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Objective We aimed to examine the effects of COVID-19 pneumonia on cardiac ischemia detected by myocardial perfusion imaging with single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients presenting with chest pain and shortness of breath after recovery from COVID-19. Materials and method Patients with a history of COVID-19 confirmed by reverse transcriptase-PCR test who underwent SPECT-MPI for the evaluation of ischemia with the complaints of chest pain and shortness of breath were screened for this study. Patients who underwent thorax CT during the acute period of the COVID-19 were included. Patients with and without pneumonia were determined based on computed tomographic criteria. The patients with a summed stress score of at least 4 on SPECT-MPI were considered to have abnormal MPI in terms of ischemia. Results A total of 266 patients were included in the study. Sixty-five (24%) patients had ischemia findings on SPECT-MPI. Thorax CT showed pneumonia in 152 (57%) patients, and the patients were divided into two groups as pneumonia and nonpneumonia. Abnormal SPECT-MPI scores, which represented myocardial ischemia, were higher in the pneumonia group. Multivariate logistic regression analyses showed that the presence of hyperlipidemia and pneumonia on CT increased the risk of ischemia on SPECT-MPI (OR, 2.08; 95% CI, 1.08-3.99; P-value = 0.029; and OR, 2.90; 95% Cl, 1.52-5.54; P-value = 0.001, respectively). Conclusion COVID-19 pneumonia was identified as an independent predictor of ischemia on SPECT-MPI. Symptoms including chest pain and shortness of breath in patients who have had COVID-19 pneumonia may be attributed to coronary ischemia.

We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.

Objective: QTc interval is prolonged in acute myocardial infarction and begins to shorten after successful reperfusion. Data on the early change of QTc after reperfusion and the prognostic significance of this change are limited. We aimed to evaluate the change of QTc interval in the first hour following successful primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) patients and its relationship to reperfusion parameters such as myocardial blush grade (MBG) and ST-segment Resolution (STR%). Methods: Patients who presented with the first STEMI episode and underwent successful pPCI were included in the study. After pPCI, MBG and STR% were calculated. QTc measurements were made from the electrocardiography(ECG) recorded at admission (Pre-pPCI QTc), 1 hour after pPCI (Post-pPCI QTc), and the 24th hour. Results: 105 patients who had successful pPCI with adequate ECG data were enrolled in the study. The mean Pre-pPCI QTc was 409±34 ms, post-pPCI QTc was 427±32 ms. A statistically significant prolongation was observed in the QTc interval after pPCI (QTc-Change) (21 ms (-3, 37 IQR), p

WOS:000648071100001 PMID: 33955313 Introduction We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients. Material and method Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters. Results Median age was 68 (60-76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049-1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238-2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007-1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048-1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006-1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521-0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001-1.010; p = .010) were found associated with in-hospital mortality. Conclusion In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.

Hypocalcemia prolongs the QTc interval. Total calcium (TCa) measurement can be misleading in cases where the concentration of albumin is abnormal. We aimed to investigate which calcium level —ionized calcium (iCa) or TCa—may be more closely related to the QTc interval in COVID-19 patients in whom hypocalcemia and hypoalbuminemia are observed frequently. Adult patients hospitalized for COVID-19 were included in this study. ICa levels were obtained from the venous blood gas sample examined during the emergency department admission, and the TCa levels were obtained from the biochemistry results on admission. The pH-adjusted iCa (Corrected-iCa) and albumin-adjusted TCa (corrected-TCa) were calculated. The QT interval was measured from the admission ECG and corrected for heart rate using the Bazett formula. Hundred and thirty-two patients were included in the study. The mean age was 50±19 years, and 62 (47%) patients were female. Median iCa level was 1,13 mmol/L (1,08-1,18 interquartile range (IQR)), median TCa level was 2.13 mmol/L (2.02-2.22 IQR). 76 patients (57%) had hypocalcemia (iCa

