Ece Yurtseven

Traumatic stress is a psychobiological response to an overwhelming life event that exceeds the individual’s capacity to cope. Emerging evidence suggests that exposure to traumatic stress: whether or not it results in post-traumatic stress disorder (PTSD) is associated with increased cardiovascular risk. This study aimed to examine the relationship between trauma-related psychiatric symptoms and markers of endothelial and cardiac autonomic function. A list of potentially traumatic life events and the self-report PTSD Symptom Checklist-5 were administered to 132 adults. To evaluate the endothelial function, carotid intima media thickness (CIMT) and flow mediated dilatation were measured for all participants. Additionally, the Ewing test results, heart rate (HR), blood pressure, and biochemical parameters were collected. Those who reported at least 1 stressor event of traumatic scope (n = 48, 36%) were compared to those who did not (n = 84, 64%) alongside participants with and without a diagnosis of PTSD. Carotid intima media thickness (0.61 mm [0.32–0.82] vs 0.41 mm [0.28–0.69], P < .0005), systolic blood pressure (SBP) (125 mm Hg [109–130] vs 114 mm Hg [95–130], P < .0005), morning HR (81 bpm [61–96] vs 77 bpm [50–100], P = .042), serum C-reactive protein (CRP, 1.40 mg/L [0.30–5.30] vs 0.30 mg/L [0.30–4.10], P = .014) values were significantly increased in the traumatic stressor group compared to the non-stressor group. Flow mediated dilatation values (8% [4–16] vs 11% [4–23], P < .0005) were lower in the traumatic stressor group than the non-stressor group. Presence of traumatic stress was positively correlated with CIMT ( R = 0.56, P < .0005), CRP ( R = 0.22, P = .03), and SBP ( R = 0.41, P < .0005). Presence of traumatic stress was negatively correlated with flow mediated dilatation ( r = −0.35, P < .0005). According to the logistic regression analysis, SBP, CIMT, and flow mediated dilatation values were independently associated with traumatic stress. The Diagnostic and Statistical Manual of Mental Disorders-5 diagnosis of PTSD (n = 19, 14%) and PTSD symptom total scores (mean = 22.3, SD = 16.1) were, however, not associated with any of the assessed biological variables. Trauma exposure regardless of PTSD diagnosis was independently associated with early signs of vascular dysfunction and elevated cardiovascular risk markers (SBP, CIMT, and flow mediated dilatation). Morever, morning HR and serum CRP values were found significantly different between the participants with and without a history of traumatic stress. These findings underscore the need to consider trauma history in cardiovascular risk assessment, even in the absence of clinically diagnosed PTSD.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Subclinical atherosclerosis is a key predictor of cardiovascular events. While inflammation plays a crucial role in atherosclerosis, the involvement of Human Neutrophil Peptides 1–3 (HNP1‐3) in its progression remains unclear. The study investigates the association of HNP1‐3 and PCSK9 with coronary atherosclerotic burden and explores the potential mediatory role of PCSK9 in HNP1‐3's effect on atherogenesis. Patients who underwent coronary computed tomographic angiography (CCTA) and had subclinical atherosclerosis (luminal stenosis < 50%) or normal coronary arteries were included in this cross‐sectional study. HNP1‐3 and PCSK9 levels were measured using ELISA, and coronary plaque burden was quantified using the modified Gensini score. Patients with subclinical atherosclerosis had significantly higher levels of HNP1‐3 ( p < 0.001), PCSK9 ( p < 0.001), and lipoprotein(a) [Lp(a)] ( p < 0.001) compared to controls. HNP1‐3 was an independent predictor of subclinical atherosclerosis ( p < 0.001), and its levels positively correlated with the modified Gensini score ( p < 0.001). In multinomial logistic regression, higher levels of HNP1‐3, PCSK9, and Lp(a) were independently associated with higher modified Gensini score tertiles. Mediation analysis revealed that PCSK9 mediated 48.7% of the effect of HNP1‐3 on the modified Gensini score. After adjusting for hsCRP and cardiovascular risk factors, the direct effect of HNP1‐3 became statistically insignificant, while the indirect effect via PCSK9 remained significant, suggesting that PCSK9 fully mediates the pro‐atherogenic effects of HNP1‐3. In conclusion, HNP1‐3 is a novel independent predictor of subclinical atherosclerosis and coronary plaque burden, with its effects being mediated through PCSK9. These findings suggest that targeting PCSK9 could mitigate the inflammatory actions of HNP1‐3, offering potential therapeutic insights for atherosclerosis prevention.

Objective: The 6-minute walk test is the most commonly used tool for evaluating prognosis in patients withpulmonary arterial hypertension (PAH). This study aims to identify the parameters associated with 6-minutewalk distance (6MWD) and its changes over time.Methods: Sixty-three patients diagnosed with PAH or chronic thromboembolic pulmonary hypertensionbetween January 2005 and January 2013 were included in the study. Demographic, clinical, echocardiographic, hemodynamic data, and initial and follow-up 6MWD were recorded. The 6MWD cut-off wasdetermined based on previous studies. Patients were then categorized into groups based on their initial6MWD: ≥ 332 m or < 332 m.Results: Patients were followed up for 31.56 ± 15.07 months. In those with a 6MWD < 332m, diffusingcapacity of the lungs for carbon monoxide (DLCO) (P = .040), estimated glomerular filtration rate (P = .018),and partial arterial oxygen pressure (PaO2) (P = .024) were significantly lower, whereas age (P = .016), rightatrial pressure (P = .034), the frequency of pericardial effusion (P = .004), and mortality (P = .020) weresignificantly higher. Low DLCO was identified as an independent predictor of walking less than 332 meters(P = .048). In the subgroup analysis, among idiopathic PAH (IPAH) patients, DLCO (P = .024) was lower inthose with 6MWD < 332 m. In patients with scleroderma-associated PAH (SSc-PAH), systolic pulmonaryartery pressure (sPAP) (P = .018), and mean PAP (p = 0.034) were higher in patients with 6MWD < 332 m.When the change in 6MWD (Δ6MWD) was evaluated based on the difference between the initial 6MWDand at the end of the follow-up period, DLCO was lower in the group with a decreased 6MWD (P < .001).Conclusion: The study identified higher DLCO as an independent predictor of 6MWD ≥ 332 m and itsimprovement over time. In IPAH, 6MWD is more closely associated with DLCO and PaO2, whereas in SScPAH, PAPs play a more significant role.Cite this article as: Yurtseven E, Özcan S, Karadağ B, Öngen HG, Öngen Z. Factors related to 6-minute walk distance in pulmonaryarterial hypertension. Cerrahpaşa Med J 2025, 49, 0015, doi: 10.5152/cjm.2025.25015.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

The Anatolian Journal of Cardiology - Peer-reviewed cardiology journal publishing original research, reviews, case reports. Impact Factor 1.5. The Anatolian Journal of Cardiology - Leading international cardiology journal with Impact Factor 1.5. Publishing original research, reviews, and case reports in cardiovascular medicine. Indexed in PubMed, Scopus, and Web of Science.

Background: Short-lasting (<30 s), nonsustained episodes of atrial fibrillation (NS-AF) are frequently observed in ambulatory ECG monitoring. Although they a

Background: Lipoprotein(a) [Lp(a)] plasma level is a well‐known risk factor for coronary artery disease (CAD). Existing data regarding the influence of sex on the Lp(a)‐CAD relationship are inconsistent.Objective: To investigate the relationship between Lp(a) and CAD in men and women and to elucidate any sex‐specific differences that may exist.Methods: Data of patients with Lp(a) measurements who were admitted to a tertiary university hospital, Koc University Hospital, were analyzed. The relationship between Lp(a) levels and CAD was explored in all patients and in subgroups created by sex. Two commonly accepted Lp(a) thresholds ≥ 30 and ≥ 50 mg/dL were analyzed.Results: A total of 1858 patients (mean age 54 ± 17 years; 53.33% females) were included in the analysis. Lp(a) was an independent predictor of CAD according to the multivariate regression model for the entire cohort. In all cohort, both cut‐off values (≥ 30 and ≥ 50 mg/dL) were detected as independent predictors of CAD (p < 0.001). In sex‐specific analysis, an Lp(a) ≥ 30 mg/dL was an independent predictor of CAD only in women (p < 0.001), but Lp(a) ≥ 50 mg/dL was a CAD predictor both in men and women (men, p = 0.004; women, p = 0.047).Conclusion: The findings of this study may suggest that different thresholds of Lp(a) level can be employed for risk stratification in women compared to men.

Aerobic capacity, defined as peak oxygen uptake (peakVO ₂ ), is a marker for aerobic fitness and is associated with left ventricular (LV) systolic and diastolic function. The aim of the study was to explore the relation between left atrial (LA) volume index (LAVI) and aerobic capacity in healthy young male adults. One hundred three healthy young male subjects (mean age: 34.2 ± 5.5years) were consecutively included in the study. All subjects underwent echocardiography to assess LAVI, LV systolic and diastolic functions. Aerobic capacity was assessed by cardiopulmonary exercise testing. All patients had normal left ventricular ejection fraction (LVEF). One hundred one subjects had normal LAVI (≤34 mL/m ² ) while 2 subjects had mildly increased LAVI (35–41 mL/m ² ). Mean peakVO ₂ predicted was 82.2 ± 14.4%. 64subjects (62.1%) had a peakVO ₂ < 85% of age-predicted and sex-predicted values and they had higher LAVI compared to those who had a peakVO ₂ higher than 85% of age-predicted and sex-predicted values (22.0 ± 4.8 mL/m ² vs 20.3 ± 4.1 mL/m ² , P = .055). Notably, only LAVI showed a significant correlation with peakVO ₂ and predicted breathing reserve (BR), while anaerobic threshold correlated with both LAVI and LVEF. Age was also a significant factor, negatively impacting peakVO ₂ ( r = −0.265, P = .007) and predicted BR ( r = −0.282, P = .004). Multivariate analysis revealed that both LAVI and age were independent predictors of peakVO ₂ and predicted BR. This study suggests that LAVI can be a valuable indicator of aerobic capacity in apparently healthy young males.