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Giriş ve Amaç: Yüksek Lipoprotien (a) [Lp (a)] düzeylerinin artmış koroner arter hastalığı riski ile ilişkili olduğu bilinmektedir. Çalışmamızda ilk kez akut koroner sendrom tanısı ile başvuran hastalarda, serum Lp (a) seviyesi ile klinik prezentasyon arasındaki ilişkiyi araştırmayı planladık. Gereç ve Yöntem: İlk kez akut koroner sendrom tablosu ile başvuran hastalar prospektif olarak çalışmamaıza dahil edildi. Hastalara ait demografik veriler dosya kayıtlarından toplandı. Lp (a) ve diğer lipid parametrelerinin ölçümü başvuru sonrası en az sekiz saatlik açlığı takiben alınan venöz kandan yapıldı. Bulgular: 105 ST segment elevasyonlu miyokard infarktüsü (STEMI), 132 ST segment elevasyonu olmayan miyokard infarktüsü (NSTEMI) hastası olmak üzere toplam 237 hasta çalışmaya dahil edildi. Yaş ve cinsiyet açısından gruplar arasında anlamlı bir fark yoktu. Serum Lp (a) seviyeleri STEMI hastalarında daha yüksek saptansa da iki grup arasında anlamlı bir fark yoktu [10.2 (19.7) mg/dl vs. 8.5 (12.7) mg/dl, p: 0.393]. Lp (a) ≥ 30 mg/dl olup, LDL ≥ 100 mg/dl olanlar, LDL < 100 mg/dl olanlara göre 4.95 kat daha fazla STEMI kliniği ile prezente olmakta idiler (odds oranı:4.95, % 95 güven aralığı:1.31-16.5, p:0.027). Diğer taraftan LDL ≥ 100 mg/dl olup, Lp (a) ≥ 30 mg/dl olanların, Lp (a) < 30 mg/dl olanlara göre 2.45 kat daha fazla STEMI kliniği ile prezente olduklarını saptadık (odds oranı:2.45, % 95 güven aralığı:1.04-5.6, p:0.039). Sonuç: Lp (a) ≥ 30 mg/dl ve LDL ≥ 100 mg/dl olan hastaların akut koroner sendrom klinik prezentasyonlarının STEMI lehine olduğunu saptadık. Bu hasta grubunda daha erken ve etkin yaşam tarzı değişikliklerine ihtiyaç gözükmektedir.

Aims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and nonischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation.Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90 degrees versus an fQRS angle 90 degrees group and 26.1% and 29.9% in the fQRS 90 degrees patient group versus the fQRS 90 degrees was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients.(c) 2022 Elsevier Inc. All rights reserved.

Correction to: Wien Klin Wochenschr 2015 https://doi.org/10.1007/s00508-015-0854-z The original version of this article unfortunately contained a mistake. The first names of Dr. Ismail Dogu Kilic were interchanged.

Aim VCAM-1 and ICAM-1 are two important members of the immunoglobulin gene superfamily of adhesion molecules, and their potential role as biomarkers of diagnosis, severity and prognosis of cardiovascular disease has been investigated in a number of clinical studies. The aim of the present study was to determine the relationship between circulating ICAM-1 and VCAM-1 levels and aortic stiffness in patients referred for echocardiographic examination. Methods Aortic distensibility was determined by echocardiography using systolic and diastolic aortic diameters in 63 consecutive patients referred for echocardiography. Venous samples were collected in the morning after a 12-hour overnight fast, and serum concentrations of ICAM-1 and VCAM-1 were measured using commercial enzyme immunoassay kits. Results Data of a total of 63 participants (mean age 55.6 ± 10.5 years, 31 male) were included in the study. Circulating levels of adhesion molecules were VCAM-1: 12.604 ± 3.904 ng/ml and ICAM-1: 45.417 ± 31.429 ng/ml. We were unable to demonstrate any correlation between indices of aortic stiffness and VCAM-1 and ICAM-1 levels. Conclusion The role of soluble adhesion molecules in cardiovascular disease has not been fully established and clinical studies show inconsistent results. Our results indicate that levels of circulating adhesion molecules cannot be used as markers of aortic stiffness in patients.

Aim. This study was designed to assess the effect of patient education on the knowledge of safety and awareness about living with cardiac implantable electronic devices (CIEDs) within the context of phase I cardiac rehabilitation. Methods. The study was conducted with 28 newly implanted CIED patients who were included in “education group (EG)”. Patients were questioned with a survey about living with CIEDs and electromagnetic interference (EMI) before and 1 month after an extensive constructed interview. Ninety-three patients who had been living with CIEDs were included in the “without education group (woEG)”. Results. Patients in EG had improved awareness on topics related to physical and daily life activities including work, driving, sports and sexual activities, EMI of household items, harmful equipment, and some of the medical devices in the hospital setting (p Conclusion. It was demonstrated that a constructed education interview on safety of CIEDs and living with these devices within the context of phase I cardiac rehabilitation is important for improving the awareness of patients significantly. Thus, patients might achieve a faster adaptation to daily life and decrease disinformation and misperceptions and thus promote the quality of life after the device implantation.

