Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology最新文献

Objective: This study sought to assess the prevalence and identify factors associated with depression among patients with cardiovascular diseases and followed-up in a public teaching hospital.

Methods: A cross-sectional study was conducted with a systematic random sample of 302 out-patients with cardiovascular diseases and followed-up in the cardiology outpatient department at Tripoli University Hospital. Stable adults (>18 years of age) were eligible to be included in this study. Face-to-face interviews were conducted to complete a questionnaire comprising questions on demographic, medical, and lifestyle issues besides the Patient Health Questionnaire-9 tool. Statistical Package for the Social Sciences, Version 22, was used to analyze the data.

Results: Age ranged between 29 and 84 years with a mean age of 60.6 ± 10.4 years; 60.6% were females and 75.8% were married. The highest prevalent morbidity was hypertension (76.2%) followed by diabetes mellitus (48%), ischemic heart disease (39%), and different types of arrhythmias (22.8%). About 59.3% of screened patients had different degrees of depression from mild to severe. The participants with a positive history of psychological problems, those complicated with cardiomyopathy, those who were females, patients with a history of cerebrovascular accident, and patients who were living alone were more likely to be depressed.

Conclusion: Prevalence of depression is found to be higher among patients with cardiovascular diseases and a family history of psychological illnesses, and cardiomyopathy had the highest contribution as independent predictor for depression. Screening of all patients with cardiovas-cular diseases is essential to identify and treat the patients at greater risk of depression.

Objective: The primary function of sclerostin is the regulation of bone metabolism. Research investigating the cardiovascular effects of sclerostin had conflicting results. We aimed to study serum sclerostin levels in coronary artery plaque types.

Methods: Coronary calcium scores of 175 patients were evaluated. Patients with normal coronary arteries and calcium score of greater than zero constituted control (n = 47) and study groups (n = 83), respectively. Patients' plaques were further categorized as non-calcified plaque, calcified plaque, or mixed plaque (n = 45, n = 40, and n = 43, respectively).

Results: The study group had increased serum sclerostin levels than that of controls. Moreover, sclerostin levels were significantly higher in patients with calcified or mixed plaques compared to those without plaque or non-calcified plaque (median 248.5, 60.7-790.4) pg/mL and 1085.8 (185.8-3902.2) pg/mL versus 68.7 (34.0-141.3) pg/mL, and 67.7 (48.6-94.9) pg/mL, P < 0.001, respectively). Sclerostin showed a high correlation with coronary calcium scores (r = 0.95, P < 0.001). Serum sclerostin concentration of 106.27 pg/mL had 97.5% sensitivity and 67.4% specificity for the prediction of calcific plaque, whereas the level of 308.55 pg/mL had 95.3% sensitivity and 90.9% specificity for the prediction of mixed plaque. Coronary calcium scores, serum sclerostin, and C-reactive protein levels were significant predictors of 1-year major adverse cardiac events.

Conclusions: Increased serum sclerostin level is a marker of coronary atherosclerosis burden and has a value for the prediction of 1-year major adverse cardiac events.

Objective: Electrocardiography is used in the initial risk assessment of patients with non-ST-elevation myocardial infarction. The frontal QRS-T angle is an electrocardiography parameter that may be affected by the alterations in the coronary blood flow. This study aimed to explore the relationship of the frontal QRS-T angle with coronary flow grade and adverse events in non-ST-elevation myocardial infarction patients.

Methods: A total of 191 non-ST-elevation myocardial infarction patients were divided into 2 groups based on the thrombolysis in myocardial infarction (TIMI) flow level on coronary angiography before revascularization, namely TIMI 0/1 and TIMI 2/3. The frontal QRS-T angle obtained before revascularization was compared between the groups and its relationship with adverse events was examined. In-hospital all-cause mortality, repeat target lesion revascular-ization, new-onset heart failure, ventricular arrhythmias, and atrial fibrillation were defined as adverse events.

Results: Frontal QRS-T angle was wider in the patients with TIMI 0/1 flow compared to the patients with TIMI 2/3 flow (P  <  0.001). The frontal QRS-T angle was determined to be a predictor of TIMI flow grade 0/1 before revascularization in patients with non-ST-elevation myocardial infarction (odds ratio: 1.51; 95% CI: 1.30-1.75; P < 0.001). The frontal QRS-T angle was a predictor of the adverse events during hospitalization in the patients with non-ST-elevation myocardial infarction (odds ratio: 1.11; 95% CI: 1.04-1.19; P = 0.002). The cut-off values of the frontal QRS-T angle for TIMI flow grade and adverse events were determined to be 73.5°, based on receiver operating characteristic curve analysis.

Conclusion: Increased frontal QRS-T angle may be a useful electrocardiography parameter for determining TIMI flow grade and the need for an early invasive strategy in patients with non-ST-elevation myocardial infarction.

Objective: It has been shown that migration has an increasing effect on the risk of cardiovascular events. However, these studies are mostly related to international migration. There are very few studies on the relationship between internal migration and cardiovascular disease. The aim of the current study was to evaluate the effect of internal migration on the age of the first acute coronary syndrome episode.

Methods: The study was designed as a cross-sectional, observational study that enrolled 1261 consecutive patients diagnosed with the first episode of acute coronary syndrome between 2014 and 2020. Patients born and living in Antalya were included in the nonimmigrated group, and those born in another city in Türkiye and settled to live in Antalya were included in the immigrated group. The effect of internal migration and other risk factors on the age of the first acute coronary syndrome was calculated by regression analysis.

