Is there a difference between aortic and brachial vein blood lipoprotein and total cholesterol levels?

OBJECTIVE: Atherosclerosis is a disease of the arteries that is not practically observed in veins. There are a lot of proposed mechanisms underlying this phenomenon. We aimed to compare the lipoprotein and total cholesterol levels in aortic and venous blood samples. METHODS: A total of 125 patients ≥18 years of age were included in the study. After overnight fasting, we drew blood from the proximal ascending aorta and brachial vein. Serum lipid profiles were compared between these samples. RESULTS: Out of 125 patients, 45 (36%) were females, and 80 (64%) were males. The mean age of the patients was 62 years (24-85 years). Notably, 39 (31%) patients were using statin treatment. Coronary angiography showed that 103 (82%) patients had coronary artery disease. Mean arterial total cholesterol (low-density lipoprotein), high-density lipoprotein, and triglyceride levels were significantly lower than mean venous total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels (187.3±45.3 mg/dL vs. 204.5±52.6 mg/dL, p<0.001; 116.7±41.5 mg/dL vs. 128±45 mg/dL, p<0.001; 40.8±12.9 mg/dL vs. 45.3±13.3 mg/dL, p<0.001; and 142.8±81.5 vs. 161.5±100.3 mg/dL, p<0.001, respectively). CONCLUSION: Aortic lipoprotein and total cholesterol levels are significantly lower than venous lipoprotein and total cholesterol levels in patients presenting to the hospital for coronary angiography.

Increased discharge heart rate might be associated with increased short-term mortality after acute coronary syndrome.

BACKGROUND: In acute coronary syndrome (ACS) patients there are mostly studies evaluating prognostic value of admission heart rate. We tried to understand the prognostic value of discharge heart rate in a spectrum of ACS patients. METHODS: A total of 473 consecutive ACS patients were included in the study. Forty-three (9.1%) of them were unstable angina pectoris, 268 (56.7%) were non-ST elevation myocardial infarction and 162 (34.2%) of them were ST elevation myocardial infarction patients. Discharge heart rates of the patients were recorded and the patients were followed-up for 1 year. The primary end-point was all-cause mortality. RESULTS: The mean age of the patients was 64 ± 12. The patients were divided into three subgroups according to discharge heart rates (<78, 78-89, ≥90 beats per minute). Patients with a higher discharge heart rate had higher serum troponin, glucose levels and higher admission heart rates, had lower ejection fraction values and had acute heart failure complication more frequently than the patients with a lower discharge heart rate. A total of 72(16%) patients died during 1 year follow-up. In multivariate logistic regression analysis, an increased discharge heart rate was independently associated with 1-month mortality after ACS, but it was not independently associated with 6-month or 1-year mortality after ACS. Every 1 bpm increase in discharge heart rate resulted in a significant increased risk of 8.2% in 1-month all-cause mortality. CONCLUSION: Increased heart rate at discharge is an independent predictor of 1-month mortality in ACS patients. This relationship disappears after 1-month through 1-year follow-up.

Is there a difference between aortic and brachial vein blood lipoprotein and total cholesterol levels?

SUMMARY OBJECTIVE: Atherosclerosis is a disease of the arteries that is not practically observed in veins. There are a lot of proposed mechanisms underlying this phenomenon. We aimed to compare the lipoprotein and total cholesterol levels in aortic and venous blood samples. METHODS: A total of 125 patients ≥18 years of age were included in the study. After overnight fasting, we drew blood from the proximal ascending aorta and brachial vein. Serum lipid profiles were compared between these samples. RESULTS: Out of 125 patients, 45 (36%) were females, and 80 (64%) were males. The mean age of the patients was 62 years (24-85 years). Notably, 39 (31%) patients were using statin treatment. Coronary angiography showed that 103 (82%) patients had coronary artery disease. Mean arterial total cholesterol (low-density lipoprotein), high-density lipoprotein, and triglyceride levels were significantly lower than mean venous total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels (187.3±45.3 mg/dL vs. 204.5±52.6 mg/dL, p<0.001; 116.7±41.5 mg/dL vs. 128±45 mg/dL, p<0.001; 40.8±12.9 mg/dL vs. 45.3±13.3 mg/dL, p<0.001; and 142.8±81.5 vs. 161.5±100.3 mg/dL, p<0.001, respectively). CONCLUSION: Aortic lipoprotein and total cholesterol levels are significantly lower than venous lipoprotein and total cholesterol levels in patients presenting to the hospital for coronary angiography.

Comparison of IQOS (heated tobacco) and cigarette smoking on cardiac functions by two-dimensional speckle tracking echocardiography.

AIMS: IQOS is a novel tobacco product claimed to be safer than conventional cigarette smoking due to the heat-not-burn system. This study aimed to evaluate the acute effects of IQOS smoking on myocardial systolic and diastolic functions and also compare the acute impacts of IQOS with cigarette smoking. METHODS: In this prospective study, twenty-seven healthy participants who were using IQOS were included. Transthoracic echocardiography was performed three times for each participant; before smoking any tobacco product (group1), after IQOS smoking (group 2), after cigarette smoking (group3). In addition to conventional echocardiographic measurements, left ventricle (LV) and right ventricle (RV) strain analyses were performed by speckle tracking echocardiography. RESULTS: In comparison with non-smoking status, LV global longitudinal strain (GLS) decreased after IQOS and cigarette smoking (-18.9 ± 2.4% in baseline vs. -17.9 ± 2.4% in IQOS vs. -17.9 ± 2.8% in cigarette smoking; p = 0.003, p = 0.001; respectively). LV global circumferential strain (GCS) reduced after IQOS and cigarette smoking (-19.8 ± 4.4% in baseline vs. -18.3 ± 3.9% in IQOS vs. -17.5 ± 3.9% in cigarette smoking; p = 0.005, p < 0.001; respectively). RV GLS was significantly lower in groups smoking IQOS and cigarette (-23.2 ± 4.6% in baseline vs. -21.4 ± 4.1% in IQOS vs. -19.4 ± 4.1% in cigarette smoking; p < 0.001, p = 0.001; respectively). CONCLUSION: IQOS (heat-not-burn) tobacco smoking impairs myocardial systolic and diastolic functions in the acute phase like conventional cigarette smoking. The use of IQOS is rising among young adults in recent years, so further studies should be designed to evaluate the chronic effects of IQOS on myocardial function.

The beneficial effect of low-intensity exercise on cardiac performance assessed by two-dimensional speckle tracking echocardiography.

BACKGROUND: Regular physical activity is associated with cardiovascular health; however, intensive exercise can have harmful effects on the heart. Two-dimensional (2D) speckle tracking echocardiography (STE) is a well-established diagnostic tool to evaluate subclinical myocardial dysfunction and has been widely used in athletes in recent years. This study is designed to evaluate whether low-intensity exercise has beneficial effects on myocardial performance. We aimed to evaluate systolic and diastolic functions of myocardium derived from STE in sports practitioners in a low-intensity exercise training program. METHOD: Eighty-four sports practitioners and eighty-two sedentary healthy controls were prospectively included in our study. In addition to standard 2D echocardiographic measurements, left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, RV-free wall strain (FWS), left atrium (LA) strain, and strain rate were analyzed. RESULTS: Mean LV GLS was significantly higher in sports practitioners compared with sedentary population (-19.21 ± 2.61% vs -18.37 ± 2.75%, P = .044). RV GLS was significantly higher in sports practitioners than sedentary population (-21.82 ± 4.86% vs -20.04 ± 4.62%, P = .016). Longitudinal strain and strain rate of LA conduit phase were significantly higher in sports practitioners than sedentary participants (-23.60 ± 6.83% vs -20.20 ± 6.64%, P = .001; -2.45 ± 0.81 L/s vs -2.10 ± 0.89 L/s, P = .010; respectively). Also, LA conduit phase strain/contraction phase strain and conduit phase strain rate/contraction phase strain rate ratios were higher in sports practitioners (1.88 ± 0.93 vs 1.48 ± 0.63, P = .001; 1.42 ± 0.65 vs 1.16 ± 0.53, P = .005; respectively). CONCLUSION: The findings in the current study suggest that regular low-intensity exercise may have a beneficial effect on both systolic and diastolic functions of the myocardium.

