Background:Pulmonary embolism severity index, its simplified version, and shock index have been used for risk stratification in acute pulmonary embolism. In this study, we proposed a modification in severity index and evaluated the correlates and prognostic value of modification in severity index in this setting.Methods:The study group comprised retrospectively evaluated 181 patients with acute pulmonary embolism. Systematic workup including pulmonary embolism severity index, its simplified version, shock index, biomarkers, and echocardiographic and multidetector computed tomography assessments was performed in all patients. Moreover, we calculated modification in severity index by multiplying original shock index (heart rate/systolic blood pressure ratio) and a third component, 1/pulse oxymetric saturation (pSat O2%) ratio. The primary endpoint was defined as all-cause mortality and hemodynamic collapse during the hospital stay.Results:On the basis of initial risk stratification, ultrasound-assisted thrombolysis, systemic tissue-type plasminogen activator, and unfractionated heparin therapies were utilized in 83 (45.9%), 37 (20.4%), and 61 (33.7%) patients, respectively. The primary endpoint occurred in 13 (7.2%) patients. Receiver-operating curve analysis revealed that modification in severity index had the highest area under the curve of 0.739 (0.588-0.890, P =.002) compared with shock index, pulmonary embolism severity index, or its simplified version. The modification in severity index > 0.989 predicted primary endpoint with 73% sensitivity and 54% specificity.Conclusions:The modification in severity index seems to be a simple, quick, and comprehensive risk assessment tool for bedside evaluation at initial stratification, in monitoring the clinical benefit from therapies, and decision-making for escalation to other reperfusion strategies in patients with acute pulmonary embolism. However, the prognostic value of modification in severity index needs to be validated with further studies.

Background:To evaluate the application value of artificial intelligence-based auxiliary diagnosis for congenital heart disease.Methods:From May 2017 to December 2019, 1892 cases of congenital heart disease heart sounds were collected for learning- and memory-assisted diagnosis. The diagnosis rate and classification recognition were verified in 326 congenital heart disease cases. Auscultation and artificial intelligence-assisted diagnosis were used in 518 258 congenital heart disease screenings, and the detection accuracies of congenital heart disease and pulmonary hypertension were compared.Results:Female sex and age > 14 years were predominant in atrial septal defect (P < .001) compared with ventricular septal defect/patent ductus arteriosus cases. Family history was more prominent in patent ductus arteriosus patients (P < .001). Compared with no pulmonary arterial hypertension, a male predominance was seen in cases of congenital heart disease–pulmonary arterial hypertension (P < .001), and age was significantly associated with pulmonary arterial hypertension (P = .008). A high prevalence of extracardiac anomalies was found in the pulmonary arterial hypertension group. A total of 326 patients were examined by artificial intelligence. The detection rate of atrial septal defect was 73.8%, which was different from that of auscultation (P = .008). The detection rate of ventricular septal defect was 78.8, and the detection rate of patent ductus arteriosus was 88.9%. A total of 518 258 people from 82 towns and 1220 schools were screened including 15 453 suspected and 3930 (7.58%) confirmed cases. The detection accuracy of artificial intelligence in ventricular septal defect (P = .007) and patent ductus arteriosus (P = .021) classification was higher than that of auscultation. For normal cases, the recurrent neural network had a high accuracy of 97.77% in congenital heart disease–pulmonary arterial hypertension diagnosis (P = .032).Conclusion:Artificial intelligence-based diagnosis is an effective assistance method for congenital heart disease screening.

Background:Over the past few years, smartwatches have become increasingly popular in the monitoring of arrhythmias. Although the detection of atrial fibrillation with smartwatches has been the subject of various articles, there is no comprehensive research on the detection of arrhythmias other than atrial fibrillation. In this study, we included individual cases from the literature to identify the characteristics of patients with smartwatch-detected arrhythmias other than atrial fibrillation.Methods:PubMed, Embase, and SCOPUS were searched for case reports, case series, or cohort studies that reported individual participant-level data, until January 6, 2022. The following search string was used for each databases: (“Smart Watch” OR “Apple Watch” OR “Samsung Gear”) AND (“Supraventricular Tachycardia” OR “Cardiac Arrhythmia” OR “Ventricular Tachycardia” OR “Atrioventricular Nodal Reentry Tachycardia” OR “Atrioventricular Reentrant Tachycardia” OR “Heart Block” OR “Atrial Flutter” OR “Ectopic Atrial Tachycardia” OR “Bradyarrhythmia”).Results: A total of 52 studies from PubMed, 20 studies from Embase, and 200 studies from SCOPUS were identified. After screening, 18 articles were included. A total of 22 patients were obtained from 14 case reports or case series. Four cohort studies evaluating various arrhythmias were included. Arrhythmias, including ventricular tachycardia, atrial fibrillation, atrial flutter, atrioventricular nodal reentry tachycardia, atrioventricular reentrant tachycardia, second- or third-degree atrioventricular block, and sinus bradycardia, were detected with smartwatches.Conclusions: Cardiac arrhythmias other than atrial fibrillation are also commonly detected with smartwatches. Smartwatches have an important potential besides traditional methods in the detection of arrhythmias and clinical practice.

Background:Although energy drinks have been consumed for many years, their effects on the cardiovascular system continue to be investigated. Today, the most frequently used area of energy drinks is the entertainment sector, and this study investigates the effects of energy drinks and alcohol consumption on rats’ limb and myocardium tissue.Methods:Forty Wistar Albino rats were used and divided into 4 groups. Energy drinks were given to the first group (the energy drink group), alcohol was given to the second group, and energy drinks and alcohol were given to the third group Redbull-Alcohol (RA). Blood samples, leg muscles, and heart tissues were studied after the ischemia–reperfusion model was created at the infrarenal level.Results:In the histopathological examination of heart muscles, the damage was significantly more severe in the RA group than in the control group (P < .05). There was no significant change in the RA group in the limb muscle; however, muscle fiber abnormality was higher. The energy drink group was more prone to carbon dioxide retention and hypoxia, resulting in respiratory acidosis. (P = .05). Lactate was significantly higher in the energy drink group (P = .002). Glucose concentrations of energy drink and RA groups were higher (P = .02).Conclusion:The high lactate values of the energy drink group and more damaged fibers in the striated muscles in the RA group showed that they are more susceptible to ischemia. Long-term energy drinks and alcohol use may cause damage to the heart muscle and endothelium. Also, the effects of long-term alcohol and energy drink use on the respiratory system should be investigated with more specific studies.

Background:Fetal growth disturbance can be associated with cardiac dysfunction. This study aimed to assess the modified myocardial performance index in growth-restricted and appropriate for gestational age fetuses and evaluate both its prognostic value in perinatal period and also its association with adverse perinatal outcomes.Methods:Totally 131 pregnant women were included in this prospective study. Of these, 56 cases were in study group with a diagnosis of small fetus and 75 cases were in control group with a diagnosis appropriately grown fetus. Fetal echocardiography was performed in all pregnant women to measure modified myocardial performance index. Umbilical, middle cerebral and uterine artery Doppler ultrasound parameters were measured in the study group. Small fetuses were categorized into 2 subgroups of late-onset fetal growth restriction and small for gestational age.Results:Modified myocardial performance index was significantly higher in small fetuses compared to controls (0.45 vs. 0.37, P < .001). Newborn intensive care unit admission rates were significantly higher in small fetuses than in controls (chi-square test, P < .001). The highest mean modified myocardial performance index was recorded in the late-onset fetal growth restriction subgroup (0.45 vs. 0.41 vs. 0.37). The sensitivity and specificity of modified myocardial performance index in predicting adverse outcomes at a cut-off value of 0.41 were 63% and 75%, respectively. There was a significant negative correlation between modified myocardial performance index values and birth weights.Conclusions:We found higher left fetal heart modified myocardial performance index values in small fetuses indicating the presence of prenatal cardiac dysfunction. Fetal myocardial performance deteriorates in concordance with severity of growth restriction. Modified myocardial performance index can also be used to predict adverse perinatal outcomes among growth-restricted fetuses.

Background:The endothelium is crucial for the control of vascular homeostasis and plays a role in angiogenesis. Leptin, a protein released mainly by adipose tissue, plays a key role in the regulation of energy balance and angiogenesis. We aimed to investigate the changes of endothelial nitric oxide synthetase expression on human umbilical vein endothelial cells wound healing model after leptin treatment.Methods:In this study, 5 groups were planned as Group 1: control (untreated), Group 2: treated with 0.1 ng/mL leptin, Group 3: treated with 1 ng/mL leptin, Group 4: treated with 10 ng/mL leptin, and Group 5: treated with 100 ng/mL leptin. Closure rates of wound areas were calculated by the Image J program after 24 hours of leptin treatment. The WST-1 assay was used to calculate the cell viability. Immunocytochemical analysis was performed for endothelial nitric oxide synthase expression and H-Score was calculated.Results:The closure rates of wound areas were calculated as 80.24%, 89.73%, 87.40%, 90.73%, and 93.70%, respectively. When all groups treated with leptin were compared with the control group, there was a statistically significant difference (P < .05). The WST-1 results showed that the most increasing levels of viable cells were found in the groups treated with 0.1 ng/mL leptin and 100 ng/mL leptin when compared to the control group. H-Score values of each group were calculated as 284.8 ± 15.22, 288.6 ± 8.41, 291 ± 8.16, 295.2 ± 11.60, and 308.8 ± 4.32, respectively. The difference between the control group and the group treated with 100 ng/mL leptin was statistically significant (P < .05).Conclusions:Endothelial nitric oxide synthase expression in human umbilical vein endothelial cells increased depending on the leptin dose and the highest increase was in the group treated with 100 ng/mL leptin.