Journal articles: 'HM-ECG'

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Stepanets, E. A., D. P. Salivonchik, and V. P. Krupenin. "Comparative analysis of daily electrocardiogram monitoring recording using the “standard” and “optimized” techniques of electrode placement on the chest." Health and Ecology Issues 19, no. 1 (March 30, 2022): 27–34. http://dx.doi.org/10.51523/2708-6011.2022-19-1-04.

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Objective. To analyze a HM ECG recording in the placement of the electrodes in accordance with the procedure established by the manufacturer for the domestic recorder “Cardian-SDM” and in changed placement of the electrodes.Materials and methods. The study included 30 patients, the average age of the subjects was 34.7 ± 16.9 years, the median was 23 years, of which males accounted for 40 % (n = 12), females – 60 % (n = 18). When analyzing the HM ECG, the amplitude of the main ECG teeth, the displacement of the ST segment, and the change in the morphology of extrasystolic complexes were evaluated using the “standard” and “optimized” recording techniques. Such parameters as sensitivity and specificity of the proposed method were determined. The statistical analysis was carried out using the SPSS Statistics program.23 and Microsoft Excel.Results. During the automatic analysis of significant deviations in the amplitude of the ECG waves, rhythm disturbances, no ST segment changes were not registered when using the “optimized” technique compared to the “standard” one. The analysis of 30 HM ECG episodes taking into account the amplitude of the main teeth according to the “optimized” technique has a specificity of 93.4 % and sensitivity of 96.7 %, the deviation of the amplitude parameters has no significant differences, p > 0.05.Conclusion. The changes in the amplitude of the teeth did not exceed 10 %, the duration of the complexes, segments, and intervals did not change, p > 0.05. The specificity of the proposed “optimized” technique was 93.4 %, sensitivity – 96.7 %. The “optimized” technique can be used instead of the existing one to improve the quality of the ECG recorded in patients during physical exercise.

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Kalacheva, T. P., S. V. Fedosenko, O. A. Denisova, G. M. Chernyavskaya, T. M. Poponina, A. O. Naumov, I. A. Palchikova, G. V. Dudko, and M. A. Karnaushkina. "Clinical and functional features of the course of respiratory sarcoidosis in real practice." Russian Pulmonology 30, no. 2 (June 21, 2020): 204–12. http://dx.doi.org/10.18093/0869-0189-2020-30-2-204-212.

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As a rule, heart damage in patients with sarcoidosis of respiratory organs (SOD) is not diagnosed in time, so a very important and urgent task is to identify common heart rhythm and conduction disorders.The aim of the study was to investigate the main clinical manifestations of sarcoidosis in SOD, depending on the peculiarities of the disease course and to compare the frequency and severity of pulmonary and extrapulmonary manifestations of sarcoidosis, including myocardial lesions and electrocardiographic (ECG) signs of heart rhythm disorders.Methods. In the period 2006– 2016, the pilot open prospective uncontrolled study conducted at the Pulmonology Department of the Regional State Autonomous Healthcare Institution "Tomsk Regional Clinical Hospital" included patients (n = 84) aged 20–67 years with the diagnosis of SOD. Patients were divided into 2 clinical groups: the 1st comprised 45 (53.5%) patients with a favorable course of sarcoidosis, the second one included 39 (46.4%) patients with an unfavorable course of the disease. A full range of studies was carried out, including the analysis of medical history and clinical and epidemiological data, instrumental methods (including ECG and Holter ECG monitoring (HM), pathomorphological study of lung biopsy samples.Results. According to the data of frequency analysis of occurrence of pulmonary and extrapulmonary clinical manifestations in ODS, it was shown that the leading clinical manifestations, most frequently occurring in patients of both groups, included asthenia syndrome (72.6%), bronchial syndrome (66.7%) and fever syndrome (33%). In 33% of cases, clinical manifestations of myocardial damage were detected. In 41 (51.2%) patients in both groups, changes on ECG were recorded at rest. Regardless of the course of the disease, in 23.5% of patients of both clinical groups, according to the results of the HM ECG, rhythm and conduction disturbances were found – a combination of ventricular arrhythmias and conduction disorders (ventricular extrasystole and right His bundle branch block of various degrees) and a combination of supraventricular arrhythmias and conduction disturbances (supraventricular extrasystole and right His bundle branch block of various degrees).Conclusion. Thus, regardless of the severity of the disease course, SOD patients are concerned about complaints from both respiratory system and extrapulmonary manifestations, including cardiac complaints, as well as heart rhythm and conduction disorders (according to the results of ECG and HM ECG), the frequency of which, according to the comparative analysis, has not significantly changed in both clinical groups, which indicates the non-specific character of clinical manifestations.

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Frigy, Attila, Annamária Magdás, Victor-Dan Moga, Ioana Georgiana Coteț, Miklós Kozlovszky, and László Szilágyi. "Increase of Short-Term Heart Rate Variability Induced by Blood Pressure Measurements during Ambulatory Blood Pressure Monitoring." Computational and Mathematical Methods in Medicine 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/5235319.

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Objective.The possible effect of blood pressure measurements per se on heart rate variability (HRV) was studied in the setting of concomitant ambulatory blood pressure monitoring (ABPM) and Holter ECG monitoring (HM).Methods.In 25 hypertensive patients (14 women and 11 men, mean age: 58.1 years), 24-hour combined ABPM and HM were performed. For every blood pressure measurement, 2-minute ECG segments (before, during, and after measurement) were analyzed to obtain time domain parameters of HRV: SDNN and rMSSD. Mean of normal RR intervals (MNN), SDNN/MNN, and rMSSD/MNN were calculated, too. Parameter variations related to blood pressure measurements were analyzed using one-way ANOVA with multiple comparisons.Results.2281 measurements (1518 during the day and 763 during the night) were included in the analysis. Both SDNN and SDNN/MNN had a constant (the same for 24-hour, daytime, and nighttime values) and significant change related to blood pressure measurements: an increase during measurements and a decrease after them (p<0.01for any variation).Conclusion.In the setting of combined ABPM and HM, the blood pressure measurement itself produces an increase in short-term heart rate variability. Clarifying the physiological basis and the possible clinical value of this phenomenon needs further studies.

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Wang, Zheming, Elena A. Asafieva, and Tatiana I. Makeeva. "Predictive value of the N-terminal prohormone of brain natriuretic peptide in the long-term prognosis of ventricular arrhythmia in diabetic patients with acute coronary syndrome of young and middle age." Актуальные проблемы медицины 43, no. 4 (December 30, 2020): 522–38. http://dx.doi.org/10.18413/2687-0940-2020-43-4-522-538.

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The article investigates the prognostic value of pro-B-type N-terminal natriuretic peptide (NTproBNP) in connection with ventricular extrasystoles (VES) in a population of patients with diabetes mellitus with acute coronary syndrome (ACS) after successful coronary reperfusion by percutaneous coronary intervention (PCI). Patients with ACS were examined by defining biomarkers and performing echocardiography (EchoCG) on the first day of ACS after PCI with stenting of the infarction-related coronary artery, and Holter monitoring of electrocardiography (HM-ECG) on the second day after PCI; 12 months later, EchoCG, HM-ECG and NT-proBNP determination were repeated. It was found that the incidence of VES in the long-term prognosis among ACS patients with diabetes of young and middle age was more frequent than in patients without diabetes. A positive correlation was found between the NTproBNP level and ventricular arrhythmia in ACS patients with diabetes mellitus. It has been proven that a high level of NT-proBNP on the first day in patients with ACS after PCI as an independent indicator of risk to development of VES in long-term prognosis.

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Nekrasov, A. A., E. S. Timoshchenko, T. A. Nekrasova, M. V. Timoshchenko, and A. V. Suleimanova. "The effect of rivaroxaban low doses on the stable angina of the II–III functional class clinical manifestations and the quality of life in patients with ischemic heart disease." Kardiologiia 61, no. 9 (September 30, 2021): 47–51. http://dx.doi.org/10.18087/cardio.2021.9.n1696.

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Aim To evaluate the effect of low-dose rivaroxaban on quality of life of patients and clinical manifestations of functional class (FC) II-III stable angina.Material and methods 26 patients with ischemic heart disease (IHD) with FC II-III stable angina, who were newly prescribed rivaroxaban 2.5 mg twice a day in combination with acetylsalicylic acid 75-100 mg, were followed for 10 weeks. During the first (before the beginning of treatment) and the last weeks of study, patients kept diaries, in which they reported angina attacks and short-acting nitrate intake, filled in an angina questionnaire (SAQ), and underwent electrocardiogram (ECG) Holter monitoring (HM).Results The treatment was associated with decreases in the frequency of angina attacks (by 19.5 %; р=0.027) and the number of taken short-acting nitrate pills (by 17.1 %; р=0.021) and an improvement of quality of life according to stability scales (р=0.042). Data from ECG HM showed decreases in the number and duration of ischemic episodes (p≤0.05).Conclusion The treatment of IHD patients with rivaroxaban 2.5 mg twice a day in combination with acetylsalicylic acid 75-100 mg for 2 mos. was associated with decreased frequency of angina attacks, reduced requirement for short-acting nitrate, and with improvement of quality of life.

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Kurman, Michael R., Philip Sager, Marc S. Rudoltz, Joel Eisner, Daniel Goodman, Eugene Heyman, Daniel Salvail, Caroline Bell, and William R. Moore. "Cardiovascular safety profile of VT-464 in patients (pts) with castrate-resistant prostate cancer (CRPC)." Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 198. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.198.

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198 Background: VT-464 is a dual selective inhibitor of CYP17,20 lyase and an androgen receptor antagonist in development for the treatment of CRPC. In early clinical testing, several pts receiving VT-464 in 28-day cycles were noted to have syncopal, pre-syncopal or vaso-vagal episodes with typical prodromes. To further evaluate these events, Holter monitoring (HM) was performed in pts enrolled in two clinical studies. Methods: Continuous HM was performed at Screening, after the first dose of VT-464 C1D8, and C2D1 for study INO-VT-464-CL-001; and at Screening, after the first dose of VT-464, and C2D1 for study INO-VT-464-CL-004. The Screening visit HM data was considered the baseline. Plasma levels of VT-464 (in selected pts) and 12-lead ECGs of 10-seconds duration were extracted in triplicate for each pt from the HM data at Baseline, Day 1 and C2D1 at multiple time points. Results: 57 pt screened for VT-464 treatment, underwent HM. Nonsustained ventricular tachycardia (NSVT) was seen in 6 pts (11%) prior to VT-464, providing a background estimate in this population. 37 pts were treated with VT-464 and had > 1 post-screen HM; 4 pts (11%; all with cardiac disorders) had post-treatment NSVT (all < 5 beats); no episodes of sustained VT were seen. 28 pts had ECG data extracted from HMs that coincided with peak plasma levels of VT-464. There was no QTcF or QRS prolongation; increases in the HR (mean 13.1-19.5 BPM but with a non-significant VT-464 concentration/HR relationship) and small PR increases (mean 32.9 ms; partially driven by several pts) without second degree AV block were observed. Conclusions: VT -464 did not prolong QTcF or QRS intervals and the lack of a significant exposure response HR analysis suggests that the HR increases may not be drug related. The PR prolongation is unlikely to be clinical significance. HM showed a frequency of NSVT consistent with background frequency for this pt population.A detailed examination of study pts experiencing syncope or presyncope revealed these to likely be vasovagal in nature, consistent with the increased vagal tone observed in nonclinical testing. There does not appear to be a pro-arrhythmogenic potential of VT-464 based on data from both nonclinical and clinical assessments. Clinical trial information: NCT02361086.

