FRONTMATTER | |
1. | Front Matter Pages I - III |
EDITORIAL | |
2. | EDITORIAL Page IV |
EDITORIAL COMMENT | |
3. | Evaluation of demographic and clinical characteristics of female patients presenting with MINOCA Merih Kutlu doi: 10.5543/tkda.2022.21292 Pages 1 - 3 Abstract | |
ORIGINAL ARTICLE | |
4. | Evaluation of demographic and clinical characteristics of female patients presenting with MINOCA and differences between male patients: A subgroup analysis of MINOCA-TR registry Gülay Gök, Ali Çoner, Tufan Çınar, Salih Kılıç, Mustafa Yenerçağ, Ahmet Öz, Cenk Ekmekçi, Özlem Özlük, Mehdi Zoghi, Asım Oktay Ergene, Uğur Önsel Türk doi: 10.5543/tkda.2022.86219 Pages 4 - 13 Aim: Although the MINOCA (Myocardial Infarction with Non-obstructive Coronary Arteries) prevalence is higher in rate in female patients than male counterparts in previous cohorts, potential demographic and clinical differences between in female patients who are diagnosed as MINOCA vs MIOCA (Myocardial Infarction with obstructive Coronary Arteries) have not been studied until to date. The present study aimed to document these characteristics and to compare them between female MINOCA and MIOCA patients. Methods: The study was a subgroup analysis of the MINOCA-TR study. The study was a multi-center, observational cohort study that was conducted in Turkey between March 2018 and October 2018. In this study, 477 (29.3%) female patients who have been diagnosed with acute myocardial infarction were evaluated. Results: Among those women 49 (10.3%) of them were diagnosed as MINOCA (mean age: 58.9±12.9) and 428 (89.7%) of them had a final diagnosis of MIOCA (mean age: 67.4±11.8). The prevalences of hypertension, hyperlipidemia, and diabetes mellitus were significantly lower in the MINOCA group than in the MIOCA group. Additionally, the MINOCA group had higher rates of recent flu history and non-ST elevation myocardial infarction (NSTEMI) presentation compared with the MIOCA group. There were significant clinical differences in MINOCA patients in terms of gender. When compared to male cases, female patients were older, had higher systolic blood pressure and lower hemoglobin levels. Conclusion: The study revealed that traditional coronary artery disease risk factors were in lower prevalence in female MINOCA patients compared to female patients who had final diagnosis of MIOCA. |
5. | A study on the association of IL-10 promoter polymorphisms with rheumatic heart disease in Turkish female patients Ayşegül Başak Akadam Teker, Erhan Teker doi: 10.5543/tkda.2022.77756 Pages 14 - 21 Objective: Rheumatic heart disease (RHD) is an inflammatory disease that develops following streptococcal infections. With the help of the pleiotropic effect, interleukin-10 (IL-10) has a role in regulating the responses of the immune system. However, impaired IL-10 expression or signal can impair antigen clearance during acute bacterial infections, creating a favorable environment for persistent inflammation. The aim of our study is to evaluate the relationship between variants' sensitivity of IL-10 (rs1800896, rs1800871, rs1800872) or severity of RHD in Turkish population. Methods: In this case-control study, 390 female participants (170 RHD/220 control) were examined in terms of IL-10 rs1800896, rs1800871, rs1800872 using the TaqMan 5 'Allelic Discrimination Testing. Results: It was found out that there was no statistically significant difference between study groups in terms of IL-10 rs1800896, rs1800871, rs1800872 genotypes. However, the rs1800896 variant made a statistically significant difference when both the group with combined valve lesions and the group with a single valve lesion were compared(χ 2=7.532,p=0.023), as well as the group with combined valve lesions and the control group(χ 2 =12.860, p=0.002). Conclusion: The findings suggest that IL-10 rs1800896, rs1800871, rs1800872 variants are not associated with the pathogenesis of the disease in women in Turkish context. IL-10 rs1800896, rs1800871, rs1800872 variants Turkish population cannot be suggested as a suitable genetic marker for RHD. However, the IL-10 rs1800896 variant appears to be a risk factor for valve involvement. Further studies are needed to clarify the mechanism in this regard. |
6. | Association of polymorphisms in the sex hormone genes with the presence and severity of coronary artery disease Neslihan Çoban, Aybike Sena Özuynuk, Aycan Fahri Erkan, Aysem Kaya, Berkay Ekici, Filiz Güçlü Geyik, Evin Ademoğlu, Günay Can, Nihan Erginel Ünaltuna doi: 10.5543/tkda.2022.17203 Pages 22 - 33 Objective: Coronary artery disease (CAD) is an important public health problem worldwide. Therefore, it is important to identify the molecular mechanisms and the candidate gene polymorphisms involved in the development of CAD. In this study, we focused on 2 polymorphisms of the atherosclerosis-related genes, ESR1 and CYP19A1. Methods: Unselected 339 individuals who underwent coronary angiography were divided into 2 groups: those with normal coronary arteries (≤30% stenosis) and those with critical disease (≥50% stenosis). Individuals were genotyped for CYP19A1 rs10046 C/T and ESR1 rs2175898 A/G polymorphisms using hybridization probes in real-time PCR. In addition, Gensini and SYNTAX scores were assessed. Results: ESR1 polymorphism was significantly associated with CAD in men (p=0.036) via G allele carriage. Multiple logistic regression analyses showed that ESR1 rare allele carriage was associated with CAD presence (Odds ratio=2.12, 95% confidence interval 1.01–4.1, p=0.025), adjusted for age, HDL-C, LDL-C and smoking status in the male group. CYP19A1 rs10046 T allele carriers had a 2.84-fold increased risk for complex CAD in multiple logistic regression analysis (p=0.016). Furthermore, the univariate analysis of variance indicated that T allele carriage of rs10046 polymorphism was associated with increased SYNTAX and Gensini scores (p<0.05). Female patients who were ESR1 G allele carriers with CAD had higher adiponectin levels (p=0.005), whereas HbA1c levels were associated with T allele of CYP19A1 in the CAD group (p=0.004) and male CAD group (p=0.018). Conclusion: The CYP19A1 and ESR1 polymorphisms were associated with the presence and severity of CAD. These gene polymorphisms warrant further studies for the elucidation of their contribution to CAD development. |
7. | Val109Asp polymorphism in Intelectin 1 gene is associated with coronary artery disease severity in women Filiz Güçlü Geyik, Aycan Fahri Erkan, Aybike Sena Özuynuk, Berkay Ekici, Neslihan Çoban doi: 10.5543/tkda.2022.21003 Pages 34 - 45 Objective: Intelectin-1 is an anti-inflammatory adipokine encoded by the Intelectin 1 (ITLN1) gene. Genetic variations in the ITLN1 gene affect the risk of coronary artery disease (CAD) and related CAD risk factors. In this study, we aimed to investigate whether the ITLN1 gene Val109Asp polymorphism has an effect on the severity of CAD and serum lipid levels in both men and women. Methods: A total of 493 subjects who underwent coronary angiography (43.5% women, mean age 63.1±9.5 years) were grouped as individuals with critical CAD (≥70% stenosis, n=202), non-critical CAD (31%-69% stenosis, n=90), and non-CAD (control group) (1%-30% stenosis, n=201). Genotyping was performed using LightSNiP assay in Real-Time PCR. Results: The frequency of the Val allele was significantly different among all the patients with critical CAD (n=41) and non-CAD control (n=51) groups in women (p=0.033) but not in men (n=77 and n=38). Women with the Val allele had a 1.69-fold increased risk for critical CAD (p=0.033). In addition, the presence of Val allele was associated with higher coronary stenosis after adjustment for several confounders only in women with critical CAD (p=0.025). Furthermore, carriers of the Val allele exhibited an increased low-density lipoprotein cholesterol (LDL-C) in men with critical CAD than in those with non-CAD (p<0.05). Conclusion: These results suggest that the Val allele of the ITLN1 Val109Asp polymorphism is associated with critical CAD and high LDL-C levels in our study population. Further studies are required to elucidate the effect of Val109Asp polymorphism on CAD pathogenesis. |
