Objective: The aim of this study was to investigate changes in heart rate variability (HRV) and QT dispersion (QTd) in patients with differentiated thyroid cancer at different TSH suppression levels. Methods: The study included 125 DTC patients, who had been on TSH suppression treatment (TSHST) for at least 1 year. The patients were categorized into three groups: patients with TSH < 0.1 mIU/L (n:30), those with TSH 0.1 to 0.5 mIU/L (n:56), and those with TSH 0.5 to 2 mIU/L (n:39). The first two groups were classified as suppression groups, and the last as replacement (control) group. All patients underwent 12-lead electrocardiogram (ECG) recording and 24-hour rhythm holter echocardiography analysis. Results: The HRV results derived from a 24-hour rhythm holter did not exhibit any significant difference (p < 0.05). In dispersion evaluations, the QTd was significantly longer in the suppression groups (groups 1 and 2), than in the replacement group (group 3) (p < 0.001 and p:0.002, respectively). The same was found for corrected QT dispersion (QTcd) (p < 0.001 and p: 0.008, respectively). In multivariate linear regression analysis, TSH was found to affect QTd (beta = -0.299; p = 0.002) and QTcd (beta = -0.300; p = 0.002) values independently. Conclusion: In this study, it was shown that in patients with DTC receiving TSHST, QT dispersion prolonged as the TSH suppression level increased. Especially in high-risk DTC patients, evaluation of QTd may be useful in terms of evaluating cardiovascular risk and regulating TSHST level.
AMAÇ: Bu çalışmanın amacı opere diferansiye tiroid kanserli (DTK) hastalarda tiroid-stimüle edici hormon (TSH) supresyon düzeylerine göre kardiyak yapı ve diyastolik fonksiyonlardaki değişikliklerin araştırılmasıdır. GEREÇ VE YÖNTEM: Kesitsel olarak dizayn edilen bu araştırmaya hastanemiz endokrinoloji polikliniğinde takipli, tiroid cerrahisi sonrası bir yıldan uzun süredir tiroid hormon replasmanı ve TSH supresyon tedavisi alan 125 DTK’lı hasta dahil edildi. Çalışmamızda olgular American Thyroid Association (ATA) 2015 kılavuzu risk değerlendirmelerine uygun olarak gruplara ayrılmıştır. Buna göre hastalar birinci grup TSH seviyesi <0,1 mIU/L olanlar (n:30), ikinci grup TSH düzeyi 0,1-0,5 mIU/L arasında olanlar (n:56) ve üçüncü grup ise TSH düzeyi 0,5-2 mIU/L arasında olanlar (n:39) şeklinde üç gruba kategorize edilmiştir. İlk iki grup supresyon, 3. grup ise replasman (kontrol) grubu olarak belirlenmiştir. Tüm hastalara M-mode ve pulse-vave doku dopler ekokardiyografi yapılmıştır. BULGULAR: Sol ventrikül diyastol sonu çapı (EDD), TSH aralığı <0,1 mIU/L olan grupta, replasman grubuna göre anlamlı olarak daha uzun bulunmuştur (45,35±3,54 ve 42,74±6,08; p=0,016). Yine erken diastolik dolumda mitral kapak velositesini gösteren E velocity grup 1 de, replasman grubuna göre anlamlı olarak daha düşük bulunmuştur (0,7(0,6-0,8) ve 0,84(0,7-0,98); p=0,010). A, E’ velositeleri ve E/A oranı gruplar arasında farklılık göstermemiştir. SONUÇ: Diferansiye tiroid kanseri nedeniyle TSH supresyon tedavisi alan hastalarda, klinik semptom olmamasına rağmen, farklı TSH supresyon düzeylerinde, miyokard yapı ve fonksiyonlarında değişiklikler farklı olabilmektedir. Diyastolik disfonksiyonun erken saptanması açısından özellikle yüksek riskli DTK grubunda kardiyak değerlendirmelerin yapılması önemlidir. TSH supresyonu yapılan hastaların takiplerinin aksatılmaması ve supresyon seviyelerinin bireysel olarak uyarlanması gereklidir.
Resumo Fundamento A patologia subjacente da ectasia da artéria coronária (EC) isolada não foi totalmente elucidada. Objetivo Nosso objetivo foi examinar a relação entre o índice de inflamação imune sistêmica (Sıı), que corresponde à multiplicação da razão neutrófilos-linfócitos (RNL) e as contagens de plaquetas, e EC isolada. Método A população do estudo retrospectivo incluiu 200 pacientes com EC isolada, 200 consecutivos com doença arterial coronariana obstrutiva e 200 consecutivos com angiografia coronária normal. Um valor de p bicaudal <0,05 foi considerado significativo. Resultados Sıı, RNL, razão plaqueta-linfócito (RPL) e razão monócito-colesterol de lipoproteína de alta densidade (MHR) foram significativamente maiores no grupo EC em comparação com os outros grupos (todos p<0,001). Na análise multivariada, Sıı (p<0,001, OR = 1,005, IC 95% =1,004-1,005) foi considerado um preditor independente de EC isolada. Na análise da curva Receiver Operating Characteristic (ROC), Sıı teve uma área sob a curva maior em comparação com RNL, RPL e MHR. O valor de Sıı >517,35 tem 79% de sensibilidade, 76% de especificidade para a predição do EC [AUC: 0,832, (p<0,001)]. Sıı teve correlação significativa com o número de artérias coronárias ectásicas e classificação de Markis (r: 0,214 p=0,002; r:-0,195, p=0,006, respectivamente). Conclusão Até onde sabemos, este é o primeiro estudo em que Sıı foi significativamente associado à presença isolada de EC e gravidade anatômica.
BACKGROUND:The underlying pathology of isolated coronary artery ectasia (CE) has not been fully elucidated. OBJECTIVE:We aimed to examine the relationship between the systemic immune inflammation index (Sıı), which corresponds to the multiplying of the neutrophil-to-lymphocyte ratio (NLR) and the platelet counts, and isolated CE. METHOD:The retrospective study population included 200 patients with isolated CE, 200 consecutive with obstructive coronary artery disease, and 200 consecutive with a normal coronary artery angiogram. A 2-sided p-value of <0.05 was considered significant. RESULTS:Sıı, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-high density lipoprotein cholesterol ratio (MHR) were significantly higher in the CE group compared with the other groups (all p<0.001). In multivariate analysis, Sıı (p<0.001, OR = 1.005, 95% CI =1.004-1.005) was found to be an independent predictor of isolated CE. In Receiver Operating Characteristic curve analysis, Sıı had a higher Area Under the Curve than NLR, PLR, and MHR. Sıı value of >517.35 has 79% sensitivity, 76% specificity for the prediction of the CE [AUC: 0.832, (p<0.001)]. Sıı had a significant correlation with the number of ectatic coronary arteries and Markis classification (r:0.214 p=0.002; r:-0.195, p=0.006, respectively). CONCLUSION:To the best of our knowledge, this is the first study that Sıı was significantly associated with isolated CE presence and anatomical severity.
As inflammation plays a significant role in the development of coronary artery disease, we hypothesized that there may be a relation between the systemic immune inflammation index (SII) and saphenous vein graft disease (SVGD). The study population consisted of 716 consecutive patients who underwent elective coronary angiography (CAG) >1 year after bypass grafting. The patients were divided into 2 groups depending on the extent of SVG patency. SII value was significantly higher in the SVGD(+) group compared with the SVGD(−) group ( P < .001). In multivariate logistic regression analysis, SII ( P < .001, odds ratio (OR) = 3.27, 95% CI = 1.94–5.65) and neutrophil-to-lymphocyte ratio (NLR) ( P < .001, OR = 2.08, 95% CI = 1.59–3.11) were found to be independent predictors of SVGD. An SII value of >935 (x103/ml) has 89.2% sensitivity and 70.6% specificity for the prediction of the SVGD, and an NLR value of >4.15 has 54.6% sensitivity and 68.5% specificity for the prediction of the SVGD. The AUC of SII was found to be greater than the AUC of NLR ( P = .002), platelet-to-lymphocyte ratio (PLR) ( P = .009), lymphocyte-to-monocyte ratio (LMR) ( P = .013), MPV ( P = .011), and C-reactive protein (CRP) ( P = .034) in predicting SVGD. In conclusion, we demonstrated that SII, which is among the new inflammation indexes, is a more reliable predictor in determining SVGD than the NLR, PLR, and LMR.
