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

{"title":"Evaluation of Systemic Embolism in Patients with Prosthetic Valve Endocarditis: Key Insights and Implications.","authors":"Semih Kalkan, Ahmet Güner, Mustafa Ozan Gürsoy, Macit Kalçık, Mahmut Yesin, Emrah Bayam, Sabahattin Gündüz, Mehmet Özkan","doi":"10.5543/tkda.2025.87292","DOIUrl":"https://doi.org/10.5543/tkda.2025.87292","url":null,"abstract":"<p><strong>Objective: </strong>Prosthetic valve endocarditis (PVE) is a serious complication following heart valve surgery, presenting considerable diagnostic and therapeutic challenges. Despite advances in treatment, systemic embolism remains a major adverse event associated with poor outcomes. This study aimed to identify predictors of in-hospital systemic embolism in patients with PVE and to evaluate treatment outcomes.</p><p><strong>Method: </strong>This retrospective, single-center study included 96 patients diagnosed with mechanical PVE between 2012 and 2024. Diagnoses were established based on the modified Duke criteria. Data on demographics, comorbidities, clinical presentation, imaging findings, and treatment strategies were collected and analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were employed to identify risk factors.</p><p><strong>Results: </strong>The study cohort had a median age of 52.4 years (range 22-82). Systemic embolic events occurred in 39 patients (40.6%), with stroke being the most common manifestation (26%). Multivariate analysis identified vegetation size as the only independent predictor of systemic embolism (odds ratio [OR]: 2.34, P = 0.037). ROC analysis determined a vegetation size threshold of 2 cm², with 66% sensitivity and 78% specificity. Elevated erythrocyte sedimentation rate (ESR) and a prior history of stroke were also associated with increased embolic risk. Among 31 patients who underwent surgery, early intervention did not significantly reduce embolism rates compared to delayed surgery. Successful treatment was associated with a lower risk of embolism (P = 0.045).</p><p><strong>Conclusion: </strong>Larger vegetations, elevated ESR, and a prior history of stroke are key risk factors for systemic embolism in PVE. Early identification of high-risk patients and implementation of individualized management strategies are essential to improve clinical outcomes. Further multicenter studies are warranted to refine treatment protocols.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"319-327"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562514","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: 'Comparative Evaluation of Chatbot Responses on Coronary Artery Disease'.","authors":"Levent Pay, Ahmet Çağdaş Yumurtaş, Tuğba Çetin, Tufan Çınar, Mert Hayıroğlu","doi":"10.5543/tkda.2025.05691","DOIUrl":"https://doi.org/10.5543/tkda.2025.05691","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"372-373"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562520","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 Long-Term Mortality Predictors in Hypertrophic Cardiomyopathy Patients with Low Risk of Sudden Cardiac Death.","authors":"Koray Kalenderoğlu, Mert İlker Hayıroğlu, Levent Pay, Tuğba Çetin, Ahmet Çağdaş Yumurtaş, Şeyda Dereli, Hikmet Kadıoğlu, Tufan Çınar, Kadir Gürkan","doi":"10.5543/tkda.2025.54957","DOIUrl":"https://doi.org/10.5543/tkda.2025.54957","url":null,"abstract":"<p><strong>Objective: </strong>Hypertrophic cardiomyopathy (HCM) is a common hereditary cardiac disorder. Clinical presentations in the Turkish population may differ from those observed in other countries. This study aimed to evaluate the relationship between the sudden cardiac death (SCD) risk score and long-term mortality in low-risk HCM patients and to identify predictors of long-term mortality. Additionally, it investigated the clinical characteristics and outcomes of HCM patients at a tertiary cardiology center.</p><p><strong>Method: </strong>Between 2004 and 2021, a total of 340 HCM patients without implantable cardioverter defibrillators were followed at a single tertiary cardiology center in Türkiye. This was a retrospective study. The HCM Risk-SCD score was used to integrate demographic and clinical variables to estimate the predicted five-year risk of death. Patients with an HCM Risk-SCD score of less than 4% were divided into three equal tertiles, ranging from low to high SCD scores. These tertiles were then compared.