Aim: The current study aimed to investigate the predictors of recurrence in patients with paroxysmal atrial fibrillation (AF) undergoing cryoballoon
ablation.
Materials and Methods: This study was ...conducted with the participation of the patients who underwent cryoballoon ablation between October
2013 and March 2016. Patients’ medical records were retrospectively evaluated. Patients were divided into two groups as those with AF recurrence
and those without AF recurrence.
Results: A total of 68 patients undergoing cryoballoon ablation were included in the study. The mean age of the patients was 57.3±12 years, and
32% were male. Concomitant conditions included coronary artery disease in 25 patients (36.8%), diabetes mellitus in 9 (13.2%), hypertension in 46
(67.6%), and history of cerebrovascular event in 3 (4.4%). During the early period involving the initial three months, AF recurrence was found in 16
patients (23.5%), while 52 (76.5%) remained in the sinus rhythm during the follow-up. There were significant differences between two groups in
left atrium size (38±5.3 and 44±6.6, p=0.003), left atrial appendage (LAA) flow rate 38 (24-62) cm/sec and 28 (22-55) cm/sec, p=0.001, presence
of pulmonary venous anomaly 5 (9.6%) and 6 (37.5%), p=0.016, the number of antiarrhythmic drugs before the ablation (1.78±0.7 and 2.43±0.5,
p=0.002), interventricular septal thickness (11±1.7 mm and 12±1.47 mm, p=0.008), left ventricular posterior wall thickness (11±0.9 mm and 12±1.3
mm, p=0.007), and left ventricular mass (195±51 g and 181±37.9 g, p=0.028).
Conclusion: According to the results, AF recurrence after ablation was found to be associated with the use of multiple antiarrhythmic drugs before
the ablation, increased left atrial diameter, the reduced flow rate in the LAA, presence of a pulmonary venous anomaly, increased interventricular
septal thickness, left ventricular posterior wall thickness, and left ventricular mass.
Objective
Acute pulmonary embolism (PE) is one of the main causes of death and has a course as massive (MPE) or non-massive (NMPE). The study investigates the indicator potential of Glucose to ...Potassium ratio (GPR) in the differential diagnosis of MPE and NMPE.
Materials and Methods
The study was designed as a retrospective cross-sectional clinical cohort in patients with PE. A total of 111 participants enrolled in the research separating two groups: MPE (n:54) and NMPE (n:67). The GPR was calculated by dividing serum glucose by potassium levels and its results were compared with D-Dimer, Pulmonary Artery Pressure (PAP), and C-Reactive Protein Test (CRP).
Results
D-Dimer was measured as 6.5 ± 5.7 µg/L in the MPE and found higher than the NMPE (3.9 ± 5.2 µg/L) (P = .019). CRP (100 ± 83.5 to 30.9 ± 42.7 mg/L; P = .0001) and PAP (49.5 ± 11.9 to 34.8 ± 7.3 mmHg; P = .0001) were found increased in the MPE. GPR strongly increased in the MPE (30.7 ± 7.5 to 24.9 ± 4.3; P = .0003) in line with CRP, D-Dimer and PAP. GPR showed a stronger diagnostic value (AUC: 0.733; P = .00001; Sensitivity:72%; Spesifity:70%; Cut-off: 26.5). PAP and GPR showed significant efficiency on occurrence of the MPE according to the binary logistic regression.
Conclusion
The GPR, as a novel and cheap marker, can be useful for diagnostic differentiation of MPE from NMPE, but weaker than PAP and better than D-dimer.
Type of Study and Level of Evidence
Level-II, Retrospective clinical cohort study.
Introduction: In this study, we compared frontal QRS-T angles between normotensive subjects with high blood pressure (BP) respons to exercise test and the control group. Methods: Patients who were ...scheduled for an exercise test between January 2017 and January 2022 were included in the study. The patient group consisted of people who responded to the exercise test with elevated BP, and the control group included people who responded to the exercise test with normal BP. The data in the electrocardiography device’s report section was used to calculate the QRS and T-axis. The frontal QRS-T angle was identified as the absolute difference between these two axes. Results: Frontal QRS-T angles were found to be significantly higher in the patient group compared with the control group (36.09±14.51 and 20.46±8.12; p<0.001). In multivariate analysis, frontal QRS-T angles were found to be an independent predictor of higher BP response to exercise test odds ratio: 1,189, 95% confidence interval (CI); 1,083-1,305; p<0.001. Receiver operating characteristic curve analysis showed that the frontal QRS-T angle value predicting an excessive BP response to exercise test was 27.5º with a sensitivity of 71% and a specificity of 75% (area under the curve: 0.832; 95% CI: 0.75-0.91; p<0.001). Conclusion: The frontal QRS-T angles were found to be significantly higher in the group that gave higher BP response to the exercise test compared to the control group. Patients with a high BP response to exercise test can be detected using the frontal QRS-T angle before the test.
Background/Aim: In our study, we aimed to evaluate the effect of mean platelet volume/platelet count ratio on the development of peripheral artery disease (PAD) by comparing it with the control ...group.
Material and Methods: A total of 115 patients with peripheral artery disease as a result of lower extremity color Doppler ultrasonography examination in our hospital were included in the study as the patient group and 100 individuals without peripheral artery disease as the control group.
Results: History of coronary artery disease (p<0.001), diabetes mellitus (p=0.009), hypertension (p<0.001) and smoking history (p<0.001) were significantly higher in the PAD group than in the control group. Serum glucose (121.27±25.66 vs. 104.81±34.77; p<0.001), MPV levels (9.99±0.79 vs. 9.04±0.7; p<0.001) and MPV/PLT ratio (0.041±0.07 vs. 0.037±0.006, p< 0.001) were found to be significantly higher in the PAD group than in the control group. Serum HDL levels (45.03±11.5 vs. 48.67±12.52 p=0.026) were significantly lower in the PAD group than in the control group. In multivariate analysis, age, MPV and MPV/PLT ratio were determined as independent predictors for peripheral arterial disease.
Conclusion: In our study, we found that MPV and MPV/PLT ratio were independent predictors of peripheral artery disease.
Amaç: Çalışmamızda ortalama trombosit hacmi/trombosit sayısı oranının periferik arter hastalığı (PAH) gelişimine etkisini kontrol grubu ile karşılaştırarak değerlendirmeyi amaçladık.
Yöntem: Hastanemizde alt ekstremite renkli Doppler ultrasonografi incelemesi sonucu periferik arter hastalığı saptanan toplam 115 hasta ile periferik arter hastalığı olmayan 100 kişi kontrol olarak çalışmaya alınmıştır.
Bulgular: Periferik arter hastalığı (PAD) olan grupta ortalama yaş kontrol grubuna göre anlamlı olarak yüksek bulunmuştur (69.12±10.58 vs. 52.83±13.05, p<0.001). Grupların cinsiyet oranlarında istatistiksel olarak anlamlı fark yoktur (p=0.218). Koroner arter hastalığı öyküsü (p<0.001), diabetes mellitus (p=0.009), hipertansiyon (p<0.001) ve sigara öyküsü (p<0.001) PAH grubunda kontrol grubuna göre anlamlı olarak yüksek bulunmuştur. Serum glukozu (121,27±25,66 - 104,81±34,77; p<0,001), MPV seviyeleri (9,99±0,79 - 9,04±0,7; p<0,001) ve MPV/PLT oranı (0,041±0,07 - 0,037±0,006, p< 0.001) PAD grubunda kontrol grubuna göre anlamlı olarak yüksek bulunmuştur. Serum HDL düzeyleri (45,03±11,5'e karşı 48,67±12,52 p=0,026) PAD grubunda kontrol grubuna göre anlamlı olarak düşüktür. Çok değişkenli analizde yaş, MPV ve MPV/PLT oranı periferik arter hastalığı için bağımsız belirteçler olarak belirlenmiştir.
