Multi-source observations on the effect of atmospheric blocking on air quality in Istanbul: a study case.

Air pollution is affected by the atmospheric dynamics. This study aims to determine that air pollution concentration values in Istanbul increased significantly and reached peak values due to atmospheric blocking between the 30th of December 2022 and the 5th of January 2023. In this study, hourly pollutant data was obtained from 16 air quality monitoring stations (AQMS), the exact reanalysis data was extracted from ERA5 database, and inversion levels and meteorological and synoptic analyses were used to determine the effects of atmospheric blocking on air pollution. Also, cloud base heights and vertical visibility measurements were taken with a ceilometer. Statistical calculations and data visualizations were performed using the R and Grads program. Omega-type blocking, which started in Istanbul on December 30, 2022, had a significant impact on the 1st and 2nd of January 2023, and PM10 and PM2.5 concentration values reached their peak values at 572.8 and 254.20 µg/m3, respectively. In addition, it was found that the average concentration values in the examined period in almost all stations were higher than the averages for January and February. As a result, air quality in Istanbul was determined as "poor" between these calendar dates. It was found that the blocking did not affect the ozone (µg/m3) concentration. It was also found that the concentrations of particulate matter (PM) 10 µm or less in diameter (PM10) and PM 2.5 µm or less in diameter (PM2.5) were increased by the blocking effect in the Istanbul area. Finally, according to the data obtained using the ceilometer, cloud base heights decreased to 30 m and vertical visibility to 10 m.

The relationship between PM10 and meteorological variables in the mega city Istanbul.

PM10, one of the air pollutants, occurs regularly in Istanbul during the winter months, namely in December, January, and February. PM10 pollutant is affected by numerous factors. Among these factors are various meteorological variables and climatological factors. This article aims to determine the relationship between PM10 and meteorological variables (wind speed, wind direction, temperature, and relative humidity) and to interpret these results. PM10 and meteorological data were examined between 2011 and 2018. To determine the relationship, multiple linear regression, Pearson's correlation coefficient (PCC), Spearman's rank correlation, Kendall Tau correlation, autocorrelation function (ACF), cross-correlation function (CCF), and visuals were determined using the R program (open-air) packages. In the study, the relationship between wind, temperature, and relative humidity with PM10 was determined, and it was observed that the PM10 concentration was maximum between January and February. PM10 concentrations have a positive relationship with relative humidity and wind direction, while a negative relationship with wind speed and temperature was observed. The correlation values for relative humidity and temperature were found to be 0.01 and - 0.15, respectively. Furthermore, the relationship between wind speed and PM10 was calculated from multiple linear regression model, and the estimated value was - 0.12 while looking at the wind direction value, it was approximately 0.03.

An investigation of the effects of sand and dust storms in the North East Sahara Desert on Turkish airports and PM10 values: 7 and 8 April, 2013 events.

Between April 7 and April 10, 2013, a cyclone with a value of 995 hPa that developed in the central Mediterranean transported dust from the Sahara Desert towards Turkey. At 13 airports in Turkey, dust haze and widespread dust were seen during different occasions in this period and caused the observation of so-called "Blowing dust events." This cyclone blew dust towards the Cappadocia airport, and the prevailing visibility decreased to 3800 m, making it the lowest value measured during the transition of this cyclone. In this study, Aviation Routine Weather Report (Metar) and Aviation Selected Special Weather Report (Speci) observations of airports in North Africa and Turkey were evaluated for the period between April 3 and April 11, 2013. With this cyclone the prevailing visibility at Benina Airport in Libya decreased to 50 m on April 6, 2013. This study aims to evaluate long-distance dust transport's effects on meteorological visibility at airports in Turkey and examine the episodic changes of PM10 values measured by air quality monitoring stations. Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model outputs were used to determine the trajectories of long-distance dust particles. Powder red, green, and blue (RGB) and Moderate Resolution Imaging Spectroradiometer (MODIS) satellite images, Cloud-Aerosol LIDAR Infrared Pathfinder Satellite Observations (CALIPSO) images, the Barcelona Supercomputing Center-Dust Regional Atmosphere Model (BSC-DREAM8b) outputs, and Global Forecast System (GFS) synoptic maps were used for analysis. In addition, PM10 values obtained from air quality monitoring stations were examined. According to the data obtained from the CALIPSO images, the dust concentration on the Eastern Mediterranean reaches up to 5 km. The episodic values obtained from certain air quality measurement stations are Adana 701, Gaziantep 629, Karaman 900, Nevsehir 1343, and Yozgat 782 µg/m3 on an hourly average.

Ambient air quality assessment at the airports based on a meteorological perspective.

Natural mineral dust episodes elevate particle concentrations and eventually decrease air quality. Air pollutant emissions from aircraft, airport ground operations, and long-range dust transport are producing problems for the aviation sector. Dust transport from the Sahara Desert, one of the primary dust sources globally, significantly affects the eastern Mediterranean basin, including Türkiye. This study investigates the effect of long-range dust transport on particulate matter (PM) concentrations at Turkish airports. Three different approaches were used to analyse dust episodes in the study area. Firstly, routine reports of meteorological conditions at the airports were investigated. For this purpose, airport routine meteorological reports (Metar) and aviation-selected special weather report (Speci) codes, recorded at 11 airports from 2012 to 2021, were used to determine the dust episode days. Secondly, the hourly PM measurement dataset was analyzed from the closest air quality monitoring stations to the airports. Finally, regional atmospheric model results and backward-trajectory analysis were used to validate the dust episodes and determine the dust origin. Results showed that 163 dust episodes occurred during the study period, 17% from North Africa and 12% from the Mediterranean region.

An urban air quality assessment based on a meteorological perspective.

An integrated approach to understanding all measured pollutants with multi-discipline in different time scales and understanding the mechanisms hidden under low air quality (AQ) conditions is essential for tackling potential air pollution issues. In this study, the air pollution of Sivas province was analyzed with meteorological and PM2.5 data over six years to assess the city's AQ in terms of PM2.5 pollution and analyze the effect of meteorological factors on it. It was found that the winter period (January-February-November-December) of every year except 2019-which has missing data-is the period with the highest air pollution in the province. In addition, the days exceeding the daily PM2.5 limit values in 2016, 2017, 2020, and 2021 were also seen in the spring and summer months, which inclined the study to focus on additional pollutant sources such as long-range dust transport and road vehicles. The year 2017 has the highest values and was analyzed in detail. Pollution periods with the most increased episodes in 2018 were analyzed with the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) and Dust Regional Atmospheric Model (DREAM) models. As a result of the study, the average PM2.5 values in 2017 were 31.66 ± 19.2 µg/m3 and a correlation of -0.49 between temperature and PM2.5. As a result of model outputs, it was found that the inversion is intensely observed in the province, which is associated with an increase of PM2.5 during the episodes. Dust transport from northwestern Iraq and northeastern Syria is observed, especially on days with daily average PM2.5 values above 100 µg/m3. Additionally, planetary boundary layer (PBL) data analysis with PM pollution revealed a significant negative correlation (r = -0.61). Air pollutants, particularly PM2.5, were found to be higher during lower PBL levels.

Increased Circulating Copeptin Levels Are Associated with Vaso-Occlusive Crisis and Right Ventricular Dysfunction in Sickle Cell Anemia.

OBJECTIVE: Vaso-occlusive crisis (VOC) is a common clinical manifestation of sickle cell anemia (SCA) and is associated with increased proinflammatory mediators. Copeptin is the C-terminal part of the prohormone for provasopressin and seems clinically relevant in various clinical conditions. Right ventricular (RV) dysfunction significantly appears in SCA patients due to pulmonary hypertension. This study aimed to investigate the association of copeptin levels in VOC patients and evaluate RV dysfunction. MATERIALS AND METHODS: A total of 108 patients were enrolled in the study. Twenty-eight SCA patients in steady state (30.2 ± 0.9 years), 25 SCA patients in VOC (36.8 ± 11.8 years), and 55 healthy individuals (31.9 ± 9.4 years) with HbAA genotype were included. Clinical, echocardiographic, and laboratory data were recorded. ELISA was used for the determination of serum levels of copeptin. RESULTS: VOC patients had significantly higher copeptin level compared both with controls and SCA subjects in steady state (22.6 ± 13.0 vs. 11.3 ± 5.7 pmol/L, 22.6 ± 13.0 vs. 12.4 ± 5.8 pmol/L, p = 0.009 for both). Additionally, the copeptin level was significantly higher in SCA patients with RV dysfunction than those without RV dysfunction (23.2 ± 12.2 vs. 15.3 ± 9.5 pmol/L, p = 0.024). Multiple logistic regression analysis revealed that high-sensitivity C-reactive protein and copeptin levels were found to be associated with VOC. CONCLUSION: This study showed that copeptin and hs-CRP levels were increased in patients with VOC, and it was found that RV dysfunction was more common in SCA patients with VOC than in the control group. Copeptin can be considered for use as a potential biomarker in predicting VOC crisis in SCA patients and in the early detection of patients with SCA who have the potential to develop RV dysfunction.

