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

{"title":"Conservative Management of Left Ventricular Pseudoaneurysm After Transfemoral Transcatheter Aortic Valve Implantation.","authors":"Belma Kalaycı, Ezgi Polat Ocaklı, Özgür Enes Sözen, Murat Tulmaç","doi":"10.5543/tkda.2024.45617","DOIUrl":"10.5543/tkda.2024.45617","url":null,"abstract":"<p><p>Left ventricular pseudoaneurysm is a rare complication, most commonly occurring after myocardial infarction or cardiac surgery. It carries a high risk of spontaneous rupture and may lead to ventricular arrhythmias, heart failure, or thromboembolism. Cases of left ventricular pseudoaneurysm following transcatheter aortic valve implantation (TAVI) are extremely rare, with most requiring emergency surgical intervention. We present a case of a patient who developed ventricular arrhythmia following transfemoral TAVI. Approximately one week after the procedure, the patient presented to the emergency department with ventricular tachycardia and was treated with amiodarone. A diagnosis of left ventricular pseudoaneurysm was established; however, the patient refused surgical treatment. Instead, an implantable cardioverter-defibrillator was placed, and the patient was managed with medical follow-up. The six-month follow-up period was uneventful.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 3","pages":"211-214"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733816","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":"Artificial Intelligence in Cardiac Rehabilitation: Assessing ChatGPT's Knowledge and Clinical Scenario Responses.","authors":"Muhammet Geneş, Salim Yaşar, Serdar Fırtına, Ahmet Faruk Yağcı, Erkan Yıldırım, Cem Barçın, Uygar Çağdaş Yüksel","doi":"10.5543/tkda.2025.57195","DOIUrl":"10.5543/tkda.2025.57195","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac rehabilitation (CR) improves survival, reduces hospital readmissions, and enhances quality of life; however, participation remains low due to barriers related to access, awareness, and socioeconomic factors. This study explores the potential of artificial intelligence (AI), specifically ChatGPT, in supporting CR by providing guideline-aligned recommendations and fostering patient motivation.</p><p><strong>Method: </strong>This cross-sectional study evaluated ChatGPT-4's responses to 40 questions developed by two cardiologists based on current cardiology guidelines. The questions covered fundamental principles of CR, clinical applications, and real-life scenarios. Responses were categorized based on guideline adherence as fully compliant, partially compliant, compliant but insufficient, or non-compliant. Two expert evaluators assessed the responses, and inter-rater reliability was analyzed using Cohen's kappa coefficient.</p><p><strong>Results: </strong>ChatGPT provided responses to all 40 questions. Among the 20 general open-ended questions, 14 were rated as fully compliant, while six were compliant but insufficient. Of the 20 clinical scenario-based questions, 16 were fully compliant, and four were compliant but insufficient. ChatGPT demonstrated strengths in areas such as risk stratification and patient safety strategies, but limitations were noted in managing elderly patients and high-intensity interval training. Inter-rater reliability was calculated as 90% using Cohen's kappa coefficient.</p><p><strong>Conclusion: </strong>ChatGPT shows promise as a complementary decision-support tool in CR by providing guideline-compliant information. However, limitations in contextual understanding and lack of real-world validation restrict its independent clinical use. Future improvements should focus on personalization, clinical validation, and integration with healthcare professionals.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 3","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733812","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":"Exercise and Sports Participation in Patients with Cardiac Implantable Electronic Devices.","authors":"Remzi Karaoğuz, Mustafa Şahingeri","doi":"10.5543/tkda.2024.24952","DOIUrl":"10.5543/tkda.2024.24952","url":null,"abstract":"<p><p>The term cardiac implantable electronic devices (CIEDs) encompasses pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices, which are well-established treatments for cardiac arrhythmias and heart failure with reduced ejection fraction. Advances in CIED therapy have led to an increasing number of patients with cardiovascular disease (CVD) receiving such devices. In general, low levels of physical activity are associated with a higher risk of cardiac and all-cause mortality in patients with CIED. These patients are considered eligible for exercise programs not only to improve prognosis related to their underlying heart disease but also to facilitate psychological adaptation to living with the device, to enhance evaluation of device performance and, particularly in ICD recipients, to reduce the risk of inappropriate shocks. Studies have shown that exercise training improves physical performance in CIED patients without increasing the risk of adverse events. A comprehensive clinical evaluation, a personalized exercise plan, appropriate device programming, and regular follow-up are essential to ensure that patients can safely engage in effective physical activity tailored to their specific needs. Participation in sports is another consideration for many CIED patients. Recent guidelines recommend encouraging individuals with CIEDs to engage in sports activities, unless contraindicated by their underlying heart conditions. It is generally accepted that low- to moderate-intensity leisure-time sports activities are safe and clinically beneficial for most individuals with a CIED. However, individualized recommendations may vary significantly depending on the patient's cardiovascular health, the impact of physical activity on their underlying disease, and the type of implanted device.