The relationship between QRS-T angle and left ventricular global longitudinal strain in prehypertensive patients.

BACKGROUND AND AIM: This study aims to examine the relationship between the QRS-T angle (QRS-Ta) detected on electrocardiography and left ventricular global longitudinal strain (LV-GLS) calculated on echocardiography in prehypertensive patients. MATERIALS AND METHODS: A total of 300 patients were included in our study, and the median value of QRS-Ta of the entire population was 27.The patients were divided into two groups (supramedian 148 patients, inframedian 152 patients) according to the median value. Statistical analysis was performed between the two groups. RESULTS: LV-GLS was lower in the supramedian QRS-Ta group [20 (16-26) vs. 21 (16-27); p < 0.001]. A statistical difference was found between the two groups in age (p < 0.001), BMI (p < 0.001), Hs-troponin I (p < 0.001), aortic velocity (p = 0.023) and TAPSE (p = 0.005) parameters except for LV-GLS.The correlation between QRS-Ta and LV-GLS was determined by Spearman's correlation test (p < 0.001).In the multivariable logistic regression analysis model, LV-GLS (OR: 0.365, 95%CI 0.171-0.780, p = 0.009) was one of the independent predictors for increased QRS-Ta. Others were determined as age (p < 0.001) and TAPSE (p = 0.015). CONCLUSIONS: In this study, a strong relationship was found between QRS-Ta, which is easily calculated by ECG, and LV-GLS, which is an advanced echocardiographic examination, in prehypertensive patients.

Can HALP score predict post-contrast acute kidney injury and 6-year mortality in patients undergoing endovascular abdominal aneurysm repair?

BACKGROUND: The aim of this study is to investigate the relationship between HALP score and post-contrast acute kidney injury (PC-AKI) and average 6-year mortality in patients undergoing endovascular abdominal aortic aneurysm repair (EVAR). METHODS: 125 patients who underwent EVAR between January 2015 and December 2020 were included in our study. HALP score was calculated with the formula "hemoglobin × albumin × lymphocyte count/platelet count." In the first phase of the study, two groups were developed: those who developed PC-AKI and those who did not. In the second stage, statistical analysis was performed by creating two groups: average 6-year mortality and survivors group. RESULTS: HALP score was found to be lower in the PC-AKI group [26.12 (14-61.54) versus 40.53 (7.22-103.61); p < .001]. Low HALP score was found to be both a dependent and independent predictor of the development of PC-AKI (p = .019). HALP score was also found to be lower in the mortality group compared to the survivors [28.97 (12.6-103.61) versus 40.81 (7.22-99) p = .004]. Low HALP score was found to be only a dependent predictor of mortality. The development of PC-AKI was found to be an independent predictor of mortality (p = .042). CONCLUSIONS: The HALP score, which can be calculated with a simple formula, can be used to predict PC-AKI and medium-long-term mortality in EVAR patients.

The relationship between serum osteoprotegerin levels and right atrial and ventricular speckle-tracking measurements in essential hypertension patients with normal left ventricular systolic function.

OBJECTIVE: We planned to reveal the relationship between OPG (osteoprotegerin) level and right heart function in hypertensive patients with normal ejection fraction, using strain analysis, which is a sensitive method in demonstrating subclinical dysfunction. METHODS: Between February and June 2018, 625 consecutive patients with a diagnosis of hypertension who applied to the cardiology out-patient clinic of our hospital were evaluated for our study and 175 eligible patients were included. The patients were divided into two groups according to their OPG level. Strain analysis was performed in the echocardiographic evaluation. RESULTS: The mean OPG value was 6.33 ± 1.87 pg/l. There were 93 patients (age 51.1 ± 8.5 years) in the low OPG group and 82 patients (age 54.6 ± 10.4 years) in the high OPG group. A significant difference was found between the two groups with regard to age (p = 0.016), statin use (p = 0.026), C-reactive protein level (p = 0.048), office systolic blood pressure (SBP) (p = 0.001) and office diastolic blood pressure (DBP) (p = 0.001). A significant difference was found between values of strain during reservoir phase (RASr) (p = 0.01), strain during conduit phase (RAScd) (p < 0.001) and peak strain rate during reservoir phase (pRASRcd) (p = 0.044). In multivariate regression analysis, age (OR: 1.162, 95% CI: 1.064-1.269, p = 0.001), office DBP (OR: 1.089, 95% CI: 1.020-1.161, p = 0.011) and RAScd (OR: 0.890, 95% CI: 0.815-0.972, p < 0.010) were found to be independent predictors of high OPG. CONCLUSIONS: In our study, we found high OPG level was inversely correlated with right atrial strain values and linearly associated with high blood pressure. In order to take advantage of the negative indicators of high OPG, positive results can be obtained in strain values of the right heart by indirectly reducing the afterload of the right heart. This can be done by reducing high systemic blood pressure and providing tight blood pressure control.

The use of systemic immune-inflammation index to predict new onset atrial fibrillation in the context of acute coronary syndrome.

Aim    The objectives of this study were to determine the relationship between the systemic immune-inflammation index (SII) and new onset atrial fibrillation (NOAF) in patients with acute coronary syndrome (ACS), and to assess the use of this relation, if any, to predict NOAF in the context of ACSMaterial and Methods    A total of 622 patients diagnosed with ACS and followed up between September 2019 and September 2021 were included in this study. 35 (5.6 %) of these patients, suffering from NOAF, were designated as the patient group, and the remaining 577 (94.4 %) patients were designated as the control group. SII was calculated with the formula [ (platelet count x neutrophil count) / lymphocyte count] in all patients.Results    SII was significantly increased in the NOAF group [1641 (778-4506) vs. 660 (54-2835); p<0.001. The multivariable logistic regression analysis revealed that SII [OR: 1.002, 95 %CI: 1.001-1.002, p<0.001] is one of the independent predictors for NOAF, in addition to age (p=0.003) and left atrium size (p=0.005).Conclusion    The SII index is an independent predictor of NOAF in ACS patients. This index can be used as an easily accessible value in the clinic. Assessment of risk factors for NOAF may permit early treatment and close follow-up of patients with poor prognosis who may develop AF.