Dilation of left cardiac chambers offers a suitable terrain for thrombus formation. The high probability of LAA thrombosis should be kept in mind when designing the treatment strategy for patients with dilated cardiomyopathy at sinus rhythm.

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Introduction: Atrial septal aneurysm (ASA) is often associated with other atrial septal abnormalities, particularly with atrial septal defect type ostium secundum or patent foramen ovale. ECG signs of incomplete or complete right bundle branch block are known to be associated with atrial septal defects, however such correlation with other atrial septal abnormalities is not documented.

Introduction:Thromboembolic events are a frequent cause of mortality in patients with congestive heart failure. The aim of or study was to evaluate the relationship of left ventricular end diastolic diameter (LVEDD) to left atrial (LA) size and left atrial appendage (LAA) size in patients with dilated cardiomyopathy in sinus rhythm, as well as to determine the prevalence of thrombi in LV and LA /LAA.Methods:This was a prospective cross-sectional study, conducted from December 2009 until December 2011. The study included 95 patients with dilated cardiomyopathy in sinus rhythm. Patients with swallowing problems, acute myocardial infarction, atrial fibrillation/flatter, severe systolic dysfunction, and/or patients who were taking oral anticoagulation therapy were excluded.Results:Mean patient age was 58.6 ± 12.2 years and 68.4% were men. Mean LVEDD of our population was 66.5 ± 6.5 mm, while mean LA atrium, LA volume and LAA maximal area were 46 ± 5.1 mm, 87.2 ± 38.7 cm3 and 4.7 ± 1.2 cm2, respectively. LA diameter (p<0.001) and LAA maximal area (p=0.01) showed to be independent predictors of LV size. LV thrombus was detected in 13 (13.7%) patients, while LAA thrombus in 46 (48.4%) patients of our study population.Conclusions:In conclusion, dilated LV size is associated with enlarged LA and LAA size. On the other hand, dilation of LV, LA and LAA is related to high prevalence of left chamber cardiac thrombi.

We consider that our study sheds light to the high possibility of LAA thrombi formation in addition to LV thrombi in patients with chronic dilated ischemic cardiomyopathy in sinus rhythm. LV size, LV EF, LAA maximal area and lack of aspirin therapy are shown to be independent predictors of left heart chamber thrombi in this patient category.

Right bundle branch block should serve as a valuable indicator to motivate a detailed search for interatrial septal abnormalities.

Background:Data on the lowering effects of statins in hypertensive patients have been mixed and highly controversial. Some studies shows reductions effects of statins in blood pressure, whereas others do not. The evidence in the literature on the effects of statins on blood pressure raises the possibility that statins may directly lower blood pressure in addition to reduce cholesterol levels–pleiotropic effects of statins.Aim of the study:The role of statins as additional treatment in patients with severe hypertension and advanced aortic atherosclerotic plaques. Methods. We enrolled 62 patients. Study has been approved by Committee of Ethics and patients signed a Term of Free Informed Consent. All patients were studied with transoesophageal echocardiography at baseline and 12 months after enrolment. Inclusion criteria were severe hypertension and presence of aortic atherosclerotic plaques. Patients have been divided into two groups; group A (treated with antihypertenives and statins) and group B (treated, just with antihypertensives).Results:Twenty patients, of totally 38, from group A (20/38 or 52.6%) had significantly plaque reduction. One patient of totally 24 (1/24 or 4.1% ) from group B had significantly atherosclerotic plaque reduction. Difference of plaques reduction between two groups was highly significant. Regarding blood pressure levels, statins users had significantly reduction on systolic and diastolic blood pressure compared to statins nonusers.Conclusion:Hypertensive patients with presence of AA plaques treated with antihypertensives and statins have more BP reduction compared will hypertensive patients treated with antihypertensives alone.

Arterial hypertension complicated with atherosclerosis presents the most common cause of death in hypertensive patients. Eyes suffer vascular damage as a result of high blood pressure (BP) and these changes can be detected by funduscopy, although its role has recently been questioned. The aims of this study were to assess the prevalence of atherosclerotic plaques and other disorders of thoracic aorta by transesophageal echocardiography (TEE) in patients with severe arterial hypertension of at least 1 year duration and to analyze the association between aortic atherosclerotic plaques and hypertensive retinopathy. This was a prospective TEE study conducted on 56 hypertensive patients from September 2008 to January 2010. Mean patient age was 62.8 ± 8.2 years and 67.86% of them were women. Aortic atherosclerotic plaques were found on 96.4% of patients, whereas hypertensive retinopathy was present on 94.6% of them. The mean thickness of maximal atherosclerotic plaque found on each patient was 4.3 ± 1.9 mm and 28.6% of patients had ulcerative plaques, while descending aorta was the most common location of the lesions. Grade 1 and 2 hypertensive retinopathy was diagnosed in 14.3% and 80.3% of patients, respectively. Hypertensive retinopathy correlated highly with aortic atherosclerotic score (r = 0.76, p < 0.0001), as it correlated significantly with aortic plaque thickness (r = 0.69, p < 0.0001). Application of funduscopy should be encouraged since it is a noninvasive procedure that provides a good window of retinal arterioles. Hypertensive retinopathy, even in mild forms, should serve as a marker of atherosclerosis elsewhere in the organism.