The Relationship Between Global Left Ventricular Function, as Indicated by the Tei Index, and Long-Term Survival in Patients With Non-Ischemic, Dilated Cardiomyopathy

AIM

Idiopathic dilated cardiomyopathy (DCM) is one of the leading causes of low ejection fraction (EF) heart failure (HF). The Tei index is a reliable marker that reflects both left ventricular (LV) systolic and diastolic function, and it has prognostic value in patients with DCM. We aimed to investigate the relationship between the Tei index and long-term survival in non-ischemic, DCM patients.

MATERIAL AND METHODS

The present study included 98 patients with non-ischemic DCM. The mean survival time of the patients was 59 mos.

RESULTS

The Tei index was prominently higher in patients who died (0.64±0.08 vs 0.71±0.12, respectively; p=0.01). LV end-systolic volume and LV ejection fraction (LVEF) were independent prognostic factors and predicted worse long-term survival. Additionally, the patients with LVEF ≥32.7 % and the Tei index ≤0.76 had significantly longer survival.

CONCLUSION

The present study showed that the Tei index was significantly associated with mortality and the patients with both low LVEF (≤32.7 %) and high Tei index (≥0.76) values had a shorter life expectancy. As a result, we suggest that the Tei index may be a useful echocardiographic marker to predict long-term survival in DCM patients.

COVID-19 survivors may exhibit deterioration in frontal plane QRS-T angle and other electrocardiogram parameters

OBJECTIVE

COVID-19 infection is known to injure myocardial tissue and increase arrhythmic events. However, data on the subject is limited in the literature. In our study, our aim was to investigate possible arrhythmic damages in COVID-19 survivors using the frontal plane QRS-T [f(QRS)-T] angle and a few other ECG parameters.

PATIENTS AND METHODS

269 patients who recovered from COVID-19 between April 2020 and January 2021 were included into the study. Pre-admission electrocardiograms and first-month outpatient clinic control ECGs of the patients were compared.

RESULTS

After COVID-19, left bundle branch block (p<0.001), right bundle branch block (p<0.001), right bundle branch block (p<0.001), and atrial fibrillation (p<0.001) rates had increased. Prolongation was detected in QRS duration (p<0.001), QT interval (p=0.014), adjusted QT interval (p=0.007) and Tpe interval (p=0.012). F(QRS)-T angle (p<0.001) and fragmented QRS rate (p<0.001) were increased.

CONCLUSIONS

It was observed in our study that even if patients survived COVID-19, permanent deterioration in ECG parameters may occur.

Monocyte count to high-density lipoprotein cholesterol ratio and mean platelet volume may be related to the severity of carotid artery stenosis

Funding Acknowledgements

Type of funding sources: None.

Objective

The pathophysiology of carotid artery stenosis (CAD) is not fully understood. Research has shown that mean platelet volume (MPV) is a potential marker for platelet activation and a key factor in the pathophysiology of atherosclerosis. Recently, the ratio of monocyte count to HDL (MHR) has been identified as a predictor of cardiovascular events in patients. In the light of these findings, the goal of this study was to evaluate the potential association of MPV and MHR with the severity of CAD.

Material-Method

The patients were divided into three groups: CAD≥ 60% (40 patients), CAD &lt;60% (40 patients) and no carotid atherosclerotic disease (40 individuals). Patients' demographic characteristics, clinical features and laboratory findings were compared between the groups.

Results

MPV and MHR levels were lower in the control group than CAD &lt;60 group and lower in CAD &lt;60 group than CAD ≥60 group (p &lt;0.001, p &lt;0.001). Higher MPV (OR= 6.050; 95% CI: 2.946-12.427; p &lt;0.001) and MHR (OR= 1.107; 95% CI: 1.045-1.159; p &lt;0.001) levels were detected as an independent predictor for ≥60% carotid artery stenosis after multiple linear regression analysis. In the correlation analysis, a positive correlation was found between MPV and the rate of carotid artery stenosis (p&lt;0.001, r=0.680).

Conclusion

In our study, a potential relationship between MPV and MHR with carotid artery disease was determined. Our study may make contributions to understanding the pathophysiology of carotid artery atherosclerosis and developing treatments for it.

Covid-19 survivors may have deterioration in frontal plane qrs-t angle and the other electrocardiogram parameters

Funding Acknowledgements

Type of funding sources: None.

Background

COVID-19 infection is known to damage myocardial tissue and increase arrhythmic events. However, the data in the literature on permanent attachments are limited. In our study, we planned to investigate possible arrhythmic damages in COVID-19 survivors using the frontal plane QRS-T [f(QRS)‐T] angle and some other ECG parameters.

Patients & Methods

269 patients who recovered from COVID-19 between April 2020 and January 2021 were included into the study. Pre-admission electrocardiograms and first-month outpatient clinic control ECGs of the patients were compared.

Results

After COVID-19, left bundle branch block (p<0.001), right bundle branch block (p<0.001), right bundle branch block (p<0.001), atrial fibrillation (p<0.001) rates had increased. Prolongation was detected in QRS duration (p<0.001), QT interval (p=0.014), adjusted QT interval (p =0.007) and Tpe interval (p=0.012). F(QRS)‐T angle (p<0.001) and fragmented QRS rate (p<0.001) were increased.

Conclusions

It was observed in our study that; even if patients survive after COVID-19, permanent deterioration in ECG parameters may occur.

The dietary approaches to stop hypertension diet effects on ventricular premature complexes

Funding Acknowledgements

Type of funding sources: None.

Introduction

Rhythm disturbances in the heart significantly affect the quality of life of the patients. The aim of this study was to evaluate the relationship between ventricular premature complexes (VPC) and The dietary approaches to stop hypertension diet (DASH) score.

Material-Method

This study was conducted on 50 patients with palpitations who were referred to the cardiology outpatient clinic and had more than 10000 VES per day as a result of a 24-hour holter, and 50 patients who presented with palpitations but had less than 10000 VES in the holter. Three-day food consumption records of the patients were questioned. DASH diet compliance scale was used for patients. The achievement of nine nutrients to the targeted quantities with food consumption records was evaluated by scoring method (between 0 and 9 points). All data were compared between groups.

Results

There was no difference between the two groups in terms of clinical and demographic characteristics. DASH scores were found to below in the VPC group (p&lt;0.001). There was a significant negative correlation found between VPC and DASH diet score (p&lt;0.001, r = -0.458).

Discussion

The protective role of DASH type nutrition on the frequency of VPC was observed in our study. This study, which is one of the limited number of studies examining the relationship between DASH diet and VPC, may be helpful in understanding the pathophysiology of VPC.

Evaluation of Mediterranean diet adherence in patients with a history of coronary revascularization

INTRODUCTION

Lifestyle modification is an important component of the secondary prevention strategies; and a healthy diet is one of the cornerstones in management of the coronary heart disease. We aimed to investigate the dietary habits of the patients with history of coronary revascularization, characteristics of the ones with good adherence by using alternate MedDiet questionnaire.

METHODS

We included outpatients who had a history of coronary revascularization at least 6 months prior to enrollment. Each participant filled out a questionnaire to collect the data of demographics and clinical characteristics. Alternate MedDiet score was calculated to evaluate the Mediterranean style dietary adherence. Alternate MedDiet was originally based on 14-item questionnaire; we adjusted it to our population (max 13 points).

RESULTS

We enrolled 226 consecutive outpatients (age 61.7±10.9 years, 72% males). The median duration after revascularization was 60 months. A total of 112 (49.6%) patients had previous percutaneous coronary intervention (PCI), 77 (34.1%) had coronary by-pass graft surgery (CABG), and 36 (15.9%) had both revascularization procedures. The median MedDiet score was 6. Patients were stratified into two subgroups (MedDiet score ≥7 vs. <7). A total of 61 (26.9%) patients had MedDiet score ≥7. By univariate analysis, good MedDiet scores were associated with older age, waist circumference, body mass index, high education level, regular follow-up, duration after first revascularization and revascularization with CABG+PCI. In the multivariate analysis, high education level (P=.002, OR=8.212, 95%CI: 2.155-31.291) and duration after revascularization (P=.034, OR=1.007, 95%CI: 1.001-1.013) were independent predictors of good MedDiet scores.

CONCLUSION

The adherence rate to a healthy diet was low in patients with previous coronary revascularization. MedDiet score seems to be practical and useful item to evaluate the dietary habits in outpatient setting. Mediterranean diet adherence rates were associated with high education level, and duration after revascularization.