Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir最新文献

{"title":"A Novel Technique to Extract Implanted Leads Using Simple Stylets and Reused Rotational Sheaths in Patients with a Cardiac Implantable Electronic Device.","authors":"Serkan Çay, Görkem Kuş, Meryem Kara, Elif Hande Özcan Çetin, Özcan Özeke, Idriz Merovci, Ahmet Korkmaz, Fırat Özcan, Serkan Topaloğlu","doi":"10.5543/tkda.2025.64865","DOIUrl":"https://doi.org/10.5543/tkda.2025.64865","url":null,"abstract":"<p><strong>Objective: </strong>Transvenous lead extraction (TLE) is used in various clinical scenarios, such as device-related infections. Mechanically powered sheaths are one of the most commonly used tools for TLE procedures. We evaluated the procedural and clinical outcomes of a novel extraction technique for chronically implanted leads in the treatment of device-related infections.</p><p><strong>Method: </strong>The novel extraction technique utilizing standard implantation stylets, snares, reused rotational sheaths, catheters, and wires was evaluated for procedural success and clinical outcomes.</p><p><strong>Results: </strong>A total of 12 consecutive patients with device-related infections underwent the novel TLE procedure. Complete procedural success was achieved in all patients, with a minor complication rate of 8% (one patient). No major complications or procedure-related mortality were observed. During a median follow-up period of 435 days, one patient died due to a multidrug-resistant systemic infection, one due to end-stage heart failure, and one underwent valve surgery for concomitant valve endocarditis. No cases of reinfection were reported in the study population. Additionally, this novel technique was approximately 85% less costly than the conventional standard technique using locking stylets and unused rotational sheaths.</p><p><strong>Conclusion: </strong>In situations where unused extraction tools are unavailable or limited by reimbursement constraints, this novel TLE technique offers an effective and safe alternative.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Bundle Branch-Optimized Cardiac Resynchronization Therapy in a Patient with a Carillon Annuloplasty Device: Challenges and Solutions.","authors":"Hasan Kan, Ahmet Taha Şahin, Ahmet Lütfü Sertdemir, Enes Elvin Gül","doi":"10.5543/tkda.2025.53506","DOIUrl":"10.5543/tkda.2025.53506","url":null,"abstract":"<p><p>Cardiac resynchronization therapy (CRT) improves outcomes in heart failure, but prior interventions like percutaneous mitral annuloplasty may hinder lead placement. We present a 70-year-old male with ischemic cardiomyopathy and severe functional mitral regurgitation who previously received a Carillon device. Due to coronary sinus inaccessibility, left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) was performed. The procedure was successful, with improved QRS duration, echocardiographic findings, and clinical status. This case highlights LOT-CRT as a viable alternative in patients with challenging anatomy, offering physiological pacing when conventional CRT is not feasible.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Inflammatory Indices in Patients with Infective Endocarditis: Peak C-Reactive Protein/Albumin Ratio as a Better Biomarker.","authors":"Duygu İnan, Alev Kılıçgedik, Ayşe İrem Demirtola Mammadli, Arslan Erdoğan, Duygu Genç Albayrak, Funda Özlem Karabulut, Sevil Tuğrul Yavuz, Fatmatuz Zehra Eroğlu, Cemal Ozanalp, Ahmet İlker Tekkeşin, Ömer Genç","doi":"10.5543/tkda.2025.85356","DOIUrl":"https://doi.org/10.5543/tkda.2025.85356","url":null,"abstract":"<p><strong>Objective: </strong>Infective endocarditis (IE) is a severe and potentially fatal infection associated with significant morbidity and mortality. Early identification of patients at high risk of adverse outcomes is essential for improving clinical management and prognosis. This study aimed to evaluate the prognostic value of various inflammatory indices, with a particular focus on the peak C-reactive protein/albumin ratio (CAR), in predicting in-hospital mortality among IE patients.</p><p><strong>Method: </strong>This retrospective, single-center study included IE patients admitted between June 2020 and June 2023. The primary outcome was in-hospital mortality. For all patients, inflammatory indices, including peak serum CAR levels, were calculated, and their association with mortality was assessed.</p><p><strong>Results: </strong>Of 165 patients, 62 (37.6%) experienced in-hospital mortality. Non-survivors had significantly higher peak CAR levels (8.1 vs. 5.0, P < 0.001) and elevated levels of other inflammatory indices compared to survivors. Peak CAR demonstrated the highest discriminatory ability for predicting in-hospital mortality, with an area under the curve (AUC) of 0.764, outperforming other indices. Multivariate analysis confirmed that peak CAR was an independent predictor of mortality (adjusted hazard ratio = 1.16, 95% confidence interval: 1.10-1.23, P < 0.001). Net reclassification improvement and integrated discrimination improvement analyses further supported the superior reclassification and discrimination capabilities of peak CAR.</p><p><strong>Conclusion: </strong>Peak CAR is a significant prognostic marker for in-hospital mortality in IE patients compared to traditional inflammatory indices. Incorporating peak CAR into clinical practice may improve risk stratification and guide treatment decisions.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Lipoprotein(a) with Coronary Artery Calcification and Bone Mineral Density in Elderly Individuals.","authors":"Ece Yurtseven, Gizem Timoçin Yığman, Gizem Yaşa, Nigar Bakhshaliyeva, Kayhan Çetin Atasoy, Erol Gürsoy, Kemal Baysal, Saide Aytekin, Vedat Aytekin","doi":"10.5543/tkda.2025.87282","DOIUrl":"https://doi.org/10.5543/tkda.2025.87282","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery calcification (CAC) and osteoporosis are common age-related conditions that may share underlying mechanisms such as inflammation and lipid dysregulation. Lipoprotein(a) [Lp(a)] has been suggested as a potential contributor to both processes. This study aims to investigate the relationship between CAC, bone mineral density (BMD), and Lp(a) levels in a statin-naive elderly population.</p><p><strong>Method: </strong>This retrospective study included 310 patients aged ≥ 55 years who underwent coronary computed tomography angiography and Lp(a) measurement. CAC was assessed visually, and BMD was measured using vertebral Hounsfield units. Patients were stratified into three groups according to Lp(a) levels: ≤ 30, 30-49, and ≥ 50 mg/dL. Propensity score matching was performed for age and sex.</p><p><strong>Results: </strong>Patients with CAC had higher Lp(a) levels [36.4 +- 33.2 vs. 21.7 +- 27.8 mg/dL, P < 0.001], lower high-density lipoprotein cholesterol (HDL-C) [52.6 +- 14.6 vs. 57.5 +- 17.9 mg/dL, P = 0.010], and lower BMD [152.9 +- 50.2 vs. 169.1 +- 51.0 HU, P = 0.009]. In multivariate analysis, both Lp(a) and HDL-C were independent predictors of CAC. Low BMD and CAC prevalence increased stepwise across Lp(a) strata: in patients with Lp(a) ≤ 30 mg/dL, low BMD was present in 28.9% and CAC in 52.6%; in those with Lp(a) 30-49 mg/dL, 37.2% and 66.7%; and in those with Lp(a) ≥ 50 mg/dL, 58.6% and 80.3%, respectively (P = 0.002 and P = 0.001).</p><p><strong>Conclusion: </strong>Elevated Lp(a) is associated with both CAC and low BMD. Lp(a) ≥ 50 mg/dL may serve as a shared biomarker to identify individuals at risk for concurrent vascular and skeletal deterioration.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between the CHA2DS2-VASc Score and Lesion Complexity and Long-Term Outcomes in Peripheral Arterial Disease.","authors":"Ali Evsen, Adem Aktan, Raif Kılıç, Tuncay Güzel, Mehmet Özbek","doi":"10.5543/tkda.2025.66505","DOIUrl":"https://doi.org/10.5543/tkda.2025.66505","url":null,"abstract":"<p><strong>Objective: </strong>Originally designed to evaluate stroke risk in individuals with atrial fibrillation unrelated to valvular disease, the CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes mellitus, prior Stroke/transient ischemic attack/systemic embolism, Vascular disease, Age 65-74 years, and Sex category - female) is now additionally utilized for the prognostic evaluation of cardiovascular diseases. This study aimed to evaluate the predictive role of the CHA2DS2-VASc score for lesion severity and long-term survival outcomes in individuals with peripheral artery disease (PAD).</p><p><strong>Method: </strong>This retrospective analysis included 784 patients diagnosed with PAD via computed tomography (CT) angiography, consecutively enrolled from two medical centers. The CHA2DS2-VASc score was determined for all participants. Lesion severity was assessed according to the TASC II (Trans-Atlantic Inter-Society Consensus II) criteria, and patients were categorized into TASC-AB (simple) and TASC-CD (complex) lesion groups. Mortality data were obtained from hospital and social security records.</p><p><strong>Results: </strong>The study included 784 patients (average age: 61.7 +- 9.9 years; 17.2% female). In the regression analysis performed to predict lesion severity, we found that the CHA2DS2-VASc score (P < 0.007) and left ventricular ejection fraction (P = 0.009) were independent predictors. The receiver operating characteristic (ROC) curve indicated that a CHA2DS2-VASc score threshold of 3.5 predicted long-term mortality with 70% sensitivity and 79% specificity (P < 0.001). Kaplan-Meier survival estimates indicated that patients with higher CHA2DS2-VASc scores had significantly lower survival rates over the 60-month follow-up period (P < 0.001).</p><p><strong>Conclusion: </strong>The CHA2DS2-VASc score was independently associated with both lesion severity and adverse long-term outcomes in individuals with PAD.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Large Language Models Guide Aortic Stenosis Management? A Comparative Analysis of ChatGPT and Gemini AI.","authors":"Ali Sezgin, Veysel Ozan Tanık, Murat Akdoğan, Yusuf Bozkurt Şahin, Kürşat Akbuğa, Vedat Hekimsoy, Çağatay Tunca, Erhan Saraçoğlu, Bülent Özlek","doi":"10.5543/tkda.2025.54968","DOIUrl":"https://doi.org/10.5543/tkda.2025.54968","url":null,"abstract":"<p><strong>Objective: </strong>Management of aortic stenosis (AS) requires integrating complex clinical, imaging, and risk stratification data. Large language models (LLMs) such as ChatGPT and Gemini AI have shown promise in healthcare, but their performance in valvular heart disease, particularly AS, has not been thoroughly assessed. This study systematically compared ChatGPT and Gemini AI in addressing guideline-based and clinical scenario questions related to AS.