Predictors of the paroxysmal atrial fibrillation recurrence following cryoballoon-based pulmonary vein isolation: Assessment of left atrial volume, left atrial volume index, galectin-3 level and neutrophil-to-lymphocyte ratio.

BACKGROUND: Cryoballoon-based pulmonary vein isolation (PVI) is a treatment option for atrial fibrillation (AF). Left atrial volume (LAV) and left atrial volume index (LAVi) are important parameters for long term success of PVI. Galectin-3 (Gal-3) and neutrophil to lymphocyte ratio (N/L ratio) are biomarkers to demonstrate the cardiac fibrosis and remodelling. METHODS: 50 patients with symptomatic PAF despite ≥1 antiarrhythmic drug(s), who underwent PVI were enrolled. LAV, LAVi, Gal-3 and N/L ratio were calculated before ablation and after ablation at 6 and 12 months. According to AF recurrence patients were divided into two groups, recurrent AF (n = 14) and non-recurrent AF (n = 36). RESULTS: In both groups (recurrent and non-recurrent), initial and 12 months follow-up LAV values were 41.39 ±â€¯18.13 ml and 53.24 ±â€¯22.11 ml vs 48.85 ±â€¯12.89 ml and 42.08 ±â€¯13.85 (p = 0.037). LAVi were 20.9 ±â€¯8.91 ml/m2 and 26.85 ±â€¯11.28 ml/m2 vs 25.36 ±â€¯6.21 and 21.87 ±â€¯6.66 (p = 0.05) for recurrent and non-recurrent AF groups, respectively. In both groups PVI had no significant effect on serum Gal-3 levels and N/L ratio during 12 months follow-up. The comparison between two groups at the end of 12th month showed Gal-3 values of 6.66 ±â€¯4.09 ng/ml and 6.02 ±â€¯2.95 ng/ml (p = 0.516), N/L ratio values of 2.28 ±â€¯1.07 103/µl and 1.98 ±â€¯0.66 103/µl (p = 0.674). CONCLUSION: LAV and LAVi are useful to predict the remodelling of the left atrium and AF recurrence after cryoballoon-based PVI. However, biomarkers such as Gal-3 and N/L ratio are not associated with AF recurrence.

Association among tenascin-C and NT-proBNP levels and arrhythmia prevalence in heart failure.

PURPOSE: Tenascin-C (TN-C) and amino-terminal fragment of the B-type natriuretic peptide (NT-proBNP) are the important predictors in prognosis of heart failure (HF). The aim of this study was to analyze the relationship of TN-C and NT-proBNP levels with the frequency and severity of ventricular arrhythmia. MATERIALS AND METHODS: Our study included 107 HF patients with EF < 45%. According to Holter analysis, the patients were divided into two groups as malignant arrhythmia group (n=29) with Lown Class 4a and 4b arrhythmia and benign arrhythmia group(n=78) with Lown Class 0-3b arrhythmia. The groups were compared with respect to levels of TN-C and NT-proBNP. The relationship of TN-C and NT-proBNP levels with frequency of ventricular premature beat (VPB) was also analyzed. FINDINGS: NT-proBNP (5042.1±1626 versus 1417.1±1711.6 pg/ml) and TN-C (1089±348.6 versus 758.5±423.9 ng/ml) levels were significantly higher in the malignant arrhythmia group than that of the benign arrhythmia group (p.

Carotid Intima-Media Thickness as the Cardiometabolic Risk Indicator in Patients with Nonfunctional Adrenal Mass and Metabolic Syndrome Screening.

BACKGROUND: Our purpose was to show the association of adrenal incidentaloma and metabolic syndrome in consideration of the studies and to detect the increase in the carotid intima-media thickness which is regarded as the precessor of atherosclerosis. MATERIAL/METHODS: Eighty-one patients who were diagnosed with adrenal mass were included in the study. Hormonal evaluation, insulin rezistance measurement with the HOMA-IR and 1-mg DST were performed of all patients. The patients were classified as follows: mass size <3 cm (K1) and mass size of at least 3 cm (K2). Echocardiography and carotid intima-media thickness of the patients were measured using B-mode ultrasound. Thirty-three healthy individuals were enrolled as the control group. RESULTS: Mass size of 64.19% K1, while mass size of the remainder (35.81%) K2 was calculated. Five of the patients with adrenal mass were detected to have subclinical Cushing syndrome. The remaining 76 patients were accepted as nonfunctional. It was seen with regard to metabolic and biochemical parameters that plasma glucose (p=0.01), insulin (p=0.00) and triglyceride (p=0.012) values of all patients were significantly high compared to those of the control group. It was detected that measured heart rate (p=0.00), end-diastolic diameter (p=0.02), end-systolic diameter (p=0.014) and carotid intima-media thickness (p=0.00) values of the patients with adrenal mass were significantly higher than those of the healthy control group. CONCLUSIONS: We found that the increased insulin resistance, increased risk of cardiovascular disease with the increase in the thickness of carotid intima-media and diastolic disfunction parameters, although the patients with adrenal incidentaloma are nonfunctional.

Ultrasound Accelerated Thrombolysis May Be an Effective and Safe Treatment Modality for Intermediate Risk/Submassive Pulmonary Embolism.

Pulmonary embolism (PE) is a potentially life-threatening condition and the fact that 90% of PE originate from lower limb veins highlights the significance of early detection and treatment of deep vein thrombosis. Massive/high risk PE involving circulatory collapse or systemic arterial hypotension is associated with an early mortality rate of approximately 50%, in part from right ventricular (RV) failure. Intermediate risk/submassive PE, on the other hand, is defined as PE-related RV dysfunction, troponin and/or B-type natriuretic peptide elevation despite normal arterial pressure. Without prompt treatment, patients with intermediate risk PE may progress to the massive category with a potentially fatal outcome. In patients with PE and right ventricular dysfunction (RVD), in hospital mortality ranges from 5% to 17%, significantly higher than in patients without RVD.

Assessment of insulin-like growth factor-1 (IGF-I) level in patients with rheumatic mitral stenosis.

OBJECTIVES: Insulin-like growth factor-1 may serve some regulatory function in the immune system. Rheumatic mitral stenosis is related to autoimmune heart valve damage after streptococcal infection. The aim of this study was to assess the level of insulin-like growth factor-1 and its correlation with the Wilkins score in patients with rheumatic mitral stenosis. METHODS: A total of 65 patients with rheumatic mitral stenosis and 62 age- and sex-matched control subjects were enrolled in this study. All subjects underwent transthoracic echocardiography. The mitral valve area and Wilkins score were evaluated for all patients. Biochemical parameters and serum insulin-like growth factor-1 levels were measured. RESULTS: Demographic data were similar in the rheumatic mitral stenosis and control groups. The mean mitral valve area was 1.6±0.4 cm2 in the rheumatic mitral stenosis group. The level of insulin-like growth factor-1 was significantly higher in the rheumatic mitral stenosis group than in the control group (104 (55.6-267) versus 79.1 (23.0-244.0) ng/ml; p=0.039). There was a significant moderate positive correlation between insulin-like growth factor-1 and thickening of leaflets score of Wilkins (r=0.541, p<0.001). CONCLUSIONS: The present study demonstrated that serum insulin-like growth factor-1 levels were significantly higher in the rheumatic mitral stenosis group compared with control subjects and that insulin-like growth factor-1 level was also correlated with the Wilkins score. It can be suggested that there may be a link between insulin-like growth factor-1 level and immune pathogenesis of rheumatic mitral stenosis.

Aortic isthmic atresia and aorta-right atrial communication: a case report.

The development of an aorta-right atrial fistula is a very rare complication of aortic isthmic atresia. We described a case of aorta-right atrial communication associated with isthmic atresia.

[Isolated right ventricular myocardial infarction misdiagnosed as anteroseptal myocardial infarction on ECG: a case report]. / EKG'de anteroseptal miyokart enfarktüsünü düsündüren tek basina sag ventrikül miyokart enfarktüsü: Olgu sunumu.

In this article, we present a case with isolated right ventricular myocardial infarction (MI) who underwent coronary angiography on suspicion of acute anteroseptal MI detected on ECG; however, occlusion of the proximal right coronary artery (RCA) was detected. A female patient aged 65 years was brought to the emergency room due to loss of consciousness 1 hour before. From the patient's history, it was understood that she had undergone stent placement to her proximal RCA 5 days before. On ECG, a decreasing elevation in ST segment elevation from V1 to V4 was seen, and pathologic Q waves were present at DIII and AVF. A complete AV block was detected on ECG. In the coronary angiography, thrombosis of the stent in the proximal RCA was seen. Stenosis detected in the mid-left anterior descending artery was 50% and at the distal part was 60%. The circumflex coronary artery was found normal. Percutaneous transluminal coronary angioplasty was performed to the 95% thrombotic lesion in the stent of the proximal RCA, and full patency was established. In our case, a decreasing elevation in the ST segment elevation from V1 to V4 was seen. Right ventricular MI usually occurs by an acute stenosis of the non-dominant proximal RCA branch that does not receive collateral flow. In our case, RCA was codominant and an acute stenosis of the stent in the proximal RCA was present. The occlusion of the non-dominant RCA can appear as isolated right ventricular MI without causing a left ventricular infarct, since it does not feed the left ventricle.

Can stellate ganglion blockage be an alternative treatment for refractory ventricular arrhythmias: Case series.

INTRODUCTION: Ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening conditions which increase in frequency over the years. Electrical storm (ES) is defined as the occurrence of 3 or more continuous ventricular arrhythmia. The sympathetic nervous system has an important role in Ventricular arrythmias (VA) and is the target of treatment. Studies show that stellate ganglion blockade (SGB) can reduce cardiac sympathetic tone and is an alternative bridge therapy in VAs. PATIENT CONCERNS: Among the patients who were admitted to the hospital with the complaints of general condition disorder and palpitation. DIAGNOSIS: Patients were referred to the Cardiology department and diagnosed VA and ES. Patients who applied to the Cardiology Department with the diagnosis of VA or ES and did not benefit from antiarrhythmic drug therapy were selected and evaluated by a team of 2 anesthesiologists (cardiothoracic and pain specialists) and 2 cardiologists (1 of whom is an electrophysiology specialist). INTERVENTION: In our study, ultrasound (USG) guided left SGB was applied to 10 VA and ES patients with implantable cardiac defibrillator (ICD). The 6-month results of the patients were evaluated retrospectively. For blockage, the solution was prepared by adding 8 mg dexamethasone, 40 mg lidocaine and 10 mg bupivacaine to 10 mL with physiological saline. The success of the procedure was evaluated with the development of Horner syndrome in the left eye. OUTCOMES: Resistant VA developed in 2 of 10 patients who had left SGB due to VF/VT ES and were excluded from the study. One (1) month after the procedure it was seen that there was a statistically significant decrease in the number of shocks in 8 patients in the 6th month controls compared to the pre-procedure. The number of VES in the 1st and 6th months of the patients was also statistically significantly decreased compared to the pre-SSD (P = .01, P = .01, P = .01, respectively). CONCLUSION: Unilateral USG-guided SGB application is an effective and safe method in patients with ES and VA. Long-term results can be satisfactory in successful responders in whom SGB is performed with a combination of local anesthetic and steroid.

Expanding the phenotypic landscape of Gaucher disease type 3c with a novel entity - Transient neonatal cholestasis.

