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SUMMARY OBJECTIVE: Prealbumin has been a reliable marker to predict protein energy malnutrition and hypercatabolic state. In this analysis, we particularly aimed to investigate the potential association between serum prealbumin levels and right ventricular dysfunction in patients receiving programmed hemodialysis. METHODS: A total of 57 subjects were included in the analysis. The subjects were then categorized into two groups: right ventricular dysfunction (n=18) and non-right ventricular dysfunction (n=39) groups. In all patients, detailed transthoracic echocardiography (following hemodialysis) were performed along with the evaluation of complete blood count, routine biochemistry parameters, and, in particular, serum prealbumin levels. RESULTS: Mortality rate at 3 years was found to be significantly higher in the right ventricular dysfunction group (p=0.042). Serum prealbumin levels were also significantly lower in the right ventricular dysfunction group compared with the non-right ventricular dysfunction group (23.83±8.50 mg/dL versus 31.38±6.81 mg/dL, p=0.001). In the receiver operating characteristics curve analysis, a prealbumin cutoff value of

OBJECTIVE: This study aimed to evaluate the acute effect of cryoballoon ablation (CB-A) on electrocardiographic parameters that have been suggested to reflect heterogeneity in atrial conduction and ventricular repolarization. METHODS: A total of 67 patients (52.6±13.2 years, 43 men) without any exclusion criteria who had undergone CB-A for atrial fibrillation (AF) between January 01, 2015, and December 31, 2018, constituted our study population. Electrographic recordings obtained before and after the ablation procedure on the same day were retrospectively evaluated for the P-wave dispersion, QTc dispersion, Tp-Te interval, and Tp-Te/QT ratio. The pre- and post-ablation values were tested for significant differences. The association of the possible CB-A-related changes in these parameters with AF recurrence during follow-up was evaluated. RESULTS: P dispersion (30.1±6.8 vs. 35.9±9.4 ms, p

Eisenmenger syndrome is a rare disease primarily characterized by severe degrees of irreversible pulmonary arterial hypertension in the setting of congenital heart disease. In this report, we aim to report, on a yearly basis, the clinical, hemodynamic and echocardiographic parameters of a female patient with Eisenmenger syndrome who had been under bosentan treatment during an 11-year follow-up.

Contact allergy to cardiac implantable electronic devices is a rare problem in patients. Clinical evaluation and patch tests have an important place in its diagnosis. Also in this case, the diagnosis is supported by ultrasonography. It has been reported in the literature that allergic dermatitis developed after permanent pacemaker implantation in the first few days until the current year. In our case report, we showed that the allergic reaction in the patient was too late. In this article, we present a 94-year-old male patient with a permanent pacemaker who came to us with the complaint of redness and itching in the left chest area and was diagnosed with contact allergy.

The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial has been the largest study ever conducted among patients in Turkey regarding aspirin treatment. In the subgroup analysis of the hypertensive group of the Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial, we aimed to evaluate the physicians' adherence to current guidelines regarding their aspirin treatment preferences.The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial is a cross-sectional and multicenter study conducted among 5007 consecutive patients aged ≥18 years. The study population consisted of outpatients on aspirin treatment (80-300 mg). The patient data were obtained from 30 different cardiology clinics of 14 cities from all over Turkey. In this subgroup analysis, patients were divided into 2 groups: the hypertensive group (n=3467, 69.3%) and the group without hypertension (n=1540, 30.7%) according to the 2018 European Society of Cardiology/ European Society of Hypertension Guidelines for the Management of Arterial Hypertension.Aspirin use for primary prevention was higher in patients with hypertension compared to patients without hypertension [328 (21.3%); 1046 (30.2%); P.001]. Treatment with a dose of 150 mg aspirin (n=172, 5%) was mostly preferred by internists for hypertensive patients (n =226, 6.5%); however, a daily dose of 80-100 mg aspirin therapy (n=1457, 94.6%) was mostly prescribed by cardiologists (n=1347, 87.5%) for patients without hypertension.Aspirin was found to be used commonly among patients with hypertension for primary prevention despite the current European Society of Cardiology Arterial Hypertension Guideline not recommending aspirin for primary prevention in patients with hypertension.

BACKGROUND There is limited data regarding the effect of idiopathic premature ventricular complexes (PVC) on myocardial repolarisation. Most of PVC's originate from right and left ventricular outflow tracts (RVOT and LVOT). AIM The aim of this study is to evaluate the acute effect of outflow tract PVC ablation on electrocardiographic repolarisation markers. METHODS A total of 180 patients (49.2 ± 13.6 years, 74 male) without any exclusion criteria who had undergone outflow tract PVC ablation between 1 January 2015 and 1 November 2018 constituted our study population. Electrocardiographic recordings that had been obtained before and after ablation procedure on the same day were retrospectively evaluated for the QTc dispersion, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Significance of difference between pre- and postablation values was tested. RESULTS There was no significant difference regarding QTc dispersion between pre- and post-ablation state (36.5 ± 20.9 vs. 35.3 ± 16.4 ms, p: NS). However, Tp-e and Tp-e/QT values in all lateral precordial derivations were observed to decrease significantly after PVC ablation (in the respective order on derivation V5: 104.0 ± 21.6 ms vs. 91.1 ± 14.8 ms, p

