Background: Prolongation of the peak and the end of T wave (Tp-e) has been reported to be associated with ventricular arrhythmias. Tp-e/QT ratio and Tp-e/QTc ratio are used as an index of ventricular arrhythmogenesis. An increased incidence of ventricular arrhythmias has been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess ventricular repolarization in patients with OSA by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.Methods: We have studied 72 patients who underwent overnight polysomnography (PSG) between the years 2010-2011 at our institution. Patients with moderate and severe OSA (23 patients; mean age: 45 ± 10), according to the apnea-hypopnea index, constituted the study group. Patients with normal PSG (23 patients; mean age: 42 ± 11) were used as the control group. In all patients, Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, as well as some other electrocardiogram intervals were measured. Independent samples t-tests were used for comparison of continuous and categorical variables and correlations were calculated by Spearman rank correlation.Results: Although QT and QTc intervals were not different between the groups, mean Tp-e interval (81.6 ± 11.1 msn; 63.9 ± 7.3 msn; respectively; P < 0.001), Tp-e/QT ratio (0.21 ± 0.03; 0.17 ± 0.02; respectively; P < 0.001), and Tp-e/QTc ratio (0.20 ± 0.03; 0.16 ± 0.02; respectively; P < 0.001) were prolonged in the study group compared to the control group. Correlation analysis showed a significant positive correlation between the presence of moderate and severe OSA and Tp-e interval (r = 0.72; P < 0.001), Tpe/QT ratio (r = 0.70; P < 0.001), and Tp-e/QTc ratio (r = 0.70; P < 0.001). Conclusions:Address for reprints: Alptug Tokatli, M.D., GATA Haydarpasa Egitim Hastanesi, Kardiyoloji servisi, Uskudar-34668; Istanbul, Turkey. Fax: 90 0 212 296 75 12;

Neutrophil-lymphocyte ratio, an emerging marker of inflammation, was independently associated with the presence of LA thrombus in patients with nonvalvular AF.

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INTROduCTION According to the World Health Organization, the number of diabetic patients will increase from 135 million in 1995 to 300 million in the first quarter of the 21st century. In Turkey, 5.2% of the population in 1995 had diabetes and it is estimated that this proportion will have reached 7.2% by 2025. 1 It is known that diabetes increases the risk of coronary artery disease, stroke, blindness, kidney failure, leg amputation, and early death. 2,3 Scientific evidence shows that diabetes-related complications may be prevented if a good metabolic control is achieved. 4,5 To achieve good metabolic control, it is important not only to measure glycated hemo globin (HbA 1c) levels regularly, but also to educate patients on diabetes. Sufficient knowledge can be acquired in diabetes education programs, 6-8 which not only develop patients' awareness and understanding of the disease and strengthen motivation and self-care, but also reduce the economic costs of diabetes treatment by preventing complications. 8 Despite clear evidence on the benefits of tight glycemic control in diabetics, 4,5 many patients are not able to reach an optimal glycemic target and thus fail to significantly reduce a long-term cardiovascular risk. 9,10 Moreover, it has been shown that inadequate knowledge about diabetes

Objective: To investigate whether or not the CHA₂DS₂-VASc score predicts left atrial (LA) thrombus detected on pre-cardioversion transoesophageal echocardiography (TEE). Materials and Methods: The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation (AF). The CHA₂DS₂-VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study. Results: A total of 309 patients were identified. The mean age was 70.1 ± 9.8 years and 151 (49%) patients were males and 158 (51%) were females. LA thrombus was seen in 32 (10.3%) of the 309 patients. Fifty (16.2%) patients had a low CHA₂DS₂-VASc score (0-1), 230 (74.4%) had an intermediate score (2-4) and 29 (9.4%) had a high score (5-9). The incidence of LA thrombus in the low, intermediate and high CHA₂DS₂-VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA₂DS₂-VASc scores. On multivariate logistic analysis, the CHA₂DS₂-VASc score (OR 3.26, 95% CI 2.3-4.65; p = 0.001) and age (OR 0.93, 95% CI 0.88-0.98; p = 0.004) were independent risk factors for LA thrombus in patients with non-valvular AF. Conclusion: A high CHA₂DS₂-VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF.