Investigation of left atrial mechanical function and left ventricular systolic and diastolic parameters in athletes performing resistance exercise and combined exercise.

Some individuals who go to fitness centers for various purposes perform resistance exercise (RE) alone, while others engage in combined exercise (CE) by including cardio exercises along with RE. Studying the effects of these two different training methods on left ventricular (LV) systolic and diastolic parameters and left atrial mechanical function is an important step toward understanding the effects of different types of exercise on cardiac function. This knowledge has significant implications for public health, as it can inform the development of targeted and effective exercise programs that prioritize cardiovascular health and reduce the risk of adverse outcomes. Therefore, the primary aim of this study is to comprehensively investigate the LV systolic and diastolic parameters of athletes who engage in RE and CE using ECHO, to contribute to the growing body of literature on the cardiovascular effects of different types of exercise. Forty-two amateur athletes aged between 17 and 52 were included in our study. The participants consisted of the RE (n = 26) group who did only resistance exercise during the weekly exercise period, and the CE group (n = 16) who also did cardio exercise with resistance exercises. After determining sports age (year), weekly exercise frequency (day), and training volume (min) in addition to demographic information of RE and CE groups, left ventricular systolic and diastolic parameters and left atrial functions were determined by ECHO. Findings from our study revealed that parameters including the left ventricular end-diastolic diameter (LVEDD) (p = .008), left ventricular end-diastolic volume (LVEDV) (p = .020), stroke volume index (SV-I) (p = .048), conduit volume (CV-I) (p = .001), and aortic strain (AS) (p = .017) were notably higher in the RE group compared to the CE group. Also left atrial active emptying volüme (LAAEV) of CE was higher than the RE group (p = .031). In conclusion, the cardiac parameters of the RE group showed more athlete's heart characteristics than the CE group. These results may help to optimize the cardiovascular benefits of exercise routines while minimizing the potential risks associated with improper training.

The effect of body mass index on complications in cardiac implantable electronic device surgery.

BACKGROUND: Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications. METHODS: 1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m2 ), overweight (25 ≤ BMI < 30 kg/m2 ), and obese (BMI ≥ 30 kg/m2 ). The primary endpoint was accepted as cumulative events, including the composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of cumulative events. RESULTS: The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156-3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470-9.204, p < .001), BMI (OR:1.069, 95%CI:1.012-1.129, p = .01) were independent predictors of cumulative events rates. CONCLUSIONS: Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.

The insufficiency of recreational exercises in improving cardiovascular fitness: an investigation of ventricular systolic and diastolic parameters and left atrial mechanical functions.

AIM: This study aimed to compare the left ventricular (LV) systolic and diastolic parameters and left atrial (LA) mechanical functions of individuals engaging in recreational sports and resistance exercises on a weekly basis. METHODS: A total of 43 male amateur athletes were included in this study, of which 24 performed resistance exercises (REs) (29.70 ± 8.74 year, weight: 81.70 ± 12.64 kg, height: 176.05 ± 7.73 cm, BMI: 27.64 ± 4.97 kg/m2), and 19 participated in recreational football training and were included in the recreational sports group (31.73 ± 6.82 year, weight: 86.00 ± 18.52 kg, height: 178.62 ± 4.95 cm, BMI: 25.55 ± 3.42 kg/m2). The exercises were standardized according to the weekly exercise frequency and volume. After recording the participants' demographic information, the LV systolic and diastolic parameters and LA mechanical functions were measured using echocardiography (ECHO) and Tissue Doppler Imaging. RESULTS: Significant differences were observed in various cardiac parameters between the recreational sports group (REG) and resistance exercise Group (RSG). Specifically, the left ventricular (LV) diastolic diameter, LV end diastolic volume index (LVEDVi), and stroke volume index were notably higher in the REG compared to the RSG (t = 2.804, p = .010, effect size (ES) = 2.10; t = 3.174, p = .003, ES = 0.98; t = 3.36, p = .002, ES = 1.02, respectively). Notably, the RSG exhibited higher values for LV mass index (LVMi) and isovolumic relaxation time (IVRT) than the REG (t = 2.843, p = .007, ES = 0.87; t = 2.517, p = .016, ES = 0.76) in terms of LV systolic and diastolic parameters. Regarding left atrial (LA) mechanics, the REG demonstrated increased LA total emptying volume index, LA maximum volume index, LA volume before systole measured at the onset of the p-wave index, and conduit volume index compared to RSG (t = 2.419, p = .020, ES = 0.75; t = 2.669, p = .011, ES = 0.81; t = 2.111, p = .041, ES = 0.64; t = 2.757, p = .009, ES = 0.84, respectively). CONCLUSION: Our study revealed significant variations in LV and LA functions between REG and RSG. Our data suggest that REs led to substantial cardiac remodeling, altering myocardial structure and function. In contrast, the effect of recreational exercise on cardiac adaptation was less pronounced than that of resistance exercise. Consequently, we propose that individuals engaging in recreational exercise should consider modalities that impose higher cardiovascular demand for more effective cardiac conditioning.