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Bogdan, T. V., V. O. Onishchenko, O. V. Savchenko, and O. V. Slobodianyk. "The case report of myocarditis caused by COVID-19." Likarska sprava, no. 1-2 (May 25, 2021): 9–13. http://dx.doi.org/10.31640/jvd.1-2.2021(2).

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Introduction. Myocarditis is known to occur in 5–25 % of COVID-19 cases and is associated with increased mortality. According to studies, even a mild course of COVID-19 is associated with a high risk of cardiovascular disease. Possible mechanisms of myocarditis are a combination of direct viral damage to the myocardium and the human immune response to the affected myocardium. Along with acute manifestations, as fulminant myocarditis, COVID-19 may also be associated with an increased risk of long-term cardiovascular complications. Case report and discussion. The article presents a case of myocarditis that developed five weeks after active coronovirus infection in patient I., 47 years old, Ukraine, Kyiv. She described such symptoms as palpitations, shortness of breath, fever, general malaise. According to magnetic resonance imaging (MRI) of the heart: signs of focal myocarditis; according to laboratory tests, an increase in the level of acute phase indicators; according to Holter monitoring of the electrocardiogram (HM ECG) – AV blockade of the II degree (Mobitz II). The patient was prescribed : eplerinone, bisoprolol fumorate, rivaroxaban, trimetazidine. After four months of treatment, the condition of the patient gradually improved. Positive dynamics was revealed according to HM ECG and MRI of the heart. Thus, the patient was diagnosed with long-term consequences of coronavirus infection – focal myocarditis. Conclusions. Coronavirus infection causes myocardial damage with the development of myocarditis. Myocarditis can develop both in the acute period of the disease and in the long term. Scientists and physicians should pay attention to the possible consequences of COVID-19 from the first contact with the patient, and conduct long-term follow-up of patients in the long term.

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Stronа, V. I., Y. G. Gorb, and I. R. Komir. "THE VARIABILITY OF HEART RHYTHM IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE AND DIABETES MELLITUS TYPE 2." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 18, no. 4 (December 20, 2018): 59–64. http://dx.doi.org/10.31718/2077-1096.18.4.59.

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The purpose of this study is to evaluate the time and spectral parameters of heart rate variability (HRV) in patients with stable type of coronary heart disease and type 2 diabetes mellitus by findings obtained by daily ECG Holter monitoring. Material and methods. The study involved 61 individuals aged 42-64 years (mean age 46.4±4.6 years) with IHD, stable exertional angina pectoris of II-III functional classes, of them 34 individuals (I group) were diagnosed to have diabetes mellitus 2 types, and 27 individuals (II group) were found to have no disorders of carbohydrate metabolism. The control group consisted of 15 individuals with essential hypertension of stage II without IHD and diabetes mellitus. All patients underwent 24-hour Holter electrocardiogram monitoring (HM ECG) with subsequent analysis of HRV parameters and evaluation of heart rhythm disturbances. Results and discussion. It was found that in both groups of IHD patients regardless the presence of diabetes, there was a decrease in the circadian index in comparison with patients with essential hypertension that probably indicates a vegetative "denervation" of the heart, the development of rigidity of the circadian circadian heart rate profile in IHD patients. With an increase in the level of glycosylated hemoglobin in the patients of I group, the temporal indices of the variability of the heart rhythm and the circadian index declined. The number of supraventricular and ventricular extrasystoles per day was statistically significantly higher in patients of I group (p <0.001, p <0.002, respectively) compared with the patients with IHD without diabetes. In the patients with coronary artery disease and diabetes, HM ECG data showed a decrease in HRV timing. This category of patients was found to have a general decrease in HRV: a SDNN decline, changes in spectral characteristics (a decrease in the high-frequency component of the spectrum (HF), an increase in the LF/HF ratio) with a shift of balance toward the sympathetic (low-frequency) component. Conclusions. Patients with stable form of ischemic heart disease and diabetes mellitus type 2 have a decrease in both temporal and spectral HRV indices that indicates a decrease in the total activity of neurohumoral effects on the heart rhythm. These changes are associated with an increase in the ectopic activity of the myocardium.

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Skuratova, N. A., A. V. Mikityuk, and V. V. Fedorova. "The Clinical and Functional Description of the Cardiovascular System in Children with Diseases of the Circulatory System." Health and Ecology Issues, no. 2 (June 28, 2019): 48–52. http://dx.doi.org/10.51523/2708-6011.2019-16-2-9.

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Objective: to give the clinical and functional characteristics of the cardiovascular system in children with diseases of the circulatory system. Material and мethods. The study involved 188 children aged 8-16 with different cardiovascular diseases (CVD) examined at the Cardiology Ward of Gomel Regional Children`s Hospital. Depending on the profile of their diseases, the children were divided into five main groups: group 1 - children with minor anomalies of heart development, group 2 - children with congenital heart diseases, group 3 - children with rhythm disorders, group 4 - children with autonomic dysfunction, group 5 - children with arterial hypertension. Along with the clinical examination the children were performed an electrocardiogram (ECG) and underwent Holter monitoring (HM). Results. The polymorphism of complaints was typical of the children of all the groups, according to the ECG data, conduction disturbances were the most common in the children of the first and second groups, and excitability disorders were typical of the children of the third group. Normal ECG was most often recorded in the children of the fourth and fifth groups. By the НM data arrhythmia (II Lown class and higher) was most frequently detected in the children of the first and third groups, arrhythmia of V class prevailed in the second group of the children. Conclusion. The cardiologic examination found that the children with CVD had various complaints and different arrhythmia classes, while the ECG of the majority of the children with autonomic dysfunction and hypertension detected mild arrhythmias, which is indicative of prognostically favorable disease outcomes. Clinically significant arrhythmias were revealed most frequently in the children with minor anomalies of heart development, cardiac rhythm disorders and congenital heart diseases.

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Mjahad, Azeddine, Alfredo Rosado-Muñoz, Juan Guerrero-Martínez, Manuel Bataller-Mompeán, Jose Francés-Villora, and Malay Dutta. "Detection of Ventricular Fibrillation Using the Image from Time-Frequency Representation and Combined Classifiers without Feature Extraction." Applied Sciences 8, no. 11 (October 25, 2018): 2057. http://dx.doi.org/10.3390/app8112057.

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Due the fact that the required therapy to treat Ventricular Fibrillation (V F) is aggressive (electric shock), the lack of a proper detection and recovering therapy could cause serious injuries to the patient or trigger a ventricular fibrillation, or even death. This work describes the development of an automatic diagnostic system for the detection of the occurrence of V F in real time by means of the time-frequency representation (T F R) image of the ECG. The main novelties are the use of the T F R image as input for a classification process, as well as the use of combined classifiers. The feature extraction stage is eliminated and, together with the use of specialized binary classifiers, this method improves the results of the classification. To verify the validity of the method, four different classifiers in different combinations are used: Regression Logistic with L2 Regularization (L 2 R L R), adaptive neural network (A N N C), Bagging (B A G G), and K-nearest neighbor (K N N). The Hierarchical Method (HM) and Voting Majority Method (VMM) combinations are used. ECG signals used for evaluation were obtained from the standard MIT-BIH and AHA databases. When the classifiers were combined, it was observed that the combination of B A G G , K N N , and A N N C using the Hierarchical Method (HM) gave the best results, with a sensitivity of 95.58 ± 0.41%, a 99.31 ± 0.08% specificity, a 98.6 ± 0.04% of overall accuracy, and a precision of 98.25 ± 0.29% for V F . Whereas a sensitivity of 94.02 ± 0.58%, a specificity of 99.31 ± 0.08%, an overall accuracy of 99.14 ± 0.43%, and a precision of 98.59 ± 0.09% was obtained for V T with a run time between 0.07 s and 0.12 s. Results show that the use of T F R image data to feed the combined classifiers yields a reduction in execution time with performance values above to those obtained by individual classifiers. This is of special utility for V F detection in real time.

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Uzunova, Anna N., and Maria V. Nazarova. "Features of the cardiovascular system in newborns, carrying out the cerebral ischemia." Pediatrics. Consilium Medicum, no. 1 (May 10, 2022): 15–19. http://dx.doi.org/10.26442/26586630.2022.1.201421.

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Aim. To identify the features of the function of the cardiovascular system in newborns with cerebral ischemia (CI) of hypoxic origin. Materials and methods. In the neurological department of the children's hospital in 64 newborns coming from maternity hospitals with CI, a clinical and instrumental examination confirmed the diagnosis of CI of hypoxic origin after excluding structural damage to cardiomyocytes, infectious, traumatic and dysmetabolic causes of its occurrence; 12.2% of children were diagnosed with CI of easy degree, 81.2% CI of moderate severity; the control group consisted of 24 healthy full-term children, comparable in age. All patients were examined by a pediatric cardiologist with an electrocardiogram (ECG), echocardiographic ultrasound screening assessment of the heart (ECHO-CG), Holter electrocardiogram monitoring, cardiointervalography. Results. In newborns, who underwent CI, there is a higher heart rate, more often there is a single supraventricular extrasystole. Bradycardia with heart rate less than 100 beats/min, sino-atrial block II degree, atrioventricular block II degree were recorded only in newborns after CI. According to ECHO-CG data, a hypokinetic type of hemodynamics takes place in newborns with CI. A decrease in cardiac output reflects a narrowing of the adaptive range of its regulation. In every second child with CI, homeostasis is achieved by a sharp overstrain of the autonomic nervous system regulatory systems, which is most likely based on a shift in regulation from the reflex vegetative to the humoral-metabolic type. As the severity of CI progresses, depletion of reserves to support reflex and humoral homeostasis has been established. Conclusion. In connection with the revealed clinical and instrumental features of the cardiovascular system, newborns with CI who came under the supervision of pediatricians at children's clinics, at the age of one month, in addition to a neurological examination, an examination of a pediatric cardiologist with an ECG is shown. If, according to ECG data, heart rhythm and conduction abnormalities, fluctuations in the duration of the QT interval are detected, CI and/or HM-ECG are indicated to determine further observation tactics.

