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Access site-related vascular complications are common complications of trans- catheter aortic valve replacement. In this study, we aimed to investigate the efficacy and safety of prophylactic cannulation of the ipsilateral distal femoral artery in the management of access site-related vascular complications.One hundred sixty-four patients, who were evaluated by the Heart Team of our institution and found eligible for transcatheter aortic valve replacement procedure between January 2016 and August 2019, were included in this retrospective study. Patients were divided into two groups according to the management of peripheral complications. The antegrade crossover was used as bailout treatment in the first 70 patients. Prophylactic cannulation of the ipsilateral distal femoral artery was performed in the last 94 patients. These 2 groups were compared.Peripheral complications developed in 15 of the first 70 patients included in the study. The percutaneous intervention was unsuccessful in 4 of the patients who underwent bailout antegrade crossover. Peripheral complications developed in 14 of the last 94 patients in whom prophylactic cannulation of the ipsilateral distal femoral artery was performed, and all these patients were managed successfully with percutaneous intervention.Prophylactic cannulation of the ipsilateral distal femoral artery is a simple, effec- tive, and safe method in the management of access site-related vascular complications.

Introduction: The aim of the study is to evaluate the quality and reliability of videos on manual blood pressure measurement on YouTube. Patients and Methods: In January 2021, the first 100 videos found as a result of a search with the keywords ‘manual blood pressure measurement’ on YouTube were watched and evaluated. Based on the exclusion criteria, 75 videos were included in the study. Duplicate videos, irrelevant videos, and videos in languages other than English were excluded from the study. Each video was scored according to the questions prepared based on the guidelines. The GQS score and the ‘reliability’ score were used to assess the quality of the videos. Results: According to the checklist prepared based on the hypertension consensus report, the mean score of the videos was 8.33 ± 2.1. When the videos were evaluated according to their sources, the average score of the videos of the health sites was 9 ± 2.5, the average score of the videos of the individual healthcare professionals was 8.66 ± 1.8, the average score of the videos of unidentified individuals was 7.54 ± 2.1. Conclusion: Manual blood pressure measurement videos on YouTube have little educational value. Videos of health websites should be preferred for education.

Background Ectatic infarct-related artery (IRA) has been shown to be associated with higher thrombus burden, no-reflow, stent thrombosis (ST) and major adverse cardiovascular events in patients with ST-elevation myocardial infarction (STEMI). The effect of ectatic non-IRA on ST without ectatic IRA is not known. We aimed to assess the effect of ectatic non-IRA presence on ST within 1 month after primary percutaneous intervention (pPCI) in patients with STEMI. Methods A total of 1541 patients with a diagnosis of STEMI and underwent pPCI between 2015 and 2020 were retrospectively included in the study. Patients with and without 1 month ST were compared. Penalised logistic regression method was used to assess the association between ST and candidate predictors due to the risk of overfitting. Results Median age of the study group was 56.5 (48.7 to 67.2) years. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score, ectatic non-IRA presence and use of tirofiban were significantly higher in the ST group (18.2±9.9 vs 15.1±9.9, p=0.03; 25% vs 7.2%, p Conclusion Ectatic non-IRA presence without ectatic IRA in patients with STEMI increases the risk of ST within the first month of pPCI.

Data regarding the possible role of heparanase (HPA) in the occurrence of left atrial/left atrial appendage (LA/LAA) thrombus in patients with atrial fibrillation (AF) is lacking. The goal of the present study was to assess the association between plasma levels of HPA and LA/LAA thrombus in AF.A total of 687 patients with nonvalvular AF (NVAF) without anticoagulation therapy were included from January 2016 to June 2019. Serum HPA analysis was performed with a commercially available human ELISA kit. Logistic regression models were used to test for association.Serum HPA levels were significantly higher in patients with LA/LAA thrombus than in those without LA/LAA thrombus (270.8 [193.4 ± 353.2] pg/mL vs 150.3 [125.2 ± 208.4] pg/mL; P 0.001). In multivariate analysis, serum HPA remained a significantly independent predictor of LA/LAA thrombus (odds ratio 1.674, 95% confidence interval [CI] 1.339-2.289, P 0.001). In the receiver operating characteristic (ROC) curve analysis, HPA showed a predictive value with an area under the curve (AUC) of 0.757 (95% CI 0.652-0.810, P 0.001). The optimal cutoff level for HPA predicting LA/LAA thrombus was 210.7 pg/mL, with a sensitivity of 74.3% and a specificity of 64.8%.An elevated HPA level was associated with the presence of LA/LAA thrombus in patients with AF. HPA might portend the risk for the prothrombotic state in AF patients.HINTERGRUND: Es fehlen Daten zur möglichen Rolle von Heparanase (HPA) beim Auftreten eines Thrombus linksatrial oder im linken Herzohr (LA/LAA) bei Patienten mit Vorhofflimmern (VF). Ziel der vorliegenden Studie war es, den Zusammenhang zwischen den Plasmaspiegel von HPA und einem LA/LAA-Thrombus bei VF zu untersuchen.Von Januar 2016 bis Juni 2019 wurden in die Studie 687 Patienten mit nichtvalvulärem VF (NVVF) ohne Antikoagulationstherapie einbezogen. Eine Serum-HPA-Analyse erfolgte mit einem kommerziell erhältlichen humanen ELISA-Kit. Logistische Regressionsmodelle wurden zur Prüfung des Zusammenhangs eingesetzt.Die Serum-HPA-Spiegel waren bei Patienten mit LA/LAA-Thrombus signifikant höher als bei Patienten ohne LA/LAA-Thrombus (270,8 [193,4 ± 353,2] pg/ml vs. 150,3 [125,2 ± 208,4] pg/ml; p 0,001). In der multivariaten Analyse blieb die Serum-HPA ein signifikant unabhängiger Prädiktor eines LA/LAA-Thrombus (Odds Ratio 1,674; 95 %-Konfidenzintervall, 95 %-KI: 1,339–2,289; p 0,001). In der Receiver-Operating-Characteristic(ROC)-Kurvenanalyse zeigte sich für HPA ein prädiktiver Wert mit einem Areal unter der Kurve (AUC) von 0,757 (95 %-KI: 0,652–0,810; p 0,001). Der optimale Grenzwert für HPA zur Vorhersage eines LA/LAA-Thrombus betrug 210,7 pg/ml, mit einer Sensitivität von 74,3 % und einer Spezifität von 64,8 %.Ein erhöhter HPA-Spiegel ging mit dem Vorliegen eines LA/LAA-Thrombus bei Patienten mit VF einher. Der HPA-Wert könnte ein Hinweis auf das Risiko eines prothrombotischen Zustands bei VF-Patienten sein.

Introduction: Hypertriglyceridemia is known as an independent risk factor for coronary artery disease (CAD). Fenofibrate that is used for the treatment of hypertriglyceridemia can prevent cardiovascular events in patients with CAD. However, there is little information regarding the vascular effects of fenofibrate on arterial wall stiffness in patients with hypertriglyceridemia and without CAD, diabetes mellitus (DT), and hypertension (HT). The objective of this study is to evaluate the effects of fenofibrate treatment on the arterial stiffness in the patients with pure hypertriglyceridemia. Patients and Methods: We included 37 patients with hypertriglyceridemia without CAD, HT, and DT in this study. We performed pre- and post-treament physical examination of the patients and took their blood samples. Patients were allocated fenofibrate for a duration of 168 ± 14 days for its administration. We assessed arterial stiffness by aortic pulse wave velocity (PWV) using a SphygmoCor device. Importantly, we estimated central arterial pressure waveform parameters by radial artery applanation tonometry and used augmentation index (AIx) as a measure of wave reflections. Results: Fenofibrate treatment resulted in significantly greater reductions in total cholesterol (201.3 ± 61.0 mg/dL vs. 270.0 ± 93.4 mg/dL), triglycerides (261.3 ± 234.3 mg/dL vs. 704.7 ± 338.7 mg/dL), and the C/H levels (5.3 ± 2.6 vs. 7.2 ± 1.9, respectively) as compared with the pretreatment levels (p< 0.001). There was a tendency of high-sensitivity C-reactive protein (hs-CRP) to decline after fenofibrate treatment as change in hs-CRP was significant (0.47 ± 0.41 mg/dL vs. 0.32 ± 0.31 mg/dL respectively, p< 0.01). AIx remained unchanged from the pretreatment levels (24.2% ± 12.4% vs. 22.0% ± 11.4%, respectively, p> 0.05). There was a significant reduction in PWV after fenofibrate treatment (11.3 ± 2.9 m/s vs. 9.2 ± 2.2 m/s, p= 0.001). Conclusion: Fenofibrate treatment appears to effectively improve the arterial wall stiffness in the patients with pure hypertriglyceridemia.

