Background: Narrow fragmented QRS (fQRS) has recently been recognized as a significant predictor of prognosis in various cardiovascular diseases.Hypothesis: We hypothesized that the presence of narrow fQRS on admission electrocardiogram (ECG) in patients with decompensated systolic heart failure (HF) of any cause would be associated with long‐term prognosis.Methods: Patients hospitalized for decompensated HF due to ischemic or nonischemic dilated cardiomyopathy (left ventricular ejection fraction <35%) were retrospectively analyzed. The primary clinical end points were cardiovascular mortality, sudden cardiac death, and rehospitalization for HF.Results: The mean duration of follow‐up was 3.73 ± 1.41 years. Patients were classified as fQRS(+) group (n = 114; mean age, 63.49 ± 12.04 years) and fQRS(−) group (n = 113 patients; mean age, 65.04 ± 11.95 years). fQRS on ECG was significantly correlated with New York Heart Association (NYHA) functional class (P = 0.001). In multivariate Cox proportional hazard analysis, narrow fQRS (odds ratio [OR]: 3.130, 95% confidence interval [CI]: 1.560‐2.848, P = 0.001), chronic renal failure (OR: 2.455, 95% CI: 1.120‐5.381, P = 0.025), NYHA class (OR: 8.305, 95% CI: 2.568‐26.855, P < 0.0001), and hypoalbuminemia (OR: 2.099, 95% CI: 1.122‐3.926, P = 0.020) were independent predictors of cardiovascular mortality. In Kaplan‐Meier survival analysis, narrow fQRS on admission ECG predicted worse survival rate at 84 months; survival probability significantly decreased in the fQRS(+) group compared with fQRS(−) group (P < 0.0001).Conclusions: Presence of narrow fQRS is associated with worse NYHA functional class in patients hospitalized for decompensated HF. Narrow fQRS predicts cardiovascular mortality in a specific subgroup of systolic HF patients, namely those hospitalized for decompensated HF of both ischemic and nonischemic causes.

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 1, January–April 2023 16 AFRICA The impact of daily troponin I and D-dimer serum levels on mortality in

The aim of this study is to investigate the differences on admission troponin values among gender in hospital outcomes and in the 2-year follow-up period in coronavirus disease (COVID-19) patients. Data of 826 patients with moderate-to-severe COVID-19 disease were analyzed retrospectively. All patients had nasal and oropharyngeal swab samples taken according to Ministry of Health guidelines on admission. Patients were divided into female (n = 438) and male (n = 388) groups and were follow-up for 2 years. Clinical events such as need for intensive care unit, respiratory failure, need for inotropic initiation, acute renal failure, cardiac injury, and in-hospital mortality were also recorded. The cumulative endpoints were determined as all-cause mortality, re-hospitalization, and stroke during the 2-year follow-up period. Also, factors affecting the cumulative endpoints were investigated. In clinical events and cumulative endpoints, the differences of troponin values between the gender were investigated and the factors causing cardiac injury were determined separately in men and women. Mean age (59.43 ± 19.15 vs 58.14 ± 16.66) and comorbidities were significantly higher in the female group. There were no differences between genders in terms of clinical events except respiratory failure, which was more frequent in the male group (P = .016). In-hospital survivor rate in the female group was 16 ± 2.5 days (95% confidence interval: 11.08–20.91), in the male group was 14 ± 0.92 days (95% confidence interval: 12.18–15.81) P = .008, while there were no differences between groups among in-hospital morality rates (P = .208). During the 2-year follow-up period cumulative endpoints were more in the male group (P < .05). Troponin value in female ≥ 93 pg/mL, in male ≥ 28 pg/mL was related with cardiac injury. All clinical events occur at lower troponin values in the male group. In both groups, independent risk factors for in-hospital mortality were troponin and the existence of fragmented QRS; for cumulative endpoints were respiratory failure, cardiac injury, and age. We observed that in COVID-19 disease, troponin value differs by gender. A lesser increase in troponin levels in men was indicative of cardiac injury. Even slight increases in troponin levels in men should alert clinicians for cardiac injury and other clinical events.

Yurdumuzun birçok bölgesinden ve değişik hastanelerden değerli uzmanlarımızın hazırladığı bu vakalarla kardiyoloji kitabı umarım sizlerin beğenisini kazanır, yazarların emeği yerini bulur ve daha sonraki baskıları veya yeni kitaplar için cesaret verici olur. Bu arada kitap ile ile ilgili eleştirilerinizi yazıp gönderirseniz ilerdeki baskılar için yol gösterici olur. Kitapta göreceğiniz gibi ağırlık girişimsel kardiyoloji vakalarına ait. Bu da kardiyologların en çok hangi alanlarda çalıştıklarını ve ilgilendiklerini gösteriyor. Umarım sonraki baskılarda girişimsel olmayan, özellikle görüntüleme teknikleri ile ilgili yazılar da olacaktır.