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Anatol J Cardiol: 22 (3)
Volume: 22  Issue: 3 - September 2019
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1.Fixed risk factors at baseline versus variability of risk factors in predicting cardiovascular outcome
Mustafa Kılıçkap
PMID: 31475959  doi: 10.14744/AnatolJCardiol.2019.9  Page 99
Abstract | Full Text PDF

2.Initial combination treatment in the 2018 ESC/ESH hypertension guidelines
Giuseppe Mancia
PMID: 31475949  doi: 10.14744/AnatolJCardiol.2019.03292  Pages 100 - 101
Abstract | Full Text PDF

3.The cystathionine γ-lyase/hydrogen sulfide pathway mediates the trimetazidine-induced protection of H9c2 cells against hypoxia/reoxygenation-induced apoptosis and oxidative stress
Wenqing Zheng, Chao Liu
PMID: 31475956  doi: 10.14744/AnatolJCardiol.2019.83648  Pages 102 - 111
Objective: Trimetazidine is a piperazine-derived metabolic agent. It exerts cardioprotective effects against myocardial ischemia/reperfusion (I/R) injury. In addition, studies confirm that the cystathionine γ-lyase (CSE)/hydrogen sulfide (H2S) pathway serves a beneficent role in attenuating myocardial I/R injury. However, the underlying role of the CSE/H2S pathway in the trimetazidine-induced protection against myocardial I/R injury remains elusive. Therefore, this study investigated whether trimetazidine ameliorates hypoxia/reoxygenation (H/R)-induced H9c2 cardiomyocyte injuries in an in vitro cell model of myocardial I/R injury, by enhancing the CSE/H2S pathway.
Methods: The H9c2 cell viability was determined with a cell counting Kit-8.
Results: Trimetazidine significantly increased the cell viability and decreased lactate dehydrogenase (LDH) release in H/R-treated H9c2 cells. Additionally, trimetazidine increased the H2S levels and the CSE mRNA and protein levels, promoting the CSE/H2S pathway under H/R conditions. The inhibition of the CSE/H2S pathway, induced by transfection with specific siRNA against human CSE (si-CSE), eliminated the trimetazidine-induced upregulation of cell viability, downregulation of LDH release, increase of caspase-3 activity and apoptosis regulator BAX expression, and the decrease of apoptosis regulator Bcl-2 expression, which suggests involvement of the CSE/H2S pathway in trimetazidine-induced cardioprotection. Furthermore, trimetazidine mitigated the H/R-induced increase in reactive oxygen species production and NADPH oxidase 2 expression, and decrease in superoxide dismutase activity and glutathione level, in H9c2 cells. These effects were also reversed by si-CSE.
Conclusion: This study revealed that the CSE/H2S pathway mediates the trimetazidine-induced protection of H9c2 cardiomyocytes against H/R-induced damage by inhibiting apoptosis and oxidative stress.

4.The effect of blood pressure variability on the prognosis of hypertensive patients
Ziad A Taher, Waleed W Khayyat, Marwan M Balubaid, Mohamed Y Tashkandi, Haifaa Akif Khayyat, Abdulhalim Jamal Kinsara
PMID: 31475948  doi: 10.14744/AnatolJCardiol.2019.00905  Pages 112 - 116
Objective: Our study aims to compare the effects of blood pressure variability (BPV) during ambulatory blood pressure measurement (ABPM) and visit-to-visit measurements to predict future cardiovascular complications among hypertensive patients.
Methods: This is a retrospective case-control study of patients with hypertension over 10 years. All adult patients with at least one recorded ABPM, and at least three recorded visit measurements were included. Patients with incomplete ABPM readings, a history of a tested outcome, or the occurrence of any of the tested outcomes within the measurement period were excluded. The outcome was the development of any of the following: acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), or stroke.
Results: Of the 305 cases reviewed, 152 were included. The mean follow-up was 6.6±2.3 years. The mean age was 53.5±14.3 years. Eighty-two (53.9%) patients were male, while 70 (46.1%) were female. Risk factors included diabetes mellitus (53.9%), dyslipidemia (39.5%), obesity (16.4%), and smoking (8.6%). Comorbidities included stroke (2%), ACS (8.6%), IHD (20.4%), HF (2.6%), and renal failure (1.3%). One or more complications were seen in 22.4 % of the included patients. The variation of the daytime systolic ABP had been found to predict the future risk of developing IHD (OR=1.94; 95% CI=1.09–3.45; p=0.025). Moreover, IHD was associated with night-time systolic standard deviation (SD) in ABPM (OR=1.23; 95% CI=1.00–1.51; p=0.048). On the other side, ACS was found to be associated with systolic SD in visit-to-visit measurement (OR=1.10; 95% CI=1.01–1.21; p=0.04).
Conclusion: Hypertensive patients with high variability of daytime and night-time SD in ABPM are more likely to have IHD. Whereas, having high variability in systolic SD in visit-to-visit measurements is associated with developing ACS.

