Wael Abuzeid

Rate and Predictors of the Conversion of Abstracts Presented at the Canadian Cardiovascular Congress Scientific Meetings to Full Peer-Reviewed Publications

The rate of conversion of abstracts presented at scientific meetings into peer-reviewed published manuscripts is an important metric for medical societies, because it facilitates translation of scientific knowledge into practice. We determined the rate and predictors of conversion of scientific abstracts presented at the Canadian Cardiovascular Congress (CCC) from 2006 to 2010 into peer-reviewed article publications within 2 years of their initial presentation. Using a previously validated computer algorithm, we searched the International Statistical Institute Web of Science to identify peer-reviewed full manuscript publications of these abstracts. A multivariable logistic regression was used to identify independent factors associated with successful publication. From 2006 to 2010, 3565 abstracts were presented at the CCC. Overall 24.1% of presented abstracts were published within 2 years of the conference. Mean impact factor for publications was 5.2 (range, 0.4-53.2). The type of presentation (for poster vs oral; odds ratio, 0.71; 95% confidence interval, 0.60-0.83; P < 0.001) and category of presentation (P < 0.001) were significantly associated with successful publication. Late breaking abstracts and those related to cancer and clinical sciences were more likely to be published, compared with prevention, vascular biology, and pediatrics. In conclusion, the publication rate at the CCC is only marginally lower than that reported for large international North American and European cardiology conferences (30.6%). Efforts should focus on several identified barriers to improve conversion of abstracts to full report publication.

Management of Chronic Total Coronary Occlusion in Stable Ischemic Heart Disease by Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting Versus Medical Therapy

Coronary chronic total occlusions (CTOs) are found in approximately 20% of angiograms. We sought to assess the variation in the management of patients with CTOs and to compare the clinical outcomes of CTO lesions with those of non-CTO lesions. We conducted a population-based cohort study and included all patients with stable angina who underwent cardiac catheterization from October 1, 2012, to June 30, 2013, in Ontario, Canada. The primary outcome was a composite of mortality and hospitalization for myocardial infarction. A total of 7,864 patients were included, of whom 2,279 (29%) had a CTO. There were substantial differences in revascularization rates for patients with CTOs across hospitals in Ontario (44.9% to 94.1%). Revascularization was associated with improved outcomes in the overall cohort. Although the advantage of coronary artery bypass grafting over medical therapy was consistent in both patients with CTOs and patients without CTOs, the benefit of percutaneous coronary intervention (PCI) was limited to patients without CTOs (hazard ratio 0.56, 95% confidence interval 0.40- to 0.78), with no difference in patients with CTOs. The CTO lesion, however, was revascularized in few of the PCI cases (41.1%), with PCI limited to the non-CTO lesion in most patients.

CRT-100.40 Incremental Predictive Benefit Of Pre-procedural CTA In Predicting Successful CTO PCI: Systematic Review

Percutaneous revascularization of coronary chronic total occlusions (CTO) is technically more difficult but can benefit a select patient population. The angiographic JCTO score is validated to predict anterograde CTO recanalization success. This score consists of four components, namely the presence

Old Drugs for New Indications in Cardiovascular Medicine

Inflammation participates in the initiation and progression of atherosclerotic cardiovascular disease, and it is a critical inciting factor leading to acute ischemic events. Evidence has shown that certain anti-inflammatory medications used to treat non-atherosclerotic inflammatory diseases reduce cardiovascular events. This article reviews evidence that commonly used anti-inflammatory therapies (colchicine, allopurinol, methotrexate), reduce cardiovascular events. We discuss potential mechanisms of action, efficacy, and safety of these therapies and propose a clinical trials design to investigate their efficacy.

Cystic tumour of the atrioventricular node: treatment dilemma

An asymptomatic 18-year-old black woman was found to have an incidental finding of third-degree atrioventricular (AV) block on a routine ECG. 2-Dimensional transthoracic echocardiography showed a heterogeneous mass in the region of the peri-membranous septum in the AV node area. A cardiac MRI showed a well-defined cystic mass arising from the right side of the interatrial septal wall. An MRI compatible permanent pacemaker was implanted with plans to monitor the tumour with non-invasive imaging. Cystic tumour of the AV node is a rare primary cardiac tumour. It is known as the smallest and most common primary cardiac tumour that can cause sudden death. All previous six cases of living patients with cystic tumour of the AV node reported in the literature were females and symptomatic. We present a rare case of a patient with cystic tumour of the AV node, and we highlight the treatment dilemmas for this condition.

