Obsidian Sources in the Regions of Erzurum and Kars (North-East Turkey): New Data

International audienceThe obsidian sources on the Erzurum–Kars Plateau have not been extensively surveyed, and their geochemical signatures are still poorly understood. Yet a significant number of artefacts from archaeological sites in Georgia and Armenia have produced chemical compositions that are unrelated to any Turkish or Caucasian source analysed so far. Their origins may lie in these poorly known deposits. The objective of the collaborative project undertaken by the University of Erzurum and the French mission ‘Caucasus’ is to study the sources of obsidian in the Erzurum and Kars regions, in order to shed light on the intensity of exploitation of this material, and to highlight the exchange networks that may have existed between north‐eastern Turkey and the southern Caucasus. The analyses that we have carried out on the samples taken during this exploratory survey have enabled a definite extension of the territory of circulation of this obsidian to western Transcaucasia. The lack of knowledge concerning the diffusion of obsidian from the regions of Erzurum and Kars thus appears for the moment mainly related to insufficient geochemical characterization of the sources, confirming the importance of future surveys

Obsidian Sources in the Regions of Erzurum and Kars (North-East Turkey): New Data

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Forage yield stability of common vetch (Vicia sativa L.) genotypes in the çukurova and GAP regions of Turkey [Çukurova ve GAP Bölgesinde Yaygın Fig (Vicia sativa L.) Genotiplerinin Ot Verimi Stabilitesi]

Improving forage production for an expanding livestock population is essential in the Çukurova and GAP (South-eastern Anatolia Project) regions of Turkey. Feed shortages, especially evident during winter, can be alleviated by introducing high yielding common vetch (Vicia sativa L.) cultivars into crop rotations. The objectives of this research were to determine the genotype × environment interactions and stability parameters for hay yield of 15 vetch lines and cultivars. The vetch genotypes were evaluated in the Çukurova (2 locations for 3 years) and South-eastern Anatolia (1 location for 2 years) regions. In the South-eastern Anatolia region, the rainfall limits plant growth, while the Çukurova region has much better soil and climatic conditions. Since local climatic variation is significant, each location in each year is treated as a separate environment, to give 8 environments. Linear regression techniques were used to analyse genotype × environment interactions (G × E). The hay yield was significantly different between genotypes and environments, while a genotype × environment interaction was present. The variation amongst environments was highly significant, and the mean hay yield ranged from 7453 kg ha-1, in Dogankent (2002-03), to 2687 kg ha-1, in Balcali{dotless} (2003- 04). The genotypes 'V7' and 'V12', which had regression coefficients significantly greater than 1.0 and produced mean hay yields above the overall mean, were well adapted to favourable environments. Three entries (V5, V9, and V10) possessed regression coefficients significantly less than 1.0, with hay yield above the grand mean, suggesting that these genotypes were better adapted to poor environments and insensitive to environmental change. Our study demonstrated that previously selected genotypes and cultivars can be successfully grown and make a significantly positive contribution to animal husbandry in the Çukurova and South- eastern Anatolia regions.© TÜBITAK

Clinical features of heart failure with mid-range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Objectives: To compare real-world characteristics and management of individuals aged 80 and older with heart failure (HF) and mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) derived from a large cohort of survey and to compare them with those younger than 80 from the same survey. Methods: This is an observational, multicentre and cross-sectional study conducted in Turkey (NCT03026114). Consecutive 1065 (mean age of 67.1 ± 10.6 years) patients admitted to the cardiology outpatient units with HFmrEF and HFpEF were included. Results: Participants aged 80 and older (n = 123, 11.5%) were more likely to be female (66.7% vs 52.5%, P = 0.003), had a higher prevalence of atrial fibrillation (49.6% vs 34%, P = 0.001), and anaemia (46.3% vs 33.4%, P = 0.005) than those who were younger than 80. N-terminal pro B-type natriuretic peptide levels were higher in those aged 80 and older than in those younger than 80 (1037 vs 550 pg/ml, P  0.05) in both groups. Octogenarians did not significantly differ from younger patients in the prevalence of HFmrEF (24.4% vs 22.9%) and HFpEF (75.6% vs 77.1%). Coronary artery disease was associated with HFmrEF (P < 0.05), whereas atrial fibrillation was associated with HFpEF (P < 0.05) in octogenarians. Conclusions: This study revealed that nearly 12% of the individuals with HFmrEF and HFpEF in this real-world sample were aged 80 and older. Participants aged 80 and older are more likely to be female and have more comorbidities than those who were younger than 80. However, HF medication profiles were similar in both groups. This study also showed that associated factors with HFmrEF and HFpEF were differ in octogenarians. © 2019 John Wiley & Sons Lt

