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- MakaleYalnız künye2025Pan-immune-inflammation value predicts sustained ventricular arrhythmias in NSTEMI: a novel inflammatory risk marker
Sahin, Yusuf Bozkurt; Tanik, Veysel Ozan; Koçu, Gokturk Kaan; Özkan, Mehmet Taha; Akdogan, Murat; Seçkin, Ozden; Tunca, Cagatay; Sezgin, Ali; Akbuga, Kursat; Özlek, Bulent
BackgroundSystemic inflammation contributes to arrhythmogenesis in acute coronary syndromes, but its role in NSTEMI-related ventricular arrhythmias remains poorly defined. The pan-immune-inflammation value (PIV) is a novel composite biomarker reflecting immune and thrombotic activity derived from routine blood counts. This study aimed to assess the association between PIV and the risk of sustained VT/VF in NSTEMI.MethodsIn this retrospective cohort study, 1,788 NSTEMI patients who underwent percutaneous coronary intervention were analyzed. The primary endpoint was the occurrence of sustained VT or VF during hospitalization. PIV was calculated as (neutrophil x platelet x monocyte)/lymphocyte. Logistic regression, ROC analysis, Kaplan - Meier curves, reclassification indices (NRI, IDI), and restricted cubic spline modeling were used.ResultsVT/VF occurred in 34 patients (1.9%). Those with VT/VF had significantly higher PIV values (median 1132 vs. 329, p < 0.001). In multivariable analysis, PIV remained an independent predictor (OR: 1.356 per 1000 unit increase; 95% CI: 1.028-1.787; p = 0.031). The risk of VT/VF rose progressively across PIV quartiles (Q4 vs. Q1 OR: 4.0, p for trend < 0.001). Adding PIV to conventional predictors improved risk classification (NRI: +0.089; IDI: 0.007). Kaplan - Meier analysis showed significantly reduced arrhythmia-free survival in high-PIV tertiles (log-rank p < 0.001), and cubic spline modeling revealed a non-linear association with increased arrhythmic risk at higher PIV levels.ConclusionsElevated PIV is independently associated with malignant ventricular arrhythmias in NSTEMI. As an accessible biomarker, PIV may aid early arrhythmic risk stratification and guide clinical surveillance strategies.
- MakaleAçık Erişim2025Athlete's Heart in Women's Contact Sports: Echocardiographic and Strain-Based Insights From Elite Rugby Players
Tunca, Cagatay; Gök, Saner Bahadir; Günes, Ozan; Özkan, Mehmet Taha; Tas, Alperen; Ibis, Ayse Nur Ozkaya; Sahin, Yusuf Bozkurt; Akdogan, Murat; Kivrak, Ahmet; Akbuga, Kursat
Background: Athlete's heart encompasses cardiac adaptations to long-term intensive training. Although male-dominated sports have been widely studied, limited data exist on structural and functional cardiac remodeling in female contact-sport athletes. This study aimed to evaluate cardiac changes in elite female rugby players using conventional and strain echocardiography. Methods: This cross-sectional study included 66 elite female rugby players and 50 sedentary controls. Anthropometric measurements and transthoracic echocardiographic assessments, including speckle tracking-derived global longitudinal strain (GLS), were performed. Linear, multivariable, and partial correlation analyses evaluated associations between GLS, active playing years (APY), and body mass index (BMI). Results: Compared to controls, athletes exhibited increased ventricular diameters, wall thicknesses, and left atrial size, with preserved left ventricular ejection fraction (LVEF). GLS values were significantly lower in rugby players (p < 0.001), though within normal limits. APY and BMI both showed significant inverse correlations with GLS (r = -0.456 and -0.370, respectively). In multivariable analysis, APY (beta = -0.392, p = 0.001) and BMI (beta = -0.225, p = 0.013) independently predicted GLS. Partial correlation confirmed the independent association of APY with GLS (r = -0.412, p = 0.001). GLS showed strong discriminative performance for >= 5 years of play (AUC = 0.816) and moderate performance for BMI >= 24.13 (AUC = 0.666). Conclusion: Elite female rugby athletes demonstrate physiological cardiac remodeling, including reduced GLS associated with training duration and BMI. These findings highlight the need for sex- and sport-specific echocardiographic reference values and further longitudinal research to clarify long-term clinical implications.