EDITORIAL COMMENT | |
8. | Fat, Fit, or Myth? Asiye Ayça Boyacı doi: 10.5543/tkda.2022.21324 Pages 46 - 47 Abstract | |
ORIGINAL ARTICLE | |
9. | Reversal of metabolic syndrome with weight loss decreases epicardial fat more than weight loss alone in women with obesity Duygu Ersan Demirci, Deniz Demirci, Remziye Nur Eke doi: 10.5543/tkda.2022.21063 Pages 48 - 56 Objective: In this study, we aimed to investigate the impact of weight loss with diet and exercise on echocardiographically measured epicardial fat thickness (EFT) in women with obesity and whether the change in EFT can be different between the groups whose metabolic syndrome (MetS) status has changed or remained the same with weight loss. Methods: Seventy four women with obesity who were scheduled for a one-year weight reduction (WR) program were prospectively enrolled in the study. Anthropometric, laboratory, clinical, and echocardiographic parameters were assessed at baseline and after one year for twenty eight women who completed the program and had weight reduction. At the end of one year, all the participants were divided into two groups on the basis of whether their MetS status had changed or remained the same. Results: Body mass index was significantly reduced from 37.17±5.94 to 31.61±5.55 kg/m2 (p<0.001) after the oneyear WR program. A significant reduction in EFT was noted after weight loss compared with baseline measurements (0.51±0.15 cm to 0.39±0.14 cm, p=0.001). The decrease in EFT was significantly higher in the patient group with reversal of MetS than in the group whose MetS status did not change with weight loss (0.16±0.68 cm vs. 0.09±0.07 cm, p=0.018, respectively). Reversal of MetS was found to be an independent predictor of the change in EFT. Conclusion: Long-term, sustained weight loss can significantly reduce echocardiographic EFT, and EFT can be used as an indicator of metabolic profile for WR interventions in women with obesity |
10. | Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women Hongju Zhang, Tao Sun, Yutong Cheng, Jing Zhang, HaiXia Zhang, Chayakrit Krittanawong, Edward El-Am, Roukoz Abou Karam, Su Wang, Qian Wang, Ning Ma doi: 10.5543/tkda.2022.47443 Pages 57 - 65 Objective: Data on the impact of metabolic syndrome (MetS) and systemic inflammation on endothelial function remains scarce. In this study, we aimed to investigate the combined effects of MetS and systemic inflammation on endothelial function in postmenopausal women. Methods: We identified 423 postmenopausal women from February 2019 through July 2020. MetS was diagnosed according to the International Diabetes Federation (IDF) criteria, and high sensitivity C-reaction protein (hs-CRP) was measured to assess the degree of underlying inflammation. The measurement of endothelial function was using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index, RHI). Results: There were 156 patients with MetS and 267 without MetS. Compared to the group without MetS, patients with MetS had significantly lower natural logarithmic RHI (0.66±0.29 versus 0.91±0.31; p<0.001), but higher levels of hs-CRP (0.98 [0.31, 3.54] versus 0.53 [0.20, 2.14]; p<0.001). In sequential multivariable analysis, the presence of hs-CRP (ΔR2 =0.047, p=0.004) had a significant and independent influence on natural logarithmic RHI. Furthermore, the interaction of hs-CRP*MetS was synergistically associated with endothelial dysfunction even in the fully adjusted model (β=-0.107, 95% CI [-0.161~-0.053], p=0.009). Conclusion: MetS and systemic inflammation are synergistically associated with endothelial dysfunction in postmenopausal women. Postmenopausal women with both these conditions appear to be at a significantly higher risk for adverse cardiovascular events. |
CASE REPORT | |
