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Diferenças entre Duas Condições Cardíacas Hipertróficas Distintas: Doença de Fabry Versus Cardiomiopatia Hipertrófica Distintas
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Akhan, Onur

; Kış, Mehmet

; Güzel, Tuncay

; Zoghi, Mehdi

Arquivos Brasileiros de Cardiologia

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Jan 2024, Volume 121 Nº 1 elocation e20230229

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A cardiomiopatia hipertrófica (CMH) e a doença de Fabry (DF) são doenças herdadas geneticamente com características fenotípicas de hipertrofia ventricular esquerda (HVE) que causam resultados cardíacos adversos. Objetivos Investigar as diferenças demográficas, clínicas, bioquímicas, eletrocardiográficas (ECG) e ecocardiográficas (ECO) entre CMH e DF. Métodos 60 pacientes com CMH e 40 pacientes com DF foram analisados retrospectivamente como uma subanálise do “estudo LVH-TR” após exclusão de pacientes com fibrilação atrial, ritmo de estimulação, bloqueios de ramo e bloqueios atrioventriculares (AV) de segundo e terceiro graus. O nível de significância foi aceito como <0,05. Resultados O sexo masculino (p=0,048) e a creatinina (p=0,010) são significativamente maiores a favor da DF; entretanto, infradesnivelamento do segmento ST (p=0,028), duração do QT (p=0,041), espessura do septo interventricular (SIVd) (p=0,003), espessura da parede posterior (PWd) (p=0,009), insuficiência mitral moderada a grave (IM) (p=0,013) e o índice de massa ventricular esquerda (IMVE) (p=0,041) são significativamente maiores a favor da CMH nas análises univariadas. Na análise multivariada, a significância estatística apenas permanece na creatinina (p=0,018) e na duração do intervalo QT (0,045). A DF foi positivamente correlacionada com a creatinina (rho=0,287, p=0,004) e a CMH foi positivamente correlacionada com o PWd (rho=0,306, p=0,002), IVSd (rho=0,395, p<0,001), IM moderada-grave (rho= 0,276, p<0,005), IMVE (rho=0,300, p=0,002), espessura relativa da parede (ERP) (rho=0,271, p=0,006), duração do QT (rho=0,213, p=0,034) e depressão do segmento ST (rho =0,222, p=0,026). Conclusão Características bioquímicas, ECG e ECO específicas podem auxiliar na diferenciação e no diagnóstico precoce da CMH e da DF. (CMH (DF HVE (HVE adversos demográficas clínicas bioquímicas (ECG (ECO 6 4 estudo LVHTR LVH TR LVH-TR atrial estimulação AV (AV graus 005 0 05 <0,05 p=0,048 p0048 p 048 (p=0,048 p=0,010 p0010 010 (p=0,010 entretanto p=0,028, p0028 p=0,028 , 028 (p=0,028) p=0,041, p0041 p=0,041 041 SIVd (SIVd p=0,003, p0003 p=0,003 003 (p=0,003) (PWd p=0,009, p0009 p=0,009 009 (p=0,009) (IM p=0,013 p0013 013 (p=0,013 (IMVE (p=0,041 univariadas multivariada p=0,018 p0018 018 (p=0,018 0,045. 0045 0,045 . 045 (0,045) rho=0,287, rho0287 rho 287 (rho=0,287 p=0,004 p0004 004 rho=0,306, rho0306 306 (rho=0,306 p=0,002, p0002 p=0,002 002 p=0,002) rho=0,395, rho0395 395 (rho=0,395 p<0,001, p0001 p<0,001 001 p<0,001) moderadagrave rho= 0276 276 0,276 p<0,005, p0005 p<0,005 p<0,005) rho=0,300, rho0300 300 (rho=0,300 ERP (ERP rho=0,271, rho0271 271 (rho=0,271 p=0,006, p0006 p=0,006 006 p=0,006) rho=0,213, rho0213 213 (rho=0,213 p=0,034 p0034 034 0222 222 =0,222 p=0,026. p0026 p=0,026 026 p=0,026) 00 <0,0 p=0,04 p004 04 (p=0,04 p=0,01 p001 01 (p=0,01 p002 p=0,02 02 (p=0,028 p000 p=0,00 (p=0,003 (p=0,009 0,04 (0,045 rho=0,287 rho028 28 (rho=0,28 rho=0,306 rho030 30 (rho=0,30 rho=0,395 rho039 39 (rho=0,39 p<0,00 027 27 0,27 rho=0,300 rho=0,271 rho027 (rho=0,27 rho=0,213 rho021 21 (rho=0,21 p=0,03 p003 03 022 22 =0,22 <0, p=0,0 p00 (p=0,0 (p=0,02 (p=0,00 0,0 (0,04 rho=0,28 rho02 2 (rho=0,2 rho=0,30 rho03 3 (rho=0,3 rho=0,39 p<0,0 0,2 rho=0,27 rho=0,21 =0,2 <0 p=0, p0 (p=0, 0, (0,0 rho=0,2 rho0 (rho=0, rho=0,3 p<0, =0, < p=0 (p=0 (0, rho=0, (rho=0 p<0 =0 p= (p= (0 rho=0 p< = (p (

Abstract Background Hypertrophic cardiomyopathy (HCM) and Fabry disease (FD) are genetically inherited diseases with left ventricular hypertrophy (LVH) phenotype characteristics that cause adverse cardiac outcomes. Objectives To investigate the demographic, clinical, biochemical, electrocardiographic (ECG), and echocardiographic (ECHO) differences between HCM and FD. Methods 60 HCM and 40 FD patients were analyzed retrospectively as a subanalysis of the ‘LVH-TR study’ after excluding patients with atrial fibrillation, pace rhythm, bundle branch blocks, and second and third-degree atrioventricular (AV) blocks. The significance level was accepted as <0.05. Results Male gender (p=0.048) and creatinine (p=0.010) are significantly higher in favor of FD; however, ST depression (p=0.028), QT duration (p=0.041), interventricular septum thickness (IVSd) (p=0.003), posterior wall thickness (PWd) (p=0.009), moderate-severe mitral regurgitation (MR) (p=0.013), and LV mass index (LVMI) (p=0.041) are significantly higher in favor of HCM in the univariate analyses. In multivariate analysis, statistical significance only continues in creatinine (p=0.018) and QT duration (0.045). FD was positively correlated with creatinine (rho=0.287, p=0.004) and HCM was positively correlated with PWd (rho=0.306, p=0.002), IVSd (rho=0.395, p<0.001), moderate-severe MR (rho=0.276, p<0.005), LVMI (rho=0.300, p=0.002), relative wall thickness (RWT) (rho=0.271, p=0.006), QT duration (rho=0.213, p=0.034) and ST depression (rho=0.222, p=0.026). Conclusion Specific biochemical, ECG, and ECHO characteristics can aid in the differentiation and early diagnosis of HCM and FD. (HCM (FD LVH (LVH outcomes demographic clinical biochemical ECG , (ECG) (ECHO 6 4 ‘LVHTR LVHTR ‘LVH TR study fibrillation rhythm blocks thirddegree third degree AV (AV 005 0 05 <0.05 p=0.048 p0048 p 048 (p=0.048 p=0.010 p0010 010 (p=0.010 however p=0.028, p0028 p=0.028 028 (p=0.028) p=0.041, p0041 p=0.041 041 (IVSd p=0.003, p0003 p=0.003 003 (p=0.003) (PWd p=0.009, p0009 p=0.009 009 (p=0.009) moderatesevere moderate severe (MR p=0.013, p0013 p=0.013 013 (p=0.013) (LVMI (p=0.041 analyses analysis p=0.018 p0018 018 (p=0.018 0.045. 0045 0.045 . 045 (0.045) rho=0.287, rho0287 rho 287 (rho=0.287 p=0.004 p0004 004 rho=0.306, rho0306 306 (rho=0.306 p=0.002, p0002 p=0.002 002 p=0.002) rho=0.395, rho0395 395 (rho=0.395 p<0.001, p0001 p<0.001 001 p<0.001) rho=0.276, rho0276 276 (rho=0.276 p<0.005, p0005 p<0.005 p<0.005) rho=0.300, rho0300 300 (rho=0.300 RWT (RWT rho=0.271, rho0271 271 (rho=0.271 p=0.006, p0006 p=0.006 006 p=0.006) rho=0.213, rho0213 213 (rho=0.213 p=0.034 p0034 034 rho=0.222, rho0222 222 (rho=0.222 p=0.026. p0026 p=0.026 026 p=0.026) (ECG 00 <0.0 p=0.04 p004 04 (p=0.04 p=0.01 p001 01 (p=0.01 p002 p=0.02 02 (p=0.028 p000 p=0.00 (p=0.003 (p=0.009 (p=0.013 0.04 (0.045 rho=0.287 rho028 28 (rho=0.28 rho=0.306 rho030 30 (rho=0.30 rho=0.395 rho039 39 (rho=0.39 p<0.00 rho=0.276 rho027 27 (rho=0.27 rho=0.300 rho=0.271 rho=0.213 rho021 21 (rho=0.21 p=0.03 p003 03 rho=0.222 rho022 22 (rho=0.22 <0. p=0.0 p00 (p=0.0 (p=0.02 (p=0.00 0.0 (0.04 rho=0.28 rho02 2 (rho=0.2 rho=0.30 rho03 3 (rho=0.3 rho=0.39 p<0.0 rho=0.27 rho=0.21 rho=0.22 <0 p=0. p0 (p=0. 0. (0.0 rho=0.2 rho0 (rho=0. rho=0.3 p<0. < p=0 (p=0 (0. rho=0. (rho=0 p<0 p= (p= (0 rho=0 (rho= p< (p ( rho= (rho

