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Background and Objectives: Studies have shown that inflammation markers can be used as prognostic tools in predicting acute ischemic stroke. In this study, we conducted a comparison of several inflammation scores in predicting left atrial thrombosis (LAT) in patients with ischemic stroke without AF. Materials and Methods: In this single-center, retrospective study, we included 303 consecutive patients with ischemic stroke. Each patient underwent a transesophageal echocardiography (TEE) examination within 10 days of admission to detect the presence of LAT. To identify independent predictors of LAT, we conducted a multivariate logistic regression analysis. Results: In total, 303 patients who had ischemic stroke were included in the analysis. LAT was detached in 34 patients at the time of the TEE examination. The patients were categorized into two groups based on their LAT status. The Prognostic Nutritional Index (PNI), HALP score, and C-reactive Protein–Albumin Ratio (CAR) were identified as statistically significant predictors of LAT. Based on the results of the multivariate regression analysis, the CAR emerged as the only independent predictor of LAT. Conclusions: Among several inflammation scores, the PNI, HALP, and CAR were statistically significant predictors of LAT in ischemic stroke patients without AF. CAR was identified as the optimal score for the prediction of LAT in patients with stroke and without AF.

Background Single-photon emission computed tomography (SPECT) analysis relies on qualitative visual assessment or semi-quantitative measures like total perfusion deficit that play a critical role in the non-invasive diagnosis of coronary artery disease by assessing regional blood flow abnormalities. Recently, machine learning (ML) -based analysis of SPECT images for coronary artery disease diagnosis has shown promise, with its utility in predicting long-term patient outcomes (prognosis) remaining an active area of investigation. In this review, we comprehensively examine the current landscape of ML-based analysis of SPECT imaging with an emphasis on prognostication of coronary artery disease. Main body Our systematic search yielded twelve retrospective studies, investigating SPECT-based ML models for prognostic prediction in coronary artery disease patients, with a total sample size of 73,023 individuals. Several of these studies demonstrate the superior prognostic capabilities of ML models over traditional logistic regression (LR) models and total perfusion deficit, especially when incorporating demographic data alongside SPECT imaging. Meta-analysis of 6 studies revealed promising performance of the included ML models, with sensitivity and specificity exceeding 65% for major adverse cardiovascular events and all-cause mortality. Notably, the integration of demographic information with SPECT imaging in ML frameworks shows statistically significant improvements in prognostic performance. Conclusion Our review suggests that ML models either independently or in combination with demographic data enhance prognostic prediction in coronary artery disease.

Pulmonary hypertension (PH) is characterized by increased pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) due to loss of arterial elasticity and vascular obstruction. The dicrotic notch index (DNI) represents reflected wave characteristics and vascular elasticity, potentially serving as an important marker in PH assessment. This study evaluates the relationship between DNI and PVR, PAPs, and other hemodynamic and clinical parameters in PH patients. A retrospective analysis was conducted on 76 patients diagnosed with pulmonary arterial hypertension (PAH), chronic thromboembolic pulmonary hypertension (CTEPH), or normal PAPs who underwent right heart catheterization (RHC). PAP waveforms were analyzed to determine DNI. Correlations between DNI and hemodynamic, clinical, and echocardiographic parameters were assessed using Pearson's correlation coefficient. Logistic regression and ROC analysis were performed to evaluate the DNI's predictive value. DNI showed significant positive correlations with systolic PAP (sPAP) ( = 0.972, < 0.001), diastolic PAP (dPAP) ( = 0.876, < 0.001), mean PAP (mPAP) ( = 0.987, < 0.001), right atrial (RA) pressure ( = 0.741, = 0.018), and PVR ( = 0.814, < 0.001). Significant negative correlations were observed with cardiac index (CI) ( = -0.573, = 0.012) and pSO ( = -0.516, = 0.043). Univariable logistic regression identified DNI as a significant predictor of PH (O = 1.100, 95% CI: 1.048-1.155, < 0.001). ROC analysis showed an AUC of 0.922 for DNI, indicating excellent predictive value. DNI is correlated with key hemodynamic parameters such as PVR and mPAP, underscoring its potential as a crucial marker in the assessment of PAH and CTEPH patients. Additionally, DNI exhibited significant correlations with echocardiographic measurements and clinical indicators, suggesting its utility in evaluating pulmonary arterial stiffness and resistance. Further research is needed to validate these findings in larger cohorts and to establish standardized protocols for DNI measurement in clinical practice.

