Impact of Coronary Collateral Circulation on In-Hospital Death in Patients with Inferior ST Elevation Myocardial Infarction

Objectives. Coronary collateral circulation (CCC) may limit the size of right ventricular (RV) infarcts but does not fully explain the relationship between CCC and clinical adverse events in patients with inferior STEMI. In this study, it was aimed to assess the relationship between preintervention angiographic evidence of CCC and clinical outcomes in patients with inferior STEMI who have undergone percutaneous coronary intervention. Methods. A total of 235 inferior STEMI patients who presented within the first 12 hours from the symptom onset were included. CCC to the right coronary artery (RCA) before angioplasty were angiographically assessed, establishing two groups: 147 (63%) patients without CCC and 88 (37%) with CCC according to presence of CCC. Results. RV infarction, complete atrioventricular block, VT/VF, cardiogenic shock, and in-hospital death were noted less frequently in patients with CCC than in those without CCC. Absence of CCC to RCA was found to be the independent predictor for in-hospital death among them (odds ratio 4.0, 95% CI 1.8–12.6; p=0.03). Conclusion. Presence of angiographically detectable CCC was associated with better in-hospital outcomes including RV infarction, complete AV block, cardiogenic shock, and VT/VF in patients with inferior STEMI

EPICARDIAL ADIPOSE TISSUE THICKNESS AND SYSTEMIC SCLEROSIS

Aim: Microvasculopathy and endothelial damage are obvious features of systemic sclerosis (SSc) and increases risk of cardiovascular disease. Epicardial adipose tissue (EAT) is localized beneath the visceral pericardium and has been shown to be closely related with coronary artery disease (CAD). The aim of this study was to investigate the thickness of EAT in SSc patients who had no previous or current history of cardiac involvement

The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF). Method This multicenter, cross-sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination. Result Overall, the median age was 50 (38-60) and 139 (49.4\%) were female. Percentage of median PVC burden was 9\% (IQR: 4\%-17.4\%). Median LVEF was found 60\% (55-65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (\%) (regression coefficient (RE) -0.644 and 95\% CI -1.063, -0.225, p < .001), PVC QRS duration (RE-0.191 and 95\% CI -0.529, 0.148, p = .049), and age (RE-0.249 and 95\% CI -0.442, -0.056, p = .018) were associated with decrease in LVEF. This inverse relationship between the PVC burden and LVEF become more prominent when PVC burden was above 5\%. A nomogram developed to estimate the individual risk for decrease in LVEF. Conclusion Our study showed that increase in PVC burden \%, age, and PVC QRS duration were independently associated with decrease in LVEF in patients with idiopathic PVC. Also, inverse relationship between PVC burden and LVEF was observed in lower PVC burden than previously known