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Objectives:Aortic valve calcification (AVC) is a chronic, degenerative and progressive condition that results of endothelial injury, cholesterol deposition, myofibroblast differentiation and subsequent valve calcification, involving complex pathophysiological mechanisms such as the activation of inflammatory and immune system cells. The frequency of AVC increased in the presence of chronic renal failure (CRF) and with age. The study aimed to reveal the relationship between AVC and systemic immune inflammation index (SII) that includes peripheral neutrophil, lymphocyte and platelet counts in the elderly population with chronic renal failure.Materials and Methods:Patients over 65 years of age who applied to the cardiology outpatient clinic with chronic renal failure between March 2018 and October 2022 were included in the study. The patients were divided into two groups as group 1 (control group- undetected AVC on echocardiography) (70 patients) and group 2 (AVC detected on echocardiography) (70 patients). SII of all patients was defined as: SII = neutrophil count × platelet count/lymphocyte count. Our study was a retrospective, observational study.Results:The mean SII value was statistically significantly higher in group 2 (754.2±268.7) than group 1 (622.79±297.2, p=0.007). In the univariable regression analysis of the factors affecting AVC in elderly patients with CRF, neutrophil [odds ratio (OR): 0.752; 95% confidence interval (CI): 0.605-0.934, p=0.01], lymphocytes (OR: 2,197; 95% CI: 1,346-3,585, p=0.002), and SII (OR: 0.998; 95% CI: 0.997-1.000, p=0.009) were predictors. In the multivariable regression analysis: SII (OR: 1.002; 95% CI: 1.000-1.005, p=0.034), lymphocytes (OR: 5,660; 95% CI: 2,349-13,637, p 633.4, 64% sensitivity, and 65% specificity (receiver operating characteristic area under curve: 0.672, 95% CI: 0.582-0.762, pConclusion:High SII in the elderly with chronic renal failure is associated with the presence of AVCs.Keywords:Aort calcification, systemic immune inflammation index, and predictivity

Background The European Society of Cardiology has recently defined heart failure (HF) patient group with a left ventricular ejection fraction (LVEF) of 41-49% as a different category with the term heart failure with mildly reduced ejection fraction (HFmrEF). In this study, we aimed to conduct a research about the correlation between left atrial volume index (LAVI) and atrial fibrillation in patients HFmrEF. Methods A total of 282 patients HFmrEF who were admitted to the cardiology department from three different centres were included in the study. The study was planned as multicenter, cross-sectional study. The patients were divided into two groups as sinus rhythm and atrial fibrillation based on their electrocardiographic findings. Results It was found out that Nt-ProBNP, LA area, LAVI, pulmonary artery pressure, and severe mitral regurgitation rates were significantly higher in the AF group (p < 0.001). ROC analysis resulting in LAVI > 30.5 had 64% sensitivity and 66% specificity in the predicting presence of AF (ROC area under the curve: 0.660, 95% CI: 0.587-0.733, p < 0.001). We also observed that the LA area being >16.55 predicting presence of AF with 60% sensitivity and 58% specificity (ROC area under the curve: 0.624, 95% CI: 0.549-0.699, p = 0.002). Conclusion In the study conducted, we found a correlation between AF and LAVI values in patients in the HFmrEF group. If the LAVI value increases in the follow-up of this group of patients with echocardiography, close follow-up in terms of AF may allow the early control and treatment of AF-related incidents.

Background and aims The Friedewald equation (LDL-Cf) is known to produce inaccurate estimations of low-density lipoprotein cholesterol (LDL-C) when triglycerides are high (>400 mg/dL) or LDL-C is low (

