No abstract

There is an increase in the number of older persons worldwide. Because of this in the future we will much more manage the diseases which are more commonly seen in elderly in daily practice. One of the mortal diseases commonly seen in elderly patients is aortic aneurysm. Aort aneurysms are vary rare in patients under 50 age. When a patient over 65 age is examined, aortic aneurysm should take place in differential diagnosis list. aneurysm may be seen at both thoracic and abdominal aorta, but abdominal aorta is a more common site. Risk factors for aortic aneurysms are similar with coronary artery disease risk factors. Clinically aneurysms may be asymptomatic, symptomatic or ruptured. Asymptomatic patients are diagnosed either accidentally or after screening. Patients with aortic aneurysm should be followed up at certain intervals according to aneurysm diameter, growth rate and concomitant diseases. During this period, necessary life style modification and medical treatament should be recommended. Finally, if the aneurysm diameter reaches at high levels to be ruptured, consideringly both anatomical convenience of aorta and surgical risk of the patient either open surgical repair or endovascular repair is decided.

Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: ≥50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5±3.1 years) aged ≥80 years and 4596 patients (male, 50.2 %; mean age, 71.1±4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were ≥80 years and 27.1% for patients 65–79 years old. For patients aged ≥80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65–79 years, 43.9% (548) had HFpEF, and 56.1% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged ≥80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.

Blood pressure (BP) normally decreases during sleep, and certain metabolic and cardiovascular alterations may affect this circadian pattern. 1 Leading reasons for a non-dipping BP pattern are obesity, sleep disorders, obstructive sleep apnea, chronic kidney disease, excessive salt consumption, diabetes mellitus, orthostatic hypotension, autonomic dysfunction, and advanced age. 2 An arbitrary cut-off point has been proposed to define patients as "dippers" if their nocturnal BP falls by ≥10% of the daytime mean BP value. 2 A non-dipper BP pattern is associated with high cardiovascular mortality and morbidity in people with both normal BP and hypertension. 3,4 In recent years, hematological parameters such as the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR), and systemic immune-inflammation index (SII) have been investigated in different systemic diseases as indicators of inflammation. [5][6][7][8][9][10][11][12] Although studies are searching for

Introduction: Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden death in eligible patients. However, it is thought that there is a relationship between the ICD shocks and increased morbidity and mortality. In this study, we examined the relationship between ICD shocks and the CHA 2 DS 2 -VASc scoring, which has gained frequent use in predicting cardiac events recently. Material and Methods: Retrospective baseline characteristics and three-year follow-ups of patients with ICDswith appropriate indication were studied. Patients were divided into two groups: patients who have received ICD shock(s) and patients who have not received any ICD shock. These groups were compared for baseline characteristics and CHA 2 DS 2 -VASc scores.Results: CHA 2 DS 2 -VASc scores of heart failure (HF) patients in our study population were significantly higher than those who did not receive any shock within three years following the ICD implantation. The rate of appropriate or inappropriate ICD shocks was %16 in the HF patients implanted with ICD for primary prevention while it was %66 in patients implanted with ICD for secondary prevention. The incidence of atrial fibrillation was 68% in 37 patients who received inappropriate shock while it was 7% in those who did not receive inappropriate shock (those who received appropriate shocks or did not receive any shock) (p<0.001). Conclusion:In conclusion, this study demonstrated a relation between the CHA 2 DS 2 -VASc score and appropriate and inappropriate ICD shocks. The CHA 2 DS 2 -VASc score is a simple tool that may predict ICD shocks.