ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 27 (9)
Volume: 27  Issue: 9 - September 2023
EDITORIAL
1.APOLLON Study and Others
Çetin Erol
PMID: 37655738  PMCID: PMC10510421  doi: 10.14744/AnatolJCardiol.2023.9  Page 503
Abstract |Full Text PDF

META ANALYSIS
2.Meta-Analysis of Prophylactic Renal Replacement Therapy after Cardiac Catheterization in Patients with Chronic Kidney Disease
Yutthapong Temtanakitpaisan, Suchaorn Saengnipanthkul, Wasawat Vutthikraivit
PMID: 37599634  PMCID: PMC10510418  doi: 10.14744/AnatolJCardiol.2023.3443  Pages 504 - 512
Background: The benefits of prophylactic renal replacement therapy after cardiac catheterization in patients with chronic kidney disease remain unclear. The aim of this study is to confirm the benefit of prophylactic renal replacement therapy after cardiac catheterization.

Methods: We systematically searched for studies published from inception to December 2022 examining the benefits of prophylactic renal replacement therapy after cardiac catheterization in MEDLINE and EMBASE. Data analysis was performed according to the PRISMA statement using the Mantel–Haenszel method.

Results: Five studies met the inclusion criteria, which comprised of 532 chronic kidney disease patients who underwent coronary angiography (268 had prophylactic renal replacement therapy and 264 did not have prophylactic renal replacement therapy). The pooled analysis revealed a non-significant decreased risk of 1-year mortality in chronic kidney disease patients who underwent coronary angiography and prophylactic renal replacement therapy compared to those who did not have prophylactic renal replacement therapy (RR = 0.59; P =.18; CI: 0.28-1.2795, I2 = 60.4%). The risk of hemodialysis during hospitalization and renal replacement therapy requirement in 1 year in chronic kidney disease patients who underwent coronary angiography and prophylactic renal replacement therapy were lower than in those who did not have prophylactic renal replacement therapy (RR = 0.13; P =.001; CI: 0.04-0.43, I2 = 9.1% and RR = 0.29; P =.015; CI: 0.11-0.78, I2 = 49.9%, respectively). The sensitivity analysis demonstrated that the overall findings remained consistent and did not significantly alter.

Conclusions: Prophylactic renal replacement therapy did not seem to lower 1-year mortality among chronic kidney disease patients who underwent coronary angiography. However, prophylactic renal replacement therapy appeared to reduce the risk of hemodialysis during hospitalization and renal replacement therapy requirement in 1 year.

ORIGINAL ARTICLE
3.Neutrophil Gelatinase-Associated Lipocalin Level Can Predict Early Organ Damage in Primary Hypertensive Patients: A Pilot Study
Serdar Gökhan Nurkoç, Serkan Ünlü, Bayram Şen, Atike Burçin Tefon, Murat Hasanreisoglu, Asife Şahinarslan
PMID: 37288862  PMCID: PMC10510419  doi: 10.14744/AnatolJCardiol.2023.2991  Pages 513 - 518
Background: Early detection and treatment of complicated arterial hypertension will prevent its effect on the target organs. In line with this purpose, we aimed to reveal the prediction capability of neutrophil gelatinase-associated lipocalin to complicated hypertension.

Methods: In total, 46 patients with hypertension and 21 healthy volunteers were included in the study. Left ventricle morphology and geometry, as systolic and diastolic functions, were analyzed. Global longitudinal strain was measured from recorded apical 3-chamber views. An ophthalmic examination was performed to investigate the presence of retinopathy in individuals with hypertension. In addition, plasma neutrophil gelatinase-associated lipocalin values were evaluated via the method of the enzyme-linked immunosorbent assay.

Results: Both neutrophil gelatinase-associated lipocalin levels and global longitudinal strain percentages were statistically significant between the groups with diastolic dysfunction and the groups without diastolic dysfunction. Complicated hypertension was detected in 42 patients. Here, it was found that the neutrophil gelatinase-associated lipocalin level of 144.3 ng/mL predicted complicated hypertension with 0.872 sensitivity and 0.65 specificity values.

Conclusion: Analyzing neutrophil gelatinase-associated lipocalin levels in patients with hypertension in routine practice can easily and practically detect complicated hypertension patients earlier.

4.Effects of Cavitation from Extracorporeal Shock Wave Combined with Sulfur Hexafluoride Microbubble on Myocardial Ultrastructure in Rats
Yajing Miao, Xiaoxu Wang, Hongning Yin, Ruoling Han
PMID: 37288863  PMCID: PMC10510423  doi: 10.14744/AnatolJCardiol.2023.2946  Pages 519 - 528
Background: In the present study, the effects of extracorporeal cardiac shock waves combined with different concentrations of sulfur hexafluoride ultrasound microbubbles on myocardial ultrastructure in rats were observed.

