G. Ajami, Fathi Alwasabi, N. Mehdizadegan, M. Edraki, H. Mohammadi, A. Amirghofran, Bahram Ghasemzade, K. Keshavarz, H. Amoozgar, H. Arabi, A. Naghshzan, M. Borzouee, Farah Peiravian
Objectives: TOF is the most common cyanotic CHD. We investigated left ventricular (LV) function after surgical pulmonary valve replacement (sPVR) in patients with repaired Tetralogy of Fallot (rTOF) by Speckle Tracking Echocardiography (STE).Methods: 58 volunteers participated in this study who divided into 3 groups including 22 PVR patients (mean age 18.96±7 year), 16 repaired Tetralogy of Fallot and 20 healthy age match control. For all patients, we performed 2D echocardiography and STE.Results: 2D echocardiography in all groups showed normal LV ejection fraction without a significant statistical difference (64% sPVR, 60% in repaired Tetralogy of Fallot and 62.5% in the control group). However, the mean global longitudinal strains (GLS) of LV were significantly reduced in both sPVR (-17.5±2.5%) and repaired Tetralogy of Fallot (-17.1±4.7%) patients rather than control group (-20.2±0.7%) (P = 0.003). But GLS had no statistically significant difference between repaired Tetralogy of Fallot and sPVR patients (P=0.9). Segmental analysis of longitudinal strain (LS) showed a significant decrease in sPVR patients and repaired Tetralogy of Fallot group in basal anterior, basal septal, basal anterolateral segments, mid-anterior and anterolateral segments. Except for lower LS in the apical-anteroseptal segment, this level was mostly spared in both sPVR and repaired Tetralogy of Fallot patients.Conclusion: LVEF was within normal range after sPVR patients, but the pattern of impaired segmental LS and GLS did not change as compared with rTOF. Surgical PVR in patients with repaired TOF may not have a significant effect on the improvement of LV function assessed by STE. LV damage which happens during surgical correction of TOF may have a permanent deteriorating effect on LV function.
{"title":"Speckle tracking echocardiography before and after Surgical pulmonary valve replacement in Tetralogy of Fallot patients: Can STE elucidate early left ventricular dysfunction?","authors":"G. Ajami, Fathi Alwasabi, N. Mehdizadegan, M. Edraki, H. Mohammadi, A. Amirghofran, Bahram Ghasemzade, K. Keshavarz, H. Amoozgar, H. Arabi, A. Naghshzan, M. Borzouee, Farah Peiravian","doi":"10.21203/rs.2.19898/v1","DOIUrl":"https://doi.org/10.21203/rs.2.19898/v1","url":null,"abstract":"\u0000 Objectives: TOF is the most common cyanotic CHD. We investigated left ventricular (LV) function after surgical pulmonary valve replacement (sPVR) in patients with repaired Tetralogy of Fallot (rTOF) by Speckle Tracking Echocardiography (STE).Methods: 58 volunteers participated in this study who divided into 3 groups including 22 PVR patients (mean age 18.96±7 year), 16 repaired Tetralogy of Fallot and 20 healthy age match control. For all patients, we performed 2D echocardiography and STE.Results: 2D echocardiography in all groups showed normal LV ejection fraction without a significant statistical difference (64% sPVR, 60% in repaired Tetralogy of Fallot and 62.5% in the control group). However, the mean global longitudinal strains (GLS) of LV were significantly reduced in both sPVR (-17.5±2.5%) and repaired Tetralogy of Fallot (-17.1±4.7%) patients rather than control group (-20.2±0.7%) (P = 0.003). But GLS had no statistically significant difference between repaired Tetralogy of Fallot and sPVR patients (P=0.9). Segmental analysis of longitudinal strain (LS) showed a significant decrease in sPVR patients and repaired Tetralogy of Fallot group in basal anterior, basal septal, basal anterolateral segments, mid-anterior and anterolateral segments. Except for lower LS in the apical-anteroseptal segment, this level was mostly spared in both sPVR and repaired Tetralogy of Fallot patients.Conclusion: LVEF was within normal range after sPVR patients, but the pattern of impaired segmental LS and GLS did not change as compared with rTOF. Surgical PVR in patients with repaired TOF may not have a significant effect on the improvement of LV function assessed by STE. LV damage which happens during surgical correction of TOF may have a permanent deteriorating effect on LV function.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"14 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44827835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Khameneh, A. Rostamzadeh, M. Nemati, Paul M Brown, N. Sepehrvand
