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OBJECTIVE: The electromechanical window (EMW) was investigated as a new predictor of arrhythmia in the presence of long QT. However, the use of EMW to predict idiopathic frequent ventricular premature complexes (PVCs) in those with normal QT intervals has not been clarified. PATIENTS AND METHODS: This single-center study included consecutive patients who presented to the Cardiology Clinic with palpitations and were found to have idiopathic PVC on 24-hour Holter monitoring. Those with a PVC/24-hour frequency of < 1% were defined as group 1, 1-10% as group 2, and > 10% as group 3. The EMW was defined as the time difference (in ms) between the aortic valve closure and the end of the QT interval, measured from an ECG on the concurrent echocardiogram. RESULTS: A total of 148 patients were included in the study, 64% (n = 94) of which were female. The patients' mean age was 50.11 ± 14.7. The groups were similar in terms of the patients' age, BMI, and comorbidities. There was a statistically significant difference between the three groups in terms of the EMW measurements (group 1: 3.78 ± 19.6, group 2: -7 ± 30.9, group 3: -34.83 ± 55.2 ms: p < 0.001). In the multivariate regression analysis, the EMW (OR 0.971, p = 0.007) and every 10-ms decrease in the EMW (OR 1.254, p = 0.011) were thus determined to be independent predictors of PVC > 10%. An EMW value of = -15 ms was associated with the frequency of 24-h PVC > 10%, with a sensitivity of 70% and a specificity of 70% (AUC 0.716, 95% CI: 0.636-0.787 p < 0.001). CONCLUSIONS: The results showed that a negative increase in the EMW may be associated with frequent idiopathic PVCs. [ABSTRACT FROM AUTHOR]

Bu araştırma, erken çocuklukta öğrenmeye ilişkin ebeveynlerin görüşlerinin incelenmesi amacıyla karma desenin eşzamanlı iç içe geçmiş modelinde tasarlanmıştır. Araştırmanın çalışma grubunu İstanbul, Ankara, İzmir, Antalya, Bursa, Eskişehir, Konya, Kayseri, Balıkesir, Mersin, Malatya, Erzurum, Adıyaman, Diyarbakır, Kars, Şanlıurfa, Van ve Ağrı illerinde okul öncesi dönemde çocuğu olan 355 ebeveyn oluşturmaktadır. Araştırmada veri toplama aracı olarak araştırmacılar tarafından hazırlanan “Erken Çocuklukta Öğrenme Anketi” kullanılmıştır. Verilerin analizinde anketteki kapalı uçlu sorular için ağırlıklı ortalama hesaplanmış ve ki-kare analizi yapılmıştır. Anketteki açık uçlu sorular için ise içerik analizi yapılmıştır. Araştırmanın sonucuna göre, araştırmaya katılan ebeveynler erken çocuklukta öğrenmede en çok sosyal gelişime katkı sağlayan durumlara önem vermekte ve öğrenmenin gerçekleşmesi için en çok çocuğun bir şeye ilgi ve merak duymasını önemli görmektedir. Ayrıca ebeveynler çocuklarında en çok öğrenme sürecine katılım gösterme davranışını gözlemlemekte ve öğrenme davranışlarının geliştirilmesi için en çok çocukları dinlemek ve onların düşünce şekillerini anlamaya çalışmak gerektiğini belirtmektedir. Araştırmadan elde edilen sonuçlar ışığında öneriler şu şekilde sunulabilir: Ebeveynlerin erken çocuklukta öğrenmeyle ilgili bilgi ve faaliyetlerini artırmak amacıyla destekleyici eğitimler verebilirler. Çocukların ilgi ve merakları ebeveynler tarafından dikkate alınarak sosyal faaliyetlerde bulunmaları sağlanabilir.

Araştırmanın amacı, “Eğitici Oyuncaklarla Verilen Kavram Eğitimi’nin 60-72 Aylık Çocukların Temel Kavram Kazanımına Etkisi”ni incelemektir. Araştırmanın evrenini 2017-2018 eğitim öğretim yılında Ankara ili Pursaklar ilçesi Milli Eğitim Bakanlığı’na (MEB) bağlı bağımsız anaokullarına devam eden, tipik gelişim gösteren 60-72 aylık çocuklar oluşturmaktadır. Araştırmanın çalışma grubunu, bağımsız anaokullarına devam eden 60-72 aylık çocuklar arasından tesadüfî olarak seçilen 65 çocuk oluşturmuştur. Araştırmada veri toplama aracı olarak; “48-72 Aylık Çocuklar İçin Temel Kavram Kazanımını Değerlendirme Ölçeği”, “Sınıf İçi Eğitici Oyuncak Ortamını Değerlendirme Formu” , “Evde Eğitici Oyuncak Ortamını Değerlendirme Formu”, “Öğretmen Gözlem Formu”, “Öğretmen Görüşme Formu” ve “Ebeveyn Görüşme Formu” kullanılmıştır. Araştırmanın sonucunda, deney ve kontrol grubu ön-test puan karşılaştırmalarında anlamlı düzeyde fark bulunmazken, son-test puan ortalamalarında deney grubunun lehine anlamlı düzeyde fark olduğu belirlenmiştir. Deney grubu ön-test/son-test puan ortalamaları karşılaştırıldığında son test lehine anlamlı düzeyde fark bulunurken, kontrol grubu ön-test/son-test puan ortalamaları karşılaştırıldığında matematik alt ölçek puanları ile toplam puanlarında anlamlı düzeyde fark bulunmuştur.

