Background In heart failure (HF), various biomarkers have been established for prognosis. However, little is known about the relevance of copeptin measurements to HF. This study aimed to explore the prognostic value of copeptin for predicting cardiovascular (CV) death or HF-related re-hospitalisation in patients with acute decompensated HF. Materials and Methods We prospectively enrolled 155 consecutive patients with acute signs and symptoms of HF. Plasma copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission. Patients were monitored for 90 days regarding the composite endpoint of CV death or acute HF-related re-hospitalisation. Results Of the 155 patients enrolled, 40 reached the endpoint, and 115 were in a stable condition during follow-up. Patients who reached an adverse endpoint showed higher NT-proBNP and copeptin levels compared to patients in stable condition. Receiver operating characteristic curve analysis revealed that the area under curve of copeptin 0.844 (95% CI, 0.753-0.935) was superior to that of NT-proBNP 0.809 (95% CI, 0.729-0.890) for the prediction of adverse events within 90 days. Meanwhile, compared to the group with lower copeptin levels (= 34 pmol/L) were at a 10.672-times higher risk of CV death or acute HF-related re-hospitalisation. Multivariate Cox proportional hazards regression analysis revealed that increased copeptin level was a significantly independent predictor of adverse events (risk ratio, 1.051; 95% CI, 1.020-1.083;p < 0.001). Conclusion Copeptin was found to be a strong, novel marker for predicting CV death or HF-related re-hospitalisation in patients with acute decompensated HF.

Introduction: Ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening conditions which increase in frequency over the years. Electrical storm (ES) is defined as the occurrence of 3 or more continuous ventricular arrhythmia. The sympathetic nervous system has an important role in Ventricular arrythmias (VA) and is the target of treatment. Studies show that stellate ganglion blockade (SGB) can reduce cardiac sympathetic tone and is an alternative bridge therapy in VAs. Patient concerns: Among the patients who were admitted to the hospital with the complaints of general condition disorder and palpitation. Diagnosis: Patients were referred to the Cardiology department and diagnosed VA and ES. Patients who applied to the Cardiology Department with the diagnosis of VA or ES and did not benefit from antiarrhythmic drug therapy were selected and evaluated by a team of 2 anesthesiologists (cardiothoracic and pain specialists) and 2 cardiologists (1 of whom is an electrophysiology specialist). Intervention: In our study, ultrasound (USG) guided left SGB was applied to 10 VA and ES patients with implantable cardiac defibrillator (ICD). The 6-month results of the patients were evaluated retrospectively. For blockage, the solution was prepared by adding 8 mg dexamethasone, 40 mg lidocaine and 10 mg bupivacaine to 10 mL with physiological saline. The success of the procedure was evaluated with the development of Horner syndrome in the left eye. Outcomes: Resistant VA developed in 2 of 10 patients who had left SGB due to VF/VT ES and were excluded from the study. One (1) month after the procedure it was seen that there was a statistically significant decrease in the number of shocks in 8 patients in the 6th month controls compared to the pre-procedure. The number of VES in the 1st and 6th months of the patients was also statistically significantly decreased compared to the pre-SSD (P = .01, P = .01, P = .01, respectively). Conclusion: Unilateral USG-guided SGB application is an effective and safe method in patients with ES and VA. Long-term results can be satisfactory in successful responders in whom SGB is performed with a combination of local anesthetic and steroid.

Aim: Obesity is associated with structural and functional cardiac abnormalities, including left ventricular hypertrophy, diastolic dysfunction, and subclinical myocardial impairment. Global longitudinal strain (GLS) is a sensitive marker for detecting early myocardial impairment before changes in left ventricular ejection fraction (LVEF) occur. This study aimed to evaluate the early effects of laparoscopic sleeve gastrectomy (LSG) on cardiac remodeling and myocardial mechanics using conventional and speckle-tracking echocardiography.Methods: This retrospective single-center study included 66 patients with severe obesity who underwent LSG. Clinical, metabolic, and echocardiographic parameters were evaluated before surgery and at a mean follow-up of approximately 3-6 months. Conventional and speckle-tracking echocardiography were used to assess left ventricular structure and myocardial mechanics. Preoperative and postoperative parameters were compared using paired-samples t-test.Results: The mean age was 36.9 ± 11.7 years, and 75.8% of patients were female. Following LSG, significant reductions were observed in body weight, body mass index, and blood pressure (all p

Sodium–glucose cotransporter-2 (SGLT2) inhibitors reduce cardiorenal events, but their association with insulin resistance in routine care is incompletely characterised, particularly where medication records cannot exclude exogenous insulin use. In this prospective, single-arm, single-centre cohort study, 54 adults with type 2 diabetes initiating an SGLT2 inhibitor were assessed at baseline, 3 and 6 months. Outcomes were HOMA-IR and the insulin-independent triglyceride–glucose (TyG) index within a family of 15 metabolic and laboratory variables, tested by Wilcoxon signed-rank test with Benjamini–Hochberg control and summarised as the rank-biserial correlation. Median HOMA-IR fell from 8.38 (IQR 3.47–13.26) to 3.14 (2.19–4.39), −62.6% (r = −0.79, adjusted p < 0.001), and the TyG index from 9.45 to 9.04 (−4.3%, r = −0.63, adjusted p < 0.001). Haemoglobin rose 5.0%, consistent with plasma-volume contraction. Change in HOMA-IR did not track change in HbA1c (ρ = −0.15, p = 0.27). An exploratory kidney-disease × time interaction was nominally significant for TyG (β = +0.31, p = 0.040) but not log-HOMA-IR (β = +0.39, p = 0.077). Because the design was single-arm and confounders unrecorded, these are associations observed during therapy, not treatment effects. The divergence between insulin-dependent and insulin-independent indices is relevant to endpoint selection in controlled studies.

Objective: Contrast-induced nephropathy (CIN) is a clinically relevant complication of percutaneous coronary intervention (PCI), particularly in acute coronary syndrome (ACS). Calculated plasma osmolality (PO), derived from routine laboratory measurements, may reflect fluid and solute disturbances associated with renal vulnerability. This study evaluated the relationship between admission PO and CIN in patients with ACS undergoing PCI.Methods: This retrospective, single-center study included 542 patients with ACS who underwent coronary angiography and PCI between January 2016 and December 2017. The cohort comprised 81 patients with unstable angina pectoris, 288 with non-ST-segment elevation myocardial infarction, and 173 with ST-segment elevation myocardial infarction. PO was calculated from admission sodium, glucose, and blood urea nitrogen levels. CIN was defined as an absolute increase of ≥0.5 mg/dL or a relative increase of ≥25% in serum creatinine within 72 hours after contrast exposure. Associated factors were examined using multivariable logistic regression.Results: CIN developed in 62 patients (11.4%). Admission PO was higher among patients who developed CIN than among those who did not (295.4 [290.9–302.3] vs. 287.7 [283.4–292.6] mOsm/kg H₂O, p