Damir Fabijanić

Impact of diabetes on mortality in peripheral artery disease: a meta-analysis

There are accumulating studies showing the association between diabetes and all‐cause mortality in peripheral vascular disease. However, the results in these studies are conflicting regarding the impact of diabetes on outcome.

Helicobacter pylori infection and severity of coronary atherosclerosis in patients with chronic coronary artery disease

Aim Controversy exists concerning the relation between Helicobacter pylori (HP) infection and coronary artery disease (CAD). We aimed to examine the relationship between HP infection and severity of coronary atherosclerosis in patients with chronic CAD. Patients and methods A total of 150 patients (109 [73%] men; mean age 62.61±10.23 years) scheduled for coronary artery bypass grafting surgery were consecutively enrolled in the cross-sectional study. According to rapid urease test and/or gastric biopsy samples stained with hematoxylin and eosin and according to Giemsa, patients were classified as HP positive (n=87; 58%) or HP negative (n=63; 42%). Coronary angiograms were scored by quantitative assessment, using multiple angiographic scoring system: 1) vessel score (number of coronary arteries stenosed ≥50%), 2) Gensini score (assigning a severity score to each coronary stenosis according to the degree of luminal narrowing and its topographic importance) and 3) angiographic severity score (number of coronary artery segments stenosed ≥50%). Results In comparison to HP-negative patients, HP-positive patients were more frequently hypertensive (P=0.014), had higher values of systolic (P=0.043) and diastolic (P=0.005) blood pressure and total cholesterol (P=0.013) and had lower values of high-density lipoprotein-cholesterol (HDL-C; P=0.010). There were no significant differences between the groups in the severity of coronary atherosclerosis: vessel score (P=0.152), Gensini score (P=0.870) and angiographic severity score (P=0.734). Conclusion It is likely that HP infection is not a risk factor for the severity of coronary atherosclerosis in chronic CAD patients.

Lipomatous Hypertrophy of the Interatrial Septum: A 3-Dimensional Transesophageal Echocardiography Appearance

Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac disorder characterized by massive fatty deposits in the interatrial septum.1),2),3) Although the precise etiology is unknown, it has been suggested that LHIS is associated with obesity and aging.1),2) Mostly asymptomatic, LHIS is usually an incidental finding which does not require any specific treatment. Surgical management should be considered very rare, in patients with intractable severe rhythm disorders, hemodynamic instability, symptoms of superior vena cava syndrome or right atrium obstruction.1),2),3) Despite the fact that to date more than 200 cases have been published, LHIS remains under recognized and frequently misdiagnosed as a malignant tumor. Therefore, recognition of this lesion, with reported incidence of up to 8%, is of highest importance.1),2) A 72-year-old asymptomatic obese woman (body mass index = 29 kg/m2) referred to our cardiology department because transthoracic echocardiography showed a right atrial mass highly suspicious of a tumor. Echocardiographic findings suggestive for LHIS were revealed by 2-dimensional and real time 3-dimensional transesophageal echocardiography (RT3DTEE). Moreover, as it is shown in Fig. 1, the advantage of RT3DTEE is the possibility of detailed and accurate spatial visualization of cardiac structures which enabled diagnosis of LHIS without using other imaging techniques (e.g., computed tomography, cardiac magnetic resonance imaging) or tissue biopsy. Fig. 1 2D (A) and 3D (B and C) transesophageal echocardiography appearance of lipomatous hypertrophy of the interatrial septum (IAS, asterisks) can be summarized as: 1) IAS thickening > 2 cm, 2) a projection of the mass only into the right atrium, 3) ...