Anatolian Journal of Cardiology最新文献

{"title":"Dirty Earth, Diseased Hearts: Soil, Water, and Plastic Pollution in the Cardiovascular Exposome.","authors":"Thomas Münzel, Marin Kuntic, Jos Lelieveld, Michael Aschner, Mark J Nieuwenhuijsen, Omar Hahad, Andreas Daiber, Philip J Landrigan","doi":"10.14744/AnatolJCardiol.2026.6593","DOIUrl":"10.14744/AnatolJCardiol.2026.6593","url":null,"abstract":"<p><p>Healthy soils and clean water are essential for human survival, yet, both are increasingly compromised by chemical and plastic pollution. This preventable crisis causes an estimated 9 million premature deaths each year, including about 0.9 million linked to soil pollution and 1.3 million to water pollution. In 2019 alone, pollution contributed to 5.5 million cardiovascular deaths, underscoring its role in the global burden of non-communicable disease. A key underrecognized driver is the rapid rise in plastic production and plastic-associated chemicals. Global plastic output has increased more than 250-fold since 1950 and is projected to nearly triple by 2060, while less than 10% is effectively recycled. As highlighted by the Lancet Countdown on health and plastics, plastics threaten human health across their lifecycle, from fossil fuel extraction to waste, fragmentation, and environmental persistence. Soils and water systems are increasingly contaminated by heavy metals, pesticides, persistent synthetic chemicals, and micro- and nanoplastics. These pollutants degrade soil, reduce agricultural productivity, contaminate food chains, and spread through aquatic ecosystems, thereby amplifying disease risk. Micro- and nanoplastics have been detected in human blood, placenta, brain, and cardiovascular tissues, raising concern about biological effects. These exposures are drivers of cardiovascular disease. Despite their chemical diversity, they converge on shared mechanisms, including oxidative stress, inflammation, endocrine disruption, and circadian dysregulation. Their persistence reflects policy failure. Reducing soil, water, and plastic pollution must become a central pillar of cardiovascular prevention through enforceable, lifecycle-based policies that protect human health. #These authors contributed equally and should be considered as joint first and joint last authors.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257075","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":"Integrative Identification of Frailty Status in Elderly Patients with Atrial Fibrillation Using a Noise-Resilient Multimodal Machine Learning Approach.","authors":"Shangying Hu, Chao Feng","doi":"10.14744/AnatolJCardiol.2026.5642","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.5642","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common yet underdiagnosed in elderly patients with atrial fibrillation (AF), worsening outcomes and complicating treatment. Traditional assessments are time-consuming and subjective, while physiological monitoring offers potential for automated detection. Combining machine learning (ML) with multimodal data, especially electrocardiogram (ECG) and clinical features, may improve frailty identification, even in noisy real-world conditions. To develop a noise-resilient ML framework for identifying frailty status in elderly patients with AF using multimodal clinical and ECG data and to compare traditional and deep learning models under varying signal conditions.</p><p><strong>Methods: </strong>This retrospective study included 110 patients aged ≥65 with documented AF. Frailty was assessed via a composite of the Fried Phenotype and Clinical Frailty Scale. Electrocardiogram data (resting 12-lead and Holter) were processed through a denoising and segmentation pipeline. Over 180 ECG features and clinical parameters were used as inputs. Five models (Random Forest, Extreme Gradient Boosting, 1-dimensional convolutional neural network, bidirectional long short-term memory-attention, SiamAF) were trained and evaluated using an 80:20 split. Performance metrics included accuracy, F1-score, receiver operating characteristic-area under the curve (ROC-AUC), and Brier score; robustness was tested with synthetic noise.</p><p><strong>Results: </strong>Frailty and pre-frailty prevalence were 41.82% and 34.55%. The SiamAF achieved the best performance (accuracy 90.00%, F1-score 89.75%, ROC-AUC 93.00%, Brier score 0.084), maintaining robustness under noise. Deep learning models also showed strong performance (ROC-AUC > 90%). Key predictors included standard deviation of normal-to-normal (NN) intervals, corrected QT interval, N-terminal pro-brain natriuretic peptide, and grip strength.</p><p><strong>Conclusion: </strong>Multimodal ML effectively identifies frailty status in elderly patients with AF. The SiamAF model demonstrated strong discriminatory performance and noise robustness in this single-center cohort; however, these findings should be considered hypothesis-generating and require external validation in larger, multicenter AF populations before clinical adoption. Given the limited sample size relative to the high-dimensional feature space, these results should be interpreted as exploratory and hypothesis-generating. The present framework primarily leverages predefined ECG-derived features rather than fully end-to-end raw-signal learning.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257072","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":"Methodological Concerns Regarding Cardioprotective Effects of PCSK9 Inhibition in Diabetic Rats.","authors":"Abdulmecit Afşin, Kadir Uçkaç, Güney Sarıoğlu","doi":"10.14744/AnatolJCardiol.2026.6415","DOIUrl":"10.14744/AnatolJCardiol.2026.6415","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257155","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":"Reply to the Letter to the Editor: \"Exploring the Multifaceted Nexus of Hypertrophic Cardiomyopathy and Clinical Outcomes\".","authors":"Gamze Babur Güler, Arda Güler, İbrahim Halil Tanboğa, Mehmet Karacan, İrem Türkmen, Sezgin Atmaca, Aysel Türkvatan Cansever, Hasan Şahin, Gizemnur Coşkun, Sinem Aydın, Dilara Pay, Utku Yartası, Nail Güven Serbest, Muayad Almasri, Mustafa Can Gündoğdu, Duygu İnan, Özgür Sürgit, Mehmet Ertürk","doi":"10.14744/AnatolJCardiol.2026.6550","DOIUrl":"10.14744/AnatolJCardiol.2026.6550","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248825","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":"Tetralogy of Fallot with Left Common Carotid Artery Arising from the Main Pulmonary Artery: A Rare Combination.","authors":"Shuxuan Qin, Lin He, Wan Li, Cong Liu, Yuman Li","doi":"10.14744/AnatolJCardiol.2026.6419","DOIUrl":"10.14744/AnatolJCardiol.2026.6419","url":null,"abstract":"<p><p>#These authors contributed equally.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222635","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":"Permanent Pacemaker Implantation After Minimally Invasive Robotic Cardiac Surgery and Long-Term Pacemaker Dependence Rates.","authors":"Özkan Eravcı, Salim Yaşar, Hatice Taşkan, Tuna Demirkıran, Ahmet Arslan, Alperen Çomoğlu, Ahmet Faruk Yağcı, Cemal Dinç, Furkan Kırık, Suat Görmel, Serdar Fırtına, Serkan Asil, Mehmet Sadık Karpat, Ender Murat, Yusuf Öztürk, Ayşe Saatçi Yaşar, Erkan Yıldırım, Barış Buğan, Murat Kadan, Cem Barçın, Uygar Çağdaş Yüksel, Murat Çelik, Hasan Kutsi Kabul","doi":"10.14744/AnatolJCardiol.2026.6150","DOIUrl":"https://doi.org/10.14744/AnatolJCardiol.2026.6150","url":null,"abstract":"<p><strong>Background: </strong>The role of minimally invasive robotic heart surgery in the surgical field is swiftly expanding due to technological advancements and the acknowledgment that its safety is comparable to conventional cardiac surgery. The aim of this study was to evaluate permanent pacemaker (PPM) implantation rates, associated perioperative determinants, and the course of pacing rates during follow-up in a single-center cohort undergoing minimally invasive robotic cardiac surgery.</p><p><strong>Methods: </strong>This retrospective study was conducted on 276 patients who received robotic heart surgery utilizing the da Vinci Si HD surgical system (Intuitive Surgical, Inc.) at the center. Patients were categorized into 2 groups: those who had PPM implantation post-surgery and those who did not. The general demographic data of patients, comorbidities, and intraoperative variables were retrospectively analyzed.</p><p><strong>Results: </strong>Permanent pacemakers were implanted in 5.4% (n = 15) of patients after robotic cardiac surgery. Patients had an average age of 53.50 (±16.15) years. Age, gender, and comorbidities were similar between groups. Patients who received PPM implantation had substantially longer cardiopulmonary bypass (CPB) times (median = 210) than those who did not (median = 150) (P = .035). Additionally, the distribution of surgical types showed a significant difference according to PPM implantation status (P = .033), and mitral-tricus-pid valve surgery was observed at a higher rate in the PPM group (40.0% vs. 10.3%).</p><p><strong>Conclusion: </strong>This study shows that prolonged CPB duration and concurrent mitral-tricuspid valve surgery elevate the risk of PPM implantation in patients undergoing minimally invasive robotic heart surgery; furthermore, patients needing pacemaker implantation showed significant long-term pacing burden during follow-up.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222577","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":"Outcomes of Percutaneous Interventions for Aortic Coarctation: Experience from a Tertiary Care Center.","authors":"Tuğba Çetin, Şeyda Dereli, Günseli Miray Özdemir, Utku Uluköksal, Fatma Can, Can Yücel Karabay","doi":"10.14744/AnatolJCardiol.2026.6127","DOIUrl":"10.14744/AnatolJCardiol.2026.6127","url":null,"abstract":"<p><strong>Background: </strong>Coarctation of the aorta (CoA) is a congenital obstructive anomaly that may remain undiagnosed until adulthood, often presenting with systemic hypertension. While percutaneous interventions, including balloon angioplasty and stent implantation, are increasingly utilized in adults, real-world data on procedural outcomes, complications, and long-term mortality remain limited. This study aimed to evaluate procedural outcomes, complication rates, and short- and long-term mortality associated with percutaneous interventions in adult patients with CoA.