Background: Coronary artery ectasia (CAE), while being considered a variant of atherosclerosis, harbors distinct features that significantly differ from atherosclerosis in terms of pathophysiological mechanisms. On the other hand, headache appears to be the most common side effect of nitrates that have been used traditionally for decades. In this context, we aimed to compare the frequency and temporal characteristics of nitrate-induced headache (NIH) between subjects with sole coronary artery disease (CAD) and subjects with CAD and coexisting CAE. Materials and Methods: Two hundred and forty-four patients who had undergone coronary angiogram (CAG) and received a single dose of sublingual isosorbide dinitrate during the procedure comprised in this retrospective study population. CAG is performed in the indications due to guidelines. All patients who had undergone CAG were held under close supervision, at least, for 6 h following CAG (and administration of sublingual nitrate); duration and emergence time of NIH were recorded for all patients. Of these 244 patients, 225 patients having sole CAD were assigned to Group I, whereas 19 patients having both CAD and CAE were assigned to Group II. Results: NIH was observed in 19 out of 225 patients (8%) with sole CAD and in 9 out of 19 patients (56%) with CAD and CAE (P = 0.003). The mean interval between the administration of sublingual isosorbide dinitrate and NIH onset was significantly lower in Group II in comparison to Group I (44 14 min vs. 87 +/- 63 min, respectively, P = 0.018). However, the duration of NIH was comparable between the two groups (Group I: 203 +/- 53 min vs. Group II: 173 +/- 61 min, P = 0.24); logistic regression analysis revealed an independent association between NIH and CAE (odds ratio: 11.5, 95% confidential interval: 3.9-33.8, P < 0.001). Conclusion: We have demonstrated that sublingual nitrates might induce NIH more frequently in subjects with CAE and CAD in comparison to those with sole CAD. Furthermore, NIH has been demonstrated to be independently associated with CAE.

Objective: This study aims to explore the impact of sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a newer class of oral antidiabetic drugs, on atrial electromechanical delay (EMD) in patients with type 2 diabetes mellitus (DM).This is particularly relevant given the significantly higher incidence of atrial fibrillation (AF) in diabetic patients compared to the general population.Atrial electromechanical delay is recognized as an important factor influencing the development of atrial fibrillation.Methods: This study included 30 type 2 DM patients (53.3% female, mean age 60.07 ± 10.03 years), initiating treatment with SGLT-2 inhibitors.The patients were assessed using echocardiography at baseline and again at 6 months, focusing on basic echocardiographic parameters and atrial electromechanical delay times (EMD) measured via tissue Doppler imaging.Results: No significant changes were observed in intra-atrial EMD times.However, significant reductions were noted in interatrial EMD times, decreasing from 15.13 ± 5.87 ms to 13.20 ± 6.12 ms (P = 0.029).Statistically significant shortening occurred in lateral pulmonary acceleration (PA) times (from 58.73 ± 6.41 ms to 54.37 ± 6.97 ms, P < 0.001), septal PA times (from 50.90 ± 6.02 ms to 48.23 ± 5), and tricuspid PA times (from 43.60 ± 6.28 ms to 41.30 ± 5.60 ms, P = 0.003).Additionally, there was a significant reduction in the E/e' ratio from 8.13 ± 4.0 to 6.50 ± 2.37 (P = 0.003). Conclusion:SGLT-2 inhibitors might positively influence atrial electromechanical conduction, reducing DM-related functional impairments and the risk of arrhythmias, particularly AF.

OBJECTIVE:The use of cardiac implantable electronic devices has increased in recent years. It has also brought some issues. Among these, the complications of cardiac implantable electronic devices infection and pocket hematoma are difficult to manage. It can be fatal with the contribution of patient-related risk factors. In this study, we aimed to find mortality rates in patients who developed cardiac implantable electronic devices infection and pocket hematoma over 5 years. We also investigated the risk factors affecting mortality in patients with cardiac implantable electronic devices. METHODS:A total of 288 cardiac implantable electronic devices patients were evaluated. Demographic details, history, and clinical data of all patients were recorded. Cardiac implantable electronic devices infection was defined according to the modified Duke criteria. The national registry was used to ascertain the mortality status of the patients. The patients were divided into two groups (exitus and survival groups). In addition, the pocket hematoma was defined as significant bleeding at the pocket site after cardiac implantable electronic devices placement. RESULTS:The cardiac implantable electronic devices infection was similar in both groups (p=0.919), and the pocket hematoma was higher in the exitus group (p=0.019). The exitus group had higher usage of P2Y12 inhibitors (p≤0.001) and novel oral anticoagulants (p=0.031). The Cox regression analysis, including mortality-related factors, revealed that renal failure is the most significant risk factor for mortality. Renal failure was linked to a 2.78-fold higher risk of death. CONCLUSION:No correlation was observed between cardiac implantable electronic devices infection and mortality, whereas pocket hematoma was associated with mortality. Furthermore, renal failure was the cause of the highest mortality rate in patients with cardiac implantable electronic devices.

BACKGROUND:Atrial fibrillation (AF) is one of the most common heart rhythm disorders. Identification and early treatment of AF risk factors can improve mortality and morbidity rates. This study aimed to compare the renal venous stasis index (RVSI) and intra-renal venous flow (IRVF) patterns evaluated by intra-renal Doppler ultrasonography in patients with AF and sinus rhythm (SR). MATERIAL AND METHODS:A total of 68 patients, 34 with AF (lasting >12 months AF) and 34 with SR (no previous diagnosis of AF and no AF attack in 24-h Holter monitoring) were included in the study. The RVSI was calculated, and the IRVF patterns were determined using intra-renal Doppler ultrasonography. High RVSI was defined as >0.12 RVSI. In addition, echocardiography and a 6-min walk test were performed. A model including diabetes mellitus, hypertension, creatine, Pro-BNP, left ventricular ejection fraction, presence of AF, and systolic pulmonary artery pressure was created to evaluate the effects of variables on high RVSI. RESULTS:The RVSI value was significantly higher in patients with AF than in those with SR (P=0.004). The SR group exhibited a higher prevalence of the continuous flow pattern, which is one of the IRVF patterns (P=0.015). In contrast, the biphasic flow pattern was observed more frequently in patients with AF (P=0.003). The presence of AF was found to predict the high RVSI (P=0.002, OR=14.134, 95% CI 2.083-71.277). CONCLUSIONS:The presence of AF may affect the IRVF and cause an increase in RVSI.

BACKGROUND: This study aimed to examine whether two different doses of dexamethasone (DXM), which is a corticosteroid, and amifostine (AMI), which reduces cumulative tissue toxicity induced by cisplatin in advanced-stage cancer patients, have ameliorative effects on pathologic changes associated with cardiac contusion (CC) induced in rats.METHODS: Forty-two Wistar albino rats were equally divided into six groups (n=7): C, CC, CC+AMI 400, CC+AMI 200, CC+AMI+DXM, and CC+DXM. Tomography images and electrocardiographic analyzes were performed, mean arterial pressure was measured from the carotid artery, and blood and tissue samples were obtained for histopathological and biochemical analyses after trauma-induced CC. RESULTS: While the total oxidant status and disulfide parameters in the cardiac tissue and serum were significantly higher (p<0.05), the total antioxidant status, total thiol, and native thiol parameters were significantly lower (p<0.01) in rats with trauma-induced CC. The most frequently observed finding in the electrocardiography analyze was ST elevation.CONCLUSION: According to evaluation based on histological, biochemical, and electrocardiographic examinations, we believe that only 400 mg/kg dose of AMI or DXM can be effective in the treatment of myocardial contusion in rats. Evaluation based on histological findings.

Objective: The post-COVID-19 process is not completely understood, as it affects COVID-19 survivors at all levels of disease severity, not all of whom are hospitalized. One of the long-lasting COVID-19 symptom categories, cardiovascular disorders (including acute heart failure, palpitations, hypotension, venous thromboembolic diseases, arrhythmias, myocarditis, and increased heart rate), may derive from a systemic inflammatory response to the viral infection. NETs (neutrophil extracellular traps) that fight invading viruses in extracellular cardiac spaces accumulate due to COVID-19, hyperinflammation and cytokine storms. Our study focuses on cardiovascular disorders as COVID-19 sequelae. To determine the role of NETs in these disorders, we aimed to measure levels of PAD4, MPO, MMP-9, and H3Cit. Methods: In this study, forty people with long-term cardiac complications associated with a history of COVID-19 were recruited along with forty healthy people. Results: We found significant differences in PAD4, H3Cit, and MPO plasma levels between the post-COVID-19 and control groups (p values < 0.05). The expression levels of PAD4 mRNA were lower and MMP-9 mRNA levels was higher in the post-COVID-19 group compared with the control subjects. Conclusion: These findings suggest that PAD4, MPO, MMP-9, and H3Cit are potential biomarkers of NET dysregulation and may cause post-COVID-19 symptoms, especially cardiovascular disorders.

