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Background In this study, we aimed to compare the management and clinical outcomes of patients with acute coronary syndrome (ACS) before and during pandemic. Methods A total of 239 patients with ACS were enrolled into the study. Patients who were admitted during pandemic were compared with pre-pandemic patients according to their demographic, biochemical, angiographic features, revascularisation strategies and clinical outcomes. Results During the pandemic period, we observed an increase in total number of patient with ST elevation myocardial infarction patients compared to the pre-pandemic period. Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients (1953 pg/ml versus 259 pg/ml for troponin I and 14 ng/ml versus 6 ng/ml for CK-MB p 0.05). Conclusion Although clinical, laboratory, and angiographic features were worse in ACS patients during pandemic, the mortality rate of ACS was similar in both pre-pandemic and pandemic era. It is important to keep coronary intensive care units and catheter labs open and fully-functioning during the pandemic.

Purpose: Those hospitalised with coronavirus disease 2019 (COVID-19) have recently been shown to have impaired right ventricular (RV) strain, but data about the course of heart function after discharge are limited. Our aim was to compare right ventricular strain and right atrial reservoir strain (RASr) associated with COVID-19 between acute disease (during hospitalisation) and follow-up (after discharge). Methods: In this retrospective single-center study, we analysed the echocardiograms of 43 patients hospitalised for non-severe COVID-19 between December 2020 and March 2021, undergoing echocardiography both during and after hospitalisation. In addition to conventional echocardiographic parameters, we applied 2-dimensional speckle tracking to obtain RV global longitudinal strain (RV-GLS), RV free wall strain (RV-FWS), and RASr. Results: Mean (standard deviation) age of the study population was 50 (9) years, and 18 (42%) of the participants were women. Median duration between exams was 6 months (range, 5-7 months). Both mean RV-GLS and mean RV-FWS significantly increased at follow-up (-20.8 [3.8] vs. -23.5 [2.8], p < 0.001 and -23.3 [4.2] vs. -28.2 [2.8], p < 0.001; respectively), and RASr significantly improved as well (-32.3 [6.6] vs. -41.9 [9.8], p < 0.001). Conclusion: In patients hospitalised for non-severe COVID-19 pneumonia, RV-GLS, RV-FWS, and RASr improved significantly between acute disease and 6 months after discharge. 35670268

Background: The first reports on coronaviruse disease 2019 (COVID-19) revealed an exaggerated mortality rate in hypertensive patients. In this regard, concerns about angiotensin-converting enzyme (ACE) inhibitors’ and angiotensin-receptor blockers’ (ARBs) have been aroused. Our aim in this study was to evaluate the potential bad outcome effect of hypertension and anti-hypertensive therapy on COVID-19. Methods: 183 patients with polymerase-chain-reaction (PCR)-proven COVID-19, who were admitted to our hospital and consulted to cardiology department between 15th of March and 15th of April 2020 were included. Data were recruited from hospital records. Results: Thirty-two out of 183 patients with COVID-19 died in hospital. Hypertension incidence was not statistically different between patients who survived and died (76 [50.3%] vs 19 [59.4%, p = 0.352]). Although the usage rate of ACEI were similar among groups, ARB usage rate was significantly higher in patients who died than survived (11 [34.4%] vs 23 [15.2%], p = 0.011). Binary regression analysis showed an association between ARBs and mortality (OR: 0.032, 95% CI 1.045–2.623, p = 0.032). Conclusion: Our study confirmed previous concerns regarding a potential harmful effects of ARBs on COVID-19 related mortality. Kontext: První zprávy o onemocnění koronavirem v roce 2019 (coronavirus disease 2019, COVID-19) ukazovaly na zvýšenou mortalitu jedinců s hypertenzí, což vyvolalo obavy ohledně užívání inhibitorů angiotenzin konvertujícího enzymu (ACEI) a blokátorů receptoru AT1 pro angiotenzin II (ARB). Cílem naší studie bylo posoudit možnost nepříznivého vlivu onemocnění covid-19 na závažnost hypertenze a účinnost antihypertenzní léčby. Metody: Do studie bylo zařazeno 183 pacientů s onemocněním covid-19 prokázaným PCR testem, kteří byli v období od 15. března do 15. dubna 2020 přijati do naší nemocnice a následně odesláni na kardiologickou kliniku. Údaje byly získány z nemocničních záznamů. Výsledky: Celkem 32 ze 183 pacientů s onemocněním covid-19 zemřelo v nemocnici. Incidence hypertenze se mezi pacienty, kteří přežili a zemřeli, statisticky významně nelišila (76 [50,3 %] vs. 19 [59,4 %]; p = 0,352). I když podíly pacientů užívajících inhibitory ACE byly v obou skupinách podobné, léčiva ze skupiny ARB užívalo statisticky významně více pacientů, kteří zemřeli, než těch, kteří přežili (11 [34,4 %] vs. 23 [15,2 %]; p = 0,011). Binární regresní analýza prokázala souvislost mezi užíváním ARB a mortalitou (OR: 0,032; 95% CI 1,045–2,623; p = 0,032). Závěr: Naše studie potvrdila původní obavy týkající se možných škodlivých účinků lékové skupiny ARB na mortalitu v souvislosti v onemocněním covid-19.

