Researcher:
Peker, Yüksel

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Yüksel

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Peker

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Peker, Yüksel

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2018 - 2019152020 - 202445

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Researcher Of Publications: search.filters.isAuthorOfPublication.55044336-76ac-4b8b-bf2a-8114e2c3b514

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Now showing 1 - 10 of 60
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    CPAP may promote an endothelial inflammatory milieu in sleep apnoea after coronary revascularization
    (Elsevier B.V., 2024) Behboudi, Afrouz; Redline, Susan; Lyu, Jing; Wei, Ying; Gottlieb, Daniel J.; Jelic, Sanja; Peker, Yüksel; Çelik, Yeliz; School of Medicine
    Background: Continuous positive airway pressure (CPAP) has failed to reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized trials. CPAP increases angiopoietin-2, a lung distension-responsive endothelial proinflammatory marker associated with increased cardiovascular risk. We investigated whether CPAP has unanticipated proinflammatory effects in patients with OSA and cardiovascular disease. Methods: Patients with OSA (apnoea-hypopnea index [AHI] ≥15 events/h without excessive sleepiness) in the Randomized Intervention with CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or usual care following coronary revascularization. Changes in plasma levels of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor of advanced glycation end-products [sRAGE]) function from baseline to 12-month follow-up were compared across groups and associations with cardiovascular morbidity and mortality assessed. Findings: Patients with OSA (n = 189; 84% men; age 66 ± 8 years, BMI 28 ± 3.5 kg/m2, AHI 41 ± 23 events/h) and 91 patients without OSA participated. Angiopoietin-2 remained elevated whereas VEGF-A declined significantly over 12 months in the CPAP group (n = 91). In contrast, angiopoietin-2 significantly declined whereas VEGF-A remained elevated in the usual care (n = 98) and OSA-free groups. The changes in angiopoietin-2 and VEGF-A were significantly different between CPAP and usual care, whereas Tie-2, sRAGE and E-selectin were similar. Greater 12-month levels of angiopoietin-2 were associated with greater mortality. Greater CPAP levels were associated with worse cardiovascular outcomes. Interpretation: Greater CPAP levels increase proinflammatory, lung distension-responsive angiopoietin-2 and reduce cardioprotective angiogenic factor VEGF-A compared to usual care, which may counteract the expected cardiovascular benefits of treating OSA. Funding: National Institutes of Health/ National Heart, Lung, and Blood Institute; Swedish Research Council; Swedish Heart-Lung Foundation; ResMed Foundation.
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    Association of visual-based signals with electroencephalography patterns in enhancing the drowsiness detection in drivers with obstructive sleep apnea
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024) Peker, Nur Yasin; Hakkoz, Mustafa Abdullah; Erdem, Ciğdem Eroğlu; Department of Electrical and Electronics Engineering; Department of Electrical and Electronics Engineering; Minhas, Riaz; Arbatlı, Semih; Çelik, Yeliz; Gürsoy, Beren Semiz; Peker, Yüksel; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Graduate School of Sciences and Engineering; Graduate School of Health Sciences; School of Medicine; College of Engineering
    Individuals with obstructive sleep apnea (OSA) face increased accident risks due to excessive daytime sleepiness. PERCLOS, a recognized drowsiness detection method, encounters challenges from image quality, eyewear interference, and lighting variations, impacting its performance, and requiring validation through physiological signals. We propose visual-based scoring using adaptive thresholding for eye aspect ratio with OpenCV for face detection and Dlib for eye detection from video recordings. This technique identified 453 drowsiness (PERCLOS ≥ 0.3
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    Obstructive sleep apnea and pulmonary hypertension: a chicken-and-egg relationship
    (MDPI, 2024) Akdeniz, Bahri; Balcan, Mehmet Baran; Peker, Yüksel; School of Medicine
    Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep, and it is closely linked to several cardiovascular issues due to intermittent hypoxia, nocturnal hypoxemia, and disrupted sleep patterns. Pulmonary hypertension (PH), identified by elevated pulmonary arterial pressure, shares a complex interplay with OSA, contributing to cardiovascular complications and morbidity. The prevalence of OSA is alarmingly high, with studies indicating rates of 20-30% in males and 10-15% in females, escalating significantly with age and obesity. OSA's impact on cardiovascular health is profound, particularly in exacerbating conditions like systemic hypertension and heart failure. The pivotal role of hypoxemia increases intrathoracic pressure, inflammation, and autonomic nervous system dysregulation in this interplay, which all contribute to PH's pathogenesis. The prevalence of PH among OSA patients varies widely, with studies reporting rates from 15% to 80%, highlighting the variability in diagnostic criteria and methodologies. Conversely, OSA prevalence among PH patients also remains high, often exceeding 25%, stressing the need for careful screening and diagnosis. Treatment strategies like continuous positive airway pressure (CPAP) therapy show promise in mitigating PH progression in OSA patients. However, this review underscores the need for further research into long-term outcomes and the efficacy of these treatments. This review provides comprehensive insights into the epidemiology, pathophysiology, and treatment of the intricate interplay between OSA and PH, calling for integrated, personalized approaches in diagnosis and management. The future landscape of OSA and PH management hinges on continued research, technological advancements, and a holistic approach to improving patient outcomes.
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    Esophagus dilation and quality of life in adults with scleroderma and concomitant obstructive sleep apnea