</p><p><strong>Results: </strong>Our study identified older age [hazard ratio (HR) 95% confidence interval (CI): 1.048 (1.018-1.080)], a history of cerebrovascular accident [HR 95% CI: 3.675 (1.158-11.656)], and elevated neutrophil count [HR 95% CI: 1.450 (1.250-1.681)] as independent risk factors for long-term mortality in the cohort with HCM Risk-SCD < 4%. The receiver operating characteristic (ROC) curve demonstrated that the optimal HCM Risk-SCD threshold for predicting long-mortality in the overall study cohort was > 1.79, with 55% sensitivity and 55% specificity (area under the curve (AUC): 0.60, 95% CI: 0.52-0.69, P < 0.001). No statistically significant difference in long-term mortality was observed among the tertiles in the Kaplan-Meier analysis (P = 0.296).</p><p><strong>Conclusion: </strong>Advanced age, cerebrovascular accident, and elevated neutrophil count are independent predictors of long-term mortality in patients with an HCM Risk-SCD score < 4%. Patients classified as low risk should undergo further evaluation using complementary tools to help prevent SCD.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"312-318"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562522","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":"Current Approaches to Antibiotic Prophylaxis for Infective Endocarditis in Pediatric Dentistry: A Review.","authors":"Tülin Taşdemir, Gizem Erbaş Ünverdi","doi":"10.5543/tkda.2025.73623","DOIUrl":"https://doi.org/10.5543/tkda.2025.73623","url":null,"abstract":"<p><p>Infective endocarditis (IE) is a serious and potentially life-threatening bacterial infection of the cardiac epithelium, with a mortality rate of approximately 5% in children. The most common risk factor for IE in this population is congenital heart disease. The American Academy of Pediatric Dentistry acknowledges that certain medical conditions increase susceptibility to infections resulting from bacteremia. Antibiotic prophylaxis is recommended for high-risk patients prior to procedures that could induce bacteremia, with the goal of reducing or preventing transient bacteremia caused by invasive dental treatments. However, the effectiveness of prophylaxis in preventing or mitigating the frequency and severity of bacteremia associated with dental procedures remains controversial. This review explores current approaches to antibiotic prophylaxis in pediatric dentistry for the prevention of IE. While some studies suggest that preoperative antibiotics reduce these risks, others report no significant benefit. Given these uncertainties, maintaining good oral hygiene and promptly treating dental diseases are essential strategies to reduce the risk of bacteremia from routine daily activities. Historically, patients with most forms of congenital heart disease were prescribed antibiotics prior to dental procedures in line with American Heart Association guidelines. Today, however, antibiotics before dental procedures are recommended only for patients with cardiac conditions that pose a high risk for infective endocarditis. The overall health of vulnerable pediatric patients can be improved by reducing the risk of infective endocarditis through interdisciplinary collaboration, particularly between pediatric cardiologists and dentists.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562512","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: 'Can the Serum Uric Acid to Albumin Ratio be Reliable Enough to Determine Prognosis in Hypertensive Patients in the Future?'","authors":"Burcunur Karayiğit, Orhan Karayiğit, Ahmet Balun, Hamdi Temel","doi":"10.5543/tkda.2025.34017","DOIUrl":"https://doi.org/10.5543/tkda.2025.34017","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"376-377"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562519","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":"Multimodal Imaging of Huge Atrial Myxoma Accompanied with Valvular Regurgitation.","authors":"Hicaz Zencirkiran Ağuş, Dilara Pay, Serkan Kahraman, Sinem Aydın","doi":"10.5543/tkda.2025.66037","DOIUrl":"https://doi.org/10.5543/tkda.2025.66037","url":null,"abstract":"","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 