Diagnostic and prognostic potential of left atrial strain in cardiovascular disease: a narrative review.

Left atrial strain (LAS) was recently introduced as a parameter that reflects on left atrial function. Consequently, changes in LAS can inform the development of cardiovascular diseases, hence providing a window for non-invasive and cost-effective testing of these diseases and their complications at early stages of development, potentially offering a segway towards preventive interventions. LAS has yet to be implemented into standard practice.

Managing endothelial dysfunction in COVID-19 with statins, beta blockers, nicorandil, and oral supplements: A pilot, double-blind, placebo-controlled, randomized clinical trial.

Coronavirus disease 2019 (COVID-19) is associated with endothelial dysfunction. Pharmacologically targeting the different mechanisms of endothelial dysfunction may improve clinical outcomes and lead to reduced morbidity and mortality. In this pilot, double-blind, placebo-controlled, randomized clinical trial, we assigned patients who were admitted to the hospital with mild, moderate, or severe COVID-19 infection to receive, on top of optimal medical therapy, either an endothelial protocol consisting of (Nicorandil, L-arginine, folate, Nebivolol, and atorvastatin) or placebo for up to 14 days.

Transcatheter tricuspid valve intervention techniques and procedural steps for the treatment of tricuspid regurgitation: a review of the literature.

Severe tricuspid regurgitation (TR) is an undertreated common pathology associated with significant morbidity and mortality. Classically, surgical repair or valve replacement were the only therapeutic options and are associated with up to 10% postprocedural mortality. Transcatheter tricuspid valve interventions are a novel and effective therapeutic option for the treatment of significant TR.

Combined anticoagulant and antiplatelet therapy is associated with an improved outcome in hospitalised patients with COVID-19: a propensity matched cohort study.

Background: COVID-19 is a respiratory disease that results in a prothrombotic state manifesting as thrombotic, microthrombotic and thromboembolic events. As a result, several antithrombotic modalities have been implicated in the treatment of this disease. This study aimed to identify if therapeutic anticoagulation (TAC) or concurrent use of antiplatelet and anticoagulants was associated with an improved outcome in this patient population.

Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review.

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic and thromboembolic events. Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important.

Immediate and long-term results of percutaneous mitral commissurotomy: up to 15 years.

Purpose: To evaluate immediate and long-term clinical results of percutaneous mitral commissurotomy (PMC) in patients with severe mitral stenosis.

Methods: In a retrospective study, data were included from 317 patients over 18 years of age (mean age 45) who had been treated for mitral stenosis between January 1993 and March 2015 with PMC using the Inoue balloon technique. Immediate results: Valvular function improved as evidenced by an increase in mitral valve area from 1.

Evaluation of prophylactic dosages of Enoxaparin in non-surgical elderly patients with renal impairment.

Background: Thromboprophylaxis dosing strategies using enoxaparin in elderly patients with renal disease are limited, while dose adjustments or monitoring of anti-Xa levels are recommended. We sought to evaluate the efficacy and safety of enoxaparin 20 mg versus 30 mg subcutaneously daily by comparing anti-Xa levels, thrombosis and bleeding.

Methods: We conducted a prospective, single-blinded, single-center randomized clinical trial including non-surgical patients, 70 years of age or older, with renal disease requiring thromboprophylaxis.

Assessment of bleeding in chronic liver disease and coagulopathy using the IMPROVE bleeding criteria.

Background: In this study, the authors utilized the IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding definition to explore the safety profile of pharmacologic venous thromboembolism (VTE) prophylaxis in patients with chronic liver disease (CLD) and concurrent coagulopathy (INR ≥1.5).

Methods: A retrospective study was conducted on 193 adult patient admissions with a diagnosis of CLD and INR ≥1.

Achieving low-density lipoprotein cholesterol treatment goals among dyslipidemic individuals in the Levant: the CEntralized Pan-Levant survey on tHE Undertreatment of hypercholeSterolemia (CEPHEUS) study.

Background: Several studies that evaluated achieving lipid goals have demonstrated an undertreatment of dyslipidemia. We evaluated the use and efficacy of lipid-lowering agents (LLAs) in reducing low-density lipoprotein cholesterol (LDL-C) to recommended levels in the Levant region.

Design And Methods: A multi-center, cross-sectional survey enrolled 1002 dyslipidemic patients (August 2010 - January 2011) on LLAs for ≥3 months.

Myocardial perfusion in patients with a totally occluded left anterior descending coronary artery reinjected by a normal right coronary artery: the role of collateral circulation.

In this article, myocardial perfusion in patients with a totally occluded left anterior descending artery reinjected by a normal right coronary artery is assessed using stress single photon emission computed tomography (SPECT). In all, 20 patients, with a totally occluded left anterior descending artery reinjected by normal right coronary artery, underwent myocardial single photon emission computed tomography imaging within 60 days of angiography. All patients had abnormal perfusion single photon emission computed tomography results and 70% had reversible defects.

The appropriateness of use of coronary angiography in Lebanon: implications for health policy.

Background: Lebanon, characterized by a free-market health care system, has one of the highest reported per capita rates of cardiac catheterization facilities and coronary angiographies in the world. The aim of this study is to evaluate the appropriateness of performance of coronary angiography procedures in Lebanon.

Methods: Data derived from the 2004 Lebanese Interventional Coronary Registry (LICOR) included 5418 patients aged 30 years and older who had not undergone prior percutaneous coronary intervention or coronary artery bypass grafting.

An unusual complication of coronary angiography: bidirectional dissection of the right coronary artery and the ascending aorta.

Iatrogenic aortocoronary dissection is a rare but devastating complication of percutaneous coronary interventions. The authors present the case of a 45 years old woman admitted for anginal chest pain. She underwent coronary angiography and developed complete anterograde dissection of the right coronary artery simultaneously with retrograde extensive propagation to the ascending aorta.

Noninvasive assessment of coronary flow reserve in the left anterior descending artery by transthoracic echocardiography before and after stenting.

Background: Noninvasive assessment of coronary flow reserve in the left anterior descending artery (LAD) by transthoracic Doppler echocardiography (TTDE) has been already validated as a new method for determining the degree of stenosis over the proximal flow.

Objectives: The aim of the study is to determine, by TTDE, the feasibility and the value of the coronary flow reserve (CFR) (defined as the maximal increase in coronary blood flow above its basal pressure for a given perfusion pressure when coronary circulation is maximally dilated) in the mid-to-distal LAD before and after percutaneous angioplasty and to demonstrate the early recovery of microvascular tone immediately after stenting.

Methods: The study population consisted of 36 patients with significant isolated LAD stenosis (70-90%) identified by coronary angiography.

Evaluation of Tc-99m tetrofosmin scan for coronary artery disease diagnosis.

Detection of myocardial perfusion abnormalities using Tc-99m tetrofosmin was evaluated for sensitivity and specificity compared to coronary angiography. Between January 1996 and January 1998, exercise stress tests and myocardial scintigraphy were performed in 58 patients, followed by coronary angiography within 2 months. There were 48 males and 10 females, aged 33 to 72 years (mean, 57 years).