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AIMS: Few studies have assessed the prevalence and significance of right bundle branch block in athletes. Aims of this study were to evaluate the prevalence of incomplete right bundle branch block and its correlation with the nature of sports practice and to compare the athlete with right bundle branch block and the one with a normal electrocardiogram. METHODS: It was a retrospective study of the electrocardiogram and echocardiography of competitive athletes recruited in the medical-sports center of Sousse RESULTS: A total of 554 athletes were included. Mean age was 16.1 ± 2.9 years and 69 % were male. The mean training duration was 5.8 hours per week. The prevalence of incomplete right bundle branch block was 13.9 % (77 cases). Endurance sports were practiced in 71.4 % of cases among subjects with right bundle branch block versus 55.4 % in the rest of the population (p < 0.001). The basal diameter of the right ventricle was larger in athletes with right bundle branch block compared to athletes without right bundle branch block: 28 ± 3.6 mm versus 24 ± 2.4 mm (p < 0.001). CONCLUSIONS: The results of this study suggest that right bundle branch block is a marker of incomplete right ventricular remodeling. This remodeling represents a form of adaptation to sustained elevation of volumetric load observed mainly in endurance sports.
Assuntos
Bloqueio de Ramo , Eletrocardiografia , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Feminino , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/epidemiologia , Estudos Retrospectivos , Prevalência , Tunísia/epidemiologia , Eletrocardiografia/métodos , AtletasRESUMO
BACKGROUND: Despite the recent progress made in drug-eluting stents (DESs), in-stent restenosis (ISR) is still a common complication of percutaneous coronary interventions. This retrospective study from a single center aimed to compare outcomes in 79 patients with ISR treated with paclitaxel-coated balloon (PCB) angioplasty or DES implantation. RESULTS: From January 2017 to December 2021, 83 ISR lesions from 79 patients were included. Thirty-two were treated with PCB and 51 treated with available DES in the catheterization laboratory. Baseline characteristics were similar in both groups. Mean time between index angioplasty and restenosis was 27 months with a minimum of 4 months and a maximum of 70 months. Concerning Mehran ISR angiographic classification, classes II and III were more likely treated with DES. Stenosis diameter and minimal lumen diameter (MLD) were similar in both groups. PCB used was significantly shorter than DES: Mean length was 19.75 ± 5.7 versus 22.1 ± 16.5 (p < 0.001), respectively. Angiographic results immediately after intervention were similar in both groups: In-segment MLD after the procedure was 2.5 ± 0.4 in the DES group and 2.26 ± 0.55 in the PCB group. A median follow-up of 20 months was achieved for 68 patients, and 11 were lost to follow-up. There was also no difference in both groups regarding free from events survival. CONCLUSIONS: The findings from this study support recent international studies that have shown no significant differences between DES and PCB and in-stent restenosis. This suggests that PCB use is an option to consider in our local daily practice.
RESUMO
BACKGROUND: The incidence of in-stent restenosis (ISR) remains relatively common despite the use of drug-eluting stents. Outcomes and prognostic factors following ISR revascularization are still being investigated. We aimed to describe the outcomes following different ISR treatment strategies in order to identify prognostic factors associated with worse outcomes. RESULTS: In a retrospective cohort study, we included patients who were admitted to our department and treated for ISR, from January 2017 to December 2018. All patients were followed up for a median period of 24 months. Major cardiac adverse event (MACE) was a composite outcome of the following events: myocardial infarction, target vessel revascularization, target lesion revascularization or cardiovascular death. MACEs were collected during follow-up. Our population consisted of 116 patients. Mean age was 60 years old with a sex ratio of 2.8. During follow-up, 44 patients (37.9%) had at least one MACE. Independent factors identified by multivariate logistic regression were ISR of the proximal left anterior descending artery [Odds ratio (OR) = 1.29; 95% confidence interval (95% CI) 1.16-1.81; p = 0.05], diffuse ISR [OR = 2.16; 95% CI 1.1-3.47; p = 0.022], double or triple vessel disease [OR = 2.97; 95% CI 1.2-6.8; p = 0.008], two or more stents per lesion [OR = 1.82; 95% CI 1.14-2.21, p = 0.031] and absence of post-dilatation in the initial angioplasty [OR = 1.32; 95% CI 1-1.35; p = 0.04]. CONCLUSIONS: Our study suggested that ISR is related to poor outcomes. Identifying prognostic factors would play a key role in the refinement of interventional techniques.
