Circulating adhesion molecules and arterial stiffness

Aim: VCAM-1 and ICAM-1 are two important members of the immunoglobulin gene superfamily of adhesion molecules, and their potential role as biomarkers of diagnosis, severity and prognosis of cardiovascular disease has been investigated in a number of clinical studies. The aim of the present study was to determine the relationship between circulating ICAM-1 and VCAM-1 levels and aortic stiffness in patients referred for echocardiographic examination. Methods: Aortic distensibility was determined by echocardiography using systolic and diastolic aortic diameters in 63 consecutive patients referred for echocardiography. Venous samples were collected in the morning after a 12-hour overnight fast, and serum concentrations of ICAM-1 and VCAM-1 were measured using commercial enzyme immunoassay kits. Results: Data of a total of 63 participants (mean age 55.6 ± 10.5 years, 31 male) were included in the study. Circulating levels of adhesion molecules were VCAM-1: 12.604 ± 3.904 ng/ml and ICAM-1: 45.417 ± 31.429 ng/ml. We were unable to demonstrate any correlation between indices of aortic stiffness and VCAM-1 and ICAM-1 levels. Conclusion: The role of soluble adhesion molecules in cardiovascular disease has not been fully established and clinical studies show inconsistent results. Our results indicate that levels of circulating adhesion molecules cannot be used as markers of aortic stiffness in patients

Sustained ventricular tachycardia in a patient with isolated non-compaction cardiomyopathy

Isolated non-compaction of the left ventricular myocardium (INVM) was first described in 1984 as an unclassified cardiomyopathy, not being dilated, hypertrophic or restrictive. It is assumed to occur as a result of an arrest in endomyocardial morphogenesis during normal development of the heart. The disease is characterised by heart failure due to systolic and diastolic left ventricular (LV) dysfunction, systemic emboli and ventricular arrhythmias. Echocardiography has been shown to be the method of choice in diagnosis. INVM is a rare congenital cardiomyopathy and only a few cases of this condition have been reported. It is characterised by prominent and excessive trabeculation in a ventricular wall segment, with deep inter-trabecular spaces perfused from the ventricular cavity. We report a case of INVM with ventricular tachycardia induced during electrophysiological study in a 24-year-old female patient with a family history of sudden death

Atrial tachycardia treated by coil embolization of a giant coronary artery fistula

Coronary artery fistulas are the second most frequently seen coronary anomaly following abnormalities of coronary artery origin and distribution. A coronary fistula is defined as a direct communication between a coronary artery and any cardiac chamber or vessel. Treatment options include percutaneous embolization and surgical intervention. Herein, we present a case of a giant coronary artery fistula and right atrial tachycardia that was induced during a diagnostic electrophysiologic study but was not inducible after the successful treatment of the fistula. This is the first case indicating this association. © 2013 Sociedade Portuguesa de Cardiologia

Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices

The aim of this study is to investigate the presence of limitations in the shoulder range of motion (ROM) or the loss of upper extremity function on the affected side in patients with cardiac implantable electronic devices (CIEDs) with respect to the implantation time. Forty-nine patients (30 men and 19 women), mean age 64.84 ±11.18 years, who had been living with a CIED for less than 3 months were included in the short-term recipient (STR) group and 127 patients (85 men and 42 women), mean age 64.91± 14.70 years, and with the device for longer than 3 months were included in the long-term recipients group. Shoulder ROMs were measured using a digital goniometer. The other arm was used as the control. The Constant-Murler Score, Shoulder Pain Disability Index, and Shoulder Disability Questionnaire were used to assess the functional status. Limitations of ROM for flexion, abduction, and internal rotation were found to be significantly lower in the arm on the side of CIED compared with the control arm. Significant differences in shoulder flexion, abduction, and external rotation in STRs were found compared with longterm recipient (P<0.05). However, the functional comparison of groups by the Constant-Murler Score was not significant. A low to moderate amount of shoulder disability measured by Shoulder Pain Disability Index and Shoulder Disability Questionnaire was found in patients with CIEDs, which was more prominent in STRs (P<0.05). Pain, association of CIED with pectoral muscles, a possible subtle ongoing capsular pathology, and avoidance behaviors of patients to minimize the risk of lead dislodgement might be related to restriction of motion and function in the shoulder joint in patients with CIEDs. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved