Risk Factors/complications

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Editorial

Multi-Arterial Grafting in Surgical Coronary Revascularization. The Renewed Quest for Enhanced Outcomes

With a large body of contemporary and historic evidence strengthening coronary artery bypass surgery (CABG) as the most effective procedure for treating advanced atherosclerotic coronary artery disease (CAD), the quest for enhanced outcomes and quality improvement is steadily underway.

Long-term graft patency is crucial for the benefits afforded by surgery, averting spontaneous myocardial infarction rate (MI) and increasing long-term survival, which is demonstrated with the employment of internal thoracic artery (ITA) conduits anastomosed to the left anterior descending coronary artery.

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Original Article

Left Ventricular Remodeling Patterns in Primary Healthcare

Roberto de Castro Meirelles de Almeida et al. Antonio José Lagoeiro Jorge Maria Luiza Garcia Rosa Adson Renato Leite … Dayse Mary S. Correia Evandro Tinoco Mesquita Sergio Chermont Jocemir Ronaldo Lugon Wolney de Andrade Martins

Abstract

Background:

Left ventricular remodeling (LVR) is related to both non-fatal and fatal outcomes.

Objective:

To describe the geometric patterns of the LV and their associations.

Methods:

A total of 636 individuals between the ages of 45 and 99 years in Rio de Janeiro, Brazil, were submitted to clinical evaluation, laboratory tests, electrocardiogram, and tissue Doppler echocardiography (TDE). The difference between categories was tested with Kruskall-Wallis with post hoc tests, once all variables studied are non-normally distributed and Pearson’s Qui-square (categorical variables). Gross and adjusted ORs were estimated by logistic regression. The level of significance was 5% for all tests. Subjects had LVR characterized as: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH).

Results:

The prevalence of altered patterns was 33%. Subjects presented NG (n = 423; 67%); EH (n = 186; 29%); CH (n = 14; 2%); and CR (n = 13; 2%). The variables of gender, age, level of education and albumin/creatinine ratio (A/C), showed a relationship with the chance of EH even after adjustment.

Conclusion:

Approximately one third of the studied individuals had LVR and were at risk for developing heart failure. Altered A/C in urine was associated with EH, indicating an early relationship between cardiac and renal dysfunction.