The relationship of serum asymmetric dimethylarginine concentrations and lung involvement in patients with COVID-19 infection

Aim: COVID-19 infections the tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine (ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID-19 disease. Methods: We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1st month control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups. Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified log CRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001) as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r: 0.318, p: 0.003). Conclusion: We revealed elevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not

Increased epicardial fat tissue thickness predicts advanced interatrial block among hypertensive patients

Cetin, Mustafa/0000-0001-6342-436XWOS: 000568824000003PubMed: 32480038Background: Recent studies demonstrated that epicardial fat tissue (EFT) was associated with prevalent AF and recurrences following the catheter ablation. We evaluated the value of EFT for the prediction of advanced interatrial block (a-IAB) in the surface electrocardiography (ECG) among hypertensive patients. Methods: Patients with prior diagnosis of hypertension (HT) were included in the study. Surface ECG and transthoracic echocardiography (TTE) were performed to each patient. A-IAB was defined as P-wave duration longer than 120 ms with biphasic morphology in the inferior leads. EFT was identified by using TTE and was measured perpendicularly in front of the right ventricular free wall at the end-systole. Results: Between February 2019 and February 2020 245 patients met the eligibility criteria. A-IAB was found among 35 patients and compared to those without IAB, they had increased waist circumference, elevated left ventricular mass index (LVMI) and left atrial volume index (LAVI), lower LDL and increased P wave duration. EFT thickness was higher in patients with a-IAB compared to those without (5.3 +/- 2.2 mm vs 7.6 +/- 2.4 mm). Multivariable analysis revealed that increased EFT thickness and lower LDL level predicted a-IAB. Conclusion: Among patients with prior diagnosis of HT, higher EFT thickness evaluated by TTE predicted the presence of a-IAB on the surface ECG. (C) 2020 Elsevier Inc. All rights reserved

Usefulness of whole blood viscosity estimated by de Simeone's formula to predict left ventricular thrombus formation within one year following acute anterior myocardial infarction

Dursun, Ihsan/0000-0001-7503-7949WOS: 000550220500004PubMed: 32444531BACKGROUND: Despite improvements in treatment of ST-segment myocardial infarction (STEMI), thrombus formation in the left ventricle is still a concerning complication that may lead to systemic thromboembolism and stroke. OBJECTIVES: To evaluate the predictive value of estimated whole blood viscosity (WBV) for left ventricular thrombus development in patients surviving an acute anterior myocardial infarction (AAMI). MATERIALS & METHODS: Seven hundred eighty AAMI patients who were treated percutaneously were enrolled consecutively. Serial echocardiographic examinations were performed within 24h of admission, before hospital discharge, and at 1, 3, 6 and 12 months following hospital discharge. WBV was calculated according to de Simones formula. RESULTS: One hundred patients (12.8%) developed thrombus formation within one year following AAMI. Patients with left ventricular thrombus (LVT) had significantly higher WBV values. Supramedian values of WBV at both low (0.5 sec(-1)) and high (208 sec(-1)) shear rates were found to be an independent predictor of LVT development. CONCLUSION: As an easily accessible parameter, WBV might be a useful predictor of LVT formation within one year following acute anterior myocardial infarction

Epicardial adipose tissue predicted prolonged QTc interval in patients with arterial hypertension

Cetin, Mustafa/0000-0001-6342-436XWOS: 000588795400001PubMed: 33183070Introduction: It is important to identify those at higher risk for ventricular arrhythmia among hypertensive patients. Epicardial adipose tissue (EAT) leads to electromechanical changes in the heart by endocrine and paracrine effects with cytokines and mediators. Higher amount of EAT carries the risk of QT prolongation. Therefore, we investigated the association between EAT thickness and QTc interval in patients with arterial hypertension. Methods: A total of 230 patients who previously diagnosed with arterial hypertension between February 2019 to March 2020 were included in the study. Patients with atrial fibrillation, U-wave, atrioventricular block, left anterior or posterior fascicular block, right bundle branch block, left bundle branch block, and taking QT-prolonging medication were excluded. the corrected QT (QTc) interval was calculated with Bazzet's formula following the calculated QT interval in the semi-automatic application tool. EAT was measured at the point on the free wall of the right ventricle using transthoracic echocardiography. Results: the mean age was 62.1 +/- 11.4 years and 95 (41.3%) of the patients were male. QTc was over 450 ms were considered as the prolonged interval. Both groups were similar in terms of age (p = .862), gender (p = .265) and other demographic characteristics. Left ventricle mass index (LVMI) (82.5 +/- 29.5 vs 91.9 +/- 32.6 g/1.7.m(2), p = .051) and EAT thickness (5.3 +/- 2.3 vs 6.6 +/- 2.6 mm, p = .001) were higher in the prolonged QTc group. Serum potassium (K) level was lesser in the prolonged QTc group (4.2 +/- 0.39 vs 4.1 +/- 0.4 mmol/mL, p = .005). Multivariate Cox regression analysis revealed that EAT thickness [OR = 1.227, 95% CI: 1.081-1.393, p = .002] and serum K level [OR = 0.348, 95% CI: 0.157-0.772, p = .009] predicted the prolonged QTc interval, independently. Conclusion: EAT thickness predicted prolonged QTc interval in patients with arterial hypertension. Patients with higher amount of EAT should be followed by closely monitoring to prevent arrhythmic events that may develop in the future. in addition, medications that have a potential effect on QTc interval prolongation may be carefully used in patients with higher EAT thickness

