Objective Stroke is the leading cause of mortality and long-term disabilities worldwide. In addition to clinical presentation, many scoring systems and various laboratory values have been associated with predicting prognosis. In this study, we aimed to investigate the relationship between the aortic knob width (AKW) and prognosis in people presenting to the emergency department with stroke. Material and Methods Three hundred fifty-two patients, who admitted to the emergency department of our hospital with acute ischemic (206 males, 146 females, mean age, 68.3±13.3 years) stroke were included to the study. The number of patients who died in the hospital were recorded. Those who were discharged were followed up and called from the central information system and by phone, and it was recorded whether they were exitus within 3 months. AKW were obtained from the chest radiographies of the patients. Results Total of 95 patients became exitus during their hospitalization and within the 3 months to follow. Two groups were created; group 1: 95 patients that became exitus (48 males, 47 females; mean age 75.5±11.8 years); group 2: 257 patients (158 males, 99 females, mean age 65.6±12.7 years). AKW was significantly higher in group 1 as compared to group 2 (44.1±6.9 vs. 39.7±7.6 mm; p<0.001). When the AKW value was correlated with scoring systems, there was a weak but significant correlation. Multivariate logistic regression analysis revealed, AKW was one of the independent predictors of mortality. For AKW predicting in-hospital mortality, cut-off value was 42.05 mm with 72.7% sensitivity and 65.4% specificity. Conclusion AKW, which can be easily obtained from chest radiography, can also be correlated with 3 months mortality and prognosis in stroke patients. The patients with a finding of AKW over 42.05 mm may be correlated with a poorer outcome

Objective Non-dipper blood pressure (NDBP) pattern is associated with end-organ damage and cardiovascular mortality. Predicting and managing the NDBP pattern can prevent cardiovascular adverse events.The study aims to investigate the relationship between NDBP pattern and aortic valve sclerosis (AVS) detected during routine echocardiography in hypertensive patients. Material and Methods A total of 222 patients using at least one antihypertensive drug were included in the study. The patients were divided into two groups as dipper and NDBP pattern according to ambulatory blood pressure monitoring (ABPM). NDBP pattern was defined as reducing night systolic BP by <10% compared to daytime systolic BP. Patients outside this definition were defined as dipper hypertensives. AVS was defined as the thickening or calcification in the semilunar cusps, without stenosis in transthoracic echocardiography. Results The average age of patients with the NDBP pattern was 68.21±6.22, while it was 66.80±5.38 for patients with dipper BP pattern (p=0.075). As a result of ABPM, dipper BP (45%) was detected in 100 patients, and NDBP (55%) was detected in 122 patients. AVS was detected in 39 patients (17.6%), and the majority of them were in the NDBP group (3.6% vs. 14%, p<0.001). As a result of multivariate regression analysis, the only independent predictor of the NDBP pattern was AVS (odds ratio =3,078, 95% confidence interval 1.280-7.403, p=0.012) Conclusion In hypertensive patients, AVS detected by transthoracic echocardiography is associated with NDBP. The presence of AVS may be an essential factor in the detection of the NDBP pattern, that is closely related to major cardiovascular events.

Objective In our study, we examined the relationship between cardiac arrhythmia predictive parameters and migraine. The clinical symptoms of migraine are generally attributed to involvement of the autonomic nervous system, particularly the disruption of circulatory control and autonomic balance. Migraine is a common neurovascular disease with a complex relationship with cerebrovascular and cardiovascular disorders. It can cause cardiac arrhythmias by affecting the autonomic nervous system of the heart with its neurological and vascular components Material and Methods Patients who had been followed up with migraine for at least three years were included in the study. Patients with a history of cardiac arrhythmia or those using any antiarrhythmics were excluded from the study. All patients were in sinus rhythm and electrocardiogram records were examined and PWST, Tp-e, Tp-e/QTc and electrophysiological balance index-c (ICEB-c) were compared with the control group. Results PWST, Tp-e, Tp-e/QTc and ICEB-c parameters, which are predictive of cardiac arrhythmia, did not show statistical differences in migraine patients (p-value 0.301, 0.967, 0.982 and 0.814 respectively). Conclusion Migraine, a disorder characterized by both neurological and vascular degeneration, does not possess a specific risk factor for cardiac arrhythmia. There is no significant difference in electrophysiological characteristics that can be used to predict cardiac arrhythmia in patients who have been followed up for a long period.