Background: The aim of this study was to retrospectively evaluate the clinical and electrophysiological characteristics of elderly patients with typical atrioventricular nodal reentrant tachycardia (AVNRT), and to assess the acute safety and efficacy of slow-pathway radiofrequency (RF) ablation in this specific group of patients. Methods and Results: The present study retrospectively included a total of 1,290 patients receiving successful slow-pathway RF ablation for typical slow-fast AVNRT. Patients were divided into 2 groups: group I included 1,148 patients aged 65 years. The required total procedure duration and total fluoroscopy exposure time were significantly higher in group II vs. group I (P=0.005 and P=0.0001, respectively). The number of RF pulses needed for a successful procedural end-point was significantly higher in group II than in group I (4.4 vs. 7.2, P=0.005). While the ratio of the anterior location near to the His-bundle region was significantly higher in group II, the ratio of posterior and midseptal locations were significantly higher in group I (P=0.0001). The overall procedure success rates were similar. There was no significant difference between the 2 groups in respect of the complications rates. Conclusions: This experience demonstrates that RF catheter ablation, targeting the slow pathway, could be considered as first-line therapy for typical AVNRT patients older than 65 years as well as younger patients, as it is very safe and effective in the acute period of treatment. © 2015, Japanese Circulation Society. All rights reserved.

Isolated non-compaction of the left ventricular myocardium (INVM) was first described in 1984 as an unclassified cardiomyopathy, not being dilated, hypertrophic or restrictive. It is assumed to occur as a result of an arrest in endomyocardial morphogenesis during normal development of the heart. The disease is characterised by heart failure due to systolic and diastolic left ventricular (LV) dysfunction, systemic emboli and ventricular arrhythmias. Echocardiography has been shown to be the method of choice in diagnosis. INVM is a rare congenital cardiomyopathy and only a few cases of this condition have been reported. It is characterised by prominent and excessive trabeculation in a ventricular wall segment, with deep inter-trabecular spaces perfused from the ventricular cavity. We report a case of INVM with ventricular tachycardia induced during electrophysiological study in a 24-year-old female patient with a family history of sudden death.

Radiofrequency (RF) ablation of accessory bypass tracts associated with the Wolff-Parkinson-White (WPW) syndrome has become the treatment of choice for many arrhythmias. Complications are unusual and acute coronary artery occlusion is very rare. We here present a 38-year-old male patient with an acute occlusion of proximal left anterior descending (LAD) coronary artery after RF ablation of a left free wall accessory pathway. An interesting feature is the site of the coronary artery occlusion which is remote from the RF application site. The occlusion was successfully treated with the placement of an intracoronary stent.

Özet Koroner perforasyonlar kardiyoloji kateter laboratuarlarında korkulan ve potansiyel olarak ölümcül olabilen komplikasyonlardır. Uzun süreli balon şişirilmesi, antikoagulan tedavinin etkisinin ortadan kaldırılması, distal damarın embolizasyonu ve cerrahi tamir tedavi seçeneklerini oluşturmaktadır. Ayrıca, koroner arterin proksimal ve mid bölgesini tutan geniş yırtıklarda kaplı stent kullanılması bir diğer tedavi alternatifidir. Yoğun profil yapısı ve zayıf fleksibilitesi nedeniyle politetrafloroetilen (PTFE) kaplı stentlerin hedef damara yerleştirilmesi, özelliklede damar yapısı yoğun kalsifik ve tortüyöz olduğu durumlarda genellikle zordur. Bunlar genellikle koroner perforasyonları etkili şekilde kapatmalarına rağmen diğer tüm stentlerde olduğu gibi kaplı stentlerinde tam olarak açıldığından emin olunmalıdır. Bununla beraber, hayati tehlike taşıyan bu komplikasyonun yarattığı kaotik ortamda bu detay gözden kaçırılabilmektedir. Kaplı stentlerin optimal açılmasının klinik önemine işaret etmesi açısından bu vaka takdimini sunuyoruz.

Internal mammary artery (IMA) grafts have been shown to be superior to saphenous vein grafts in terms of rare atherosclerotic involvement, biochemical and physical qualities, and long-term patency rates. The IMA originates from the subclavian artery, just distal to the vertebral artery, and an occlusion or a hemodynamically significant stenosis proximal to the IMA ostium would cause a pressure drop distally and a reversal of flow from the coronary arteries to the IMA in patients with this graft. This condition is referred to as "coronary subclavian steal syndrome" (CSSS). In most cases, the cause of this syndrome is atherosclerotic disease; however, other causes of subclavian artery stenosis (SAS) have the potential to lead to CSSS. Patients with CSSS present with the symptoms of myocardial ischemia due to coronary steal, vertebrobasilar insufficiency, or limb ischemia. Discrepancy in the blood pressure (BP) measurements in two arms should warn the clinician of SAS. A diminished pulse or the bruit of jet flow on the lesion side can be noticed. Doppler ultrasonography, computed tomography angiography, and magnetic resonance angiography are safe and accurate noninvasive modes of diagnosis. Treatment can be surgical or percutaneous.

