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Introduction: Heart failure is an important leading cause of mortality and morbidity despite optimal medical treatment and device therapy. Sacubitril/valsartan, a first-generation drug, was approved to use heart failure treatment recently. There are limited studies on the relationship between sacubitril/valsartan and left ventricular contraction. In our study, we aimed to evaluate the changes in left ventricular ejection fraction (LVEF) after sacubitril/valsartan treatment. Patients and Methods: Fifty-two patients with heart failure and reduced ejection fraction (HFrEF) were enrolled in this study. The baseline demographic, clinical, and echocardiographic characteristics of 52 patients were compared using the Bayesian method. Results: Fifty-two patients with heart failure and reduced ejection fraction (HFrEF) were included in the final analysis (66.2 ± 9.3 years, 69.2% male). Sacubitril/valsartan initial dose was low in 44.2% of patients, and intermediate in 55.8%. In the low initial dose population, the increase in absolute LVEF was 3.87 (95% HDI 1.53-6.20) and in the intermediate initial dose population, the increase in absolute LVEF was 5.89 (95% HDI 4.18-7.61). In the female population, the increase in absolute LVEF was 5.56 (95% HDI 3.49-7.63) and in the male population 4.75 (95% HDI 2.91-6.58) respectively. Conclusion: In this study, we demonstrated that sacubitril/valsartan is associated with increased LVEF regardless of baseline clinical characteristics.

Aim Comprehensive studies on the coexistence of COVID-19 and pericardial effusion (PEff) are limited. In this study, we investigated the relationship between pneumonia severity and PEff, predisposing factors, and the effect of PEff on clinical prognosis and mortality in COVID-19 patients.Material and methods Between March and November 2020, 5 575 patients were followed up in our pandemic hospital due to COVID-19. 3 794 patients with positive polymerase chain reaction (PCR) test results and thoraxcomputerized tomography (CT) imaging at admission were included in the study. The clinical and demographic characteristics, CT images, hematological and biochemical parameters of these patients were retrospectively examined. Pulmonary involvement of 3794 patients was divided into three groups and its relationship with PEff was investigated retrospectively.Results There were 560 patients who did not have pulmonary involvement, 2 639 patients with pulmonary involvement below 50 %, and 595 patients with 50 % or more pulmonary involvement. As pulmonaryinvolvement or the severity of the disease increased, male gender and advanced age become statistically significant. The mean age of patients with PEff was higher, and PEff was more common in males. Patients with PEff had more comorbid diseases and significantly elevated serum cardiac and inflammatory biomarkers. The need for intensive care and mortality rates were higher in these patients. While the in-hospital mortality rate was 56.9 % in patients with PEff and pulmonary involvement above 50 %, in-hospital mortality rate was 34.4 % in patients with pulmonary involvement above 50 % and without PEff (pConclusion As the severity of pulmonary involvement or the clinical severity of the disease increased, PEff occurred in patients or the degree of PEff increased. The clinical prognosis of patients presenting with PEff was quite poor, and the frequency of intensive care admissions and mortality were significantly higher. PEff was an important finding in the follow-up and management of patients with COVID-19, and it reflected the clinical prognosis.

Objective: The transthoracic echocardiography (TTE) is the primary method to evaluate the right ventricular (RV) functions, but the assessment of the RV by TTE can be difficult due to the complex structural and anatomical position of the RV. The transesophageal echocardiography (TEE) is a good alternative to TTE when faced with difficulties in obtaining images. In this study, we investigated the agreement between TTE and TEE for the evaluation of the RV functions.Material and Methods: This study was carried out on 78 patients between January 2017 and May 2017. The TTE and TEE records of the patients were compared by using Bland Altman analysis, and the mean difference and confidence interval between them were analyzed.Results: Seventy-eight patients were involved in this study. The mean age of patients was 42 years, and 34% of the participants were female. In Bland Altman analysis, there was a moderate agreement between TTE and TEE in terms of mean difference of the E velocity, the A velocity, E’, A’. In contrast, there was a good agreement between TTE and TEE in terms of mean difference of RV strain, RV strain rate E, RV strain rate A, RV strain rate S which means that it could be appropriate to use them interchangeably.Conclusion: The deformation parameters are essential for analyzing the RV functions, making a clinical decision, and estimating adverse events. The deformation parameters measured using TEE may yield information as accurate and useful as those measured using TTE, and they may be used interchangeably in making a clinical decision.

