Fundamento: Não há estudos avaliando o intervalo T pico-T fim (Tpe), a relação Tpe/QT e a relação Tpe/QTc para avaliar arritmias cardíacas em pacientes com COVID-19. Objetivo: Visamos investigar se há alterações nos intervalos QT, QTc e Tpe e nas relações Tpe/QT e Tpe/QTc em pacientes com COVID-19. Métodos: O estudo incluiu 90 pacientes com infecção por COVID-19 e 30 controles saudáveis pareados por sexo e idade. Foram aferidos os intervalos QT, QTc e Tpe e as relações Tpe/QT e Tpe/QTc. Os participantes incluídos no estudo foram divididos nos seguintes 4 grupos: controles saudáveis (grupo I), pacientes com COVID-19 sem pneumonia (grupo II), pacientes com COVID-19 e pneumonia leve (grupo III) e pacientes com COVID-19 e pneumonia grave (grupo IV). Significância estatística foi definida por valor p < 0,05. Resultados: Verificou-se que a frequência cardíaca basal, a presença de hipertensão e diabetes, a contagem de leucócitos, o nitrogênio ureico no sangue, a creatinina, o potássio, o aspartato aminotransferase, a alanina aminotransferase, o NT-proBNP, a proteína C reativa de alta sensibilidade, o dímero-D, a TncI-as, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc aumentaram do grupo I para o grupo IV e foram significativamente mais altos em todos os pacientes do grupo IV (p < 0,05). A pressão arterial sistólica, a hemoglobina e os níveis de cálcio eram menores no grupo IV e significativamente menores em comparação com os demais grupos (< 0,05). Os intervalos QT e QTc eram semelhantes entre grupos. Determinou-se que os níveis elevados de frequência cardíaca, cálcio, dímero-D, NT-proBNP e PCR-as eram significativamente relacionados a Tpe, Tpe/QT e Tpe/QTc. Conclusões: Em pacientes com COVID-19 e pneumonia grave, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc, que estão entre os parâmetros de repolarização ventricular, foram aumentados, sem prolongação dos intervalos QT e QTc. A partir deste estudo, não podemos definitivamente concluir que as alterações eletrocardiográficas observadas estão diretamente relacionadas à infecção por COVID-19 ou à inflamação, mas sim associadas a cenários graves de COVID-19, que podem envolver outras causas de inflamação e comorbidades.
Nonalcoholic fatty liver disease is very common in patients with polycystic ovary syndrome (PCOS). In patients with PCOS, the clinical use of liver stiffness (LS) and whether LS increases or decreases are still unclear. The purpose of this study was to determine the parameters related to LS and whether there is an increase in LS in patients with PCOS compared with healthy controls. Thirty-eight women diagnosed with PCOS according to Rotterdam criteria and 28 healthy ageand sex-matched controls were included in this study. In addition to routine follow-up parameters for all patients, serum homeostatic model assessment of insulin resistance (HOMA-IR) and complement C1q/ tumor necrosis factor-related protein 3 (CTRP3) levels were measured, and point shear wave elastography was performed. Body mass index; waist circumference; systolic blood pressure; serum glucose, alanine aminotransferase, highly sensitive C-reactive protein, and dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels; and luteinizing hormone/follicle-stimulating hormone ratio were higher in PCOS group compared with healthy controls (P < 0.05). Serum CTRP3 levels were lower in patients with PCOS (P < 0.05). Liver stiffness value was significantly higher in PCOS group than healthy controls (P < 0.001). Positive correlation was found between LS and waist circumference as well as calcium, dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels (P < 0.05 for each one). Negative correlation was found between LS and CTRP (P < 0.01 for each one). In linear regression analysis, only CTRP3 level was found to be related to LS (P < 0.001 and β = 0.734). Liver stiffness value obtained by point shear wave elastography increases in patients with PCOS compared with healthy controls and is closely and negatively related to serum CTRP3 levels.
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experience syncope and present with signs of cardiomyopathy and heart failure as a result of nonsustained ventricular tachycardia (VT), sustained VT, or ventricular fibrillation, caused by PVCs. Triggering factors of PVCs include stress, dehydration, caffeine and alcohol consumption, medical treatment, hormonal cycles in women, and poor sleep quality (PSQ). 3 In daily practice, PSQ is frequently associated with PVCs and it is often overlooked that PSQ may occur due to PVCs. In the routine evaluation of patients with PVCs, lifestyle changes INTRODUCTION Premature ventricular contractions (PVCs) are a very common arrhythmia in clinical practice. In the general population, it has been seen in 1% to 4% of patients on electrocardiography (ECG) and in 40% to 75% on 24-hour Holter ECG. 1,2 This condition, which is generally benign, may cause sudden cardiac death in patients with structural heart disease. Numerous patients with PVCs are asymptomatic. Those symptomatic complain of palpitations, dizziness, near-syncope, dyspnea, chest pain, and fatigue. Apart from that, patients may
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: Radiofrequency catheter ablation (RFA) treatment is applied in patients with symptomatic supraventricular tachycardia (SVT). It is known that the frequency of SVT increases in patients with poor sleep quality (PSQ). However, especially in patients with frequent SVT episodes at night, PSQ occurrence and the effect of RFA therapy on PSQ have not been evaluated. The aim of this study was to evaluate PSQ in patients undergoing RFA treatment due to SVT and detect the effect of RFA treatment on PSQ. Material and Methods:This cross-sectional study included 153 patients who underwent RF ablation with a diagnosis of SVT in our clinic. Self-reported sleep quality was carried out in all patients in addition to routine examinations before ablation and at the first month control. The effect of RFA treatment on self-reported sleep quality in patients with SVT was evaluated.Results: Patients with SVT had a PSQ of 66%. RFA treatment in patients with SVT was shown to positively and significantly reduce subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, daytime dysfunction, and global Pittsburgh Sleep Quality Index (PSQI) (54%) (p< 0.001). Conclusion:PSQ is common in patients with SVT, and PSQ improves significantly with RF ablation therapy. While evaluating patients with SVT, it should be kept in mind that PSQ may have occurred especially due to SVT and that presence of PSQ increases SVT incidence. Also, as a result of the data obtained, we believe that performing subjective sleep quality test in addition to complaints of palpatation would be beneficial in questioning whether SVT patients are symptomatic or not.
The apelinergic system plays an important role in the modulation of the cardiovascular system via the apelin peptide and the apelin receptor (APJ receptor). Apelin and elabela, also known toddler, are peptide ligands for the apelin receptor. These two peptides show similar biological actions, such as vasodilatation, increased myocardial contractility, angiogenesis, and energy metabolism. However, the serum levels of elabela in patients with hyperthyroidism are not well known. The aim of this study was to investigate the changes in serum elabela levels in patients with hyperthyroidism and its association with hypertension. This cross-sectional study included 74 patients with newly diagnosed hyperthyroidism due to Graves' disease and 20 healthy individuals. Serum elabela levels were measured by enzyme-linked immunosorbent assay. The patients were divided into two groups: hyperthyroid patients without hypertension (n = 51) and those with hypertension (n = 23). Basal heart rate, serum glucose and highsensitive C reactive protein were significantly higher in hyperthyroid patients with and those without hypertension than in healthy controls (p < 0.05 for each). Serum elabela levels were significantly elevated in hyperthyroid patients compared with healthy controls, with higher serum elabela levels found in hyperthyroid patients with hypertension than those without hypertension. Linear regression analysis showed that serum elabela levels were correlated with systolic blood pressure (p < 0.001). In conclusion, serum elabela levels were significantly increased in patients with hyperthyroidism, especially in hyperthyroid patients with hypertension. Elevation in serum elabela levels may contribute to alleviation of cardiovascular complications of hyperthyroidism and hypertension.
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