5","pages":"367-368"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562517","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 Outcomes of Double Kissing Culotte and Mini-Culotte Stenting in Non-Left Main Coronary Bifurcation Lesions: The OPTIMUM Trial.","authors":"Serkan Kahraman, Deniz Demirci, Gökhan Demirci, Yunus Emre Erata, Mustafa Ali Yavaş, İrem Türkmen, Ahmet Yaşar Çizgici, Serkan Aslan, Hicaz Zencirkiran Agus, Ümit Bulut, Ahmet Güner, Ahmet Arif Yalçın, Ali Kemal Kalkan, Mehmet Ertürk","doi":"10.5543/tkda.2025.98697","DOIUrl":"https://doi.org/10.5543/tkda.2025.98697","url":null,"abstract":"<p><strong>Objective: </strong>Culotte stenting is one of the most commonly used bifurcation stenting techniques. Double kissing mini-culotte (DKC) stenting, a modified version of culotte stenting, is currently recommended by clinical guidelines. This study aimed to compare the outcomes of DKC and mini-culotte (MC) techniques in true non-left main coronary bifurcation lesions (CBLs).</p><p><strong>Method: </strong>A total of 200 patients with non-left main CBLs undergoing percutaneous coronary intervention were assigned to either MC stenting (n = 92) or DKC stenting (n = 108). The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR) at one- and three-year follow up.</p><p><strong>Results: </strong>The incidence of TLF was significantly lower in the DKC group at both one year [7 (7.6%) vs. 1 (0.9%), P = 0.017] and three years [18 (19.6%) vs. 6 (5.6%), P = 0.002], primarily driven by a reduction in TLR at one year [6 (6.5%) vs. 1 (0.9%), P = 0.033] and three years [13 (14.1%) vs. 5 (4.6%), P = 0.018]. Fewer patients experienced TVMI [4 (4.3%) vs. 3 (2.8%), P = 0.551] and cardiac death [5 (5.4%) vs. 1 (0.9%), P = 0.064] in the DKC group at three years.</p><p><strong>Conclusion: </strong>In patients with true non-left main CBLs, the DKC technique was associated with a lower incidence of TLF and TLR at three years compared to the MC technique.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 4","pages":"238-246"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210642","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":"An Overlooked Family with a Rare Mutation for Fabry Disease.","authors":"Gamze Babur Güler, Arda Güler, Abdullah Doğan, Zümrüt Arslan Gülten, Aysel Türkvatan Cansever, Mehmet Karacan","doi":"10.5543/tkda.2024.27488","DOIUrl":"10.5543/tkda.2024.27488","url":null,"abstract":"<p><p>Fabry disease is a rare disorder characterized by multi-organ involvement, caused by mutations in the GLA gene. Although more than 1,000 mutations have been identified in the GLA gene, the discovery and detection of new mutations continue to enhance this dataset. We report a patient examined at our clinic for heart valve disease, who had a history of kidney transplantation and hemodialysis. With a high clinical suspicion, we diagnosed Fabry disease and will discuss its significant impact on the family. Effective family screening allowed us to identify unaffected family members, thus preventing or mitigating potential future organ involvement. Additionally, the mutation found in this family, although rarely reported before, is still described as a variant of uncertain significance (VUS) in some sources. We believe this finding will make a valuable contribution to genetic literature.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 4","pages":"281-285"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210639","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 the Guidelines: The Critical Role of Type 1 Iron Deficiency in Predicting Mortality in Patients with Heart Failure.","authors":"Tuğce Çolluoğlu, Tuğba Kapanşahin, Yeşim Akın","doi":"10.5543/tkda.2025.91335","DOIUrl":"https://doi.org/10.5543/tkda.2025.91335","url":null,"abstract":"<p><strong>Objective: </strong>The criteria for iron deficiency (ID) may encompass depleted iron stores alongside unmet iron demands by cardiomyocytes, potentially serving as predictors of adverse outcomes in patients with heart failure (HF).</p><p><strong>Method: </strong>We included 570 patients with HF. Based on newly proposed definitions of ID, patients were categorized into three groups: Type 1 (transferrin saturation [TSAT] < ≈15-16% with anemia), Type 2 or 3 (TSAT < ≈20% with no or mild anemia) and those meeting HF guideline-defined ID criteria. Binary logistic regression was used to identify independent predictors of one-year all-cause mortality in patients with HF. Cox proportional hazard regression was performed to assess the impact of Type 1 ID on mortality.