Gender disparities in heart failure with mid-range and preserved ejection fraction: Results from APOLLON study

Objective: This study aimed to examine gender-based differences in epidemiology, clinical characteristics, and management of consecutive patients with heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF). Methods: The APOLLON trial (A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON) is a multicenter, cross-sectional, and observational study. Consecutive patients with HFmrEF or HFpEF who were admitted to the cardiology clinics were included (NCT03026114). Herein, we performed a post-hoc analysis of data from the APOLLON trial. Results: The study population included 1065 (mean age of 67.1±10.6 years, 54% women) patients from 11 sites in Turkey. Compared with men, women were older (68 years vs. 67 years, p&lt;0.001), had higher body mass index (29 kg/m2 vs. 27 kg/m2, p&lt;0.001), and had higher heart rate (80 bpm vs. 77.5 bpm, p&lt;0.001). Women were more likely to have HFpEF (82% vs. 70.9%, p&lt;0.001), and they differ from men having a higher prevalence of hypertension (78.7% vs. 73.2%, p=0.035) and atrial fibrillation (40.7% vs. 29.9%, p&lt;0.001) but lower prevalence of coronary artery disease (29.5% vs. 54.9%, p&lt;0.001). Women had higher N-terminal pro-B-type natriuretic peptide (691 pg/mL vs. 541 pg/mL, p=0.004), lower hemoglobin (12.7 g/dL vs. 13.8 g/dL, p&lt;0.001), and serum ferritin (51 ng/mL vs. 64 ng/mL, p=0.001) levels, and they had worse diastolic function (E/e’=10 vs. 9, p&lt;0.001). The main cause of heart failure (HF) in women was atrial fibrillation, while it was ischemic heart disease in men. Conclusion: Clinical characteristics, laboratory findings, and etiological factors are significantly different in female and male patients with HFmrEF and HFpEF. This study offers a broad perspective for increased awareness about this patient profile in Turkey. (Anatol J Cardiol 2019; 21: 242-52). © Copyright 2019 by Turkish Society of Cardiology

Left and right ventricle functions in patients obstructive sleep apnea and their relationship with apelin levels [Obstruktif uyku apneli hastalarda sol ve sağ ventrikül fonksiyonları ve apelin düzeyleri ile ilişkisi]

Aim of this study is to determine the left and right ventricle functions by echocardiography in patients with newly diagnosed obstructive sleep apnea (OSA) and to investigate whether there is a relationship between the apelin levels and systolic and diastolic functions of the right and left ventricles. Study included 44 patients (30 males, 14 females; mean age 49.8±11.5 years) diagnosed with obstructive sleep apnea according to polysomnographically determined apnea hypopnea index, and 30 control subjects (25 males, 5 females; mean age 43.03±10.89 years) diagnosed with simple snoring. Apelin levels of all the study subjects are measured. Systolic and diastolic functions of both ventricles were evaluated with the help of conventional and tissue Doppler methods. Results: Systolic and diastolic blood pressure levels of the OSA group were significantly higher compared to those of the AHI control group. Lateral inferior and anterior E’ were significantly lower whereas E/E’ was significantly higher in the OSA group compared to the control group (8.40±3.24 vs. 10.80±3.24; p=0.001, 7.50±2.60 vs 9.00±2.51; p=0.009, 7.90±2.68 vs. 8.90±2.73; p=0.006, 7.57±3.20 vs. 6.44±1.55; p=0.023, respectively). Although the apelin levels were higher in the OSA group compared to the control group, this difference did not reach statistical significance. Age, AHI, and echocardiographic indices were not correlated with the apelin levels. There was no relationship between the severity of OSA and the apelin levels, either. This study showed diastolic functions may be impaired in patinets with newly diagnosed OSA. Apelin levels which has been shown to play an important role in cardiovascular hemodynamics, had no significant correlation with OSA severity. Moreover, there was no significant correlation between the apelin levels and echocardiographically assessed systolic and diastolic functions of both ventricles. © 2015, TIP ARASTIRMALARI DERNEGI. All Rights Reserved