Te role of chronic Cytomegalovirus (CMV) infection and inflammation in the pathogenesis of atherosclerosis and Coronary Artery Disease (CAD) is still not clear. Objectives: Tis study aimed to explore the seroprevalence of anti-CMV antibodies and inflammatory markers in patients with stable angina who had undergone diagnostic coronary angiography for clinical suspicion of CAD. Patients and Methods: Tis cross-sectional, descriptive study was conducted on 181 patients with stable angina selected randomly among the patients referred to Seyyedoshohada Heart Hospital of Urmia, Iran for diagnostic coronary angiography between August 2012 and December 2013. Te patients were categorized into CAD and non-CAD groups based on their angiographic fndings. Ten, anti-CMV IgG and IgM antibodies were tested using the Enzyme-Linked Immunosorbent Assay (ELISA) method (Diapron, Rome, Italy). Serum C-Reactive Protein (CRP) was also measured by a qualitative method (Aniston Kit). Results: Based on angiographic fndings, 141 patients (77.9%) had atheromatous plaques in their coronary arteries, while coronary arteries were free of any plaques in 40 cases (22.1%). Besides, 99.3% of the patients in the CAD group and all the patients in the non-CAD group were anti-CMV IgG positive. Te rate of anti-CMV IgM seropositivity was 11.7% in the CAD group and 13.2% in the non-CAD group (P = 0.78). However, no signifcant difference was observed between the groups with and without angiographicallydocumented CAD in terms of CRP seropositivity (64.7% vs. 56.4%, P = 0.34). Conclusions: Regardless of having angiographically-proven CAD, almost all the cases referred for coronary angiography in our study had a previous exposure to CMV infection as determined by the presence of anti-CMV IgG antibodies in their sera. In fact, the results indicated no signifcant associations between CMV infection and the presence of CAD.
{"title":"Cytomegalovirus Infection and Coronary Artery Disease: A Single- Center Serological Study in Northwestern Iran","authors":"Z. Khameneh, A. Rostamzadeh, M. Nemati, Paul M Brown, N. Sepehrvand","doi":"10.17795/ICRJ-10(03)118","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)118","url":null,"abstract":"Te role of chronic Cytomegalovirus (CMV) infection and inflammation in \u0000the pathogenesis of atherosclerosis and Coronary Artery Disease (CAD) is still not clear. \u0000Objectives: Tis study aimed to explore the seroprevalence of anti-CMV antibodies and \u0000inflammatory markers in patients with stable angina who had undergone diagnostic \u0000coronary angiography for clinical suspicion of CAD. \u0000Patients and Methods: Tis cross-sectional, descriptive study was conducted on \u0000181 patients with stable angina selected randomly among the patients referred to \u0000Seyyedoshohada Heart Hospital of Urmia, Iran for diagnostic coronary angiography \u0000between August 2012 and December 2013. Te patients were categorized into CAD \u0000and non-CAD groups based on their angiographic fndings. Ten, anti-CMV IgG and \u0000IgM antibodies were tested using the Enzyme-Linked Immunosorbent Assay (ELISA) \u0000method (Diapron, Rome, Italy). Serum C-Reactive Protein (CRP) was also measured by \u0000a qualitative method (Aniston Kit). \u0000Results: Based on angiographic fndings, 141 patients (77.9%) had atheromatous plaques \u0000in their coronary arteries, while coronary arteries were free of any plaques in 40 cases \u0000(22.1%). Besides, 99.3% of the patients in the CAD group and all the patients in the \u0000non-CAD group were anti-CMV IgG positive. Te rate of anti-CMV IgM seropositivity \u0000was 11.7% in the CAD group and 13.2% in the non-CAD group (P = 0.78). However, no \u0000signifcant difference was observed between the groups with and without angiographicallydocumented CAD in terms of CRP seropositivity (64.7% vs. 56.4%, P = 0.34). \u0000Conclusions: Regardless of having angiographically-proven CAD, almost all the cases \u0000referred for coronary angiography in our study had a previous exposure to CMV infection \u0000as determined by the presence of anti-CMV IgG antibodies in their sera. In fact, the results \u0000indicated no signifcant associations between CMV infection and the presence of CAD.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ladan, D. Javidi, Amin Vahdani, Azar Nazar, Ali Zarin Ara, Y. Alimohamadi
Background: Impaired cardiac performance is a frequent presentation after Coronary Artery Bypass Graft (CABG) surgery. Intra-Aortic Balloon Pump (IABP), as a mechanical support, is lifesaving in many cases of low cardiac output state. IABP is needed to be in place from a few hours to a few days. Weaning is usually done according to patients’ hemodynamic response. Up to now, many studies have addressed the withdrawal methods, but few are related to predict the support time. Objectives: This study aimed to evaluate whether high serum lactate levels are early predictors of IABP dependency after CABG surgery. Patients and Methods: This prospective cohort study was performed on 843 patients who underwent CABG surgery from April 2009 to January 2014 in Pars hospital. Among these patients, 47 ones required IABP support and were all entered into our study. Arterial blood samples were collected by 2-hour intervals during the first 12 hours after the operation. Serum lactate levels were compared according to IABP dependency. The data were analyzed using chi-square, t-test, and correlation coefficient and α = 0.05 was considered to be the significance level. Results: Based on the results, 97.8% of the patients (n = 46) were successfully weaned from IABP support and 95.7% (n = 45) survived to discharge from the hospital. Two patients with persistent serum lactate levels > 15 mmol/L in the first 12 hours of IABP support had the worst prognosis. A significant association was found between the mean serum lactate levels ≥ 6 mmol/L in the first 12 hours after the surgery and ≥ 48 hours dependency on IABP (P = 0.030). Conclusions: Prediction of IABP dependency may be possible by measuring serum lactate levels in the first 12 hours after CABG surgery.
{"title":"Weaning from IABP after CABG Surgery: Impact of Serum Lactate Levels as an Early Predictor","authors":"M. Ladan, D. Javidi, Amin Vahdani, Azar Nazar, Ali Zarin Ara, Y. Alimohamadi","doi":"10.17795/ICRJ-10(03)135","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)135","url":null,"abstract":"Background: Impaired cardiac performance is a frequent presentation after Coronary Artery Bypass Graft (CABG) surgery. Intra-Aortic Balloon Pump (IABP), as a mechanical support, is lifesaving in many cases of low cardiac output state. IABP is needed to be in place from a few hours to a few days. Weaning is usually done according to patients’ hemodynamic response. Up to now, many studies have addressed the withdrawal methods, but few are related to predict the support time. Objectives: This study aimed to evaluate whether high serum lactate levels are early predictors of IABP dependency after CABG surgery. Patients and Methods: This prospective cohort study was performed on 843 patients who underwent CABG surgery from April 2009 to January 2014 in Pars hospital. Among these patients, 47 ones required IABP support and were all entered into our study. Arterial blood samples were collected by 2-hour intervals during the first 12 hours after the operation. Serum lactate levels were compared according to IABP dependency. The data were analyzed using chi-square, t-test, and correlation coefficient and α = 0.05 was considered to be the significance level. Results: Based on the results, 97.8% of the patients (n = 46) were successfully weaned from IABP support and 95.7% (n = 45) survived to discharge from the hospital. Two patients with persistent serum lactate levels > 15 mmol/L in the first 12 hours of IABP support had the worst prognosis. A significant association was found between the mean serum lactate levels ≥ 6 mmol/L in the first 12 hours after the surgery and ≥ 48 hours dependency on IABP (P = 0.030). Conclusions: Prediction of IABP dependency may be possible by measuring serum lactate levels in the first 12 hours after CABG surgery.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ansar Karimian, S. Farajnia, M. Ghojazadeh, F. Khaki-Khatibi
Background: Coronary artery disease (CAD) caused by atherosclerosis. Studies have shown that there are a number of factors which are closely related to the development and progression of CAD that include Cellular binding molecules like Plasminogen Activator Inhibitor-1(PAI-1), Lipid peroxidation, inflammation and hemostasis. Objectives: The present case-control study aimed to evaluate the association between Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G polymorphism and oxidative stress markers and Coronary Artery Disease (CAD). might be important in correlation with some other factors, such as increased or decreased triglyceride, cholesterol, and LDL and HDL levels. However, no significant correlation was observed between PAI-1 polymorphism