Funding Acknowledgements Type of funding sources: None. OnBehalf CVSCORE-TR study group Background Friedewald equation (LDL-Cf) is known to produce inaccurate estimations of low-density lipoprotein cholesterol (LDL-C) when triglycerides are high (>400 mg/dl) or LDL-C is low ( Purpose In this pragmatic study, we aimed to evaluate the agreement between LDL-C calculated using LDL-Cmh, LDL-Cs and LDL-Cf equations and to understand whether using LDL-Cmh or LDL-Cs instead of LDL-Cf leads to significant changes on the clinical decision-making Methods 4196 cardiology outpatient cases that were included in a multicenter registry database were analyzed. Each case was assigned into a cardiovascular risk class using web-based SCORE (Systematic COronary Risk Evaluation) algorithm calibrated for high-risk European countries, and relevant European guidelines were used to assess LDL-C targets. LDL-Cf, LDL-Cs and LDL-Cmh were calculated as previously described. Results Compared to LDL-Cmh and LDL-Cs, LDL-Cf was able to correctly identify 96.9%-98.08% of cases as within or out of LDL-C target, respectively, while 1.95%-2.8% of cases were falsely identified as within LDL-C target. Kappa coefficients for agreement between LDL-Cf vs. LDL-Cmh and LDL-Cf vs. LDL-Cs were 0.868 and 0.918 (p Conclusions Friedewald equation had an excellent degree of agreement with the novel Martin/Hopkins and Sampson formulas in most cardiology outpatients, especially those within the lower end of the cardiovascular risk spectrum. In selected patients, especially those with high or very high risk in whom LDL-Cf 400 mg/dl, agreement was far worse and thus novel equations might have an incremental usefulness for clinical decision making. Table 1 Reference Comparison Correct estimation Underestimation Overestimation Kappa (p value) All patients that were not on cholesterol-lowering treatment LDL-Cmh LDL-Cf 2785 (98.1%) 51 (1.8%) 3 (0.1%) 0.962 ( Abstract Figure

Background: Infective endocarditis (IE) is an infection of the heart’s endocardial surface. In recent years, nuclear imaging methods have gained importance in the diagnosis of IE. The present study aims to investigate the imaging potential of 99mTc-labeled vancomycin (99mTc-Vancomycin) as a new agent that would enable the diagnosis of IE in its early stages when it is difficult to diagnose or has small vegetation in the experimental rat model. Methods: 99mTc-Vancomycin scintigraphy was evaluated for its accumulation in IE with Staphylococcus aureus performed in an experimental rat model. Serial planar scintigraphic and biodistribution analysis of infected vegetations are compared to rats with sterile vegetations. The heart was identified as an infected organ, the liver was identified as a non-infected organ and the heart/liver uptake ratio (T / NT ratio) was compared between infective endocarditis and sterile endocarditis groups. Results: Planar scintigrams (in vivo measurements) showed more uptake in the heart of rats in the infective endocarditis group compared to the uptake in the heart of rats in the sterile endocarditis group, but this difference was not statistically significant (p>0.05). From the ex vivo measurements, the 99mTc-Vancomycin heart uptake increased significantly (p = 0.016), liver uptake was significantly decreased (p = 0.045) and the T/NT ratio was significantly higher (p = 0.014) in the infective endocarditis group compared to the sterile endocarditis group. Conclusions: In this experimental study, 99mTc-Vancomycin scintigraphy ensured the detection of ex vivo infected tissue in a rat model of IE. In addition, the absence of significant 99mTc-Vancomycin uptake in the sterile endocarditis group indicates that this agent targeted the infected tissue instead of the sterile inflammatory tissue. Finally, this agent should also be evaluated with animal- specific imaging devices.

OBJECTIVE: Infective endocarditis (IE) is defined as infection of the endocardial surface of the heart. Updates are needed in the diagnosis and treatment of IE, as well as in animal models of IE. Based on this need, a new model of infective endocarditis induced by S. aureus was described in our study. METHODS: This study was performed on 7 Wistar albino male rats, each aged six months and weighing 250-300 g. Underwent the surgical implantation of a 20 G catheter, to gain access to right common carotid artery. Twenty-four hours after implantation, 0.5 ml 100.000 colony forming unit (cfu) of S. aureus was injected via the tail vein and 3 days later echocardiography was performed and rats subsequently sacrificed. IE was later diagnosed histopathologically. RESULTS: Two of the rats were exitus one day after S. auerus was given. The mortality rate of the experiment was 28.5%. Histopathological examination revealed vegetations and bacterial colonization were detected in the endocardium in all rats that protruded from the endocardium to the cardiac cavity. CONCLUSION: Our study is the first study in the literature to identify the IE rat model using the 20 G catheter. Due to the practical application of the surgical procedure (use of 20 G catheter) in our study, we think that it will provide much convenience to the researchers in the experimental research on IE diagnosis and treatment.

