INTRODUCTIONWith an increasing number of coronary angiography (CAG) procedures, coronary invasive procedures and cardiac bypass surgeries performed each day, knowledge of the variations, anomalies and anatomical pattern of coronary arteries is gaining in importance. Although many individuals have a normal coronary anatomy, variations and anomalies are not unusual, and may lead to complications during procedures. (1) There are two main coronary arteries that supply oxygenated blood to the myocardium -the left main coronary artery (LMCA) and the right coronary artery (RCA). The LMCA originates from the left sinus of Valsalva (SV), while the RCA originates from the right SV. There is typically no artery arising from the posterior SV. The LMCA bifurcates into the left anterior descending (LAD) artery and the circumflex artery (CXA). An additional artery called the intermediate artery (IMA) may arise at the bifurcation of the LMCA, forming a trifurcation.The LAD artery runs in the anterior interventricular sulcus, providing the penetrating septal branches. The left CXA runs along the left atrioventricular sulcus and gives rise to at least one obtuse marginal (OM) branch, while the RCA lies in the right atrioventricular sulcus and gives rise to the acute marginal branch. The IMA, which supplies the left ventricular free wall, is located anterior to the first OM artery and posterior to the first diagonal artery. It can also originate from the proximal part of the LMCA, LAD artery or CXA. In some cases, it is not possible to distinguish between the IMA and OM artery using anatomical or angiographic examinations. However, an important point of distinction is that the left ventricular free wall is supplied by the IMA.(1-3)The artery that supplies the posterior descending artery determines coronary dominance. Approximately 70%-80% of the general population is right-dominant (i.e. supplied by the RCA), while 5%-10% is left-dominant (i.e. supplied by the CXA) and 10%-20% is co-dominant (i.e. supplied by both the RCA and CXA).(3-5) A more accurate definition of dominance refers to the arterial supply to the atrioventricular nodal artery, which is generally supplied by the RCA. (3)(4)(5) Typically, there are two coronary ostia. However, in some cases where the LMCA is absent, three ostia can be detected.In individuals with such a condition, the LAD artery and CXA originate from different ostia. Absence of the LMCA is a common anomaly that can be detected in 0.4%-8% of the population. (4,5) Coronary arteries can be anatomically categorised into three groups based on their anatomical features: normal coronary anatomy, anatomic variations of the coronary artery and coronary artery anomalies (CAAs). CAAs, which are congenital disorders in the coronary anatomy that are observed in less than 1% of the general population, are evaluated using CAG series.

Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF). Method This multicenter, cross‐sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination. Result Overall, the median age was 50 (38–60) and 139 (49.4%) were female. Percentage of median PVC burden was 9% (IQR: 4%–17.4%). Median LVEF was found 60% (55–65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (%) (regression coefficient (RE) −0.644 and 95% CI −1.063, –0.225, p < .001), PVC QRS duration (RE‐0.191 and 95% CI −0.529, 0.148, p = .049), and age (RE‐0.249 and 95% CI −0.442, −0.056, p = .018) were associated with decrease in LVEF. This inverse relationship between the PVC burden and LVEF become more prominent when PVC burden was above 5%. A nomogram developed to estimate the individual risk for decrease in LVEF. Conclusion Our study showed that increase in PVC burden %, age, and PVC QRS duration were independently associated with decrease in LVEF in patients with idiopathic PVC. Also, inverse relationship between PVC burden and LVEF was observed in lower PVC burden than previously known.

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Background: Growing evidence suggests that endothelial dysfunction plays a key role in the pathophysiology of Slow Coronary Flow (SCF). This study investigated the association between endothelial biomarkers endocan and soluble Thrombomodulin (sTM) and SCF. Methods: The study population consisted of 89 subjects (54 patients with SCF and 35 controls). Coronary flow rate was assessed using the Thrombolysis in Myocardial Infarction (TIMI) Frame Count (TFC) method. The serum endocan and sTM levels of all subjects were analysed. Results: Significantly higher endocan levels (1.14 ± 0.22 vs. 0.96 ± 0.32 ng/ml; p=0.009) and sTM levels (657.06 ± 198.18 vs. 592.76 ± 128.45 pg/ml; p=0.119) were observed in the SCF group relative to the control group. A positive correlation was detected between endocan and TFC (r=0.563; p=0.016). Multivariate logistic regression analysis revealed endocan as a predictor of SCF. Conclusions: The endocan level in SCF patients was significantly higher than in controls and the sTM level was also increased, although the difference was not significant. These results suggest that endocan may serve as a biomarker to predict SCF.

Bu çalışmada primer spontan pnömotoraks olgularındaki elektrokardiyografik (EKG) değişiklikler değerlendirildi.