Fontan operation has been defined as a palliative surgery connecting systemic venous return and pulmonary circulation in patients with certain forms of complex congenital heart disease (CHD). Fortunately, it has improved overall survival and chance of successful pregnancies among these patients. However, Fontan circulation (FC), as a potential trade-off, might be associated with specific late or post-gestational complications, including peripartum cardiomyopathy (PPCM) largely through its adverse effects on the placenta and inflammation-oxidation stress. Importantly, diagnosis of superimposed PPCM in women with FC might be a diagnostic challenge, requiring a high index of suspicion. Accordingly, the present paper aims to highlight the potential association of FC with PPCM evolution largely based on certain mechanistic and clinical perspectives.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as an immediate and global problem just within a few months after its first description in Wuhan-China. Beyond its alarming mortality rate and easily transmissible nature through air droplets, it has also resulted in significant challenges in the cardiovascular area not only due to its higher mortality rates in cardiovascular disease and certain associated conditions, including diabetes mellitus and hypertension, but also due to the theoretically facilitated inoculation of lung tissue by the culprit agent, SARS-CoV-2 in these conditions [1,2]. This worrisome concern has been largely attributed to the potential upregulation of angiotensin enzyme 2 (ACE2) in hypertensive and diabetic patients, and more interestingly; in those receiving angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) [3]. WOS:000639294800001

Patients and medical staff expose to significant radiation during electro-physiological (EP) procedures. There are few data regarding the leading factors of longer fluoroscopy time and higher scattered radiation in a laboratory giving EP training during those interventions.The patients' recordings that underwent EP procedure in a single centre arrhythmia unit from February 2019 to January 2020 were examined. Prospectively collected data regarding procedure duration, fluoroscopy time and total air kerma, demographic characteristics of the patients, type of procedure, success of ablation and the use of electro anatomic mapping were retrospectively evaluated. Predictors of total air kerma were analysed with linear regression analysis.Study population consisted of 437 patients with a median age of 47 (39-56); 184 (42.1%) were male. Median fluoroscopy time was 768 (420-1320) seconds and median cumulative air kerma was 369 (191-750) mGy. Fluoroscopy time and cumulative air kerma were significantly lower in diagnostic EP studies compared to other procedures. There was no difference in terms of total air kerma between the procedures other than the diagnostic EP study. In multivariable linear regression analysis; body surface area, fluoroscopy time, not using the electro-anatomical mapping, unsuccessful ablation and atrial flutter ablation were predictors of total air kerma in EP studies performed by trainees.Scattered radiation during EP procedures performed by in-training operators is related with some factors. Awareness about those may help to effort reducing the harmful effect of ionising radiation.

Background: The renin–angiotensin system regulates the haemodynamics. ACE gene polymorphisms are known to influence serum angiotensin converting enzyme level. Contrast nephropathy develops after exposure to intravascular contrast media that influence vascular hemodynamics. ACE gene polymorpisms may have an enhancing role in contrast media related renal injury. The aim of the study: The aim of this study was to investigate the impact of ACE insertion/deletion (I/D) polymorphism in contrast-induced nephropathy (CIN) development. Methods: 194 patients with chronic kidney disease that were administered iodinated contrast media were examined. Patients were monitored for at least 7 days for CIN development after parenteral contrast exposure. Control and patient groups were divided in terms of CIN development status. Polymerase chain reaction was performed for the genotyping of the ACE gene polymorphism from DNAs that were isolated from peripheral blood of the patients. Results: 83 patients with CIN (34 women, 49 men) and 111 control patients without CIN (43 women, 68 men) were enrolled. Gender was not statistically different between the two groups (p = 0.75). The average age of the CIN group (71) was greater than that of the control group (68). No association was detected between ACE gene polymorphism (II, ID AND DD genotypes) and CIN in both patients and controls. Conclusion: ACE gene polymorphisms does not influence contrast induced nephropathy development.

Dear Editor, Takotsubo cardiomyopathy (TTC) has been universally regarded as a unique form of reversible myocardial dysfunction associated with a variety of emotional and physical stressors. In their recently published elegant article, Dell'Aquila et al. have reported an interesting case of TTC triggered by an exacerbation of relapsing-remitting multiple sclerosis (MS). However, we would like to comment on this interesting case and its particular implications... WOS:000587752100020 32724231