Introduction: We aimed to investigate the role of electrocardiography (ECG) findings in determining infarct related coronary arteries of patients hospitalized with a diagnosis of acute inferior myocardial infarction (AIMI). Patients and Methods: The first ECG records taken on admission to hospital and demographic characteristics of 132 patients, who were followed with the diagnosis of AIMI (mean age, 57.3 ± 11, 118 men) in our center between January 2004-January 2009, were evaluated. Results: When coronary angiography were evaluated, it was detected that the infarct-related coronary artery (IRCA) was the right coronary artery (RCA) in 70.4% of all patients, whereas it was circumflex artery (Cx) in 29.6% respectively. It was detected that DIII-ST elevation was higher than DII (94.6% sensivity, and 75.9% specifity, p= 0.001) and there was st depression in aVL and DI leads in cases which IRCA was RCA (88.2% sensivity and 75.2% specifity, p= 0.011). Although ST depression in aVL lead was higher than st depression in DI in cases which RCA was IRCA, this finding was defined statistically significant (%95.7 sensivity; %73.6 specifity; p= 0.016). RCA was the IRCA significantly in patients with inferior wall MI accompanied by right ventricular myocardial infarction (p= 0.005). Although Cx was observed as the culprit artery in cases which was accompanied by posterior wall infarction, no statistically finding was detected (p= 0.3). ST-depression was detected in V1-2 leads in ECG of patients whose culprit artery was Cx (%84.6 sensitivity, %36.3 specificity, p= 0.009). Conclusion: The findings based on surface ECG of the patients who underwent AIMI shows that IRCA can be predicted., Giriş: Akut inferiyor miyokart enfarktüsü (AİME) tanısıyla hastaneye yatırılan olguların enfarktüsten sorumlu koroner arterlerinin belirlenmesinde elektrokardiyografi (EKG) bulgularının önemini araştırdık. Hastalar ve Yöntem: Merkezimizde Ocak 2004-Ocak 2009 tarihleri arasında AİME tanısı ile takip edilen 132 hastanın (ortalama yaş; 57.3 ± 11, 118 erkek); hastaneye başvuru sırasında çekilen ilk EKG kayıtları ve demografik özellikleri retrospektif olarak değerlendirildi. Bulgular: Koroner anjiyografi tetkikleri değerlendirildiğinde; olguların %70.4'ünde enfarktüsten sorumlu koroner arterin (ESKA) sağ koroner arter (RCA), %29.6'sında sirkumfleks arter (Cx) olduğu saptandı. Sorumlu arterin RCA olduğu olgularda; DIII derivasyonundaki ST segment yükselmesinin, DII derivasyonundan daha fazla olduğu (%94.6 duyarlılık, %75.9 özgüllük, p= 0.001),aVL ve DI derivasyonlarının her ikisinde de ST segment çökmesinin bulunduğu saptandı (%88.2 duyarlılık, %75.2 özgüllük, p= 0.011). Sorumlu arterin RCA olduğu olgulara aVL derivasyonundaki ST segment çökmesinin, DI derivasyonundaki ST segment çökmesinden daha fazla olmasının istatistiksel olarak anlamlı olduğu belirlendi (%95.7 duyarlılık, %73.6 özgüllük p= 0.016). İnferiyor yüz enfarktüse, sağ ventrikül miyokart enfarktüsünün eşlik ettiği hastalarda sorumlu arter anlamlı olarak RCA idi (p= 0.005). Posterior duvar infarktüsünün eşlik ettiği olgularda sorumlu arterin daha çok Cx olduğu gözlense de bu durum istatistiksel olarak anlamlı değildi (p= 0.3). Sorumlu arterin Cx olduğu olguların EKG'lerinde V1-2 derivasyonlarında ST segment çökmesi saptandı (%84.6 duyarlılık, %36.3 özgüllük p= 0.009). Sonuç: AİME geçiren olguların yüzey EKG'lerinden elde edilen bulgular, enfarktüsten sorumlu koroner arterin tahmin edilebileceğini göstermektedir.