Background/Aim: Evidence of increased mortality in perfusion abnormalities on myocardial perfusion scintigraphy (MPS) can be found. However, electrocardiography (ECG) is a cheaper and more easily accessible examination than MPS. Fragmented QRS (fQRS) is also considered to be associated with mortality in some cardiological diseases. The present study aimed to analyze the relationship between fQRS based on electrocardiography (ECG) and mortality in patients without reversible defects whose fixed hypoperfusion/perfusion defects were diagnosed and associated with myocardial infarction (MI) based on myocardial perfusion scintigraphy (MPS). Methods: Non-ischemic patients (2289 patients) with MI diagnoses based on scintigraphy were selected based on retrospective scintigraphy reports. The presence of fQRS was investigated in 85 patients whose 12-lead electrocardiographs could be accessed from the hospital archive, and their deaths due to all causes were questioned from the death information system. The relationship between left ventricular ejection fraction (LVEF), fQRS, type of exercise, number of leukocytes, other parameters, and mortality rates was analyzed. Results: The numbers of living (n = 69) and deceased (n = 16) patients were obtained. They were divided into two groups: (1) surviving patients (n = 69, number of fQRS positive 42) and (2) deceased (n = 16, number of fQRS positive 11). No distributional differences were found between mortality rates and fQRS and demographic features between groups (P = 0.558). However, a statistically significant effect was observed between mortality rates and low LVEF levels, pharmacological stress, number of leukocytes, and a low HDL level. Conclusion: The present study suggests that it may be useful to define benign features of fQRS. LVEF levels may be a very important parameter in decision-making for pharmacological stress, and its role in prediction of mortality may be higher than that obtained by fQRS.

OBJECTIVE:Cardiac autonomic neuropathy is a serious microvascular complication of type 2 diabetes mellitus that affects a significant portion of patients. Due to decreased parasympathetic activity, the sympathetic nervous system becomes dominant, causing several problems that lead to increased cardiovascular morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors have been shown to reduce sympathetic nervous system activity previously. This is a promising finding for restoring the impaired sympathovagal balance in cardiac autonomic neuropathy. The aim of this study is to evaluate the effect of at least 6 months of sodium-glucose cotransporter-2 inhibitor treatment on sympathetic nervous system activity with sympathetic activity index and heart rate variability parameters in patients with type 2 diabetes mellitus.METHODS:Holter-electrocardiogram recordings of 50 patients who were using an sodiumglucose cotransporter-2 inhibitor (empagliflozin or dapagliflozin) for at least 6 months and 50 patients who did not were analyzed retrospectively. The sympathetic activity index and heart rate variability parameters of these 2 groups, which were similar in terms of age, gender, hemoglobin A1c, and duration of diabetes, were compared.RESULTS:The ratio of low-frequency to high-frequency power reflecting the sympathovagal balance [-1.495 (-2.165/-1.196) vs. -1.224 (-1.619/-0.863), P=.008] and sympathetic activity index [1.44 (1.06/2.76) vs. 2.47 (1.42/3.68), P=.009] was lower in the sodiumglucose cotransporter-2 inhibitor group than in the control group. In addition, the sympathetic activity index was correlated with the ratio of low-frequency to high-frequency power (r=0.418, P < .001).CONCLUSION:Sodium-glucose cotransporter-2 inhibitor treatment for at least 6 months was found to result in lower values of sympathetic activity index and the ratio of low-frequency to high-frequency power in patients with type 2 diabetes mellitus. These findings indicate lower sympathetic nervous system activity, which supports the sympathoinhibitor effects of sodiumglucose cotransporter-2 inhibitors.

