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Background: Vitamin D deficiency is a common clinical picture associated with poor cardiovascular prognosis. It is also associated with impaired diastolic dysfunction in stable coronary artery disease. We investigated the relationship between vitamin D levels and diastolic dysfunction in patients with acute coronary syndrome (ACS)., Methods: One hundred seventeen patients with the ACS were enrolled in this cross-sectional study. The diastolic function of the patients was evaluated using echocardiography before discharge. We analyzed the relation between serum levels of 25(OH)D and echocardiographic measures of diastolic dysfunction., Results: IVRT and E/e' were found to be significantly greater in patients with low vitamin D levels (115.48±13.64 vs. 106.88±14.80 ms, P<0.05; 10.19±2.80 vs. 8.1±3.2, P<0.05). When regression tests were performed, it was shown that vitamin D level was a predictor (OR=0.935, 95% CI: 0.886-0.987; P=0.015) and independent risk factor (OR=0.942, 95% CI: 0.888-0.998; P=0.042) for the development of diastolic dysfunction., Conclusions: We found that low vitamin D levels are associated with impaired diastolic function in patients with ACS with preserved left ventricular systolic function.

Aim: To appraise the prediction of tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (SPAP) with regard to hospitalization and the effect of spironolactone use. Materials & methods: A total of 245 patients were evaluated for the study. Patients were followed for 1 year and cardiovascular outcomes were determined. Results: It was determined that TAPSE/SPAP was an independent predictor of hospitalization. A 0.1-mmHg decrease in TAPSE/SPAP was associated with a 9% increase in relative risk. No event was observed above the 0.47 level. Negative correlation with TAPSE (uncoupling) began in the spironolactone group when SPAP was ≥43 and in nonusers when SPAP was 38 (Pearson's correlation coefficient: -,731 vs -,383; p < 0.001 vs p = 0.037). Conclusion: TAPSE/SPAP measurement may be useful in predicting 1-year hospitalization in asymptomatic heart failure patients. This ratio was also found to be higher in patients who used spironolactone.

Objective The importance of nutritional status in non-ST segment elevated acute coronary syndrome (NSTE-ACS) is not clear. In this study, the importance of prognostic nutritional index (PNI) in terms of in-hospital mortality in patients with NSTE-ACS and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods A total of 498 consecutive NSTE-ACS patients were recorded retrospectively. PNI for nutritional status assessment of patients with NSTE-ACS. PNI was calculated as 10 × serum albumin (g / dL) + 0.005 × total lymphocyte count (per mm3). The association between PNI and GRACE risk score was assessed.Results Patients were classified as low-risk group (≤108 points, n=222), medium-risk group (109-140 points, n=161) and high-risk group (&gt;140 points, n=115) according to the GRACE score. The mean PNI value was found to be the lowest in the high-risk group compared to other risk groups. There was a significant negative correlation between GRACE risk score and PNI (p&lt;0.001). In multivariate analysis, PNI resulted as a predictor of in-hospital mortality independent of GRACE risk score (OR=0.909; 95 % CI: 0.842-0.981; p=0.01). PNI value in the high risk group for in-hospital mortality was determined to have significant predictive ability (AUC=0.710; 95 % CI: 0.61-0.80; p&lt;0001).Conclusions PNI evaluation is a useful and easy method to evaluate the nutritional status of patients with NSTE-ACS. Our study suggests that the PNI is significantly associated with in-hospital mortality, and GRACE risk score in patients with NSTE-ACS. This study is the basis for new studies to investigate whether PNI contributes additional prognostic to the GRACE risk score.