Background: Liver is one of the target organs in patients with symptomatic severe aortic stenosis and reduced ejection fraction. We aimed to evaluate the prognostic impact of liver function reserve as assessed by albumin-bilirubin score on 30-day and 1-year mortality and rehospitalization at 1 year in patients with severe symptomatic aortic stenosis and reduced ejection fraction undergoing transcatheter aortic valve implantation.

Methods: The patients with severe symptomatic aortic stenosis and reduced ejection fraction who were hospitalized between 2013 and 2021 were included in this single-center retrospective study. Preoperative bilirubin and albumin levels were used for albumin-bilirubin score calculation as in the original report. The total primary outcomes were defined as 30-day and 1-year all-cause mortality and hospitalization for decompensated heart failure within 1 year. Two groups were generated based on albumin-bilirubin score scores: high (>−2.25) and low (≤−2.25) albumin-bilirubin score groups.

Results: A total of 77 patients (49 male) were included in the study. and 29 (37.7%) patients died within 1 year of follow-up with 17 corresponding to 30-day mortality. There was no difference between high and low albumin-bilirubin score groups in terms of length of hospital stay, postprocedural complications, and re-hospitalization within 1 year, while 30-day mortality (50.0% vs. 4.3%, P < 0.0001) and 1-year mortality (80.0% vs. 10.6%, P < 0.0001) were significantly higher in the high albumin-bilirubin score group. Hence, total primary outcomes (86.7% vs. 44.7%, P < 0.0001) were significantly higher in the high albumin-bilirubin score group.

Conclusion: High albumin-bilirubin score (> -2.25) was found as an independent risk factor associated with 30-day and 1-year mortality and total primary outcomes. The results of this study suggest that preprocedural assessment of the albumin-bilirubin score gives additional information to stratify of patients with severe symptomatic aortic stenosis with reduced ejection fraction.

Objective: Isolated ostial diagonal stenoses are very rare lesions in which percutaneous intervention could cause significant vessel compromise, and the long-term results have been reported in a few studies. This study sought the characteristics and long-term follow-up of the patients with isolated osteal diagonal stenosis regarding percutaneous coronary intervention and presence of angina.

Methods: The study was an observational retrospective study conducted between January 2014 and December 2020. A total of 9769 patients who underwent coronary angiography were analyzed, and 87 patients had isolated diagonal stenosis. The patients were evaluated according to treatment modality and angina severity in long-term pattern.

Results: Median follow-up time was 36 months. A total of 54 (83.1%) patients were followed up with only medical treatment, and 11 (16.9%) patients underwent revascularization in addition to medical treatment. The degree of stenosis of the diagonal artery was significantly
higher in the percutaneous coronary intervention group than medical group (P = 0.002) and the patients with wider reference diameter of diagonal artery complaint of more angina (P = 0.007). Class I angina was significantly higher in percutaneous coronary intervention group than medical and the patients with no angina were significantly higher in medical group than percutaneous coronary intervention group.

Conclusion: Percutaneous coronary intervention was mainly performed for diagonal arteries with a higher degree of stenosis; however, the patients who underwent percutaneous coronary intervention had angina more than 50% rates. Furthermore, the patients with ongoing angina had a larger diameter of the diagonal artery regardless of the type of treatment.

Objective: Carcinoembryonic antigen is a serological marker used in the diagnosis of malignancies and is also associated with inflammatory events. It has also been reported that carcinoembryonic antigen is associated with cardiovascular diseases. However, not much is known about the relationship between arterial stiffness and carcinoembryonic antigen. In this study, we investigated the relationship between serum carcinoembryonic antigen levels and arterial stiffness.

Methods: The data of 371 (female = 192, male = 179) individuals who applied for cardiac check-up without obvious cardiovascular diseases were analyzed cross-sectionally. Echocardiography was used to assess the participants’ aortic stiffness index.