Introduction: Atrial dispersion showing increased electrical heterogeneity may be associated with the occurence of atrial fibrillation (AF). In our study, it was aimed to investigate the effects of atrial dispersion evaluated by speckle tracking echocardiography on the occurence of AF on in patients with mild to moderate rheumatic mitral stenosis. Patients and Methods: Sixty-two patients with rheumatic mitral stenosis with sinus rhythm, asymptomatic or NYHA 1 symptoms were included in the study. The time to peak atrial strain was measured for each segment by speckle tracking echocardiography in two and four-chamber views. Atrial dispersion was calculated by taking the standard deviation of time to peak strain in 12 left atrial segments. Echocardiographic and clinical parameters of the patients were compared according to the development of AF. Results: During follow-up (mean follow-up duration, 49.9 ± 12.9 months), 19 patients (30%) developed AF. Compared to patients who did not develop AF at follow-up, patients with AF were older (46.8 ± 10.2 vs. 35.9 ± 12, p= 0.001), while mitral valve area (MVA) (1.38 ± 0.1 vs. ± 1.49 ± 0.18 vs. p= 0.02), PALS (13.7 ± 4 vs. 18.8 ± 5.5, p= 0.001) and PACS (6 ± 2.3 vs. 8.2 ± 3.8, p= 0.002) were found to be lower. Atrial dispersion was found to be increased in patients who developed AF (63.2 ± 13.5 vs. 46.1 ± 22.3, p= 0.003). Age, atrial dispersion and PALS were determined as independent predictors of AF development in Cox regression analysis. Conclusion: Atrial dispersion, a new parameter measured by STE, predicts the development of AF. Increased atrial dispersion may provide additional benefits in initiating prophylactic antiarrhythmic drug therapy or anticoagulants.
The effect of physiological circulatory changes during pregnancy on hypertrophic cardiomyopathy (HCM) has been reported with limited data. This study aimed to provide information regarding outcomes of pregnant women with HCM and to identify predictors of major adverse cardiac event (MACE). A total of 45 pregnancies with HCM were retrospectively reviewed. The primary endpoint was a MACE that occurred within an 8‑week period after delivery, including maternal death, heart failure (HF), syncope, and malignant ventricular arrhythmias (VAs). Baseline and outcome data were analyzed for all patients. Patients with and without MACE were compared, and patients with obstructive HCM were compared with those who had non-obstructive HCM. The study population was divided into two subgroups of patients having or not having an implantable cardioverter defibrillator implantation (ICD). At least one MACE occurred in 11 patients (24.4
Background: In this study, we investigated whether left atrial functions evaluated by speckle tracking echocardiography , classic echocardiographic and clinic parameters predict appropriate Implantable Cardioverter Defibrillator (ICD) shock in patients who underwent ICD implantation for hypertrophic cardiomyopathy. Methods: Totally 87 patients who received ICD implantation for primary or secondary prevention were included in the study. Patients' clinical, electrocardiographic, 2 dimension classic, and speckle tracking echocardiographic data were collected. Left atrial functions were assessed by speckle tracking echocardiography. Left atrial strain just before mitral valve opening was taken as peak atrial longitudinal strain. Appropriate ICD therapy was defined as cardioversion or defibrillation due to ventricular tachycardia or fibrillation. Patients were divided into 2 groups as occurrence or absence of appropriate ICD therapy during follow-up (mean, 50.2 +/- 9.3 months). Patients with an European Society of Cardiology (ESC) risk score >6% were considered high-risk patients. Results: A total of 24 (27.5%) patients were observed to have an appropriate ICD therapy. In patients on whom appropriate ICD therapy was performed, a higher Sudden Cardiac Death risk Score and decreased peak atrial longitudinal strain and global longitudinal peak strain were observed. In patients with high ESC risk score (> 6%), in Cox regression analysis, peak atrial longitudinal strain (odds ratio: 0.806, P= .008), Sudden Cardiac Death risk score (odds ratio: 1.114, P= .03) and global longitudinal peak strain (odds ratio: 1.263, P = .02) were found to be independent predictors of occurrence of appropriate ICD therapy. Conclusion: Easily measurable peak atrial longitudinal strain may provide additional information in predicting ventricular arrhythmias or deciding on prophylactic medical treatment to prevent ventricular arrhythmias or reduce the frequency of appropriate shock in high-risk patients with ICD implanted.
OBJECTIVE:Contrast-induced nephropathy (CIN) is a serious complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI). An interarm systolic blood pressure difference (IASBD) ≥10 mmHg has been identified as an independent risk factor for cardiovascular disease and mortality. The aim of this study was to evaluate the predictive value of the IASBD for the risk of CIN in patients with STEMI who underwent p-PCI. METHOD:We prospectively investigated 2120 consecutive patients who were hospitalized with a diagnosis of STEMI and underwent p-PCI. A relative increase in serum creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from baseline within 72 h of contrast exposure was defined as CIN. The IASBD was calculated on admission to the emergency department. The risk of CIN was evaluated. RESULTS:The incidence of CIN was 6.6% (n = 139). The patients were divided into 2 groups based on the development of CIN. Age (p = .001), baseline creatinine levels (p < .001), DM (p < .001), HT (p < .001) and anemia (p = .001) were higher in patients with CIN. An IASBD ≥10 mmHg was noted in 13 (9.3%) patients in the CIN group and 83 (4.1%) (p = .001) in the non-CIN group (Table 1). According to the multivariate analysis, the IASBD was found to be a predictor of CIN development (OR: 2.36, 95% CI: 1.42-3.90, p: 0.001). CONCLUSION:The IASBD on admission can be a potential predictor of CIN development in patients with STEMI who underwent p-PCI.
Background:The aim of this study was to examine whether left atrial dispersion and left atrial strain as measured by speckle tracking echocardiography and clinical parameters are predictors of the development of atrial fibrillation in patients with hypertrophic cardiomyopathy.Methods:A total of 151 patients (69% male, mean age 48.9 ± 14.2 years) with hypertrophic cardiomyopathy were included in the study. The patients' demographic, clinical, electrocardiographic, 2-dimensional classic and speckle tracking echocardiographic data were collected. Atrial fibrillation was identified by 12-lead electrocardiograms or 24-72 hours of Holter recordings during the follow-up period. Atrial dispersion was defined as the standard deviation of time to peak strain in 12 left atrial segments.Results:During the follow-up period, 40 patients (26%) developed atrial fibrillation. Peak atrial longitudinal strain (16.8 ± 6 vs. 22.1 ± 6.6, p ≤ 0.001) was significantly lower in the patients who developed atrial fibrillation than in those who did not. However, atrial dispersion was significantly higher in the group which developed atrial fibrillation (61 [46.7,78.6] vs. 41.3 [30.6-51], p ≤ 0.001). In multivariate Cox regression analysis, atrial dispersion (msn) (hazard ratio: 1.019, 95% confidence interval: 1.004-1.033, p = 0.01), peak atrial longitudinal strain, and age were found to be independent predictors of atrial fibrillation.Conclusions:In patients with hypertrophic cardiomyopathy, atrial dispersion, peak atrial longitudinal strain and age are predictive of the development of atrial fibrillation. Atrial dispersion measured by a speckle tracking-based method may provide further information on left atrial function in patients with hypertrophic cardiomyopathy or other disease states.
