FRONTMATTER | |
1. | Front Matter Pages I - II |
EDITORIAL | |
2. | How to Manage Heart Failure Patients with Not Reduced Ejection Fraction Based on Available Evidence? Dilek Ural doi: 10.5543/tkda.2022.EE1 Pages 237 - 238 Abstract | English Full Text |
EDITORIAL COMMENT | |
3. | Coronary Slow Flow İbrahim Akın İzgi doi: 10.5543/tkda.2022.22485 Pages 239 - 241 Abstract | English Full Text |
ORIGINAL ARTICLE | |
4. | The Relationship Between H2FPEF Score and Coronary Slow Flow Phenomenon Caner Türkoğlu, Taner Şeker, Ömer Genç, Abdullah Yıldırım, Mustafa Topuz doi: 10.5543/tkda.2022.21291 Pages 242 - 249 Objective: Diastolic dysfunction plays an important role in the pathophysiology of both coronary slow flow phenomenon and heart failure with preserved ejection fraction, which could be predicted by the H2FPEF score. We sought to investigate the association of H2FPEF score with coronary slow flow phenomenon in subjects undergoing coronary angiography for suspected stable ischemic heart disease. Methods: The study included 228 consecutive individuals [60.5% male, mean age 52.6 (10.1)]. Subjects with non-obstructive coronary artery disease were classified as coronary normal flow (n = 112) and coronary slow flow (n = 116) after confirmation of coronary angiography results. H2FPEF score of each participant was calculated. Results: Subjects with coronary slow flow phenomenon were more likely to be male (75% vs. 45.5%, P <.001) and have a higher body mass index than that of normal flow group [30.5 (2.9) vs. 29.3 (2.8), P =.001]. H2FPEF score was significantly higher in the former group [2 (2-4) vs. 0 (0-1), P <.001]. H2FPEF score was also positively correlated with mean corrected thrombolysis in myocardial infarction frame count (r = 0.725, P <.001). On multivariate logistic regression analysis, male gender [odds ratio: 4.580, 95% CI: 1.700-12.336, P =.003], current smoker [OR: 2.398, 95% CI: 1.064-5.408, P =.035], total cholesterol [OR: 1.011, 95% CI: 1.001-1.021, P =.026], and H2FPEF score [OR: 3.111, 95% CI: 2.160-4.480, P <.001] were found to be the independent predictors of coronary slow flow phenomenon. Conclusion: We found that the H2FPEF score, which is useful in demonstrating diastolic dysfunction, is independently associated with coronary slow flow pattern in suspected ischemic heart disease. |
5. | The Mean Corrected TIMI Frame Count Could Predict Major Adverse Cardiovascular Events in Patients with Coronary Slow-Flow Phenomenon Esra Poyraz, Göktuğ Savaş, Aysun Erdem, Lale Dinç Asarcıklı, Selçuk Yazıcı, Altuğ Ösken, Özge Güzelburç, Sait Terzi doi: 10.5543/tkda.2022.21309 Pages 250 - 255 Objective: The aim of the present study was to investigate the association between the mean corrected thrombolysis in myocardial frame count and major adverse cardiovascular events in patients with the coronary slow-flow phenomenon. Methods: A total of 98 patients with coronary slow-flow phenomenon who met inclusion criteria from 2015 to 2020 were retrospectively included in the analysis. The patients were ranked according to their mean corrected thrombolysis in myocardial frame count values and were divided into quartiles based on those. Group 1 consisted of patients who had a mean corrected thrombolysis in myocardial frame count value >36.68 (third quartile), while group 2 consisted of patients who had a mean corrected thrombolysis in myocardial frame count value ≤36.68 (first quartile + second quartile). Mortality and non-fatal cardiovascular complications were compared between the groups. Results: Mean follow-up duration was 3.93 Å} 1.50 years. Recurrent chest pain and major adverse cardiovascular events increased in group 1 compared to group 2 (P ≤.001, P ≤.001, respectively). Hypertension (odds ratio 2.627, P =.033), hyperlipidemia (odds ratio 2.469, P =.028) and mean corrected thrombolysis in myocardial frame count (odds ratio 1.106, P =.002) were independent predictors of recurrent chest pain according to Cox regression analysis. Although older age (odds ratio 1.125, P =.011), hypertension (odds ratio 6.081, P =.026), hyperlipidemia (odds ratio 12.308, P = 0.019), and mean corrected thrombolysis in myocardial frame count (odds ratio 1.476, P =.001) were found to be significantly related with major adverse cardiovascular events in patients with coronary slow-flow phenomenon, only mean corrected thrombolysis in myocardial frame count (odds ratio 1.161, P =.021) was an independent predictor of major adverse cardiovascular events in Cox regression analysis. Conclusion: Higher mean corrected thrombolysis in myocardial frame count could predict major adverse cardiovascular events in patients with the coronary slow-flow phenomenon. |
6. | Prognostic Impact of New-Onset Atrial Fibrillation After Single or Double Stent Left Main Bifurcation PC Gianluca Rigatelli, Marco Zuin, Claudio Picariello, Filippo Gianese, Gianni Pastore, Enrico Baracca, Francesco Zanon, Loris Roncon doi: 10.5543/tkda.2022.21203 Pages 256 - 263 Objective: Incidence and prognostic value of new-onset atrial fibrillation after single versus double stent strategy in bifurcation left main disease has not been yet investigated. Methods: We retrospectively analyzed the procedural and medical data of patients referred to our center for complex left main bifurcation disease, treated using crossover provisional stenting, T or T-and-Protrusion, Culotte, and Nano-inverted-T techniques between January 1, 2008, and May 1, 2018. Multivariate Cox-regression analysis was used to assess the role of different stent strategies, adjusted for confounders, on the risk of new-onset atrial fibrillation during the follow-up period. Results: Five hundred two patients (316 males, mean age 70.3 ± 12.8 years, mean Syntax score 31.6 ± 6.3) were evaluated. At a mean follow-up of 37.1 ± 10.8 months (range: 22.1-39.3 months); Target lesion failure rate was 10.1%. Stent thrombosis and cardiovascular mortality were observed in 1.2% and 3.6% in of cases, respectively. New-onset atrial fibrillation occurred in 23 out of 502 patients (4.6%). Patients with new-onset atrial fibrillation resulted more frequently female, older, obese, and diabetic and more frequently experienced target lesion failure and cardiovascular death. New-onset atrial fibrillation-free survival favored single versus double stent technique and among double stent techniques nano-inverted-T techniques compared to the others. Single stent strategy had a lower risk of new-onset atrial fibrillation compared to double stent technique on multivariate analysis (Hazard Ratio (HR): 1.14, 95% CI: 1.10-1.19, P <.001 vs. HR: 1.28, 95% CI: 1.23-1.32, P <.0001). Conclusion: New-onset atrial fibrillation in distal left main bifurcation disease treated with percutaneous coronary intervention had a low incidence but resulted more frequently after double than after single stenting technique and was associated with worse outcomes. |
7. | The Influence of Low and Iso-osmolar Contrast Media on Diagnostic Performance of Contrast Fractional Flow Reserve Measurement Reza Rahmani, Mohammad Ramezani, Akbar Shafiee doi: 10.5543/tkda.2022.21273 Pages 264 - 269 Objective: For fractional flow reserve measurement, contrast media can be used as an alternative for adenosine. However, contrast media with different physical characteristics (e.g., osmolality and viscosity) may have different effects on hyperemia. This study aimed to determine if the diagnostic accuracy of contrast fractional flow reserve was influenced by 2 commonly used contrast media (Visipaque and Ultravist). Methods: In this diagnostic study, candidates for coronary angiography with intermediate coronary lesion were enrolled and randomized to receive either an iso-osmolar contrast media (Visipaque) or a low osmolar contrast media (Ultravist) for fractional flow reserve measurement. The gold standard was fractional flow reserve measured by adenosine fractional flow reserve. Then cFFR and adenosine fractional flow reserve were compared between the groups, and the diagnostic values of both contrasts were calculated. Finally, the cut-point for diagnosing adenosine fractional flow reserve ≤ 0.8 was calculated for cFFR in both groups. Results: In this study, 46 patients were studied (24 patients received Ultravist and 22 patients received Visipaque). There was no significant difference between the groups in adenosine fractional flow reserve. Also, the mean cFFR was not different from the mean adenosine fractional flow reserve in both groups. There was a strong correlation between cFFR and adenosine fractional flow reserve for each of the contrasts (r=0.937 for Ultravist and r=0.927 for Visipaque). Both contrasts had high specificity to diagnose fractional flow reserve ≤ 0.8 (specificity=1), and the sensitivities of cFFR for Ultravist and Visipaque were 83.3% and 94.7%. The cut-point to predict adenosine fractional flow reserve ≤ 0.80 was 0.845 for Ultravist and 0.835 for Visipaque. Conclusions: Both iso-osmolar or low osmolar contrast media have an acceptable diagnostic accuracy in measuring cFFR. |
8. | Comparison of Equations for the Calculation of LDL-Cholesterol in Familial Hypercholesterolemia: Data from Iranian Registry Golnaz Vaseghi, Parastesh Rezvanian, Marzieh Taheri, Mohammad Amin Sadri, Atefeh Amerizadeh, Shaghayegh Haghjooy Javanmard, Masoud Shekarchizadeh, Ramesh Hosseinkhani, Ali Pourmoghadas, Jamshid Najafian, Nizal Sarrafzadegan doi: 10.5543/tkda.2022.21159 Pages 270 - 275 Objective: Low-density lipoprotein cholesterol is the mainstay of diagnosis, treatment, and follow-up of patients with familial hypercholesterolemia, the most prevalent autosomal dominant disorder among humans. Since the reference measurement method (ultracentrifugation) is time-consuming and expensive, many formulas emerged to calculate low-density lipoprotein cholesterol levels and are commonly used in laboratories. Methods: To compare the performance of 3 low-density lipoprotein cholesterol calculation equations with a direct method (enzymatic photometric assay), the lipid profiles of 1148 patients of the registry of familial hypercholesterolemia in Iran were analyzed retrospectively, 270 of which had a possible or definite familial hypercholesterolemia diagnosis according to Dutch criteria. While measured using the direct method, we calculated the low-density lipoprotein cholesterol levels using the Friedewald, Chen, and Anandaraja formulas. Results: Our results showed that all 3 formulas are highly correlated with the direct method, and the Chen formula showed the highest intra-class correlation coefficient among all (0.954 among all patients with hypercholesterolemia and 0.947 among the familial hypercholesterolemia population). In addition, the Chen formula was the most sensitive, and the Friedewald formula was the most specific formula using a low-density lipoprotein cholesterol cut-off of 100 in familial hypercholesterolemia patients. Conclusion: Our findings encourage applying the Chen formula in addition to the Friedewald formula to make better clinical decisions for familial hypercholesterolemia patients. |
9. | Hypertension: A National Cross-Sectional Study in India Sayantan Chakraborty, Gainel Ussatayeva, Ming-shinn Lee, Koustuv Dalal doi: 10.5543/tkda.2022.21207 Pages 276 - 283 Objective: Hypertension is a global public health problem. This article aimed to estimate the national prevalence of hypertension in India for both women and men. The study had also examined the demographic and socioeconomic status of hypertensive women and men. Methods: The study used the National Family Health Survey 4 from all over India. Hypertension of 661 771 women (15-49 years) and 104 357 men (15-54 years) and their demographic and socioeconomic variables were assessed. Crosstabulation, chi-square tests, and multivariate logistic regression were used. Results: The prevalence of hypertension in women and men were 11.40% and 18.10%, respectively. State-wise, Sikkim had shown the maximum prevalence. Older women (45-49 years) and men (50-54 years) had the highest hypertension prevalence among all age groups. Urban people had shown proportionately more hypertension than rural people. Education, working status, and richer economic status emerged as significant risk factors. Women with lower educational status and men with higher educational status were more likely to be hypertensive. Working people were more hypertensive than their non-working peers. Economically, sound men were more hypertensive than poor people. Hypertensive people accessed medical care more. Conclusion: There are various modifiable risk socioeconomic factors associated with hypertension. Policymakers can consider the current findings for better preventive planning. The risk factors identified in the study should be considered with appropriate weightage. |
REVIEW | |
10. | Low Cardiac Output Syndrome After Cardiac Surgery: A Life-Threatening Condition from the Perspective of Pediatric Intensivists Nagehan Aslan, Dinçer Yıldızdaş doi: 10.5543/tkda.2022.21212 Pages 284 - 292 Low cardiac output syndrome is a clinical picture insourcing from insufficient oxygen supply to tissues so as to meet the metabolic demand, myocardial dysfunction, and cardiovascular insufficiency. Low cardiac output syndrome is seen in nearly 25% of pediatric patients who underwent corrective or palliative surgery due to congenital heart defects. It is a clinical condition occurring typically 6-18 hours after surgery in pediatric patients undergoing cardiac surgery and causes organ failure, prolonged hospital and intensive care hospitalization time, increased resource utilization, and mortality. The identification and correct management of this serious complication in the early period is very important. However, there is no clear consensus or consensus report on the follow-up of this patient group and the definition of low cardiac output syndrome. Clinicians generally produced low cardiac output syndrome definitions according to their own approach. In this review, we aim to draw attention to low cardiac output syndrome and hope to summarize the pathophysiology, etiology, clinical definition, and treatment options of low cardiac output syndrome as a life-threatening condition in pediatric intensive care unit. |
CASE REPORT | |
11. | Stent Dislodgement During Percutaneous Coronary Intervention: How to Get the Ring Off? Ziad Dahdouh doi: 10.5543/tkda.2022.21199 Pages 293 - 299 Iatrogenic coronary artery dissection is a rare but serious complication during percutaneous coronary intervention. Stent dislodgment or stent loss is another potential complication that can occur under certain circumstances. We herein present a case of stent dislodgment that was intended to treat an iatrogenic left main coronary artery dissection. Several percutaneous techniques for the management of such complication are discussed, and an illustration of the approach used in our case is presented. |
12. | A Rare Case of Primary Cardiac Lymphoma Presenting with Acute Myocardial Infarction: to Be Happy or to Be Sorry? Dilay Karabulut, Gülsüm Türkyılmaz doi: 10.5543/tkda.2022.21217 Pages 300 - 303 Among primary malignant tumors of the heart, primary cardiac lymphomas are extremely rare. Early diagnosis is crucial in primary cardiac lymphoma cases as its non-specific symptoms often lead to delayed diagnosis and poor prognosis. In this case report, we presented a challenging case of primary cardiac lymphoma that was noticed during echocardiography of a patient admitted with acute myocardial infarction. A 32-year-old man was admitted to the emergency department with acute anterior ST-elevated myocardial infarction. His angiogram revealed an acute occlusion in the proximal left anterior descending artery with otherwise normal coronary arteries. After the total occlusion was passed with a guidewire, only a dense thrombus was observed. Therefore, an embolic source was suspected. Echocardiography revealed a giant mass (6 cm × 2.5 cm) attached to the interatrial septum. The patient was referred to early surgery for the resection of the mass. Histopathology and immunohistochemistry of the resected specimen demonstrated B cell non-Hodgkin lymphoma. Positron emission tomography and computerized tomography showed no lymph node and organ involvement. Two weeks after surgery, he was discharged and referred to the hematology department for chemotherapy. After 6 cycles, the positron emission tomography scan showed no abnormal accumulation indicating complete remission 7 months later. The clinical course of the patient was favorable for 1 and a half years. Acute myocardial infarction may be a manifestation of a rare entity such as primary cardiac lymphoma and an embolic source should always be considered. This is a case of pathologically diagnosed and successfully treated primary cardiac lymphoma. |
CASE IMAGE | |
13. | Cardiac Metastasis Masquerading as Acute Coronary Syndrome Zübeyir Bulat, Hidayet Ozan Arabacı, Mehmed Emin Gökçe, Abdallah Ömer Ebeoğlu, Ümit Yaşar Sinan doi: 10.5543/tkda.2022.22406 Pages 304 - 305 Abstract | English Full Text |
LETTER TO EDITOR | |
14. | Evaluation of the Perception of Illness and Quality of Life in Patients with Acute Myocardial Infarction doi: 10.5543/tkda.2022.22421 Pages 306 - 307 Abstract | English Full Text |
15. | Cordova Formula, A Better Alternative to Martin’s Formula for the Calculation of LDL-C in Patients with TG above 350 mg/dL Sojit Tomo, Shrimanjunath Sankanagoudar doi: 10.5543/tkda.2022.22368 Pages 308 - 309 Abstract | English Full Text |
OTHER ARTICLES | |
16. | Comments on Cardiology Ertan Ural Pages 310 - 311 Abstract | English Full Text |
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