Is there any Link Between Vitamin D and Recurrence of Atrial Fibrillation after Cardioversion?

INTRODUCTION: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly population. In symptomatic patients, restoration and maintenance of sinus rhythm improve quality of life. Unfortunately, AF recurrence still occurs in a considerable number of patients after cardioversion (CV). In this study, we aimed to evaluate the association between vitamin D (VitD) and AF recurrence after electrical or medical CV. METHOD: A total of 51 patients who underwent CV for symptomatic AF were included in the study. AF recurrence was defined as an AF pattern in 12-lead electrocardiography (ECG) recording after CV within 6 months or ECG Holter recording of AF lasting more than 30 seconds at 6-month follow-up. RESULTS: Mean vitD level was 21.4 ng/ml in our study population. VitD level was lower in the AF recurrence group than in the non-recurrence group (18 ng/ml vs. 26.3 ng/ml, respectively; P=0.001). Additionally, left atrial diameter was larger in the AF recurrence group compared to the non-recurrence group (4.4 vs. 4.1, P=0.025). Patients with AF recurrence were older than patients without AF recurrence, and, although the prevalence of hypertension is higher in the AF recurrence group, there was no statistically significant difference (P=0.107, P=0.867). CONCLUSION: In our study, there is a strong association between vitD level and AF recurrence after CV. VitD deficiency might be a predictor of high risk of AF recurrence after CV and vitD supplementation during the follow-up might help the maintenance of sinus rhythm.

Is there any link between vitamin D deficiency and vasovagal syncope?

BACKGROUND: This study aimed to investigate serum 25[OH]D levels between patients with vasovagal syncope (VVS) diagnosed with head-up tilt table test (HUTT) and age-matched healthy people. METHODS: The study included 75 consecutive patients (32.3 ± 10.7 years), who presented with syncope and underwent HUTT and 52 healthy controls (32.9 ± 14.1 years). HUTT patients were divided into two groups according to whether there was syncope response to the test. Patients underwent cardiac, psychiatric, and neurological investigation. Serum 25[OH]D levels were measured by chemiluminescent microparticle immunoassay method. RESULTS: There was no difference between the two groups in terms of age, gender, body mass index (BMI), echocardiographic findings (P > .05). Mean serum 25[OH]D (24.5 ± 6.3 vs 20.1 ± 8.8 ng/mL, P = .003) and vitamin B12 levels (436.4 ± 199.2 vs 363.1 ± 107.6 pg/mL, P = .009) was lower in syncope patients when compared to the control group. In correlation analyses, syncope was shown as correlated with the vitamin D (r = -264, P = .003) and vitamin B12 levels (r = -233, P = .009). But, multivariate regression analyses showed that only vitamin D increased risk of syncope [OR: 0.946, 95% CI (0.901-0.994)]. There was no difference in terms of age, gender, BMI, echocardiographic findings between the in HUTT positive (n = 45) and negative groups (n = 29). Only vitamin D level was significantly lower in HUTT positive group (17.5 ± 7.7 vs 24.4 ± 9.1 ng/mL, P = .002). There was no difference among in the vasovagal subgroups in terms of vitamin D level and other features. CONCLUSION: Vitamin D and B12 levels were reasonably low in syncope patients, but especially low Vitamin D levels were associated with VVS diagnosed in HUTT.

Is there any link between vitamin d and recurrence of atrial fibrillation after cardioversion?

Abstract Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia in the elderly population. In symptomatic patients, restoration and maintenance of sinus rhythm improve quality of life. Unfortunately, AF recurrence still occurs in a considerable number of patients after cardioversion (CV). In this study, we aimed to evaluate the association between vitamin D (VitD) and AF recurrence after electrical or medical CV. Method: A total of 51 patients who underwent CV for symptomatic AF were included in the study. AF recurrence was defined as an AF pattern in 12-lead electrocardiography (ECG) recording after CV within 6 months or ECG Holter recording of AF lasting more than 30 seconds at 6-month follow-up. Results: Mean vitD level was 21.4 ng/ml in our study population. VitD level was lower in the AF recurrence group than in the non-recurrence group (18 ng/ml vs. 26.3 ng/ml, respectively; P=0.001). Additionally, left atrial diameter was larger in the AF recurrence group compared to the non-recurrence group (4.4 vs. 4.1, P=0.025). Patients with AF recurrence were older than patients without AF recurrence, and, although the prevalence of hypertension is higher in the AF recurrence group, there was no statistically significant difference (P=0.107, P=0.867). Conclusion: In our study, there is a strong association between vitD level and AF recurrence after CV. VitD deficiency might be a predictor of high risk of AF recurrence after CV and vitD supplementation during the follow-up might help the maintenance of sinus rhythm.

Effects of chronic cigarette smoking on myocardial deformation parameters by two-dimensional speckle tracking echocardiography.

BACKGROUND: Cigarette smoking causes myocardial damage with several mechanisms such as sympathetic nervous system activation, oxidative stress, and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with cardiac events. We aimed to compare the myocardial deformation parameters between chronic smokers and nonsmoker healthy population. METHOD: Forty-two healthy participants (mean age 33.48 ± 10.00 years) without smoking history, 40 participants (mean age 33.98 ± 9.27 years) who had been smoking were prospectively included. In addition to conventional echocardiographic measurements, global longitudinal strain (GLS) of left ventricle (LV), GLS of right ventricle (RV), left atrial strain, and strain rate were analyzed. RESULTS: Smokers had lower peak early diastolic velocity (E) and E/a (early diastolic velocity/late diastolic velocity) ratio in mitral inflow (70.0 ± 13.9 cm/sec vs 77.1 ± 13.3 cm/sec, P = .023; 1.4 ± 0.4 vs 1.7 ± 0.4, P = .011; respectively). Peak early diastolic velocity of mitral valve septal annulus (Em) and Em/Am ratio (peak early diastolic velocity of mitral valve/late diastolic velocity of mitral valve) (11.0 ± 2.1 cm/sec vs 12.1 ± 2.4 cm/sec, P = .023; 1.2 ± 0.3 vs 1.4 ± 0.4, P = .039; respectively) were lower in smokers. LV GLS and RV GLS were significantly lower in smokers (-17.6% ± 3.01 vs -19.2% ± 2.5; P = .013, -18.9% ± 4.4 vs -21.0% ± 4.5; P = .039; respectively). CONCLUSION: Impaired LV and RV deformation were found in chronic smokers in our study. Although there was no statistically significant difference with left ventricular ejection fraction, LV GLS which is the early indicator of LV systolic dysfunction was lower in chronic smokers. The assessment of early harmful effects of smoking on left and right ventricle might be evaluated with speckle tracking echocardiography.

Improvement of abnormal systolic motion of the interventricular septum with cardiac resynchronization therapy.

BACKGROUND: There is no consensus in the literature regarding what is the responsible mechanism of left ventricular dyssynchrony; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB). METHODS: A total of 26 patients undergoing CRT implantation with LBBB, wide QRS duration (≥120 ms), and low ejection fraction (EF) (<35%) were included. Pulsed TDI was taken from apical 4-chamber view and parasternal short axis view (PSAX). All echocardiographic parameters were measured when CRT is on and off. RESULTS: Systolic ejection time (ET) of anteroseptal and posterolateral wall of LV in PSAX was statistically significantly longer in CRT on group (321.6 ± 62.7 vs 237.5 ± 59.3 ms, P < .001; 323.9 ± 58.0 vs 289.4 ± 43.7 ms, P = .015, respectively). In apical 4-chamber view, septal annulus systolic ET is significantly longer in CRT on group than CRT off group (315.8 ± 57.2 vs 287.3 ± 42.2, P = .014). Also, there was a strong correlation between systolic ET of the septum in PSAX with aortic velocity time integral (VTI), QRS duration and EF (r = .587, P = .002; r = .479, P = .013; r = .440, P = .025; respectively). CONCLUSION: Circumferential contraction of septal myocardial fibers is improved with CRT and it is strongly correlated with increase of aortic VTI and shortening of QRS duration. These findings predict the deterioration of septal contraction as the main mechanism in patients with LBBB pattern and, CRT may improves myocardial contraction by correcting septal systolic motion.

A case of coronary microfistula: A newborn microfistula.

