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Anatol J Cardiol: 20 (2)
Volume: 20  Issue: 2 - August 2018
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EDITORIAL
1.New Impact Factor and the New Issue
Çetin Erol
PMID: 30088493  doi: 10.14744/AnatolJCardiol.2018.8  Page 69
Abstract | Full Text PDF

META ANALYSIS
2.Association between caspase recruitment domain-containing protein 8 rs2043211 polymorphism and cardiovascular disease susceptibility: A systematic review and meta-analysis
Hui Juan Huang, Qi Bi, Heng Wei, Bei Bei Luo, Yan He
PMID: 30088494  doi: 10.14744/AnatolJCardiol.2018.32650  Pages 70 - 76
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
3.Comparative performance of AnTicoagulation and Risk factors In Atrial fibrillation and Global Registry of Acute Coronary Events risk scores in predicting long-term adverse events in patients with acute myocardial infarction
Gökhan Çetinkal, Cüneyt Koçaş, Betül Balaban Kocaş, Şükrü Arslan, Okay Abacı, Osman Şükrü Karaca, Yalçın Dalgıç, Özgür Selim Ser, Kudret Keskin, Ahmet Yıldız, Sait Mesut Dogan
PMID: 30088481  doi: 10.14744/AnatolJCardiol.2018.54815  Pages 77 - 84
Objective: This study is designed to evaluate the recently developed AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) risk score (RS), which determines the predisposition to thromboembolic and hemorrhagic events in atrial fibrillation, as a predictor of prognosis in patients having acute myocardial infarction (AMI), and to compare the predictive ability of ATRIA RS with GRACE RS.
Methods: We analyzed 1627 patients having AMI who underwent coronary angiography and/or percutaneous coronary intervention (PCI) between January 2011 and February 2015. The primary endpoints included all-cause mortality, non-fatal MI, and cerebrovascular events during follow-up.
Results: Multivariate Cox regression analysis showed that the ATRIA RS>3 was an independent predictor of major adverse cardiac events in patients with AMI [hazard ratio, 2.00, 95% confidence interval, 1.54 to 2.60, p<0,001]. The area under the curve (AUC) for ATRIA RS and GRACE RS was 0.66 and 0.67 (p<0.001, and p<0.001), respectively. We performed a pair-wise comparison of receiver operating characteristic curves,and noted the predictive value of ATRIA RS with regard to primary endpoints was similar to that of GRACE RS (By DeLong method, AUCATRIA vs. AUCGRACE z test=0.64, p=0.52).
Conclusion: ATRIA RS may be useful in predicting prognosis in patients having AMI during long-term follow-up.

4.Effect of inflammation on the biomechanical strength of involved aorta in type A aortic dissection and ascending thoracic aortic aneurysm: An initial research
Zhixuan Bai, Jun Gu, Yingkang Shi, Wei Meng
PMID: 30088482  doi: 10.14744/AnatolJCardiol.2018.49344  Pages 85 - 92
Objective: Type A aortic dissection (AD) and ascending thoracic aortic aneurysm (AA) are thoracic vascular diseases with similar initial pathology but inequable clinical features and outcomes, where local and systemic inflammation play an important part. We aimed to observe and analyze the differences and correlation between inflammation and pathological changes in the aorta and biomechanical strength between AD and AA.
Methods: From August 2011 to February 2013, 20 patients with AD (AD group) and 13 patients with AA (AA group) who underwent aorta surgery were included. Serum concentrations of total cholesterol (TC), triglycerides (TG), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were measured just before surgical anesthesia. The longitudinal vessel samples of the affected ascending aorta were harvested during surgery and prepared for subsequent pathological observation and uniaxial tension test to measure the longitudinal tensile strength (TS). Samples were also prepared for further measurement of tissue homogenized TNF-α and IL-6 concentrations.
Results: No significant difference was seen between the two groups with respect to baseline data, and the serum concentrations of TC and TG of both the groups were within the normal range (p>0.05). Blood and tissue homogenized levels of IL-6 and TNF-α were significantly higher in the AD group than in the AA group (p<0.001). Pathological observation of the aortic tissue showed more inflammatory cells infiltration and elastic fiber destruction in the AD group than in the AA group, indicating significant aortic medial degeneration. Uniaxial tensile tests showed that the longitudinal TS was significant lower in the AD group than in the AA group (p<0.001). The longitudinal TS showed negative correlations with serum and tissue homogenized concentrations of IL-6 and TNF-α in the AD group (p<0.05), whereas no such significant correlation was seen in the AA group.
Conclusion: Patients with AD had acute systemic inflammation, along with acute inflammation and declined biomechanical strength of the affected aorta. The serum and tissue homogenized concentrations of IL-6 and TNF-α showed a significant correlation with the biomechanical strength of affected aorta in AD.

5.Evaluation of the Tp-Te interval, Tp-Te/QTc ratio, and QT dispersion in patients with Turner syndrome
Adem Atıcı, Cafer Panç, Ekrem Bilal Karaayvaz, Ahmet Demirkıran, Orkide Kutlu, Kamber Kaşalı, Elmas Kekeç, Lütfullah Sarı, Zeynep Nur Akyol Sarı, Ahmet Kaya Bilge
PMID: 30088483  doi: 10.14744/AnatolJCardiol.2018.98250  Pages 93 - 99
Objective: To evaluate ventricular repolarization parameters using the interval from the peak to the end of the T wave (Tp–Te), together with QT and corrected QT (QTc) intervals, QT dispersion (QTd), and Tp-Te/QTc ratio in patients with Turner syndrome (pwTS) and to compare the results with those from healthy controls.
Methods: In total, 38 patients previously diagnosed with Turner syndrome (TS) and 35 healthy girls (controls) were included in our cross-sectional study. Twelve-lead electrocardiography (ECG) and echocardiography after a 30-min rest were performed. The QT, QTc, QTd, Tp-Te interval, and Tp-Te/QTc ratio were determined.
Results: No differences in age or sex were observed between the groups. QT intervals were similar in both groups [pwTS: 354.76±25.33 ms, controls (C): 353.29±17.51 ms, p=0.775]. pwTS had significantly longer QTc and QTd than controls (411.87±22.66 ms vs. 392.06±13.21 ms, p<0.001 and 40.31±2.02 ms vs. 37.54±1.83 ms, p<0.001, respectively). Similarly, the Tp-Te interval and Tp-Te/QTc ratio were significantly longer in pwTS than in controls (71.89±3.39 ms vs. 65.34±2.88 ms, p<0.001 and 0.17±0.01 vs. 0.16±0.01, p=0.01).
Conclusion: As pwTS have longer QTc, QTd, Tp–Te interval, and Tp-Te/QTc ratio, an annual follow-up with ECG can provide awareness and even prevent sudden death in them. Also avoiding the use of drugs that makes repolarization anomaly and having knowledge about the side effects of these drugs are essential in pwTS.