Gaucher disease (GD) is the most frequent lysosomal storage disorder due to biallelic pathogenic variants in GBA gene. Only homozygous D409H variant has been associated with the cardiovascular phenotype which is also known as Gaucher disease type 3c. In this descriptive study, we presented phenotypic heterogeneity and a novel clinical finding among 13 patients with GD type 3c. Patients presented with varying degrees of cardiac valve and/or aortic calcifications (84,6%) and corneal opacities (76,9%) in addition to visceral (100%), hematological (92,3%), neurological (92,3%), and skeletal (30%) manifestations. Also, cervical dystonia (38,4%) and psychiatric disorders (46,1%) were not infrequent entities with respect to neurological involvement in GD type 3c. In this report, we highlight transient neonatal cholestasis (38,4%) as a novel finding in GD type 3c. Neonatal cholestasis is a finding associated with Gaucher type 2, but transient neonatal cholestasis has not been reported in GD patients, so far. The clinical features of GD type 3c are highly heterogeneous, from disease severity or age of onset to disease progression. Also, we concluded that phenotypic spectrum may be associated with age at onset of clinical symptoms. As, patients presenting in infancy or childhood had mainly visceral and hematological involvement and patients presenting in adolescence and adulthood had mainly cardiac, neurological involvement, and psychiatric behavioral disorders. Identifying the heterogeneous clinical course of these patients in this fatal disease, may lead a sufficient understanding of the pathophysiology which will enable targeted therapeutic interventions.

Electrocardiographic right ventricular hypertrophy predicts the severity of pulmonary hypertension in patients with mitral stenosis.

OBJECTIVES: Rheumatic heart disease is still common in developing countries. Mitral stenosis impedes left atrial emptying, increases left atrial and pulmonary venous pressure, and thus causes pulmonary hypertension. Pulmonary hypertension results in right ventricular hypertrophy (RVH), implying that the disease is long lasting and needs interventional treatment. The aim of our study was to predict the severity of pulmonary hypertension in patients with mitral stenosis by evaluating electrocardiographic RVH. STUDY DESIGN: Patients admitted to our hospital with mitral stenosis were evaluated. Their clinical, electrocardiographic, and echocardiographic parameters were recorded. Electrocardiographic RVH was diagnosed when at least 2 of the following criteria were present at the same time: V1R+V5S or V6S >10.5 mm, V1R >6 mm, R >S in V1, V1 S <2 mm, V6 R/S <0.4, V5.6 R <3 mm, aVR R >4 mm, and right axis deviation. RESULTS: Sixty-seven patients (13 males, 54 females; mean age: 44.9±14.5 years; range 18 to 80 years) were included in the study. One male patient and 14 female patients were diagnosed as having electrocardiographic RVH. Pulmonary arterial pressure, right atrial and ventricular dimensions, peak and mean transmitral gradients were higher, and mitral valve area was lower in patients with RVH. The presence of RVH predicted pulmonary arterial pressure as 60 mmHg or higher with the sensitivity of 93% and specificity of 92%. CONCLUSION: Electrocardiographic RVH was found to be related to more severe mitral stenosis, higher pulmonary arterial pressure, and larger right heart chambers. RVH can be a simple and useful parameter to predict the severity of pulmonary hypertension.

Analysing of atmospheric conditions and their effects on air quality in Istanbul using SODAR and CEILOMETER.

In this study, first, air pollution that is caused by the air pollutants' concentration exceeding the limit value in Istanbul between 2017 and 2020 were analysed. In addition to this analysis, the effects of meteorological parameters on pollution were also examined within the same period of time. Second, for a 14-day period during which the concentration values of the air pollutants were calculated higher than the standards, therefore, were selected as an episode. In that respect, measurements of both pollutant and meteorological parameters were obtained from air quality monitoring stations. The Weather Research and Forecasting (WRF) model was used to examine the changes of meteorological parameters in the surface and upper atmospheric levels. The cross-correlation function (CCF) was performed together with both air quality monitoring station and the WRF model output data to examine the effects of temporal changes in meteorological parameters on air pollutant concentrations on a temporal scale. In addition, some meteorological parameters were obtained from remote sensing systems (SODAR and Ceilometer). Finally, with the help of the trajectory analysis model, it was determined whether the pollutant parameters were transported or not. Consequently, within a 3-year period, the most critical parameters in terms of pollution throughout the city were assessed as NO2 and PM10. Moreover, low wind speeds and high pressure values during the episode prevented the dispersion of pollutants and caused air pollution in Istanbul.

Uterine arcuate artery calcification as a potential marker of cardiovascular risk-a preliminary study.

OBJECTIVE: Atherosclerotic cardiovascular disease is the most common cause of death in postmenopausal women. As this is a progressive disease, it is important to identify markers at an early stage during the subclinical period. Arterial calcifications are an indicator of overall atherosclerotic disease and therefore may be used as a marker for the estimation of future atherosclerotic cardiovascular events. The aims of this study are to investigate the relationship between uterine myometrial calcification (UMC) and carotid artery intima-media thickness (CIMT) and to evaluate whether UMC can be a predictive marker for the estimation of future atherosclerotic cardiovascular risk in asymptomatic postmenopausal women. METHODS: In this cross-sectional study, we assessed 81 postmenopausal women without gynecological complaints for cardiovascular risk factors, UMC, and CIMT. Participants were divided into two risk groups according to their cardiovascular risk factors. The level of UMC was determined using a new scoring system, which was based on transvaginal ultrasonography. Demographic, clinical, and laboratory parameters, UMC scores, and measurements of CIMT were evaluated. RESULTS: A moderately positive correlation was detected between CIMT and UMC scores ( r = 0.62). There was a significant relationship between UMC scores and atherosclerotic cardiovascular risk; the risk of atherosclerosis was 15.4 times higher (OR: 15.4, 95% CI: 5.1-46.8; P = 0.001) in participants with a high UMC score (≥2). According to the multivariable logistic regression model adjusted by age and duration of menopause, the risk of cardiovascular atherosclerosis increased 27.8 fold for those with CIMT of 0.075 or greater (OR: 27.8, 95% CI: 5.3-147.1; P = 0.001) and 9.2 fold for those with a UMC score of 2 or greater (OR: 9.2, CI: 1.22-69.3; P = 0.032). CONCLUSIONS: The presence of UMC has been identified as an independent predictive factor for atherosclerotic risk. Accordingly, considering UMC as an atherosclerotic cardiovascular risk factor may provide an opportunity to identify cardiovascular disease in asymptomatic postmenopausal women. When UMC is detected, women should be assessed for cardiovascular risk.

Cyanoacrylate for septal ablation in hypertrophic cardiomyopathy.

OBJECTIVE: Alcohol septal ablation (ASA) has been shown to be an effective treatment in patients with hypertrophic obstructive cardiomyopathy (HOCM) who are refractory to medical treatment. We describe an alternative approach for septal ablation with glue (cyanoacrylate), which is particularly useful in patients with the collateral formation to the right coronary artery in whom ASA is contraindicated. METHODS: In our method left coronary ostium was cannulated with 6-8F guiding catheter. Septal branch was cannulated with a 4F catheter and a microcatheter then cyanoacrylate mixture was instilled into the septal artery. Immediate polymerization prevents the leak into the left anterior descending coronary artery, and also into the right coronary artery (RCA) via septal collaterals. RESULTS: Glue septal ablation (GSA) was performed in 18 patients (6 patients had collateral branches to RCA). Immediately after the procedure peak left ventricular outflow (LVOT) gradient reduced significantly both in cardiac catheterization (65.0 ± 13.8 vs. 14.2 ± 5.7 mmHg, P < 0.001) and Doppler echocardiographic measurements (75.8 ± 19.9 vs. 18.0 ± 9.1 mmHg, P < 0.001). LVOT tract gradient reduction persisted after 6 months follow-up. Septal wall thickness (20.2 ± 3.7 mm vs. 16.5 ± 3.2 mm, P = 0.003) reduced and NYHA functional class (3.1 ± 0.4 vs. 2.2 ± 0.3, P < 0.001) improved. There was no significant complication during the procedure and within 6 months follow-up period. CONCLUSIONS: GSA seems to be an efficient and safe approach to HOCM, especially in patients with the collateral formation. Further experience is needed in order to assess the long-term efficacy and safety of this technique.