Acute pulmonary embolism (APE) is an important cause of cardiovascular morbidity and mortality. PESI scoring is used in risk classification. This study was designed to determine the relationship between echocardiographic pulmonary vein measurements and PESI score, which is an important tool in diagnosis and treatment.A total of 210 patients were evaluated. Pulmonary vein measurements and PESI scores of the patients at the time of diagnosis were calculated. Correlation analysis was performed to determine the relationship between the two parameters.Total PESI scores were 112.9 ± 33.9. The pulmonary vein S wave .39 ± .14, the D wave .48 ± .18, and the S/D ratio was found to be .86 ± .35. It was determined that there was a significant correlation between pulmonary S/D ratio and PESI score. (Pearson correlation coefficient = -.693, R2 Linear:.484; p .001) The AUC of S/D for mortality prediction was .729 (95% CI = .653-.804; p .001), the cutoff value was .63, the sensitivity and specificity were 55.6% and 55.7%, respectively.Pulmonary vein measurements were found to be correlated with the PESI score and were found to be a parameter that could predict mortality.

The aim of this study is to investigate the relationship between the model for end-stage liver disease (MELD) score and disease progression and mortality in COVID-19 patients. The files of 4213 patients over the age of 18 who were hospitalized with the diagnosis of COVID-19 between March 20, 2020 and May 1, 2021 were retrospectively scanned. Sociodemographic characteristics, chronic diseases, hemogram and biochemical parameters at the time they were diagnosed with COVID-19 of the patients, duration of hospitalization, duration of intensive care unit (ICU), duration of intubation, in-hospital mortality from COVID-19 and outside-hospital mortality for another reason (within the last 1 year) and recurrent hospitalization (within the last 1 year) were recorded. The MELD scores of the patients were calculated. Two groups were formed as MELD score 10 and MELD score ≥ 10. The rate of ICU, in-hospital mortality from COVID-19 and outside-hospital mortality from other causes, intubation rate, and recurrent hospitalization were significantly higher in the MELD ≥ 10 group. The duration of ICU, hospitalization, intubation were significantly higher in the MELD ≥ 10 group (p 0.001). As a result of Univariate and Multivariate analysis, MELD score was found to be the independent predictors of ICU, in-hospital mortality, intubation, and recurrent hospitalization (p 0.001). MELD score 18.5 predicted ICU with 99% sensitivity and 100% specificity (area under curve [AUC]: 0.740, 95% confidence interval [CI]: 0.717-0.763, p 0.001) also MELD score 18.5 predicted in-hospital mortality with 99% sensitivity and 100% specificity (AUC: 0.797, 95% CI: 0.775-0.818, p 0.001). The MELD score was found to be the independent predictors of in-hospital mortality, ICU admission, and intubation in COVID-19 patients.

Many complications can be observed after ST-elevation myocardial infarction (STEMI). The systemic immune-inflammatory index (SII) is a sensitive indicator of the inflammatory state, and this parameter may also be associated with cardiovascular diseases. In this study, we investigated the relationship between malignant ventricular arrhythmias (MVA) development and SII in STEMI patients. A total of 1708 STEMI patients were included in the study. Propensity score matching (PSM) analysis was performed. Patients were divided into 2 groups according to the development of MVA, and predictors of MVA development were investigated. After the PSM analysis, the mean age of 158 patients was 61.6 years, and 68.4% were male. In the univariate analysis, neutrophil count, SII, C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR) were associated with the development of MVA; while in the regression analysis, CAR and SII was found to be independent predictors of the development of MVA. In this study, we demonstrated that SII is a better independent predictor than other inflammatory parameters for predicting the development of MVA. This index may be useful in clinical use.

