Duration of DM and poor glycemic control were found to be associated with radial artery electron microscopic changes. doi: 10.1111/jocs.12761 (J Card Surg 2016;31:410-415).

ÖZETAmaç: Hayvansal biyokütle yakıtı (tezek) dumanı inhalasyon ürünlerine kronik olarak maruz kalan bireylerde endoteliyal fonksiyonların değer-lendirilmesi. Yöntemler: Doğumlarından itibaren tezek dumanı inhalasyon ürünleri maruziyeti olan 47 sağlıklı birey (ortalama yaş 31.6±6.8 yıl, 21 erkek) enine kesitli gözlemsel çalışmaya dahil edildi. Kontrol grubu ise 32 sağlıklı kişiden (ortalama yaş 27.9±4.4 yıl, 11 erkek) oluşturuldu. Tüm bireylerde, karotis intima media kalınlığı (CIMT), akım ile ilişkili dilatasyon (FAD %) ve endotel-bağımlı olmayan vazodilatasyon (GTN %) değerlendirildi. CIMT, lümen-intima ile media-adventisya yüzeylerinin önde gelen kenarları arasındaki mesafe olarak hesaplandı. FAD %, reaktif hiperemi sıra-sında brakiyal arter lümen çapının başlangıç düzeyine göre yüzde değişimi olarak tanımlanırken, GTN % ise, 400 µg gliseriltrinitrat uygulandıktan dört dakika sonra ölçülen brakiyal arter lümen çapının başlangıç düzeyine göre yüzde değişimi olarak tanımlanmıştır. İstatistiksel analiz Student t-testi, Ki-kare testi ve Spearman korelasyon katsayısı analizi ile yapıldı. Bulgular: Her iki grubun CIMT değerleri arasında istatistiksel açıdan anlamlı farklılık yoktur (0.47±0.09'a karşın 0.49±0.06 mm, p=0.138). Ancak, kontrol grubu ile karşılaştırıldığında, çalışma grubundaki kişilerin FAD % değerleri belirgin azalmış olarak saptanmıştır (5.06±4.95'e karşın 10.70±4.64, p<0.001). Buna ilaveten, tezek maruziyeti olan kimselerin GTN % değerleri de kontrol grubuna göre düşük düzeylerde bulunmuştur (14.41±8.47'ye karşın21.85±7.87, p<0.001). ABSTRACTObjective: To evaluate the effect of chronic biomass fuel (BMF) smoke exposure on peripheral endothelial functions. Methods: Forty-seven healthy subjects who have been exposed to BMF smoke since birth (mean age 31.6±6.8 years, 21 male) were enrolled in the present cross-sectional observational study. The control group consisted of 32 healthy subjects (mean age 27.9±4.4 years, 11 male). The carotid intima media thickness (CIMT), flow associated dilatation (FAD %) and endothelium independent vasodilatation (GTN %) were assessed in all subjects. The carotid CIMT was defined as the distance between the leading edge of the lumen-intima and the media-adventitia interfaces. FAD % was defined as the percentage change in the internal diameter of the brachial artery during reactive hyperemia related to the baseline. GTN % was defined as the change in diameter in response to the application of 400 µg of glyceril trinitrate relative to the baseline scan at the end of the fourth minute. Statistical analysis was performed using Student's t-test, Chi-square test and Spearman rank order correlation analysis. Results: The average exposure time of the subjects to biomass fuel smoke was 31.7±6.6 years. They have been exposed to dung inhalation products meanly 8.3±1.8 months in a year seasonally. The average daily exposure time was 15.7±3.3 hours. CIMT values of the two groups were not statistically different from each other (0.47±0.09 vs. 0.49±0.06 mm, p=0.138). However, a markedly...

Background : Alcohol septal ablation is recommended for hypertrophic obstructive cardiomyopathy patients who had refractory symptoms despite optimal medical treatment. We compared the periprocedural, short-, and long-term clinical outcomes and mortality predictors in hypertrophic obstructive cardiomyopathy patients who underwent alcohol septal ablation. Methods Hypertrophic obstructive cardiomyopathy patients aged ≥18 years (63 females and 71 males) who underwent alcohol septal ablation were included. The primary endpoint was all-cause mortality. Results The mean patient age was 60.0 (standard deviation 13.7) years. The median follow-up time was 13 (7.6-18.5) years. During the procedure, 9, 2, and 1 patients developed ventricular fibrillation, remote site myocardial infarction, and pericardial tamponade, respectively, but none died. One patient died during hospitalization. During the long-term follow-up, 17, 5, 20, and 8 patients developed heart failure, myocardial infarction, chronic atrial fibrillation, and non-fatal stroke, respectively, and 24 died. There was no significant difference between the sexes (all P > .05). Age (hazard ratio = 0.69, 95% CI = 0.61‒0.78, P < .001), body mass index (hazard ratio = 1.20, 95% CI = 1.04-1.40, P = .01), age at diagnosis (hazard ratio = 1.57, 95% CI = 1.34-1.78, P < .001), and time from diagnosis to ablation (hazard ratio = 1.57, 95% CI = 1.35-1.84, P < .001) predicted all-cause mortality. In Kaplan‒Meier curves, long-term all-cause mortality was similar in men and women ( P [log-rank] = .43). Conclusion Alcohol septal ablation has similar short- and long-term outcomes for both sexes in hypertrophic obstructive cardiomyopathy patients. Risk factors for long-term mortality were age, body mass index, diagnosis age, and time delay to operation. Therefore, alcohol septal ablation timing is essential for better clinical outcomes. Our findings may contribute to the increased performance of alcohol septal ablation in hypertrophic obstructive cardiomyopathy patients in our country.

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Background: The complexity of coronary artery disease is usually a neglected factor in risk stratification systems. We aimed to analyze the discriminative ability of the clinical SYNTAX score (CSS) for acute kidney injury (AKI) following on- and off-pump coronary artery surgery. Methods: A total of 193 patients were reviewed in this study. Patients were divided into two groups according to the surgical procedure (group I: off-pump coronary artery bypass grafting, n = 89; group II: on-pump coronary artery bypass grafting, n = 104). Preoperative demographic data, the CSS and postoperative renal functions were evaluated. The postoperative AKI classification was made using the RIFLE (Risk, Injury, Failure, Loss of function, and End-stage renal disease) criteria. Results: Postoperative AKI occurred in 14 of 89 patients (15.7%) in group I and in 29 of 104 patients in group II (27.8%; p = 0.046). The CSS did not vary much between the groups (31.52 ± 13.08 vs. 29.89 ± 15.70; p = 0.638). In group I, the CSS was not different between patients with AKI and those without AKI (30.167 ± 3.93 vs. 31.91± 14.75; p = 0.78). In group II, the CSS was 36.85 ± 18.33 in patients with AKI and 28.02 ± 12.32 in those without, and the difference was significant (p = 0.02). The discriminative ability of the CSS for postoperative AKI using the AUC analysis was 0.500 in group I and 0.840 in group II. Conclusion: The CSSmay be a simple and successful means of risk prediction of postoperative AKI in on-pump coronary artery surgery.