Coronary artery fistula is an abnormal connection between a coronary artery and a cardiac chamber, a great artery or the vena cava. Although coronary artery fistulas are known to be congenital malformations they might occur due to infection, trauma or may be iatrogenic. We present a case with acquired coronary microfistula, without any history of interventional procedure.

The Effects of Cigarette Smoking on the Tp-e Interval, Tp-e/QT Ratio and Tp-e/QTc Ratio.

BACKGROUND: Cigarette smoking increases the risk of sudden cardiac death. Smoking may predispose individuals to ventricular fibrillation and sudden cardiac death by altering ventricular repolarization and stimulating sympathetic nervous system activity. OBJECTIVES: The aim of the study was to investigate the instantaneous effects of smoking on ventricular repolarization. MATERIAL AND METHODS: The study included 47 healthy subjects; 24 long-term heavy smokers (10 women, mean age: 40 ± 5 years) constituted the study group, and 23 non-smokers (10 women, mean age: 42 ± 10 years) constituted the control group. ECGs were performed on all the subjects. The Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were measured and compared between the groups. RESULTS: There were no significant differences between smokers and nonsmokers in the basic clinical and echocardiographic variables (p > 0.05). The QT interval and QTc interval were similar in both groups. The Tp-e interval (p = 0.02) and Tpe/QT ratio (p = 0.001) were higher in the heavy smokers than in the non-smokers. The Tpe/QTc ratio (p = 0.001) was also higher in the smokers. Other ECG parameters were similar between the smokers and nonsmokers. CONCLUSIONS: The results show that chronic cigarette smoking is associated with a prolonged Tp-e interval, increased Tp-e/QT ratio and Tp-e/QTc ratio. These observations may indicate that there may be a relationship between smoking and altered ventricular repolarization. Abnormal ventricular repolarization values on an ECG may explain the increased cardiovascular event risk in long-term heavy cigarette smokers.

Gene-gene interaction of ACE I/D, endothelial nitric oxide synthase 4 a/b and ApoE does not affect coronary artery disease severity.

OBJECTIVES: Previous studies have shown the impact of angiotensin converting enzyme (ACE) insertion/deletion (I/D), endothelial nitric oxide synthase (eNOS) polymorphisms and ApoE genotypes on coronary artery disease (CAD). The aim of this study is to investigate the relationship between the genetic polymorphisms and the severity of CAD and to evaluate their potential interactions. MATERIAL AND METHODS: All patients underwent coronary angiography; coronary score (CS) and severity score (SS) were calculated for them. ACE I/D, eNOS and ApoE polymorphisms were detected by polymerase chain reaction (PCR). RESULTS: Neither CS nor SS showed a direct relationship with eNOS and ApoE genotypes. CS and SS were found to be high in patients carrying the ACE DD allele (p = 0.034 and p = 0.009). In the gene interactions, there was an increase in the SS only in patients with coexisting eNOS b/b genotype and ACE DD allele (p = 0.043). CONCLUSIONS: The interactions of the gene polymorphisms investigated don't play an important role in determining an individual's risk for the severity of CAD.

Severity of coronary artery disease and echocardiographic parameters of ventricular diastolic function.

OBJECTIVE: The objective of this study was to determine the relation between the severity of the coronary artery disease (CAD) and left ventricular (LV) diastolic function in patient with stable CAD and normal LV ejection fraction. METHODS: Sixty patients with stable CAD were included in the study. All angiographic variables pertinent to SYNTAX Score (SS) and Gensini score (GS) calculation were computed by two experienced interventional cardiologists. All patients underwent echocardiographic examination. RESULTS: We divided the patients into 4 groups according to median of SS and GS. It was observed that LV diastolic function was impaired in 26 patients (86.7%) in under group of SS, 23 patients (76.7%) in upper group of SS, and 27 patients (87.1%) in under group of GS, and 22 patients (75.9%) in upper group of GS. There was no significant difference between the SS, GS, clinical, and echocardiographic findings. CONCLUSION: The diastolic function did not demonstrate any impairment according to the severity of the CAD in patients which coronary angiography performed with the diagnosis of stable CAD.

The prognostic value of arterial stiffness in systolic heart failure.

