Aim: This work was designed to investigate the relationship between cardiac outcomes and Naples Prognostic Score (NPS) among heart failure (HF) patients. Materials & methods: This retrospective obs... Plain language summary Heart failure is a serious condition that affects millions of individuals around the world. This study was designed to investigate whether there is a relationship between Nap... Tweetable abstract This study reveals Naples Prognostic Score (NPS) as a strong predictor of mortality and rehospitalization in patients with advanced heart failure. NPS also outperforms other scor...

In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey. The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT). After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median TIT was 195 (115-330) min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI. The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment.

We evaluated whether updated pulmonary hypertension definitive criteria proposed in sixth World Symposium on Pulmonary Hypertension had an impact on diagnosis of overall pulmonary hypertension and pre‐capillary and combined pre‐ and post‐capillary phenotypes as compared to those in European Society of Cardiology/European Respiratory Society 2015 pulmonary hypertension Guidelines. Study group comprised the retrospectively evaluated 1300 patients (age 53.1 ± 18.8 years, female 807, 62.1%) who underwent right heart catheterization with different indications between 2006 and 2018. Mean pulmonary arterial pressure ≥25 mmHg (European Society of Cardiology) and PAMP (mean pulmonary arterial pressure) >20 mmHg (World Symposium on Pulmonary Hypertension) right heart catheterization definitions criteria were used, respectively. For pre‐capillary pulmonary hypertension, pulmonary artery wedge pressure ≤15 mmHg and pulmonary vascular resistance ≥3 Wood units criteria were included in the both definitions. Normal mean pulmonary arterial pressure (<21 mmHg), borderline mean pulmonary arterial pressure elevation (21–24 mmHg), and overt pulmonary hypertension (≥25 mmHg) were documented in 21.1, 9.8, and 69.1% of the patients, respectively. The pre‐capillary and combined pre‐ and post‐capillary pulmonary hypertension were noted in 2.9 and 1.1%, 8.7 and 2.5%, and 34.6 and 36.6% of the patients with normal mean pulmonary arterial pressure, borderline, and overt pulmonary hypertension subgroups, respectively. The World Symposium on Pulmonary Hypertension versus European Society of Cardiology/European Respiratory Society definitions resulted in a net 9.8% increase in the diagnosis of overall pulmonary hypertension whereas increases in the pre‐capillary pulmonary hypertension and combined pre‐ and post‐capillary pulmonary hypertension diagnosis were only 0.8 and 0.3%, respectively. The re‐definition of mean pulmonary arterial pressure threshold seems to increase the frequency of the overall pulmonary hypertension diagnosis. However, this increase was mainly originated from those in post‐capillary pulmonary hypertension subgroup whereas its impact on pre‐capillary and combined pre‐ and post‐capillary pulmonary hypertension was negligible. Moreover, criteria of pre‐capillary pulmonary vascular disease and combined pre‐ and post‐capillary phenotypes were still detectable even in the presence of normal mean pulmonary arterial pressure. The obligatory criteria of pulmonary vascular resistance ≥3 Wood units seems to keep specificity for discrimination between pre‐capillary versus post‐C pulmonary hypertension after lowering the definitive mean pulmonary arterial pressure threshold to 20 mmHg.

Aim: This study aimed long-term prognostic factors for percutaneous coronary intervention (PCI) in left main coronary artery (LMCA) disease, focusing on inflammatory parameters like Pan Immune-Inflammation Value (PIV) and Systemic Immune-Inflammation Index (SII).Materials & methods: This retrospective, observational study involved 121 patients receiving unprotected LMCA PCI.The study's primary end point was MACE, including all-cause death, repeat revascularization and myocardial reinfarction.Results: The PIV and SII scores emerged as independent predictors of MACE occurrence in patients undergoing PCI for unprotected LMCA disease (p:0.045,p:0.048;respectively).In addition, age, ejection fraction, creatinine, shock presentation and the residual syntax score were identified as significant independent predictors of MACE in both models.Conclusion: This study showed a significant, independent correlation between PIV, SII and MACE in patients undergoing PCI for LMCA disease, with PIV showing slightly better predictive capability than SII.

Background: The precise etiology of hypoplasia of the posterior mitral valve leaflet (PMVL) remains incompletely elucidated; however, it has been hypothesized to stem from genetic mutations occurring during fetal development. Herein, we present the anatomical characteristics of the mitral valve and associated cardiac pathologies in patients with hypoplastic PMVL. Methods: This single-center retrospective study involved patients who presented between 2015 and 2021 at a tertiary healthcare facility. Among the cohort, 44 individuals had hypoplastic PMVL and were divided into 2 groups: those with severe mitral regurgitation (MR) and those with non-severe MR. Results: Among the patients, 11 (25%) had severe MR. The median lengths for the PMVL was 5 mm (5-6). Moreover, 10 patients had concomitant muscular formation. We found that 13 patients had bicuspid aortic valve (BAV), while the second most common concomitant cardiac congenital pathology was secundum atrial septal defect (ASD) in 7 patients. The anterior mitral leaflet (AML) length (P = .007), AML prolapse (P < .001), and A2P2 distance (P = .008) were higher in the group with severe MR. In addition, muscular formation was more common in patients with hypoplastic PMVL with severe MR (P < .001). Conclusion: Hypoplastic PMVL is a rare but significant anomaly that causes MR. While it can coexist with numerous congenital conditions, the most frequent associations include BAV and, secondly, ASD. Severe MR is particularly observed in cases accompanied by dilated mitral annulus, AML prolapse, and muscular formation.