Kosuyolu Heart Journal
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412
(FIVE YEARS 151)

H-INDEX

2
(FIVE YEARS 1)

Published By Bilimsel Tip Publishing House

2149-2980, 2149-2972

Author(s):  
Mehmet Fatih Yılmaz ◽  
Sedat Kalkan

Objectives: The aim of the study is to evaluate the quality and reliability of videos on manual blood pressure measurement on Youtube. Patients and Methods: In January 2021, the first 100 videos found as a result of a search with the keywords 'manual blood pressure measurement' on Youtube were watched and evaluated. According to exclusion criteria, 75 videos were included in the study. Duplicate videos, irrelevant videos, and videos in languages other than English were excluded from the study. Each video was scored according to the questions prepared based on the guidelines. The GQS score and the 'Reliability' score were used to assess the quality of the videos. Results: According to the checklist prepared according to the hypertension consensus report, the mean score of the videos was 8.33 ± 2.1. When the videos were evaluated according to their sources, the average score of the videos of the health sites was 9±2.5, the average score of the videos of the individual health workers was 8.66±1.8, the average score of the videos of the unidentified people was 7.54±2.1. Conclusion: Manual blood pressure measurement videos on Youtube have little educational value. Videos of health websites should be preferred for education.


Author(s):  
Mehmet Erdem Toker ◽  
Cüneyt Arkan ◽  
Ahmet Erdal Taşçi ◽  
Erdal Polat ◽  
Üzeyi̇r Yilmaz ◽  
...  

Objectives: Active cancer and heart disease, which share similar environmental and biological characteristics, can occur concomitantly. Open heart surgery may be required for these patients when indicated. The aim of this study is to demonstrate the early and long-term results and discuss the intervention strategy in patients with different types of active malignancies, who underwent open heart surgery. Patients and Methods: Between January 2012 and May 2020, open heart surgery was performed on 10 patients with active malignancies. The mean age was 65.5 (52–77), and 4 of the patients were female. 2 patients were operated emergently due to advanced pleural effusion. AVR+CABG, CABG, CABG+left upper lobectomy and AVR+MVR were performed in 4 patients with lung cancer; AVR+CABG were performed in 1 patient with colon cancer; CABG was performed in 4 patients each with one of the following conditions: lymphoma, breast cancer, essential thrombocytosis, meningioma); and mass resection operation from the left atrium and left ventricle was performed in one patient with osteosarcoma. Results: 8 patients were discharged and 2 patients died in the early postoperative period. Postoperative left hemiparesis developed in 1 patient. 6-month, 1-year and 5-year survival rates were 79%, 37.5% and 25%, respectively. Conclusion: Open heart surgery can be successfully performed with acceptable mortality and morbidity rates on the high-risk patient group with active cancer. We believe that, where percutaneous coronary intervention and/or TAVI are not considered or deemed appropriate, surgical intervention should be performed with careful patient selection in patients with multi-vessel coronary artery disease, coronary artery stenosis +aortic stenosis, and in cases requiring double valve replacement.


Author(s):  
İsmail Gürbak ◽  
Arda Güler ◽  
Cafer Panç ◽  
Ahmet Güner ◽  
Mehmet Ertürk

Objectives: Radial artery spasm (RAS) is associated with several pathophysiological pathways, including endothelial and autonomic dysfunction, and causes failed coronary interventions. Heart rate recovery (HRR) is a simple measurement of autonomic nervous system dysfunction. We aimed to investigate the relationship between HRR and RAS during coronary angiography (CA) in the present study. Patients and Methods: This study included 167 patients (mean age 54.6 ± 8.2, 131 males) who underwent a treadmill stress test (TST) according to the Bruce protocol before trans-radial CA. HRR in the first minute (HRR1) was calculated as the difference between peak heart rate and heart rate one minute after the TST. Patients were divided into two groups according to the presence of RAS. Results: Among the study population, RAS developed in 26 patients (15.5%). HRR1 and HRR in the third minute (HRR3) were lower in the RAS group. Also, the abnormal HRR1 rate was higher in the RAS group (35.5% vs. 76.9%, p < 0.001). Total procedural time, more than one puncture attempt, more than one catheter use, fluoroscopy time, radiation exposure, contrast volume was higher in the RAS group. Female gender, total procedural time, more than one catheter use, and abnormal HRR1 were independent predictors of RAS. Conclusion: The current data suggest that a significant relationship was found between abnormal HRR1 and RAS. HRR, a simple autonomic dysfunction parameter, can provide additional information regarding the success of radial procedures.


