Increased microvascular resistance due to chronic inflammation is assumed to be one of the mechanisms associated with coronary slow flow (CSF). Previous studies have shown that the platelet-to-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation for various diseases. In this study we aimed to evaluate the relationship between CSF and PLR-NLR. Seventy-eight patients with CSF and 50 patients with normal coronary flow were enrolled into this study. The study subjects underwent medical examination and testing, after which their platelet-to-lymphocyte ratios and NLR values were calculated. An independent observer measured the coronary flow rate by Thrombolysis in Myocardial Infarction Frame Count (TFC) method. The platelet-to-lymphocyte ratio and NLR values were compared between the groups and correlation analysis was performed to explore the relationship between mean TFC with PLR and NLR. Platelet-to-lymphocyte ratio and NLR values were significantly higher in patients with CSF (p < 0.001). There was a positive significant correlation between TFC with NLR and PLR (Spearman’s Rho: 0.59, p < 0.001 and Spearman’s Rho: 0.30, p = 0.001, respectively). Multivariate logistic regression analysis revealed that NLR is the one independent predictor for CSF. This study demonstrated an association between CSF and PLR-NLR. Although the exact mechanism could not be explained, our findings support the possible role of inflammation in CSF physiopathology.

Background and Objectives: Aortic stenosis (AS) is a widespread valvular disease in developed countries, primarily among the elderly. Transcatheter aortic valve replacement (TAVR) has become a viable alternative to aortic valve surgery for patients with severe AS who are deemed a high surgical risk or for whom the AS is found to be inoperable. Predicting outcomes after TAVR is essential. The Naples Prognostic Score (NPS) is a new scoring method that evaluates nutritional status and inflammation. Our study is aims to examine the relationship between the NPS and outcomes for patients receiving TAVR. Material and Methods: We conducted a retrospective study of 370 patients who underwent TAVR across three tertiary medical centres from March 2019 to March 2023. The patients were divided into two groups based on their NPS, namely, low (0, 1, and 2) and high (3 and 4). Our study is primarily aimed to determine the one-year mortality rate. Results: Within one year, the mortality rate for the entire group was 8.6%. Nonetheless, the low-NPS group had a rate of 5.0%, whereas the high-NPS group had a rate of 13%. The difference between the two groups was statistically significant, with a p-value of 0.06. Conclusions: Our results show that NPS is an independent predictor of one-year mortality in patients undergoing TAVR.

Background and Objectives: In-stent restenosis (ISR) is a major problem in patients undergoing percutaneous coronary intervention. The prognostic nutritional index (PNI) is a nutritional status score used in the literature to determine the prognosis of coronary artery disease. In this study, we aimed to investigate the effect of preprocedural PNI values on the risk of ISR in patients with stable coronary artery disease who underwent successful percutaneous coronary intervention. Materials and Methods: This retrospective study included 809 patients. Stent restenosis was evaluated in the follow-up coronary angiography of the patients due to stable angina pectoris or acute coronary syndrome. The patients were divided into two groups based on those with (n = 236) and without (n = 573) in-stent restenosis, and their nutritional status was compared with PNI. The PNI values before the first angiography of the patients were calculated. Results: The mean PNI score was significantly lower in patients with ISR than in those without ISR (49.5 vs. 52.3, p < 0.001). Concerning the results of the Cox regression hazard model for predictors of ISR, PNI was significantly associated with the development of ISR (HR = 0.932, 95% CI: 0.909–0.956, p < 0.001). In addition, stent type, stent length, and diabetes mellitus were associated with the development of ISR. Conclusions: A low PNI value indicates poor nutritional status, which is thought to accelerate inflammation processes and cause atherosclerosis and ISR.

A 53-year-old man presented with angina pectoris and ST-segment elevation in V(1)-V(4) leads. Electrocardiogram changes and chest pain were completely resolved with nitroglycerine infusion. Coronary angiogram revealed normal epicardial vessels. These findings suggest that the acute myocardial ischemia was secondary to coronary vasospasm. From his medical history we learned that he was taking L-thyroxine and the dose had been increased two months previously. He was found to be in thyrotoxic state at admission. L-thyroxine treatment was withheld and diltiazem was given. He had no further symptoms. In conclusion we think that acute myocardial ischemia was likely secondary to L-thyroxine-induced coronary spasm.

Purpose We aimed to investigate the role of QRS duration on the surface electrocardiogram (ECG) in predicting response to levosimendan therapy in patients with acute systolic heart failure. Methods Patients with an ejection fraction (EF) lower than 35% who required intravenous inotropic support despite optimal heart failure therapy were included in this study. Patients were divided into two groups according to QRS durations on ECG. Group 1 (n = 16) included patients with a QRS duration equal to or shorter than 120 ms and group 2 (n = 14) included patients with a QRS duration longer than 120 ms. New York Heart Association (NYHA) functional class, plasma BNP levels and echocardiographic measurements were compared within and between groups before and after the infusion. Results In both groups statistically significant improvement was observed in NYHA class, plasma BNP levels and left ventricular end-systolic diameter after the levosimendan infusion compared to baseline (P < 0.025). In addition, in group 1 patients, left atrial diameter, left atrial volume, left ventricular end-diastolic diameter, left ventricular end-diastolic volume, left ventricular end-systolic volume (LVESV), left ventricular EF, mitral E velocity, mitral annular Aa and Sa parameters improved after the infusion compared to the baseline values (P < 0.025). Comparison of both groups revealed improvement of NYHA class, an increase of left ventricular EF and a signficant decrease of LVESV after levosimendan in group 1 (P < 0.05). Conclusion QRS duration on ECG may be used as a practical bedside indicator in estimating short-term response to levosimendan therapy.

Amaç: Mikrovasküler angina, epikardiyal koroner arterlerde tıkayıcı lezyon olmaksızın, eforla göğüs ağrısı, elektrokardiyografik değişiklikler, myokardiyal iskeminin objektif olarak gösterilmesi ve koroner epikardiyal spazmın ekarte edilmesi ile tanı konan klinik bir durumdur. Etiyoloji tam olarak aydınlatılmamış olsa da kronik inflamasyon ile ilişkisi ortaya konmuştur. Eozinofil/lenfosit oranı nispeten yeni bir inflamatuar belirteçtir ve sistemik hastalıklarda prognoz ve advers etkiler ile ilişkisi gösterilmiştir. Biz bu çalışmamızda mikrovasküler angina tanısı alış hastalarda eosinofil/lenfosit oranını araştırıp koroner arter hastalığı olmayan bireyler ile karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamıza göğüs ağrısı şikâyeti ile kardiyoloji polikliniğine başvurup, miyokard perfüzyon sintigrafisinde miyokardiyal iskemi tespit edilen ve yapılan koroner anjiografide tıkayıcı koroner arter lezyonu saptanmayan 96 hasta alındı. Kontrol grubuna ise genel kontrol için başvurmuş, anginal yakınması ve elektrokardiyografik değişikliği olmayan 80 hasta dahil edildi. Bulgular: Her iki gruptaki hastalar bazal karakteristik özellikler açısından benzerdi. Mikrovasküler angina grubunda eozinofil/lenfosit oranı 0.108 ± 0.102; kontrol grubunda ise 0.068 ± 0.048 idi ve gruplar arasındaki fark istatistiksel olarak anlamlı idi (p=0.02). Her iki grup arasında diğer kan parametreleri açısından fark tespit edilmedi. Sonuç: Bu çalışmamızda mikrovasküler angina tanısı almış hastalarda eozinofil/lenfosit oranının sağlıklı bireylere göre anlamlı olarak daha yüksek olduğunu tespit ettik. Bulgularımız kronik inflamasyonun özellikle de eozinofillerin mikrovasküler angina patogenezinde önemli rol oynadığını göstermiş olup daha önce yapılan çalışmaları desteklemektedir. Bununla birlikte çalışmamız bu hasta popülasyonunda eozinofil/lenfosit oranını değerlendiren ilk çalışma olma özelliği taşımaktadır.