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Objectives This study investigated the appropriateness of treatment for patients admitted with ST-segment elevation myocardial infarction (STEMI) according to the current guidelines. We also aimed to determine in-patient and out-patient factors affecting optimal reperfusion therapy. Study design The reperfusion therapy of 176 patients with STEMI was determined. The time period from first contact with a healthcare provider to the time of balloon inflation (door to balloon time), and from the time period of first contact with a healthcare provider to the time of initiation of a thrombolytic (door to needle time) were calculated. Similarly, the time from admission at the emergency service (ES) of our hospital after referral to the moment of balloon inflation (ES to balloon time) and the period from admission to ES at our hospital to the moment of initiation of a thrombolytic (ES to needle time) were calculated. In order to determine the amount of in-hospital delay, the time from ES admission to the call to the cardiology department and the time for the cardiologist to evaluate the patient and transfer time were recorded. Whether the referring physician was a cardiologist and the effect of work hours on the reperfusion period was also recorded. Results The door to balloon time in the referred patient group was calculated as an average of 228 minutes, while the time for patients directly admitted to ES was calculated as an average of 98 minutes. Patients referred for the mechanical reperfusion period compared to American Heart Association (AHA) guidelines consisted of only 6% of the eligible patients, while according to the European Society of Cardiology (ESC) guidelines 13% of patients were appropriate. Patients who were directly admitted to ES, experienced rates according to AHA guidelines and 73% experienced these rates according to ESC guidelines. We also found no significant effect of working hours or referring physician's specialty (cardiologist or other) on reperfusion time. Conclusion Compliance rates of reperfusion therapy for patients presenting with STEMI was very low. We realized, when taking into consideration the reasons for delay in terms of both health community and the policy of the country, it is obvious that we have to take strict measures.

AIM: Atrial fibrillation (AF) is the most common arrhythmia with an incidence of 25-40%, after coronary artery bypass grafting (CABG). Resistin is a newly identified adipocyte-secreted hormone belonging to a cysteine-rich protein family. This study examined the relation of preoperative and postoperative early serum resistin level, which can play an important role as an inflammatory marker to predict AF after CABG. METHODS: We prospectively analyzed 40 consecutive patients (mean age, 59.2+10.3 years; 31 men and nine women) who were undergoing CABG between September and November 2009 at our department. Blood samples were taken to examine quantities of resistin level, the day before surgery and on the 24th hour in the intensive care unit. RESULTS: The incidence of AF was 25% (n=10, 2.2+1.1 days, 1.2+0.4 episodes). Preoperative resistin level was higher in the AF group (10.6+3.3 vs. 9.1+4.5 ng/ml, P=0.33), but it was not statistically significant. Postoperative resistin level was significantly higher in the AF group (27.4+8.4 vs. 17.9+9.1 ng/ml, P=0.012) compared with the sinus rhythm group. Resistin levels significantly increased after the surgery in both groups [9.1+4.5 vs. 17.9+9.1 ng/ml, P

Background: Idiopathic hyperhidrosis (IH) is characterized by excessive and uncontrolled production of sweat, mainly localized to the soles, palms, axillae and craniofacial area. Although IH is a disease concerning the autonomic nervous system, it is not clear yet whether this dysfunction is local or systemic. Objective: To evaluate the autonomic control of cardiovascular system by measuring values of heart rate recovery (HRR) and systolic blood pressure recovery (SBPR) obtained at various time intervals after maximal graded exercise treadmill testing in patients with IH compared with controls. Methods: The study population comprised 36 patients with IH (20 men, 16 women; mean age 25 ± 7 years) and 36 healthy controls (HCs) (12 men, 24 women; mean age 27 ± 5 years). All patients were selected from young, nonobese and healthy sedentary individuals. Results: Peak HR values reached in patients with IH were significantly higher compared with the HC group (P < 0.001). The obtained HRR values at minutes 3, 4 and 5 were significantly lower in the IH than the HC group [57 ± 16 vs. 64 ± 9 (P = 0.03); 61 ± 14 vs. 68 ± 9 (P = 0.03); 64 ± 12 vs. 70 ± 7 (P < 0.01)]. In addition, calculated mean values for SBPR1 and SBPR2 were > 1 in patients with IH (1.04 ± 0.15 vs. 0.98 ± 0.08 and 1.0 ± 0.12 vs. 0.94 ± 0.06, respectively) and these were statistically significant compared with the HC group (P = 0.04 and P = 0.03, respectively). Conclusions: The significantly impaired SBPR and decreased HRR values we observed in patients with IH may indicate that the autonomic dysfunction in IH is a systemic disorder with cardiovascular effects, rather than a merely local disease. Both HRR and SBPR values may provide additional information about predicting adverse cardiovascular events in the future even in apparently healthy young patients with IH. © 2016 British Association of Dermatologists

Objective: The present study compared heart rate variability (HRV) parameters in patients with coronary artery ectasia (CAE) and coronary artery disease (CAD). Methods: The study population consisted of 60 consecutive patients with CAE (14 women; mean age 51.63±7.44 years), 60 consecutive patients with CA (15 women; mean age 53.67±9.31 years), and 59 healthy individuals (13 women; mean age 52.85±8.19 years). Electrocardiograms, 24-hour Holter analyses, and routine biochemical tests were performed, and clinical characteristics were evaluated. Coronary angiography images were analyzed. Time-domain HRV parameters, including the standard deviation (SD) of normal-to-normal intervals (SDNN) and the root mean square of difference in successive normal-tonormal intervals (RMSSD) were evaluated, as were frequencydomain HRV parameters including low-frequency (LF), very lowfrequency (VLF), high-frequency (HF), the proportion derived by dividing low- and high-frequency (LF/HF), and total power (TP). Results: SDNN was lower in both the CAE and CAD groups, compared to the healthy group (140.85±44.21, 96.51±31.28, and 181.05±48.67, respectively). A significant difference in RMSSD values among the groups was determined (p=0.004). Significantly decreased VLF and HF values were found in the CAE group, compared with the healthy group (VLF p

