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Introduction: Transradial coronary angiography (TRA) is associated with a lower incidence of bleeding rate and access site complications and is associated with better outcomes compared to transfemoral angiography. However, radial artery spasm (RAS) is an important limitation of TRA procedures. Little is known regarding the relationship of serum vasodilator and inflammatory markers with RAS. Therefore, the present study aimed to investigate the association between serum adropin level and RAS in patients undergoing TRA. Methods: From February 2020 to January 2021, 39 consecutive patients who underwent elective daiagnostic TRA and experienced RAS during the procedure, and 42 age and sex matched controls who did not experience RAS were prospectively included into the study. The groups were compared regarding serum adropin levels and inflammatory markers. Results: Although adropin levels were found to be lower in the RAS group, this difference was not statistically significant between the the patients with RAS and controls (14.9 vs. 16.1,P=0.105). However, inflammatory parameters monocyte count and MHR (monocyte/HDLcholesterol ratio) were found to be statistically significantly higher in the RAS group compared to controls (P=0.001 and P=0.010, respectively). Moreover, a significant positive correlation was found between the monocyte count and RAS (r:0.360, P

Introduction: Cardiovascular disease (CVD) is the leading cause of death in type 2 diabetes mellitus (DM). DM is a substantial risk factor in atherosclerotic cardiovascular disease. We aimed to investigate relationship between the presence of established neutrophil to lymphocyte ratio (NLR) and coronary artery disease (CAD) in DM. Methods: 104 diabetic patients who had coronary lesion with a diameter stenosis of at least 50% and 64 diabetic patients who had normal coronary anatomy matched with age and sex were retrospectively selected and classified CAD (+) and CAD (-) group respectively. Baseline NLR in two groups was compared. Results: NLR was higher in CAD (+) group compared to group without CAD (-) (2.69±1.74 vs. 1.98±.85, p

Abstract Background: Ventricular premature contractions (VPCs) may trigger lethal ventricular arrhythmias in patients with structural heart disease. However, this role of VPCs in healthy people remains controversial once that not enough clinical trials are available. Recently, some myocardial repolarization markers, such as Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios, have been reported to be useful for predicting lethal ventricular arrhythmias in various clinical disorders without structural heart disease. Objective: In this study, we aimed to investigate the relation between VPC frequent and myocardial repolarization markers in individuals without structural heart disease. Methods: This study included 100 patients who had complaints of dizziness and palpitations. Twelve-lead electrocardiography and 24-hour ambulatory Holter recordings were obtained from all patients. VPC burden was calculated as the total number of VPCs divided by the number of all QRS complexes in the total recording time. P-values < 0.05 were considered significant. Results: Tp-e interval and Tp-e/QTc ratio were significantly higher in patients with higher VPC burden than in patients with lower VPC burden, and a positive correlation was found between these markers and VPC burden. Tp-e (β = 1.318, p = 0.043) and Tp-e/QTc (β = -405.136, p = 0.024) in the lead V5 were identified as independent predictors of increased VPC burden. Conclusions: Tp-e interval and Tp-e/QTc ratio increased in patients with high VPC number. Our study showed that VPCs may have a negative effect on myocardial repolarization. This interaction may lead to an increased risk of malignant arrhythmias.

Myocarditis is defined as myocardial edema associated with non-ischemic necrosis in myocardial tissue. Acute viral myocarditis may cause several electrocardiographic changes. These include conduction disturbances, disorders of repolarization, ventricular ectopic beats, and ventricular tachycardia. “Torsade de pointes” is a malignant ventricular arrhythmia associated with prolongation of the QT interval. In this report, we present a case with myocarditis that developed Torsade de pointes and sudden cardiac arrest.

Objective: Although early repolarization pattern (ERP) has been recognized as a benign variant, in recent studies have shown that it is associated with life-threatening arrhythmias. There are different studies demonstrated that there is a strong relationship between life-threatening arrhythmias and the severity of coronary artery disease (CAD). In this study, we aimed to determine whether Gensini score (GS) values were higher in patients with ERP compared to patients without ERP.Materials and Methods: Totally 110 patients with ERP and 90 control subjects were enrolled to the study. GS was calculated for each patient. p values lt; 0.05 were considered significant.Results: GS was significantly higher in the ERP patients compared with the control group (19.5±20.2 vs 2.15±4.1; p lt;0.001). There was significant correlation between GS and age (r=0.507, p lt;0.001). GS was an independent predictor of ERP in multivariate logistic regression analysis (OR=0.655, 95% CI=0.557-0.769, p lt;0.001). In addition to, age and low-density lipoprotein cholesterol were independent predictors associated with GS in linear regression analysis (OR=0.370, 95% CI=0.085-0.655, p=0.011 and OR= -0.094, 95% CI= (-0.176-0.013), p=0.024, respectively). Conclusions: An increase in the severity of CAD may be shown as a mechanism that leads to the emergence of ERP.

