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OBJECTIVES: This study aims to investigate whether cumulative dose-dependent isotretinoin (Roaccutane®) could affect orthodontic tooth movement (OTM) and root resorption. MATERIALS AND METHODS: Ninety male Wistar Albino rats were divided into 4 groups. While, the control (SALINE), solvent (SOYBEAN) and orthodontic drug (ISOTM) groups underwent orthodontic force, the non-orthodontic drug group (ISO) did not. The rats were administrated saline, soybean oil (SBO) and isotretinoin diluted in SBO (ISOTM, ISO) for 30 days, respectively. Six rats were euthanized in each orthodontic group. Fifty grams of orthodontic force was applied to the remaining rats' first molars using the incisors as anchorage. Six more rats in each group were euthanized on the 7th, 14th and 21st days of the force application. In the ISO group, six rats were euthanized on the 37th, 44th and 51st days of administration. Six rats that were euthanized for ISOTM on the 30th day were also used for ISO to reduce the number of rats used. Micro-computed tomography (micro-CT) and histological analysis were performed. RESULTS: Independent of orthodontic force, isotretinoin caused root resorption in the apical region. However, there was no statistically significant influence of isotretinoin on OTM and orthodontically induced root resorption (OIRR). CONCLUSIONS: Despite the lack of strong evidence supporting the orthodontically induced resorptive effect of isotretinoin, this study provided findings regarding the resorptive effects of isotretinoin on non-orthodontic root resorption. Therefore, the present results underscore the importance of close monitoring during orthodontic treatment to mitigate potential root resorption in patients who use isotretinoin because of acne complaints.
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BACKGROUND: The purpose of this study was to assess the effects of systemically given krill oil (KO) on the development of new bone formation in the sutura palatina media following rapid maxillary expansion (RME). METHODS: 28 4-5 week-old male Wistar albino rats were randomly divided into 4 groups: Control (C), Only Expansion (OE) (no supplement but undergoing expansion and retention), KE (supplemented during both the expansion and retention phases), Krill Oil Nursery Group (KN) (supplemented during the 40-day nursery phase as well as during the expansion and retention phases). A 5-day RME was followed by a 12-day retention period. All rats were euthanized simultaneously. Micro-computerized tomography (Micro-CT), hemotoxylen-eosin (H&E) staining, and immunohistochemical analysis were conducted. Kruskal-Wallis and Dunn tests with Bonferonni corrrection were applied (p < 0.05). RESULTS: Expansion and KO supplementation did not cause a statistically significant change in bone mineral density (BMD), bone volume fraction (BV/TV), spesific bone surface (BS/BV) and trabecular thickness (Tb.Th). While the expansion prosedure increased the trabecular seperation (Tb.Sp), KO supplemantation mitigated this effect. The KE group exhibited a statistically significantly increase in trabecular number (Tb.N) compared to the OE group. Although receptor activator of nuclear factor-kappa-Β ligand (RANKL)/osteoprotegerin (OPG) ratios did not show significant differences between groups, the KE and OE groups demonstrated the lowest and highest value, respectively. KE showed a reduced amount of tartrate-resistant acid phosphatase (TRAP) compared to the OE. CONCLUSION: KO positively affected the architecture of the new bone formed in the mid-palatal suture. In this rat model of RME, results support the idea that administering of KO during the expansion period or beginning before the RME procedure may reduce relapse and enhance bone formation within the mid-palatal suture.