Amaç: Endotel fonksiyon bozukluğu koroner arter hastalığı gelişiminde ve prognozunda önemli rol oynar. Koroner arter hastalığında, uzun süreli ortalama glisemik indeksi gösteren bir parametre olan glikolize hemoglobinin (HbA1c) endotel fonksiyonları üzerine etkilerini değerlendirmeyi amaçladık. Gereç ve yöntemler: Koroner anjiyografi ile belgelenmiş koroner arter hastalığı olan 56 hasta çalışmaya dahil edildi. Akım aracılı vazodilatasyon (AAD) testi ile endotel fonksiyonları değerlendirildi. İstatistiksel analiz için IBM SPSS Statistics 25.0 Programı kullanıldı. Nümerik değişkenlerin normal dağılıma uygunluğu Kolmogorov-Smirnov (n>=50) testiyle incelendi. HbA1c ve ADD yüzdelik değişim arasındaki korelasyonu değerlendirmek için Spearman korelasyon analizi kullanıldı. Bulgular: Çalışmaya dahil edilen 56 hastanın ortalama yaşı 61.5±10.3 yıldır. Hastaların %71’ i erkek, %29’ u kadın ve ortalama vücut kitle indeksi 27.5±5.5 kg/m2’ dir. AAD testinde ortalama radial arter bazal çapı 0.25 (±0.028) cm, AAD sonrası ortlama radial arter çapı 0.28 (±0.033) cm olarak saptandı. HbA1c düzeyleri ile endotel fonksiyonlarını gösteren arter çapındaki yüzdelik değişim arasında negatif yönde zayıf bir ilişki olduğu görüldü ( r = -0.306, p = 0.022). Sonuç: Koroner arter hastalığında, uzun süreli ortalama glisemik indeksi gösteren HbA1c düzeyleri endotel fonksiyon bozukluğunda bağımsız bir faktör olarak düşünülebilir.

Amaç: Bruselloz dünyada en sık görülen bakteriyel zoonotik enfeksiyon hastalığıdır. Çalışmamızda hastalığın endemik olarak görüldüğü Güneydoğu Anadolu bölgesinde ikinci basamak bir hastaneye başvuran ve bruselloz tanısı ile takip edilen 111 bruselloz olgusunun değerlendirilmesi amaçlandı. Yöntem: Çalışmada ikinci basamak bir hastanenin Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji polikliniğine Aralık 2018 – Aralık 2019 tarihleri arasında başvuran bruselloz tanısı ile ayaktan veya yatarak takip edilen 111 olgunun demografik özellikleri, klinik bulguları, olası bulaş yolları, tedavi rejimleri, komplikasyon verileri ve relaps oranları retrospektif olarak incelendi. Bulgular: Hastaların 77’si (%69.3) kadın ve olguların yaş ortalaması 36.4 (yaş aralığı 14-94) idi. Meslek dağılımı açısından, hastaların 69’u (%62.1) ev hanımıydı, 17’si (%15.3) hayvancılıkla uğraşmaktaydı. Olguların 88’inde (%79.2) taze peynir yeme öyküsü vardı. Hastalarda en sık görülen semptomlar, halsizlik (%92.7) ve artralji (%87.3) olarak saptandı. Çalışmaya alınan hastalarda CRP yüksekliği %39.6, anemi %37.8 oranı ile en sık görülen laboratuvar bulguları olarak tespit edildi. Etkilenen organ ve sistemler incelendiğinde olguların 49’unda (%44) hematolojik tutulum, 23’ünde (%20.7) karaciğer tutulumu, 11’inde (%10) osteoartiküler tutulum görüldü. Bir (%0.9) hastada brusellozun nadir bir komplikasyonu olarak izole perikardit, bir (%0.9) hastada da brusella epididimoorşiti saptandı. Çalışmaya dahil edilen hastaların 12’sinde (%10.3) tedavileri bittikten sonraki bir yıllık izlemde relaps saptandı. Sonuç: Bruselloz birçok organ ve dokuyu etkileyebilmektedir. Bu nedenle çok değişik klinik belirti ve bulgularla ortaya çıkabilmekte ve birçok hastalıkla karışabilmektedir. Endemik bölgelerde yaşayan nonspesifik semptom ve bulgular ile başvuran hastalar mutlaka bruselloz açısından değerlendirilmelidir., Aim: Brucellosis is the most common bacterial zoonotic infection disease in the world. In our study, we aimed to evaluate 111 brucellosis cases who were admitted to a secondary-line hospital by followed up with the diagnosis of brucellosis in the Southeastern Anatolia region where the disease was seen as endemic. Method: In this study, demographic characteristics, clinical findings, possible transmission routes, treatment regimens, complication data and relapse rates of 111 patients who were admitted to an infectious diseases and clinical microbiology clinic of a second-line hospital between December 2018 and December 2019 were examined retrospectively. Results: Seventy-seven of the patients (69.3%) were female and the mean age of the patients was 36.4 (age range 14-94). In terms of profession distribution, 69 (62.1%) of the patients were housewives, 17 (15.3%) of the patients were engaged in animal husbandry. There was a history of eating fresh cheese in 88 (79.2%) patients. The most common symptoms of the patients were malaise (92.7%) and arthralgia (87.3%). The most common laboratory findings in patients included in the study were 39.6% CRP elevation and 37.8% anemia. When the affected organs and systems are examined, hematological involvement was observed in 49 (44%) patients, liver involvement in 23 (20.7%) patients, osteoarticular involvement in 11 (10%) patients. There was found to one patient (0.9%) had isolated pericarditis that was a rare complication of brucellosis, and brucella epididymoorchitis in one (0.9%) patient. In the one-year follow-up after treatment, relapses were detected in 12 patients (10.3%). Conclusion: Brucellosis can affect many organs and tissues. For this reason, it can appear with many different clinical signs and symptoms and can be confused with many diseases. In patients presenting with nonspecific symptoms and signs, who were living in endemic regions, brucellosis infection should definitely be considered, and patients should be evaluated for brucellosis.

