ABSTRACT
Objective: The aim of this study was to determine whether the Macruz index [P/P-R segment] could predict the severity of valvular involvement and the success of percutaneous mitral balloon valvuloplasty [PMBV] in patients with mitral stenosis [MS]
Subjects and Methods:Sixty-one patients with MS eligible for PMBV and 72 healthy subjects [61 females and 11 males] with sinus rhythm were enrolled into this study. PMBV was performed in all patients using a percutaneous transseptal antegrade approach and a multitrack balloon technique. The P/P-R segment ratio and echocardiographic variables were measured before and 48-72 h after the procedure. The optimal cutoff point for differences in the Macruz index to determine clinical success was evaluated by receiver operating characteristic analysis by calculating the area under the curve as giving the maximum sum of sensitivity and specificity for the significant test
Results:In the patient group [mean age 42.9 +/- 11.1 years], the preprocedural Macruz index was significantly higher than in the control group [2.79 +/- 1.03 vs. 1.29 +/- 0.11; p < 0.001]. In the successful-procedure group [n = 53], the mean postindex value was significantly lower [2.12 +/- 0.71 vs. 2.81 +/- 1.0, p = 0.020], and the decrease in the Macruz index was significantly higher than in the unsuccessful-procedure group [p = 0.007]. An index decrease of 0.105 was the best cutoff value to distinguish the successful-PMBV group from the unsuccessful- PMBV group [area under the curve = 0.888, 95% confidence interval 0.788-0.988, p < 0.001]
Conclusion:The Macruz index was significantly higher in patients with MS compared to healthy subjects. A greater decrease in the Macruz index was associated with a successful PMBV
ABSTRACT
Objective: In the present study, the association between red cell distribution width [RDW] with functional significance of intermediate coronary artery lesions was investigated
Materials and Methods: Two hundred and forty-six consecutive patients, 168 males and 78 females, who underwent fractional flow reserve [FFR] measurement for angiographically intermediate coronary stenosis [40-70% in quantitative coronary analysis] in the left anterior descending coronary artery were enrolled into the study. The functional significance of intermediate coronary artery lesions was determined by FFR measurement. An FFR value <0.75 was defined as functionally significant. Venous blood samples were taken within 48 h before the FFR measurement, and RDW levels were determined by a Coulter LH Series hematology analyzer. Logistic regression analysis was used to examine the association between functional significance in FFR measurement and other variables
Results: Of the 246 patients, 62 [25.2%] exhibited significant functional stenosis [FFR <0.75] in the FFR measurement. The mean RDW level was significantly higher in patients with significant stenosis [14.19 +/- 0.73 vs. 13.69 +/- 0.77, p < 0.001]. In stepwise multivariate logistic regression analysis, RDW [OR = 2.489, 95% CI = 1.631-3.799, p < 0.001] and male gender [OR = 2.826, 95% CI = 1.347-5.928, p = 0.006] were independent predictors of significant functional stenosis
Conclusion: Increased RDW levels were associated with functional significance of angiographically intermediate coronary artery stenoses
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Erythrocyte Indices , Coronary Stenosis , Coronary Angiography , Fractional Flow Reserve, Myocardial , Logistic ModelsABSTRACT
BACKGROUND AND OBJECTIVES: Coronary artery ectasia (CAE) is an angiographic finding characterized by dilation of an arterial segment with a diameter at least 1.5 times that of its adjacent normal coronary artery. Fragmented QRS (fQRS) complexes are electrocardiographic signals which reflect altered ventricular conduction around regions of a myocardial scar and/or ischaemia. In the present study, we aimed to evaluate the presence of fQRS in patients with CAE. SUBJECTS AND METHODS: The study population included 100 patients with isolated CAE without coronary artery disease (CAD) and 80 angiographically normal controls. fQRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous leads corresponding to a major coronary artery territory. RESULTS: The two groups were similar in terms of age, sex, hypertension, dyslipidemia, and family history of CAD. The presence of fQRS was significantly (p<0.05) higher in the CAE group than that in the normal coronary artery group (29% vs. 6.2%, p=0.008). Isolated CAE were detected most commonly in the right coronary artery (61%), followed by left anterior descending artery (52%), left circumflex artery (36%), and left main artery (9%). Multivariate stepwise logistic regression analysis showed that CAE {odds ratio (OR) 1.412; 95% confidence interval (CI) 1.085-1.541; p=0.003} and diabetes (OR 1.310; 95% CI 1.025-1.482; p=0.041) were independently associated with fQRS. CONCLUSION: The presence of fragmented QRS associated with increased risk for arrhythmias and cardiovascular mortality was significantly higher in patients with CAE than in patient with normal coronary artery. Further studies are needed to determine whether the presence of fragmented QRS is a possible new risk factor for patients with CAE.