ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 28 (4)
Volume: 28  Issue: 4 - April 2024
EDITORIAL
1.Telemedicine Interventional Therapy, Extra-cavity LV Image Registration…
Çetin Erol
PMID: 38551222  doi: 10.14744/AnatolJCardiol.2024.4  Page 176
Abstract |Full Text PDF

META ANALYSIS
2.Role of Telemedicine Intervention in the Treatment of Patients with Chronic Heart Failure: A Systematic Review and Meta-analysis
Chaoqun Wang, Yanqun Ba, Jiajia Ni, Runzhi Huang, Xiaofeng Du
PMID: 38430113  doi: 10.14744/AnatolJCardiol.2023.3873  Pages 177 - 186
Objective: Although telemedicine interventional therapy is an innovative method to reduce public medical burden and improve heart failure, its effectiveness is still controversial. This meta-analysis evaluates the role of telemedicine interventional therapy in the treatment of patients with chronic heart failure.

Methods: Relevant literature on telemedicine in chronic heart failure treatment was screened and extracted based on predefined criteria. Quality assessment used Cochrane Handbook 5.1.0 tool, and meta-analysis was conducted using R 4.2.2 software.

Results: Fifteen English-language articles were ultimately included in this meta-analysis. The risk bias evaluation determined that 4 articles were low-risk bias and 11 articles were unclear risk bias. The meta-analysis revealed that, compared to the routine intervention group, the all-cause hospitalization rate of patients in the telemedicine intervention
group decreased [OR = 0.63, 95% CI (0.41; 0.96), P =.03], and the hospitalization rate of heart failure also decreased [OR = 0.70, 95% CI (0.48; 0.85), P <.01]. However, there were no differences in mortality [OR = 0.64, 95% CI (0.41; 1.01), P =.05], length of hospitalization [MD = −0.42, 95% CI (−1.22; 0.38), P =.31], number of emergency hospitalizations [MD = −0.09, 95% CI (−0.33; 0.15), P =.45], medication compliance [OR = 1.67, 95% CI (0.92; 3.02), P =.09], or MLHFQ scores [MD = −2.30, 95% CI (−6.16; 1.56), P =.24] among the patients.

Conclusion: This meta-analysis showed that telemedicine reduced overall and heart failure-related hospitalizations in chronic heart failure patients, suggesting its value in clinical management. However, it did not significantly affect mortality, hospital stay length, emergency visits, medication adherence, or quality of life. This suggests the need to optimize specific aspects of telemedicine, identify key components, and develop strategies for better treatment outcomes.

ORIGINAL ARTICLE
3.Antiplatelet or Anticoagulant Therapy for Abdominal Aortic Aneurysms: Growth and Clinical Outcomes
Aysun Erdem Yaman, Esra Poyraz
PMID: 38284566  doi: 10.14744/AnatolJCardiol.2023.3719  Pages 187 - 193
Background: Intraluminal thrombi in the abdominal aortic aneurysms (AAA) were demonstrated to increase aneurysm growth. The effect of treatments on thrombus reduction upon AAA enlargement and clinical endpoints is uncertain Therefore, this study aimed to investigate the effect of antiplatelet and anticoagulant therapy on AAA growth and clinical outcomes.

Method: A total of 357 patients with AAAs were enrolled in this study. They were divided into 2 groups based on their medical therapies. Patients on antiplatelet and anticoagulant therapy were assigned to group 1 (n = 234) and group 2 (n = 92), respectively.

Results: The greatest reduction in thrombus diameter change was observed in patients with anticoagulant therapy (group 1, −2.26 mm; group 2, –8.16 mm; P =.001). The greatest aneurysmal enlargement was found in patients with antiplatelet therapy. There was less AAA progression with anticoagulant therapy than with the other therapy (group 1, 2.08 mm; group 2, 1.31 mm P =.027. The more operational need was observed in patients with antiplatelet therapy than in patients with anticoagulant therapy (group 1 67, group 2 16, P =.036)

Conclusion: In our study, it was revealed that anticoagulant therapy has been associated with decreased thrombus diameter and less aneurysmal enlargement compared with antiplatelet therapy. Furthermore, this beneficial effect on the thrombus size and aneurysmal diameter decreased the operational need in patients with anticoagulant therapy.

4.Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study
Chengchun Zuo, Xiaoye Li, Yingyun Guan, Linlin Fan, Jing Li, Dan Tian, Can Chen, Xiaoyu Li, Zhichun Gu, Chi Zhang, Xiaolan Bian, Qianzhou Lv
PMID: 38430112  doi: 10.14744/AnatolJCardiol.2023.3857  Pages 194 - 200
Background: The aim of this study was to investigate the influence of aging on the effectiveness and tolerance of sacubitril/valsartan (sac/val) among hypertensive patients complicated with heart failure in a real-world setting.

Methods: This multicenter, retrospective study included patients (≥18 years old) admitted with a diagnosis of hypertension and heart failure, starting sac/val therapy between January 2020 and December 2021 from 3 medical centers. Patients were grouped by the cutoff age of 65 years. Outcomes were collected 31-365 days after the initiation of sac/val and were compared in a matched cohort after 1: 1 propensity score matching (PSM).

Results: A total of 794 patients were finally analyzed. Blood pressure and cardiac functions improved significantly compared with values at baseline. There were 269 patients in each cohort (<65 years and ≥65 years) after PSM. After PSM, the incidence of hyperuricemia and hypotension in the elderly patients (≥65 years) was significantly higher than in those <65 years of age. Kaplan–Meier estimate suggested that the cumulative incidence of new or recurrent cardiovascular events increased significantly at the age of ≥65 years after the point of 3 months (log-rank P =.00087).