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Euphausiacea , Osteogênese , Técnica de Expansão Palatina , Ratos Wistar , Microtomografia por Raio-X , Animais , Microtomografia por Raio-X/métodos , Masculino , Ratos , Osteogênese/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Imuno-Histoquímica , Óleos/farmacologia , Distribuição Aleatória , Palato/diagnóstico por imagem , Palato/patologia , Suturas Cranianas/efeitos dos fármacos , Suturas Cranianas/diagnóstico por imagem , Maxila/diagnóstico por imagem , Maxila/efeitos dos fármacosRESUMO
PURPOSE: To present the antibacterial effect of new generation boron-doped carbon quantum dots (B-CQD) and compare the antibacterial effect of silk sericin (SS), hydrolyzed silk peptide (HSP) and SS/HSP coated silver nanoparticle (AgNP) and B-CQDs on titanium alloy (Ti) surfaces. METHODS: SS and HSP were formed on the surface of the Ti alloy (Ti-SS/HSP). Different concentrations of citric acid and boric acid, B-CQDs and AgNP were attached to Ti-SS/HSP surfaces. To characterize all samples, Fourier Transform Infrared (FTIR), scanning electron microscopy (SEM) and energy dispersive X-ray (EDS) analyses were performed. Their antibacterial potential was analyzed against gram-positive Staphylococcus aureus (S. aureus) and gram-negative Pseudomonas aeruginosa (P. aeruginosa) with Mueller-Hinton Test. One-way ANOVA was used to assess any difference between groups. P< 0.05 was considered statistically significant. RESULTS: No antibacterial activity was detected for Ti and SS/HSP. Inhibition holes ranged from 11 mm to 25.7±3.2 mm and 11 mm to 26.3±0.6 mm in the S. aureus and P. aeruginosa cultures respectively, showing that AgNP was the molecule which had the least antibacterial effect regardless of type of bound silk protein on both bacteria, and B-CQD had antibacterial superiority against S. aureus and P. aeruginosa on Ti-SS surfaces. CLINICAL SIGNIFICANCE: The application of boron-doped carbon quantum dots to titanium alloy surfaces is a new approach for the development of a powerful bactericidal method to prevent implant failures.
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Nanopartículas Metálicas , Pontos Quânticos , Seda/farmacologia , Boro , Staphylococcus aureus , Titânio/farmacologia , Prata/farmacologia , Ligas , Antibacterianos/farmacologia , CarbonoRESUMO
OBJECTIVES: To evaluate the bisphenol release of different brands of clear aligner materials. MATERIALS AND METHODS: Six different clear aligner materials were used in this study: Duran (Scheu-Dental GmbH, Iserlohn, Germany), Zendura Flx (Bay Materials LLC, Fremont, CA, USA), Zendura A (Bay Materials), Essix (Raintree Essix Inc., Metairie, LA, USA), Taglus Premium (Laxmi Dental Export Pvt. Ltd, Mumbai, India), and Smart Track (Align Technology, San Jose, CA, USA). The samples were kept in saline solution for 8 weeks in airtight test tubes at 37°C. The ratio between the weights of the samples and the volumes of the dilutions was prepared as 0.1 g/mL as suggested by International Standards Organization parameters. To evaluate the bisphenol release of materials, liquid chromatography-mass spectrometry/mass spectrometry analysis was performed. Data were analyzed with the Kruskal-Wallis test (α = 0.05). RESULTS: Bisphenol A (BPA) values in Smart Track were found to be significantly higher than the Zendura A and Zendura Flx groups (P = .02, P = .03, respectively). There was no statistically significant difference among the samples in terms of Bisphenol F (BPF) values (P = .108). In terms of Bisphenol S (BPS) values, a statistically significant difference was found (P = .002) indicating that Smart Track released significantly more BPS than Zendura A (P = .001). CONCLUSIONS: Under the test conditions, the amounts of leached BPA, BPF, and BPS were less than the reference dose for daily intake. However, the cumulative effect of these appliances should not be underestimated.
