Introduction: Diabetes mellitus is one of the major risk factors for coronary artery disease. Intravascular ultrasound (IVUS) imaging has an important role in the evaluation of atherosclerotic coronary artery disease. The aim of the study was to investigate the potential link between diabetes mellitus and plaque vulnerability in patients with coronary artery disease. Methods: In total, 26 patients with acute coronary syndrome (eight with diabetes mellitus) and 34 with stable angina pectoris (16 with diabetes mellitus) constituted the study population. Patients underwent IVUS ultrasound and virtual histology (VH)-IVUS imaging during routine diagnostic catheterization procedures. A total of 70 plaques in 60 patients were examined. Results: Patients with diabetes mellitus had a significantly greater percentage of fibrofatty components in the minimal lumen area (MLA) (17 ± 12 in diabetics; 12 ± 6 in non-diabetics; p=0.06). Thin-cap fibroatheromas were more frequent in patients with diabetes mellitus (72% versus 45%; p=0.012). There was a positive correlation between the presence of attenuated plaque and hemoglobin A1C (HbA1c) levels as well (7.09 ± 1.66 versus 6.02 ± 1.00; p=0.011). Patients with HbA1C ≥7.5% also had the highest prevalence of attenuated plaque. Conclusion: As shown by VH-IVUS, the prevalence of vulnerable plaques in patients with diabetes mellitus was much higher than that in non-diabetic patients. The presence of attenuated plaque detected in grayscale intravascular ultrasonography was associated with high HbA1C levels in diabetic patients. Diabetes mellitus may cause cardiovascular vulnerability by changing the plaque morphology.

İntroduction: Systemic inflammation resulting from comorbidities such as arterial hypertension, diabetes, and obesity is responsible for the pathogenesis of myocardial structural and functional changes in heart failure. The neutrophil-to-lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) are novel biomarkers of inflammation. The aim of this study was to evaluate the relationship between blood NLR and PLR levels and one-year cardiac mortality in primary prevention patients with left ventricular ejection fraction (LVEF) ≤35%, using an intracardiac defibrillator. Methods: A total of 180 compensated heart failure patients with LVEF<35% (ischemic or nonischemic) and implantable cardioverter-defibrillator (ICD) therapy for primary prevention who applied to the cardiology outpatient clinic of Zonguldak Bülent Ecevit Üniversitesi Hospital, Zonguldak, Türkiye, between March 2018 and June 2019 were consecutively included. The patients were followed for one year after the application. Results: In the multivariate logistic regression analysis model, only NLR (OR: 1.328; 95%CI: 1.129-1.563; p <0.01) was found independently associated with the risk of one-year cardiovascular mortality. Based on the NLR, levels were 2.69 ng/ml, and the area under the curve was found to be 0.795 (95%CI: 0.729-0.862) in the evaluation made with the receiver operating characteristic curve. Conclusion: High NLR ratio levels independently predicted one-year cardiac mortality in patients with LVEF<35% and ICD for secondary protection. Large-scale randomized studies are needed to fully demonstrate the relationship between NLR levels and cardiovascular mortality in patients with severe left ventricular dysfunction and ICD.

Purpose: Exercise capacity is associated with diastolic function. The aim of our study is to investigate the short-term effects of cardiopulmonary rehabilitation and NMES on functional capacity and myocardial tissue doppler (MTD) after coronary artery surgery. Methods: Forty patients with coronary artery bypass graft were randomly divided into two groups: CPR+NMES and CPR. Functional capacity were analyzed through 2 minutes walk test (2MWT) and sit to stand test (SST), left ventricular (LV) diastolic functions were analyzed with MTD and thoracic expansion was analyzed with chest wall measurement on the 2nd and 7th postoperative days. Results: Statistically significant difference was identified between the groups in 2MWT distance (CPR+NMES, Zt*p=0.000*), SST (CPR, Zt*p=0.000*), E' (CPR+NMES, Zt*p=0.002*), E (CPR+NMES, Zt*p=0.025*), E/E' (CPR+NMES, Zt*p=0.007*), A (CPR, Zt*p=0.006*) (p<0.05). Statistically significant difference has been observed in group comparisons in E' (CPR+NMES, G*p=0.000*) ve E/E'(CPR+NMES, G*p=0.007* postoperative 2nd day; G*p=0.019* postoperative 7th day) (p0.05), except for E'(Zg*p=0.000*), E/E' (Zg*p=0.003*) parameters (p<0.05). Conclusion: It was seen that NMES, which we applied in addition to early cardiopulmonary rehabilitation, made a positive contribution to LV filling pressure and LV filling rate in the CPR+NMES group. Additionally, in the intergroup comparisons of the CPR+NMES group, it was observed that there was a statistically significant increase in the 2 MWT distance on the postoperative 7th day compared to the postoperative 2nd day.

Bilgi üreten Üniversiteler, mütemadiyen güncelledikleri bilgi ile eğitimlerini sürdürmekte; dolayısıyla bir yandan toplumun refahına katkı sağlarken diğer yandan da kendi geleceklerini güvence altına almaktadır. Bilginin güncellenmesi yeni ve derinlikli araştırmalarla mümkündür. Derinlikli araştırma ise alan hakimiyetine ve bilimsel araştırma yeteneğine bağlıdır. Bu imkanı sağlayacak olanlar ise biritecrübeli bilim insanı, diğeri de alan hakimiyetini kolaylaştıracak olan temel bilgi kitaplarıdır.Dünyanın Covid-19 pandemisiyle uğraştığı bir dönemde hekimlerimizin yükü katlanarak artmıştır. Görev ve sorumluluk bilinciyle kendilerini korumayı ikinci planda değerlendiren hekimlerimizin, bu yoğun iş yükü altında akademik metin üretimine zaman ayırmaları ve tıp camiasında başvuru kitabı olarak işlev üstlenecek böyle bir eseri literatüre kazandırmaları her türlü takdirin üstündedir. Eserinortak bir çalışmanın ürünü olarak gün yüzüne çıkmış olması, daha nitelikli eserlerin habercisi olarak değerlendirdiğimiz için, gelecek açısından bizi ümitledirmektedir.