Prognostic Nutritional Index as a Novel Predictor of In-Stent Restenosis: A Retrospective Study.

Background and Objectives: In-stent restenosis (ISR) is a major problem in patients undergoing percutaneous coronary intervention. The prognostic nutritional index (PNI) is a nutritional status score used in the literature to determine the prognosis of coronary artery disease. In this study, we aimed to investigate the effect of preprocedural PNI values on the risk of ISR in patients with stable coronary artery disease who underwent successful percutaneous coronary intervention. Materials and Methods: This retrospective study included 809 patients. Stent restenosis was evaluated in the follow-up coronary angiography of the patients due to stable angina pectoris or acute coronary syndrome. The patients were divided into two groups based on those with (n = 236) and without (n = 573) in-stent restenosis, and their nutritional status was compared with PNI. The PNI values before the first angiography of the patients were calculated. Results: The mean PNI score was significantly lower in patients with ISR than in those without ISR (49.5 vs. 52.3, p < 0.001). Concerning the results of the Cox regression hazard model for predictors of ISR, PNI was significantly associated with the development of ISR (HR = 0.932, 95% CI: 0.909-0.956, p < 0.001). In addition, stent type, stent length, and diabetes mellitus were associated with the development of ISR. Conclusions: A low PNI value indicates poor nutritional status, which is thought to accelerate inflammation processes and cause atherosclerosis and ISR.

Left atrial mechanical functions in patients with the metabolic syndrome.

OBJECTIVE: Metabolic syndrome (MS) is a cluster of risk factors leading to cardiometabolic diseases.The aim of the present study was to investigate the effect of MS on left atrial function, which is an important determinant of left ventricular filling. METHODS: Left atrial (LA) volumes were measured echocardiographically in 32 MS patients and 32 age- and sex-matched controls. LA volumes were determined at the time of mitral valve opening (maximal, Vmax), at the onset of atrial systole (p wave on the electrocardiogram, Vp) and at the mitral valve closure (minimal, Vmin) according to the biplane area-length method in apical 4-chamber and 2-chamber view. All volumes were corrected to the body surface area, and following left atrial emptying functions were calculated. LA passive emptying volume =Vmax- Vp LA passive emptying fraction = LA passive emptying volume/Vmax . Conduit volume= LV stroke volume - (Vmax- Vmin), LA active emptying volume =Vp- Vm,, LA active emptying fraction= LA active emptying volume/Vp, LA total emptying volume = (Vmax -Vmin), LA total emptying fraction = LA total emptying volume/Vmax. RESUITS: LA maximal volume and LA presystolic volume were significantly higher in MS patients than in controls (P <0.001). But LA minimum volume was significantly lower in MS patients than in controls (P <0.001). Although LA passive emptying volume (P <0.03), LA passive emptying fraction (P <0.001) and conduit volume (P <0.001) were found to be significantly lower in MS patients than in controls, LA active emptying volume (P <0.001) and LA active emptying fraction (P< 0.001) were significantly greater in MS patients than in controls. Conclusion In our study, metabolic syndrome was associated with increased left atrial volume, decreased left atrial passive emptying function and increased pump function. Increased left atrial pump function represents a compensatory mechanism in patients with MS.Thus, these results underline the importance of maintaining a sinus rhythm in these patients.

Charlson comorbidity index and 1-year poor outcomes in elderly patients undergoing successful percutaneous coronary intervention: A retrospective study.

Elderly patients with acute syndrome are frailer due to the burden of comorbidity. Comorbidities that increase with age result in an increased risk of mortality in patients with acute coronary syndrome (ACS). Many scales have been developed to assess the burden of comorbidity, including the Charlson Comorbidity Index (CCI). The aim of our study is to show the effect of the CCI on 1-year mortality and poor clinical outcomes in elderly patients who underwent percutaneous coronary intervention due to ACS. This single-center retrospective study included 704 patients aged 75 years and older. The study population consisted of patients who were admitted to the hospital with ACS between April 2017 and September 2021 and underwent successful percutaneous intervention. The patients were divided into 3 groups according to their CCI scores as CCI 0 (n:156), 1 (n:266), and ≥2 (n:282). Stroke development was significantly higher in patients with CCI scores ≥ 2 compared to the other 2 groups (P = .005). Mortality rates were found to be 28.4%, 7.5%, and 2.6% in patients with CCI ≥ 2, CCI 1, and CCI 0, respectively. The mortality rate of the CCI ≥ 2 group was significantly higher than those of the other 2 groups (P < .001). The multivariate Cox proportional hazard regression model showed that CCI was an independent predictor for 1-year all-cause mortality (hazard ratio: 1.632; 95% confidence interval: 1.403-1.898; P < .001). CCI may contribute to treatment and follow-up management, as it indicates a poor prognosis in elderly patients who have undergone percutaneous coronary intervention.

Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow-up.

BACKGROUND: Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings. RESULTS: A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction. CONCLUSIONS: Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.

The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study.

Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 ( P = .003), SDNN index was 66 ± 20 versus 56 ± 12 ( P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 ( P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 ( P = .001), HF was 450 ± 270 versus 225 ± 130 ( P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 ( P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.

The Prognostic Value of Geriatric Nutritional Risk Index in Evaluating Rehospitalization and One-Year Mortality in Patients With Heart Failure.

BACKGROUND: Malnutrition is frequently observed in patients with heart failure, and malnutrition causes poor prognosis in these patients. Various calculation tools are used to assess malnutrition, with the geriatric nutritional risk index (GNRI) being one that is frequently used. In our study, we aimed to investigate the value of GNRI in assessing one-year mortality and rehospitalization in patients with heart failure. METHOD: A total of 196 patients aged 60 years and older were included in this retrospective study. A GNRI ≤ 98 was defined as malnutrition. Patients were divided into two groups: GNRI ≤ 98 (malnutrition) and GNRI > 98 (non-malnutrition). Rehospitalization due to heart failure and mortality were compared between both groups in the one-year follow-up. RESULTS: The duration of hospitalization was significantly lower in the malnourished group compared to the non-malnutrition group (11.5 ± 7.5 days vs. 20.9 ± 16.3 days). All-cause mortality was significantly higher in the malnutrition group (30.8% vs. 18.1, p = 0.045). Risk factors were evaluated to predict all-cause death by Cox regression analysis, and GNRI (hazard ratio (HR) = 0.968; 95%CI: 0.942-0.995; p = 0.018) was associated with all-cause mortality. CONCLUSIONS: GNRI, which is used as an indicator of malnutrition, is associated with all-cause mortality at one-year follow-up. Higher mortality was observed in the group with low GNRI, but it was observed that this group was hospitalized for less time due to heart failure.

Evaluation of electrocardiographic parameters in amputee football players.

Objective: The present study aimed to compare electrocardiographic (ECG) parameters of amputee football players (AF) with football players without disability (FP) and sedentary individuals without disability (SI). Methods: A total of 32 participants (AF = 9, FP = 11, SI = 12) were included in the study. ECG parameters including P-wave amplitude, P-wave duration, PR interval, QRS duration, RR interval, QT interval, corrected-QT interval (QTc), ST segment duration, Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were assessed in all the study participants by using a 12-lead ECG device. OneWay ANOVA Test was used for statistical analysis. Results: Of all ECG parameters, P-wave amplitude and QTc were significantly higher in the AF group in comparison to FP and SI groups. QRS duration was found to be lower in the AF group when compared to FP and SI groups. Myocardial repolarization parameters including Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were similar between groups, as were other parameters such as P-wave duration, PR interval, RR interval, QRS duration and QT interval. Conclusion: It was found that some ECG parameters of amputee football players differ from those with non-disabled players and non-disabled sedentary individuals. These different parameters were within normal limits.

White Blood Cell Subtypes and Neutrophil-Lymphocyte Ratio in Prediction of Coronary Thrombus Formation in Non-ST-Segment Elevated Acute Coronary Syndrome.

Leukocytes are reported as crucial not only for plaque activation but also in thrombus formation in acute coronary syndromes (ACSs). Among the markers of inflammation, in coronary artery disease neutrophil-lymphocyte ratio (NLR) has been reported to have the greatest predictive power of poor outcomes. Our aim was to evaluate the association of NLR with coronary thrombus in patients with non-ST-segment elevated ACSs (NST-ACSs). A total of 251 patients were hospitalized with a diagnosis of NST-ACS including non-ST-segment elevated myocardial infarction and unstable angina pectoris. Coronary angiographies were performed. In 167 patients, coronary thrombus was detected. Between the patient groups with and without coronary thrombus, neutrophil count, platelet count, and NLR are significantly increased, and lymphocyte count is significantly decreased in the group with coronary thrombus as compared to patient group without coronary thrombus. Leukocyte count and NLR may give an indication about the presence of coronary thrombus. In NST-ACS, blood parameters may give valuable information about the status of the coronary arteries.