Abstract Background: Coronavirus disease (COVID-19) can cause permanent damage to vascular structures by directly or indirectly affecting the cardiopulmonary system. Lipoprotein(a) [Lp(a)] is an important identified risk factor for vascular endothelial cell dysfunction. Objective: The aim of this study was to reveal the relationship between Lp(a) levels measured at the time of COVID-19 diagnosis and the pulmonary artery (PA) to the ascending aorta (Ao) ratio (PA:Ao ratio) in survivors evaluated by transthoracic echocardiography (TTE). Methods: The study sample consisted of 100 patients who recovered from COVID-19 in the past 3 to 6 months. The relationship between the change in the PA:Ao ratio (ΔPA:Ao) and the Lp(a) levels measured at the time of diagnosis was evaluated. Diameter measurements at baseline and follow-up were evaluated with TTE. Results: A significant increase was found in PA, Ao, and epicardial adipose tissue (EAT) thickness in TTE (p< 0.001 for all). There was a weak correlation between D-dimer and high-sensitivity cardiac troponin measured at the time of diagnosis and ΔPA:Ao and ΔEAT in survivors. However, a positive and strong correlation was observed between Lp(a) levels and ΔPa:Ao (r = 0.628, p< 0.001) and ΔEAT (r = 0.633, p< 0.001). Conclusion: There may be dysfunction in vascular structures due to COVID-19. For the first time in the literature, a strong correlation was shown between the Lp(a) levels measured at the time of diagnosis and ΔPA:Ao and ΔEAT values in patients with COVID-19.

Abstract Cardiac implantable electronic device (CIED) infections have been rising around the world. Many microorganisms can lead to this disease. Corynebacterium species are catalase-positive Gram-positive bacilli, also known as "diphtheroids" or "coryneform" bacteria, were once almost universally dismissed as contamination when recovered from patients, but they are now increasingly being linked to serious infections and have the ability to form biofilms and rarely cause CIED infections and this can be complicated as infective endocarditis. Corynebacterium spp. are frequently overlooked as contaminants in blood cultures, yet they can cause a serious infective endocarditis (IE). Antibiotic resistance is increasing among Corynebacterium spp., and this makes treatment more challenging. There are few reports of IE caused by Corynebacterium spp., and more research is needed. Here, we report a case of 55- year old man with Corynebacterium spp. cardiac device-related infective endocarditis.

Resumen Las infecciones por dispositivos electrónicos implantables cardíacos (CIED) han ido en aumento en todo el mundo. Muchos microorganismos pueden conducir esta enfermedad. Las especies de Corynebacterium son bacilos grampositivos catalasa positivos, también conocidos como bacterias "difteroides" o "corineformes" que, alguna vez, se descartaron casi universalmente como contaminación cuando se recuperaron de los pacientes, pero ahora se los vincula cada vez más con infecciones graves y tienen la capacidad de forman biopelículas y rara vez causan infecciones por CIED, y esto puede complicarse como una endocarditis infecciosa. Corynebacterium spp. a menudo se pasan por alto como contaminantes en los hemocultivos, pero pueden causar una endocarditis infecciosa (EI) grave. La resistencia a los antibióticos está aumentando entre Corynebacterium spp., y esto hace que el tratamiento sea más desafiante. Hay pocos informes de EI causada por Corynebacterium spp., y se necesita más investigación. Aquí reportamos un caso de un hombre de 55 años con EI por Corynebacterium spp. relacionada con dispositivos cardíacos.

Abstract Introduction: Coronary artery ectasia (CAE) is one of the uncommon cardiovascular disorders with a clinical spectrum ranging from asymptomatic cases to myocardial infarction. Atherosclerosis plays a pivotal role in the pathogenesis of CAE. Recently, it has been determined that the atherogenic index of plasma (AIP) is a strong predictive marker for atherosclerosis. The aim of this study was to investigate whether there is a relationship between obstructive CAE and AIP in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Materials and methods: In this retrospective study, hospital electronic patient records were retrospectively examined. A total of 213 NSTE-ACS patients were included in the study. Patients were divided into two groups according to non-obstructive and obstructive CAE. The AIP value was compared between groups and regression analysis evaluated whether it is an indicator to predict the risk of obstructive CAE. Results: The AIP value was found to be numerically and statistically significant in the obstructive CAE group compared to the non-obstructive CAE group. The multivariate logistic regression analysis identified AIP as a predictor of obstructive CAE in NSTE-ACS patients in the receiver operating curve analysis, AIP values above 0.33 had 90% sensitivity and 68% specificity to predict obstructive CAE in NSTE-ACS patients. Conclusions: AIP values were increased in the presence of obstructive CAE in NSTE-ACS patients. Our findings suggest that AIP may be involved in the pathogenesis of obstructive CAE.

Resumen Introducción: La ectasia arterial coronaria (EAC) es uno de los trastornos cardiovasculares poco frecuentes con un espectro clínico que va desde casos asintomáticos hasta infarto de miocardio. La aterosclerosis juega un papel fundamental en la patogenia de la CAE. Recientemente, se ha determinado que el índice aterogénico del plasma (AIP) es un fuerte marcador predictivo de aterosclerosis. El objetivo de este estudio fue investigar si existe una relación entre el CAE obstructivo y la PAI en pacientes con síndrome coronario agudo sin elevación del segmento ST (SCASEST). Materiales y métodos: En este estudio retrospectivo, se examinaron retrospectivamente las historias clínicas electrónicas de los pacientes. Se incluyeron en el estudio un total de 213 pacientes con SCASEST. Los pacientes se dividieron en dos grupos según el CAE obstructivo y no obstructivo. El valor de AIP se comparó entre grupos y el análisis de regresión evaluó si es un indicador para predecir el riesgo de EAC obstructivo. Resultados: Se encontró que el valor AIP era numérica y estadísticamente significativo en el grupo CAE obstructivo en comparación con el grupo CAE no obstructivo. El análisis de regresión logística multivariable identificó a la AIP como predictor de EAC obstructiva en pacientes con SCASEST en el análisis de la curva operativa del receptor, valores de AIP superiores a 0,33 tenían una sensibilidad del 90 % y una especificidad del 68 % para predecir EAC obstructiva en pacientes con SCASEST. Conclusiones: Los valores de AIP se incrementaron en presencia de EAC obstructivo en pacientes con SCASEST. Nuestros hallazgos sugieren que AIP puede estar involucrado en la patogenia de CAE obstructivo.

RESUMEN Introducción: El tejido graso epicárdico (TGE) es un importante factor de riesgo de enfermedades cardiovasculares. Este estudio tuvo como objetivo investigar si existe una relación entre el índice de fibrosis-4 (índice FIB-4) y TGE en pacientes hipertensos recién diagnosticados y explorar la utilidad del índice FIB-4 para predecir la presión arterial (PA) no dipper. patrón. Materiales y métodos Nuestro estudio de casos y controles consistió en 210 pacientes en 3 grupos según los valores de PA, a saber, grupos normotensos, dipper y no dipper. A todos los pacientes se les realizó ecocardiografía transtorácica y monitorización ambulatoria de la PA de 24 h. Resultados: La mediana del índice FIB-4 fue mayor en el grupo no dipper [1,56 (1,10-2)] que en los grupos dipper [1 (0,71-1,32)] y normotensos [0,96 (0,69-1,32)] (p<0.001, para ambos). Se observó una correlación positiva entre TGE y el índice FIB-4 (r = 0,389, p < 0,001). En análisis de regresión logística multivariante, EFT (odds ratio (OR): 0,506, intervalo de confianza (IC) 95%: 1,288-2,135; p<0,001) e índice FIB-4 (OR: 1,099, IC95%: 1,621-5,556; p<0,001) resultaron ser predictores independientes de PA no dipper. En el análisis de la curva característica operativa del receptor, el índice FIB-4 tuvo una sensibilidad del 68 % y una especificidad del 72 % a un valor >1,25 (área bajo la curva: 0,751, IC95%: 0,679-0,823, p<0,001). Conclusiones: En hipertensos de nuevo diagnóstico, el índice FIB-4 se relaciona con patrones de PA no dipper. El índice FIB-4 parece ser una herramienta útil para evaluar el riesgo asociado con la enfermedad cardiovascular.

