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Fundamento: Embora se saiba que a fração de ejeção (FE) do ventrículo esquerdo (VE) medida por eletrocardiograma seja preservada em pacientes com acromegalia, não há informação suficiente sobre deformação longitudinal global e deformação do átrio esquerdo (SLG-VE e SAE). Objetivo: O objetivo deste estudo foi avaliar as funções do ventrículo esquerdo (VE) e do átrio esquerdo (AE) por ecocardiograma strain (ES) em pacientes com acromegalia. Métodos: Este estudo incluiu 50 pacientes com acromegalia na forma ativa da doença e 50 controles saudáveis com idade, sexo e área de superfície corporal similares. Além dos ecocardiogramas de rotina, medições de SLG-VE e SAE foram realizadas com o ES. Resultados: Os valores dos SAE e SLG-VE foram significativamente mais baixos em pacientes com acromegalia (p<0,05 para todos). Na análise bivariada, a pressão arterial sistólica, o pró-hormônio N-terminal do peptídeo natriurético cerebral, o fator de crescimento semelhante à insulina tipo 1, e detectou-se que os níveis de IMVE tinham correlação positiva com SAE e SLG-VE (p<0,05). O nível de IGF-1 tinha forte correlação com SAE e SLG-VE (p<0,001 e β=0,5 vs. p<0,001 e β=0,626, respectivamente); 48% dos pacientes com acromegalia têm SLG-VE reduzido (<20%). O índice de massa do ventrículo esquerdo (IMVE) determina independentemente a presença de SLG-VE reduzido, e cada 1g/m² de aumento no nível de IMVE aumenta a probabilidade de redução de SLG-VE em 6%. Conclusão: Embora a fração de ejeção de VE seja normal em pacientes com acromegalia, os valores de SAE e SLG-VE são significativamente mais baixos. Além do aumento em IMVE, outro achado do envolvimento cardíaco pode ser a redução de SAE e SLG-VE. Portanto, além do ecocardiograma de rotina, SAE e SLG-VE podem ser úteis para avaliar os sinais iniciais de envolvimento cardíaco antes da ocorrência de alterações cardíacas irreversíveis.

Background The coarse F waves on the 12‐lead surface electrocardiogram (ECG) in patients with atrial fibrillation (AF) are known as atrial viability and contractility indicator. Our aim in this study was to investigate the effect of coarse F wave on thromboembolism in patients with permanent AF. Methods In our study, 328 patients with permanent AF were included. Routine laboratory, echocardiographic and electrocardiographic parameters were examined. Cerebrovascular event (CVE) or acute artery occlusion was considered a thromboembolic event. Results In our study, 46 (14.0%) of the patients were found to have thromboembolic events and 282 (86%) of them were found without thromboembolic events. In the group with thromboembolic event, the number of patients with hypertension (HT) (P < .001) and history of coronary artery disease (P = .003) and elderly patients (P < .001) was significantly higher and warfarin use was significantly lower (P = .025). In the group of patients without thromboembolic events, the number of patients with a coarse F wave in surface ECG was significantly lower (P = .001). Age (OR: 1.105, 95% CI: 1.066‐1.145, P < .001), HT (OR: 2.831, 95% CI: 1.266‐6.331, P = .011), and coarse F wave (OR: 0.290, 95% CI: 0.126‐ 0.670, P = .004) were determined as independent variables for thromboembolic events. Conclusion Coarse F wave in 12‐lead surface ECG in patients with permanent AF may be associated with good prognosis.

Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients.

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Background In our study, we aimed to evaluate left ventricular global longitudinal strain (LV‐GLS) value in patients with premature ventricular contractions (PVCs) and reduced LV ejection fraction (LVEF) and to determine the effect of radiofrequency catheter ablation (RFA) procedure on LV‐GLS. Methods In this cross‐sectional study, 150 patients who underwent three‐dimensional RFA with the diagnosis of PVCs were included. LV‐GLS was measured with strain echocardiography in all patients before RFA and in the sixth‐month control. Patients included in the study were grouped as LVEF <50% (Group I) and LVEF ≥50% (Group II) according to baseline LVEF, and patients within Group I were grouped as LVEF <50% (Group A) and LVEF ≥50% (Group B) according to the sixth‐month LVEF. Results There were 39 patients (26%) with baseline LVEF <50%. In 14 (36%) of these patients, LVEF <50% was observed to continue during the sixth‐month controls. Both the baseline and sixth‐month LV‐GLS values were significantly lower in Group I patients (<0.01). RFA treatment significantly increased both LVEF and LV‐GLS (<0.01). It was found that age, N‐terminal pro‐brain natriuretic peptide, LV diameters, and baseline LVEF were higher, and baseline LV‐GLS level was lower in Group A patients (P < .01). Baseline LVEF and LV‐GLS values were found to independently determine the patients in Group A (P < .01). In receiver operator characteristic analysis, when the limit value is accepted as 40% for baseline LVEF and 18% for baseline LV‐GLS, it can determine Group A with acceptable sensitivity and specificity. Conclusions LV‐GLS decreases significantly in patients with reduced LVEF and PVCs. In these patients, RFA treatment significantly increases both LVEF and LV‐GLS.

Objective The aim of this study was to compare the anaesthesia parameters, procedure duration, and the effect on hemodynamics and clinical parameters during the procedure in patients undergoing transesophageal echocardiography (TEE) with conscious sedation applied with midazolam or propofol. Methods This cross-sectional study included 401 patients (198 males, 203 females, mean age 52.9 ± 14.8 years) applied with TEE in our clinic. The demographic, clinical and laboratory parameters of the patients were recorded before the procedure. A record was made of pre-procedure ASA score and basal SaO2, the time to sedation to TEE, TEE duration, time to recovery, and during the procedure the minimum SaO2, the need for non-invasive mechanical ventilation (NIMV), the change in systolic and diastolic blood pressure (SBP and DBP), O2 saturation change, and pulse change. The data were compared between the patients in two groups according to the conscious sedation agent used; midazolam and propofol. Results The demographic, clinical, and laboratory data of the midazolam and propofol groups were found to be similar (p > 0.05 for each). The procedure duration, and time to recovery were determined to be significantly shorter in the midazolam group than in the propofol group, and the time to onset of the sedation effect was significantly longer (p < 0.05 for each). Of the respiratory parameters, the minimum SaO2 during the procedure, the absolute change in O2 saturation, and the need for NIMV were determined to be significantly lower in the midazolam group (p < 0.05 for each). The absolute pulse and change in SBP and DBP values were found to be significantly higher in the propofol group (p < 0.05 for each). Conclusions The study results demonstrated that conscious sedation applied with midazolam during TEE can be applied with a shorter procedure duration and better hemodynamic and clinical results compared to sedation with propofol.

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