5–8 Yaş Çocuklar için Görsel Uzamsal Akıl Yürütme Becerileri Testi’nin geçerlik ve güvenirliliğin incelendiği bu araştırmada, genel tarama modeli kullanılmıştır. 2018–2019 eğitim öğretim yılında Gaziantep’te Milli Eğitim Müdürlüğü’ne bağlı bağımsız anaokulu ve ilkokullara devam eden, 5–8 yaş aralığında, 459 çocuk, araştırmanın çalışma grubudur. Veri toplama aracı olarak kişisel bilgi formu, bireysel kayıt formu ve 5–8 Yaş Çocuklar İçin Görsel Uzamsal Akıl Yürütme Becerileri Testi kullanılmıştır. Veri toplama sürecinde testin uygulaması, birebir uygulama ile yapılmıştır. Geçerlik çalışmaları kapsamında kapsam ve yapı geçerliği sınanmıştır. Kapsam geçerliği için, alan yazından faydalanılmıştır. Bilişsel Gelişim Kuramı, Beyin Temelli Öğrenme Kuramı ve çoklu zekâ kuramları ışığında kuramsal alt yapı oluşturulmuş, erken çocukluk eğitimi yaklaşımları, erken çocukluk dönemi görsel uzamsal akıl yürütme becerileri gelişimsel yapı taşları, teste benzer değerlendirme araçları incelenmiştir. Kuramsal bilgiler ışığında testin içsel ve dışsal beceriler olarak iki boyutta, içsel durağan, içsel dinamik, dışsal durağan ve dışsal dinamik beceriler olarak dört alt boyutta yapılandırılması düşünülmüştür. Bu bağlamda 7 uzmandan görüş alınmış, her bir madde için madde indeksi hesaplanmış, 0.80 ölçütünü sağlayan maddeler aday testte yerini almıştır. Yapı geçerliği için, var olan test yapısının uygunluğunun sınanması için doğrulayıcı faktör analizi testin tamamı, iki boyutu ve dört alt boyutu için uygulanmıştır. DFA sonucunda p değerleri ve uyum indeksleri dikkate alınarak teste son hali verilmiştir. Testin güvenirliğin belirlenmesinde güvenirlik katsayısı hesaplanmış ve KR-20 değeri 0,81 olarak bulunmuştur. Sonuçta, 5–8 Yaş Çocuklar İçin Görsel Uzamsal Akıl Yürütme Becerileri Testi geçerli ve güvenilir bulunmuştur.

Longitudinal myocardial function (LMF) may be impaired while systolic function is still normal. We investigated relationship between LMF and hypertensive organ damage in newly diagnosed stage I hypertensive patients. A total of 57 patient with never treated stage I hypertension and 48 matched healthy control subject were enrolled in the study. Conventional 2-D, Doppler and tissue wave Doppler imaging (TDI) echocardiography were used. LMF was evaluated by the septal and lateral strain (S) and strain rate (SR) measurements. Hypertensive complications were evaluated by the urine microalbumin levels and retinal examination. A multivariate regression analysis was perfomed to assess the relation between the variables. Ejection fraction, mid-wall fractional shortenning, systolic movement rates (TDs) in TDI were similar both in hypertensive and control groups. In patients with left ventricular hypertrophy, septal TDs (7.29 +/- 1.28 vs. 8.06 +/- 1.19 cm, P = 0.03), lateral TDs (8.46 +/- 1.83 vs. 9.87 +/- 2.42 cm, P = 0.01) and lateral S (-13.02 +/- 7.83 vs. -18.86 +/- 8.60%, P = 0.01) values were significantly lower. Septal S (-13.67 +/- 3.52 vs. -19.09 +/- 5.96%, P < 0.01) and SR (-0.83 +/- 0.29 vs. -1.22 +/- 0.28 1/S, P < 0.01) were significantly decreased in hypertensive patients with microalbuminuria. Septal S value was also significantly decreased in patients with retinopathy (-14.76 +/- 5.55 vs. -20.20 +/- 5.44%, P = 0.01). Multivariate analysis showed that only septal and lateral S values were independent factors for the retinopathy and left ventricular hypertrophy, respectively. In hypertensive patients, LMF established by the measurement of S and SR, might be impaired and also related with end organ damage while global circumferential function is preserved. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Workplace incivility is low intensity deviant behaviors and this type of behavior can be seen in the work environment of nurses. This research was designed to test the linguistic adaptation, reliability and validity of the Workplace Incivility Scale on nurses. METHODS: This research is a methodological study and it was conducted between February and June 2015. The scale includes a 12-item survey. It is Likert type scale and responses to each question are rated on a 5-point Likert scale. The sample of the research was composed of 120 nurses. The reliability of the scale was assessed by internal consistency and the validity is performed by construct, content and criteria validity. RESULTS: Cronbach alpha coefficient of the scale was 0.90, as a result of the internal consistency analysis repeated by removing item wasn't found a problematic item. Exploratory factor analysis is used for the construct validity of the scale and as a result of this analysis; total variance was found 60.41%. Kaiser-Meyer-Olkin for compliance data to factor analysis was found as 0.87, Barlett Sphericity test χ2 value was calculated as 751.219 (p

