Anatolian Journal of Cardiology最新文献

{"title":"Is It Time to Pay Attention to Right and Left Ventricular Apical Angles as Clinically Relevant Computed Tomography Measures in Acute Pulmonary Embolism?","authors":"Barkın Kültürsay, Cihangir Kaymaz, Yiğit Cengiz Erkuş, Bahadir Erdem Öcal, Seda Tanyeri Üzel, Hacer Ceren Tokgöz, Çağlar Emre Çağlıyan, Berhan Keskin, Çağdaş Buluş, Doğan Şen, İpek Akkuş, Azmican Kaya, Oğuz Dönmez, Ömer Doğukan Ertan, Muhammet Bulut, Aykun Hakgör, Şeyhmus Külahçıoğlu, Nihal Özdemir","doi":"10.14744/AnatolJCardiol.2026.6458","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6458","url":null,"abstract":"<p><strong>Background: </strong>In acute pulmonary embolism (PE), abrupt right ventricular (RV) pressure overload and ventricular interdependence are primary determinants of hemodynamic deterioration and short-term mortality. Conventional computed tomographic pulmonary angiography (CTPA) markers, such as the RV/left ventricular (LV) diameter ratio, exhibit variable prognostic performance and may not fully capture early geometric remodeling. It was hypothesized that CTPA-derived apical angle metrics, reflecting biventricular geometric distortion, provide complementary prognostic information beyond established clinical scores.</p><p><strong>Methods: </strong>In this retrospective study of 535 consecutive patients with acute PE, novel CTPA-derived apical geometry metrics were evaluated: the RV apical angle (α1), the LV apical angle (α2), and their ratio (α1/ α2). The primary outcome was in-hospital mortality; long-term all-cause mortality served as the secondary outcome.</p><p><strong>Results: </strong>Higher α1 and α1/α₂ values were significantly associated with greater pulmonary arterial obstruction, severe RV dysfunction, and higher clinical risk status. In-hospital mortality increased significantly across α1 tertiles (P = .017). In multiple logistic regression models, after adjustment for the Pulmonary Embolism Severity Index (PESI) score and the conventional RV/LV diameter ratio, both α1 and α1/α₂ remained independently associated with in-hospital mortality. Adding these apical metrics to the PESI-based baseline model significantly improved prognostic accuracy, demonstrating substantial incremental value for short-term risk stratification. Mortality risk increased linearly beyond thresholds of α1>32.5° and α1/α₂ > 1.17. In multiple Cox proportional hazards analysis, no imaging-derived parameter independently predicted long-term mortality.</p><p><strong>Conclusions: </strong>Computed tomographic pulmonary angiography-derived apical angle metrics provide physiologically meaningful, continuous measures of acute RV geometric remodeling in acute PE. These metrics offer significant incremental prognostic value for in-hospital mortality beyond the PESI score and conventional CT markers.</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":"149023707","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":"Computed Tomography Angiography-Guided Bypass for Adult Long-Segment Aortic Coarctation.","authors":"Jie Wang, Wei Qu, Lin Xu, Ping Hu, Xiao-Jing Ma","doi":"10.14744/AnatolJCardiol.2026.6964","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6964","url":null,"abstract":"<p><p>#Jie Wang, Wei Qu, Lin Xu, and Ping Hu contributed equally to this work and should be considered co-first authors.</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":"149023730","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: \"Interpreting Reduced-Dose Slow-Infusion Thrombolysis in Intermediate-High-Risk Pulmonary Embolism\".","authors":"Barkın Kültürsay, Seda Tanyeri, Berhan Keskin, Hacer Ceren Tokgöz, Dicle Sırma, Çağdaş Buluş, Şeyma Zeynep Atıcı, Şeyma Nur Çiçek, Furkan Baturalp Erdoğan, Ahmet Sekban, Mustafa Bulut, Zübeyde Bayram, Selahattin Akyol, Aykun Hakgör, Şeyhmus Külahçıoğlu, Ali Karagöz, Nihal Özdemir, Cihangir Kaymaz","doi":"10.14744/AnatolJCardiol.2026.6764","DOIUrl":"10.14744/AnatolJCardiol.2026.6764","url":null,"abstract":"","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":"149023744","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":"Low-Dose Slow-Infusion Alteplase for a Thrombus-Dominant ST-Segment Elevation Myocardial Infarction in a Young Adult: A Case Report and Narrative