Results: In our sample, aortic stiffness index and carcinoembryonic antigen were determined as median = 8.98, interquartile range 7.60 and median = 1.58 ng/mL, interquartile range 1.52, respectively. Aortic stiffness index and carcinoembryonic antigen levels were significantly higher in males than females. A significant correlation was observed between carcinoembryonic antigen and aortic stiffness index in the whole sample (r = 0.550, P < 0.001) and separately in females (r = 0.480, P < 0.001) and males (r = 0.602, P < 0.001). In multivariate stepwise regression analysis, female gender (r = -0.081, P < 0.001), age (r = 0.006, P < 0.001), BMI (r = 0.007, P = 0.002), and carcinoembryonic antigen (r = 0.375, P < 0.001) were determined as the strongest independent variables associated with aortic stiffness. When the model was adapted separately for females and males, age and carcinoembryonic antigen were determined as independent variables for aortic stiffness in both genders.

Conclusion: Carcinoembryonic antigen level is associated with aortic stiffness in healthy individuals. However, the clinical significance of this relationship is unknown.

Objective: Beta thalassemia major is an inherited hemoglobin disorder resulting in chronic hemolytic anemia. Cardiac involvement is the main cause of death in patients. Speckle-tracking echocardiography is a feasible method for the evaluation of cardiac function via an assessment of the longitudinal deformation of the myocardium through the cardiac cycle. The aim of our study is to evaluate the association between vitamin D deficiency and deformation of the left ventricular myocardium measured by speckle-tracking echocardiography in children with thalassemia major.

Methods: In this prospective study, 33 thalassemic patients with vitamin D deficiency were enrolled. Cardiac magnetic resonance T2* value, conventional echocardiography, and speckle tracking, and also left ventricular longitudinal and circumferential strain values were measured. Myocardial functions of the patients with vitamin D deficiency or insufficiency were evaluated by speckle-tracking echocardiography before and after vitamin D replacement.

Results: The mean age of the patients was 15.4 ± 3.09 years. Vitamin D level was deficient in 30 (90%) and insufficient in 3 (10%) of them. Speckle-tracking analysis showed a significantly decreased absolute value of the left ventricular global longitudinal strain before vitamin D replacement. A significant improvement in the global longitudinal strain was detected after vitamin D replacement (P < 0.05). A statistically significant increase was observed in parameters showing left ventricular systolic and diastolic functions after vitamin D replacement.

Conclusion: Vitamin D deficiency is frequently observed and causes decreased contractility in thalassemic patients. In our study, we observed that our patients’ cardiac functions had improved after vitamin D replacement therapy.

Objective: Left ventricular non-compaction is a rare cardiomyopathy following an early arrest in endomyocardial morphogenesis. This study aimed to present the clinical and electrocardiographic characteristics, diagnostic features, treatment strategies, effects of systolic dysfunction on clinical and diagnostic parameters, and follow-up of pediatric patients diagnosed with left ventricular non-compaction.

Methods: We retrospectively reviewed children with isolated left ventricular non-compaction at Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital from January 2010 to June 2020.

Results: Fifty-five children were diagnosed with left ventricular non-compaction. Thirty-two patients (58.2%) were male, and the median age of presentation was 8.5 years (1 month-17.9 years). The median follow-up of the study was 19 months (1-121 months). Fourteen (25.5%) presented with systolic dysfunction (ejection fraction < 45%), and 2 presented with resuscitated/aborted cardiac arrest. Electrocardiographic abnormalities were present in 78.2%. Fragmented QRS was observed in 6 patients, and QTc duration was 450 milliseconds and above in 17 patients (30.9%). Electrocardiographic abnormalities, low QRS voltage, fragmented QRS, and thrombus were common in patients with ejection fraction < 45% group. Atrial and ventricular arrhythmias (including ventricular fibrillation-VF) were found with similar frequency in both ejection fraction < 45% and ≥45% groups. One patient with a complete atrioventricular block and 1 with long QT syndrome and severe bradycardia underwent permanent pacemaker implantation. Five (9.1%) patients died.

