Browsing by Publisher "Czech Society of Cardiology Z.S"
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Item Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients(Czech Society of Cardiology Z.S, 2021) Yavuz V.; Ozyurtlu F.; Cetin N.Background: Hydroxychloroquine (HCQ) alone or with some antibiotic and antiviral agents is used off label in the treatment of Coronavirus Disease 2019 (COVID-19). It seems that the most important safety problem about these medications are their cardiac side effects. Although there are data on arrhythmogenic events associated with the use of HCQ alone, such as corrected QT (QTc) prolongation, Torsade de pointes (TdP) or bradycardia, there are insufficient data on its combination with moxifloxacin (MOX). Objective: The aim of our study is to analyze the effect of HCQ alone or in combination with the use of MOX on QTc interval, heart rate, and arrhythmic events in patients with a diagnosis of COVID-19. Methods: This is a single center cohort study of non-intensive care unit (ICU) patients hospitalized with clinical signs consistent with pneumonia and at least one positive COVID-19 nasopharyngeal polymerase chain reaction test result. QTc intervals and heart rates in patients whose treatment consisted of HCQ alone or its separate combination with MOX at baseline and post-treatment were calculated and compared. Results: 312 patients were included (median age of 42 [IQR: 31.25–57.75] years, 54.16% male). Patients were divided into two groups based on their in-hospital treatment strategy as follows: HCQ alone (n: 166, 53.20%) or HCQ + MOX (n: 146, 46.79%). As compared to baseline, QTc intervals were significantly increased in all patients after treatment (406.00 [388.00–422.00] ms vs 418.00 [401.00–435.00] ms, p< 0.001). When the baseline QTc intervals were evaluated, there was no statistically significant difference between HCQ alone and HCQ + MOX groups (403.00 [384.50–419.00] ms vs. 409.50 [390.00–425.00] ms, p: 0.086). After treatment period, QTc intervals were significantly higher in HCQ + MOX group compared to the group in which patients only used HCQ (413.00 [398.00–430.00] ms vs. 426.50 [405.00–441.00] ms, p< 0.001). We found a significant decrease in heart rate in both groups after treatment period. From 79.00 (70.00–88.00) bpm to 70.00 (63.00–79.00) bpm in HCQ alone group (p< 0.001) and from 80.00 (70.00–88.00) bpm to 70.50 (63.00–78.75) bpm in HCQ + MOX group (p< 0.001). On the other hand, no statistically significant difference was observed between the groups in terms of heart rates either before or after the treatment. Conclusion: In this cohort study, patients who received HCQ for the treatment of COVID-19 were at high risk of QTc prolongation, and concurrent treatment with MOX was associated with greater changes in QTc. However, none of patients experienced malignant ventricular arrhythmia or death during treatment. Clinicians should carefully weigh risks and benefits with close monitoring of QTc if considering treatment with HCQ especially concomitant use with MOX. Further prospective studies are needed to determine the exact implications of these drugs on arrhythmias in patients with COVID-19. © 2021, ČKS.Item Prognostic implication of uncontrolled hypertension in hospitalized patients with COVID-19(Czech Society of Cardiology Z.S, 2021) Özdemir İ.H.; Özlek B.; Özen M.B.; Gündüz R.; Çetin N.Objective: In this study, we aimed to investigate the effect of hypertension (HT) and antihypertensive treatment on prognosis, which is one of the cardiovascular risk factors affecting the prognosis of COVID-19. Methods: We included 117 patients diagnosed with COVID-19 by nasopharyngeal polymerase chain reaction (PCR). The patients were divided into a hypertensive group and a control group. Biochemical, complete blood count and imaging data of the patients were recorded. Mortality of patients with and without HT was evaluated. The effect of antihypertensive therapy on mortality was evaluated. Results: In thorax CT, ground glass opacity and pneumonic consolidation were found statistically significantly higher in the hypertensive group (p <0,001). Hospital stay duration (days) of the patients were significantly longer in the hypertensive group and need for intensive care unit was statistically higher in the hypertensive group (p <0,001). Mortality of hypertensive patients was higher than of those without hypertension (p <0,001). There was no statistically significant difference in mortality in antihypertensive treatment groups (p = 0,801). Conclusion: Hypertension is an important risk factor that increases mortality in COVID-19 patients. Uncontrolled hypertension was common in most patients. Inflammatory parameters are higher especially in patients with uncontrolled hypertension. Patients with uncontrolled hypertension have a higher risk of mortality. There is no data to suggesting that the use of ACEI/ARB worsens prognosis. High blood pressure on admission to the hospital is important and the patient’s current antihypertensive therapy should not be discontinued. © 2021, ČKS.Item Two uncommon complications of COVID-19 in same patient: MINOCA and pneumothorax(Czech Society of Cardiology Z.S, 2022) Gunduz R.; Yildiz B.S.; Ozdemir I.H.; Ozen M.B.; Erbuyun S.C.COVID-19 has several clinical manifestations in the respiratory system and the cardiovascular system. Pneumothorax and myocardial infarction with nonobstructive coronary arteries (MINOCA) are two different clinical complications in COVID-19. However, pneumothorax and MINOCA have not been described yet in the same patient until now. A COVID-19 patient was admitted due to respiratory distress. He had pneumothorax and MINOCA. We report how we proceeded with diagnosis and treatment of pneumothorax and MINOCA. Respiratory and cardiovascular system manifestations of COVID-19 have made numerous clinical appearances. MINOCA and pneumothorax are rare clinical appearances, but they can be seen in COVID-19 as shown in our case. © 2022 Czech Society of Cardiology Z.S. All rights reserved.Item A patient with Duchenne muscular dystrophy and complete AV block undergoing a successful left bundle area pacing implantation(Czech Society of Cardiology Z.S, 2024) Gündüz R.; Yildiz B.S.; Ozgur S.The use of septal pacing, a novel pacemaker technique, is particularly recommended for patients with heart failure and a pacing requirement of ≥40% within a 24-hour period. The feasibility and effectiveness of left bundle area pacing remain unknown in Duchenne muscular dystrophy patients. Our case represents the fi rst instance in Duchenne muscular dystrophy patients demonstrating the applicability of conduction system pacing. © 2024 Czech Society of Cardiology Z.S. All rights reserved.