11. | Unexpected huge post-stenting coronary perforation during complex left main revascularization Gianluca Rigatelli, Marco Zuin, Loris Roncon doi: 10.5543/tkda.2022.21075 Pages 66 - 69 A 78-year-old man with a tight left main and a long calcified disease of the left anterior descending coronary artery refused surgery. After stenting, the patient went into a shock because of a large coronary artery ruptur. Pericardial drainage with blood reinfusion, without heparin reversal, allowed for completion of revascularization. |
12. | Percutaneous closure of an iatrogenic ventricular septal defect associated with transcatheter aortic valve implantation Göktuğ Savaş, Selçuk Yazıcı, Özgür Kılıç, Sait Terzi doi: 10.5543/tkda.2022.21093 Pages 70 - 78 An 81-year-old man who had dyspnea was admitted to our hospital with a diagnosis of severe aortic stenosis. A transcatheter aortic valve implantation was successfully performed with a 29 mm Edwards Sapien XT valve using a transfemoral access. After the procedure, the echocardiography showed a restrictive ventricular septal defect (VSD) in the membranous septum. As the patient had no symptoms, it was decided to follow him up conservatively. However, he was readmitted within three weeks with symptoms suggestive of biventricular failure. A control echocardiography revealed a membranous VSD, 8 mm in size, right chambers dilatation with moderate tricuspid regurgitation, and systolic pulmonary artery pressure of 60 mm Hg. The previously deployed aortic valve was normal in function. The decision to perform a percutaneous VSD closure was made. The defect was then closed with a 10 mm muscular VSD occluder. During and after the procedure, there was no dysfunction in the bioprosthetic aortic valve. At the one-year follow-up, the patient was still asymptomatic. |
13. | Modafinil-induced ventricular arrhythmia: A case report Deniz Mutlu, Barkın Kültürsay, Ali Karagöz doi: 10.5543/tkda.2022.21084 Pages 79 - 82 Modafinil is a central nervous system stimulant that promotes wakefulness and is approved for the treatment of narcolepsy and several other conditions. However, there is a big concern about drug abuse, especially among students to enhance cognitive performance and to reduce the need for sleep. In this case report, we present a 23-yearold female admitted to the cardiology outpatient clinic owing to recurrent palpitations. She stated that she started modafinil 100 mg twice a day one month earlier to increase performance while studying for her exams. Her electrocardiogram (ECG) demonstrated sinus rhythm and a right bundle branch block (RBBB). No structural heart disease or metabolic pathology was detected. A 24-hour ambulatory ECG record showed 11 attacks of non-sustained ventricular tachycardia (NSVT), the longest of which was eight beats. The drug was discontinued and two weeks later, the patient was symptom-free, and her control ECG showed normal sinus rhythm with no RBBB. A control ambulatory ECG was performed, and no ventricular tachycardia was observed. Modafinil, which is considered safer than amphetamine derivatives in terms of cardiovascular side effects, rarely causes serious arrhythmic events, even in healthy subjects. Thus, we suggest evaluating patients for cardiac symptoms after starting on modafinil, and they should be also interrogated regarding the abuse of this drug. |
CASE IMAGE | |
14. | Differences in fractional flow reserve derived from coronary computed tomography angiography according to coronary artery bifurcation angle Toshimitsu Tsugu, Kaoru Tanaka doi: 10.5543/tkda.2022.21104 Pages 83 - 84 |
15. | A frequently overlooked cause of chest pain: Acute aortic intramural hematoma Ibrahim Altun, Özcan Başaran, Oğuzhan Çelik, Ilknur Altun, Neşat Cullu doi: 10.5543/tkda.2022.81317 Page 85 |
EDITORIAL COMMENT | |
16. | COP26 and health: some progress, but too slow and not enough Laurie Laybourn-langton, Richard Smith doi: 10.5543/tkda.2022.EY1 Pages 86 - 88 Abstract | |
OTHER ARTICLES | |
17. | Kardiyoloji yayınlarında gündem ve yorumlar Ertan Ural Page 89 Abstract | |
18. | HAKEMLERİMİZE TEŞEKKÜRLER Page E1 Abstract | |
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