ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 26 (11)
Volume: 26  Issue: 11 - November 2022
EDITORIAL
1.COP27 Climate Change Conference Editorial, TAVI, SGLT2 inhibitors…
Çetin Erol
doi: 10.5152/AnatolJCardiol.2022.11  Page 798
Abstract |Full Text PDF

2.COP27 Climate Change Conference: Urgent action needed for Africa and the world
Lukoye Atwoli, Gregory E. Erhabor, Aiah A. Gbakima, Abraham Haileamlak, Jean-marie Kayembe Ntumba, James Kigera, Laurie Laybourn- Langton, Bob Mash, Joy Muhia, Fhumulani Mavis Mulaudzi, David Ofori- Adjei, Friday Okonofua, Arash Rashidian, Siaka Sidibé, Abdelmadjid Snouber, James Tumwine, Mohammad Sahar Yassien, Paul Yonga, Lilia Zakhama, Chris Zielinski
doi: 10.5152/AnatolJCardiol.2022.13  Pages 799 - 801
Abstract |Full Text PDF

META ANALYSIS
3.Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year Follow-Up
Changgan Chen, Beibei Xi, Qiufeng Deng, Xinyuan Zhang, Weicheng Lin, Liangwan Chen, ZhiHuang Qiu
doi: 10.5152/AnatolJCardiol.2022.1665  Pages 802 - 809
Background: Previous studies have shown that transcatheter aortic valve implantation is the best alternative therapy to surgical aortic valve replacement in high-risk surgical patients with aortic stenosis. However, it is not clear whether transcatheter aortic valve implantation can be utilized in low-risk surgical patients with aortic stenosis. This studyaimed to evaluate the safety and efficacy of transcatheter aortic valve implantation in low-risk patients.

Methods: From the outset of our initiative until April 2022, PubMed, EMBASE, and the Cochrane database were thoroughly searched, yielding the selection of 3 randomized controlled trials including 2644 patients with aortic stenosis, to assess outcome measures at distinct follow-up time.

Results: The mean Society of Thoracic Surgeons Predicted Risk of Mortality score of patients was 2.2. At the 30-day and 1-year follow-up, transcatheter aortic valve implan- tation was associated with a lower incidence of all-cause mortality, cardiovascular mor- tality, acute kidney injury (stage 2 or 3), life-threatening or significant bleeding, and new atrial fibrillation but an increased risk of permanent pacemaker implantation. At the 2-year follow-up, transcatheter aortic valve implantation only had an advantage in new atrial fibrillation (relative risk, 0.27; 95% CI, 0.14-0.51; P <.0001), with no significant differ- ence in all-cause mortality or cardiovascular mortality.

Conclusions: For low-risk surgical patients with aortic stenosis, compared to surgical aortic valve replacement, transcatheter aortic valve implantation was associated with lower all-cause mortality at 30-day follow-up and lower cardiovascular mortality at 1-year follow-up. Except for the advantages in new atrial fibrillation, transcatheter aor- tic valve implantation had no significant impact on mortality at 2-year follow-up.

Cite this article as: Chen C, Xi B, Deng Q, et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement in low-risk patients: A meta-analysis based on a 2-year follow-up.

ORIGINAL INVESTIGATION
4.Duration of Ciprofloxacin Use Is Important in the Development of Abdominal Aortic Aneurysm in a Rat Model
Yekta Çulpan, İrem Keçeci, İrem Sandıkçı, Şeyda Gökçe, Hande Göker, Nagehan Özyılmaz Yay, Rabia Ergelen, Dilek Akakın, Rezzan Gülhan Aker
doi: 10.5152/AnatolJCardiol.2022.1939  Pages 810 - 817
Background: Recent findings suggest that fluoroquinolones, most prescribed antibiotic to treat various infections, have increased abdominal aortic aneurysm formation. We aimed to investigate the relation of the development of abdominal aortic aneurysm and the duration of ciprofloxacin use.

Methods: Male Sprague–Dawley rats were divided into 2 groups to administer saline to the control groups and CaCl2 to the aneurysm groups. These groups were then divided into 3 subgroups: intraperitoneal saline, ciprofloxacin for 2 weeks, and ciprofloxacin for 4 weeks. At the end of 4 weeks, the diameter of abdominal aorta was determined by ultrasonography and animals were sacrificed to obtain abdominal aorta specimens. Elastic fiber fracture, tunica media layer thickness, and aortic tissue damage were evaluated histologically.