Journal of Cardiovascular ElectrophysiologyVolume 34, Issue 1 p. 241-245 EP ROUNDS Multiple wide QRS tachycardias in the same individual with ischemic cardiomyopathy Elif Hande Ozcan Cetin MD, Elif Hande Ozcan Cetin MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorAhmet Korkmaz MD, Ahmet Korkmaz MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorMeryem Kara MD, Meryem Kara MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorIdriz Merovci MD, Idriz Merovci MD orcid.org/0000-0003-4483-8158 Department of Cardiology, University Clinical Center of Kosovo, Prishtina, KosovoSearch for more papers by this authorKemal Gocer MD, Kemal Gocer MD Department of Cardiology, Kahramanmaraş Sütçü Imam University, Kahramanamaras, TurkeySearch for more papers by this authorEkrem Aksu MD, Ekrem Aksu MD Department of Cardiology, Kahramanmaraş Sütçü Imam University, Kahramanamaras, TurkeySearch for more papers by this authorSuhaib Abusaif MD, Suhaib Abusaif MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorOzan Oguz MD, Ozan Oguz MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorOzcan Ozeke MD, Corresponding Author Ozcan Ozeke MD [email protected] orcid.org/0000-0002-4770-8159 @ozcanozeke Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, Turkey Correspondence Ozcan Ozeke, MD, Sağlık Bilimleri Üniversitesi, Ankara Şehir Hastanesi, Kardiyoloji Klinigi, Bilkent, Ankara 06800, Turkey. Email: [email protected]Search for more papers by this authorSerkan Cay MD, Serkan Cay MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorFirat Ozcan MD, Firat Ozcan MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorDursun Aras MD, Dursun Aras MD Department of Cardiology, İstanbul Medipol University, İstanbul, TurkeySearch for more papers by this authorSerkan Topaloglu MD, Serkan Topaloglu MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this author Elif Hande Ozcan Cetin MD, Elif Hande Ozcan Cetin MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorAhmet Korkmaz MD, Ahmet Korkmaz MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorMeryem Kara MD, Meryem Kara MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorIdriz Merovci MD, Idriz Merovci MD orcid.org/0000-0003-4483-8158 Department of Cardiology, University Clinical Center of Kosovo, Prishtina, KosovoSearch for more papers by this authorKemal Gocer MD, Kemal Gocer MD Department of Cardiology, Kahramanmaraş Sütçü Imam University, Kahramanamaras, TurkeySearch for more papers by this authorEkrem Aksu MD, Ekrem Aksu MD Department of Cardiology, Kahramanmaraş Sütçü Imam University, Kahramanamaras, TurkeySearch for more papers by this authorSuhaib Abusaif MD, Suhaib Abusaif MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorOzan Oguz MD, Ozan Oguz MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorOzcan Ozeke MD, Corresponding Author Ozcan Ozeke MD [email protected] orcid.org/0000-0002-4770-8159 @ozcanozeke Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, Turkey Correspondence Ozcan Ozeke, MD, Sağlık Bilimleri Üniversitesi, Ankara Şehir Hastanesi, Kardiyoloji Klinigi, Bilkent, Ankara 06800, Turkey. Email: [email protected]Search for more papers by this authorSerkan Cay MD, Serkan Cay MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorFirat Ozcan MD, Firat Ozcan MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this authorDursun Aras MD, Dursun Aras MD Department of Cardiology, İstanbul Medipol University, İstanbul, TurkeySearch for more papers by this authorSerkan Topaloglu MD, Serkan Topaloglu MD Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, TurkeySearch for more papers by this author First published: 13 December 2022 https://doi.org/10.1111/jce.15776 Disclosures: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat REFERENCES 1Aslan AO, Merovci I, Tunçez A, et al. Widening of the QRS complex during the wide complex tachycardia: what is the mechanism. J Cardiovasc Electrophysiol. 2022; 33(7): 1605-1608. 10.1111/jce.15567 PubMedWeb of Science®Google Scholar 2Klein GJ, Guiraudon GM, Kerr CR, et al. “Nodoventricular” accessory pathway: evidence for a distinct accessory atrioventricular pathway with atrioventricular node-like properties. 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OBJECTIVE:To investigate the relationship between chronic total occlusion (CTO) development and oxidative stress markers in stable coronary artery patients.STUDY DESIGN:A cohort study.PLACE AND DURATION OF STUDY:Cardiology Clinic, Kahramanmaras Sutcu Imam University Medical Faculty, between January 2018 and December 2019.METHODOLOGY:Patients, who underwent coronary angiography for stable chest pain, were consecutively included. The study group consisted of those with CTO and the control group from those without CTO. Serum total oxidant/anti-oxidant, dynamic thiol/disulfide, antioxidant (ascorbate, alfa-tocopherol, beta-carotene) vitamin levels, and routine biochemistry tests of the patients were compared.RESULTS:The study group (24 men, 5 women, mean age 63.79 ± 9.21 years) and control group (23 men, 6 women, mean age 61.38 ± 8.20 years) consisted of 29 patients each. The oxidative stress markers (total thiol, native thiol, disulfide, reduced thiol ratio, oxidized thiol ratio, thiol oxidation-reduction ratio, total antioxidant status, total oxidant status, and vitamin E) were found to have similar values between the groups. However, of the anti-oxidative vitamins, vitamin C, vitamin A and vitamin C/vitamin E ratio were significantly lower in the CTO group and predicted a CTO lesion (AUC: 0.084, p<0.001, 95% CI: 0.007-0.162; AUC: 0.285, p=0.005, 95% CI: 0.154-0.416 and AUC: 0.181, p <0.001, 95% CI: 0.062-0.299, respectively).CONCLUSION:The lower serum vitamin C and vitamin A levels and low vitamin C/vitamin E ratio may be useful in predicting the risk of CTO in stable patients with non-critical stenosis in coronary angiography.KEY WORDS:Chronic total occlusion, Oxidative balance, Stable coronary artery disease, Vitamin A, Vitamin C, Vitamin C / vitamin A ratio.

