Non-Alcoholic Fatty Pancreas Disease is Associated with SYNTAX Score in Acute Coronary Syndrome.

Background: Evidence that individuals with excess fat in the pancreas have an increased risk of cardiovascular disease has been growing recently. Risk evaluation in acute coronary syndrome (ACS) patients plays a crucial role for both prognosis prediction and decision-making. Aim: The main aim of this study was to investigate the relationship between non-alcoholic fatty pancreas disease (NAFPD) and the complexity and severity of coronary artery disease as assessed using the SYNTAX score (SXscore) in ACS patients. Methods: A total of 99 consecutive patients with a first-time diagnosis of ACS were recruited. NAFPD was evaluated using transabdominal ultrasonography (TUS). SXscore was calculated using the SXscore algorithm. Results: The patients with NAFPD had a significantly higher SXscore than those without NAFPD (12.3 ± 6.4 and 8.2 ± 4.3, p < 0.001). Univariable analysis showed that hypertension (p = 0.033) and presence of NAFPD (p = 0.001) were associated with increased SXscore. Moreover, multivariable analysis showed that the presence of NAFPD (p = 0.002) was associated with increased SXscore. Conclusions: NAFPD is easily detected by TUS. The presence of NAFPD in ACS patients may be a warning signal of complexity and severity of coronary artery disease.

[Cardiac device related infective endocarditis; analysis of 15 cases]. / Kardiyak cihazlara bagli olarak gelisen enfektif endokardit; 15 olgunun analizi.

OBJECTIVES: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemaker (PM) and implantable cardioverter-defibrillator (ICD) endocarditis in this study. STUDY DESIGN: The study population consisted of 15 patients with permanent PM and ICD endocarditis. Data on demographics, medications, clinical procedures, microbiology, echocardiography, surgery, and outcome were collected. RESULTS: The mean age of the patients was 57 ± 16. Seven patients (47%) were female. Of the 15 permanent PM and ICD endocarditis patients, 5 died during hospital follow-up (33%). Four patients (27%) experienced a pulmonary embolism. Culture-negative endocarditis was seen in 5 cases (33%). Staphylococci were the most common causative organisms (60%). Three patients had undergone surgical treatment (20%). CONCLUSION: Cardiac device-related endocarditis remain a rare but potentially fatal complication of device implantation.

A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis.

OBJECTIVE: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. METHODS: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. RESULTS: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. CONCLUSIONS: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.

Prolonged P wave dispersion in pre-diabetic patients.

BACKGROUND: It is known that overt diabetes as well as chronic hyperglycaemia can lead to atrial fibrillation. A P wave dispersion (PWD) represents heterogeneity in atrial refractoriness. AIM: To investigate PWDs in patients with pre-diabetes. METHOD: Based on the results of examinations, 84 pre-diabetic patients (the pre-DM group; 50 female, 34 male; mean age 54 ± 8.6 years) who had no overt diabetes, coronary artery disease or hypertension, whose fasting blood glucose was higher than 100 mg/dL and/or whose 2 h glucose concentrations on an oral glucose tolerance test was in the range of 140 to 199 mg/dL, and 48 healthy volunteers (the non-DM group, 30 female, 18 male; mean age 51.7 ± 7.3 years) with no illnesses, were enrolled in this study. Standard 12-lead electrocardiograms of all patients were taken at 50 mm/s and 20 mm/mV standardisation. Maximum (P(max)) and minimum (P(min)) P-wave durations were measured. The PWD was defined as the difference between P(max) and P(min). RESULTS: The P(max) and PWD values were significantly higher in pre-DM compared to non-DM (104 ± 13 ms vs 98 ± 12 ms; p < 0.05, 42 ± 13 ms vs 34 ± 11 ms; p <0.01 respectively). A positive correlation was found between PWD and fasting blood glucose (r = 0.32; p < 0.01). There was no correlation between PWD and HbA(1c) levels (r = 19; p > 0.05). Multivariate regression analysis showed no relationship between PWD and age, left atrial diameter, E, A, E/A or HbA(1c). However, there was a relationship between PWD and fasting blood glucose. CONCLUSIONS: The P(max) and PWD are increased in pre-diabetic patients who have no coronary artery disease, hypertension or left ventricular hypertrophy