Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

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Spontaneous Dissection of Right Coronary Artery Manifested with Acute Myocardial Infarction

Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women without traditional risk factors for coronary artery disease during pregnancy or postpartum period. However, it has also been reported in patients with atherosclerotic coronary disease. We present a case of spontaneous right coronary artery dissection in a 48-year male with recent myocardial infarction and previous percutaneous coronary intervention

STENTS IN CORONARY VESSEL ANGIOPLASTY

THE SHORT AND LONG - TERM CLINICAL AND ANGIOGRAPHIC RESULTS AND CONSEQUENCES OF CORONARY ANGIOPLASTY WITH IMPLANTATION OF THE PALMER - SCHATZ STENT WERE STUDIED IN 131 CORONARY ARTERY LESIONS. QUANTITATIVE CORONARY ANALYSIS WAS PERFORMED BEFORE THE ANGIOPLASTY, IMMEDIATELY AFTER STENT IMPLANTATION AND AT THE FOLLOW - UP ANGIOGRAM. THE EARLY USE OF STENTS IN CASES OF ACUTE OR IMPENDINGOCCLUSION COMPARED TO HISTORICAL CONTROLS WAS EFFECTIVE IN REDUCING THE MYOCARDIAL INFARCTION RATE AND EMERGENCY CORONARY BYPASS SURGERY RATE. THE FREQUENCY OF RESTONOSIS WAS HIGHER IN VESSELS WITH DIAMETER 10 MM AND WHEN MULTIPLE STENTS WERE DEPLOYED IN TANDEM. THE MAJOR DETERMINANT OF RESTENOSIS HAS THE HYPERPLASTIC RESPONSE.ΜΕΛΕΤΗΣΑΜΕ ΤΟΣΟ ΑΜΕΣΑ ΟΣΟ ΚΑΙ ΤΑ ΑΠΩΤΕΡΑ ΚΛΙΝΙΚΑ ΚΑΙ ΑΓΓΕΙΟΓΡΑΦΙΚΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΤΗΣ ΤΟΠΟΘΕΤΗΣΗΣ ΤΩΝ ΕΝΔΟΠΡΟΣΘΕΣΕΩΝ ΤΥΠΟΥ PALMER - SCHATZ ΣΕ 131 ΣΤΕΝΩΣΕΙΣ ΣΤΕΦΑΝΙΑΙΩΝ ΑΓΓΕΙΩΝ. ΕΓΙΝΑΝ ΠΟΣΟΤΙΚΕΣ ΜΕΤΡΗΣΕΙΣ ΤΩΝ ΔΙΑΜΕΤΡΩΝ ΤΩΝ ΑΓΓΕΙΩΝ ΚΑΙ ΣΤΕΝΩΣΕΩΝ ΠΡΙΝ ΑΠΟ ΤΗΝ ΑΓΓΕΙΟΠΛΑΣΤΙΚΗ, ΑΜΕΣΩΣ ΜΕΤΑ ΤΗΝ ΤΟΠΟΘΕΤΗΣΗ ΤΩΝ ΕΝΔΟΠΡΟΣΘΕΣΕΩΝ ΚΑΙ ΣΕ ΣΤΕΦΑΝΙΟΓΡΑΦΙΑ ΠΑΡΑΚΟΛΟΥΘΗΣΗΣ. Η ΕΓΚΑΙΡΗ ΧΡΗΣΙΜΟΠΟΙΗΣΗ ΤΩΝ ΕΝΔΟΠΡΟΣΘΕΣΕΩΝ ΣΕ ΟΞΕΙΕΣ Η ΕΠΑΠΕΙΛΟΥΜΕΝΕΣ ΑΠΟΦΡΑΞΕΙΣ ΕΙΝΑΙ ΑΠΟΤΕΛΕΣΜΑΤΙΚΗ ΣΤΗΝ ΑΠΟΦΥΓΗ ΕΠΕΙΓΟΥΣΑΣ ΑΟΡΤΟΣΤΕΦΑΝΙΑΙΑΣ ΠΑΡΑΚΑΜΨΗΣ ΚΑΙ ΣΤΟΝ ΠΕΡΙΟΡΙΣΜΟ ΤΗΣ ΣΥΧΝΟΤΗΤΑΣ ΕΜΦΡΑΓΜΑΤΟΣ. Η ΣΥΧΝΟΤΗΤΑ ΤΗΣ ΕΠΑΝΑΣΤΕΝΩΣΗΣ ΗΤΑΝ ΥΨΗΛΟΤΕΡΗ ΣΕ ΑΓΓΕΙΑ ΜΕ ΔΙΑΜΕΤΡΟ 10 MM ΚΑΙ ΟΤΑΝ ΥΠΗΡΧΑΝ ΠΟΛΛΕΣ ΠΑΡΑΚΕΙΜΕΝΕΣ ΕΝΔΟΠΡΟΣΘΕΣΕΙΣ. Ο ΚΥΡΙΟΣ ΠΑΡΑΓΟΝΤΑΣ ΤΗΣ ΕΠΑΝΑΣΤΕΝΩΣΗΣ ΗΤΑΝ ΤΟ ΜΕΓΕΘΟΣ ΤΗΣ ΥΠΕΡΠΛΑΣΤΙΚΗΣ ΑΝΤΙΔΡΑΣΗΣ

Data on diagnostic performance of stress perfusion cardiac magnetic resonance for coronary artery disease detection at the vessel level

