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Objective: Cardiac resynchronization therapy (CRT) is a reliable treatment modality in patients with systolic dysfunction. However, not every patient appears to benefit from CRT. The systemic immune inflammation index (SII) is closely linked to the poor prognosis of various cardiovascular disorders. However, there is no study investigating whether SII has predictive value in determining response to CRT in dilated cardiomyopathy patients. Therefore, we intend to investigate the association between SII and response to CRT. Methods: A total of 220 patients (mean age 61.2±10.8 years; 120 men) implanted with CRT were involved in this study. Echocardiographic and laboratory measurements were evaluated prior to CRT. Response to CRT was determined as a≥ 15% decrease in left ventricular end-systolic volume at one-year follow-up. Results: Patients grouped as CRT responders and non-responders. Of these, 143 (64.6%) were considered to be CRT responders, while the remaining 77 (33.4%) were non-responders. Female sex (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS duration (OR: 1.224, CI: 1.158-1.335 p

The association between hypertensive retinopathy and left atrial (LA) impairment is unknown. Accordingly, it was aimed to investigate the possible relationship between hypertensive retinopathy and LA phasic functions by means of two-dimensional speckle-tracking echocardiography (2D-STE).A total of 124 hypertensive patients and 27 control subjects were included in the study. LA reservoir strain (LAHypertensive patients (with and without retinopathy) displayed an obvious reduction in the LA reservoir strain (LAImpaired LA reservoir and conduit strain may be used to predict hypertensive patients at higher risk of developing hypertensive retinopathy, and to determine which patients should be followed more closely for hypertensive retinopathy.

Objective: Electrocardiographic alterations were investigated following the second dosage of COVID-19 mRNA vaccination. Methods: A total of 260 individuals after two doses of COVID-19 vaccine with Pfizer-BioNTech were included in the study. The electrocardiographic parameters recorded at baseline and approximately one week later after two doses of Pfizer-BioNTech vaccine were compared for all patients. Results: PR interval was increased and QTc maximum interval was decreased significantly after second dose COVID-19 mRNA vaccination. Baseline and post-second dose vaccination states regarding P wave dispersion and QT dispersion/Tp-e interval which have been recognized to imply inhomogeneous atrial conduction and heterogeneity in ventricular repolarization were similar between groups. Conclusion: Our findings suggest that there should be no concern related to asymptomatic involvement of the myocardium subsequent the second dose of COVID-19 mRNA vaccination., Amaç: Bu çalışmanın amacı, ikinci doz COVID-19 mRNA aşılamasından sonra elektrokardiyografik değişi-klikleri değerlendirmektir. Yöntem: Çalışmaya Pfizer-BioNTech ile iki doz COVID-19 aşısı yapılan toplam 260 hasta dahil edildi. Başlangıçta ve iki doz Pfizer-BioNTech aşısından yaklaşık 1 hafta sonra kaydedilen elektrokardiyo-grafik parametreler tüm hastalar için karşılaştırıldı. Bulgular: İkinci doz COVID-19 mRNA aşılamasından sonra PR aralığı arttı ve QTc maksimum aralığı önemli ölçüde azaldı. Sırasıyla ventriküler repolarizasyonda homojen olmayan atriyal iletimi ve heterojenliği yansıttığı varsayılan P dalgası dispersiyonu ve QT dispersiyonu/Tp-e aralığı ile ilgili olarak başlangıç ve ikinci doz aşılama durumları arasında anlamlı bir fark yoktu. Sonuç: Bulgularımız, ikinci doz COVID-19 mRNA aşılamasından sonra miyokardın asemptomatik tutulumu ile ilgili herhangi bir endişe olmaması gerektiğini düşündürmektedir.

