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Volume : 25 Issue : 1 Year : 2021
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The Anatolian Journal of Cardiology - Anatol J Cardiol: 25 (1)
Volume: 25  Issue: 1 - January 2021
EDITORIAL
1.New year and our 20th Anniversary, Thomas F. Lüscher, pulmonary hypertension
Çetin Erol
PMID: 33382058  doi: 10.14744/AnatolJCardiol.2021.1  Page 1
Abstract | Full Text PDF

VIEW POINT
2.Classification of heart failure: A farewell to ejection fraction?
Thomas F. Lüscher
PMID: 33382057  doi: 10.14744/AnatolJCardiol.2020.70138  Pages 2 - 6
Abstract | Full Text PDF

META ANALYSIS
3.A meta-analysis of randomized controlled trials investigating tirofiban combined with conventional drugs by intracoronary administration for no-reflow prevention
Qian Zeng, Long-Dan Zhang, Wei Wang
PMID: 33382055  doi: 10.14744/AnatolJCardiol.2020.99469  Pages 7 - 16
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
4.Sex difference in clinical outcomes of Chinese patients with atrial fibrillation and coronary stenting according to age
Jian-Yong Zheng, Dong-Tao Li, Yu Chen, Yi-Da Tang, Cheng-Jun Guo, Yun-Dai Chen, Zhi-Min Ma, Tian-Chang Li
PMID: 33382053  doi: 10.14744/AnatolJCardiol.2020.80930  Pages 17 - 23
Objective: Sex differences in the clinical outcomes of patients with atrial fibrillation (AF) and coronary stenting should be assessed according to age.
Methods: We analyzed the clinical data of all patients with nonvalvular AF who underwent coronary stenting between January 2010 and June 2015 in 12 hospitals of Beijing, China.
Results: A total of 2,146 patients (71.8% men and 28.2% women) were included in the study. The mean age of the patients was 66.6±9.4 years. Women in this study were older and had higher prevalence of hypertension, diabetes, chronic kidney disease (CKD), and anemia. Smoking history was found to be higher in men, and women were less likely to be current smokers. The mean follow-up duration was 39.7 months. Women younger than 65 years had a remarkably higher mortality (11.2% vs. 5.3%, p=0.012) and a significantly lower rate of repeat revascularization (1.6% vs. 6.3%, p=0.034) than men. Female gender remained an independent predictor for all-cause mortality [hazard ratio (HR)=2.03, 95% confidence interval (CI): 1.09–3.79, p=0.025], along with heart failure (HR=3.64, 95% CI: 2.02–6.57, p<0.001) and CKD (HR=2.46, 95% CI: 1.09–5.57, p=0.031) after multivariate regression analysis. No significant difference was noted between men and women with regard to mortality, ischemic events, and major bleeding in elderly patients.
Conclusion: In Chinese patients younger than 65 years with AF and coronary stenting, female gender was independently associated with increased mortality; men were more likely to receive repeat revascularization possibly due to the current smoking. Whether it was a biological difference or a recognition disparity of the disease between men and women warrants further investigation.

5.Chronic thromboembolic pulmonary hypertension in patients with persistent chest symptoms after acute pulmonary embolism
Elif Sahutoglu, Esin Tuncay, Gülfidan Aras, Esin Yentürk, Dilek Kanmaz, Hurrem Gul Ongen, Zeki Ongen
PMID: 33382052  doi: 10.14744/AnatolJCardiol.2020.69057  Pages 24 - 29
Objective: This study aimed to analyze the role of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with persistent chest symptoms after acute PE.
Methods: Patients aged between 18 and 80 years who were followed up for acute PE were screened for chest symptoms which persisted after the anticoagulation treatment. Patients suffering other types of pulmonary hypertension (PH) or metastatic malignancies were excluded in this study. Demographic and functional data of patients included this study were collected. The patients underwent transthoracic echocardiography and ventilation/perfusion (VQ) scans. Also, invasive hemodynamic studies were done to patients with intermediate/high probability of VQ scans.
Results: Of the 140 patients screen for this study, 29 patients (Female/Male=16/13) with mean age of 56.1±11.2 years and follow-up time of 35.1±17.7 months met the inclusion criteria. The mean systolic pulmonary artery blood pressure (sPAP) on transthoracic echocardiography was 28.9±4.9 mm Hg (range=20–40 mm Hg). Furthermore, intermediate or high probability of VQ scans was detected in 2 patients, who were subsequently diagnosed with CTEPH (6.9%) via right heart catheterization.
Conclusion: CTEPH was diagnosed at a low rate in patients with persistent chest symptoms after the anticoagulation treatment for PE. CTEPH is still an elusive entity, which requires a multidisciplinary and invasive approach.