Background: The results of previous studies evaluating the effects of cardiac resynchronization therapy (CRT) on myocardial blood flow (MBF) and their relation with the response to CRT are conflicting. Materials and Methods: Sixty-one patients diagnosed with idiopathic dilated cardiomyopathy (IDC), a functional capacity (New York Heart Association [NYHA]) Class II or III, and left bundle branch block (LBBB) (QRS width >150 ms) were enrolled in the study. We aimed to evaluate the effects of CRT on MBF in patients with IDC and LBBB by coronary flow reserve (CFR) measurements and thereby tried to predict the responders. Results: Sixty-one patients with IDC were enrolled. CFR and hyperemic fractional flow reserve (FFR) increased after CRT. The only parameter affecting the increase in CFR was the change in FFR after CRT. Then, 44 patients who responded to the CRT treatment at 6 months were compared with 17 patients who did not. Left ventricle outflow tract time-velocity integral (LVOT-TVI), stroke volume (SV) and cardiac output index (COi) was detected significantly higher also left ventricular end-diastolic pressure (LVEDP) was lower in the CRT responders. However, there were no significant differences in coronary flow velocity measurements between the two groups. Moreover the regression analysis revealed that the baseline NYHA class, LVOT TVI, SV, COi, and LVEDP, which were changed due to increased blood flow after CRT implantation, is not associated with response to CRT. Conclusions: Our results suggest that MBF increased after CRT in patients with IDC probably by improving microvascular functions. However, the response to CRT treatment is not related to the changes in the coronary blood flow velocities after CRT.

Objective: Studies have shown that electrolyte abnormalities can be seen in Coronavirus disease 2019 (COVID-19) patients and are associated with the severity of the disease. We aimed to investigate the electrolyte imbalance such as hypocalcemia and hypokalemia in patients hospitalized with COVID-19 and its effect on the QTc interval. Materials and Methods: 185 hospitalized patients with COVID-19 whose diagnosis was confirmed by a real-time reverse transcriptase-polymerase chain reaction and/or Computed Tomography of the chest were included in the study. The potassium and calcium measurements on the admission and third day of hospitalization were recorded. The QTc interval measurement was performed on the admission (QTc-B) and the 3rd-day (QTc-AT) electrocardiography. Results: The median age was 43 (31-56 IQR) and 102 (55.1%) of patients were male. Median baseline potassium level was 4.0 mEq/L (3.7-4.3 IQR) and corrected calcium level was 8.48 mg/dl (8.24-8.73 IQR), whereas the 3rd-day median potassium level was 4.2 mEq/L (3.9-4.5 IQR) and corrected calcium level was 8.42 mg/dl (8.16-8.70 IQR).The median QTc-B interval was found as 427 ms (409-447 IQR) whereas the median QTc-AT interval was found as 438 ms (414-459 IQR). Median 9 ms (-5- 28 IQR) prolongation was observed in the QTc interval, which was statistically significant (p

Background The effect of favipiravir on the QTc interval during the treatment of Coronavirus Disease 2019 (COVID-19) patients is unclear. Thus, the current study objective was to evaluate any change in the QTc interval in patients who were hospitalized due to COVID-19 receiving favipiravir treatment. Method Patients hospitalized with COVID-19 were assessed in this single-center retrospective study. 189 patients, whose diagnosis was confirmed using real-time PCR, were included in the study. The patients were divided into three groups: those using hydroxychloroquine (Group 1, n = 66), hydroxychloroquine plus favipiravir (Group 2, n = 66), and favipiravir only (Group 3, n = 57). The QTc interval was measured before treatment (QTc-B) and 48 h after (i.e., the median) starting treatment (QTc-AT). Results The median age was 53 (39–66 IQR) and 97 (51%) of patients were female. The median QTc(Bazett)-change was 7 ms (p = 0.028) and 12 ms (p

Background Thrombolysis in Myocardial Infarction Frame Count (TFC) is an index that provides a quantitative evaluation of coronary microvascular dysfunction. In this study, we aimed to examine the effect of COVID-19 infection on TFC in patients admitted with chest pain and dyspnoea after COVID-19 disease and had abnormal findings in myocardial perfusion scintigraphy. Methods For this single-center retrospective study, patients with and without a history of COVID-19 who were underwent coronary angiography for abnormal findings in myocardial perfusion scintigraphy between January 1, 2021 and June 30, 2021 were analysed. Patients were divided into two groups as patients with COVID-19 history and those without. After exclusion criteria, patients with adequate angiographic monitoring and data were included in the study. Results A total of 210 patients, 48 with a history of COVID-19, were included in the study. The mean age was +/- 55 10 years, and 122 (58%) patients were women. In patients with a history of COVID-19, TFC was significantly higher in the LAD (p < 0.001) and LCx (p < 0.001) arteries and RCA TFC (p = 0.223) was similar in both groups. In the linear mix model, male gender (beta = 2.38, 95% CI = 1.26-3.51, p < 0.001) and history of COVID-19 (beta = 1.51, 95% CI = 0.49-2.53, p = 0.004) were significantly associated with TFC. Conclusion TFC may be elevated due to coronary microvascular dysfunction in patients with a history of COVID-19.

The frontal QRS-T (f-QRST) angle is a measure of depolarization and repolarization heterogeneity and may be a predictor of poor ventricular health. We aimed to investigate whether the f-QRST angle indicates myocardial damage and predicts newly diagnosed true hypertension (HT) in patients with white coat hypertension.We measured the f-QRST angle of 63 subjects with WHC and 105 patients with newly diagnosed HT. Laboratory tests and ABPM were followed up in all patients. The f-QRST angle was calculated on the surface ECGs.Of the patients in the study, 38.9% were female and 61.1% were male. The mean age was calculated as 59 ± 11 years. A comparison between both groups with the f-QRST angles was seen to be statistically significantly higher in the true HT group. The results of the receiving operating characteristic curve showed that the AUC value of the f-QRST angle was 0.94 (95% confidence interval, 0.91-0.97), the cutoff value was 60.5°, the sensitivity was 89.5%, and the specificity was 81%.In our study, the f-QRST angle was found to be lower in patients with WHC than in true hypertensive patients. We think that ECG, which is a simple test, can be used to distinguish between true HT and WHC.

Objective: In recent years, sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to improve symptoms and reduce mortality in patients with heart failure (HF). Empagliflozin is an antidiabetic drug that SGLT-2 inhibitor. Empagliflozin has beneficial cardiac effects like other SGLT-2 inhibitors. However, data on how empagliflozin treatment affects echocardiographic parameters are limited. We aim to evaluate the changes in left ventricular myocardial strain parameters with 2-dimensional speckle tracking echocardiography (2D-STE) in patients with diabetes mellitus and normal ejection fraction after empagliflozin treatment.Material and Method: A total of 48 patients were included in our study. The left ventricular ejection fraction (LVEF) of the patients were normal and there were no HF symptoms and findings. Demographic, clinical, and echocardiographic parameters of study population were evaluated. Empagliflozin 10 mg once daily was given to all patients. Initial and at the end of 3rd month, the 2D-STE parameters of all patients were examined.Results: The median age of the study population was 55.0 (45.0 – 62.5, IQR) years and 27 (56.3 %) of them were female. There was a significant increase in the left ventricle global longutidunal strain (LV-GLS) and left ventricle global circumferential strain (LV-GCS) compared to baseline [respectively; -19.7(-17.5;-20.9) vs -19.2(-17.6;-20.2), p= 0.016 and -18.9(-16.0;-20.8) vs -17.1(-15.8;-18.7), p= 0.003]. Although left ventricular global radial strain (LV-GRS) was increased compared to baseline, it was not significant [37.0(31.0-41.6) vs 36.3(32.4-40.3), p= 0.776].Conclusion: In our study, left ventricular myocardial strain parameters such as LV-GLS and LV-GCS were improved in diabetic patients with normal ejection fraction after empagliflozin treatment.