Purpose Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status. Methods We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows. Result A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD. Conclusion HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE.

Background: The early and late term results of who underwent transcatheter aortic valve implantation (TAVI) in our center were evaluated in this study. Patients and Methods: The early and late term results of 48 patients with severe aortic stenosis who underwent the TAVI procedure in our clinic between 2011 and 2013 years were evaluated. All of our patients were implanted with CoreValve bioprosthetic valves through the transfemoral approach and followed-up for 17.4±15.3 months. Results: Before the procedure, the mean aortic valve area (AVA) was 0.7±0.2cm 2 , the mean valvular gradients (MnG) were 55.4±19.8 mmHg and the mean functional class was 2.5±0.4. Following the TAVI procedure the AVA, MnG and functional class were improved, significantly. The technical success rate was %87.5, and mean 1.5±0.5 valves was implanted in all patients. Surgical AVR was required for 1 patient because of severe paravalvular leakage. At the procedure, in 3 patients third degree atrioventricular (AV) block and in 2 patient coronary occlusion were developed. The patients with third degree AV block was required permanent pacemaker. In the early term after TAVI in 3 patients transient ischemic attack and in 2 patients minors hemoragy were developed. 3 patient was dead of cardiac tamponade in the procedure, 1 patient was dead from infections and sepsis postoperative 28th days, 2 patients were dead from cardiac arrest because of complex ventricular arrythmia, 2 patients were dead of noncardiac reasons on the 1st and 4th months, respectively. In this study 3 years survi of TAVI procedure was %75. Conclusion: In the patients with high surgery risk or inoperable aortic stenosis TAVI is a rather safe and successful method in the early and late terms as an alternative therapy to surgery.

Percutaneous closure of atrial septal defects is challenging in cases where the device is perpendicular to the septum during the procedure. Hence, different techniques, maneuvers, and auxiliary equipment may be required. We aimed to demonstrate the effectiveness of the FlexCath steerable catheter application in percutaneous closure of atrial septal defect cases in which the device was perpendicular to the septum.Patients with atrial septal defect who presented to our clinic between January 2017 and December 2020 and were deemed eligible for percutaneous closure were included in the study.Atrial septal defects of 101 patients out of 110 patients were successfully closed using standard methods. Nine patients in whom it was seen if the device was perpendicular to the interatrial septum were successfully closed with FlexCath steerable catheter support. There was no statistically significant difference between patients in terms of age, gender, floopy rim, and multiple defects. In the group that was treated with FlexCath steerable catheter support, the aortic rim was smaller, and the defect diameter and the size of the atrial septal defects device were larger. The success of the procedure was 100% while using the flexcath steerable catheter in patients with the device perpendicular to the interatrial septum. There were no complica tions during the procedure.Percutaneous closure with FlexCath steerable catheter support in difficult cases with atrial septal defects was effective in those with the atrial septal closure device being per pendicular to the interatrial septum and was performed easily without any safety issues.

Several studies have shown that high uric acid (UA) and low serum albumin (SA) values increase the risk of cardiovascular disease and mortality in ST-elevation myocardial infarction (STEMI). We determined whether the uric acid/albumin ratio (UAR) is a predictor of mortality in STEMI patients. All patients who presented at our center with a diagnosis of STEMI and underwent percutaneous intervention from 2015 to 2020 were screened consecutively; 4599 patients were included. A Cox proportional hazards model was used to evaluate UAR, and adjusted predictors obtained from laboratory findings and clinical characteristics contributed to mortality. Also, a regression model was presented with a directed acyclic graph (DAG). The median age of the patients was 58 years (IQR [interquartile range]: 50–67); 3581 patients (77.9%) were male. The incidence of mortality in the entire patient group was 11.9%. Median follow-up duration of all groups was 42 months. Multivariate Cox proportional regression (model-1) analysis showed age (increase 50 to 67 years; HR [hazard ratio]: 1.34, 95% CI 1.18–1.52) and UAR (increase 1.15–1.73; HR: 1.33, 95% CI 1.16–1.52) were associated with mortality. UAR may be a prognostic factor for mortality in STEMI patients and an easily accessible parameter to identify high-risk patients.