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Фролов, А. В. "Information Support for Primary Prevention of Sudden Cardiac Death." Кардиология в Беларуси, no. 2 (April 27, 2022): 145–55. http://dx.doi.org/10.34883/pi.2022.14.2.001.

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Введение. Профилактика внезапной сердечной смерти (ВСС), основанная на популяционных факторах риска, имеет низкую степень персонализации и недостаточную предиктивную точность 51,3–66,7%.Цель. Разработка информационной технологии первичной профилактики ВСС на основе ЭКГ-маркеров электрической нестабильности миокарда (ЭНМ), ориентированной на поликлиническое звено, где сконцентрирован основной поток кардиологических пациентов.Материалы и методы. Выполнен анализ ЭКГ высокого разрешения 1014 пациентов с коронарными и некоронарогенными заболеваниями, средний возраст 49,9±5,9 года. Первичные конечные точки: желудочковая тахикардия, успешная сердечно-легочная реанимация, разряды ИКД или ВСС. Период наблюдения 5,0 (2,1; 5,9) года. Контролировали ЭхоКГ, ХМ-ЭКГ и ЭКГ-маркеры ЭНМ: фрагментация QRS, угол QRS-T, длительность и дисперсия QRS, альтернация Т-волны, длительность и дисперсия QT, Tpeak-Tend, турбулентность и замедление сердечного ритма. Использовалась компьютерная программа «Интекард 7.3».Результаты. Среди ЭКГ-маркеров ЭНМ в фазе деполяризации наибольшей прогностической мощностью обладают фрагментация QRS – относительный риск (ОР) 4,3, 95% ДИ (3,5–6,3), p<0,001 и пространственный угол QRS-T – ОР=2,2, 95% ДИ (1,5–2,5), p<0,001. В фазе реполяризации наиболее высокие значения ОР имеют альтернация Т-волны – ОР=4,1, 95% ДИ (2,2–6,2), p<0,001 и дисперсия интервала QT – ОР=2,7, 95% ДИ (1,3–5,4), p<0,001. Маркеры дисфункции вегетативной регуляции турбулентность и замедление сердечного ритма имели ОР, равные 1,7, 95% ДИ (1,0–5,5) и 1,4, 95% ДИ (1,1–5,9) соответственно, p<0,05. Разработан персонифицированный алгоритм первичной профилактики ВСС на основе оценки ФВ, ХМ-ЭКГ и ЭКГ-маркеров ЭНМ. Риск стратифицируется на низкий, средний, высокий и критический. В соответствии с уровнем риска пациентам рекомендуется имплантация ритм-поддерживающих систем, медикаментозная терапия или мониторинг. При клинической апробации алгоритма у 52% пациентов зафиксирован низкий риск, у 42% – средний и у 6% – высокий риск ВСС.Заключение. Предложенная стратегия управления кардиоваскулярными рисками направлена на снижение преждевременной смертности от сердечно-сосудистых заболеваний. Неинвазивность, персонификация и высокая пропускная способность создают предпосылки для широкого внедрения программы первичной профилактики ВСС. Introduction. Prevention of sudden cardiac death (SCD) based on population risk factors has a low degree of personalization and, as a result, an insufficient predictive accuracy of 51.3–66.7%.Purpose. Development of information technology for primary prevention of SCD based on ECG-markers of electrical myocardial instability (EMI), focused on the polyclinics, where the main stream of cardiological patients is concentrated.Materials and methods. High-resolution ECG analysis was performed in 1014 patients with coronary and non-coronary heart diseases, mean age 49.9±5.9 years. Primary endpoints: ventricular tachycardia, successful cardiopulmonary resuscitation, ICD shocks or SCD. Follow-up period was 5.0 (2.1; 5.9) years. Controlled echoCG, HM-ECG and ECG- markers of the EMI: QRS fragmentation, QRS-T angle, QRS duration and dispersion, T-wave alternans, QT duration and dispersion, Tpeak-Tend, turbulence and deceleration of heart rate. The "Intecard 7.3" computer program was used.Results. Among the ECG-markers of EMI in the depolarization phase, QRS fragmentation has the highest predictive power – relative risk (RR)=4.3 95% CI (3.5–6.3), p<0.001 and QRS–T angle – RR=2.2 95% CI (1.5–2.5), p<0.001. In the repolarization phase, the highest RR values have T wave alternans – RR=4.1 95% CI (2.2–6.2), p<0.001 and QT interval dispersion – RR=2.7 95% CI (1.3–5.4), p<0.001. Autonomic regulation dysfunction markers heart rhythm turbulence and deceleration rate had RRs of 1.7 95% CI (1.0–5.5) and 1.4 95% CI (1.1–5.9), respectively, p<0.05. The personalized algorithm for the primary prevention of SCD based on the assessment of EF, HM-ECG and ECG-markers of EMI has been developed. The risk is stratified into low, medium, high and critical. According to the level of risk, implantation of rhythm-support systems, drug therapy or monitoring is recommended. In clinical testing of the algorithm, 52% of patients had a low risk, 42% – an average risk, and 6% – a high risk of SCD.Conclusion. The proposed strategy for managing cardiovascular risks is aimed at reducing premature mortality from cardiovascular diseases. Non-invasiveness, personalization and high throughput create the prerequisites for the widespread introduction of the SCD primary prevention program.

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Kovalenko, V. M., E. G. Nesukay, S. V. Cherniuk, N. S. Polenova, R. M. Kirichenko, I. I. Giresh, E. Yu Titov, A. S. Kozliuk, and Yu A. Botsiuk. "Diagnosis of myocarditis as one of the actual problems in cardiology." Ukrainian Journal of Cardiology 27, no. 4 (October 1, 2020): 78–89. http://dx.doi.org/10.31928/1608-635x-2020.4.7889.

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Nowadays the diagnosis and prognosis of myocarditis is one of the most pressing, complex and incompletely solved problems in modern cardiology, that exist due to the large polymorphism of clinical manifestations of this disease and because of the lack of specific symptoms and diagnostic criteria. In most cases, the occurrence of heart failure, pain, heart rhythm and conduction disorders or other clinical manifestations are observed on the 2nd week after the onset of infectious disease, but inflammatory heart disease may not have a clear connection with the infection. Among the main methods used to diagnose myocarditis in clinical practice are electrocardiography (ECG), Holter monitoring (HM) ECG, echocardiography (echocardiography) and speckle-tracking (ST) echocardiography, cardiac magnetic resonance (CMR) imaging and endomyocardial biopsy. ECG and HMECG are highly informative methods for detection, prediction and dynamic monitoring of frequent complications of myocarditis – arrhythmias and conduction disorders. Two-dimensional echocardiography is a mandatory technique for assessing myocardial contractility that allows to assess the size of the heart chambers, systolic and diastolic function, global and regional contractility, the presence of thrombosis in the cavities, pericardial effusion and, most importantly. In recent years, there has been increasing data on the use of CT echocardiography for the diagnosis of myocarditis, based on the assessment of myocardial deformation and its rate in the longitudinal, radial and circular directions. Contrast-enhanced magnetic resonance imaging of the heart is non-invasive and one of the most informative methods for detecting signs of inflammatory myocardial damage. CMR allows to visualize the anatomy, study the structure and characterize the tissue of the heart, determine the functional features of the atria and ventricles. However, the gold standard for verifying the diagnosis of myocarditis to this day remains endomyocardial biopsy. Laboratory methods of diagnosis are additional researches, that in a complex with instrumental methods allow to estimate changes of myocardial inflammatory process at long supervision.

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Roach, Myles William, and Peter Currie. "‘Tax-otsubo’: stress cardiomyopathy following an encounter with the Inland Revenue." BMJ Case Reports 13, no. 1 (January 2020): e232225. http://dx.doi.org/10.1136/bcr-2019-232225.

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An 89-year-old man developed chest pain and palpitations shortly after finishing a stressful 40 min phone call to HM Revenue and Customs. After admission to the emergency department, he had a cardiovascular collapse followed soon after by a cardiac arrest due to ventricular fibrillation (VF). The troponin T was elevated and his ECG showed extensive deep T wave inversion with prolongation of the QT interval. A portable hand-held ultrasound device (VScan; GE Healthcare) was used to demonstrate classical apical ballooning of the left ventricular apex indicating a diagnosis of takotsubo stress cardiomyopathy. Shortly following admission to the cardiac care unit, he had a further episode of VF, which was successfully defibrillated. A coronary angiogram was performed, which was normal. He was treated with a short course of benzodiazepines. He was discharged after 8 days without any neurological deficit. His echocardiogram subsequently showed complete resolution of the abnormalities of the left ventricular function.

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Gai, Zhongshuai, Yu Wang, Jutang Jiang, Hui Xie, Zhaotang Ding, Shibo Ding, and Hui Wang. "The Quality Evaluation of Tea (Camellia sinensis) Varieties Based on the Metabolomics." HortScience 54, no. 3 (March 2019): 409–15. http://dx.doi.org/10.21273/hortsci13713-18.

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The identification and evaluation of tea [Camellia sinensis (L.) O. Kuntze] germplasm resources are of great significance for tea plant breeding. In recent years, various methods, such as morphology, biochemistry, molecular markers, and sensory evaluation, have been used to evaluate the tea germplasm resources. However, the evaluation of tea germplasms based on metabolomics is rarely reported. In this study, we first measured the main agronomic characters and biochemical components of tea young shoots in spring, and then analyzed the metabolic profiles using gas chromatography-mass spectrometry (GC-MS) and liquid chromatography with tandem mass spectrometry (LC-MS/MS). The results indicate that tea germplasm accessions QN3 and QN38 had excellent agronomic traits with early germination and high yield compared with HM. The biosynthesis of flavonoids in young shoots of QN3 was more vigorous, especially for the biosynthesis of epigallocatechin gallate (EGCG) and epicatechin gallate (ECG). Accession QN3 had highest content of luteoloside, myricetin and rutin, whereas QN38 had highest content of most amino acids. On the basis of sensory quality evaluation, accession QN3 and QN38 all had higher total quality scores. By using these approaches, we found that QN3 and QN38 are excellent breeding materials with high yield and high quality for making green teas. We also believe that the evaluation system constructed by the approaches described here is suitable for the identification of tea germplasms.

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Вайханская, Т. Г., Л. Н. Сивицкая, Т. Т. Геворкян, Т. В. Курушко, Т. В. Русак, О. Д. Левданский, Н. Г. Даниленко, and А. В. Фролов. "Arrhythmogenic Cardiomyopathy. Part II: Clinical and Genetic Assessment of the New Phenotypes." Кардиология в Беларуси, no. 1 (March 19, 2021): 16–30. http://dx.doi.org/10.34883/pi.2021.13.1.002.