Sonuç: Çalışmamızda MPV ve MPV/PLT yapıları periferik arter yapısından bağımsız aygıtları bulunmuştur.
Background The aim of this study was to investigate the relationship between the triglyceride-glucose (TyG) index and peripheral artery disease. Methodology This was a single-center, observational, ...retrospective study that included patients evaluated with color Doppler ultrasonography. A total of 440 individuals, 211 peripheral artery patients and 229 healthy controls, were included in the study. Results The TyG index levels were significantly higher in the peripheral artery disease group than in the control group (9.19 ± 0.57 vs. 8.80 ± 0.59; p < 0.001). The multivariate regression analysis conducted to determine the independent predictors of peripheral artery disease revealed that age (odds ratio (OR) = 1.111, 95% confidence interval (CI) = 1.083-1.139; p < 0.001), male gender (OR = 0.441, 95% CI = 0.249-0.782; p = 0.005), diabetes mellitus (OR = 1.925, 95% CI = 1.018-3.641; p = 0.044), hypertension (OR = 0.036, 95% CI = 0.285- 0.959; p = 0.036), coronary artery disease (OR = 2.540, 95% CI = 1.376-4.690; p = 0.003), white blood cell count (OR = 1.263, 95% CI = 1.029-1.550; p = 0.026), creatinine (OR = 0.975, 95% CI = 0.952-0.999; p = 0.041), and TyG index (OR = 1.111, 95% CI = 1.083-1.139; p < 0.001) were independent predictors of peripheral artery disease. The cut-off value of the TyG index in predicting peripheral artery disease was determined to be 9.06 with a sensitivity of 57.8% and a specificity of 70% (area under the curve = 0.689; 95% CI = 0.640-0.738; p < 0.001). Conclusions High TyG index values can be used as an independent predictor of peripheral artery disease.
Objectives
Sleep deprivation (SD) has been found to be associated with an increased incidence of adverse cardiovascular disease (CVD) events. The aim of this study was to investigate whether or not ...acute SD has a pathological effect on the geometry and the systolic and diastolic functions of the right and left heart chambers by standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE) in healthy individuals with acute SD.
Methods
Nurses with no history of acute or chronic diseases underwent TTE and STE after working a night shift, a sleepless period of 24 h and 7 days of normal sleep after the night shift. Measurements of TTE and STE taken in the rested state were compared with those taken after 24 h of sleep deprivation.
Results
The study included 52 nurses (38 women, 73%). The mean age of the study population was 27.9 ± 7.4 years and mean BMI was 24.1 ± 4.8. Left atrial reservoir (51.5 ± 13.5 vs. 45.4 ± 10;
p
= 0.004), conduit (− 37.3 ± 11.3 vs. − 33.6 ± 7.9;
p
= 0.01), left ventricular global longitudinal strain (LVGLS, − 22.6 ± 2.4 vs. − 21.3 ± 2.4;
p
= 0.001), right ventricular global longitudinal strain (RVGLS, − 25.3 ± 3.7 vs. − 23.5 ± 3.9;
p
= 0.005) and right ventricular free wall longitudinal strain (RVFWSL, − 29.1 ± 4.2 vs. − 27 ± 4.5;
p
= 0.001) were impaired significantly after SD.
Conclusion
This study is the first to investigate the negative effects of acute sleep deprivation on LV and RV strain in healthy adults using echocardiography. The findings showed that acute sleep deprivation leads to deterioration in function of both ventricles and left atrium. Speckle tracking echocardiography demonstrated subclinical diminished heart function.
Objective
Systemic inflammatory response and pro‐coagulator factors are critical in acute pulmonary embolism. Recently, there is increasing evidence that the multi‐inflammatory index (MII) may be ...prognostic in many clinical situations. The study investigated whether MII‐1 and MII‐2 can distinguish massive (MPE) and non‐massive pulmonary embolism (NMPE).