Review.","authors":"Mücahit Tan, Meral Kayikcioglu","doi":"10.14744/AnatolJCardiol.2026.6863","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6863","url":null,"abstract":"","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":"149023705","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":"Impact of Anesthetic Strategy and the Institutional Learning Curve on Outcomes After Transcatheter Aortic Valve Implantation.","authors":"İsmail Balaban, Özgecan Pırıl Zanbak Mutlu, Barkın Kültürsay, Deniz Mutlu, Seda Tanyeri Uzel, Ahmet Karaduman, Nesri Danışman, Azmican Kaya, Ebru Girgin Dinç, Esin Öner","doi":"10.14744/AnatolJCardiol.2026.6573","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6573","url":null,"abstract":"<p><strong>Background: </strong>As transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis, the optimal anesthetic strategy remains debated. In addition to anesthesia choice, institutional experience may influence procedural efficiency and outcomes; however, their interplay remains unclear. This study aimed to evaluate the association between anesthetic strategy and outcomes after elective transfemoral TAVI and to assess whether these associations are modified by institutional experience.</p><p><strong>Methods: </strong>In this retrospective observational study, consecutive patients undergoing elective transfemoral TAVI at a high-volume tertiary center between 2020 and 2025 were analyzed. To reduce selection bias, inverse probability weighting with double-robust outcome modeling was applied. The primary outcome was intensive care unit (ICU) stay duration, and in-hospital mortality was evaluated as a secondary outcome. Institutional experience was modeled as chronological case sequence, with an interaction term to assess effect modification.</p><p><strong>Results: </strong>A total of 852 patients were included. After weighting, baseline characteristics were well balanced between conscious sedation (CS) and general anesthesia (GA) groups. General anesthesia utilization decreased from 71% in 2020 to 13% in 2025. Conscious sedation was associated with shorter ICU stay compared with GA (21.0 vs. 23.0 hours; P < .001). In adjusted analysis, GA remained independently associated with longer ICU stay (rate ratios = 1.46, P < .001, 95% CI: 1.28-1.66). Anesthetic strategy was not associated with in-hospital mortality (OR = 1.14, P = .667, 95% CI: 0.62-2.10), and no significant interaction with case sequence was observed.</p><p><strong>Conclusion: </strong>Conscious sedation was associated with shorter ICU stay, while no significant differences were observed in mortality outcomes.</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":"149023725","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":"Approach to Distal Left Main Coronary Artery Bifurcation Lesions.","authors":"Kerim Esenboğa, Mehmet Emre Özerdem","doi":"10.14744/AnatolJCardiol.2026.6808","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6808","url":null,"abstract":"<p><p>Distal left main coronary artery (LMCA) bifurcation lesions are associated with a worse prognosis than other coronary bifurcation lesions. Although coronary artery bypass grafting remains a safe and effective treatment option in this patient population, percutaneous coronary intervention (PCI) has been increasingly adopted in patients with low-to-intermediate anatomical complexity due to its less invasive nature and the favorable long-term outcomes demonstrated in major randomized clinical trials. Given the substantial impact of LMCA revascularization on patient prognosis, meticulous procedural planning and optimization are of paramount importance. The use of intravascular imaging has proven to be of significant value both in making revascularization decisions and in optimizing PCI outcomes. Since the side branch in distal LMCA bifurcation lesions is the left circumflex artery, which supplies a significant portion of the myocardium, accurately predicting and preventing damage to this side branch is of vital importance. Intravascular imaging plays a key role in predicting side branch compromise and in determining the most appropriate stenting strategy, including provisional stenting or an upfront 2-stent approach. Regardless of the stenting strategy employed, achieving optimal minimal stent area targets is essential for improving long-term clinical outcomes. Adverse events following distal LMCA PCI most frequently occur at the left circumflex ostium, highlighting the importance of maintaining long-term side branch patency. Drug-coated balloons, which have demonstrated favorable results in bifurcation interventions, may represent a promising adjunctive therapy for side branch treatment during provisional stenting. However, further large-scale randomized studies are required to establish their role in distal LMCA bifurcation.