Although COVID-19 disease primarily affects the respiratory system, it has been seen in many studies that it causes thromboembolic (TE) events in many tissues and organs. So that, to prevent TE can reduce mortality and morbidity. In this context, this study aimed to investigate the relationship between the previous use of warfarin or other new direct oral anticoagulants (OAC) and mortality in patients hospitalized with a diagnosis of COVID-19 before hospitalization. A total of 5575 patients who were diagnosed with COVID-19 were hospitalized and started treatment between March 21 and November 30, 2020 were included in the study. The primary outcome was in-hospital all-cause mortality. A retrospective cohort study design was planned. Patients were followed up until death or censoring on November 30, 2020. The candidate predictors for primary outcome should be clinically and biologically plausible, and their relationships with all-cause death should be demonstrated in previous studies. We considered all candidate predictors included in the model in accordance with these principles. The main candidate predictor was previous OAC use. The primary analysis method was to compare the time to deaths of patients using and not using previous OAC by a multivariable Cox proportional hazard model (CPHM). In the CPHM, previous OAC use was found to be associated with a significantly lower mortality risk (adjusted hazard ratio 0.62, 95% CI 0.42-0.92, p = 0.030). In hospitalized COVID-19 patients, in patients who previously used anticoagulantswas associated with lower risk of in-hospital death than in those who did not.

People with comorbid conditions are at increased risk of developing severe/fatal coronavirus disease 2019 (COVID-19). We aimed to investigate the relationship between lipid levels and mortality in patients hospitalized for COVID-19 infection. In this retrospective study, we collected the details of 5274 COVID-19 patients who were diagnosed using the polymerase chain reaction and/or computed tomography and were hospitalized between March and November 2020. Patients (n = 4118) whose blood lipid levels were checked within the first 24 h after hospitalization were included in the study. Multivariable cox proportional hazards regression was used to assess the relationship between lipid variables such as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) and death. There was a statistically significant association between LDL-C, HDL-C, and TG levels and the risk of death ( P =.002

The Naples score is a new prognostic score developed according to inflammatory and nutritional status and frequently evaluated in cancer patients. The present study aimed to evaluate using the Naples prognostic score (NPS) to predict the development of decreased left ventricular ejection fraction (LVEF) after acute ST-segment elevation myocardial infarction (STEMI). The study has a multicenter and retrospective design and included 2280 patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) between 2017 and 2022. All participants were divided into 2 groups according to their NPS. The relationship between these 2 groups and LVEF was evaluated. The low-Naples risk group (Group-1) included 799 patients, and the high-Naples risk group (Group-2) had 1481 patients. Hospital mortality, shock, and no-reflow rates were found to be higher in Group 2 compared with Group 1 ( P < .001, P = .032, P = .004). The NPS was significantly inversely associated with discharge LVEF (B coefficient: −1.51, 95% CI-2.26; −.76, P = .001). NPS, a simple and easily calculated risk score, may help identify high-risk STEMI patients. To the best of our knowledge, the present study is the first to demonstrate the relationship between low LVEF and NPS in patients with STEMI.

We aimed to investigate association between mean platelet volume (MVP), platelet distribution width (PDW) and red cell distribution width (RDW) and mortality in patients with COVID-19 and find out in which patients the use of acetylsalicylic acid (ASA) affects the prognosis due to the effect of MPV on thromboxan A2. A total of 5142 patients were divided into those followed in the intensive care unit (ICU) and those followed in the ward. Patient medical records were examined retrospectively. ROC analysis showed that the area under curve (AUC) values were 0.714, 0.750, 0.843 for MPV, RDW and D-Dimer, the cutoff value was 10.45fl, 43.65fl, 500.2 ng/mL respectively. (all P 10.45 f/l and D-Dimer >500.2 ng/mL, treatment with ASA had lower in-hospital and 180-day mortality than patients without ASA in ICU patients (HR = 0.773; 95% CI = 0.595-0.992; P = .048, HR = 0.763; 95% CI = 0.590-0.987; P = .036). Administration of low-dose ASA in addition to anti-coagulant according to MPV and D-dimer levels reduces mortality.