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Compostos Benzidrílicos , Aparelhos Ortodônticos Removíveis , Cromatografia Líquida , Compostos Benzidrílicos/análise , Espectrometria de Massas em TandemRESUMO
PURPOSE: In this prospective study we aimed to determine the rate of Fabry Disease (FD) in patients with left ventricular hypertrophy (LVH), and to evaluate the clinical presentations of patients with FD in a comprehensive manner. In addition, we aimed to raise awareness about this issue by allowing early diagnosis and treatment of FD. METHODS: Our study was planned as national, multicenter, observational. Totally 22 different centers participated in this study. A total of 886 patients diagnosed with LVH by echocardiography (ECHO) were included in the study. Demographic data, biochemical parameters, electrocardiography (ECG) findings, ECHO findings, treatments and clinical findings of the patients were recorded. Dry blood samples were sent from male patients with suspected FD. The α-Gal A enzyme level was checked and genetic testing was performed in patients with low enzyme levels. Female patients suspected of FD were genetically tested with the GLA Gene Mutation Analysis. RESULTS: FD was suspected in a total of 143 (16.13%) patients included in the study. The α-Gal-A enzyme level was found to be low in 43 (4.85%) patients whom enzyme testing was requested. GLA gene mutation analysis was positive in 14 (1.58%) patients. Male gender, E/e' mean ,and severe hypertrophy are important risk factor for FD. CONCLUSION: In daily cardiology practice, FD should be kept in mind not only in adult patients with unexplained LVH but also in the entire LVH population. Dry blood test (DBS) should be considered in high-risk patients, and mutation analysis should be considered in required patients.
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Doença de Fabry , Adulto , Humanos , Masculino , Feminino , Doença de Fabry/diagnóstico por imagem , Doença de Fabry/epidemiologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/epidemiologia , Estudos Prospectivos , Prevalência , Turquia/epidemiologia , alfa-Galactosidase/genética , Valor Preditivo dos TestesRESUMO
BACKGROUND: Despite advances in therapeutic management of patients with heart failure, there is still an increasing morbidity and mortality all over the world. In this study, we aimed to present the 3-year follow-up outcomes of patients included in the Journey HF-TR study in 2016 that has evaluated the clinical characteristics and management of patients with acute heart failure admitted to the hospital and present a national registry data. METHODS: The study was designed retrospectively between November 2016 and December 2019. Patient data included in the previously published Journey HF-TR study were used. Among 1606 patients, 1484 patients were included due to dropout of 122 patients due to inhospital death and due to exclusion of 173 due to incomplete data. The study included 1311 patients. Age, gender, concomitant chronic conditions, precipitating factors, New York Heart Association, and left ventricular ejection fraction factors were adjusted in the Cox regression analysis. RESULTS: During the 3-year follow-up period, the ratio of hospitalization and mortality was 70.5% and 52.1%, respectively. Common causes of mortality were acute decompensation of heart failure and acute coronary syndrome. Angiotensin receptor blockers, betablockers, statin, and sacubitril/valsartan were found to reduce mortality. Hospitalization due to acute decompensated heart failure, acute coronary syndrome, lung diseases, oncological diseases, and cerebrovascular diseases was associated with the increased risk of mortality. Implantation of cardiac devices also reduced the mortality. CONCLUSIONS: Despite advances in therapeutic management of patients with heart failure, our study demonstrated that the long-term mortality still is high. Much more efforts are needed to improve the inhospital and long-term survival of patients with chronic heart failure.
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Síndrome Coronariana Aguda , Insuficiência Cardíaca , Humanos , Volume Sistólico , Seguimentos , Função Ventricular Esquerda , Estudos Retrospectivos , Síndrome Coronariana Aguda/tratamento farmacológico , Tetrazóis/efeitos adversos , Prognóstico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVE: Although the prevalence and rate of myocardial infarction with non-obstructive coronary arteries (MINOCA) are higher in women than in men in previous cohorts, potential demographic and clinical differences between women who are diagnosed with MINOCA versus myocardial infarction with obstructive coronary arteries (MIOCA) have not been studied till date. In this study, we aimed to document these characteristics and to compare them between female patients with MINOCA and MIOCA. 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 had been diagnosed with acute myocardial infarction were evaluated. RESULTS: Of these women, 49 (10.3%) were diagnosed with MINOCA (mean age 58.9±12.9 years) and 428 (89.7%) had a final diagnosis of MIOCA (mean age 67.4±11.8 years). The prevalence of hypertension, hyperlipidemia, and diabetes mellitus was significantly lower in the MINOCA group than in the MIOCA group. In addition, the MINOCA group had higher rates of recent flu history and non-ST elevation myocardial infarction (NSTEMI) presentation than the MIOCA group. There were significant clinical differences in patients with MINOCA in terms of sex. The female patients were older, had higher systolic blood pressures, and lower hemoglobin levels than male patients. CONCLUSION: The study revealed that the prevalence of traditional coronary artery disease risk factors was lower in female patients with MINOCA than in those who had final diagnosis of MIOCA.
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Doença da Artéria Coronariana , Infarto do Miocárdio , Idoso , Angiografia Coronária/efeitos adversos , Vasos Coronários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Prevalência , Sistema de Registros , Fatores de RiscoRESUMO
INTRODUCTION: Exercise electrocardiography (EET) is a safe and cost-effective method to predict the presence, prognosis, and severity of coronary artery disease (CAD). Various score models have been developed to increase predictive power of EET. In this study, we aimed to evaluate whether adding ST depression duration could have an effect on increasing the value of Duke treadmill score (DTS) in predicting obstructive CAD. METHODS: In this single centred, cross-sectional study, we evaluated a total of 258 patients who presented with a complaint of chest pain and undergone coronary angiogram in result of a positive EET. DTS was calculated for all the patients. The new score-revised DTS- was calculated by adding total ST depression time to classical DS parameters. We compared area under the curve (AUC) of DTS and revised DTS by Delongi method. RESULTS: Mean age of the group was 58.43 ± 9.37, and 37.2% (n = 96) were female. Mean total ST-depression duration was 171.72 ± 91.43 msec in normal artery group,241.54 ± 118.11 msec in non-obstructive CAD group, and 281.26 ± 113.64 in obstructive CAD group.ST-depression duration in both exercise and recovery, and total ST depression duration were significantly higher in obstructive CAD group than non-obstructive and normal artery groups (p = 0.024, p = 0.01, p < 0.01, and p < 0.01, respectively). Revised DTS had significantly higher predictive value of obstructive CAD compared to classical DS (AUC (95%CI): 0.744 vs. 0.626, p < 0.001). The AUC of DS was significantly lower than the new score (z-score:3.274, p = 0.011). CONCLUSION: In conclusion, adding ST depression duration to DTS calculation is increasing the discriminative value of DTS to predict obstructive CAD. Benefits of EET within the context of the management of CAD is well-known, hence, it is clear that physicians may use revised DTS.
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Doença da Artéria Coronariana , Humanos , Feminino , Masculino , Doença da Artéria Coronariana/diagnóstico , Teste de Esforço/métodos , Estudos Transversais , Depressão , Eletrocardiografia , Angiografia Coronária , Valor Preditivo dos TestesRESUMO
The pandemic of Novel Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has provoked hundreds of thousands of deaths, resulting in catastrophe for humans. Although some insights have been garnered in studies on women, children and young adults infected with COVID-19, these often remain fragmented in literature. Therefore, we discussed the impact of COVID-19 pandemic on women, children and young patients, particularly those with underlying cardiovascular comorbidities or congenital heart disease. Furthermore, we gathered and distilled the existing body of literature that describes their cardiovascular complications and the recommended actions in favour of those patients toward the post-peak pandemic period. Although many questions still require answers, this article is sought to help the practicing clinician in the understanding and management of the threatening disease in special populations.
