Spectrochemical and explainable artificial intelligence approaches for molecular level identification of the status of critically ill patients with COVID-19.

This study explores the molecular alterations and disease progression in COVID-19 patients using ATR-FTIR spectroscopy combined with spectrochemical and explainable artificial intelligence (XAI) approaches. Blood serum samples from intubated patients (IC), those receiving hospital services (SC), and recovered patients (PC) were analyzed to identify potential spectrochemical serum biomarkers. Spectrochemical parameters such as lipid, protein, nucleic acid concentrations, and IgG glycosylation were quantified, revealing significant alterations indicative of disease severity. Notably, increased lipid content, altered protein concentrations, and enhanced protein phosphorylation were observed in IC patients compared to SC and PC groups. The serum AGR (Albumin/Globulin Ratio) index demonstrated a distinct shift among patient groups, suggesting its potential as a rapid biochemical marker for COVID-19 severity. Additionally, alterations in IgG glycosylation and glucose concentrations were associated with disease severity. Spectral analysis highlighted specific bands indicative of nucleic acid concentrations, with notable changes observed in IC patients. XAI techniques further elucidated the importance of various spectral features in predicting disease severity across patient categories, emphasizing the heterogeneity of COVID-19's impact. Overall, this comprehensive approach provides insights into the molecular mechanisms underlying COVID-19 pathogenesis and offers a transparent and interpretable prediction algorithm to aid decision-making and patient management.

High CRP-albumin ratio is associated high thrombus burden in patients with newly diagnosed STEMI.

In patients undergoing primary percutaneous coronary intervention (pPCI) due to ST-segment elevation myocardial infarction (STEMI), an increased intracoronary thrombus burden is a strong predictive factor for adverse cardiovascular events. The C-reactive protein (CRP)-serum albumin (SA) ratio (CAR), used as an inflammatory marker, is closely associated with thrombogenicity. In this study, we investigated the relationship between coronary thrombus burden and CAR in patients undergoing pPCI due to newly diagnosed STEMI. A total of 216 patients who underwent pPCI due to STEMI were retrospectively included for the study. Angiographic thrombus burden was assessed according to thrombolysis in myocardial infarction (TIMI) grading, and those with grade 1, 2, 3 were classified as low thrombus burden (n = 120) and those with grade 4, 5 were classified as high thrombus burden (HTB) (n = 96). CAR was calculated as the ratio of CRP to SA. The average age of the patients was 60 ± 9.8, and the male ratio was 61.1. Compared to the LTB group, the HTB group had higher CAR, age, SYNTAX score, baseline cTnT, peak cTnT, CRP, glucose, WBC, and NLR while the LVEF and SA levels were lower (P < .05). Spearman's correlation analysis revealed a significant correlation between thrombus burden and CAR. The multivariable logistic regression analysis revealed that CAR (odds ratio: 10.206; 95% confidence interval: 2.987-34.872, P < .001) was a independent risk factor for HTB. According to the receiver operating characteristic (ROC) analysis, when the cutoff value for CAR was taken as ≥1.105 CAR could predict HTB with a sensitivity of 70.8% and specificity of 67.7%. Our data indicate that CAR an independent risk factor for thrombus burden.

Infrared spectrochemical findings on intermittent fasting-associated gross molecular modifications in rat myocardium.

Cardiovascular diseases are among the primary life-threatening conditions affecting human society. Intermittent fasting is shown to be functional in the prevention of cardiovascular diseases, however, the information on fasting-associated modifications in myocardial biomolecules is limited. This study aimed to determine the impact of 18-h intermittent fasting administered for five weeks on 12 months-old rats using supervised linear discriminant analysis and support vector machine algorithms constructed on spectrochemical data obtained from myocardial tissues. These algorithms revealed gross biomolecular modifications, while quantitative analyses demonstrated higher amounts of saturated lipids (19%), triglycerides (11%), and lipids (56%), in addition to enhancement in membrane dynamics (18%). The concentrations of nucleic acids and glucose are increased by 52%, while the glycogen content is diminished by 61%. The protein carbonylation/oxidation is reduced by 38%, whereas a 35% increase in protein content was measured. Phosphorylated proteins have been calculated to be at higher concentrations in the 13-62% range. The study findings demonstrated significant molecular changes in the myocardium of rats subjected to intermittent fasting.

Comparison of Serum Selenium Levels Between Patients with Newly Diagnosed Atrial Fibrillation and Normal Controls.

Atrial fibrillation (AF) is the most common sustained dysrhythmia in the elderly population. It is estimated to affect more than 30 million people worldwide. AF occurs when abnormal electrical impulses start to activate in the atria and override the heart's natural pacemaker, which can no longer control the heart's rhythm. Since atrial contractility is impaired in AF, blood flow in the atria becomes stasis over time and causes thrombus formation. This thrombus causes the risk of embolism and causes complications such as stroke. Therefore, it is a fundamental cause of cardiovascular mortality and morbidity. The diagnosis of AF is usually made with the help of electrocardiography (ECG). The absence of P waves in ECG and irregular R-R interval is sufficient for diagnosis. AF is most commonly associated with advanced age, hypertension, diabetes mellitus, thyroid dysfunction, obesity, alcohol use, physical inactivity, and underlying ischemic heart diseases. As well as to all these usual risk factors, electrolyte disorders and mineral deficiencies also play an essential role in the etiology of AF. Previous studies have clearly demonstrated that serum electrolyte changes have a role in the etiology of AF. These include electrolytes such as serum magnesium, calcium, potassium, and chloride. However, there is not enough information in the literature about the effects of trace elements on AF. Selenium is a trace element that plays an important role in many systems in the human body. It has a vital role in inflammation, regulation of antioxidant reactions, and fibrosis of tissues in both animals and humans. It is known that selenium deficiency causes many cardiovascular diseases such as heart failure, coronary artery disease, and arrhythmia. Our study aimed to compare serum selenium levels in newly diagnosed AF patients with the healthy control group.

Myocardial performance index increases at long-term follow-up in patients with mild to moderate COVID-19.

BACKGROUND: The long-term cardiovascular effects of Coronavirus disease-2019 (COVID-19) are not yet well known. Myocardial performance index (MPI) is a non-invasive, inexpensive and reproducible echocardiographic parameter that reflects systolic and diastolic cardiac functions. The aim of the study was to compare MPI with a healthy control group in patients with mild or moderate COVID-19 infection who subsequently had unexplained cardiac symptoms. METHODS: The study included 200 patients aged 18-70 years who were diagnosed with COVID-19 infection at least 2 months ago and defined cardiac symptoms in their follow-up. Patients with mild or moderate symptoms, no history of hospitalization, and no other pathology that could explain cardiac symptoms were included in the study. As the control group, 182 healthy volunteers without COVID-19 were evaluated. Echocardiographic examination was performed on the entire study group. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT), and ejection time (ET) were measured by tissue Doppler imaging. MPI was calculated with the IVCT+IVRT/ET formula. RESULTS: The mean age of the study group was 44.24 ± 13.49 years. In the patient group the MPI was significantly higher (.50 ± .11 vs .46 ± .07, p < .001), IVRT was longer (69.67 ± 15.43 vs 65.94 ± 12.03 ms, p = . 008), and ET was shorter (271.09 ± 36.61 vs 271.09 ± 36.61 ms, p = .028). IVCT was similar between groups (63.87 ± 13.66 vs. 63.21 ± 10.77 ms, p = .66). Mitral E and mitral A wave, E', A', and E/A were similar in both groups. CONCLUSIONS: Our study showed that conventional diastolic function parameters were not affected in patients who survived COVID-19 with mild symptoms but had symptoms in the long term. However, MPI measurements showed left ventricular dysfunction. To our knowledge, this is the first echocardiographic follow-up study to evaluate left ventricular systolic and diastolic functions with MPI in COVID-19 patients. We think that when cardiac involvement assessment is required in patients who have survived COVID-19, MPI should be measured alongside other echocardiographic measurements.

The Effect of Serum Magnesium Level on Stable Anticoagulation in Patients Using Warfarin for Various Cardiac Indications.

Warfarin is a vitamin K antagonist agent that inhibits clotting factors used for long-term anticoagulation. Time in therapeutic range (TTR) in patients using warfarin is one of the primary treatment effectiveness requirements. We aim to investigate the relationship between serum magnesium levels, the international normalized ratio (INR) values, and TTR values in people using warfarin for various indications. Our study is a single-center, cross-sectional, and retrospective study that included 169 patients between 18 and 70 who used warfarin for various indications. Demographic data, biochemical analysis, and coagulation parameters, including TTR calculation, were evaluated for all patients. Those with a TTR value below 60 were defined as labile INR, and those with 60 and above as stable INR group and compared. The mean INR value was higher in the labile INR group than the stable INR group (3.7 ± 2.9, 3.2 ± 0.3, respectively; p = 0.030). The Mg values are significantly lower in the labile INR group than the stable group (1.8 ± 0.2 mg/dL, 2.0 ± 0.1 mg/dL, respectively; p < 0.001). In binary multivariate logistic regression analysis, magnesium value was the most influential INR stabilization factor (p < 0.001). As a result of our study, it was concluded that magnesium levels are an influential factor in stabilizing INR. We can state that we have contributed to the literature and can be a reference for future studies.

Hypoglycemia in the emergency, is there any effect on endothelial and diastolic functions?

INTRODUCTION: Several homeostatic changes like an increase in sympathoadrenal response and oxidative stress occur in hypoglycemia. As a result of these findings, an increase in inflammation and preatherogenic factors is observed, and these changes may lead to endothelial dysfunction. AIM: Our study aims to reveal possible cardiac risks (systolic-diastolic functions and endothelial dysfunctions) in patients who have applied to the emergency department with hypoglycemia. METHODS: This cross-sectional, case-control study included 46 hypoglycemia patients who admitted to the emergency with symptoms compatible with hypoglycemia and diagnosed with hypoglycemia and 30 healthy volunteers. All patients were evaluated with baseline echocardiography, tissue-Doppler imaging (carotid and brachial artery). Also, the fasting blood tests of the patients referred to the internal medicine department were examined. RESULTS: There were no differences between the groups regarding age, weight, body mass index, and systolic blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and fasting blood glucose levels were similar in the groups' blood tests (all P values > .05). We observed a statistically significant decrease in diastolic dysfunction parameters: E/A and E/e' ratios (respectively, P = .020 and 0.026). It was shown that insulin resistance was influential in forming these considerable differences. The patient group observed that the carotid intima-media thickness was more remarkable (P = .001), and the brachial flow-mediated dilatation value was smaller (P = .003), giving an idea about endothelial functions. CONCLUSION: As a message, we can say that hypoglycemia may affect diastolic functions in addition to endothelial dysfunction. Therefore, even young individuals without any chronic diseases may need follow-up in terms of possible risks.

