Search

Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0–10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence. [ABSTRACT FROM AUTHOR]

Background: Early systolic lengthening is a echocardiographic strain parameter previously used to determine the lesion severity in patients with stable coronary artery disease. In the present study, we aimed to evaluate the relationship between early systolic lengthening and anatomic SYNTAX score in troponin (-) and (+) groups among patients with non-ST-elevation acute coronary syndrome (ACS). Methods: A total of 95 patients diagnosed with non-ST-elevation ACS were included in the prospective, non-randomized, single-center study. The patients were categorized into 2 groups as troponin (+) and troponin (-). The patients were evaluated in terms of echocardiographic, clinical, and angiographic parameters. Results: The baseline characteristics, including age (58 ± 13 vs. 60 ± 10 respectively, P = .340), a history of hypertension (67.1% vs. 64%, respectively, P = .479), diabetes (28.6% vs. 32%, respectively, P = .467), global longitudinal strain (-14.37 ± 5.11 vs. -16.42 ± 3.93, respectively, P = .095), left ventricular ejection fraction (58.71 ± 8.73 vs. 57.20 ± 8.70, respectively, P = .263), and E/e' (8.44 ± 2.13 vs. 8.33 ± 1.99, respectively, P = .785), were similar between troponin (+) and troponin (-) groups. Left ventricle end-systolic diameter (3.2 ± 0.78; 3.50 ± 0.74 vs. 3.2 ± 0.78, respectively, P = .031), left ventricle end-systolic volume (55.57 ± 32.17 vs. 38.28 ± 13.63, respectively, P = .013), left ventricle end-diastolic volume (115.31 ± 49.54 vs. 91.23 ± 20.57, respectively, P = .042), the rate of early systolic lengthening (65.7% vs. 28%, respectively, P = .001), the duration of early systolic lengthening (24.02 ± 31 ms vs. 15.56 ± 30.19 ms, respectively, P = .009), and the SYNTAX score (16 ± 11 vs. 10 ± 10, respectively, P = .023) were higher in the troponin (+) group. Furthermore, a significant correlation was found between early systolic lengthening and SYNTAX score (r = 0.43, P < .001). Conclusion: The rate and duration of early systolic lengthening were higher in patients in the troponin (+) group. Early systolic lengthening is related to SYNTAX score in patients with non-ST-elevation ACS. [ABSTRACT FROM AUTHOR]

Introduction: Opioid withdrawal is one of the most critical complications of opioid use disorder. In this study, we aimed to examine the possible risk of ventricular arrhythmia and sudden cardiac death by calculating electrocardiography (ECG) changes, the markers of ventricular repolarization, in opioid withdrawal. Methods: A total of 90 patients diagnosed with opioid withdrawal who met the inclusion and exclusion criteria were included in the study. QT, QTc, TPe/QT, and TPe/QTc ratios of patients with a Clinical Opiate Withdrawal Scale (COWS) score higher than five and a Framingham heart risk score lower than 10% were measured in 12-lead ECG. Results: A significant difference was found between the patients' heart rate, QT, QTc, and TPe/QT values during withdrawal (entry-first) and after withdrawal (second) (p<0.05). Mean QT First Value (380.69±22.46) was significantly different and higher than Mean QT Second Value (372.82±19.998); Mean QTc First Value (435.41±16.22) was significantly different and higher than Mean QTc Second Value (418.03±17.79); Mean Tpe First Value (81.62±6.009) was significantly different and higher than Mean Tpe Second Value (79.93±5.524); and The Mean Tpe/QT First Value (0.221±0.005) was significantly different and higher than the Mean Tpe/ QT Second Value (0.213±0.004) (p<0.05). Conclusion: The findings of our study show that electrocardiographic QT, QTc, Tpe and Tpe/QTc values, which indicate the risk of sudden cardiac death and ventricular arrhythmia, are significantly higher during opioid withdrawal. In addition to the regulation of addiction treatment during opioid withdrawal, it should be considered that individuals may be at cardiac risk, and the patient should be monitored for cardiac arrhythmia during the withdrawal period. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Electrical storm is a lethal clinical situation that consists of ventricular tachycardia or ventricular fibrillation attacks, which are usually resistant to pharmacologic or electrical cardioversion. In patients with heart failure; refractory ventricular tachycardia attacks worsen organ perfusion and precipitate acute decompensation, multi-organ failure, and mortality. Extracorporeal membrane oxygenation is very successful for managing periprocedural acute decompensatio n and it facilitates radiofrequency catheter ablation by adequate mapping and more substrate ablation. Five patients were enrolled whose electrical storm had been treated with either catheter ablation under extracorporeal membrane oxygenation support or other approaches (device setting changes, stellate ganglion blockade, or sympathetic denervation). One patient had a catheter ablation history and was treated with only implantable cardioverter-defibrillator setting changes on this admission. Three of the patients were under veno-arterial extracorporeal membrane oxygenation support, one patient was under left ventricular assist device support. Two patients under e xtracorporeal membrane oxygenation also needed sympathetic denervation after radiofrequency ablation and stellate ganglion blockade was performed on one of them, before sympathetic denervation. Electrical storms should be managed with multidisciplinary and various treatment approaches. Although radiofrequency catheter ablation is central in treatment, the use of additional modalities including sympathetic denervation may be beneficial. Furthermore, radiofrequency catheter ablation under mechanical support especially with extracorporeal membrane oxygenation may be quite effective, and lifesaving. [ABSTRACT FROM AUTHOR]

