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Introduction: Invasive physiologic variables such as fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are used in clinical practice to assess the functional significance of epicardial coronary stenosis and guide the management. However, these two variables may show discrepancies when binary cut-offs are used to decide for revascularization strategy. We investigated the clinical characteristics of lesions with discordance between iFR and FFR. Methodology: 256 vessels (220 patients mean age 61 ± 12, 77% males) with available pre-intervention FFR and iFR values were included in the study. The vessels were classified according to FFR and iFR into concordant normal (Group 1 [n = 112]; FFR > 0.8 and iFR > 0.89); discordant with abnormal FFR and normal iFR (Group 2 [n = 12); FFR 0.89); discordant with normal FFR and abnormal iFR (Group 3 [n = 43], FFR > 0.8 and iFR

Introduction: Arterial stiffness and wave reflection are independent prognosticators of cardiovascular morbidity and mortality. There are two types off arteries in the body; elastic and muscular. The elastic arteries receive the blood directly from the heart while the muscular arteries distribute the blood to various organs of the body. The elasticity of the major arteries decreases with age and therefore may play a key role in the development and control of hypertension and subsequently the choice of drug therapy. The aim of the study is to evaluate the effects of the amlodipine, on arterial stiffness in essential hypertension, compared to hydrochlorothiazide. Methodology: We randomised 24 hypertensive patients hypertension (clinic blood pressure (BP) > 140/90 mmHg and ambulatory >135/85 mmHg) to amlodipine 5 mg or hydrochlorothiazide 12.5 mgs in a single blind parallel group study for one month and measured aortic pulse wave velocity (PWV) and augmentation index (AIx) at baseline and one month after treatment. The patients were studied fasting, having abstained from smoking, caffeinated beverages and alcohol 12 h prior to the measurements. Brachial BP and heart rate (Omron), pulse wave velocity (PWV, Complior) and augmentation index (AIx, SphymoCor), a measure of wave reflection, were measured in the supine position after a rest of 15 min. Results were analysed with JMP (SAS for Windows) using Wilcoxon-Rank Sums test and ANOVA. Results are expressed as mean ± SEM, p

Introduction: Hypertrophic Cardiomyopathy (HCM), a relatively uncommon entity, is the most common form of genetic cardiovascular disorders. It is the most common cause of sudden death in the young and also heart failure which can occur at any age. While HCM is a well-described global disorder, there is paucity of data on this important clinical entity in Saudi Arabia. Therefore, the aim of this study was to explore the clinical characteristics and outcome of HCM in a Saudi population attending King Abdul Aziz Cardiac Center (KACC), Riyadh. Methodology: We retrospectively collected electronic echocardiographic data in adult HCM patients at KACC, Riyadh, between January 1st 2002 and December 31st 2016 (Xcelera™). Cases of secondary left ventricular hypertrophy were excluded. In addition, demographic, anthropometric, comorbidities and outcome data was also recorded (Apollo Lx). Data was analysed using JMP version 7.1 (SAS for Windows). Results: Data were available for 77 patients, mean age 40 ± 17 years, 63.6% males. Commonest comorbidities included hypertensive (23.5%), diabetes mellitus (15.6%), coronary artery disease (15.6%) stroke (10.4%), atrial fibrillation (13 %) and ventricular tachycardia (5%). Half of the population had associated mitral regurgitation. Nine percent of patients had a history of syncope and 13% family history of sudden cardiac death. There was a significant interaction between age and HCM morphology (p