Objective: Erectile dysfunction (ED) and cardiovascular disease share common vascular pathologies, particularly endothelial dysfunction and atherosclerosis. Growing evidence indicates that ED may serve as an early indicator of underlying cardiac abnormalities, particularly diastolic dysfunction (DD), even in the absence of clinically apparent cardiovascular disease. Method: This prospective, single-center study included 87 patients with ED, matched with 53 healthy controls based on age and body mass index. The severity of ED was assessed using the International Index of Erectile Function (IIEF) and categorized as mild, moderate, or severe. Diastolic dysfunction was evaluated according to established guidelines. Results: Patients with ED exhibited significant impairments in left ventricular diastolic function, including reduced E/A and e' velocities, prolonged isovolumetric relaxation time (IVRT), and left atrial (LA) enlargement. A correlation was observed between the severity of ED and worsening right ventricular (RV) diastolic indices, specifically reduced RV e' and elevated RV E/e' ratios. Notably, LA enlargement and prolonged IVRT emerged as independent predictors of ED. Conclusion: Erectile dysfunction is independently associated with subclinical biventricular DD, even in the absence of overt cardiovascular disease. Echocardiography may help detect subclinical cardiac dysfunction in men with ED and improve cardiovascular risk assessment. Keywords: Diastolic dysfunction, erectile dysfunction, transthoracic echocardiography Amac: Erektil disfonksiyon (ED) ile kardiyovaskuler hastaliklar, ozellikle endotel disfonksiyonu ve ateroskleroz gibi benzer vaskuler patolojileri paylasmaktadir. Artan kanitlar, klinik kardiyovaskuler hastalik bulunmasa dahi, ED'nin altta yatan kardiyak anormalliklerin, ozellikle diyastolik disfonksiyonun (DD) erken bir belirtisi olabilecegini gostermektedir. Yontem: Bu prospektif, tek merkezli calismada, yas ve beden kitle indeksi acisindan eslestirilmis 87 ED hastasi ile 53 saglikli birey karsilastirilmistir. ED siddeti, Uluslararasi Erektil Fonksiyon Indeksi (IIEF) kullanilarak degerlendirilmis ve hafif, orta ve agir ED olarak siniflandirilmistir. Diyastolik fonksiyon, kilavuzlara uygun sekilde ekokardiyografi ile degerlendirilmistir. Bulgular: ED'li hastalarda sol ventrikul DD'sinde anlamli bozulmalar gozlenmistir; bunlar azalmis E/A ve e' hizlari, uzamis interventrikuler gevseme suresi (IVRT) ve sol atriyum (LA) genislemesi ile karakterizedir. ED siddetindeki artisla birlikte, sag ventrikul (RV) diyastolik parametrelerinde bozulmalar (dusuk RV e', artmis RV E/e' orani) arasinda korelasyon saptanmistir. Ozellikle LA genislemesi ve IVRT, ED'nin bagimsiz belirleyicileri olarak tanimlanmistir. Sonuc: ED, belirgin kardiyovaskuler hastalik olmasa bile subklinik biventrikuler DD ile bagimsiz olarak iliskilidir. ED'li erkeklerde transtorasik ekokardiyografi ile yapilacak degerlendirme, gizli kardiyak disfonksiyonun erken saptanmasina katki saglayabilir ve kardiyovaskuler risk degerlendirmesini iyilestirebilir. Anahtar Kelimeler: Diyastolik disfonksiyon, erektil disfonksiyon, transtorasik ekokardiyografi

Background Inflammatory markers have been proposed as prognostic tools for predicting in-hospital mortality in infective endocarditis (IE). Nonetheless, it is unclear whether these markers provide additional prognostic value over established indicators. This study compared nine different inflammation scores to assess their effectiveness in enhancing the prediction of in-hospital mortality. Methods Patients with IE diagnosed between 2017 and 2023 at two cardiology centers in Istanbul were included in this study. Pre-treatment inflammatory markers were obtained from the hospital electronic database system. In-hospital mortality prognostication was assessed using Cox proportional hazards models. Results A total of 122 patients who were diagnosed with IE were included in the analysis. Overall, 38 patients died during the hospital stay. The patients were categorized into two groups based on their mortality status. The prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were identified as statistically significant predictors of in-hospital mortality. Based on the results of Cox regression analysis, the PNI (hazard ratio [HR]: 0.921, 95% confidence interval [CI]: 0.853–0.994, p  = 0.035) emerged as the only independent predictor of in-hospital mortality of IE patients. Conclusion Nine inflammatory scores were evaluated in this study. The PNI, PLR, and mGPS were statistically significant predictors of in-hospital mortality in patients with IE. The PNI was identified as the optimal score.

