Ecem Gürses

The J-CTO score is a well-established tool for evaluating lesion complexity and predicting procedural success in chronic total occlusion (CTO) percutaneous

Aims: Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline‐directed medical therapy. Low‐dose colchicine has demonstrated prognostic benefits in randomized trials; however, real‐world data regarding its effects on functional capacity and angina‐related outcomes are limited. Methods: This multicenter, real‐world observational study included 614 patients with CCS receiving low‐dose colchicine therapy for secondary prevention. Functional capacity and angina‐related quality of life were assessed before and after colchicine treatment using the Seattle Angina Questionnaire. Changes in daily physical activities, angina frequency, nitroglycerin use, treatment satisfaction, and Canadian Cardiovascular Society (CCS) angina class were evaluated. Clinical outcomes and tolerability, including hospitalization, revascularization, and gastrointestinal adverse effects, were also analyzed. A clinically meaningful improvement was defined as a ≥ 10‐point increase in the composite Seattle Angina Questionnaire score. Results: The mean age of the study population was 68.8 ± 11.5 years, and 70.5% of patients were male. Following colchicine therapy, significant improvements were observed in functional capacity, including walking on level ground, household activities, and carrying heavy objects (all p < 0.001). Angina frequency scores improved, accompanied by reduced nitroglycerin use ( p < 0.001). Treatment satisfaction increased and limitations in enjoyment of life decreased significantly ( p < 0.001). CCS angina class decreased from 2.61 ± 0.7 to 1.4 ± 0.62 ( p < 0.001). A clinically meaningful improvement in SAQ score was observed in 78.7% of patients. During follow‐up, hospitalization occurred in 9.0% of patients, revascularization in 4.4%, and gastrointestinal adverse effects were reported in 9.4%. Conclusions: In a multicenter real‐world cohort of patients with chronic coronary syndrome, low‐dose colchicine therapy was associated with significant improvements in functional capacity, angina severity, and quality of life, with an acceptable safety profile. The high rate of clinically meaningful patient‐reported improvement further supports colchicine as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice.

Postoperative atrial fibrillation (POAF) is associated with an increased risk of morbidity and mortality. This study aims to investigate the predictive value of uric acid/albumin ratio (UAR) for POAF following isolated coronary artery bypass grafting (CABG). This retrospective study screened patients who underwent isolated CABG between June 2017 and January 2024. POAF was diagnosed using standard clinical criteria. UAR was calculated by dividing the uric acid level by the albumin value. This study included a total of 396 patients, who were categorized into two groups: POAF- and POAF+. Among them, 321 patients (mean age: 61.7 ± 10.8 years; 74.7% male) belonged to the POAF- group, while 75 patients (mean age: 71.3 ± 10.04 years; 68.1% male) were in the POAF+ group. While there were no significant differences observed between the groups in terms of sex, those in the POAF+ group were statistically older. The univariate and multivariate regression analyses revealed that age, C-reactive protein, hypertension, serum uric acid level, and UAR are independent risk factors for POAF. In the receiver operating characteristics analysis, the UAR (area under the curve [AUC]: 0.775) was found to be a better indicator compared to uric acid (AUC: 0.649) and serum albumin (AUC: 0.606), with a sensitivity of 70.5% and a specificity of 69.2%. UAR was shown to be an independent risk factor for POAF following isolated CABG.

Objectives: This study aims to evaluate the predictive value of the Mehran score for contrast-induced nephropathy (CIN) following peripheral transcatheter angioplasty (PTA) in patients with peripheral artery disease (PAD). Patients and methods: Between January 2020 and July 2024, a total of 103 patients (74 males, 29 females; mean age: 62.6±10.1 years; range, 44 to 75 years) who underwent PTA were retrospectively analyzed. The Mehran score was calculated for all patients meeting inclusion criteria. Contrast-induced nephropathy was defined as an absolute increase in serum creatinine ≥0.5 mg/dL or a relative increase ≥25% within 48 to 72 h post-procedure. The predictive value of the Mehran score was calculated using the receiver operating characteristic (ROC) curve analysis. Multivariate logistic regression identified independent risk factors for CIN. Results: Contrast-induced nephropathy occurred in 19 patients (18.4%). Patients who developed CIN received significantly higher contrast volumes (p<0.05). The optimal Mehran score cut-off for predicting CIN was 11.2, with an area under the curve (AUC) of 0.712 (95% confidence interval [CI]: 0.612-0.826; sensitivity 69%, specificity 73%). Independent predictors of CIN included advanced age, diabetes mellitus, higher contrast volume, baseline glomerular filtration rate, and the Mehran score. Patients with CIN had longer hospital stays (3.9±1.7 vs. 1.9±0.7 days, p=0.002) and higher amputation rates (10.6% vs. 2.9%, p=0.004). Conclusion: The Mehran score is a valuable tool for predicting CIN after PTA in PAD patients. Risk stratification using the Mehran score may guide preventive strategies, although PAD-specific models incorporating additional parameters are warranted.