Parallel to the aging of the world population, the complexity of patients with cardiac problems has increased, especially in intensive cardiology care units, and the importance of multidisciplinary care has become more evident. The aim of this study was to analyze the clinical characteristics and gender-related differences of patients hospitalized in a large intensive cardiology care unit.This single-center, retrospective, cross-sectional study includes all hospitalizations in a large intensive cardiology care unit between January 2016 and March 2021. All data were obtained using data collection software and transferred to MEDULLA, Turkey's general database system.Of the 55 737 consecutive patients included in the analysis, 16342 (29%) were women. The mean age of males was 59.71 ± 12 years, and the mean age of females was 63.3 ± 14 years (P.001). Over a period of 5 years, the most common reason for hospitalization in the intensive cardiac care unit was acute coronary syndrome. The number of acute coronary syndrome patients who underwent coronary angiography was found to be 17 478 (31%), of which 12 878 were males and 26.3% were female. The number of patients who underwent at least 1 stent implantation was 13 952 (80% of coronary angiography procedures), and 2960 (21%) were women. The second cause of hospitalization in the intensive cardiology care unit was arrhythmias (5654 patients [10%]) followed by advanced heart failure (932 patients [1.7%]). During follow-up in the intensive cardiology care unit, the percentage of development of multiorgan failure was found to be approximately 18%. The mortality rate was 7% in women, which was higher than in men (4%). While the most common cause of death was acute coronary syndrome, the highest rate of death was found in patients with advanced heart failure. Among the patients who died, the mean age of females was higher than that of males, and the length of hospital stay was longer.Although numerically the highest death rate was observed in male acute coronary syndrome patients, the highest mortality rate was found in patients with advanced heart failure. Due to the elderly population and the increase in the number of patients requiring multidisciplinary treatment, the development of multiorgan failure in intensive cardiology care units seems to be one of the most important causes of death. Although the number of females hospitalized in the intensive cardiology care unit is lower than that of males, the mean age and mortality rate were found to be higher than males.

Atrial arrhythmias are well-known complications of atrial septal defect (ASD), and associated with substantial morbidity. After ASD closure, right atrial and ventricular enlargement regresses, however, the risk of atrial arrhythmia development continues. In this study, we aimed to investigate the relationship between the Crochetage sign, which is a possible reflection of heterogeneous ventricular depolarization due to long-term hemodynamic overload, and the development of late atrial arrhythmia after ASD closure.This retrospective study included a total of 314 patients (mean age: 39.5 (30-50) years; male: 115) who underwent percutaneous device closure for secundum ASD. The study population was divided into two groups according to the presence or absence of the Crochetage sign. The Crochetage sign was defined as an M-shaped or bifid pattern notch on the R wave in one or more inferior limb leads. Cox-regression analysis was performed to determine independent predictors of late atrial arrhythmia development.Fifty-seven patients (18.1%) presented with late atrial arrhythmia. Of these 57 patients, 30 developed new-onset atrial fibrillation/atrial flutter (AF/AFL), and 27 patients with pre-procedure paroxysmal AF/AFL had a recurrence of AF/AFL during follow-up. History of paroxysmal AF/AFL before the procedure (HR: 4.78; 95% CI 2,52-9.05; p0.001), the presence of Crochetage sign (HR: 3.90; 95% CI 2.05-7.76; p0.001), and older age at the time of ASD closure (HR: 1.03; 95% CI 1.01-1.06; p = 0.002) were found as independent predictors for late atrial arrhythmia.The presence of Crochetage sign may be used to predict the risk of late atrial arrhythmia development after transcatheter ASD closure.

IntroductionAcute pulmonary embolism (APE) is an emergent cardiothoracic disorder. The PESI score is used to estimate 30-day mortality in patients diagnosed with non-high-risk APE. Also, there are biomarkers for predicting prognosis and mortality in APE. Catestatin (CST) is accepted as a marker ofsympathetic nervous system activity which has been shown that the sympathetic nervous system activation can contribute pathogenesis in APE. So, we attempt herein to investigate the correlation of PE diagnosis and prognostic determination with plasma CST levels in PE patients.Material and methodsBlood samples were drawn at admission for laboratory assays and CST measurements. Plasma levels of CST were measured by ELISA according to the manufacturer’s instruction. Transthoracic echocardiography was performed for the assessment of RV dysfunction using a Toshiba Applio 500 echocardiographic system within 24 h of the admission.ResultsPlasma CST levels were higher in patients with APE than in the control group (17.5 ±6.1 ng/ml vs. 27.3 ±5.7 ng/ml, p < 0.001). Plasma CST levels were higher in the sPESI ≥ 1 (n = 72) than in the patients with sPESI < 1 (37.3 ±6.1 vs. 24.2 ±5.3 ng/ml, p < 0.001). There was a positive correlation between CST level and sPESI score (±0.581, p < 0.001). Mortality occurred in 20 patients with sPESI ≥ 1 (27.7%) and in 9 patients with sPESI < 1 (10.2%) (p = 0.010). Receiver operating characteristic (ROC) curve analysis using a cut-off level of 31.2 ng/ml, and the CST level predicted mortality with a sensitivity of 100% and specificity of 52.6% (AUC = 0.883, 95% CI: 0.689–0.921). Furthermore, the CST level was correlated with right ventricular dysfunction.ConclusionsCST can predict sPESI score and mortality in patients with 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.