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COVID-19/terapia , COVID-19/transmissão , Saúde da Mulher , Antipiréticos/uso terapêutico , Antivirais/uso terapêutico , Cardiomiopatias/virologia , Criança , Controle de Doenças Transmissíveis , Feminino , Cardiopatias Congênitas/complicações , Humanos , Pandemias , Gravidez , Complicações Cardiovasculares na Gravidez/virologia , Complicações Infecciosas na Gravidez , Distribuição por Sexo , Cardiomiopatia de Takotsubo/virologiaRESUMO
OBJECTIVE: The purpose of this study is to assess the effects of rapid maxillary expansion on metabolic activity in the temporomandibular joints of young adult patients using scintigraphy. METHODS: The images belonging to temporomandibular joints were obtained from the retrospective scintigraphic records taken from 17 adult females (16.1 and 18.8 years of age and the mean age was 17.3±0.86 years) who had non-functional bilateral posterior crossbite, deep palatal vault and dental crowding, and had been treated with rapid maxillary expansion. Bone scintigraphy images were collected at three-time intervals: at the beginning of treatment (T1), during the opening of the mid palatal suture (T2), and at the end of screw activation (T3). Alteration in bone activity in the temporomandibular joint regions were evaluated in sagittal and transaxial slices. To determine the differences between the intervals, repeated analysis of variance and Bonferroni multiple comparison tests were applied. RESULTS: In the right and left temporomandibular joint regions, significantly increased metabolic activity was exhibited between T1-T2 (p<0.001). At the time of opening the maxillary mid-palatal suture, the metabolic activity increased approximately 60% compared to the initial status. At the end of the active expansion period (T3), the change in metabolic activity was approximately 20% reduced compared to T2. CONCLUSION: Metabolic activity intensification occurs in the regions of interest in the temporomandibular joint during rapid maxillary expansion. After mid-palatal suture opening, activity noticeably decreased (T2-T3). This decrease in bone activity suggests that the temporomandibular joint complex adapts to rapid maxillary expansion forces.
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Aims: Women's participation is steadily growing in medical schools, but they are still not sufficiently represented in cardiology, particularly in cardiology leadership positions. We present the contemporary distribution of women leaders in cardiology departments in the World Health Organization European region. Methods and results: Between August and December 2020, we applied purposive sampling to collect data and analyse gender distribution of heads of cardiology department in university/third level hospitals in 23 countries: Austria, Azerbaijan, Belgium, Bosnia-Herzegovina, Croatia, France, Germany, Greece, Italy, North Macedonia, Morocco, Poland, Portugal, Russia, Serbia, Slovakia, Slovenia, Spain, Switzerland, Tunisia, Turkey, Ukraine, and the UK. Age, cardiology subspecialty, and number of scientific publications were recorded for a subgroup of cardiology leaders for whom data were available. A total of 849 cardiology departments were analysed. Women leaders were only 30% (254/849) and were younger than their men counterpart (â 52.2 ± 7.7 years old vs. â 58.1 ± 7.6 years old, P = 0.00001). Most women leaders were non-interventional experts (â 82% vs. â 46%, P < 0.00001) and had significantly fewer scientific publications than men {â 16 [interquartile range (IQR) 2-41] publications vs. â 44 (IQR 9-175) publications, P < 0.00001}. Conclusion: Across the World Health Organization European region, there is a significant gender disparity in cardiology leadership positions. Fostering a diverse and inclusive workplace is a priority to achieve the full potential and leverage the full talents of both women and men.
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INTRODUCTION: Rheumatic heart disease predisposes to structural changes in the mitral valve including commissural fusion and calcification with subsequent narrowing of the mitral valve orifice resulting in rheumatic mitral stenosis (RMS). To define the best therapeutic strategy, an accurate measurement of mitral valve area (MVA) for RMS is of paramount importance. The propose of the present study was to assess the agreement between the mitral navigation method (MVN) and three-dimensional (3D) planimetry in the assessment of MVA in patients with RMS. METHODS: Patients who were diagnosed with a different degree of mitral stenosis with the standard transthoracic echocardiography methods such as the pressure half time and planimetry underwent 3D transesophageal echocardiography (TEE) examination. 3D TEE zoom mitral valve planimetry was measured in the diastolic frame during the mitral valve's largest opening. By using MVN software of the Philips Q-Lab, MVA was measured at its maximum diastolic opening. Both 3D planimetry (3DPL) and MVN were measured at the mid diastole during the mitral valve's largest opening. RESULTS: In this retrospective analysis, we examined consecutive 37 RMS patients (mean age 51.1 ± 11.6 years, 31 patients were female). MVA measured by the MVN method was found to be highly correlated with the 3D MVA measured by 3DPL (r = 0.937, p<.001). CONCLUSIONS: Based on our results, we showed that the MVN method may be additionally used in detecting the severity of RMS.
