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OBJECTIVE: Endothelium-related events in patients with coronavirus disease 2019 are linked to a poor prognosis. Lipoprotein(a) plays a role in vascular endothelial cell dysfunction. This research aims to investigate whether baseline serum lipoprotein(a) levels could be a predictor for intensive care unit admission and related clinical parameters in coronavirus disease 2019 patients. MATERIAL AND METHODS: The research covers 126 patients who were hospitalized in intensive care unit or the non-intensive care unit in our hospital. This prospective cohort study was conducted from January 2021 to June 2021. The patients who were positive for severe acute respiratory syndrome coronavirus 2 according to real-time polymerase chain reaction test results were included in the study. Two groups were created according to the status of intensive care unit admission. Lipoprotein(a) was studied from blood samples taken at the time of hospital admission. RESULTS: According to the results of the first clinical evaluation, 46 patients were admitted to the intensive care unit and 80 patients were admitted to non-intensive care unit in the hospital. Patients with intensive care unit admission had significantly higher serum lipoprotein(a) levels than patients without intensive care unit admission (40.9 ng/mL and 17.4 ng/mL, P < .001, respectively). The regression analysis revealed that serum lipoprotein(a) levels were independently related to intensive care unit admission (odds ratio 1.242, 95% CI 1.109-1.391, P < .001). In receiver operating characteristic curve analysis, lipoprotein(a) level =31.42 ng/mL had 82.6% sensitivity and 72.5% specificity in predicting intensive care unit admission. The risk of intensive care unit admission was seen to be 12.522-fold higher in cases with lipoprotein(a) level =31.42. CONCLUSION: Lipoprotein(a) could be used as a useful biomarker for the triage of coronavirus disease 2019 patients. Baseline serum lipoprotein(a) levels may serve as a useful prognostic biomarker in patients hospitalized for coronavirus disease 2019. [ABSTRACT FROM AUTHOR]

Objectives: Coronary tortuosity (CT) is a common coronary angiography result and the clinical significance of CT is not clearly understood. In this study, the relationship between the presence of CT with CHA2DS2-VASc score and atrial fibrillation (AF) was analyzed. Materials and Methods: Our study included 511 patients who underwent coronary angiography with evidence of coronary artery ischemia. All patients were assessed for the presence and severity of CT. Three or more bends that caused at least 45° changes in the main body of the coronary artery in both systole and diastole were defined as CT. The study patients were divided into groups according to the presence and severity of CT. Results: CHA2DS2-VASc score was higher in the significant (SCT) group (p=0.001). Increased CHA2DS2-VASc score, regardless of age and female gender, was statistically SCT only for the presence of LAD SCT [p=0.003, adjusted odds ratio (OR): 1.95, 95% confidence interval (CI): 1.69-2.20]. Left anterior descending (LAD) SCT (p=0.014, OR: 3.11, 95% CI: 1.25-7.69) was reported to be a possible predictor of AF. Conclusion: Patients who have LAD SCT observed on coronary angiography should be considered for periodic verification with electrocardiography in terms of AF development. [ABSTRACT FROM AUTHOR]

Background: Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve. Materials and Methods: We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg. Results: PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734-0.882; P < 0.001; area under ROC curve: 0.808). Conclusion: We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage. [ABSTRACT FROM AUTHOR]

Objective: Impairment in left ventricular (LV) function due to excessive ventricular extrasystoles (VESs) occurs during long-time follow-up. Speckle tracking echocardiography (STE) has been shown to be superior to conventional methods for evaluating cardiac functions. We aimed to use STE for early detection of LV dysfunction in patients with apparently normal hearts who have frequent VESs. Methods: Fifty-five patients with frequent VESs were identified according to the Lown classification (Grade 2; unifocal more than 30 times in 1 h). Subjects aged 22-60 years with frequent VESs that had been detected for at least 1 year were included in the study according to the inclusion criteria. Forty-five subjects with similar demographic characteristics, but without VESs, were included as the control group. All participants were evaluated by STE. Results: Fifty-five patients with frequent VESs (mean age 47 years, range 22-60 years; 42.2% male) and 45 control subjects (mean age 46 years, range 22-60 years; 37.8% male) were enrolled in the study. Global LV longitudinal strain (GLS) was decreased in patients with frequent VESs (-18.41±3.37 and -21.82±2.43; p<0.001). In addition, global LV circumferential strain was decreased in patients with frequent VESs (-16.83±6.06, -20.51±6.02; p<0.001). The frequency and exposure time of VESs were negatively correlated with GLS (r=-0.398, p<0.001; r=-0.191, p=0.001, respectively). Conclusion: STE revealed that LV functions were decreased in patients with VESs. This deterioration increased with the frequency and exposure time of VESs. Impairment of LV function due to excessive VESs occurs during long-time follow-up. STE may be used for early detection of LV dysfunction. [ABSTRACT FROM AUTHOR]

