3-year follow-up results of heart failure patients included in the Journey HF-TR study

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Autonomic dysfunction and metabolic disorders as the possible sequelae of COVID-19 infection

- OBJECTIVE: The Coronavirus dis-ease 2019 (COVID-19) infection is associated with autonomic dysfunction. Data on the long-term re-lationship between COVID-19 infection, heart rate recovery (HRR), and exaggerated blood pressure response to exercise (EBPR) are very limited. In our study, we aimed at investigating the long-term association between COVID-19, HRR, EBPR, metabolic, and echocardiographic parameters.PATIENTS AND METHODS: The study includ-ed 65 patients in the study group (33 female, median age 46) and 57 in the control group (30 female, 39 median age) between 1 April 2020 and 1 January 2021. Office blood pressure mea-surement, 24-hour ambulatory blood pressure monitoring, treadmill test, echocardiography, and metabolic parameters were evaluated.RESULTS: The frequency of blunted HRR (25 subjects, 38.5%, p < 0.001) and EBPR (7 subjects, 10.8%, p = 0.014) were significantly higher in study group. The study group had higher levels of white blood cell (p = 0.002), neutrophil, c -reac-tive protein, and uric acid (p < 0.001). Diameters of left atrium, aortic root, and ascending aorta were significantly higher in study group (p < 0.05). Age adjusted multiple logistic regression analysis showed that neutrophil levels (odds ra-tio (OR), 9.21; 95% confidence interval (CI), 1.52-55.75, p = 0.016), glomerular filtration rate (OR, 1.34; 95% CI, 1.13-1.59, p = 0.001), basal heart rate (OR, 1.58; 95% CI, 1.17-2.12, p = 0.003), and mean heart rate (OR, 1.22; 95% CI, 1.03-1.45, p = 0.0021) were independently associated with COVID-19 infection.CONCLUSIONS: The frequency of blunted HRR and EBPR, and uric acid levels were significant-ly higher in the study group compared to the control group, suggesting autonomic dysfunc-tion as the possible sequelae of the COVID-19 infection and increased risk of cardiovascular events in the future

The relationship of masked hypertension with autonomic dysfunction and cardiometabolic parameters: a case-control study

OBJECTIVE: Masked hypertension (MH) is associated with cardiovascular events and mortality. Data on the association between exaggerated blood pressure response (EBPR) to exercise, heart rate recovery (HRR), which are indicators of autonomic dysfunction, and MH are lacking. This study aimed at evaluating the association between EBPR, HRR, and MH. PATIENTS AND METHODS: Between January 2020 and January 2021, 130 MH (57 male, median age = 52.8 years) and 60 healthy (28 male, median age = 40.8 years) subjects were included in this single-center, case-control, and cross-sectional study. Office blood pressure measurement, 24-hour ambulatory blood pressure monitoring, treadmill test, echocardiography, and specific biochemical parameters were evaluated. RESULTS: The frequency of blunted HRR (73 subjects, 56.2%) and EBPR (40 subjects, 30.8%) were significantly higher in patients with MH (p < 0.001). Patients with MH had higher serum uric acid levels and frequency of hyperlipidemia (p < 0.05). Diameters of the left atrium (LA), aortic root, and ascending aorta were significantly higher in MH patients (p < 0.05). Thirty-two (24.6%) patients with MH had left ventricular hypertrophy and 33 (25.4%) had diastolic dysfunction (p < 0.001). Multivariate analysis identified the presence of blunted HRR as an independent predictor factor of MH as well as smoking, hyperlipidemia, GFR, LA diameter, and aortic root diameter were other independent factors. CONCLUSIONS: The frequency of blunted HRR and EBPR were significantly higher in the MH group compared to the control group, suggesting a close relationship between MH and autonomic dysfunction

C-reactive protein to albumin ratio predicts for severity of coronary artery disease and ischemia

OBJECTIVE: Myocardial perfu-sion scintigraphy (MPS) has prognostic importance in demonstrating myocardial ischemia, and the Syntax score (SS) in coronary angiogra-phy has prognostic importance in demonstrat-ing the extent of coronary artery disease (CAD). C-reactive protein (CRP) and albumin are prognostic markers for both atherosclerosis and inflammation. In this study, we aimed at investigating the relationship of CRP/albumin ratio (CAR) with the severity of myocardial ischemia and SS in patients with stable CAD. PATIENTS AND METHODS: We retrospec-tively evaluated 355 patients between January 2018 and January 2020. Patients were divided into normal, mild-moderate, and severe ischemia groups according to MPS. SS was classi-fied as low risk (= 32) groups. The association between CAR, SS, and MPS findings were analyzed. RESULTS: The median CAR level was high-er in the high-risk group compared to the low -risk group (20.7 vs. 13.8, p 10.2 was a common point in predicting both low -risk and mild-moderate ischemia (AUC: 0.736, p < 0.001; AUC: 0.741, p < 0.001, respectively). CONCLUSIONS: High CAR level was an inde-pendent predictor of both the severity of ischemia and the extent of CAD. Therefore, CAR can be a potential screening tool in patients with suspected CAD and in risk stratification