The clinical effect of intracoronary thrombus aspiration during percutaneous coronary intervention in patients with unstable angina pectoris is unknown. In this study, we aimed to assess how thrombus aspiration during percutaneous coronary intervention affects in-hospital and 30-month mortality and complications in patients with unstable angina pectoris. We undertook an observational cohort study of 645 consecutive unstable angina pectoris patients who had performed percutaneous coronary intervention from February 2011 to March 2013. Before intervention, 159 patients who had culprit lesion with thrombus were randomly assigned to group 1 (thrombus aspiration group) and group 2 (stand-alone percutaneous coronary intervention group). All patients were followed-up 30 months until August 2015. Thrombus aspiration was performed in 64 patients (46%) whose cardiac markers (ie, creatinine kinase [CK-MB] mass and troponin T) were significantly lower after percutaneous coronary intervention than in those of group 2 (CK-MB mass: 3.801.11 vs 4.230.89, P=0.012; troponin T: 0.0120.014 vs 0.0180.008, P=0.002). Left ventricular ejection fraction at 6, 12, and 24 months postintervention was significantly higher in the group 1. During a mean followup period of 28.876.28 months, mortality rates were 6.3% in the group 1 versus 12.9% in the group 2. Thrombus aspiration was also associated with significantly less long-term mortality in unstable angina pectoris patients (adjusted HR: 4.61, 95% CI: 1.16-18.21, P=0.029). Thrombus aspiration in the context of unstable angina pectoris is associated with a limited elevation in cardiac enzymes during intervention that minimises microembolization and significantly improves both of epicardial flow and myocardial perfusion, as shown by angiographic TIMI flow grade and frame count. Thrombus aspiration during percutaneous coronary intervention in unstable angina pectoris patients has better survival over a 30-month follow-up period. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Introduction:We aimed to evaluate the importance of theEuroSCORE-II (ES-II) risk-scoring system in predicting the development of acuteischemic heart failure (AIHF) after acute anterior ST segment elevationmyocardial infarction (A-STEMI).Patientsand Methods: A total of 261 patients (206 male; mean age,63.5 ± 14.2 years) admitted to our centre with A-STEMI between April 2012 andJanuary 2013 were included in the study. The patients were divided into twogroups according to their clinical findings and were prospectively followedduring the hospitalisation period for the development of cardiac morbidity andmortality. These groups were the AIHF group (n= 69) and non-AIHF group (n=192). For the diagnosis of AIHF, we considered the recommendations of theEuropean Society of Cardiology Guidelines on Heart Failure and the Framinghamcriteria.Results: Accordingto our results, the morbidity and mortality rates were higher in the AIHFgroup. Symptom-to-balloon time, ejection fraction (EF), glomerular filtrationrate (gfr), no-reflow phenomenon, left main coronary artery disease and ES-II,which are the predictors of the development of AIHF, were determined vialogistic regression analysis. ROC analysis revealed that symptom-to-balloontime > 209.5 min, EF < 36.5%, gfr < 68.5 mg/dL/1.73 m2 andES-II > 4.9% were the cut-off values in the development of AIHF.Conclusion: Patients with A-STEMI complicatedby AIHF have significantly high mortality rates. With the pre-estimation of thedevelopment of AIHF, complication rates can be reduced. For this purpose, ES-IIscore > 4.9% can be used as a predictor of AIHF after A-STEMI., Giriş:Akut anterior ST yükselmeli miyokart infarktüsü(A-STEMİ) sonrası akut iskemik kalp yetersizliği (AİKY) gelişimini öngörmedeEuroSCORE-II skorlama sisteminin önemini değerlendirmeyi amaçladık. Hastalarve Yöntem: Çalışmaya Nisan 2012-Ocak2013 tarihleri arasında merkezimize A-STEMİ nedeniyle kabul edilen 261 hasta(206 erkek, ortalama yaş 63.5 ± 14.2) dahil edildi. Hastalar klinik bulgularınagöre iki farklı gruba ayrıldı ve hastanede yatış periyodu süresince kardiyakmorbidite ve mortalite gelişimi bakımından prospektif olarak takip edildi. Bu gruplarAİKY grubu ((n= 69) ve non-AİKY grupları (n= 192) idi. AİKY tanısı koyabilmekiçin Avrupa Kardiyoloji Cemiyeti kalp yetersizliği klavuzu ve Framinghamkriterleri göz önünde bulunduruldu.Bulgular:Çalışmamız sonuçlarına göre AİKY grubunda morbiditeve mortalite daha yüksekti. Regresyon analizleri sonuçlarına göre semptom-balonzamanı, ejeksiyon fraksiyonu, no-reflow fenomeni, sol ana koroner hastalığı, üçdamar koroner arter hastalığı, SYNTAX skoru ve ES-II’nin AİKY gelişimininprediktörleri oldukları belirlendi. ROC analizlerinin sonuçlarına goresemptom-kapı zamanının > 229.5 dakika, EF < %36.5, SYNTAX skoru >27.75 ve EsII > %4.9 değerlerinin AİKY gelişimini öngördürebilecek sınırdeğerler oldukları belirlendi.Sonuç: AİKY gelişen A-STEMİ’li hastalarda mortaliteoranları artmaktadır. AİKY gelişiminin önceden öngörülmesi kardiyakkomplikasyonları azaltabilir. Bu amaçla Es-II’nin > %4.9 olması A-STEMİsonrası AİKY gelişimim öngördürücüsü olarak kullanılabilir.

In patients with coronary artery disease (CAD), though aspirin inhibits platelet activation and reduces atherothrombotic complications, it does not always sufficiently inhibit platelet function, thereby causing a clinical situation known as aspirin resistance. As hyperuricemia activates platelet turnover, aspirin resistance may be specifically induced by increased serum uric acid (SUA) levels. In this study, we thus investigated the association between SUA level and aspirin resistance in patients with CAD. We analyzed 245 consecutive patients with stable angina pectoris (SAP) who in coronary angiography showed more than 50% occlusion in a major coronary artery. According to aspirin resistance, two groups were formed: the aspirin resistance group (Group 1) and the aspirin-sensitive group (Group 2). Compared with those of Group 2, patients with aspirin resistance exhibited significantly higher white blood cell counts, neutrophil counts, neutrophil-to-lymphocyte ratios, SUA levels, high-sensitivity C-reactive protein levels, and fasting blood glucose levels. After multivariate analysis, a high level of SUA emerged as an independent predictor of aspirin resistance. The receiver-operating characteristic analysis provided a cutoff value of 6.45 mg/dl for SUA to predict aspirin resistance with 79% sensitivity and 65% specificity. Hyperuricemia may cause aspirin resistance in patients with CAD and high SUA levels may indicate aspirin-resistant patients. Such levels should thus recommend avoiding heart attack and stroke by adjusting aspirin dosage. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

WOS: 000384427500006, PubMed ID: 27004707, Objective: Atrial functions are relatively suppressed in heart failure (HF). We aimed to investigate the associations of intra-and inter-atrial electromechanical conduction delay (EMCD) with functional class and mortality over a 12-month follow-up period. Methods: The prospective study included 65 patients with systolic HF and 65 healthy subjects with normal sinus rhythm. Left ventricular (LV) systolic functions and left atrial (LA) dimensions and volumes were evaluated by transthoracic echocardiography. Tissue Doppler imaging (TDI) signals at the lateral border of the mitral annulus (lateral PA'), septal mitral annulus (septal PA'), and tricuspid annulus (tricuspid PA') were measured. Intra-and inter-atrial EMCD were calculated. Results: Mitral inflow velocities were studied using pulsed-wave Doppler after placing the sample volume at the leaflets' tips. The peak early (E wave) and late (A wave) velocities were measured. The septal annular E/E' ratio was relatively higher and lateral, septal, and right ventricular S,E', and A' waves were significantly lower in the HF group than in the control group (12.49 +/- 6.03-7.16 +/- 1.75, pE/E'

Transcatheter aortic valve implantation is preferred to treat high surgical risk patients with severe aort stenosis. Wrapping of a pig tail catheter with device struts during transcatheter aortic valve implantation is a very rare complication. In this report, we present the images and videos of an attempt of retrieval of an aortic valve wrapped with pig tail catheter during transcatheter aortic valve implantation in a 71-year-old man. (C) 2015 Elsevier Inc. All rights reserved.

Acute coronary syndromes (ACS) are one of the leading causes of death and morbidity in industrialized countries. Typical presentation includes acute chest pain, cardiac troponin elevation and possibly associated electrocardiogram abnormalities. In great majority of the cases, myocardial infarction (MI) is due to atherosclerosis, usually with plaque rupture and consequent vessel occlusion. However, a minority of patients may suffer an MI for a range of other rare reasons such as coronary vasospasm, coronary thrombosis in situ or embolization from a distal source, hypercoagulable states, spontaneous coronary dissection, some coronary anomalies including coronary bridges and inflammatory states., Psöriyazis ve kardiyovasküler hastalık arasındaki ilişki son yıllardaki epidemiyolojik veriler ile desteklenmiştir. Psöriyazis hastalarında kardiyovasküler hastalıklarının birlikte görülme sıklığının artmasından dolayı dermatoloji uzmanları bu hastalığını bir sistemik hastalık olarak düşünmeli ve dikkatli olmalıdır. Bundan dolayı çalışmalar psöriyazis hastalığında kardiyovasküler hastalık gelişme riskini araştırmaya, özel stratejilerin ve kılavuzların geliştirelebilmesine yoğunlaşmıştır

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Brugada syndrome is associated with sudden cardiac death in patients with a structurally normal heart. The electrocardiogram (ECG) pattern of Brugada syndrome is characterised by complete or incomplete right bundle branch block and ST-segment elevation in the right precordial leads. These ECG signs may not always be apparent but can be unmasked with certain anti-arrhythmia agents. We report here a case of a 26-year-old woman without detectable structural heart disease but with a history of syncope, cardiac arrest, intubation and defibrillation for ventricular fibrillation. We performed challenge tests with propafenone and ajmaline. After infusion of propafenone, there were minimal ECG changes which were not diagnostic for Brugada syndrome. One week later the provocation test was repeated with ajmaline. During infusion of ajmaline, prominent J waves and ST-segment elevation appeared in the right precordial leads (V1-3). Premature ventricular complexes were seen on a 12-lead ECG. The patient's ECG showed Brugada type 1 pattern. She received an internal cardioverter/defibrillator and was discharged with a beta-blocker.

