OBJECTIVE:Methemoglobinemia is potentially serious complication of local anesthetic use during cardiac implantable electronic device (CIED) implantation. Although it is mostly asymptomatic limited awareness may delay diagnosis and treatment. METHOD:This prospective observational study included 126 patients undergoing CIED implantation under local anesthesia. Prilocain 2% has been used in all procedures. Arterial blood gases and methemoglobin levels were evaluated at baseline, 60, and 120 minutes after the procedure. Fraction of methemoglobin levels > 1.5 % results in methemoglobinemia. Patients were categorized into three groups based on 60-minute fractional methemoglobin (FMetHb) levels: ≤1.5%, 1.5-3%, and >3%. Clinical parameters, anesthetic dosage, and outcomes were compared between groups. RESULTS:Methemoglobin levels >1.5% were observed in 80.2% of patients. Three patients required treatment; all recovered fully. Patients with FMetHb >3% received higher anesthetic doses (p<0.001). Drug dose and pCO₂ were observed between groups. Among the clinical parameters, prilocaine dose demonstrated the strongest predictive value for methemoglobinemia, with an optimal cut-off of ≥24.50 mg identified by ROC analysis (AUC: 0.693, p<0.001). CONCLUSION:Methemoglobinemia may occur more frequently than expected following CIED implantation and early recognition and stratification using practical thresholds such as >3% FMetHb support timely management and improved outcomes.

Objectives:Heart failure (HF) is a significant global health problem that continues to increase in prevalence, morbidity, and mortality, particularly in aging populations. Relative wall thickness (RWT), an echocardiographic parameter reflecting geometric remodeling of the heart, is easily measurable and may possess prognostic value. This study aimed to evaluate the predictive power of RWT for 5-year mortality in patients with HF. Methods:In this retrospective observational analysis, a total of 232 individuals diagnosed with acute decompensated heart failure were enrolled. RWT values were calculated using echocardiographic measurements. In this single retrospective cohort, participants were stratified into two subgroups based on their 5-year survival status. Demographic, clinical, laboratory, and echocardiographic parameters were compared between these subgroups. Results:After 5 years of follow-up, 133 patients had died. Patients in the mortality group were significantly older (p = 0.001). The mortality cohort demonstrated a higher prevalence of chronic renal failure, atrial fibrillation, and mitral regurgitation compared with survivors. Echocardiographically, elevated systolic pulmonary artery pressure (sPAP) was associated with mortality (p = 0.009). However, regression analysis did not find sPAP to be statistically significant [95% confidence interval (CI), hazard ratio: 1.047 (0.818-1.340), p:0.7)]. RWT values ​​did not show a significant difference between the groups (0.39 ± 0.13 compared to 0.37 ± 0.06; p = 0.225). Area under the curve for RWT was 0.50 (95% CI: 0.43-0.57), indicating poor predictive power. Kaplan-Meier analysis showed no significant difference in survival between RWT groups (log-Rank:0.984, p: 0.32). Conclusion:RWT has limited ability to predict 5-year mortality among patients with advanced stages of HF. Age emerged as the strongest independent predictor. RWT should be evaluated in conjunction with multiple clinical and laboratory parameters rather than in isolation when managing HF.

Left ventricular thrombus (LVT) in ischemic heart failure carries embolic risk; tools to anticipate persistence are limited. We studied 190 consecutive patients with imaging-confirmed LVT managed with guideline-concordant anticoagulation and serial echocardiography. The primary outcome was 6-month non-regression; 1-year MACE was secondary. We combined classical statistics with explainable machine learning. CatBoost yielded the best discrimination for non-regression (CV-AUC 0.76; test accuracy 0.79). SHAP highlighted left atrial diameter, pulmonary artery pressure, platelet count, and LV end-diastolic diameter as leading predictors. For 1-year outcomes, thrombus size and CHA2DS2-VA were independently associated with MACE (logistic AUC 0.71), whereas “regression vs persistence” alone was not. Baseline remodeling and coagulability markers, captured by an interpretable ML model, stratify early risk of LVT persistence and complement clinical decision-making for imaging follow-up and anticoagulation intensity.