Aim: Inflammatory markers such as C-reactive protein and Albumin have previously been associated with poor prognosisin ST-elevation myocardial infarction (STEMI). The present study aims to investigate the relationship between theinfarct-related arteries (IRA) patency and C-reactive protein/Albumin ratio (CAR) before primary percutaneous coronaryintervention (p-PCI) in patients with STEMI.Material and Methods: A total of 822 patients who underwent p-PCI for acute STEMI were included in this study. Patientswere divided into two groups according to IRA patency as TIMI flow 0-1 (n = 551) and TIMI flow 2-3 (n = 271). CAR ratiomeasured at admission was compared with IRA patency.Results: The average age of 822 patients was 55±12, and 84.3% (693) of the patients were male. The mean CAR levelof the patients was determined as 0.26 (0.08-0.48). CAR level was statistically significantly higher in TIMI flow 0-1 groupwhen compared to TIMI flow 2-3 group [0.31 (0.09-0.51) vs 0.23 (0.06-0.42); p, Amaç: C-reaktif protein ve Albumin gibi inflamatuar markerlar STEM’de daha önce kötü prognoz ile ilşkilendirilmiştir.Çalışmamızda ST elevasyonlu miyokard enfarktüsü (STEMI) geçiren hastalarda pirmer Perkütan Girişim (p-PKG) öncesienfarktüsten sorumlu koroner arter açıklığı ile C-reaktif protein/Albumin oranı (CAR) arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntem: STEMI nedeni ile p-PKG uygulanmış 822 hasta çalışmaya dahil edildi. Hastalar IRA açıklığına göre TIMI akım0-1 (n=551) ve TIMI akım 2-3 (n=271) olarak iki gruba ayrıldı. Başvuru sırasında ölçülen CAR oranı, IRA açıklığı ile karşılaştırıldı.Bulgular: 822 hastanın yaş ortalaması 55±12’ di ve %84,3 (693)’ ü erkekti. Tüm çalışma hastalarının ortalama CAR düzeyi0.26 (0.08-0.48) olarak tespit edildi. CAR düzeyi TIMI akım 0-1 grubunda TIMI akım 2-3 grubuna göre istatiksel anlamlılıkladaha yüksek bulundu [0.31 (0.09-0.51) vs 0.23 (0.06-0.42); p

WOS:000681541900001 PMID34354253 Hypertension is a major concomitant disease in hospitalized patients with COVID-19 (Coronavirus disease 2019) infection. The adverse effect of hypertension on prognosis in COVID-19 is known. Nevertheless, it is not known how COVID-19 progresses in resistant hypertensive patients. In this study, we aimed to examine the effect of resistant hypertension (ResHT) on in-hospital mortality in patients hospitalized with COVID-19. In our single-center retrospective study, included 1897 COVID-19 patients. The patients were divided into three groups according to the non-hypertensive (n = 1211), regulated HT (RegHT) (n = 574), and ResHT (n = 112). These three groups were compared according to demographic features, clinical signs, laboratory findings, and follow-up times. The median age of the study population was 62 (50–72 IQR) and 1000 (52.7%) of patients were male. The total mortality of the study population was 18.7% (n = 356). Mortality rates were similar in the hypertensive patient group (27.5% for the RegHT and 32.1% for ResHT, p = 0.321). In a multivariable analysis, ResHT was independently associated with a significantly increased risk of inhospital mortality of COVID-19, while no significant increased risk was observed with RegHT [respectively, Odds Ratio (OR) = 2.013, Confidence Interval (CI) 1.085–3.734, p = 0.026 and OR = 1.194, CI 0.795–1.794, p = 0.394]. Also, age, male gender, chronic renal failure, lymphocyte, procalcitonin, creatinine, and admission SpO2 levels were determined as independent predictors of in-hospital mortality. In our study, it was found that ResHT was an independent predictor of mortality in patients hospitalized with COVID-19; however, this situation was not found in RegHT.

Background Recent findings indicate that thrombosis is one of the underlying pathophysiology and complication of COVID‐19 infection. Therefore, the prognosis of the disease may be more favourable in people who were under oral anticoagulant treatment before the COVID‐19 diagnosis. This study aims to evaluate the effects of chronic DOAC use on ICU admission and mortality in hospitalized patients due to COVID‐19 infection. Method Between 1 September and 30 November 2020, 2760 patients hospitalized in our hospital due to COVID‐19 were screened. A total of 1710 patients who met the inclusion criteria were included in the study. The patients were divided into two groups as those who use DOAC due to any cardiovascular disease before the COVID‐19 infection and those who do not. Results Seventy‐nine patients were enrolled in the DOAC group and 1631 patients in the non‐DOAC group. Median age of all study patient was 62 (52‐71 IQR) and 860 (50.5%) of them were female. The need for intensive care, in‐hospital stay, and mechanical ventilation were observed at higher rates in the DOAC group. Mortality was observed in 23 patients (29%) in the DOAC group, and it was statistically higher in the DOAC group (P = .002). In the multivariable analysis, age (OR: 1.047, CI: 1.02‐1.06, P

Çökelimli sertleşebilir 7xxx serisi alüminyum alaşımlar, otomotiv ve havacılık sanayinde oldukça yaygın kullanılmaktadır. Her ne kadar literatürde 7075 serisi alaşımlar üzerine yapılan çalışmalar öne çıksa da 7050 serisi alaşımların kırılma tokluğu ve gerilme korozyonuna dirençleri daha iyidir. Bu çalışmada, kriyo-haddelemenin 7050 çökelimli sertleşebilir alüminyum alaşımının yaşlandırma sonrasındaki mekanik özelliklerine ve mikroyapısına etkisi sırasıyla sertlik ölçümü ve SEM analizleri ile karakterize edilmiştir. Bu amaçla, 470°C'de 1 saat çözeltiye alınan plakalar kriyo-haddelenerek %5-20 deformasyona tabii tutulmuşlardır. 120°C'de farklı sürelerde uygulanan yaşlandırma sonucunda, deformasyon ile alaşımın azami sertliğinde önemli bir değişim gözlemlenmezken doruk yaşlanma süresinin artan deformasyon miktarı ile azaldığı görülmüştür. Üretim hızı açısından önemli bir parametre olan doruk yaşlanma süresindeki düşüş, yüksek dislokasyon yoğunluğuna bağlı olarak artan çekirdeklenme hızına bağlanmıştır. The precipitation hardenable 7xxx series aluminum alloys are extensively used in automotive and aviation industry. Although the studies on 7075 series alloys are prominent in the literature, 7050 series alloys have better fracture toughness and resistance to stress corrosion. In the scope of this study, the effect of cryorolling on the mechanical properties and microstructure after ageing of precipitation hardenable 7050 aluminum alloy has been characterized with hardness measurements and SEM analysis, respectively. With this purpose, the plates, which have been solution treated at 470°C for 1 hour, were subjected to %5-20 deformation by cryorolling. As a result of aging at 120 ° C for varying time periods, no significant change was observed in the maximum hardness of the alloy after deformation while the peak aging time decreased with increasing amount of deformation. The decrease in peak aging time, which is an important parameter for production speed, was attributed to the increased nucleation rate due to the high density of dislocations. 60

The aim of this study is to investigate the impact of ticagrelor as compared to clopidogrel based dual antiplatelet therapy (DAPT) during post-discharge management on the incidence of left ventricular (LV) thrombus in patients with first acute anterior ST elevation myocardial infarction (STEMI).641 patients who met the inclusion criteria were divided into two groups based on the receipt of either ticagrelor or clopidogrel based DAPT.Left ventricular thrombus was detected in 73 (11.4%) patients at the first month echocardiographic examination. Ticagrelor based DAPT was associated with significantly less incidence of LV thrombus when compared to clopidogrel [20 (7.4%) vs 53 (14.0%) OR: 0.50 (0.29-0.86)]. Penalized maximum likelihood estimation (PMLE) logistic regression analyses were performed to fourteen candidate variables for identifying the independent predictors of LV thrombus, ticagrelor (compared with clopidogrel) [OR: 0.53 (0.28-0.96), p = 0.039], body mass index (BMI) [OR: 0.58 (0.44-0.77), p 0.001], KILLIP class (I vs II-IV) [OR: 0.35 (0.14-0.83), p = 0.017], age [OR: 1.22 (1.08-1.40), p 0.001], poor postprocedural myocardial blush grade (MBG) [OR: 3.35 (1.32-8.15), p = 0.012] and LVEF predischarge [OR: 0.79 (0.72-0.86), p 0.001] were found to be associated with LV thrombus.Our study demonstrated that the incidence of LV trombus was significantly lower with ticagrelor than clopidogrel-based DAPT during postdischarge treatment for anterior STEMI patients.