Objectives: This study aims to evaluate left ventricular (LV) function using global longitudinal strain (GLS) in patients with coronary slow flow (CSF) and to compare myocardial deformation between treated and untreated groups. Patients and methods: Between October 2022 and October 2024, a total of 52 patients (25 males, 27 females; mean age: 55.8±1.1 years, range, 44 to 67 years) diagnosed with CSF were included. Thirty-two patients received pharmacological treatment, while 20 were untreated. Transthoracic echocardiography including two-dimensional (2D) speckle-tracking was performed to assess LV GLS. Clinical data and comorbidities were recorded. Results: The mean age of the untreated group was higher than the treated group (59.5±1.1 vs. 52.8±6.4 years, p=0.001). Global longitudinal strain was significantly reduced in untreated patients (−17.26±0.56) compared to treated patients (−22.28±1.17) (p=0.001). Conventional LV ejection fraction was normal and similar in both groups. Conclusion: Strain echocardiography is a sensitive tool for detecting subclinical LV dysfunction in CSF. Pharmacological treatment correlates with improved myocardial strain, indicating potential myocardial protection. Early diagnosis and treatment may improve cardiac outcomes in CSF patients.

To assess the effect of beta-blocker treatment on left ventricular global longitudinal strain (LV Gls) as measured by echocardiography in patients with MB (Myocardial Bridge).Between January 2019 a...

Objective This study aims to research the effect of the increased interstitial fluid accumulation in patients with congestive heart failure on the diffusion capacity of the alveolar-capillary membrane. Methods This prospective study is conducted on 77 in-patients diagnosed with pulmonary edema and decompansated heart failure. The B-line counts of the patients are calculated through echocardiography and thoracic ultrasonography within the first 24 hours of their admission and the patients are categorized into two groups based on their B-line counts being higher or lower than 15. After sufficient diuretic treatment, the patients are subjected to respiratory function test, diffusion test(DLCO) and 6 minute walk test. Results The following results in study have been found in the echocardiography of the patients in the higher-than-15 B-line group: lower RVEF (p=0,003), lower RVSm (p=0,014), higher SPAP (p<0,0001), higher TRV (p=0,001), more dilated VCI radius (p15 (p<0,0001), higher pleural effusıon (p=0,014). The following results have been found in the respiratory function test, DLCO and 6 minute walk test of the patients in the higher-than-15 B-line group: lower FVC (p <0,0001),lower FEV1 (p=0,002), lower corrected DLCO (p<0,0001), lower 6 minute walk test (p<0,0001).16 of the 77 patients have undergone right heart catheterization during their stay in the hospital and higher PVR (p=0,039) has been found in the higher-than-15 B-line group. Conclusion B-line counts of higher than 15 may be predictor of decrease in diffusion capacity, restrictive patern in respiratory function, decrease in right ventricular function and increase in pulmonary vascular resistance.

Objectives: In this study, it was aimed to evaluate the effect of beta-blocker use on left ventricular global longitudinal strain (LV Gls) in echocardiography in patients with MB (Myocardial Bridge). Patients and methods: A single-center study was conducted prospectively in which patients with coronary angiography were performed and myocardial bridging was detected between January 2019 and February 2022. A total of 100 patients (38 females, 62 males; mean age: 57.3±9.6 years; range, 32-75 years) with myocardial bridging were recruited consecutively and strain echocardiography was performed. Results: All patients in our study were followed in sinus rhythm, and there was a statistically significant difference in mean heart rate between groups I and II (pConclusion: LV Gls is positively affected in echocardiography thanks to the negative chronotropic effect obtained with beta-blocker therapy in patients with MB detected in coronary angiography.