We evaluated TAPSE/PAi, defined as the ratio of tricuspid annular plane systolic excursion to the indexed main pulmonary artery diameter, as a pragmatic functional-structural index and compared it with TAPSE/sPAP. In this retrospective study, 53 patients with PAH were analyzed. Associations of TAPSE/PAi and TAPSE/sPAP with clinical, biomarker, and invasive hemodynamic variables were assessed. Discrimination for WHO-FC ≥ 3, 6MWD < 165 m, and PVR > 5 WU was evaluated by direction-aligned ROC analysis with Youden-optimal thresholds. Age- and sex-adjusted logistic regression models reported odds ratios (ORs) per 1-SD increase. TAPSE/PAi correlated more strongly than TAPSE/sPAP with WHO-FC (ρ=-0.592 vs. -0.384) and 6MWD (ρ = 0.493 vs. 0.378), whereas TAPSE/sPAP correlated more strongly with NT-proBNP/proBNP (ρ=-0.619 vs. -0.484) and with mPAP/PVR. TAPSE/PAi showed better discrimination for WHO-FC ≥ 3 and 6MWD < 165 m while TAPSE/sPAP performed modestly better for PVR > 5 WU The Youden-optimal TAPSE/PAi threshold was ≤ 1.296 for both WHO-FC ≥ 3 and 6MWD < 165 m. The higher TAPSE/PAi remained associated with lower odds of WHO-FC ≥ 3 and 6MWD < 165 m after age- and sex-adjustment. TAPSE/PAi better reflects functional severity and exercise limitation, whereas TAPSE/sPAP is more closely related to biomarker/hemodynamic burden. The indices appear complementary, and TAPSE/PAi may be a practical TR-independent severity marker in PAH.

Contrast-enhanced transcranial Doppler (c-TCD) is a promising noninvasive method for detecting patent foramen ovale (PFO) in adults, but its diagnostic accuracy compared to the gold standard transesophageal echocardiography (TEE) requires up-to-date evaluation. We conducted a systematic review and meta-analysis of studies from 2015 to 2025 assessing c-TCD for PFO detection in adults, following the PRISMA guidelines. A comprehensive search identified 37 relevant articles; of these, five primary studies met the inclusion criteria for quantitative analysis. Data on sensitivity, specificity, and othervdiagnostic performance metrics were extracted, and study quality was appraised using QUADAS-2. The included studies (mostly cryptogenic stroke patients) indicated that c-TCD had high sensitivity (~95%) and good specificity (~90%) for detecting PFO compared to TEE. In our meta-analysis, the summary sensitivity of c-TCD was 94.8% (95% confidence interval [CI]: 91%-98%) and the specificity was 89.7% (95% CI: 85%-94%). The pooled positive likelihood ratio was ~9, and the negative likelihood ratio was ~0.06. The diagnostic odds ratio was approximately 150, and the area under the curve of the summary receiver operating characteristic curve was approximately 0.97, reflecting excellent overall accuracy. Contrast TCD demonstrates robust diagnostic performance for PFO detection, approaching that of TEE. A negative result on c-TCD reduces the likelihood of clinically significant PFO in patients with stroke, whereas a positive c-TCD strongly suggests PFO and should prompt confirmatory TEE for anatomical details. These findings support the use of c-TCD as a first-line screening tool in the evaluation of cryptogenic stroke.

Pseudoaneurysm (PA) is a well-known vascular complication following percutaneous interventions, typically occurring in the early post-procedural period. However, delayed-onset PA associated with deep vein thrombosis (DVT) is an uncommon presentation. This case highlights a late external iliac artery (EIA) PA diagnosed in a patient who initially underwent coronary angiography. A 65-year-old male underwent a routine coronary angiography via the femoral artery and was discharged without complications. Twenty days later, he presented with unilateral lower limb swelling and pain. Doppler ultrasonography revealed extensive external iliac DVT, and contrast-enhanced computed tomography (CT) angiography confirmed a PA of the EIA. Endovascular stent graft placement was performed successfully. The patient was followed for 1 week, during which the limb swelling and pain resolved completely, and he was discharged without complications. This case underscores the importance of considering delayed PA formation in patients with unexplained limb swelling after arterial access procedures. Early diagnosis and intervention are crucial in preventing complications and ensuring favorable outcomes.

