Prognostic value of coronary atherosclerosis and CAC score for the risk of chemotherapy-related cardiac dysfunction (CTRCD): The protocol of ANTEC study.

BACKGROUND: Cardiological complications of oncological treatment, including the most serious one, heart failure, constitute a significant and still unsolved clinical problem. A history of dyslipidemia and complications of atherosclerosis, including coronary artery disease, are established risk factors for cardiotoxicity in cancer patients. In recent years, a protective effect of statin treatment on the development of heart failure in cancer patients has been observed. This protocol describes a study aiming to assess the prognostic value of coronary atherosclerosis burden and the CAC score on the onset of cardiac dysfunction associated with cancer therapy. METHODS: ANTEC (Atherosclerosis iN chemoTherapy-rElated Cardiotoxicity) is a single-site, prospective, observational study to evaluate the influence of the coronary atherosclerosis and CAC score assessed by computed tomography on the development of left ventricular systolic dysfunction in cancer patients with at least moderate cardiotoxicity risk. A group of 80 patients diagnosed with cancer prior to high-dose anthracycline chemotherapy (doxorubicin ≥ 240 mg / m2 body weight or epirubicin ≥ 600 mg / m2 body weight), without a history of heart failure and coronary artery disease, will be included in the study. Patient follow-up is planned for 12 months. In all patients, coronary computed tomographic angiography (CCTA) will be performed once at the beginning of the study. The primary endpoint is the onset of cancer therapy-related cardiovascular toxicity, defined as mild, moderate, severe and very severe according to ESC 2022 Cardio-oncology guidelines. During follow up, echocardiography with GLS assessment will be performed every three months. Additionally, new biomarkers of atherosclerosis (IL-6, MPO, TNF-alpha) will be measured every 6 months. The study registration identifier on clinicaltrials.gov is NCT05118178. CLINICAL TRIALS REGISTRY: This study is listed on cinicaltrials.gov with identifier NCT05118178.

Aortic pathology in patients with bicuspid aortic valve assessed with computed tomography angiography.

PURPOSE: The aim of the study was to assess thoracic aorta pathologies coexisting with bicuspid aortic valve (BAV) using dual-source computed tomography. MATERIALS AND METHODS: A total of 102 patients with BAV diagnosed by electrocardiogram-gated computed tomography angiography of the thoracic aorta were analyzed retrospectively. The morphology of BAV was characterized on the basis of the presence and orientation of cusps and raphes as "pure BAV" (i.e., without raphe) or "BAV with raphe." The assessment included aortic diameters and pathologies such as dilatation, aneurysm, dissection, or coarctation (CoA). RESULTS: Of the 102 patients, 75 (73.5%) had BAV with raphe, and 27 patients (26.5%) had pure BAV. The analysis revealed significant differences in the diameter of the annulus, the sinuses of Valsalva, the tubular portion of the ascending aorta, and the part of the aorta proximal to the innominate artery between patients with pure BAV and BAV with raphe (respectively 27.18±4.33 vs. 29.88±4.18 mm, P=0.005; 38.11±7.2 vs. 41.77±6.9 mm, P=0.022; 39.07±8.3 vs. 46.31±7.8 mm, P=0.0001; 30.85±6.7 vs. 34.89±5.08 mm, P=0.02). There was a significant difference in prevalence of dilatation and aneurysm of the thoracic aorta between patients with pure BAV and BAV with raphe [58.06% vs. 84.5% (18/31 vs. 60/71), P=0.004]. The prevalence of aortic CoA was higher in patients with pure BAV than in patients with BAV with raphe [44.4% vs. 13.3% (12/27 vs. 10/75), P=0.001]. CONCLUSIONS: BAV with raphe is more common than pure BAV and is more often associated with dilatation and aneurysm of the ascending aorta. Pure BAV is more commonly associated with CoA.

Intra-atrial course of right coronary artery - case report.

BACKGROUND: Intra-atrial course of the right coronary artery is a rare anomaly. The recognition of this entity is crucial to avoid potential hazards related to vessel injury during interventional procedures such as right heart catheterization, pacemaker implantation, invasive electrophysiology testing or atrial flutter ablation. CASE REPORT: We present a case of a 62-year old female with paroxysmal atrial flutter and atrial fibrillation, whose cardiac computed tomography revealed an anomalous course of the right coronary artery through the right atrium. CONCLUSIONS: Cardiac computed tomography examination enables an accurate assessment of morphology and location of the anomalous vessel course.