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Drug-induced atrioventricular block (AVB) is generally considered reversible and does not require a permanent pacemaker implantation (PPM). However, some studies have demonstrated a failure of AVB cessation even when the inducing agent has been discontinued. This study has investigated the use of systemic immune-inflammation index (SII) to predict irreversible drug-induced AVB after drug discontinuation.Files of patients with high-degree AVB that required a temporary pacemaker (TPM) were retrospectively analyzed. Sixty-three patients in which AVB was drug-induced were included in the study. The patients were divided into the following two groups: (1) those whose AVB reversed after discontinuation of the related drug, and (2) those in which AVB did not reverse.AVB reversed in 24 patients (38%) after the inducing agent was discontinued while in the remaining 39 patients (62%) PPM was required. The most common drugs to induce AVB were beta-blockers (n = 46, 73%). Follow-up time with TPM was significantly longer in the irreversible group (2.91 ± 1.05 days vs. 4.94 ± 2.15 days, p .001). Multivariate logistic regression analysis showed that SII (odds ratio [OR] = 1.002; 95% confidence interval [CI] = 1.000-1.003; p = .01) was an independent predictor of the requirement for a PPM. An SII 752.05 was found to be a predictor of irreversible AVB requiring PPM with a sensitivity of 64% and specificity of 75% (receiving-operating characteristics [ROC] area under the ROC curve [AUC]: 0.704, 95% CI = 0.570-0.838, p = .007).Approximately 2/3 of drug-induced high-degree AVBs are irreversible. SII is an easily available and cheap inflammatory biomarker that can be used to predict irreversible AVB.

The treatment process of patients using warfarin is expected to be hindered during the COVID-19 pandemic. Therefore we investigated whether the time in therapeutic range (TTR) and bleeding complications were affected during the COVID-19 pandemic. 355 patients using warfarin were included between March 2019 to March 2021. Demographic parameters, INR (international normalized ratio), and bleeding rates were recorded retrospectively. The TTR value was calculated using Rosendaal’s method. The mean age of the patients was 61 ± 12 years and 55% of them were female. The mean TTR value during the COVID-19 pandemic was lower than the pre-COVID-19 period (56 ± 21 vs 68 ± 21, P < 0.001). Among the patients, 41% had a lack of outpatient INR control. During the COVID-19 pandemic, 71 (20%) patients using VKA suffered bleeding. Among patients with bleeding, approximately 60% did not seek medical help and 6% of patients performed self-reduction of the VKA dose. During the COVID-19 pandemic, TTR values have decreased with the lack of monitoring. Furthermore, the majority of patients did not seek medical help even in case of bleeding.

Backround We aimed to evaluate the utility of the preprocedural platelet–lymphocyte ratio (PLR) for predicting the no‐reflow phenomenon after thrombus aspiration during percutaneous coronary intervention (PCI) in patients with ST‐segment elevation myocardial infarction (STEMI). Method We retrospectively analyzed postprocedural thrombolysis in myocardial infarction (TIMI) flow grades and myocardial blush grades (MBG) of 247 patients who underwent a PCI procedure with thrombus aspiration.We divided these patients into two groups according to whether they had no‐reflow (TIMI, No reflow developed in 43 (17%) of 247 patients who underwent thrombus aspiration during the PCI procedure.Independent predictors of no‐reflow were found as follows;higher preprocedural platelet‐lymphocyte (PLR),mean corpuscular volüme (MCV) and SYNTAX Score‐2.PLR > 144 had 79% sensitivity and 75% specificity for determining no‐reflow phenomenon.