{"title":"The Association between PAI-1 Gene Promoter Polymorphism and Serum Serpin E1, MDA, and Hs-CRP Levels in Coronary Artery Disease","authors":"Ansar Karimian, S. Farajnia, M. Ghojazadeh, F. Khaki-Khatibi","doi":"10.17795/ICRJ-10(03)129","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)129","url":null,"abstract":"Background: Coronary artery disease (CAD) caused by atherosclerosis. Studies have shown that there are a number of factors which are closely related to the development and progression of CAD that include Cellular binding molecules like Plasminogen Activator Inhibitor-1(PAI-1), Lipid peroxidation, inflammation and hemostasis. Objectives: The present case-control study aimed to evaluate the association between Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G polymorphism and oxidative stress markers and Coronary Artery Disease (CAD). might be important in correlation with some other factors, such as increased or decreased triglyceride, cholesterol, and LDL and HDL levels. However, no significant correlation was observed between PAI-1 polymorphism","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":"129-134"},"PeriodicalIF":0.2,"publicationDate":"2016-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anomalous Origin of Right Coronary Artery from Distal Left Circumflex Artery: A Very Rare Variant of Single Coronary Artery Anomaly","authors":"A. Gholoobi","doi":"10.17795/ICRJ-10(03)146","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)146","url":null,"abstract":"","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2016-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68175099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Firouzi, Kamran Aeinfar, H. Shahsavari, H. Sanati, Farshad Shakerian, R. Kiani, A. Mehr
Background: No-reflow phenomenon is a serious complication of primary Percutaneous Coronary Intervention (PCI), which may increase the risk of progressive myocardial damage, profound left ventricular dysfunction, and death. Objectives: This study aimed to investigate the incidence of no-reflow phenomenon and its clinical, para-clinical, and angiographic determinants in patients who underwent primary PCI for ST Elevation Myocardial Infarction (STEMI). Patients and Methods: This non-randomized prospective cohort study was conducted on 397 patients in a cardiovascular tertiary care center in Tehran, Iran from April 2012 to April 2014. The inclusion criteria of the study were presenting with acute STEMI of ≤ 12 h duration or having admitted between 12 and 24 hours after onset with symptoms and signs of ongoing ischemia. The participants underwent standard coronary angiography. No-reflow phenomenon was defined as a Thrombolysis In Myocardial Infarction (TIMI) flow ≤ 2 and no presence of spasm, distal embolization, or dissection after completion of the procedure. The association between no-reflow and its determinants was assessed by chi-square, student’s t-test, or Mann–Whitney U test. Logistic regression models were also used for multivariate analysis. P values < 0.05 were considered to be statistically significant. Results: The participants’ mean (SD) age was of 59 (12.2) years and female/male ratio was 83/314. The incidence of no-reflow phenomenon was 63 (15.9%). Besides, the results of multivariate analysis showed that only thrombus burden, lesion length, time to reperfusion, and type of occlusion had an adjusted association with this phenomenon. Conclusions: The study results suggested that no-reflow phenomenon after primary PCI would be predictable. Thus, preventive measures, such as using distal protective devices or administration of platelet glycoprotein IIb/IIIa antagonists, are advised to be used in
{"title":"The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction","authors":"A. Firouzi, Kamran Aeinfar, H. Shahsavari, H. Sanati, Farshad Shakerian, R. Kiani, A. Mehr","doi":"10.17795/ICRJ-10(03)107","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)107","url":null,"abstract":"Background: No-reflow phenomenon is a serious complication of primary Percutaneous Coronary Intervention (PCI), which may increase the risk of progressive myocardial damage, profound left ventricular dysfunction, and death. Objectives: This study aimed to investigate the incidence of no-reflow phenomenon and its clinical, para-clinical, and angiographic determinants in patients who underwent primary PCI for ST Elevation Myocardial Infarction (STEMI). Patients and Methods: This non-randomized prospective cohort study was conducted on 397 patients in a cardiovascular tertiary care center in Tehran, Iran from April 2012 to April 2014. The inclusion criteria of the study were presenting with acute STEMI of ≤ 12 h duration or having admitted between 12 and 24 hours after onset with symptoms and signs of ongoing ischemia. The participants underwent standard coronary angiography. No-reflow phenomenon was defined as a Thrombolysis In Myocardial Infarction (TIMI) flow ≤ 2 and no presence of spasm, distal embolization, or dissection after completion of the procedure. The association between no-reflow and its determinants was assessed by chi-square, student’s t-test, or Mann–Whitney U test. Logistic regression models were also used for multivariate analysis. P values < 0.05 were considered to be statistically significant. Results: The participants’ mean (SD) age was of 59 (12.2) years and female/male ratio was 83/314. The incidence of no-reflow phenomenon was 63 (15.9%). Besides, the results of multivariate analysis showed that only thrombus burden, lesion length, time to reperfusion, and type of occlusion had an adjusted association with this phenomenon. Conclusions: The study results suggested that no-reflow phenomenon after primary PCI would be predictable. Thus, preventive measures, such as using distal protective devices or administration of platelet glycoprotein IIb/IIIa antagonists, are advised to be used in","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2016-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. M. Cauti, A. Radinovic, P. Mazzone, D. Regazzoli, F. Guarracini, S. Sala, M. Ancona, N. Trevisi, P. Bella
Brugada syndrome is a rare channelopathy characterized by an increased risk of sudden cardiac death. Patients with confirmed Brugada pattern and a history of palpitations without major events should be scheduled for risk stratification. Herein, we reported a patient with type I Electrocardiogram (ECG) pattern induced at the Ajmaline test and a family history of sudden cardiac death who had episodes of palpitations. We, therefore, described our flowchart in order to assess his sudden cardiac death risk.
{"title":"EP Testing in Asymptomatic Brugada Patients with Recurrent Palpitations. Just do it","authors":"F. M. Cauti, A. Radinovic, P. Mazzone, D. Regazzoli, F. Guarracini, S. Sala, M. Ancona, N. Trevisi, P. Bella","doi":"10.17795/ICRJ-10(03)140","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)140","url":null,"abstract":"Brugada syndrome is a rare channelopathy characterized by an increased risk of sudden cardiac death. Patients with confirmed Brugada pattern and a history of palpitations without major events should be scheduled for risk stratification. Herein, we reported a patient with type I Electrocardiogram (ECG) pattern induced at the Ajmaline test and a family history of sudden cardiac death who had episodes of palpitations. We, therefore, described our flowchart in order to assess his sudden cardiac death risk.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":"140-142"},"PeriodicalIF":0.2,"publicationDate":"2016-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68175193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioannis Karathanasis, M. Benjamin, I. Kouerinis, G. Peskesis, C. Kantsos, G. Karagkiouzis, G. Sarri, U. Trivedi
Congenital Coronary Artery Fistulae (CAF) originating from Right Coronary Artery (RCA) and draining into Coronary Sinus (CS) demonstrate high gradients and high flows, which result in ectasia of the entire artery. The anatomic margin between the ectatic RCA and the fistula are not clear and most cardiologists and cardiac surgeons tend to misname the entire vessel as “fistula”. We presented a 60-year-old female with multiple CAF draining into CS. The fistula originating from the RCA was huge and caused severe ectasia of the entire artery. The patient had progressive breathlessness due to high left to right shunt. Both fistulae were ligated under cardiopulmonary bypass. Our introduced term “ectatic-fistulous lesion” comes to address the confusion with nomenclature. It not only offers the theoretical advantage of precise description of the above complex pathology, but also allows the cardiac team to identify the anatomical margins between the ectasia and the fistula and, thus, to proceed to closure of the coronary fistula with safety.
{"title":"Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature","authors":"Ioannis Karathanasis, M. Benjamin, I. Kouerinis, G. Peskesis, C. Kantsos, G. Karagkiouzis, G. Sarri, U. Trivedi","doi":"10.17795/ICRJ-10(03)143","DOIUrl":"https://doi.org/10.17795/ICRJ-10(03)143","url":null,"abstract":"Congenital Coronary Artery Fistulae (CAF) originating from Right Coronary Artery (RCA) and draining into Coronary Sinus (CS) demonstrate high gradients and high flows, which result in ectasia of the entire artery. The anatomic margin between the ectatic RCA and the fistula are not clear and most cardiologists and cardiac surgeons tend to misname the entire vessel as “fistula”. We presented a 60-year-old female with multiple CAF draining into CS. The fistula originating from the RCA was huge and caused severe ectasia of the entire artery. The patient had progressive breathlessness due to high left to right shunt. Both fistulae were ligated under cardiopulmonary bypass. Our introduced term “ectatic-fistulous lesion” comes to address the confusion with nomenclature. It not only offers the theoretical advantage of precise description of the above complex pathology, but also allows the cardiac team to identify the anatomical margins between the ectasia and the fistula and, thus, to proceed to closure of the coronary fistula with safety.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Naghshtabrizi, Z. Sohrabi, F. Emami, B. Manafi, Shafee Membari
Background : Major Adverse Cardiac and Cerebrovascular Events (MACCE) include cardiac death, nonfatal Myocardial Infarction (MI), cerebrovascular events, and Target Vessel Revascularization (TVR) that may happen after Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG). Objectives : This study aimed to compare the incidence of MACCE between the patients who underwent PCI or CABG due to significant Left Anterior Descending (LAD) stenosis with and without other coronary arteries involvement. Patients and Methods : This randomized mixed cohort study was conducted on 400 patients with Coronary Artery Disease (CAD), 200 with proximal LAD stenosis and 200 with non-proximal LAD stenosis, selected through census. Half of each group underwent PCI and the rest underwent CABG. The participants were followed at fixed intervals after the procedure and the incidence of MACCE was documented in their checklists. Then, relative risk index was used to compare the two groups regarding the incidence of MACCE. Statistical analysis was done using the Stata software, version 11 and P < 0.05 was considered to be statistically significant. Results : The study participants included 281 males and 119 females with the mean age of 61.36 ± 10.66 years. The results showed a significant difference between the two groups regarding the incidence of MACCE (31.58% vs. 3%, P = 0.001). However, no significant difference was found between the effects of PCI with drug eluting stent and CABG on proximal LAD (3.70% vs. 3%, P = 1.00). Conclusions for proximal LAD stenosis. This randomized mixed cohort study was performed to evaluate the rate of MACCE in the patients with proximal or non-proximal LAD lesions with or without other coronary arteries involvement who underwent PCI or CABG. The study results revealed similar rates of MACCE among the patients with proximal LAD stenosis who underwent PCI with DES or CABG.