Background: Cardiac autonomic neuropathy is a frequent complication of type 2 diabetes mellitus. Cardiac autonomic neuropathy, in which sympathetic tone predominates over parasympathetic activity, increases both cardiovascular morbidity and mortality and unfortunately has no definitive treatment. Sodium-glucose cotransporter-2 inhibitors have been suggested to reduce sympathetic nervous system activity, based on the results from previous studies. In this study, we aimed to investigate the effect of 24-week treatment with dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, on cardiac autonomic function measures in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy. Methods: Dapagliflozin 10 mg/day (n=42) or non-sodium-glucose cotransporter-2 inhibitor oral antidiabetic(s) (n=38) was added to the treatment of patients whose glycemic control could not be achieved with existing treatments. The patients with definite or confirmed cardiac autonomic neuropathy diagnosed by cardiovascular autonomic reflex tests underwent 24-hour Holter-electrocardiogram recordings to obtain heart rate variability and heart rate turbulence parameters before starting additional medication and after a 24-week treatment period. Results: In-group analyses showed that dapagliflozin 10 mg/day for 24 weeks improved heart rate variability and heart rate turbulence parameters and decreased the frequency of ventricular premature beats relative to their baseline values. No such findings were observed in the control group despite similar glycemic control. Comparisons between dapagliflozin group and the control group showed that these effects of dapagliflozin were significantly better than non-sodium-glucose cotransporter-2 inhibitor oral antidiabetics. Conclusion: Dapagliflozin improves measures of cardiac autonomic function compared to the control group in type 2 diabetic patients with cardiac autonomic neuropathy. This intergroup benefit, demonstrated for the first time, may be promising for the regression of cardiac autonomic neuropathy with sodium-glucose cotransporter-2 inhibitors.