Amaç: Atriyal fibrilasyon, popülasyondaen sık görülen aritmidir ve prevalansı yaşla artar ayrıca en sıkrastlanılan morbidite ve mortalite oluşturan aritmidir. Genellikle persistanatriyal fibrilasyonun başlangıcı paroksismal atriyal fibrilasyonun (PAF)tekrarlayan bölümleridir. Paroksismal atriyal fibrilasyonun öngörülmesi, buaritminin önlenmesine ve dolayısıyla olumsuz sonuçların önlenmesine nedenolabilir. Bu çalışmada paroksismal atriyal fibrilasyonu öngörebilecek dokuDoppler görüntüleme (TDI) ve pik hızlanma süresi (pkAcc) parametreleriniaraştırmayı amaçladık. Gereç ve Yönetemler: 20-73 yaşları arasında (ortalama47,5) PAF tanısı almış 50 kişi ile hasta grubu oluşturuldu.. Hasta grubu ilebenzer temel demografik özelliklere sahip olan ve persistan veya PAF bulunmayan50 kişi ile kontrol grubu oluşturuldu.Tüm kontrol ve çalışma gruplarınatranstorasik ekokardiyografik (TTE) değerlendirme yapıldı. Doku Dopplerparametreleri ve pkAcc TTE'de ölçüldü ve istatistiksel analizler yapıldı.Bulgular: TTE değerlendirmesinde, hastagrubunda sol atriyum ejeksiyon fraksiyonu çalışma grubundan daha düşüktü (%50,6 vs.% 59,2, p, Aim: Atrialfibrillation is the most common arrhythmia in the population and its prevalanceincreases with age; and also is the most morbid and mortal arrhythmia. Usuallythe beginning of the persistant atrial fibrillation is recurrent episodes ofthe paroxysmal atrial fibrillation (PAF). Prediction of the paroxysmal atrialfibrillation can cause prevention of this arrhythmia and thus prevention of theadverse outcomes. We aimed to investigate tissue Doppler imaging (TDI) and peakacceleration time (pkAcc) parameters that can predict the paroxysmal atrialfibrillation in this study.Material and Methods: 20-73years old (mean 47,5) 50 individuals that are diagnosed with PAF included thepatient group. 50 individuals who have the similar baseline demographiccharasteristics with patient group and who have no persistant or PAF includedthe control group. Transthoracic echocardiogaphic (TTE) evaluation is appliedall of the control and study groups. Tissue Doppler parameters and pkAcc ismeasured in TTE and statistical analyses is performed. Results: InTTE evaluation, left atrium ejection fraction is lower in the patient groupthan the study group (%50,6 vs. %59,2, p

WOS: 000374722700029, PubMed: 26164686, Objectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24 hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 +/- 10.2 ms vs. 102.2 +/- 7.5 ms, p = 0.02; 40.6 +/- 7.6 ms vs. 33.6 +/- 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 +/- 7.8 ms vs.11.2 +/- 4.4 ms, p < 0.001; 9.0 +/- 7.3 ms vs. 6.0 +/- 3.8 ms, p = 0.002, and 7.4 +/- 5.2 ms vs. 5.1 +/- 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428,p < 0.001). Conclusions: In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Contrast-induced encephalopathy (CIE) is a rare temporary phenomenon after intravenous injection of contrast media. The prognosis is generally good. Neurological symptoms develop within hours and resolve spontaneously over days. Global syndromes such as confusion can also be seen with cortical and subcortical deficits. There is a good correlation between the volume of contrast extravasation and clinical picture. In addition, this extravasation can be confused with intracranial hemorrhage in the early stage with imaging. In this case, we presented a 62-year-old male patient who developed CIE after coronary angioplasty mimicking subarachnoid hemorrhage and spontaneously recovered on the 2nd day of the event.

WOS: 000343257800001, PubMed: 25260530, Background: Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that correlates with cardiac events. This study assessed the association between NLR and the presence of chronic coronary total occlusion (CTO). Methods: The study population included 225 patients, a control group (n = 75), a coronary artery disease group (n = 75), and a CTO group (n = 75). NLR was compared in the three groups. Results: NLR levels were significantly higher in the CTO than in the other two groups (p < 0.001). Bivariate correlation analysis showed a positive correlation between NLR and SYNTAX Score, and multivariate logistic regression analysis found that NLR was an independent predictor of CTO. ROC analysis showed that an NLR cut-off of 2.09 could distinguish between patients with and without CTO (AUC = 0.74; 95% CI, 0.68-0.81), with a specificity of 69.3% and a sensitivity of 61%. Conclusion: NLR may be useful as a marker of CTO.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Cardiac involvement is present in more than half of the patients with SLE. Fragmentation of QRS (fQRS) is presumed marker of cardiovascular risk and has not been previously evaluated in SLE.A total of 56 women previously diagnosed with SLE were recruited. In addition, a control group consisting of 51 healthy people was formed. QRS complexes were also evaluated in terms of fragmentations. All patients with SLE and control subjects underwent transthoracic echocardiographic examination. Erythrocyte sedimentation rate and C-reactive protein levels were also obtained.Frequency of fQRS was higher in patients with SLE (41% vs. 21%, p = 0.03). Left ventricular posterior wall thickness and mass index were higher in the patients with SLE. CRP levels and age were significantly higher, and disease duration was significantly longer in the fQRS(+) group (p = 0.02, 0.01, and 0.006, respectively).A careful cardiovascular evaluation and follow-up is essential to continuously improve survival in SLE. For this purpose, fQRS may be used for the early detection in patients with SLE.