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INTRODUCTION: Left Main Compression Syndrome (LMCS) represents an entity described as the extrinsic compression of the left main coronary artery (LMCA) by a dilated pulmonary artery (PA) trunk. We examined the presence of LMCS in patients with pulmonary hypertension (PH) using dual-source computed tomography (DSCT), as a non-invasive diagnostic tool. METHODS: The following parameters were measured: PA trunk diameter (PAD), the distance between PAD and LMCA (LMPA) and the distance between PA and aorta (AoPA). These measurements were related with demographic, echocardiographic, hemodynamic and clinical parameters. Angiography was performed in two patients with LMCS suspected by cardiac computed tomographic angiography. Patients without PH but with angina were examined as controls, using DSCT cardiac angiography to assess the same measurements and to detect the prevalence of coronary artery disease. RESULTS: PA diameter value over 40.00 mm has been associated with PH and LMCS. Furthermore, LMCS did not occur at a distance smaller than 0.50 mm between the PA and the LMCA, and did not correlate with the distance between the PA and the aorta or with cardiac index and NT-proBNP. CONCLUSION: DSCT may represent the initial testing modality in PH patients with dilated PA trunk to exclude LMCS. A periodical rule-out of this rare entity, as assessed by DSCT, in patients with a severely dilated PA seems to be mandatory for PH patients contributing to survival improvement.
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OBJECTIVE: The present study investigates the possible associations between coronary heart disease and histological prostate carcinoma in autopsy material. MATERIAL AND METHOD: The material of our study, were 116 men between 55 years and 98 years of age, who died in the period of August 2002-January 2005. The initial segment of the aorta and the prostate glands of all cadavers were removed while the initial 30 mm of the left and right coronary arteries and the peripheral zone of the prostate gland underwent pathologic examination. RESULTS: Of all subjects examined 71.8% had pathological findings suggesting advanced coronary heart disease. Twenty out of 116 cadavers were found with histological carcinoma in their prostate specimen. Among subjects positive for prostate cancer, 12 had died of cardiovascular diseases, while 16 had macroscopic evidence of advanced coronary artery obstructive disease, a finding that was confirmed on pathologic examination. Although most of the subjects had atheromatous lesions on the coronary arteries, the percentage of men with prostate cancer, which had advanced atheromatosis, was greater when compared to those of subjects without prostate cancer. The relation between the coronary artery obstructive disease severity and the presence of latent prostate cancer was statistically significant (P = 0.02). No statistically significant correlation was obtained between body mass index and the presence of prostate cancer. CONCLUSIONS: Our results indicate that there could be an association between coronary artery obstructive disease and prostate cancer, however due to the relatively low sample further studies are needed in order to confirm such findings.
