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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]

Byline: Yusuf. Sener, Metin. Ok?ul, Vedat. Hekimsoy Sir, We have read with interest the article about the assessment of risk factors for new-onset atrial fibrillation (AF) after cardiac surgery, by [...]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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 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.

Objective: In recent years, percutaneous closure of a patent foramen ovale (PFO) has gained widespread use. This study is an evaluation of the safety and efficacy of the Figulla and Amplatzer devices for PFO closure, including long-term follow-up results., Methods: A total of 305 patients (43.6% male; mean age: 43.25±10.98 years) who underwent percutaneous PFO closure between 2003 and 2019 were enrolled. The Risk of Paradoxical Embolism (RoPE) score was calculated to predict the recurrence risk of cerebrovascular events due to PFO. Transthoracic echocardiography was used during the procedure., Results: The devices were successfully implanted in all patients. The in-hospital periprocedural complications recorded were atrial fibrillation in 1 patient (0.3%), supraventricular tachycardia in 1 patient (0.3%), and femoral hematoma in 3 patients (1%). The procedure time and fluoroscopy time was 21.92±2.93 minutes and 2.19±0.24 minutes, respectively. Recurrent ischemic stroke or transient ischemic attack (TIA) was observed in 7 (2.2%) patients during the median 85.77 months (25th-75th percentile: 10.21-108.00 months) follow-up. The RoPE score was significantly lower in patients with recurrent ischemic cerebral event (stroke or TIA) compared with asymptomatic patients (p<0.001). Kaplan-Meier curve analysis revealed that there was no significant difference between PFO device types (Amplatzer: 2.4% vs. Figulla: 3.3%) in terms of recurrent ischemic cerebral events during follow-up (log-rank; p=0.642)., Conclusion: Percutaneous PFO closure was safe, feasible, and effective. Our study confirmed the efficacy and safety of transthoracic echocardiogram guidance during percutaneous closure of PFO, which shortens the procedure time. A lower RoPE score was related to the recurrence risk of ischemic cerebrovascular events.

Aims: Pulmonary vein isolation (PVI) alone in persistent atrial fibrillation (AF) is not as successful as in paroxysmal AF, and recent data indicate the key role of non-PV triggers. We aimed to assess the long-term safety and efficacy of left atrial appendage isolation (LAAi) as an adjunct to PVI using cryoballoon (CB) in persistent AF., Methods and Results: We compared 144 persistent AF patients (59 ± 10 years, 51% females) who underwent PVI combined with LAAi with a propensity-score matched cohort of 138 persistent AF patients (59 ± 6 years, 52% female) in whom PVI-only was performed. Baseline and follow-up data including electrocardiography (ECG), 24-h Holter ECG's, and echocardiography were recorded for all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (≥30 s) after a 3-month blanking period. At a mean of 30.5 ± 5.6 months follow-up, 85 (61.6%) patients in the PVI-only group and 109 (75.7%) patients in the PVI+LAAi group were free of ATa after the index procedure (P = 0.008). Ischaemic stroke/transient ischaemic attack was detected in 4 (2.9%) patients in PVI-only group and in 5 (3.5%) patients in the PVI+LAAi group (P = 0.784). Cox regression analysis revealed that the PVI-only strategy was found as a significant predictor for recurrence (hazard ratio 3.01, 95% confidence interval 1.81-5.03; P < 0.001)., Conclusions: Our findings indicated that CB-based LAAi+PVI was associated with a favourable efficacy compared to PVI-only strategy in patients with persistent AF. Although ischaemic event rates were similar between the groups, rigorous adherence to anticoagulation regime is paramount in order to prevent thrombo-embolic complications., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)