Right Coronary Artery Originating from the Left: Do Not Miss the Diagnosis!

Objective. Left circumflex (LCx) artery originating from the right coronary arterial (RCA) system has been reported as the most common form of anomalous origination of a coronary artery from the opposite sinus (ACAOS). However, some studies claim that RCA originating from the left coronary sinus (LCS) is the most frequent form. The aim of this study was to determine the most common type of ACAOS in a single center. Materials and Methods. The database of the catheterization laboratory was retrospectively searched. All patients who were performed coronary angiography between 1999 and 2006 were included to registry. All examinations were carefully analyzed to determine the most frequent type of ACAOS. Results. We detected ACAOS in 35 cases (16 RCA originating from the LCS, 13 LCx from the RCS or the RCA, and 6 others) out of 5165 coronary angiograms. The most common form was RCA originating from LCS. Moreover, we revealed that 5 cases with RCA originating from the LCS were previously misdiagnosed and not reported as a coronary anomaly. Conclusions. RCA originating from the LCS was the most common form of ACAOS in our registry. The high change of misdiagnosis or underreporting of this anomaly could have biased the true prevalence

Congenitally severe tortuous circumflex artery fistula draining into the coronary sinus: Transcatheter closure with Guglielmi detachable coils via different delivery system

WOS: 000270758600021PubMed: 19782273Coronary artery fistulae are very rare congenital anomalies which constitute 0.2-0.4% of all congenital heart diseases. The right chambers of the heart are the most frequent communication site of the coronary fistulae and may cause hemodynamic impairment in the coronary circulation. The fistulae arise frequently from right coronary and left anterior descending arteries. Fistulae from left circumflex artery are very rare. We report a case in which transcatheter embolization was performed with 3-mm Guglielmi detachable coils in a young adult with a rare type of congenital fistula originating from the circumflex artery and draining into the coronary sinus. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved

Thrombolysis in myocardial infarction frame count in coronary arteries without visible atherosclerosis in coronary angiography of patients with stable coronary artery disease

WOS: 000269349300015PubMed: 19526167Objectives: To investigate the thrombolysis in myocardial infarction (TIMI) frame count (TFC) in the coronary arteries without visible atherosclerosis in coronary angiography of patients with stable coronary artery disease (CAD). Methods: Eighty-three patients (mean age 58 10, 31 [37%] males), who underwent coronary angiographic evaluation for stable angina in Gazi University, Ankara, Turkey, Cardiology clinic between 2006-2007 were enrolled. Forty patients with normal coronary arteries were defined as group 1. Group 11 consisted-of 43 patients, who have one normal coronary artery in the setting of stable CAD defined as stenoses 50% or greater in at least one major coronary artery. Coronary blood flow and microvascular perfusion was evaluated by TFC. Results: In group 11, the TFC of left anterior descending artery (LAD) in 15 patients, TFC of circumflex artery (CX) in 18 patient, and TFC of right coronary artery (RCA) in 10 patients were evaluated. In group 11, the TFC of LAD (37 12 versus 29 12, p=0.015) and CX (22 8 versus 18 9, p=0.035) were significantly higher than those in group 1. The TFC of RCA was similar between groups (17 9 versus 17 8, p=0.990). After the adjustment of the risk factors by multivariate regression analyses, the association between TFC and clinical characteristic was statistically non-significant. Conclusion: The TFC decreased in angiographically normal LAD and CX arteries in the setting of stable angina pectoris. The important predictor was CAD alone, irrespective of the clinical parameters

Wpływ leczenia statynami na morfologię załamka P i czas przewodzenia przedsionkowego

Background and aim: The aim of this study was to evaluate the effect of statin treatment on P-wave morphology, dispersion, and tissue Doppler imaging-derived atrial conduction time (PA-TDI), which are known to be predictors of atrial fibrillation (AF). Methods: A total of 132 patients with guideline-directed statin indications but no clinical atrial tachyarrhythmias were studied. P-wave duration, P-wave dispersion, and P-wave amplitude on surface 12-lead electrocardiogram and PA-TDI were evaluated before and after three months of statin (either atrovastatin 10–40 mg/d or rosuvastatin 10–20 mg/d) treatment. Results: Total and low-density lipoprotein cholesterol were significantly reduced after statin therapy. P-wave dispersion significantly decreased from 39.6 ± 9.4 to 36.9 ± 9.6 ms. Statin treatment significantly decreased both the maximum (from 1.5 ± 0.36 to 1.45 ± 0.33 mV, p = 0.001) and the minimum (from 1.07 ± 0.28 to 1.04 ± 0.27 mV, p = 0.01) P-wave amplitude. The PA-TDI value was found to be significantly shorter after statin treatment (121.7 ± 18.7 vs. 118.7 ± 15.8 ms, p = 0.016) Conclusions: Short-term statin therapy was shown to significantly affect P-wave amplitude, P-wave dispersion, and atrial conduction time in a broad range of patients without any clinical atrial tachyarrhythmia.Wstęp i cel: Celem niniejszego badania była ocena wpływu leczenia statynami na morfologię i dyspersję załamka P oraz czas przewodzenia przedsionkowego określonego w obrazowaniu metodą doplera tkankowego (PA-TDI) uznawany za czynnik predykcyjny migotania przedsionków (AF). Metody: Przeanalizowano dane 132 chorych ze wskazaniami do stosowania statyn, zgodnie z wytycznymi terapeutycznymi, ale bez klinicznych objawów tachyarytmii przedsionkowej. Przed rozpoczęciem terapii i po 3-miesięcznym leczeniu statynami (atorwastatyna 10–40 mg/d. lub rosuwastatyna 10–20 mg/d.) oceniano czas trwania, dyspersję i amplitudę załamka P w powierzchniowym 12-odprowadzeniowym elektrokardiogramie oraz określano czas PA-TDI. Wyniki: Stężenie cholesterolu całkowitego i cholesterolu frakcji LDL było istotnie niższe po leczeniu statynami. Nastąpiło istotne zmniejszenie dyspersji załamka P z 39,6 ± 9,4 do 36,9 ± 9,6 ms. Terapia statynami spowodowała znamienną redukcję maksy­malnej (z 1,5 ± 0,36 do 1,45 ± 0,33 mV; p = 0,001) i minimalnej amplitudy załamka P (z 1,07 ± 0,28 do 1,04 ± 0,27 mV; p = 0,01). Czas PA-TDI był istotnie krótszy po leczeniu statynami (121,7 ± 18,7 vs. 118,7 ± 15,8 ms; p = 0,016) Wnioski: Wykazano, że krótkotrwała terapia statynami istotnie wpływa na amplitudę i dyspersję załamka P oraz czas przewodzenia przedsionkowego w zróżnicowanej grupie chorych bez objawowej tachyarytmii przedsionkowej

The role of oxidative DNA damage and GSTM1, GSTT1, and hOGG1 gene polymorphisms in coronary artery disease risk

Objective: Atherosclerotic coronary artery disease (CAD) appears to be a multifactorial process caused by the interaction of environmental risk factors with multiple predisposing genes. Therefore, in this study we aimed to determine the role of oxidative DNA damage and some variations in glutathione S-transferase (GSTM1 and GSTT1) and DNA repair (hOGG1) genes in CAD risk

The role of oxidative DNA damage and GSTM1, GSTT1, and hOGG1 gene polymorphisms in coronary artery disease risk

Objective: Atherosclerotic coronary artery disease (CAD) appears to be a multifactorial process caused by the interaction of environmental risk factors with multiple predisposing genes. Therefore, in this study we aimed to determine the role of oxidative DNA damage and some variations in glutathione S-transferase (GSTM1 and GSTT1) and DNA repair (hOGG1) genes in CAD risk. Methods: A case-control study was conducted on 59 individuals who had undergone coronary angiographic evaluation. Of these, 29 were patients diagnosed with CAD (mean age = 61.5 +/- 10.3) and 30 were controls examined for reasons other than suspected CAD and who had angiographically documented normal coronary arteries (mean age = 60.4 +/- 11.6). Basal DNA damage as well as pyrimidine and purine base damage were evaluated in peripheral blood lymphocytes using the modified comet assay. Polymerase chain reaction-restriction length polymorphism (PCR-RFLP)-based assay was used for genotyping. Results: Basal DNA damage levels in patients [9.16 (3.26)] were significantly higher than those in controls [7.59 (3.23); p=0.017], and basal DNA and pyrimidine base damage levels were significantly correlated with disease severity based on Gensini scoring (r=0.352, p= 0.006; r= 0.318, p=0.014, respectively). However, no significant differences were observed in terms of oxidized DNA bases between patients and controls. The frequencies of studied genotypes (GSTM1, GSTT1, and hOGG1) were similar between groups. Conclusion: The results of this study pointed out the role of DNA damage in CAD and its severity. However, GSTM1, GSTT1, and hOGG1 gene polymorphisms seemed to have no effect on individual susceptibility for disease progression

The effect of periodontal therapy on neopterin and vascular cell adhesion molecule-1 levels in chronic periodontitis patients with and without acute myocardial infarction: a case-control study

The presence of neopterin in gingival crevicular fluid (GCF) is a marker for local and acute immune activation, and the presence of vascular cell adhesion molecule (VCAM-1) in GCF is accepted as a marker for chronic vascular inflammation. Objectives: This study aimed to evaluate effects of periodontal treatment on GCF levels of neopterin and VCAM-1 in patients with chronic periodontitis (CP) with acute myocardial infarction (AMI) compared with systemically healthy CP patients. Material and methods: Sixty subjects (20 CP patients with AMI, 20 healthy CP patients, and 20 healthy controls) were included. GCF samples were analyzed at baseline and after 3 and 6 months, and the probing pocket depth (PD), clinical attachment level (CAL), bleeding on probing, gingival (GI) and plaque (PI) indices were recorded. We determined neopterin and VCAM-1 levels (concentration and total amount) using enzyme-linked immunosorbent assay (ELISA). No significant differences were seen between the AMI+ CP and CP groups for PI, GI, GCF levels of neopterin and VCAM-1 at baseline. Results: The number of teeth with 5 mm = 7 mm were significantly increased in the AMI+ CP group at baseline. There were no significant differences between the AMI+ CP and CP for PI, CAL, GCF volumes, and the AMI+ CP group had the highest clinical improvement in the number of teeth with 5 mm <= CAL< 7 mm at the sixth month. There were significant positive correlations between clinical periodontal inflammation and the presence of neopterin and VCAM-1 in GCF prior to and following periodontal treatment, and between the GCF volume and clinical parameters. Conclusions: Data suggest that the total amount and concentration of neopterin and VCAM-1 in GCF seemed to be closely associated with periodontal disease severity in CP patients with AMI. Moreover, the results of our study demonstrate that the past periodontal status is potentially correlated between groups, with similar periodontal disease severity