Patients with HFpEF and HFmrEF have different clinical characteristics in Turkey: A multicenter observational study

Background: To determine and compare the demographic characteristics, clinical profile and management of patients with heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) in a Turkish cohort. Methods: The APOLLON trial (A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON) is an observational and multicenter study conducted in Turkey. Consecutive patients admitted to the cardiology clinics who were at least 18 years of age and had HFmrEF or HFpEF were included (NCT03026114). Results: The study population included 1065 (mean age of 67.1 ± 10.6 years, 54% women) patients from 12 sites in Turkey. Among participants, 246 (23.1%) had HFmrEF and 819 (76.9%) had HFpEF. Compared to patients with HFpEF, those with HFmrEF were more likely to be male (57.7 vs 42.2%; p < 0.001), had higher N-terminal pro-B-type natriuretic peptide levels (853 vs 528 pg/ml, p < 0.001), were more likely to have ECG abnormalities (72.4 vs 53.5%, p < 0.001) and hospitalization history for heart failure (28 vs 18.6%; p = 0.002). HFmrEF patients were more likely to use ß-blockers (69.9 vs 55.2%, p < 0.001), aldosterone receptor antagonists (24 vs 14.7%, p = 0.001), statins (37 vs 23%, p < .001), and loop diuretics (39.8 vs 30.5%, p = 0.006) compared to patients with HFpEF. Conclusions: The results of APOLLON study support that the basic characteristics and etiology of HFmrEF are significantly different from HFpEF. This registry also showed that the patients with HFmrEF and HFpEF were younger but undertreated in Turkey compared to patients in western countries. © 2018 European Federation of Internal Medicin

Geographical variations in patients with heart failure and preserved ejection fraction: A sub-group analysis of the apollon registry

Background: Clinical characteristics of patients with heart failure may vary geographically. However, limited data are available regarding the geographical differences of patients with heart failure and preserved ejection fraction. Aims: The present subgroup analysis aims to investigate the geographical differences in clinical characteristics, management, and primary etiology of patients with heart failure and preserved ejection fraction in Turkey. Study Design: A cross-sectional study. Methods: A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON (APOLLON) is a multicenter and observational study conducted in seven regions of Turkey (NCT03026114). The present study is a post-hoc analysis of the APOLLON registry. In this substudy, we compared the clinical characteristics of 819 consecutive patients with heart failure and preserved ejection fraction (mean age, 67 years; 57.8% women) admitted to cardiology outpatient units in different geographical regions. Results: Based on the geographical distribution of the entire Turkish population, the highest number of patients enrolled were from Marmara (271 patients, 33.1%). All demographical characteristics, clinical and laboratory findings, comorbidities, primary etiology, and medications prescribed were significantly different between the regions. Furthermore, inter-regional gender differences were identified. Comparatively, the Aegean and Mediterranean regions had older patients with heart failure and preserved ejection fraction (p<0.001), and the Black Sea, Southeast, and East Anatolia regions had predominantly male patients (51.2, 54.5, and 56.9%, respectively; p=0.002). Notably, the Mediterranean and Southeast Anatolia had more symptomatic patients, and history of hospitalization for heart failure was more prevalent in Southeast Anatolia (33.3%, p<0.001). Prevalence of atrial fibrillation was higher in the Mediterranean and Southeast Anatolia regions (51 and 48.5%, p<0.001), and patients with heart failure and preserved ejection fraction had a higher prevalence of hypertension in the Mediterranean, Southeast Anatolia, and Black Sea regions (p=0.002). Angiotensin-converting enzyme inhibitors were more frequently prescribed in East Anatolia (52.3%, p=0.001), and the prevalence of patients with heart failure and preserved ejection fraction using loop diuretics (48.8%, p=0.003) was higher in the Black Sea region. Conclusion: This study was the first to show geographical differences in clinical characteristics of patients with heart failure and preserved ejection fraction in Turkey. Determination of the clinical characteristics of the heart failure and preserved ejection fraction population based on the geographical region may enables physicians to adopt a region-specific clinical approach toward heart failure and preserved ejection fraction. © 2019 by Trakya University Faculty of Medicine/The Balkan Medical Journal published by Galenos Publishing House