Metabolic syndrome is associated with atrial electrical and mechanical dysfunction

In this study, we aimed to investigate the left atrial [LA] electrical and mechanical functions in patients with metabolic syndrome [MetS]. Subjects and The study population consisted of 87 patients with MetS and 67 controls. Intra-atrial and interatrial electromechanical delays [EDs] were measured with tissue Doppler imaging. P-wave dispersion [Pd] was calculated from the 12-lead electrocardiograms. LA volumes were measured echocardiographically by the biplane area-length method. Intra-atrial and interatrial EDs and Pd were significantly higher in patients with MetS [10.3 +/- 6.3, 21.0 +/- 11.5 and 41.7 +/- 10.8] than in controls [7.4 +/- 5.5, 12.3 +/- 10.4 and 29.2 +/- 7.4; p = 0.003, p < 0.001 and p < 0.001, respectively]. The LA preatrial contraction volume and active emptying volumes were higher in this population, but the LA passive emptying fraction was lower. In the multivariate linear regression analysis, the presence of MetS, LA active emptying volume and left ventricular early diastolic [E] wave velocity/late diastolic [A] wave velocity [E/A] ratios were independent correlates of interatrial ED [p = 0.002, p = 0.001 and p = 0.025, respectively]. This study showed that intra-atrial and interatrial EDs and Pd were prolonged and LA mechanical functions were impaired in patients with MetS

case of anomalous origin of circumflex artery from right sinus of valsalva recognized by three-dimensional transesophageal echocardiography and coronary computed tomography angiography

Anomalous origin of the circumflex coronary artery from the right sinus of Valsalva is the most common coronary anomaly. It is thought to be of no clinical relevance unless cardiac surgery is performed. We report a 53-year-old patient with aberrant circumflex coronary artery origin from the right aortic sinus of Valsalva which was first suspected from transthoracic 2D and transesophageal 3D echocardiographic views and confirmed by coronary CT angiography. The patient did not receive further diagnostic or therapeutic options. Therefore, we recommended medical therapy with optimal treatment of his cardiovascular risk factors together with regular clinical follow up

Takotsubo cardiomyopathy resembling acute high lateral myocardial infarction

A 65-year-old female patient admitted to the emergency department was diagnosed with acute high lateral myocardial infarction, but later Takotsubo cardiomyopathy [TC] was discovered. She had squeezing chest pain that started shortly after an emotional stress. The electrocardiogram revealed a loss of R wave voltage in leads V1 to V4 and an ST-segment elevation in I and aVL. After an urgent coronary angiography and ventriculography, TC was considered, and supportive anti-ischemic treatment was started. The severe left ventricular systolic dysfunction improved and normalized during the follow-up. She was discharged without any complications. TC is a new entity of acute cardiac events, and patients usually recover completely without sequelae with proper diagnosis and management. An exact diagnosis may also prevent an inappropriate application in the setting of recurrences