Anatolian Journal of Cardiology最新文献

{"title":"Artificial Intelligence for Peer Review in Cardiovascular Journals: Promise, Pitfalls, and a Path to Responsible Hybrid Adoption.","authors":"Uğur Canpolat, Meral Kayikcioglu","doi":"10.14744/AnatolJCardiol.2026.6615","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6615","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure Risk Phenotypes Based on a 2-Dimensional Tree Structure Derived from Clinical Characteristics and Associations with Disease Prevalence and Cardiovascular Mortality in the General Population.","authors":"Yuehuan Chen, Jing Wu, Xia Zang","doi":"10.14744/AnatolJCardiol.2026.6139","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6139","url":null,"abstract":"<p><strong>Background: </strong>Using the Discriminative Dimensionality Reduction Tree (DDRTree) algorithm, a 2-dimensional tree model was constructed based on conventional clinical indicators to identify heart failure (HF) risk phenotypes with different pathophysiological characteristics from the general adult population and evaluate their association with HF prevalence and cardiovascular mortality risk.</p><p><strong>Methods: </strong>A representative sample of 24 205 general US adults from the National Health and Nutrition Examination Survey 1999-2018 was analyzed. Eleven routine clinical indicators from multiple physiological dimensions were fed into the DDRTree algorithm to project each of them in a 2-dimensional space. The resulting tree structure revealed distinct HF risk phenotypes whose links to outcome HF prevalence and cardiovascular mortality risk were quantified with weighted logistic regression and Cox proportional-hazard models.</p><p><strong>Results: </strong>Discriminant Dimensionality Reduction Tree identified 3 HF risk phenotypes: normal, metabolic (characterized by upregulated glucose-metabolism markers), and inflammatory (characterized by abnormalities in inflammatory and hepatic-renal markers). After fully adjusting for confounding factors, the metabolic phenotype was significantly associated with the risk of HF compared with the normal phenotype (odds ratio [OR] = 1.96, P < .001, 95% CI: 1.47-2.62), whereas it showed no significant correlation with the risk of cardiovascular death (hazard ratio [HR] = 0.92, P = .539, 95% CI: 0.70-1.20). In contrast, the inflammatory phenotype was significantly correlated with both HF risk (OR = 3.95, P < .001, 95% CI: 2.94-5.33) and cardiovascular mortality risk (HR = 1.47, P = .002, 95% CI: 1.16-1.87).</p><p><strong>Conclusions: </strong>This study elucidates potential risk phenotypes influencing HF and cardiovascular mortality, providing new insights for precise HF risk stratification and targeted preventive interventions in the general population.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Changes in Left Atrial Mechanics During Sodium-Glucose Cotransporter-2 Inhibitor Therapy in Heart Failure with Preserved Ejection Fraction.","authors":"Selen Cansu Altun, Nil Özyüncü, İrem Müge Akbulut Koyuncu, Türkan Seda Tan","doi":"10.14744/AnatolJCardiol.2026.6899","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6899","url":null,"abstract":"<p><strong>Background: </strong>Conventional echocardiographic improvements after sodium-glucose cotransporter-2 (SGLT2) inhibitor therapy have been reported in heart failure with preserved ejection fraction (HFpEF), but data on novel composite indices of atrial mechanics, particularly the left atrial (LA) stiffness index and the left atrioventricular coupling index (LACI), remain poorly characterized. The authors evaluated early changes in conventional diastolic parameters and atrial mechanics following initiation of SGLT2 inhibitor therapy.</p><p><strong>Methods: </strong>In this prospective, single-center observational cohort study, patients with HFpEF in sinus rhythm who were naive to SGLT2 inhibitors received empagliflozin or dapagliflozin. Clinical assessment, laboratory testing, and comprehensive echocardiography were performed at baseline and after 3 months. Echocardiographic evaluation included LA reservoir and pump strain, the LA stiffness index (E/e'/LA reservoir strain), and LACI (minimum LA volume/LV end-diastolic volume ×100).</p><p><strong>Results: </strong>Fifty patients completed follow-up (70% women; mean age, 63.9 ± 8.1 years). New York Health Association functional class improved and N-terminal pro-brain natriuretic peptide levels decreased significantly (347 [134.8-524.8] vs. 257 [161.3-427.5] pg/mL; P = .007). Left atrial volume index and E/e' decreased significantly (34.6 ± 5.5 to 32.6 ± 5.7 mL/m2 and 12.1 ± 3.2 to 9.8 ± 2.8, respectively; both P < .001). Left atrial reservoir and pump strain increased, whereas the LA stiffness index and LACI decreased significantly (all P < .001).</p><p><strong>Conclusions: </strong>In this prospective observational cohort of patients with HFpEF, initiation of SGLT2 inhibitor therapy was associated with early changes in conventional diastolic parameters and LA mechanics. Composite atrial indices, particularly the LA stiffness index and LACI, changed in parallel with established clinical and echocardiographic markers, suggesting that they may provide complementary information for monitoring early atrial remodeling during SGLT2 inhibitor therapy.