Objectives: This research was conducted in order to test the validity, reliability of "Environmental Awareness Assessment Scale for 48-66 Months Children". Materials and Methods: The study group of the research consisted of 365 children determined by simple random sampling path from six independent kindergarten tied to Eskisehir Province National Education Directorate in the Central District in Eskişehir. The reliability and validity study of "Environmental Awareness Assessment Scale for 48-66 Months Children" was conducted with the determined study group. The basic premise of the research data was collected via "Personal İnformation Form", "Environmental Awareness Assessment Scale for Children 48-66 Months". Results: For the validation study of Scale, content validity of the scale was evaluated. In order to determine the construct validity of the scale, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) were performed. In order to test the reliability of the scale KR-20 reliability coefficient was calculated. Conclusion: The results were statistically adequate, it was accepted that the scale is valid and reliable.

INTRODUCTION: This study made to compare the professional values of nurses who are and do not take graduate education. METHODS: Universe of the study that is a descriptive and cross-sectional was consisted of nurses working at a Training and Research Hospital. 308 nurses who accepted to participate in the study formed the sample of the study. The data of the study were collected by Personal Information Form and Professional Values of Nurses Scale. RESULTS: Nurses who are postgraduate education; 62.5% of them under the age of 30, 70.3% female, 65.6% single, 76.6% of less than 10 years it works, 71.9% work that as clinic nurses, 60.9% were found to receive education about professionalism. 54.5% of non-graduate nurses were over 30 years of age, 80.7% were women, 57.8% were married, 64.7% were bachelors, 54.5% were under 10 years. 83.6% worked as a clinic nurse and 84.4% was found to receive education about professionalism. In the study, it was determined that the mean and sub-dimensions of the nurses were higher and the difference was statistically significant. Besides, it was found that the mean scores of the nurses who had 10 years or less professional experience, who worked as ICU nurses and those who received professionalism training were higher and meaningful (p

Background: Although angiotensin-converting enzyme inhibitors (ACEIs) have been shown to prolong life in patients with congestive heart failure (CHF), the prognosis of these patients remains poor.Objective: The purpose of the study was to reevaluate a cohort of patients with CHF after 7 years of follow-up with cilazapril therapy to assess the renin-angiotensin system (RAS), anatomic and functional capacity of the heart, and aldosterone escape.Methods: Surviving patients from a cohort hospitalized for CHF between January 1994 and December 1994 who were treated with cilazapril in our center were included in this study. Exercise testing was carried out using the Kattus protocol, and breath-by-breath oxygen analysis, echocardiography, and hormonal analysis were done.Results: Seven patients (5 men, 2 women; mean [SD] age, 70.6 [4.4]) were included in the study. Compared with the early effects (at 15 days) of cilazapril therapy, only mean (SD) peak exercise time decreased significantly at the 7-year follow-up (8.9 [2.4] minutes vs 5.1 [1.9] minutes; P = 0.02). Mean (SD) anaerobic threshold (AT) oxygen consumption and AT ratio increased slightly from 15 days, although these changes were not statistically significant (12.86 [3.5] mL/kg x min vs 13.57 [2.6] mL/kg x min; 70.3% [7.7%] vs 78.9% [9.8%], respectively). Compared with the early effect of therapy, patients had slightly lower mean (SD) ejection fractions (EFs), but the decrease did not reach statistical significance (52% [4%] vs 48% [4%]). Aldosterone levels were within normal limits in all patients, and 2 patients had increased RAS activity.Conclusions: In this study, the observed lack of aldosterone escape, as well as patient survival during ACEI therapy, may be due to selection bias of the surviving patients, who had better EFs and lack of aldosterone escape. Therefore, the remaining issue seems to be the selection of patients who will not show aldosterone escape during chronic ACEI treatment. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D (VD) deficiency is a common disease that occurs in all stages of life. A growing number of studies call attention to the relationship between VD deficiency and cardiovascular disease. The aim of this study was to investigate the effect of VD on subclinical left ventricular (LV) function in diabetic and non-diabetic patients with no significant coronary artery disease., Material and Methods: We recruited 140 patients (80 diabetics and 60 non-diabetics) with symptoms of stable ischemic heart disease who underwent coronary angiography and who had no significant coronary artery disease in our clinic. The 25(OH)D 3 levels were measured and patients who had 25-(OH)D 3 levels below 20 ng/dl were defined as the VD deficient group. In addition to conventional echocardiographic parameters, tissue Doppler echocardiography was used for LV diastolic functions and 2D speckle tracking strain echocardiography (2D STE) for evaluating the longitudinal deformation indices of the LV myocardium., Results: In all groups, LV global longitudinal strain (GLS) was significantly impaired in patients with VD deficiency ( p < 0.001) compared to patients without VD deficiency. LV global longitudinal strain rate (GLSR) was significantly impaired in patients with VD deficiency ( p = 0.003). The GLS was negatively associated with 25-(OH)D 3 in the VD deficiency group ( r = -0.52623, p < 0.001). Conversely, GLS was positively associated with 25-(OH)D 3 levels in the normal VD group ( r = 0.28, p = 0.048)., Conclusions: VD deficiency is associated with impaired myocardial GLS. The present study demonstrated that VD deficiency may be the cause of subclinical myocardial dysfunction in patients with or without diabetes mellitus and no history of significant coronary artery disease., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Termedia & Banach.)

Background: Hypertrophic cardiomyopathy is a primary cardiac disease characterized by left ventricular hypertrophy, myocyte hypertrophy and irregularities and interstitial fibrosis in the absence of any cardiac or systemic diseases and may lead to sudden cardiac death (SCD). Galectin-3 is a β-galactoside-binding lectin that has been associated with cardiac fibrosis and inflammation. In this study, we aimed to investigate the relationship between serum galectin-3 levels and the criteria for 5-year sudden death risk, recently defined in the European Society of Cardiology guidelines (2014), in patients with hypertrophic cardiomyopathy., Materials and Methods: A total of 52 hypertrophic cardiomyopathy patients were enrolled in the study. Patients were questioned for sudden death risk predictors as outlined in the 2014 European Society of Cardiology guideline. A standardized clinical evaluation was carried out on the basis of previously described prognostic variables to calculate the 5-year risk of SCD. Blood samples were taken from all patients to measure serum galectin-3 levels. A statistical significance level of P < 0.05 was accepted in all tests., Results: We found that there was a significant correlation between the estimated 5-year risk of SCD and serum levels of galectin-3., Conclusions: Galectin-3 may be an inexpensive and easily accessible parameter to predict arrhythmia risk. In addition, it can be used to determine antiarrhythmic prophylaxis as a predictor of an arrhythmia storm in implantable cardioverter defibrillator-implanted patients who are not available for magnetic resonance imaging., (Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Inadequate ablation lesion formation may be responsible for post-ablation ventricular tachycardia (VT) recurrences.We aimed to evaluate whether visualisation of radiofrequency (RF) lesion size by cardiac magnetic resonance imaging (CMR) has any role in predicting adequacy of lesion and in estimating outcome.Retrospective pilot studyNine consecutive patients (8 male, age 60 ± 13 years) underwent ablation for sustained VT because of ischemic scar were evaluated for pre- and post-procedure scar tissue by CMR to characterize ablation lesions. Microvascular obstruction (MVO) surrounded by late gadolinium enhancement was defined as irreversible RF lesion. All patients were followed for at least 6 months for recurrences.Five of the patients had previous inferior myocardial infarction (MI), whereas remaining 4 had anterior MI. Acute procedural success, as defined by termination of the arrhythmia without recurrence in 30 minutes, was attained in all patients. Contrast enhancement and wall motion abnormality in presumed infarction area were confirmed by pre-ablation CMR images. MVO was detected at the reported ablation site in 6/9 patients, all arrhythmia- and symptom-free at median 24 months (range 8-38 months) follow-up. In remaining 3 patients who had VT recurrence (clinical VT in 2, sustain VT with a new morphology in 1), MVO was not detected despite achievement of acute procedural success. There was no correlation with pre-ablation scar size and clinical arrhythmia recurrence.CMR is a useful imaging modality to guide ablation procedures by detecting scar tissue. Additionally MVO seen by post-procedural imaging may be related to adequacy of RF ablation lesions and may correlate with clinical outcome.

A 51-year-old male patient presented with frequent and symptomatic premature ventricular complexes (PVCs) that had induced cardiomyopathy. Radiofrequency (RF) catheter ablation of the origin of the PVCs was planned and the patient underwent electrophysiological study. During activation mapping, the earliest ventricular activation was identified at the His bundle region. Small His bundle electrogram recording by the distal ablation electrode during sinus rhythm revealed that the earliest ventricular activation during PVC preceded the QRS onset by 58 milliseconds. The PVCs were successfully eliminated without occurrence of atrioventricular block using incremental application of RF energy to the para-Hisian region. At the conclusion of a 5-month follow-up period, the patient remained asymptomatic and transthoracic echocardiography demonstrated an improvement in left ventricular ejection fraction.

The prevalence of atrial fibrillation increases dramatically with advancing age. Elderly adults with atrial fibrillation-even those with high bleeding risk- benefit from anticoagulation. The risk of ischemic stroke or systemic embolism was significantly lower with new direct oral anticoagulants (DOACs) than warfarin as was the risk of major bleeding and intracranial bleeding. Antiplatelet therapy should have a limited role for stroke prevention in elderly adults. Left atrial appendix occlusion may be a suitable alternative for those with contraindications to oral anticoagulants. For symptom management, it is likely that a strategy of lenient rate control is reasonable in elderly adults with atrial fibrillation. Rhythm control should be reserved for specific circumstances, in particular when symptoms cannot be managed using rate control. In appropriately selected elderly adults with symptomatic atrial fibrillation, catheter ablation may also be a useful strategy, with acceptable safety and efficacy based on limited data. A rhythm control strategy should not preclude anticoagulation.