https://doi.org/10.36660/abc.20230229

The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement
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Aktan, Adem

; Demir, Muhammed

; Güzel, Tuncay

; Karahan, Mehmet Zülküf

; Aslan, Burhan

; Kılıç, Raif

; Günlü, Serhat

; Arslan, Bayram

; Özbek, Mehmet

; Ertaş, Faruk

Brazilian Journal of Cardiovascular Surgery

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2024, Volume 39 Nº 2 elocation e20220436

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in-hospital complications as well as mortality of patients undergoing Evolut™ R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium-3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in-hospital mortality. Patients were divided into two groups, AA ≤ 48° and AA > 48°, based on the mean AA measurement (48.3±8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted. Introduction (AA inhospital Evolut implantation Methods 26 transfemoralapproach transfemoral approach selfexpandable self expandable 201 2022 endpoints success Consortium3. Consortium3 Consortium 3. 3 Consortium-3 leak newonset onset stroke groups 48 48.3±8.8 48388 8 (48.3±8.8 Results Pvalue P value 02 0 2 0. odds OR [OR] 173 1 73 1.73 95 CI [CI] 0.893.38, 089338 0.89 3.38, 89 38 0.89-3.38 P=0.104, P0104 P=0.104 , 104 P=0.104) (OR 04 1.04 0.991.10, 099110 0.99 1.10, 99 10 0.99-1.10 P=0.099, P0099 P=0.099 099 P=0.099) 166 66 1.66 0.823.33, 082333 0.82 3.33, 82 33 0.82-3.33 P=0.155, P0155 P=0.155 155 P=0.155) 182 1.82 0.923.61, 092361 0.92 3.61, 92 61 0.92-3.61 P=0.084, P0084 P=0.084 084 P=0.084) 057 57 0.57 0.271.21, 027121 0.27 1.21, 27 21 0.27-1.21 P=0.145 P0145 145 Conclusion implanted 20 202 Consortium- 4 48.3±8. 4838 (48.3±8. [OR 17 7 1.7 9 [CI 893 0.893.38 08933 089 0.8 338 3.38 0.89-3.3 P010 P=0.10 1.0 991 0.991.10 09911 0.9 110 1.10 0.99-1.1 P009 P=0.09 09 16 6 1.6 823 0.823.33 08233 082 333 3.33 0.82-3.3 P015 P=0.15 15 18 1.8 923 0.923.61 09236 092 361 3.61 0.92-3.6 P008 P=0.08 08 05 5 0.5 271 0.271.21 02712 027 121 1.21 0.27-1.2 P=0.14 P014 14 48.3±8 483 (48.3±8 1. 0.893.3 0893 3.3 0.89-3. P01 P=0.1 0.991.1 0991 11 1.1 0.99-1. P00 P=0.0 0.823.3 0823 0.82-3. 0.923.6 0923 36 3.6 0.92-3. 0.271.2 0271 12 1.2 0.27-1. 48.3± (48.3± 0.893. 0.89-3 P0 P=0. 0.991. 0.99-1 0.823. 0.82-3 0.923. 0.92-3 0.271. 0.27-1 48.3 (48.3 0.893 0.89- P=0 0.991 0.99- 0.823 0.82- 0.923 0.92- 0.271 0.27- 48. (48. P= (48 (4 (

https://doi.org/10.21470/1678-9741-2022-0436

Comparison of Chitosan-Containing Hemostatic Pad and Manual Compression after Coronary Angiography with Femoral Access ChitosanContaining Chitosan Containing
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Kiliç, Raif

