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Vasospastic angina is a type of angina pectoris, usually associated with transient ST-segment elevation, usually spontaneously or with nitrates. Sometimes we present with chest pain clinic, sometimes with more severe pictures and cardiac arrest. The impact of environmental factors on the triggering of the disease should not be ignored. In most patients, symptoms can be controlled by medical treatment. The main backbone of medical treatment is calcium channel blockers and vasodilator drugs. In this article, we aimed to describe our patient with a resistant coronary osteal spasm.

Aim: Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease that has various adverse effects on cardiac autonomicfunctions. On the other hand, there is no data regarding the effects of cardiac rehabilitation on cardiac autonomic functions in ASpatients. In this study, we aimed to investigate the effects of cardiac rehabilitation on cardiac autonomic nervous system parametersin patients with AS.Materials and Methods: This study was designed as a prospective randomized controlled trial. The study was carried out in December2015 - August 2016. 34 patients who fulfilled the modified New York criteria were enrolled in the study. Patients were randomlyassigned into case and control groups each consisting of 17 patients. The cardiac rehabilitation program was applied to the casegroup for eight weeks. Patient evaluation with clinical assessment, echocardiography, and exercise stress testing was performedbefore and after treatment.Results: A total of 34 patients made the final study population (37.35± 5.22 years, 55.9% male). There were no significant differencesregarding the baseline characteristics between case and control groups. Patients in the case group had better MET levels, exercisetime, resting heart rate, and chronotropic reserve than the control patients following cardiac rehabilitation.Conclusion: Our results indicate that significant improvement in cardiac autonomic functions can be obtained in AS patients whenthe cardiac rehabilitation program is combined with the medical treatment.

The neutrophil to lymphocyte ratio (NLR) predicts cardiovascular events. The aim of this study was to determine whether NLR improved the positive predictive value (PPV) of dobutamine stress echocardiography (DSE) in patients with stable coronary artery disease (CAD). We conducted a retrospective review of laboratory and DSE data from the medical records of 1,012 patients who were divided into two groups according to the presence of ischemia and further subdivided into three groups according to the extent of ischemia (nonischemic segments, 1-3 ischemic segments, or > 3 ischemic segments). NLRs were compared among these groups. NLRs increased in patients with ischemia and correlated with the number of ischemic segments (P < 0.001). The optimal cutoff value of NLR determined using receiver operating characteristic analysis was > 2.04, and the diagnostic value of NLR for discriminating patients with ≥ 50% coronary stenosis in at least one of the coronary arteries from those without significant CAD was high [area under the curve (AUC) = 0.671, standard error = 0.052, P < 0.001, 95% confidence interval (CI) = 0.569-0.773)]. An NLR cutoff value of > 2.04 predicted CAD presence with significant stenosis (62.10% sensitivity and 64.10% specificity). PPV of DSE for a significant coronary artery lesion identified using coronary angiography was 73.8% (95% CI = 75.1-88.5, P < 0.001, AUC = 0.818). On including a cut-off value of > 2.04 for NLR in this multivariable predictive model, the AUC value slightly increased to 0.905 (95% CI = 85.4-95.6) and PPV of DSE increased from 73.8% to 92.6%. NLR improved PPV of DSE for patients with stable CAD.

Background The aim of this study was to examine the Tpeak-Tend (Tpe/corrected Tpe) interval, which is an indicator of transmural myocardial repolarization, measured non-invasively via electrocardiogram in patients with acute pulmonary embolism (PE), and to investigate the relationship with 30-day mortality and morbidity. Methods The study included 272 patients diagnosed with acute PE, comprising 154 females and 118 males, with a mean age of 63.1 ± 16.8 years. Tpe/cTpe intervals were calculated from the electrocardiograms with a computer program after using a ruler or vernier caliper manual measuring tool to obtain highly sensitive measurements. The relationship between the electrocardiogram values and 30-days mortality and morbidity were measured. Results The study group was divided into three groups according to cTpe intervals: Group 1, < 113 ms; Group 2, 113–133 ms; and Group 3, > 133 ms. White blood cell count and troponin T levels, corrected QT intervals with QRS complex durations, percentage of right ventricle dilatation with right/left-ventricular ratio, 30-day death, and combinations of these values were seen at a higher rate in Group 3 patients compared to the other groups. Kaplan–Meier analysis showed that the cTpe interval measured at > 126 ms could be used as a cut-off value in the prediction of mortality and morbidity. The cTpe cut-off values of 126 ms had sensivity, specificity, negative predictive value, and positive predictive value of 80.56 %, 59.32 %, 95.2 %, and 23.2 %, respectively. Conclusions cTpe interval could be a useful method in early risk stratification in patients with acute PE.