Author(s):  
Serdar Demir ◽  
Alev Kılıçgedik ◽  
Büşra Gvendi Şengör ◽  
Sleyman Çağan Efe ◽  
Gönenç Kocabay ◽  
...  

Objectives: We hypothesized that long-term morbidity and mortality can be identified by the presence of comorbidities in patients with carotid artery stenosis. In our study we aimed to investigate the relationship between clinical characteristics, laboratory findings and long-term prognosis in carotid artery stenosis patients after stenting Patients and Methods: We retrospectively enrolled 212 patients whom underwent carotid artery stenting (CAS) between January 2010 and December 2012 at Kartal-Kosuyolu Training and Research Hospital. CAS was performed in symptomatic patients with >60% stenosis and in asymptomatic patients with >80% stenosis of extracranial carotid artery. Symptoms were defined by an ipsilateral cerebral or ocular minor or major ischemic event within the past 6 months. Results: Mean age of study population was 67.4 ± 7.9 years and 158 patients (74.5%) were male. In the follow-up period 18 patients had MI, 18 patients had major stroke, 23 patients had transient ischemic attack. Twenty-one patients (9.9%) died from cerebral-cardiovascular causes. All MACCE was found in 64 patients (30.2%). Multivariate analysis revealed that age (OR: 1.09, 95% CI: 1.02-1.17, p = 0.05), heart failure (OR: 3.78, 95% CI: 1.48-9.62, p = 0.005), creatinine (OR: 3.54, 95% CI: 1.16-10.82, p=0.026) and neutrophil-lymphocyte ratio (OR: 2.88, 95% CI: 1.90-4.36, p < 0.0001) were independent predictors of the MACCE. Conclusion: Although, the short-term risk of patients undergoing CAS dominated by lesion-related factors, pre-existing comorbidities may be even more important for the long-term event. Age, heart failure, creatinine and neutrophil-lymphocyte ratio were found as the most important risk factors of MACCE.


Author(s):  
Aziz Inan Celik ◽  
Resit Coskun ◽  
Muhammet Bugra Karaaslan ◽  
Tahir Bezgin ◽  
Suleyman Karakoyun ◽  
...  

Objectives: Rheumatic mitral valve disease (RMVD) is associated with autoimmune heart valve injury. Parathyroid hormone (PTH) and vitamin D are two essential molecules that have effects on the immune system. In this study, we aimed to evaluate the relationship between PTH and vitamin D in patients with RMVD. Patients and Methods: We investigated 81 patients with RMVD and 75 healthy subjects. According to Wilkins score, baseline clinical, laboratory, and echocardiographic parameters were recorded, and all RMVD patients were analyzed. Multivariate logistic regression analysis was performed between the groups. Results: Vitamin D levels were significantly low in the RMVD group. Patients were stratified according to Wilkins score [Wilkins score < 7 (n:50) vs. Wilkins score 7 (n:31)]. Age, BMI, and PTH were significantly higher, and mitral valve area was significantly lower in Wilkins score 7 patients. In multivariate analysis, age (OR: 1.052; 95% CI 1.005-1.100, p=0.028) and PTH (OR: 1.017; 95% CI 1.000-1.033, p=0.047) were found to be independent predictors of high Wilkins score. Conclusion: This study showed that vitamin D levels were low in patients with RMVD. According to the Wilkins score, PTH levels were significantly high in patients with high Wilkins score. The contrary changes in PTH and vitamin D levels may trigger inflammation and be responsible for valve damage.