OBJECTIVE: Altered cardiac repolarization is an important mechanism in the development of malignant cardiac arrhythmia and in the occurrence of sudden cardiac death. It is known that the risk of cardiac arrhythmia and sudden death is increased in patients with chronic obstructive pulmonary disease. Evaluating the measurements of repolarization in the electrocardiogram may provide useful information to determine potential risks for lethal arrhythmias in the patients with chronic obstructive pulmonary disease. In the present study, we investigated the possible relationships between repolarization parameters in the electrocardio and demographic, clinical, and biochemical findings in patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS: In the present study, 35 patients with Global Initiative for Chronic Obstructive Lung Disease A-B constituted group 1 and 35 patients with Global Initiative for Chronic Obstructive Lung Disease C-D constituted group 2. Cardiac repolarization and dispersion (QTc interval and QT dispersion) were measured on 12-lead electrocardiogram. QTc interval, QT dispersion, TP-e, and Tp-e/ QTc were evaluated in order to determine the patients at risk of sudden cardiac death. QTc interval >440 ms in men and >460 ms in women was considered as prolonged QTc interval. RESULTS: QTc and QTd values were found to be statistically significantly prolonged in the group of GOLD C-D compared to the group of GOLD A-B (P <.001). QTc value showed negative correlation with the ratio of forced expiratory volume in 1 second to forced vital capacity and partial pressure of oxygen (P =.030, r = -0.260; P=.006, r = -0.332, respectively). No significant difference was in Tp-e and Tp-e/QTc between the groups (P=.73, P=.12, respectively). CONCLUSION: QTc and QTd are non-invasive markers reflecting arrhythmogenicity, and our findings were found to be related to prolonged QTc and QTd in patients with chronic obstructive pulmonary disease. Prolongation in the dispersion of repolarization and altered cardiac repolarization in the population with chronic obstructive pulmonary disease may be related to hypoxemia and airway obstruction. Alterations in the cardiac repolarization may put these patients at high risk for malignant ventricular arrhythmia and sudden cardiac death.

Aim Cardiac autonomic dysfunction is encountered in approximately 25 % of patients with metabolic syndrome (MetS). 24 hr Holter-ECG based heart rate variability (HRV) and heart rate turbulence (HRT) parameters are used to evaluate cardiac autonomic function. We aimed to investigate the relationship between a novel insulin resistance marker, triglyceride glucose (TyG) index and cardiac autonomic dysfunction in patients with MetS.Material and methods We examined a total of 400 non-diabetic subjects, 136 with MetS and 264 without MetS. All underwent TyG index calculations, and 24 hr Holter-ECG recordings for the measurement of HRV and HRT parameters.Results HRV and HRT parameters were lower or higher in patients with MetS than in subjects without MetS, indicating cardiac autonomic dysfunction. We observed significant correlations between TyG index and measures of cardiac autonomic function. Multiple linear regression analysis showed that the TyG index was an independent predictor of almost all HRV and HRT parameters.Conclusion This study demonstrates the independent relationship between cardiac autonomic dysfunction and the TyG index, a novel marker of insulin resistance in non-diabetic patients with MetS.

On January 7, 2020, it was announced that the Chinese Government isolated a new variant of Coronavirus (SARS CoV-2). Officials reported that populations were not equally affected in terms of the number of cases, severe illness, and death. As of 28 December 2020, 81,000,000 cases have been confirmed globally, and approximately 1,770,000 total deaths have been reported for COVID-19. Besides difficulties of COVID-19 management in the acute stage, long-term consequences of the infection could cause widespread public health problems across the World. This review article aims to examine current literature regarding COVID-19, identify post-illness sequelae, detect patients at risk for sequelae, and provide guidance to management strategies. In the report, long-term pulmonary sequels and systemic problems including cardiovascular, neurological, psychiatric, endocrinologic, nephrological, hematologic, gastrointestinal, dermatologic, etc. of COVID-19 are discussed in accordance with recent scientific publications.

Introduction: The non-invasive approach has become the first choice for the acute non-ST elevation myocardial infarction-acute coronary syndrome (NSTEMI-ACS) during the Coronavirus Disease-2019 (COVID-19) pandemic. However, most of these patients require interventional treatment. In this study, the possible role of hematological inflammatory markers in differentiating medium-high risk NSTEMI-ACS patients according to the GRACE risk classification in need of interventional treatment was investigated. Patients and Methods: Patients who underwent coronary angiography with the diagnosis of NSTEMI-ACS in a tertiary cardiology clinic between January 2018 and December 2019 were included in the study, which was designed as a retrospective cohort study. NSTEMI-ACS patients (n= 276), except for patients with exclusion criteria (n= 32), were divided into two groups as those in need of invasive treatment (n= 217) and medical treatment (n= 59) according to the results of coronary angiography. The hematological inflammatory markers were compared between groups. Results: Neutrophil to lymphocyte ratio (NLR) (AUC: 0.637, 95% CI: 0.563-0.712, p= 0.001) and systemic immune-inflammation index (SII) (AUC: 0.622, 95% CI: 0.545-0.699, p= 0.004) predicted the requirement of interventional treatment in NSTEMI-ACS. Conclusion: It is unclear whether the NLR and SII elevation, which may be a predictor of the need for invasive treatment, is a cause or a consequence of the pathophysiological process in patients with NSTEMI-ACS. However, elevated NLR and SII values can help distinguish NSTEMI-ACS patients who need invasive treatment during the COVID-19 pandemic. The results of this study, show the need for large-sized studies to determine the ideal cut-off point of NLR and SII levels in determining the treatment strategy for NSTEMI-ACS.