INTRODUCTION Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life-threatening. Several risk graduation algorithms may be applied to delineate short-term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow-outflow (RVEIO) index, which is a Doppler-based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. METHODS In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI

IntroductionThe non-O phenotype of the ABO genotype has been linked with an increased risk of cardiovascular disease. Atrioventricular (AV) block (AVB) is defined as retardation or cessation in the route of an electrical impulse passing from the atria to the ventricles because of an anatomical or functional disruption in the conduction system. We aimed to interpret the association between blood group status and high-grade atrioventricular block (HAVB).Material and methodsThis study was implemented as a retrospective review of the recorded data of patients diagnosed with high-grade AV block and a control group. The study population consisted of 640 patients with HAVB and 570 control subjects.ResultsPresence of non-O blood group (p < 0.001) was significantly more prevalent in HAVB patients than in the control subjects. Blood group type was the sole independent predictor of HAVB in multiple regression analysis (p < 0.001, OR = 1.35, 95% CI: 1.08–1.57). Also, third-degree AVB had a higher incidence in the non-O blood subgroup and also non-O blood group was a predictor of third-degree AVB (p < 0.001, OR = 1.39, 95% CI: 1.13–1.69).The incidence of HAVB did not distinguish between the two Rh (D) groups. Rh (D) status did not have an impact on HAVB.ConclusionsThis is the first study that has evaluated the potential relationship between HAVB and ABO blood groups. The main finding of this report is that patients with non-O blood group types have a higher risk for development of HAVB compared with O blood group patients.

Purpose: Stent under-expansion utmost importance for restenosis, also one of the strongest predictors of Stent Thrombosis is stent under-expansion. Thus, it remains uncertain whether Enhanced stent imaging (CLEARstent) guidance improved stent under-expansion.Our aim to assess the using Enhanced stent imaging (ESI) on stent under-expansion, after percutaneous coronary intervention (PCI, with using CLEARstent technology.Methods: This cross-sectional observational based on single center study. The subjects who applied to our cardiology clinic with stable angina or acute coronary syndrome, from March 2020 to September 2020 were recruited. A total of 164 patients who underwent post-PCI clear stent in the study group and age sex matched 77 control patients were included in the study. Post-procedural minimal lumen diameter (MLD) was calculated with quantitative coronary angiography module.Results: Approximately one third of the study population was in X-ray guided PCI group and two third of which was involved in ESI guided PCI group (32% and 68%, respectively, p=0.22). The patients in ESI guided PCI group, median age was 61 (54-69) years and 76.8% (n=126) of whom were male.The patients in ESI guided PCI group have higher minimal lumen area when compared to X-ray guided PCI group (2.88 (2.58-2.99) vs 2.55 (2.34-2.63), pConclusion: Our study addresses that use of ESI system with intend to optimize stent placement results in better procedural outcome expressed by MLD.

PURPOSE Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. MATERIAL AND METHODS Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group. RESULTS The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A' wave velocity, E/E' ratio, and time interval between E and E' waves (P

Objective: Heparanase (HPA), mammalian endo-β-D-glu­cu­ronidase, separates heparan sulfate chains of proteoglycans and changes the structure of the extracellular matrix. We investigated whether serum levels of HPA differ in patients with stable coronary artery disease (SCAD) and subjects with normal coronary arteries. Methods: This study enrolled 92 patients with SCAD and 34 controls with normal coronary arteries. Levels of HPA were measured by a commercially available human HPA enzyme-linked immunosorbent assay kit. Results: Serum HPA levels were significantly lower in the SCAD group (137.5 [104.1–178.9] vs. 198.8 [178.2–244.9] pg/mL; p < 0.001). Serum HPA levels were significantly higher in subjects with diabetes mellitus (DM) compared to those without DM (p = 0.008). Levels of HPA were lower in the SCAD group, both in the diabetic and nondiabetic subgroups, as compared to controls (p < 0.001 for both subgroups). Levels of HPA positively correlated with fasting blood glucose (FBG) (r: 0.42; p < 0.001). In multiple logistic regression analysis, serum HPA level (odds ratio [OR]: 0.975; 95% confidence interval [CI]: 0.966, 0.985; p < 0.001) and FBG (OR: 1.028; 95% CI: 1.010, 1.047; p = 0.002) were independently associated with SCAD. The receiver operating characteristic curve showed that HPA levels less than 160.6 pg/mL predicted SCAD with 65% sensitivity and 97% specificity (AUC: 0.80; 95% CI: 0.728, 0.878; p < 0.001). Conclusion: Diabetes and FBG levels were closely associated with serum levels of HPA. Low serum levels of HPA may predict SCAD in both diabetic and nondiabetic populations.