    (MDPI, 2024) Cinar, Caner; Karakurt, Sait; Direskeneli, Haner; Yalcinkaya, Yasemin; Yakut, Tuğçe; Peker, Yüksel; School of Medicine; Koç University Hospital
    (1) Background: Systemic sclerosis (SSc) is a rare systemic disease, which often affects the esophagus, leading to dilation and complications such as dysphagia and reflux. Obstructive sleep apnea (OSA) is a chronic condition with recurrent episodes of upper airway collapsibility and is known to impair quality of life (QoL). The primary aim of this study was to investigate the occurrence of esophagus dilation in patients with SSc and concomitant OSA and, further, to address the impact of these conditions on QoL. (2) Methods: In this cross-sectional cohort study, 62 consecutive patients with SSc underwent chest computer tomography (CT) and home sleep apnea testing. The OSA diagnosis was based on AHI >= 15 events/h. The QoL was quantified using the short-form (SF)-36 questionnaire. The patients were dichotomized as high- vs. low-esophageal-diameter groups, based on the median cut-off values. (3) Results: The mean age was 48 +/- 11 years;58 (93.5%) were female;the mean BMI was 26.7 +/- 5.0 kg/m(2). The median esophageal diameter was 17.47 mm. A larger esophageal diameter was more frequently associated with the diffuse cutaneous subtype of SSc (p = 0.002) and significantly higher Warrick scores (p < 0.001), indicating more severe pulmonary fibrosis. There was a significant linear correlation between the Warrick score and the esophageal diameter (standardized beta coefficient 0.544 [%95 confidence interval 0.250-0.609];p < 0.001). In the subgroup analysis, the patients with both OSA and enlarged esophageal diameter experienced a significant decline in QoL, particularly in the domains of physical functioning, role physical, general health, role emotional, and vitality. (4) Conclusions: While OSA was not directly associated with enlarged esophageal diameter in patients with SSc, those with both OSA and enlarged esophageal diameter exhibited a significant decline in QoL. These findings suggest that the presence of OSA may exacerbate the adverse effects of esophageal dilation on QoL in SSc patients. Our results underline the importance of considering both gastrointestinal and sleep-related aspects in SSc management to enhance patient QoL.
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    Association of TNF-α (-308 G/A) gene polymorphism with the changes in circulating TNF-a levels over 12 months in response to CPAP treatment in the RICCADSA cohort
    (American Thoracic Society, 2023) Yucel-Lindberg, T.; Behboudi, A.; Peker, Yüksel; Çelik, Yeliz; School of Medicine; Graduate School of Health Sciences
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    Good adherence to CPAP decreases recurrent cardiovascular events: a systematic review and individual participant data meta-analysis
    (American Thoracic Society, 2023) Sanchez De la Torre, M.; Gracia-Lavedan, E.; Benitez, I.; Sanchez-de-La-Torre, A.; Moncusi-Moix, A.; Torres, G.; Loffler, K.; Woodman, R.; Adams, R.; Labarca, G. P.; Eulenburg, C.; Thunstrom, E.; Anderson, C.; McEvoy, R.; Barbe, F.; Peker, Yüksel; Glantz, Helena; School of Medicine
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    Impact of continuous positive airway pressure on serum angiopoietin-2 following coronary revascularization in patients with obstructive sleep apnea: the RICCADSA study
    (American Thoracic Society, 2023) Behboudi, A.; Redline, S. S.; Jelic, S.; Gottlieb, D. J.; Peker, Yüksel; Çelik, Yeliz; School of Medicine; Graduate School of Health Sciences
    Critical care medicine;Respiratory system
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    Possums-based parental education for infant sleep: cued care resulting in sustained breastfeeding
    (Springer, 2021) Öztürk, Merve; Boran, Perran; Ersu, Refika; N/A; Peker, Yüksel; Faculty Member; School of Medicine; 234103
    For infants and their families, sleep consolidation is important in maturing neural and circadian rhythms, and in family dynamics. The Possums Infant Sleep Program is a cued care approach to infant sleep, responding to infant cues in a flexible manner, dialing down the infant's sympathetic nervous system. The current study evaluated the effect of the Possums program on infant sleep and breastfeeding in infants (6-12 months) from a well-child outpatient clinic in Turkey, with the program intervention group (n = 91) compared with usual care (n = 92). In total, 157 mother-infant dyads completed the study. Infant sleep and breastfeeding rates were assessed at baseline and after 3 months. Nocturnal wakefulness, daytime sleep duration, naps, and night wakening decreased in both groups. Nocturnal sleep duration and the longest stretch of time the child was asleep during the night increased significantly in both groups without any change in total sleep duration. Night wakening was significantly lower and nocturnal sleep duration was significantly higher in the intervention group. However, mixed effects model analyses indicated no significant differences between the groups on any of the sleep outcomes after adjusting for confounders. Despite this, breastfeeding rates were significantly higher in the intervention group compared with those in the usual care group at follow-up. Conclusion: The Possum infant sleep program provided equivalent positive results on sleep parameters compared to usual care while advocating a more cued response. The critical difference was evident in sustained breastfeeding.
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    Impact of CPAP treatment on leptin and adiponectin in coronary artery disease and nonsleepy obstructive sleep apnea - a secondary analysis of the RICCADSA trial
    (Amer Thoracic Soc, 2019) Balcan, B.; Yucel-Lindberg, T.; Lindberg, K.; Thunstrom, E.; N/A; Peker, Yüksel; Faculty Member; School of Medicine; 234103
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    Determinants of age-adjusted higher nt-pro-bnp values in adults with coronary artery disease and obstructive sleep apnea in the RICCADSA cohort
    (Elsevier, 2019) Glantz, H.; Thunstrom, E.; N/A; Peker, Yüksel; Aslan, Gamze; Çelik, Yeliz; Ural, Dilek; Faculty Member; Doctor; Researcher; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; N/A; N/A; School of Medicine; N/A; N/A; Koç University Hospital; N/A; 234103; N/A; N/A; 1057
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