Patient-prosthesis mismatch in patients with mechanic aortic valve replacement: Which method is better: In vitro or in vivo measurement?

Patient-prosthesis mismatch is usually accepted to be associated with poor outcomes in patients with aortic valve replacement (AVR). This study aims to evaluate prevalence, sensitivity and specificity of mismatch measured with in vivo and in vitro methods, look for a relationship between mismatch and obesity, and investigate the effect of mismatch on left ventricle mass index (LVMI) regression and mortality. A total of 72 consecutive patients who underwent mechanical AVR between December 2011 and May 2013, were prospectively evaluated. EOA was measured with echocardiography in all patients on the 6th postoperative month and an Indexed Effective Orifice Area (EOA) ≤0.85cm2/m2 was accepted as mismatch with the in vivo measurement method. For the in vitro measurement method, charts provided by the valve manufacturers were used for EOA prediction. LVMI was also evaluated on the 6th and 12th postoperative months. Postoperative follow-up is 100% complete with 68.5±14.4 months. In vivo and in vitro mismatch prevalences were 43.5% and 25.0% with slight concordance (kappa=0.172). Sensitivity of in vitro measurements was poor (35.7%), but specificity was 80.5%. LVMI regressions were significant with both mismatch methods (p0.05 in both). In vitro EOA measurements have a poor sensitivity to predict mismatch preoperatively. Left ventricular mass regressions were significant in all groups with no difference in early and late mortality. [Med-Science 2020; 9(4.000): 1045-52

A risk scoring system comprised of right heart failure findings and the New York Heart Association functional classification parameters to predict mortality associated with pericardiectomies

Background: This study aims to develop an easy and feasible risk scoring system by using right heart failure findings as well as New York Heart Association (NYHA) functional classification to predict the early and overall mortality rates in pericardiectomy

Picturing asthma in Turkey: results from the Turkish adult asthma registry

Introduction: National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. Methods: Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. Results: The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3–5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. Conclusion: The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery