Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative top re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was lower in pandemic group and distal embolization and TIMI thrombus score were significantly higher in the pandemic group compared top re-pandemic group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no statistically significant difference in hospital mortality and short –term all cause mortality, among groups (p>0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.

BACKGROUND:Aortic regurgitation(AR) is a clinical status characterized by diastolic blood backflow from aorta to the left ventricle. Grading the severity of AR is very important for clinical follow-up. In spite of numerous parameters, the severity of AR still remains unclear in some patients. In AR, left atrial(LA) mechanics can be affected in time and LA strain variations can be illuminating for the grading of AR. The purpose of this study is to determine whether the LA strain parameters are associated with the severity of aortic regurgitation or not. METHOD:64 consecutive patients with AR were included in this study.After echocardiographic examination according to the aortic regurgitation degree. Patients divided in three groups as mild(n: 22),moderate(n: 15) or severe(n: 27). All patients LA strain measurements performed and results compared between groups. RESULTS:According to echocardiographic measurements; between the groups; LA reservoir in the mild, moderate and severe AR groups were(42.0 ±18.0, 41.4±14.8, 29.2 ±6.0 repectively, p:0.002) and LA conduit in the mild, moderate and severe AR groups were (21.2±8.7, 19.3±7.4 and 13.1 ± 4.4 respectively p <0.001), statistically significant different, while no statistically significant difference was noticed on LA SRs,LA SRe,LA SRa. CONCLUSION:This study showed that LA reservoir and LA conduit parameters of the patients with severe AR significantly decreased compared to those of the mild and moderate AR group. The grading of the LA mechanics in patients with chronic AR might provide a supplementary contribution to the present parameters in the grading of AR. Keywords: Aortic regurtation, graduation, left atrial strain