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COVID-19 is a multi-systemic infectious disease. Nearly 20%-30% of hospitalized patients have evidence of acute myocardial involvement, portending a poorer prognosis. However, information about the long-term effects of the disease on cardiac functions is sparse. As a result, there is a growing concern about the cardiac sequelae of COVID-19 among survivors. This study aimed to investigate the effects of prior mild-moderate COVID-19 infection on cardiac functions, using speckle tracking echocardiography.Patients who have been diagnosed with COVID-19 within the previous 6 months and age-, sex-, and risk factor-matched healthy adults were included. All patients underwent a comprehensive echocardiographic examination. Both conventional and 2-dimensional speckle tracking echocardiographic measurements were performed. Serum cardiac biomarkers were also obtained on the day of the echocardiographic study.Compared with healthy controls, COVID-19 survivors had similar left and right ventricular longitudinal strain values at 6 months. Also, left and right atrial peak systolic strain values did not differ between the groups.Our study is valuable in putting forth the unaffected ventricular and atrial functions on long term in uncomplicated COVID-19 cases and may decrease the survivors' anxiety and the number of unnecessary applications to cardiology clinics.

Cardiac resynchronization therapy (CRT) positively affects the improvement of functional mitral regurgitation (MR) in patients with heart failure with reduced ejection fraction (HFrEF). However, geometric changes in the mitral valve apparatus, subvalvular structures and their contribution to improving mitral regurgitation after CRT have not been clearly defined. Our study aimed to evaluate the geometric parameters of mitral valve apparatus measured with three-dimensional (3D) transesophageal echocardiography (TEE) before CRT implantation and to determine the parameters predicting the improvement of MR after CRT.In this prospective study, we included thirty patients with moderate or severe MR and HFrEF planned for CRT implantation who had an indication for TEE. Before CRT implantation, effective regurgitant orifice (ERO) and regurgitant volume (RV) measurements were performed. Detailed quantitative measurements of the mitral valve were done from recorded images by 3D TEE. ERO and RV measurements were repeated to evaluate MR at the end of the third month.There were no significant changes in left ventricular EF and left ventricular diameters at third-month follow-up, whereas ERO and RV values were decreased. The posterior leaflet angle was higher in the non-responder group than the responder group (28.93 ± 8.41 vs 41.25 ± 10.90, p = 0.006). The posterior leaflet angle was an independent predictor of decreased RV and ERO.Among HFrEF patients with moderate or severe functional MR who underwent CRT implantation had a lower posterior leaflet angle, which was measured by 3D TEE, in the patient group whose MR improved after CRT.

Acute heart failure due to cardiac involvement of idiopathic hypereosinophilic syndrome has poor prognosis and high mortality rate. We present a 52 year old male patient with hypereosinophilic syndrome resulting in acute heart failure and mesenteric thromboembolism. Non ST elevation myocardial infarction (high troponin levels) was considered in the differential diagnosis of acute heart failure. However acute coronary syndrome was excluded with diagnostic coronary angiography. The laboratory results showed hypereosinophilia on the blood count. Cardiac magnetic resonance imaging (CMR) showed diffuse left ventricular dilatation, wall motion abnormalities and left ventricular apical thrombus without subendocardial fibrosis. He was treated according to heart failure guidelines and the patient status improved clinically. With the corticosteroid treatment, eosinophil count, C-reactive protein levels returned to normal range. Nevertheless, his clinical condition deteriorated due to massive mesenteric thromboembolism and died after cardiogenic shock and sepsis. In the pathogenesis of the disease, eosinophil derived granüls may be responsible for the cardiac damage and clinical variability that was ranging from cardiogenic shock to endomyocardial fibrosis. Early diagnosis and treatment can prevent morbidity and mortality.

