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Objectives: At present, clinicians face plenty of patients complaining of post-COVID-19 chest pain and dyspnea. However, it remains to be seen if these symptoms indicate pathology of the cardiovascular system. We aimed to evaluate heart functions in outpatients with post-COVID-19 chest pain and dyspnea, using 2D speckle-tracking echocardiography (2D-STE). Methods: This cross-sectional study recruited consecutive patients who presented to cardiology outpatient clinics between June 15, 2021, and July 15, 2021. A total of 78 patients had recovered from COVID-19 1-2 months before admission were included in the study. ECG and echocardiography, including 2D-STE images, were obtained for all patients. Findings were compared with sex- and an age-matched control group of 67 healthy adults. Results: The median age was 38 (IQR, 34-45) years, and 64.1% were female. There were no significant differences between the patients and control group regarding laboratory, ECG, and echocardiography findings. Moreover, the left ventricle global longitudinal strain measurements in both the patient and control groups were within the normal ranges and did not show a significant difference (-20.5 [-21.8- -17.9] vs. -19.8 [-21.4- -18.9], p=0.894). Conclusion: Post-COVID-19 chest pain and dyspnea are unlikely signs of cardiovascular involvement in outpatient young adults who have not been hospitalized with COVID-19. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the relationship between anemia and cardiac functions by conventional and speckle-tracking echocardiography (STE) in patients with end-stage renal disease (ESRD) receiving hemodialysis. Methods: One hundred and six patients with ESRD receiving hemodialysis were included in this cross-sectional study. The conventional echocardiography and STE findings were compared between the patients with and without anemia. In addition, a comparison of the findings between the ESRD patients and healthy controls consisting of 68 participants was conducted. Results: Compared to healthy controls, ESRD patients had lower left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LVGLS), and left atrial reservoir strain (LASr) [53% (48-57) vs. 65% (62-68), -15.2 (-16.9˗ -13.6) vs. -19.7 (-16.9˗ -13.6), and -21.9 (-29.5˗ -15.3) vs. -29.9 (-35.3˗ -22.8), respectively, P-value <0.001 for all]. Of the ESRD patients, 70 (66%) had anemia. ESRD patients with anemia had higher interventricular septum (IVS), posterior wall (PW), and left atrial volume index (LAVi) values than patients without anemia. In addition, ESRD patients with anemia had lower LVEF, LVGLS, and LASr than patients without anemia [median (IQR), 13 (12-15) vs. 12 (11-14), P=0.004, 13 (12-15) vs. 12 (11-13.5), P<0.005, 43 (35-55) vs. 34.7 (28-50), P=0.013, 52 (48-55) vs. 56 (47.5-60), P=0.016, -14.6 (-16.4˗ -13.5) vs. -16 (-18.6˗ -14.7), P=0.003, and -21.6 (-30.5˗ -16.3) vs. -30.5 (-33.6˗ -23.3), P=0.006, respectively]. In multivariable logistic regression analysis, diabetes, PW, LASr, and LVGLS were independently associated with the presence of anemia in ESRD patients. Conclusion: Our study confirmed impaired cardiac mechanics in ESRD hemodialysis patients and showed that anemia was associated with further worsening cardiac mechanics in this population. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the predictive role of the Geriatric Nutrition Risk Index in long-term mortality of very elderly patients with ST-segment elevation myocardial infarction and to compare it with the other known objective nutritional indices, namely the Prognostic Nutritional Index and Controlling Nutritional Status. Materials and Methods: A total of 212 eligible patients, aged 80 years or older, who were hospitalized with a diagnosis of ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention were included in the study. Baseline patient characteristics, echocardiographic assessments, laboratory findings, and nutritional indices were assessed. Results: During the median follow-up period of 34 months, 60 (28.3%) allcause mortalities were identified, and event-free cumulative rates were 46.3%, 81.4%, and 90.1% for Geriatric Nutrition Risk Index <100.5, 100.5-112.6, and >112.6, respectively (log-rank test, p < 0.0001). Receiver operating characteristic curve comparison analysis revealed that the Geriatric Nutrition Risk Index was a better predictor than the Controlling Nutritional Status, Prognostic Nutritional Index, Body Mass Index, and serum albumin (p < 0.001 for each pairwise comparison of Receiver operating characteristic curves). Conclusion: It is important to evaluate malnutrition that is known to be associated with mortality in very elderly patients with ST-segment elevation myocardial infarction, who are more fragile than young people, and Geriatric Nutrition Risk Index -a simple and easy-to-calculate index-can be a guide in this regard. [ABSTRACT FROM AUTHOR]