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.

Ventricular arrhythmias (VAs) continue even after left ventricular assist device (LVAD) implantation. The effect of LVAD on VAs is controversial. We investigated electrophysiologic changes after LVAD and its effects on VAs development. A total of 107 implantable cardioverter-defibrillator (ICD) patients, with LVAD, were included in this study. Electrocardiographic parameters including QRS duration (between the beginning of the QRS complex and the end of the S wave), QT duration (between the first deflection of the QRS complex and the end of the T wave) corrected QT (QTc), QTc dispersion, fragmented QRS (F-QRS), and ICD recordings before, and post-LVAD first year were analyzed. All sustained VAs were classified as polymorphic ventricular tachycardia (PVT) or monomorphic VT (MVT). The QRS, QT, QTc durations, and QTc dispersion had decreased significantly after LVAD implantation (p0.001 for all). Also MVT increased significantly from 28.9% to 49.5% (p = 0.019) whereas PVT decreased from 27.1% to 4.67% (p = 0.04) compared to pre-LVAD period. A strong correlation was found between QT shortening and the decrease in PVT occurrence. Besides, the increase in the F-QRS after LVAD was associated with post-LVAD de nova MVT development. Finally, F-QRS before LVAD was found as an independent predictor of post-LVAD late VAs in multivariate analysis. Pre-existing or newly developed F-QRS was associated with post-LVAD late VAs, and it may be used to determine the risk of VAs after LVAD implantation.

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

The new coronavirus disease (COVID-19) has spread rapidly all over the world and caused anxiety disorders. Recent studies have also shown that the prevalence of depression and anxiety increased during the COVID-19 outbreak. We aimed to evaluate the anxiety and depression levels during the pandemic and identify the effect of pandemic-related stress on blood pressure (BP) control in primary hypertensive patients.A total of 142 patients with primary hypertension (HT) who continued to use the same antihypertensive drugs before and during the pandemic were included in the study. Twenty-four -hour Ambulatory Blood Pressure Monitoring (ABPM) and the Hospital Anxiety and Depression Scale (HADS) questionnaire were applied to patients. We retrospectively reviewed 24-h ABPM records of the same patients for the year before the pandemic.Daytime, nighttime and 24 -hour-systolic blood pressure (SBP) levels as well as daytime, nighttime, and 24- hour-diastolic blood pressure (DBP) levels , were significantly elevated during the COVID-19 outbreak compared to the pre-pandemic period (p0.001). Higher HADS-A scores (HADS-A ≥7) were significantly associated with much greater increase in BP compared to the patients with lower HADS-A scores.Psychological stress due to the COVID-19 outbreak led to worsening of the regulation of BP in controlled hypertensive patients whose antihypertensive treatments did not change.Yeni koronavirüs hastalığı (COVID-19) tüm dünyada hızlı bir şekilde yayılarak anksiyete bozukluğuna sebep olmuştur. Yakın zamanlı çalışmalar, COVID-19 salgını sırasında depresyon ve anksiyete prevalansında artış olduğunu göstermiştir. Biz bu çalışmamızda primer hipertansif hastalarda, pandemi sırasında anksiyete ve depresyon düzeylerini değerlendirmeyi ve pandemiye bağlı stresin kan basıncı kontrolü üzerindeki etkisini belirlemeyi amaçladık.Pandemi öncesinde ve sırasında aynı antihipertansif ilaçları kullanmaya devam eden toplam 142 primer hipertansiyon hastası çalışmaya dahil edildi. Bu hastalara 24 saatlik Ambulatuar Kan Basıncı Monitorizasyonu (AKBM) yapıldı ve Hastane Anksiyete ve Depresyon Ölçeği (HADS) anketi uygulandı. Pandemiden önceki son 1 yıl için aynı hastaların 24 saatlik AKBM kayıtlarını geriye dönük olarak incelendi.Gündüz, gece ve 24 saat sistolik kan basıncı ile gündüz, gece ve 24 saat diyastolik kan basıncı, COVID-19 salgını sırasında pandemi öncesi döneme kıyasla önemli ölçüde yükseldi (p0.001). Daha yüksek HADS-A skorları (HADS-A 7), daha düşük HADS-A skoruna sahip hastalara kıyasla kan basıncında çok daha fazla artışla anlamlı şekilde ilişkilendirildi.COVID-19 salgınına bağlı psikolojik stres, antihipertansif tedavileri değişmeyen kontrollü hipertansif hastalarda kan basıncı regülasyonun bozulmasına sebep olmuştur.

BACKGROUND AND AIM OF THE STUDY Chronic severe aortic regurgitation (AR) is associated with progressive accumulation of interstitial fibrosis and disruption of myocardial structure. After aortic valve replacement (AVR), the negative remodeling process reverses, and left ventricular ejection fraction (LVEF) improves but not in all patients. In this study, we aimed to investigate the association of fragmented QRS (F-QRS), which is a possible marker of myocardial fibrosis, with postoperative left ventricular (LV) systolic dysfunction. METHODS A total of 147 consecutive patients with AVR were included in this study. F-QRS was identified by the presence of various RSR' patterns (QRS duration

The simple right ventricular contraction pressure index (sRVCPI) is a new echocardiographic variable for estimating the right ventricular systolic function. Our aim was to investigate the association between the sRVCPI, the pulmonary embolism severity index (PESI), and mortality rate in acute pulmonary embolism (APE).We included in this study 116 patients diagnosed with APE by pulmonary computed tomography angiography or ventilation/perfusion scintigraphy. They were divided into two groups based on the simplified PESIor1. Tricuspid regurgitation velocity and TAPSE were measured and used for sRVCPI calculation.Mortality was higher in patients with a higher sRVCPI (P .001). In receiver operating characteristic (ROC) curve analysis using a cut-off level of 312.8 mm Hg mm, sRVCPI predicted mortality with a sensitivity of 86.8% and specificity of 69.5% (ROC area under curve: 0.712; 95%CI 0.597-0.882; P .001). The sRVCPI was lower in the sPESI1 than in the sPESI1 group (364.3 ± 31.9 vs 511.6 ± 26.1; P .001). There was an inverse correlation between sRVCPI and the sPESI score (-0.784; P .001).The sRVCPI correlated with the sPESI score and was associated with mortality in patients with APE. This easily measurable variable may be used to predict short-term mortality in APE patients.

Background Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by the progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. Several studies have suggested that speckle tracking echocardiographic (STE) parameters such as strain (S) and strain rate (SR) may prove useful in the early detection of right ventricular (RV) dysfunction. Therefore, the aim of this study was to evaluate RV myocardial function using the STE method in both asymptomatic and symptomatic patients with ARVD and to assess its potential role in the differential diagnosis of these two presentations. Methods We recruited 34 patients with ARVD. Seventeen patients were symptomatic, and seventeen were asymptomatic. Results The RV free wall global longitudinal S and SR were significantly lower in symptomatic patients with ARVD than in asymptomatic patients. According to a cutoff value of 1.35 per seconds for RV global SR, the sensitivity and specificity for predicting ARVD were 88% and 77%, respectively. According to a cutoff value of 17.3% for RV S, the sensitivity and specificity for predicting ARVD were 82% and 77%, respectively. Conclusion In conclusion, we present strong evidence that STE-derived global S and SR in the RV free wall are decreased in symptomatic patients with ARVD compared with asymptomatic patients.