Results: Aortic diameter of control-saline (2.15 mm ± 0.06), control-2 weeks (2.25 mm ± 0.06), and control-4 weeks (3.31 mm ± 0.09) ciprofloxacin groups was significantly different (P <.0001). Also, aortic diameter of aneurysm-saline (2.07mm ± 0.02), aneurysm-2 weeks ciprofloxacin (3.33 mm ± 0.64), and aneurysm-4 weeks ciprofloxacin (8.55 mm ± 1.70) groups showed significant increase in aortic diameter with increasing duration of ciprofloxacin use (P <.01). A significant difference was found between the control-saline (0.00 ± 0.00), control-2 weeks (1.50 ± 0.33), and control-4 weeks ciprofloxacin groups (1.57 ± 0.20) in the histological aneurysm scores (P <.001). Aortic tunica media thickness did not change between control-saline and control-ciprofloxaci n groups (P >.05).

Conclusion: The study showed that ciprofloxacin caused injury in the aortic wall but not a significant change in the thickness of the aortic tunica media layer. The duration of ciprofloxacin use was important in the development of aneurysm and aneurysm severity.

5.Identification of Key Genes in Atherosclerosis by Combined DNA Methylation and miRNA Expression Analyses
Yankun Cui, Lin Wang, Yanmei Huang, Li Yongxin, Chao Liu, Bingzhi Wang, Zhengyun Zuo, Fengyun Yao
doi: 10.5152/AnatolJCardiol.2022.1723  Pages 818 - 826
Background: Atherosclerosis is a significant cause of coronary heart disease, cerebral infarction, and peripheral vascular disease. The objective of this study was to identify the key genes aberrantly expressed in atherosclerosis, which were regulated by microRNAs and DNA methylation.

Methods: We acquired data on DNA methylation and microRNA and messenger RNA expression from Gene Expression Omnibus data sets (GSE46394, GSE53675, and GSE12288, respectively) and identified differentially methylated genes, differentially expressed genes, and differentially expressed microRNAs between atherosclerosis and control samples. The miRDB, miRTarBase, and TargetScan databases were used to predict differentially expressed microRNAs-targeted genes, which were then intersected with differentially methylated genes and differentially expressed genes to identify genes associated with aberrant DNA methylation and microRNA activity. The DAVID database was used to perform functional enrichment analysis of differentially methylated genes and the key genes involved in atherosclerosis. Potential therapeutic agents for atherosclerosis were predicted by Connectivity Map analysis.

Results: In total, we identified 47 upregulated hypomethylated and 90 downregulated hypermethylated genes in atherosclerosis. Among them, 24 differentially expressed genes were found to be modulated both through aberrant DNA methylation and microRNA expression, and 10 such differentially expressed genes were defined as the key genes in atherosclerosis. Fifteen chemicals were selected for their potential effect in.

Conclusions: We identified 10 key genes significantly associated with aberrant DNA methylation and microRNA expression in atherosclerosis and suggested 15 chemicals with potential effects on these genes, which could be further investigated as candidate drugs for atherosclerosis.

6.Evaluation of Long-Term Outcomes of Crossover or Focal Ostial Stenting of Left Anterior Descending Artery Ostial Stenosis
Korhan Soylu, Ufuk Yıldırım, Muharrem Nasifov, Hakan Uçar, Ömer Taşbulak, Samir Allahverdiyev, Ömer Göktekin
doi: 10.5152/AnatolJCardiol.2022.1122  Pages 827 - 831
Background: Optimal management of patients with ostial left anterior descending artery stenosis remains an unresolved issue.

Methods: Patients with ostial left anterior descending stenosis who underwent stent implantation were included in this study. Coronary records of all patients were monitored, and long-term clinical outcomes were recorded. The patients were divided into 2 groups according to the stenting method: focal left anterior descending stenting [ostial stenting group] and stenting from the left main coronary artery to the left anterior descending [crossover stenting group].

Results: Of the 97 eligible consecutive patients, 56 were treated with ostial stenting and 41 with crossover stenting. At a mean follow-up of 23.6 ± 12.6 months, non-fatal myocardial infarction (3.9% vs. 12.8%, P=.118), target lesion revascularization (5.9% vs. 12.8%, P=.252), and all-cause death (2.0% vs. 7.7%, P=.191) rates were not statistically significant. However, the rate of major adverse cardiovascular events defined as a composite of non-fatal myocardial infarction, target lesion revascularization, or all-cause death was significantly higher in the crossover stenting group (8.2% vs. 28.2%, P =.013). In the multiple regression analysis, left main coronary artery diameter (odds ratio = 4.506; 95% CI: 1.225-16.582, P =.024) and application of the crossover stenting technique (odds ratio = 5.126; 95% CI: 1.325-19.833, P =.018) were found to be the most effective predictors of major adverse cardiovascular events.

Conclusion: In our study, the ostial stenting group was associated with better clinical outcomes in the treatment of ostial left anterior descending stenosis. However, it is notappropriate to apply a single method to all patients with such lesions.

