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264, p = 0.004), and heart rate (r = 0.275, p = 0.003) and negatively correlated with the hemoglobin level (r = -0.349, p less then 0.001). Multivariate regression analysis showed that the hemoglobin level (β = -0.254, tβ = -2.805, p = 0.006), BMI (β=0.240, t=2.770, p=0.007), and LVM (β=0.201, t=2.303, p=0.023) were independently associated with the frontal QRS-T angle. CONCLUSIONS The hemoglobin level was found to be an independent predictor of the frontal QRS-T angle.BACKGROUND Renal dysfunction, an important predictor of cardiovascular mortality, is paradoxically associated with a lower incidence of positive coronary fractional flow reserve (FFR) values, possibly due to renal disease-associated myocardial microvascular dysfunction. see more It is unknown if this relationship is influenced by arterial hypertension, a condition strongly associated with renal- and microvascular dysfunction. METHODS The incidence of positive ( less then 0.81) FFR values was retrospectively evaluated in consecutive patients with intermediate severity coronary artery lesions that were either associating or not associating renal dysfunction (creatinine clearance, CrCl less then 90ml/min/1.73m2), and had mild/moderate or severe arterial hypertension (treated by less then 3 or ≥3 different drugs). RESULTS Positive FFR values were found in 49.5% of the 109 included patients, with a significantly lower incidence in those with renal dysfunction 23 vs. 31 cases (39.7% vs. 60.8%, p=0.03). However, uni- and multivariate subpopulation analysis evidenced that renal dysfunction was a significant independent predictor of fewer positive FFR results only in severely hypertensive patients (univariate p values for mild/moderate and severe hypertension 0.80 and less then 0.01, respectively; multivariate p in severely hypertensive patients 0.04). This categorization significantly restricted the number of borderline FFR results (0.75- 0.80) where measurement interpretation could be challenging because of renal dysfunction (from 13.8% to 4.6% of the whole study population, p=0.03). CONCLUSIONS In the current study renal dysfunction was independently associated with a significantly higher incidence of negative FFR results in patients with intermediate severity coronary artery lesions only in the presence of severe arterial hypertension. This observation should be confirmed by large-scale prospective clinical trials.BACKGROUND Aortic pulse wave velocity (PWV) is a standard measurement of aortic stiffness. It has been suggested that increased arterial stiffness promotes left ventricular diastolic dysfunction (LVDD), so we designed this study to evaluate role of aortic PWV as a new diagnostic parameter for LVDD by correlation with echocardiographic LVDD indices and to evaluate its prognostic value in patients with LVDD by correlation with brain natriuretic peptide (BNP). METHODS 100 patients with age > 50; were divided into two groups, case 80 patients with asymptomatic LVDD with EF ≥50% and control 20 patients with normal LVDD. BNP blood test and echocardiography with assessment of aortic PWV were done. RESULTS Mean age was 59±7.47 vs. 57±6.35 in case and control groups respectively (P = 0.73), 38 (47.5%) males in case vs. 9 (45%) in control (P = 0.84). Aortic PWV showed positive correlation with E/e' (r=0.957, P less then 0.001), tricuspid regurgitation (TR) velocity (r=0.941, P less then 0.001), and LA volume index (r=0.947, P less then 0.001). Negative correlation with septal e' (r=-0.970, P less then 0.001) and lateral e' (r=-0.932, P less then 0.001). Moreover, positive correlation with plasma BNP (r=0.958, P less then 0.001). The area under the ROC curve for aortic PWV to detect DD was 0.86 (95% CI, 0.76-0.98; P less then 0.001) and the optimal cutoff point of 12.5 m/s produced 92.3% sensitivity and 75.0% specificity with an accuracy of 89.0%. CONCLUSIONS Echocardiographic assessment of aortic PWV appears not only to be a sensitive and reliable for LVDD detection but also has a promising prognostic value in patients with LVDD.BACKGROUND RA-related complications (e.g., no-reflow and perforation) may be associated with increased risk of CIN, causing hypotension, acute heart failure, and periprocedural myocardial infarction. Our aim was to evaluate the incidence of contrast- induced nephropathy (CIN) in patients undergoing rotational atherectomy (RA)-based vs. non- RA-based percutaneous coronary intervention (PCI). METHODS This single-centre retrospective registry included all patients who underwent PCI between 2012 and 2016 for whom post-procedural creatinine was determined. Study endpoint was CIN, defined as an increase of serum creatinine ≥0.3 mg/dl or ≥50% from baseline within 72 h post-PCI. Propensity score matching (PSM) was performed to account for selection bias between RA and non-RA patients. RESULTS Study population included 2,580 patients 70 (3%) had RA PCI and 2510 (97%) had non-RA PCI. Following PSM, there were 70 patients in RA and 280 patients in non-RA group with good overall adjustment between groups, although RA patients received larger contrast volume (263±126 vs 224±118 ml, p=0.01) and showed higher Mehran risk score at baseline (11.1±6.6 vs 8.9±4.8, p=0.01). The incidence of CIN was similar between RA and non-RA patients (15.7% vs. 13.2%, p=0.59). New need for dialysis was required in 0% vs. 0.7% patients, respectively (p=0.48). On multivariate analysis, RA PCI was not independently associated with development of CIN. CONCLUSIONS Despite being performed in patients with a higher burden of comorbidities and with larger volumes of contrast, RA PCI is not associated with higher risk of CIN, compared with PCI in non-RA patients.BACKGROUND Heavy calcified lesions can decrease effectiveness of drug eluted stents in preventing restenosis. Rotational atherectomy (RA) demonstrated to improve outcomes in patients with severely calcified lesions pretreated with debulking. However, its feasibility and its safety are continuously on stage. Our aim has been to identify predictors of clinical and procedural outcome in RA. METHODS We retrospectively analyzed a population of patients referred to our cath lab for urgent or elective coronary catheterization treated with RA. The associations between clinical variables and clinical or procedural events were evaluated using logistic regression. The primary endpoint was the occurrence of major adverse cardiovascular events (MACE) from procedure date to last day of follow-up. MACE have been defined as follows cardiovascular death, heart failure hospitalization and target lesion revascularization. RESULTS The registry included 68 of the 1908 (3.6%) patients that underwent percutaneous coronary intervention.
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