Aims: Resistant hypertension (RHT) accounts for 10-15% of hypertensive patients, and diagnosis and treatment are more complex in these cases, which means a higher risk of cardiovascular complications. Although the effect of chronic systemic inflammation on the pathophysiology of RHT is known, the effective use of biomarkers is limited. This study investigated the relationship between the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), which are composite inflammatory indices that can be used as markers of chronic inflammation, and RHT, testing their clinical utility and predictive value. Methods: Between April 2022 and January 2025, 256 hypertensive patients followed up at our clinic were defined as having controlled hypertension (CHT) and 244 as having RHT, for a total of 500 patients included in this cross-sectional study. SII and SIRI values were calculated from routine blood count results. Data were analyzed and compared using multivariate logistic regression, quartile analysis, limited cubic spline modeling, and receiver operating characteristic (ROC) curve analysis. Results: Significantly higher SII (480.2 vs. 361.7, p

Background: Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a systemic multiorgan syndrome driven by low-grade inflammation. While epicardial adipose tissue (EAT) and skeletal muscle dysfunction are known contributors to exercise intolerance, their synergistic association remains undefined. Aims: We aimed to investigate the “Adipo-Muscular” association—the synergistic interplay between local cardiac inflammatory potential and peripheral muscle fatigability—as a predictor of functional capacity in HFpEF. Methods: This cross-sectional study enrolled 192 stable HFpEF patients and 200 age- and sex-matched healthy controls. EAT thickness was quantified via echocardiography. Peripheral muscle function was assessed through maximal isometric strength and handgrip endurance (maintenance time at 50% maximal voluntary contraction), the latter serving as a surrogate for Type I fiber oxidative capacity. Functional capacity was validated using the 6-Minute Pegboard Ring Test (6PBRT), specifically chosen for its sensitivity to upper extremity “myopenia” (qualitative bioenergetic failure). A novel EAT-Endurance Index was calculated as: Index = ({EAT thickness [mm]} / {Handgrip endurance [sec]}) ×100. Results: Despite comparable BMI between groups, HFpEF patients displayed significantly greater EAT thickness (5.46 ± 1.65 vs. 3.20 ± 1.03 mm, p < 0.001). While maximal strength showed a moderate decline, handgrip endurance was profoundly compromised in HFpEF (48.48 ± 14.4 vs. 72.24 ± 12.1 s, p < 0.001), representing a massive effect size (Cohen’s d = -1.791). In multivariate analysis adjusting for age, sex, BMI, and major comorbidities (Hypertension, Diabetes, and Coronary Artery Disease), the EAT-Endurance Index emerged as the strongest independent predictor of impaired functional capacity (β = 0.385, p < 0.001). Sensitivity analysis confirmed this association was independent of glycemic status. Conclusions: We identified a distinct “Adipo-Muscular” phenotype in HFpEF, characterized by expanded epicardial fat and profound skeletal muscle fatigability. This association predicts functional decline independently of systemic obesity, maximal strength, and classic comorbidities. Targeting the interface between central adiposity and skeletal muscle mitochondrial function may offer novel therapeutic avenues for this challenging population.

Arterial stiffness is associated with increased cardiovascular risk in chronic obstructive pulmonary disease (COPD). However, whether this increase reflects disease-specific vascular effects or is primarily driven by age and hemodynamic factors remains unclear, particularly in early disease states such as pre-COPD and preserved ratio impaired spirometry (PRISm). This study aimed to evaluate arterial stiffness across the COPD spectrum and to determine the independent predictors of pulse wave velocity (PWV). This cross-sectional study included healthy controls (n=60), a combined pre-COPD/PRISm group (n=121), and COPD patients (n=120) classified according to spirometric criteria. Arterial stiffness was assessed noninvasively using brachial oscillometric PWV. Clinical characteristics, smoking exposure, spirometric parameters, symptom scores, and hemodynamic measurements were recorded. Correlation analyses and hierarchical multivariate linear regression were performed to identify independent determinants of PWV. PWV values were significantly higher in the pre-COPD/PRISm and COPD groups than in healthy controls, with the highest levels observed in COPD patients at GOLD stage E (p<0.001). Although PWV showed significant correlations with spirometric parameters and symptom scores in unadjusted analyses, these associations lost significance after adjustment for age and smoking exposure. In contrast, mean arterial pressure and central pulse pressure remained strongly associated with PWV (p<0.001). In multivariate analysis, age was the strongest independent predictor of PWV, followed by mean arterial pressure and body surface area, while FEV1% was not a significant contributor. Arterial stiffness is increased not only in COPD but also in individuals with pre-COPD/PRISm. However, this increase appears to be primarily driven by age-related and hemodynamic factors rather than disease-specific airflow limitation. These findings highlight the importance of early cardiovascular risk assessment focusing on hemodynamic parameters.