Results: Immigrants were younger than nonimmigrants at the time of acute coronary syndrome (55.4 ± 10.7 years vs. 60.0 ± 13.36 years, P < 0.001). Linear regression analysis showed that migration is an independent risk factor for acute coronary syndrome at an earlier age (-2.07, P < 0.001). The socioeconomic status of the migrant group was not lower than the nonimmigrant group.

Conclusions: Internal migration may be a risk factor associated with acute coronary syndrome at an earlier age when compared to nonimmigrants. This finding needs to be tested in multicenter epidemiological studies.

Left bundle branch block-induced cardiomyopathy is an increasingly recognized type of dilated cardiomyopathy identified in a minority but not negligible proportion of patients with newly diagnosed heart failure. However, it has not yet been included among the possible etiologies of dilated cardiomyopathies or among the unclassified cardiomyopathies. Although a few sets of diagnostic criteria have been proposed, currently there is a lack of universal consensus regarding diagnostic criteria. Some specific clinical features and electrocardiography, echocardiography, and cardiac magnetic resonance imaging findings are recommended to help physicians in the diagnosis of left bundle branch block-induced cardiomyopathy. In this review, prevalence, pathophysiological mechanisms, diagnostic criteria, diagnostic modalities, and specific features of left bundle branch block-induced cardiomyopathy have been addressed with attention to the differential diagnosis of other dilated cardiomyopathies.

Transcatheter edge-to-edge repair treatment is mainly used for patients with chronic heart failure concomitant severe mitral regurgitation. However, utilization of this system in the acute seting of myocardial infarction is still limited. In this case report authors aimed to show the effectiveness of the percutaneous treatment for severe acute mitral regurgitation early after myocardial infarction.

Persistent hypoglossal artery is a rare primitive anastomose which mainly supplies the posterior cerebral circulation by itself in the case of the absent vertebral arteries. This artery is an embryological remnant and is commonly found incidentally. It originates from the upper cervical vertebra (C1-C2 level) of the internal carotid artery. Here we present a unique case suffering from syncope related to persistent hypoglossal artery which supplies the posterior cerebral blood flow in the absence of the vertebral arteries with the classical findings on magnetic resonance imaging and our clinical approach.

Orthogonal-biplane imaging (X-plane) is relatively a new tooL and provides comprehensive information about mitral valve and left atrial appendage evaluation. On the other hand, X-plane method is a promising method in the diagnosis of semilunar valve pathologies. Below, we report 2 cases, in which X-plane method was used, in order to clarify diagnosis. Case 1: Case 1 was a 63-year-old male patient who was admitted to our clinic with dyspnea. Right ventricular dilatation and hypertrophy were assessed. In order to determine the exact reason for right ventricular pressure overload, the pulmonary valve was evaluated by X-plane, and a bicuspid pulmonary valve was represented. This patient underwent pulmonary valve percutaneous valvuloplasty. Case 2: Case 2 was a 48-year-old male patient who was admitted to our hospital with a history of cerebrovascular event. His initial transthoracic and transesophageal echocardiography showed a hyperechoic mobile mass on the non-coronary cusp. However, after X-plane was used to detect the aortic valve, it was the prolapsed part of the non-coronary cusp adjacent to the commissure. These 2 case reports demonstrated the efficacy of the X-plane method in the diagnosis of semilunar valve pathologies in daily practice.

Objective: Down syndrome is a genetic syndrome characterized with various dysmorphisms and congenital malformations such as congenital heart diseases. We aimed to evaluate the relationship between Down syndrome, hypothyroidism, and cardiac ���ndings.

Methods: Thyroid hormone pro���les and echocardiographic ���ndings were evaluated. Patients with hypothyroidism and Down syndrome were named group 1; patients with hypothyroidism without Down syndrome group 2 and group 3 was control. The echocardiographic parameters (interventricular septum and left ventricular systolic, diastolic posterior wall thickness, left ventricular end-diastolic diameter, ejection fraction) were indexed to body surface area. Left ventricular mass index and relative wall thickness were calculated. Patients with relative wall thickness equal to or below 0.42 were classi���ed as eccentric hypertrophy or normal geometry, while those over 0.42 as concentric remodeling or concentric hypertrophy.

Results: Thyroid stimulating hormone values of groups 1 and 2 were signi���cantly higher than those of group 3. There were no signi���cant di���erences for fT4 between the groups. Interventricular septum and left ventricular posterior wall end-diastolic and end-systolic thickness were signi���cantly higher in group 1 than groups 2 and 3. There was no statistically signi���cant di���erence in left ventricular mass index between groups 1 and 2. In terms of relative wall thickness, 16 out of 29 patients in group 1 were revealed as concentric remodeling, 12 as normal geometry, 1 patient as eccentric hypertrophy. In group 2, 6 patients were revealed as concentric remodeling, 14 as normal geometry. There was no statistically signi���cant di���erence of left ventricular end-diastolic thickness between 3 groups.

Conclusion: Cardiac morphology and functions were signi���cantly a���ected by hypothyroidism in patients with Down syndrome. Hypertrophy in Down syndrome may be caused by the cellular changes in myocardium.