Purpose Coronary slow flow ( CSF) is a rare condition described as the delayed angiographic passage of a contrast agent in the absence of stenosis in epicardial coronary arteries. Left ventricular ( LV) systolic and diastolic dysfunctions have been described in the presence of CSF. However, the effect of CSF on LV twist functions has not been assessed. We aimed to evaluate the effects of CSF on LV twist mechanics using speckle tracking echocardiography ( STE). Methods Twenty CSF patients (24-60 years) were enrolled according to the exclusion criteria. Twenty subjects with similar demographic characteristics and normal coronary arteries were the controls. Participants were evaluated with conventional echocardiography and STE. Results The general characteristics of the two groups were similar. LV twist, LV torsion, and apical rotation were impaired in the CSF group (P = 0.015, P = 0.012, and P < 0.001, respectively). Time to peak twist ( TPT) and time to peak untwisting ( TPU) were prolonged in CSF patients (P < 0.001 and P < 0.001, respectively). In the CSF group, rotation-deformation delay was shortened (P < 0.001) and global longitudinal strain ( GLS) was lower (P < 0.001). The thrombolysis in myocardial infarction ( TIMI) frame count was negatively correlated with LV twist, LV torsion and apical rotation (P = 0.002, r = −0.624; P = 0.002, r = −0.624; and P = 0.002, r = −0.632, respectively). Conclusions We demonstrated that LV twist mechanics are impaired in CSF patients. Worse LV twist parameters were associated with greater TIMI frame count. [ABSTRACT FROM AUTHOR]

Objective: Hepcidin is an acute-phase reactant produced in the liver displaying intrinsic antimicrobial activity. There are few studies about hepcidin considered to be acute and chronic inflammatory marker in acute coronary syndromes patients. We investigated in our study whether the level of hepcidin has increased in the acute phase of non-ST elevation myocardial infarction patients (NSTEMI) known as acute inflammatory aggravation of chronic atherosclerotic process. Methods: Seventy patients with NSTEMI and twenty healthy people were recruited as controls in this observational cross-sectional study. Serum hepcidin levels were determined by ELISA, and troponin levels were measured by standard laboratory methods. Levels of hepcidin and troponin were measured at admission and 6 hours later. Mean values of continuous variables were compared between groups using the Student t-test or Mann-Whitney U test, according to whether normally distributed or not, as tested by the Kolmogorov-Smirnov test. Serum troponin and hepcidin levels measured at admission and after 6th hours were compared using paired t-test. Results: Hepcidin level was similar between NSTEMI and controls at admission (24.55±32.13, 23.67±33.62 ng/mL, p>0.05, respectively). Also, serum hepcidin levels did not change significantly from baseline in blood samples taken after 6 hour from admission in NSTEMI patients (24.55±32.13 ng/mL, 29.75±31.48 ng/mL, p=0.62, respectively). However, serum troponin levels were increased significantly compared to baseline (0.29±3.56, 2.92±7.2 ng/mL, p<0.01). Conclusion: Our findings suggest that hepcidin could not be use as a marker of myocardial necrosis in acute phase such as troponin in patients with NSTEMI. (Anadolu Kardiyol Derg 2014; 14: 515-8) [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi 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 Journal of Turgut Ozal Medical Center is the property of Annals of Medical Research 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.)

Objective: Flow-mediated dilation (FMD) is used to evaluate endothelial functions. Computer-assisted analysis utilizing edge detection permits continuous measurements along the vessel wall. We have developed a new fully automated software program to allow accurate and reproducible measurement. Methods: FMD has been measured and analyzed in 18 coronary artery disease (CAD) patients and 17 controls both by manually and by the software developed (computer supported) methods. The agreement between methods was assessed by Bland-Altman analysis. Results: The mean age, body mass index and cardiovascular risk factors were higher in CAD group. Automated FMD% measurement for the control subjects was 18.3±8.5 and 6.8±6.5 for the CAD group (p=0.0001). The intraobserver and interobserver correlation for automated measurement was high (r=0.974, r=0.981, r=0.937, r=0.918, respectively). Manual FMD% at 60th second was correlated with automated FMD % (r=0.471, p=0.004). Conclusions: The new fully automated software© can be used to precise measurement of FMD with low intra- and interobserver variability than manual assessment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of alpha receptor blockers used in the treatment of benign prostatic hyperplasia (BPH) on endothelial functions, coagulation parameters, and arterial blood pressure. Materials and Methods: One-hundred fifteen patients admitted to the treatment protocol because of symptomatic BPH were included in this prospective study. Patients were given the following treatments: doxazosin 4 mg/d (n = 25), terazosin 5 mg/d (n = 26), alfuzosin 10 mg/d (n = 26), tamsulosin 0.4 mg/d (n = 21), and observation (n = 17). All cases were evaluated before treatment and in the 12th week of treatment, according to biochemical parameters, endothelial functions, and arterial blood pressure. Biochemical parameters were bleeding time, coagulation time, prothrombin time, activated partial thromboplastin time, total prostate-specific antigen (PSA), and free PSA. Endothelial functions were evaluated with ultrasonography of the brachial artery. Results: When coagulation tests were evaluated, there were significant increases in bleeding and coagulation times in the groups using doxazosin and terazosin. Doxazosin and terazosin lowered arterial blood pressure significantly compared with other treatments. With regard to effects on endothelial function, there were significant differences in flow-mediated dilation rates of the brachial artery at 60 and 90 seconds before and during treatment in the alfuzosin and terazosin groups. Conclusions: Alpha receptor blockers can decrease the risk of cardiovascular complications by both reducing platelet aggregation and protecting endothelial functions in patients with prostatic hyperplasia. The only drug with a favorable effect in all 4 areas of interest, including BPH symptoms, blood pressure, platelet aggregation, and endothelial functions, was terazosin. [ABSTRACT FROM AUTHOR]