Introduction: Recentstudies have shown a significant association between left atrial (LA) globallongitudinal strain (GLS) and the progression of atrial fibrillation (AF) withsignificantly decreased LA GLS in patients with paroxysmal AF. Significantlyhigher levels of serum galectin-3 have also been found in patients with non-valvularAF. This study aimed to examine the relationship of the early stage of atrialfibrosis and reduced atrial deformation with serum galectin-3 concentration inmiddle-aged patients with a first episode of non-valvular AF.Patients and Methods:Thisstudy prospectively enrolled 34 patients who were admitted to our emergencydepartment and required either a medical or electrical cardioversion due to thefirst episode of AF, without any structural or coronary heart disease and withnormal LA size. Additionally, 31 control subjects were also enrolled. Thediameter, volume, and mechanical function of LA, including strain (S) andstrain rate (SR), and serum galectin-3 levels were measured.Results: Theaverage age was 48.5 ± 10.4 years. Galectin-3 values were not significantlydifferent between the AF and control groups (r= 0.42; p= 0.51) and were foundto correlate inversely with peak negative SR on apical four chamber (r= −0.31,p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the controlgroup, the AF group had significantly lower values of peak systolic S on fourchamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR onapical four-chamber view (p= 0.04), and peak late negative SR on apical fourchamber (p= 0.03) and two-chamber (p= 0.02) views.Conclusion: Middle-aged patients withthe first episode of AF and normal LA sizes had reduced LA reservoir and activeatrial functions. Although beginning signs of LA functional remodeling wereshown on S and SR imaging, these were not completely reflected by serumgalectin-3 levels., Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)’lu ortayaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresiarasındaki ilişkiyi araştırdık.Hastalar veYöntem: Bu çalışmaya acil servisimize ilk atak AF ile başvuran,medikal ya da elektriki kardiyoversiyon yapılmış, yapısal ya da koroner kalphastalığı olmayan normal LA boyuta sahip 34 hasta ve 31 kontrol hastasıprospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındıve serum galectin düzeyleri ekokardiyografi öncesi alınan kan örneklerindenölçüldü.Bulgular: Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AFve kontrol grubu arasında anlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikaldört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntüden (r= -0.25 , p= 0.04)pik negatif SR ile negatif korele bulundu. Kontrol grubu ilekarşılaştırıldığında, AF grubunda dört boşluk görüntüden pik sistolik strain(p= 0.037), pik geç diastolik strain (p= 0.04), pik positif SR (p= 0.04) ve pikgeç negatif SR apikal dört (p= 0.03) ve iki boşluk (p= 0.02) görüntüdendeğerleri anlamlı olarak daha düşük olarak bulunmuştur.Sonuç: İlk atak AF’li orta yaşlıve normal LA boyutuna sahip hastalarda LA rezervuar ve aktif atriyalfonksiyonlar azalmıştır. Strain ve SR görüntüleme ile gösterilmiş LAfonksiyonel remodeling belirtileri başlamış olmasına rağmen bu durum serumgalectin düzeyleri ile tam olarak gösterilememiştir.

Background: Parameters derived from complete blood count, such as mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have recently been proposed as measures of inflammation in addition to C-reactive protein (CRP), a classical inflammatory marker. Significant association of these parameters with atherosclerosis and complications have increasingly been reported. Aim: The aim of the study is to evaluate the relationship between these parameters and the presence of myocardial viability assessed with positron emission tomography (PET) in patients with ischaemic cardiomyopathy (ICM). Methods: A total of 122 ICM patients who had undergone PET were enrolled in this study. The patients were dichotomised depending on the presence of transmural scar. Group 1 consisted of 21 patients who had transmural scar tissue only, who were accepted as the group having non-viable myocardium. Group 2 consisted of 101 patients who had hibernation and/or non-transmural scar, who were accepted as the group having viable myocardium. Haematological parameters within 30 days of PET imaging were retrospectively analysed. Results: There were no significant differences between the two groups regarding values of white blood cell, neutrophil, lymphocyte, platelet, haemoglobin, red cell distribution width, CRP, PLR, and NLR. Patients with non-viable myocardium have significantly higher levels of MPV (p = 0.002). In multiple logistic regression analysis, MPV (odds ratio [OR] = 0.373, 95% confidence interval [CI] 0.20–0.69, p = 0.002), was identified as an independent predictor of non-viable myocardium. In receiver-operator characteristic (ROC) analysis, a cut-point of 8.19 identified patients with non-viable myocardium (area under curve: 0.72, 95% CI 0.60–0.84). An MPV value greater than 8.19 demonstrated a sensitivity of 76% and a specificity of 55%. \ Conclusions: The present study showed that MPV is an inexpensive, clinical, and routinely measurable parameter that is associated with the presence of viable myocardium in ICM.

