BackgroundWe sought to validate total atrial conduction time (TACT) measurement via tissue Doppler imaging (TDI) by comparing the electrophysiological study (EPS) measurements of healthy subjects, according to age and sex.MethodsEighty patients with normal EPS results were included. TACT was measured by EPS and TDI. For validation, the results of TDI were compared with those of EPS. TACT was assessed by measuring the time interval between the beginning of the P-wave on the surface ECG, and the peak A-wave on TDI from the left atrial lateral wall, just over the mitral annulus. Electrophysiological TACT was defined as the time from the high right atrial electrogram to the distal coronary sinus atrial electrogram around the left lateral portion of the mitral ring.ResultsEPS and TDI measurements of the TACT were significantly and positively correlated among men and women in 20–30 years (p=0.008, r=0.412; p>0.001, r=0.706, respectively), and those in the 30–40 years group (p=0.001, r=0.649; p=0.001, r=0.696). In contrast, EPS and TDI measurements of TACT were not significantly different among men and women in the 20–30 years and those in the 30–40 years group (p>0.05, for both). On univariate regression analyses, TACT was independently associated with age (β=0.342, =0.001).ConclusionsWhen assessed according to the age and sex of healthy participants, TDI and EPS measurements during TACT assessments were similar and correlated with each other. The measurement of TACT via TDI may be used accurately and confidently than the measurement via EPS in healthy individuals.

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In this study, we aimed to evaluate the relationship between TIMI myocardial perfusion (TMP) grade, as an indicator of myocardial reperfusion, and fragmented QRS (fQRS) in standard 12-lead electrocardiogram. Also, we evaluate fQRS is an additional indicator of myocardial reperfusion. One hundred patients admitted with first STEMI to Coronary Intensive Care Unit and who were used thrombolytic therapy was included in this retrospective study. Standard 12-lead electrocardiogram records of patients simultaneous with coronary angiography (second day) were assessed and analysed for the presence of fQRS. Also, coronary angiography images were analyzed to identify the infarct related artery, TIMI grade of infarct related artery and TMP grade of infarct related artery. The patients with fQRS demonstrated a significantly lower TMP grade, TIMI grade and ejection fraction compared with the non-fQRS patients (P = 0.004, P = 0.003, P = 0.02 respectively). The patients with inadequate myocardial reperfusion demonstrated a significantly higher fQRS compared with the adequate myocardial reperfusion patients. (56.9% versus 23.5%, P = 0.002 respectively). On correlation analysis, there was a significant negative correlation between fQRS and left ventricular ejection fraction (r = -232, P = 0.02) TMP grade and adequate myocardial reperfusion (TMP 3) showed significant negative correlation with fQRS (r = -0.370, P = 0.000; r = -0.318, P = 0.001 respectively). Presence of fragmented QRS in STEMI patients was associated with inadequate myocardial reperfusion and it can be used as a simple, noninvasive parameter to evaluate myocardial reperfusion.

The present study examined the heart rate turbulence (HRT) and heart rate variability (HRV) parameters in healthy young smokers (<40 years) to assess the effects of smoking on cardiac autonomic function. The study included 75 smokers with a history of habitual smoking for at least 1 year (41 males and 34 females; mean age, 29.3 ± 7.3 years) and 30 nonsmokers (hospital staff; 16 males and 14 females; mean age, 29.0 ± 6.1 years). Addiction to smoking was evaluated using the modified Fagerström test for nicotine-dependence index (NDI). HRT, HRV, basic clinical and echocardiographic, and Holter test parameters were compared between groups. No significant differences between the two groups were found in the basic clinical and echocardiographic variables. Turbulence onset (TO) was significantly higher in the smoking group than in the controls, and turbulence slope was significantly lower in the smokers, than in the controls (p < 0.05). Standard deviation of all normal-to-normal (NN) interval index (SDNNI) was the only HRV parameter that was significantly different between the smoking and control groups (p < 0.05). The NDI was positively correlated with the TO (p < 0.05). Smoking impairs the baroregulatory function in healthy young smokers, particularly the HRT parameters and SDNNI. Our findings highlight the importance of complete smoking cessation.