Background and Objectives: Our study aimed to reveal the effect of using 4 mm bare-metal stents (BMS), 4 mm drug-eluting stents (DES), or 3 mm DES with 4 mm diameter balloon post-dilation strategies on long-term clinical outcomes and endpoints for large-diameter coronary artery percutaneous coronary intervention (PCI). Materials and Methods: In our study, patients who had undergone PCI were retrospectively screened between January 2014 and July 2020. The study included 350 patients and was divided into three groups; Group I (n = 134) included patients with direct 4.0 mm BMS implantation, Group II (n = 109) included patients with direct 4.0 DES implantation, and Group III (n = 107) included patients with 4mm NC post-dilatation after 3 mm DES implantation. Primary endpoints were determined as target lesion revascularisation, cardiac mortality, and myocardial infarction associated with the target vessel. Our secondary endpoint was all-cause mortality. Results: No differences were observed between the groups in terms of the baseline variables. Stent length was the highest in Group II and the shortest in Group III. There were no significant differences between the groups regarding major adverse cardiovascular events (MACE). Conclusions: Our study suggests that in percutaneous coronary interventions for non-complex lesions, there is no significant difference in MACE outcomes when directly implanting a 4 mm diameter DES, a 4 mm diameter BMS, or a 3 mm diameter DES, followed by post-dilation with an appropriately sized NC balloon when the target vessel diameter is in the range of 4 to 4.4 mm.

Background: Asthma is a heterogeneous inflammatory airway disease increasingly recognised to be associated with elevated cardiovascular risk. Arterial stiffness, commonly assessed by pulse wave velocity (PWV), is a well-established predictor of cardiovascular events. However, it remains unclear whether vascular involvement in asthma reflects true arterial stiffening or predominantly altered arterial wave reflection. Objectives: To investigate arterial stiffness and wave reflection characteristics in patients with controlled and uncontrolled asthma compared with healthy controls. Design: Cross-sectional observational study. Methods: A total of 158 participants (56 healthy controls, 50 patients with controlled asthma, and 52 patients with uncontrolled asthma) underwent non-invasive arterial stiffness and hemodynamic assessments. Peripheral and central blood pressures, PWV, augmentation pressure, augmentation index and reflection magnitude were measured. Group comparisons were performed using unadjusted analyses and multivariable analysis of covariance (ANCOVA). Multivariate analysis of covariance (MANCOVA) was used to evaluate wave reflection parameters simultaneously, adjusting for age, body mass index, smoking status, heart rate and systolic blood pressure. Results: PWV differed significantly between groups in unadjusted analyses, with higher values observed in asthma groups. However, this association was no longer significant after multivariable adjustment, with age and systolic blood pressure emerging as the strongest independent determinants of PWV. In contrast, MANCOVA revealed a significant overall group effect on wave reflection parameters. Subsequent univariate analyses demonstrated that reflection magnitude remained significantly higher in both controlled and uncontrolled asthma groups compared with healthy controls after adjustment, whereas augmentation pressure and augmentation index did not show independent group effects. Conclusion: Vascular involvement in asthma appears to be characterised primarily by altered arterial wave reflection rather than overt arterial stiffening. These findings suggest that vascular alterations observed in asthma are primarily related to changes in arterial wave reflection and may be influenced by systemic hemodynamic factors (e.g. blood pressure and body composition), rather than asthma control itself.