Cardioprotective Effect of Cilostazol on Ischemia-Reperfusion Injury Model

Abstract Introduction: To clarify the potential protective role of cilostazol on rat myocardial cells with ischemia-reperfusion injury (IRI) models. Methods: The study was conducted with three groups of 10 Wistar rats (control group, rats without any coronary ischemia; sham group, rats with coronary ischemia but without cilostazol administration; and cilostazol group, rats with coronary ischemia and cilostazol administration). The level of myocardial injuries was measured by analyzing cardiac troponin T and creatine kinase MB levels in blood samples. In tissue samples, adenosine triphosphate (ATP), nitric oxide, superoxide dismutase (SOD), and malondialdehyde were used to determine the amount of tissue damage. Tissues were stained with hematoxylin-eosin method, and samples were examined under light microscope. Results: The mean level of ATP was 104.4 in the cilostazol group and 149.1 in the sham group (P=0.044). SOD level was significantly higher in the cilostazol group than in the sham group (2075.3 vs. 1783.7, P=0.043). According to histopathological examination, all samples were classified as G0 in the control group. In the sham group, one sample was categorized as G1, six samples as G2, and three samples as G3. In the cilostazol group, nine samples and one sample were categorized as G1 and G2, respectively (P=0.011). Conclusion: Cilostazol has beneficial effects on Wistar rats' myocardial cells in regard to decreasing inflammatory process, necrosis, and fibrosis. Our findings revealed that the use of cilostazol significantly decreased ATP and increased SOD levels in Wistar rats' myocardial cells after IRI.

Cardioprotective Effect of Cilostazol on Ischemia-Reperfusion Injury Model.

INTRODUCTION: To clarify the potential protective role of cilostazol on rat myocardial cells with ischemia-reperfusion injury (IRI) models. METHODS: The study was conducted with three groups of 10 Wistar rats (control group, rats without any coronary ischemia; sham group, rats with coronary ischemia but without cilostazol administration; and cilostazol group, rats with coronary ischemia and cilostazol administration). The level of myocardial injuries was measured by analyzing cardiac troponin T and creatine kinase MB levels in blood samples. In tissue samples, adenosine triphosphate (ATP), nitric oxide, superoxide dismutase (SOD), and malondialdehyde were used to determine the amount of tissue damage. Tissues were stained with hematoxylin-eosin method, and samples were examined under light microscope. RESULTS: The mean level of ATP was 104.4 in the cilostazol group and 149.1 in the sham group (P=0.044). SOD level was significantly higher in the cilostazol group than in the sham group (2075.3 vs. 1783.7, P=0.043). According to histopathological examination, all samples were classified as G0 in the control group. In the sham group, one sample was categorized as G1, six samples as G2, and three samples as G3. In the cilostazol group, nine samples and one sample were categorized as G1 and G2, respectively (P=0.011). CONCLUSION: Cilostazol has beneficial effects on Wistar rats' myocardial cells in regard to decreasing inflammatory process, necrosis, and fibrosis. Our findings revealed that the use of cilostazol significantly decreased ATP and increased SOD levels in Wistar rats' myocardial cells after IRI.

Learning curve for percutaneous thrombectomy in treatment of acute lower extremity deep vein thrombosis.

OBJECTIVE: We evaluated the effect of the learning curve on percutaneous thrombectomy (PT) outcomes for the treatment of lower extremity deep vein thrombosis (DVT). METHODS: The present study was conducted between October 2019 and September 2020 and included 80 patients who had undergone PT to treat lower extremity DVT of the common iliac, external iliac, common femoral, femoral, and popliteal veins. For thrombectomy, aspiration and mechanical thrombectomy procedures were performed until the thrombus had completely dissolved using the Dovi aspiration system and Mantis mechanical thrombectomy system (Invamed, Ankara, Turkey). A total of 80 patients were divided equally into four groups, with the first 20 cases in group 1, the second 20 cases in group 2, the third 20 cases in group 3, and the final 20 cases in group 4. The groups were compared for the demographic characteristics, intraoperative outcomes, complication rates, and procedure success. RESULTS: All demographic parameters were similar between the four groups. The mean operative time was 139.3 minutes for group 1, 134.8 minutes for group 2, 111.3 minutes for group 3, and 106.7 minutes for group 4. Statistical analysis revealed that the operative time was significantly shorter for groups 3 and 4 compared with that for groups 1 and 2. In addition, the fluoroscopy time was significantly decreased in groups 3 and 4 (P = .001). The complication rate was similar between the four groups (P = .899). However, success was significantly increased after the first 20 cases, and the remaining three groups had a significantly higher success rate compared with group 1 (70% for group 1, 90% for group 2, 95% for group 3, and 100% for group 4; P = .024). CONCLUSIONS: Success in the performance of PT for the treatment of acute lower extremity DVT reaches satisfactory levels after 20 cases. Additionally, operation time and fluoroscopy time are significantly decreased after 40 cases and then start plateau.