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Ecocardiografia Tridimensional , Estenose da Valva Mitral , Cardiopatia Reumática/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/diagnóstico por imagem , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
We aimed to predict in-hospital mortality of elderly patients with heart failure (HF) by using a risk score model which could be easily applied in routine clinical practice without using an electronic calculator. The study population (n = 1034) recruited from the Journey HF-TR (Patient Journey in Hospital with Heart Failure in Turkish Population) study was divided into a derivation and a validation cohort. The parameters related to in-hospital mortality were first analyzed by univariate analysis, then the variables found to be significant in that analysis were entered into a stepwise multivariate logistic regression (LR) analysis. Patients were classified as low, intermediate, and high risk. A risk score obtained by taking into account the regression coefficients of the significant variables as a result of the LR analysis was tested in the validation cohort using receiver operating characteristic curve analysis. In total, 6 independent variables (age, blood urea nitrogen, previous history of hemodialysis/hemofiltration, inotropic agent use, and length of intensive care stay) associated with in-hospital mortality were included in the analysis. The risk score had a good discrimination in both the derivation and validation cohorts. A new validated risk score to determine the risk of in-hospital mortality of elderly hospitalized patients with HF was developed by including 6 independent predictors.
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Insuficiência Cardíaca/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , TurquiaRESUMO
INTRODUCTION: Elderly patients hospitalized with heart failure (HF) have high mortality rates and requires specific evidence based theraphy, however there are few studies which have focused on patients older than 80 years hospitalized with HF. The aim of the present study is to evaluate the overall clinical characteristics, management, and in-hospital outcomes of elderly patients hospitalized with HF. METHODS: Journey-HF study was conducted in 37 different centers in Turkey and recruited 1606 patients who were hospitalized with HF between September 2015 and September 2016. In this study, clinical profile of patients ≥ 80 years old and 65-79 years old hospitalized with HF were described and compared based on EF-related classification: HFrEF (HF with reduced ejection fraction), HFmrEF (HF with mid-range ejection fraction) and HFpEF (HF with preserved ejection fraction). RESULTS: A total of 1034 elder patients (71.6% 65-79 years old and 28.4% ≥80 years old) were recruited. Of the 65-79 years old patients 67.4% had HFrEF, 16.2% had HFmrEF and 16.3% had HFpEF. Among patients ≥80 years old 61.6% had HFrEF, 15.6% had HmrEF and 22.8% had HFpEF. When compared with patients with HFrEF and HFmrEF, patients ≥80 years old with HFpEF were more likely to be older, have atrial fibrilation (AF), and less likely to have diabetes mellitus (DM), coronary artery disease (CAD) or to be recieving an angiotensin-converting enzyme inhibitor (ACEi) or beta blocker theraphy. When compared to patients 65-79 years old with HFpEF, patients ≥80 years with HFpEF had a higher rate of AF and less likely DM. Acute coronary syndrome was the most common precipitant factor for hospitalization in both age groups with HFrEF group. Arrhythmia was a major precipitant factor for hospitalization of patients ≥80 years old with HFpEF. Non-compliance with theraphy was a major problem of patients ≥80 years old with HFrEF. CONCLUSION: Elderly patients with HFrEF, HFmrEF and HFpEF each had characterized unique patient profiles and the guideline recommended medications were less likely to be used in these patient populations. In hospital mortality rate is worrisome and reflects a need for more specific tretment strategy.