Amaç: Ayak bileği-kol basınç indeksi (AKİ), noninvaziv ve ucuz bir metod olup yaşlı popülasyonda periferik arter hastalığının (PAH) tanımlanması için kullanılır. PAH’nın bir göstergesi olarak AKİ, koroner arter hastalığını (KAH) tahmin etmek için yaygın bir şekilde kullanılmaktadır. Eritrosit dağılım genişliği (EDG) dolaşımdaki eritrositlerin boyutlarındaki değişkenliğin bir ölçüsüdür. EDG’deki artışlar hem kararlı hem de kararsız haldeki KAH ile ilişkilidir. Bu çalışmada, kararlı anjina pektoris (KAP) hastalarında EDG ve AKİ belirteçlerinin SYNTAX skoru (SS) kullanılarak koroner lezyon şiddeti üzerine prediktif bilgi sağlayıp sağlayamayacağını araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya 109 KAP hastası dahil edildi. Hastalar önce 40 hasta normal koroner arterler ve 69 hasta KAH grubuna ayrılarak değerlendirildi. Sonrasında KAH hasta grubu, KAH şiddetini anjiyografik olarak derecelendiren SS’na göre iki ayrı alt gruba (SS 1-22 (n=32) ve SS gt;22 (n=37) ayrılarak incelendi. p lt;0.05 anlamlı kabul edildi. Bulgular: Çok değişkenli regresyon analizi EDG ve AKİ’nin KAH varlığının bağımsız birer prediktörü olduğunu gösterdi (sırasıyla; OR: 6,209, p= 0,001 ve OR: -2,342, p lt;0,001). Fakat aynı analiz AKİ’nin KAH şiddetini öngörmede EDG’den daha iyi olduğunu gösterdi (sırasıyla; OR: 1,568, p= 0,215 ve OR: -1,540, p lt;0,001). Sonuçlar: Koroner arter hastalığı varlığında EDG’nin anlamlı derecede arttığı, AKİ’nin anlamlı derecede azaldığı görülmüştür. KAH varlığını öngörmede EDG ve AKİ’nin kullanışlı birer değişken olduğu tespit edilmiştir. AKİ, KAH’ın şiddetini tahmin etmede EDG'den daha güçlü bir öngördürücüdür.

Coronary artery perforation (CAP) is a rare, but potentially mortal possible complication of percutaneous coronary intervention. There are several treatment options for this complication, including prolonged balloon dilatation, use of a coronary stent graft, and bypass surgery. In this case report, a 65-year-old female patient who was admitted to the catheter laboratory with a diagnosis of acute coronary syndrome, was presented. Coronary angiography revealed total occlusion in the mid segment of the right coronary artery and a drug-eluting stent was implanted under 12 atm of pressure following pre-dilatation with a perfusion balloon. In order to perform defragmentation of the thrombus shifted into the proximal stent segment, post-dilatation was performed with a stent balloon (4–6 atm). After post-dilatation, an Ellis Class II perforation developed. In order to control the bleeding, a coronary stent graft was implanted at the perforation area. The rupture was sealed. Control coronary angiography 40 days later indicated that the stent graft was patent, but an arteriovenous fistula (AVF) draining to the right ventricle was detected. To the best of our knowledge, this is the first case of AVF seen as a late complication of CAP treated with a stent graft.

Objective: Present study is an evaluation of left atrial (LA) mechanical and conduction function in patients with bicuspid aortic valve (BAV) without significant valve dysfunction, and an investigation of relationship between LA function and aortic elasticity. Methods: Study population consisted of 34 isolated BAV patients (mean age: 34+-13 years) and 29 healthy, age- and sex-matched volunteers (mean age: 30+-10 years). LA volume was measured using biplane area-length method and LA active and passive emptying volume and fraction was calculated. Intra- and interatrial atrial conduction time (ACT) was measured with tissue Doppler imaging. Aortic elasticity parameters were calculated including aortic strain, aortic stiffness index, aortic distensibility, and aortic elastic modulus. Results: LA diameter, LA maximum volume, LA volume before atrial systole, and LA active emptying fraction were significantly higher in patients with BAV (33.2+-3.2 mm vs 34.9+-2.8 mm, p=0.030; 16.2+-4.6 mL/m2 vs 19.8+-4.8 mL/m2, p=0.004; 10.2+-3.7 mL/m2 vs 12.1+-4.9 mL/m2, p=0.029; and 30.4+-12.0% vs 39.9+-11.8%, p=0.003, respectively). ACT was similar between groups. Aortic distensibility was significantly lower and aortic stiffness index and aortic elastic modulus were significantly higher in patients with BAV (8.1+-4.6 [10-6cm2dyn-1] vs 5.1+-3.6 [10-6cm2dyn-1], p=0.006; 4.1+-2.8 vs 7.3+-4.9, p=0.003; 3.6+-2.8 [dyn.cm-2106] vs 5.9+-3.9 [dyn.cm-2106], p=0.010, respectively). In correlation analysis, LA active emptying fraction was significantly correlated with aortic stiffness index and mitral A- velocity (r=0.431, p