</p><p><strong>Results: </strong>Among the 570 HF patients, 175 (30.7%) had Type 1 ID, 250 (43.9%) had Type 2 or 3 ID, and 415 (72.8%) met the guideline-defined criteria for ID. One-year all-cause mortality rates were 38.3% in patients with Type 1 ID, 22.7% in those with Type 2 or 3 ID, and 26.0% in those meeting guideline ID criteria. Increased age (odds ratio [OR]: 1.054, 95% confidence interval [CI]: 1.025-1.084) and Type 1 ID (OR: 1.830, 95% CI: 1.044-3.208) were independent predictors of one-year all-cause mortality. Cox regression analysis demonstrated an increased risk of mortality in HF patients with Type 1 ID compared to those without, in both unadjusted (hazard ratio [HR]: 2.289, 95% CI: 1.644-3.186, P < 0.001) and adjusted (HR: 1.543, 95% CI: 1.070-2.225, P = 0.020) models.</p><p><strong>Conclusion: </strong>Type 1 ID was an independent predictor of one-year all-cause mortality in patients with HF, unlike Type 2 or 3 ID and guideline-defined ID. Patients with Type 1 ID with HF had a higher overall mortality risk compared to those without Type 1 ID.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 4","pages":"247-253"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210641","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 Metabo-Inflammatory Syndrome and Ferropathological Processes in Atherosclerotic Plaque Formation in Parkinson's Disease: Insights from High-Resolution Carotid Duplex Analysis.","authors":"Esra Demir Ünal","doi":"10.5543/tkda.2025.40390","DOIUrl":"https://doi.org/10.5543/tkda.2025.40390","url":null,"abstract":"<p><strong>Objective: </strong>Peripheral metabo-inflammatory disturbances and ferropathological processes are closely linked to steno-occlusive pathologies in Parkinson's disease (PD), though their roles remain to be fully elucidated. This study aims to investigate cardio-metabolic risk stratification in PD in the context of peripheral metabo-inflammatory and ferropathological abnormalities, and to analyze the role of iron-related dysregulation in carotid atherosclerosis.</p><p><strong>Method: </strong>This cross-sectional case-control study employed high-resolution carotid duplex imaging. Risk stratification for metabolic syndrome (MetS) was assessed using lipid-to-high-density lipoprotein cholesterol (HDL-C) ratios. Intercorrelative and multinomial regression analyses were performed for statistical comparison.</p><p><strong>Results: </strong>PD patients showed a higher tendency toward cardiovascular disease (CVD) and atherogenicity. Calcified plaque formation and Type 4 stenosis patterns were significantly more prevalent (χ2 = 21.717, χ2 = 60.609; P < 0.001), along with altered peripheral iron correlation profiles in PD. An increased risk for MetS was also observed (cholesterol/HDL-C (P = 0.015 (z = 2.434), triglyceride/HDL-C ratio (P = 0.013 (z = 2.471)), along with augmented inflammatory hematological ratios in PD. In multinomial regression analysis, a 1-unit increase in glycated hemoglobin (HbA1c) was associated with a 1.967-fold increase in the likelihood of plaque-forming classification (Odds Ratio = 1.967). Additionally, a 1-unit increase in low-density lipoprotein cholesterol was associated with a slight decrease in risk (Odds Ratio = 0.981) (Cox-Snell = 0.266, Nagelkerke = 0.294).</p><p><strong>Conclusion: </strong>Patients with PD demonstrated a higher risk of CVD and atherosclerotic plaque complications. A close association was observed between MetS and elevated cholesterol/HDL-C and triglyceride/HDL-C ratios. Additionally, there was an increased risk of oxidative stress-related atherothrombotic complications, driven by heightened inflammatory ratios and disturbed ferropathologic processes. However, peripheral iron disturbances did not show a significant relationship with stenosis patterns.</p>","PeriodicalId":94261,"journal":{"name":"Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir","volume":"53 4","pages":"228-237"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210649","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}