A rare Congenital Coronary Artery Anomaly: Woven Right Coronary Artery associated with Myocardial Infarction

Woven coronary artery (WCA) is an extremely rare and still not a clearly defined coronary anomaly. It is characterized by the division of epicardial coronary artery into thin channels which then reanastomose with the distal part of the abnormal coronary artery [1]. Since the angiographic imaging of WCA looks like an intracoronary thrombus and dissection; the differential diagnosis between atherothrombotic coronary arteries with recanalization of organized thrombi in coronary arteries and WCA may be very difficult for invasive cardiologists, especially in patients with single or two coronary artery involvements [2]

Spontaneous rupture of a giant Coronary Artery Aneurysm after acute Myocardial Infarction

Coronary artery aneurysm is commonly defined as a localized dilatation exceeding the diameter of adjacent normal coronary segments by 50% [1]. Coronary artery aneurysms may be fusiform, involving the full circumference of the coronary artery, or saccular, involving only a portion of the circumference [2]. Causes of coronary artery aneurysms include atherosclerosis (accounting for 50% of cases), Kawasaki disease, polyarteritis nodosa, infection, trauma, coronary dissection, percutaneous coronary angioplasty, and congenital malformations [3]. The abnormal blood flow within the coronary artery aneurysm may lead to thrombus formation, embolization, rupture, myocardial ischemia or myocardial infarction [4]. Here we present a case of a giant fusiform coronary artery aneurysm who passed away due to coronary rupture after acute myocardial infarction

Relation of Serum ADMA, Apelin-13 and LOX-1 Levels with Inflammatory and Echocardiographic Parameters in Hemodialysis Patients

Cardiovascular diseases are the leading causes of mortality in patients with chronic kidney disease. Nitric oxide has a critical role in both endothelial dysfunction and the atherosclerosis process. We aimed to investigate the relationships between serum asymmetric dimethyl arginine (ADMA), LOX-1, and Apelin-13 levels, which are known to act over nitric oxide with endothelial dysfunction and cardiac morphology as well as with each other in hemodialysis patients. The study comprised a total of 120 patients (53females and 67males) receiving hemodialysis three times a week for at least 6months and an age-gender matched control group (55 females and 58 males). Serum ADMA, LOX-1, and Apelin-13 levels were measured using the ELISA technique. Echocardiography, 24-h blood pressure monitoring by the Holter and carotid artery intima-media thickness (CIMT) measurement was performed on all of the included subjects. The associations between serum ADMA, LOX-1, and Apelin-13 levels with CIMT, echocardiographic parameters [left ventricular mass (LVM) and left ventricular mass index (LVMI)], and inflammatory markers [high sensitive C-reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR)] were evaluated by correlation analysis. Serum ADMA, Apelin-13, and LOX-1 levels were significantly higher in the hemodialysis group than the controls (P<0.001, P<0.001, and P<0.001, respectively). CIMT, hsCRP, and NLR levels were also significantly higher in the hemodialysis group (P<0.05, P<0.001, P<0.001, respectively). Significant correlations were observed among the serum ADMA, Apelin-13, and LOX-1 levels. Moreover, notably positive correlations were found between these three biochemical markers and LVM, LVMI, hsCRP, and CIMT. Serum ADMA, Apelin-13, and LOX-1 levels can be indicators not only for the inflammatory process but also for the pathogenesis of cardiovascular diseases in hemodialysis patients

Increased epicardial adipose tissue thickness is associated with microalbuminuria in hypertensive patients with left ventricular hypertrophy

Objective Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been previously reported. Microalbuminuria (MA) is associated with target-organ damage, especially in patients with hypertension with left ventricular hypertrophy (LVH) and suggest endothelial dysfunction. This study aimed to investigate the relationship between echocardiographic EAT thickness and presence of MA in patients with hypertension. Methods A total of 297 newly diagnosed hypertension patients who applied to the outpatient clinic were enrolled consecutively in this study. Patients were divided into two groups regarding the presence of LVH in echocardiography. An age and gender matched control group was set including 156 healthy patients without HT. All subjects underwent transthoracic echocardiography for the measurement of EAT thickness. Spot urine samples were collected for the assessment of MA. Results In hypertensive patients with LVH, the EAT thicknesses (6.6 ± 1.8 vs 5.3 ± 1.5 vs 5.1 ± 1.3, p < .001; respectively) and prevalence of MA (41.2 vs 20.1 vs 3.2%; p < .001 respectively) were significantly higher than the other two groups. In hypertensive patiens without LVH, no relationship was found between the presence of MA and EAT thickness. In multivariate regression analyses, EAT thickness (OR: 3.141, 95%CI: 2.425–6.123, p < .001) and left ventricular mass index (OR: 1.339, 95%CI: 1.145–2.143, p = .003) were determined as independent predictors for MA development in hypertensive patients with LVH. Conclusion Measurement of EAT thickness may help to identify high-risk hypertensive patients for target-organ damage especially among patients with LVH