Zeynep Seyma Turinay Ertop

Background and Objectives: Subclinical myocardial deformation and ventricular repolarization abnormalities may occur in people with HIV (PWH) despite preserved left ventricular ejection fraction (LVEF). We evaluated left ventricular global longitudinal strain (LV GLS) and Tpeak-to-end (Tp-e)-based repolarization indices in PWH and examined their within-person relationship. Materials and Methods: This prospective comparative cross-sectional study included 25 PWH and 47 HIV-negative reference participants consecutively recruited from outpatient clinics. All participants were in sinus rhythm and had LVEF ≥50%. Conventional and speckle-tracking echocardiography and 12-lead electrocardiography were performed. Multivariable linear regression assessed associations of HIV status with LV GLS, Tp-e interval, and Tp-e/QTc ratio after adjustment for age, sex, current smoking, and hyperlipidemia. Within-PWH associations were assessed using Spearman correlation with multiplicity adjustment. Results: PWH had less negative LV GLS than reference participants (−17.1% vs. −19.0%; p < 0.001), longer Tp-e intervals (74 vs. 72 ms; p = 0.001), and higher Tp-e/QTc ratios (0.185 vs. 0.173; p < 0.001). HIV status remained associated with LV GLS (B = 2.472 percentage points, 95% CI 1.672–3.272), Tp-e (B = 4.347 ms, 95% CI 2.286–6.408), and Tp-e/QTc (B = 0.013, 95% CI 0.009–0.017; all p < 0.001). Within PWH, LV GLS was not significantly correlated with Tp-e or Tp-e/QTc. Conclusions: PWH with preserved LVEF showed less negative LV GLS and less favorable Tp-e-based repolarization indices than HIV-negative reference participants. These cross-sectional findings do not establish causal, prognostic, or screening implications, and the non-significant within-PWH correlations do not exclude potentially relevant associations. Larger longitudinal studies are warranted.

Background and Objectives: Cerebrovascular events remain among the most feared complications after transcatheter aortic valve implantation (TAVI). Whether early and post-discharge cerebrovascular events are associated with distinct clinical, echocardiographic, haemodynamic, and procedural predictors remains incompletely clarified. Materials and Methods: This retrospective, observational, two-center cohort study included 556 patients who underwent TAVI for severe symptomatic aortic stenosis between October 2011 and May 2023. The primary outcomes were in-hospital stroke and mid-to-long term stroke occurring after hospital discharge. Stroke diagnoses were established by neurological assessment and confirmed by cranial computed tomography and/or magnetic resonance imaging. Univariable comparisons and Firth penalized multivariable logistic regression analyses were performed to identify predictors of each outcome. Results: In-hospital stroke occurred in 14 patients (2.5%), whereas mid-to-long term stroke occurred in 16 patients (2.9%). In Firth penalized multivariable analysis, baseline mitral regurgitation grade (odds ratio [OR] 2.174, 95% confidence interval [CI] 1.299–3.638; p = 0.003), HbA1c (OR 1.644, 95% CI 1.111–2.433; p = 0.013), and prior cerebrovascular event (OR 4.269, 95% CI 1.150–15.846; p = 0.030) were independently associated with in-hospital stroke. For mid-to-long term stroke, post-dilatation (OR 9.862, 95% CI 2.555–38.067; p < 0.001) and very severe aortic stenosis phenotype (OR 3.649, 95% CI 1.343–9.916; p = 0.011) were independently associated with the outcome. Conclusions: Early and post-discharge cerebrovascular events after TAVI were infrequent but associated with distinct predictor profiles. In-hospital stroke was associated with baseline mitral regurgitation grade, HbA1c, and prior cerebrovascular event, whereas mid-to-long term stroke was associated with post-dilatation and very severe aortic stenosis phenotype. Given the limited number of events, these findings should be interpreted as exploratory and require validation in larger prospective cohorts.

Conventional risk scores such as the Society of Thoracic Surgeons (STS) score are widely used for risk assessment in patients undergoing transcatheter aortic valve implantation (TAVI), yet they may not fully capture systemic inflammatory and nutritional burden. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is an integrated biomarker reflecting inflammation and nutritional reserve. To investigate the association between HALP and 2-year mortality after TAVI and to evaluate whether HALP provides incremental prognostic information beyond STS. This two-center retrospective cohort included 544 consecutive TAVI patients. The primary endpoint was all-cause death within 2 years after TAVI (binary outcome: yes/no). Independent predictors were assessed using multivariable logistic regression (HALP scaled per 10-unit increase). Discrimination was evaluated by receiver operating characteristic (ROC) analyses for HALP, STS, and a combined STS+HALP model. Within 2 years, 154 patients (28.3%) died. Patients who died had higher STS scores and lower HALP scores. HALP showed weak negative correlations with STS and EuroSCORE II (r ≈ - 0.11). In multivariable analysis, HALP remained independently associated with mortality (per 10-unit increase: OR 0.859, 95% CI 0.770-0.960; p = 0.007), while STS score was also independent (OR 1.112, 95% CI 1.045-1.184; p = 0.001). Discrimination was modest for HALP (AUC 0.591) and STS (AUC 0.622), and higher for the combined model (AUC 0.663). HALP is independently associated with 2-year all-cause mortality after TAVI and yielded a higher AUC when incorporated into the STS model, suggesting incremental prognostic information beyond conventional risk assessment.

Objectives: Systemic inflammation, malnutrition, and immune dysregulation have emerged as important determinants of long-term outcomes after transcatheter aortic valve implantation (TAVI). The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel immunonutritional biomarker that integrates these pathophysiological domains; however, its prognostic value in TAVI patients has not yet been investigated. This study aimed to evaluate the association between the CALLY index and 1-year mortality after TAVI. Methods: This retrospective observational study included 532 consecutive patients who underwent TAVI at a tertiary-care center between 2014 and 2023. Baseline laboratory parameters were obtained before the procedure, and the CALLY index was calculated as (albumin × lymphocyte count)/(C-reactive protein × 10). The primary endpoint was 1-year mortality. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminative ability of the CALLY index and conventional surgical risk scores. Multivariable regression analyses were used to identify independent predictors of mortality. Results: During the 1-year follow-up period, 85 patients (15.9%) died. Patients who died had significantly lower baseline CALLY index values compared to survivors (p < 0.001). The CALLY index demonstrated good discriminative performance for 1-year mortality (AUC: 0.797), outperforming EuroSCORE II (AUC: 0.705) and the Society of Thoracic Surgeons (STS) score (AUC: 0.619). A CALLY cut-off value of 0.45, derived using Youden’s index, was associated with a more than threefold increased risk of mortality. In multivariable analysis, the CALLY index remained independently associated with 1-year mortality, along with EuroSCORE II and more than mild mitral regurgitation. Conclusions: The CALLY index is a strong and independent predictor of 1-year mortality after TAVI and provides incremental prognostic value beyond conventional surgical risk scores. Given its simplicity and reliance on routinely available laboratory parameters, the CALLY index may serve as a practical tool for long-term risk stratification in patients undergoing TAVI.

Aorta Embriyolojisi ve Anatomisi Pelin ALADAĞ Aorta Hastalıklarında Patogenez ve Genetik Özlem SEÇEN Aorta Görüntülenmesinde Ekokardiyografi Kaya ÖZEN Aorta Görüntülemesinde Ultrasonografi Yiğit Can KARTAL Aorta Görüntülemesinde Bilgisayarlı Tomografi ve Manyetik Rezonans Görüntüleme Yiğit Can KARTAL Aortografi ve İntravasküler Ultrason Samet SEVİNÇ Aort Diseksiyonu Esra KOÇ AY İntramural Hematom Seda Elçim YILDIRIM Penetre Aortik Ülser Hamdi TOKÖZ Aortik Psödoanevrizma Nurcemal ŞENTÜRK Travmatik Aort Hasarı İlkin GULİYEV İyatrojenik Aort Diseksiyonu Engin ALGÜL Penetran Aortik Ülser ve İntramural Hematomda Cerrahi Tedavi Oğuz ARSLANTÜRK Aort Diseksiyonunun Cerrahi Tedavisi Barış UYMAZ Torasik Aort Anevrizmasında Tanı ve Tedavi Süleyman AKKAYA Abdominal Aort Anevrizmaları Ardi RREKA Aterosklerotik Aort Hastalıkları Ahmet TOK Leriche Sendromu Tayfur ERDOĞDU EVAR & TEVAR Prosedürü ve Komplikasyonları Hüseyin DURAK Torakal Aort Anevrizmalarının Cerrahi Tedavisi Anıl TEKİN Abdominal Aort Anevrizmalarının Cerrahi Tedavisi Onur GELDİ Dev Hücreli Arterit Zeynep KAYA Cogan Sendromu Abdulrahman NASER Takayasu Arteriti Mehrek BAHRAMISHAD IgG4 İlişkili Hastalık Kenan TOPRAK Sifilitik Aortit Ahmet KARADUMAN Genetik Sendromlarda Aort Tutulumu Güngör ÜSTÜN Biküspid Aortik Kapak Fuat BİCE Aort Koarktasyonu Kenan ERDEM Porselen Aort ve Aort Kalsifikasyonu Devrim KURT Coral Reef Aorta Bilal ÇAKIR Aortik Trombüs Fahri ÇAKAN Fibromusküler Displazi Didar Elif AKGÜN Yavuz Selim AKGÜN Radyasyon ile İlişkili Aortik Hastalıklar Remziye DOĞAN Gebelikte Aort Hastalıkları Zeynep Şeyma TURİNAY ERTOP Aortik Hastalıklarda Anestezik Yaklaşım ve Preoperatif Değerlendirme Yasemin ÇAKIR

Background: It is suggested that myocardial dysfunction in heart failure patients may result from increased oxidative stress-related membrane changes. Thiol/disulfide homeostasis is a new oxidative stress indicator. The aim of this study was to evaluate serum thiol levels and thiol/disulfide homeostasis in patients with heart failure with preserved ejection fraction (HFpEF). Materials and Methods: Eighty-four overweight patients who applied to our clinic between November 2016 and February 2018 and diagnosed with hypertension and left ventricule concentric hypertrophy with normal systolic function are included in the study. Forty-two patients who were asymptomatic and had normal N terminal pro-B type natriuretic peptide (NT-proBNP) levels (≤125) were in the control group. Forty-two patients who have cardiac failure symptoms and have high NT-roBNP levels (>125) were in the patient group. Results: Native thiol, total thiol, and disulfide values of the patient group are found to be significantly lower than the control group (P =.001; P <.001; P =.041 respectively). There is a statictically significant negative correlation between native thiol, total thiol values, and NT-proBNP. There is a statictically significant negative correlation between native thiol, total thiol values, and carbohydrate antigen 125 (CA-125) values. Conclusion: As far as we know from literature, this is the first study on HFpEF and thiol/disulfide homeostasis. It is found that native, total thiol, and disulfide values are low in HFpEF patients and that there is a negative correlation between native, total thiol values and NT-proBNP, CA-125 values. It can be said that oxidant/antioxidant balance is impaired in patients with HFpEF and that larger, randomized studies are needed in order to use oxidant/antioxidant balance in diagnosis and treatment of HFpEF.