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Insuficiência Cardíaca , Idoso , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/epidemiologia , Humanos , Prognóstico , Fatores de Risco , Volume Sistólico , TurquiaRESUMO
PURPOSE: Inappropriate sinus tachycardia (IST) is defined as a sinus heart rate > 100 bpm at rest (with a mean 24-h heart rate > 90 bpm not due to primary causes) and is associated with distressing symptoms of palpitations. The effect of IST on left atrial (LA) and left ventricular (LV) myocardial dynamics is uncertain. Thus, the aim of this study was to identify early changes in LA mechanics and LV myocardial functions in patients with IST using 3D-STE. METHODS: Sixty patients with IST and 65 age- and gender-matched controls were enrolled into the study. Conventional 2D echocardiography and 3D-STE were performed, and LAS-r, LAS-active, LAS-passive, LAEF, LAEF-active, LAEF-passive, LV-GLS, LV-GCS, LV-GAS, and LV-GRS were obtained for every patient. RESULTS: The LAS-r and LAS-active were significantly decreased in the IST group than in the control group (p < 0.001, p = 0.004, respectively). The multivariate logistic regression models revealed that LAS-r (p = 0.008, Odds ratio (OR) 5.98, 95% confidence interval (CI) 2.36-11.18), and LAS-active (p = 0.032, OR 2.16, 95% CI 1.97-4.69) were found to be independent factors for predicting IST. CONCLUSIONS: The present study is the first to evaluate the left atrial mechanics and left ventricular functions in the patients with IST using 3D-STE. We found that IST had a negative effect on left atrial mechanics. According to our findings, we can say that IST is not a completely innocent, benign clinical condition, but rather, it causes subclinical left atrial dysfunction.
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Função do Átrio Esquerdo , Ecocardiografia Tridimensional , Frequência Cardíaca , Taquicardia Sinusal/diagnóstico por imagem , Função Ventricular Esquerda , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Taquicardia Sinusal/fisiopatologia , Fatores de Tempo , Adulto JovemRESUMO
Introduction: The aim of this study was to evaluate the in-hospital and short-term predictive factors of mortality in intermediate-high risk acute pulmonary embolism (PE) patients with right ventricle (RV)dysfunction and myocardial injury. Methods: In this retrospective study, the medical records of 187 patients with a diagnosis of intermediate high risk acute PE were evaluated. A contrast-enhanced multi-detector pulmonary angiography was used to confirm diagnosis in all cases. All-cause mortality was determined by obtaining both in hospital and 30 days follow-up data of patients from medical records. Results: During the in-hospital stay (9.5±4.72 days), 7 patients died, resulting in an acute PE related in-hospital mortality of 3.2%. Admission heart rate (HR), (Odds ratio (OR), 1.028 95% Confidence interval (CI), 0.002-1.121; P = 0.048) and blood urea nitrogen (BUN) (OR, 1.028 95% CI, 0.002-1.016; P = 0.044) were found to be independent predictors for in-hospital mortality in a multi variate logistic regression analysis. In total, 32 patients (20.9%) died during 30 days follow-up.The presence of congestive heart failure (OR, 0.015, 95%CI, 0.001-0.211; P = 0.002) and dementia (OR, 0.029, 95%CI,0.002-0.516; P = 0.016) as well as low albumin level (OR, 0.049 95%CI, 0.006-0.383; P = 0.049) were associated with 30 days mortality. Conclusion: HR and BUN were independent predictors of in-hospital mortality and the presence of congestive heart failure, dementia, and low albumin levels were associated with higher 30 days mortality.
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Vasospastic coronary artery disease (CAD) usually occurs during the percutaneous interventions and responds to conventional medical treatment. However, in rare conditions, it may be resistant to medical treatment, resulting in lethal complications, including acute myocardial infarction, ventricular arrhythmia, cardiopulmonary arrest, cardiogenic shock, and acute pulmonary edema. In this case report, a 44-year-old woman was admitted to the hospital with a diagnosis of non-ST-segment elevation myocardial infarction. During a diagnostic coronary angiography and in-hospital stays, multiple catastrophic complications due to vasospastic CAD occurred, and we were able to demonstrate a successful management strategy of these complications.