Purpose In our study, we investigated the relationship between pneumonia severity and pericardial effusion, predisposing factors and the effect of pericardial effusion on clinical prognosis and mortality in COVID-19 patients. Methods A total of 3794 patients who were diagnosed with COVID- 19 by polymerase chain reaction (PCR), were hospitalized between March 21 and November 30, 2020 were included in the study. For each of the 3794 patients, the initial chest CT images, pericardial efusion (PE), pleural efusion and pneumonia severity were evaluated. Results The mean age of patients with PE was higher and it was more common in males. Patients with PE had more comorbid diseases and significantly elevated serum cardiac and inflammatory biomarkers. In addition, the need for intensive care and mortality rates were higher in these patients. While the in-hospital mortality rate was 56.9% in patients with PE and AC involvement above 50%, in-hospital mortality rate was 34.4% in patients with AC involvement above 50% and without PE (p

Purpose Atrial fibrillation (AF) is relatively frequent in the postoperative period, and is associated with an increased frequency of adverse events. The role of right atrial (RA) volume and functions in the development of AF is unknown. In this study, we investigated the effect of RA echocardiographic indices on AF development in the postoperative period. Method We enrolled 142 consecutive patients who underwent coronary artery bypass surgery, and assigned them into two groups depending on the occurrence or not of AF development in the postoperative period. Results A propensity score matching analysis was performed to balance the groups, and 37 pairs were eventually included in the analysis. The median age was 67.5 (63-75) years and 73.3% of them were males. In the univariate analysis, right atrial volume index (RAVi), right atrial strain during reservoir phase (RASr), left ventricular global longitudinal strain, right ventricular strain, left atrial volume index, left atrial strain during reservoir phase, and systolic pulmonary artery pressure were associated with AF development. In the regression analysis, we found that RAVi (OR: 3.1, 95% CI: 2.2-6.3, P: .033) and RASr (OR: 0.82, 95% CI: 0.67-0.93, P: .048) were independent predictors of AF development. Conclusions RA structure and functions are closely associated with AF development in the postoperative period, and screening of RA functions prior to surgery may be useful for preventing AF development.

Aim: Coronary slow flow phenomenon (CSFP) is a microvascular circulation disorder. It is known that serum magnesium has positive effects on anti-inflammation, vasodilatation and endothelial functions. This observational study investigated the association of serum magnesium levels with CSFP.Materials and Methods: Patients who had undergone coronary angiography (CAG) after noninvasive testing were included in the study. CAG records were reassessed for CSFP and 100 patients were diagnosed as having CSFP. Control subjects (n = 80) had normal coronary flow. Serum Mg levels and other biochemical parameters such as glucose, creatinine, cholesterol levels and hemoglobin samples were collected before CAG. Serum Mg values were categorized into two groups: Mg levels equal/under and above 1.9 mg/dL.Results: The mean patient age was 56.1±9.7 years; 68.9% of patients were men. Patient’s hypertension, diabetes mellitus history and smoking habits rate were similar between groups. Biochemical tests revealed lower serum magnesium levels (1.87 vs 1.95mg/dL, p=0.02) for CSFP patients and controls, respectively. In multivariate regression analysis, a serum magnesium level under 1.9 mg/dL (OR:3.33, 95% CI:1.75-6.37, p

Objective: heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: this is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: there were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7-17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p, NA

INTRODUCTION Despite the widespread use of both hemodialysis (HD) and peritoneal dialysis (PD), there is no study comparing the effects of these dialysis methods on the left atrial (LA) volume and functions. In this study, we investigated the impact of different dialysis methods on the LA volume and function in the patients exposed to chronic pressure overload and volume overload. METHOD This study was carried out on the patients who received dialysis treatment at our healthcare center between March, 2015 and January, 2016. Twenty-eight patients receiving hemodialysis (HD) treatment and 24 patients under PD treatment were enrolled into the study. Patients were divided into 2 groups according to the dialysis therapy, and the atrial volumetric and mechanical functions were investigated. RESULTS As the basal demographical characteristics of patients in the PD and HD groups were significantly different, 44 patients matched on a 1:1 basis were taken for final analysis (22 HD, 22 PD, and the average age of 42.4 ± 4.8; 73% was male). After propensity score matching analysis, it was determined that left atrial volume index (LAVi) was higher in the HD group while peak LA strain and LA contraction strain were higher in the PD group. Additionally, both strain parameters showed a good negative correlation with LAVi. CONCLUSION We demonstrated that the left atrial structure and functions were better in the PD group suggesting that PD may be a relatively better option for the preservation and maintenance of the left atrial functions as compared to HD.

PURPOSE Although it is affected at an early stage, there is a lack of studies investigating right ventricular (RV) function in patients with mitral stenosis (MS). We aimed to investigate the correlation between conventional echocardiographic variables and tricuspid annular plane systolic excursion (TAPSE), used as an indicator of RV dysfunction. METHODS We enrolled 59 consecutive patients with MS and assigned them in group 1 if TAPSE ≤16, or group 2 if: TAPSE >16. RESULTS The mean age of the patients was 42.2 ± 8 years, and 74.6% were females. In univariate analysis, maximal mitral valve gradient, mean mitral valve gradient, systolic pulmonary arterial pressure, RV strain, and RV strain rates were associated with RV dysfunction. In multivariate analysis, both strain variables were found to be independent predictors of RV dysfunction. Kaplan Maier survival analysis showed that patients with lower RV strain had more rehospitalization rate during the one-year follow-up period. CONCLUSIONS RV dysfunction is common in patients with MS and is associated with higher rehospitalization rate and morbidity. Evaluation of RV strain and strain rate for early detection of RV dysfunction and prediction of rehospitalization may be an appropriate approach in mitral stenosis.

Recent trials reported that risk of atrial fibrillation (AF) is increased in patients using ivabradine compared with controls. We performed this meta‐analysis to investigate the risk of AF association with ivabradine treatment on the basis of data obtained from randomized controlled trials (RCTs). We searched PubMed, EMBASE, Scopus, and the Cochrane Library for RCTs that comprised >100 patients. The incidence of AF was assessed. We obtained data from European Medicines Agency (EMA) scientific reports for the RCTs in which the incidence of AF was not reported. We used trial sequential analysis (TSA) to provide information on when we had reached firm evidence of new AF based on a 15% relative risk increase (RRI) in ivabradine treatment. Three RCTs and 1 EMA overall oral safety set (OOSS) pooled analysis (included 5 RCTs) were included in the meta‐analysis (N = 40 437). The incidence of AF was 5.34% in patients using ivabradine and 4.56% in placebo. There was significantly higher incidence of AF (24% RRI) in the ivabradine group when compared with placebo before (RR: 1.24, 95% confidence interval: 1.08‐1.42, P = 0.003, I 1980 = 53%) and after excluding OOSS (RR: 1.24, 95% confidence interval: 1.06‐1.44, P = 0.008). In the TSA, the cumulative z‐curve crossed both the traditional boundary (P = 0.05) and the trial sequential monitoring boundary, indicating firm evidence for ≥15% increase in ivabradine treatment when compared with placebo. Study results indicate that AF is more common in the ivabradine group (24% RRI) than in controls.

Purpose High-dose steroid therapy (HDST) has frequent side-effects that appear at its cessation and depend on its dose. However, there is a lack of studies about the acute effects of HDST on cardiac function in adult patients. Methods We included in this study 30 patients who underwent HDST (intravenously at doses ranging from 250 to 1000 mg) and 30 healthy control subjects with similar demographic and clinical characteristics, between September and December 2016. Echocardiographic measurements were made before and during the first 3 hours after the end of treatment, and results were compared between patients and controls. Results There was no difference in baseline biochemical and echocardiographic characteristics between the patient and control groups. While left ventricular global longitudinal strain (LVGLS) and strain rate E were higher after treatment, no significant change was observed in conventional echocardiographic variables. Conclusions LVGLS, but not conventional echocardiographic variables, showed an increase in cardiac systolic function at the acute phase of HDST.

Objective The prognosis of cardiovascular diseases (CVDs) is directly associated with systolic function based on the measurement of ejection fraction (EF), and many studies have indicated that the left ventricular global strain (LVGS) provides better predictivity than the EF measurement in the diagnosis, prognosis, survival, and CVD staging. However, these studies did not investigate the correlation between the EF measurement and the LVGS parameters, or which parameters are better correlated with LVGS, but we analyzed the association between three EF measurement methods and LVGS. Materials and Methods This study included 62 patients that applied to the clinic between October 2015 and March 2016. An echocardiography examination of these patients was performed. The exclusion criteria were atrial fibrillation and suboptimal image quality. Results Sixty-two patients (the average age 61.0±12.6 years; 56% male and 44% female) were enrolled in the study. A statistically significant association was found between the visual EF and Simpson EF measurements and the LVGS parameters (p