Methods: Thirty-six rats were randomly divided into 6 groups: control group (N), extra-corporeal cardiac shock wave group, and combined group, i.e., extracorporeal cardiac shock wave combined with different concentrations of sulfur hexafluoride microbubble (0.225 mL/kg/min, 0.45 mL/kg/min, 0.9 mL/kg/min, 1.8 mL/kg/min). The combination of extracorporeal cardiac shock wave combined with sulfur hexafluoride microbubbles of different concentrations had no significant effect on hemodynamic indexes and left ventricular function in rats.

Results: There were significant differences in cardiac troponin I (cTnI) and nitric oxide among different groups. Histopathology showed that inflammatory cells infiltrated in the shock wave + microbubble 0.9 and shock wave + microbubble 1.8 groups. The myocardial ultrastructural injury score of shock wave + microbubble1.8 group was significantly higher than that of the N group, shock wave group, shock wave + microbubble 0.225 group, and shock wave + microbubble 0.45 group. The score of shock wave + microbubble 0.9 group was higher than that of the control group (P =.009). Western blot results showed that the expression of vascular endothelial growth factor and endothelial nitric oxide synthase (eNOS) protein in the rats treated with extracorporeal cardiac shock wave combined with sulfur hexafluoride microbubbles of different concentrations was higher than that in the N group and shock wave group, with shock wave + microbubble 0.45 group having the strongest expression.

Conclusion: Myocardial ultrastructure damage occurs when high concentrations of sulfur hexafluoride microbubbles are present, but a proper concentration of sulfur hexafluoride microbubbles could promote the cavitation effect of extracorporeal cardiac shock waves. Thus combination therapy may become a new paradigm in coronary heart disease, especially contributing to the treatment of refractory angina. Combination therapy may change coronary heart disease treatment, especially for refractory angina.

5.Analysis of Coronary Angiography and Revascularization Rates Made Over 5 Years in Public Institutions in Türkiye
Attila Beştemir, Ziya Apaydın, Ali Yaşar Kılınç
PMID: 37329116  PMCID: PMC10510416  doi: 10.14744/AnatolJCardiol.2023.3112  Pages 529 - 533
Background: Coronary angiography is currently the gold standard anatomic imaging method used to diagnose obstructive epicardial coronary artery disease. In patients with critical coronary stenosis, surgical or percutaneous revascularization is provided. Normal coronary artery ratio in coronary angiography is an indirect indicator of patient selection quality. The aim of our study is to evaluate the efficiency of coronary angiography by examining the revascularization rates according to years in patients who underwent coronary angiography.

Methods: Revascularization rates will be determined by analyzing retrospectively the number of patients who underwent coronary angiography in our country between 2016 and 2021 and were revascularized interventionally or surgically. The number of patients who underwent percutaneous, surgical, and total revascularization were proportioned to the number of coronary angiography, and their percentages were determined.

Results: From 2016 to 2019, there was a continuous increase in the number of coronary angiography. In 2020, the lowest coronary angiography numbers (n = 222.159) of the last 6 years were seen with the effect of the COVID-19 pandemic. In 2021, it was observed that the number of coronary angiography increased again with the relaxation of pandemic measures and the approaching of hospital admissions to old levels. It is seen that revascularization is performed in up to one-third of the patients who underwent coronary angiography.

Conclusion: Similar to the rest of the world, revascularization rates as a result of coronary angiography procedures performed in our country are low. With this result, it should not be concluded that coronary angiography is not used effectively; on the contrary, the efficiency of coronary angiography can be increased by more effective use of noninvasive tests.

6.Individualized Blind Techniques for Puncture of Intrathoracic and Extrathoracic Subclavian Vein: Three Simple Experience Tips
Yula He, Weiping Yang, Ying Zhao, Hexiang Cheng, Minxia Zhang, Yuan Yuan
PMID: 37288868  PMCID: PMC10510415  doi: 10.14744/AnatolJCardiol.2023.2893  Pages 534 - 538
Background: Although several procedures of subclavian venipuncture have been reported, no standard method has been established yet. The purpose of this study was to investigate some more accurate and improved blind puncture tips.

Methods: A prospective study was conducted on patients who underwent cardiac radio-frequency ablation with the blind technique of subclavian venipuncture from August 2018 to June 2022. All patients were randomly assigned to an intrathoracic approach group or extrathoracic approach group. Each group of patients followed their own specific puncture scheme and tips.

Results: About 371 punctures were included. Blind subclavian venipunctures were performed with 98.9% technical success and without complications in all patients. The overall success rate with an intrathoracic and extrathoracic approach was equivalent (96.7% vs. 98.3%, P =.23). The intrathoracic group showed a higher first-pass success compared with the extrathoracic group (91.9% vs. 80.2%, P = 0.003, respectively).

Conclusion: We localized the landmark/reference and skin puncture site of an intrathoracic and extrathoracic subclavian venipuncture individually and quantitatively. These experiences make blind techniques more accurate and faster.