Stress perfusion cardiac magnetic resonance (CMR) has been proposed as an important gatekeeper for invasive coronary angiography (ICA) and percutaneous coronary interventions (PCI) in patients evaluated for possible coronary artery disease (CAD) (Fihn et al., 2012; Montalescot et al., 2013) [1,2]. Several meta-analyses have evaluated the accuracy of stress perfusion CMR to diagnose CAD at the vessel level (Danad et al., 2017; Dai et al., 2016; Jiang et al., 2016; Takx et al., 2015; Li et al., 2015; Desai and Jha, 2013; Jaarsma et al. 2012; Hamon et al., 2010; Nandalur et al. 2007) [3–11]. However, they included in the same analysis studies with different definitions of significant CAD (i.e. fractional flow reserve [FFR] < 0.75 and < 0.80 or coronary stenosis ≥ 50% and ≥ 70%), magnetic field strength (1.5 or 3 Tesla [T]), and study protocol (integration or not of late gadolinium enhancement [LGE] into stress perfusion protocol). Data of 34 studies (6091 arteries) have been pooled with the aim of analyzing the accuracy of stress perfusion CMR for the diagnosis of ischemic heart disease at the vessel level according to different definitions of significant CAD, magnetic field strength and study protocol (Arnold et al., 2010; Bettencourt et al., 2013; Cheng et al., 2007; Chiribiri et al., 2013; Cury et al., 2006; De Mello et al., 2012; Donati et al., 2010; Ebersberger et al., 2013; Gebker et al., 2008; Greulich et al., 2015; Hussain et al., 2016; Ishida et al., 2005, 2003; Kamiya et al., 2014; Kitagawa et al., 2008; Klein et al., 2008; Klem et al., 2006; Klumpp et al., 2010; Krittayaphong et al., 2009; Lockie et al., 2011; Ma et al., 2012; Merkle et al., 2007; Meyer et al., 2008; Mor-Avi et al., 2008; Pan et al., 2015; Papanastasiou et al., 2016; Pons Lladó et al., 2004; Sakuma et al., 2005; Salerno et al., 2014; Scheffel et al., 2010; van Werkhoven et al., 2010; Walcher et al., 2013; Watkins et al., 2009; Yun et al., 2015) [12–45]. This article describes data related article titled “Diagnostic Performance of Stress Perfusion Cardiac Magnetic Resonance for the Detection of Coronary Artery Disease” (Kiaos et al., submitted for publication) [46]. Keywords: Cardiovascular magnetic resonance, Stress perfusion, Coronary artery disease, Diagnostic accuracy meta-analysi

Pregnancy outcome in women with congenital heart disease: A single-center experience

Objective: Pregnancies in patients with adult congenital heart disease (ACHD) are often complicated. We aimed to highlight the nature and the rate of these complications in a single-center patient population. Methods: We retrospectively studied all the pregnancies of women who presented on an outpatient basis, and all pregnancies were reviewed for maternal and fetal outcomes. Results: Of 117 pregnancies from 52 ACHD patients (age at pregnancy 28.3 ± 6.6 years), 10 were therapeutically aborted. A proportion of 41.1% of the remaining 107 pregnancies were complicated either with cardiac (3.7%), obstetric (15.0%), or fetal/neonatal (11.2%) adverse events or with spontaneous abortion (17.8%). Hospitalization during pregnancy was required in 10 patients. Elective cesarean sections were initially planned for 31% of the 87 pregnancies, which were finally completed, while 8% required an emergency cesarean section, mostly for obstetric reasons. NYHA class deterioration after pregnancy was detected in 9.3% of our cohort. Modified WHO class III/IV, prior medication use, and higher body mass index (BMI) were related to cardiac complications during pregnancy or NYHA deterioration. Conclusion: Pregnancies in ACHD patients are at high risk for complications. Advanced modified WHO class, prior medication use, and high BMI were related to adverse cardiac events. Keywords: Pregnancy, Adult congenital heart disease, Cardiac complications, Obstetric complications, Neonatal complication

Extremely rare case of primary cardiac chondroma in a patient presenting with acute pulmonary edema

Primary tumors of the heart are rare entities, substantially less frequent than cardiac metastases. Primary chondroma is an exceptionally rare cardiac tumor. We describe the case of a patient presenting with acute pulmonary edema with the incidental echocardiographic finding of a large left atrial tumor that was histopathologically diagnosed as primary cardiac chondroma

The Interplay between Myocardial Fibrosis, Strain Imaging and Collagen Biomarkers in Adults with Repaired Tetralogy of Fallot

Background: We sought to assess the interplay between right ventricle (RV) fibrosis, biventricular dysfunction based on global longitudinal strain (GLS) analysis, and biomarkers such as Galectin-3 (Gal-3), procollagen type III (PCIII), and NTproBNP. Methods: We studied 35 adult patients with rToF. All patients underwent a cardiac magnetic resonance (CMR) scan including feature tracking for deformation imaging. Blood biomarkers were measured. Results: LGE RV was detected in all patients, mainly at surgical sites. Patients with the highest RV LGE scoring had greater RV dilatation and dysfunction whereas left ventricular (LV) function was preserved. LV GLS correlated with RV total fibrosis score (p = 0.007). A LV GLS value of −15.9% predicted LGE RV score &gt; 8 (AUC 0.754 (p = 0.02)). Neither RV GLS nor biomarker levels were correlated with the extent of RV fibrosis. A cut-off value for NTproBNP of 145.25 pg/mL predicted LGE RV score &gt; 8 points (AUC 0.729, (p = 0.03)). A cut-off value for Gal-3 of 7.42 ng/mL predicted PR Fraction &gt; 20% [AUC 0.704, (p = 0.05)]. Conclusions: A significant extent of RV fibrosis was mainly detected at surgical sites of RV, affecting RV performance. CMR-FT reveals subtle LV dysfunction in rToF patients, due to decreased performance of the fibrotic RV. Impaired LV function and elevated NTproBNP in rToF reflect a dysfunctional fibrotic RV