5.Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in non-obstructive coronary artery disease
Jun Gu, Zhao-fang Yin, Jian-an Pan, Jun-feng Zhang, Chang Qian Wang
PMID: 31475951  doi: 10.14744/AnatolJCardiol.2019.26428  Pages 117 - 124
Objective: A higher visit-to-visit variability in low-density lipoprotein cholesterol (LDL-C) is associated with an increased frequency of cardiovascular events. We investigated the association between the visit-to-visit LDL-C variability and all-cause mortality, myocardial infarction (MI), and coronary revascularization in a population with non-obstructive coronary artery disease (CAD).
Methods: From this retrospective cohort of individuals who underwent coronary angiography from 2006 to 2010, a total of 2.012 consecutive patients with non-obstructive CAD, who underwent three or more LDL-C determinations during the first 2 years, were identified and followed up for 5 years. The variability in the visit-to-visit LDL-C was measured by standard deviation (SD) and coefficient of variation (CV). The risk of all-cause mortality and composite endpoints, MI, and coronary revascularization were evaluated by a multivariable Cox regression analysis.
Results: During a 5-year follow-up, a total of 99 (4.92%) mortality cases and 154 (7.65%) cases of composite endpoints were observed. The percentage of subjects who experienced mortality or composite endpoints was higher in those with a higher LDL-C-SD or LDL-C-CV level. The association between the LDL-C variability and clinical endpoints was regardless of possible confounding factors.
Conclusion: Among the patients with non-obstructive CAD, a higher visit-to-visit LDL-C variability is associated with increasing all-cause mortality or composite endpoints during the long-term follow-up.

6.Midline one-stage complete unifocalization early outcomes from a single center
Oktay Korun, Okan Yurdakök, Mehmet Dedemoğlu, İlker Kemal Yücel, Ahmet Çelebi, Şefika Türkan Kudsioğlu, Ahmet Sasmazel, Numan Ali Aydemir
PMID: 31475955  doi: 10.14744/AnatolJCardiol.2019.58235  Pages 125 - 131
Objective: This study aims to present our experience with single-stage complete unifocalization and intraoperative flow study for the repair of
ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries.
Methods: This study was conducted through retrospective chart review of all the patients who underwent complete single-stage midline unifocalization in a single tertiary-care institution.
Results: Twenty-two patients underwent midline single-stage unifocalization. The median age was 11 months (IQR: 5–21 months). The number
of collateral arteries unifocalized was between one and three (median two). In-hospital mortality was 5%. Follow-up was complete; and the
median follow-up regarding survival was 20 months (IQR: 10–28 months). There were three late deaths, and the estimated survival rate was 80% at 10 months and on. Out of 22 patients, ventricular septal defect was closed in the first surgery in three patients (14%) and the second surgery in four patients (19%). Total seven patients underwent surgical total repair (32%). Additionally, one out of four patients whose ventricular septal defects were closed with a fenestrated patch is under follow-up with a small ventricular septal defect, while two are waiting for ventricular septal defect closure. Therefore, total eight patients (36%) have reached total correction.
Conclusion: Single-stage unifocalization is a feasible treatment option in ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries. This cohort had unfavorable results regarding the rate of complete repair. The pitfalls encountered were related to problems with meticulous surgical technique, complete unifocalization, and correct implementation of the flow study.