The cardiovascular effect of liraglutide, a glucagon-like peptide 1 analogue, when added to standard care in patients with type 2 diabetes, remains unknown. METHODS In this double-blind trial, we randomly assigned patients with type 2 diabetes and high cardiovascular risk to receive liraglutide or placebo. The primary composite outcome in the time-to-event analysis was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The primary hypothesis was that liraglutide would be noninferior to placebo with regard to the primary outcome, with a margin of 1.30 for the upper boundary of the 95% confidence interval of the hazard ratio. No adjustments for multiplicity were performed for the prespecified exploratory outcomes. RESULTS A total of 9340 patients underwent randomization. The median follow-up was 3.8 years. The primary outcome occurred in significantly fewer patients in the liraglutide group (608 of 4668 patients [13.0%]) than in the placebo group (694 of 4672 [14.9%]) (hazard ratio, 0.87; 95% confidence interval [CI], 0.78 to 0.97; P, Novo Nordisk; National Institutes of Health; LEADER ClinicalTrials.gov

Aim: Angiotensin-converting enzyme (ACE) inhibitors and beta blockers were shown to be effec-tive in prevention of atrial fibrillation (AF) recurrences after electrical cardioversion, by interfering with atrial structural and electrical remodeling. In this study, we aimed to compare the effects of ACE inhibitor cilazapril and beta blocker metoprolol after cardioversion of AF in terms of sinus rhythm maintenance.Patients and Methods: The study population comprised 120 patients with persistent atrial fibril-lation (>7 days) who underwent successful cardioversion. Randomization into 3 groups was done after successful cardioversion. Group I (n=41) was treated with amiodarone, group II (n=41) was treated with amiodarone plus metoprolol, and group III (n=38) was treated with amiodarone plus cilazapril. The primary end-point of the study was the recurrence rates between groups at one year and with those who recurred, the time to recurrence of AF.Results: After 1 year follow-up, maintenance of sinus rhythm were similar among groups (Kaplan-Meier analysis, 24%, 37% and 26% respectively; log rank=0.3). There was no difference among groups with respect to time to recurrence of AF.Conclusion: Patients treated with amiodarone only, amiodarone plus metoprolol and amiodaro-ne plus cilazapril had similar rates of recurrence of AF.

2a-1) 5 ¢ CTG GTC AGC TTT CGG TAC GA 3 ¢ , and (HSV Sir, gB 2a-2) 5 ¢ CAG GTC GTG CAG CTG GTT GC 3 ¢ . These Human herpesvirus 8 (HHV-8) is the most recent putatprimers have been amplifying both types of HSV, namely types I and II. As a positive control specimen, cerebrospinal ive human herpesvirus. Evidence was obtained using  uid of a patient with a clinical and serologically proven HSV molecular biology techniques (1). SpeciŽ c DNA encephalitis was used. sequences were Ž rst identiŽ ed in 1994 by Chang et al. (2) in Kaposi’s sarcoma tissues from patients with AIDS

Lutembacher syndrome is a rare combination of congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Although it is traditionally corrected by surgical treatment, both conditions are amenable to transcatheter treatment without the need for surgery. We present a 49-year-old woman with Lutembacher syndrome. On pretreatment transthoracic echocardiography, planimetric mitral valve area was 1.5 cm(2), maximum diastolic gradient was 17 mmHg, and mean diastolic gradient was 9 mmHg. Combined percutaneous treatment was performed including balloon valvuloplasty for MS and closure of the ASD with the Amplatzer septal occluder. The patient was discharged uneventfully. Transthoracic echocardiography performed a week later showed planimetric mitral valve area as 2.1 cm(2), maximum diastolic gradient as 9 mmHg, and mean diastolic gradient as 4 mmHg. Complete closure of the ASD was achieved. Transcatheter treatment may be an effective alternative to surgery in selected patients with Lutembacher syndrome.

In vitro activity of beta-lactam antibiotics and their beta-lactamase inhibitor combinations were evaluated for their activity against clinical isolates of Mycobacterium tuberculosis and M. tuberculosis H37Ra. Agar dilution, the BACTEC 460 system and beta-lactamase activity tests were used. Results using the BACTEC 460 and enzyme activity tests showed the best beta-lactamase inhibitor for M. tuberculosis H37Ra to be clavulanic acid. Cefazolin-clavulanic acid gave the lowest minimal inhibitory concentration (MIC) values using dilution tests and M. tuberculosis H37Ra. beta-Lactam antibiotics were combined with clavulanic acid and tested for in vitro activity against 50 selected multidrug-resistant (MDR) and 50 susceptible clinical isolates. Seventy-four percent of the isolates were inhibited by cefazolin-clavulanic acid combination. These results suggested that an appropriate combination of beta-lactam and beta-lactamase inhibitors might be useful in the treatment of tuberculosis due to multidrug-resistant strains.