Subject(s)
Echocardiography , Electrocardiography , Heart Murmurs/etiology , Heart Neoplasms/complications , Heart Neoplasms/diagnosis , Myxoma/complications , Myxoma/diagnosis , Aged , Blood Flow Velocity , Diagnosis, Differential , Diastole , Female , Heart Neoplasms/physiopathology , Heart Neoplasms/surgery , Humans , Myxoma/physiopathology , Myxoma/surgery , Regional Blood Flow , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathologyABSTRACT
OBJECTIVES: Carotid ultrasonography is noninvasive and effective for the assessment of atherosclerotic lesions. The relationship between carotid ultrasound findings and presence and severity of coronary artery disease (CAD) was examined in Japanese patients. METHODS AND RESULTS: Subjects were 116 patients who underwent carotid ultrasonography and coronary angiography. In carotid ultrasonography, mean-intima-media thickness (IMT), common carotid artery max IMT, bifurcation max IMT, plaque number, and plaque score (PS). The coronary angiographic data was obtained in the same period as carotid ultrasonography was performed. Patients were divided into two groups based on the presence or absence of coronary artery stenosis (CAS and non-CAS) and CAS group was further categorized into three groups, 1 vessel disease (1VD), 2VD, and 3VD. Physical findings, biochemical data, and carotid ultrasonogram data between the groups were compared. Items showing a significant difference between CAS and non-CAS were age, gender (male), incidence of diabetes and dyslipidemia, fasting blood sugar (FBS), triglyceride, HDL-cholesterol (HDL-C), high-sensitivity C-reactive protein, and all carotid ultrasound findings. All of the above parameters also showed a significant difference between four different severity groups. Stepwise logistic regression analysis was performed to determine which factors predict the presence and/or severity of CAS. High PS showed the strongest predictive value for both and followed by low HDL-C and high FBS. The cut-off value of PS obtained by receiver operating characteristic curve for predicting the presence of CAS was 1.9. CONCLUSIONS: Assessment of PS by carotid ultrasonography together with other risk factor assessment was clinically relevant to predict the presence and severity of CAS.
Subject(s)
Carotid Arteries/diagnostic imaging , Coronary Disease/pathology , Age Factors , Aged , Blood Glucose/analysis , C-Reactive Protein/analysis , Carotid Arteries/pathology , Cholesterol, HDL/blood , Coronary Angiography , Coronary Stenosis/pathology , Diabetes Complications , Dyslipidemias/complications , Female , Humans , Male , Severity of Illness Index , Sex Factors , Triglycerides/blood , UltrasonographyABSTRACT
Congenital coronary artery fistula (CAF) is an infrequent vascular anomaly that establishes a direct link between an epicardial coronary artery and a cardiac chamber, major vessels, or other vascular structures. In this case there was an aneurysmal-CAF between a left main trunk and the right atrium, which was initially diagnosed as a Kawasaki disease by transthoracic echocardiography and subsequently confirmed by coronary angiography and multi-slice CT angiography. A multi-slice CT angiography might well become the modality of choice for the characterization of these rare congenital anomalies.