7.Dapagliflozin Improves Cardiac Autonomic Function Measures in Type 2 Diabetic Patients with Cardiac Autonomic Neuropathy
Akif Serhat Balcıoğlu, Enes Çelik, Murat Şahin, Kemal Göçer, Ekrem Aksu, Ahmet Çağrı Aykan
doi: 10.5152/AnatolJCardiol.2022.1934  Pages 832 - 840
Background: Cardiac autonomic neuropathy is a frequent complication of type 2 diabetes mellitus. Cardiac autonomic neuropathy, in which sympathetic tone predominates over parasympathetic activity, increases both cardiovascular morbidity and mortality and unfortunately has no definitive treatment. Sodium-glucose cotransporter-2 inhibitors have been suggested to reduce sympathetic nervous system activity, based on the results from previous studies. In this study, we aimed to investigate the effect of 24-week treatment with dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, on cardiac autonomic function measures in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy.

Methods: Dapagliflozin 10 mg/day (n=42) or non-sodium-glucose cotransporter-2 inhibitor oral antidiabetic(s) (n=38) was added to the treatment of patients whose glycemic control could not be achieved with existing treatments. The patients with definite or confirmed cardiac autonomic neuropathy diagnosed by cardiovascular autonomic reflex tests underwent 24-hour Holter-electrocardiogram recordings to obtain heart rate variability and heart rate turbulence parameters before starting additional medication and after a 24-week treatment period.

Results: In-group analyses showed that dapagliflozin 10 mg/day for 24 weeks improved heart rate variability and heart rate turbulence parameters and decreased the frequency of ventricular premature beats relative to their baseline values. No such findings were observed in the control group despite similar glycemic control. Comparisons between dapagliflozin group and the control group showed that these effects of dapagliflozin were significantly better than non-sodium-glucose cotransporter-2 inhibitor oral antidiabetics.

Conclusion: Dapagliflozin improves measures of cardiac autonomic function compared to the control group in type 2 diabetic patients with cardiac autonomic neuropathy. This intergroup benefit, demonstrated for the first time, may be promising for the regression of cardiac autonomic neuropathy with sodium-glucose cotransporter-2 inhibitors.

8.Evaluation of Cardiac Function in Uncomplicated COVID-19 Survivors by 2-Dimensional Speckle Tracking Imaging
Müge Akbulut, Seda Tan, Demet Menekşe Gerede Uludağ, Volkan Kozluca, İrem Dinçer
doi: 10.5152/AnatolJCardiol.2022.1360  Pages 841 - 848
Background: COVID-19 is a multi-systemic infectious disease. Nearly 20%-30% of hospitalized patients have evidence of acute myocardial involvement, portending a poorer prognosis. However, information about the long-term effects of the disease on cardiac functions is sparse. As a result, there is a growing concern about the cardiac sequelae of COVID-19 among survivors. This study aimed to investigate the effects of prior mild-moderate COVID-19 infection on cardiac functions, using speckle tracking echocardiography.

Methods: Patients who have been diagnosed with COVID-19 within the previous 6 months and age-, sex-, and risk factor-matched healthy adults were included. All patients underwent a comprehensive echocardiographic examination. Both conventional and 2-dimensional speckle tracking echocardiographic measurements were performed. Serum cardiac biomarkers were also obtained on the day of the echocardiographic study.

Results: Compared with healthy controls, COVID-19 survivors had similar left and right ventricular longitudinal strain values at 6 months. Also, left and right atrial peak systolic strain values did not differ between the groups.

Conclusion: Our study is valuable in putting forth the unaffected ventricular and atrial functions on long term in uncomplicated COVID-19 cases and may decrease the survivors’ anxiety and the number of unnecessary applications to cardiology clinics.

CASE REPORT
9.Acute Myocardial Infarction in a 13-Year-Old Adolescent with Chronic Graft-Versus-Host Disease: A Case Report
Ya-Cong Liu, Cheng Cheng, Ri-xin Xu, Yong Xie
doi: 10.5152/AnatolJCardiol.2022.1760  Pages 849 - 851
Abstract |Full Text PDF

LETTER TO THE EDITOR
10.How to Optimize the Administration of Low-Dose Non-vitamin K Antagonist Oral Anticoagulants in Everyday Practice?
Anetta Undas
doi: 10.5152/AnatolJCardiol.2022.2190  Pages 852 - 853
Abstract |Full Text PDF

LETTER TO THE EDITOR REPLY
11.Reply to Letter to the Editor: “How to Optimize Administration of Low-Dose NOACs in Everyday Practice?”
Ze Li, Xiaozhen Wang, Aiping Wen
doi: 10.5152/AnatolJCardiol.2022.2191  Pages 854 - 855
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
12.A Rare Intraluminal Chord Crossing the Main Stem of the Left Coronary Artery
Leizhi Ku, Yafeng He, Juan Xia, Xiaojing Ma
doi: 10.5152/AnatolJCardiol.2022.2124  Pages E18 - E19
Abstract |Full Text PDF



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