ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 24 (3)
Volume: 24  Issue: 3 - September 2020
EDITORIAL
1.Mental stress-induced myocardial ischemia, resistant hypertension, cardiovascular risk in metabolic syndrome from the PURE cohort, and more
Çetin Erol
PMID: 32870179  doi: 10.14744/AnatolJCardiol.2020.9  Page 125
Abstract |Full Text PDF

REVIEW
2.Research progress regarding the diagnosis and treatment of mental stress-induced myocardial ischemia
Na Huan, Yonghui Yu, Peili Wang, Chenglong Wang
PMID: 32870175  doi: 10.14744/AnatolJCardiol.2020.69447  Pages 126 - 136
Myocardial ischemia resulting from psychological stress [mental stress-induced myocardial ischemia (MSIMI)] refers to the condition wherein psychosocial and psychological stimulations cause myocardial ischemia in patients with coronary heart disease, which is different from drug-induced myocardial ischemia. Therefore, this condition often escapes diagnosis, portends clinical risk, and affects the quality of life of MSIMI survivors. MSIMI is closely related to the poor prognosis of cardiovascular diseases, especially in young women, according to recent randomized, controlled trials (RCTs) on MSIMI. These RCTs involved different sample sizes, interventional measures, and detection techniques. Moreover, differences exist regarding the prevalence rate, distribution characteristics, possible pathogenesis, and clinical significance. Nevertheless, currently, the diagnostic criteria, pathogenesis, and treatment of MSIMI are still in the clinical exploration stage. Hence, considering recent RCTs, this paper summarizes the research status of MSIMI from the aspects of pathogenesis, diagnosis, and treatment strategies to provide a theoretical basis for the follow-up diagnostic methods and treatment guidelines for MSIMI.

CONSENSUS REPORT
3.Consensus paper on the evaluation and treatment of resistant hypertension by the Turkish Society of Cardiology
Asife Sahinarslan, Emine Gazi, Meryem Aktoz, Cigdem Ozkan, Gülay Ulusal Okyay, Ozgul Ucar Elalmis, Erdal Belen, Reviewers: Atila Bitigen, Ulver Derici, Neslihan Bascil Tutuncu, Aylin Yildirir
PMID: 32870176  doi: 10.14744/AnatolJCardiol.2020.74154  Pages 137 - 152
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
4.Comparison of the effects of coronary artery anastomosis training between senior and junior surgeons
Bo Li, Xiaokang Luo, Lei Qi, dong Zhang, Fuliang Luo, Bin Li, Yue Tang
PMID: 32870168  doi: 10.14744/AnatolJCardiol.2020.37460  Pages 153 - 159
Objective: Many countries are facing a shortage of cardiac surgeons, who are crucial in meeting the demands of growing number of patients in need of coronary artery bypass grafting. This situation poses a serious challenge, especially in China. The purpose of this study is to determine whether cardiac surgeons are suitable for training in coronary artery anastomosis at an earlier stage in their career.
Methods: We divided 12 cardiac surgeons with no prior experience in coronary artery anastomosis into senior and junior groups for training and assessment. All trainees received training in coronary artery anastomosis for a defined period. We performed in vivo and in vitro examinations before and after training, respectively. Additionally, we assessed individual surgical performance of surgeons by using performance rating scores, including different aspects of surgical skills rated on a five-point scale.
Results: The post-training scores (overall, junior, senior) were significantly higher than the pre-training scores (overall, junior, and senior). We observed no differences in pre-training and post-training scores between the junior and senior groups.
Conclusion: Senior surgeons did not had any significant advantages over junior surgeons with respect to coronary artery anastomosis in the absence of training. Junior surgeons achieved the same results as the senior surgeons after training.

5.Dysregulated circulating SOCS3 and haptoglobin expression associated with stable coronary artery disease and acute coronary syndrome: An integrated study based on bioinformatics analysis and case–control validation
Xunnan Zhang, Xi Lv, Xiandong Li, Yaping Wang, Hao-yu Lin, Jicai Zhang, Chunyan Peng
PMID: 32870172  doi: 10.14744/AnatolJCardiol.2020.56346  Pages 160 - 174
Objective: To extensively use blood transcriptome analysis to identify potential diagnostic and therapeutic targets for cardiovascular diseases.
Methods: Two gene expression datasets (GSE59867 and GSE62646) were downloaded from GEO DataSets to identify altered blood transcriptomes in patients with ST-segment elevation myocardial infarction (STEMI) compared to stable coronary artery disease (CAD). Thereafter, several computational approaches were taken to determine functional roles and regulatory networks of differentially expressed genes (DEGs). Finally, the expression of dysregulated two hub genes–suppressor of cytokine signaling 3 (SOCS3) and haptoglobin (HP)–were validated in a case–control study.
Results: A total of 119 DEGs were identified in the discovery phase, consisting of 71 downregulated genes and 48 upregulated genes; two hub modules consisting of two hub genes–SOCS3 and HP–were identified. In the validation phase, both SOCS3 and HP were significantly downregulated in the stable CAD and acute coronary syndrome (ACS) patients when compared with healthy controls. Meanwhile, HP was significantly upregulated in STEMI patients when compared with stable CAD patients (p=0.041). Logistic regression analysis indicated that: downregulated expression of HP correlated with increased risk of CAD [odds ratio (OR)=0.52, 95% confidence interval (CI)=0.31~0.87, p=0.013]; and downregulated expression of SOCS3 correlated with increased risk of ACS (OR=0.66, 95% CI=0.46~0.94, p=0.023) when age, gender, history of hyperlipidemia, diabetes and hypertension were included as covariates.
Conclusion: Future clarification of how SOCS3 and HP influence the pathogenesis of disease may pave the way for the development of novel diagnostic and therapeutic methods.

6.Comparisons of microbiota-generated metabolites in patients with young and elderly acute coronary syndrome
Mustafa Begenc Tascanov, Zulkif Tanriverdi, Fatih Gungoren, Feyzullah Besli, Musluhittin Emre Erkus, Ismail Koyuncu, Ataman Gonel, Gulsen Genc Tapar
PMID: 32870170  doi: 10.14744/AnatolJCardiol.2020.47995  Pages 175 - 182
Objective: Acute coronary syndrome (ACS) is a leading cause of death worldwide. There is great interest in defining the risk factors and underlying mechanisms of ACS among young people. The microbiota and its metabolites have recently become a popular research topic, yet there is still no study that investigated microbiota-generated metabolites as a possible risk factor in young patients with ACS. In this study, we aimed to investigate the relationship between microbiota-generated metabolites and ACS in young people.
Methods: This study included 44 young patients with ACS (<50 years of age), 39 elderly patients with ACS, and 44 patients with normal coronary arteries. Inflammatory parameters and serum trimethylamine N-oxide (TMAO) and choline levels were measured in all patients.
Results: Young patients with ACS had significantly higher levels of TMAO and choline compared to the control and elderly ACS groups. Also, elderly patients with ACS had a significantly higher level of TMAO than the control group. Linear regression analysis was performed to determine the independent predictors of TMAO. Two regression models were involved. The first model included young ACS and control groups, while the second model included young and elderly ACS groups. In the first model, we found that young ACS (ß=0.399, p=0.004) and smoking ACS (ß=0.211, p=0.046) were significantly associated with TMAO level. In the second model, young ACS was significantly associated with TMAO level (ß=0.230, p=0.035).
Conclusion: In this study, we have shown that young ACS was significantly associated with increased TMAO level.

7.The prevalence of major cardiovascular risk factors in a rural population of the Chui region of Kyrgyzstan: The results of an epidemiological study
Andrey G Polupanov, Abdimetalip Khalmatov, Aliina Altymysheva, Olga S. Lunegova, Aibek E. Mirrakhimov, Ibragim S. Sabirov, Anna Kontsevaya, Ainagul Dzhumagulova, Erkin Mirrakhimov
PMID: 32870173  doi: 10.14744/AnatolJCardiol.2020.59133  Pages 183 - 191
Objective: To study the prevalence of cardiovascular (CV) risk factors (RFs) in the rural population of the Chui region of Kyrgyzstan (Central Asia).
Methods: The sample was representative of the population in terms of age and sex and included at least 10% of the population aged 18-65 y. Of the 1,672 people included in the cohort, 1.330 people responded to the invitation (79.5% of the total sample population). All study participants were interviewed using standardized questionnaires and examined by a cardiologist. Blood pressure (BP), weight, height, waist circumference (WC), fasting serum glucose, and fasting lipid level were measured.
Results: The prevalence of major CV RFs in the examined sample was as follows: arterial hypertension 34.1%, obesity 25.7%, and abdominal obesity 52.3%; the factors were significantly more prevalent in women (68.2%) and increased with age. The frequency of lipid metabolism disorders was 88.4% in the examined subjects, and an increased level of low-density cholesterol (70.5%) was common. Hypodynamia was detected in 15.6% of the subjects, diabetes mellitus in 3.76%, and a family history of cardiovascular disease was present in 34.8% of the examined subjects. The frequency of smoking was 24.6% and was significantly higher in men (46.9%).
Conclusion: Abdominal obesity, followed by hypercholesterolemia and arterial hypertension were the most common RFs among the rural population of the Chui region of Kyrgyzstan. Smoking was the most common RF among men. The prevalence of traditional CV RFs, except smoking, increased with age.

8.Risk of cardiovascular events in patients with metabolic syndrome: Results of a population-based prospective cohort study (PURE Turkey)
Aytekin Oğuz, Mustafa Kılıçkap, Sadi Güleç, Yüksel Altuntaş, Kubilay Karşıdağ, Ahmet Temizhan, Burcu Çalık Tümerdem, Miraç Vural Keskinler, Sumathy Rangarajan, Salim Yusuf
PMID: 32870166  doi: 10.14744/AnatolJCardiol.2020.27227  Pages 192 - 200
Objective: Metabolic syndrome (MetS) includes several cardiovascular (CV) risk factors. This study aimed to assess CV risk of MetS, contribution of its components to the risk, and whether MetS provides additional risk beyond its components.
Methods: The Prospective Urban Rural Epidemiology (PURE) Turkey cohort included 3933 individuals aged between 35 and 70 years, with a median follow-up of 8.9 years. MetS was diagnosed as the presence of any of the following criteria: high blood pressure, high fasting plasma glucose, abdominal obesity, low HDL-cholesterol, or high triglycerides. The primary outcome was the composite of fatal CV events, non-fatal myocardial infarction, stroke or heart failure, adjusted for age, sex, smoking, family history of CV diseases, and LDL-cholesterol.
Results: The primary outcome was more common in the MetS group [178 (9.2%) vs. 70 (3.5%); corresponding incidence rate of 11.3 vs. 4.2 per 1000 person-years; log-rank p<0.001]. Each component was significantly associated with the primary outcome; however, when the components were sequentially included in the model, abdominal obesity and high triglycerides did not provide additional risk on top of the other three components. The hazard ratio for MetS for the primary outcome was 2.12 (95% confidence interval 1.59–2.81, p<0.001), and the discriminative ability (c-statistics) of the models with MetS and the components was similar.
Conclusion: MetS increases the risk of CV events more than two-fold. High blood pressure, high fasting plasma glucose, and low HDL-cholesterol are the top three components of MetS for CV risk. MetS and its components have a similar discriminative ability for CV events.

CASE REPORT
9.Pyrethroid insecticide-induced takotsubo syndrome
İbrahim Yıldız, Pınar Özmen Yıldız, İsmail Gürbak
PMID: 32870165  doi: 10.14744/AnatolJCardiol.2020.25668  Pages 201 - 203
Abstract |Full Text PDF | Video

10.A simple yet novel solution to prevent stent stripping in Guidezilla use
Kerim Esenboga, Kaan Akın, Nil Ozyuncu, Turkan Seda Tan, Durmus Eralp Tutar
PMID: 32870167  doi: 10.14744/AnatolJCardiol.2020.36900  Pages 203 - 205
Abstract |Full Text PDF

11.Coronary vasospasm and raspberry ketones weight-loss supplement: Is there a connection?
Arjan Khattar, Ian Beeton
PMID: 32870171  doi: 10.14744/AnatolJCardiol.2020.53496  Pages 205 - 208
Abstract |Full Text PDF

LETTER TO THE EDITOR
12.Unexpected peak of mortality: The COVID-19 burden on Bergamo transcatheter aortic valve implantation register
Alberto Cereda, Diego Cugola, Giulio Balestrieri, Angelina Vassileva, Orazio Valsecchi
PMID: 32870164  doi: 10.14744/AnatolJCardiol.2020.01955  Pages 209 - 210
Abstract |Full Text PDF

13.Paravalvular leak after transcatheter aortic valve implantation
Orhan Gökalp, Hasan Iner, Yüksel Beşir, Nihan Karakaş Yeşilkaya, Levent Yılık
PMID: 32870174  doi: 10.14744/AnatolJCardiol.2020.65259  Pages 210 - 211
Abstract |Full Text PDF

14.Author`s Reply
Bilge Duran Karaduman, Hüseyin Ayhan, Telat Keleş, Engin Bozkurt
PMID: 32870180  Pages 211 - 212
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
15.Peripheral angiographic view of severe aortic regurgitation
Abdulrahman Naser, Khagani Isgandarov, Tolga Sinan Güvenç
PMID: 32870177  doi: 10.14744/AnatolJCardiol.2020.75325  Page E8
Abstract |Full Text PDF | Video

16.Inadvertent distal coronary sinus perforation via a large thebesian vein during angiography
Halil Akın, Bernas Altıntaş, Serdar Sarıkaya, Hüseyin Ede
PMID: 32870169  doi: 10.14744/AnatolJCardiol.2020.40524  Pages E8 - E9
Abstract |Full Text PDF | Video

17.Eosinophilic myocarditis: Magnetic resonance imaging -based study of a dramatic response to steroids
Aayush Kumar Singal, Jaskaran Singh Gujral, Vineeta Ojha, Satyavir Yadav
PMID: 32870178  doi: 10.14744/AnatolJCardiol.2020.87120  Pages E9 - E10
Abstract |Full Text PDF



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