Introduction: Failure to differentiate supraventricular from ventricular arrhythmias is the most frequent cause of inappropriate implantable cardioverter-defibrillator (ICD) therapies. We hypothesized that the postpacing interval (PPI) after overdrive right ventricular pacing may differentiate ventricular (VT) from supraventricular tachycardia (SVT) such as sinus tachycardia, atrial flutter and atrial tachycardia. This hypothesis is based on the entrainment maneuver. Reentrant tachycardia circuit for VTs would haveshorter distance to RV apex than SVTs have, and the conduction time between a ventricular pacing site and the tachycardia origin is expected to be shorter in VTs than in SVTs., Methods: 220episodes from 38 patients with single chamber ICDs that RV overdrive pacing could not terminate or change the tachycardia cycle length (TCL) were retrospectively reviewed. Episodes were classified as VTs (n=115) and SVTs (n=105). TCLs, PPIs and PPI-TCL were compared between groups., Results: The cycle length of VTs was shorter than SVTs (320.6±30.3 vs 366.5±40 ms, p=0.001). PPI and PPI-TCL of VTs were shorter than SVTs (504.7±128.3 vs 689.2±121.8 ms, p=0.001, 184±103 vs 322.6±106.6 ms, p=0.001; respectively). ROC curve analysis demonstrated a 525 ms cut-off value for PPI has 89% sensitivity and 57.4% specificity to predict inappropriate ICD therapies due to SVTs (AUC:0.852). Similarly, A PPI-TCL <195 ms favored VT as a diagnosis rather than SVT with a 90% sensitivity, and 51% specificity (AUC:0.838)., Conclusion: Analyzing of PPI during overdrive pacing from RV apex may discriminate supraventricular from ventricular tachycardia. This criterion may have a potential role in implantable devices that use a single ventricular lead.

Background Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable disorder characterized by fibro-fatty replacement of right ventricular myocytes, increased risk of ventricular arrhythmias, and sudden cardiac death. Galectin-3 (GAL3) is known to play an important role in a number of fibrotic conditions, including cardiac fibrosis. Many studies have focused on the association between GAL3 levels and cardiac fibrosis in heart failure. However, the role of GAL3 in the pathogenesis of ARVD and ventricular arrhythmias has not yet been evaluated thoroughly. The aim of this study was to explore GAL3 levels in patients with ARVD and its association with ventricular arrhythmias. Methods Twenty-nine patients with ARVD and 24 controls were included. All patients with ARVD had an implantable cardiac defibrillator (ICD) for primary or secondary prevention. Ventricular arrhythmia history was obtained from a chart review and ICD data interrogation. Galectin-3 levels were measured using an enzyme-linked immunosorbent assay. Results Patients with ARVD had higher plasma GAL3 levels (16.9 ± 2.6 ng/mL vs 11.3 ± 1.8 ng/mL, P < 0.001) than the control group. Ten patients had sustained or non-sustained ventricular arrhythmias during follow-up. In the multivariable analysis, left ventricular disease involvement (HR: 1.05; 95% CI: [1.01-1.12]; P = 0.03); functional capacity >2 (HR: 1.21; 95% CI: [1.13-1.31]; P < 0.005); and GAL3 levels (HR: 1.05; 95% CI: [1.00-1.11]; P = 0.01) independently predicted VT/VF. Conclusion We demonstrated that serum GAL3 was significantly elevated in patients with ARVD. Also, serum GAL 3 levels could be regarded as a candidate biomarker in the diagnosis of ARVD which needs to be tested in larger prospective studies. In addition, GAL3 levels were higher in patients with VT/VF as compared with those without VT/VF.

Angiogenesis and arteriogenesis have a crucial role in the formation of coronary collateral vessels. It has been shown that endocan and vascular cell adhesion molecule-1 (VCAM-1) are potential angiogenetic factors. We investigated the relationship between serum endocan levels and grade of coronary collaterals, and also the correlation of endocan levels with serum VCAM-1 levels. Patients with stable angina and at least one total coronary occlusion at invasive coronary angiography were included in our study. Collateral degree was graded according to Rentrop and Cohen's classification. Patients who had grade 0 or 1 collateral vessels were included in the poorly-developed collateral group, and those with grade 2 or 3 coronary collateral vessels were included in the well-developed collateral group. Serum endocan and VCAM-1 levels were significantly higher in the well-developed collateral group (436.6 ± 213.3 ng/mL vs. 216.1 ± 78.5 ng/mL, p < .001; 11.02 ± 6.58 ng/mL vs. 6.78 ± 1.14 ng/mL, p < .001, respectively). In a logistic regression analysis, only serum endocan level remained as an independent predictor for good collateral development. In the ROC curve analysis, 282 ng/mL endocan level had an a 82 % sensitivity and 86 % specificity for prediction of the well-developed collateral group. Higher endocan level was related to better coronary collateral development. In the event that these results are confirmed in further studies, endocan may be considered as an anti-ischemic treatment strategy in order to improve collateral development.

Introduction: The role of contrast-enhanced (ce) cardiac magnetic resonance in risk stratification of patients with depressed left ventricle (LV) function is widely studied. In this study, we investigated the myocardial infarct size and characteristics by ce-magnetic resonance imaging (MRI) and its relationship with spontaneous ventricular arrhythmia occurrence during follow-up of in patients with mild LV systolic dysfunction and nonsustained ventricular tachycardia (VT)., Materials and Methods: This study enrolled 32 patients with postmyocardial infarction with an LV ejection fraction between 40% and 50% and nonsustained VT. Cardiac MRI performed to identify cardiac scar size and characteristics. Dense scar, peri-infarction zone and total infarct masses were calculated, these values to LV mass ratios were obtained. All patients were followed up 48 ± 6 months. Cardiac magnetic resonance data compared among patients with (n = 6) and without spontaneous sustained VT (n = 26)., Results: During follow-up, 6 patients experienced sustained VT (VT+ group), whereas 26 patients had no sustained ventricular arrhythmia (VT- group). The groups had similar baseline clinical characteristics. The LV masses, volumes and ejection fractions did not differ significantly between 2 groups. For the VT+ group versus VT- group dense scar to LV mass were similar (3.1 ± 0.3% versus 3.3 ± 0.9%, P = not significant). Ratio of peri-infarction zone to LV mass (30.9 ± 6.1% versus 21.3 ± 7.5%, P = 0.007) and total infarct to LV mass (34.1 ± 6.1% versus 24.6 ± 7.9%, P = 0.011) were larger in patients with sustained VT., Conclusions: This small study supports the potential utility of ce-MRI to identify patients with postmyocardial infarction prone to develop serious ventricular arrhythmias., (Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Background: The 2 predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract. Discrimination between these 2 entities is critical, as their prognoses and therapeutic options differ. The microvolt T-wave alternans (TWA) is widely used to predict lethal ventricular arrhythmias in various diseases. However, the clinical significance of TWA in patients with VT originating from the right ventricle has been unknown. This study aims to investigate the possible role of TWA to discriminate ARVC from idiopathic right ventricular outflow tract tachycardia (RVOT-VT)., Methods: This study enrolled 38 patients (23 male, 43 ± 16 years) with VT originating from the right ventricle. TWA was measured during exercise testing using the modified moving average method. TWA results were compared among patients with ARVC and RVOT-VT., Results: Twenty-five patients (16 male, 42 ± 16 years) met the Task Force criteria for the diagnosis of ARVC, and 13 patients (7 male, 45 ± 14 years) had idiopathic RVOT-VT. Twenty patients with ARVC had positive TWA test, whereas only 1 patient with RVOT-VT had (80% versus 8%, P < 0.001)., Conclusions: In patients with VT of right ventricle origin, positive TWA test supports the diagnosis of ARVC.

Aims: Scars causing ventricular tachycardia can extend deep to and beyond bipolar low-voltage areas (LVAs) and they may be a reason for endocardial ablation failure. Analysis of endocardial unipolar voltage maps has been used to detect scar transmurality and epicardial scar. We hypothesized that endocardial unipolar LVA around the overlying bipolar LVA may predict endocardial ablation recurrence in patients with structural heart disease undergoing substrate modification., Methods and Results: Twenty consecutive patients with structural heart disease (11 ischaemic and 9 non-ischaemic cardiomyopathy) and undergoing substrate modification due to unmappable ventricular tachycardia (VT) (18 males, 51 ± 11 age, LVEF: 36 ± 7%) were retrospectively reviewed. Bipolar LVA defined as <1.5 mV and unipolar LVA defined as <8.3 mV, respectively, on electro-anatomic mapping system. Peripheral unipolar LVA (pUni-LVA) surrounding bipolar LVA was measured and compared patients with and without VT recurrence at 6-month follow-up period. : Mean unipolar voltage and mean bipolar voltage was 6.26 ± 4.99 and 1.90 ± 2.30 mV, respectively. Bipolar voltage and unipolar voltage in corresponding points were correlated (r = 0.652, P = 0.0001). In all patients, unipolar LVAs were larger than the bipolar LVAs. Bipolar LVA (91.1 ± 93.5 vs. 87.5 ± 47.5 cm(2), P = 0.91) and unipolar LVA (148.1 ± 96.3 vs. 104.7 ± 44.2 cm(2), P = 0.21) were similar in patients with and without VT recurrence, respectively. Peripheral unipolar LVA was significantly larger in patients with VT recurrence than without (57.0 ± 40.4 vs. 17.2 ± 12.9 cm(2), P = 0.01)., Conclusion: In patients with structural heart disease and unmappable VT, pUni-LVA surrounding bipolar scar predicts recurrence of VT ablation. The results of this pilot study highlight the importance of intramural/epicardial substrate on endocardial VT ablation outcome., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Purpose: To explore the vertical and horizontal proportions of the face and difference between the Han and Uygur normal adults in Xinjiang area., Methods: According to certain standards, the adult Han and Uygur college students in Urumqi City were randomly selected for this study. These students were divided into male and female groups. Frontal photographs were taken for every subject in accordance with same standards. The data was imported into computer, with 20 standard anthropometric marks be determined, and 15 measurements were performed through Photoshop software. Independent sample t test was applied for measuring results by SPSS19.0 software package., Results: The face of males were shorter and wider than that of females. Compared with the females, the males had bigger alar width. However, the Han adults had smaller palpebral fissure and mouth width, bigger alar and intercanthal compared with the Uygur adults., Conclusions: This study suggests that there are significant differences between 2 nationalities and sexes in facial proportions in Xinjiang area.