It is known that there is an interaction between oral contraceptive pills and the cardiovascular-hemostatic system. In this case report, we discuss a 29-year-old female patient, who had been taking oral contraceptive drugs, who was admitted to the emergency department with chest pain. Acute anterior myocardial infarction was diagnosed

Background: Obesity alters endocrine and metabolic functions of adipose tissue and has been recognized as a chronic inflammatory disease, which in turn may contribute to the development of insulin resistance, type 2 diabetes, obesity-associated vasculopathy and cardiovascular disease. The pathogenesis of obesity involves many regulatory pathways including transcriptional regulatory networks, including microRNAs. Methods: A total of 83 patients were included in the study. Patients were recruited from a cardiology outpatient clinic and were allocated into 3 age- and sex-matched groups according to their body mass index. Group 1 included 23 morbidly obese, group 2 30 obese, and group 3 30 normal or overweight subjects. Results: In our study, we showed that miR-143 and miR-223 levels were significantly lower in groups 1 and 2 than the control group (normal BMI or overweight). Conclusions: Obesity leads to alterations in miRNA expressions and miRNA-143 and -223s can be used as biomarkers for the metabolic changes in obesity. © 2015 Elsevier B.V.

WOS: 000364706900007 PubMed: 25733317 Background: Heart rate (HR) reduction is associated with improved outcomes in patients with heart failure (HF) and biomarkers can be a valuable diagnostic tool in HF management. The primary aim of our study was to evaluate the short-term (6 months) effect of ivabradine on N-terminal pro B-type natriuretic peptide (NT-proBNP), CA-125, and cystatin-C values in systolic HF outpatients, and secondary aim was to determine the relationship between baseline HR and the NT-proBNP, CA-125, cystatin-C, and clinical status variation with ivabradine therapy. Methods: Ninety-eight patients (mean age: 65.81 +/- 10.20 years; 33 men), left ventricular ejection fraction < 35% with Simpson method, New York Heart Association (NYHA) class II-III, sinus rhythm and resting HR > 70/min, optimally treated before the study were included. Among them, two matched groups were formed: the ivabradine group and the control group. Patients received ivabradine with an average (range of 10-15) mg/day during 6 months of follow-up. Blood samples for NT-proBNP, CA-125, and cystatin-C were taken at baseline and at the end of a 6-month follow-up in both groups. Results: There was a significant decrease in NYHA class in the ivabradine group (2.67 +/- +/- 0.47 vs. 1.85 +/- 0.61, p < 0.001). When ivabradine and control groups were compared, a significant difference was also found in NHYA class 6 months later (p = 0.013). A significant decrease was found in HR in the ivabradine and control groups (84.10 +/- 8.76 vs. 68.36 +/- +/- 8.32 bpm, p = 0.001; 84.51 +/- 10 vs. 80.40 +/- 8.3 bpm, p = 0.001). When both groups were compared, a significant difference was also found in HR after 6 months (p = 0.001). A significant decrease was found in cystatin-C (2.10 +/- 0.73 vs. 1.50 +/- 0.44 mg/L, p < 0.001), CA-125 (30.09 +/- 21.08 vs. 13.22 +/- 8.51 U/mL, p < 0.001), and NT-proBNP (1,353.02 +/- 1,453.77 vs. 717.81 +/- 834.76 pg/mL, p < 0.001) in the ivabradine group. When ivabradine and control groups were compared after 6 months, a significant decrease was found in all HF parameters (respectively; cystatin-C: p = 0.001, CA-125: p = 0.001, NT-proBNP: p = 0.001). Creatinine level was significantly decreased and glomerular filtration rate (GFR) was significantly increased in the ivabradine group (1.02 +/- 0.26 vs. 0.86 +/- 0.17, creatinine: p = 0.001; 79.26 +/- +/- 18.58 vs. 92.48 +/- 19.88, GFR: p = 0.001). There was no significant correlation between NYHA classes (before and after ivabradine therapy) and biochemical markers, or HR. Conclusions: In the outpatients with systolic HF, persistent resting HF > 70/min with optimal medical therapy, the NT-proBNP, CA-125, and cystatin-C reductions were obtained with ivabradine treatment. Measurement of NT-proBNP, CA-125, and cystatin-C may prove to be useful in biomarker panels evaluating ivabradine therapy response in HF patients.