Purpose: The association between hypertensive retinopathy and left atrial (LA) impairment is unknown. Accordingly, it was aimed to investigate the possible relationship between hypertensive retinopathy and LA phasic functions by means of two‐dimensional speckle‐tracking echocardiography (2D‐STE). Methods: A total of 124 hypertensive patients and 27 control subjects were included in the study. LA reservoir strain (LAS‐S), LA conduit strain (LAS‐E), and LA booster strain (LAS‐A) parameters were used to evaluate LA myocardial functions. Results: Hypertensive patients (with and without retinopathy) displayed an obvious reduction in the LA reservoir strain (LAS‐S), and LA conduit strain (LAS‐E). Moreover, further impairment in LA reservoir and conduit strain was found in patients with hypertensive retinopathy than in the isolated hypertensive patients. There were no significant differences in LA booster strain (LAS‐A) among the three groups. Impaired LAS‐S (OR: 0.764, CI: 0.657–0.888, and p < 0.001), LAS‐E (OR: 0.754, CI: 0.634–0.897, and p = 0.001), and hypertension (HT) duration (OR: 2.345, CI: 1.568–3.507, and p < 0.001) were shown to be independent predictors of hypertensive retinopathy. Conclusion: Impaired LA reservoir and conduit strain may be used to predict hypertensive patients at higher risk of developing hypertensive retinopathy, and to determine which patients should be followed more closely for hypertensive retinopathy. [ABSTRACT FROM AUTHOR]

Purpose: Acute pulmonary embolism is a life‐threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. Material and methods: Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow‐up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30‐day follow‐up, the patients were allocated either into the benign or in the complicated clinical course group. Results: The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E‐wave velocity, E/A ratio, A′ wave velocity, E/E′ ratio, and time interval between E and E′ waves (P <.05), but lower values of tricuspid annular plane systolic excursion, A‐wave velocity, isovolumetric relaxation time, deceleration time, E′, and E′/A′ (P <.05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r =.564, P <.001), E/E′ (r =.495, P <.001), and TE‐E′ (r =.596, P <.001). Receiver operator characteristic curve analysis showed that TE‐E′ had the largest area under curve (TE‐E′ 0.82, IVRT 0.77, E/E′ 0.72). A cut‐off value of TE‐E′ = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course. Conclusion: The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism. [ABSTRACT FROM AUTHOR]

Purpose The simple right ventricular contraction pressure index (sRVCPI) is a new echocardiographic variable for estimating the right ventricular systolic function. Our aim was to investigate the association between the sRVCPI, the pulmonary embolism severity index (PESI), and mortality rate in acute pulmonary embolism (APE). Methods: We included in this study 116 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy. They were divided into two groups based on the simplified PESI < or >1. Tricuspid regurgitation velocity and TAPSE were measured and used for sRVCPI calculation. Results: Mortality was higher in patients with a higher sRVCPI (P <.001). In receiver operating characteristic (ROC) curve analysis using a cut‐off level of 312.8 mm Hg mm, sRVCPI predicted mortality with a sensitivity of 86.8% and specificity of 69.5% (ROC area under curve: 0.712; 95%CI 0.597‐0.882; P <.001). The sRVCPI was lower in the sPESI >1 than in the sPESI <1 group (364.3 ± 31.9 vs 511.6 ± 26.1; P <.001). There was an inverse correlation between sRVCPI and the sPESI score (−0.784; P <.001). Conclusion: The sRVCPI correlated with the sPESI score and was associated with mortality in patients with APE. This easily measurable variable may be used to predict short‐term mortality in APE patients. [ABSTRACT FROM AUTHOR]

