Twin Circumflex Arteries with Left Sinus of Valsalva Origin: A Case Report

Coronary artery anomalies are not uncommon. The importance of coronary anomalies varies from unimportant to life threatening. Herein, we report for the first time twin circumflex coronary arteries originating separately from the left sinus of Valsalva

Krętość tętnic wieńcowych: porównanie z tętnicami siatkówki i ocena grubości kompleksu błony wewnętrznej oraz środkowej tętnicy szyjnej

Background and aim: We conducted a prospective study to investigate the possible relationship between the tortuosity ofcoronary arteries (TCA) and carotid intima-media thickness (CIMT), and also compare TCA to retinal artery tortuosity.Methods: One hundred and five participants with nonsignificant coronary plaque or normal coronary angiogram were included. To determine subclinical atherosclerosis, maximum CIMT was measured. Retinal tortuosity was evaluated ophthalmically.Results: Among all demographic variables and risk factors, only female gender and height were significantly associated with TCA (p = 0.001, p = 0.01, respectively). Retinal artery tortuosity and retinal artery atherosclerosis were more common inpatients with TCA compared to patients without TCA (p < 0.001, R = 0.6; p = 0.002, R = 0.4, respectively). CIMT was greater in participants with TCA than patients without TCA (p = 0.001), and also the presence of carotid artery plaque was more common in patients with TCA (p < 0.001). There was a significant correlation between the presence of subclinicalatherosclerosisand TCA (p = 0.005, R = 0.3). Likewise, a significant correlation was found between subclinical atherosclerosis and retinal artery tortuosity (p = 0.02, R = 0.3). Multivariate analysis identified female gender (p < 0.008), retinal arterytortuosity (p < 0.001), and CIMT (p = 0.02) as independent predictors of TCA.Conclusions: These results indicate that, whatever the mechanism is: 1) TCA is associated with female gender and short stature; 2) TCA is associated with subclinical atherosclerosis even in patients with entirely normal appearing coronary arteries oncoronary angiography; 3) Retinal artery tortuosity is correlated with TCA and can be a surrogate for systemic arterial tortuosity.Wstęp i cel: Autorzy przeprowadzili prospektywne badanie w celu oceny możliwych zależności między krętym przebiegiem tętnic wieńcowych (TCA) a grubością kompleksu błony wewnętrznej i środkowej (IMT) tętnicy szyjnej oraz porównania TCAz krętością tętnic siatkówki.Metody: Do badania włączono 105 osób z nieistotną klinicznie blaszką miażdżycową lub prawidłowym obrazem w angiografii tętnic wieńcowych. W celu wykrycia bezobjawowej miażdżycy zmierzono maksymalną grubość IMT tętnicy szyjnej. Krętość naczyń siatkówki oceniono w badaniu okulistycznym.Wyniki: Spośród wszystkich zmiennych demograficznych i czynników ryzyka tylko płeć żeńska i wzrost były istotnie związane z TCA (odpowiednio p = 0,001 i p = 0,01). Krętość tętnic siatkówki i zmiany miażdżycowe w tętnicach siatkówki występowały częściej u pacjentów z TCA niż u osób bez TCA (odpowiednio p < 0,001; R = 0,6 i p = 0,002; R = 0,4). Grubość IMT tętnicy szyjnej była większa u osób z TCA niż u pacjentów bez TCA (p = 0,001); ponadto w grupie osób z TCA częściej stwierdzano obecność blaszek miażdżycowych w tętnicach szyjnych (p < 0,001). Wykazano istotną korelację między obecnością bezobjawowej miażdżycy a TCA (p = 0,005; R = 0,3). Istotna korelacja istniała również między bezobjawową miażdżycą a krętością tętnic siatkówki (p = 0,02; R = 0,3). W analizie wieloczynnikowej wykazano, że płeć żeńska (p < 0,08), krętość tętnic siatkówki (p < 0,001) i grubość IMT tętnicy szyjnej (p = 0,02) były niezależnymi czynnikami predykcyjnymi TCA.Wnioski: Powyższe rezultaty wskazują, że niezależnie od mechanizmów 1) TCA wiąże się z płcią żeńską i niskim wzrostem; 2) TCA wiąże się z bezobjawową miażdżycą, nawet u pacjentów z całkowicie prawidłowym obrazem tętnic wieńcowychw badaniu angiograficznym; 3) krętość tętnic siatkówki koreluje z TCA i może być zastępczym wskaźnikiem krętości tętnicw krążeniu systemowym

The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

WOS: 000423237800009PubMed ID: 28443575Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy. Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey. Study Design: Cross-sectional study. Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of the effect of warfarin and fooddrug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5% +/- 22.9 in the WARFARIN-TR study. There were statistically significant differences between regions in terms of time in therapeutic range (p<0.001). The highest rate was reported in the Marmara region (54.99%+/- 20.91) and the lowest was in the South-eastern Anatolia region (41.95 +/- 24.15) (p< 0.001). Bleeding events were most frequently seen in Eastern Anatolia (41.6%), with major bleeding in the Aegean region (5.11%) and South-eastern Anatolia (5.36%). There were statistically significant differences between the regions in terms of awareness (p< 0.001). Conclusion: Statistically significant differences were observed in terms of the efficacy, safety and awareness of warfarin therapy according to different geographical regions in Turkey

Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey

WOS: 000468584300005PubMed ID: 30930455Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.Turkish Society of CardiologyThis study was supported by Turkish Society of Cardiology

Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey

Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50\%). Results: A total of 1098 patients (male, 47.5\%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 \%; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8\% for patients who were >= 80 years and 27.1\% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67\% for hypertension (HT), 25.6\% for diabetes mellitus (DM), 54.3\% for coronary artery disease (CAD), and 42.3\% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65-79 years, 43.9\% (548) had HFpEF, and 56.1\% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged >= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF