To document the association between serum transaminases and in-hospital mortality in pulmonary embolism (PE) patients. Analytical study. Patients treated with acute PE in hospital between January 2011 and December 2019 from Sakarya University Medical School Research and Teaching Hospital, Sakarya, Turkey. Patients with PE were included. Receiver operating characteristics (ROC) analysis was conducted to define a cut-off value for AST/ALT ratio to predict in-hospital death. Simplified pulmonary embolism severity index (sPESI) scores were calculated and the AST/ALT ratio were entered into binary logistic regression analysis with components of sPESI score to document the prognostic significance of as an independent predictor of in-hospital mortality. 164 acute PE patients were included; of those, 33 (20%) died in hospital. Deceased patients had higher AST/ALT ratio (median, 1.4; 25th-75th percentile, 1.1-1.8) comparing to patients with discharged home (median, 1.1; 25th-75th percentile, 0.84-1.4) (p=0.006). ROC analysis showed that AST/ALT ratio was an indicator of in-hospital mortality, and the calculated area under the curve was 0.655 (95% CI, 0.547-0.764). The cut-off value of 1.3 was associated with a prognostic sensitivity of 61% and specificity of 65%. Binary logistic regression analysis failed to show AST/ALT ratio as an independent predictor of in-hospital mortality. AST/ALT ratio predicts in-hospital mortality with acceptable sensitivity and specificity in patients with acute PE and might be used as a biomarker for risk stratification. Key Words: Pulmonary embolism, In-hospital mortality, Transaminases.

Objective: The aim of this study was to evaluate the left (LV) and right (RV) ventricular function in euthyroid Hashimoto's thyroiditis (eHT) patients. Subjects and Methods: Forty-five patients diagnosed with eHT and 45 age- and gender-matched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities (E, A, E', A'), isovolumic relaxation (IVRT) and contraction (IVCT) times, ejection time (ET), deceleration time (DT), Tei index, pulmonary acceleration time (PAcT) and tricuspid annular plane systolic excursion (TAPSE) of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signed-rank test. Results: Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index (0.6 ± 0.2 vs. 0.4 ± 0.1, p < 0.001), higher DT (p < 0.001) and IVRT (p < 0.001) values, and higher E/E' ratios (p = 0.04). In contrast, the peak E wave velocity (p = 0.02), E/A ratio (p = 0.01) and ET (p = 0.02) were significantly lower in the eHT group than amongst the controls. The RV, Tei index (0.40 ± 0.11 vs. 0.28 ± 0.07, p < 0.001), TAPSE (2.0 ± 0.3 vs. 2.2 ± 0.2 mm, p < 0.001), PAcT (124.3 ± 22.6 vs. 149.4 ± 18.3 ms, p < 0.001), A' (p = 0.007) and IVCT (p = 0.001) were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio (p = 0.01), E' (p = 0.03) and E'/A' ratio (p = 0.001) were significantly lower in the eHT patients than the control group. Conclusions: This study demonstrated that both RV and LV functions were impaired in patients with eHT.

Objective. Epidemiological studies suggest that women with loss of ovarian function at early ages may be especially burdened by cardiovascular disease (CVD). In this study, we aimed to evaluate pulse wave velocity (PWV) and myocardial performance index (MPI) in patients with premature ovarian insufficiency (POI). Design. We enrolled 51 female patients (mean age 38.9 ± 6.7 years) with POI and 49 healthy subjects (mean age 36.8 ± 5.2 years). All participants underwent a detailed echocardiographic examination and PWV measurement, which is basically the velocity of pulse wave travelling from carotid to femoral artery. Results. Both groups were similar with regard to age, body mass index (BMI) and left ventricular ejection fraction. When diastolic functions were assessed, patients with POI had higher mean E/E’ratio (9.3 ± 1.9 vs. 7.6 ± 1.6, p < 0.001). POI patients have impaired MPI (0.9 ± 0.5 vs. 0.5 ± 0.2, p < 0.001) comparing to healthy controls but PWV measurements did not differ between two groups (5.7 ± 0.8 vs. 5.6 ± 0.6 m/s, p = 0.48). Conclusions. This study showed POI patients might have impaired global left ventricular functions comparing to age matched healthy controls and this might reflect the effects of premature lack of estrogen (E) on women’s cardiovascular (CV) system.

BACKGROUND: Left distal transradial angiography (ldTRA) is a new technique for radial coronary angiography and may be an alternative to conventional transfemoral angiography (TFA) in patients who had previously undergone coro-nary artery bypass graft (CABG) surgery. In this study we compared ldTRA with TFA in patients who had undergone CABG surgery in terms of procedural details. METHODS: Fifty-seven consecutive patients with history of previous CABG among 459 patients who were admitted to coronary angiography unit (elective and acute coronary syndromes) in our center between October 2019 and February 2020 were included in the study. Consecutive patients were randomized to ldTRA (34 patients) and TFA (23 patients) group. The difference in total procedure times was defined as primary endpoint. The difference in sheat times, fluoros-copy times, contrast volume used and radiation exposure were designated as secondary endpoints. Post angiographic complications were compared between two groups. RESULTS: Out of 34 patients, successful distal radial access was obtained in 25 patients (74%). Baseline demograph-ics, contrast use and radiation exposure were similar between groups. Sheath times in ldTRA was significantly longer (P<0.001), but total procedure times were not different (18.4 +/- 7.8 vs. 14.6 +/- 6.1, P=0.07). Non-standard angiographic equipment usage was significantly higher in ldTRA procedures (80% vs. 13%, P<0.001). There was no major bleeding in neither of groups, and three minor bleedings in FA group (0% vs.13%, P=0.10). CONCLUSIONS: ldTRA in patients with a palpable pulse and successful access might be used successfully for angiog-raphy in patient with previous CABG even early in an operator's experience. (Cite this article as: Aksoy MN, Sahinkus S, Agac MT, Tatli E. A randomized trial comparing left distal radial versus femoral approach for coronary artery bypass graft angiography: a pilot study. Minerva Cardiol Angiol 2023;71:27-34. DOI: 10.23736/ S2724-5683.21.05626-X)