Purpose The association between hypertensive retinopathy and left atrial (LA) impairment is unknown. Accordingly, it was aimed to investigate the possible relationship between hypertensive retinopathy and LA phasic functions by means of two-dimensional speckle-tracking echocardiography (2D-STE). Methods A total of 124 hypertensive patients and 27 control subjects were included in the study. LA reservoir strain (LA(S-S)), LA conduit strain (LA(S-E)), and LA booster strain (LA(S-A)) parameters were used to evaluate LA myocardial functions. Results Hypertensive patients (with and without retinopathy) displayed an obvious reduction in the LA reservoir strain (LA(S-S))(,) and LA conduit strain (LA(S-E)). Moreover, further impairment in LA reservoir and conduit strain was found in patients with hypertensive retinopathy than in the isolated hypertensive patients. There were no significant differences in LA booster strain (LA(S-A)) among the three groups. Impaired LA(S-S) (OR: 0.764, CI: 0.657-0.888, and p < 0.001), LA(S-E) (OR: 0.754, CI: 0.634-0.897, and p = 0.001), and hypertension (HT) duration (OR: 2.345, CI: 1.568-3.507, and p < 0.001) were shown to be independent predictors of hypertensive retinopathy. Conclusion Impaired LA reservoir and conduit strain may be used to predict hypertensive patients at higher risk of developing hypertensive retinopathy, and to determine which patients should be followed more closely for hypertensive retinopathy.
Introduction: In hypertensive patients, the early detection of subclinical left ventricular dysfunction could prevent or delay patients from heart failure by aggressive risk factor control and rigorous medical management. Fragmented QRS (fQRS) is a marker of myocardial fibrosis, and myocardial fibrosis causes left ventricular dysfunction in hypertensive patients. In this study, we aimed to assess the association between the presence of fQRS and LV function at hypertensive patients using the speckle tracking echocardiography method.
Background: Atrial arrhythmias are well-known complications of atrial septal defect (ASD), and associated with substantial morbidity. After ASD closure, right atrial and ventricular enlargement regresses, however, the risk of atrial arrhythmia development continues. In this study, we aimed to investigate the relationship between the Crochetage sign, which is a possible reflection of heterogeneous ventricular depolarization due to longterm hemodynamic overload, and the development of late atrial arrhythmia after ASD closure. Methods: This retrospective study included a total of 314 patients (mean age: 39.5 (30-50) years; male: 115) who underwent percutaneous device closure for secundum ASD. The study population was divided into two groups according to the presence or absence of the Crochetage sign. The Crochetage sign was defined as an M-shaped or bifid pattern notch on the R wave in one or more inferior limb leads. Cox-regression analysis was performed to determine independent predictors of late atrial arrhythmia development. Result: Fifty-seven patients (18.1%) presented with late atrial arrhythmia. Of these 57 patients, 30 developed new-onset atrial fibrillation/atrial flutter (AF/AFL), and 27 patients with pre-procedure paroxysmal AF/AFL had a recurrence of AF/AFL during follow-up. History of paroxysmal AF/AFL before the procedure (HR: 4.78; 95% CI 2,52-9.05; p < 0.001), the presence of Crochetage sign (HR: 3.90; 95% CI 2.05-7.76; p < 0.001), and older age at the time of ASD closure (HR: 1.03; 95% CI 1.01-1.06; p = 0.002) were found as independent predictors for late atrial arrhythmia. Conclusion: The presence of Crochetage sign may be used to predict the risk of late atrial arrhythmia development after transcatheter ASD closure. (c) 2021 Elsevier Inc. All rights reserved.
