Objective: Predicting postoperative atrial fibrillation (PoAF) in the preoperative period will provide a serious advantage in preventing the morbidity and mortality associated with this arrhythmia and in planning the treatment. In this study, we investigated the value of atrial electromechanical delay (AEMD) in predicting the development of PoAF. Methods: A total of 93 patients who underwent isolated coronary artery bypass grafting (CABG) operation were included in this prospective study. Patients’ demographic characteristics, laboratory parameters, echocardiographic data, and AEMD durations that could be measured by the co-use of electrocardiography and echocardiography were recorded. The patients at sinus rhythm during the postoperative period were identified as “Group 1”, and those who developed PoAF were identified as “Group 2”. Results: PoAF incidence was 26.88% (n=25). Left ventricle (LV) lateral AEMD, LV medial AEMD, right ventricle lateral AEMD, and left atrium (LA) lateral AEMD durations of Group 2 were significantly higher than Group 1 (p<0.001, p=0.004, p=0.004, p<0.001; respectively). In Univariate Logistic Regression Analysis, the age, hypertension, LA maximum volume, LA lateral AEMD and pulmonary artery pressure were significantly associated with PoAF development (p=0.01, p=0.004, p=0.004, p=0.001, p=0.01; respectively). However, only LA lateral AEMD was found as an independent predictive factor for the development of PoAF in the Multivariate Logistic Regression Analysis (OR:1.03, 95% CI:1,001-1.06, p=0.04). AUC was 0.741 for LA lateral AEMD in ROC Curve Analysis (95% CI:0.633-0.849, p<0.001). Conclusions: The development of PoAF can be predicted by AEMD durations measured in the preoperative period in patients undergoing isolated CABG.

Objective:The aim of this study is to evaluate the effect of iohexol as a contrast agent on the anticoagulant activity of oral factor Xa inhibitors. Methods:The study included 65 people who underwent contrast computerized tomography (CT). Patients in group 1 were using rivaroxaban (20 patients), patients in group 2 were using apixaban (20 patients), patients in group 3 were using edoxaban (20 patients), and group 4 was the control group (5 volunteers). Iohexol (60ml) was used as a contrast agent. Two tubes were used to collect 2 ml of blood from the patients at 4 hours after the drug dose (rivaroxaban, apixaban, or edoxaban) and 1 hour after the contrast CT (CT was performed 3 hours after the drug was taken). In the control group, at any time and 1 hour after contrast CT, 2 tubes of 2 ml of blood were collected. The anticoagulant properties of rivaroxaban, apixaban, and edoxaban were evaluated using anti-factor Xa levels. Results:The anti-factor Xa level was increased after using the contrast agent in the rivaroxaban group (0.66±0.32U/ml vs. 0.67±0.32U/ml; p=0.01) and the edoxaban group (0.74±0.35 U/ml vs. 0.76±0.36 U/ml; p=0.006). However, there was no significant difference in the apixaban group (0.66±0.33U/ml vs. 0.66±0.32U/ml; p=0.21) and control group (0.02±0.01U/ml vs. 0.03±0.01U/ml; p=0.33). Conclusion:The anticoagulant properties of rivaroxaban and edoxaban tended to increase significantly, but there was no statistically significant difference in the anticoagulant properties of apixaban with contrast agent. The increasing is too small so that these laboratory results need to validate with larger clinical trials(NCT04611386).

Objective: Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a factor that causes an increase in mortality and morbidity. Therefore, predicting post-CABG AF development is important for treatment management. In this study, we investigated the value of the ratio E/(Ea × Sa) as a combined systolic-diastolic index in predicting post-CABG AF development. Methods: This prospective study included 102 patients who underwent only isolated coronary bypass. Preoperative demographic features, biochemical and hematological parameters, and the electrocardiographic data of all patients were recorded. The E/(Ea × Sa) indices were calculated from the echocardiographic measurements. Those who retained their postoperative sinus rhythm were defined as group 1, and those who developed AF were defined as group 2. Results: Group 2 had significantly higher lateral (group 1: 1.14 ± 0.61 vs. group 2: 1.47 ± 0.87; p = 0.02), medial (group 1: 1.61 ± 0.70 vs. group 2: 1.99 ± 0.91; p = 0.02), and mean (group 1: 1.30 ± 0.58 vs. group 2: 1.62 ± 0.74; p = 0.001) E/(Ea×Sa) indices than group 1. In the univariate analysis, age, CHA2DS2-VASc score, sPAP, and mean E/(EaxSa) index were found to be significant predictors of post-CABG AF development. However, only the mean E/(EaxSa) index was found to be a significant predictor of post-CABG AF development in the multivariate analysis (OR: 2.31 95% CI 1.02–5.24; p = 0.04). Conclusions: The combined systolic-diastolic index predicted the development of post-CABG AF.

Objective:Identification of patients who are nonresponders to cardiac resynchronization therapy (CRT) with the use of simple and objective parameters may be helpful in tailoring treatment. The aim of this study is to investigate whether E/(Ea×Sa) could be a predictor of CRT nonresponders (E=early diastolic transmitral velocity, Ea=early diastolic mitral annular velocity, Sa=systolic mitral annular velocity). Methods:In total, 53 heart failure patients were evaluated for this study, and 33 patients were included according to the study criteria. Before and six months after CRT-D(CRT with a defibrillator) implantation, E, Ea, and Sa were determined at the medial and lateral mitral annular sites, and the average values were obtained. E/(Ea×Sa) was calculated (medial, lateral, average). The patients were followed for six months to monitor their CRT response. A responder was defined as a patient with a reduction in end-systolic volume of <15% and an increase in six-minute walking distance of 50 meters. Results:At a six-month follow-up, 24(72.7%) of the 33 patients responded to CRT. At the six-month follow-up, in the responder group, the E/Ea ratio, lateral mitral, and average E/(Ea×Sa) indices were significantly reduced (p<0.01 for all). The baseline lateral mitral, medial mitral, and average E/(Ea×Sa) indices were significantly lower in the responder group than in the nonresponder group (p≤0.01 for all). The ROC analysis showed that all the E/(Ea×Sa) indices predict the CRT nonresponder patients. The AUC values were 0.89(lateral E/(Ea×Sa)), 0.85(average E/(Ea×Sa)), and 0.77(medial E/(Ea×Sa))(p≤0.01 for all). Conclusion:We found that the E/(Ea×Sa) index is a novel predictor of CRT nonresponder patients.