Introduction: The aim of this study was to evaluate the correlation between the epicardial fat tissue thickness (EFTT) and serum omentin levels in patients with cardiac syndrome X (CSX). Patients and Methods: A total of 51 patients with CSX admitted to our clinic were included in the patient group, and 46 healthy subjects were included in the control group. Demographics, routine laboratory tests, and high sensitive C-reactive protein (hsCRP) levels of all patients were recorded. The EFTT was measured with transthoracic echocardiography (TTE). Serum omentin levels were measured with the enzyme-linked immunosorbent assay. Results: The EFTT was significantly higher in the CSX group (p< 0.001). Serum omentin levels were significantly lower in patients with CSX in comparison with the control group (p< 0.001). The median age was significantly higher in the CSX group (p< 0.001). The white blood count and hsCRP levels showed no significant difference between the CSX and the control group (p= 0.46 and p= 0.49, respectively). Conclusion: In our study, we found increased epicardial fat tissue (EFT) thickness and decreased serum omentin levels in patients with CSX, a finding similar with the literature. Thus, increased EFT thickness may play a role in the pathophysiology of CSX by causing a decrease in the serum omentin level.

Background: Inflammatory mechanisms play an important role in both atherosclerosis and stroke. There are several inflammatory peripheral blood count markers associated with carotid artery stenosis degree, symptomatic carotid artery lesions and carotid artery stent restenosis that reported in previous studies. However, the prognostic role of the blood cell counts and their ratios in predicting in-hospital and long-term outcomes in patients undergoing carotid artery stenting (CAS) has not been comprehensively investigated. Systemic immune-inflammation index (SII) proved its' efficiency in patients with solid tumors and its' role was rarely examined in cardiovascular disorders and stroke. The current study evaluated the effect of this novel risk index on in-hospital and long-term outcomes in a large patient population who underwent CAS. Method: A total of 732 patients with carotid artery stenosis who underwent CAS were enrolled to the study. SII was calculated using the following formula: neutrophil-to-lymphocyte ratio pound total platelet count in the peripheral blood (per mm3) and the patients were stratified accordingly: T1, T2 and T3. In-hospital and 5-year outcomes were compared between the tertiles of SII. Results: During the hospitalization, major stroke, ipsilateral stoke, myocardial infarction, death and major adverse cardiovascular events (MACE) rates were significantly higher in high SII level (T3) compared to SII levels (T1 and 2). In longterm outcomes, ipsilateral stroke, major stroke, transient ischemic attack, death, and MACE were significantly higher in the patients with higher SII level (T3). The 5-year Kaplan-Meier overall survival for T1, T2, and T3 were 97.5%, 96.7% and 86.0% respectively. In-hospital and 5-year regression analyses demonstrated that high SII was independently associated with MACE and mortality. Conclusion: SII was independently associated with in-hospital and long-term clinical outcomes in patients undergoing CAS. Immune and inflammation status, as assessed easily and quickly using SII, has a good discriminative value in these patients. WOS:000686903400007 2-s2.0-85109196298 PubMed: 34242858

Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.