Methods
A total of 146 patients (73 MPE and 73 NMPE) were included in the study that was designed as a retrospective cross‐sectional analysis. Following haemogram analysis, MII‐1 (platelet‐to‐lymphocyte x CRP) and MII‐2 (neutrophil‐to‐lymphocyte x CRP) were calculated manually.
Results
MII‐1 and 2 showed a positive significant correlation with PLR and NLR, moderate positive correlation with CPR, and weak positive correlation with PAP (P < .001). CRP, MII‐1, MII‐2, PAP and systolic BP variables showed strong diagnostic value in distinguishing MPE and NMPE AUC (SE): 0.816 (0.037), 0.811 (0.038), 0.810 (0.037), 0.870 (0.032) and 0.864 (0.032); respectively (P < .001). MPR, MPV, RDW, and PLR in distinguishing MPE and NMPE groups did not show significance (P > .05).
Conclusion
Although MII‐1 and MII‐2 are simple, cheap, and easy indexes to calculate, they showed a strong ability to distinguish MPE and NMPE compared with the previously studied classical inflammatory indexes.
Aim: Multimerin-2 is an adhesion substrate between pericytes and basal membrane during angiogenesis. The present study aimed to assess the relationship between serum Multimerin-2 and coronary ...collateral flow grade. Materials and Method: Between April 2022 and August 2022, 88 patients presented with subacute ST-elevation myocardial infarction included. The main inclusion criteria were patients who present 12-48 hours after symptom onset and aged between 18 and 90 years. The patients were divided into two groups according to the Rentrop classification: poor collateral group (Rentrop grade 0-1) and good collateral group (Rentrop grade 2-3). Biochemical, and hematological parameters were measured before coronary angiography. Results: Serum multimerin-2 levels were found to be significantly different between the two groups and levels were higher in the Rentrop 2-3 group than in the Rentrop 0-1 group (3527.9 ± 1194.2 pg/mL and 946.7 ± 249.1 pg/ml; p < 0.00). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.918 (p = 0.001) and the best cutoff value of 849 pg/mL had a sensitivity of 90.1% and a specificity of 84.1% for predicting Rentrop grade 2-3 coronary flow. The number of patients with low LVEF by echocardiography at 30 days was significantly higher in patients with poor collateralization. Conclusion: Multimerin-2 levels were found to be higher in patients with Rentrop grade 2-3 coronary flow than Rentrop grade 0-1 coronary flow after myocardial infarction. We detected a potential relationship between MMR-2 and good coronary collateral formation.
We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physicians' recommendations on vaccination rates.
This was a ...multicenter, observational, prospective cohort study. Patients over the age of 18 from 40 hospitals in different regions of Turkey who applied to the cardiology outpatient clinic between September 2022 and August 2021 participated. The vaccination rates were calculated within three months of follow-up from the admitting of the patient to cardiology clinics.
The 403 (18.2%) patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n = 1808) was 61.9 ± 12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor, and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The main differences between vaccinated and unvaccinated patients were related to education level and ejection fraction. The physicians' recommendations were positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant correlation between vaccination and female sex OR = 1.55 (95% CI = 1.25-1.92),
< 0.001, higher education level OR = 1.49 (95% CI = 1.15-1.92),
= 0.002 patients' knowledge OR = 1.93 (95% CI = 1.56-2.40),
< 0.001, and their physician's recommendation OR = 5.12 (95% CI = 1.92-13.68),
= 0.001.
To increase adult immunization rates, especially among those with or at risk of cardiovascular disease (CVD), it is essential to understand each of these factors. Even if during COVID-19 pandemic, there is an increased awareness about vaccination, the vaccine acceptance level is not enough, still. Further studies and interventions are needed to improve public vaccination rates.
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