Association Between C-Reactive Protein to Albumin Ratio and Left Ventricular Thrombus Formation Following Acute Anterior Myocardial Infarction

Cirakoglu, Omer Faruk/0000-0002-1815-437X; Yilmaz, Ahmet Seyda/0000-0003-3864-4023WOS: 000542354100001PubMed: 32567322Left ventricular thrombus (LVT) is associated with inflammatory response in survivors with anterior ST-elevation myocardial infarction (STEMI). the C-reactive protein to albumin ratio (CAR) has been proposed as a marker of inflammation. However, there is a lack of data with respect to the role of CAR in LVT development. We investigated the relationship between CAR and LVT development in patients with anterior STEMI treated percutaneously; 955 consecutive patients were enrolled and LVT was observed in 126 (13.2%) patients. Clinical, demographic, and laboratory parameters were recorded. the CAR was significantly higher in patients with LVT (12.6 [8.6-16.1] vs 18.1 [11.5-23],P1 diseased arteries, higher total protein level, neutrophil count, and peak creatine kinase myocardial band activity. in conclusion, the CAR may be useful as a simple tool for predicting LVT development among survivors of anterior STEMI

Prognostic value of serum albumin-to-creatinine ratio in acute coronary syndrome

Aim: The association between serum albumin-to-creatinine ratio (sACR) and in-hospital mortality remains unclear in patients with acute coronary syndrome (ACS). In this study we aimed to investigate the prognostic value of sACR in predicting in-hospital mortality in ACS. Materials and Methods: The study was conducted in a single tertiary center. Patients hospitalized with both ST Elevation Myocardial Infarction (STEMI) and Non-STEMI were retrospectively analyzed. The sACR and other clinically related parameters were recorded. The primary outcome was in-hospital mortality. Logistic regression (LR) models were used to investigate the association between sACR and in-hospital mortality. Receiver operating characteristic (ROC) curve was used to find out the cut-off level of sACR. Results: A total of 686 patients with ACS were enrolled, of whom 59 (%8.6) died in- hospital follow-up. The sACR was significantly lower in patients who died in hospital (2.9 (2.3-3.7) vs 3.9 (3.3-4.6)). Multivariable LR analysis showed that sACR is an independent predictor of in-hospital mortality in patients with ACS. Area under the curve value gen- erated by ROC curve analysis was 0.719 (95% CI: 0.656-0.783). The sensitivity of sACR predicting in-hospital mortality was 77.5% with the specificity of 59.3%. Conclusion: In this study, lower sACR on admission was found significantly associated with in-hospital mortality in patients with ACS

Predictive outcomes of APACHE II and expanded SAPS II mortality scoring systems in coronary care unit

© 2022 Elsevier B.V.Objective: We investigated the predictive values of the expanded Simplified Acute Physiology Score (SAPS) II and Acute Physiologic Score and Chronic Health Evaluation (APACHE) II score in predicting in-hospital mortality in coronary care unit (CCU) patients. Methods: In this study, expanded SAPS II and APACHE II scores were calculated in the CCU of a single-center tertiary hospital. Patients admitted to CCU with any cardivascular indication were included in the study. Both scores were calculated according to previously determined criteria. Calibration and discrimination abilities of the scores in predicting in-hospital mortality were tested with Hosmer-Lemeshow goodness-of-fit C chi-square and receiver operating characteristics (ROC) curve analyses. Results: A total of 871 patients were included in the analysis. The goodness-of-fit C chi-square test showed that both scores have a good performance in predicting survivors and nonsurvivors in CCU. Expanded SAPS II score has a sensitivity of 80% and a specificity of 91.8% with the cut-off value of 5.55, while APACHE II has a sensitivity of 75.9% and a specificity of 87.4% with the cut-off value of 16.5 in predicting mortality. Conclusion: Expanded SAPS II and APACHE II scores have good ability to predict in-hospital mortality in CCU patients. Therefore, they can be used as a tool to predict short-term mortality in cardiovascular emergencies

ASSOCIATION OF SLEEP QUALITY AND DAYTIME SLEEPINESS WITH COGNITION IN THE ELDERLY

Turkey. The aim of the study was to evaluate the association between sleep quality and daytime sleepiness with cognitive functioning and to identify factors that influence cognitive state in the elderly

Increased Epicardial Adipose Tissue is Associated with the Extent of Aortic Dissection

WOS: 000588732200005PubMed: 33299785Background: Epicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection. Methods: We retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of the dissection flap at sagittal images. Results: We included 78 patients with the mean age of 63.9 +/- 11.7 and 57 (73.5%) patients were male. Dissection length was correlated positively with EAT (r = 0.409, p < 0.001), body mass index (r = 0.408, p = 0.018), and admission systolic blood pressure (r = 0.830, p = 0.026) whereas an inverse correlation existed between age and dissection length (r = 0.318, p = 0.005). Multivariate analysis identified age and EAT as independent predictors of dissection length. Conclusion: Increased EAT was independently associated with the extent of aortic dissection. We think that either paracrine and endocrine functions of EAT might have contributed to the extent of aortic dissection