Infective endocarditis (IE) is an infection of the heart's endocardial surface. In recent years, nuclear imaging methods have gained importance in the diagnosis of IE. The present study aims to investigate the imaging potential ofPlanar scintigrams (in vivo measurements) showed more uptake in the heart of rats in the infective endocarditis group compared to the uptake in the heart of rats in the sterile endocarditis group, but this difference was not statistically significant (p0.05). From the ex vivo measurements, theIn this experimental study

Objective To compare radial vasomotor functions at three different access sites namely right, left main radial artery, and left distal radial (LDR) artery. Study design Observational study. Place and duration of study Department of Cardiology, EGE University, Turkey, from September 2017 to February 2018. Methodology Forty-one patients scheduled for transradial elective coronary angiography and intervention were consecutively enrolled. Access site decision was left free to operators being blind of the study. Main radial vasomotor function measured through flow mediated vasodilation test was compared between other radial access sites on admission, 1 day and 2 months post-catheterisation. Results Five patients were intervened through the left main radial, whereas the LDR and the right main radial access were used in 17 and 19 patients respectively. In contrast to other radial access sites, LDR approach showed significantly less influenced vasomotor functions the day after the procedure. This feature continued to be preserved for two months of follow-up. Conclusion: Left distal radial branch in the anatomic snuffbox is a reliable access in terms of vasomotor function preservation compared to conventional left and right radial artery accesses. Key Words: Transradial access, Flow mediated vasodilatation, Endothelial function.6re6445.

Transradiyal koroner anjiyografi (KAG), transfemoral KAG’ye kıyasla daha az girişim yerikomplikasyonu, daha kısa hospitalizasyon, daha iyi hasta konforu ve erken mobilizasyon ileilişkilendirilmektedir. Bununla birlikte, KAG’de radiyal girişim kullanımı giriş yeri komplikasyonlarınada neden olabilir. Transradiyal KAG sonrası radiyal arter psödoanevrizması, işlemlerin%0,1’inden azında bildirilen nadir bir komplikasyondur. Bu raporda transradiyal KAG sonrasıDoppler ultrasonografisi ile sağ radiyal arter psödoanevrizması tanısı konan ve cerrahi dışıyollarla tedavi edilen 78 yaşında bir hasta sunulmuştur., Compared to transfemoral coronary angiography (CAG), transradial CAG has been associ¬ated with less access site complications, shorter hospitalization, better patient comfort, and early mobilization. However, the use of radial access in CAG may also cause entry site compli¬cations. Radial pseudoaneurysm after transradial CAG is a rare complication reported in less than 0.1% of the procedures. In this report, we present a 78-year-old patient who was diag¬nosed with right radial artery pseudoaneurysm by Doppler ultrasonography after transradial CAG and treated nonsurgically