Background:Inflammation and malnutrition have negative effects on heart failure. The Naples Prognostic Score (NPS) is a new scoring system that incorporates these two parameters. Objectives:Our aim was to investigate the relationship between the NPS and long-term mortality in patients with advanced-stage heart failure. Methods:The study included 148 patients with advanced-stage heart failure. The patients were divided into two groups: those who died, and those who survived. Demographic, clinical, and laboratory characteristics of the groups were compared. The impact of NPS on mortality was examined. Results:The patients were further classified into three groups according to NPS. The patients with NPS 3 had a higher mortality rate compared to those with NPS 1 and NPS 2 (died vs. survived respectively, NPS 3: 75% vs. 25%, NPS 1: 31.1% vs. 68.9%, NPS 2: 48.9% vs. 51.1%, p < 0.001). In multivariate regression analysis, NPS 3 was found to be an independent predictor [odds ratio: 0.13, 95% confidence interval (CI): 0.051-0.333; p = 0.0001]. Receiver operating characteristic analysis revealed that NPS had a sensitivity of 82% and specificity of 53% for mortality, with an area under curve of 0.699 (95% CI: 0.614-0.784, p = 0.0001). Kaplan-Meier survival analysis demonstrated a higher mortality rate in those with a high NPS (long-rank: 5.29, p = 0.021). In patients with advanced-stage heart failure, NPS may be considered a determinant of long-term mortality. Conclusions:This study demonstrated an association between NPS and long-term mortality in patients with advanced-stage heart failure. NPS, indicating inflammation and nutritional status, can be utilized as a long-term prognostic indicator in patients with advanced-stage heart failure.

Background:Rheumatoid arthritis (RA) is an autoimmune disease and affects various parts of the body, especially the joints, through inflammation. Sestrins are molecules that are known to have anti-inflammatory properties and have been shown to play a role in the stress response in the body. Methods:Our study is an observational study. Fifty-five RA patients followed in the Rheumatology outpatient clinic and 55 control groups with similar demographic characteristics to this patient group were included in the study. The disease activity scores, cardiac parameters and Sestrin-1 levels of the participants were measured and both groups were compared. Results:There were no differences observed between the two groups in demographic characteristics. Right Carotid intima media thickness (CIMT) levels were found to be significantly higher in RA patients (p = 0.036). Sestrin-1 levels were determined to be significantly lower in RA patients compared to the control group (p<0.001). According to multivariate analysis results, a 1 unit decrease in Sestrin-1 measurement reduces the risk of RA by 0.633 times (p = 0.031). Conclusion:Our study is the first to show that decreasing of Sestrin-1 may play a potential role of subclinical atherosclerosis in RA patients. However, the nature of this relationship and the potential role of Sestrin-1 in the treatment of RA still requires further investigation.

Background The aim of this study was to investigate mortality in elderly patients diagnosed with massive pulmonary embolism (PE), and to examine the impact of thrombolytic therapy (TT) on mortality. Methods This retrospective cohort study included 109 patients. The clinical, demographic, and laboratory variables of the patients were compared between the survival and mortality groups, between those who received TT and those who did not, and across different age groups. Results The study results showed that the mortality group had a significantly higher mean age (79.4 ± 9.3 vs. 76 ± 7.2, p = 0.04). Key clinical features such as RV SM (p = 0.004) and PESI score (p = 0.03) were significantly different between the groups. Regarding TT, patients who received thrombolysis were younger (p = 0.004) and had a higher EF (p = 0.048). Additionally, RV SM was significantly higher in the TT group (p = 0.04), suggesting better overall RV function in treated patients. Mortality rates were significantly lower in the TT group (p = 0.003). Cox regression analysis identified that receiving TT in patients aged over 75 years was an independent predictor for reduced mortality (HR = 6.05, p = 0.002). Conclusion The findings suggest that TT may play a crucial role in reducing mortality, especially in the population over 75 years of age with massive PE. Age alone should not be a contraindication for TT in elderly patients with massive PE. TT should continue to be a cornerstone of treatment to improve right ventricular function and achieve hemodynamic stabilization.

Background: Contrast-induced nephropathy (CIN) is a serious complication following acute coronary syndrome (ACS), leading to increased morbidity and mortality. Machine learning (ML), combined with parameters such as shock indices, can potentially improve CIN risk prediction by analyzing complex variable interactions and creating accessible, clinically applicable models. Methods: This retrospective case-control study included 719 ACS patients who underwent percutaneous coronary intervention (PCI). Patients were divided into two groups (CIN and non-CIN), and clinical, procedural, and hemodynamic parameters, including shock indices, were analyzed using machine learning algorithms. A new predictive model, CIN-Predict 5, was developed using the Gradient Boosting Machine (GBM) algorithm, incorporating clinically relevant and statistically significant variables. Correlations between model predictions and secondary outcomes, including in-hospital mortality and hospitalization duration, were evaluated. Results: Among the variables used in the GBM algorithm, the Modified Shock Index emerged as the most significant predictor, with an importance score of 0.25. The CIN-Predict 5 model achieved an AUC of 0.87, outperforming the Mehran Risk Score (Area Under the Curve (AUC) = 0.75) for predicting CIN. The secondary outcomes showed that CIN-Predict 5 correlated significantly with in hospital mortality (r = 0.16, P < 0.001) and hospitalization duration (r = 0.20, P < 0.001). Conclusions: The GBM-based model we developed, utilizing shock indices and derived through ML, provides a practical tool for early identification of high-risk CIN patients post-ACS, enabling timely preventive strategies and improving clinical decision-making.

