Comparison of the Relationship Between Inflammatory Markers and Atrial Fibrillation Burden.

BACKGROUND: Atrial fibrillation is a complex disease with irregular ventricular response and tachycardia as a result of irregular and rapid contraction of the atria, with poor cardiovascular outcomes unless treated. Various mechanisms are involved in its pathohysiology. Inflammation has an important place among these mechanisms. Many cardiovascular events accompany inflammation. Understanding and correct evaluation of inflammation in current situations contribute to the diagnosis and severity of the disease. The aim of our study was to understand the role of inflammatory biomarkers in patients with atrial fibrillation and to evaluate the difference between whether the disease is paroxysmal and persistent (atrial fibrillation burden). METHODS: The study was done retrospectively, and a total of 752 patients who were admitted to the cardiology outpatient clinic were recruited. The normal sinus rhythm group of the study consisted of 140 patients, and the atrial fibrillation group consisted of 351 [permanent atrial fibrillation (n = 206) and paroxysmal atrial fibrillation (n = 145)] patients. Inflammation markers were evaluated by dividing the patients into 3 groups. RESULTS: Higher permanent atrial fibrillation [209.71 (40.73-604.0)], paroxysmal atrial fibrillation [188.51 (53.95-617.46)], normal sinus rhythm [629.47 (104-4695)]; permanent atrial fibrillation [4.53 (0.27-17.94)], paroxysmal atrial fibrillation [3.09 (0.40-11.0)], normal sinus rhythm [2.34 (0.61-13.51)] (P <.05); and permanent atrial fibrillation [1569.54 (139-6069)], paroxysmal atrial fibrillation [1035.09 (133-4013)], normal sinus rhythm [130.40 (26.42-680.39)] (P <.05) were detected in the systemic immune inflammation index, neutrophil-lymphocyte ratio, and platelet/lymphocyte ratio atrial fibrillation groups compared to normal sinus rhythm group. Correlation between C-reactive protein and systemic immune inflammation index (r = 0.679, r = 0.483 P <.05, respectively) was found in the permanent atrial fibrillation and paroxysmal atrial fibrillation groups. CONCLUSION: Systemic immune inflammation index, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio were found to be higher in permanent atrial fibrillation compared to paroxysmal atrial fibrillation and in the whole atrial fibrillation group compared to the normal sinus rhythm group. This indicates that inflammation is associated with AF burden and the SII index is successful in reflecting this.

The effect of dapagliflozin therapy on ventricular repolarization parameters in electrocardiography in patients with diabetic cardiovascular disease.

BACKGROUND: Dapagliflozin is an agent that has both antihyperglycemic effects and is significantly associated with a lower risk of cardiovascular events in patients with diabetes mellitus (DM). However, there is insufficient data and information about the effect of dapagliflozin on electrocardiographic (ECG) parameters. AIM: The effects of dapagliflozin on ventricular repolarization parameters have not been fully elucidated yet. This study aimed to investigate whether dapagliflozin has a positive effect on ventricular repolarization heterogeneity parameters in patients with type 2 DM. METHOD: We retrospectively enrolled 140 patients with a known diagnosis of type 2 DM who were newly prescribed dapagliflozin in addition to standard anti-diabetic therapy. The patients were divided into two groups according to whether they had cardiovascular disease (CVD). The effect of dapagliflozin treatment on ventricular repolarization parameters (frontal plane QRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion) was investigated, patient groups were compared before and after treatment. RESULTS: Among 140 patients, 70 (50 %) had CVD and 70 (50 %) did not have CVD. Dapagliflozin treatment resulted in significant reductions in ventricular repolarization parameters over the study period in the CVD group with diabetes. Mean fQRST angle, Tp-e interval, Tp-e/QTc, QTc, and QTc dispersion were significantly lower than baseline values at 6-month follow-up visits in the CVD group (61.61 ± 9.22° vs 52.55 ± 8.31°, 74.45 ± 16.06 msec vs 63.27 ± 13.99 msec, 0.19 ± 0.03 vs 0.16 ± 0.03, 384.12 ± 47.93 msec vs 356.15 ± 43.31 mesc, 55.28 ± 5.50 msec vs 48.08 ± 6.48 msec for all pairwise comparisons p < 0.001). CONCLUSION: Similar antihyperglycemic effects were found with dapagliflozin treatment in patients with and without CVD. However, significant reductions in ventricular repolarization parameters were observed only in patients with CVD.

Rationale, Design, and Methodology of the MORCOR-TURK Trial: Predictors of In-hospital MORtality in CORonary Care Patients in Turkey.

BACKGROUND: Coronary care units are sophisticated clinics established to reduce deaths due to acute cardiovascular events. Current data on coronary care unit mortality rates and predictors of mortality in Turkey are very limited. The MORtality predictors in CORonary care units in TURKey (MORCOR-TURK) trial was designed to provide information on the mortality rates and predictors in patients followed in coronary care units in Turkey. METHODS: The MORCOR-TURK trial will be a national, observational, multicenter, and noninterventional study conducted in Turkey. The study population will include coronary care unit patients from 50 centers selected from all regions in Turkey. All consecutive patients admitted to coronary care units with cardiovascular diagnoses between 1 and 30 September 2022 will be prospectively enrolled. All data will be collected at one point in time, and the current clinical practice will be evaluated (ClinicalTrials.gov number NCT05296694). In the first step of the study, admission diagnoses, demographic characteristics, basic clinical and laboratory data, and in-hospital management will be assessed. At the end of the first step, the predictors and rates of in-hospital mortality will be documented. The second step will be in cohort design, and discharged patients will be followed up till 1 year. Predictors of short- and long-term mortality will be assessed. Moreover, a new coronary care unit mortality score will be generated with data acquired from this cohort. RESULTS: The short-term outcomes of the study are planned to be shared by early 2023. CONCLUSION: The MORCOR-TURK trial will be the largest and most comprehensive study in Turkey evaluating the rates and predictors of in-hospital mortality of patients admitted to coronary care units.

Association between lower extremity venous insufficiency and duration of atrial fibrillation.

OBJECTIVE: Physiologic studies have shown that atrium has an active role in venous blood return from lower extremity. In this context we investigated the association between AF and chronic venous disease (CVD). METHODS: In this observational study we included 392 AF patients which were divided into two groups (chronic AF, 218 (56%)) and non-chronic. AF, 174 (44%)). These two groups were compared in terms of CVD after matching conventional risk factors for CVD. RESULTS: CEAP classification was different between chronic and non-chronic patients (C0-C2: 72% vs 47%; C3-C6: 28% vs 53% <0.001). Chronic AF patients had also higher rate of venous reflux on Doppler ultrasound (38% vs 16% P < 0.05). There was a correlation between AF duration, right atrial volume index and CEAP classification respectively (rho:0.314 p < 0.001), (rho:0.258, p < 0.001). CONCLUSION: Prevalence of CVD is higher in patients with chronic AF. In addition, atrial volume is directly correlated with CVD.