; Güzel, Tuncay

; Aktan, Adem

; Kaya, Ahmet Ferhat

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20240020

Resumo: En | Texto: En | PDF: En

Abstract Background Femoral access remains a common choice in coronary angiography due to its easy accessibility and high success rate. Various techniques exist for achieving hemostasis following femoral artery catheterization. Objectives The aim of our study is to compare the methods of chitosan-containing hemostatic pad (HP) and manual compression (MC) in terms of efficacy and safety in patients undergoing percutaneous coronary intervention (PCI) with coronary angiography via femoral access. Method A total of 204 patients from 3 centers were included in our study between August 2021 and June 2023. The patients were divided into 2 groups, HP and MC, with 102 patients in each. Patients were evaluated for back and low back pain, complications, and duration of hemostasis immediately after angiography and up to 24 hours. Student’s t test and Mann-Whitney U test were used for numerical variables, while chi-square test was used for categorical variables. P < 0.05 was considered statistically significant. Results Hemostasis time and back and low back pain were significantly lower in the HP group (7.5 ± 1.1 versus 15.1 ± 1.6, p < 0.001 and 2.13 ± 1.29 versus 4.22 ± 1.69, p < 0.001, respectively). While ecchymosis was found to be significantly lower in the HP group (2.9% versus 14.7%, p = 0.003), there was no significant difference in terms of other complications. Conclusion HP was found to be more advantageous than MC in patients who underwent coronary angiography with femoral access. While ecchymosis and back and low back pain were found to be lower in the HP group, the absence of the need for sandbags also increases patient comfort. rate catheterization chitosancontaining chitosan containing (HP (MC PCI (PCI 20 202 2023 groups 10 each complications hours Students Student s MannWhitney Mann Whitney variables chisquare chi square 005 0 05 0.0 7.5 75 7 5 (7. 11 1 1. 151 15 15. 16 6 1.6 0001 001 0.00 213 13 2.1 129 29 1.2 422 4 22 4.2 169 69 1.69 respectively. respectively . respectively) 2.9% 9 (2.9 147 14 14.7% 0.003, 0003 0.003 , 003 0.003) comfort 00 0. 7. (7 000 21 2. 12 42 4. 2.9 (2. 14.7 ( (2 14.

https://doi.org/10.36660/ijcs.20240020

Reply to the letter: “Postintervention pain levels after elective coronary angiography” letter Postintervention angiography
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Kılıç, Raif

; Güzel, Tuncay

; Aktan, Adem

Revista da Associação Médica Brasileira

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2024, Volume 70 Nº 4 elocation e20231580

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1806-9282.20231580

Terapia Antiplaquetária Dupla Combinada em Pacientes com Doença Arterial Coronariana em uma População na Turquia: DAPT-TR Turquia DAPTTR DAPT TR
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Öz, Ahmet