</p><p><strong>Method: </strong>Forty open-ended AS-related questions were developed, comprising 20 knowledge-based and 20 clinical scenario items based on the 2021 European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines. Both models were queried independently. Responses were evaluated by two blinded cardiologists using a structured 4-point scoring system. Composite scores were categorized, and comparisons were performed using Wilcoxon signed-rank and chi-square tests.</p><p><strong>Results: </strong>Gemini AI achieved a significantly higher mean overall score than ChatGPT (3.96 +- 0.17 vs. 3.56 +- 0.87; P = 0.003). Fully guideline-compliant responses were more frequent with Gemini AI (95.0%) than with ChatGPT (72.5%), although the overall compliance distribution difference did not reach conventional significance (P = 0.067). Gemini AI performed more consistently across both question types. Inter-rater agreement was excellent for ChatGPT (κ = 0.94) and moderate for Gemini AI (κ = 0.66).</p><p><strong>Conclusion: </strong>Gemini AI demonstrated superior accuracy, consistency, and guideline adherence compared to ChatGPT. While LLMs show potential as adjunctive tools in cardiovascular care, expert oversight remains essential, and further model refinement is needed before clinical integration, particularly in AS management.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Iron Deficiency in Heart Failure: The Prognostic Value of Type 1 Iron Defiency.","authors":"Çağrı Zorlu","doi":"10.5543/tkda.2025.29473","DOIUrl":"https://doi.org/10.5543/tkda.2025.29473","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Bradycardia Before Transcatheter Aortic Valve Implantation in a Patient with Mechanical Tricuspid and Mitral Valve Replacement.","authors":"Mert Doğan, Uğur Canpolat, Ahmet Hakan Ateş, Mehmet Levent Şahiner, Ergün Barış Kaya, Kudret Aytemir","doi":"10.5543/tkda.2025.60402","DOIUrl":"https://doi.org/10.5543/tkda.2025.60402","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) has proven to be a safe and effective method, especially in patients with aortic stenosis whose surgical risk score is moderate to high. One of the possible complications after TAVI is bradyarrhythmia resulting from high-grade atrioventricular block. Some patients in this situation may require permanent pacemaker (PM) implantation. In this case, we presented a case with symptomatic intermittent pauses and severe aortic stenosis, who underwent permanent PM implantation through the coronary sinus before TAVI due to a history of mechanical tricuspid and mitral valve replacement, and subsequently underwent successful TAVI. The patient remained stable with no periprocedural complications.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile Dysfunction as a Marker of Subclinical Biventricular Diastolic Dysfunction: A Prospective Echocardiographic Study.","authors":"Vedat Çiçek, Serkan Akan, Samet Yavuz, Şahhan Kılıç, Almina Erdem, Mert Babaoğlu, Caner Ediz, Ahmet Öz, Tufan Çınar, Ulaş Bağcı","doi":"10.5543/tkda.2025.95270","DOIUrl":"https://doi.org/10.5543/tkda.2025.95270","url":null,"abstract":"<p><strong>Objective: </strong>Erectile dysfunction (ED) and cardiovascular disease share similar vascular pathologies, particularly endothelial dysfunction and atherosclerosis. Increasing evidence indicates that ED may serve as an early signal of underlying cardiac abnormalities, particularly diastolic dysfunction (DD), even in the absence of clinical cardiovascular disease.</p><p><strong>Method: </strong>This prospective, single-center study involved 87 patients with ED, matched with 53 healthy controls based on age and body mass index. The severity of ED was evaluated using the International Index of Erectile Function (IIEF), categorizing patients into mild, moderate, and severe ED. The DD was assessed according to established guidelines.</p><p><strong>Results: </strong>Patients with ED demonstrated significant impairments in left ventricular DD, characterized by reduced E/A and e' velocities, prolonged isovolumetric relaxation time (IVRT), and left atrial (LA) enlargement. There was a correlation between increasing severity of ED and worsening right ventricular (RV) diastolic indices, specifically reduced RV e' and elevated RV E/e'. Notably, LA enlargement and IVRT were identified as independent predictors of ED.</p><p><strong>Conclusion: </strong>ED is independently linked to subclinical biventricular DD, even when overt cardiovascular disease is not present. Echocardiography may help detect subclinical cardiac dysfunction in men with ED and improve cardiovascular risk assessment.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incremental Diagnostic Value of Computed Tomography Attenuation in the Differential Diagnosis of Malignant Pericardial Effusion: A Retrospective Observational Study.","authors":"Muhammet Geneş","doi":"10.5543/tkda.2025.77427","DOIUrl":"https://doi.org/10.5543/tkda.2025.77427","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}