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The aim of this study is to investigate the presence of limitations in the shoulder range of motion (ROM) or the loss of upper extremity function on the affected side in patients with cardiac implantable electronic devices (CIEDs) with respect to the implantation time. Forty-nine patients (30 men and 19 women), mean age 64.84 ±11.18 years, who had been living with a CIED for less than 3 months were included in the short-term recipient (STR) group and 127 patients (85 men and 42 women), mean age 64.91± 14.70 years, and with the device for longer than 3 months were included in the long-term recipients group. Shoulder ROMs were measured using a digital goniometer. The other arm was used as the control. The Constant-Murler Score, Shoulder Pain Disability Index, and Shoulder Disability Questionnaire were used to assess the functional status. Limitations of ROM for flexion, abduction, and internal rotation were found to be significantly lower in the arm on the side of CIED compared with the control arm. Significant differences in shoulder flexion, abduction, and external rotation in STRs were found compared with longterm recipient (P

ÖZET Hemodiyalize bağımlı son evre böbrek yetmezliği olan hastalarda arteriovenöz fistül olu- şturulmasında bazı problemlerle karşılaşılmaktadır. Arteriyel yatağın aterosklerotik olmasına bağlı kan akımının yetersiz olması, venöz damar çaplarının yetersizliği ve venlerin flebitik veya trombotik olması gibi hastaya ait faktörler önemli rol oynar. Cerrahi anastomozun kalitesi de olmazsa olmaz koşuldur. Kronik böbrek yetmezlikli hastalarda radial arter aterosklerotik olduğunda önkolda arteriovenöz fistül oluşturmak güçleşir. Öncelikle radial arter kan akımının düzeltilmesi gerekir. Biz 4 hastada otojen safen ven grefti ile "brakio-radial bypass" yaparak, radial arter kan akımını düzelttikten sonra eş zamanlı grefto-sefalik arteriovenöz fistül oluşturduk. Postoperatif izlemlerde fistüller patent, trill pozitif idi. Hastalar hemodiyalize devam etmektedir. İleri derecede radial arter aterosklerozu olan hastalarda bu tekniğin uygulanabileceğini düşünüyoruz.

Background: Metabolic syndrome (MS) refers to a group of cardiovascular risk factors associated with endothelial dysfunction and impaired coronary blood flow (CBF). Homocysteine (Hcy) is another risk factor for the development of insulin resistance and endothelial dysfunction. However, the relationship between Hcy levels and CBF in patients with MS has not been investigated specifically. In the present study, we aimed to evaluate the relationship between Hcy levels and CBF in MS patients with normal coronary arteries. Methods: The study population included 36 patients with MS (20 males, 16 females; mean age = 55 ± 9 years) and 36 control subjects (20 males, 16 females; mean age = 51 ± 7 years). All subjects had angiographically proven normal coronary arteries. Plasma Hcy concentrations were evaluated after a fast of 12 h or longer. The CBF rates of all subjects were documented by the thrombolysis in myocardial infarction (TIMI) frame count method. Results: The TIMI frame counts for each major epicardial coronary artery and mean TIMI frame count were found to be significantly higher in the MS group compared with the control group (left anterior descending coronary artery (LAD): 53 ± 26 vs. 39 ± 17; p = 0.01, left circumflex artery (LCx): 32 ± 12 vs. 26 ± 11; p = 0.01, right coronary artery (RCA): 33 ± 14 vs. 26 ± 12; p = 0.02, mean TIMI frame count: 39 ± 16 vs. 20 ± 12; p = 0.01). Plasma Hcy levels in patients with MS were significantly higher compared with controls (MS group = 11.6 ± 4 and control group = 9.6 ± 2.6; p = 0.01). Additionally, plasma Hcy levels were positively correlated with each calculated TIMI frame count value in the MS group (LAD, r: 0.28 and p = 0.006; LCx, r: 0.25 and p = 0.022; RCA, r: 0.26 and p = 0.042; mean TIMI frame count, r: 0.28 and p = 0.004). Conclusion: Plasma Hcy levels and TIMI frame counts were significantly higher in patients with MS. Impaired CBF in MS may be related to elevated levels of Hcy, even if Hcy levels are normal. © 2015, Springer-Verlag Wien.

Isolated non-compaction of the left ventricular myocardium (INVM) was first described in 1984 as an unclassified cardiomyopathy, not being dilated, hypertrophic or restrictive. It is assumed to occur as a result of an arrest in endomyocardial morphogenesis during normal development of the heart. The disease is characterised by heart failure due to systolic and diastolic left ventricular (LV) dysfunction, systemic emboli and ventricular arrhythmias. Echocardiography has been shown to be the method of choice in diagnosis. INVM is a rare congenital cardiomyopathy and only a few cases of this condition have been reported. It is characterised by prominent and excessive trabeculation in a ventricular wall segment, with deep inter-trabecular spaces perfused from the ventricular cavity. We report a case of INVM with ventricular tachycardia induced during electrophysiological study in a 24-year-old female patient with a family history of sudden death.