We aimed to investigate whether or not cardiotrophin-1 (CT-1) can be used as a predictor of sinus rhythm constancy in patients with atrial fibrillation (AF) converted to sinus rhythm. Thirty two patients with AF (48-78 years), without any structural heart disease were enrolled for the study. The control group consisted of 32, age and gender matched healthy persons. Measurements of CT-1 were made after transthoracic and transesophageal echocardiography prior to cardioversion (CV). Relapses of AF were investigated by monthly electrocardiograms (ECGs) and ambulatory ECGs at 1st, 3rd, and 6th month. At the end of 6th month, measurements of CT-1 were repeated. At the beginning patients with AF had increased CT-1 levels when compared to controls (0.94 ± 0.32 pg/mL vs. 0.30 ± 0.12 pg/mL, [p < 0.001]). At the end of follow-up of the 32 patients, 17 (53%) had AF relapse. Age, initial duration of AF, left ventricle diameters, ejection fraction, left atrium appendix flow rates were similar among patients with and without AF relapse. However, basal left atrium diameter (4.24 ± 0.14 cm vs. 4.04 ± 0.22 cm, p = 0.005), pulmonary artery pressure (32.82 ± 5 vs. 28.60 ± 6.23 mmHg, p = 0.004) and CT-1 values (1.08 ± 0.37 vs. 0.82 ± 0.16 pg/mL, p = 0.02) were significantly increased in patients with AF relapse. Furthermore, patients with relapsed AF had higher CT-1 levels at 6th month when compared to those in sinus rhythm (1.00 ± 0.40 vs. 0.71 ± 0.23 pg/mL). We conclude that post-CV, AF relapses are more frequent among patients with increased baseline CT-1 levels, and CT-1 may be a potential predictor of AF relapse.

Background: The two predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract (RVOT). Discrimination between these two entities is critical, as their prognoses and therapeutic options differ. The Tpeak -Tend (Tpe) interval reflects the transmural repolarization dispersion and its prolongation is associated with high mortality., Methods: We compared the sinus rhythm electrocardiogram (ECG) of 43 patients (24 male, 43 ± 16 years) with VT originating from right ventricle. Five patients under antiarrhythmic drug therapy were excluded. Tpe interval was measured in each precordial leads and compared among patients with ARVC and RVOT-VT., Results: Twenty-five patients (16 male, 42 ± 16 years) met the Task Force criteria for the diagnosis of ARVC, and 13 patients (seven male, 45 ± 14 years) had idiopathic RVOT tachycardia. Patients with ARVC had significantly prolonged Tpe intervals in all precordial leads compared to patients with idiopathic RVOT VT (137.1 ± 32.6 ms vs 93.8 ± 16.9 ms; P < 0.001 in V1, 133.2 ± 35.5 ms vs 104.7 ± 16.9 ms; P = 0.01 in V2, 125.7 ± 31.5 ms vs 99.1 ± 19.6 ms; P = 0.09 in V3, 121.9 ± 26.5 ms vs 92.3 ± 19.7 ms; P = 0.001 in V4, 123.1 ± 26.5 ms vs 99.5 ± 20:1 ms; P = 0.04 in V5 and 126.9 ± 32.2 ms vs 89 ± 11.3 ms; P < 0.001 in V6, respectively). For the diagnosis of ARVC, Tpe cut-off value of 97 ms in V1 had 84% sensitivity and 62% specificity (area under curve = 0.880)., Conclusion: In patients with VT of RV origin, the prolonged Tpe interval in sinus rhythm electrocardiogram supports the diagnosis of ARVC., (©2014 Wiley Periodicals, Inc.)

Objective: Cardiovascular involvement causes significant morbidity and mortality among patients with human immunodeficiency virus (HIV) infection. Since the introduction of highly active antiretroviral treatment (HAART), subtle changes in left ventricular (LV) function, which may be clinically silent, have become more pronounced in HIV patients. Echocardiographic strain imaging (SI) may detect subclinical myocardial dysfunction at an earlier stage compared with conventional echocardiography. The aim of this study was to evaluate tissue Doppler-derived LV strain and strain rate (SR) along with conventional measures of LV function in asymptomatic, stable adult HIV patients on HAART., Methods: Twenty-one patients with HIV infection (mean age: 37.8 ± 11.9 years, 11 males) who had no cardiovascular complaints and 27 healthy volunteers (mean age: 40.9 ± 5.8 years, 14 males) were enrolled. Traditional parameters including LV ejection fraction (EF) were measured along with tissue velocity imaging (TVI) and tissue Doppler SI parameters using transthoracic echocardiography., Results: The mean duration of HIV infection was 30.8 ± 25.1 (3-120) months. The mean LVEF in HIV group was within normal limits but lower than controls (64.5% ± 10.2% vs. 72.2% ± 6.4%, P = 0.003). There were no differences in other major traditional measures, as well as TVI parameters between groups. LV systolic strain and SR parameters were impaired indicating subtle LV systolic dysfunction in HIV group. No difference in diastolic function was observed between groups., Conclusion: Left ventricular systolic strain parameters may be utilized to demonstrate subtle LV systolic dysfunction in asymptomatic HIV patients., (© 2014, Wiley Periodicals, Inc.)