Objective: Individuals across all age groups may experience elevated blood pressure due to a combination of internal and environmental factors. Factors influencing arterial pressure include diet, stress, sleep patterns, and lifestyle. This study aims to investigate the susceptibility to high blood pressure among occupational groups working night shifts. Method: The study included healthcare worker participants who had at least six night shifts per month. A control group consisted of participants performing the same roles during daytime. Participants with chronic diseases or those taking blood pressure-affecting medication were excluded. Holter recordings were made over a minimum of 48 hours, including both a free day and a work day. Results: The study involved 114 participants–55 in the study group and 59 in the control group. Statistically significant differences were noted between the groups in the daylight-night ratios of systolic and diastolic pressures, with P values of 0.006 and 0.005, respectively. The systolic daylight-night difference was -5.7 [+ or -] 5.5% in the study group and -9.0 [+ or -] 7.0% in the control group. The diastolic daylight-night difference was -7.9 [+ or -] 9.6% in the study group and -12.7 [+ or -] 8.2% in the control group. Conclusion: Occupations with nighttime work schedules are often associated with non-dipping blood pressure patterns due to sleep disturbances. It is crucial to consider the blunted dipping of blood pressure induced by night shift work when assessing and monitoring hypertension and related medical conditions. Keywords: Blood pressure, night shift, cardiovascular risk, healthcare workers, hypertension Amac: Tum yas gruplarindaki bireyler hem internal hem de cevresel faktorlerin birlesiminin bir sonucu olarak yuksek kan basincina maruz kalabilirler. Arteriyel basinc diyet, stres, uyku duzeni ve yasam tarzi gibi cesitli faktorlerden etkilenir. Bu calismada gece calisan meslek gruplarinda yuksek tansiyona yatkinligin gozlemlenmesini amacladik. Yontem: Calismamizi ayda en az 6 gece nobeti olan saglik calisani katilimcilari ile tasarladik. Gunduz saatlerinde ayni isi yapan katilimcilar kontrol grubuna dahil edildi. Herhangi bir kronik hastalik veya tansiyonu etkileyen ilac kullanimi katilimcilari calisma disi birakti. Holter kayitlari 48 saat yapildi ve bu sure katilimcilarin hem bos gununu hem de calisma gununu kapsiyordu. Bulgular: Bu calismada, 55'i calisma grubunda, 59'u kontrol grubu olmak uzere toplam 114 katilimci takip edildi. Katilimcilarin sistolik ve diyastolik basinclarinin gunduz-gece oranlamalari arasinda istatistiksel olarak anlamli farkliliklar gozlendi (sirasiyla P degerleri, 0,006 ve 0,005). Sistolik gunduz-sistolik gece degisimi calisma grubunda %-5,7 [+ or -] 5,5, kontrol grubunda ise %-9,0 [+ or -] 7,0 idi. Diyastolik gunduz- diastolik gece degisimi calisma grubunda -%7,9 [+ or -] 9,6, kontrol grubunda ise %-12,7 [+ or -] 8,2 idi. Sonuc: Gece vardiyasi iceren meslekler, uyku bozukluklarinin bir sonucu olarak siklikla non dipper olarak tanimlanan kan basinci modelleri sergileyebilir. Gece vardiyasinda calismanin neden oldugu korelmis dipping kan basincinin dikkate alinmasi, uzun donemde hipertansiyonun ve iliskili tibbi durumlarin degerlendirilmesi ve izlenmesinde onem arz eden bir unsur olarak goze carpmaktadir. Anahtar Kelimeler: Kan basinci, gece vardiyasi, kardiyovaskuler risk, saglik calisanlari, hipertansiyon

OBJECTIVEIndividuals across all age groups may experience elevated blood pressure due to a combination of internal and environmental factors. Factors influencing arterial pressure include diet, stress, sleep patterns, and lifestyle. This study aims to investigate the susceptibility to high blood pressure among occupational groups working night shifts.METHODThe study included healthcare worker participants who had at least six night shifts per month. A control group consisted of participants performing the same roles during daytime. Participants with chronic diseases or those taking blood pressure-affecting medication were excluded. Holter recordings were made over a minimum of 48 hours, including both a free day and a work day.RESULTSThe study involved 114 participants—55 in the study group and 59 in the control group. Statistically significant differences were noted between the groups in the daylight-night ratios of systolic and diastolic pressures, with P values of 0.006 and 0.005, respectively. The systolic daylight-night difference was -5.7 ± 5.5% in the study group and -9.0 ± 7.0% in the control group. The diastolic daylight-night difference was -7.9 ± 9.6% in the study group and -12.7 ± 8.2% in the control group.CONCLUSIONOccupations with nighttime work schedules are often associated with non-dipping blood pressure patterns due to sleep disturbances. It is crucial to consider the blunted dipping of blood pressure induced by night shift work when assessing and monitoring hypertension and related medical conditions.