Introduction: The aim of this study was to investigate an easily available inflammatory marker and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in patients with cardiac syndrome X (CSX). Patients and Methods: The study population included 100 patients of which 50 had CSX (CSX group) and 50 had normal coronary angiograms (control group). Results: Total white blood cell (WBC) count, monocyte count, neutrophil count, NLR, high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP) and MHR were higher in the CSX group (p< 0.05), whereas high-density lipoprotein cholesterol (HDL-C) level was significantly lower in the CSX group as compared with that in the control group (p< 0.05). In the correlation analysis, MHR revealed a significantly positive correlation with hs-CRP (r= 0.375, p< 0.001) and CRP (r= 0.403, p< 0.001). In the multivariate logistic regression analysis, MHR was independently associated with the presence of CSX (odds ratio: 1.250, 95% confidence interval [CI]: 1.240-1.461, p< 0.001). Using a cut-off level of 90.6, pre-procedural MHR predicted the presence of slow coronary flow (SCF) with a sensitivity of 78% and specificity of 70%. Conclusion: In conclusion, our findings revealed that higher MHR levels were significantly and independently associated with the presence of CSX.

Introduction: P wave axis is one of the most practical clinical tool for evaluation of cardiovascular disease. The aim of our study was to evaluate the P wave axis in electrocardiogram (ECG), left atrial function and association between the disease activity score in patients with systemic lupus erythematosus (SLE). Methods: Standard 12-lead surface ECGs were recorded by at a paper speed of 25 m/s and an amplifier gain of 10 mm/mV. The heart rate (HR), the duration of PR, QRS, QTd (dispersion), the axis of P wave were measured by ECG machine automatically. Results: The P wave axis was significantly increased in patients with SLE (49 ± 20 vs. 40 ± 18, P = 0.037) and the disease activity score was found positively correlated with P wave axis (r: 0.382, P = 0.011). The LA volume and the peak systolic strain of the left atrium (LA) were statistically different between the groups (P = 0.024 and P = 0.000). The parameters of the diastolic function; E/A and E/e’ were better in the control group than the patients with SLE (1.1 ± 0.3 vs. 1.3 ± 0.3, P = 0.041 and 6.6 ± 2.8 vs. 5.4 ± 1.4, P = 0.036, respectively). Conclusion: P wave axis was found significantly increased in patients with SLE and positively correlated with SELENA-SLEDAI score. As the risk score increases in patients with SLE, P wave axis changes which may predict the risk of all-cause and cardiovascular mortality.

Objective: Myocardial involvement in systemic lupus erythematosus (SLE) has great importance. The aim of this study is to evaluate the rotation and twisting mechanics of the left ventricle (LV) in patients with SLE. Methods: Forty-three patients fulfilled at least four of the American College of Rheumatology criteria for SLE and 30 individuals as controls were included in the study. SLE disease activity was assessed using the SELENA–SLEDAI score. Echocardiography was performed for all subjects. The patients fulfilled at least four of the American College of Rheumatology criteria for SLE were enrolled in the study. SLE disease activity was assessed using the SELENA-SLEDAI score. Echocardiography was performed for all individuals. Comparisons between groups were made using independent samples t-test with the standard statistical software (SPSS, version 15.0; SPSS Inc., Chicago, IL, USA). Each image was digitally stored for offline analysis. Measurement of global strain assessed by 17-segment model and rotational parameters were performed. LV ejection fraction was calculated by the biplane Simpson's method. Comparisons between groups were made using the independent samples t-test with the standard statistical software. A p value of 0.05 was considered statistically significant. Results: The values of mean global longitudinal strain, basal global circumferential strain (GCS), mean basal radial strain, and apical GCS were significantly lower in SLE patients. The difference between basal rotation, apical rotation, twist of the LV, and torsion of the LV in the SLE patients and controls were not significant (8.8±5.5 vs. 10.6±5.8, p=0.183;-4.7±3.0 vs. -4.8±3.2, p=0.947; 11.7±6.4 vs. 13.2±6.4, p=0.366; and 1.8±0.8 vs. 1.9±2.3, p=0.725, respectively). Although there was not any significant relationship between SELENA–SLEDAI score and myocardial strain analyses of the LV, the basal rotation and the torsion of the LV were lower in patients with SLE having a SLEDAI score of ≥17 (p=0.024 for basal rotation and p=0.032 for torsion). Conclusion: The number of segmental and global strain analyses were decreased in SLE patients with globally normal LVEF. The twist and torsion mechanics of the LV were preserved according to the control group, and the left ventricular torsion and basal rotation were found to be significantly decreased in those with an activity score of ≥17.