Objective: Acute kidney injury (AKI), which is prevalent in ST-segment elevated myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI), is associated with poor cardiovascular outcomes. As high pulse pressure (PP) is associated with adverse cardiovascular events, the present study's aim was to evaluate the relationship between fractional PP (PPf) and AKI in patients with STEMI who underwent primary PCI.Subjects and Methods: All laboratory findings as well as echocardiographic and angiographic data of 1,170 consecutive STEMI patients were retrospectively screened. PPf was calculated from the pressures invasively measured after sheath insertion and before performing coronary angiography.Results: From 1,170 eligible STEMI patients (mean age 56 years, 18.2% female), AKI developed in 143 (12.2%) patients. The PPf and pulsatility index were significantly higher in patients with AKI than those without (0.53 ± 0.10 vs. 0.61 ± 0.10, p < 0.001, and 0.80 ± 0.03 vs. 0.82 ± 0.03, p < 0.001, respectively). PPf was also found to be associated with AKI in univariable (OR 2.183, 95% CI 1.823-2.614, p< 0.001) and multivariable (OR 1.874, 95% CI 1.513-2.322, p < 0.001) analysis. In-hospital mortality was higher in patients with AKI than those without.Conclusion: Invasively measured PPf, which can be easily measured and has no additional cost in STEMI patients undergoing coronary intervention, is an independent predictor of AKI. In addition, PPf is superior to other blood pressure values and derivatives in AKI prediction. [ABSTRACT FROM AUTHOR]

Background: The relationship between acute kidney injury (AKI) and C-reactive protein (CRP) and albumin has been previously demonstrated in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). However, to our knowledge, CRP to albumin ratio (CAR), a newly introduced inflammation-based risk score, has not yet been studied. In this study, we aimed to investigate the possible relationship between the CAR and AKI.Method: A total of 815 consecutive STEMI patients treated with pPCI were reviewed.Results: One hundred ten 110 (13.5%) patients developed AKI in the study population. The subjects were divided into two groups according to AKI development. The in-hospital mortality rate was higher in patients with AKI than those without AKI (15.5% vs. 1.3%; p<0.001). The patients with AKI had significantly higher mean value of CRP and CAR (0.29 [0.16-0.50] vs. 0.55 [0.37-1.05]; p<0.001) and lower mean levels of albumin than those without AKI. Age, diabetes mellitus, haematocrit, left ventricular ejection fraction, hypotension, and CAR (Odds ratio [OR]2.307, 95% confidence interval [CI] 1.397-3.809, p=0.001) were independent predictors of AKI.Conclusion: The CAR may be a useful inflammation-based risk score to predict AKI development in STEMI patients treated with pPCI. [ABSTRACT FROM AUTHOR]

The association of coronary artery disease (CAD) severity with increased C-reactive protein (CRP) and decreased albumin levels has been reported. However, to our knowledge, no study has investigated the usefulness of the CRP to albumin ratio (CAR) in predicting intermediate–high SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score (SS) and high SS II. Consecutive patients (n = 344) treated with percutaneous coronary intervention comprised the study population. The study population was divided into 2 groups according to SS >22 and mean SS II values, respectively. Patients with intermediate–high SS and high SS II had higher CAR than patients with low SS and SS II. History of diabetes mellitus, decreased albumin, lower left ventricular ejection fraction, and elevated CAR (odds ratio [OR]: 1.020; 95% confidence interval [CI], 1.009-1.031; P < .001) were independent predictors of high SS. The presence of hypertension, decreased hemoglobin and albumin levels, and increased CAR (OR: 1.014; 95% CI, 1.004-1.023; P < .001) were independent predictors of SS II. In receiver operating characteristic curve comparison, CAR was superior to CRP and albumin in prediction of intermediate–high SS, but only CRP in prediction of high SS II. The CAR calculated from the admission blood samples could be a useful parameter for predicting CAD severity using SS and SS II. [ABSTRACT FROM AUTHOR]