背景:主要不良心脑血管事件(MACCE)包括心源性死亡、非致死性心肌梗死(MI)、脑血管事件和靶血管重建术(TVR)，这些可能发生在经皮冠状动脉介入治疗(PCI)或冠状动脉旁路移植术(CABG)后。目的:本研究旨在比较因明显左前降支(LAD)狭窄而行PCI或CABG的患者(伴或不伴其他冠状动脉受累者)MACCE的发生率。患者和方法:本随机混合队列研究通过人口普查选择400例冠心病(CAD)患者，200例LAD近端狭窄和200例LAD非近端狭窄。两组各有一半行PCI，其余行CABG。手术后每隔一段时间对参与者进行随访，并在检查表中记录MACCE的发生率。然后采用相对风险指数比较两组MACCE的发生率。统计学分析采用Stata软件，版本11,P < 0.05为差异有统计学意义。结果:研究对象男性281人，女性119人，平均年龄61.36±10.66岁。结果显示两组间MACCE发生率有显著差异(31.58% vs. 3%， P = 0.001)。而药物洗脱支架PCI与CABG对近端LAD的影响差异无统计学意义(3.70% vs. 3%， P = 1.00)。结论:近端LAD狭窄。这项随机混合队列研究的目的是评估有近端或非近端LAD病变，伴或不伴其他冠状动脉受累者行PCI或CABG后MACCE的发生率。研究结果显示，在行PCI合并DES或CABG的LAD近端狭窄患者中，MACCE发生率相似。
{"title":"Evaluation of the Incidence of Major Adverse Cardiac and Cerebrovascular Events after Percutaneous Coronary Intervention or Coronary Artery Bypass Graft on Proximal Left Anterior Descending Artery with and without Other Coronary Arteries Involvement","authors":"B. Naghshtabrizi, Z. Sohrabi, F. Emami, B. Manafi, Shafee Membari","doi":"10.17795/ICRJ-10(2)61","DOIUrl":"https://doi.org/10.17795/ICRJ-10(2)61","url":null,"abstract":"Background : Major Adverse Cardiac and Cerebrovascular Events (MACCE) include cardiac death, nonfatal Myocardial Infarction (MI), cerebrovascular events, and Target Vessel Revascularization (TVR) that may happen after Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG). Objectives : This study aimed to compare the incidence of MACCE between the patients who underwent PCI or CABG due to significant Left Anterior Descending (LAD) stenosis with and without other coronary arteries involvement. Patients and Methods : This randomized mixed cohort study was conducted on 400 patients with Coronary Artery Disease (CAD), 200 with proximal LAD stenosis and 200 with non-proximal LAD stenosis, selected through census. Half of each group underwent PCI and the rest underwent CABG. The participants were followed at fixed intervals after the procedure and the incidence of MACCE was documented in their checklists. Then, relative risk index was used to compare the two groups regarding the incidence of MACCE. Statistical analysis was done using the Stata software, version 11 and P < 0.05 was considered to be statistically significant. Results : The study participants included 281 males and 119 females with the mean age of 61.36 ± 10.66 years. The results showed a significant difference between the two groups regarding the incidence of MACCE (31.58% vs. 3%, P = 0.001). However, no significant difference was found between the effects of PCI with drug eluting stent and CABG on proximal LAD (3.70% vs. 3%, P = 1.00). Conclusions for proximal LAD stenosis. This randomized mixed cohort study was performed to evaluate the rate of MACCE in the patients with proximal or non-proximal LAD lesions with or without other coronary arteries involvement who underwent PCI or CABG. The study results revealed similar rates of MACCE among the patients with proximal LAD stenosis who underwent PCI with DES or CABG.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":"61-66"},"PeriodicalIF":0.2,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68175037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO), because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI) techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.
{"title":"Pathology of Coronary Chronic Total Occlusion","authors":"K. Sakakura, K. Yahagi, R. Virmani, M. Joner","doi":"10.17795/ICRJ-10(2)55","DOIUrl":"https://doi.org/10.17795/ICRJ-10(2)55","url":null,"abstract":"There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO), because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI) techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.","PeriodicalId":43653,"journal":{"name":"International Cardiovascular Research Journal","volume":"10 1","pages":"55-60"},"PeriodicalIF":0.2,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68175032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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