Background Patients with peripheral artery disease (PAD) frequently have concomitant coronary artery disease (CAD) and display a higher risk for myocardial infarction, stroke, and death due to cardiovascular events. In order to prevent cardiovascular events, there is an increasing interest in new markers of atherosclerosis. Vascular calcifications (VC) are often present in the early stages of atherogenesis and could be considered an early marker. The aim of this study is to correlate the extent of lower limbs, aortic, and coronary arterial calcification diagnosed by non-contrast multislice CT with the severity of coronary artery disease diagnosed by conventional coronary angiography. Results There is borderline significant association between CAD (Gensini score) and each of total lower limb and aorto-iliac calcifications. There is significant association between the number of diseased coronaries and lower limb calcifications. Also, there is significant association between the coronary artery calcifications and lower limb arterial calcifications (total and segmental). Diabetes mellitus and hypertension are significantly associated with lower limb calcification (total, aorto-iliac, and infra-popliteal). Moreover, lower limb arterial calcifications (total and segmental) are positively correlated with increasing age. Conclusion Lower limb arterial calcifications, as diagnosed by non-contrast MSCT, is a noninvasive measure for evaluation of the atherosclerotic burden that correlate to the CAD; it can aid to refine risk stratification and the need for more aggressive preventive strategies.
Background Atrial fibrillation (AF) is a common type of arrhythmia with higher incidence in countries with increased prevalence of rheumatic heart disease (RHD), where AF contributes to significant morbidity and mortality in young population. Atrial fibrosis is a common feature of AF. Delayed enhancement MRI (DE-MRI) is a well-established method for characterizing fibrosis in ventricles. The use of DE-MRI to detect left atrial fibrosis helps to evaluate the extent of atrial structural remodeling non-invasively. The aim of this study is to evaluate the atrial fibrosis in patients with mitral valve disease, using the DE MRI, regarding its amount, distribution, and relation to AF. Results Patients with AF were older and have longer duration of symptoms, smaller valve area, larger LA size, and more fibrosis at the left atrium (with the posterior wall most frequently involved) in comparison to those with sinus rhythm. Patients with atrial fibrosis were older and have longer duration of symptoms, smaller valve area, and larger LA, and most of them had AF compared to those without fibrosis. The comparison between types of AF showed a significant difference in the amount of atrial fibrosis that increases across the spectrum of AF. Conclusion In patients with rheumatic mitral valve diseases, AF is associated with more atrial fibrosis as assessed by DE-MRI. Atrial fibrosis is the best independent predictor of AF.
Background Severe symptomatic aortic stenosis is a common disorder in the elderly and is associated with high morbidity and mortality rate. Traditionally, surgical aortic valve replacement has been considered the most effective treatment for advanced disease. Transcatheter aortic valve implantation (TAVI) has been established as a valuable alternative treatment option for inoperable and high-risk patients with symptomatic severe aortic stenosis. Pre-procedure ECG-gated CT aortography study is important in planning the procedure. The aim of the study was to correlate the aortic valve calcium score with the post-TAVI complications. Results Thirty patients who were candidates for TAVI procedure were enrolled for ECG-gated CT aortic valve calcium score and CT aortography. The calcium score was calculated. The patients were followed up both clinically and by echocardiography every 3 months for 1 year. Those who developed complications were enrolled for another CT study. Fourteen out of 30 patients (46.7%) presented with post-TAVI complications [9 cases (30%) presented with paravalvular leak (PVL) and 5 cases (16.7%) presented with major adverse cardiac events (MACE), while 16 cases (53.3%) had no complications]. There was a strong correlation between the calcium score and post-procedure complications. Conclusions The degree of aortic valve calcification can be considered as a predictor of post-TAVI complications: PVL and MACE.
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