Objective Fractional flow reserve (FFR) provides more useful information regarding myocardial metabolism and demand-supply convenience as compared to anatomical measurements. In this study, we aimed to investigate FFR predictors after propensity score matching (PSM) analysis in patients with intermediate coronary lesions. Methods Patients who underwent coronary angiography between January 2014 and March 2015 due to suspicion of coronary artery disease were included in this study. Patients were divided into two groups according to the FFR status and predictors of FFR before and after PSM analysis were investigated. Results A total of 290 patients (a total of 310 lesions) were included in this study (61±12 years, 75.5% male). In univariate analysis, after PSM analysis, Diameter stenosis (DS) and proximal LAD lesion (PLL) were associated with lower FFR values. Conclusion This study indicated that the majority of traditional FFR predictors did not reach the limit of significance after PSM analysis and we suggest that DS and PLL are one step ahead of predicting lesion severity compared to other traditional risk factors.

INTRODUCTION Although various risk factors have been defined for the development of postoperative atrial fibrillation (PAF), these parameters have not been adequately verified and validated. We investigated the atrial fibrillation detection capabilities of echocardiographic parameters in PAF developing and the determination of predictive values for clinical use. METHOD We enrolled 60 consecutive patients with 234 lesions who underwent CABG surgery. All patients underwent preoperative echocardiographic evaluation. Patients were divided into two groups according to PAF development status. RESULTS The mean age of the patients was 67, and 73% were male and PAF occurred in 19 patients. In univariate analysis, left atrial volume index (LAVi), left ventricular global strain (LVGS) and ejection fraction were associated with PAF development. Parameters which were significant in univariate analysis were included in a logistic regression model to determine the independent predictors of PAF. LAVi was found to be an independent predictor of PAF. CONCLUSION Although several parameters have been defined for PAF development, LAVi is more advantageous than the other conventional methods in clinical decision making.

Bortezomib genellikle multipl myeloma tedavisi için kullanılan bir proteazom inhibitörüdür ve bazı kardiyak yan etkilere sahiptir. Klinik çalışmalardaki bortezomib tedavisiyle ilişkili kalp yetmezliği insidansı tesadüfi olarak kalır. Biz Uluslararası skorlama sistemine göre Evre 3 multipl myeloması olan 82 yaşında bir hastayı sunuyoruz. Bu hastaya kombine kemoterapi (her bir siklusta bortezomib 1,3 mg/m2 D1, D8, D15, D22 ve 40 mg/gün deksametazon [D1–4]) başlandı. Kemoterapisinin 3 siklusunun tamamlanmasından 2 gün sonra (bortezomib tedavisinin 12. dozu) hasta bilateral alt extremitelerde hafif ödem nedeniyle başvurdu. Ekokardiyografide ejeksiyon fraksiyonun tedavi öncesi >%55’den %30–35’e düştüğünü gösterdi. Bu nedenle bortezomib tedavisi kesildi ve konjestif kalp yetmezliği için hasta tedavi edildi. Bortezomib kesilmesinden 3 ay sonra hastanın klinik semptomları düzeldi ve ejeksiyon fraksiyonu normale döndü., Bortezomib is a proteasome inhibitor commonly used for the treatment of multiple myeloma, and it has some cardiac side effects. The incidence of cardiac failure associated with bortezomib therapy in clinical trials remains incidental. We describe a 82-year-old patient with International Staging System Stage III multiple myeloma. Combined chemotherapy with bortezomib 1.3 mg/m2 on days 1, 8, 15, 22 of each cycle and 40 mg/day dexamethasone (days 1 to 4) was started to him. Two days after the end of the 3rd cycle of chemotherapy (12th dose of bortezomib), he admitted with mild edema of bilateral lower extremity. Echocardiography revealed a drop in the left ventricular ejection fraction from pretreatment levels of >55% to 30–35%. Therefore; bortezomib treatment was postponed and he was treated for congestive heart failure. The patient’s symptoms improved and the ejection fraction normalized after three months following discontinuation of bortezomib.