ABSTRACT
Several competing geometric and hemodynamic factors are suggested as contributing mechanisms for functional mitral regurgitation [MR] in heart failure patients. We aimed to study the relationships between the severity of MR and the QRS duration and dyssynchrony markers in patients with ischemic or dilated cardiomyopathy. We prospectively evaluated 251 heart failure patients with indications for echocardiographic evaluation of possible cardiac resynchronization therapy. All the patients were subjected to transthoracic echocardiography and tissue Doppler imaging to evaluate the left ventricular [LV] synchronicity. The patients were divided into two groups according to the severity of MR: /= moderate MR. The effects of different dyssynchrony indices were adjusted for global and regional left ventricular remodeling parameters. From the 251 patients [74.5% male, mean age = 53.38 +/- 16.68 years], 130 had /= moderate MR. There were no differences between the groups regarding the mean age, frequency of sex, and etiology of cardiomyopathy. The LV systolic and diastolic dimensions were greater in the patients with >/= moderate MR [all p values < 0.001]. Among the different echocardiographic factors, the QRS duration [150.75 +/- 34.66 vs. 126.77 +/- 29.044 ms; p value = 0.050] and interventricular mechanical delay [41.60 +/- 29.50 vs. 35.00 ms +/- 22.01; p value = 0.045] were significantly longer in the patients with
ABSTRACT
Whether coronary artery ectasia [CAE] is a unique clinical finding or results from other clinical entities is still unknown. We aimed to determine the CAE prevalence, investigate the relationship between CAE and patients' demographic and clinical characteristics, and assess the prognosis at follow-up in a sample of Iranian population. Totally, 10057 patients who underwent coronary angiography were divided into three categories: normal coronary arteries without co-existing coronary artery disease; CAE without co-existing coronary artery narrowing < 50%; and coronary artery stenosis with > 50% luminal narrowing [CAS]. The prevalence of CAE was 1.5%. Compared to the normal individuals, the CAE patients were older, were more frequently male, and had higher rates of myocardial infarction [MI]. The CAE patients had a lower frequency of diabetes and MI than the CAS group. The CAE patients were largely focused between 40 to 60 years of age. The right coronary and left anterior descending arteries were the most involved arteries, and ectasia was located more frequently in the proximal part of these arteries. Patients with ectasia in the three main vessels had higher rates of MI. After a mean follow-up of 54.23 +/- 18.41 months, chest pain and dyspnea on exertion remained the main complaint in more than 97% of the patients, leading to hospital admission in more than 14%. There was no relationship between the presence of ectasia and conventional risk factors. According to our study, pure CAE may be deemed a benign feature of atherosclerosis; however, it can lead to frequent hospital admissions because of the persistence of cardiovascular symptoms