RESUMO
BACKGROUND: The long-term patency of arterial and venous grafts is crucial for the success of CABG. This study was designed to investigate graft patency using 128-slice coronary computed tomography angiography (CCTA) and compared the results with those obtained using invasive coronary angiography (ICA). In this observational cross-sectional study, we included 40 symptomatic post-CABG patients underwent CCTA and ICA within the same month. RESULTS: Fifty-five percent were aged more than 60 years, and 80% were males. 67.5% had diabetes, 90% had hypertension, and 30% were smokers. Mean body mass index was 28.89 ± 5.17 kg/m2. Mean duration since CABG was 5.25 ± 4.04 years. In total, 124 native vessels and 97 grafts were assessed using CCTA and ICA. CCTA delineated 8 non-cannulated venous grafts and 6 non-cannulated left internal mammary artery grafts. CCTA required a significantly lower radiation dose (1165.77 ± 123.54 vs. 47,589.78 ± 6967.53, p < 0.001). CONCLUSION: CCTA can be as accurate as ICA in assessing bypass grafts with less radiation dose, providing a non-invasive reliable tool for evaluation.
RESUMO
BACKGROUND: The management of hypertensive disorders of pregnancy (HDP) during hospitalization requires an accurate blood pressure (BP) measurement, mainly by invasive intra-arterial reading. Nevertheless, little is known about the precision of non-invasive (NI) central BP measurements in HDP. We aimed to assess the accuracy of NI central BP assessment in comparison to invasive BP measurement in HDP. This cross-sectional study included all patients with HDP that were admitted to university hospitals for high BP control, from December 2018 till December 2019, and 10 healthy matched non-hypertensive controls. Patients were compared for demographic, anthropometric, and echocardiographic data. In all subjects, invasive BP assessment was done by radial arterial cannulation and NI assessment of BP was performed by an oscillometric automated device (Mobil-O-Graph); the comparison was done after initial control of BP. RESULTS: One hundred patients were included and divided into 3 groups (pre-existing hypertension (HTN), gestational HTN, and pre-eclampsia). There was no statistically significant difference between NI central and invasive methods in measuring both systolic BP (SBP) (126.39 ± 14.5 vs 127.43 ± 15.3, p = 0.5) and diastolic BP (82.41 ± 9.0 vs 83.78 ± 8.9, p = 0.14) among the total studied population. A strong positive correlation was found between NI central and invasive SBP (r = 0.96, p < 0.001). HDP was associated with an increase in arterial stiffness, left ventricular diastolic dysfunction, and complications. CONCLUSION: Non-invasive measurement of BP using oscillometric automated devices is as accurate as the invasive method, and it is a practical safe method in pregnant women with hypertensive disorders (CTR no. = NCT04303871).
RESUMO
The mitral valve surgery decision is made mainly according to echocardiographic (ECHO) criteria. As the asymptomatic patients are still candidates for surgery in some situations, this makes the accurate assessment of mitral regurgitation (MR) severity and cardiac dimensions even more important. We aimed to compare ECHO and cardiac magnetic resonance imaging (CMR) in the assessment of MR severity and cardiac dimensions. In this prospective study, we included all patients with more than mild MR by ECHO and referred to our university hospital from 1st of April 2017 and 1st of April 2019. Exclusion criteria were critically ill patients, presence of other valve lesions, planned revascularization, pregnancy and contraindication for CMR. All patients had full history taking, examination, body surface area, and ECG. MR severity and left atrial and left ventricular dimensions were assessed in 50 patients with both 2D-ECHO and CMR in the same day. There were no significant differences in baseline clinical characteristics between moderate (24 patients) and severe MR (26 patients) groups. Poor degree of agreement was present between CMR and ECHO assessment for MR severity (same degree of MR only in 36% (18/50 patients) with kappa grade = 0.19). Furthermore, ECHO overestimated grades of MR compared to CMR (severe MR in 52% vs. 38.4%, p = 0.01 respectively). Based on the etiology of MR, primary (30 patients) vs. secondary MR (20 patients) showed the same dis-agreement between CMR and ECHO assessment of MR severity. Left atrial and ventricular dimensions showed good agreement between CMR and ECHO. Our results suggest that CMR could be more accurate than ECHO in assessing the severity of MR especially in severe cases that need surgery.