Author(s):  
Fi̇li̇z Kızılırmak Yılmaz ◽  
Fatih Yilmaz ◽  
Arzu Yıldırım ◽  
Hacı Murat Güneş ◽  
Tayyar Gökdeniz ◽  
...  

Objectives: In this study, we aimed to investigate the relationship between autonomic dysfunction (AD) determined according to the blood pressure (BP) and heart rate (HR) response in exercise treadmill test (ETT) prior to cryoballoon ablation (CBA), and the recurrence of atrial fibrillation (AF) after CBA in patients with paroxysmal AF. Patients and Methods: Seventy-six patients (mean age 53±11 years, 61.8% male) with paroxysmal AF who underwent CBA were enrolled. Before CBA the ETT was performed by all patients. BP and HR response in ETT were compared between patients with and without AF recurrence. Results: AD rate was significantly higher in the group with recurrence compared to the non- recurrent group (p<0.001). In addition to AD, age, female gender and lower exercise capacity were also associated with post-CBA AF recurrence ( p>0.05 for all ). Examining AD parameters, systolic blood pressure at peak exercise (SBPpeak) (p<0.001) and diastolic blood pressure at peak exercise (DBPpeak) (p<0.001), slow heart rate recovery (HRR) (p<0.001) were significantly higher in the recurrent group. Conclusion: AD may associated with AF recurrence after CBA in patients with paroxysmal AF. SBPpeak, DBPpeak and slow HRR appear to be predictors of AF recurrence after ablation.


Author(s):  
Oktay Şenöz ◽  
Volkan Emren ◽  
Zeynep Yapan Emren ◽  
Ahmet Erseçgin ◽  
Ferhat Siyamend Yurdam ◽  
...  

Objectives: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3±15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p=0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR = 3.447; 95% CI = 1.266, 9.386; p = 0.015), and receiving antithrombotic therapy (OR = 2.306; 95% CI = 1.078, 4.932; p=0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality.


Author(s):  
Şeyhmus Külahçıoğlu ◽  
Zeynep Esra Güner ◽  
Barkın Kültürsay ◽  
Mehmet Aytürk ◽  
Ayhan Küp ◽  
...  

Takotsubo syndrome (TS) is an acute but transient heart failure syndrome and it is very uncommon for TS to present as syncope with complete atrioventricular (AV)block.In this report,we aimed to present a case of TS complicated by third-degree AV block presented to the emergency department with syncope and requiring permanent pacemaker implantation.A 53-year-old female admitted to our emergency department with complaints of syncopal episodes and chest pain.Due to ongoing chest pain,electrocardiography (ECG) findings and segmentary wall motion abnormality on the transthoracic echocardiography (TTE),she was immediately transferred to cardiac catheterization laboratory.Coronary angiogram revealed normal coronary arteries and left ventriculography demonstrated apical ballooning and hypokinesis of the apex.As the diagnosis of TS was established,patient was transferred to coronary intensive care unit(CICU).Initial ECG at CICU demonstrated complete AV block with a heart rate of 35 beats/min.On third day of hospitalization,repeat TTE showed improved left ventricular functions with an ejection fraction of 50%.During the follow-up period in CICU,complete AV block persisted and the rhythm did not return to normal sinus rhythm after 6 days of monitorization.An electrophysiologic study demonstrated supra-hisian atrioventricular block and atrioventricular dissociation.On seventh day of hospitalization,TTE demonstrated recovered ventricular functions with an ejection fraction of 65% and a dual pacemaker was then implanted.Her third month follow-up was uneventful and TTE showed normal left ventricular functions but pacemaker interrogation revealed 99% of ventricular pacing.This case report demonstrated that,the decision to implant a permanent pacemaker on such patients should be considered on a case-by-case basis,and electrophysiologic study could be valuable on this decision.


