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This study aimed to assess the effect of aromatherapy administered before coronary angiography on anxiety levels and physiological parameters. Material and method: The study used a randomized controlled trial design. The study group consisted of a total of 96 individuals. The research data were collected using the descriptive information form, the State-Trait Anxiety Inventory (STAI), and the Physiological Parameters Assessment Form. Results: The results of this study indicated a significant difference between the groups in terms of pain levels and mean STAI-I scores prior to coronary angiography. Conclusion: The results revealed that aromatherapy administered before angiography reduced the anxiety and pain levels of patients.

© 2022, The Author(s), under exclusive licence to Springer Nature B.V.Purpose: The objective of this study was to investigate subclinical left ventricular dysfunction in patients diagnosed with myocardial infarction with non-occlusive coronary arteries (MINOCA). Methods: Thirty-five patients with MINOCA (average age 54.26 ± 12.24 years) and thirty-five patients with ischemia with non-obstructed coronary artery disease (INOCA) (average age 55.20 ± 8.36 years) were enrolled in the study. All clinical conditions that could affect left ventricular functions were considered exclusion criteria. Echocardiographic studies were conducted in the patient and control groups in the left lateral decubitus position using a medical ultrasound device (EPIQ 7, Philips Medical System, USA). The left ventricle was examined longitudinally with apical images of chamber 4-3-2 using the available software (QLAB 6.0). Results: There were no differences in age, blood pressure level, baseline echocardiogram measurements, and tissue Doppler parameters between the two groups. In two-dimensional speckle tracking echocardiography (2D-STE) measurements, left ventricular longitudinal strain and strain rate in systole, early and late diastole from apical 4-3-2 chamber and global measurements of each parameter were significantly decreased in the MINOCA group compared to the INOCA group (p < 0.05). A significant negative correlation was observed between the global longitudinal strain rate and the troponin I in the MINOCA patients group (r=-0.43 p = 0.009). Conclusions: Our study showed that while standard echocardiographic parameters for patients diagnosed with MINOCA were normal, their left ventricular systolic and diastolic functions were reduced by the 2D-STE method.

The association between insulin resistance (IR) and heart rate recovery index (HRRI) has been reported previously, but the cardiovascular disease (CVD) risk profile of the subjects was unclear in these studies. Therefore, we evaluated the association between IR and HRRI in apparently healthy individuals without metabolic syndrome who had a low-to-moderate CVD risk profile. A total of 182 eligible subjects were retrospectively included in the study. The subjects were divided into two groups according to the homeostasis model assessment of IR (HOMA-IR) value. HOMA-IR ≥2.5 was defined as IR (+) group (92 subjects), and

Background: The COVID 19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. Cardiac complications secondary to this infection are common and associated with mortality. This study aimed to evaluate whether subclinical myocardial dysfunction using left ventricular global longitudinal strain (LVGLS) in non-hospitalized mildly symptomatic COVID-19 patients.Methods: In this cross-sectional, single-center study, data were collected from non-hospitalized mildly symptomatic COVID-19 patients between January 01 and February 01, 2021. Fifty (26 male, 24 female) COVID-19 patients and 50 age- and sex-matched healthy volunteers have included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions.Results: The mean age of the COVID-19 patients was 39.55±8.96, 52% of them were male. The most prevalent presenting symptoms were fever (in 34 (68%)), asthenia (in 30 (60%)), loss of appetite (in 21 (42%)), myalgia (in 20 (40%)), and cough (in 13 (26%)). Plasma levels of C-reactive protein (CRP) were significantly higher in the COVID-19 patients than in the controls (10.84±12.44 vs. 4.50±2.81, p < 0.001). There was no significant difference between the groups in terms of standard echocardiography and Doppler parameters (p>0.05). Left ventricular longitudinal strain and strain velocity parameters were significantly decreased in COVID-19 patients compared to healthy individuals. LV-GLS values (-21,72 ± 3,85% vs. -23,11 ± 4,16%; P =0,003) were significantly lower in COVID-19 patients when compared with the healthy controls.Conclusion: Mildly symptomatic COVID-19 patients also have subclinical myocardial dysfunction similar to hospitalized patients. STE has the potential for detecting subclinical LV systolic dysfunction and can provide useful information on the risk stratification in the mildly symptomatic COVID-19 population.