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Введение. В последнее десятилетие парадигма аритмогенной правожелудочковой кардиомиопатии (АПЖК) сменилась новой концепцией аритмогенной кардиомиопатии (АКМП) с расширением спектра фенотипов и признанием новых (в т. ч. недесмосомных) генов заболевания, с которыми ассоциированы бивентрикулярные и лево-доминантные формы АКМП. Новые нозологические термины все чаще применяются в практике для диагностики клинических фенотипов, наблюдаемых при поражении одного или обоих желудочков.Цель. Изучить генотип-фенотипический профиль АКМП с классическим вовлечением правого желудочка (АПЖК), с лево-доминантным вариантом при преимущественном поражении левого желудочка (АЛЖК) и при бивентрикулярной форме АКМП.Материалы и методы. В исследование включили 49 пациентов с АКМП: средний возраст составил 41,4±14,7 года, мужчины – 36 (73,5%), семейная форма – 31 (63,2%); ФВЛЖ 37,6±15,3%;ФВПЖ 38,9±12,7%; период наблюдения – медиана 37 [23; 59] мес. В представленной когорте АПЖК вариант выявлен у 10 (20,4%) лиц; у 39 (79,6%) пациентов обнаружено вовлечение ЛЖ (у 13/26,5% – фенотип АЛЖК; у 26/53,1% – бивентрикулярный вариант АКМП). Для диагностики левожелудочковых фенотипов применяли новые критерии Падуи (Padua, 2020 г). Всем пациентам проведен комплекс исследований: ЭКГ-12, ЭхоКГ, ХМ, МРТ с контрастированием и генотипирование (NGS проводили с использованием панели секвенирования TruSight Cardiomyopathy sequencing panel, выявленные варианты подтверждали секвенированием по Сэнгеру).Результаты. В структуре выявленных мутаций в группе АПЖК у носителей доминировали варианты в генах десмосом (PKP2, DSP, DSG2), тогда как недесмосомные варианты (TTN, LMNA, SCN5A, TRPM4, DES, MYPN, BAG3, FLNC) преобладали у пациентов с АЛЖК и бивентрикулярной АКМП.В результате рангового анализа Спирмена обнаружены значимые корреляции между количеством отведений ЭКГ с инверсией Т-волны и увеличением конечно-диастолического объема ПЖ (r=0,55; p<0,0001), а также с дисфункцией ПЖ (TAPSE: r=–0,54; p<0,0001) и ЛЖ (ФВЛЖ: r=–0,42; p=0,006). В 3-летний период наблюдения в группе пациентов с АЛЖК было выполнено больше превентивных имплантаций КВД (χ2=23,2; p=0,0001) и трансплантаций сердца в группе с бивентрикулярной АКМП (χ2=11,7; р=0,003) по сравнению с АПЖК. Полная блокада левой ножки пучка Гиса чаще регистрировалась в группе АЛЖК (χ2=20,7; р=0,0001) и бивентрикулярной АКМП (χ2=25,3; р=0,0001) по сравнению с АПЖК.В результате многофакторного ROC-анализа определены независимые предикторы жизнеопасных тахиаритмий: инверсия Т-волны в 4 и более отведениях (AUC=0,801; p=0,011); удлинение QTс≥443 мс (AUC=0,796; p=0,012) и фрагментация QRS в 4 и более отведениях ЭКГ (AUC=0,741; p=0,041). Бивентрикулярная систолическая дисфункция традиционно подтвердила высокую информативность для прогнозирования прогрессирующей СН (TAPSE: AUC=0,927; p=0,0001; ФВЛЖ: AUC=0,826; p=0,002).Выводы. Поражение ЛЖ характерно для пациентов с АКМП, ассоциированной с патогенными или вероятными патогенными вариантами в генах LMNA, TTN, FLNC, DES, DSP и SCN5A. В результате проведенного исследования подтвердился высокий потенциал рутинной ЭКГ для оценки фенотипа АКМП и прогнозирования тяжести поражения ПЖ и ЛЖ, дисфункция которых является одной из наиболее важных клинических детерминант осложнений заболевания. Introduction. In the last decade, the paradigm of arrhythmogenic right ventricular cardiomyopathy (ARVC) has been replaced by a new concept of arrhythmogenic cardiomyopathy (ACM) with the expansion of phenotypes spectrum and the recognition of new (including non-desmosomal) disease genes that are associated with biventricular and left-dominant forms. New nosological terms are increasingly used in practice for the diagnosis of clinical phenotypes observed in lesions of one or both ventricles.Purpose. To study the genotype-phenotypic ACM profile with the classic involvement of the right ventricle (ARVC), the left-dominant variant with primary lesion of the left ventricle (ALVC) and with the biventricular ACM.Materials and methods. The study included 49 patients (pts) with ACM: the average age was 41.4±14.7 years, male – 36 (73.5%), family form – 31 (63.2%); LVEF 37.6±15.3%; RVEF 38.9±12.7%;follow-up period: median – 37 [23; 59] months. In the presented cohort, ARVC variant was detected in 10 (20.4%) individuals; in 39 (79.6%) patients, LV involvement was found (13/26.5% – ALVC phenotype; 26/53.1% – biventricular ACM variant). For verification of the left ventricular phenotypes, the new Padua criteria were used (Padua, 2020). All patients underwent a series of studies: ECG-12, Echo, HM, contrasting MRI, and genotyping (NGS was performed using TruSight Cardiomyopathy sequencing panel; the identified variants were confirmed with the Sanger method).Results. In the structure of the revealed mutations in ACM carriers, the variants in desmosome genes (PKP2, DSP, DSG2) dominated while non-desmosomal variants (TTN, LMNA, SCN5A, TRPM4, DES, MYPN, BAG3, FLNC) prevailed in ALVC and biventricular ACM pts.Spearman’s rank analysis revealed significant correlations between the number of ECG leads with T wave inversion (TWI) and RV end-diastolic enlargement (r=0.55; p<0.0001), as well as bothventricles dysfunction (TAPSE: r=–0.54; p<0.0001; LVEF: r=–0.42; p=0.006). In the ALVC pts (vs ARVC), during the 3-year follow-up period, more preventive ICD implantations (χ2=23.2; p=0.0001) were performed and more heart transplantations were done for biventricular ACM pts (χ2=11.7; p=0.003) if compared with ARVC pts. Complete LBBB was found more often in ALVC pts (χ2=20.7; p=0.0001) and biventricular ACM (χ2=25.3; p=0.0001) vs ARVC pts.As a result of multivariate ROC analysis, the independent predictors of life-threatening VT were determined: TWI≥4 ECG leads (AUC=0.801; p=0.011), QTc≥443 ms (AUC=0.796; p=0.012), and QRS fragmentation in the ECG leads≥4 (AUC=0.741; p=0.041). Biventricular systolic dysfunction showed traditionally high information content for predicting progressive heart failure (TAPSE: AUC=0.927; p=0.0001; LVEF: AUC=0.826; p=0.002).Conclusions. LV lesion is typical for ACM associated with pathogenic or probable pathogenic variants in the LMNA, TTN, FLNC, DES, DSP and SCN5A genes. The study confirmed the high potential of the routine ECG for assessing ACM phenotypes and predicting the severity of RV and LV lesions, the dysfunction of which is one of the most important clinical determinants of disease complications.

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Danilevych, TD, and VP Ivanov. "Instrumental markers of frequent symptomatic atrial fibrillation in patients with arterial hypertension." EP Europace 23, Supplement_3 (May 1, 2021). http://dx.doi.org/10.1093/europace/euab116.007.

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Abstract Funding Acknowledgements Type of funding sources: None. Introduction Great attention of researchers is focused on the study of the features of electrical and structural remodeling of the heart in patients with atrial fibrillation (AF) and arterial hypertension (AH). Holter monitoring of the electrocardiogram (HM ECG) and echocardiography are used as methods for evaluating these changes. Objectives to determine instrumental markers of frequent symptomatic AF in patients with AH. Methods 146 patients with AH stage II with AF (males 68 (46.6%)) and 26 patients with AH stage II (males 11 (42.3%)) were examined in Vinnitsa regional center of cardiovascular pathology. Mean age of patients with AH and AF was (61.2 ± 0.7) years and in group with AH (59.3 ± 2.2) years. The duration of AF was (5,7 ± 0,5) years. The frequency of AF attacks was (23,6 ± 1,2) days. Paroxysmal AF was in 56 (38.4%) patients and persistent AF was in 90 (61.6%) patients. 31 (21.2%) patients have vagal, 70 (47.9%) patients have adrenal and 45 (30.9%) patients have mixed variant of AF (by Coumel). All patients underwent HM ECG and transthoracic echocardiography according to the standard protocol. Results ECG markers of frequent symptomatic AF are: amount of frequent supraventricular premature beats (SPB) (2198 vs 24, p < 0,0001), including paired and group SPBs (83,3% vs 0, p < 0,0001), presence of short asymptomatic episodes supraventricular paroxysmal tachycardia (SVPT)(33,3% vs 0, p < 0,0001) or AF (41,1% vs 0, p < 0,0001), increasing dispersion of QT interval (90 vs 70, p = 0,03) and decreasing dispersion ratio PQ/QT (0,50 vs 0,73, p = 0,03). Using the method of multiple linear regression, we determined the most informative combination of these markers: presence of SPBs more than 330 episodes/day + presence of pair and group SPBs and + presence of asymptomatic episodes of SVPT/AF (R = 0,52, p = 0,00002). Hemodynamic markers of frequent symptomatic AF are: significant increasing of absolute and relative indices of size/volume of left atrium (LA) (p < 0,0001), increasing of LA/right atrium (1,12 vs 0,92, p < 0,0001) and LA volume (LAV)/left ventricular myocardial mass (LVMM) (0,27 vs 0,21, p < 0,0001), decreasing Ve/Va (0,82, vs 0,92, p = 0,01) and isovolumic relaxation time (IVRT)(88 vs 97, p = 0,01); mitral (72,2% vs 46,2%, p = 0,01) and tricuspid (48% vs 23,1%, p = 0,02) regurgitation. Using the method of multiple linear regression, the most informative combination of these markers is: the ratio of LAV/LVMM > 0.23 ml/g + LA> 40 mm + presence of mitral regurgitation (R = 0,49, p = 0,00009). Conclusions As the most informative ECG markers of frequent symptomatic AF in patients with AH is combination of frequent SPBs (> 330 episodes/day) with pair and group SPBs and asymptomatic episodes SVPT/AF (R = 0,52, p = 0.00002 ), while echocardiography combination of markers is ratio of LAV/LVMM > 0.23 ml/g + LA> 40 mm + presence of mitral regurgitation (R = 0.49, p = 0.00009).

