The development of atrial fibrillation (AF) has important prognostic implications in patients undergoing percutaneous coronary intervention (PCI), due to the concurrent need for both antiplatelet and anticoagulant therapies. This study aimed to evaluate the long-term incidence and predictors of AF in patients with acute coronary syndrome (ACS) undergoing PCI. We prospectively enrolled 337 consecutive ACS patients in sinus rhythm who underwent PCI and did not develop AF during hospitalization. Patients were followed every six months for up to 72 months. Follow-up data were available for 300 patients (89%); 37 patients were lost to follow-up. At the end of follow-up, 34 patients (11.3%) had developed AF. Kaplan–Meier analysis demonstrated that mitral annular calcification (MAC) was significantly associated with an increased incidence of AF from the early stages (χ² = 24.620, log-rank p < 0.001). Multivariate Cox regression identified body mass index (BMI) (HR: 1.070; 95% CI: 1.010–1.130; p = 0.022), left ventricular ejection fraction (LVEF) (HR: 0.942; 95% CI: 0.918–0.916; p < 0.001), mitral annular late diastolic velocity (Am) (HR: 0.785; 95% CI: 0.707–0.872; p < 0.001), and mitral annular calcification (MAC) (HR: 4.066; 95% CI: 1.976–8.368; p < 0.001) as independent predictors. These findings provide important insights into the long-term risk of AF after PCI in ACS patients and may support early identification and management of high-risk individuals.

Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is related to an increased atherosclerotic cardiovascular disease (ASCVD) risk. This study investigated a potential relationship between liver fibrosis scores (LFS) reflecting NAFLD and ascending aortic dilatation (AAD). Methods: This is an observational and cross-sectional study. Patients were consecutively enrolled from a cardiology clinic. The NAFLD fibrosis score (NFS), fibrosis-4 (FIB-4) index, aspartate aminotransferase (AST) to platelet ratio (APRI), and BARD scores of each patient were calculated. The ascending aortic diameters were evaluated by transthoracic echocardiography according to current clinical guidelines. The patients were allocated into two groups with and without AAD. Results: A total of 272 patients were included in the study. In AAD group, age, patients with hypertension (HT), coronary artery disease (CAD), FIB-4 index, BARD score and the NFS were significantly higher. As compared to the AAD group, body mass index (BMI), hemoglobin, and diuretic use were significantly higher in patients without aortic dilatation. The NFS with AAD, and NFS and FIB-4 index with indexed aortic diameter (AI) showed significant positive correlation (R=0.546, R=0.332, R=0.314 with p<0.001, respectively). In multivariate logistic regression analysis hemoglobin levels (OR=0.728, 95%CI: 0.553-0.958; p=0.023), BMI (OR=0.762, 95%CI: 0.668-0.869, p<0.001), HT (OR=3.269, 95%CI: 1.045-10.220; p=0.042), BARD score (OR=1.248, 95%CIL 0.815-1.955; p=0.044), and FIB-4 index (OR=2.432, 95%CI: 1.395-4.246; p=0.002) were found to be independently related to AAD. Conclusions: Our study demonstrated a statistically significant relationship between NFS, FIB-4 index, BARD score and AAD. The presence of positive correlation among LFS and AAD in our study is remarkable. This may emphasize the increased risk of AAD in NAFLD.

Background: Familial Mediterranean Fever (FMF) is a chronic autoinflammatory disorder that is characterized by increased arterial stiffness and subtle cardiovascular dysfunction. Colchicine remains the mainstay of treatment and may provide vascular benefits that extend beyond its anti-inflammatory effects. However, the association between colchicine therapy and ventriculoarterial coupling (VAC), a hemodynamic marker of cardiovascular efficiency, has not been previously studied. Methods: In this cross-sectional study, 97 patients with FMF receiving colchicine therapy for at least one year and 81 colchicine-naive individuals without FMF were consecutively enrolled from a tertiary rheumatology outpatient clinic. The VAC was evaluated using the Chen method, calculated as the ratio of arterial elastance (Ea) to end-systolic elastance (Es), based on echocardiographic measurements and noninvasive brachial blood pressure. Correlation analyses and stepwise multivariate linear regression analyses were performed to identify independent predictors of VAC. Results: Patients with FMF demonstrated significantly lower VAC values compared to controls (1.23 ± 0.34 vs. 1.40 ± 0.57; p = 0.001). The colchicine dose was inversely correlated with VAC (r = −0.243; p = 0.001) and remained an independent predictor in multivariate analysis (β = −0.186, p = 0.018). Beta-blocker use was positively associated with VAC (β = 0.194, p = 0.014), whereas female sex showed a borderline inverse association. Conclusions: Colchicine use in patients with FMF was associated with more favorable VAC in a dose-dependent manner. These findings suggest that colchicine may exert cardiovascular effects beyond the control of inflammation. VAC may be a useful noninvasive marker for assessing vascular–ventricular interactions in FMF.