6.How did the updated hemodynamic definitions affect the frequency of pulmonary hypertension in patients with systemic sclerosis?
Alper Sarı, Yusuf Ziya Şener, Berkan Armağan, Levent Kılıç, Ergün Barış Kaya, Vedat Hekimsoy, Ömer Karadağ, Şule Apras Bilgen, Sedat Kiraz, Ihsan Ertenli, Lale Tokgozoğlu, Ali Akdoğan
PMID: 33382047  doi: 10.14744/AnatolJCardiol.2020.46625  Pages 30 - 35
Objective: Pulmonary hypertension (PH) is a one of the major causes of death in patients with systemic sclerosis (SSc). In this study, we investigated the impact of updated hemodynamic definition proposed by the 6th PH World Symposium (6th WSPH) on the frequency of PH and its subtypes in patients with SSc.
Methods: Patients with SSc admitted between 2015 and 2019 and who underwent right heart catheterization (RHC) were included. The frequency of PH and its subgroups based on the hemodynamic definitions of both 2015 European Society of Cardiology/European respiratory Society (ESC/ERS) PH guidelines and 6th WSPH was compared.
Results: Of the 65 patients with SSc, 23 (35.4%) had normal mean pulmonary arterial pressure (mPAP), 20 (30.8%) had mildly elevated mPAP (21–24 mm Hg), and 22 (33.8%) had PH [pulmonary arterial hypertension (PAH) (n=16, 24.6%), group 2 PH (n=5, 7.7%), group 3 PH (n=1, 1.5%)] according to the 2015 ESC/ERS PH definition. Based on the updated criteria, 7 (10.8% of total cohort) additional patients were reclassified as having PH [PAH (n=3), group 2 PH (n=3), group 3 PH (n=1)].
Conclusion: The impact of the updated definition on the frequency of PH and PAH in our cohort was greater than previously reported, which may be caused by the difference in screening strategies for PAH.

7.Pulmonary hypertension in patients with sarcoidosis: A single-center experience
Deniz Kaptan Özen, Bülent Mutlu, Derya Kocakaya, Burak Turan, Sena Sert Şekerci, Berrin Ceyhan
PMID: 33382054  doi: 10.14744/AnatolJCardiol.2020.88054  Pages 36 - 41
Objective: Sarcoidosis is a systemic granulomatous disease rarely complicated by pulmonary hypertension (PH). The prevalence of PH in sarcoidosis is unclear and has differences between ethnic groups. This study aimed to investigate the prevalence and predictors of PH in a Turkish cohort.
Methods: The study included 55 patients with biopsy-proven sarcoidosis in a single center. All patients underwent detailed transthoracic echocardiography (TTE) to assess the probability of PH as recommended. Right heart catheterization (RHC) was performed for patients with intermediate–high risk of PH. Patients with mean pulmonary artery pressure >20 mm Hg by RHC were defined as PH. Demographic and clinical characteristics, laboratory data, spirometry, 6-min walk test, and TTE were compared between low and intermediate–high risk PH groups.
Results: The probability of PH was low with 47 patients. Eight patients had intermediate–high probability of PH, and two of them refused to undergo RHC. Of six intermediate–high probability patients, three had PH, and all of them had post-precapillary PH. The prevalence of PH in sarcoidosis was 5.5% (3/55). Six-minute walk distance (6 MWD) and diastolic parameters (E/A ratio, E’ wave, and left atrial volume) were significantly lower, and New York Heart association class and N-terminal probrain natriuretic peptide (NT-proBNP) level were higher in intermediate–high risk PH patients compared with low-risk PH patients.
Conclusion: The frequency of PH in sarcoidosis was 5.5% in a Turkish cohort. NT-proBNP, 6 MWD, diastolic function parameters, and myocardial strain parameters can be useful predictors of PH in patients with sarcoidosis, besides known echocardiographic parameters.

8.Evaluation of radial artery endothelial functions in transradial coronary angiography according to different radial access sites
Elton Soydan, Mehmet Kış, Mustafa Akın
PMID: 33382049  doi: 10.14744/AnatolJCardiol.2020.59085  Pages 42 - 48
Objective: Radial endothelial dysfunction may occur after transradial coronary angiography (CAG). This study aimed to make a comparative evaluation of the radial endothelial functions before and after catheterization between three different radial access sites: left radial (LR) artery, left distal radial (LDR) artery, and right radial (RR) artery.
Methods: Seventy patients scheduled for elective transradial CAG and intervention from September 6, 2017 to March 6, 2018 were consecutively enrolled. Radial artery endothelial functions of the catheterization arm were measured by flow-mediated vasodilation (FMD) upon admission, at 24 hours, and 2 months following the procedure.
Results: LR access was used in 17 patients, whereas the LDR and the RR access were used in 27 and 26 patients, respectively. Basal radial diameters and FMD median values measured on the intervention arm were found to be similar between groups (LR 3.04±0.29 mm, 13.33%; LDR 2.79±0.31 mm; 13.64%; RR 2.74±0.29 mm; 12.52%, p=0.952). The radial vasodilation percentage change expressed as median decreased in all groups 24 hours after the procedure; however, the one with the LDR access was found to be significantly higher than with the LR (9.7% vs. 6.25% p=0.013) and the RR access (9.7% vs. 3.39 p<0.001). A partial recovery of endothelial functions was seen at 2 months after the procedure, approximating to basal values (11.11%; 12%; 10.62%, p=0.079, respectively).
Conclusion: Radial artery functions deteriorate early after transradial catheterization. The LDR access seems safer than the other conventional radial access sites in terms of preservation of radial endothelial functions.

CASE REPORT
9.An intriguing case of acute coronary syndrome caused by rotten tuna
Chiara Gargiulo, Silvana De Martino, Alberto Somaschini, Stefano Cornara, Gabriele Crimi
PMID: 33382044  doi: 10.14744/AnatolJCardiol.2020.28934  Pages 49 - 50
Abstract | Full Text PDF | Video

10.Failed transcatheter mitral valve-in-ring implantation followed by transapical valve-in-valve within the ring and ad hoc paravalvular leak closure
Beytullah Çakal, Sinem Çakal, Hacı Murat Güneş, Mehmet Onur Omaygenç, Aydın Yıldırım
PMID: 33382050  doi: 10.14744/AnatolJCardiol.2020.59163  Pages 50 - 53
Abstract | Full Text PDF | Video

11.A rare cause of mitral regurgitation after aortic valve replacement: Iatrogenic mitral valve perforation
Begüm Uygur, Ömer Çelik, Anıl Şahin, Ali Rıza Demir, Mehmet Ertürk
PMID: 33432932  doi: 10.14744/AnatolJCardiol.2020.31766  Pages 53 - 54
Abstract | Full Text PDF | Video

DIAGNOSTIC PUZZLE
12.What is your diagnosis?
Yavuzer Koza, Ferhat Kanbay, Muhammed Hakan Tas, Fatih Alper
PMID: 33382046  doi: 10.14744/AnatolJCardiol.2020.46151  Page 55
Abstract | Full Text PDF

LETTER TO THE EDITOR
13.Percutaneous left atrial cardiac biopsy under multidectector computed tomography guidance
Umberto Geremia Rossi, Anna Maria Ierardi, Maurizio Cariati
PMID: 33382048  doi: 10.14744/AnatolJCardiol.2020.53840  Pages 56 - 57
Abstract | Full Text PDF

14.Shock wave therapy in cardiology: A comment
Sergei V Jargin
PMID: 33382056  doi: 10.14744/AnatolJCardiol.2020.95071  Pages 57 - 58
Abstract | Full Text PDF

DIAGNOSTIC PUZZLE - ANSWER
15.A 32-year-old woman with worsening dyspnea
Yavuzer Koza, Ferhat Kanbay, Muhammed Hakan Taş, Fatih Alper
PMID: 33382059  Page 59
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
16.An extremely rare coronary artery anomaly: Monster left anterior descending coronary artery
Savaş Çelebi, Özlem Özcan Çelebi
PMID: 33382051  doi: 10.14744/AnatolJCardiol.2020.68782  Pages E1 - E2
Abstract | Full Text PDF | Video

17.Weird pacing spikes
Chao-Yu Chen, Ju-Yi Chen
PMID: 33382045  doi: 10.14744/AnatolJCardiol.2020.32527  Pages E2 - E3
Abstract | Full Text PDF