Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability and requires urgent evaluation and management. Most of the causes of acute limb ischemia are thrombosis of a limb artery or bypass graft, embolism from the heart or a disease artery, dissection, and trauma. Assessment determines whether the limb is viable or irreversibly damaged. Prompt diagnosis and revascularization by means of catheter-based thrombolysis or thrombectomy and by surgery reduce the risk of limb loss and mortality. Amputation is performed in patients with irreversible damage. Despite urgent revascularization, amputation rate is 10%–15% in patients during hospitalization, mostly above the knee, and mortality within 1 year is 10%–15% due to the coexisting conditions.

Background: Right ventricular (RV) failure is an important cause of morbidity and mortality in patients with left ventricular (LV) end-stage heart failure (ESHF). Pulmonary artery pulsatility index (PAPi) and RV stroke work index (RVSWI) are invasive parameters related to RV function. This study aimed to investigate the prognostic impact of PAPi and RVSWI in these patients. Methods and Results: In this study, 416 patients with ESHF were included. The adverse cardiac event (ACE) was defined as LV assist device implantation, urgent heart transplantation, or cardiac mortality. There were 218 ACE cases and 198 non-ACE cases over a median follow-up of 503.50 days. Patients with ACE had lower PAPi and similar RVSWI compared to those without ACE (3.1 ± 1.9 vs. 3.7 ± 2.3, p = 0.003 and 7.3 ± 4.9 vs. 6.9 ± 4.4, p = 0.422, respectively). According to the results of multivariate analysis, while PAPi (from 2 to 5.65) was associated with ACE, RVSWI (from 3.62 to 9.75) was not associated with ACE (hazard ratio [HR]: 0.75, 95% confidence interval [CI] [0.55–0.95], p = 0.031; HR: 0.79, 95% CI: [0.58–1.09], p = 0.081, respectively). Survival analysis revealed that PAPi ≤2.56 was associated with a higher ACE risk compared to PAPi >2.56 (HR: 1.46, 95% CI: 1.11–1.92, p = 0.006). PAPi ≤2.56 could predict ACE with 56.7% sensitivity and 51.3% specificity at 1 year. Furthermore, the association between RVSWI and ACE was nonlinear (J-curve pattern). Low and high values seem to be associated with higher ACE risk compared to intermediate values. Conclusion: The low PAPi was an independent risk for ACE and it had a linear association with it. However, RVSWI seems to be have a nonlinear association with ACE (J-curve pattern).

BackgroundThe objective of this study was to analyze the effects of cardiac rehabilitation (CR) on the atrial function of patients with acute myocardial infarction (AMI) who had been successfully revascularized through percutaneous coronary intervention (PCI).MethodsForty-two AMI patients having undergone CR were enrolled in this observational study. Assessments were performed before and after 6 weeks of CR. Left atrial strain analysis was carried out by two-dimensional speckle tracking echocardiography. Left ventricular ejection fraction (LVEF) was measured by the biplane Simpson's method. Pulsed-wave Doppler at the tip of mitral valve leaflets enabled us to measure early (E) and late (A) diastolic filling velocities, deceleration time (DT) of early filling velocity and isovolumic relaxation time (IVRT). Left ventricle tissue velocity was measured by tissue Doppler imaging of the lateral mitral annulus (e’) and E/e’ was subsequently calculated. Ratio of E/e’ to left atrium (LA) peak strain was used to estimate LA stiffness.ResultsFollowing CR, LVEF (P=0.010), LA strain (P<0.001) and LA stiffness (P=0.013) all showed improvement, while other parameters remained unchanged.ConclusionPost-AMI cardiac rehabilitation and revascularization by PCI might have favourable effects on LA function

This study aimed to evaluate the cardiopulmonary function and impairment of exercise endurance in patients with COVID-19 after 3 months of the second wave of the pandemic in Turkey. A total of 51 consecutive COVID-19 survivors, mostly healthcare providers, still working in the emergency room and intensive care units of the hospital after the second wave of Covid 19 pandemia were included in this study. Cardiopulmonary exercise stress test was performed. The median of the exercise time of the COVID-19 survivors, was 10 (4.5–13) minutes and the mean 6.8 ± 1.3 Mets was achieved. The VO ₂ max of the COVID-19 survivors was 24 ± 4.6 ml kg ⁻¹ min ⁻¹ which corresponds the 85 ± 10% of the predicted VO ₂ max value. The VO ₂ WRs value which was reported about 8.5–11 ml min ⁻¹ per watt in healthy individuals as normal was found lower in Covid 19 survivors (5.6 ± 1.4). The percentage of the maximum peak VO ₂ calculated according to the predictable peak VO ₂ of the COVID-19 survivors, was found significantly lower in male patients (92 ± 9.5% vs 80 ± 8.5%, p : 0.000). Also, there was a positive correlation between the percentage of the maximum predicted VO ₂ measurements and age ( r : 0.320, p : 0000). The peak VO ₂ values of COVID-19 survivors decreased, and simultaneously, their exercise performance decreased due to peripheral muscle involvement. We believe that COVID-19 significantly affects men and young patients.