Background
Hypertension is an important risk factor for cardiovascular diseases and cognitive function. Blood pressure (BP) variability has been associated with cognitive dysfunction, but data are ...sparse regarding the relationship between BP variability and cognitive function in geriatric patients with well-controlled BP.
Aim
The aim of this study was to demonstrate the relationship between blood pressure variability and cognitive functions in geriatric hypertensive patients with well-controlled BP.
Method
We analyzed 435 hypertensive patients (167 male, 74.9 ± 8.3; 268 female, 76.1 ± 8.6) treated at least with one antihypertensive drug. All patients underwent ambulatory BP monitoring and the standardized mini mental test (sMMT).
Results
We divided the weighted standard deviation (SD) of systolic BP (SBP) as a measure of BP variability into quartiles. The top quartile group (≥ 18.5 mmHg) had a significantly lower total sMMT score (23.3 ± 3.2,
p
< 0.001). According to the results of multivariate logistic regression analysis for sMMT, the SD of 24-h SBP was related to sMMT (
p
= 0.007, 95% confidence interval − 0.301 − 0.370 to − 0.049).
Discussion
Although there are some inconsistencies among the studies investigating the relationship between blood pressure variability and cognitive functions in elderly patients, we demonstrated the relationship between increased 24-h blood pressure variability and cognitive functions assessed with sMMT in geriatric population with well-controlled BP.
Conclusion
The increased blood pressure variability was associated with poorer cognitive functions in geriatric hypertensive patients with well-controlled blood pressure.
Background
Permanent junctional reciprocating tachycardia (PJRT) is an infrequent form of atrioventricular re-entrant tachycardia. We report the clinical and electrophysiological properties of PJRT ...and outcomes of radiofrequency catheter ablation (RCA) in a large group of patients.
Methods
We included 62 patients with the diagnosis of PJRT. Radiofrequency catheter ablation was performed in all.
Results
Location of accessory pathway was right posteroseptal in 37 (59,7%) cases, right midseptal in 3 (4,8%), left posterior in 7 (11,3%), left lateral in 5 (8,1%), left posterolateral in 3 (4,8%), left anterolateral in 2 (3,2%), left posteroseptal in 2 (3,2%), middle cardiac vein in 2 (3,2%), and left coronary cusp in 1 (1,6%). Single procedure success rate was 90.3%. None of patients had recurrence during follow-up after repeat ablations. Overall long-term success rate was 98.4%. Left ventricular systolic function recovered in all patients with tachycardia-induced cardiomyopathy (TIC).
Conclusion
Retrograde decremental accessory pathways are mainly located in posteroseptal region. Radiofrequency catheter ablation is a safe and effective approach in patients with PJRT.
Aims: The purpose of this study is to evaluate the association between nutritional status and coronary artery disease (CAD) severity in patients with acute coronary syndrome (ACS). Methods: Patients ...with ACS who underwent coronary angiography were evaluated retrospectively. SYNTAX scores were calculated for each patient to determine the severity of CAD. The patients were divided into three groups based on their SYNTAX scores as low SYNTAX score (less than or equal to 22), intermediate SYNTAX score (23-32) and high SYNTAX score (greater than or equal to 33). The Prognostic Nutritional Index (PNI) score was calculated with the formula using serum albumin and total lymphocyte count. The "The Control Nutritional Status (CONUT)" score was calculated by using three parameters which are serum albumin, total cholesterol and total lymphocyte count. Data on cardiovascular mortality and rehospitalization within six months of diagnosis were obtained from records. Results: The study included 177 patients with ACS. The mean age of patients was 63.34 + or - 10.94 years and 64.4% were male. Patients with high SYNTAX score had statistically significantly lower PNI score and higher CONUT score than patients with low and intermediate SYNTAX scores. There was a positive correlation between SYNTAX score and CONUT score (r=0.256, p=0.002), and a negative correlation between SYNTAX score and PNI score (r=-0.328, p<0.001). Within six months of ACS diagnosis, patients with cardiovascular mortality and rehospitalization had lower PNI scores and higher CONUT scores. According to multivariate logistic regression analysis, CONUT score was an independent predictor for high SYNTAX score (odds ratio=1.584; 95% confidence interval=1.014-2.473; p=0.043). Conclusions: In our study, nutritional status assessed by PNI and CONUT scores was associated with the extent of coronary atherosclerosis in patients with ACS. Keywords: Acute coronary syndrome, malnutrition, SYNTAX score
Optimal valve sizing provides improved results in transcatheter aortic valve replacement. Operators hesitate about the valve size when the annulus measurements fall into borderline area. Our purpose ...was to compare the results of borderline versus non-borderline annulus and to understand the impact of valve type and under or oversizing.
Data from 338 consecutive transcatheter aortic valve replacement procedures were analyzed. The study population was divided into 2 groups as 'borderline annulus' and 'non-borderline annulus.' Balloon expandable valves already have a grey zone definition. Similar to balloon expandable valves, annulus sizes that are within 15% above or below the upper or lower limit of a particular self-expandable valve size are defined as the 'borderline annulus' for self-expandable valves. The borderline annulus group was also divided into 2 subgroups according to the smaller or larger valve selection as 'undersizing' and 'oversizing.' Comparisons were made regarding the paravalvular leakage and residual transvalvular gradient.
Of these 338 patients, 102 (30.1%) had a borderline and 226 (69.9%) had a non-borderline annulus. Both the transvalvular gradient (17.81 ± 7.15 vs. 14.44 ± 6.27) and the frequency of paravalvular leakage (for mild, mild to moderate, and moderate, 40.2%, 11.8%, and 2.9% vs., 18.8%, 6.7%, and 0.4%, respectively) were significantly higher in the borderline annulus than the non-borderline annulus group (P <.001). There were no significant differences between the groups balloon expandable versus self-expandable valves and oversizing versus undersizing regarding the transvalvular gradient and paravalvular leakage in patients with borderline annulus (P >.05).
Regardless of the valve type and oversizing or undersizing, borderline annulus is related to significantly higher transvalvular gradient and paravalvular leakage when compared to the non-borderline annulus in transcatheter aortic valve replacement.
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