Objective: Microvolt T-wave Alternans (TWA) is associated with abnormal repolarization and predicts arrhythmic mortality in patients with previous myocardial infarction (MI). Infarct tissue size and heterogeneity characterized by cardiac magnetic resonance (CMR) has been shown to be associated with arrhythmogenic substrates and sudden cardiac death. Although both delayed enhancement-CMR (de-CMR) and TWA are useful in risk stratification of post-MI patients with preserved left ventricular function, the relationship between scar size and TWA has not studied yet. In this study, we aimed to study the relation between TWA and scar size and characteristics assessed with CMR in post-MI patients (pts) with relatively preserved systolic function presented with nonsustained VT., Methods: This observational cross-sectional study was enrolled 36 post-MI patients with mild-systolic dysfunction and non-sustained ventricular tachycardia. Eight pts were excluded. Both TWA and contrast enhanced CMR were performed. Left ventricular ejection fraction (LVEF), dense scar, peri-infarct zone and total scar masses were assessed and these values to left ventricular (LV) mass ratios were calculated. Infarct ratios and characteristics were determined and compared among patients with negative TWA and those with positive TWA., Results: For the positive (n=12) vs. negative (n=16) TWA patients there were no significant difference between LVEF (44.9 ± 5.4% vs. 44.0 ± 3.2%, p=NS) and LV masses (121.89 ± 26.56 g vs. 106.14 ± 21.16 g, p=NS). The ratio of scar core to LV mass (3.37 ± 0.68% vs. 3.31 ± 1.01%, p=NS), peri-infarct zone to LV mass (23.61 ± 7.93% vs. 21.64 ± 9.08%, p=NS), total scar to LV mass (26.98 ± 7.86% vs. 24.96 ± 9.62%, p=NS) were all similar., Conclusion: There were no association between scar size and infarct heterogeneity and prevelance of TWA in post-MI patients with relatively preserved LVEF with non-sustained VT. Our data suggest that these two modalities may reflect different arrhythmogenic mechanisms in this cohort.

Background: The extent of peri-infarct zone (PIZ) by contrast-enhanced cardiac magnetic resonance (ce-CMR) has been related to inducibility of ventricular arrhythmia in patients with ischemic cardiomyopathy. However, this relationship has not been established in postmyocardial infarction (post-MI) patients with relatively reserved left ventricular (LV) systolic function yet. In this study, we investigated myocardial scar size and characteristics and its relationship with ventricular arrhythmia inducibility in patients with relatively preserved LV systolic function., Methods: This study enrolled 28 post-MI patients with a left ventricular ejection fraction between 40% and 50% and nonsustained ventricular tachycardia who underwent programmed ventricular stimulation (PVS) for risk stratification. Cine and gadolinium-enhanced cardiac magnetic resonance imaging was performed before PVS. A computer-assisted algorithm quantified the total scar (TS) size and divided it into the dense scar (DS) and the PIZ based on signal intensity thresholds (>6 standard deviations [SDs] and 2 to 6 SDs above remote normal myocardium, respectively). Scar measurements were determined and compared among noninducible (n = 19) and inducible patients (n = 9)., Results: The groups had similar baseline clinical characteristics. The LV masses, volumes, and ejection fractions did not differ significantly between the groups. For the inducible versus noninducible patients, DS percent was similar (3.11 ± 1.02% vs 3.44 ± 0.79%, P = NS). PIZ percent (28.02 ± 7.49% vs 19.86 ± 7.82%, P = 0.01) and TS percent (31.14 ± 7.96% vs 23.31 ± 8.21%, P = 0.02) were associated with inducibility of monomorphic VT. Multivariate analysis demonstrated that PIZ percent (P = 0.021, OR [odds ratio] 1.18, 95% CI [confidence interval] 1.03-1.35), and TS percent (P = 0.03, OR 1.15, 95% CI 1.01-1.30) were independent predictors of inducibility., Conclusions: Higher PIZ percent and TS percent were correlated with increased ventricular inducibility. These data support the hypothesis that ce-CMR may be used to identify the substrate for ventricular arrhythmia in this cohort., (©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.)

Objective: Increasing evidence suggests a relationship between vitamin D (VD) insufficiency and cardiovascular disease. The present study evaluated the effect of VD insufficiency on epicardial coronary flow rate, subclinical atherosclerosis, and endothelial function., Methods: The present study was cross-sectional and observational. We enrolled 222 consecutive patients who had undergone coronary angiography for suspected ischemic heart disease and were found to have normal or near-normal coronary arteries. Thereafter, 25(OH)D3 levels were measured and the coronary flow rate was assessed using the thrombolysis in myocardial infarction frame count. Slow coronary flow (SCF) was defined as a thrombolysis in myocardial infarction frame count greater than 27/frame. Endothelial function was assessed by brachial artery flow-mediated dilatation. Carotid intima-media thickness, an indicator of subclinical atherosclerosis, was measured using B-mode ultrasonography., Results: The mean level of 25(OH)D3 was 31.8 ng/ml, and 47% (n=106) of the patients had insufficient 25(OH)D levels (<30 ng/ml). Baseline characteristics were similar between VD-insufficient and VD-sufficient groups. The incidence of SCF was significantly higher in the VD-insufficient group than in patients with sufficient VD (relative risk=3.5, 95% confidence interval=1.1-10.5, P=0.01). After adjusting for cardiovascular disease risk factors, VD insufficiency was independently associated with SCF. The linear regression analysis showed that VD insufficiency was correlated independently with % flow-mediated dilatation (β=0.424, P<0.001) and carotid intima-media thickness (β=0.43, P<0.001)., Conclusion: A strong association was found between VD insufficiency and the SCF phenomenon. In addition, VD insufficiency was associated with endothelial dysfunction and subclinical atherosclerosis. We believe that further studies are required to clarify the role of VD in patients with SCF.