Copyright of Medeniyet Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aim of the study: Chronic severe aortic regurgitation (AR) is associated with progressive accumulation of interstitial fibrosis and disruption of myocardial structure. After aortic valve replacement (AVR), the negative remodeling process reverses, and left ventricular ejection fraction (LVEF) improves but not in all patients. In this study, we aimed to investigate the association of fragmented QRS (F‐QRS), which is a possible marker of myocardial fibrosis, with postoperative left ventricular (LV) systolic dysfunction. Methods: A total of 147 consecutive patients with AVR were included in this study. F‐QRS was identified by the presence of various RSR' patterns (QRS duration <120 ms) such as additional R wave (R prime)or notching of the R or S wave in at least two consecutive leads. Patients were compared in two groups based on the presence or absence of F‐QRS. A logistic regression model was used to determine independent predictors of postoperative LV systolic dysfunction (LVEF <50%). Results: Patients with F‐QRS were associated with poor recovery of LV systolic function after AVR compared to the patients without F‐QRS, regardless of preoperative LVEF (p =.008). F‐QRS was found to be an independent predictor of postoperative LV systolic dysfunction (LVEF <50%). Lower preoperative LVEF and increased LV end diastolic diameter index were also found as independent risk factors for postoperative LV systolic dysfunction. Conclusions: As a possible marker of myocardial fibrosis, F‐QRS was associated with postoperative LV systolic dysfunction. Therefore, as a simple and convenient clinical parameter, F‐QRS may be used to predict poor recovery of LVEF after AVR. [ABSTRACT FROM AUTHOR]

Purpose: Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status.Methods: We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows.Result: A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD.Conclusion: HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE. [ABSTRACT FROM AUTHOR]

Introduction: Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life‐threatening. Several risk graduation algorithms may be applied to delineate short‐term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow‐outflow (RVEIO) index, which is a Doppler‐based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. Methods: In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI ≥ 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured. Results: There were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581‐0.814; P <.001). RVEIO index was higher in the sPESI ≥ 1(n:72) than in the patients with sPESI < 1(14.27 ± 2.13 vs 10.63 ± 2.09; P <.001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P <.001). Conclusion: As well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well‐correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short‐term mortality in APE patients. [ABSTRACT FROM AUTHOR]

Introduction: Acute pulmonary embolism (APE) is an emergent cardiothoracic disorder. The PESI score is used to estimate 30-day mortality in patients diagnosed with non-high-risk APE. Also, there are biomarkers for predicting prognosis and mortality in APE. Catestatin (CST) is accepted as a marker of sympathetic nervous system activity which has been shown that the sympathetic nervous system activation can contribute pathogenesis in APE. So, we attempt herein to investigate the correlation of PE diagnosis and prognostic determination with plasma CST levels in PE patients. Material and methods: Blood samples were drawn at admission for laboratory assays and CST measurements. Plasma levels of CST were measured by ELISA according to the manufacturer's instruction. Transthoracic echocardiography was performed for the assessment of RV dysfunction using a Toshiba Applio 500 echocardiographic system within 24 h of the admission. Results: Plasma CST levels were higher in patients with APE than in the control group (17.5 ±6.1 ng/ml vs. 27.3 ±5.7 ng/ml, p < 0.001). Plasma CST levels were higher in the sPESI ≥ 1 (n = 72) than in the patients with sPESI < 1 (37.3 ±6.1 vs. 24.2 ±5.3 ng/ml, p < 0.001). There was a positive correlation between CST level and sPESI score (±0.581, p < 0.001). Mortality occurred in 20 patients with sPESI ≥ 1 (27.7%) and in 9 patients with sPESI < 1 (10.2%) (p = 0.010). Receiver operating characteristic (ROC) curve analysis using a cut-off level of 31.2 ng/ml, and the CST level predicted mortality with a sensitivity of 100% and specificity of 52.6% (AUC = 0.883, 95% CI: 0.689-0.921). Furthermore, the CST level was correlated with right ventricular dysfunction. Conclusions: CST can predict sPESI score and mortality in patients with APE. [ABSTRACT FROM AUTHOR]

Introduction: The non-O phenotype of the ABO genotype has been linked with an increased risk of cardiovascular disease. Atrioventricular (AV) block (AVB) is defined as retardation or cessation in the route of an electrical impulse passing from the atria to the ventricles because of an anatomical or functional disruption in the conduction system. We aimed to interpret the association between blood group status and high-grade atrioventricular block (HAVB). Material and methods: This study was implemented as a retrospective review of the recorded data of patients diagnosed with high-grade AV block and a control group. The study population consisted of 640 patients with HAVB and 570 control subjects. Results: Presence of non-O blood group (p < 0.001) was significantly more prevalent in HAVB patients than in the control subjects. Blood group type was the sole independent predictor of HAVB in multiple regression analysis (p < 0.001, OR = 1.35, 95% CI: 1.08-1.57). Also, third-degree AVB had a higher incidence in the non-O blood subgroup and also non-O blood group was a predictor of third-degree AVB (p < 0.001, OR = 1.39, 95% CI: 1.13-1.69). The incidence of HAVB did not distinguish between the two Rh (D) groups. Rh (D) status did not have an impact on HAVB. Conclusions: This is the first study that has evaluated the potential relationship between HAVB and ABO blood groups. The main finding of this report is that patients with non-O blood group types have a higher risk for development of HAVB compared with O blood group patients. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio) in asymptomatic ARVD patients METHODS: We selected 27 patients with asymptomatic ARVD and 27 age- and gender-match young, healthy volunteers.Results: Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.57, P = 0.02; r = -0.85, P = 0.02; r = -0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = -0.61, P < 0.01; r = -0.67, P < 0.01; r = -0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp-e, Tp-e/QT, and Tp-e/QTc (r = - 0.64, P < 0.001, r = - 0.75, P < 0.01; r = -0,69, P < 0.01; respectively) CONCLUSION: In conclusion, we have presented strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in asymptomatic ARVD patients. [ABSTRACT FROM AUTHOR]

Background Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by the progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. Several studies have suggested that speckle tracking echocardiographic (STE) parameters such as strain (S) and strain rate (SR) may prove useful in the early detection of right ventricular (RV) dysfunction. Therefore, the aim of this study was to evaluate RV myocardial function using the STE method in both asymptomatic and symptomatic patients with ARVD and to assess its potential role in the differential diagnosis of these two presentations. Methods We recruited 34 patients with ARVD. Seventeen patients were symptomatic, and seventeen were asymptomatic. Results The RV free wall global longitudinal S and SR were significantly lower in symptomatic patients with ARVD than in asymptomatic patients. According to a cutoff value of 1.35 per seconds for RV global SR, the sensitivity and specificity for predicting ARVD were 88% and 77%, respectively. According to a cutoff value of 17.3% for RV S, the sensitivity and specificity for predicting ARVD were 82% and 77%, respectively. Conclusion In conclusion, we present strong evidence that STE-derived global S and SR in the RV free wall are decreased in symptomatic patients with ARVD compared with asymptomatic patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The awareness, time in therapeutic range (TTR), and safety of warfarin therapy were investigated in the adult Turkish population. Methods: This multicenter prospective study includes 4987 patients using warfarin and involved regular international normalized ratio (INR) monitoring between January 1, 2014 and December 31, 2014. TTR was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of warfarin's affect and food-drug interactions. Results: The mean TTR of patients was 49.52±22.93%. The patients with hypertension (55.3%), coronary artery disease (23.2%), congestive heart failure (24.5%), or smoking habit (20.8%) had significantly lower TTR levels than the others. Of the total number of patients, 42.6% had a mechanical valve, 38.4% had non-valvular atrial fibrillation (AF), and 19% had other indications for warfarin. Patients with other indications had lower TTR levels than those with mechanical valve and non-valvular AF (p=0.018). Warfarin awareness decreased in higher age groups. The knowledge of warfarin's food-drug interactions was 55%. People with higher warfarin awareness had higher TTR levels. Patients with ≤8 INR monitoring/year had lower TTR levels (46.4±25.3 vs. 51.1±21.3, respectively, p<0.001) and lower awareness (44.6% vs. 60.6%, p<0.001) than patients with ≥8 INR monitoring/year. In this study, 20.1% of the patients had a bleeding event (major bleeding 15.8%, minor bleeding 84.2%) within a year. Conclusion: Both the mean TTR ratios and awareness of the Turkish population on warfarin therapy were found to be low. It was thought that low TTR levels of the Turkish population may be caused by the low awareness of warfarin, warfarin's food-drug interactions, and high rates of concomitant diseases. [ABSTRACT FROM AUTHOR]

Objective: Myocardial involvement in systemic lupus erythematosus (SLE) has great importance. The aim of this study is to evaluate the rotation and twisting mechanics of the left ventricle (LV) in patients with SLE. Methods: Forty-three patients fulfilled at least four of the American College of Rheumatology criteria for SLE and 30 individuals as controls were included in the study. SLE disease activity was assessed using the SELENA-SLEDAI score. Echocardiography was performed for all subjects. The patients fulfilled at least four of the American College of Rheumatology criteria for SLE were enrolled in the study. SLE disease activity was assessed using the SELENA-SLEDAI score. Echocardiography was performed for all individuals.Comparisons between groups were made using independent samples t-test with the standard statistical software (SPSS, version 15.0; SPSS Inc., Chicago, IL, USA). Each image was digitally stored for offline analysis. Measurement of global strain assessed by 17-segment model and rotational parameters were performed. LV ejection fraction was calculated by the biplane Simpson's method. Comparisons between groups were made using the independent samples t-test with the standard statistical software. A p value of 0.05 was considered statistically significant. Results: The values of mean global longitudinal strain, basal global circumferential strain (GCS), mean basal radial strain, and apical GCS were significantly lower in SLE patients. The difference between basal rotation, apical rotation, twist of the LV, and torsion of the LV in the SLE patients and controls were not significant (8.8±5.5 vs. 10.6±5.8, p=0.183;-4.7±3.0 vs. -4.8±3.2, p=0.947; 11.7±6.4 vs. 13.2±6.4, p=0.366; and 1.8±0.8 vs. 1.9±2.3, p=0.725, respectively). Although there was not any significant relationship between SELENA-SLEDAI score and myocardial strain analyses of the LV, the basal rotation and the torsion of the LV were lower in patients with SLE having a SLEDAI score of ≥17 (p=0.024 for basal rotation and p=0.032 for torsion). Conclusion: The number of segmental and global strain analyses were decreased in SLE patients with globally normal LVEF. The twist and torsion mechanics of the LV were preserved according to the control group, and the left ventricular torsion and basal rotation were found to be significantly decreased in those with an activity score of ≥17. [ABSTRACT FROM AUTHOR]

Amitriptyline is a member of the tricyclic antidepressant (TCA) drug group and can cause electrocardiographic (ECG) changes. Some of these changes include the prolongation of the QRS and QTc intervals, increment of R/s ratio on derivation aVR besides of arrhythmias such as supraventricular tachycardia (SVT) and ventricular tachycardia (VT) on overdose. Here, we present a case concerning a QRS interval prolongation caused by the intentional use of high doses of amitriptyline and treated with an intravenous lipid emulsion (ILE) infusion. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD). Patients and methods: A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist. Results: There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P<0.001) and Beck Depression Scale scores (11.24±6.15 and 6.58±5.69, respectively, P<0.01) were significantly higher in CD patients. P-wave dispersion measurements did not show any significant differences between conversion patients and control group (46±5.7 vs 44±5.5, respectively, P=0.156). Regarding QTc and QTd, there was a statistically significant increase in all intervals in conversion patients (416±10 vs 398±12, P,0.001, and 47±4.8 vs 20±6.1, P<0.001, respectively). Conclusion: A similar relation to that in literature between QTd and anxiety and somatoform disorders was also observed in CD patients. QTc and QTd were significantly increased compared to the control group in patients with CD. These results suggest a possibility of increased risk of ventricular arrhythmia resulting from QTd in CD patients. Larger samples are needed to evaluate the clinical course and prognosis in terms of arrhythmia risk in CD patients. [ABSTRACT FROM AUTHOR]

The article presents the case of a 39-year-old male who was rushed to emergency department due to sudden onset of pain, coldness and cyanosis in his distal phalanx of the right fifth digit to discuss the management of brachial artery aneurysm with rivaroxaban therapy and percutaneous intervention.

The article presents transthoracic echocardiogram (TTE) and transesophageal echocardiography (TEE) images that illustrate the unusual coexistence of atrial myxoma and mitral stenosis in a 22-year-old woman with a history of transient ischemic attack.