Objectives. Coronary collateral circulation (CCC) may limit the size of right ventricular (RV) infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention.Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA) before angioplasty were angiographically assessed, establishing two groups: 147 (63%) patients without CCC and 88 (37%) with CCC according to presence of CCC.Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6;p=0.03).Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI.

Adams-Oliversyndrome is characterized by scalp defects with terminal transverse limbanomalies. Most reports on this syndrome demonstrate autosomal dominantpedigrees. Cutis marmorata telangiectasia congenita accompanies the syndrome inmany cases. Here, we describe a case of Adams-Oliver syndrome with cardiacmalformation and Eisenmenger syndrome. Because this is a rare case, thedetailed case and literature data are presented., Adams-Oliversendromu (AOS) skalp defekti ve uç uzuv anomalisi ile karakterizedir. Birçokrapor bu sendromun otozomal dominant kalıtımını kanıtlamıştır. Birçok olgudakutis marmarotus telenjektazia konjenita eşlik etmektedir. Bu olguda biz AOS’aeşlik eden Eisenmenger sendromu ve kardiyak malformasyontanımladık.Literatürümüzde bulunan çok nadir bir olgu olduğu için detaylı olguve literatür bilgisi hazırlandı.

The aim of this study was to investigate the prognostic value of restrictive right ventricular filling pattern (RRVFP) in patients with the first acute inferior wall myocardial infarction (IWMI) complicated by right ventricular myocardial infarction (RVMI) undergoing primary percutaneous coronary intervention (p-PCI).A total of 152 patients with acute IWMI complicated by RVMI undergoing p‑PCI were divided into two groups according to the presence of RRVFP. RRVFP was defined as tricuspid diastolic early/late flow velocities (Et/At) 2 and Et deceleration time (DT) 120 ms.There were 23 patients with RRVFP in the study cohort. At, DTt, isovolumetric relaxation time (IVRT), and tissue Doppler tricuspid annular late velocity (A't) were reduced significantly in patients with RRVFP than in those without RRVFP (At 19.6 ± 2.7 vs. 39.1 ± 7.4 cm/s, p 0.001; DTt 106 ± 13 vs.156 ± 21 ms, p = 0.001; IVRT 59 ± 6.7 vs. 62 ± 7.4 ms, p = 0.01; A't 4.6 ± 1.1 vs. 8.6 ± 1.05, p = 0.001). Et/At ratios were higher in patients with RRVFP than in those without RRVFP (Et/At 2.20 ± 0.2 vs. 1.15 ± 0.37, p 0.001). Et, tissue Doppler tricuspid annular early velocity (E't), E't/A't ratio, and Et/E't ratio were not significantly different between groups (Et 43.3 ± 5.4 vs. 40.7 ± 9.2 cm/s p = 0.18; E't 8.8 ± 1.4 vs. 9.5 ± 2.3, p = 0.15; E't/A't 1.08 ± 0.24 vs. 1.13 ± 0.30, p = 0.52; Et/E't ratio 5.0 ± 1.1 vs. 4.5 ± 1.5 p = 0.09). Presence of E't/A't 2, short DTt, RRVFP, unsuccessful p‑PCI, and cardiogenic shock on admission were independent predictors of in-hospital mortality (p 0.05) in multivariable logistic regression analysis.Presence of RRVFP is associated with in-hospital mortality in patients presenting with their first IWMI complicated by RVMI.

