Left ventricular assist devices (LVADs) are widely used as end-stage therapy in patients with advanced heart failure, whereas implantation increases the risks of development of sustained ventricular tachycardia at the later postimplantation stage. Therefore, this study aimed to evaluate the clinical efficacy of orally administered amiodarone and propranolol in 3 patients with ventricular tachycardia (VT) after LVAD implantation who were resistant to initial anti-antiarrhythmic drugs. This retrospective cohort study consisted of the initial evaluation of the clinical data of 14 adult patients who underwent implantation of LVAD between January 2019 and March 2021. A total of 3 patients with resistant VT were finally included. In all cases, the patients were initially administered amiodarone in the different doses intravenously to stabilize the critical condition, whereas its oral form along with that of propranolol was used as maintenance therapy in the first 2 cases. In the third case, amiodarone was withdrawn because of the risk of development of hyperthyroidism, while oral propranolol was used in the treatment. The assessment in the 16-month follow-up period after discharge did not show presence of non-sustained and sustained VT in all 3 cases. In the ventricular arrhythmia-free group, the total mortality rate within the follow-up period was 11.1 ± 7.78 months in the 3 patients. We suggest that maintenance oral therapy of propranolol and amiodarone can significantly decrease the risks of complications in patients with VT after implantation of ventricular assist device in the long term.

Background/Objectives: The only intravenous P2Y12 inhibitor used in the management of acute and chronic coronary syndromes is cangrelor. Previous studies have demonstrated the efficacy of cangrelor. However, limited real-world data are available for cangrelor usage. This study aimed to investigate the use of cangrelor in large-volume percutaneous coronary intervention (PCI) centers in Türkiye, and examine the indications, patient characteristics, bleeding, and ischemic events. The efficacy and safety of cangrelor in this high-risk group were evaluated. Methods: This study was conducted retrospectively in 14 high-volume centers in Türkiye with extensive cangrelor experience. Cangrelor indications, patient clinical characteristics, periprocedural and postprocedural treatments, in-hospital and follow-up bleeding, ischemic events, and mortality were analyzed. Results: This study recruited 411 patients (mean age: 63.8 ± 12.7 years; 76% male). The most common conditions in which cangrelor is used in Türkiye are cardiogenic shock, intubation and nausea/vomiting, where P2Y12 cannot be used adequately due to impaired oral intake. The incidence rate of any bleeding within 48 h was 6.4% (n = 26), with major bleeding accounting for 1.7% of all cases (n = 7). The bleeding rates were similar between patients aged <75 years and those aged ≥75 years (6.0% vs. 8.8%, p = 0.326), as well as between patients with chronic kidney disease (CKD) and those without CKD (6.3% vs. 7.9%, p = 0.600). Conclusions: This is the first multicenter, large-cohort study to examine cangrelor use in Türkiye, providing real-world evidence for the efficacy and safety in high-risk patients with complex clinical features and lesion characteristics.

Background: Chronic coronary syndrome (CCS) remains a major cause of morbidity and mortality worldwide, and real-world data on outpatient management are limited. Methods: In total, 697 patients with previously diagnosed CCS who visited outpatient cardiology clinics at 25 centers in Turkey between June 2023 and December 2023 were prospectively enrolled and followed up for 12 weeks. Demographic and clinical characteristics, diagnostic and therapeutic strategies, a modified questionnaire derived from the Seattle Angina Questionnaire (modified SAQ-based questionnaire), and clinical outcomes were recorded. Results: The most common diagnostic modalities were exercise stress testing (31.6%) and coronary angiography (38.2%). Medical therapy (58.5%) was preferred over interventional treatment (41.5%). Among patients who were not receiving the respective medication at baseline, beta-blockers (61.8%), statins (46.5%), and ranolazine (40.4%) were the most commonly newly initiated medications. Patients in the intervention group were younger, were more frequently current smokers, had greater nitrate use, and had lower ejection fraction than those in the medical treatment group. Patient-reported responses to the modified SAQ-based questionnaire shifted toward less functional limitation, lower angina burden, and better perceived quality of life over the 12-week follow-up. Conclusions: Medical therapy was the predominant management strategy for CCS in Turkey. The observed diagnostic and therapeutic patterns reflect real-world management of patients with established CCS, with substantial use of invasive coronary angiography and high baseline utilization of guideline-directed medical therapies.

Objectives: Coronavirus disease (COVID-19) is a disease with high mortality due to acute respiratory distress syndrome (ARDS) secondary to viral pneumonia. In addition to its effects on the respiratory system, coronavirus is known to have serious systemic effects on the cardiovascular system. In this study, we aimed to investigate the association between prolonged QTc duration and COVID-19 specific pulmonary involvement Methods: Between December 2020 and February 2021, 112 patients who were diagnosed with COVID-19 in our COVID-19 outpatient clinic and met the inclusion criteria were evaluated for the association between cardiac variables (heart rate, PR width, QRS width, fQRS, and QTc interval), other patient characteristics and lung involvement. Results: A significant difference was found between the QTc intervals of COVID-19 patients with and without lung involvement (p < 0.026). In the ROC analysis for the QTc interval, which was found to be significant in the multivariate regression analysis, the cut-off value of 419.5 ms had a sensitivity of 72% and a specificity of 51.6% in predicting pulmonary involvement. Conclusions: Prolonged QTc duration may be useful in predicting COVID-19 pulmonary involvement in patients admitted to the emergency department.

Aim Doppler echocardiography has become the standard imaging modality for diastolic function and provide pathophysiological insight into systolic and diastolic heart failure. In this study we aimed to obtain normal echocardiographic Doppler parameters of healthy Turkish population. Methods Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination and The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used for echocardiographic Doppler measurements. Results A total of 967 healthy participants were enrolled in this study after applying exclusion criteria. Echocardiographic examination was obtained from all subjects following predefined protocols. Mitral E wave velocity and E/A ratio were higher in females and decreased progressively in advancing ages. E wave deceleration time and A wave velocity were increased with aging. Assessment of tissue Doppler velocities showed that left ventricular lateral e’, septal e’ and septal s’ were higher in younger subjects and in females. E/e’ ratio was increased progressively with advancing decades. Right ventricular e’and s’ were decreased but a’ was increased with increasing age. Septal e’ lower than 8 cm/s was 1.9% in the fifth decade and 13.7% in ages older than 50-years. The E/e’ ratio greater than 15 (and also 13) was not found. Conclusion This study, for the first time, provides echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population which will be useful in routine clinical practice as well as in future clinical trials.