Anatolian Journal of Cardiology最新文献

{"title":"A Compact Unified Model for Moderate-to-Severe Carotid Artery Stenosis Using Image Segmentation: A Multicenter Study.","authors":"Ahmet Tavlı, İlker Gül, Haluk Mergen, Bülent Çümen, Murat Ertürk, Haydar Yaşa, Talat Tavlı","doi":"10.14744/AnatolJCardiol.2026.5879","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.5879","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the diagnostic performance of a new artificial intelligence model, the compact unified model (CU-Model), for moderate-to-severe carotid artery stenosis using digital subtraction angiography (DSA) images compared to clinical reference standards.</p><p><strong>Methods: </strong>In this retrospective multicenter study, 156 patients with confirmed moderate-to-severe carotid artery stenosis were included. A pretrained CU-Model (trained on public non-clinical datasets for optical flow and stereo matching) was applied to raw DSA images without any fine-tuning on clinical data to avoid data leakage. The model served exclusively as a post-acquisition support tool: cardiologists applied it immediately after procedures for automated vessel segmentation and highlighting. Final North American Symptomatic Carotid Endarterectomy Trial (NASCET) measurements and interpreta-tions were performed manually under expert supervision by 2 blinded researchers.</p><p><strong>Results: </strong>The CU-Model identified left internal carotid artery (ICA) stenosis in 84 patients and right ICA stenosis in 72. It misclassified only 1 moderate left ICA stenosis case as normal, achieving 99.4% sensitivity (155/156) for any stenosis detection. For stenosis severity grading, strong agreement with DSA was observed (moderate: 57.68 ± 5.94 vs. 57.71 ± 6.19, r = 0.83, P < .001, 95% CI: 0.76-0.88; severe: 86.96 ± 5.97 vs. 87.02 ± 6.18, r = 0.91, P < .001, 95% CI: 0.85-0.95). Of 156 cases, 106 were moderate (50%-69%) and 50 severe (≥70%), using NASCET-adapted thresholds accounting for measurement variability. Hypertension (77%), smoking, and syncope were common, with significant association in symptomatic patients (P < .05).</p><p><strong>Conclusion: </strong>The CU-Model demonstrates strong concordance with DSA as a practical, post-procedure support tool for vessel segmentation. Pending larger validation studies, it shows promise for enhancing clinical workflow efficiency.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102805","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: \"Antiplatelet Strategy After Drug-Coated Balloon Angioplasty for Isolated Side Branch Lesions: The Missing Piece of the Puzzle\".","authors":"Halil Akın, Önder Bilge, Ferhat Işık, Abdurrahman Akyüz, Emre Kıvrak, Esra Yılmaz, İlke Çelikkale, Özcan Özdemir, İbrahim Halil Tanboğa","doi":"10.14744/AnatolJCardiol.2026.6894","DOIUrl":"10.14744/AnatolJCardiol.2026.6894","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073440","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":"Apolipoprotein E: A Genetic Bridge Between Premature Atherosclerosis and Alzheimer Disease.","authors":"Meral Kayikcioglu","doi":"10.14744/AnatolJCardiol.2026.7025","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.7025","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073358","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":"Weight-Adjusted Waist Index Outperforms Conventional Adiposity Indices in Predicting All-Cause Mortality: A Population-Based Cohort Study.","authors":"Ercan Kahraman, Şirin Çetin, Özkan Özler","doi":"10.14744/AnatolJCardiol.2026.6756","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6756","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI), the most widely used adiposity metric, cannot differentiate fat distribution from lean mass, limiting its prognostic utility. This study compared the weight-adjusted waist index (WWI) with BMI, waist-to-height ratio, and relative fat mass (RFM) as predictors of all-cause and cardiovascular mortality using a z-standard-ized framework.</p><p><strong>Methods: </strong>Data from 18 496 adults aged ≥20 years from the National Health and Nutrition Examination Survey 2011-2018 were linked to the National Death Index through December 31, 2019. Four adiposity indices were z-standardized and analyzed using survey-weighted Cox models with sequential adjustment. Dose-response relationships were assessed using restricted cubic splines, and subgroup analyses examined the effect modification by sex, multimorbidity, and estimated glomerular filtration rate (eGFR).</p><p><strong>Results: </strong>Over a median follow-up of 4.83 years, 976 all-cause and 291 cardiovascular deaths occurred. Weight-adjusted waist index demonstrated the strongest association with all-cause mortality (hazard ratio [HR] 1.34; 95% CI 1.23-1.46; P < .001); BMI and RFM did not reach significance. After mutual adjustment, WWI retained its association (HR 1.40; P < .001) while BMI did not reach statistical significance in the adjusted model. Weight-adjusted waist index showed a linear dose-response relationship, contrasting the J-shaped curve of BMI. The association was consistent across subgroups but attenuated in participants with eGFR < 60 (interaction P = .034).</p><p><strong>Conclusion: </strong>Weight-adjusted waist index was the strongest independent predictor of all-cause and cardiovascular mortality among 4 adiposity indices. Its linear dose-response relationship, consistency across subgroups, and calculability from waist circumference and body weight alone support its use as a practical alternative to BMI for mortality risk stratification.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030026","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":"Transcatheter Management of Clinically Significant Paravalvular Leak After Sutureless Aortic Valve Replacement: A Case Series.","authors":"Şenol Coşkun, Didar Mirzamidinov, Tayfun Şahin, Teoman Kılıç","doi":"10.14744/AnatolJCardiol.2026.6584","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6584","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030048","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":"A Study on the Association Between Social Activity and Depression and Cognitive Function in Patients with Heart Disease: The Mediating Role of Activities of Daily Living.","authors":"Jia Xu, Ping Wang, Dong Chang, Chunji Ye, Jing Shen","doi":"10.14744/AnatolJCardiol.2026.6275","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6275","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart disease are frequently accompanied by heightened depressive symptoms and cognitive decline. Social activity (SA) and activities of daily living (ADL) may affect these associations. This study aims to investigate the associations between depression, cognitive function, and SA in patients with heart disease, and further assess the mediating role of ADL.</p><p><strong>Methods: </strong>Multivariate linear and logistic regression models were adopted to assess the correlations between SA scores (SAs), depression, and cognitive function. Restricted cubic spline (RCS) regression was employed to detect potential non-linear relationships. Subgroup and interaction analyses were conducted to identify heterogeneous associations across population subgroups, while mediation analysis was performed to assess indirect pathways through ADL.</p><p><strong>Results: </strong>Higher SAs were significantly correlated with lower odds of depression (OR = 0.90, 95% CI: 0.86-0.94, P < .001) and higher cognitive scores (β = 0.15, 95% CI: 0.09-0.22, P < .001) with evident dose-response trends. RCS results showed no significant non-linear associations between SAs and depression or cognitive function (P-non-linear > .05). Subgroup analysis showed that the association between SAs and cognitive function was modified by urban-rural disparities (P for interaction = .028). Exploratory mediation analysis showed that ADL could account for 28.5% and 20.3% of the total effect of SA on depression and cognitive function, respectively.</p><p><strong>Conclusion: </strong>Higher SA engagement was associated with lower odds of depression and better cognitive function in patients with heart disease. Cardiac rehabilitation strategies should encourage active participation in SA while emphasizing recovery of daily functioning.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029974","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":"Interpreting Reduced-Dose Slow-Infusion Thrombolysis in Intermediate-High-Risk Pulmonary Embolism.","authors":"Aslıhan Gürün Kaya, Serhat Erol","doi":"10.14744/AnatolJCardiol.2026.6598","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6598","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030023","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":"Prognostic Value of the Endothelial Activation and Stress Index in Patients with Non-ST-Segment Elevation Myocardial Infarction.","authors":"Muhammed Erzurum, Veysel Ozan Tanık, Alperen Taş, Mehmet Taha Özkan, Tuğba Kapanşahin, Mehmet Ali Felekoğlu, Nadire Işık Erol Algül, Faruk Aydınyılmaz, İlkin Guliyev, Kamuran Kalkan","doi":"10.14744/AnatolJCardiol.2026.6620","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6620","url":null,"abstract":"<p><strong>Background: </strong>Early risk stratification is essential in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The Endothelial Activation and Stress Index (EASIX) reflects endothelial dysfunction and systemic stress; however, its prognostic value in NSTEMI remains unclear. This study aimed to investigate the association between EASIX and in-hospital mortality in patients with NSTEMI.</p><p><strong>Methods: </strong>This retrospective, single-center observational study included 1001 consecutive NSTEMI patients hospitalized between January 2015 and August 2025. Endothelial Activation and Stress Index was calculated at admission using lactate dehydrogenase, creatinine, and platelet count. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. Discriminative performance was assessed using receiver operating characteristic analysis and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>In-hospital mortality occurred in 41 patients (4.1%). Non-survivors had significantly higher EASIX values than survivors (median 1.76 vs. 0.94, P < .001). In multivariable analysis, EASIX (OR 1.66, 95% CI 1.24-2.23; P = .001), GRACE score (OR 1.04, 95% CI 1.03-1.06; P < .001), and revascularization (OR 0.37, 95% CI 0.15-0.55; P = .003) remained independent predictors of in-hospital mortality. EASIX demonstrated good discriminative ability (AUC 0.770), and higher levels were associated with worse survival.</p><p><strong>Conclusion: </strong>Endothelial Activation and Stress Index is an independent and practical predictor of in-hospital mortality in NSTEMI and may aid early risk stratification using routine laboratory data.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030046","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":"Unraveling the Mechanisms of Neutrophil Extracellular Trap Formation and the Role of Reactive Oxygen Species in Myocardial Bridging.","authors":"Admina Šenderović, Semira Galijašević","doi":"10.14744/AnatolJCardiol.2026.6570","DOIUrl":"10.14744/AnatolJCardiol.2026.6570","url":null,"abstract":"<p><p>Myocardial bridging (MB) is a congenital coronary anomaly in which a segment of a coronary artery courses through the myocardium, resulting in systolic compression and alterations in coronary vasoreactivity. Consequently, morphological, functional, and hemodynamic changes may occur, with various clinical implications. Although traditionally considered a benign anatomical variant, accumulating evidence suggests an association between MB and endothelial dysfunction, oxidative stress, local inflammatory activation, and atherosclerotic plaque formation, predominantly in the arterial segment proximal to the bridge. Reduced wall shear stress in the proximal segment is associated with a pro-inflammatory and prooxidative vascular environment characterized by reduced nitric oxide (NO) bioavailability, despite increased endothelial nitric oxide synthase (eNOS) expression, consistent with impaired eNOS signaling and possible functional uncoupling, together with activation of reactive oxygen species-generating pathways. Myeloperoxidase (MPO), released from activated neutrophils, is a key mediator of oxidative vascular injury and may contribute to endothelial dysfunction by reducing NO bioavailability, generating highly reactive oxidants such as hypochlorous acid, and promoting oxidative endothelial injury. Hemodynamic alterations characteristic of MB may promote MPO activation and the MPO-H2O2 pathway, thereby facilitating mechanisms involved in neutrophil extracellular trap (NET) formation and contributing to the pro-inflammatory vascular environment. MPO- and NET-mediated pathways may represent biologically plausible contributors to endothelial dysfunction and proximal atherogenesis in MB. However, the role of these pathways in the pathophysiology of MB remains insufficiently investigated and should currently be regarded as a hypothesis rather than an established pathophysiological mechanism.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029987","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":"Predictors of All-Cause Mortality in Patients with Classical Low-Flow Low-Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.","authors":"Büşra Güvendi Şengör, Cemalettin Yılmaz, Mustafa Ferhat Keten, Aykun Hakgör, Doğan Şen, Süleyman Çağan Efe, İsmail Balaban, Seda Tanyeri Uzel, Tuba Unkun, Elnur Alizade, Regayip Zehir","doi":"10.14744/AnatolJCardiol.2026.6553","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6553","url":null,"abstract":"<p><strong>Background: </strong>Classical low-flow low-gradient aortic stenosis (cLFLG AS) is associated with poor prognosis and adverse clinical outcomes despite transcatheter aortic valve implantation (TAVI). Identifying prognostic markers in this high-risk population may improve risk stratification and clinical management. This study aimed to investigate independent predictors of all-cause mortality in patients with cLFLG AS undergoing TAVI.</p><p><strong>Methods: </strong>In this single-center retrospective study, 151 patients with cLFLG AS undergoing TAVI between January 2018 and December 2024 were included. Multivariable Cox proportional hazards regression analysis was performed to identify predictors of all-cause mortality. Two separate multivariable models incorporating tricuspid annular plane systolic excursion (TAPSE) and TAPSE/systolic pulmonary artery pressure (sPAP) ratio were constructed to evaluate the prognostic impact of right ventricular (RV) systolic function and RV-pulmonary vascular interaction. The prognostic performance of TAPSE was further assessed using receiver operating characteristic (ROC) and restricted cubic spline analyses.</p><p><strong>Results: </strong>During a median follow-up of 26 (15-42) months, all-cause mortality occurred in 37 (25%) patients. In multivariable analysis, reduced TAPSE remained independently associated with all-cause mortality after adjustment for age and left ventricular ejection fraction (LVEF) (HR: 0.11, 95% CI: 0.04-0.30, P < .001). A lower TAPSE/sPAP ratio was also independently associated with mortality (HR: 0.08, 95% CI: 0.01-0.85, P = .036). Advanced age and reduced LVEF were independently associated with mortality in both models. Time-dependent ROC analysis demonstrated consistent discriminative performance of TAPSE over time.</p><p><strong>Conclusion: </strong>Reduced TAPSE, advanced age, and reduced LVEF were independent predictors of all-cause mortality in patients with cLFLG AS undergoing TAVI.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023775","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}