There is not a widely accepted optimal rate of stent opening in patients underwent carotid artery stenting. In this study we evaluated the effect of carotid stent opening rate (CSOR) without performing post-dilation on in-hospital and long-term outcomes.A total of 825 patient patients underwent carotid artery stenting without post-dilation enrolled to the study. The patients divided into two groups according to their final CSOR (50% ≤ Post-stent deployment (SD)80% and 80% ≤ Post-SD ≤ 100%). In-hospital and 3-year outcomes were compared between the groups.During hospitalization, the rate of ipsilateral stroke, major stroke and transient ischemic attacks were similar between the groups (respectively; 6.2% vs. 4.1, P = 0.190; 1.5% vs. 1.8, P = 0.811; 1.5% vs. 1.9%, P = 0.683). The 3-year Kaplan-Meier overall survival rates for the first and second groups were 87.6% and 84.4%, respectively (log rank test P = 0.426). The 3-year Kaplan-Meier overall cumulative ipsilateral stroke rates for the first and second groups were 88.0% and 88.6%, respectively (log rank test P = 0.409) CONCLUSION: Our study demonstrated that a CSOR higher than 50% without performing a post-dilation might be an effective therapeutic approach since there was not a significant difference regarding outcomes between the patients with a 50% ≤ Post-SD80% and 80% ≤ Post-SD ≤ 100%. The need for post-stent balloon dilation might have been eliminated due to subsequent stent self-expansion.

Objective The frequency, significance and prognostic value of left ventricle obstruction (LVO) induced with provocation (latent LVO) is controversial for hypertrophic cardiomyopathy (HC) patients. This study was designed to assess the value of latent LVO in predicting the clinical course in 101 patients with HC. Methods and results Patients were followed for a mean of 82 ± 48 months (range 2 to 148 months) for clinical end points defined as a composite of cardiovascular death resuscitated cardiac arrest, appropriate defibrillator shock or hospitalization due to worsening of heart failure symptoms. Presence of LVO (hazard ratio 3.63; 95% confidence interval, 1.85 to 7.12; P = 0.0001) and log NT-proBNP levels (hazard ratio, 1.40; 95% confidence interval, 1.14 to 1.72; P = 0.001) were the independent variables associated with an increased risk of experiencing clinical end points. HC patients with latent LVO have a trend toward decreased survival when compared with HC patients without LVO (log rank P = 0.027), but better survival than patients with resting LVO (log rank P = 0.007). HC patients with NT-proBNP levels

