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    Cardiac Involvement is the Reason for Persistent Dyspnea in Post COVID-19 Patients without Pulmonary Sequelae: A Retrospective Study
    (OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2022) Çöllüoglu, T.; Acat, M.; Özsaraç, Ö.; Akin, Y.; Önalan, O.
    Objective: Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019 (COVID-19) infection and also it has been shown that acute infection is responsible for cardiac symptoms. However, the data on cardiac involvement and associated symptoms in chronic phase remains unclear. Recent evidence have shown that the reason for persistent dyspnea can be persistent cardiac dysfunction in post COVID-19 infection. The aim of our study was to investigate the relationship between persistent dyspnea and cardiac involvement in post COVID-19 patients without pulmonary sequelae. Material and Methods: In our study, we recruited 30 post COVID-19 patients with dyspnea between January 2021 and July 2021. In all patients, the absence of pulmonary sequelae was detected with PFT and chest- CT. 2D-TTE, 2D-STE and MPS were performed for each case. Results: Left ventricular dysfunction was detected in 63.3% of patients and also 93.3% of patients had extensive abnormal GLS at 3 month follow-up. Of the patients, 33.3% had myocardial perfusion defect (MPD) and all MPDs were observed to be reversible defects. MPD was obviously seen in anterior wall (60%) and mid (20%) to apical (70%) segments. As compared with patients without MPD, patients with MPD had higher CK-MB (p: 0.016) and troponin I (p: 0.011), lesser PW thickness (p:0.020) and lower peak systolic strain rate at A2C view (p:0.031). Patients with NYHA III had more impaired GLS than patients with NYHA II (p:0.035). Conclusion: Our study suggests ischemic or non-ischemic cardiac dysfunction may be associated with persistent dyspnea in post- COVID- 19 patients without lung sequelae. © 2022 by Türkiye Klinikleri.
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    Effectiveness of statin treatment in reducing red cell distribution width and mean platelet volume in patients with stable coronary artery disease: A retrospective study
    (Wolters Kluwer Medknow Publications, 2022) Çolak, A.; Akin, Y.
    Objectives: Mean platelet volume (MPV) has been shown to be a predictor of platelet activation and plays a crucial role in the pathogenesis of atherosclerosis. Red cell distribution width (RDW) is a measure of the variability of erythrocyte volumes and might reflect underlying chronic inflammation. Both MPV and RDW are related to increased risk for cardiovascular disease. Since statins have pleiotropic effects, we aim to investigate the effect of statins on this possible hematologic markers of atherosclerotic risk in stable coronary artery disease (CAD). Materials and Methods: One hundred and twenty-one statin-naive patients who had undergone coronary angiography for stable CAD between June 2012 and June 2013 were retrospectively enrolled in this study. Patients were treated with atorvastatin or rosuvastatin. The lipid profile and hematological parameters were measured at baseline and after statin treatment. Results: One hundred and twenty-one patients were included in the study. The mean age was 60.5 ± 9 years and 38% of patients were women. Out of 121 patients, 106 (87.6%) patients received atorvastatin therapy and 15 (12.4%) patients received rosuvastatin therapy. After a median follow-up period of 36 days, statin treatment markedly reduced low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) levels (P = 0.0001, for all). For hematological parameters, only RDW significantly decreased after statin treatment (P = 0.0001). The ? RDW were not associated with ? LDL-C (r = 0.03; P = 0.72), ?TG (r = 0.06; P = 0.49) and ? TC levels (r = 0.05; P = 0.55). Statins had no effect on MPV levels (P = 0.32). Conclusions: Statin therapy significantly reduces the RDW levels in stable CAD irrespective of cholesterol levels, which might confirm the anti-inflammatory effect of statins. However, the association between decreased RDW levels and prognosis in stable CAD has to be established by multi-center, prospective studies in large populations. © 2022 Society of Cardiovascular Academy. All rights reserved.
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    The social, psychological and clinical implications of the covid-19 pandemic in cardiovascular patients using angiotensin converting enzyme inhibitor or angiotensin receptor blocker
    (Turkiye Klinikleri, 2021) Ege, M.R.; Paç, A.F.; Sayin, S.; Akin, Y.; Demirkan, B.
    Objective: The heart expresses angiotensin converting enzyme (ACE)-2 that makes it vulnerable to severe acute respiratory syn-drome-coronavirus-2. Besides ACE inhibitors/angiotensin receptor blockers (ARBs) are used for cardiovascular diseases. Although no sig-nificant increase in the risk of coronavirus disease-2019 (COVID-19) infection and no increase in the severity of disease in patients receving ACE inhibitor/ARB therapy were shown, it has been noticed that some patients have tendency to stop the use of these agents. The aim of this study is to determine the behavior attitude of the cardiovascular outpatients during pandemic who use ACE inhibitor/ARB and to asses the impact of COVID-19 on them. Material and Methods: One hundred outpatients were in-cluded. A survey questioning the social, psychological and the clinical implications of COVID-19 was applied to volunteers. To measure the anxiety and despair levels, Beck scorings were used. Results: A small num-ber of patients stopped using ACE inhibitors/ARBs. Severe hopelessness and severe anxiety levels were seen in a few patient. Gender, fear of get-ting sick, thinking to have enough information about COVID-19 and ac-cessibilty to cardiovascular drugs were the factors affecting the Beck scores. Social distancing and cleaning hands are stated as the best measures for protection. Most of the patients preferred primary health clinics for routine controls and a few patient had knowledge about tele-medicine. Conclusion: Although a confusion has occured in the public about the use of ACE inhibitors/ARBs, drug release rates were found to be low. The anxiety and disparity levels are subsantially not severe. But it is still impor-tant to continue informing patients about the precautions and the use of tele-medicine. © 2021 by Türkiye Klinikleri.