Authors' reply

[No abstract available

Ortner's Syndrome caused by ductus arteriosus aneurysm

PubMedID: 27372626[No abstract available

Atypical form of left ventricular noncompaction resembling mass appearance in papillary muscles

PubMedID: 23912970[No abstract available

Assessment of insulin-like growth factor-1 (IGF-I) level in patients with rheumatic mitral stenosis

PubMedID: 24625682Objectives: Insulin-like growth factor-1 may serve some regulatory function in the immune system. Rheumatic mitral stenosis is related to autoimmune heart valve damage after streptococcal infection. The aim of this study was to assess the level of insulin-like growth factor-1 and its correlation with the Wilkins score in patients with rheumatic mitral stenosis. Methods: A total of 65 patients with rheumatic mitral stenosis and 62 age- and sex-matched control subjects were enrolled in this study. All subjects underwent transthoracic echocardiography. The mitral valve area and Wilkins score were evaluated for all patients. Biochemical parameters and serum insulin-like growth factor-1 levels were measured. Results: Demographic data were similar in the rheumatic mitral stenosis and control groups. The mean mitral valve area was 1.6±0.4 cm2 in the rheumatic mitral stenosis group. The level of insulin-like growth factor-1 was significantly higher in the rheumatic mitral stenosis group than in the control group (104 (55.6-267) versus 79.1 (23.0-244.0) ng/ml; p=0.039). There was a significant moderate positive correlation between insulin-like growth factor-1 and thickening of leaflets score of Wilkins (r=0.541, p<0.001). Conclusions: The present study demonstrated that serum insulin-like growth factor-1 levels were significantly higher in the rheumatic mitral stenosis group compared with control subjects and that insulin-like growth factor-1 level was also correlated with the Wilkins score. It can be suggested that there may be a link between insulin-like growth factor-1 level and immune pathogenesis of rheumatic mitral stenosis. © Cambridge University Press 2014

Predictors of the paroxysmal atrial fibrillation recurrence following cryoballoon-based pulmonary vein isolation: Assessment of left atrial volume, left atrial volume index, galectin-3 level and neutrophil-to-lymphocyte ratio

Background: Cryoballoon-based pulmonary vein isolation (PVI) is a treatment option for atrial fibrillation (AF). Left atrial volume (LAV) and left atrial volume index (LAVi) are important parameters for long term success of PVI. Galectin-3 (Gal-3) and neutrophil to lymphocyte ratio (N/L ratio) are biomarkers to demonstrate the cardiac fibrosis and remodelling. Methods: 50 patients with symptomatic PAF despite ?1 antiarrhythmic drug(s), who underwent PVI were enrolled. LAV, LAVi, Gal-3 and N/L ratio were calculated before ablation and after ablation at 6 and 12 months. According to AF recurrence patients were divided into two groups, recurrent AF (n = 14) and non-recurrent AF (n = 36). Results: In both groups (recurrent and non-recurrent), initial and 12 months follow-up LAV values were 41.39 ± 18.13 ml and 53.24 ± 22.11 ml vs 48.85 ± 12.89 ml and 42.08 ± 13.85 (p = 0.037). LAVi were 20.9 ± 8.91 ml/m2 and 26.85 ± 11.28 ml/m2 vs 25.36 ± 6.21 and 21.87 ± 6.66 (p = 0.05) for recurrent and non-recurrent AF groups, respectively. In both groups PVI had no significant effect on serum Gal-3 levels and N/L ratio during 12 months follow-up. The comparison between two groups at the end of 12th month showed Gal-3 values of 6.66 ± 4.09 ng/ml and 6.02 ± 2.95 ng/ml (p = 0.516), N/L ratio values of 2.28 ± 1.07 10 3 /µl and 1.98 ± 0.66 10 3 /µl (p = 0.674). Conclusion: LAV and LAVi are useful to predict the remodelling of the left atrium and AF recurrence after cryoballoon-based PVI. However, biomarkers such as Gal-3 and N/L ratio are not associated with AF recurrence. © 2018 Indian Heart Rhythm Societ

The Incidence and the Risk Factors of Silent Embolic Cerebral Infarction after Coronary Angiography and Percutaneous Coronary Interventions

PubMedID: 26253467Silent embolic cerebral infarction (SECI) is a major complication of coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients with stable coronary artery disease (CAD) who underwent CAG with or without PCI were recruited. Cerebral diffusion-weighted magnetic resonance imaging was performed for SECI within 24 hours. Clinical and angiographic characteristics were compared between patients with and without SECI. Silent embolic cerebral infarction occurred in 12 (12%) of the 101 patients. Age, total cholesterol, SYNTAX score (SS), and coronary artery bypass history were greater in the SECI(+) group (65 ± 10 vs 58 ± 11 years, P =.037; 223 ± 85 vs 173 ± 80 mg/dL, P =.048; 30.1 ± 2 vs 15 ± 3, P <.001; 4 [33.3%] vs 3 [3.3%], P =.005). The SECI was more common in the PCI group (8/24 vs 4/77, P =.01). On subanalysis, the SS was significantly higher in the SECI(+) patients in both the CAG and the PCI groups (29.3 ± 1.9 vs 15 ± 3, P <.01; 30.5 ± 1.9 vs 15.1 ± 3.2, P <.001, respectively). The risk of SECI after CAG and PCI increases with the complexity of CAD (represented by the SS). The SS is a predictor of the risk of SECI, a complication that should be considered more often after CAG. © SAGE Publications

Association among tenascin-C and NT-proBNP levels and arrhythmia prevalence in heart failure

PubMedID: 29256387Purpose: Tenascin-C (TN-C) and amino-terminal fragment of the B-type natriuretic peptide (NT-proBNP) are the important predictors in prognosis of heart failure (HF). The aim of this study was to analyze the relationship of TN-C and NT-proBNP levels with the frequency and severity of ventricular arrhythmia. Materials and Methods: Our study included 107 HF patients with EF < 45%. According to Holter analysis, the patients were divided into two groups as malignant arrhythmia group (n=29) with Lown Class 4a and 4b arrhythmia and benign arrhythmia group(n=78) with Lown Class 0-3b arrhythmia. The groups were compared with respect to levels of TN-C and NT-proBNP. The relationship of TN-C and NT-proBNP levels with frequency of ventricular premature beat (VPB) was also analyzed. Findings: NT-proBNP (5042.1±1626 versus 1417.1±1711.6 pg/ml) and TN-C (1089±348.6 versus 758.5±423.9 ng/ml) levels were significantly higher in the malignant arrhythmia group than that of the benign arrhythmia group (p<0.001). A significantly strong positive correlation (r=0.741, p<0.001) was found between the NT-proBNP levels and VPB numbers of the patients, whereas a significantly weak positive correlation was detected between the TN-C levels and VPB numbers of the patients (r=0.347, p<0.001). Conclusion: This study has shown that NT-proBNP and TN-C levels increase in the HF patients with malignant arrhythmia. In the HF patients; the frequency of ventricular arrhythmias also increases as NT-proBNP and TN-C levels increase. However, in this study, the old NT-pro BNP seems better than the TN-C. © 2017 CIM

Exploring decision-making techniques for evaluation and benchmarking of energy system integration frameworks for achieving a sustainable energy future

Energy Systems Integration (ESI) involves coordinating and planning energy systems to provide reliable and affordable energy services while minimizing environmental harm. It optimizes interactions among different energy sources to achieve sustainability goals and promotes efficient resource usage. However, evaluating and benchmarking ESI frameworks to select the most suitable and transparent ones is a complex Multi-Criteria Decision-Making (MCDM) problem. This complexity arises from trade-offs, conflicts, and importance considerations of the six ESI evaluation characteristics: Multidimensional, Multivectoral, Systemic, Futuristic, Systematic, and Applied. Hence, this study aims to address this complexity by integrating Fuzzy-Weighted Zero-Inconsistency (FWZIC) and Multi-Attributive Border Approximation Area Comparison (MABAC). The proposed methodology consists of two phases. Firstly, the development of a Dynamic Decision Matrix (DDM) to handle 26 ESI frameworks as alternatives and the six ESI characteristics criteria. Secondly, the integration of mathematical processes is formulated based on the FWZIC-MABAC methods. Using the FWZIC technique, the ESI evaluation criteria were weighted based on the preferences of twelve experts. ESI-C2 (Multivectoral) and ESI-C1 (Multidimensional) criteria received the highest weights of 0.195 and 0.190, respectively, while the ESI-C5 (Systematic) criterion received the lowest weight of 0.110. The remaining criteria, namely ESI-C3 (Systemic), ESI-C6 (Applied), and ESI-C4 (Futuristic) obtained weights of 0.189, 0.168, and 0.147, respectively. The MABAC benchmarking results showed that A11 (Energy Security) and A15 (Energy Security under decarbonization) ranked first with the highest score value of 0.28081 for both. Conversely, A19 (EJM) had the lowest score value of −0.17022. The systematic rank and sensitivity analysis assessments were conducted to verify the efficiency of the proposed methodology. We benchmarked the proposed methodology against three other benchmark studies and achieved a score of 100 % across three key perspectives. This methodology offers valuable support in making informed and sustainable decisions in the energy sector

Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study

Objective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ≥18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic. © 2020 by Turkish Society of Cardiology