ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 27 (10)
Volume: 27  Issue: 10 - October 2023
EDITORIAL
1.Preventive Cardiology and New Methods
Çetin Erol
PMID: 37776104  PMCID: PMC10541783  doi: 10.14744/AnatolJCardiol.2023.10  Page 556
Abstract |Full Text PDF

REVIEW
2.Current Insights for Catheter-Directed Therapies in Acute Pulmonary Embolism: Systematic Review and Our Single-Center Experience
Cihangir Kaymaz, Hacer Ceren Tokgöz, Barkın Kültürsay, Aykun Hakgör, Berhan Keskin, Ahmet Sekban, Ali Karagöz
PMID: 37599636  PMCID: PMC10541784  doi: 10.14744/AnatolJCardiol.2023.3639  Pages 557 - 566
In this review, the current status of the worldwide experience on different catheter-directed treatment systems utilized as alternative reperfusion methods in acute pulmonary embolism was evaluated, and the risk stratification algorithms in which catheter-directed treatments may be implemented, source of evidence in this setting, adjudication of benefits and risks of available techniques, and innovative multidisciplinary frameworks for referral patterns and care delivery were discussed. Moreover, our perspectives on risk-based catheter-directed treatment utilization strategies in acute pulmonary embolism were summarized.

ORIGINAL ARTICLE
3.Integrating the Left Atrium Diameter to Improve the Predictive Ability of the Age, Creatinine, and Ejection Fraction Score for Atrial Fibrillation Recurrence After Cryoballoon Ablation
Gökay Taylan, Murat Gök, Alparslan Kurtul, Abdulkadir Uslu, Ayhan Küp, Serdar Demir, Kamil Gülşen, Servet Altay, Taylan Akgün, Kenan Yalta
PMID: 37329114  PMCID: PMC10546214  doi: 10.14744/AnatolJCardiol.2023.2857  Pages 567 - 572
Background: Several clinical trials have assessed predictors for atrial fibrillation recurrence following cryoballoon catheter ablation. With these predictors, a practical and new scoring system can be developed to evaluate atrial fibrillation recurrence. The present study aimed to analyze the predictive value of the age, creatinine, and ejection fraction-left atrium score for potential recurrence of atrial fibrillation following cryoballoon catheter ablation in patients with symptomatic paroxysmal or persistent atrial fibrillation.

Methods: We retrospectively analyzed records of patients undergoing cryoballoon catheter ablation. atrial fibrillation recurrence was defined as an emerging atrial fibrillation episode around 12-month follow-up (with the exclusion of a 3-month blanking period). Univariate and multivariate analyses were performed to assess predictors of atrial fibrillation recurrence. In addition, receiver operating characteristic analysis was harnessed to evaluate the performance of the age, creatinine, and ejection fraction, left atrium score in determining the risk of atrial fibrillation recurrence.

Results: The study population comprised 106 subjects (age 52 ± 13 years, 63.2% women) with paroxysmal (84.9%, n = 90) or persistent (15.1%, n = 16) atrial fibrillation. age, creatinine, and ejection fraction, left atrium score was significantly higher in subjects with atrial fibrillation recurrence in comparison to those with the maintenance of sinus rhythm. However, on multivariate logistic regression analysis, only the age, creatinine, and ejection fraction, left atrium score (OR = 12.93, 95% CI: 2.22-75.21, P =.004) served as an independent predictor of atrial fibrillation recurrence following cryoballoon catheter ablation.

Conclusion: Age, creatinine, and ejection fraction, left atrium score had an independent association with the risk of atrial fibrillation recurrence in subjects with atrial fibrillation undergoing cryoballoon catheter ablation. Therefore, this score might potentially serve as a useful tool for risk stratification of patients with atrial fibrillation.

4.Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography
Marek Jedrzejek, Michal Kozlowski, Ewa Peszek-przybyla, Tomasz Jadczyk, Piotr Pysz, Wojciech Wojakowski, Grzegorz Smolka
PMID: 37288866  PMCID: PMC10541781  doi: 10.14744/AnatolJCardiol.2023.3008  Pages 573 - 579
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as preprocedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in 3D Slicer, a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.

5.Assessment and Evaluation of Cardiology Residency Training in Türkiye: A National Survey
Aylin Yıldırır, Sevgi Turan
PMID: 37288861  PMCID: PMC10541786  doi: 10.14744/AnatolJCardiol.2023.3282  Pages 580 - 591
Background: Workplace-based assessment methods are essential in the assessment and evaluation of competency-based cardiology residency training. This study aims to determine the assessment and evaluation methods used in cardiology residency training in Türkiye and to reach the opinions of the institutions on the applicability of the workplace-based assessments.

Methods: In this descriptive study, a Google Survey was sent to the heads/trainers of residency educational centers and their opinions about the currently used assessment and evaluation methods, applicability of cardiology competency exams, and the workplace-based assessments were asked.

Results: Responses were received from 65 (76.5%) of 85 training centers. Of the centers, 89.2% reported using resident report cards, 78.5% case-based discussion, 78.5% direct observation of procedural skills, 69.2% multiple-choice questions, 60% traditional oral exams, and less commonly other exam types. About 74% of responders gave a positive opinion on the requirement of being successful in the Turkish Cardiology Competency knowledge exam before specialty. Case-based discussion was the most common work-place-based assessments that the centers think could be applied as suggested by the current literature. A common idea was the adaptation of workplace-based assessments based on international standards and our national norms. The trainers supported a nationwide examination for all training centers to ensure standardization.

Conclusion: In Türkiye, it was promising to see that the trainers are positive about the applicability of workplace-based assessments, but they commonly thought that the proposed workplace-based assessments should be adapted before nationwide applicability. Medical educators and field experts need to work together on this issue.

6.Assessment of Myocardial Mechanics in Acute Rheumatic Fever Using Speckle-Tracking Echocardiography
Utku Pamuk, Hazım Alper Gürsu, Emine Azak, İbrahim İlker Çetin
PMID: 37466023  PMCID: PMC10541787  doi: 10.14744/AnatolJCardiol.2023.1792  Pages 592 - 596
Background: This study aims to evaluate the role of speckle-tracking echocardiography to identify myocardial deformation in acute rheumatic fever.

Methods: Twenty-seven patients and 27 healthy children were prospectively evaluated. The patient group was divided into 2 subgroups based on echocardiographic findings, with or without carditis. The left ventricular global longitudinal strain and strain rate, left ventricular global circumferential strain and strain rate, and right ventricular global longitudinal strain and strain rate were assessed by speckle-tracking echocardiography.

Results: In the acute phase of the disease, all values except the right ventricular global longitudinal strain were found to be significantly below the control group in the patient cohort. No significant difference was found between the patients grouped as carditis and non-carditis in the acute period. Comparison of the acute period with the post-treatment period revealed a significant increase in all strain values of the patients with carditis and significant increases observed in all values except left ventricular global longitudinal strain rate, left ventricular global circumferential strain rate, and right ventricular global longitudinal strain rate values in patients without carditis. Apart from the right ventricular global longitudinal strain rate, which was significantly lower in the non-carditis group compared to the control group, there was no significant difference in strain values between the patient and control groups following treatment.

Conclusion: In the present study, we found that all patients, including patients in whom no valvular involvement was detected by echocardiography in the acute phase of acute rheumatic fever, had a lower right and left ventricular strain and strain rate measurements and that these findings improved after treatment, suggesting that strain echocardiography may be a helpful diagnostic method, especially in patients without valvular involvement.

7.Distribution and Economic Burden of Diabetes-Related Microvascular Complications in Türkiye
Suayip Birinci, Berna Simten Malhan
PMID: 37779367  PMCID: PMC10541788  doi: 10.14744/AnatolJCardiol.2023.3762  Pages 597 - 607
Background: The aim of the study was to map microvascular complications associated with diabetes mellitus from personal health records and to guide chronic disease management by revealing the economic burden of the disease.

Method: The data of patients with diabetes who developed microvascular complications were obtained from the e-Pulse database of the Ministry of Health, with the definitions of the disease. First, the distribution of patients by province and gender was determined and then patients with multiple complications were identified. Only direct costs and their distribution on the basis of complications were determined from the database according to the cost of illness methodology from the payer’s perspective. Then, average annual per-patient costs were determined using a top-down costing approach.

Results: Between 2016 and 2020, a total of 7 656 700 patients with diabetes were reached. The number of patients with microvascular complications between 2016 and 2020 obtained from the e-Pulse database with the above definitions was 1 466 387. Regarding the complications, a total of 66 838 people developed nephropathy, 314 706 people developed retinopathy, and 1 084 843 people developed neuropathy. The total cost of patients with microvascular complications was $1 482 278 950.76 and the average annual cost per patient was $1010.84. The average annual cost of neuropathy is $659 862 971.96, retinopathy is $356 594 282.51 and nephropathy is $465 821 696.29, with per-patient costs of $701.82, $1495.24, and $10 516.11, respectively.

Conclusion: Diabetes mellitus, with its microvascular complications, causes significant disease and economic burden. Türkiye’s national health database system, e-Pulse, is an important database that provides patient follow-up at both individual and population levels and helps with the management of the disease and taking preventive measures before the development of the complications.

CASE REPORT
8.Thromboembolic Events in Patients with Hypertrophic Cardiomyopathy and Atrial Fibrillation During New Oral Anticoagulant Therapy
Myeonghyun An, Yae Min Park, Jeongduk Seo, Joonpyo Lee, Albert Youngwoo Jang, Woong Chol Kang, Wook-Jin Chung, In Suck Choi
PMID: 37599635  PMCID: PMC10541780  doi: 10.14744/AnatolJCardiol.2023.3474  Pages 608 - 610
Abstract |Full Text PDF | Video

LETTER TO THE EDITOR
9.Single-Stent Double-Kissing Nano-Crush Technique for the Management of Side Branch Ostial Lesions: A Game Changer? Or Just Another Player in the Game?
Kenan Yalta
PMID: 37776105  PMCID: PMC10541785  doi: 10.14744/AnatolJCardiol.2023.3694  Pages 611 - 612
Abstract |Full Text PDF

LETTER TO THE EDITOR REPLY
10.Reply to Letter to the Editor: “Single-Stent Double-Kissing Nano-Crush Technique for the Management of Side Branch Ostial Lesions: A Game Changer? Or Just Another Player in the Game?”
Emrah Acar, Yılmaz Güneş, İbrahim Akın İzgi, Cevat Kırma
PMID: 37786326  PMCID: PMC10541782  doi: 10.14744/AnatolJCardiol.2023.3696  Pages 613 - 614
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
11.A Rare Case of Primary Biatrial and Coronary Venous Sinus Rhabdomyosarcoma
Leizhi Ku, Youping Chen, Yafeng He, Xiaojing Ma
PMID: 37288867  PMCID: PMC10541789  doi: 10.14744/AnatolJCardiol.2023.3305  Pages E30 - E31
Abstract |Full Text PDF



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