ABSTRACT Introduction: Epicardial fat tissue (EFT) is a significant risk factor for cardiovascular diseases. This study aimed to investigate whether there is a relationship between the fibrosis-4 index (FIB-4 index) and EFT in newly-diagnosed hypertensive patients and explore the usability of the FIB-4 index in predicting non-dipper blood pressure (BP) pattern. Materials and methods: Our case–control study consisted of 210 patients in 3 groups according to BP values, namely normotensive, dipper, and non-dipper groups. Transthoracic echocardiography and 24-h ambulatory BP monitoring were performed in all patients. Results: The median FIB-4 index was higher in the non-dipper group [1.56 (1.10-2)] than in the dipper [1 (0.71-1.32)] and normotensive groups [0.96 (0.69-1.32)] (p < 0.001, for both). A positive correlation was observed between EFT and the FIB-4 index (r=0.389, p<0.001). In multivariate logistic regression analysis, EFT (odds ratio (OR): 0.506, 95% confidence interval (CI): 1.288-2.135; p<0.001) and FIB-4 index (OR: 1.099, 95% CI: 1.621–5.556; p<0.001) were found to be independent predictors of non-dipper BP. In the receiver operating characteristic curve analysis, the FIB-4 index had 68% sensitivity and 72% specificity at a value >1.25 (area under the curve: 0.751, 95%CI: 0.679-0.823, p<0.001). Conclusions: In newly-diagnosed hypertensive people, the FIB-4 index is related to non-dipper BP patterns. FIB-4 index appears to be a helpful tool in assessing risk associated with cardiovascular disease.

Abstract Introduction: Although infective endocarditis (IE) is rare disease, this disease has importance due to its high morbidity and mortality rates. The exact incidence is not known as it is not a reportable disease. Unlike developed countries, the disease affects the young more than the elderly in developing countries. Most of the time, the diagnosis cannot be made at the first examination and the disease is often overlooked. In order to reduce the mortality and morbidity of this disease, it is important to quickly recognize the disease by following current diagnosis and treatment methods, to identify the causative agent and to treat accordingly. Both the epidemiology and the management of IE are changing due to medical advances. This situation may also be reflected in scientific publications. We aimed to analyze the global researches on IE. Material and methods: The Scopus database was searched for bibliometric analysis without selecting document type. Data were retrieved for the time period January 1, 1940 and Semptember 26, 2021, containing the keywords " Infective'' and''endocarditis " in their title. Results: 7911 publications were included in the study. The first publication was made in the year 1891. Most of the publications were research articles [n=5784 (73.11%)] and were from the United States of America (USA) [n =1622 (20.50%)]. Japan, France, United Kingdom and Spain were also in the top 5 publishing countries on IE. Conclusions: Infective endocarditis is still an important reason of mortality, and there are many unanswered questions about the managament and preventation of this disease. This situation reflected the scientific publications. Since this is a global problem, not just some developed countries involved in the IE research, also more countries should be encouraged to participate the studies on IE.

Resumen Introducción: Si bien la endocarditis infecciosa (EI) es una enfermedad rara, esta enfermedad tiene importancia por sus altas tasas de morbilidad y mortalidad. No se conoce la incidencia exacta ya que no es una enfermedad de notificación obligatoria. A diferencia de los países desarrollados, la enfermedad afecta más a los jóvenes que a los ancianos en los países en desarrollo. La mayoría de las veces, el diagnóstico no se puede hacer en el primer examen y la enfermedad a menudo se pasa por alto. Para reducir la mortalidad y morbilidad de esta enfermedad, es importante reconocer rápidamente la enfermedad siguiendo los métodos de diagnóstico y tratamiento actuales, para identificar el agente causal y tratar en consecuencia. Tanto la epidemiología como el manejo de la EI están cambiando debido a los avances médicos. Esta situación también puede verse reflejada en publicaciones científicas. Nuestro objetivo era analizar las investigaciones globales sobre la EI. Material y métodos: Se buscó en la base de datos Scopus para el análisis bibliométrico sin seleccionar el tipo de documento. Se recuperaron datos para el período de tiempo del 1 de enero de 1940 y el 26 de septiembre de 2021, que contenían las palabras clave "Infeccioso" y "Endocarditis" en su título. Resultados: Se incluyeron 7911 publicaciones en el estudio. La primera publicación se realizó en el año 1891. La mayoría de las publicaciones fueron artículos de investigación [n = 5784 (73,11%)] y fueron de los Estados Unidos de América (EE.UU.) [n = 1622 (20,50%)]. Japón, Francia, Reino Unido y España también se encontraban entre los 5 principales países editores en la EI. Conclusiones: La endocarditis infecciosa sigue siendo una causa importante de mortalidad y hay muchas preguntas sin respuesta sobre el manejo y prevención de esta enfermedad. Esta situación reflejó las publicaciones científicas. Dado que este es un problema global, no solo algunos países desarrollados involucrados en la investigación de EI, también se debe alentar a más países a participar en los estudios sobre EI.

Resumo Fundamentos: A gordura epicárdica é um depósito de gordura visceral na parte superior do organismo que pode desempenhar um papel importante no desenvolvimento de perfis cardiovasculares e metabólicos adversos. Há uma relação direta significativa entre a quantidade de gordura epicárdica e a adiposidade corporal geral (índice de massa corporal, IMC), mas dados sobre a adiposidade subcutânea são limitados. Objetivos: Realizamos um estudo para determinar a associação entre a circunferência do pescoço e a espessura da gordura epicárdica em jovens saudáveis do sexo masculino, além de avaliar as suas correlações individuais com a adiposidade corporal geral e fatores de risco cardiometabólicos. Métodos: Cem pacientes consecutivos do sexo masculino com idade igual ou superior a 18 anos e sem nenhuma condição médica importante e conhecida foram incluídos no estudo. Todos os participantes foram submetidos a um exame físico detalhado que incluiu medida da pressão arterial, peso, altura, razão cintura/quadril e circunferência do pescoço. Sangue foi coletado para determinação da glicemia de jejum e parâmetros lipídicos. Um exame ecocardiográfico padrão foi realizado com determinação adicional da espessura da gordura epicárdica. Resultados: Entre os 100 participantes do estudo, a circunferência do pescoço mostrou correlação significativa com o peso, circunferência de cintura, IMC, glicemia e níveis séricos de colesterol total, lipoproteína de baixa densidade (LDL-colesterol) e triglicerídeos. Não foi observada correlação significativa entre a circunferência do pescoço e níveis de colesterol de alta densidade (HDL-colesterol). A circunferência do pescoço correlacionou moderadamente e positivamente com a espessura da gordura epicárdica à ecocardiografia. Conclusão: Entre pacientes com baixo risco cardiometabólico, o aumento da circunferência do pescoço foi associado a um aumento da espessura da gordura epicárdica.

Abstract Background: Epicardial fat is an upper body visceral fat depot that may play a significant role in the development of adverse metabolic and cardiovascular risk profiles. There is a significant direct relationship between the amount of epicardial fat and general body adiposity (body mass index, BMI), but data regarding subcutaneous adiposity is limited. Objective: We conducted a study to determine the association between neck circumference and epicardial fat thickness in healthy young male individuals, and assess their individual correlations with general body adiposity and cardiometabolic risk factors. Methods: One hundred consecutive male patients aged 18 years or older with no known major medical conditions were included in the study. All participants underwent detailed physical examination including measurement of blood pressure, weight, height, waist/hip ratio, and neck circumference. Blood was collected to determine fasting glucose and lipid parameters. A standard echocardiographic examination was performed with additional epicardial fat thickness determination. Results: Among 100 study participants, neck circumference correlated significantly with weight, waist circumference, BMI, blood glucose, serum total cholesterol, low-density (LDL)-cholesterol, and triglycerides levels. No significant correlation was found between neck circumference and high-density lipoprotein (HDL)-cholesterol levels. Neck circumference correlated moderately and positively with echocardiographic epicardial fat thickness. Conclusion: Among patients with low cardiometabolic risk, increased neck circumference was associated with increased epicardial fat thickness.