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided versus Fluoroscopy-Guided Femoral Access for Structural Heart Procedures: Outcomes From Transcatheter Aortic Valve Implantation and Left Atrial Appendage Closure.","authors":"Ahmet Kıvrak, Can Sezer, Uğur Canpolat, Ahmet Hakan Ateş, Selahattin Çöp, Cem Çöteli, Hikmet Yorgun, Mehmet Levent Şahiner, Ergün Barış Kaya, Necla Özer, Kudret Aytemir","doi":"10.14744/AnatolJCardiol.2026.6536","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6536","url":null,"abstract":"<p><strong>Background: </strong>Transfemoral access is the default approach for transcatheter aortic valve implantation (TAVI) and left atrial appendage closure (LAAC). Although ultrasound (US)-guided femoral puncture improves first-pass success and reduces vascular complications in randomized trials, real-world data in contemporary structural heart interventions, including both arterial and venous large-sheath access, remain limited. The authors aimed to compare US-guided vs. conventional transfemoral access in patients undergoing TAVI and LAAC.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included 165 consecutive patients undergoing transfemoral structural procedures between January 2022 and December 2024 (93: TAVI; 72: LAAC). Ultrasound guidance was used in 57 procedures (34.5%). Arterial and venous cohorts were analyzed separately. Primary outcomes were absolute hemoglobin decrease (ΔHb) and access-site vascular complications (hematoma, pseudoaneurysm, and arteriovenous fistula). In the arterial cohort, 1 : 1 propensity score matching was performed to adjust for baseline differences.</p><p><strong>Results: </strong>Hemoglobin decline was significantly smaller with US guidance in both venous (0.80 ± 0.95 vs. 1.50 ± 1.11 g/dL; P = .009) and arterial procedures (0.58 ± 0.97 vs. 1.29 ± 1.00 g/dL; P = .002). In the venous cohort, complication rates were numerically lower but not statistically different (3.8% vs. 17.4%; P = .143). In contrast, arterial complications were significantly reduced with US guidance. After propensity matching (31 patients per group), complications occurred in 3.2% vs. 29.0% [Absolute Risk Reduction(ARR) = 25.8%, Number Need to Treat (NNT) = 4, P = .013].</p><p><strong>Conclusions: </strong>Ultrasound-guided transfemoral access was associated with reduced hemoglobin decline and fewer vascular complications, particularly in large-bore arterial procedures, supporting routine integration of real-time US guidance in structural interventions.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HFpEF and BREATH2 score: From Prognostic Risk to Etiological Heterogeneity.","authors":"Maria Giulia Bellicini","doi":"10.14744/AnatolJCardiol.2026.7063","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.7063","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Sudden Cardiac Death Prevention to Performance Optimization: A Conceptual Framework for Cardiovascular Assessment in Elite Athletes.","authors":"Akın Torun","doi":"10.14744/AnatolJCardiol.2026.6779","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6779","url":null,"abstract":"<p><p>Cardiovascular pre-participation evaluation in elite athletes primarily aims to identify cardiovascular conditions associated with sudden cardiac death. Current international recommendations emphasize comprehensive medical history, physical examination, and resting 12-lead electrocardiography (ECG), with additional investigations guided by clini-cal findings and individual risk. However, advances in sports cardiology, cardiovascular imaging, and exercise physiology provide opportunities to integrate cardiovascular risk assessment with physiological performance evaluation. This article proposes a concep-tual, hypothesis-generating framework integrating structural, electrical, and functional cardiovascular assessment in elite athletes. The framework consists of 3 sequential components: comprehensive clinical assessment with resting ECG; transthoracic echo-cardiography for structural evaluation and longitudinal reference; and cardiopulmonary exercise testing (CPET) as an optional complementary investigation. Cardiopulmonary exercise testing may provide information on maximal oxygen uptake, ventilatory thresh-olds, oxygen pulse, ventilatory efficiency, heart rate recovery, and exercise-induced arrhythmias, potentially supporting individualized training prescription and longitudinal physiological monitoring. Cardiac magnetic resonance and coronary computed tomog-raphy angiography (CCTA) may be considered selectively when clinically indicated. A one-time CCTA strategy during an athlete's career is proposed as a research hypothesis requiring prospective assessment of clinical utility and cost-effectiveness. Importantly, CPET and CCTA are not proposed as universal screening requirements. This framework is intended to complement, rather than replace, current evidence-based international recommendations. As the proposed model is based on available literature and expert opinion and has not undergone prospective clinical validation, future multicenter stud-ies are required to determine whether integrated cardiovascular assessment improves risk stratification, athlete safety, clinical decision-making, performance monitoring, and cost-effectiveness.