7.Comparing the Diagnostic Performance of HFA-PEFF and H2FPEF Scoring Systems in Heart Failure with Preserved Ejection Fraction Patients: Insights from the APOLLON Registry
Gurbet Özge Mert, Bülent Özlek, Eda Özlek, Hicaz Zencirkiran Ağuş, Mehmet Tekinalp, Serkan Kahraman, Cem Çil, Oğuzhan Çelik, Özcan Başaran, Volkan Doğan, Bedri Caner Kaya, İbrahim Rencüzoğulları, Altuğ Ösken, Lütfü Bekar, Mustafa Ozan Çakır, Yunus Çelik, Kadriye Memiç Sancar, Samet Sevinç, Murat Biteker, Kadir Uğur Mert
PMID: 37655737  PMCID: PMC10510413  doi: 10.14744/AnatolJCardiol.2023.3345  Pages 539 - 548
Background: Heart failure with preserved ejection fraction is a complex and heterogeneous clinical syndrome, poses significant diagnostic challenges. The HFA-PEFF [Heart Failure Association of ESC diagnostic algorithm, P (Pretest Assessment), E  (Echocardiographic and Natriuretic Peptide score), F1 (Functional testing in Case of Uncertainty), F2 (Final Aetiology)] and H2FPEF [Heavy (BMI>30 kg/m2), Hypertensive (use of ≥2 antihypertensive medications), atrial Fibrillation (paroxysmal or persistent), Pulmonary hypertension (Doppler Echocardiographic estimated Pulmonary Artery Systolic Pressure >35 mm Hg), Elderly (age >60 years), Filling pressure (Doppler Echocardiographic E/e’ >9)] scoring systems were developed to aid in diagnosing heart failure with preserved ejection fraction. This study aimed to assess the concordance and clinical accuracy of these scoring systems in the “A comPrehensive, ObservationaL registry of heart faiLure with mildly reduced and preserved ejection fractiON” cohort.

Methods: A comPrehensive, ObservationaL registry of heart faiLure with mildly reduced and preserved ejection fractiON study was conducted as a multicenter, cross-sectional, and observational study; to evaluate a group of Heart failure with mildly reduced ejection fraction and heart failure with preserved ejection fraction patients who were seen by cardiologists in 13 participating centers across 12 cities in Türkiye.

Results: The study enrolled 819 patients with heart failure with preserved ejection fraction, with high probability heart failure with preserved ejection fraction rates of 40% and 26% for HFA-PEFF and H2FPEF scorings, respectively. The concordance between the 2 scoring systems was found to be low (Kendall’s taub correlation coefficient of 0.242, P < .001). The diagnostic performance of both scoring systems was evaluated, revealing differences in their approach and ability to accurately identify heart failure with preserved ejection fraction patients.

Conclusion: The low concordance between the HFA-PEFF and H2FPEF scoring systems underscores the ongoing challenge of accurately diagnosing and managing patients with heart failure with preserved ejection fraction. Clinicians should be aware of the strengths and limitations of each scoring system and use them in conjunction with other clinical and laboratory findings to arrive at an accurate diagnosis. Future research should focus on identifying additional diagnostic factors, developing more accurate and comprehensive diagnostic algorithms, and investigating alternative methods of diagnosis or stratification of patients based on different clinical characteristics.

CASE REPORT
8.Platypnea–Orthodeoxia Syndrome Following Transcatheter Aortic Valve Replacement
Selçuk Küçükseymen, Niccolò Ciardetti, Miroslava Stolcova, Carlo Di Mario, Francesco Meucci
PMID: 37551749  PMCID: PMC10510414  doi: 10.14744/AnatolJCardiol.2023.3217  Pages 549 - 551
Abstract |Full Text PDF

LETTER TO THE EDITOR
9.Pros and Cons of a Novel Coronary Stenting Technique for Medina 0.0.1 Lesions: Osdokina Crush
Ahmet Güner, Fatih Uzun, Serkan Kahraman, Ahmet Yaşar Çizgici, Mehmet Ertürk
PMID: 37487231  PMCID: PMC10510420  doi: 10.14744/AnatolJCardiol.2023.3542  Pages 552 - 553
Abstract |Full Text PDF

LETTER TO THE EDITOR REPLY
10.Reply to Letter to the Editor: “Pros and Cons of a Novel Coronary Stenting Technique for Medina 0.0.1 Lesions: Osdokina Crush”
Emrah Acar, Yılmaz Güneş, İbrahim Akın İzgi, Cevat Kırma
PMID: 37487230  PMCID: PMC10510422  doi: 10.14744/AnatolJCardiol.2023.3541  Pages 554 - 555
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
11.A 39-Year-Old Woman with Chest Pain: The Importance of Incidental Imaging Findings
Yavuzer Koza, Birkan Bedir, Hakan Taş, Fatih Alper
PMID: 37288860  PMCID: PMC10510417  doi: 10.14744/AnatolJCardiol.2023.3365  Page E29
Abstract |Full Text PDF



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