IntroductionThe aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension.Material and methodsA total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI).ResultsThe total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 ±2.43 vs. 2.33 ±1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 ±3.21 vs. 3.58 ±2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI.ConclusionsThis study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.

Early identification of diastolic dysfunction of patients with diabetes is important in preventing cardiac events. In this study, we aimed to show that both myocardial perfusion and diastolic function parameters can be evaluated in diabetic patients with possible silent cardiac symptoms using gated single-photon emission computed tomography (G-SPECT). We examined eighty patients: Forty with and forty without diabetes. The patients were compared in terms of systolic and diastolic parameters obtained using G-SPECT. 99mTc-sestamibi was used to obtain 8-frame images in each cardiac cycle, with calculation of the left ventricular ejection fraction (LVEF), peak filling rate (PFR), mean filling rate during the first third of diastolic time (MFR/3), and time to peak filling (TTPF) using the QGS software. G-SPECT results were compared in forty diabetic and forty nondiabetic patients of similar age and sex. Of the diastolic function parameters, PFR was found to be lower in patients with than without diabetes (2.31 ± 0.68 vs. 2.76 ± 0.68, respectively; P = 0.004). The TTPF and MFR/3 in both groups were similar. PFR was negatively correlated with end-diastolic volume and end-systolic volume (ESV) and positively correlated with LVEF. This correlation was stronger in patients with diabetes. The diastolic parameter PFR, obtained using G-SPECT, was significantly lower in patients with than without diabetes. We believe that these parameters should be noted for the early diagnosis or prevention of heart disease in patients with a risk of diastolic dysfunction.

Amaç: Bu çalışmanın amacı akut miyokard infarktüs (AMİ) geçiren hastalarda depresyon, anksiyete ve travma sonrası stres bozukluğu (TSSB) belirtilerini araştırmaktır. Çalışmamızda ruhsal belirtilerin klinik bulgular ile ilişkisi de incelenmiştir. Yöntem: Bu çalışmaya AMİ geçirdikten bir ay sonra kardiyoloji polikliniğine kontrol amaçlı gelen 50 hasta alınmıştır. Hastalara sosyodemografik form, Hastane Ankiyete-Depresyon (HAD) ve Travma Sonrası Stres Bozukluğu Kontrol Listesi (Sivil Sürümü) (PTSB-CL) ölçekleri doldurtulmuştur. AMİ sonrası TSSB belirtilerine yol açabilecek bedensel, fiziksel veya ruhsal olay yaşayan hastalar çalışmaya alınmamıştır. Bulgular: Hastaların anksiyete ölçeğinin ortalama puanı 8.7±4.3 olarak bulundu. Anksiyete ölçeğinin kesme puanına göre değerlendirme yapıldığında; hastaların % 26'sının anksiyete bozukluğu olabileceği gösterildi. Depresyon ölçeğinin ortalama puanı 7.2±3.6 idi ve ölçeğin kesme puanına göre hastaların % 36'sında (n=18) depresif bozukluk olabileceği saptandı. PCL-C ölçeğinin ortalama puanı 22.1±5.1 idi. Hastaların % 24'ü PCL-C ölçeğine göre kesme puanının üzerinde bir değerdeydi ve bu hastalarda TSSB olasılığı düşünüldü. Sonuç: Bu çalışmada AMİ geçiren hastalarda yüksek oranda TSSB belirtileri saptanmıştır. Hastanede yatış süresi ve taburculuk sonrası anjina şikayetleri TSSB belirtileri ile ilişkili bulunmuştur. AMİ geçiren hastalarda depresif bulguların yanı sıra TSSB belirtilerine de dikkat edilmesi gerektiğini düşünmekteyiz.

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