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antihypertensive Treatment Patterns and Factors Associated with Blood Pressure Control Across Türkiye: A Multicenter Cross-Sectional Study.","authors":"Ersan Gürsoy, Yasemin Çayır, Güzin Zeren Öztürk, Mehmet Akif Düzenli, Muzaffer Değertekin, Seçil Arıca, Cüneyt Ardıç, Burcu Kayhan Tetik, Hülya Çiçekçioğlu, Sadık Volkan Emren, Gökçe İşcan, Veysel Oktay, İsmail Arslan, Dursun Çadırcı Barut, Şenay Koçakoğlu, Erhan Şimşek, Muhammed Mustafa Uzan, Ali Öztürk","doi":"10.14744/AnatolJCardiol.2026.6887","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6887","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate office blood pressure control, antihypertensive treatment patterns, and factors associated with uncontrolled office blood pressure among adults attending family health centers across Türkiye.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted across the 7 geographical regions of Türkiye from February to December 2025. Adults aged ≥ 18 years with previous hypertension, antihypertensive treatment, and/or elevated office blood pressure at the study visit were included. Controlled office blood pressure was defined as <140/90 mm Hg for the primary analysis; achievement of <130/80 mmHg was assessed descriptively. Antihypertensive agents, drug classes, clinical characteristics, and laboratory parameters were recorded. Multiple binary logistic regression analysis identified factors independently associated with uncontrolled office blood pressure.</p><p><strong>Results: </strong>Among 1483 participants, median age was 63.0 years and 60.2% were female. Of 1456 participants with classifiable blood pressure, 902 (62.0%) had office blood pressure < 140/90 mm Hg. At the lower threshold, 438 of 1458 participants (30.0%) had office blood pressure < 130/80 mm Hg. Two-drug therapy was most common (38.7%), followed by monotherapy (27.1%) and 3-drug therapy (18.5%). Older age and higher body mass index were associated with greater odds of uncontrolled office blood pressure, whereas female sex was associated with lower odds; geographical region and antihypertensive treatment category were also independently associated with office blood pressure control.</p><p><strong>Conclusion: </strong>Office blood pressure was <140/90 mm Hg in nearly two-thirds of participants, whereas 30.0% met the descriptive <130/80 mm Hg threshold. Combination therapy predominated, and office blood pressure control was associated with demographic, clinical, regional, and treatment-related factors.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid Regurgitation Severity and 1-Year Mortality in Echocardiography-Selected Adult Intensive Care Unit Patients: A Medical Information Mart for Intensive Care-IV-Echocardiogram Cohort Study.","authors":"Sevil Tuğrul Yavuz, Sercan Bulut, Gurur Nar Sağır, Hasan Burak İşleyen","doi":"10.14744/AnatolJCardiol.2026.6797","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6797","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between tricuspid regurgitation (TR) severity measured near intensive care unit (ICU) admission and 365-day all-cause mortality in echocardiography-selected adult ICU patients.</p><p><strong>Methods: </strong>This secondary analysis linked Medical Information Mart for Intensive Care-IV (MIMIC-IV) version 3.1 with MIMIC-IV-echocardiogram. Adults with transthoracic echocardiography from 24 hours before to 72 hours after ICU admission and documented TR severity were included. None/trivial and mild TR were combined as the low-grade reference group; moderate and severe TR were compared with this group. Multiple Cox regression analyses evaluated 28-, 90-, and 365-day mortality. Sodium-adjusted and biomarker-availability analyses evaluated additional laboratory information.</p><p><strong>Results: </strong>The cohort included 16 991 patients: 12 417 (73.1%) had low-grade, 3467 (20.4%) moderate, and 1107 (6.5%) severe TR. Crude mortality increased across TR severity at 28 days (15.1%, 24.5%, and 32.7%), 90 days (20.3%, 32.5%, and 42.7%), and 365 days (27.2%, 42.9%, and 53.4%). Compared with low-grade TR, 365-day multiple-adjusted estimates were hazard ratio (HR) = 1.32, P < .001, 95% CI: 1.24-1.41 for moderate TR and HR = 1.67, P < .001, 95% CI: 1.52-1.83 for severe TR; 28- and 90-day estimates were directionally consistent, and sodium-adjusted estimates were similar.</p><p><strong>Conclusion: </strong>Moderate and severe TR on early echocardiography were associated with higher 1-year mortality in echocardiography-selected adult ICU patients. This observational association remained consistent after sodium adjustment but should not be interpreted as a treatment effect.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vericiguat in Experimental Atrial Fibrillation: Distinguishing Remodeling from Rhythm Control.","authors":"Hasan Burak İşleyen, Emirhan Hancıoğlu, Sevil Tuğrul Yavuz","doi":"10.14744/AnatolJCardiol.2026.6998","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6998","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the Letter to the Editor: \"What Does BREATH2 Predict in HFpEF? From Prognostic Risk to Etiological Heterogeneity\".","authors":"Halit Emre Yalvaç","doi":"10.14744/AnatolJCardiol.2026.7069","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.7069","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}