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Telesca, Alessandro, Eleonora Gnan, Antonio De Vita, Saverio Tremamunno, Tamara Felici, Salvatore Emanuele Ravenna, Crea Filippo, and Gaetano Antonio Lanza. "235 Ventricular arrhythmias and cardiac autonomic function in patients with severe aortic valve stenosis before and after transcatheter aortic valve implantation." European Heart Journal Supplements 23, Supplement_G (December 1, 2021). http://dx.doi.org/10.1093/eurheartj/suab127.048.

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Abstract Aims Transcatheter aortic valve implantation (TAVI) has become a first-line treatment for most patients with severe aortic stenosis (AS) at intermediate/high surgical risk, resulting in significant improvement of clinical outcome. However, whether ventricular arrhythmias (VAs) or cardiac autonomic dysfunction influence outcome and whether TAVI has any effects on VAs and cardiac autonomic function is unknown. Thus, this study was aimed to investigate: I1) whether VAs and autonomic dysfunction [as assessed by heart rate variability (HRV)] are associated with clinical outcome and (2) the effects of TAVI on VAs and HRV, in patients with severe AS. Methods and results We studied 71 consecutive patients with severe aortic stenosis, admitted to our department of Cardiovascular Medicine to undergo TAVI. Patients with previous cardiac surgery, percutaneous coronary revascularization, acute coronary syndrome, and other significant heart valve disease or relevant comorbidities were excluded. The day before TAVI all patients underwent transthoracic Doppler echocardiography (TTDE), including global longitudinal strain (GLS) assessment, and 24-h ECG Holter monitoring (HM), to assess VA burden and HRV. A clinical follow-up was performed at 6 months from discharge. Furthermore, TTDE and 24-h HM were performed at follow-up in 38 (54.5%) and 29 (40.8%) patients, respectively. The primary endpoint was the occurrence of major clinical events (MACE), that include death, hospitalization for cardiac causes, pacemaker implantation, myocardial infarction, or stroke. Of 71 patients (48 female, mean age 80.5 ± 6.5 years) enrolled in the study, a 6-month clinical follow-up could be performed in 54 (76%). MACE occurred in 21 patients (38.9%), 8 of whom (14.8%) had hospitalization for heart failure, 13 (24%) required pacemaker implantation, and 3 had stroke (5.6%). Compared to baseline, at follow-up the mean aortic valve gradient (50.6 ± 11.4 vs. 8.38 ± 3.23 mmHg, P < 0.001), left ventricle (LV) mass index (131.4 ± 38.9 vs. 112.9 ± 28.3 g, P = 0.007), pulmonary artery systolic pressure (37.3 ± 5.8 vs. 30.2 ± 9.8 mmHg; P < 0.001), and the ratio of Doppler transmitral early filling velocity to tissue-Doppler early diastolic mitral annular velocity (E/e′) (16 ± 5.3 vs. 13.2 ± 4.7 P < 0.001) were significantly reduced. In contrast no changes were observed in VAs. The number of premature ventricular complexes (PVCs) at HM was indeed 1062 ± 3833 vs. 1206 ± 3322 at follow-up and baseline, respectively (P = 0.11). Furthermore, PVCs >10 per hour were detected in a higher number of patients at 6-month follow-up, compared to baseline (23.8% vs. 45.2%; P = 0.022). No significant differences were detected in most time-domain and frequency-domain HRV parameters. Unexpectedly, SDNNi (62.8 ± 19.1 vs. 41.9 ± 16.5; P = 0.008), RMSSD (54.6 ± 36.6 vs. 30.1 ± 17.9; P = 0.024) and VLF (56.4 ± 49.6 vs. 29 ± 12.7; P = 0.028) were found to be significantly higher at follow-up compared to baseline. Conclusions Our data show that, in patients with severe AS, TAVI does not seem to have significant effects on VA burden, despite echocardiographic and clinical improvement. Similarly, our data failed to show significant improvement of sympatho-vagal balance at follow-up compared to baseline in these patients.

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Vaikhanskaya, T., L. N. Sivitskaya, A. D. Liaudanski, N. G. Danilenko, and O. G. Davydenko. "Non-compaction cardiomyopathy: genetic and clinical features, 5-years outcomes." European Heart Journal 41, Supplement_2 (November 1, 2020). http://dx.doi.org/10.1093/ehjci/ehaa946.2071.

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Abstract Presence of morphological sign as a left ventricular non-compaction (LVNC) only, without supporting clinical criteria, does not determine diagnosis of non-compaction cardiomyopathy (NCCM). Objective To study of the spectrum of NCCM-associated genes, analysis of phenotype-genotype correlations and predictors of life-threatening ventricular tachyarrhythmia (ltVTA), myocardial fibrosis, and adverse outcome. Methods Of 93 pts with identified (Echo/MRI) morphological criteria for LVNC (follow-up median 5,1 years), 60 unrelated pts were included in the study (aged 38.5±13.8 years; 33/55% male; LVEF 42.1±12.9%) with clinical confirmed NCCM (presence any one obligate criteria): family history, neuromuscular disorder, abnormal 12-lead ECG, arrhythmia, HF or thromboembolism (Figure). Genetic testing by NGS (174 genes) was performed; all variants considered as pathogenic (PV) and likely pathogenic (LPV) were confirmed by a Sanger sequencing. Baseline and follow-up data (ECG, HM, Echo, MRI, device interrogation) were collected. Combined adverse outcomes (HF death; SCD; LVAD; HTx; and ltVTA: VT/VF, successful resuscitation, ICD shock) were accepted as composite endpoint. Results PV and LPV were detected in 33 (55%) pts. The most common variants were identified in sarcomere genes – TTNtv, MYBPC3, and MYH7 (47.4%); ion channel genes – 18.2%; digenic mutations were found in 21.6% pts. Gene positivity was associated with systolic dysfunction (LVEF≤49%); the highest risk of low LVEF revealed for digenic carriers (OR 38; 95% CI 4.74–305; p=0.0001). According to CATREG analysis, predictive model was built (R=0,80; R2=0,65; F=10,1; p=0,0001); the presence of disease-causing PV/LPV (β=0.46; F=15.2; p=0,0001) along with low LVEF (β=−0.28; F= 5.96; p=0,018), fibrosis (β=0.21; F= 3.05; p=0,037), wide QRS (β=0.22; F= 4.11; p=0,011) were identified as independent predictors of adverse outcomes. As a result of ROC analysis, independent predictors of ltVTA were determined: fibrosis (nLGE≥2: AUC 0.824; 95% CI: 0.716–0.931; p=0.0001; sen 69%, spe 79%), systolic dysfunction (LVEF≤39%: AUC 0.832; 95% CI: 0.720–0.943; p=0.0001; sen 85%, spe 70%) and nsVT (HR≥150 bmp: AUC 0.829; 95% CI: 0.719–0.940; p=0.0001; sen 76%, spe 83%). According to ROC curves analysis, independent markers of myocardial fibrosis (LGE) were found: nsVT (HR≥150 bpm: AUC 0.766; 95% CI: 0.635–0.897; sen 80%, spe 77%); QRS fragmentation (nQRSfr≥4 leads ECG: AUC 0.822; 95% CI: 0.706–0.938; sen 76%, spe 92%); QTc duration (QTc≥450 ms: AUC 0.828; 95% CI: 0.722–0.935; sen 80%, spe 72%) and native MRI T1-relaxation (T1≥1086 ms: AUC 0.752; 95% CI: 0.626–0.879; sen 70%, spe 70%). Conclusion This results show a basically genetic causing NCCM with predominant mutations in sarcomere genes. As per predictive model, the strongest predictor of poor outcome was gene positivity. Identifying the genetic cause allows risk stratification and management optimization with counseling NCCM pts and their relatives. Study design Funding Acknowledgement Type of funding source: None

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Cheema, Faryal Murtaza, Hasan Mujtaba Cheema, and Zubair Akram. "Identification of risk factors of acute coronary syndrome in young patients between 18-40 years of age at a teaching hospital." Pakistan Journal of Medical Sciences 36, no. 4 (May 15, 2020). http://dx.doi.org/10.12669/pjms.36.4.2302.

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Objectives: To identify the risk factors in acute coronary syndrome. Methods: It was a case series study, conducted in coronary care unit of Jinnah Hospital, Lahore from January to December 2018. Convenient sampling was used for patients’ selection. The serum cardiac enzymes level was measured, and serial ECG was done at admission and repeated if required. Blood samples were collected after an overnight fast of 14 hours and tests were done for total cholesterol and HDL cholesterol. Results: Out of 300 patients of acute coronary syndrome, 100 (33.33%) were female and 200 (66.67%) were males. Majority of patients 180 (60%) belonged to age group of 25-40 years. Out of 300 patients 94 (31.33%) had diabetes mellitus, while 139 (46.3%) were suffering from hypertension. Out of 290 patients 95 (32.7%) had family history of coronary artery disease. Out of 298 patients 125 (41.9%) were smokers. Conclusion: Acute coronary syndrome in age group of 18-40 Years showed a male predominance with major modifiable risk factors; Hypertension followed by Diabetes mellitus, smoking and Dyslipidemia. Positive family history a non-modifiable risk factor in patients of ACS was also a common finding. doi: https://doi.org/10.12669/pjms.36.4.2302 How to cite this:Cheema FM, Cheema HM, Akram Z. Identification of risk factors of acute coronary syndrome in young patients between 18-40 years of age at a teaching hospital. Pak J Med Sci. 2020;36(4):821-824. doi: https://doi.org/10.12669/pjms.36.4.2302 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Alekseeva, K., T. Kruchina, O. Gordeev, I. Ginzburg, G. Novik, and D. Egorov. "P927Electrophysiological features in children with premature ventricular contractions." EP Europace 22, Supplement_1 (June 1, 2020). http://dx.doi.org/10.1093/europace/euaa162.334.

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Abstract Background Premature ventricular contractions (PVCs) is the one of the most frequent arrhythmias in children. There is no clear understanding regarding the causes of PVCs in children without structural heart diseases. There is also little information about the state of the conduction system (CS) of the heart in children with PVCs. Purpose:The aims of the study were to estimate the electrophysiological properties of the sinus node (SN) and atrioventricular node (AVN) in children with PVCs, and to evaluate the effect of atropine test on the frequency and nature of the PVCs. Methods: 167 children(54(32,3%) girls and 113(67,7%) boys with PVCs without structural heart disease were examined. Mean age at the time of the first examination was 14,5 ± 5,3years (6-18 years). Examination included: ECG, 24-hour Holter monitor (HM), echocardiogram, treadmill test, transesophageal pacing study (TEPS), atropine test.Results:The duration of the PVCs was 3,3 ± 1,5years (6-14 years). The burden of the PVCs was 7-29% according to HM data. 5(3%) children had syncope. Frequent PVCs were recorded in 43(25,7%) patients, single PVC in 59 (35,3%), and the rest of children did not have PVCs during TEPS. SN recovery time (SNRT) was 1118,1 ± 292,4ms (541-2300ms) which exceeded the age-dependent limit in 23(13,7%) children. Corrected SNRT was 350,1 ± 171,1ms (41-1317ms), which exceeded the age-dependent limit in 15(8,9%) children. Max.rate of 1:1 conduction through AVN was 166,7 ± 39,1 imp/min (90-220 imp/min); in 16(9,6%) children it was less than 120 imp/min, while 8 (4,8%) children had enhanced AV nodal conduction (more than 200imp/min). The effective refractory period (ERP) of AVN was 325,1 ± 91,7ms (190-650ms), exceeding the age norm in 18(10,7%) children. 16(9,6%) children had a discontinuous AV nodal conduction. The frequency of stimulation which suppressed PVCs was 100-160imp/min. Atropine test was performed in 100(59,9%) children (0,1% sol. Atropini sulfatis 0,02 mg/kg IV). After administration of atropine the increase in heart rate constituted 7-131%, with an average of 57%. The SNRT was 665,5 ± 154,4 ms (406-1512ms), maximal rate of 1:1 conduction through AVN was 213,2 ± 31,9 imp/min (150-270 imp/min). Among patients who initially had PVCs during TEPS, after atropine test PVCs disappeared in 61(59,8%) children, in 16(15,7%) children there was a significant decrease, and 4(3,9%) patients had an increase in the number of PVCs and episodes of stable ventricular bigeminy, and in 1(0.9%) child there were short runs of ventricular tachycardia (up to 8 QRS complexes).Conclusions: In children with PVCs normal electrophysiological parameters of cardiac CS were noted in most cases. In 35% of children there was a hypervagotonic influence on SN or AVN, and in 75,5% cases there was a disappearance or decrease in PVCs after atropine test. This suggests that the preferential nature of PVCs in children without structural heart diseases is autonomic system dependent

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Emelina, E., G. Gendlin, and I. Nikitin. "Outcome of 5-years active cardiological management of oncohematological patients on targeted therapy." European Heart Journal 42, Supplement_1 (October 1, 2021). http://dx.doi.org/10.1093/eurheartj/ehab724.2834.

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Abstract Background The overall survival of oncohematological patients (pts) depends not only on the severity of the cancer, the anticancer therapy used and the comorbidity of the pts. The most important role in the management of these pts is played by the supervision of a cardiologist. Purpose To assess the effect of active cardiac management on the overall survival of oncohematological pts on targeted therapy with ibrutinib. Methods We examined and observed in dynamics for 5 years 217 pts with chronic lymphocytic leukemia (CLL), constantly receiving ibrutinib, inducing arterial hypertension (AH) and atrial fibrillation (AF) in a part of the pts. All pts underwent echocardiography (Echo), 24-hour Holter ECG monitoring (HM), assessment of comorbidity using the Charlson index and screening of fragility using the G8 questionnaire. Everyday measurement of blood pressure, heart rate in the morning and in the evening with keeping a measurement diary was recommended for all pts, but 89 pts were performed, who constantly contacted us remotely using instant messengers and formed an active cardiac management (ACM) group. Results We studied the overall survival of pts with CLL receiving targeted therapy with ibrutinib, depending on cardiac monitoring, starting from the first visit. The age of pts in the ACM group (n=89) and in other pts (n=138) did not differ and amounted to 66.0 (60.0–70.0) years and 66.0 (59.0–74.0) years respectively. The number of men and women in the groups was comparable. In the ACM group, there were significantly more pts with AH - 86.5% and with AF - 42.7% compared to 50.4% with AH and 15.9% with AF in the rest of the pts (p<0.0001 in both cases) and a comparable number of pts with coronary artery disease. According to the screening HM, there were more pts with short AF episodes in the ACM group - 31.4% versus 8.0% in the rest of the pts (p<0.0001). Accordingly, the number of pts who received cardiological treatment in the ACM group was 87.6%, in the group of other pts - 53.6% (p<0.0001). Echo parameters did not differ in the groups. Indicators that significantly affect survival in the general group (Charlson index, scores of the G8 questionnaire) did not differ significantly in the ACM group and in other pts with CLL. The groups also did not differ in hematological status and the number of cases of second tumors. At the same time, despite a significantly more pronounced cardiac comorbidity, oncohematological pts under active cardiac monitoring, including continuous remote monitoring, demonstrated better survival compared to other pts (p<0.0001). Conclusions Conducting active cardiac management, including constant remote observation, allows achieving higher overall survival rates of hematological cancer patients, despite a more severe cardiac status compared to other pts under periodic supervision of a cardiologist. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): no founding sources

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Vaikhanskaya, T., L. N. Sivitskaya, N. G. Danilenko, A. D. Liaudanski, and O. G. Davydenko. "Comparative genetic, clinical features, and 5-years outcomes for dilated vs noncompaction cardiomyopathy." European Heart Journal 41, Supplement_2 (November 1, 2020). http://dx.doi.org/10.1093/ehjci/ehaa946.2036.

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Abstract Non-compaction cardiomyopathy (NCCM) and dilated cardiomyopathy (DCM) are associated with high risk of adverse cardiovascular events. Objective To investigate the genetic architecture of NCCM and DCM with comparing the incidence rate of NCCM/DCM related cardiovascular events. Method The study enrolled 120 unrelated pts with NCCM (n=60; age 38.5±13.8 years; 33/55% male; LVEF 42.1±12.9%) and DCM (n=60; age 40.5±13.5 years; 37/61.7% male; LVEF 30.5±11.1%). Diagnosis of NCCM was confirmed by any three accepted criteria as Echo (Jenni/Stöllberger) and MRI (Petersen/Jacquier) with supporting by clinical evidence (family history, neuromuscular disorders, abnormal ECG, arrhythmia, heart failure or thromboembolism). All pts were examined by ECG, HM, Echo, and MRI. Genetic testing was performed by NGS (174 genes) with Sanger verification. The composite end point was accepted as a major adverse cardiac event (MACE) during follow-up: SCD, HF death, LVAD, HTx, successful resuscitation, sustained VT/VF or appropriate ICD/CRT-D shock. Clinical, genetic data, and MACE during a median follow-up of 5.1 years were compared. Results Sarcomere gene (SG) variants (TTNtv, MYBPC3, and MYH7) were the most common pathogenic mutations (47.4%) found in gene-positive NCCM (n=33/55% pts). In general, a similar gene structure (SG – 44.4% vs 47.4%; ion channel protein genes – 25.9% vs 18.2%) was detected for genetic DCM (n=27/45% pts) except for LMNA gene (29.6% vs 6.06%, χ2=4,6; p<0.05). Risk of systolic dysfunction (LVEF<49%) was high for NCCM carriers and higher for multiple mutations (Cochran test: OR=38; 95% CI 4.74–305; p=0.0001) and association of gene positivity with a composite end point was determined at the level of prognostic significance (McNemar's test χ2=22.9; p=0.0001). NCCM patients had a similar MACE risk compared with DCM pts (OR 0.93; 95% CI 0.45–1.92). The incidence rates of all-cause mortality, stroke, HTx, VT/VF, and cardiac device implantation was comparable in DCM vs NCCM groups (Fig.A). As a result of multiple regression analysis, MACE risk models were constructed with step-by-step inclusion: similar common predictors for NCCM et DCM such as low LVEF (β=−0.37 vs β=−0.32), myocardial fibrosis (nLGE: β=0.19 vs β=0.23), width QRS (β=0.17 vs β=0.21), and a strong predictor for NCCM only - the gene positivity (β=0.85; p=0.0001). Kaplan-Meier analysis confirmed this (Fig. B,C). So, amazing fact revealed for NCCM such as systolic dysfunction (but not extent/number trabeculation or NC/C) and disease-causing gene mutations (β=0.85) that were associated with high MACE risk (R=0.90; R2=0.81; F(5.41)=34.8; p<0.00001). Conclusions NCCM pts had a similar cardiovascular risk and mainly genetic spectrum when compared with DCM pts. The unifying MACE predictor was LV dysfunction for both groups. However, gene positivity was associated with adverse outcomes for NCCM pts only (without detailed analysis the specific/localization causing genetic variants). Funding Acknowledgement Type of funding source: None

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"Clinical detection of myocardial ischemia." Heart and Metabolism, no. 81 (April 2020): 32–35. http://dx.doi.org/10.31887/hm.2020.81/glanza.

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Myocardial ischemia involves several pathophysiologic mechanisms. To assess suspected myocardial ischemia in relation to obstructive coronary artery disease (CAD)—the most frequent case—the reference test would be an electrocardiogram (ECG) exercise stress test; in the event of inconclusive results, an imaging (either radionuclide or echocardiographic) stress test can be indicated. Pharmacologic stress tests with imaging are indicated in patients unable to exercise. The same tests can be applied in patients with suspected microvascular angina; in such patients, a diagnostic clue would be induced angina and ECG changes in the absence of regional wall motion abnormalities on echocardiographic stress testing. Spasm provocation tests using either acetylcholine or ergonovine might be necessary to detect myocardial ischemia in patients in whom this is caused by coronary epicardial, or even microvascular, spasm. ECG Holter monitoring can be helpful to identify and characterize myocardial ischemic episodes that occur during daily life.

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Kovalchuk, T. S., E. V. Yakovleva, S. G. Fetisova, T. L. Vershinina, T. M. Pervunina, A. A. Kostareva, and E. S. Vasichkina. "Emery-Dreifuss muscular dystrophy presenting as a heart rhythm disorders in children." European Heart Journal 42, Supplement_1 (October 1, 2021). http://dx.doi.org/10.1093/eurheartj/ehab724.0286.