Purpose:The study was carried out descriptively in order to determine the attitudes of the nurses to the safe use of medical instruments. Patients and Methods:: In the collection of data, the student information form which contains the introductory features of the students consisting of eight questions was used, and the attitude scale for the safe use of medical tools by the health workers was used. In the evaluation of the data obtained from the study, number, percentage distribution, means, Independent-sample t-test, One-way ANOVA test were used Results:The scores of the affective subscale scores of the students aged 21 and over, the behavioral subscale scores of the females, the cognitive subscale scores of the 4th grade students, the total scale scores of the students receiving education and the behavioral subscale scores were found to be significantly higher (p <0.05). Conclusion:It was determined that the students whose age and clinical experience increased and received education increased their attitudes towards safe use of medical instruments. It is advisable to provide training to the students before starting clinical practice, and to develop and disseminate institutional policies to prevent the use of hospital authorities for stab wounds.

Background/Aim: Hypertension is well defined in preeclamptic individuals and those with a history of preeclampsia. However, the relationship between blood pressure pattern and fragmented QRS on electrocardiography (ECG) has not been elucidated in normotensive patients with a history of preeclampsia. This study aimed to investigate the frequency of non-dipper blood pressure (BP) patterns in normotensive individuals with a history of preeclampsia and to evaluate the relevance of this pattern to fragmented QRS (fQRS). Methods: Sixty-three normotensive (office BP measurement) patients with a history of preeclampsia were included in this study between August 2020 and January 2021. These individuals underwent 24-hour ambulatory BP monitoring. The patients were divided into two groups as dipper and non-dipper, according to their BP patterns. The two groups were compared in terms of echocardiographic parameters, laboratory values, and QRS fragmentation on ECG. Results: Left ventricular diastolic dysfunction (LVDD) diagnosed by echocardiography (P= 0.015) and fQRS on ECG (P=0.002) were significantly higher in the non-dipper group than in the dipper group. Tricuspid regurgitation velocity (P=0.004) and average E/e' ratio (P

DOI: 10.14744/ejmi.2021.79007 EJMI 2021;5(2):172–179

BACKGROUND:Preeclampsia increases the risk of cardiovascular mortality and morbidity both during pregnancy and long term after the labor by causing cardiac changes that may lead to atrial and ventricular arrhythmias. OBJECTIVE:We aimed to investigate noninvasive predictors of atrial and ventricular arrhythmias and cardiac structural changes in preeclampsia. METHODS:The study included 34 preeclampsia patients as the study group and 33 healthy pregnant women as the control group. The presence of fragmented QRS morphology, P dispersion, QT dispersion, Tp-e/QTc ratio, inter- and intra-atrial electromechanical delay, left ventricular mass index was evaluated in the groups by 12 lead- ECG and standard and tissue Doppler echocardiography. RESULTS:Left ventricular mass index and relative wall thickness, and E/Em ratio was significantly higher in preeclampsia. Inter- and intra-atrial electromechanical delay and Tp-e were prolonged, and P dispersion, QT dispersion, and Tp-e/QTc ratio were increased significantly in patients with preeclampsia. In addition, fragmented QRS morphology was seen in 76.5% of patients with preeclampsia while it was present in only 27.3% of the control group (p < .001). CONCLUSION:Preeclampsia causes significant cardiac structural and electrocardiographic alterations that may increase the risk of atrial and/or ventricular arrhythmias. A more thorough and earlier cardiac assessment and closer follow-up of these patients would be useful to avoid further complications.