6.Combination of peripheral blood mononuclear cell miR-19b-5p, miR-221, miR-25-5p, and hypertension correlates with an increased heart failure risk in coronary heart disease patients
Yuan Yao, Tao Song, Gang Xiong, Zhaogui Wu, Qi Li, Hao Xia, Xuejun Jiang
PMID: 30088484  doi: 10.14744/AnatolJCardiol.2018.43255  Pages 100 - 109
Objective: The aim of this study was to explore the differences in microRNA (miRNA) profiles in peripheral blood mononuclear cells (PBMCs) between coronary heart disease (CHD) patients with and without heart failure (HF) and to assess the values of differentially expressed miRNAs (DEMs) regarding HF risk in CHD patients.
Methods: Six CHD patients with HF and six age- and gender-matched CHD patients without HF were enrolled in the exploration stage, and 44 CHD patients with HF and 42 age- and gender-matched CHD patients without HF were recruited in the validation stage. Peripheral blood samples were collected from all the participants, and PBMCs were separated for miRNA detection. miRNA microarray and quantitative polymerase chain reaction were performed to assess the miRNA expression.
Results: In the exploration stage, heat map analysis showed that CHD patients with HF could be distinguished from those without HF using PMBC miRNA expressions; 63 downregulated DEMs and 84 upregulated DEMs in PBMCs were identified in CHD patients with HF using volcano map, and top 8 DEMs were selected based on their p values. In the validation stage, PBMC miR-221, miR-19b-5p, and miR-25-5p were found to be markedly dysregulated in CHD patients with HF. Multiple logistic regression analysis showed PBMC miR-221, miR-19b-5p, miR-25-5p, and hypertension to be the independent predictive factors for HF in CHD patients. A receiver operating characteristic curve demonstrated that area under curve of the combination of miR-221, miR-19b-5p, miR-25-5p, and hypertension was 0.871 (95% CI: 0.794-0.944).
Conclusion: CHD patients with and without HF could be differentiated according to PBMC miRNA profiles, and the combination of PBMC miR-19b-5p, miR-221, miR-25-5p, and hypertension correlates with an increased HF risk in CHD patients.

7.Higher diuretic dosing within the first 72 h is predictive of longer length of stay in patients with acute heart failure
Hirotaka Kato, Perry Fisher, Dahlia Rizk
PMID: 30088485  doi: 10.14744/AnatolJCardiol.2018.81568  Pages 110 - 116
Objective: High-dose diuretic strategies during the first 72 h of hospitalization have been shown to improve symptom resolution in patients with acute heart failure with decreased ejection fraction; however, they have not been shown to decrease length of stay (LOS). This study aimed to examine a possible relationship between higher diuretic dosing in the first 72 h of hospitalization and longer LOS in such patients.
Methods: In this retrospective study, we included 333 consecutive patients hospitalized for acute heart failure with decreased or preserved ejection fraction between July 2014 and June 2015 in an urban academic medical center. Multiple regression models with stepwise selection were used for data analysis. We also performed mediation analysis to assess the relationships between diuretic dose, worsening renal function (WRF) during the hospitalization, and LOS.
Results: In the multiple regression analysis, higher diuretic dosing in the first 72 h independently predicted longer LOS [β=0.42, 95% CI (0.27, 0.56), p<0.001] after adjustments for baseline characteristics, disease severity, and comorbidities. In the mediation analysis, higher diuretic dosing remained a significant predictor for longer LOS even after controlling for the mediator WRF [β=0.39, 95% CI (0.26, 0.53), p<0.001]. WRF had a weak mediation effect on the relationship between higher diuretic dosing and longer LOS [indirect effect of higher diuretic dosing on longer LOS: 0.07, 95% CI (0.02, 0.14)].
Conclusion: Higher diuretic dosing in the first 72 h of hospitalization was an independent predictor for longer LOS.

