The cardiac sequelae of coronavirus disease 2019 , a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.
The main aim of this study was to investigate the relation between anterior tragal crease (ATC) and coronary artery lesion complexity and severity assessed using the SYNTAX score (SXscore) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). A total of 121 patients with a first-time diagnosis of NSTEMI were consecutively enrolled. ATC was defined as ≥1 crease that was close to the tragus and descended anteriorly. SXscore was calculated using the SXscore algorithm. The SXscore was higher in the ATC-positive group than in the ATC-negative group (11.85 ± 8.20 vs 7.52 ± 6.38, P = .003). In the univariate analysis, hemoglobin (male: 11.7-17.4 g/dL, female: 11.7-16.1 g/dL; P = .006), diabetes mellitus ( P = .031), current smoking ( P = .022), and presence of ATC ( P = .022) were significantly associated with increased SXscore. Multivariate analysis revealed ATC (95% confidence interval [CI]: 1.313-7.800, P = .011), current smoking (95% CI: 2.034-13.893, P = .001), and hemoglobin (95% CI: 0.433-0.822, P = .002) as independent determinants of increased SXscore. Anterior tragal crease is easily detected by physical examination. Presence of ATC in patients with NSTEMI may be a warning signal of complexity and severity of coronary artery disease (CAD).
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.
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