Conclusion: Sac/val benefited patients in both cohorts by improving blood pressure and cardiac function. Elderly patients (≥65 years) were susceptible to hypotension, low diastolic blood pressure, hyperuricemia, and underwent cardiac-related readmissions more frequently.

5.Extra-Cavity Image Registration via the Aortic Root During Left Ventricular Mapping and Ablation
Shao-Long Li, Bo Liu, Qi-Wei Liao, Sen Yang, Chen-De He, Xue-feng Guang
PMID: 38327189  doi: 10.14744/AnatolJCardiol.2023.3264  Pages 201 - 207
Background: Computed tomography (CT) image integration is of limited use in left ventricular (LV) ablation due to inadequate accuracy of registration. The current study aimed to investigate the accuracy and feasibility of extra-cavity LV image registration via the coronary cusp.

Methods: Consecutive patients were enrolled as the validation group (n = 41) and feasibility group (n = 48). After extra-cavity registration via the aortic root, the LV anatomy derived from CT image was activated and moved into real space. Accuracy of LV anatomy via this registration method was verified by intracardiac echocardiography reconstruction in the validation group and tested further in the feasibility group via measuring the location differences (<3 mm) and volume difference (<8 mL).

Results: In validation group, the LV volume of CT image and ICE map were comparable (113.6 ± 15.5 mL vs. 109.0 ± 15.3 mL, P =.27), and the location difference was 3.1 ± 1.1 mm at LV summit, 1.8 ± 0.9 mm at the free wall, and 1.8 ± 0.7 mm at the LV apex. There was a mean of 2.9 ± 1.2 mm and 3.0 ± 1.0 mm length difference in anterior PM and posterior PM, the position difference of the PM’s base was 2.8 ± 0.9 mm for anterior PM and 2.2 ± 0.9 mm for posterior PM. In feasibility group, the distance differences of LV summit, LV septum, LV apex, and LV free averaged 1.8 ± 0.8 mm, 1.5 ± 0.7 mm, 1.4 ± 0.6 mm, 1.3 ± 0.7 mm, respectively. Compared with validation group, acute success (100% vs. 96.5%, P =.51), complications rate (4.9% vs. 2.0%, P = 0.59) and fluoroscopic time (1.6 ± 1.1 vs. 1.9 ± 1.6 minutes, P =.30) exhibited no significant difference, but was significantly reduced with procedure time (74.5 ± 8.1 vs. 61.2 ± 9.5 minutes, P <.001) with CT image registration only.

Conclusion: LV mapping and ablation could be successfully achieved by extra-cavity registration via coronary cusp without needing positions within LV beforehand.

6.Fragmented QRS as a Predictor of Cardiovascular Events in Patients with Type 2 Diabetes Mellitus: A 36-Month Follow-Up Data
Şükrü Çetin, Ali Bayraktar, Önder Demiröz, Kanber Öcal Karabay, Emre Yalçınkaya
PMID: 38430111  doi: 10.14744/AnatolJCardiol.2024.3744  Pages 208 - 212
Background: Major cardiovascular events (MACE) are more common in type 2 diabetes mellitus (T2DM) patients, and early diagnosis can prevent significant morbidity and mortality. The aim of this study was to investigate the predictiveness of fragmented QRS (fQRS) showing MACE in T2DM patients.

Methods: A total of 227 T2DM patients (mean age 52, 51% male) without any cardiovascular disease who came to the cardiology outpatient clinic between March 01 and July 31, 2019, were included in the study. The patients were divided into 2 groups according to fQRS on electrocardiography (ECG), and 36 months of follow-up was done. The development of acute coronary syndrome, coronary revascularization, and cerebrovascular accident were accepted as MACE.

Results: More MACE was seen in the group with fQRS on ECG (P =.026). Although there
were more fQRS in patients with proteinuria, it was not statistically significant (P =.069). More myocardial infarcts (7.9%) and more cerebrovascular events (6.3%) were seen in the group with fQRS. While revascularization was performed on 3 patients in the fQRS group, revascularization was not performed on the patients in the non-fqrs group. In multiple
Cox regression analysis, fQRS showed an independent predictor of MACE [P =.025, hazard ratio = 2.42 (1.117-5.221)], more MACE was seen in the fQRS (+) group in the kaplan-meier analysis (P =.022).

Conclusion: More MACE was seen in the fQRS group in T2DM patients without a previous history of cardiovascular events. Fragmented QRS was found to be an independent predictor in showing MACE. Care should be taken in terms of MACE development in T2DM patients with fQRS.

LETTER TO THE EDITOR
7.A Modified Medina and Movahed (3M) Classification of Coronary Bifurcation Lesions
Xiaohui Zhao, QingSong Liu, Lorenzo Azzalini
PMID: 38430114  doi: 10.14744/AnatolJCardiol.2023.4019  Pages 213 - 214
Abstract |Full Text PDF

LETTER TO THE EDITOR REPLY
8.Reply to Letter to the Editor: “A Modified Medina and Movahed (3M) Classification of Coronary Bifurcation Lesions’’
Mustafa Tarık Ağaç, Mehmet Bülent Vatan, Mehmet Akif Çakar, Ersan Tatlı
PMID: 38430115  doi: 10.14744/AnatolJCardiol.2023.4020  Page 215
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
9.Cavernous Hemangiomas in the Right Ventricular Outflow Tract
Zeyi Cheng, Haozhe Wang
PMID: 38221791  doi: 10.14744/AnatolJCardiol.2023.3981  Pages E13 - E14
Abstract |Full Text PDF | Video

10.Fistulous Communication Between Left Pulmonary Artery and Left Atrial Appendage
Rajshree Uttamrao Dhadve, Parag Vijaysingh Patil
PMID: 38327183  doi: 10.14744/AnatolJCardiol.2023.4060  Pages E15 - E16
Abstract |Full Text PDF



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