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Unlabelled: In order to evaluate the prevalence of carotid atherosclerosis (CA) in patients with coronary artery disease (CAD) and to identify the differential role of traditional risk factors, we analyzed data concerning 290 patients aged 61.9 +/- 10.8 years who underwent color duplex ultrasound of extracranial arteries before coronary angiography. Significant CA (stenosis > or = 50% in at least one extracranial artery) was disclosed in 44 patients (15%); significant CAD (stenosis > or = 70% at least in a major epicardial vessel) was documented in 238 patients (82%). Age and smoking were significantly associated with both CAD (respectively, p = 0.034 and p = 0.050) and CA (respectively, p = 0.000 and p = 0.000), but a stronger correlation was documented with CA (r = 0.325 vs r = 0.125 for age; r = 0.218 vs r = 0.114 for smoking). Diabetes (p = 0.031) and male gender (p = 0.016) were significantly associated with CAD, and hypertension (p = 0.029) with CA., Conclusions: Traditional risk factors play different roles in the pathogenesis of atherosclerotic disease of carotid and coronary circulation. Color duplex evaluation of the carotid arteries can be useful in high-risk patients, particularly if candidates for coronary surgery.

Left ventricular remodeling, through long-term left ventricular chamber dilation and increased wall stress can result in alteration of ventricular architecture and impairment of systolic and diastolic performance. Most of the studies regard post acute myocardial infarction remodeling, knowledge is still lacking about preoperative and postoperative factors which predict the long-term prognosis of patients who underwent venous coronary artery bypass graft surgery. We evaluated 243 patients (225 males, 18 females, mean age 65 +/- 7.3 years) submitted to venous coronary artery bypass graft surgery and 10-year follow-up (123 +/- 20 months). Global mortality was 17.6% (n = 43), significantly higher in patients with ejection fraction (EF) < 50% (log-rank test p < 0.001). The survivors (n = 200) were subdivided into two groups according to postoperative EF: patients with EF > or = 50% (n = 160) and patients with EF < 50% (n = 40). Multivariate analysis revealed that cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, smoking), number of grafts and infarct location were not associated with EF reduction. Only multivessel disease was significantly associated with EF reduction (p = 0.008). Preoperative echocardiographic parameter analysis evidenced that regional ventricular wall motion score was significantly higher in patients with reduced EF (EF < 50% 11 +/- 7.5; EF > or = 50% 6 +/- 4.1, p < 0.001) and left ventricular dilation (p < 0.001). Multivariate analysis revealed that the strongest correlates of EF < 50% were left ventricular wall motion score index > 10 (odds ratio 5.8, 95% confidence interval 2.8-11.7) and multivessel disease (odds ratio 9.0, 95% confidence interval 2.6-31.08). This study revealed that echocardiographic detection of preoperative ventricular wall motion score may be useful to assess patients at high risk of ventricular remodeling after venous coronary artery bypass graft surgery.