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Article Citation - WoS: 9Citation - Scopus: 13The Evaluation of Oxidative Stress in the Young Adults With Covid-19 Mrna Vaccines Induced Acute Pericarditis- Myopericarditis(Dove Medical Press Ltd, 2022) Dursun, Ali Dogan; Saricam, Ersin; Sariyildiz, Gulcin Turkmen; Iscanli, Murat Dogan; Cantekin, Omer FarukBackground: During COVID-19 pandemic, several vaccines have been developed such as mRNA vaccines. However, acute pericarditis and myocarditis/myopericarditis cases have been described after mRNA vaccination. The mechanism for the development of cardiac involvement is unknown. Potential mechanism for oxidative stress associated with vaccine-induced heart involvement is unidentified. This study aimed to examine the role of oxidative stress and the heart involvement in young adults vaccinated with COVID-19 mRNA vaccines. Methods: In this cross-sectional study, a total of 23 participants were included and 10 of these participants were asymptomatic patients (control group). Comparison of the cardiac involvement and control group was made by using troponin I, C-reactive protein (hsCRP), D-dimer levels, and oxidative stress tests including nitric oxide, and imaging techniques (ECG, echocardiography, cardiovascular magnetic resonance). Results: The median age of acute pericarditis group (10 patients) was 22 years (Q1-Q3: 18.5-31), and the mean age was 24.4 +/- 7.5 years. The median age of myopericarditis group (3 patients) was 22 years (Q1-Q3 18.0-25.0), and the mean age was 21.6 +/- 3.5 years. All the myopericarditis cases were male. The patients with myopericarditis had higher troponin I level, hsCRP, and D-dimer levels (troponin I level; 1600.00 ng/mL; D-dimer; 1.20 mu g/mL, hsCRP; 3.0 mg/L, respectively; p < 0.05). Serum nitric oxide levels and OSI (total oxidant status, H2O2/total antioxidant status) were lower in myopericarditis group than the control and acute pericarditis group (p < 0.05). This shows inflammatory and procoagulant state. Conclusion: Vaccine-induced myopericarditis cases are associated with oxidative stress test abnormality (abnormal NO, OSI levels). However, there is no relationship between NO levels and other oxidative stress tests difference in vaccine-induced acute pericarditis. It is thought that vaccine-induced pericarditis and myopericarditis could have different pathogenesis. This could make it necessary to reassess the second dose of vaccination for vaccine-induced cardiac involvement cases.Article Citation - WoS: 20Laboratory and Imaging Evaluation of Cardiac Involvement in Patients With Post-Acute Covid-19(Dove Medical Press Ltd, 2021) Saricam, Ersin; Dursun, Ali Dogan; Sariyildiz, Gulcin Turkmen; Can, Nalan; Bozkurt, Engin; Gonullu, Ugur; Unlu, MustafaBackground: In the post-acute COVID-19 syndrome, many patients suffer from palpitations, effort-associated fatigue, and even sudden death. The mechanism of heart involvement in this syndrome is uncertain. The main purpose of the study was to identify possible cardiac involvement causes in patients with post-acute COVID-19 by using biomarkers such as NT-proBNP and nitric oxide (NO) and cardiac imaging modalities. Methods: In this cross-sectional study, a total of 105 participants were included according to the existence of symptoms, and 40 of these participants were asymptomatic patients. The ages of the participants ranged from 20 to 50 years. All patients were healthy before COVID-19. The symptoms were defined as palpitations and/or fatigue association with exercise in post-acute COVID-19 term. The comparison of the two groups was made by using biochemical parameters (NT-proBNP, Troponin I, NO) and imaging techniques (echocardiography, cardiovascular magnetic resonance (CMR) and cardiac positron emission tomography (PET)). Results: The symptomatic patients had higher NT-proBNP levels compared with asymptomatic patients (132.30 +/- 35.15; 76.86 +/- 16.79, respectively; p < 0.001). Interestingly, the symptomatic patients had lower NO levels than asymptomatic patients (9.20 +/- 3.08; 16.15 +/- 6.02, respectively; p < 0.001). Echocardiography and CMR were normal. However, we found regional increased 18F-FDG uptake on cardiac PET to be compatible with myocardial fatigue. Conclusion: We found elevated NT-proNBP levels, low serum NO levels, and increased 18F-FDG uptake on cardiac PET in post-acute COVID syndrome. Cardiac PET could replace or be added to CMR for detecting subtle subacute/chronic myocarditis. The follow-up of patients with post-acute COVID-19 could target the possibility of risk of heart failure.Article New Ecg Algorithm for the Prediction of Culprit Vessel in Acute Myocardial Infarction Involving Lateral Part of the Ventricle: Ilkay Classification(Dove Medical Press Ltd, 2023) Saricam, Ersin; Erdol, Mehmet Akif; Bozkurt, Engin; Ilkay, Erdogan; Cantekin, Omer FarukBackground: Isolated lateral myocardial infarction sometimes does not meet ST-segment elevation myocardial infarction (STEMI) criteria according to contiguous leads. This condition could cause late diagnosis and the need for revascularization therapy.Aim: To accurately predict the occlusion of lateral surface of the left ventricle, we defined a new electrocardiogram (ECG) algorithm by using angiographic and electrocardiographic correlations.Methods: This was a retrospective, multicenter observational study. The study population consisted of 200 patients with STEMI affecting lateral surface of myocardium, between 2021 and 2022. According to the coronary angiography results, we identified 74 eligible patients for study protocol. The study patients were divided into two groups: isolated DB (14 patients) or circumflex obtuse marginal group (60 patients).Results: ST depression in lead V2 had high positive predictive values for the prediction of obtuse marginal occlusion (positive predictive values (PPV), 100%; negative predictive value (NPV), 90%). ST elevation in V2 in ECG, in conjunction with ST depression in lead III had high positive predictive values for prediction of diagonal branch of LAD. Moreover, the presence of hyperacute T wave (& GE;10 mm) in lead V2 and & GE;2 mm ST depression in lead III had large diagonal branch of LAD (PPV, 98%; NPV, 100%). However, <10 mm T wave in lead V2 and <2 mm ST depression in lead III had small diagonal branch of LAD.Conclusion: We comprehensively classified the lateral STEMI definition through new electrocardiographic scheme as Ilkay classification, whereby we could accurately predict infarct-related artery and its occlusion level in lateral myocardial infarction.