Background: The aim of our study was to determine the coronary angiographic distribution and frequency of atherosclerotic lesions in the coronary arteries in patients with stable angina and metabolic syndrome (MS) as well as to assess the association of these lesions with TIMI frame count and combinations of MS criteria. Methods: Two hundred sixty-one patients aged 61.8±1.4 years were included in the study. All subjects were divided into three large groups: group 1 - patients with significant coronary artery stenosis and with MS (n=148), group 2 - patients with significant coronary artery stenosis and without MS (n=75), and group 3 - patients without significant coronary artery stenosis and without MS (n=38). At the same time, the patients in group 1 were again divided into 3 subgroups based on the number of MS criteria. Arterial blood pressure (BP), waist circumference (WC), and levels of fasting glucose (FG), triglycerides (TG) and high-density lipoproteins (HDL) were measured in all patients. All subjects underwent coronary angiography and TIMI frame count was calculated. Results: According to the results in patients with stable angina with 5 criteria of MS, the TIMI frame count was significantly greater than in patients with stable angina with 3 and 4 criteria of MS. While in the group of patients with stable angina with 3 criteria of MS, the most frequent combination found was BP +WC + FG (28.3±6.2%), in patients with stable angina with 4 MS criteria, it was BP + WC + FG + HDL combination (48.0±7.1%). Conclusions: The TIMI frame count method is simple, inexpensive and broadly applicable and plays role in the understanding of the physiology and pathophysiology of coronary artery blood flow in patients with stable angina and MS. For this reason, the calculation of TIMI frame count in patients with stable angina and MS has an important place in selecting the treatment options and determining the prognosis of the disease. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi 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.)

The article presents a case study of a 42-year-old woman with prosthetic mitral valve who was pronounced dead after the occlusion of a left main coronary (LMC) artery. It mentions the execution of an emergency angioplasty for LMC artery embolism to provide effective flow of blood for left anterior descending (LAD) artery but the intervention has worsened the patient's condition. It cites the importance of diagnosing coronary embolism (CE) accurately to define appropriate treatment options.

The relationship between coronary slow flow (CSF) and coronary sinus (CS) reflux has not been previously studied. This study aimed to investigate the relationship between CSF and CS reflux and Thebesian valve presence as well as the relationship between CS reflux and serum annexin-V and ICAM-1 levels. In this case–control study, patients were divided into two groups: CSF (n = 13) and control (n = 7) groups. CS flow parameters and Thebesian valve presence were evaluated by cardiac magnetic resonance (CMR). Moreover, serum ICAM-1 and annexin-V levels were measured. Regurgitation volume and regurgitation fraction, indicators of reflux flow in CS, were higher in the CSF group than in the control group (p = 0.039 and p = 0.019). Fewer Thebesian valves were observed in the CSF group than in the control group (p = 0.022). Furthermore, a positive correlation was found between regurgitation volume and regurgitation fraction and serum annexin-V and ICAM-1 levels (r = 0.813, p < 0.001 and r = 0.996, p < 0.001; r = 0.817, p < 0.001 and r = 0.993, p < 0.001, respectively). This study revealed the significant relationship between CSF and reflux flow in CS. The fact that the patients in the CSF group have fewer Thebesian valves suggests the importance of the valve in preventing backward flow from the coronary vein. A positive correlation between serum ICAM-1 and annexin-V levels with regurgitation volume and regurgitation fraction indicates that after a certain threshold, CS reflux should be considered an abnormal condition. • Coronary slow flow (CSF) is associated with coronary sinus reflux. • Fewer Thebesian valves were observed in the CSF group. • Regurgitation volume was positively correlated with serum ICAM-1 levels. • Regurgitation volume was also positively correlated with serum annexin-V levels. [ABSTRACT FROM AUTHOR]