[Evaluation of the relationship between erectile dysfunction and epicardial fat tissue thickness and carotid intima-media thickness in patients with newly diagnosed hypertension]. / Yeni tani konmus hipertansiyonu olan hastalarda erektil disfonksiyon ile epikardiyal yag dokusu kalinligi ve karotis intima-media kalinligi arasindaki iliskinin degerlendirilmesi.

OBJECTIVE: This study is an investigation of the relationship between erectile dysfunction and epicardial adipose tissue and carotid intima-media thickness, which are indicators of endothelial dysfunction and subclinical atherosclerosis, in patients with newly diagnosed hypertension. METHODS: The epicardial adipose tissue and carotid intima-media thickness of 101 male patients with newly diagnosed hypertension were measured using echocardiography between May 1, 2018 and May 31, 2019. Evaluation of erectile dysfunction was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) in a face-to-face interview in the urology outpatient clinic. The data of patients with and without erectile dysfunction were compared. RESULTS: There was a significant relationship between the presence and severity of erectile dysfunction and epicardial fat tissue and carotid intima-media thickness in patients with newly diagnosed hypertension. Left ventricular diastolic function was found to be more impaired in patients with erectile dysfunction. CONCLUSION: Erectile dysfunction was determined to be related to increased epicardial fat tissue and carotid intima-media thicknesses in patients with newly-diagnosed hypertension.

Serum Uric Acid Levels among Patients who Died in Recent Year due to Heart Failure with Reduced Ejection Fraction.

OBJECTIVE: To examine the relationship of uric acid levels in the last one year with exitus due to heart failure (HF) with clinical and demographic data of patients. STUDY DESIGN: Cross-sectional, descriptive study. PLACE AND DURATION OF STUDY: Bilecik State Hospital, Bilecik, Turkey, from January 2019 to January 2020. METHODOLOGY: The files of 90 people who had exitus due to HF were scanned retrospectively. Demographic data and echocardiography results were recorded. Serum uric acid levels were noted in the 2nd month, 6th month, and 12th month by taking the baseline in the last year before exitus. Mean repeated measurements of uric acid levels that changed over time in patients were compared with ANOVA variance analysis. P <0.05 were accepted as statistically significant. RESULTS: The mean of the left ventricular ejection fraction (LVEF) of the patients was 35.6±6.6%. Mean serum uric acid levels of the patients for one year before excitus were 5.6±2.2 mg/dL (baseline), 6.1±2.3 mg/dL (2th month), 7.1±2.6 mg/dL (6th month), 8.5±3.0 mg/dL (12th month) respectively. There was a statistically significant difference between the basal uric acid mean with the 6th and 12th month uric acid levels both p <0.001. Age and LVEF were not significantly associated with the uric acid increase over time (p=0.250 and p=0.327, respectively) but were statistically different according to gender (p=0.036). CONCLUSION: In heart failure with reduced ejection fraction (HFrEF), the uric acid level increases progressively towards the last periods before exitus. This increase is more pronounced in men. Key Words: Heart failure, Serum uric acid levels, Prognosis, Gender.

Can myocardial performance index predict early cardiac risks in erectile dysfunction?

AIM: Myocardial performance index (MPI) is an easy-to-apply and non-invasive method that shows both systolic and diastolic functions of the heart. In this study, it was aimed to evaluate the relationship between erectile dysfunction (ED) and MPI. Methods: The study included 45 male patients admitted to the urology outpatient clinic for ED and 48 healthy male volunteers. Echocardiographic evaluation of all participants was performed. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured. MPI was calculated using the IVCT + IVRT/ET formula. Results: The average age of the study population was 50 ± 5.3. Early diastolic mitral inflow (E)/late diastolic mitral inflow (A) ratio was significantly lower in the ED group (p ≤ 0.05). In the TDI evaluation between the groups, while early diastolic mitral annular velocity (Em) was significantly higher in the ED group, there was no significant difference in late diastolic mitral annular velocity (Am) and systolic peak velocities (Sm) (p < 0.01 and p = 0.417 and p = 0.092, respectively). While IVRT was significantly lower in the ED group (p < 0.05), there was no significant difference in IVCT and ET (p = 311 and p = 0.261, respectively). MPI was statistically significantly higher in the ED group (p < 0.05). Conclusion: ED has been found to affect MPI. This parameter, which is easily and non-invasively measured, can be used to predict the risk of CVDs in ED.