Acute right-sided heart failure (RHF) is a complex clinical syndrome, with a wide range of clinical presentations, associated with increased mortality and morbidity, but about which there is a scarcity of evidence-based literature. A temporary right-ventricular assist device (t-RVAD) is a potential treatment option for selected patients with severe right-ventricular dysfunction as a bridge-to-recovery or as a permanent solution. We sought to conduct a systematic review to determine the safety and efficacy of t-RVAD implantation. Thirty-one studies met the inclusion criteria, from which data were extracted. Successful t-RVAD weaning ranged between 23% and 100%. Moreover, 30-day survival post-temporary RAVD implantation ranged from 46% to 100%. Bleeding, acute kidney injury, stroke, and device malfunction were the most commonly reported complications. Notwithstanding this, t-RVAD is a lifesaving option for patients with severe RHF, but the evidence stems from small non-randomized heterogeneous studies utilizing a variety of devices. Both the etiology of RHF and time of intervention might play a major role in determining the t-RVAD outcome. Standardized endpoints definitions, design and methodology for t-RVAD trials is needed. Furthermore, efforts should continue in improving the technology as well as improving the timely provision of a t-RVAD.

Background: Epicardial fat reflects abdominal visceral adiposity and visceral fat plays an important role in the development of an unfavorable metabolic and atherosclerosis risk profile. Intracoronary thrombus burden is an important factor aff...

Background: Association of premature ventricular complexes (PVC) with left ventricular systolic dysfunction (LVSD) and efficacy of catheter ablation treatment have been demonstrated in studies. The role of left atrial (LA) mechanics in the etiopathogenesis of PVC-induced cardiomyopathy (PVC-CMP) as well as changes in LA mechanics with catheter ablation have not been studied before. Methods: A total number of 61 patients (Mean Age 43 ± 3) with idiopathic outflow tract (OT) PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. ECG, 24 h Holter, and echocardiographic evaluation with left ventricular (LV) diastolic functions and LA volumetric assessments were performed before and three months after RFCA. Results: Along with a marginal increase in left ventricle ejection fraction (LVEF), improvement in diastolic functions and left atrial mechanics were observed in the study (LVEF 53 ± 7 versus 57 ± 6, p < 0.01) in short-term follow-up. The frequency of LV diastolic dysfunction (LVDD) decreased with catheter ablation (n = 5 to 0, p = 0.02). The overall LA function improved. Left atrium passive and overall emptying fraction (LAEF) increased significantly (0.32 ± 0.04 to 0.41 ± 0.04, p < 0.05 and 0.62 ± 0.04 to 0.65 ± 0.004, p < 0.05, respectively). Active LAEF decreased significantly (0.29 ± 0.005 to 0.24 ± 0.006, p < 0.05). Conclusions: The results of this study are indicative of “PVC-induced atriomyopathy” which responds to RFCA in short-term follow-up. Atrial dysfunction might play a role in symptoms and etiopathogenesis of LVSD.

Background: We aimed to investigate the relationship between hemoglobin A1c (HbA1c) and coronary thrombus load in type-2 diabetes mellitus (T2DM) patients with non-ST segment elevation myocardial infarction (NSTEMI). Materials and Methods: Ninety diabetic patients with NSTEMI were recruited for the study. They were separated into two groups according to HbA1c levels. Forty-seven patients having HbA1c ≤6.5% formed Group-I (35 male, mean age 58 ± 10.5 years) and the remaining 43 patients with HbA1c >6.5% formed Group-II (23 male, mean age 58 ± 11.1 years). Both the groups were evaluated in terms of thrombolysis in myocardial infarction (TIMI) thrombus score and Syntax score. Results: Baseline patient characteristics were comparable in both the groups. TIMI thrombus score and Syntax score were higher in Group II than in Group I (3.2 ± 1.4 vs. 4.7 ± 0.5 and 20.2 ± 3.4 vs. 26.3 ± 3.0 respectively, P < 0.05). No significant difference was found in other parameters. In stepwise linear regression analysis, prepercutaneous coronary intervention (PCI) and post-PCI TIMI frame number and HbA1c were significantly related to the coronary thrombus scale. However, no significant relationship has been found between thrombus formation and hypertension, previous PCI history, pre-PCI heart rate, pre-PCI cholesterol status, and high-sensitive troponin T. Conclusion: In NSTEMI with T2DM, increased HbA1c (HbA1c >6.5%) is related with coronary thrombus in the target vessel. In those patient population, strict anticoagulation should be considered to prevent potential adverse events.

Aim: To investigate any relationship between choroid thickness (CTh) and coronary artery disease (CAD), particularly in its earlier stages before clinically evident. Methods: The study was performed in two institutions, in B. C. Hospital and B. E. R. Hospital. The ophthalmological examinations and coronary angiograms were performed in B. C. Hospital. The analysis of the coronary angiograms including determination of Gensini scores (Gsc) were conducted in B. E. R. Hospital. The study group comprised 136 eyes (in 68 patients) with documented CAD and 120 healthy eyes (in 60 healthy control subjects). Following measurements of macular thickness and retinal nerve fiber layer, CTh of both eyes was assessed by enhanced depth imaging optical coherence tomography. During the analyzes, main outcome measures were CTh in CAD patients and healthy subjects, correlation between CAD severity-based on Gsc- and CTh in CAD patients. Results: The study group comprised 68 patients (136 eyes) with documented CAD and 60 healthy controls (120 eyes) without any CAD or CAD equivalent disease. In all measured areas (central fovea, nasal and temporal area), CTh was thinner in all Gsc subgroups of CAD patients compared to the healthy group. Even in the lower Gsc subgroup, CTh was significantly thinner compared to the healthy group. A multivariate logistic analysis was conducted and lower CTh in temporal-1000 regions were significantly associated with an increased likelihood of early CAD [OR: 0.812 (CI: 0.762, 0.944), P : 0.032]. Receiver operating characteristic (ROC) curve analysis disclosed CTh at temporal 1000 < 259 μm may predict early CAD (Gsc < 11) with 82% sensitivity and 58% specificity (AUC: 0.68, P < 0.001, CI: 0.65–0.76). Conclusion: Even in its earlier stages, CAD has inverse relationship with CTh, which may give oppurtunity for CTh measurement to predict CAD at earlier phases.