BACKGROUND: Increased arterial stiffness is an indicator of mortality. This study consists of an 18-month follow-up of the mortality in advanced heart failure patients with increased arterial stiffness. METHODS: The study followed up 98 patients with a diagnosis of heart failure in NYHA class III and IV (76 males, 22 females and mean age of 60 ± 12 years) with a left ventricular ejection fraction ≤ 35% as determined by the Simpson method. Augmentation index (Aix) and pulse wave propagation velocity (PWV) parameters were used as indicators of arterial stiffness. Aix and PWV values were measured by arteriography. RESULTS: 36 patients died. Both Aix and PWV were powerful determinants of mortality, independent of other prognostic variables (p = 0.013, OR: 0.805; p = 0.025, OR: 0.853). A cutoff value for Aix of -14.33 gave 91.2%, 80.3% sensitivity and specificity. A cutoff value for PWV of 11.06 gave 82.4%, 65.4% sensitivity and specificity mortality was predicted. Left ventricular ejection fraction (p = 0.008, OR: 0.859) and B-type natriuretic peptide (p = 0.01, OR: 0.833) was the other independent determinant of mortality. A significant difference was found in both Aix and PWV between the compensated measurements and decompensated heart failure measurements made in 70 patients (p = 0.035, p = 0.048). CONCLUSIONS: Measurement of arterial stiffness is a convenient, inexpensive and reliable method for predicting mortality in patients with advanced heart failure.

[Monomorphic ventricular tachycardia during the ajmaline test]. / Ajmalin testi sirasinda gelisen monomorfik ventrikül tasikardisi.

A 44-year-old male patient admitted with palpitations was diagnosed with tachycardia with wide QRS, but recovered after being treated with amiodarone. The patient's coronary angiography was normal. As the patient's resting ECG was compatible with Brugada type 2, an ajmaline challenge test was scheduled. The infusion procedure was suspended following an observation of type 1 ECG findings in the 4th minute of infusion. Approximately 10-15 seconds later, a monomorphic ventricular tachycardia with a rate of 150 beats/minute developed. In the follow-up, the patient's heartbeat returned spontaneously to the sinus rhythm within 3-4 minutes. Polymorphic ventricular tachycardia or ventricular fibrillation tachyarrhythmias usually result in syncope or sudden cardiac death in cases of Brugada syndrome, while monomorphic tachycardia, as in our case, is rare. Here, we present a rare case of monomorphic ventricular tachycardia, which was observed during the ajmaline challenge test.

Determination and comparison of microbial loads in atmospheres of two hospitals in Izmir, Turkey.

INTRODUCTION AND OBJECTIVES: Nosocomial infections, also known as hospital-acquired infections, has become one of the most important health problems in health care units worldwide. The presented study aims to determine the average amount of microorganism loads and to show that the atmospheres of the two hospitals can be a potential source regarding nosocomial infections. The effect of surface and floor disinfection processes in the two hospitals and the antibiotic susceptibility of the bacterial isolates were also evaluated. MATERIALS AND METHODS: Microorganisms were isolated from air samples collected from different areas (patient wards, corridors, operating theatres and postoperative units) of the two hospitals in Izmir. Sampling was conducted between December 2006 - March 2007. RESULTS: During the 3-month sampling period, the average number of live microorganisms in the air samples collected from second-class environments in the hospital 1 and the hospital 2 was found to be 224.44 and 536.66 cfu/m(3) , respectively. The average number of microorganisms in hospital 2 collected before the disinfection process was higher than those after the disinfection process. However, because of the closure of the air-conditioning system and the hepa filters after the disinfection process, this was reversed in hospital 1. In total, 54 and 42 isolates were obtained from hospital 1 and hospital 2, respectively. 49 isolates from hospital 1 and 35 isolates from hospital 2 were identified as Staphylacoccus sp. The remaining isolates were identified as Aerococcus sp. and Enterococcus sp. Pseudomonas sp. was not determined in the air samples of the two hospitals. CONCLUSIONS: It was detected that the microbial loads in the atmospheres of the two hospitals studied varied greatly depending on the number of people in the environment. As the results indicate, the total number of microorganisms in the atmospheres of operating theatres in both hospitals does not pose a threat according to the Air Microbe Index.