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 3","pages":"198-205"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733803","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":"Sodium-Glucose Cotransporter 2 Inhibitors Significantly Lower the Cardiac Electrophysiological Balance Index in Type 2 Diabetes Patients.","authors":"Emrah Özdemir, Murat Ziyrek, Esra Dönmez, Sevgi Özcan, Orhan İnce, Ceyla Zeynep Çolakoğlu Gevher, Bahar Özdemir, Ertuğrul Okuyan","doi":"10.5543/tkda.2024.07280","DOIUrl":"10.5543/tkda.2024.07280","url":null,"abstract":"<p><strong>Objective: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a novel group of oral antidiabetic drugs, have demonstrated cardioprotective benefits and positive metabolic effects in patients with diabetes mellitus (DM). The cardiac electrophysiological balance index (ICEB) is an eletrocardiographic ratio that provides information about the equilibrium between left ventricular depolarization and repolarization duration, offering valuable insights into the predisposition to ventricular arrhythmias. The aim of this study is to analyze the potential impact of SGLT2 inhibitors on ICEB.</p><p><strong>Method: </strong>Patients were prospectively selected from a pool of 2,789 consecutive type 2 DM patients. After exclusions, 174 patients formed the monotherapy group, and 143 age- and sex-matched patients who were switched to SGLT2 inhibitor combination therapy constituted the combination therapy group. All treatment changes were supervised by endocrinologists blinded to the patient groups. Baseline and six-month electrocardiogram (ECG) data of both groups were analyzed. ICEB was defined as QT/QRS, and ICEBc as QTc/QRS.</p><p><strong>Results: </strong>Although there was no statistically significant difference between the monotherapy and combination therapy groups in terms of baseline ECG parameters, QT (385.05 +- 13.21 vs. 372.32 +- 4.32; P < 0.001), QTc (409.24 +- 8.17 vs. 383.72 +- 7.24; P < 0.001), ICEB (4.15 +- 0.51 vs. 4.03 +- 0.54; P = 0.004), and ICEBc (4.40 +- 0.75 vs. 4.16 +- 0.61; P < 0.0001) values at the six-month mark were significantly lower in the SGLT2 inhibitor group.</p><p><strong>Conclusion: </strong>SGLT2 inhibitors significantly lower ICEB and ICEBc, potentially reducing ventricular susceptibility to arrhythmias as early as six months into treatment for diabetic patients.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545286","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":"A Rare Case of Stent Loss in the Y-Connector During Percutaneous Coronary Intervention.","authors":"Konstantinos C Theodoropoulos, Konstantinos Tsakiridis, Charalampos Kakderis, Matthaios Didagelos, George Kassimis, Antonios Ziakas","doi":"10.5543/tkda.2024.99649","DOIUrl":"https://doi.org/10.5543/tkda.2024.99649","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"150-151"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545254","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":"Improving Infective Endocarditis Diagnosis by Combining Semi-Quantitative and Visual Findings Obtained from Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging.","authors":"Özge Vural Topuz, Furkan Gür, Burcu Esen Akkaş, Meryem Kaya","doi":"10.5543/tkda.2024.41994","DOIUrl":"10.5543/tkda.2024.41994","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess visual and semi-quantitative outputs of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) for diagnostic purposes in infective endocarditis (IE) and determine whether increased spleen or bone marrow FDG uptake secondary to infection can aid in the diagnosis of IE.</p><p><strong>Method: </strong>Patients who underwent F-18 FDG PET/CT examinations for a preliminary diagnosis of IE between July 2020 and January 2024 were analyzed. IE diagnostic criteria were used to confirm diagnoses, categorizing patients into an IE-positive group and a control group (IE excluded). Demographics and imaging-related data, including mean standardized uptake value (SUVmean) and/or SUVmax for lesions, liver, spleen, and lumbar vertebrae, were recorded. Spleen hypermetabolism and bone marrow hypermetabolism (BMH) were defined as spleen-to-liver or bone marrow-to-liver ratios exceeding 1, respectively. Visually assessed FDG uptake was scored from 0 to 3, forming the uptake score, which was dichotomized into low and high uptake groups.</p><p><strong>Results: </strong>The study included 48 IE patients and 21 control patients. Lesion SUV, uptake score, spleen hypermetabolism, and BMH demonstrated significant differences between the groups. For distinguishing IE, a high uptake score showed a sensitivity of 85.42% and an overall accuracy of 84.06%, while lesion SUVmax (> 3.5) achieved the highest specificity (95.24%) and positive predictive value (96.77%).</p><p><strong>Conclusion: </strong>Visual detection of uptake exceeding blood pool values on F-18 FDG PET/CT images, coupled with an SUV greater than 3.5, appears to distinguish IE patients with high accuracy. Additionally, increased bone marrow FDG uptake was strongly associated with IE.