Predictive value of CHA2DS2-VASc and CHA2DS2-VASc-HS scores for failed reperfusion after thrombolytic therapy in patients with ST-segment elevation myocardial infarction

Background: Thrombolytic therapy is recommended for patients with acute ST-segment elevation myo- cardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study was to demonstrate the value of CHA2DS2-VASc and CHA2DS2- -VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy.  Methods: A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined with the lack of symptom relief, < 50% ST resolution-related electrocardiography within 90 min from initiation of the thrombolytic therapy, presence of hemodynamic or electrical instability or in-hospital mortality. CHA2DS2-VASc and CHA2DS2-VASc-HS scores, which incorporate hyperlipi- demia, smoking, switches between female and male gender, were previously shown to be markers of the severity of coronary artery disease (CAD). Results: History of hypertension, diabetes mellitus, hyperlipidemia, heart failure, smoking, and CAD were significantly common in failed reperfusion patients (for all; p < 0.05). For prediction of failed rep- erfusion, the cut-off value of CHA2DS2-VASc score was ≥ 2 with a sensitivity of 80.90% and a specificity of 41.01% (area under curve [AUC] 0.660; 95% confidence interval [CI] 0.618–0.700; p < 0.001) and the cut-off value of CHA2DS2-VASc-HS score was ≥ 3 with a sensitivity of 76.13% and a specificity of 67.63% (AUC 0.764; 95% CI 0.725–0.799; p < 0.001). The CHA2DS2-VASc-HS score was found to be statistically and significantly better than CHA2DS2-VASc score to predict failed reperfusion (p < 0.001).  Conclusions: The findings suggest that the CHA2DS2-VASc and especially CHA2DS2-VASc-HS scores could be considered as predictors of risk of failed reperfusion in STEMI patients.

A Historical Electrocardiographic Finding: Masquerading Bundle Branch Block.

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKEYWOS: 00040730920005

Congenital and acquired Lutembacher's syndrome presenting in two adults

The coexistence of atrial septal defect (ASD) and mitral stenosis (MS) is defined as Lutembacher's syndrome (LS). LS was originally defined as the development of MS in a patient having a congenital ASD diagnosis. However, as the percutaneous interventions for MS have become widespread, the persistence of associated iatrogenic ASDs caused has given rise to a different form of the disease. LS may occur as spontaneous or iatrogenic ASD concomitant with acquired MS; this form is known as “acquired LS.” This report presents two cases illustrating congenital LS and “acquired LS.

Assessment of atrial functional remodeling in patients with atrioventricular nodal reentrant tachycardia with and without drug-induced type 1 Brugada pattern: A case-control study

WOS:000619187600001PubMed: 33599988Purpose The time interval between the onset of the P-wave on electrocardiogram (ECG) and peak A ' velocity of the lateral left atrial wall assessed by tissue Doppler imaging (PA-TDI interval) determine total atrial conduction time (TACT) which reflects atrial remodeling and arrhythmic substrate. in this retrospective study, we aimed to assess TACT in patients with atrioventricular nodal reentrant tachycardia (AVNRT) with and without drug-induced type 1 Brugada electrocardiogram ECG pattern (DI-Type 1 BrP) and control subjects. Methods Study population consisted of 62 consecutive patients (46 women; mean age 44 +/- 12 years) undergoing electrophysiological study and ablation for symptomatic, drug-resistant AVNRT, and 42 age-matched and sex-matched control subjects. All patients and control subjects underwent ajmaline challenge test and tissue Doppler imaging. Results A DI-Type 1 BrP was uncovered in 24 of 62 patients with AVNRT (38.7%). PA-TDI interval was similar among AVNRT patients with and without DI-Type 1 BrP (124 +/- 12 ms vs 119 +/- 14 ms, respectively, P = .32), but significantly longer in patients with AVNRT with as well as without DI-Type 1 BrP than in control subjects (124 +/- 12 ms and 119 +/- 14 ms vs 105 +/- 11 ms, respectively, P < .001). Conclusion The TACT assessed by PA-TDI interval is longer in patients with AVNRT with and without DI-Type 1 BrP than in age-matched and sex-matched healthy control subjects

Enterococcus gallinarum endocarditis: high- grade atrioventricular block as a early sign of bioprosthetic aortic valve endocarditis and aortic root abscess

WOS: 00039667750002

Profile of infective endocarditis cases at a tertiary hospital in Turkey: our 15-year experience

WOS: 000396677500008Background: This study aims to evaluate the clinical, echocardiographic, and microbiological profile and in-hospital complication and mortality rates of infective endocarditis cases in the tertiary setting. Methods: A total of 210 consecutive cases (138 males, 72 females; mean age 48.8 +/- 17.9 years; range, 18 to 89 years) who were diagnosed with definite infective endocarditis based on the modified Duke criteria and treated between September 2000 and September 2015 were retrospectively analyzed. Results: The rate of prosthetic valve infective endocarditis was 12.3%. Rheumatic heart disease was the most common predisposing factor (20.5%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 174 cases (82.9%). Causative microorganisms were identified in 119 cases (56.7%) as Staphylococci (30.5%), Streptococci (15.2%), and Enterococci (7.6%). Cultures were negative in 91 cases (43.3%). Surgical therapy was necessary in 111 cases (53%). Twenty-four percent of cases had a total recovery with appropriate antibiotheraphy without needing any surgical procedures. The most common complications were septic embolism (25.2%) and congestive heart failure (13.4%). In-hospital mortality occurred in 41 cases (19.5%). Conclusion: Our study results show that infective endocarditis is still associated with high in-hospital mortality and morbidity rates

Microbiological Profile, Echocardiographic Characteristics and Early Results of Infective Endocarditis: A Review of 194 Cases at a Tertiary Care Center in Turkey

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400182Turkish Soc Cardio