RESUMEN
OBJECTIVE: The relationship between oral health and general health has gained increased attention in recent years. This study sought to assess the knowledge, attitudes, and practices of cardiologists in Türkiye concerning the link between periodontal disease and cardiovascular disease (CVD). METHODS: After a pilot test, a modified survey was dispatched to 1,894 practicing cardiologists in Türkiye. Two mailings were carried out, and descriptive statistics were used to analyze the data. RESULTS: Of the 1,894 cardiologists surveyed, 166 responded, yielding a response rate of 11.5%. The majority of respondents (77%) were male and held professional positions in academia (45%), as assistant doctors (17.5%), or in private practice (12.7%). Ninety percent of respondents accurately recognized periodontal disease as a chronic, multifactorial inflammatory disease. Meanwhile, 78% concurred that inflammation is a pivotal connection between periodontal disease and CVD. On the topic of whether treating periodontal disease could reduce a patient's CVD risk, 37% of the polled cardiologists expressed uncertainty, while 9% disagreed. Seventy six percent believed that periodontists and cardiologists should collaborate to reduce shared risk factors for both cardiovascular and periodontal diseases. Additionally, 80% expressed interest in deepening their understanding of the link between periodontitis and CVD. CONCLUSION: While the vast majority of participants acknowledged that microbially-associated, host-mediated inflammation is a hallmark of periodontitis, consensus was lacking on inflammation being the primary factor linking periodontal diseases and CVDs. The majority of respondents expressed eagerness understand better the relationship between these two diseases, with the intention of enhancing oral health content in medical school and attending relevant seminars.
Asunto(s)
Cardiólogos , Enfermedades Cardiovasculares , Enfermedades Periodontales , Periodontitis , Humanos , Masculino , Femenino , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Turquía , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/epidemiología , Periodontitis/complicaciones , Inflamación/complicacionesRESUMEN
OBJECTIVE: Sarcoidosis is a systemic granulomatous disease rarely complicated by pulmonary hypertension (PH). The prevalence of PH in sarcoidosis is unclear and has differences between ethnic groups. This study aimed to investigate the prevalence and predictors of PH in a Turkish cohort. METHODS: The study included 55 patients with biopsy-proven sarcoidosis in a single center. All patients underwent detailed transthoracic echocardiography (TTE) to assess the probability of PH as recommended. Right heart catheterization (RHC) was performed for patients with intermediate-high risk of PH. Patients with mean pulmonary artery pressure >20 mm Hg by RHC were defined as PH. Demographic and clinical characteristics, laboratory data, spirometry, 6-min walk test, and TTE were compared between low and intermediate-high risk PH groups. RESULTS: The probability of PH was low with 47 patients. Eight patients had intermediate-high probability of PH, and two of them refused to undergo RHC. Of six intermediate-high probability patients, three had PH, and all of them had post-precapillary PH. The prevalence of PH in sarcoidosis was 5.5% (3/55). Six-minute walk distance (6 MWD) and diastolic parameters (E/A ratio, E' wave, and left atrial volume) were significantly lower, and New York Heart association class and N-terminal probrain natriuretic peptide (NT-proBNP) level were higher in intermediate-high risk PH patients compared with low-risk PH patients. CONCLUSION: The frequency of PH in sarcoidosis was 5.5% in a Turkish cohort. NT-proBNP, 6 MWD, diastolic function parameters, and myocardial strain parameters can be useful predictors of PH in patients with sarcoidosis, besides known echocardiographic parameters.
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Hipertensión Pulmonar , Sarcoidosis , Cateterismo Cardíaco , Ecocardiografía , Atrios Cardíacos , Humanos , Hipertensión Pulmonar/diagnóstico por imagen , Fragmentos de PéptidosRESUMEN
BACKGROUND: Sarcoidosis is a multisystem and granulomatous disease associated with impaired functional capacity as a result of pulmonary and cardiac involvement. Factors adversely effecting functional capacity in patients with sarcoidosis have not been systematically assessed including myocardial strain imaging on echocardiography which enable to diagnose subclinical cardiac dysfunction. We aimed to evaluate the effect of left and right ventricular global longitudinal strain (GLS) on submaximal exercise capacity in patients with sarcoidosis who do not have clinically manifest cardiac involvement. METHODS: Extracardiac biopsy proven 56 patients with sarcoidosis and 26 controls were included consecutively. Submaximal exercise capacity of the subjects was assessed with six-minute walk test (6 MWT). Pulmonary function tests and standard transthoracic and two-dimensional speckle tracking echocardiography were performed to the all subjects. Linear regression analysis was performed to find independent predictors of 6 MWT. RESULTS: Fifty-six patients (18% male) with a mean age of 52.5 ± 10.7 years were included. Patients with sarcoidosis had low 6 MWT performance and higher New York Heart Association classes and NT-proBNP levels. There were no significant differences between controls and patients with sarcoidosis in parameters of pulmonary function test. Biventricular GLS levels and biatrial reservoir and conduit function values were lower and systolic pulmonary artery pressure (SPAP) was significantly higher in patients with sarcoidosis as compared with controls. Older age and higher SPAP were found as independent predictors of poor 6 MWT performance. CONCLUSION: Although biventricular GLS levels were lower in the patients with sarcoidosis, only age and SPAP elevations were independent predictors of the submaximal exercise capacity. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (1): 63-73).
Asunto(s)
Tolerancia al Ejercicio , Contracción Miocárdica , Sarcoidosis Pulmonar/diagnóstico , Función Ventricular Izquierda , Función Ventricular Derecha , Prueba de Paso , Caminata , Adulto , Factores de Edad , Presión Arterial , Estudios de Casos y Controles , Ecocardiografía Doppler de Pulso , Femenino , Humanos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Arteria Pulmonar/fisiopatología , Pruebas de Función Respiratoria , Sarcoidosis Pulmonar/fisiopatología , Factores de TiempoRESUMEN
In December 2019, in the city of Wuhan, in the Hubei province of China, treatment-resistant cases of pneumonia emerged and spread rapidly for reasons unknown. A new strain of coronavirus (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) was identified and caused the first pandemic of the 21st century. The virus was officially detected in our country on March 11, 2020, and the number of cases increased rapidly; the virus was isolated in 670 patients within 10 days. The rapid increase in the number of patients has required our physicians to learn to protect both the public and themselves when treating patients with this highly infectious disease. The group most affected by the outbreak and with the highest mortality rate is elderly patients with known cardiovascular disease. Therefore, it is necessary for cardiology specialists to take an active role in combating the epidemic. The aim of this article is to make a brief assessment of current information regarding the management of cardiovascular patients affected by COVID-19 and to provide practical suggestions to cardiology specialists about problems and questions they have frequently encountered.