Background:The aim of this study was to determine changes in endothelial PAS domain protein-1 (EPAS-1) levels, a biomarker proven to increase with hypoxia, at the time of diagnosis and after treatment in addition to laboratory parameters and scoring systems examined at the time of admission in patients with pulmonary thromboembolism. Methods:The study included 60 pulmonary embolism (PE) patients followed at the Cardiology clinic and 60 control participants with similar demographic characteristics. Laboratory parameters determined at the time of admission were examined. PE risk and severity scores were calculated, and EPAS-1 levels were also measured. To determine the response, EPAS-1 levels were checked 3 days later and compared with the control group. Results:There were no differences between the two groups in terms of demographic characteristics and comorbidities. EPAS-1 levels were higher at the time of diagnosis compared to the control group [(3.6 ± 1.42/1.57 ± 0.45), p < 0.001]. EPAS-1 levels were significantly positively correlated with pulmonary embolism severity index (PESI) severity score and risk score in the patient group. EPAS-1 levels decreased after treatment in the patients, and the tendency to decrease was different according to the types of treatment. In the patients who died, EPAS-1 levels continued to increase despite treatment (p = 0.014). Conclusions:Our study is important in that EPAS-1 levels were correlated with scoring systems and other laboratory parameters used in PE patients, and that it can be used as a predictor in the diagnosis of the disease and play a complementary role in the evaluation of treatment response.

BACKGROUND:Acute decompensated heart failure (ADHF) is one of the leading causes of mortality, highlighting the importance of early identification of high-risk patients. The fibrosis-5 (FIB-5) index, traditionally used to evaluate hepatic fibrosis, may hold prognostic value in ADHF patients by reflecting systemic congestion, inflammation, and organ dysfunction. The hypothesis of this study is that the FIB-5 index is an independent predictor of 1-month mortality in patients with ADHF. METHODS:This retrospective study included 155 patients diagnosed with ADHF between 2020 and 2024. Patients were divided into two groups based on their left ventricular ejection fraction (LVEF ≤ 40% or LVEF > 50%). Survival was monitored for one month, and clinical, biochemical, and echocardiographic parameters were compared between survivors and death. Logistic regression and receiver operating characteristic curve analyses were performed to assess the prognostic value of the FIB-5 index. RESULTS:During the 1-month follow-up, 66 patients (42.6%) died. The mean FIB-5 index was significantly lower in non-survivors (-10.46 ± 6.93) compared to survivors (-8.10 ± 6.67) (P = 0.03). Multivariate regression analysis identified the FIB-5 index as an independent predictor of 1-month mortality (OR = 1.089, 95% CI: 1.022-1.160, P = 0.009). The receiver operating characteristic curve analysis demonstrated an area under the curve of 0.609 (95% CI: 0.51-0.699) with sensitivity of 59.6% and specificity of 63.4%. Kaplan-Meier survival analysis revealed significantly higher mortality rates among patients with lower FIB-5 values (log-rank: 7.887, P = 0.005). CONCLUSIONS:The FIB-5 index is an independent predictor of 1-month mortality in ADHF patients. Its low cost, non-invasive nature, and ability to reflect systemic inflammation and congestion make it a promising tool for risk stratification. Prospective studies are needed to validate its utility in clinical practice and evaluate its role in guiding therapeutic decisions.

Atrial fibrillation (AF) is one of the leading arrhythmias that causes serious complications. Our aim is to investigate the factors predicting the success of cardioversion in patients who underwent the procedure due to AF.

