Objective: Peripheral metabo-inflammatory disturbances and ferropathological processes are closely linked to steno-occlusive pathologies in Parkinson’s disease (PD), though their roles remain to be fully elucidated. This study aims to investigate cardio-metabolic risk stratification in PD in the context of peripheral metabo-inflammatory and ferropathological abnormalities, and to analyze the role of iron-related dysregulation in carotid atherosclerosis.

Method: This cross-sectional case-control study employed high-resolution carotid duplex imaging. Risk stratification for metabolic syndrome (MetS) was assessed using lipid-to-high-density lipoprotein cholesterol (HDL-C) ratios. Intercorrelative and multinomial regression analyses were performed for statistical comparison.

Results: PD patients showed a higher tendency toward cardiovascular disease (CVD) and atherogenicity. Calcified plaque formation and Type 4 stenosis patterns were significantly more prevalent (χ2 = 21.717, χ2 = 60.609; P < 0.001), along with altered peripheral iron correlation profiles in PD. An increased risk for MetS was also observed (cholesterol/HDL-C (P = 0.015 (z = 2.434), triglyceride/HDL-C ratio (P = 0.013 (z = 2.471)), along with augmented inflammatory hematological ratios in PD. In multinomial regression analysis, a 1-unit increase in glycated hemoglobin (HbA1c) was associated with a 1.967-fold increase in the likelihood of plaque-forming classification (Odds Ratio = 1.967). Additionally, a 1-unit increase in low-density lipoprotein cholesterol was associated with a slight decrease in risk (Odds Ratio = 0.981) (Cox-Snell = 0.266, Nagelkerke = 0.294).

Conclusion: Patients with PD demonstrated a higher risk of CVD and atherosclerotic plaque complications. A close association was observed between MetS and elevated cholesterol/HDL-C and triglyceride/HDL-C ratios. Additionally, there was an increased risk of oxidative stress-related atherothrombotic complications, driven by heightened inflammatory ratios and disturbed ferropathologic processes. However, peripheral iron disturbances did not show a significant relationship with stenosis patterns.

Objective: Culotte stenting is one of the most commonly used bifurcation stenting techniques. Double kissing mini-culotte (DKC) stenting, a modified version of culotte stenting, is currently recommended by clinical guidelines. This study aimed to compare the outcomes of DKC and mini-culotte (MC) techniques in true non-left main coronary bifurcation lesions (CBLs).

Method: A total of 200 patients with non-left main CBLs undergoing percutaneous coronary intervention were assigned to either MC stenting (n = 92) or DKC stenting (n = 108). The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR) at one- and three-year follow up.

Results: The incidence of TLF was significantly lower in the DKC group at both one year [7 (7.6%) vs. 1 (0.9%), P = 0.017] and three years [18 (19.6%) vs. 6 (5.6%), P = 0.002], primarily driven by a reduction in TLR at one year [6 (6.5%) vs. 1 (0.9%), P = 0.033] and three years [13 (14.1%) vs. 5 (4.6%), P = 0.018]. Fewer patients experienced TVMI [4 (4.3%) vs. 3 (2.8%), P = 0.551] and cardiac death [5 (5.4%) vs. 1 (0.9%), P = 0.064] in the DKC group at three years.

Conclusion: In patients with true non-left main CBLs, the DKC technique was associated with a lower incidence of TLF and TLR at three years compared to the MC technique.

Objective: The criteria for iron deficiency (ID) may encompass depleted iron stores alongside unmet iron demands by cardiomyocytes, potentially serving as predictors of adverse outcomes in patients with heart failure (HF).

Method: We included 570 patients with HF. Based on newly proposed definitions of ID, patients were categorized into three groups: Type 1 (transferrin saturation [TSAT] < ≈15-16% with anemia), Type 2 or 3 (TSAT < ≈20% with no or mild anemia) and those meeting HF guideline-defined ID criteria. Binary logistic regression was used to identify independent predictors of one-year all-cause mortality in patients with HF. Cox proportional hazard regression was performed to assess the impact of Type 1 ID on mortality.

Results: Among the 570 HF patients, 175 (30.7%) had Type 1 ID, 250 (43.9%) had Type 2 or 3 ID, and 415 (72.8%) met the guideline-defined criteria for ID. One-year all-cause mortality rates were 38.3% in patients with Type 1 ID, 22.7% in those with Type 2 or 3 ID, and 26.0% in those meeting guideline ID criteria. Increased age (odds ratio [OR]: 1.054, 95% confidence interval [CI]: 1.025-1.084) and Type 1 ID (OR: 1.830, 95% CI: 1.044-3.208) were independent predictors of one-year all-cause mortality. Cox regression analysis demonstrated an increased risk of mortality in HF patients with Type 1 ID compared to those without, in both unadjusted (hazard ratio [HR]: 2.289, 95% CI: 1.644-3.186, P < 0.001) and adjusted (HR: 1.543, 95% CI: 1.070-2.225, P = 0.020) models.

Conclusion: Type 1 ID was an independent predictor of one-year all-cause mortality in patients with HF, unlike Type 2 or 3 ID and guideline-defined ID. Patients with Type 1 ID with HF had a higher overall mortality risk compared to those without Type 1 ID.

Objective: Whether Coronavirus Disease 2019 (COVID-19) infection and vaccination contribute to the development of acute coronary syndrome (ACS) or myocarditis, particularly in young adults, remains controversial. This study aimed to evaluate the hospitalization rates for ACS and myocarditis in patients under 45 years of age during the pre-pandemic, pandemic, and post-pandemic periods.