Author(s):  
Murat Çi̇çek ◽  
Oktay Korun ◽  
Okan Yurdakök ◽  
Hüsnü Fırat Altın ◽  
Mehmet Akif Önalan ◽  
...  

Objectives: There is limited data on totally anomalous pulmonary venous connection (TAPVC) repair results in our country. The aim of this study is to evaluate the early postoperative results of a large series of TAPVC patients operated in our clinic. Patients and Methods: The data of the patients who underwent TAPVC repair in our clinic between May 2005 and May 2021 were retrospectively reviewed using hospital records Results: A total of 150 TAPVC patients aged between 0 days and 39 years (median 3 months, IQR: 18 days – 9 months), 92 males (61%) and 58 females (39%) underwent surgical intervention. The median length of hospital stay was 12 (IQR:7-16) days. Overall mortality was 14% (21 patients). Seventeen out of 32 patients with additional cardiac anomalies (53%) and 4 out of 118 patients with isolated TAPVC (3%) died. The presence of additional cardiac anomalies was associated with mortality (p<0.00001). Mortality rate in univentricular patients was 59% (10 patients). This rate was higher in comparison to the mortality rate of biventricular patients (8%; p<0,00001). Three patients were reoperated due to postoperative pulmonary venous stenosis. Conclusion: The TAPVC outcomes in isolated and biventricular patients were favorable with a low mortality and postoperative pulmonary venous stenosis in this cohort. Patients with a single ventricle physiology and/or heterotaxia had a significantly increased risk of mortality, which might be due to the intrinsic challenges of the univentricular physiology regarding the balance between the pulmonary and systemic circulations. Tendency for increased mortality in the cases with preoperative pulmonary venous obstruction is a potential target for improvement.


2021 ◽  
Author(s):  
Dogac Oksen ◽  
Mert Sarilar ◽  
Gursu Demirci ◽  
Ismail Haberal ◽  
Okay Abaci

Objectives: We evaluated in-hospital and long-term outcomes of patients who underwent primary percutaneous coronary intervention (PCI) in a tertiary center. Patients and Methods: We examined 1550 patients (mean age: 58.5 years, 83.1% male) admitted with acute ST-segment elevation myocardial infarction (AMI) who underwent primary PCI and were followed-up prospectively. The primary outcomes were in-hospital death and major adverse cardiac events (MACE) at follow-up. Results: The mean duration of ischemia at admission was 2.85 ± 2.49 hours; and the mean door-to-device time was 43.2 ± 20.3 minutes. During hospitalization, all-cause mortality occurred in 73 patients (4.7%). Multivariate analysis revealed that advanced age, impaired left ventricular ejection function, high Killip functional class, hemoglobin level at admission, ventricular arrhythmias, and advanced atrioventricular block were independent predictors of poor prognosis (OR: 1.07, 0.93, 15.34, 1.44, 3.79, and 4.26, respectively). Among discharged patients with a median follow-up of 49.5 (25‒73) months, 12.4% experienced all-cause mortality, 12.5% had recurrent myocardial infarction (MI), and 2.3% had a cerebrovascular accident. The strongest independent MACE predictors were impaired left ventricular function, poor glomerular filtration rate, low albumin level, and a history of cerebrovascular disease (HR: 0.97, 0.99, 0.65, and 2.50, respectively). Secondary outcomes were contrast-induced acute kidney injury (16.7%), ventricular arrhythmias (6.1%), advanced atrioventricular block (3.7%), atrial fibrillation (7.6%), and major bleeding (1.6%). Conclusion: AMI still has a poor long-term prognosis. These results emphasize the advantages of rapid, non-delayed revascularization. Patients should be followed-up closely after discharge in both the short- and long-term.


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