Effect of Obesity on Percutaneous Thrombectomy Outcomes in the Treatment of Lower Limb Deep Vein Thrombosis.

OBJECTIVE: To evaluate the effect of obesity on percutaneous thrombectomy (PT) results for the management of lower limb deep vein thrombosis (DVT). STUDY DESIGN: Retrospective cohort study. PLACE AND DURATION OF STUDY: Department of Cardiology, Avcilar Hospital, Istanbul, Turkey, between August 2020 and January 2021. METHODOLOGY: Patients who underwent PT for lower limb DVT were included. Patients' demographic characteristics, operative parameters, and postoperative outcomes were recorded in prospective manner. Patients were divided into two groups, as patients with body mass index (BMI) <30 kg/m2 (Group 1) and patients with BMI ≥30 kg/m2 (Group 2). The two groups were compared according to patient demographic properties, intraoperative results, and postoperative outcomes. RESULTS: Eventually, 62 patients were enrolled into the non-obese group and 30 patients had BMI ≥30 Kg/m2. Comparison of the groups demonstrated that the mean operation time and the mean fluoroscopy time were significantly higher in obese patients (121.5 min vs. 134.5, p = 0.017 and 19.8 min vs. 25.9 min, p = 0.006, respectively). In addition, the mean hospitalisation period and the mean ICU stay were significantly longer in patients with ≥30 kg/m2 (p = 0.025 and p = 0.007). Postoperative visual analog scale (VAS) score in the first hour was significantly higher in obese patients (2.4 vs. 3.0, p = 0.008). The presence of obesity did not have a significant effect on success and complication rates following PT (p = 0.368 and p = 0.646). CONCLUSION: Obesity prolonged operation time and fluoroscopy time during PT. Additionally, obesity was associated with significantly longer hospitalisation period, and ICU stay, and higher VAS score in the first hour following PT. Key Words: Complication, Deep vein thrombosis, Obesity, Percutaneous thrombectomy, Success, VAS score.

Characteristics of YouTube Videos About Peripheral Artery Disease During COVID-19 Pandemic.

INTRODUCTION: To examine English language YouTube videos that covered both COVID-19 and peripheral artery disease (PAD). METHODS: The research was planned from October 1 to 5, 2020. Two cardiologists (CB and ES) executed online searches in which the term COVID-19/coronavirus was paired with common keywords about PAD, including 'peripheral artery disease + COVID-19,' 'leg pain + coronavirus,' 'leg vascular disease + COVID-19,' 'atherosclerosis + COVID-19,' and 'claudication + coronavirus.' For each video, a record was made of the number of days on YouTube, length, number of views and comments, and the number of 'likes' and 'dislikes'. Videos were also categorized according to content as informative videos (with accurate content about the frequency of disease, symptoms, transmission, prevention techniques, and proven treatment methods), patient experience videos (with patient testimonies), or news update videos (i.e., those uploaded by professional news channels). Moreover, DISCERN and Medical Information and Content Index (MICI) were evaluated. RESULTS: Totally, 91 YouTube videos met study inclusion criteria. News update videos were the most-watched when compared with informative and patient experience videos (63,910 views vs 43,725 views vs19,778 views, p=0.032). The DISCERN score was significantly higher in the informative group: 2.8 for informative videos, 1.7 for patients' experience videos, and 1.8 for news update videos (p= 0.001). The most common theme was clinical symptoms in the informative videos (82.4%). The mean MICI score was calculated as 3.7±1.4 points for informative videos. CONCLUSION: YouTube videos about COVID-19 and PAD are widely-viewed information sources for patients. Our study has demonstrated that YouTube videos about COVID-19 and PAD generally had poor quality content.

Association of Metabolic Syndrome Components and Overactive Bladder in Women.

