Bu çalışma, Koronavirüs hastalığı-2019 (COVID-19) şüpheli veya kesin tanısı ile yatışı yapılan hastalarda kalp hızı değişkenliğinin (KHD) sağlıklı kontrollerle kıyaslanması ve proinflamatuvar sitokinler bağlamında değerlendirilmesi amacı ile tasarlandı. Gereç ve Yöntemler: Bu çalışmaya, 3 alt gruptan oluşan (53 kesin COVID-19 tanısı almış hasta, 42 şüpheli COVID-19 tanısı almış hasta ve 20 sağlıklı kontrol) toplam 115 denek dahil edildi. Hasta demografik özellikleri, inflamatuvar belirteçler (C-reaktif protein [CRP], D-Dimer, ferritin ve prokalsitonin) ve 24-saat Holter monitorizasyon parametrelerine ait veriler kaydedildi. Bulgular: Holter monitorizayonu parametrelerinin hiçbiri, şüpheli ve kesin COVID-19 tanısına sahip gruplar arasında anlamlı fark göstermedi. Şüpheli ve kesin COVID-19 tanılı her iki grupta, bütün NN intervallerinin standart sapması (SDNN, her biri için p<0,001) ve KHD triangular indeksi (her biri için p<0,001) değerleri kontrol grubu değerlerine göre anlamlı olarak daha düşük iken, ardışık normal NN intervalleri arasındaki farkların karekökü (RMSSD, her biri için p<0,001), düşük frekans (LF, sırasıyla p=0,001 ve p<0.001), yüksek frekans (HF, her biri için p<0,001) ve LF/HF oranı (her biri için p<0,001) değerleri kontrol grubu değerlerine göre anlamlı olarak daha yüksek bulundu. Prokalsitonin ve SDNN değerleri arasında pozitif korelasyon mevcuttu (r=0,227, p=0,044). Sonuç: Bulgularımız COVID-19 hastalarında KHD'nin hem zaman-bağımlı hem de frekans-bağımlı parametreler açısından önemli değişimler gösterdiğine ve bu değişimin viral yükten bağımsız olup, otonom sinir sistemi disfonksiyonu lehine olduğuna işaret etmektedir. Dolayısıyla bulgularımız, KHD'nin COVID-19 hastalarında altta yatan inflamatuvar sürece veya tedavi yan etkilerine bağlı gelişen otonom disfonksiyonun değerlendirilmesi açısından kullanışlı bir klinik araç olarak sitokin fırtınasının erken tahmini, tiraj, hastalık progresyonunun izlenmesi ve tedavi bakımından klinisyenlere yol gösterebileceği yönündedir.

We found that E/(Ea×Sa) and Ea/(Aa×Sa) indices are novel predictors of AF recurrence.

Objectives: Cardiac rehabilitation is known to have positive effects on the inflammatory processes. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were found to be indicative of inflammation. The purpose of this study is to determine the effects of cardiac rehabilitation on the NLR and PLR ratios of ST elevation myocardial infarction (STEMI) patients. Methods: The study includes 101 STEMI patients that underwent primary percutaneous coronary intervention (PCI). The patients were randomized into two groups: the cardiac rehabilitation group (CR group, n = 68), and the control group (n = 33). One month after primary PCI, cardiac rehabilitation was applied to CR group with cycle ergometer for 8 weeks (30 sessions). The NLR and PLR parameters were calculated from the complete blood count results from before and after the cardiac rehabilitation application for both groups. Results: When the baseline values of the two groups were evaluated, the hemoglobin value of the control group (13.10 ± 1.52 g/dL vs. 13.79 ± 1.26 g/dL; p = 0.03) and the PLR value of the CR group (122.50 ± 43.89 vs. 92.41 ± 23.70; p = 0.001) were significantly higher. The post-cardiac rehabilitation complete blood count parameters, and the NLR and PLR values were similar in both groups. The NLR (3.11 ± 1.95 vs 2.39 ± 1.03; p = 0.003) and PLR (122.50 ± 43.89 vs. 108.68 ± 41.83; p = 0.025) parameters significantly decreased after the cardiac rehabilitation application in the CR group, whereas there wasn't a change in the control group. Conclusion: It was found that cardiac rehabilitation applied in STEMI patients caused a significant decrease in NLR and PLR parameters, which are indicators of inflammation.

Aim: We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physicians’ recommendations on vaccination rates. Methods: This was a multicenter, observational, prospective cohort study. Patients over the age of 18 from 40 hospitals in different regions of Turkey who applied to the cardiology outpatient clinic between September 2022 and August 2021 participated. The vaccination rates were calculated within three months of follow-up from the admitting of the patient to cardiology clinics. Results: The 403 (18.2%) patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n = 1808) was 61.9 ± 12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor, and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The main differences between vaccinated and unvaccinated patients were related to education level and ejection fraction. The physicians’ recommendations were positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant correlation between vaccination and female sex [OR = 1.55 (95% CI = 1.25–1.92), p < 0.001], higher education level [OR = 1.49 (95% CI = 1.15–1.92), p = 0.002] patients’ knowledge [OR = 1.93 (95% CI = 1.56–2.40), p < 0.001], and their physician’s recommendation [OR = 5.12 (95% CI = 1.92–13.68), p = 0.001]. Conclusion: To increase adult immunization rates, especially among those with or at risk of cardiovascular disease (CVD), it is essential to understand each of these factors. Even if during COVID-19 pandemic, there is an increased awareness about vaccination, the vaccine acceptance level is not enough, still. Further studies and interventions are needed to improve public vaccination rates.