Objective Although coronavirus disease-2019 (COVID-19) primarily affects the respiratory system, it can also affect other systems. Cardiovascular effects in COVID-19 disease are common in hospitalized patients, and it has been shown that myocardial damage, pericarditis and pericardial effusion (PE) may develop. In our study, we aimed to evaluate the frequency and clinical significance of PE that may develop secondary to COVID-19 infection. Material and Methods Thoracic computed tomography images of 989 consecutive COVID-19 patients, who remained after assessing the exclusion criteria, were evaluated. The presence of patients’ non-physiological PE was examined by a radiologist blinded to the study data. The patients were divided into two groups as those with and without PE. The presence of myocardial injury was defined according to hs-TnI levels (=34 ng/dL). Results PE was observed in 125 patients (12.6%). Sixty-three (50.4%) of the patients with PE were female, and there was no difference in terms of PE between the genders (p=0.315). The mean age of patients with PE was 72.8±14.3 years, while it was 64.8±14.9 years in patients without effusion (p<0.001). The frequency of myocardial injury was found to be higher in the group with PE (33.6% vs. 21.4%, p=0.023). In the group with PE (pulmonary embolism), the mortality rate was 36%, while it was 25% in the group without PE (p=0.009). In the group of patients who experienced mortality, age >65, male gender, hypertension, chronic obstructive pulmonary disease, chronic kidney failure, coronary artery disease, heart failure, atrial fibrillation, severe lung parenchymal involvement on CT, and presence of myocardial injury were observed at higher rates (all p-values <0.05). Conclusion The presence of PE in hospitalized COVID-19 patients may develop due to either a systemic inflammatory response or direct myocardial injury. Mortality was observed more frequently in this patient group. The presence of PE can be used as a mortality risk predictor in COVID-19 patents, so its routine evaluation in tomography is recommended.

Objective Atherosclerotic coronary artery disease is a major health problem worldwide. Endothelial dysfunction in atherosclerosis is considered a precursor phenomenon of atherosclerosis. In this inflammatory process, many mediators interact with each other and influence the formation of atherosclerosis in the vascular bed. Asymmetric dimethylarginine (ADMA) appears to cause vascular damage by reducing nitric oxide (NO) amounts. Oxidized-low-density lipoprotein (LDL) induces the protein arginine methyl transferase enzyme, which enables ADMA synthesis; it also increases ADMA levels by inhibiting the enzyme dimethylarginine dimethylaminohydrolase, which breaks down ADMA, thus indirectly reducing NO synthesis. Ox-LDL is formed through the process of lipid peroxidation, and measurement of malondialdehyde (MDA) in biological material is used as an indicator of lipid peroxide levels. In our study, the relationship between the levels of the mentioned enzymes and coronary artery disease was examined. Material and Methods In our study, ADMA and symmetric dimethylarginine (SDMA), high-pressure liquid chromatography (HPLC) method (Eureka kit); Ox-LDL, ELISA method (Immunodiagnostic kit); and MDA levels were measured by HPLC (Immuchrom kit)-spectrophotometric methods. The relationship of these parameters both between the groups and with each other was evaluated. The patient population was selected from patients who presented to the cardiology outpatient clinic with chest pain and were found to have evidence of ischemia on a non-invasive stress test. Results The low total cholesterol and LDL values in the severe coronary artery disease (CAD) group were attributed to the effect of statin use. It is possible that statin-type drugs used in severe CAD groups reduce lipid levels as well as ADMA levels. We think that low ADMA levels will be effective in reducing the negative effects of ADMA on the vascular bed. This hypothesis needs to be supported by larger-scale studies. Conclusion According to the statistical results of the study, in terms of ADMA, SDMA, Ox-LDL and MDA levels; there was no statistically significant difference between the control group with normal coronary arteries and the groups with minimal and severe coronary artery disease (p>0.05).

Pulmonary hypertension (PH) is a progressive vascular disease characterized by right ventricular failure and high mortality rates. Monotherapy in treatment strategies has shown limited efficacy, leading to an increasing emphasis on combination therapy approaches. Combination therapy involves the concurrent use of agents targeting different pathways, such as endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclin analogs. This approach can result in significant reductions in vascular resistance, improvements in quality of life, and a slowing of disease progression. Recent clinical studies have demonstrated that combination therapy is superior to monotherapy in both hemodynamic parameters and long-term patient outcomes. This review aims to explore the efficacy, safety, and potential future research areas of combination strategies in the treatment of PH.