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Background/aim: Little is known about the prevalence and causes of pulmonary hypertension (PH) in Behçet's disease (BD). This study was conducted to determine the prevalence and causes of PH in BD. Materials and methods: In this descriptive study, we screened 154 patients with BD for PH using transthoracic echocardiography between February 2017 and October 2017. An estimated systolic pulmonary arterial pressure (sPAP = 40 mmHg) was used as the cutoff value to define PH. Patients with BD were categorized into 5 groups according to organ involvement including mucocutaneous/articular, ocular, vascular, gastrointestinal, and neurologic involvement. Additional laboratory and imaging results were obtained from hospital file records to determine the causes of PH. Results: PH was detected in 17 (11%) patients. Nine (52.9%) of these patients had group II PH (due to left heart disease), 4 (23.5%) had IV PH (due to pulmonary arterial involvement), and 1 had III PH (due to chronic obstructive lung disease). The frequency of PH was higher in BD patients with vascular involvement than those without (52.9% vs 28.5%; p = 0.04). Among 10 patients with pulmonary artery involvement (PAI) 4 (40%) had PH. Although the vascular BD group had the highest rate of PH, we observed no statistically significant difference in the frequency of PH between the predefined BD subgroups. Conclusions: PH is not rare in patients with BD. The majority of BD patients with PH are in group II or IV PH. Patients with vascular involvement carry a higher risk for the development of PH. Monitoring BD patients with PAI should be considered for the development of group IV PH. [ABSTRACT FROM AUTHOR]

The article offers information on Membranous Nephropathy (MN) and cardiovascular events are increased in patients with primary MN and gender, age, statin use and diabetes are the predictive factors of cardiovascular events in this patient group. Topic include associated with solid organ tumours, and tumours can be detected after MN diagnosis in half of the patients.

Amaç: Behçet hastalığı (BH), seyrinde pulmoner arter tutulu-munun (PAI) da görülebildiği sistemik bir vaskiilittir. Bu çalışmanın amacı, BH'larında pulmoner hipertansiyonun (PH) sıklığı ve nedenlerinin saptanmasıdır. Yöntem: Şubat-Ekim 2017 arasında Hacettepe Üniversitesi Romatoloji bölümüne başvuran, "BH uluslararası çalışma grubu kriterlerine" göre BH tanısı almış 154 hasta, transtorasik ekokardiyografi ile değerlendirildi. Hastalar baskın organ tutu-lumlarına göre 5'e ayrıldı: grup 1 mukokütanöz ve artiküler, grup 2 oküler, grup 3 vasküler, grup 4 gastrointestinal, grup 5 nörolojik tutulum. Grup 1 dışında birden fazla organ tutulumu olanlar, gruplandırılırken birden fazla gruba dahil edildi. Sisto-lik pulmoner arter basıncı (sPAB) >40 mmHg olan hastalar BH-PH olarak kabul edildi. PH olan hastalar ise; grup 1 pulmoner arteriyel hipertansiyon (PAH), grup 2 sol kalp hastalıklarına bağlı PH, grup 3 akciğer hastalıklarına bağlı PH, grup 4 kronik tromboembolik PH (KTEPH), grup 5 nedeni belirsiz PH olarak gruplandırıldı. Bulgular: PH olan ve olmayan hastaların demografik ve klinik özellikleri Tablo SS-29'da gösterildi. BH'larının 17 (%11.0)'sin-de PH olduğu görüldü. Vasküler tutulum, PH'ı olan hastalarda olmayanlara göre daha fazlaydı (%52.9 vs. %28.5; p=0.04). Görüntüleme yöntemleriyle 10 hastada PAI olduğu görüldü ve PH olan hastalarda olmayan göre daha sıktı [%23.5 (4/17 hasta) vs. %4.4 (6/137 hasta); p=0.003]. Organ tutulumlarına göre hastalar gruplandırdığında; PH en sık vasküler tutulumu olan hasta grubunda olsa da gruplar arasında istatistiksel anlamlı fark bulunmadı. 9 (%52.9) hasta PH kliniği açısından semptoma tik (NYHAFS >1) idi. En sık PH nedeni; 9 (%52.9) hasta ile sol kalp hastalığıydı (Grup II). Dört (%23.5) hastada grup IV PH vardı ve bunların 3 tanesi (%75) semptomatik idi. Diyastolik disfonksiyon 32 (%20.8) ve sistolik disfonksiyon 1 hastada tespit edildi. BH-PH grubunda, LV diyastolik fonksiyon bozukluğu PH olmayan gruba göre anlamlı olarak fazlaydı, sırasıyla (8 (47.1%) vs 24 (17.6%), p=0.005). Sonuç: Pulmoner hipertansiyon, BH'larında nadir değildir ve en sık nedeni grup II PH'dır. Grup IV PH'da sıklıkla görülebilmektedir. Bizim verilerimiz PH'dan şüphenden tüm BH'lanmngrup II ve IV PH açısından dikkatlice araştırılması gerektiğini göstermektedir. Behçet hastalarındaki sekel arteriyel stenoz ve/veya oklüzyonlar, PH gelişimine KTEPH benzeri katkı sağlıyor olabilir. Endarterektomi bu hastalarda bir tedavi seçeneği olabilir. [ABSTRACT FROM AUTHOR]

The authors discuss a report on the effects of sinus rhythm restoration on the recurrence of cardioembolic events in patients with a history of ischemic stroke/transient ischemic attack. Topics mentioned include the relevance of cancer-related metabolic pathways and anticancer drugs to increased thromboembolic events, interaction of warfarin with several antineoplastic agents, and the importance of appropriate use of anticoagulants for preventing stroke.