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OBJECTIVE: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. METHODS: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: ≥50%). RESULTS: A total of 1098 patients (male, 47.5%; mean age, 83.5+-3.1 years) aged ≥80 years and 4596 patients (male, 50.2 %; mean age, 71.1+-4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were ≥80 years and 27.1% for patients 65-79 years old. For patients aged ≥80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65-79 years, 43.9% (548) had HFpEF, and 56.1% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged ≥80 years with HFrEF (p<0.01). CONCLUSION: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.
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Idoso Fragilizado , Insuficiência Cardíaca/epidemiologia , Admissão do Paciente , Idoso , Idoso de 80 Anos ou mais , Demografia , Feminino , Serviços de Saúde para Idosos , Insuficiência Cardíaca/etiologia , Humanos , Masculino , Prevalência , Turquia/epidemiologiaRESUMO
INTRODUCTION: Rheumatic mitral stenosis (MS) is an important health issue in developing countries. Assessment of the correct mitral valve area (MVA) is essential for the timing of intervention. Most of the parameters for the assessment of rheumatic MS are derived from Two-dimensional (2D) echocardiography. Three-dimensional (3D) echocardiography is commonly used in our daily practice at the present time. The aim of this study was to assess the value of 3D echocardiography mitral valve vena contracta area (VCA) in predicting the severity of Rheumatic MS by comparing 3D planimetry. METHODS: The patients, who had been diagnosed as mild, moderate, and severe rheumatic MS with conventional methods (pressure half time, planimetry) by 2D transesophageal echocardiography (TEE)/ transthoracic echocardiography (TTE), underwent 3D TEE evaluation. Also, the patients who had an atrial fibrillation and more than moderate aortic regurgitation were included in the study. 3D TEE full volume mitral valve VCA was measured in end-diastole during its largest dimensions. 3D TEE full volume and 3D zoom MVA planimetry were measured at the end-diastole during the mitral valve`s largest opening. RESULTS: We studied 40 patients (the mean age: 51.1 ± 11.6 years, 31 females) with rheumatic MS. 3D TEE VCA was found to be highly correlated with the 3D TEE MVA (r = 0.82, P < 0.001). CONCLUSION: Our study findings provide evidence that 3D TEE mitral valve VCA can be additionally used in detecting the severity of rheumatic MS.
Assuntos
Ecocardiografia Tridimensional/métodos , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/etiologia , Cardiopatia Reumática/complicações , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Estenose da Valva Mitral/patologia , Reprodutibilidade dos Testes , Cardiopatia Reumática/patologia , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Secondary prevention plays an important role after acute coronary event due to high risk of adverse events in elderly. In present study we aimed to evaluate the lifestyle, management of risk factors and medical treatment for secondary protection in elderly patients with known coronary heart disease (CHD). METHODS: ELDERTURK is a non-interventional, multi-centered, observational study, which included total of 5694 elderly patients ( > 65 years) from 50 centers in Turkey. In this study elderly patients from the ELDERTURK population with known CHD were evaluated for cardiovascular risk factors, comor- bidities and medication usage. RESULTS: A total of 2976 (52.3% of study) out of 5694 patients included in the ELDERTURK study were evaluated. All had known CHD with a mean age of 73.4 ± 6.2 years and 60.3% were male. 13.0% of patients were smokers, 42.4% were overweight and 21.1% were obese. Only 23.6% of patients reported to do regular exercise, 73.4% had history of hypertension, 47.4% had dyslipidemia and 33.9% had diabetes mellitus. The rate of patients with systolic blood pressure > 140 mmHg were 31.1% and only 13.9% of patients had a recommended ≤ 70 mg/dL level of low-density lipoprotein cholesterol. Anti- platelet, statin, beta-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker usage was limited to 27.3%. CONCLUSIONS: The ELDERTURK study shows that many patients with CHD have a high prevalence of modifiable risk factors and unhealthy lifestyle. Apart from this, many patients are not receiving thera- peutic intervention and as a consequence most were not achieving the recommended goals.