8.Computational imaging of aortic vasa vasorum and neovascularization in rabbits using contrast-enhanced intravascular ultrasound: Association with histological analysis
Manolis Vavuranakis, Theodore G. Papaioannou, Dimitrios Vrachatis, Michael Katsimboulas, Elias A. Sanidas, Sophia Vaina, George Agrogiannis, Efstratios Patsouris, Ioannis Kakadiaris, Christodoulos Stefanadis, Dimitrios Tousoulis
PMID: 30088486  doi: 10.14744/AnatolJCardiol.2018.35761  Pages 117 - 124
Objective: Neoangiogenesis is pathophysiologically related to atherosclerotic plaque growth and vulnerability. We examined the in vivo performance of a computational method using contrast-enhanced intravascular ultrasound (CE-IVUS) to detect and quantify aortic wall neovascularization in rabbits. We also compared these findings with histological data.
Methods: Nine rabbits were fed with a hyperlipidemic diet. IVUS image sequences were continuously recorded before and after the injection of a contrast agent. Mean enhancement of intensity of a region of interest (MEIR) was calculated using differential imaging algorithm. The percent difference of MEIR before and after the injection of microbubbles (d_MEIR) was used as an index of the density of plaque or/and adventitial neovascularization. Aortic segments were excised for histological analysis.
Results: CE-IVUS and histological analysis were performed in 11 arterial segments. MEIR was significantly increased (~20%) after microbubble injection (from 8.1±0.9 to 9.7±1.8, p=0.016). Segments with increased VV/neovessels in the tunica adventitia (histological scores 2 and 3) had significantly higher d_MEIR compared with segments with low presence of VV/neovessels (score 1); 40.5±22.9 vs. 8±14.6, p=0.024, respectively.
Conclusion: It is possible to detect VV or neovessels in vivo using computational analysis of CE-IVUS images, which is in agreement with histological data. These findings may have critical implications on vulnerable plaque assessment and risk stratification.

INVITED REVIEW
9.The time-to-treatment concept in acute heart failure: Lessons and implications from REALITY-AHF
Nobuyuki Kagiyama, Yuya Matsue
PMID: 30088487  doi: 10.14744/AnatolJCardiol.2018.88935  Pages 125 - 129
Acute heart failure (AHF) is a clinical syndrome with devastating prognosis. Despite considerable improvements in the treatment of chronic heart failure, most trials of new drugs for AHF, such as vasodilators, inotropes, and diuretics, have failed to show a prognostic benefit. Therefore, pharmacological treatment of AHF has changed very little, and loop diuretics have remained a cornerstone drug for decades. One of the emerging factors possibly playing an important role in AHF management is the time course of treatment. Several recent retrospective studies have highlighted the importance of early treatment in AHF; however, at the time, support from a prospective study with an adequate number of enrolled patients was lacking. The Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure (REALITY-AHF) was the first prospective study to specifically focus on the time course of treatment in the very acute phase and its prognostic implication in patients with AHF. Data from the REALITY-AHF revealed that early treatment with intravenous furosemide is significantly associated with lower in-hospital mortality. Although pathophysiological background of this association remains to be investigated, the time course of treatment may be a critical component of AHF treatment, and it will be important to take this factor into account in future clinical studies on AHF.

CASE REPORT
10.Endovascular treatment of an aortic aneurysm and patent ductus arteriosus
Serban Mihai Balanescu, Adrian Laurentiu Linte, Ioana Mihaela Dregoesc, Madalin Constantin Marc, Adrian Corneliu Iancu
PMID: 30088488  doi: 10.14744/AnatolJCardiol.2018.67365  Pages 130 - 131
Abstract | Full Text PDF | Video

11.An uncommon percutaneous treatment of aortic pseudoaneurysm
Ahmet Arif Yalçın, Serkan Kahraman, Aydın Yıldırım, Korhan Erkanlı
PMID: 30088489  doi: 10.14744/AnatolJCardiol.2018.08068  Pages 132 - 133
Abstract | Full Text PDF

LETTER TO THE EDITOR
12.Pathophysiological insights from dobutamine-induced Takotsubo syndrome
John Madias
PMID: 30088490  doi: 10.14744/AnatolJCardiol.2018.50708  Page 134
Abstract | Full Text PDF

13.Author`s Reply
Shokoufeh Hajsadeghi, Mohammad Hossein Rahbar, Aida Iranpour, Ali Salehi, Omolbanin Asadi, Scott R. Jafarian
PMID: 30088491  Page 134
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
14.Diastolic paradoxical septal motion in Ebstein anomaly
Muzaffer Kahyaoğlu, Çetin Geçmen, Özkan Candan, İbrahim Akın İzgi
PMID: 30088492  doi: 10.14744/AnatolJCardiol.2018.79026  Page E3
Abstract | Full Text PDF | Video



 
 
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