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

{"title":"Predictors of One-Year Restenosis After Percutaneous Mitral Balloon Valvuloplasty in Rheumatic Mitral Stenosis: Real-World Data From 555 Patients and the Limited Impact of Periinterventional Transesophageal Echocardiography.","authors":"Tuğba Aktemur Özalp, Kohei Ukita, Sezgin Atmaca, Cennet Yıldız, Erhan Melikoğlu, Dilara Pay, Yusuf Karadağ, Mehmet Ertürk, İbrahim Faruk Aktürk","doi":"10.5543/tkda.2026.99527","DOIUrl":"10.5543/tkda.2026.99527","url":null,"abstract":"<p><strong>Objective: </strong>Mitral balloon valvuloplasty remains an established first-line treatment for appropriately selected patients with rheumatic mitral stenosis. However, predictors of long-term restenosis and the additional value of periinterventional transesophageal echocardiography remain incompletely defined.</p><p><strong>Method: </strong>This retrospective, single-center study included 555 patients who underwent percutaneous mitral balloon valvuloplasty for rheumatic mitral stenosis between January 2010 and January 2025 at Mehmet Akif Ersoy Heart Center, İstanbul, Türkiye. Patients were divided according to the presence or absence of restenosis at the 1-year follow-up. Restenosis was defined as a mitral valve area <1.5 cm². Procedural success was defined as less than moderate mitral regurgitation at the end of the procedure and the absence of transseptal puncture-related complications. Clinical, echocardiographic, procedural, and laboratory variables were analyzed to identify predictors of restenosis and procedural success.</p><p><strong>Results: </strong>Restenosis occurred in 94 patients (17%). The mean age of the overall cohort was 47.81+-12.29 years, and 467 patients (84.1%) were female. Patients with restenosis had higher preprocedural systolic pulmonary artery pressure, postprocedural transmitral gradient, postprocedural systolic pulmonary artery pressure, and preprocedural Wilkins score. In multivariable analysis, only the preprocedural Wilkins score remained an independent predictor of restenosis (OR: 1.907, 95% CI: 1.339-2.718, P < 0.001). Post-balloon transmitral gradient and postprocedural left atrial pressure ≥12 mmHg were associated with procedural success. Periinterventional transesophageal echocardiography was not associated with restenosis or procedural success.</p><p><strong>Conclusion: </strong>In patients undergoing percutaneous mitral balloon valvuloplasty for rheumatic mitral stenosis, the preprocedural Wilkins score was the only independent predictor of 1-year restenosis. Routine periinterventional transesophageal echocardiography did not significantly influence procedural success or long-term restenosis rates. These findings suggest that, in appropriately selected patients, percutaneous mitral balloon valvuloplasty can be safely and effectively performed under transthoracic echocardiographic guidance without routine periinterventional transesophageal echocardiography.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"570-579"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877040","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":"Clinical Perspectives on Lactate in Complete Atrioventricular Block.","authors":"Gazi Çapar","doi":"10.5543/tkda.2026.32488","DOIUrl":"10.5543/tkda.2026.32488","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"637-638"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027276","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":"Reply to the Letter to the Editor: 'Beyond the Frontal QRS-T Angle: Toward Integrated Cardiovascular Phenotyping in Acute Ischemic Stroke'.","authors":"Songül Usalp","doi":"10.5543/tkda.2026.76649","DOIUrl":"10.5543/tkda.2026.76649","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"635-636"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027346","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 e-Consultation Paradox in Cardiology: The Conflict Between the Clinical Agility of Instant Messaging and Medicolegal Concerns Created by Current Legislation.","authors":"Nazile Bilgin Doğan","doi":"10.5543/tkda.2026.23495","DOIUrl":"10.5543/tkda.2026.23495","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical use of instant-messaging e-consultation among cardiologists in Türkiye, self-reported treatment delays attributed to the perceived quality of transmitted data, and variations in medicolegal concern according to professional seniority.</p><p><strong>Method: </strong>A total of 253 cardiologists completed a cross-sectional online survey covering consultation patterns, acute myocardial infarction (AMI)-related support, types of shared data, data quality-related treatment delays, regulatory awareness, and the 15-item Medicolegal Implications of Digital Consultation in Cardiology Scale (MIDCCS). The primary analysis compared MIDCCS domain scores across seniority groups using the Kruskal-Wallis H test with Holm-Bonferroni correction; a single-item ordinal regression analysis of global concern was exploratory.</p><p><strong>Results: </strong>Among current users, 86.9% (213/245) reported at least one AMI-related informal support activity: preliminary assessment, 71.5%; triage, 60.1%; catheterization laboratory activation support, 36.4%; and early management, 42.7%. The most frequently shared data type was the ECG (95.2%). A self-reported treatment delay attributed to perceived poor data quality was reported by 23.7% (58/245), most commonly involving ECG photographs. Medicolegal concern differed markedly across seniority groups after correction (P<.001 in every domain), with specialists and faculty members scoring higher than residents. In an exploratory ordinal model, a history of treatment delay was directionally but nonsignificantly associated with greater concern (common OR=1.711; 95% CI, 0.994-2.946). The MIDCCS demonstrated good internal consistency (Cronbach α=0.86).