Objective: In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey. Methods: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT). Results: After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median TIT was 195 (115-330) min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI. Conclusion: The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment., Turkish Society of Cardiology from AstraZeneca, Statistical analyses were conducted by Omega CRO, Ankara, Turkey. The electronic case report form and the data capture program (OpenClinica LLC and collaborators, Waltham, MA, USA) hosted were by Omega CRO, Ankara, Turkey. TURKMI registries are investigator-initiated trials and sponsored by the Turkish Society of Cardiology, which received major, unrestricted funding from AstraZeneca for this project. The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Aktaş, Halil ( Aksaray, Yazar ), Objective: Several studies have investigated different cardiac biomarkers as predictors of the prognosis after percutaneous coronary interventions (PCI) in patients with chronic ischemic heart disease; nevertheless, the results of these studies are conflicting. High sensitive troponin T (Hs-TnT) measurement is a novel and sensitive method. The aim of this study was to investigate if Hs-TnT levels are a predictor of major adverse cardiovascular events (MACE) in the first year after a successful elective PCI in patients with stable angina pectoris (SAP). Material and methods: 100 patients who presented with SAP and underwent successfully elective PCI were included in the study. Patients with elevated troponin I levels (>0.1 ng/mL) before the procedure excluded from the study. Hs-TnT levels were measured before the procedure and at 3-4 hours (h) (early period) and 12-24 hours (late period) after the procedure and Hs-TnT level >14 pg/mL was considered positive. The incidence of MACE during the first year was recorded. Results: Hs-TnT levels were positive in 36% of the patients in the early period and in 54% of the patients in the late period. The incidence rate of MACE for the first year was significantly higher in the patients with positive Hs-TnT levels in the early period but not the late period (36.1% vs. 15.6%; p = 0.026) and logistic regression analysis yielded an odds ratio of 3.36. Conclusion: Hs-TnT levels measured 3-4 h after a successful elective PCI in patients with SAP can predict the incidence of MACE within the first year. Nonetheless, these results must be corroborated by other larger studies.

Background: Heart failure (HF) is a clinical syndrome characterized with a wide spectrum of left ventricular (LV) structural and functional abnormalities. LV ejection fraction (EF) is considered important with respect to classifying HF patients because of differing patient demographics and prognosis; as well as the response to HF therapies. We aimed to investigate the clinical characteristics, demographics, in-hospital management and in-hospital outcome of HF patients with mid-range EF (HFmrEF) in comparison with those with HF patients with reduced EF (HFrEF) or HF patients with preserved EF (HFpEF) in a large acute HF (AHF) cohort. Materials-Methods and Results: The Journey HF-TR study is a multicenter, and observational registry. One thousand six hundred and six patients who were diagnosed with AHF were enrolled in this study. The mean age was 67.8 ± 13.0 years and 57.2% of the study population was male. Patients were classified as HFrEF (n = 1028, 64%), HFmrEF (n = 305, 19%), and HFpEF (n = 273, 17%) according to LVEF. HFmrEF patients were elder than HFrEF patients but younger than HFpEF patients and the female proportion was the highest in HFpEF group followed by HFmrEF and HFrEF groups (P < 0.001 and P = 0.03, respectively). The prevalence of coronary artery disease was 56.7% in HFmrEF patients. It was lower than HFrEF patients (65.2%) and higher than HFpEF patients (41.4%) (P < 0.001). The prescription of evidence-based HF drugs (Renin-Angiotensin-System blocker, beta-blocker, mineralocorticoid receptor antagonist) was similar in HFrEF and HFmrEF patients and higher than HFpEF patients. The in-hospital mortality rate was the lowest in patients with HFmrEF (1.8%, 7.3%, and 7.5%, respectively for HFmrEF, HFrEF, and HFpEF patients) (P < 0.001). Conclusion: Patients with HFmrEF has unique clinical, echocardiographic, hemodynamic, and biomarker features compared with HFrEF and HFpEF. However, patients with HFmrEF seem to be more similar to HFrEF, in terms of etiology and use of guideline recommended medical therapy.