In this study, the urbanization process in city of Gaziantep is handled during the period of 1927‐2018 and the distribution pattern of the urban population is revealed in the neighborhood level. The main purpose of the study is to reveal the factors that are effective in shaping city of Gaziantep. In addition to this, it is aimed to determine the potential development areas of the city by taking into consideration distribution of the population in the city. Thus, checking the future distribution of the city population or determining the potential development areas of the city will be easier through distribution of the population. The findings show that the city of Gaziantep exhibits developments in the historical process of urbanization of Turkey, as well as some unique features. In this study, population and density maps were made to show the distribution of urban population. According to this, the neighborhoods in the core part of the city have lost population. The most important reason for this is that these neighborhoods are located within the boundaries of the central business district and are related to the high use of non‐residential areas. Neighborhoods which are on the edge of the city have gained population. This population increase was mostly due to migrations to the city after 1980. Network relations have played an important role in the neighborhood preferences of the migrants who migrated to the city. The neighborhoods in which the south of the city are the most populated settlements nowadays. The reason for this is that Gaziantep University and the Faculty of Medicine are located in this region, the city is developing in this direction, the land that has adequate demand and the applications of TOKİ., Bu çalışmada Gaziantep Kenti’ndeki kentleşme süreci 19272018 dönemi boyunca ele alınmakta ve kentli nüfusun dağılım düzeni mahalle ölçeğinde ortaya konulmaktadır. Çalışmanın esas amacı, Gaziantep’in kent olarak şekillenmesinde etkili olan faktörleri ortaya çıkarmaktır. Bunun yanı sıra, kentte nüfusun dağılış düzenini ele alarak kentin potansiyel gelişim alanlarını belirlemektir. Böylece kent nüfusunun gelecekteki dağılışının kontrol edilmesi veya kentin potansiyel gelişim alanlarının tespit edilmesi nüfusun dağılım düzeninin ortaya konulmasıyla daha da kolay olabilecektir. Elde edilen bulgular, Gaziantep Kenti’nin Türkiye kentleşme hareketlerinin tarihsel süreçte geçirdiği gelişmeleri sergilemesi yanında kendine has bazı özellikler de taşıdığını göstermektedir. Çalışmada kentsel nüfusun dağılımını göstermek için nüfus miktarı ve yoğunluğu haritaları yapılmıştır. Buna göre kentin çekirdek kısmında yer alan mahalleler nüfus kaybetmişlerdir. Bunun en önemli nedeni bu mahallelerin merkezi iş sahası sınırları içerisinde yer alması sebebiyle konut dışı kullanım alanlarının fazla olmasıyla ilişkilidir. Kentin kenarında bulunan mahalleler ise nüfus kazanmışlardır. Bu nüfus artışı daha çok 1980 sonrası kente yapılan göçlerle gerçekleşmiştir. Kente göçle gelen kesimin mahalle tercihlerinde hemşerilik bağları gibi ağ ilişkileri önemli rol oynamıştır. Günümüzde kentin güneyindeki mahalleler nüfusun en fazla olduğu yerleşmelerdir. Bunun sebebi, Gaziantep Üniversitesi’nin ve Tıp Fakültesinin bu bölgede konumlanmış olması, kentin bu istikamette gelişmesi, yeterli talep gören arazi varlığı ve TOKİ uygulamalarıdır.

A patient who had undergone closure of the perimembranous ventricular septal defect and aortic valve replacement for bicuspid aortic valve with a mechanical prosthesis was being admitted to our department. He was afebrile, blood cultures were negative and there was no sign of endocarditis. Transthoracic echocardiogram showed a normally functioning aortic prosthesis with a aortic root by the occurrence of systolic expansion and diastolic collapse (Fig. 1A; Video 1 in the online-only Data Supplement). Transesophageal echocardiogram revealed a pulsatile, thin-walled echolucent space, protruding into the left atrium which was defected in the mitralaortic intervalvular fibrosa (MAIF) (Fig. 1B, C, and E; Video 2 in the online-only Data Supplement). Color Doppler examination revealed space flow from the left ventricular outflow tract in systole and this space was emptied during diastole (Fig. 1D, E, and F; Video 3 in the online-only Data Supplement). These findings were consistent with the pseudoaneurysm of the MAIF (PA-MAIF). Multidetector computed tomography (MDCT) delineated a pulsatile PA-MAIF below the aortic valve annulus (Fig. 2A). Cardiac magnetic resonance imaging clearly showed localized protrusions of the MAIF with diastolic collapse and pulsing in systole with contrasting insides (Fig. 2B, C, and D; Video 4 in the online-only Data Supplement). Fig. 1 Fig. 2 In our case, bicuspid aortic valves and dehiscence of sutures along the anastomotic line are the possible explanations of this complication, due to congenital weaknesses in the area of the MAIF.1),2) Although transthoracic and transesophageal echocardiograms are the initial diagnostic tools for PA-MAIF, due to their relatively posterior location and complex anatomy, the MRI and MDCT are selected as the diagnostic technique for prompt diagnosis and timely institution of treatment.3) With such techniques, a further evaluation of adjoining pseudoaneurysm is feasible, and planning of the proper surgical intervention4) is enabled.