Background: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disorder characterized by sustained systemic inflammation that may affect cardiac structure and function. Colchicine is the cornerstone of FMF therapy and has cardiovascular benefits in inflammatory settings. Methods: This cross-sectional study enrolled 106 participants: 53 patients with FMF receiving long-term colchicine therapy and 53 age- and sex-matched controls. Participants underwent transthoracic echocardiography with speckle-tracking imaging. Conventional parameters and strain-derived indices of the left ventricular (LV) and left atrial (LA) function were assessed. Correlation analyses and multivariable linear regression models were used to evaluate the association between FMF presence and cardiac strain parameters. Results: The LV ejection fractions were comparable between the groups. The FMF group showed thinner ventricular walls and larger chamber dimensions than the control group. Patients with FMF exhibited higher LA reservoir strain, while conduit and contractile atrial contributions were reduced, as shown by lower passive and active emptying fractions and reduced LA ejection fraction. LA volumes and stiffness indices were lower in the FMF group, indicating smaller and more compliant atrial structures. Left ventricular global longitudinal strain (LVGLS) was more negative in patients with FMF, indicating preserved LV longitudinal systolic function. FMF was independently associated with LVGLS and LA strain parameters after adjusting for cardiovascular risk factors. Conclusions: In patients with FMF receiving long-term colchicine therapy, cardiac strain imaging showed preserved LV longitudinal function and distinct LA mechanics with preserved reservoir strain but reduced conduit and contractile function. Strain echocardiography may provide insights into cardiac involvement in well-controlled FMF, although prospective studies are needed to clarify the clinical significance of these findings.

Objective: This study aimed to evaluate the association between mitral annular calcification (MAC) and ventricular tachycardia (VT) in patients with reduced and mildly reduced ejection fraction and to identify independent predictors of VT. Materials and Methods: A total of 143 patients with heart failure and left ventricular ejection fraction (LVEF) under 50% were included in this retrospective cross-sectional study. Patients were classified into two groups according to the presence of VT. Clinical, biochemical, and echocardiographic variables were compared between groups. Independent predictors of VT were identified using multivariable logistic regression analysis. Results: MAC was significantly more prevalent in the VT group compared with controls (43.6% vs. 17.4%, p < 0.001) and was the strongest independent predictor of VT (OR: 2.74; 95% CI: 1.13–6.65; p = 0.026). Higher inflammatory activity, lower serum albumin levels, increased left atrial volume, renal dysfunction, and elevated diastolic filling pressures were also associated with VT. Conclusions: MAC is a strong and independent predictor of ventricular tachycardia in patients with reduced and mildly reduced ejection fraction. Incorporating MAC into the overall arrhythmic risk profile alongside inflammatory, metabolic, and structural parameters may improve risk stratification in this population.

Background/Objectives: Chronic total occlusion (CTO) is one of the most complex forms of coronary artery disease, and myocardial perfusion in patients with CTO largely depends on the adequacy of coronary collateral circulation (CCC). Identifying simple and non-invasive electrocardiographic markers associated with impaired collateralization remains clinically important. The R-wave peak time (RWPT), a surface electrocardiography (ECG) marker representing the time to peak R-wave deflection and an electrocardiographic surrogate of early intraventricular conduction, may provide insight into ischemia-related ventricular activation delay. The aim of this study was to evaluate whether RWPT is associated with poor CCC in patients with CTO. Methods: This cross-sectional observational study included 92 consecutive patients with CTO and complete clinical, angiographic, and 12-lead ECG data. Patients were categorized according to CCC adequacy into good (n = 52) and poor (n = 40) CCC groups. Demographic, laboratory, angiographic, and ECG parameters were compared. Variables showing significant differences were subjected to univariate analysis, followed by multivariate logistic regression using a backward stepwise selection method. Statistical significance was set at p < 0.05. Results: Patients with poor CCC were significantly older and exhibited longer QRS duration and prolonged RWPT, whereas triglyceride levels were significantly lower. In multivariate analysis, both age (OR: 1.058; 95% CI: 1.005–1.114; p = 0.033) and RWPT (OR: 1.069; 95% CI: 1.013–1.128; p = 0.015) were significantly associated with poor CCC. Conclusions: RWPT may provide adjunctive, non-invasive information regarding collateral adequacy rather than serving as a definitive predictive marker. As an easily obtainable ECG parameter, RWPT may offer incremental diagnostic information when interpreted alongside clinical and angiographic findings in patients with CTO.