Endocan is a recently introduced marker of endothelial dysfunction and is also associated with inflammation and atherosclerosis. To date, the relationship between cardiac syndrome X (CSX) and endocan has not been studied. The objective of this study was to compare the serum endocan levels of patients with CSX with those of control subjects. In this study, 50 patients were included in the CSX group and 28 patients in the control group. Patients with pathological conditions that could potentially influence endothelial functions were excluded. Endocan serum concentrations were measured using an enzyme-linked immunosorbent assay. The mean endocan level of the CSX group was significantly higher than that of the control group (3051.3 ± 1900.5 ng/l vs. 2088.1 ± 522.2 ng/l; p = 0.002). There was no difference between the two groups in terms of age, gender, hypertension, diabetes mellitus, dyslipidemia, and smoking status. In receiver operating characteristic (ROC) curve analysis, endocan levels greater than 2072 ng/l had a 72% sensitivity and 54% specificity (p = 0.002) for accurately predicting a diagnosis of CSX. The results of this study suggest that patients with CSX have higher endocan levels. Therefore, endocan may be valuable in helping uncover the underlying pathogenesis of CSX.

Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF). Method This multicenter, cross‐sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination. Result Overall, the median age was 50 (38–60) and 139 (49.4%) were female. Percentage of median PVC burden was 9% (IQR: 4%–17.4%). Median LVEF was found 60% (55–65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (%) (regression coefficient (RE) −0.644 and 95% CI −1.063, –0.225, p

Objective: Heparanase (HPA) is an endo-β-D-glucuronidase capable of degrading heparin sulphate (HS) and heparin side chains. HPA plays a role in tumour growth, angiogenesis, cell invasion a...

Tam Metin / Full Text A large proportion of road and railway bridges, present in Turkey served for many years, have been completed their service life or will soon. Continuing safety and sustainability of these bridges under traffic loads have been of great increasing importance to roadway and railway transportation line to be continuous servicing. In addition, the demolition and reconstruction of bridges that have reached the end of their service life or are nearing completion will have a negative impact on the country's economy. All of these requirements' detailed examination of bridges in order to provide economical and safe service, considering current vehicle loads and earthquake loads. The Mahmutçavuş Bridge is investigated as a simply supported continuous composite roadway bridge at this work. The finite-element model of the bridge is constituted by site investigation and measurement. Different truckloads using for the design of the bridge are determined, and static analysis of the bridge is conducted. Seven earthquake records are scaled for two different earthquake design spectrums. The nonlinear time-history analyses are conducted, considering Δ-δ effects. The performance of the bridge for varying truckloads and earthquake loads is investigated, and results are discussed in detail

Renal arteriyel emboli apikal anevrizma veya atriyal fibrilasyon zemininde kalp kaynakli distal embolizasyonla meydana gelir. Renal arteriyel embolinin basvuru sekilleri degisiklik gosterebilir. Tani muphem semptomlardan oturu genelde gecikmeli konulur ve dubleks ultrasonografi, kontrast bilgisayarli tomografi, gadolinyumlu manyetik rezonans goruntuleme veya konvansiyonel renal anjiyografi ile konulabilir. Renal tromboembolinin geleneksel tedavisi antikoagulasyon ve acik cerrahi yontemlerdir. Endovaskuler teknolojideki ilerlemelere paralel olarak perkutan intraarteryel tromboliz ve mekanik trombektomi de kullanilmistir. Tromboliz uygulama karari hasta bazinda degerlendirilmeli; trombolizin mutlak ve mutlak olmayan kontraendikasyonlari goz onunde bulundurulmalidir. Distal embolizasyon, arteriyel ruptur, kardiyak problemler ve olum endovaskuler tedavinin komplikasyonlari arasinda yer alir. Biz bu yazida endovaskuler yontemle tedavi edilen bir renal arteriyel emboli olgusunu ele aldik.