PP-190 The aim of the present study was to analyze anterolateral papillary muscle longitudinal strain (ALPM-St), posteromedial papillary muscle longitudinal strain (PMPM-St), anterolateral papillary muscle time to peak longitudinal strain (ALPM-time), posteromedial papillary muscle time to peak

WOS: 000298684500001, PubMed ID: 22216022, Objectives. To investigate the effects of proton pump inhibitors (PPIs) and H-2 receptor antagonists on ileum motility in rats with peritonitis and compare changes with control group rats. Methods. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another of 8 rats underwent a sham operation and were accepted as controls. Twenty-four hours later after the operation, the rats were killed, and their ileum smooth muscle was excised and placed in circular muscle direction in a 10mL organ bath. Changes in amplitude and frequency of contractions were analyzed before and after PPIs and H-2 receptor blockers. Results. PPI agents decreased the motility in a dose-dependent manner in ileum in both control and intraabdominal sepsis groups. While famotidine had no significant effect on ileum motility, ranitidine and nizatidine enhanced motility in ileum in both control and intraabdominal sepsis groups. This excitatory effect of H-2 receptor antagonists and inhibitor effects of PPIs were significantly high in control group when compared to the peritonitis group. The inhibitor effect of pantoprazole on ileum motility was significantly higher than the other two PPI agents. Conclusions. It was concluded that H-2 receptor antagonists may be more effective than PPIs for recovering the bowel motility in the intraabdominal sepsis situation.

WOS: 000270841600009, PubMed ID: 19824112, AIM: To determine the effects of high osmolarity contrast media (HOCM) and iso-osmolar contrast. media (CM) application, with or without pressure, on hepato-pancreato-biliary (HPB) system. METHODS: Sixty rats were divided into six equal groups as follows: Group 1: (0.9% NaCl, control), Group 2: (diatrizoate meglumine Na, ionic HOCM, Urographin (R)), Group 3: (iodixanol, iso-osmolar nonionic CM, Visipaque (R)); each of which was applied without pressure, whereas the animals of the remaining three groups (1p, 2p, 3p) were subjected to the same CM with pressure. We performed a duodenal puncture and introduced a catheter into the ampulla. After the catheterization, 0.2 mL CM or 0.9% NaCl was injected with or without pressure. Blood samples were taken for biochemical evaluations. The histopathological examinations of liver, common bile duct, and pancreas were performed. RESULTS: There were no significant differences between the six groups for blood amylase, alanine aminotransferases, aspartate aminotransferases, bilirubin levels (P > 0.05). Alkaline phosphatase and gamma glutamyl transaminase levels were higher (P < 0.05) in the Urographin (R) groups (2, 2p) than the Visipaque (R) groups (3, 3p), or control groups (1, 1p). Hepatocyte necrosis, portal area inflammation, and Kupffer's cell hyperplasia were higher (P < 0.05) in the study groups than the control group. However, there were no significant differences (P > 0.05) between HOCM (2, 2p) and iso-osmolar CM (3, 3p) groups. Bile duct proliferation and regeneration in the Urographin (R) groups (2, 2p) were significantly higher (P < 0.05) than the Visipaque (R) groups (3, 3p) or the control groups (1, 1p). Although CM caused minor damage to the pancreas, there were no statistically significant differences (P > 0.05) between the groups. Application of the CM with pressure did not cause additional damage to the HPB system. CONCLUSION: Iso-osmolar, non-ionic CM could be more reliable than the ionic HOCM, whereas the application of pressure during the CM application had no effect on the HPB system. (C) 2009 The WJG Press and Baishideng. All rights reserved.