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Abstract Introduction Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects, sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentations, though, can be severe and life-threatening. The disease usually manifests during the third decade of life with elbow joint contractions and progressive muscle weakness and atrophy. Objective To present our clinical experience of diagnosis and treatment of arrhythmias in children with Emery-Dreifuss muscular dystrophy Materials and methods We enrolled 5 patients with different forms of EDMD (X-linked and autosomal dominant) linked to the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no leading skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial flutter, atrial fibrillation and conduction disturbances that progress over time. Clinical examination included physical examination, 12-lead electrocardiography, Holter ECG monitoring (HM), transthoracic echocardiography, neurological examination and biochemical and hormone tests. Also we performed CMR, electrophysiological study (EPS), treadmill test of some patients. One patient underwent an endomyocardial biopsy to exclude inflammatory heart disease. Target sequencing was performed using a panel of 108 or 172 genes Results We observed five patients with EDMD and cardiac debut during first-second decades of life: 3 with 1st subtype (variants in EMD gene) and 2 with 2nd subtype (variants in LMNA gene). All patients were males. The mean age of cardiac manifestation was 13,2±3,11 (from 9 to 16 y.o.). The mean follow-up period was 7,4±2,6 years. All patients presented with sinus node dysfunction and four out of five with AV conduction abnormalities. The leading arrhythmic phenotypes included various types of supraventricular arrhythmias: multifocal atrial tachycardia (AT) (n=4), premature atrial captures (PACs) (n=4), atrial flutter, (AF) (n=3), atrial fibrillation (AFib) (n=3) and AV nodal recurrent tachycardia (AVRNT). Heart rhythm disorders were the first manifestation in all three patients with 1st EDMD subtype. Radiofrequency ablation was performed in 2 patients, one of them received permanent pacemaker implantation. Conclusions In conclusion, while being the rare cases, heart rhythm disorders can represent the first and for a long time, the only clinical symptom of EDMD even in the pediatric group of patients. Therefore, thorough laboratory and neurological screening along with genetic studies, are of importance in each pediatric patient presenting with complex heart rhythm disorders of primary supraventricular origin to exclude EDMD or other neuromuscular disorders. Funding Acknowledgement Type of funding sources: None.

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"Troponin elevation: is it ischemia?" Heart and Metabolism, no. 81 (April 2020): 7–11. http://dx.doi.org/10.31887/hm.2020.81/eorsini.

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Cardiac troponin is the preferred biomarker for myocardial infarction, thanks to its sensitivity and absolute specificity for the heart. The availability of high-sensitivity assays (hs-cTnT and hs-cTnI), capable of measuring with excellent analytical precision very low levels of circulating troponin, raised the issue of whether transient ischemia is a sufficient stimulus for troponin release. For this purpose, in a series of patients submitted to a stress test (exercise ECG/echo test; dipyridamole echo test; dobutamine echo test), we measured plasma levels of hs-cTnT at baseline and 6 hours after the end of the test. Plasma concentrations of hs-cTnT significantly increased in the vast majority of patients after the test. Significant elevations were documented in response to each stressor, regardless of the test result, after both positive and negative tests. Moreover, troponin significantly increased in response to the stress, both in patients with and in patients without obstructive coronary artery disease. Despite a good sensitivity (80% and 89%), troponin showed a very low specificity (32% and 47%) for stress-induced ischemia and coronary artery disease, respectively. Myocardial release of troponin is a multifactorial process, mediated not only by cardiomyocyte necrosis, but also through several different mechanisms such as myocardial ischemia, increase in cardiac work, and hemodynamic overload. Transient elevation of high sensitivity cardiac troponin is not a useful tool for detecting spontaneous or stress-induced ischemia. L