</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":"149023754","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":"MASLD, HDL-C, Vericiguat.","authors":"Çetin Erol","doi":"10.14744/AnatolJCardiol.2026.9","DOIUrl":"10.14744/AnatolJCardiol.2026.9","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":"30 9","pages":"555"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Transient Receptor Potential Channel mRNA Expression in the Aortas of Patients with Hypertension.","authors":"Algül Dilara Dokumacı, Belgin Alaşehirli, Akif Serhat Balcıoğlu, Sibel Oğuzkan Balcı, Nadire Eser, İbrahim Seyfettin Çelik, Mehmet Acıpayam","doi":"10.14744/AnatolJCardiol.2025.5123","DOIUrl":"10.14744/AnatolJCardiol.2025.5123","url":null,"abstract":"<p><strong>Background: </strong>Arterial hypertension (HT) is a major risk factor for cardiovascular disease; however, its underlying mechanisms, particularly in primary HT, remain largely unclear. This knowledge gap has hindered the development of effective treatment strategies. Transient receptor potential (TRP) channels, which play a critical role in signal transduction, have been implicated in HT based on previous studies in cell culture and animal models. This study is the first study to analyze aortic tissue from patients with primary HT.</p><p><strong>Methods: </strong>Ascending aortic tissue samples, reflecting central blood pressure (BP), were collected from patients with chronic HT (n = 59) and normotensive controls (n = 22) undergoing coronary artery bypass graft surgery. Transient receptor potential channel mRNA expression was analyzed using quantitative real-time polymerase chain reaction. Subgroup analyses were performed to assess the influence of demographic characteristics, biochemical parameters, antihypertensive medications, and coexisting cardiometabolic conditions on gene expression.</p><p><strong>Results: </strong>Although no significant differences were observed in TRPC1 and TRPV3 mRNA expression between HT and control groups, TRPC6, TRPV1, TRPV2, TRPV4, and TRPM8 mRNA levels were significantly lower in patients with HT. TRPC6 expression showed a positive correlation with age, while TRPV1 expression demonstrated a negative correlation with diastolic BP.</p><p><strong>Conclusion: </strong>These findings suggest that TRP channels could serve as potential therapeutic targets for HT and contribute to a better understanding of its pathogenesis.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":"472-479"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Vital Genes Common to Dilated and Hypertrophic Cardiomyopathy Using Machine Learning and Bioinformatics.","authors":"Yang Li, Ran Zhang","doi":"10.14744/AnatolJCardiol.2026.5935","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.5935","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a complex clinical syndrome and a leading cause of hospitalization and mortality worldwide, with significantly increasing mortality rates over time. Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are 2 major myocardial diseases that can lead to progressive HF. Dilated cardiomyopathy is characterized by left ventricular dilation and systolic dysfunction, while HCM primarily presents with left ventricular wall thickening; both are closely associated with mutations in genes encoding cardiac sarcomere contractile proteins and exhibit genetic heterogeneity. Although previous studies have revealed alterations in transcription and protein expression in failing hearts, it may have neglected molecular changes in less frequent cell types.