Filiz Izci,1 Hilal Hocagil,2 Servet Izci,3 Vedat Izci,4 Merve Iris Koc,5 Rezzan Deniz Acar3 1Department of Psychiatry, Istanbul Bilim University, Sisli Florence Nightingale Hospital; 2Department of Emergency, Faculty of Medicine Hospital Zonguldak Bulent Ecevit University, Zonguldak, Turkey; 3Department of Cardiology, KosuyoluHigh Specialization Training andResearch Hospital, Istanbul, Turkey; 4Department of Emergency, Kartal Training and Research Hospital, Istanbul, Turkey; 5Department ofPsychiatry, Erenköy Training andResearch Hospital for Psychiatry, Istanbul, Turkey Objective: The aim of this study was to investigate QT dispersion (QTd), which is the noninvasive marker of ventricular arrhythmia and sudden cardiac death, and P-wave dispersion, which is the noninvasive marker of atrial arrhythmia, in patients with conversion disorder (CD).Patients and methods: A total of 60 patients with no known organic disease who were admitted to outpatient emergency clinic and were diagnosed with CD after psychiatric consultation were included in this study along with 60 healthy control subjects. Beck Anxiety Inventory and Beck Depression Scale were administered to patients and 12-lead electrocardiogram measurements were obtained. Pd and QTd were calculated by a single blinded cardiologist.Results: There was no statistically significant difference in terms of age, sex, education level, socioeconomic status, weight, height, and body mass index between CD patients and controls. Beck Anxiety Inventory scores (25.2±10.8 and 3.8±3.2, respectively, P

Objective: Bicuspid aortic valve (BAV) is a complex developmental anomaly caused by abnormal aortic leaflet formation during valvulogenesis. The present study is an assessment of the effects of BAV disease on the ascending aorta and pulmonary artery (PA), and an evaluation of the consequences for systolic and diastolic functioning of the left and right ventricles. Methods: Total of 66 patients were eligible for inclusion. Pulmonary artery maximum diameter (PAD) was obtained 1 cm distal to the pulmonary annulus. Using pulsed-wave tissue Doppler imaging, left ventricular (LV) early diastolic velocity (E′) measurement was obtained at the annulus with placement of sample volume. Right ventricle (RV) peak global strain rate during systole (RV-SRS), early diastole (RV-SRE), and late diastole (RV-SRA) were calculated. Results: In this study, 40.9% (n=27) of patients were female and average age was 35±11years. RV-SRS values (β=-.781, t=-2.723; p=0.010) and log-LV tissue Doppler imaging E’ (β=2.996, t=-5.405; p=

Objectives: Aim of the present study was to investigate correlation between left atrial (LA) deformation parameters assessed using 2-dimensional (2D) speckle tracking echocardiography (STE) and complexity of coronary artery disease according to SYNTAX score (SXscore) in patients with stable coronary artery disease (SCAD). Study design: Total of 60 moderate-risk SCAD patients (40 men, 20 women) who underwent coronary angiography and 30 healthy controls were included. Measurements of conventional echocardiographic parameters as well as peak LA strain during ventricular systole (LA-RES), peak LA strain during atrial systole (LA-PUMP), peak LA strain rate during ventricular systole (LA-SRS), peak LA strain rate during early diastole (LA-SRE), and peak LA strain rate during atrial systole (LA-SRA) were obtained. Results: Patients were categorized into 2 groups: low SXscore of

Variant form of angina was first described by Prinzmetal as transient and recurrent coronary spasm leading to recurrent episodes of myocardial ischemia1. Although so many factors can trigger or aggravate coronary vasospasm; endothelial dysfunction was considered as an important mechanism underlying this situation. The location and extent of vasospasm determine the seriousness of the clinical picture, which can include myocardial infarction severe arrhythmias, cardiogenic shock and even death2.

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.