; Toprak, Kenan

; Aydin, Ertan

; Saraç, İbrahim

; Doğduş, Mustafa

; Opan, Selçuk

; Yenerçağ, Mustafa

; Tascanov, Mustafa Begenc

; Kümet, Ömer

; Karaağaç, Miraç

; Özmen, Murat

; Murat, Bektaş

; Kertmen, Ömer

; Bekler, Özkan

; İnci, Sinan

; Huyut, Mustafa Ahmet

; Özderya, Ahmet

; Er, Fahri

; Duran, Mustafa

; Ardahanlı, İsa

; Baş, Mehmet Memduh

; Güzel, Tuncay

; Ceyhun, Gökhan

; Özdemir, İbrahim Halil

; Özen, Mehmet Burak

; Gündüz, Ramazan

; Erdoğan, Aslan

; Çetin, İlyas

; Barış, Veysel Özgür

; Yayla, Çağrı

; Karaduman, Medeni

; Aşkın, Lütfü

; Bekar, Lütfü

; Tanrıverdi, Okan

; Özkan, Eyüp

; Yeşil, Emrah

; Çalışkan, Serhat

; Kuzu, Zülfiye

; Uğuz, Berat

; Böyük, Ferit

; Kunak, Ayşegül Ülgen

; Murat, Selda

; Asil, Serkan

; Kayhan, Özkan

; Erdoğan, Emrah

; Duz, Ramazan

; Katkat, Fahrettin

; Ekin, Tuba

; İbişoğlu, Ersin

; Ateş, Bilge Nazar

; Ayça, Burak

; Ergene, Asım Oktay

; Zoghi, Mehdi

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 Nº 11 elocation e20240202

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A Terapia Antiplaquetária Dupla (DAPT, do inglês dual antiplatelet therapy) é o tratamento de escolha para pacientes com síndromes coronarianas agudas e crônicas, uma vez que ela reduz mortalidade e previne complicações trombóticas recorrentes. A avaliação da carga isquêmica e do risco de sangramento é crucial na escolha da DAPT e de sua duração. Objetivos O objetivo de nosso estudo foi conduzir um acompanhamento clínico prospectivo de pacientes recebendo terapia combinada (AAS 75mg + clopidogrel 75 mg). Nosso estudo é um estudo multicêntrico, transversal, observacional, do tipo coorte. Métodos Foram incluídos 1500 pacientes que iniciaram DAPT combinada para o tratamento de síndrome coronariana aguda ou síndrome coronariana crônica. Os desfechos primários foram internação hospitalar por qualquer motivo, internação por causa cardiovascular, infarto agudo do miocárdio, trombose de stent, revascularização de vaso alvo e sangramento; os desfechos secundários foram morte por qualquer razão ou por causa cardiovascular e acidente vascular cerebral. O nível de significância adotado na análise estatística foi 5%. Resultados A idade mediana foi 63 anos; 78,5% dos pacientes estavam recebendo DAPT por síndrome coronariana aguda. As taxas de internação por causas cardiovasculares, de infarto agudo do miocárdio, de trombose de stent e de revascularização de vaso alvo foram 7,9%, 2,3%, 1,3% e 4,2%, respectivamente. Enquanto a taxa de sangramento segundo a escala BARC tipo 1 foi de 3,3%, a taxa de sangramento BARC tipo 5, 3, ou 2 foi 0,6%. As taxas dos desfechos secundários morte por qualquer razão, morte por causa cardiovascular e acidente vascular cerebral foram 0,5%, 0,3% e 0,3%, respectivamente. Conclusão Nosso estudo mostrou que a DAPT em regime combinado de doses fixas de AAS e clopidogrel é eficaz e seguro em pacientes com síndrome coronariana aguda ou crônica adequadamente selecionados. DAPT, (DAPT therapy crônicas recorrentes duração mg 7 mg. . mg) multicêntrico transversal observacional coorte 150 motivo miocárdio 5 5% 6 anos 785 78 78,5 cardiovasculares 79 9 7,9% 23 3 2,3% 13 1,3 42 4 4,2% respectivamente 33 3,3% 06 0 0,6% 05 0,5% 03 0,3 selecionados 15 78, 7,9 2,3 1, 4,2 3,3 0,6 0,5 0, 7, 2, 4,

Abstract Background Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued. Objectives The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study. Methods A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%. Results Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes. (DAPT complications continued followup follow up fixeddose fixed dose ASA 7 mg. . mg) multicentric crosssectional, crosssectional cross sectional, sectional cross-sectional observational 150 infarction 5 5% 6 years 785 78 78.5 reasons infartion targetvessel 79 9 7.9% 23 3 2.3% 13 1.3 42 4 4.2% respectively 33 3.3% 06 0 0.6% 05 0.5% 03 0.3 Conclusion 15 78. 7.9 2.3 1. 4.2 3.3 0.6 0.5 0. 7. 2. 4. 3.

https://doi.org/10.36660/abc.20240202

Comparison of pain levels of traditional radial, distal radial, and transfemoral coronary catheterization radial
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Kılıç, Raif

; Güzel, Tuncay

; Aktan, Adem

; Arslan, Bayram

; Aslan, Muzaffer

; Günlü, Serhat

; Karahan, Mehmet Zülküf

Revista da Associação Médica Brasileira

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2023, Volume 69 Nº 7 elocation e20230198

Resumo: En | Texto: En | PDF: En

SUMMARY OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale. METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7±1.6, traditional radial artery: 3.9±1.9, and distal radial artery: 4.9±2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724–0.815, p<0.0001)]. CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain. OBJECTIVE angiography METHODS 202 2022 54 18 bed RESULTS 2716 2 7 1 6 2.7±1.6 3919 3 9 3.9±1.9 4921 4 4.9±2.1 respectively p<0.001. p0001 p p<0.001 . 0 001 p<0.001) mild moderate score time (p<0.001) analysis index298 29 8 index>29. kgm2 kgm kg m2 m kg/m 725 72 5 72.5 732 73 73.2 area curve 0770 770 0.770 95%CI 95CI CI 95 07240815 724 815 0.724–0.815 p<0.0001. p00001 p<0.0001 0001 p<0.0001)] CONCLUSION 20 271 2.7±1. 391 3.9±1. 492 4.9±2. p000 p<0.00 00 (p<0.001 index29 index>29 72. 73. 077 77 0.77 0724081 81 0.724–0.81 p0000 p<0.000 000 p<0.0001) 27 2.7±1 39 3.9±1 49 4.9±2 p00 p<0.0 (p<0.00 index2 index>2 07 0.7 072408 0.724–0.8 2.7± 3.9± 4.9± p0 p<0. (p<0.0 index> 0. 07240 0.724–0. 2.7 3.9 4.9 p<0 (p<0. 0724 0.724–0 2. 3. 4. p< (p<0 072 0.724– (p< 0.724 (p 0.72

https://doi.org/10.1590/1806-9282.20230198

Prognostic value of age, creatinine, and left ventricular ejection fraction risk score in patients evaluated with fractional flow reserve: a cross-sectional study age creatinine reserve crosssectional cross sectional
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Aktan, Adem

; Güzel, Tuncay

Revista da Associação Médica Brasileira

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2023, Volume 69 Nº 8 elocation e20230533

Resumo: En | Texto: En | PDF: En

SUMMARY OBJECTIVE: In this study, we investigated the relationship between age, creatinine, and left ventricular ejection fraction risk score and the severity of coronary lesions detected by applying fractional flow reserve in the patient group presenting with chronic coronary syndrome. Also, we presented long-term follow-up results in patients whose age, creatinine, and left ventricular ejection fraction score was evaluated by the fractional flow reserve procedure. METHODS: This study was planned retrospectively and in two centers. For this purpose, 114 patients who met the study criteria and who underwent elective fractional flow reserve between January 2014 and January 2019 were included in the study. Age, creatinine, and left ventricular ejection fraction was calculated as age/left ventricular ejection fraction +1 (if estimated glomerular filtration rate<30 mL/min). RESULTS: They were divided into two groups according to the cutoff value of the age, creatinine, and left ventricular ejection fraction score. A total of 76 patients had an age, creatinine, and left ventricular ejection fraction score of ≤1.17 (Group I) and 38 patients had an age, creatinine, and left ventricular ejection fraction score of >1.17 (Group II). The number of patients with severe lesions in fractional flow reserve was significantly higher in Group II compared with Group I (60.5 vs. 32.9%, p=0.005). According to the Kaplan-Meier analysis, a significant increase was observed in major adverse cardiac events and mortality during the follow-up period in the group with a high-risk score (Log Rank: 15.01, p<0.001 and Log Rank: 8.51, p=0.004, respectively). CONCLUSION: In light of the data we obtained from our study, we found a correlation between the severity of the lesion detected in fractional flow reserve and the age, creatinine, and left ventricular ejection fraction scores. In addition, we found that patients with high age, creatinine, and left ventricular ejection fraction scores had higher mortality and major adverse cardiac events rates during follow-up. OBJECTIVE age creatinine syndrome Also longterm long term followup follow up procedure METHODS centers purpose 11 201 Age ageleft 1 + if rate30 rate 30 rate<3 mL/min. mLmin mL/min . mL min mL/min) RESULTS 7 117 17 ≤1.1 3 >1.1 II. II) 60.5 605 60 5 (60. vs 329 32 9 32.9% p=0.005. p0005 p p=0.005 0 005 p=0.005) KaplanMeier Kaplan Meier analysis highrisk Rank 1501 15 01 15.01 p0001 001 p<0.00 851 8 51 8.51 p0004 004 p=0.004 respectively. respectively respectively) CONCLUSION addition followup. up. 20 rate3 rate< ≤1. >1. 60. 6 (60 32.9 p000 p=0.00 00 150 15.0 p<0.0 85 8.5 2 ≤1 >1 (6 32. p00 p=0.0 15. p<0. 8. ≤ > ( p0 p=0. p<0 p=0 p< p=

https://doi.org/10.1590/1806-9282.20230533

Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia QRST QRS T
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Karahan, Mehmet Zulkuf

; Aktan, Adem

; Güzel, Tuncay

; Kayan, Fethullah

; Günlü, Serhat

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20230055

Resumo: En | Texto: En | PDF: En

Abstract Background: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE. Background (CAE 15 1 5 1. segment arrhythmias failure death ischemia Objectives QRST QRS T Methods groups chisquare chi square test Students Student s ttest. ttest t t-test 005 0 05 0.0 12lead lead 12 ECGs (ECGs machine Results 632 63 2 63. 34 3 4 3. years them 611 61 61. 32 0.001, 0001 0.001 , 001 0.001) duration 0.002 0002 002 TpTe Tp Te interval 0.02 02 QTd, QTd (QTd) 004 04 0.04 Conclusion timeefficiently efficiently 00 0. 6 000 0.00 (QTd

https://doi.org/10.36660/ijcs.20230055

Relationship between contrast-induced nephropathy and long-term mortality after percutaneous coronary intervention in patients with chronic coronary total occlusion
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Güzel, Tuncay

; Aktan, Adem

; Demir, Muhammed

; Özbek, Mehmet

; Aslan, Burhan

Revista da Associação Médica Brasileira

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Ago 2022, Volume 68 Nº 8 Páginas 1078 - 1083

Resumo: En | Texto: En | PDF: En

SUMMARY OBJECTIVE: Intervention in chronic total occlusion lesions involves long procedure time, a serious contrast load, and complex procedures. In this study, we aimed to investigate mortality rate of patients who had procedural coronary angiography done for chronic total occlusion lesions in coronary angiography series and who developed contrast-induced nephropathy. METHODS: A total of 218 patients with chronic total occlusion lesion in at least one coronary artery, from three different medical centers, who underwent procedural coronary angiography were recruited for the study. Patient population was divided into two groups: those who developed contrast-induced nephropathy and those who did not. Mortality due to all causes was investigated between both groups throughout a 100-month follow-up. RESULTS: Mean age of patients with incidence of contrast-induced nephropathy was 66.7±11.8, and 23.8% of them were comprised by female. We found a significantly higher mortality in long-term follow-up in the patient group with contrast-induced nephropathy (42.9 vs. 57.1%, p≤0.001). According to Kaplan-Meier analysis performed additionally, survival during follow-up was significantly shorter in this group and, in logistic regression analysis, it was an independent predictor of mortality (OR 3.02; 95%CI 1.41–6.45, p=0.004). CONCLUSION: We identified that the development of contrast-induced nephropathy is associated with long-term mortality. It might be possible to reduce adverse events with prophylactic approaches before the procedure and close follow-up of such patients after the procedure.

https://doi.org/10.1590/1806-9282.20220283

10.

The effect of nutritional scores on mortality in COVID-19 patients
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Aktan, Adem

; Güzel, Tuncay

; Demir, Muhammed

; Özbek, Mehmet

Revista da Associação Médica Brasileira

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Ago 2022, Volume 68 Nº 8 Páginas 1096 - 1102

Resumo: En | Texto: En | PDF: En

SUMMARY OBJECTIVES: While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up. METHODS: A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality. RESULTS: The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02–1.06, p<0.001), admission oxygen saturation value (SaO2) (OR 0.85; 95%CI 0.83–0.87, p<0.001), and Controlling Nutritional Status score (OR 1.34; 95%CI 1.23–1.45, p<0.001), were independent predictors. The patient groups with a low Controlling Nutritional Status score had a higher rate of discharge with recovery (p<0.001). CONCLUSIONS: Higher Controlling Nutritional Status scores may be effective in determining in-hospital mortality in patients with COVID-19. Nutrition scores can be used as a useful and effective parameter to determine prognosis in patients with COVID-19.

https://doi.org/10.1590/1806-9282.20220577

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