Relationship between echocardiographic parameters and ALBI score in patients with rheumatic mitral stenosis.

An increase in the volume and pressure of the heart chambers has been shown to increase liver stiffness. The Albumin-Bilirubin (ALBI) score is useful and easy-to-use for objectively assessing liver function. There is no information in the literature regarding changes in ALBI scores in patients with rheumatic mitral stenosis (MS). The aim of our study was to investigate changes in ALBI score and its clinical impact in patients with MS. Of the 247 patients analyzed, 54 were excluded from the study. The remaining 193 patients with MS were divided into two groups: Group I (64 patients with mitral valve area > 1.5 cm2 and mean transmitral gradient < 10 mmHg) and Group II (129 patients with mitral valve area ≤ 1.5 cm2 and mean transmitral gradient ≥ 10 mmHg). The ALBI score was calculated based on serum albumin and total bilirubin levels using the following formula: ALBI= (log10 bilirubin [µmol/L] × 0.66) + (albumin [g/L] × - 0.085). A significant correlation was found between the ALBI score and mitral valve area in patients with MS (r = - 0.479, p < 0.001*) (Table 4; Fig. 3A). An ALBI score greater than - 2.61 was associated with severe MS (mitral valve area < 1.5 cm2), with a sensitivity of 72% and a specificity of 69% (Area under the ROC curve = 0.726; p < 0.001; 95% CI 0.650-0.802) (Fig. 4A). A significant correlation was found between the ALBI score and mean transmitral gradient in patients with MS (r = 0.476; p < 0.001*) (Table 4; Fig. 3B). An ALBI score greater than - 2.57 was associated with severe MS (mean transmitral gradient < 10 mmHg), with a sensitivity of 65% and a specificity of 67% (Area under the ROC curve = 0.684; p < 0.001; 95% CI 0.608-0.759) (Fig. 4B). In multivariate linear regression analysis, mitral valve area and mean transmitral gradient were significantly associated with increased ALBI scores (p < 0.05). Mitral valve area, mean transmitral gradient, and NT-proBNP levels were significantly associated with the ALBI score. The ALBI score could provide an information about the severity of MS. The ALBI score is a simple, evidence-based, objective, and discriminatory method for assessing liver function in patients with MS.Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.Authors and their respective affiliations are correctly identified.

The relationship between echocardiographic parameters and albumin bilirubin score in patients with acute pulmonary thromboembolism.

PURPOSE: The Albumin-Bilirubin (ALBI) score is useful and easy-to-use for objectively assessing liver function. We investigated whether the ALBI score, a parameter indicating liver stiffness, congestion and fibrosis, has any relationship with echocardiographic parameters in patients with acute pulmonary thromboembolism (PTE). MATERIAL AND METHODS: A total of 140 patients diagnosed with acute PTE were retrospectively analyzed. These patients were divided into three groups according to the hemodynamic severity of acute PTE: Group I [Low risk]; Group II [Submassive or intermediate-risk]; and Group III [Massive or high-risk]. Biochemical data obtained from venous blood samples taken at admission were analyzed. In addition, data were also analyzed from transthoracic echocardiography and pulmonary computed tomographic angiography performed at admission. ALBI, Bova, and PESI scores were calculated. RESULTS: ALBI scores (-3.32 ± 0.21 vs -2.86 ± 0.15 vs -2.46 ± 0.2, p < .001) were statistically significantly higher in Group III than Groups I and II. There was a significant difference between the three groups in terms of echocardiographic parameters, and LVEF and TAPSE values tended to decrease from group I to group III. In multivariate linear regression analysis, sPAP, RV/RA diameter, and NT-pro-BNP were found to be significantly associated with the ALBI score. An ALBI score higher than -2.87 was associated with Bova stage II-III in patients with Group I and Group II PTE, with a sensitivity of 87% and a specificity of 62% (AUC = 0.804; 95% CI 0.713-0.895; p < .001). CONCLUSION: The ALBI score, which is a common, easy-to-use, and inexpensive method, may be beneficial to select intermediate and high-risk patients in patients with acute PTE. Additionally, it may have prognostic value in distinguishing low and intermediate-risk acute PTE patients.

Comparison of thromboembolic risk scores for evaluating in-hospital events of COVID-19 patients.

Aim: To compare the effectiveness of thromboembolic risk scores in determining in-hospital events of COVID-19 patients. Methods: This retrospective study included a total of 410 consecutive COVID-19 patients. Scores including CHA2DS2-VASc-HS (congestive heart failure, hypertension, age, diabetes mellitus, stroke/transient ischemic attack, vascular disease, sex, hyperlipidemia, smoking); modified R2CHA2DS2-VASc (CHA2DS2-VASc plus renal function), m-ATRIA (modified Anticoagulation and Risk Factors in Atrial Fibrillation score), ATRIA-HSV (ATRIA plus hyperlipidemia, smoking and vascular disease) and modified ATRIA-HSV were calculated. Participants were divided by in-hospital mortality status into two groups: alive and deceased. Results: Ninety-two (22.4%) patients died. Patients in the deceased group were older, predominantly male and had comorbid conditions. CHA2DS2-VASc-HS (adjusted odds ratio [aOR]: 1.31; p = 0.011), m-R2CHA2DS2-VASc (aOR: 1.33; p = 0.007), m-ATRIA (aOR: 1.18; p = 0.026), ATRIA-HSV (aOR: 1.18; p = 0.013) and m-ATRIA-HSV (aOR: 1.24; p = 0.001) scores were all associated with in-hospital mortality. m-R2CHA2DS2-VASc and modified ATRIA-HSV had the best discriminatory performance. Conclusion: We showed that m-R2CHA2DS2-VASc and m-ATRIA-HSV scores were better than the rest in predicting mortality among COVID-19 patients.