Effects of bisphosphonate and calcium carbonate on normal aortic valve and cholecalciferol induced in vivo rabbit aortic stenosis model

Abstract Background Calcific aortic valve disease (CAVD) is the most common valvular heart disease. Bisphosphonates are stable analogs of pyrophosphates and commonly prescribed in the treatment of osteoporosis. The effects of bisphosphonate treatment on CAVD are not clearly known and there are inconsistent results. Similarly, the effect of calcium supplementation on CAVD remains controversial. Purpose The aim of this study was to assess the effects of bisphosphonate therapy on the normal aortic valve and vitamin D induced in vivo rabbit aortic stenosis (AS) model. Methods The impact of calcium supplementation on the rabbit AS model was also evaluated. A total of 30 New Zealand white rabbits were divided into five equal groups: no treatment (Group I); 25,000 IU/day vitamin D3 (cholecalciferol) (Group II, rabbit AS model); 25,000 IU/day cholecalciferol plus 2500 mg/day calcium carbonate (Group III); 20 μg/kg/week intravenous alendronate (Group IV) and 25,000 IU/day cholecalciferol plus 2500 mg/day calcium carbonate plus 20μg/kg/week alendronate (Group V). Echocardiography was performed at baseline and after 12 weeks of treatment. The left ventricular mass index (LVMI), aortic valve area (AVA), transvalvular velocities and gradients were recorded. Radiologic and histopathologic examination was performed at the end of the 12th week. Control animals displayed no abnormalities of the aortic valve. Results There was no echocardiographic change in Group IV. In Groups II, III and V, there was a significant decrease in AVA and increases in transvalvular velocities and gradients. However, these stenotic changes were significantly prominent in Group V (p=0.001 for all, via repeated measures ANOVA). Moreover, LVMI was only increased in Group V (p&amp;lt;0.05). Calcification of aortic valvar complex was detected in 14 (46.7%) cases by radiologic imaging and 10 (33.3%) cases by histopathologic examination. Most frequent calcification was found in Group V (5 for each method, 83.3%). Agatston, volume and equivalent mass scores of calcific foci in Group V were significantly higher than other groups (p&amp;lt;0.05 for all). There was no significant difference between groups regarding with presence of osteoclasts in calcific foci. Conclusion Calcium supplementation has no effect on the in vivo rabbit AS model. Alendronate treatment aggravates the stenosis and increases the calcification in the rabbit AS model. Alendronate treatment has no effect on the normal valve in which there was no osteogenesis and osteoclastogenesis. Based on these findings, in patients with CAVD, alendronate treatment should be given with regular echocardiographic follow-up or may not be preferred. Central figure Funding Acknowledgement Type of funding source: None </jats:sec

Association among CO-RADS score, co-morbid diseases, and short-term prognosis in COVID-19 infection

OBJECTIVE: CO-RADS scoring system is used as a diagnostic tool. However, the data about its association with co-morbid diseases and effectiveness in predicting intensive care need and short-term mortality are lacking. In our study. we aimed to investigate the association among CO-RADS score, co-morbid diseases, intensive care need. and 28-day-mortality

Computerized dynamic pupillometry indices mirrors the heart rate variability parameters

OBJECTIVE: Dynamic pupillometry (DP) is a simple, non-invasive computerized assessment of pupillary light response which provides data concerning both branches of the autonomous nervous system (ANS). Heart rate variability (HRV) analysis assess cardiac health and the ANS modulation on the heart. In this study, we aimed to evaluate the utility of DP as a predictor of cardiac autonomic activity assessed by HRV

Assessment of the relationship between dynamic pupillometry and exercise heart rate recovery among healthy subjects

OBJECTIVE: Dynamic pupillometry (DP) is a simple, non-invasive computerized technique for assessment of pupillary light response which provides data concerning the balance of both branches of the autonomous nervous system (ANS). Heart rate (HR) recovery (HRR) after graded exercise reflects cardiac autonomic activity and predicts cardiovascular events. In this study, we aimed to evaluate the utility of DP as a predictor of cardiac autonomic activity assessed by HRR