</p><p><strong>Methods: </strong>A single-center, retrospective observational study was conducted, including adult patients with CoA who underwent percutaneous intervention between July 2017 and July 2023. Procedural success was defined as a residual peak systolic gradient ≤20 mmHg without major complications. Patient demographics, comorbidities, procedural details, complications, and follow-up outcomes were analyzed.</p><p><strong>Results: </strong>Twenty-nine patients (median age 40 [29-45] years; 31% female) were included. Endovascular stent placement was performed in 89.7% of patients, 74% of whom were covered stents (mean length 39 mm). Balloon angioplasty alone was used in 10.3% of cases. The procedure was associated with a marked reduction in the peak systolic gradient, decreasing from a median of 57.5 mmHg [50.0-68.8] before the procedure to 9.0 mmHg [1.2-11.8] after the procedure. Complications occurred in 6.9%, including 1 aortic rupture and 1 access site bleeding. Recoarctation developed in 14% of patients at a median of 17.5 months. No in-hospital deaths occurred; out-of-hospital mortality was 6.9%, including 1 death of unknown cause and 1 following posterior mediastinal hematoma after aortic rupture.</p><p><strong>Conclusions: </strong>Percutaneous interventions in adult CoA achieve favorable procedural success and low in-hospital mortality, while rare but serious complications underscore the necessity for meticulous management and lifelong follow-up.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222615","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":"Comparison of Kinesiophobia, Upper Limb Function, and Grip Strength in Patients with Pacemakers and Coronary Artery Disease.","authors":"Benil Nesli Ata, Zeynep Alev Özçete, Barış Ünal, Buğra İnce","doi":"10.14744/AnatolJCardiol.2026.5638","DOIUrl":"10.14744/AnatolJCardiol.2026.5638","url":null,"abstract":"<p><strong>Background: </strong>To compare kinesiophobia, shoulder range of motion (ROM), functional disability, and handgrip strength (HGS) between patients with cardiac pacemakers and those with stable coronary artery disease (CAD).</p><p><strong>Methods: </strong>This cross-sectional study enrolled 60 individuals aged ≥50 years with preserved left ventricular systolic function, including 30 patients with standard left-sided cardiac pacemakers and 30 individuals with CAD. Kinesiophobia was assessed using the validated Turkish version of the Tampa Scale for Kinesiophobia-Heart (TSK-Heart). Shoulder ROM, HGS, and upper limb function [quick disabilities of the arm, shoulder, and hand (QuickDASH)] were evaluated using standardized clinical protocols. Analysis of covariance was used for between-group comparisons.</p><p><strong>Results: </strong>The TSK-Heart scores were similar between the pacemaker and CAD groups, with no statistically significant difference (P = .061). Internal rotation of the left shoulder was significantly more limited in the pacemaker group (P = .031, Cohen's d = 0.58). No significant differences were observed in other shoulder ROM parameters, QuickDASH scores, or HGS between the groups.</p><p><strong>Conclusion: </strong>Kinesiophobia levels were similarly elevated in patients with pacemakers and those with CAD, suggesting that fear of movement is a generalized phenomenon across chronic cardiac populations rather than a device-specific issue. The selective internal rotation limitation observed exclusively in pacemaker recipients highlights the importance of targeted musculoskeletal assessment during clinical follow-up. Recognition of such functional impairments, alongside awareness of elevated kinesiophobia, is critical for comprehensive patient management.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222617","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":"Reply to the Letter to the Editor: \"Integrated Clinical, Multimodality Imaging, and Electrophysiological Markers for Improved Prediction of Sudden Cardiac Death in Hypertrophic Cardiomyopathy\".","authors":"İsmail Balaban, Seda Tanyeri, Ahmet Karaduman, Barkın Kültürsay, Ezgi Gültekin Güner, Mustafa Ferhat Keten, Süleyman Çağan Efe, Elnur Alizade","doi":"10.14744/AnatolJCardiol.2026.6486","DOIUrl":"10.14744/AnatolJCardiol.2026.6486","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209803","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":"Reply to the Letter to the Editor: \"Interpreting Early Reticulocyte Response After Intravenous Iron Therapy in Heart Failure\".","authors":"Zeynep Kumral, Hacer Uysal, Mehmet Birhan Yılmaz","doi":"10.14744/AnatolJCardiol.2026.6560","DOIUrl":"10.14744/AnatolJCardiol.2026.6560","url":null,"abstract":"","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209871","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}