Xanthelasma is associated with an increased amount of epicardial adipose tissue

Objective: In the present study, we aimed to compare the amount of epicardial adipose tissue in subjects with and without xanthelasma

Subjects and Methods:Fifty-two subjects with xanthelasma and 52 age- and gender-matched control subjects were enrolled in this study. Epicardial adipose tissue was assessed by measuring epicardial fat thickness [EFT] with echocardiography. Participants were dichotomized according to median EFT, which was 4 mm. The group with EFT >4 mm was defined as the supramedian group. Body mass index [BMI] was calculated by weight [kilograms] divided by height [meters] squared. Conditional logistic regression analysis was performed to find independent factors associated with supramedian EFT [>4 mm]

Results: Subjects with xanthelasma had higher BMI [31.2 +/- 5.6 vs. 28.6 +/- 5.7, p = 0.01] and higher levels of total cholesterol [216 +/- 54 vs. 181 +/- 42 mg/dl, p < 0.001], LDL cholesterol [142 +/- 45 vs. 115 +/- 36 mg/dl, p = 0.003] and triglycerides [median, 154 vs. 101 mg/dl, p = 0.01] than control subjects. EFT was significantly higher in subjects with xanthelasma than in controls [5.04 +/- 2.02 vs. 3.81 +/- 2.03 mm, p = 0.002]. In the conditional logistic regression analysis, the presence of xanthelasma [OR, 3.55; 95% CI, 1.43-8.78, p = 0.006] and lower HDL cholesterol level [OR, 0.96; 95% CI, 0.92-0.99, p = 0.023] were independently associated with supramedian EFT

Conclusion:The amount of epicardial adipose tissue found in subjects with xanthelasma was higher than in subjects without xanthelasma. In addition, the presence of xanthelasma was independently associated with supramedian EFT

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

Epicardial adipose tissue increased in patients with newly diagnosed subclinical hypothyroidism

To investigate whether or not patients with subclinical hypothyroidism [SH] have increased epicardial adipose tissue [EAT]. Sixty-one patients with newly diagnosed SH and without any known cardiovascular disease were enrolled. Twenty-four subjects matched for age, gender and body mass index without any thyroid dysfunctions were included as a control group. The EAT was measured by echocardiography and thyroid functions were assessed by routine blood examination. Patients with SH had higher EAT values than control subjects [3.6 +/- 0.9 vs. 2.8 +/- 1.4, p = 0.005]. Also, SH patients with thyroid-stimulating hormone [TSH] >/= 10 mU/l had higher EAT than those with SH with TSH <10 mU/l and control subjects [p = 0.013]. In addition, while there was significant correlation between EAT and TSH [r = 0.31, p = 0.014] in patients with SH, there was no significant relation between EAT and TSH in normal subjects [r = 0.09, p = 0.64]. There was a higher level of EAT in patients with SH compared with normal subjects and a significant correlation between EAT and TSH was found

Computed tomography evaluation of different chest tube sites for residual pleural volumes after coronary artery bypass surgery

We investigated the efficacy of pleural drainage with the use of different chest tube methods in patients after coronary artery bypass graft [CABG] surgery. Prospective randomized study of 60 patients undergoing elective on-pump single CABG surgery. The left internal mammary arterial grafts were harvested from all patients. The patients were separated into three groups: In one group [IC6, n=20], pleural tubes were inserted through the sixth intercostal space at the midaxillary line; in the second group [SX-r, n=20], rigid straight pleural tubes were inserted from the mediastinum through the subxiphoid area; and in the third group [SX-s, n=20], soft curved drainage tubes were inserted from the mediastinum through the subxiphoid area. The residual pleural effusion was examined by multislice CT scans within 8 hours of removal of the drainage tubes. Pain was evaluated according to standard methods. The groups did not differ with respect to volume of residual pleural effusion [P>.05]. The IC6 group had a higher mean pain score than the other two groups [P<.05], whose mean pain scores did not differ significantly from each other [P>.05]. IC6 group patients had a higher requirement for analgesics. The rate of atelectasis was higher in group IC6 [P<.05]. CT scans revealed that different chest tube insertion sites have the same efficiency for draining of pleural effusion, although drainage tubes inserted through the thoracic cage may result in more severe pain