</p><p><strong>Methods: </strong>The overlapping differentially expressed genes (DEGs) that overlapped between datasets GSE141910 and GSE249925 were identified, and a functional enrichment analysis was carried out. Overlapping genes in LASSO, SVM-RFE, and the key module in Weighted Gene Co-expression Network Analysis were seen as potentially significant. The receiver operating characteristic (ROC) curve was utilized to assess their potential for prognostic stratification. Immune cell infiltration was evaluated with cell-type identification by estimating relative subsets of RNA (CIBERSORT), and the findings were validated using the GSE165303 and GSE36961 datasets. Finally, the JASPAR database was utilized to predict potential transcription factors governing these key genes.</p><p><strong>Results: </strong>One hundred eighty-three overlapping DEGs were identified in HCM and DCM, and the functional enrichment analysis revealed they were closely related to the inflammatory and immune response. The genes FRZB, FNDC1, and SMOC2 were identified as potentially crucial, with ROC curves suggesting their potential utility for risk stratification in both test and validation datasets. The analysis using CIBERSORT revealed a relationship between immune cells that infiltrate and important potential genes. Secreted protein acidic and rich in cysteine-related modular calccium-binding protein 2 (SPARC-SMOC2) was identified as a hub gene with potential utility for patient stratification. Estrogen receptor 1 (ESR1) showed the strongest likelihood to be the regulator.</p><p><strong>Conclusion: </strong>The research aimed at thoroughly understanding the pathogenesis of HCM and DCM. Discovering SMOC2 could help in understanding the shared mechanisms of HF, potentially serving as therapeutic targets in the future.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823950","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":"Major In-Hospital Complications During Contemporary Chronic Total Occlusion Percutaneous Coronary Intervention: A Multicenter Turkish Registry.","authors":"Semi Öztürk, Ahmet Seyfeddin Gürbüz, Sefa Sural, Şevket Görgülü","doi":"10.14744/AnatolJCardiol.2026.6590","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6590","url":null,"abstract":"<p><strong>Objective: </strong>To examine the incidence, predictors, and strategy-specific patterns of major in-hospital complications during contemporary chronic total occlusion percutaneous coronary intervention (CTO PCI) in a multicenter Turkish registry.</p><p><strong>Methods: </strong>This retrospective analysis of a prospective multicenter registry included 2375 consecutive CTO PCI procedures performed from January 2020 to February 2026. The primary endpoint comprised death, myocardial infarction (MI), stroke, treatment-requiring coronary perforation, donor-vessel complication, emergency repeat percutaneous coronary intervention, or emergency coronary artery bypass grafting. Myocardial infarction and stroke were based on site-reported fields without central adjudication. Predictors were evaluated using logistic regression, with 500 bootstrap resamples for internal validation.</p><p><strong>Results: </strong>Major complications occurred in 87 procedures (3.7%) and in-hospital death in 14 (0.6%). Event rates ranged from 1.3% in Japanese-Chronic Total Occlusion (J-CTO) 0-1 lesions to 7.3% in J-CTO ≥4 lesions and were 2.3% vs. 7.1% in planned antegrade-only vs. planned retrograde or hybrid procedures. With actual retrograde involvement, the complication rate was 8.1% vs. 2.2% without retrograde use (P < .001). Treatment-requiring perforation occurred in 52 procedures and donor-vessel complications in 22. The primary multiple logistic regression model yielded odds ratio (OR) of 1.02 per year for age (P = .042, 95% CI: 1.00-1.05); OR of 1.23 per 10 mm for CTO length (P = .002, 95% CI: 1.08-1.40); and OR of 1.92 for moderate or severe calcification (P = .005, 95% CI: 1.22-3.03). Model discrimination was area under the curve (AUC) of 0.668 (P < .001, 95% CI: 0.614-0.722); bootstrap optimism-corrected AUC = 0.643.</p><p><strong>Conclusion: </strong>Major complications occurred in 3.7% of procedures, with rates varying across J-CTO strata and planned strategy groups. These findings may inform preprocedural counseling and procedural planning.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823999","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}