Protez kapak endokardit komplikasyonunun değerlendirilmesinde multimodal görüntülemenin artan değeri

A 47-year-old male patient was admitted to the hospital with complaints of fever (38.3°C), palpitations, chills, and weakness. He had undergone a surgical graft interposition repair of the ascending aorta and aortic valve replacement (AVR) (No. 19; St. Jude Medical Inc., St. Paul, MN, USA) of the bicuspid aortic valve with severe aortic stenosis and an ascending aortic aneurysm 2 years earlier. Laboratory tests indicated a high erythrocyte sedimentation rate and an elevated white blood count and C-reactive protein level

Factor XIII Val34Leu polymorphism in patients with cardiac syndrome X

Background: The aim of the study was to examine the frequency of factor XIII polymorphism among patients with cardiac syndrome X (CSX).Methods: This study was designed as a cross-sectional and observational study. Forty-eight female patients with CSX and 36 controls matched by age, gender, diabetes, and hypertension were studied. CSX was defined as typical chest pain during rest or effort, abnormal test result for exercise ECG, and presence of angiographically normal epicardial coronary arteries after ruling out inducible spasm. Factor XIII gene polymorphism was investigated by using CVD Strip Assay (ViennaLab Diagnostic GmbH) commercial kit.Results: The frequency of factor XIII (Val/Leu + Leu/Leu) mutation was significantly higher in patients with CSX (43%) than in controls (19%) (p = 0.02). Frequency of the Leu allele was significantly higher in the patient group (23.5% vs. 11.1%, p = 0.04). Factor XIII (Val/Leu + Leu/Leu) mutation (p = 0.01, OR = 3.42; 95% CI 1.22–9.58) and smoking (p = 0.04, OR = 3.33, 95% CI 1.05–10.58) were identified as independent predictors of the disease in multivariate regression analysis.Conclusions: This study indicates that there is an evidence for association between factor XIII Val34Leu polymorphism and CSX

Geographical Variations in Patients with Heart Failure and Preserved Ejection Fraction: A Sub-Group Analysis of the APOLLON Registry

Background: Clinical characteristics of patients with heart failure may vary geographically. However, limited data are available regarding the geographical differences of patients with heart failure and preserved ejection fraction.Aims: The present subgroup analysis aims to investigate the geographical differences in clinical characteristics, management, and primary etiology of patients with heart failure and preserved ejection fraction in Turkey.Study Design: A cross-sectional study.Methods: A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON (APOLLON) is a multicenter and observational study conducted in seven regions of Turkey (NCT03026114). The present study is a post-hoc analysis of the APOLLON registry. In this substudy, we compared the clinical characteristics of 819 consecutive patients with heart failure and preserved ejection fraction (mean age, 67 years; 57.8% women) admitted to cardiology outpatient units in different geographical regions.Results: Based on the geographical distribution of the entire Turkish population, the highest number of patients enrolled were from Marmara (271 patients, 33.1%). All demographical characteristics, clinical and laboratory findings, comorbidities, primary etiology, and medications prescribed were significantly different between the regions. Furthermore, inter-regional gender differences were identified. Comparatively, the Aegean and Mediterranean regions had older patients with heart failure and preserved ejection fraction (p0.001), and the Black Sea, Southeast, and East Anatolia regions had predominantly male patients (51.2, 54.5, and 56.9%, respectively; p0.002). Notably, the Mediterranean and Southeast Anatolia had more symptomatic patients, and history of hospitalization for heart failure was more prevalent in Southeast Anatolia (33.3%, p0.001). Prevalence of atrial fibrillation was higher in the Mediterranean and Southeast Anatolia regions (51 and 48.5%, p0.001), and patients with heart failure and preserved ejection fraction had a higher prevalence of hypertension in the Mediterranean, Southeast Anatolia, and Black Sea regions (p0.002). Angiotensin-converting enzyme inhibitors were more frequently prescribed in East Anatolia (52.3%, p0.001), and the prevalence of patients with heart failure and preserved ejection fraction using loop diuretics (48.8%, p0.003) was higher in the Black Sea region.Conclusion: This study was the first to show geographical differences in clinical characteristics of patients with heart failure and preserved ejection fraction in Turkey. Determination of the clinical characteristics of the heart failure and preserved ejection fraction population based on the geographical region may enables physicians to adopt a region-specific clinical approach toward heart failure and preserved ejection fraction

ST yükselmesiz akut koroner sendrom hastalarında TIMI risk skoru ile hemoglobin değeri arasındaki ilişkinin değerlendirilmesi

Introduction: The relationship between hemoglobin (Hb) levels at admission and the thrombolysis in myocardial infarction (TIMI) risk score in patients with non-ST elevation acute coronary syndrome (NSTEACS) was investigated. Patients and Methods: In total, 286 NSTE-ACS patients were included in the study. Hb levels and biochemical parameters were measured at admission. The patients were grouped into the following three groups according to the TIMI risk score: low-intermediate-, and high-risk groups. Results: Hb levels (in g/dL) at admission in low-, intermediate-, and high-risk groups were 13.5 &plusmn; 1.9, 12.5 &plusmn; 1.9, and 11.3 &plusmn; 1.9, respectively (p &lt; 0.001). We found a negative moderate correlation between Hb levels and TIMI risk scores (r= -0.408, p &lt; 0.001). In univariate regression analysis, it was found that with the increase in the TIMI risk score, Hb levels at admission were signifi cantly reduced (estimate= -0.406; p&lt; 0.001; 95% confi dence interval; -0.521 to -0.290). Conclusion: We found that as the TIMI risk score of patients admitted to hospital presenting with NSTEACS increased, their Hb levels at admission correspondingly decreased. Thus, the simple and commonly measured Hb level can be a useful parameter in stratifying the risks of patients presenting with NSTE-ACS during admission.Giriş: ST yükselmesiz akut koroner sendrom hastalarının geliş hemoglobin seviyesi ile TIMI risk skoru arasındaki ilişki araştırıldı.Hastalar ve Yöntem: ST yükselmesiz akut koroner sendromlu 286 hasta çalışmaya dahil edildi. Tüm hastaların geliş anında hemoglobin ve biyokimyasal parametreleri çalışıldı. Hastalar TIMI risk skoruna göre düşük, orta ve yüksek risk olarak 3 gruba ayrıldı.Bulgular: Geliş hemoglobin seviyesi (g/dL) düşük, orta ve yüksek TIMI risk grubunda sırasıyla (13.5 ± 1.9, 12.5 ± 1.9, 11.3 ± 1.9, p< 0.001) olarak saptandı. Hemoglobin seviyesi ve TIMI risk skoru arasında orta düzeyde negatif korelasyon bulundu (r: -0.408, p< 0.001). Tek değişkenli regresyon analizinde TIMI risk skoru artışı ile geliş hemoglobin seviyelerinin önemli derecede düşük olduğu saptandı (Estimate; -0.406, p< 0.001, %95 GA[-0.521-(-0.290)].Sonuç: ST yükselmesiz akut koroner sendrom ile hastaneye yatırılan hastaların risk skoru attıkça geliş hemoglobin seviyelerinin bağlantılı olarak düşük olduğu tespit edildi. Basit ve yaygın bir test olarak kullanılan hemoglobin seviyesi, ST yükselmesiz akut koroner sendrom hastalarının geliş anındaki risk durumunu belirlemede kullanılabilir