COVID-19 continues to be a pandemic that threatens human health all over the world. The main aim of our study was to examine the relationship between risk scores routinely used to determine the probability of clot formation in various cardiovascular diseases and in-hospital deaths of COVID-19 patients. The study comprised 410 adult patients hospitalized with a confirmed diagnosis of COVID-19. The clinical and laboratory data were obtained from the hospital registry system. All risk scores in the study were significantly greater in people who died from COVID-19 than in those who survived. Moreover, scoring systems that include kidney function outperformed the rest in determining in-hospital death. As a result, we discovered that specific risk scores used to indicate a person's likelihood of developing clot formation at a routine cardiology clinic are connected to in-hospital deaths among hospitalized COVID-19 patients.

Predictive value of echocardiography-derived arterial compliance for increased arterial stiffness in hypertensive patients.

OBJECTIVE: Increased arterial stiffness is a predictor of cardiovascular events. The cardio-ankle vascular index (CAVI) is a measure of arterial stiffness. The stroke volume (SV) to pulse pressure (PP) ratio is an estimate of arterial compliance (AC). The main purpose of this study was to investigate the association between echocardiography-derived AC and arterial stiffness. METHODS: One hundred and forty asymptomatic hypertensive patients were enrolled consecutively. AC was calculated as SV/PP and adjusted to body surface area to calculate the SV/PP index (SV/PPi). Arterial stiffness was assessed by a VaSera-1000 CAVI instrument. RESULTS: There was statistically significant negative correlation between SV/PPi and CAVI (r=-0.402; P<0.001). Multivariate binary logistic regression analysis demonstrated SV/PPi as an independent predictor of increased CAVI (CAVI≥9) (95% confidence interval: 0.001-0.147; P<0.001). There were lower SV/PPi values in abnormal CAVI groups (CAVI≥9) than normal and borderline CAVI (CAVI<9) (0.68±0.23 vs. 0.93±0.27; P<0.001). Analysis using the receiver operating characteristic curve has demonstrated that SV/PPi of 0.61 ml/m/mmHg constitutes the cut-off value for the presence of abnormal CAVI with 89% sensitivity and 53% specificity (area under the curve: 0.771, 95% confidence interval 0.674-0.868). CONCLUSION: Assessment of AC during echocardiography examination may provide predictive information of increased arterial stiffness in asymptomatic hypertensive patients.

The effect of valsartan on left ventricular myocardial functions in hypertensive patients with left ventricular hypertrophy.

BACKGROUND: It has been shown by various diagnostic methodologies that angiotensin receptor blockage reduces left ventricular mass, improves diastolic function and increases contractility in hypertensive left ventricular hypertrophy (LVH). We planned to detect the effect of angiotensin receptor blockage on midwall mechanics and myocardial dynamics in hypertensive patients with LVH. METHODS: Angiotensin 2 type 1 receptor blocker (valsartan 80-160 mg) was administered to 38 previously untreated hypertensive patients with LVH for 6 months. Left ventricular midwall mechanics and tissue Doppler velocities were measured at baseline and at the end of the study. RESULTS: Mean blood pressure was reduced from 152 ±â€Š14/92 ±â€Š8 to 131 ±â€Š14/83 ±â€Š9 mmHg (P < 0.05). Left ventricular mass index was decreased from 135 ±â€Š15 to 114 ±â€Š14 g/m(2) (P < 0.001). Midwall fractional shortening was increased from 19.0 ±â€Š4 to 22.4 ±â€Š3% (P < 0.05). Circumferential end-systolic wall stress was decreased from 131 ±â€Š44 to 119 ±â€Š37 × 10(3) dyn/cm(2) (P < 0.05). Left ventricular interventricular septal myocardial tissue peak systolic velocity was increased from 6.7 ±â€Š1 to 8.1 ±â€Š0.9 cm/s (P < 0.001) and lateral wall myocardial tissue peak systolic velocity was increased from 7.5 ±â€Š1 to 9.0 ±â€Š1 cm/s (P < 0.001), and E/E(m) ratio was significantly decreased (11.0 ±â€Š0.3 to 8.90 ±â€Š0.1, P < 0.05) with 6-month valsartan therapy. CONCLUSION: This study suggests that valsartan exhibits not only blood pressure-lowering qualities but also cardioprotective actions in patients with hypertension because it enhances regression of LVH and improves left ventricular myocardial contractility and relaxation.