T1 mapping and echocardiographic GLS can serve to guide endomyocardial biopsy selectively.

Objective:Resistin, a cysteine-rich peptide, is associated with atherosclerosis and diabetes. Resistin levels increase corresponding to coronary artery disease (CAD) and heart failure severity. Since resistin level tends to elevate with symptomatic heart failure, it is expected to be associated with left ventricular end-diastolic pressure (LVEDP). However, there is no relevant literature on the relationship between resistin levels and LVEDP. We aimed to evaluate the association between resistin levels and LVEDP, severity of CAD, carotid intima-media thickness (CIMT), and echocardiographic diastolic dysfunction parameters.Methods:For this study, 128 euvolemic patients with creatinine clearance >50 mg/dL and without acute coronary syndrome, who had typical chest pain or were stress test positive, were enrolled. Resistin level was measured by Enzyme-linked immunosorbent assays (ELISA) method. Severe CAD is defined as ≥50% stenosis in one of the major coronary arteries. LVEDP was measured during left heart catheterization.Results:After coronary angiography, 60 patients (46.9%) had severe CAD. The mean LVEDPs were similar for patients with and without severe CAD (p=0.480). The resistin levels did not differ between the groups (p=0.154). The resistin levels did not correlate with LVEDP (r=−0.045, p=0.627), ejection fraction (EF; r=0.110, p=0.228), the Gensini score (r=−0.091, p=0.328), and CIMT (r=0.082, p=0.457). No significant correlation was found between the echocardiographic diastolic dysfunction parameters and resistin levels.Conclusion:There was no significant correlation between resistin level and LVEDP, CAD severity, echocardiographic diastolic dysfunction parameters, and CIMT. Further studies are warranted to determine the efficacy of resistin in clinical use.

Amaç: COVID-19 hastalarının yönetimindeki önemli gelişmelere rağmen, tedaviyi yönlendirecek, hastalık şiddetini öngören belirteçlere ihtiyaç vardır. Biz de bu çalışmada; C-reaktif protein/Albumin (CRP/Alb) oranının hastalık şiddeti ile ilişkisini ve yoğun bakım ihtiyacını tahmin etmedeki rolünü değerlendirmeyi amaçladık. Materyal ve metod: Ocak 2021 ile Haziran 2021 tarihleri arasında hastanemizde COVID-19 enfeksiyonu nedeniyle takip edilen hastaların klinik bulguları, laboratuar sonuçları ve akciğer bilgisayarlı tomografisi retrospektif olarak incelendi. Toplam 131 hasta ve benzer yaş ve cinsiyetteki 81 sağlıklı kontrol grubu çalışmaya dahil edildi. CRP, albumin ve CRP/Alb oranı verileri analiz edildi ve COVID-19 hastaları ile sağlıklı kontrol grubu arasında karşılaştırıldı. Bulgular: COVID-19 hastaları ile sağlıklı kontrol grubunun yaş ortalaması ve cinsiyet dağılımı benzerdi (sırası ile p= 0.1 p= 0.31). COVID-19 hastalarının CRP/Alb oranı kontrol grubuna göre anlamlı yüksekti (p< 0.009). COVID-19 hastaları klinik durumlarına göre kritik ve non-kritik olarak sınıflandırıldığında; kritik hastalar non-kritik hastalara göre daha yaşlı (p< 0.001) ve CRP/Alb oranı daha yüksekti (p<0.001). Yapılan ROC analizinde CRP/Alb oranı cut-off 14.7 mg/dl alındığında 89% duyarlılıkla ve 91% özgüllük ile COVID-19 kritik klinik durumu predikte etti. Sonuç: Sonuç olarak, CRP/Alb oranı, rutin olarak kullanılabilecek pratik, ucuz ve kolay erişilebilir bir testdir. Çalışmamızda; CRP/Alb oranı yoğun bakım ihtiyacı olan kritik COVID-19 hastalarını ayırt etmede potansiyel bir parametre olarak tespit edilmiştir.

No abstract

Objectives: Residual pulmonary hypertension challenges the right ventricular function and worsens the prognosis in heart transplant recipients. The complex geometry of the right ventricle complicates estimation of its function with conventional transthoracic echocardiography. We evaluated right ventricular function in heart transplant recipients with the use of 3-dimensional echocardiography in relation to systolic pulmonary artery pressure. Materials and Methods:We performed 32 studies in 26 heart transplant patients, with 6 patients having 2 studies at different time points with different pressures and thus included. Right atrial volume, tricuspid annular plane systolic excursion, peak systolic annular velocity, fractional area change, and 2-dimensional speckle tracking longitudinal strain were obtained by 2-dimensional and tissue Doppler imaging. Threedimensional right ventricular volumes, ejection fraction, and 3-dimensional right ventricular strain were obtained from the 3-dimensional data set by echocardiographers. Systolic pulmonary artery pressure was obtained during right heart catheterization. Results: Overall mean systolic pulmonary artery pressure was 26±7 mm Hg (range, 14-44 mmHg). Three-dimensional end-diastolic (r = 0.75; P < .001) and end-systolic volumes (r = 0.55; P = .001)correlated well with systolic pulmonary artery pressure. Right ventricular ejection fraction and right atrium volume also significantly correlated with systolic pulmonary artery pressure (r = 0.49 and P = .01 for both). However, right ventricular 2-and 3-dimensional strain, tricuspid annular plane systolic excursion, and tricuspid annular velocity did not. Conclusions:The effects of pulmonary hemodynamic burden on right ventricular function are better estimated by a 3-dimensional volume evaluation than with 3-dimensional longitudinal strain and other 2-dimensional and tissue Doppler measurements. These results suggest that the peculiar anatomy of the right ventricle necessitates 3-dimensional volume quan tification in heart transplant recipients in relation to residual pulmonary hypertension.