Aims: Primary hyperparathyroidism (PHPT) is a clinical entity characterized by hypercalcemia caused by excessive parathyroid hormone (PTH) secretion from the parathyroid gland and is the most common cause of hypercalcemia in outpatient clinics. Atrial fibrillation (AF) is a common arrhythmia encountered in cardiology practice, the prevalence of which increases with concomitant heart disease and age. P-wave peak time (PWPT) is the time from the onset of the p-wave to its peak and is a recently defined electrocardiographic (ECG) parameter. Recently, studies on the relationship between PWPT and cardiovascular events have been published. In this study, we aimed to evaluate the risk of AF in PHPT patients by detecting PWPT, a new ECG parameter. Methods: The study included 21 PHPT patients and 20 healthy subjects as a control group. The groups were compared in terms of demographic characteristics, laboratory findings, echocardiography, and ECG findings. D2 and V1 leads were used for PWPT, as recommended in the literature. Results: When the patient group was compared with the control group, no difference was detected in terms of demographic characteristics and laboratory findings. When compared with the control group, patients with PHPT had significantly longer PWPT (PWPTV1 56.07 msec ± 8.33 s vs. 50.25 msec ± 7.00 s p<0.05, PWPTD2 54.57 msec ± 6.28 msec vs. 48.05 msec ± 5.91 msec p<0.01). Conclusion: We observed that PWPT was longer in patients with PHPT compared to controls, and our results suggest that PHPT patients are at risk of AF.

Aim: Inflammation is very important in the pathogenesis of atherosclerosis and CAD. Chronic total occlusion (CTO) is a chronic form of CAD and is common in patients with severe CAD. The aim of this study was to determine the association of the systemic inflammatory response index (SIRI), a marker of inflammation, with CTO. Materials and Methods: Our study was retrospective and included 100 CAD patients with CTO and 100 CAD patients without CTO. SIRI was compared between the two groups. Results: Among the basic clinical and laboratory characteristics of the patients, age, white blood cell, and neutrophil counts were statistically higher in the CTO group (p=0.044, p=0.044, p=0.036, respectively). SIRI parameters were similar between the groups, and no statistical difference was observed (p=0.111). According to the ROC analysis, the optimum cut-off value for SIRI was >1040 (sensitivity 70.0% and specificity 44.0%). Conclusion: SIRI is not a useful predictor for the detection of CTO.

Dissection of the left main coronary artery (LMCA) during diagnostic coronary angiography is a rare but catastrophic event with a poor prognosis. Immediate reperfusion with hemodynamic support should be the primary goal in patients who develop impaired blood flow distal to the acute LMCA and the first option is coronary artery by-pass grafting. We present a 37-year-old female patient in the postpartum period who was admitted to the emergency department because of chest pain and was urgently admitted to our catheterization laboratory with the diagnosis of NONSTMI. During coronary angiography, the patient developed a dissection that started with the left main coronary artery and progressed to the circumflex and left descending artery. The patient was successfully treated with emergency percutaneous intervention.

The exercise electrocardiography test (EET) is still used before coronary angiography in the diagnosis of chronic coronary syndromes. This study aimed to demonstrate the value of the combination of a positive EET with the systemic inflammatory index (SII), the plasma atherogenic index (PAI), and the monocyte/HDL-C ratio (MHR) in the determination of obstructive coronary artery disease (CAD). This single-center, retrospective study included 540 patients who underwent coronary angiography after ETT. The patients were separated into Group 1, comprising 434 patients with normal coronary arteries and non-obstructive CAD, and Group 2, including 106 with obstructive CAD. In Group 2, the patients were separated into SYNTAX ≤ 22 or ≥23. Glucose, low-density lipoprotein, white blood cells, and MHR were determined to be significantly higher in Group 2 (p < 0.05). According to the multivariate logistic regression analysis, age, gender, diabetes mellitus, and low-density lipoprotein were determined to be independent predictors of CAD. In the ROC curve analysis, a cut-off value of 12 for the MHR in the determination of obstructive CAD had a sensitivity of 60.4% and a specificity of 53.0%. The main result of this study was that a high MHR is an indicator of obstructive CAD in patients with positive EET and suspected CAD.

Background: Right-sided cardiac abnormalities and venous congestion may contribute to the development of type 1 cardiorenal syndrome (CRS) in acute decompensated heart failure (ADHF). However, the association between myocardial deformation assessed early after admission and subsequent type 1 CRS remains insufficiently characterized. We investigated the associations of right ventricular (RV) free-wall and interventricular septal longitudinal strain with the development of type 1 CRS in patients hospitalized with ADHF. Methods: This prospective, single-center observational cohort study included patients admitted to the coronary care unit with ADHF. Transthoracic echocardiography was performed within 24 h of admission, and renal function was monitored for 7 days. Type 1 CRS was defined as the development of acute kidney injury according to the serum creatinine component of the Kidney Disease: Improving Global Outcomes criteria. RV free-wall and interventricular septal longitudinal strain were evaluated separately using multivariable logistic regression models adjusted for age, baseline estimated glomerular filtration rate, and log₂-transformed N-terminal pro-B-type natriuretic peptide. Results: Among 84 patients included in the final analysis, 40 developed type 1 CRS and 44 did not. Patients who developed CRS had larger RV basal diameter and RV areas, lower fractional area change, and less-negative RV free-wall and interventricular septal strain values. Greater absolute RV free-wall strain magnitude was independently associated with lower odds of CRS (odds ratio [OR] per 1-percentage-point increase, 0.555; 95% confidence interval [CI], 0.418–0.735; p < 0.001). Greater absolute interventricular septal strain magnitude was also independently associated with lower odds of CRS (OR, 0.491; 95% CI, 0.348–0.691; p < 0.001). Both associations remained significant in exploratory sensitivity analyses additionally including fractional area change or RV basal diameter. Conclusions: Less-negative RV free-wall and interventricular septal longitudinal strain measured early after admission were independently associated with the development of type 1 CRS in patients with ADHF. These findings suggest that myocardial deformation assessment may provide complementary information for early cardiorenal risk characterization; however, validation in larger multicenter cohorts is required.