ABSTRACT:Background: Contrast-induced nephropathy (CIN) is a serious complication following acute coronary syndrome (ACS), leading to increased morbidity and mortality. Machine learning (ML), combined with parameters such as shock indices, can potentially improve CIN risk prediction by analyzing complex variable interactions and creating accessible, clinically applicable models. Methods: This retrospective case-control study included 719 ACS patients who underwent percutaneous coronary intervention (PCI). Patients were divided into two groups (CIN and non-CIN), and clinical, procedural, and hemodynamic parameters, including shock indices, were analyzed using machine learning algorithms. A new predictive model, CIN-Predict 5, was developed using the Gradient Boosting Machine (GBM) algorithm, incorporating clinically relevant and statistically significant variables. Correlations between model predictions and secondary outcomes, including in-hospital mortality and hospitalization duration, were evaluated. Results: Among the variables used in the GBM algorithm, the Modified Shock Index emerged as the most significant predictor, with an importance score of 0.25. The CIN-Predict 5 model achieved an AUC of 0.87, outperforming the Mehran Risk Score (Area Under the Curve (AUC) = 0.75) for predicting CIN. The secondary outcomes showed that CIN-Predict 5 correlated significantly with in hospital mortality (r = 0.16, P < 0.001) and hospitalization duration (r = 0.20, P < 0.001). Conclusions: The GBM-based model we developed, utilizing shock indices and derived through ML, provides a practical tool for early identification of high-risk CIN patients post-ACS, enabling timely preventive strategies and improving clinical decision-making.

Background/Aims: Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory arthritis associated with an increased cardiovascular (CV) risk due to persistent inflammation. Sestrin-1, a stress-inducible pro-tein with antioxidant and anti-inflammatory properties, has been impli-cated in cardiovascular protection. This study aimed to investigate the relationship between Sestrin-1 levels, cardiovascular markers, and echocar-diographic findings in r-axSpA patients. Materials and Methods: This controlled study included 48 r-axSpA patients diagnosed according to the modified New York criteria and 48 age- and sex-matched healthy controls. Demographic, biochemical, and echocar-diographic data were collected. Sestrin-1 levels were measured using an enzyme-linked immunosorbent assay kit, and carotid intima-media thick-ness (CIMT) was assessed via ultrasound. Statistical analyses evaluated dif-ferences between groups, as well as correlations between Sestrin-1 levels and inflammatory and cardiovascular parameters. Results: r-axSpA patients exhibited significantly lower Sestrin-1 levels com-pared to controls (P = .003). Sestrin-1 levels were negatively correlated with C-reactive protein (CRP) (r = -0.42) and erythrocyte sedimentation rate (ESR) (r = -0.38). Echocardiographic findings revealed increased CIMT (P< .001), reduced right ventricular systolic motion (RVSM), and lower tricus-pid annular plane systolic excursion (TAPSE) in r-axSpA patients. No sig-nificant correlation was observed between Sestrin-1 levels and disease activity, as measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP. Conclusion: r-axSpA patients exhibit reduced Sestrin-1 levels and signifi-cant subclinical cardiovascular changes, including increased CIMT and impaired right ventricular function. These findings suggest that dimin-ished Sestrin-1 may exacerbate oxidative stress and inflammation, thereby contributing to cardiovascular risk in r-axSpA. Further research is needed to explore the potential of Sestrin-1 as a biomarker for cardiovascular com-plications in r-axSpA.

Abstract Background and Objectives We aimed in this study was to determine the changes in EPAS-1 levels, which is a biomarker proven to increase with hypoxia, at the time of diagnosis and after treatment in addition to the laboratory parameters and scoring systems examined at the time of admission in patients with pulmonary thromboembolism. Methods Our study included 60 pulmonary embolism patients followed in the Cardiology clinic and 60 control groups with similar demographic characteristics. Laboratory parameters determined at the time of admission were examined. Pulmonary embolism risk and severity scores were applied and EPAS-1 levels were also studied. To determine the response, EPAS-1 levels were checked 3 days later and compared with the control group. Results There was no difference between the two groups in terms of demographic characteristics and comorbidities.EPAS-1 levels were found to be higher at the time of diagnosis compared to the control group ((3.6±1.42/1.57±0.45), p<0.001). It showed a statistically significant positive correlation with PESI severity score and risk score in the patient group. EPAS-1 levels were shown to decline with the treatment of the patients and the tendency to decline was different according to the types of treatment. In patients who died, EPAS-1 levels continued to increase despite treatment (p:0.014). Conclusions Our study is important in that EPAS-1 levels, which are correlated with scoring systems and other laboratory parameters used in pulmonary embolism patients, can be used as a predictive value in the diagnostic process of the disease and play a complementary role in the evaluation of treatment response.