7.Comparison of left ventricular and biventricular pacing: Rationale and clinical implications
Polychronis Dilaveris, Christos Konstantinos Antoniou, Panagiota Manolakou, Ioannis Skiadas, Konstantinos Konstantinou, Nikolaos Magkas, Panagiotis Xydis, Christina Chrysohoou, Konstantinos Gatzoulis, Dimitrios Tousoulis
PMID: 31475952  doi: 10.14744/AnatolJCardiol.2019.35006  Pages 132 - 139
Cardiac resynchronization therapy constitutes a cornerstone in advanced heart failure treatment, when there is evidence of dyssynchrony,
especially by electrocardiography. However, it is plagued both by persistently high (~30%) rates of nonresponse and by deterioration of right
ventricular function, owing to iatrogenic dyssynchrony in the context of persistent apical pacing to ensure delivery of biventricular pacing. Left
ventricular pacing has long been considered an alternative to standard biventricular pacing and can be achieved as easily as inserting a single
pacing electrode in the coronary sinus. Although monoventricular left ventricular pacing has been proven to yield comparable results with the
standard biventricular modality, it is the advent of preferential left ventricular pacing, combining both the powerful resynchronization potential of
multipolar coronary sinus and right-sided electrodes acting in concert and the ability to preserve intrinsic, physiological right ventricular activation. In this review, we aim to present the underlying principles and modes for delivering left ventricular pacing, as well as to highlight advantages of preferential over monoventricular configuration. Finally, current clinical evidence, following implementation of automated algorithms, regarding performance of left ventricular as compared with biventricular pacing will be discussed. It is expected that the field of preferential left ventricular pacing will grow significantly over the following years, and its combination with other advanced pacing modalities may promote clinical status and prognosis of patients with advanced dyssynchronous heart failure.

8.Turkish Society of Cardiology consensus report on recommendations for athletes with high-risk genetic cardiovascular diseases or implanted cardiac devices
Erdem Özel, Mustafa Feridun Koşar, Emin Evren Ozcan, Burak Hünük, Taner Ulus, Vedat Aytekin, Reviewers: Aylin Yildirir, Bülent Özin, Izzet Erdinler, Ömer Akyürek
PMID: 31475950  doi: 10.14744/AnatolJCardiol.2019.09633  Pages 140 - 151
Abstract | Full Text PDF

9.First case of cardiac amyloidosis presenting as right atrial mass
Aynur Acibuca, Sefa Okar, Tuba Canpolat, Zafer Koc, Hakan Güllü
PMID: 31475954  doi: 10.14744/AnatolJCardiol.2019.49683  Pages 152 - 154
Abstract | Full Text PDF | Video

10.Rare presentation and wide intrafamilial variability of Fabry disease: A case report and review of the literature
Sebastian Militaru, Robert Adam, Lucian Dorobantu, Paolo Ferrazzi, Maria Iascone, Viorica Radoi, Gener Ismail, Bogdan A. Popescu, Ruxandra Jurcut
PMID: 31475953  doi: 10.14744/AnatolJCardiol.2019.47969  Pages 154 - 158
Abstract | Full Text PDF | Video

11.Infrequent concomitant mitral, pulmonary, and tricuspid valve prolapse associated with right ventricular failure: Correct diagnosis using multimodality imaging
Semih Kalkan, Ferhat Keten, İsmail Balaban, Cengiz Koksal, Gokhan Kahveci
PMID: 31475958  doi: 10.14744/AnatolJCardiol.2019.91571  Pages E5 - E7
Abstract | Full Text PDF | Video

12.Right atrial appendage aneurysm: Does it have to be resected?
Honghua Yue, Tailong Zhang, Xueshan Zhao, Zhong Wu
PMID: 31475957  doi: 10.14744/AnatolJCardiol.2019.91073  Page E7
Abstract | Full Text PDF

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