Background To identify associations between metabolic syndrome (MS) components and overactive bladder (OAB) in women. Methodology The present study was conducted prospectively between February 2021 and April 2021 and included the assessment of women admitted to the cardiology outpatient clinic and their female relatives. Records were made of the demographic characteristics of patients and blood tests, including cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglyceride, and fasting glucose levels (FG). In addition, the score on the Overactive Bladder Questionnaire-8-item (OAB-V8) form was noted. The study population was divided into two groups according to OAB-V8 score. The groups were compared in terms of participant demographic properties, OAB-V8 scores, metabolic component values, and blood test results. Results In total, 200 participants with a mean age of 49.8 years were enrolled in the study. Participants with OAB had significantly higher body mass index (BMI) (30.1 kg/m2 versus 27.1 kg/m2; p = 0.001) and longer waist circumference (97.8 cm versus 89.0 cm; p = 0.001). Similarly, the mean FG and LDL levels were significantly higher in participants with OAB (p = 0.001 and p = 0.001). Lastly, mean OAB-V8 score was 20.2 for participants with OAB and 4.8 for participants without OAB. Multivariate regression analysis showed that higher BMI and longer waist circumference were significantly associated with OAB (1.228-fold; p = 0.001 and 1.058-fold; p = 0.001, respectively). Additionally, multivariate regression analysis found that higher LDL level and FG were predictive factors for OAB (1.115-fold; p = 0.003 and 1.229-fold; p = 0.001, respectively). Conclusions The present study found that higher BMI, longer waist circumference, and higher LDL and FG levels were predictive factors for OAB development in women.

Sürücü index and others.

BACKGROUND: In this study, we have aimed to evaluate the correlation between echocardiographic parameters that test systolic and diastolic function together. METHOD: The study population was divided into two groups according to Vp. Group-1 (n = 103) represented the control group (Vp > 50 cm/s) and group-2 (n = 86) represented patients with systolic and diastolic dysfunctions together (Vp ≤ 50 cm/s). The echocardiographic parameters that evaluate systolic and diastolic function together, such as the Tei and the Sürücü indices, were compared between the groups. RESULTS: In group-2, the Tei index was higher (p = 0.001) and the Sürücü index was lower (p < 0.001). We also showed that the Tei and Sürücü indices were significantly and negatively correlated. That is, as the Sürücü index decreases, the Tei index increases (p = 0.001). CONCLUSION: Vp is an index more affected by diastolic parameters but rarely by systolic parameters because it is measured at diastolic period. The Tei index, on the other hand, is affected by preload variables and needs two different heart cycles for calculation. The Modified Tei index, however, has limited diagnostic value because of high inter-observer variability. In this study, the usability of the Sürücü index is shown in comparison with other indices used for this purpose. Considering that it is less affected by preload variables, can be calculated over a single heart cycle, and has the ability to test variables of both systolic and diastolic periods unlike Vp. We postulate that the Sürücü index is more usable and reliable.

Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: a review of 68 cases at a tertiary care center in Turkey.

OBJECTIVES: This study was designed to evaluate clinical, laboratory, microbiological, and echocardiographic characteristics of infective endocarditis (IE) at a tertiary care center in Turkey and to identify predictors of in-hospital mortality. STUDY DESIGN: Based on a systematic retrospective review of clinical records covering 1997 to 2007, we analyzed data and outcomes of 68 patients (40 males, 28 females; mean age 51+/-20 years) with definite or possible IE according to the modified Duke criteria. RESULTS: Native valve endocarditis (NVE) was seen in 28 patients (41.2%), and prosthetic valve endocarditis (PVE) was seen in 38 patients (55.9%). Pacemaker endocarditis (PE) was observed in only two patients (2.9%). Nineteen patients (27.9%) had nosocomial IE. The most frequent predisposing factor for NVE was rheumatic heart disease (n=11; 39.3%). Echocardiography failed to show any signs of involvement in five patients (13.2%) with PVE. The most common causative microorganisms of NVE, PVE, and PE were staphylococci (n=28; 41.2%). At least one complication developed in 46 patients (67.7%), congestive heart failure being the most common (n=38; 55.9%). Forty-one patients (60.3%) underwent combined medical and surgical treatment. In-hospital mortality occurred in 17 patients (25%). Mortality rates were 37.5%, 30%, and 14.3% for early and late PVE and NVE, respectively. Mortality was significantly higher with nosocomial IE (57.9%) compared to 12.2% in the remaining patients. In multivariate analysis, septic shock (p=0.011) and nosocomial infection (p=0.032) were independently associated with in-hospital mortality. CONCLUSION: Compared to the European series, IE in our cohort occurred in a relatively younger population, with rheumatic heart disease as the most common underlying heart disease. The rates of PVE, nosocomial IE, and surgical treatment were about the same.