Background/Aims: Polycythemia vera (PV) and essential thrombocythemia (ET) are chronic myeloproliferative diseases. Along with the increase in myeloproliferative cell lines, they can cause various clinical outcomes such as arterial and venous thrombosis, pulmonary hypertension, and myocardial infarction. This study was designed to evaluate the cardiac effects of these diseases via electrocardiography and echocardiography. Methods: A total of 50 patients with a diagnosis of PV, 50 patients with a diagnosis of ET, and 50 healthy individuals as a control group were included in this study. Data on patient demographics were recorded in all subjects. All patients and control subjects had electrocardiography (ECG) recordings and routine transthoracic echocardiographic examination. Pulse wave velocity (PWV) was assessed with a Holter blood pressure device. Results: In total, 50 PV patients, 50 ET patients, and 50 control group were included in the study. The demographic characteristics of the PV, ET and control groups were similar. The PR interval was significantly shorter in control subjects than in PV and ET patients (p:0.007, p:0.024). Although the measured values were within normal limits, diastolic posterior wall thickness was significantly lower in the control group compared to PV and ET patients (p:0.019, p:0.009). PWV was significantly higher in ET patients compared to the control group (p:0.012). Conclusion: In this study, evaluating the effects of PV and ET on electrocardiography and transthoracic echocardiography; ECG parameters used to predict ventricular arrhythmias (QT, QTc, Tp-Te, Tp-Te/QT) and Pulmonary Artery Pressure showed no significant change, in opposition to existing literature. Nonetheless, similar to previous publications, PV and ET were found to negatively affect the diastolic function parameters on transthoracic echocardiography. While the aortic stiffness was significantly higher in ET patients compared to the control group, no significant difference was noted between PV patients and control subjects in terms of aortic stiffness.

Aim: The aim of this study was to utilize optical coherence tomography-angiography (OCT-A) for evaluating changes in the retinal microvascular network, aiming to predict the cardiovascular risk profile among Acute Coronary Syndrome (ACS) patients and identify potential distinctive markers indicative of atherosclerosis risk. Material and Methods: This prospective study enrolled patients admitted to the intensive care unit with a diagnosis of ACS. Within the initial 72 hours of ACS onset, patients underwent ophthalmic examination, and selected parameters were assessed using OCT-A. Additionally, blood parameters, electrocardiographic and echocardiographic evaluations of the patients were performed on the first day. Results were compared with a control group. Results: The study comprised thirty male patients diagnosed with ACS and thirty healthy controls. OCT-A measurements revealed decreased densities in both the deep and superficial capillary plexuses among the ACS group, particularly notable in the perifoveal region (49.9-52.2, p:0.008). Additionally, the foveal avascular zone (FAZ) appeared broader in the ACS group (0.27-0.24, p:0.039). ACS patients exhibited lower HDL values and elevated white blood cell (WBC) and neutrophil counts compared to controls (p<0.001). Moreover, LVEF was significantly diminished in the ACS cohort compared to controls (LVEF: 49.7%-63.1%, p<0.001). Discussion: Our findings substantiate the adverse impacts on retinal microvasculature observed in the newly diagnosed Acute Coronary Syndrome (ACS) cohort devoid of known comorbidities or ocular issues. In light of these results, employing OCT-A in ophthalmic screenings is deemed potentially beneficial for predicting the cardiovascular risk profile.

Background Heart failure (HF) is a leading cause of hospitalization and mortality worldwide and places a great economic burden on healthcare systems. Identification of prognostic factors in HF patients is of great importance to establish optimal management strategies and to avoid unnecessary invasive and costly procedures in end-stage patients. Objectives In the current study, we aimed to investigate the association between diastolic strain parameters including E/e’ SR, and short-term outcomes in advanced HF patients. Methods The population study included 116 advanced HF with reduced ejection fraction (HFrEF) patients. Clinical, laboratory, and echocardiographic evaluations of the patients were performed within the first 24 hours of hospital admission. Patients were followed for one month and any re-hospitalization due to worsening of HF symptoms and any mortality was recorded. The level of significance adopted in the statistical analysis was 5%. Results E/e’ SR was significantly higher in the patient group compared to the control group (p=0.001). During one-month follow-up, 13.8% of patients died and 37.1% of patients were rehospitalized. Serum NT-ProBNP (p=0.034) and E/e’ SR (p=0.033) were found to be independent predictors of mortality and ACEİ use (p=0.027) and apical 3C strain (p=0.011) were found to be independent predictors of rehospitalization in the patient group. Conclusion Findings of the current prospective study demonstrate that E/e’ SR measured by speckle tracking echocardiography is an independent and sensitive predictor of short-term mortality in advanced HFrEF patients and may have a role in the identification of end-stage HFrEF patients.