Background: Family history of premature atherosclerosis imposes a high risk to people. The relationship between atherosclerosis and gene polymorphisms of various biomarkers such as Endothelial Nitric Oxide Synthase (eNOS), C-Reactive Protein (CRP), and Interleukin-6 (IL-6) has shown in previous studies. Aims: The major aim of the study was to evaluate the CRP, eNOS, and IL-6 gene polymorphisms in a group of adolescents who have a parental history of early coronary artery disease (CAD). Study Design: Case-control study. Methods: Thirty-six volunteers with a father with obstructive CAD during the first four decades and 46 subjects with a father with normal coronary arteries documented with coronary angiography were included in the study. Polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze CRP, eNOS, and IL-6 polymorphisms. Results: We did not find any differences between the two groups with regard to age, sex, body mass index, renal functions, systolic and diastolic blood pressures, lipid profile, and fasting glucose, hemoglobin, and high sensitivity CRP. A significant difference was only observed in IL-6-572 G/C genotype distribution and allele frequency between two groups (Pc=0.036 OR=3.48 CI (95%) 1.17-10.32). Conclusion: The present study showed a significant association between the IL-6-572 G/C gene polymorphism (presence of C allele) and adolescents with a parental history of premature CAD.

Objectives: Diastolic dysfunction occurs as a result of interstitial fibrosis in hypertensive patients. Fragmented QRS (fQRS) on ECG signifies myocardial fibrosis in various clinical situations. We investigated whether fQRS on ECG is related to diastolic dysfunction in patients with hypertension. Study design: The study population included 72 hypertensive patients with normal coronary angiogram. Fragmented QRS was defined as the presence of an additional R wave (R'), notching of the R or S wave or fragmentation in two contiguous leads corresponding to a major coronary artery. Echocardiography was performed to all patients to detect diastolic dysfunction. Diastolic dysfunction was regarded as non-severe if patients had normal diastolic function or grade 1 diastolic dysfunction or severe if they had grade ≥2 diastolic dysfunction. Results: Thirty-two patients had fQRS on ECGs (fQRS [+] group) and there were 40 patients who did not have fQRS on their ECGs (fQRS [-] group). The two groups were similar in terms of baseline characteristics. In patients with fQRS on the ECG, severe diastolic dysfunction was more prevalent (59.4% vs. 7.5%, p

Objective: Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that inreased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with rheumatoid arthritis (RA), and to assess the relation with inflammation. Study design: Ninety-six patients with RA and and 50 controls were included. From the 12-lead electrocardiogram Tp-e interval and Tp-e/QT ratio were measured. Blood samples were taken for erythrocyte sedimentation rate (ESR) and plasma levels of C-reactive protein (CRP). These parameters were compared between groups. The relationship between ventricular repolarization and inflammation was assessed by Pearson correlation coefficients. Results: Tp-e interval and Tp-e/QT ratio were increased in RA patients compared to the controls (72.6+-8.2 vs 66.4+-8.5 milliseconds, 0.20 +- 0.02 vs 0.18 +- 0.02; P

Objectives: Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) is associated with lower rates of procedural success and higher complication rates compared with PCIs in non-CTO lesions. The purpose of this study was to analyze the relationship between lesion characteristics and procedural success rates and in-hospital outcomes after PCI for CTO with novel equipment. Study design: We evaluated the prospectively entered data of 63 consecutive patients undergoing PCI for CTO at our institute between August 2009 and June 2012. Results: A total of 63 patients (mean age: 64+-11, 71% male) with one CTO lesion each underwent PCI. There were 46 patients (mean age: 63+-10, 70% male) in the CTO success group and 17 patients (mean age: 65+-13, 76.5% male) in the CTO failure group. Successful revascularization was achieved in 73% of patients. We used antegrade approach in 61 cases and retrograde approach in 2 cases. Our predominant strategy was single-wire technique, which was used in 54 cases (85.7%), followed by parallel-wire technique in 7 cases (11.1%). Moderate-to-severe tortuosity (odds ratio [OR]: 9.732, 95% confidence interval [CI]: 1.783- 53.115, p=0.009) and occlusion duration (OR: 1.536, 95% CI: 1.178-2.001, p=0.002) were independent predictors of procedural failure in the multivariate analysis. No in-hospital major cardiac events occurred. Conclusion: We have reported a study with a relatively high success rate of PCI with very low procedural and in-hospital complications. Moderate-to-severe tortuosity was observed as the most challenging problem despite the utilisation of novel equipment and techniques for CTO recanalization.

Longed QT syndromes are cardiac repolarization disorders characterized by longed QT intervals on ECG. This electrophysiological abnormality may lead to syncope or sudden cardiac death due to rapid, polymorphic ventricular tachycardia (VT). Licorice root (Glycyrrhizin glabra root) contains Glycyrrhizin, sterols and many flavones. Glycyrrhizin may have effects on cardiac repolarization and depolarization through the autonomic nervous system. We present a case of polymorphic VT (torsades de pointes) secondary to drinking 5-6 glasses of licorice root tea for constipation for 2 days prior to admission to emergency department. Licorice root consumption should be taken into account in all patients admitted to the hospital for cardiac arrhythmia. It may cause cardiac arrhythmia when consumed regularly and in excessive amounts.