Background and Aim of the study Chronic severe aortic regurgitation (AR) is associated with progressive accumulation of interstitial fibrosis and disruption of myocardial structure. After aortic valve replacement (AVR), the negative remodeling process reverses, and left ventricular ejection fraction (LVEF) improves but not in all patients. In this study, we aimed to investigate the association of fragmented QRS (F-QRS), which is a possible marker of myocardial fibrosis, with postoperative left ventricular (LV) systolic dysfunction. Methods A total of 147 consecutive patients with AVR were included in this study. F-QRS was identified by the presence of various RSR' patterns (QRS duration <120 ms) such as additional R wave (R prime)or notching of the R or S wave in at least two consecutive leads. Patients were compared in two groups based on the presence or absence of F-QRS. A logistic regression model was used to determine independent predictors of postoperative LV systolic dysfunction (LVEF <50%). Results Patients with F-QRS were associated with poor recovery of LV systolic function after AVR compared to the patients without F-QRS, regardless of preoperative LVEF (p = .008). F-QRS was found to be an independent predictor of postoperative LV systolic dysfunction (LVEF <50%). Lower preoperative LVEF and increased LV end diastolic diameter index were also found as independent risk factors for postoperative LV systolic dysfunction. Conclusions As a possible marker of myocardial fibrosis, F-QRS was associated with postoperative LV systolic dysfunction. Therefore, as a simple and convenient clinical parameter, F-QRS may be used to predict poor recovery of LVEF after AVR.
In this study, we investigated whether early systolic lengthening (ESL) which reflects subclinical ischemia and other echocardiographic and clinic parameters predict primary outcome [appropriate ICD shock, cardiovascular mortality and ventricular tachycardia (VT) or fibrillation] in patients with hypertrophic cardiomyopathy (HCM). 202 Patients with HCM (68% male, mean age 48 ± 13.9 years) were included in the study. Patients’ clinical, electrocardiographic, 2D classic and speckle tracking echocardiography (STE) data were collected. ESL was defined as time from onset of the Q wave on ECG (onset of the R wave if the Q wave was absent) to maximum myocardial systolic lengthening. Patients were divided into two groups as occurrence or absence of primary outcome during 5 years follow up. During the follow-up period of 5 years (mean follow-up duration, 45.9 ± 10.8 months), 31 patients (15%) developed primary outcome [appropriate ICD shock 22 (11%), cardiovascular death 6 (3%), VT/VF 3(1.5%)]. Higher HCM Risk SCD score, longer ESL, and decreased global longitudinal peak strain (GLPS) were observed in patients with primary outcome. A Cox regression analysis, ESL, GLPS and HCM Risk SCD score were found to be independent predictors of occurrence of primary outcome. In ROC curve analysis, ESL > 53.5 msn could discriminate between groups with and without a primary outcome (AUC 0.768, 80% sensitivity and 60% specificity, CI 95% 0.666–0.871). ESL were found to be predictive for primary outcome in patients with HCM. Readily measurable ESL could be helpful to distinguish patients at high risk who could optimally benefit from ICD therapy.
A 48-year-old male patient was admitted to our outpatient clinic with complaints of shortness of breath. He also had a holo-diastolic murmur at the right sternal border and an apical impulse being displaced laterally and inferiorly. Transthoracic echocardiography showed a severe aortic regurgitation without aortic valve stenosis and a mildly dilated left ventricle accompanied by an ejection fraction of 55%. The aortic regurgitation jet was eccentric and there were significant holodiastolic flow reversals in the descending thoracic aorta. Surgical management was advised for this patient because of symptomatic severe aortic regurgitation. Then, the patient underwent preoperative coronary angiography through the right femoral artery route. The left coronary ostium could be engaged with a 6 Fr Judkins left diagnostic catheter; however, the catheter jumped through the ascending aorta. Afterwards, the catheter was engaged and again jumped through the ascending aorta. Engagement and jumping cycles observed between successive systole to diastole. In our opinion, this catheter movement is explained by wide pulse pressure, like the severe characteristic physical findings of severe aortic regurgitation. Further studies are needed to understand whether this catheter movement is angiographically evidence of severe aortic regurgitation.