Background: Acute inferior ST-segment elevation myocardial infarction (STEMI) is associated with increased in-hospital morbidity and mortality particularly among patients with coexisting right ventricular (RV) involvement. High neutrophil to lymphocyte ratio (NLR) is an independent predictor of major adverse cardiac events and mortality in patients with myocardial infarction. This study evaluated the relationship between the NLR and RV dysfunction (RVD) in patients with inferior STEMI who underwent primary percutaneous coronary intervention (PCI). Methods: A total of 213 subjects with inferior STEMI were divided into two groups according to the presence of RVD. The groups were compared according to NLR and receiver operating characteristic (ROC) analysis was performed to access the predictability of NLR on having RVD. Results: The NLR was significantly higher in the group with RVD compared to that without RVD (p 3.5 predicted RVD with sensitivity of 83% and specificity of 55%. In a multivariate regression analysis, NLR remained an independent predictor of RVD (OR 1.55, 95% CI 1.285–1.750, p < 0.001). Conclusions: NLR was an independent predictor of RVD in patients with inferior STEMI undergoing primary PCI.

Erkan Baysal,1 Cengiz Burak,2 Serkan Cay,2 Tolga Aksu,3 Bernas Altintaş,1 Bariş Yaylak,1 Utkan Sevük,4 Önder Bilge1 1Department of Cardiology, Diyarbakir Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey; 2Department of Cardiology, Ankara Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey; 3Department of Cardiology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey; 4Department of Cardiovascular Surgery, Diyarbakir Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey Background: Rheumatic heart disease (RHD) is a serious health concern in developing countries. Rheumatic mitral stenosis (RMS) is the most long-term sequel in RHD. The neutrophil to lymphocyte ratio (NLR) is a novel marker, and a higher NLR has been associated with poor clinical outcomes in various cardiovascular disorders. We evaluated the availability of NLR to predict severity of mitral stenosis (MS) in patients with RHD. Methods: We analyzed 300 consecutive patients with RMS. The patients were divided into tertiles according to NLR: 0.85< NLR ≤1.85 (n=100, tertile 1), 1.86≤ NLR ≤2.46 (n=100, tertile 2), and 2.47≤ NLR ≤7.08 (n=100, tertile 3). Patients with RMS were divided into three groups based on the degree of MS as mild, moderate, and severe MS. After the initial evaluation, 187 patients with moderate-to-severe RMS (Group 1) and 113 patients with mild RMS (Group 2) were reassessed. Results: The patients with severe RMS had significantly elevated NLR, mean platelet volume, and pulmonary artery systolic pressure values compared to patients with moderate and mild MS (P

Aims: Occupational head exposure of radiation was suggested to be associated with brain tumors in interventional cardiologists. The brain is of particular interest, because it is one of the least protected organs during interventional procedures. Our aim was to investigate the efficacy of the lead cap in radiation protection of the head and compare it with that of a ceiling mounted lead glass screen in a real life setting. Our secondary goal was to test the comfort and convenience of the lead cap when worn on a regular daily basis. Methods-Results: Radiation dose to the operator was recorded by the three dosimeters placed outside the lead cap, inside the cap and outside the apron at the level of trunk for a total of 18 months. Only the lead cap (Burkhart Roentgen International, St Petersburg, Florida, USA) but not the ceiling suspended protective glass screen was used during the first three months of measurement of radiation dose to the head. Later concomitant use of both protection devices was analyzed. The dosimeter outside the cap recorded a dose of 2.77 mSv radiation when the ceiling mounted screen was not used during the first 3 months. The doses were 2.4 to 12.5 times higher in comparison to the measurements that were recorded when the ceiling suspended screen was used. However, a remarkable dose of radiation (ranged between 1.16-0.22 mSv) was received by the operators head despite the use of ceiling mounted screen. Yet, even without the protection of the ceiling mounted screen, the dose recorded by the dosimeter inside the lead cap during the first period was