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Cengiz, Fevzi. "+45T>G single nucleotide polymorphism of adiponectin gene: Is it a factor in childhood obesity? Original Article September 2018 537 Views Aim: Childhood obesity is increasing in incidence and is strongly associated with obesity in adulthood. Several studies to explain the role of genetics in the pathogenesis of obesity have been performed. The aim of this study was to investigate the relation between +45T>G single nucleotide polymorphism (SNP) and childhood obesity. Material and Method: 268 obese and 185 healthy (control) children… Additional Info Recieved 02.02.2018 Accepted 11.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5735 Author Tuba Kasap, Ömer Ateş, Samet Özer, Ali Gül, Resul Yılmaz, Ergün Sönmezgöz, Osman Demir, Emel Ensari Identifier J Clin Anal Med 2018;9(5): 376-80 Index Page 376-80 Citations in Google Scholar Google Scholar How to Cite Tuba Kasap, Ömer Ateş, Samet Özer, Ali Gül, Resul Yılmaz, Ergün Sönmezgöz, Osman Demir, Emel Ensari. +45T>G single nucleotide polymorphism of adiponectin gene: Is it a factor in childhood obesity? J Clin Anal Med 2018;9(5): 376-80 Running Title Childhood obesity Download attachments: JCAM-5735.pdf Read more... Healthcare staff’s attitude on hand hygiene and exposure to contaminated materials Original Article September 2018 485 Views Aim: Healthcare staff may be exposed to many risks as part of their profession. Infection control and prevention measures aim to reduce risks to the hospital and healthcare staff. This study evaluated knowledge and attitudes of healthcare staff for hand hygiene and exposure to contaminated materials. Material and Method: The descriptive study was conducted among healthcare staff who volunteered to… Additional Info Recieved 21.02.2018 Accepted 10.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5781 Author Yeşim Alpay Identifier J Clin Anal Med 2018;9(5): 416-20 Index Page 416-20 Citations in Google Scholar Google Scholar How to Cite Yeşim Alpay . Healthcare staff’s attitude on hand hygiene and exposure to contaminated materials. J Clin Anal Med 2018;9(5): 416-20 Running Title Healthcare staff’s attitude on hygiene Download attachments: JCAM-5781_1.pdf Read more... Prognostic value of soluble factors of angiogenesis and adhesion processes in head and neck squamous cell carcinomas Original Article September 2018 479 Views Aim: In this study, we aimed to define the prognostic value of two factors related to angiogenesis and adhesion processes of head and neck squamous cell carcinomas. The prominent angiogenesis molecule is vascular endothelial growth factor (VEGF). The vascular cell adhesion molecule (VCAM) first attracted attention more than two decades ago as endothelial adhesion receptor with key function for leukocyte… Additional Info Recieved 26.02.2018 Accepted 12.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5788 Author Taylan Gün, Aykut İkinciogullari, Osman Fatih Boztepe, Serdar Ensari, Huseyin Dere Identifier J Clin Anal Med 2018;9(5): 421-4 Index Page 421-4 Citations in Google Scholar Google Scholar How to Cite Taylan Gün, Aykut İkinciogullari, Osman Fatih Boztepe, Serdar Ensari, Huseyin Dere. Prognostic value of soluble factors of angiogenesis and adhesion processes in head and neck squamous cell carcinomas. J Clin Anal Med 2018;9(5): 421-4 Running Title Head and neck squamous cell carcinomas Download attachments: JCAM-5788.pdf Read more... Assessment of auditory brainstem responses in hypothyroidism and hyperthyroidism Original Article September 2018 460 Views Aim: This study aimed to determine the effect of thyroid hormone changes on hearing pathways by assessing audiometry and auditory brainstem responses of hypothyroid and hyperthyroid patients and to determine whether hypothyroidism and hyperthyroidism patients are at risk for hearing loss. Material and Method: Between June 2008-July 2009, 25 hyperthyroidism (Graves, Multinodular Goitre) and 25 hypothyroidism (Hashimato hypothyroidism) patients who… Additional Info Recieved 20.02.2018 Accepted 12.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5780 Author Elif Karalı, Ender Güçlü Identifier J Clin Anal Med 2018;9(5): 411-5 Index Page 411-5 Citations in Google Scholar Google Scholar How to Cite Elif Karalı, Ender Güçlü. Assessment of auditory brainstem responses in hypothyroidism and hyperthyroidism. J Clin Anal Med 2018;9(5): 411-5 Running Title Evaluation of hearing in thyroid disease Download attachments: JCAM-5780.pdf Read more... The impact of liver transplantation on quality of life and the psychiatric consequences in one year Original Article September 2018 482 Views Aim: Liver transplantation (LT) is a challenging operation with a burden affecting patients, families, and donors. The aim of the study was to compare the prevalence of psychiatric disorders and symptoms, and the quality of life of patients waiting for LT, with patients one year after transplantation. Material and Method: The patients in the LT waiting list (n: 68), and… Additional Info Recieved 20.02.2018 Accepted 15.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5770 Author Ceyhun Can, Can Cimilli, Yarkın Özenli, Gül Ergör, Elif Onur Aysevener, Tarkan Ünek, İbrahim Astarcıoğlu Identifier J Clin Anal Med 2018;9(5): 396-401 Index Page 396-401 Citations in Google Scholar Google Scholar How to Cite Ceyhun Can, Can Cimilli, Yarkın Özenli, Gül Ergör, Elif Onur Aysevener, Tarkan Ünek, İbrahim Astarcıoğlu. The impact of liver transplantation on quality of life and the psychiatric consequences in one year. J Clin Anal Med 2018;9(5): 396-401 Running Title Liver transplantation and quality of life Download attachments: JCAM-5770.pdf Read more... Procalcitonin, c-reactive protein, leukocyte, mean platelet volume levels in bloodstream infections Original Article September 2018 497 Views Aim: Levels of Serum Procalcitonin (PCT), C-Reactive Protein (CRP), Leukocyte (WBC) and Mean Platelet Volume (MPV) were evaluated in sepsis patients. We evaluated the diagnostic accuracy of different inflammatory markers to discriminate sepsis caused by different pathogens. Material and Method: In this study we included 126 episodes of bacteremia from 126 patients with sepsis. Medical records of patients who had… Additional Info Recieved 13.02.2018 Accepted 21.03.2018 Published Online 28.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5766 Author Arzu İrvem, Sebahat Aksaray Identifier J Clin Anal Med 2018;9(5): 391-5 Index Page 391-5 Citations in Google Scholar Google Scholar How to Cite Arzu İrvem, Sebahat Aksaray. Procalcitonin, C-Reactive Protein, Leukocyte, Mean Platelet Volume in Early Diagnosis of Sepsis Caus. J Clin Anal Med 2018;9(5): 391-5 Running Title Sepsis Download attachments: JCAM-5766.pdf Read more... Relationship Between Neutrophil to Lymphocyte Ratio with Scoring Systems of Pneumonia Severity Original Article September 2018 480 Views Aim: Today, community-acquired pneumonia remains one of the causes of high mortality and morbidity. In this study, we aimed to demonstrate the relationship between NLR, which was found to be a marker related to the systemic inflammation in the recent studies, and PSI, CURB-65, and PIRO, which were developed to predict hospitalization, being taken to an intensive care unit, and… Additional Info Recieved 12.03.2018 Accepted 30.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5817 Author Yasemin Kaya, Nilay Taş, Ebru Çanakçı, Zübeyir Cebeci, Muhammet Özbilen, Havva Keskin, Berna Botan Yıldırım Identifier J Clin Anal Med 2018;9(5): 452-7 Index Page 452-7 Citations in Google Scholar Google Scholar How to Cite Yasemin Kaya, Nilay Taş, Ebru Çanakçı, Zübeyir Cebeci, Muhammet Özbilen, Havva Keskin, Berna Botan Yıldırım. Relationship Between Neutrophil to Lymphocyte Ratio with Scoring Systems of Pneumonia Severity. J Clin Anal Med 2018;9(5): 452-7 Running Title Relation of neutrophil to lymphocyte ratio and pneumonia severity Download attachments: JCAM-5817.pdf Read more... Impact of resistive exercise versus aerobic exercise on bone mineral density in postmenopausal women Original Article September 2018 468 Views Aim: Osteoporosis is a major public health problem and the most common skeletal disorder. It has been described as a silent disease affecting millions worldwide. This study was aimed to determine the impact of resistive exercise versus aerobic exercises on bone mineral density in post-menopausal women. Material and Method: Forty post-menopausal women participated in this study, ranging in age from… Additional Info Recieved 10.03.2018 Accepted 30.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5814 Author Engy Mohamed El Nahas, Heba Mohamed Embaby, Amir Arabi Gabr, Hamada Ahmed Hamada, Saud Mashi Alrawaili Identifier J Clin Anal Med 2018;9(5): 442-6 Index Page 442-6 Citations in Google Scholar Google Scholar How to Cite Engy Mohamed El Nahas, Heba Mohamed Embaby, Amir Arabi Gabr, Hamada Ahmed Hamada, Saud Mashi Alrawaili. Impact of resistive exercise versus aerobic exercise on bone mineral density in postmenopausal women. J Clin Anal Med 2018;9(5): 442-6 Running Title Impact of resistive exercise versus aerobic exercise on bone mineral density Download attachments: JCAM-5814.pdf Read more... Comparison of liquid based cytology cervical smears with histopathological findings Original Article September 2018 432 Views Aim: Cervical cancer is still a health problem in countries where cervical cancer screening is not routinely performed. A significant decrease in the rate of mortality from cervical cancer has been observed since the Pap test was introduced. Within the last decade liquid-based cytology (LBC) has replaced the Pap test. Our aim is to compare cervical smears prepared with the… Additional Info Recieved 22.02.2018 Accepted 28.03.2018 Published Online 04.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5763 Author Seyhan Özakkoyunlu Hasçiçek, Tuba Oğuzsoy, Kamile Gülçin Eken, Fevziye Kabukçuoğlu Identifier J Clin Anal Med 2018;9(5): 359-62 Index Page 359-62 Citations in Google Scholar Google Scholar How to Cite Seyhan Özakkoyunlu Hasçiçek, Tuba Oğuzsoy, Kamile Gülçin Eken, Fevziye Kabukçuoğlu. Comparison of liquid based cytology cervical smears with histopathological findings. J Clin Anal Med 2018;9(5): 359-62 Running Title Comparison of cervical cytology with histopathology Download attachments: JCAM-5763.pdf Read more... Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report Case Report September 2018 658 Views Hyaluronic acid is widely used in medical procedures such as intra-articular injections. In addition to some risks of this procedure such as sepsis and injury to neighboring structures, deep vein thrombosis and pulmonary embolism should be kept in mind as rare complications. For this reason it is recommended that intra-articular injection of hyaluronic acid be performed by the ultrasound guidance… Additional Info Recieved 20.03.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.201 DOI 10.4328/JCAM.5831 Author Özgür Altınbaş, Hakan Çomaklı Identifier J Clin Anal Med 2018;9(5): 466-8 Index Page 466-8 Citations in Google Scholar Google Scholar How to Cite Altınbaş Ö, Çomaklı H.Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report. J Clin Anal Med 2018;9(5): 466-8 Running Title Deep vein thrombosis due to sodium hyaluronate Download attachments: JCAM-5831.pdf Read more... The evaluation of thyroid function tests in patients presenting to the family medicine clinics Original Article September 2018 481 Views Aim: Publications concerning the effects in society of recommendations regarding iodine supplementation over the last approximately 30 years are inconsistent. In addition to studies suggesting that iodine supplementation is insufficient, others report that it can lead to hyperthyroidism. We planned this study in order to investigate the results of iodine supplementation in our region through the retrospective screening of records… Additional Info Recieved 10.03.2018 Accepted 30.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5812 Author Yılmaz Sezgin, Ali Emre Akgün Identifier J Clin Anal Med 2018;9(5): 439-41 Index Page 439-41 Citations in Google Scholar Google Scholar How to Cite Sezgin Y, Akgün AE. The evaluation of thyroid function tests in patients presenting to the family medicine clinics. J Clin Anal Med 2018;9(5): 439-41 Running Title The evaluation of thyroid function tests Download attachments: JCAM-5812.pdf Read more... Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation Original Article September 2018 378 Views Aim: Paroxysmal atrial fibrillation (PAF), which is in the sub-group of atrial fibrillation that spontaneously resolves within 48 hours and does not last more than 7 days, is one of the most important causes of cryptogenic stroke. Other than ECG findings, there are no biochemical diagnostic criteria for PAF. Early diagnosis of PAF reduces the risk of morbidity and mortality.… Additional Info Recieved 13.03.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5815 Author Ismail Koyuncu, Ataman Gonel Identifier J Clin Anal Med 2018;9(5): 447-51 Index Page 447-51 Citations in Google Scholar Google Scholar How to Cite Koyuncu İ, Gönel A. Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation. J Clin Anal Med 2018;9(5): 447-51 Running Title Carnitine profiling and PAF Download attachments: JCAM-5815.pdf Read more... Linear fractures of the cranium: follow-up and management results of 442 cases Original Article September 2018 481 Views Aim: We aimed to evaluate the clinical and radiological follow-up of cases with isolated linear fractures detected in the cranium in the post-traumatic period, to determine on which cases and when to perform control radiological examinations and to suggest follow-up protocol. Material and Method: 442 cases with isolated linear cranium fracture were evaluated in the study. Imaging examinations and clinical… Additional Info Recieved 25.02.2018 Accepted 29.03.2018 Published Online 02.04.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5792 Author Ziya Asan, Haci Mehmet Calıskan, Yahya Sahın, Canan Sahın, Fatih Durna Identifier J Clin Anal Med 2018;9(5): 425-9 Index Page 425-9 Citations in Google Scholar Google Scholar How to Cite Asan Z, Calıskan HM, Sahin Y, Sahin C, Durna F. Linear fractures of the cranium: follow-up and management results of 442 cases. J Clin Anal Med 2018;9(5): 425-9 Running Title Linear fractures of cranium Download attachments: JCAM-5792.pdf Read more... Prognostic value of hematological parameters Original Article September 2018 580 Views Aim: Acute bacterial and viral infections are usually associated with elevations of the mean platelet volume. We correlated infection with influenza changes in mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), to determine whether these might be predictors for the duration of hospitalization or mortality. Material and Method: A total of 122 influenza patients (54 males and… Additional Info Recieved 24.01.2018 Accepted 10.03.2018 Published Online 13.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5719 Author Songul Ozyurt, Yasin Yildiz, Ugur kostakoglu, Aysegul Copur-Cicek, İlknur Esen Yildiz, Ayse Erturk Identifier J Clin Anal Med 2018;9(5): 363-8 Index Page 363-8 Citations in Google Scholar Google Scholar How to Cite Ozyurt S, Yildiz Y, Kostakoglu U, Copur-Cicek A, Yildiz İE, Erturk A. Prognostic Value of Hematological Parameters. J Clin Anal Med 2018;9(5): 363-8 Running Title Influenza Download attachments: JCAM-5719.pdf Read more... Prevalence and characteristics of CAAs in the black sea region Original Article September 2018 537 Views Aim: To date there has been no data about the prevalence of coronary artery anomaly (CAA) in the Turkish population of the Black Sea Region who underwent trans-radial coronary angiography. We aimed to determine the frequency and characteristics of CAA in our patients. Material and Method: All the coronary angiographies performed from September 2015 to September 2016 in our hospital… Additional Info Recieved 26.01.2018 Accepted 04.03.2018 Published Online 08.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5731 Author Osman Kayapinar, Ahmet Egemen Sayin, Adnan Kaya, Cem Ozde, Muhammed Keskin Identifier J Clin Anal Med 2018;9(5): 369-75 Index Page 369-75 Citations in Google Scholar Google Scholar How to Cite Kayapinar O, Sayin AE, Kaya A, Ozde C, Keskin M. Prevalence and characteristics of CAAs in the black sea region. J Clin Anal Med 2018;9(5): 369-75 Running Title CAAs in the black sea region Download attachments: JCAM-5731.pdf Read more... Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions Original Article September 2018 607 Views Aim: The aim was the presentation of results from 131 interventions in which a quick and practical modified surgical approach was applied in carpal tunnel syndrome surgery. Material and Method: In total, 131 surgical interventions were made in 121 cases. 22 cases were male, 99 cases were female. Boston Carpal Tunnel Syndrome Questionnaire scores were obtained on the postoperative 12th-14th… Additional Info Recieved 03.02.2018 Accepted 05.03.2018 Published Online 09.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5751 Author Ziya Asan Identifier J Clin Anal Med 2018;9(5): 381-5 Index Page 381-5 Citations in Google Scholar Google Scholar How to Cite Asan Z. Modified mini-incision surgery for carpal tunnel syndrome: Results of 131 interventions. J Clin Anal Med 2018;9(5): 381-5 Running Title Carpal tunnel syndrome surgery Download attachments: JCAM-5751.pdf Read more... The predictive role of computed tomography on respiratory complications following coronary artery bypass surgery Original Article September 2018 450 Views Aim: Pulmonary complications are frequently seen complications following especially after coronary artery bypass grafting. Attempts are made to detect those complications preoperatively by pulmonary function tests and clinical evaluation.In our study, we investigated the effect of computed tomography findings in predicting postoperative complications in patients with normal respiratory function tests. Material and Method: Between January 2012 and August 2017, imaging… Additional Info Recieved 19.02.2018 Accepted 05.03.2018 Published Online 11.03.2018 Printed 01.09.2018 DOI 10.4328/JCAM.5775 Author Özlem Erçen Diken, Adem İlkay Diken, Adnan Yalçınkaya, Sertan Özyalçın, Muhammed Onur Hanedan Identifier J Clin Anal Med 2018;9(5): 402-6 Index Page 402-6 Citations in Google Scholar Google Scholar How to Cite Diken ÖE, Diken Aİ, Yalçınkaya A, Özyalçın S, Hanedan MO. The Predictive Role of Computed Tomography on Respiratory Complications Following Coronary Artery Bypass Surgery. J Clin Anal Med 2018;9(5): 402-6 Running Title Pulmonary risk and coronary surgery Download attachments: JCAM-5775.pdf Read more... Endoscopic extirpation of a fork after three days; Case report and review of the literature." Journal of Clinical and Analytical Medicine 9, no. 5 (September 1, 2018). http://dx.doi.org/10.4328/jcam.5790.

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Journal articles on the topic 'HM-ECG'

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