Abstract: Background: The ratio of serum C‐reactive protein (CRP) to albumin has been proven to be a more accurate indicator than albumin and CRP levels alone in determining the prognosis of patients with cancer and critical illness. The aim of this study was to determine whether the CRP/albumin ratio (CAR) can be linked to imperfect reperfusion that can worsen the prognosis of ST‐elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (pPCI). Materials and methods: A total of 1217 consecutive STEMI patients who achieved epicardial vessel patency with pPCI were recruited to this study. Results: The study population was divided into 2 groups: reflow (n = 874) and no‐reflow (NR) (n = 343) groups. The white blood cell count (WBC), neutrophil‐to‐lymphocyte ratio (NLR) and CAR (0.03 [0.01‐0.04] vs 0.06 [0.03‐0.12] (P < .001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. The best cut‐off value of CAR predicting NR was 0.59 with a sensitivity of 54.7% and specificity of 86.7. The predictive power of CAR surpassed that of CRP, albumin, WBC count and NLR in the receiver operator curve (ROC) curve comparison. Conclusion: No‐reflow can be predicted by systemic inflammation markers including WBC count, NLR and CAR measured from the blood sample obtained on admission. CAR has a higher clinical value than CRP, albumin level, WBC count and NLR in NR prediction. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the effects of branched chain amino acids (BCAAs) consumption on myocardium and coronary arteries, in rats subjected to regular and intense exercise. Eight-week old, 30 male rats were randomly divided into experimental- and controlgroups. For a total of 8 weeks, every other day, both groups were subjected to a ladder-climbing exercise on a 1.5 m long ladder, with 2.5 cm steps interval, at 70 degrees angle. The experimental group, besides the standard diet, was additionally fed BCAA-supplement at a dose of 1.5 mg/g/day. This study showed that, the experimental group had more frequent atherosclerotic lesions compared to the control group (61.5% vs. 21.4%; p=0.034). Although creatine kinase was similar between the groups, creatine kinase - myocardial band isoform (CK-MB) was significantly higher in the experimental group compared both to control and baseline levels. This is the first study that examines the effects of consuming BCAA supplements on myocardium and coronary arteries in rats subjected to prolonged exercise. We demonstrated that continuous and long-term consumption of BCAA supplement in endurance exercises was associated with coronary atherosclerotic process and myocardial injury. [ABSTRACT FROM AUTHOR]

Objective: T-peak-T-end (TPE) interval, which represents the dispersion of repolarization, is defined as the interval between the peak and end of the T-wave, and is associated with increased malignant ventricular arrhythmia and sudden cardiac death (SCD) in patients with ST elevation myocardial infarction (STEMI). Although prolonged TPE interval is associated with poor short- and long-term outcomes, even in patients with STEMI treated with successful primary percutaneous coronary intervention (pPCI), clinical, angiographic, and laboratory parameters that affect TPE remain to be elucidated. The aim of our study was to evaluate the potential relationship between prolonged TPE interval and reperfusion success using ST segment resolution (STR) in patients with STEMI undergoing pPCI. Methods: In the current study, 218 consecutive patients with STEMI who underwent pPCI were enrolled, after exclusion, 164 patients were included in the study population. Results: Patients were divided into two groups according to the presence of complete (STR%≥70) or incomplete (STR%<70) STR. Preprocedural corrected TPE (cTPEPRE;116±21 ms vs. 108±21 ms, p=0.027), postprocedural TPE (TPEPOST, 107±16 ms vs. 92±21 ms, p<0.001), and postprocedural cTPE (cTPEPOST, 119±19 ms vs. 102±17 ms, p<0.001) intervals were significantly longer in patients with incomplete STR than in patients with complete STR, whereas there was no statistically significant difference between the two groups in terms of pre- and postprocedural and corrected QT intervals. cTPEPRE and cTPEPOST were found to be independent predictors for incomplete STR. Conclusion: To our knowledge, this is the first study that evaluated the relationship between TPE interval and no-reflow defined by STR in patients with STEMI who were treated with pPCI. [ABSTRACT FROM AUTHOR]

Aim: Non ST segment elevation myocardial infarction (NSTEMI) is one of the most common presentations of coronary arterial disease (CAD). Syntax II score (SSII) is a recently developed scoring system consisting two anatomical and six clinical variables which is used to predict mortality of patients with complex CAD. Neutrophil/lymphocyte ratio (NLR) basically shows basal inflammatory response. The aim of our study was to evaluate the relationship between NLR and CAD severity using Syntax score (SS) and SSII in NSTEMI patients. Material and Method: Consecutive 271 NSTEMI patients who referred to Kafkas University between February 2015 and June 2016 and underwent coronary angiography have been included in this study. Peripheral venous blood samples were taken from all patients. Hemogram parameters including NLR, biochemical parameters and cardiac biomarkers were evaluated. SS and SSII were calculated from recorded coronary angiograms. Results: The study population consisted of 194 NSTEMI patients. Due to the fact that there was no definitive previous classification of SSII, the patients were divided into 2 groups according to median SSII value. (SSII<31.5 low score group [n=97] and >31.5 high score group [n=97]. NLR was significantly higher at SSII high score group than low score group 3.22 (2.30-4.86) vs 4.05 (2.83-7.21) p=0.004). While there was no correlation between NLR and SS (r=0.023, p=0.759), there was a correlation between NLR and SSII (r=0.218, p=0.002). Therefore correlation analysis was performed between NLR and SSII components. Our analysis demonstrated that there was a correlation between NLR and left ventricular ejection fraction (r=-0.161, p=0.026), as well as between NLR and creatinine clearance (r=-0.161, p=0.025). However, there was no correlation with other parametric components of SSII. Conclusion: Our study demonstrated that there was a correlation between NLR and SSII, but no correlation between NLR and SS. High NLR can predict that patients have high SSII scores, and this prediction is related to comorbidities rather than anatomical score system. [ABSTRACT FROM AUTHOR]