*Gül, Murat ( Aksaray, Yazar ), The objective of our study was to investigate the possible relationship between poor perinatal outcome and foetal cardiac functions in pregnant women with reduced foetal movements (RFM). This cross-sectional study included 126 pregnant women with normal foetal movements (Group 1, Controls) and 42 pregnant women over 32 weeks gestation with RFM (Group 2). Group 2 was further divided into two subgroups according to their perinatal outcome: normal perinatal outcome (Group 2a) and poor perinatal outcome (Group 2b). Cardiotocography, the E/A ratio in both atrioventricular valves, myocardial performance index (MPI) and foetal tricuspid annular plane systolic excursion (f-TAPSE) were evaluated. Foetuses with poor perinatal outcome had a higher MPI (p =.003), higher tricuspid and mitral E/A (p

Cetin, Mustafa/0000-0001-6342-436X; duman, hakan/0000-0002-1441-7320 WOS: 000472793500006 PubMed: 31360181 Introduction: Psoriasis vulgaris is a chronic, multisystem disease that results in the development of atrial fibrillation (AF) over time. in this study, our goal was to assess predictors of AF in patients with psoriasis, including total atrial conduction time (TACT) and left atrial global longitudinal strain (LAGLS). Material and methods: A total of 80 individuals, including 40 psoriasis patients and 40 healthy controls, were enrolled in the study. A physical examination was performed, biochemical parameters were studied, and Holter electrocardiography was carried out. Conventional echocardiography, atrial tissue Doppler, and speckle tracking echocardiography were recorded. Results: No significant difference was observed between psoriasis patients and healthy controls with regard to age, and the average duration of psoriasis was 5.7 years. High-sensitivity C reactive protein levels were higher in the patient group compared to the control group (respectively, group 1: 1 +/- 0.8; group 2: 0.6 +/- 0.3, p < 0.05). Atrial arrhythmia was not detected in the Holter ECG monitoring. A significant moderate negative correlation between TACT and LAGLS (r = -0.57, p < 0.05) was observed, and there was a significant moderate positive correlation between the duration of disease and TACT (r = 0.52, p < 0.05). Conclusions: in the current study, we determined that LAGLS decreased, TACT was prolonged, and P-wave dispersion increased in patients with psoriasis. the current results may improve predictions of AF risk in psoriasis patients in clinical practice.

BACKGROUND: Atrial fibrillation (AF) prevalence in patients with acute myocardial infarction (MI) ranges from 3% to 25%. However demographic, clinical, and angiographic characteristics of AF patients who admitted with de novo MI are unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. METHODS: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to presenting cardiac rhythm. RESULTS: A total of 1793 patients were screened and 1626 were included in the study. The mean age was 61.5 (12.5) years. 70.7% of patients were men. The prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p

*Gül, Murat ( Aksaray, Yazar ), Objective To evaluate the mid-term effects of ivabradine on right ventricular functions in patients with heart failure. Methods A prospective study was conducted on 52 patients who had heart failure in normal sinus rhythm (59% male, age: 64.76 +/- 12.49 years). Right ventricular functions were measured at baseline, after one month and one year by conventional and tissue Doppler echocardiography imaging. The parameters, right ventricular (RV) longitudinal strain (LS), RV systolic longitudinal strain rate (LSRs), RV early diastolic longitudinal strain rate, and late diastolic longitudinal strain rate, were evaluated by apical four-chamber grayscale imaging through the free wall of RV in accordance with the automated function imaging protocol. Results During the follow-up, the pulmonary artery systolic pressure (PASP), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI), E peak, and A peak values were similar to the basal values. While comparing the basal values of the global longitudinal systolic strain (GLS), LS, LSRs, longitudinal strain rate diastolic early filling (LSRe), and longitudinal strain rate diastolic late tilling (LSRa), there were no differences in the first month but a significant increase was observed on one-year follow-up (p

*Gül, Murat ( Aksaray, Yazar ) *İnci, Sinan ( Aksaray, Yazar ), Arterial stiffness has been identified as a powerful and independent risk factor for cardiovascular disease. Obesity is associated with an increased risk of aortic stiffness (AS) and adverse cardiovascular events. Herein, we aimed to evaluate the effects of weight loss after laparoscopic sleeve gastrectomy (LSG) on AS in individuals with morbid obesity by using the transthoracic echocardiography (TTE). A total of 53 patients with obesity (17 males, 36 females) who underwent LSG and did not have any known heart disease were included in the study. The AS parameters were measured with TTE. The demographic and echocardiographic data of the patients were studied before, at 1 month and 12 months after surgery. The mean age of the study group was 34.41±11.62, 68% of whom were female. There were no significant differences in terms of the standard echocardiography and Doppler measurements as compared with preoperative values (all p>0.05). When the elastic parameters of the aorta were compared, no significant differences were detected regarding aortic strain (%) ((16.28±4.11) vs (16.68±4.56), p=(0.998)), distensibility (cm2/dyn) ((6.74±1.78) vs (7.03±2.31), p=(0.997)) and Aortic Stiffness Index values ((10.73±3.84) vs (10.63±3.34), p=0.998) between baseline and first month after surgery. In the 12-month follow-up, it was determined that the aortic strain ((16.28±4.11) vs (22.74±5.79), p≤0.001) and distensibility ((6.74±1.78) vs (10.34±3.059), p

Incidentalni echokardiograficke nalezy u asymptomatických pacientů mohou při rozhodovani v klinicke praxi představovat problem. Regurgitace mitralni chlopně je castou srdecni vadou a hlavni přicinou rozvoje městnaveho srdecniho selhani a umrti. Přes řadu možnosti lecby se v připadě vhodných anatomických poměrů dava přednost plastice mitralni chlopně. Transapikalni metoda plastiky mitralni chlopně s implantaci umělých slasinek představuje novou a minimalně invazivni metodu pro pacienty s degenerativnim postiženim mitralni chlopně. Je prokazano, že tento výkon je bezpecný, ucinný a ma vynikajici dlouhodobe výsledky. I když se tato metoda při plastice srdecni chlopně použiva casto, v připadě mitralni chlopně se tento výkon provadi vzacně. V tomto clanku popisujeme připad asymptomatickeho pacienta s kombinaci plastiky mitralni a trikuspidalni chlopně s použitim umělých slasinek. © 2021, CKS.

Aim: The prevalence of atrial fibrillation (AF) in patients with myocardial infarction (MI) ranges widely and has been reported to be as high as 21%. However, the demographic, clinical, and angiographic characteristics of AF patients with de novo MI is unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. Methods: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to their presenting cardiac rhythm. Results: A total of 1793 patients were screened and 1626 were included in the study. Mean age was 61.5 (12.5) years. 70.7% of patients were men. Prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p

*Gül, Murat ( Aksaray, Yazar ) *İnci, Sinan ( Aksaray, Yazar ) *Özkan, Namık ( Aksaray, Yazar ), Background Obese patients have an increased risk of arrhythmias and sudden death, even in the absence of structural heart disease and cardiac dysfunction. This study aimed to determine whether weight loss by bariatric surgery has an effect on arrhythmia-related electrocardiographic (ECG) variables in morbidly obese patients. Methods In this prospective study, the data of 48 patients were analyzed. All ECG variables that have the potential to predict ventricular arrhythmia were evaluated before surgery, and were compared with the 1-month and 6-month follow-up results. Results The mean body mass index was 45.74 +/- 5.60 kg/m(2) before surgery. There was a statistically significant decline in body mass index in the first and sixth month after surgery (39.26 +/- 5.00 kg/m(2) and 31.71 +/- 4.49 kg/m(2), respectively; p < 0.001). Furthermore, notable reduction was found in terms of heart rate measurements-QTc-d, JTc, JTc-d, Tp-e, TP-e/QT, TP-e/QTc-in the first month and sixth month compared with baseline (p < 0.001 for all comparisons). Several ECG variables, such as heart rate (r = 0.369, p = 0.001), QTc-d (r = 0.449, p = 0.001), JTc-d (r = 0.324, p = 0.002), Tp-e (r = 0.592, p = 0.001), Tp-e/QTc (r = 0.543, p = 0.001), Tp-e/JTc (r = 0.515, p = 0.001), exhibited a positive and significant correlation with weigh loss. Moreover, a negative and weakly significant correlation was found between the index of cardiac electrophysiological balance (r = -0.239, p = 0.004) and body mass index. Conclusion Substantial weight loss following laparoscopic sleeve gastrectomy in obese patients is accompanied by a significant improvement in ventricular repolarization. Therefore, this effect may lead to a decrease in the incidence of lethal ventricular arrhythmia and sudden cardiac death.