The totally implantable venous access device (TIVAD) is widely used for drug access or infusion during cancer treatment (1). A central venous catheter can improve the quality of the patient’s life by administering chemotherapy agents and drugs. Sometimes, several complications associated with the use of these devices can be seen. Fracture of the catheter may be the most serious complications, which could lead to pulmonary embolism, arrhythmic events, endocarditis, and perforation of the myocardium; although it occurs in around 1% of the patients (2). About 90% of foreign materials can be extracted by percutaneous transcatheter removal technique, a minimally invasive approach (3). Forceps, basket, gooseneck snare, and triple loops snare were reported to retrieve the fractured catheter successfully (4). To the best of our knowledge, herein, we report the first case of successful percutaneous transvenous removal of a fractured chemotherapy port catheter with a novel technique, balloon-supported retrieval.
Aim: Slow flow (SF) that develops after percutaneous coronary intervention (PCI) is significantly associated with poor prognosis in Non-ST elevation myocardial infarction (Non-STEMI) patients. Increased Selvester QRS score and Frontal QRS-T angle [f(QRS-T)] are related to adverse cardiovascular outcomes. We aimed to investigate the predictive role of the Selvester QRS score and f(QRS-T) for the development of post-PCI SF in patients with Non-STEMI. Method and results: In a retrospective study, 210 patients with Non-STEMI were divided into two groups as SF (29) and Non-SF (181) according to their TIMI coronary flow grade. For all patients the Selvester QRS score and f(QRS-T) were calculated from automatic electrocardiography (ECG) reports. The mean age of the study population was 63 (55-75) years and 102 (68.6%) of patients were male. The Selvester QRS score and f(QRS-T) were higher in the SF group than in the Non-SF group [(5[3-8], 3[2-5]); (67 degrees [42 degrees-88 degrees], 39 degrees [24 degrees-59 degrees]), respectively, all p <0.01]. In a logistic regression analysis, the Selvester QRS score (OR = 4,862; 95% (CI) = 1,131-20,904, p = 0.03) and f(QRS-T) (OR = 5,489; 95% (CI)= 11,433-21,034, p =0.01) were found independent predictors of post-PCI SF in Non-STEMI patients. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic values of the Selvester QRS score [86% sensitivity; 44% specificity; cut off 2; (AUC, 0.693)] and f(QRS-T) [62% sensitivity; 73% specificity; cut off 58 degrees; (AUC, 0.778)]. Conclusion: The Selvester QRS score and f(QRS-T), both easy-to-calculate ECG parameters, are predictors of post-PCI SF in Non-STEMI patients. (c) 2021 Elsevier Inc. All rights reserved.
OBJECTIVE:Left atrial (LA) function is an important predictor of adverse cardiovascular outcomes in patients with hypertension (HT). Therefore, recognition of subtle LA dysfunction in the early stages of HT is essential for controlling modifiable variables. Several electrocardiographic and echocardiographic parameters have been studied to show early LA dysfunction. The goal of this study was to investigate the relationship between newly defined morphology-voltage-P wave duration electrocardiography (MVP ECG) score and early LA dysfunction in hypertensive patients.MATERIALS AND METHODS:Eighty-nine hypertensive patients were included in this study. Based on speckle tracking echocardiography results, the patients were divided into two groups: 67 patients with normal LA function were included in Group 1, and 22 patients with abnormal LA function in Group 2.RESULTS:Age, diabetes mellitus history, duration of HT history, left ventricular mass index, E/Em, and MVP ECG score values were statistically significant between the two groups. Based on the results of the multivariate logistic regression test, duration of HT history, E/Em, and MVP ECG score were determined as independent predictive parameters for early LA dysfunction in hypertensive patients.CONCLUSION:In conclusion, MVP ECG score assessment could be a novel approach to detect early LA dysfunction in hypertensive patients.