WOS: 000384427500009, PubMed ID: 27004711, Objective: The awareness, time in therapeutic range (TTR), and safety of warfarin therapy were investigated in the adult Turkish population. Methods: This multicenter prospective study includes 4987 patients using warfarin and involved regular international normalized ratio (INR) monitoring between January 1, 2014 and December 31, 2014. TTR was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of warfarin's affect and food-drug interactions. esults: The mean TTR of patients was 49.52 +/- 22.93%. The patients with hypertension (55.3%), coronary artery disease (23.2%), congestive heart failure (24.5%), or smoking habit (20.8%) had significantly lower TTR levels than the others. Of the total number of patients, 42.6% had a mechanical valve, 38.4% had non-valvular atrial fibrillation (AF), and 19% had other indications for warfarin. Patients with other indications had lower TTR levels than those with mechanical valve and non-valvular AF (p=0.018). Warfarin awareness decreased in higher age groups. The knowledge of warfarin's food-drug interactions was 55%. People with higher warfarin awareness had higher TTR levels. Patients with = 8 INR monitoring/year. In this study, 20.1% of the patients had a bleeding event (major bleeding 15.8%, minor bleeding 84.2%) within a year. Conclusion: Both the mean TTR ratios and awareness of the Turkish population on warfarin therapy were found to be low. It was thought that low TTR levels of the Turkish population may be caused by the low awareness of warfarin, warfarin's food-drug interactions, and high rates of concomitant diseases.

BACKGROUND: Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. 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 increased Tp‐e interval and Tp‐e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12‐lead surface electrocardiogram (including Tp‐e interval, Tp‐e/QT, and Tp‐e/QTc ratio) in asymptomatic ARVD patients METHODS: We selected 27 patients with asymptomatic ARVD and 27 age‐ and gender‐match young, healthy volunteers. RESULTS: Tp‐e interval, Tp‐e/QT and Tp‐e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp‐e, Tp‐e/QT, Tp‐e/QTc ration (r = −0.57, P = 0.02; r = −0.85, P = 0.02; r = −0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp‐e, Tp‐e/QT, Tp‐e/QTc ration (r = −0.61, P < 0.01; r = −0.67, P < 0.01; r = −0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp‐e, Tp‐e/QT, and Tp‐e/QTc (r = − 0.64, P < 0.001, r = − 0.75, P < 0.01; r = −0,69, P < 0.01; respectively) CONCLUSION: In conclusion, we have presented strong evidence suggesting that Tp‐e interval, Tp‐e/QT ratio, and Tp‐e/QTc ratio were increased in asymptomatic ARVD patients.

Single coronary artery is a coincidental finding during coronary angiography or at autopsy. Although it is a rare condition and most of time has an asymptomatic clinic; prognosis varies. We would like to report a case about percutaneous coronary intervention in a patient who has anomalous single coronary artery arising from right sinus valsalva.

Background Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. 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 increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12-lead surface electrocardiogram (including Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio) in asymptomatic ARVD patients Methods We selected 27 patients with asymptomatic ARVD and 27 age- and gender-match young, healthy volunteers. Results Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = −0.57, P = 0.02; r = −0.85, P = 0.02; r = −0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp-e, Tp-e/QT, Tp-e/QTc ration (r = −0.61, P < 0.01; r = −0.67, P < 0.01; r = −0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp-e, Tp-e/QT, and Tp-e/QTc (r = − 0.64, P < 0.001, r = − 0.75, P < 0.01; r = −0,69, P < 0.01; respectively) Conclusion In conclusion, we have presented strong evidence suggesting that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in asymptomatic ARVD patients.

Endocardial cushion defect (ECD) can be partial (with two distinct valves) or complete (only one atrioventricular valve), and surgical therapy is usually required. The optimal surgical technique is controversial but De Vega’s annuloplasty is widely performed. Tricuspid valve thrombosis are rarely seen after surgery. We present a 39-year-old male patient with tricuspid valve thrombosis after De Vega’s annuloplasty without the use of a ring.

Amitryiptiline which is a member of tricyclic antidepressant(TCA) drug group can cause electrocardiographic (ECG)changes like prolongation of QRS and QTc interval, increment of R/S ratio on derivation AVR besides of arrythmias such as supraventricular tachycardia(SVT) and ventricular tachycardia(VT) on overdose. In this paper;we present a case about the treatment of QRS interval prolongation caused by intentional use of high dose amitryiptiline with intravenous lipid emulsion(ILE) infusion.