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545264","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":"[Comments on Cardiology].","authors":"Ertan Ural","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"157"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545051","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":"Atrial Myxoma in the Presence of an Interatrial Septal Defect: Uncommon Coexistence of Two Conditions.","authors":"Mostafa Yahyazadeh, Kyomars Abbasi, Narges Shahbazi, Ali Hosseinsabet","doi":"10.5543/tkda.2024.28303","DOIUrl":"https://doi.org/10.5543/tkda.2024.28303","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"148-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545261","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":"Predictors of Absence of Depression in Hospitalized Patients with Heart Failure and Reduced Ejection Fraction.","authors":"Onur Argan, Serdar Bozyel","doi":"10.5543/tkda.2024.67284","DOIUrl":"10.5543/tkda.2024.67284","url":null,"abstract":"<p><strong>Objective: </strong>Mental health is directly related to mortality in heart failure (HF) patients. Nevertheless, depression is often underdiagnosed and undertreated in HF patients. We aimed to determine the parameters associated with the absence of depression in hospitalized HF patients.</p><p><strong>Method: </strong>A total of 143 hospitalized HF patients with reduced ejection fraction were included in this study. The Patient Health Questionnaire-9 (PHQ-9) scale was used for screening depression symptoms. HF patients who scored < 5, defined as patients without depression, were compared with HF patients who scored ≥ 5.</p><p><strong>Results: </strong>Depression was absent in 65 (45.5%) of the 143 hospitalized HF patients. Diabetes mellitus (P = 0.006) and beta-blocker usage (P = 0.011) were less frequent; New York Heart Association (NYHA) class (P = 0.003) and B-type natriuretic peptide (BNP) levels (P = 0.006) were lower; and estimated glomerular filtration rate (eGFR) levels (P = 0.038) were higher in HF patient without depression in our study. In multivariate analysis, NYHA class [P = 0.003, odds ratio (OR) (95% confidence interval [CI]) 0.426 (0.242-0.751)] and beta-blocker usage [P = 0.045, OR (95% CI) 0.288 (0.085-0.972)] were independently correlated with the absence of depression in hospitalized HF patients. Correlation analysis revealed a significant positive correlation between NYHA class and PHQ-9 score (r = 0.258, P = 0.002).</p><p><strong>Conclusion: </strong>In our study, 45.5% of the hospitalized HF patients had no depression. Diabetes mellitus and beta-blocker usage were less frequent, NYHA class and BNP levels were lower, and eGFR levels were higher in HF patients without depression. Additionally, NYHA class and beta-blocker usage were independent predictors of the absence of depression in hospitalized HF patients. This study highlights the need for physicians to recognize the strong interaction between depression and HF and to incorporate regular depression screening into clinical practice.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"120-126"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545280","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 Role of Clefts and Cleft-Like Indentations in Mitral Regurgitation Etiology Detected by Three-Dimensional Echocardiography in Patients with Hypertrophic Cardiomyopathy.","authors":"Ceren Yıldırım Karakan, Arda Güler, İbrahim Halil Tanboğa, Ali Birant, Begum Uygur, Hicaz Zencirkiran Agus, Seda Tükenmez Karakurt, Aysel Türkvatan Cansever, Mehmet Ertürk, Gamze Babur Güler","doi":"10.5543/tkda.2024.50328","DOIUrl":"10.5543/tkda.2024.50328","url":null,"abstract":"<p><strong>Objective: </strong>Mitral regurgitation (MR) is a critical determinant in patients with hypertrophic cardiomyopathy (HCM). Three-dimensional (3D) echocardiography has transformed the imaging of the mitral valve by enabling real-time, direct visualization. This study aims to determine the frequency of clefts and cleft-like indentations (CLIs) and assess their contribution to MR in HCM patients.</p><p><strong>Method: </strong>A total of 50 patients with HCM and moderate or severe MR who underwent 3D transesophageal echocardiography (TEE) were enrolled. For the control group, 200 patients with moderate or severe MR but without HCM were selected. The two groups were compared in terms of demographic characteristics, echocardiographic findings, and cardiac magnetic resonance imaging results.</p><p><strong>Results: </strong>Patients with HCM were younger and had higher regurgitant volumes and effective regurgitant orifice areas compared to the control group. Clefts or CLIs were present in 14 patients (28%) in the HCM group compared to 31 patients (15.6%) in the control group (P = 0.041). Evaluation of MR jet direction in relation to the presence of clefts or CLIs revealed a significant association between anteriorly directed jets and the presence of clefts (P = 0.003).</p><p><strong>Conclusion: </strong>In this study, the frequency of clefts or CLIs was higher in patients with HCM compared to the control group. Clefts influence the direction of MR jets (anteriorly), whereas CLIs do not. 3D-TEE can aid in the differential diagnosis of HCM in patients with anteriorly directed MR jets. However, using 3D-TEE to identify CLIs alone has no significant impact on the management of MR.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 2","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545483","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}