The authors comment on a study by Dodgus et al on the relationship between subclinical left ventricular dysfunction and body mass index. They agree that stable coronary artery diseases (SCAD) is an important factor that affects left ventricular global longitudinal strain rate. They note however that subjects in the study were not asked questions about symptoms indicating SCAD to evaluate potential CAD risks. They believe that undiagnosed SCAD might have influenced the results of the study.

Lactate is a product of anaerobic metabolism and increases in states of tissue hypoxia. Furthermore, it is demonstrated that lactate level is correlated with the extent of infarct area and short term (30-day) mortality rates in patients with acute coronary syndrome with ST segment elevation (STE-ACS). Therefore, we aimed to test the prognostic value of this easily obtainable parameter on outcomes in patients presenting with STE-ACS. All adult patients who admitted with STE-ACS between 2019 and 2020 were screened. The cases with admission lactate levels were included. Patients were separated into two groups as low (<2mmol/l) and high (>2mmol/l) lactate groups. A total of 70 patients were enrolled. The mean age of the study population was 62.3 ± 15.0 years and 53 (75.7%) of them were male. The most common infarct related artery was the left anterior descending (LAD) artery. The median lactate level was 2.5 (0.80-15.3) mmol/L. Malignant arrhythmia, contrast induced nephropathy (CIN), and in-hospital mortality rates were not different between the high and low lactate groups. However, all-cause mortality was significantly higher in the high lactate group during the follow-up (p=0.005). Among all included parameters; lactate level [OR:1.76, (CI: 1.28-2.42); p<0.001] and age [OR:1.10, (CI: 1.03-1.17); p=0.004] were predictors for all-cause mortality. Admission lactate level can predict all-cause mortality in patients with STE-ACS. In addition, high admission lactate levels could help to raise more attention even if the patients have been discharged from the hospital. [ABSTRACT FROM AUTHOR]

Background: Empagliflozin is a selective SGLT2 inhibitor and provides a significant reduction in hospitalizations in heart failure patients and a reduction in combined cardiovascular deaths regardless of diabetes. The mechanisms of favorable effects remain unclear. Improvement in left ventricular diastolic function and a decrease in filling pressure are any mechanisms of positive effects. These effects may show themselves with some changes on the electrocardiography (ECG). So, we aimed to evaluate the effect of empagliflozin on P wave parameters in type 2 diabetes mellitus patients without HF. Method: Fifty‐three patients were included in the study. The electrocardiographic and echocardiographic evaluations were examined at the baseline and end of the third month for all patients. Results: The median age of all patients was 55 (45–64 IQR). After treatment, LA volume (p <.001) and diameter (p =.001) in both the parasternal long‐axis (p =.001) and the apical four‐chamber view decreased. E/e′ and systolic pulmonary arterial pressure were significantly decreased after treatment. P wave duration max,min, PWDmin, and PWdis were significantly shorter after treatment. The P wave peak time (PWPT) in lead Dıı and V1 were significantly shorter after treatment. Conclusion: We found shortening of PWPT, PWdis, and PWD as reflections of improvements in left atrial volume and LV diastolic function on ECG after empagliflozin treatment. [ABSTRACT FROM AUTHOR]

We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients. Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters. Median age was 68 (60–76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049–1.083; p <.001), DM (OR: 1.682, 95%CI: 1.238–2.286; p =.001), neutrophil (OR: 1.041, 95%CI: 1.007–1.077; p =.019), creatinine (OR: 1.178, 95%CI: 1.048–1.325; p =.006), CRP (OR: 1.008, 95%CI: 1.006–1.010; p <.001), ACEI (OR: 0.718, 95%CI: 0.521–0.988; p =.042), AST (OR: 1.005, 95%CI: 1.001–1.010; p =.010) were found associated with in-hospital mortality. In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality. [ABSTRACT FROM AUTHOR]

We aimed to present the long-term prognostic role of coronary computed tomography angiography (CTA) in a cohort of patients with coronary artery disease (CAD) and noncritical stenosis. A total of 1138 patients who underwent coronary CTA for suspected CAD were included in the study. For the categorization of the coronary atherosclerotic plaque (CAP), the coronary system was divided into 16 segments. For each segment, CAPs were categorized as calcified, noncalcified, and mixed. All-cause and cardiovascular (CV) mortality data were collected for prognostic evaluation. Coronary CTA analyses showed that 34.5% of patients had noncalcified CAP, 14.5% of patients had calcified CAP, and 11% of patients had mixed CAP. During a median of 141.5 months follow-up, CV and all-cause mortality was observed in 57 (5%) and 149 (13.1%) patients, respectively. In multivariable Cox regression analysis, calcified CAP morphology and the extent of involved segments were significant predictors of both CV and all-cause mortality. The presence of calcified CAP morphology and the higher number of diseased coronary segments via coronary CTA might help stratify patients at risk for adverse CV outcomes during long-term follow-up. Patients with these features at index coronary CTA may be evaluated more closely with aggressive preventive measures. [ABSTRACT FROM AUTHOR]