Method: This retrospective, single-center study included 944 patients under the age of 45 who were admitted to the coronary care unit with a diagnosis of ACS or myocarditis. Patients were categorized into three groups based on admission periods: pre-pandemic (January 2019 to March 31, 2020), pandemic (April 1, 2020 to September 30, 2022), and post-pandemic (October 1, 2022 to December 31, 2023).

Results: There were no significant differences in the proportion of patients under 45 years old among total coronary care unit admissions across the three periods (12.9% vs 11.0% vs. 11.8%, respectively; P = 0.134). Similarly, although a slight increase was observed in the proportion of myocarditis cases relative to ACS over time, the difference was not statistically significant (29.9% vs. 70.1%, 32.0% vs. 68.0%, and 34.2% vs. 65.8%, respectively; P = 0.600). The rate of myocarditis was comparable between vaccinated and unvaccinated patients, with no significant differences based on vaccine types.

Conclusion: Hospitalization rates for ACS and myocarditis among patients under 45 years of age at our center were similar across the pre-pandemic, pandemic, and post-pandemic periods. These findings support previous studies suggesting no association between COVID-19 infection or vaccination and the occurrence of ACS or myocarditis. However, as a single-center retrospective study, our findings are limited to hospitalized cases and do not provide data on the overall incidence, prevalence, or causal relationships between these conditions and the pandemic.

Objective: The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has gained interest as a potential predictive biomarker for various clinical outcomes across multiple diseases. This study aimed to evaluate the efficacy of the HALP score in predicting the recurrence of atrial fibrillation (AF) following cryo-balloon ablation (CBA).

Method: A total of 399 patients who underwent CBA for AF were included in the study. Patients were divided into three equal groups based on their HALP scores, and post-procedural AF recurrence was evaluated retrospectively across these groups.

Results: After adjusting for confounding independent variables, patients in Tertile 1 had 2.1-fold higher rate of AF recurrence compared to those in Tertile 3, which served as the reference group. Receiver operating characteristic (ROC) curve analysis showed that the HALP score predicted AF recurrence with an area under the curve (AUC) of 0.69, 65% sensitivity, and 65% specificity (hazard ratio [HR]: 0.69, 95% confidence interval [CI]: 0.63-0.74, P < 0.001).

Conclusion: This study suggests that the HALP score may serve as an independent predictor of AF recurrence following CBA.

Objective: This study aimed to evaluate the level of pain caused by routine procedures during cardiac catheterization and explore ways to enhance patient comfort during the procedure based on the findings.

Method: The study involved 24 pediatric patients with congenital heart disease who underwent cardiac catheterization at our center. Pain perception was assessed using skin conductance activity, a non-invasive and sensitive method, at four time points: before the procedure with maternal presence (T0), during local anesthesia following general anesthesia (T1), during femoral vascular intervention (T2), and after the procedure with maternal presence (T3).

Results: Significant differences in pain levels were observed at T0, T1, and T2. While no significant correlation was found between midazolam dosage and pain perception, a statistically significant association was identified between ketamine dosage and pain levels at T3, when the mother was present after the cardiac catheterization.

Conclusion: Effective sedation planning requires a clear understanding of the degree of pain children experience during procedures. This study showed that, despite the use of local anesthetic and procedural sedation, discomfort may still occur. These findings highlight the need for improved pain management strategies to enhance patient comfort during cardiac catheterization.

Coronary artery disease (CAD) is the leading cause of death worldwide. The most widely used and precise method for diagnosing CAD is invasive coronary angiography (ICA). Fractional flow reserve (FFR) is an index of the functional severity of coronary stenoses that requires additional invasive intervention during ICA. With advancements in artificial intelligence (AI) technology, the estimation of FFR using AI is gaining popularity to meet the need for fast, accurate, and less invasive FFR estimation that can integrate into physicians’ workflows. This review presents the current progress in this area by analyzing studies employing various approaches.

Fabry disease is a rare disorder characterized by multi-organ involvement, caused by mutations in the GLA gene. Although more than 1,000 mutations have been identified in the GLA gene, the discovery and detection of new mutations continue to enhance this dataset. We report a patient examined at our clinic for heart valve disease, who had a history of kidney transplantation and hemodialysis. With a high clinical suspicion, we diagnosed Fabry disease and will discuss its significant impact on the family. Effective family screening allowed us to identify unaffected family members, thus preventing or mitigating potential future organ involvement. Additionally, the mutation found in this family, although rarely reported before, is still described as a variant of uncertain significance (VUS) in some sources. We believe this finding will make a valuable contribution to genetic literature.

The main disadvantage of bioprosthetic heart valves is their potential for degeneration in the medium to long term. Due to the high risk associated with reoperation, the percutaneous valve-in-valve (ViV) approach is preferred for patients with bioprosthetic degeneration following tricuspid valve replacement. However, the procedure can be challenging when the implanted bioprosthetic valve is not radio-opaque. We present three cases performed at our hospital, detailing a step-by-step approach and alignment techniques when the valve is not visible on fluoroscopy. All patients were admitted with right heart failure and demonstrated severe dysfunction of their tricuspid bioprosthetic valves. In the first case, the bioprosthetic valve was clearly visible on fluoroscopy, which facilitated the alignment process. In the other two cases, the valves were not visible. Predilation was performed, and the resulting indentation line served as a reference. Echocardiographic (ECHO) imaging, along with right atrial and ventricular angiograms, was used to guide the alignment of the balloon-expandable valve. The ViV procedure was successful in all three cases. The transcatheter ViV approach appears to be an effective treatment option for patients with tricuspid bioprosthetic valve degeneration. In cases where the valve is not radio-opaque, the procedure can be safely performed by using the indentation point from balloon dilatation, right ventricular and atrial angiography, and transthoracic or transesophageal echocardiography to guide valve alignment.