Plicni embolie a infarkt myokardu s elevacemi useku ST jsou castou přicinou akutniho postiženi kardiovaskularniho systemu, ktere může rychle vest ke zhorseni hemodynamiky pacienta. Sedmdesatileta žena byla přivezena na odděleni akutniho přijmu se srdecni zastavou. EKG vysetřeni prokazalo sinusový rytmus s blokadou praveho Tawarova ramenka s elevacemi useku ST v inferolateralnich svodech. Podle koronarogramu byla přicinou neobstrukcni ischemicka choroba srdecni s několika platy. CT angiografie plic prokazala subtotalni uzavěr leve plicni tepny a cetne defekty plněni v obou distalnich segmentech plic. Tato kazuistika upozorňuje na nutnost podezřeni na akutni plicni embolii u každeho pacienta s infarktem myokardu s elevacemi useku ST a nepostiženými koronarnimi tepnami. © 2020, CKS.

Cardiovascular “risk” is an abstract concept that is frequently misunderstood by the general public. However, correct estimation of one’s own cardiovascular risk is important as risk unawareness is associated with noncompliance with interventions aimed to reduce risk burden. Knowing the prevalence and factors linked with an increased probability of risk unawareness are therefore important to develop strategies aimed to increase risk awareness. Aims. To study prevalence of risk unawareness and to understand risk markers associated with risk underestimation and overestimation. Design. A total of 1716 participants were enrolled to the study in 33 centers across Turkey. Relevant demographic and clinical data were collected by direct interview. Cardiovascular risk of the participants was calculated using SCORE risk charts. Results. Ten-year risk for a fatal cardiovascular event was calculated as low in 633 (36.8%), intermediate in 513 (29.9%) and high-very high in 570 (33.2%) participants, respectively. According to these findings, 34.6% (n = 593) of the participants estimated their risk correctly, whereas 22.7% (n = 390) of the participants overestimated and 42.7% (n = 733) of the participants underestimated their risk. Male gender was the sole factor that was associated with an increased risk of underestimation, while having hypertension, significant valve disease or atrial fibrillation was associated with increased odds for risk overestimation. Conclusions. Only one-thirds of the sample was aware of their calculated risk for cardiovascular mortality and risk underestimation was the most common mode of risk unawareness, prompting concerns on the possible impact of the latter on adherence to the strategies aimed to reduce cardiovascular risk. Illustration summarizing study flow and main takeaways. Out of 1716 participants included to the present analysis, only one-third of the participants were aware of their risk. Of those who were unaware of their risk, roughly two-thirds underestimated and one-third overestimated their calculated risk. Several demographic and clinical factors were associated with a higher or lower odds for risk unawareness. See text for details.

WOS: 000451243100006, Indroduction: Listening to music has been used as an intervention during treatment, rehabilitation and also in disease prevention. Coronary angiography is an invasive procedure and is stressful for the patient. This randomized controlled trial assessed the effect of listening to music during the coronary angiography on the level of anxiety and physiological parameters. Methods: This randomized controlled trial consisted of 91 patients in the intervention group and 80 patients in the control group. The intervention group listened to music during their angiography procedure (15-20 min on average). The control group received no music intervention. Results: Study data was collected introductory information form, a physiological parameter evaluation form and State-Trait Anxiety Inventory. The difference between the mean state anxiety scores during the coronary angiography procedure was not statistically significant between the intervention group and the control group (p > 0.05). There was no difference in heart rate, respiratory rate and diastolic blood pressure between the groups (p > 0.05). However, there was a difference in systolic blood pressure (p < 0.05) and pain (p < 0.001) between the groups. Conclusion: Music listening as an intervention for patients undergoing coronary angiography procedures was highly feasible. Although the intervention was not effective in reducing anxiety levels, systolic blood pressure and pain were significantly lower in patients who listened to music., Scientific Research Project Unit of Aksaray University [2017-043], This study (project no 2017-043) was supported by Scientific Research Project Unit of Aksaray University. We thank the patients subjects for their kind participation.

WOS: 000442738200012, PubMed: 30181944, Iatrogenic left main coronary artery dissection is a rare but potentially life-threatening complication of invasive coronary procedures. The newer generation drug eluting stents have shown a greater safety and efficacy compared to first generation drug eluting stents. We report a 60-year-old woman with iatrogenic left main coronary artery dissection who failed bailout stenting and underwent coronary artery bypass grafting. The strategy for managing left main coronary artery dissection is variable and depends upon the mechanism, the comorbidities of the patient and degree of hemodynamic stability. Longitudinal stent deformation is a rarely encountered complication but can be seen in complex lesions such as ostial, bifurcation and left main coronary artery lesions. The interventionists must be aware of this complication.