Conclusions: Left ventricular non-compaction has heterogeneous clinical findings in childhood. It is essential to follow-up with the patients closely for the development of ventricular dysfunction or arrhythmias due to the progressive course of the disease. Further studies are needed since life-threatening ventricular arrhythmias can be seen, even in patients with preserved ejection fraction.

Objective: The current study investigated the contribution of the dissertations produced in the field of cardiology to the scientific literature and the factors affecting the publication process.

Methods: The study included 1049 cardiology dissertations archived in the national thesis center database between January 2010 and December 2017. The titles (English and Turkish), abstracts, and author names of cardiology dissertations were searched in Google Academic, TR Directory, and PubMed Central databases. In addition to their publication rates, the subject of the cardiology dissertations, the type of research, the type of institution, the academic title of the cardiology dissertation advisors, the duration of publication, the index of the published journals, and the quartile ranking of the Science Citation Index and Science Citation Index Expanded journals were examined.

Results: Among the reviewed 1049 cardiology dissertations 42.7% (n = 448) were published in a journal. The publication rate of cardiology dissertations among male authors was 43.5% and among female authors 40.1%. The cardiology dissertations were published at the highest rate after the 60th month. Among the published cardiology dissertations, 63.4% (n = 284) appeared in journals indexed by the Science Citation Index and Science Citation Index Expanded. There was no statistically significant relationship between the academic titles of cardiology dissertation advisors and the quartile ranking of Science Citation Index and Science Citation Index Expanded journals (P = 0.072).

Conclusions: There were difficulties in transforming into a publication of dissertations in the field of cardiology to gain an academic identity. Incentives should be created to increase the desire and motivation of the residents.

Wolff–Parkinson–White syndrome is rarely associated with a right atrial aneurysm. However, when such a condition occurs, it will be hard to manage since pre-excitation will be induced as long as the aneurysm persists. A 14-year-old female patient received emergency treatment for irregular wide QRS complex tachycardia in our center, and a pre-excitation pattern was then observed on the surface electrocardiogram. An initial electrophysiological study revealed a high-risk right posterior accessory pathway that was resistant to both radiofrequency and irrigated radiofrequency ablations. Subsequently, fluoroscopy showed that this was due to a right atrial aneurysm. Although successful ablation with irrigated radiofrequency was performed in the second procedure, the procedure was considered suboptimal due to the association of aneurysm. Accordingly, we initiated anti-thrombotic and anti-arrhythmic drug therapy. We decided to omit surgery and followed the case under medical treatment for 2 years without complications. Here, we report this rare coexistence and our treatment approach in detail.

Secondary infection of the aorta is a sporadic and life-threatening disease. It is usually caused by infection and abscess in an adjacent structure. The most common mechanism for secondary aortic infection is a psoas abscess eroding the aortic wall, which rarely results in non-aneurysmal aortic rupture. Primary treatment is surgical aortic reconstruction, but the risk of emergency surgical treatment is high. Endovascular aortic stent-graft implantation can be lifesaving in this setting by stopping the bleeding. However, the crucial question of durability and late infections remains unanswered and warrants long-term antibiotic treatment and follow-up. In this report, we present a case of primary psoas abscess, which resulted in non-aneurysmal aortic rupture and its endovascular treatment.

Fractional flow reserve derived from computed tomography decreases across severe coronary stenosis. The diagnostic accuracy of fractional flow reserve-derived computed tomography is high for severe coronary stenosis. In this report, we present a case of no significant fractional flow reserve-derived computed tomography changes even in severe coronary stenosis. A 75-year-old man showed severe stenosis (85% diameter stenosis) in the distal segment of the right coronary artery on both computed tomography angiography and invasive coronary angiography. However, fractional flow reserve-derived from computed tomography showed no significant changes from the proximal (0.97) to the distal (0.95) segments despite the presence of severe stenotic lesion. This patient had different features including the presence of a large acute marginal branch and significantly lower plaque components in the stenotic lesion compared with another patient who had coronary stenosis in the same segment. A large bifurcation branch and/or proportion of plaque components can affect fractional flow reserve-derived from computed tomography hemodynamics.