Background No gold standard exists for grading tricuspid regurgitation (TR) severity. We developed a simple parameter, the right ventricular (RV) early inflow-outflow (RVEIO) index, using the early diastolic filling velocity and RV outflow velocity integrated over the systolic ejection period. We hypothesized that this index would help identify severe TR in clinical practice. Methods We obtained data from routine transthoracic echocardiograms. All records reporting moderate (n=395) or severe (n=395) TR were reanalyzed to measure vena contracta (VC) width, TR jet area, effective regurgitant orifice (EROA) derived with the proximal isovelocity surface area method, RVEIO index, and right-sided chamber volumes. Results Significant linear trends were demonstrated for right atrial volume index, end-diastolic volume index, E-wave velocity, RV velocity time integral, TR jet area, VC width, and EROA with increasing TR severity. Independent predictors of severe RT included RVEIO index ≥ 10, VC width ≥ 0.7 cm, TR jet area>10 cm2, and EROA ≥ 0.4 cm2. Conclusion RVEIO index is a useful, simple, accurate, and independent predictor of severe TR that adds incrementally to traditional methods of quantifying TR severity. Accurate quantification and classification of TR severity is critical for clinical decision-making and management; therefore, the incorporation of RVEIO index into the integrative approach to grading TR severity should be considered.

Major depression is the most common psychiatric disorder. The diagnosis of depression depends on a patient's subjective complaints, and the nature of the heterogeneous disorder. Thus, there is no known biomarker for depression to date. Previous research has indicated that microRNAs are dysregulated in bipolar disorder and schizophrenia. We aimed to investigate microRNA dysregulation in plasma samples of patients with major depression. Venous blood samples of 50 depressed patients and 41 healthy controls were collected and the quantification of microRNAs was established using qRT-PCR. We found miR-320a significantly downregulated and miR-451a significantly upregulated in depressed patients. We also found miR-17-5p and miR-223-3p upregulated, but not as significantly as miR-451a. Merging our results with previous published data shows that the blood miR-320 family may be a potential microRNA family dysregulated in major depression. Research should be performed on miR-320-related pathways and their relationship to depression. Additionally, miR-451a could serve as a candidate biomarker for depression based on the acting mechanism of ketamine. Studies targeting miR-451a levels before and after treatment could be helpful.

Introduction: Atrial septal defect (ASD) is the most common congenital anomaly in adults. The aim of this study was to assess the operation success of percutaneous closure of ASD and patent foramen ovale (PFO) and the short-term results based on our experience.Patients and Methods: Patients with ASD and PFO in whom percutaneous intervention was performed were evaluated retrospectively. Minor and major complication rates, success rate and short-term outcomes of the procedure were assessed.Results: The overall success rate of the procedure was 96.9%. The minor complication rate was 2.7%. There were no major complication and in-hospital deaths. Left atrium volume and pulmonary artery pressure were decreased significantly after the closure of the septal defects. Two patient in whom percutaneous ASD closure was performed had a residual shunt. One patient developed minimal pericardial effusion and one had mild fever following the procedure.Conclusion: The results of our series confirm that percutaneous closure of septal defects is an effective and safe technique according to the short term results and complication rates when it is performed in selected patients., Giriş: Atriyal septal defekt (ASD), erişkinlerde en sık görülen konjenital kardiyak anomalidir. Bu çalışmanın amacı, kendi deneyimimize dayanarak perkütan yöntemlerle ASD ve patent foramen ovale (PFO) kapatılan hastaların işlem başarısı ve erken dönem sonuçlarını değerlendirmektir.Hastalar ve Yöntem: Perkütan girişim yapılmış ASD ve PFO hastaları retrospektif olarak değerlendirilmiştir. Minör ve majör komplikasyon oranları, işlem başarısı ve erken dönem sonuçları değerlendirilmeye alınmıştır.Bulgular: İşlem başarısı %96,9 olarak değerlendirilmiştir. Minör komplikasyon oranı %2,7 olarak ölçülmüştür. Majör komplikasyon veya hastane içi ölüm görülmemiştir. Septal defektlerin kapatılması sonrası sol atriyum bolümü ve pulmoner arter basıncı anlamlı olarak düşmüştür. Perkütan girişimle ASD kapatılmış olan iki hastada rezidüel şant tespit edilmiştir. Bir hastada minimal perikardiyal efüzyon ve bir hastada da işlem sonrası hafif ateş tespit edilmiştir.Sonuç: Uygun hastalarda septal defektlerin perkütan yolla kapatılması, kısa dönem sonuçları ve komplikasyon oranları değerlendirildiğinde, etkili ve güvenilir bir yöntemdir.

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Background and Objectives Balloon sizing remains the main technique for determining occluder device size for atrial septal defects (ASDs). New evidence has proposed that accurate estimation of device size could be possible without using the balloon technique. Operators have predicted the amount of possible enlargement depending on their experiences. Thus, selection criteria have mostly relied on personal observations and experiences. The objective of this study was to determine the relationship between age, sex, defect size, and deployed device size based on the balloon technique. Subjects and Methods Sixty-six patients who underwent percutaneous ASD closure with a Cardi-O-Fix occluder between 2011 and 2012 were retrospectively evaluated. Patients whose maximum defect size and device size were available were included. Enlargement amount (EA) (device size−defect size) and enlargement ratio (ER) (EA/defect size) were calculated. The relationship between these 2 calculations and age, sex, and defect size were analyzed. Results EA and ER were 5.2±3.6 mm (min: 0, max: 15, median: 5) and 39.3%±31.5% (min: 0, max: 125, median: 32), respectively. EA and ER did not differ between genders (p=0.800; p=0.430). EA and ER were not correlated with maximum defect size (p=0.310; p=0.050). EA and ER showed no correlation with age (p=0.970; p=0.640). However when patients were dichomotized based on age 40, ER was significantly lower in older group (p=0.030). Unexpectedly, no difference was observed between the 2 groups in terms of EA (p=0.110). Size of deployed device had a strong correlation with defect size measured with two-dimensional (2D) transesophageal echocardiography (TEE; device size=1.1177×TEE defect size+3.5297; R=0.84; p

Corrigendum to “Comparison of plasma MicroRNA levels in drug naive, first episode depressed patients and healthy controls” [J. Psychiatr. Res. 69 (2015) 67e71] Mehmet Akif Camkurt a, , Senel Acar , Salih Coskun , Mehmet Gunes , Serkan Gunes , Mehmet Fatih Yilmaz , Aysegul G€ orur , Lulufer Tamer g a Afsin State Hospital, Psychiatry Clinic, Kahramanmaras, Turkey b Mersin University, Teaching Hospital, Psychiatry Department, Mersin, Turkey c Dicle University, Faculty of Medicine, Department of Medical Genetics, Diyarbakir, Turkey d Dicle University, Faculty of Medicine, Psychiatry Department, Diyarbakir, Turkey e Mersin University, Teaching Hospital Child and Adolescent Psychiatry Department, Mersin, Turkey f Kahramanmaras State Hospital, Kahramanmaras, Turkey g Mersin University, Teaching Hospital, Clinical Biochemistry Department, Mersin, Turkey

Sexual dysfunctions such as diminished libido, erectile dysfunction, arousal problems, or delayed orgasm are common side effects of antidepressant medication. However, spontaneous ejaculation is a rare side effect caused by antidepressants. Several case of spontaneous ejaculation have been reported about escitalopram, venlafaxine and reboxetine in the literature. In this paper, a 46-year-old man who developed spontaneous ejaculation with duloxetine is discussed.

Objective: In this study, we aimed to evaluate and compare the anxiety levels of office workers employed in a public health department and see if there was a difference between the 5 days of a week. Methods: A sociodemographic form, the State-Trait Anxiety Inventory (STAI-I and II) and the Beck Anxiety Inventory (BAI) were performed to 50 office workers and 6 managers working only in morning shift in Ardahan Public Health Department in every working day of a week (Monday, Tuesday, Wednesday, Thursday, Friday). Questionnaires were filled during 3 weeks for a better rating. SPSS 17.0 program was used to analyze the collected data. Results: Mean Monday STAI-I score was 39.14, although showing clinically significant anxiety levels, it was not statistically significant. Mean STAI-II score for Monday was 40.84, which is a statistically significant anxiety level. Analyses to determine the differences among days showed significant differences between Monday STAI-II score and the STAI-II scores of Tuesday, Wednesday, and Friday. BAI scores were also different among days and these differences were statistically significant between Monday-Wednesday, Monday-Friday, and Thursday-Friday. Minority of the participants (15-30%) has shown a steadily increasing anxiety level from Monday to Friday. Conclusion: High anxiety levels on Mondays as a psychosocial state affects more than half of the workers. When preparing weekly working schedules, work load should be homogeneously dispersed. On the other hand, we also observed a group that has an increased anxiety level on Friday, this observation needs further researches.