Brusellozda perikardit genellikle endokardit ile birlikte görülen bir komplikasyondur ve izole perikardit nadir görülür. Bu yazıda, kardiyak belirti ve bulgularla seyreden, endokarditin eşlik etmediği bruselloza bağlı nadir bir izole perikardit vakası sunulmaktadır.Brusellozda perikardit genellikle endokardit ile birlikte görülen bir komplikasyondur ve izole perikardit nadir görülür. Bu yazıda, kardiyak belirti ve bulgularla seyreden, endokarditin eşlik etmediği bruselloza bağlı nadir bir izole perikardit vakası sunulmaktadır., In brucellosis, pericarditis is usually a complication associated with endocarditis, and isolated pericarditis is rare. In this paper, we present a rare case of isolated pericarditis due to brucellosis without endocarditis, associated with cardiac signs and symptoms.In brucellosis, pericarditis is usually a complication associated with endocarditis, and isolated pericarditis is rare. In this paper, we present a rare case of isolated pericarditis due to brucellosis without endocarditis, associated with cardiac signs and symptoms

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.

Objectives: Endothelial dysfunction plays an important role in the initial stage of atherosclerosis, the growth ofatherosclerotic plaque and the development of thrombogenic events. Low-density lipoprotein (LDL) cholesterol levels areassociated with the risk of cardiovascular disease. It also inhibits endothelium-dependent vasodilation by disrupting theactivity of nitric oxide (NO) synthase and causes endothelial dysfunction. It has been shown that high-density lipoprotein(HDL) cholesterol increases the production of NO and endothelial NO synthase that causes vascular dilatation directly orindirectly, and also supports endothelial cell migration and proliferation through different mechanisms. In our study, weaimed to investigate the relationship between HDL/LDL ratios and endothelial functions in patients with coronary arterydisease (CAD) documented through coronary angiography (CAG).Materials and Methods: Fifty-seven patients with CAD documented through CAG were included in the study.Endothelial functions were evaluated with the flow mediated vasodilation (FMD) test, which is the most commonlyused non-invasive method for endothelial function assessment. In statistical analysis, the change in arterial diameter wasexamined by the paired sample t-test.Results: The average age of 57 patients included in the study was 61.1±10.1 years and 70% of these patients were maleand 30% were female. The mean body mass index was 27.8±5.7 kg/m2 and 57.9% of the patients were NYHA class I. Inthe FMD test, the mean radial artery percentage diameter change was found to be 12.61% (±3.62). The average HDL/LDLratio of the patients included in the study was 0.53 (±0.26), and the median value was 0.42 (minimum 0.27 - maximum1.50). There was a weak positive correlation between HDL/LDL ratios and FMD percentage change (r =+0.379, p=0.04).Conclusion: As HDL/LDL ratios increase in patients with CAD, the percentage change of flow-mediated dilatation,which is an indicator of endothelial functions, also increases.

Bu yazıda Türkiye'deki kardiyovasküler hastalığı olan ileri yaş grubu hastaların klinik ve epidemiyolojik araştırmalarının topluma özgü sonuçları sunulmuştur. Kardiyovasküler hastalıklar ve risk faktörlerinin sıklığı ve dağılımının geriatri popülasyonumuzda belirlenmesi tedavilerinde gerçekçi bir stratejinin izlenmesine olanak sağlayacaktır., The specific population-based results of clinical and epidemiologic studies in geriatric patients with cardiovascular disease in Turkey were presented in this paper. The determining of the frequency and distribution of the cardiovascular disease and risk factors in our geriatric population would contribute to following a realistic strategy for management of them.