Traumatic septal coronary perforation after a motor vehicle collision

A 21-year-old man presented to our institution after a motor vehicle collision. His vitals were normal. He had normal heart sounds with no murmurs. Electrocardiogram (EKG) showed ST-segment elevations in leads I, AVL.,V1 to V3. Troponin was elevated at 1810 ng/L (<15 ng/L). Chest CT revealed multiple rib fractures and a haematoma in the antero-septum of the left ventricle (LV). An echocardiogram revealed mild LV systolic dysfunction with a severely hypokinetic septum and moderate right ventricular (RV) systolic dysfunction. Coronary angiogram showed no evidence of atherosclerosis. There was a traumatic dissection of the second diagonal artery and septal coronary perforation with …

Aortic regurgitation secondary to an aberrant mitral chord traversing the aortic valve

Aberrant mitral valve chords are a rare cause of mitral and aortic regurgitation. We present a rare etiology of aortic regurgitation caused by an aberrant mitral valve chord traversing a normal trileaflet aortic valve and inserting into the aortic root. A 40 year-oldmanwas referred for evaluation of atypical chest pain. He reported six months of non-exertional left-sided chest pain and intermittent fevers over the preceding three days. He denied risk factors for endocarditis. Vitals showed BP 140/77, heart rate 55 bpmand hewas afebrile. Cardiovascular exam revealed normal S1 and S2 and a 2/6 decrescendo murmur loudest at the base of the heart. There were no stigmata for endocarditis on physical exam. A stress echocardiogram was negative for ischemia. Surface 2D parasternal images revealed an LVOTmass andmild aortic regurgitation (Fig. 1 panel A) with preserved biventricular size and systolic function. The patientwas sent to the emergency department to rule out endocarditis. Serial blood cultures were negative. A TEE showed no vegetation, rather an aberrant secondary mitral chord extending from the anterior mitral leaflet, traversing a trileaflet aortic valve, and terminating at the right sinus of Valsalva. (Fig. 1 panels B, C, D). The mechanism of aortic regurgitation is due to interference of the anomalous mitral chord with aortic valve closure. The TEE and 3D images showed normal trileaflet aortic valve with no attachment to the anomalous mitral chord. Our patient represents the second report of an aberrantmitral chord attaching into the aortic sinus and resulting in aortic regurgitation. The

Percutaneous Coronary Intervention in a Patient With Severe Systemic Vasculitis and Myocardial Infarction

A 72-year-old woman presented with acute coronary syndrome. There was diffuse coronary ectasia and severe stenosis in the proximal left anterior descending artery consistent with coronary vasculitis. Despite treatment with high-dose immunosuppression, she underwent percutaneous coronary intervention for refractory angina.

Left Atrial Compression After Laparoscopic Gastric Banding

A 50-year-old woman was referred for cardiac assessment to rule out endocarditis. She reported a 1-week history of fevers, nausea, vomiting, and productive cough. Vital signs at the time showed a blood pressure of 130/80, a heart rate of 80 bpm, and a temperature of 38.8 C. She was diagnosed with left lower lobe pneumonia and gram-positive bacteremia. She had undergone a laparoscopic gastric banding in 2005 and was able to lose 180 lb from a baseline of 380 lb. She had regular follow-up for only the first year. Cardiovascular examination revealed normal S1 and S2 heart sounds, an S4 heart sound, and no murmurs. Transthoracic echocardiography showed a wellcircumscribed compressive echogenic mass posterior to the left atrium (Fig. 1). An electrocardiogram showed sinus rhythm and no left atrial enlargement. A computed tomographic scan revealed a dilated esophagus measuring 5 cm in dimension (Fig. 2). Her symptoms resolved on deflation of the gastric band by her general surgeon. Megaesophagus is a rare complication, affecting 1.9% of patients after gastric banding, with only a few cases of its echocardiographic manifestations reported. Recurrent aspi-