left ventricular size increased significantly. There was a statistically significant improvement in left and right ventricular Tei indices. Pulmonary vein systolic velocity and the ratio of systolic to diastolic wave decreased, while atrial reversal wave (ARW) velocity increased immediately after the procedure. Although the concentration of BNP was increased on the first day after the procedure, its levels reduced and had reached the pre-procedure values at 1 month of follow-up. In the study, a significant improvement in the right and left ventricular functions was detected after transcatheter closure of secundum ASD in the short-term follow-up. In addition, we found a significant reduction in right heart sizes with corresponding global functional improvement in the right ventricle after the procedure.
    The Turkish journal of pediatrics 12/2013; 55(4):401-10. · 0.43 Impact Factor
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    ABSTRACT: Limited data are available related to the effects of cardiovascular risk factors on abdominal arterial stiffness using carotid and brachial artery indices. Therefore, we aimed to determine arterial changes in obese children and investigate any relation with cardiovascular risk factors. Thirty-eight obese children (mean body mass index [BMI]: 28.35 ± 4.65 kg/m2) and 34 age- and sex-matched healthy subjects underwent ultrasound measurements of abdominal, carotid and brachial arteries. Aortic strain (S), pressure strain elastic modulus (Ep), pressure strain normalized by diastolic blood pressure (Ep*), carotid intima-media thickness (cIMT), carotid artery compliance (CAC), brachial artery flow-mediated dilatation (FMD), and well-known cardiovascular risk factors were assessed in the obese children. Obese children had significantly higher Ep and Ep* parameters than the healthy controls (mean: 242.6 [107.1-666.6], 164.2 [110.6-231.5]; p<0.001, and mean: 3.39 [1.76-7.5], 2.64 [1.46-4.2]; p<0.001, respectively). Ep and Ep* were significantly correlated with the homeostasis model assessment of insulin resistance (r=0.587, p=0.001; r=0.467, p=0.004, respectively). Receiver operating characteristic (ROC) curve analysis of Ep for identification of children with cardiovascular risk factors showed that the area under the curve for hyperinsulinemia was 0.80 (p<0.001) and for hypertriglyceridemia was 0.62 (p<0.01). Abdominal arterial stiffness parameters as well as cIMT and brachial arterial FMD assessment were similarly useful in identifying obese children with cardiovascular risk factors. Insulin resistance is related with the augmented rigidity of the aortic wall in obese children.
    Pediatrics International 07/2013; 55(6). DOI:10.1111/ped.12177 · 0.73 Impact Factor

  • 04/2013; 3(1):75-76. DOI:10.5222/buchd.2013.075

  • 01/2013; 2(2):1. DOI:10.5455/apr.040920131516
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    ABSTRACT: Background: The mechanisms under neurally mediated syncope (NMS) are not fully understood. This study aimed to assess the level of storage iron in children with different hemodynamic patterns in head-up tilt test. Methods: Altogether 210 children (11.31±2.49 years) with syncope or pre-syncope treated between May 2008 and September 2010 were studied prospectively. Following history taking and physical examination, their levels of hemoglobin (Hb), hematocrit (Hct) and serum ferritin were measured. Results: In the 210 children, 162 (77.1%) had NMS and 48 (22.9%) had syncope due to other causes. In the 162 children with NMS, 98 children were subjected to positive tilt test. The level of serum ferritin was significantly lower in the 98 children with NMS (P<0.001). The comparison of levels of Hb, Hct and mean cell volume (MCV) displayed no significant difference between the two groups. Reduced iron storage (serum ferritin <25 ng/mL) was found to be more prevalent in children with NMS (63% vs. 20%, P<0.001). Prevalence of iron deficiency was also significantly higher in children with NMS than in children with syncope due to other causes (27% vs. 6%, P=0.003). Conclusions: In head-up tilt test positive children with NMS, the level of serum ferritin should be evaluated. Low storage iron may be one of the underlying mechanisms of NMS.
    World Journal of Pediatrics 12/2012; 9(2). DOI:10.1007/s12519-012-0396-7 · 1.05 Impact Factor
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    ABSTRACT: Objective. Intravenous ibuprofen is an expensive drug that is being used currently for treating and preventing patent ductus arteriosus. Although oral ibuprofen is much cheaper, there is limited data published about its safety and efficacy. The aim of this study was to compare two forms of ibuprofen in terms of safety and efficacy in closure of patent ductus arteriosus. Design. This is a single-center retrospective study. Setting. Data were collected from patients' files of preterm infants who were hospitalized at the Neonatal Intensive Care Unit of Dr. Behcet Uz Children's Hospital between April 2009 and June 2010. Patients. Six hundred sixty infants were evaluated by echocardiography between 24 and 48 postnatal hours. Clinically and hemodynamically significant ductus arteriosus was defined in 66 infants with gestational age less than 32 weeks and birth weight less than 1500 g. Interventions. Oral or intravenous ibuprofen (loading dose: 10 mg/kg on day 1, followed by maintenance dose: 5 mg/kg on days 2 and 3) was administered. Outcome Measures. Treatment success was defined as a completely closed duct without reopening on follow-up. Drug-associated renal, gastrointestinal, cerebral, hematological, and metabolic side effects were monitored and compared between treatment groups. Results. Ductal closure rates were 100% and 97.6%, respectively, in the oral and intravenous groups. Hypernatremia was the remarkable side effect in the intravenous group, whereas bronchopulmonary dysplasia and septicemia were prominent in the oral group. No statistically significant difference could be demonstrated between the groups in terms of mortality rates. Conclusion. Oral ibuprofen therapy is as efficacious as intravenous ibuprofen with some concerns about increased sepsis and bronchopulmonary dysplasia incidence. However, comprehensive and large-scale pharmacokinetic studies are required in order to prove this efficacy. On the other hand, intravenous ibuprofen still remains to be the drug of choice for patent ductus arteriosus but only with meticulous control of serum sodium levels in smaller infants.
    Congenital Heart Disease 05/2012; 7(6). DOI:10.1111/j.1747-0803.2012.00668.x · 1.08 Impact Factor
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    ABSTRACT: We analyzed 519 catheterization procedures performed over a period of two years retrospectively. Several risk factors related to the patient or catheterization were analyzed. The incidence of complications was 6.2%. The most common major and minor complications were arterial thrombosis that required intervention and transient arrhythmias, respectively. The incidence of complications during interventional studies was higher (9.7%) when compared to that in diagnostic procedures (5.4%). The independent risk of any complication was greatest up to 1 year of age (p = 0.02). The risks of a major complication (p = 0.003) and development of arterial thrombosis (p = 0.02) were significantly greater in patients <1 year of age by univariate analysis. The risks of pediatric cardiac catheterization continue to decline. The complication rates associated with interventional catheterization were significantly higher than with diagnostic catheterization in this study. Younger age, particularly <1 year of age, is the strongest predictor of development of any complication.
    The Turkish journal of pediatrics 01/2012; 54(5):478-85. · 0.43 Impact Factor

  • European Heart Journal – Cardiovascular Imaging 11/2011; 12(suppl 2):ii156-ii158. DOI:10.1093/ejechocard/jer217 · 4.11 Impact Factor
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    ABSTRACT: This study investigated the predictors of chronic valvular disease in children with rheumatic carditis. The short- to mid-term follow-up records of 88 patients (mean age, 10.68 ± 2.5 years) with chronic rheumatic heart disease were reviewed. The mean follow-up period was 2.95 ± 1.4 years. Valvular involvement completely improved for 24 of the patients (27%) during the follow-up period. The multivariate logistic regression analysis found initial left ventricular dilation to be a significant independent risk factor associated with the persistence of either valvular involvement or mitral regurgitation. Furthermore, persistence of mitral regurgitation was found to be strongly correlated with cardiac murmur at admission. No significant correlation was detected between age, gender, severity of valvular involvements at initial evaluation, and chronic valvular disease. The majority of patients with rheumatic carditis had normal left ventricular systolic function. However, a significant proportion of patients had left ventricular dilation, reported in the medical literature to be associated with the severity of valve involvement. This study found no relation between initial severity of valve involvements and chronic valvular disease. For this reason, increased left ventricular end-diastolic diameter may be secondary to myocardial involvement independent of valvular regurgitation. The findings in this study also suggest that subclinic carditis had a better outcome than clinically evident carditis.
    Pediatric Cardiology 09/2011; 33(2):239-44. DOI:10.1007/s00246-011-0120-8 · 1.31 Impact Factor

  • International Journal of Cardiology 03/2011; 147. DOI:10.1016/S0167-5273(11)70481-8 · 4.04 Impact Factor

  • International Journal of Cardiology 03/2011; 147. DOI:10.1016/S0167-5273(11)70399-0 · 4.04 Impact Factor

  • Fuel and Energy Abstracts 11/2010; 86. DOI:10.1016/j.earlhumdev.2010.09.115

  • Fuel and Energy Abstracts 11/2010; 86. DOI:10.1016/j.earlhumdev.2010.09.172
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    ABSTRACT: Total anomalous pulmonary venous drainage (TAPVD) is a rare entity which forms approximately 0.4 to 2% of all congenital heart disease. The infracardiac type usually involve obstructions on pulmonary venous connections and comprising a quarter of all TAPVD cases. The clinical findings in patients with obstructed infracardiac TAPVD could mimic respiratuary distress of several different etiologies during first hours of life. In this article, we present a case of a neonate with infracardiac type of TAPVD presented with only distinct subcutaneous veins of abdominal and thoracic wall.
    The Indian Journal of Pediatrics 07/2010; 77(7):813-4. DOI:10.1007/s12098-010-0105-2 · 0.87 Impact Factor

  • International Journal of Cardiology 04/2010; 140. DOI:10.1016/S0167-5273(10)70282-5 · 4.04 Impact Factor