</p><p><strong>Conclusion: </strong>Although e-consultation was widespread and clinically functional, data quality failures and seniority-related medicolegal concerns indicate important limitations. The findings highlight the need for a secure national e-consultation infrastructure integrated into Hospital Information Management Systems that is KVKK-compliant and end-to-end encrypted, while remaining as fast and user-friendly as WhatsApp.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"596-605"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993295","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":"Indication Phenotypes and Short‑Term Clinical Outcomes in Patients Undergoing Left Atrial Appendage Closure: A Single‑Center Real‑World Experience from Türkiye.","authors":"Aykan Çelik, Alper Çağrı Ağdağ, Semih Aktürk, Emre Özdemir, Sadık Volkan Emren","doi":"10.5543/tkda.2026.85533","DOIUrl":"10.5543/tkda.2026.85533","url":null,"abstract":"<p><strong>Objective: </strong>Left atrial appendage occlusion (LAAO) is widely used for stroke prevention in patients with atrial fibrillation who are unsuitable for long‑term anticoagulation. However, whether clinical outcomes differ according to indication phenotype (bleeding‑dominant versus ischemic‑dominant) remains unclear. This study aimed to evaluate the association between indication phenotype and clinical outcomes following LAAO and to determine whether phenotype provides incremental prognostic value beyond traditional risk factors.</p><p><strong>Method: </strong>In this retrospective single‑center study, patients undergoing LAAO were classified as having either a bleeding‑dominant or ischemic‑dominant indication phenotype. The primary outcome was all‑cause mortality. The secondary outcome was a net clinical benefit composite consisting of death, recurrent stroke, or major bleeding. Associations were assessed using Kaplan-Meier and Cox analyses, and the proportional hazards assumption was tested using Schoenfeld residuals. Sensitivity analyses were performed after excluding major bleeding from the composite outcome.</p><p><strong>Results: </strong>A total of 109 consecutive patients were included. During a median follow‑up of approximately 10 months, all‑cause mortality occurred in 25.7% of patients, while the net clinical benefit composite occurred in 29.4%. No statistically significant association was observed between indication phenotype and mortality (adjusted hazard ratio [HR] 1.00, 95% confidence interval [CI] 0.38-2.62) or the composite outcome (adjusted HR 0.73, 95% CI 0.30-1.78). However, the wide confidence intervals reflect the limited sample size and event burden.</p><p><strong>Conclusion: </strong>Among patients undergoing LAAO, no statistically significant differences in short‑ term clinical outcomes were observed according to indication phenotype. Age emerged as the most consistent determinant of risk. Given the modest sample size, limited number of events, and relatively short follow‑up duration, these findings should be interpreted cautiously and considered hypothesis‑generating.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"580-587"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027323","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":"Eggshell Calcific Constrictive Pericarditis: Multimodality Diagnosis and Surgical Management.","authors":"Etkin Elifoğlu, Belma Kalaycı","doi":"10.5543/tkda.2026.44295","DOIUrl":"10.5543/tkda.2026.44295","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"631-632"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043247","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":"Beyond Left Ventricular Remodeling: Reconsidering Cardiac Recovery After Bariatric Surgery.","authors":"Sofia Arain, Maryam Arain, Warda Arain","doi":"10.5543/tkda.2026.68122","DOIUrl":"10.5543/tkda.2026.68122","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"643-644"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043230","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":"Calming the Adrenergic Storm: Mechanical Support Devices as a Life-Saving Stormbreaker in Iatrogenic Takotsubo Syndrome.","authors":"Kutluhan Eren Hazır, Selim Ekinci, Fırat Eskici, Özdemir Kuzucu, Gözde Gürsoy Çirkinoğlu","doi":"10.5543/tkda.2025.39475","DOIUrl":"10.5543/tkda.2025.39475","url":null,"abstract":"<p><p>Takotsubo syndrome is a cardiomyopathy characterized by transient ventricular dysfunction caused by excessive sympathetic discharge, which may potentially lead to a fatal outcome. This case report presents the successful management of a 41-year-old female patient with iatrogenic Takotsubo syndrome complicated by cardiogenic shock. The condition was triggered by the inadvertent administration of norepinephrine, which occurred due to a medication error in which it was mistaken for amiodarone because of look-alike/sound-alike packaging and name similarity. The management strategy focused on the use of mechanical support devices rather than agents that perpetuate the adrenergic discharge underlying the pathophysiology.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"622-628"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121575","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":"Atherogenic Index of Plasma in CTO PCI: From Construct Definition to Predictive Validation.","authors":"Hasan Burak İşleyen, Sercan Bulut, Sevil Tuğrul Yavuz, Emirhan Hancıoğlu","doi":"10.5543/tkda.2026.42495","DOIUrl":"10.5543/tkda.2026.42495","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"641-642"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893257","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":"Reply to the Letter to the Editor: Clinical Perspectives on Lactate in Complete Atrioventricular Block.","authors":"Haydar Başar Cengiz, Hamza Sunman, Şefik Görkem Fatihoğlu, Muhammed Erzurum, Engin Algül, Haluk Furkan Şahan, Sinan İşcen, Tolga Han Efe, Özcan Özdemir","doi":"10.5543/tkda.2026.90949","DOIUrl":"10.5543/tkda.2026.90949","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":" ","pages":"639-640"},"PeriodicalIF":0.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027349","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}