Introduction : Myocardial injury after percutaneous coronary intervention (PCI) occurs in approximately 30% of procedures, and is related to worse prognosis. Effects of remote ischemic preconditioning (RIPC) on reperfusion injury have been investigated before, yielding conflicting results. Aim : To assess the impact of a single episode of RIPC on myocardial injury after elective PCI. Material and methods : One hundred and four patients undergoing elective PCI, with normal baseline cardiac troponin-I (cTn-I) values, were randomized to two groups. Two patients were excluded due to data loss, and 102 patients were analyzed. Five minutes of ischemic preconditioning was delivered just before the intervention to the preconditioning group, by inflating the blood pressure cuff up to 200 mm Hg on the non-dominant arm. Postprocedural 16th hour cTn-I, cTn-I (difference between the 16th h and baseline cTn-I values) and the prevalence of type 4a myocardial infarction were compared between the two groups. Results : Median cTn-I values after the procedure were compared. 16th hour cTn-I was insignificantly lower in the preconditioning arm (0.026 µg/l vs. 0.045 µg/l, p = 0.186). The incidence of cTn-I elevation 5-fold above the upper reference limit (URL) (> 0.115 µg/l) was lower in the preconditioning group, but it was also not significant (21.6% vs. 11.8%, p = 0.184). Conclusions : A single episode of RIPC before elective PCI demonstrated less troponin elevation but failed to show a significant effect.

Introduction:Myocardialinjury after percutaneous coronary intervention (PCI) is seen frequently.Ischemia/reperfusion injury, side branch occlusion and distal embolization ofatherothrombotic debris are the main causes of myocardial injury. Remoteischemic preconditioning (RIPC) is a promising technique for protection fromischemia/reperfusion injury, but sufficient data of long-term clinical outcomesis not available. In this study we planned to investigate the effect of onecycle of RIPC on major cardiovascular events one year after elective PCI.Patientsand Methods: 102 patients, undergoing elective PCI, with normalbaseline cTroponin-I (cTn-I) values, were randomized equally into two groups.Five minutes of ischemic preconditioning was applied before the intervention tothe preconditioning group, by inflating blood pressure cuff up-to 200 mmHg onnon-dominant arm. After 1 year, the clinical outcomes of these patients(angina, heart failure, death, myocardial infarction, repeat revascularization)were questioned.Results: From a total of 102patients, 90 could be reached after an year. The mean duration of follow-up was432 vs. 423.5 days (p= 0.793). Post-PCI 16th hour cTn-I was insignificantlylower in the preconditioning arm (0.079 μg/L vs. 0.069 μg/L, p= 0.074). Theincidence of cTn-I elevation 5 fold above the URL (> 0.115 μg/L) was lowerin the preconditioning group; however, it was also insignificant (24.4% vs.13.3%, p= 0.301). Death, MI or repeat revascularization rates did not differbetween the groups., Giriş: Perkütan koroner girişim sonrası miyokart hasarı sıklıklagörülmektedir. Miyokart hasarı iskemi/reperfüzyon hasarına, yan dal tıkanmasınave aterotrombotik debrisi distal embolizasyonuna bağlı gelişmektedir. Uzaktaniskemik ön koşullanma iskemi reperfüzyon hasarından korunmada ümit vericiteknikledendir ancak uzun dönem sonuçları ile ilgili yeterli veri henüzbulunmamaktadır. Biz bu çalışmadaperkütan koroner girişim öncesi uygulanan tek sefer uzaktan önkoşullanmanın bir yıl sonunda majör kardiyovasküler olaylar üzerine etkisiniaraştırmayı planladık.Hastalar ve Yöntem: Elektif perkütan koroner girişimplanlanan 102 hasta çalışmaya alındı ve hastalar iki gruba randomize edildi. Önkoşullanma grubundaki hastalara girişimden önce, kan basıncı manşonu 5 dakikaboyunca 200 mmHg’da şişirilerek ön koşullanma uygulandı. İşlem öncesi vesonrası cTroponin-I değerlerine bakıldı. Birinci yıl sonunda hastaların klinikdurumları sorgulandı (angina, kalp yetersizliği, ölüm, miyokart infarktüsü,tekrar revaskülarizasyon).Bulgular: Yüz iki hastanın 90’ına ulaşılabildi. Ortalama takipsüresi 432 vs. 423.5 gün (p= 0.793). Ön koşullanma grubunda koroner girişimsonrası 16. saat cTroponin-I değeri kontrol grubuna göre daha düşük bulunduancak istatistiksel anlamlılık saptanmadı (0.079 μg/L vs. 0.069 μg/L, p=0.074). cTroponin-I beş kat arttığı hasta oranı da ön koşullanma grubunda dahaazdı ancak bu fark da istatistiksel olarak anlamlı saptanmadı (24.4% vs. 13.3%,p= 0.301). Ölüm, miyokart infarktüsü ve tekrar revaskülarizasyon açısındangruplar arasında fark saptanmadı.Sonuç: Tek sefer uzaktan iskemikön koşullanmanın elektif perkütan koroner girişim sonrası majör kardiyovaskülerolaylar üzerine etkisi saptanmamıştır.

Although intracardiac metastasis of germ cell tumors is rare, it can be localized in the right or left heart by disseminating spread and give their cardiac symptoms depending on the location of metastatic mass. We present a 38-year-old male patient with a preliminary diagnosis of testicular tumor who was followed by the medical oncology clinic with cerebrovascular event and heart failure symptoms.

PP-114 Recent studies identified possible roles of oxidative stress and increased inflammatory status in the pathogenesis of ascending aortic dilatation. High serum gamma-glutamyltransferase (GGT) levels indicate a marker of oxidative stress.GGT level is positively associated with the development