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Aim: Sacubitril/valsartan treatment reduces mortality and hospitalizations in heart failure with reduced ejection fraction but has limited application in hypertrophic cardiomyopathy (HCM). The aim of this study was to evaluate the effect of sacubitril/valsartan on peak oxygen consumption (VO2) in patients with non‐obstructive HCM. Methods and results: This is a phase II, randomized, open‐label multicentre study that enrolled adult patients with symptomatic non‐obstructive HCM (New York Heart Association class I–III) who were randomly assigned (2:1) to receive sacubitril/valsartan (target dose 97/103 mg) or control for 16 weeks. The primary endpoint was a change in peak VO2. Secondary endpoints included echocardiographic measures of cardiac structure and function, natriuretic peptides and other cardiac biomarkers, and Minnesota Living with Heart Failure quality of life. Between May 2018 and October 2021, 354 patients were screened for eligibility, 115 patients (mean age 58 years, 37% female) met the study inclusion criteria and were randomly assigned to sacubitril/valsartan (n = 79) or control (n = 36). At 16 weeks, there was no significant change in peak VO2 from baseline in the sacubitril/valsartan (15.3 [4.3] vs. 15.9 [4.3] ml/kg/min, p = 0.13) or control group (p = 0.47). No clinically significant changes were found in blood pressure, cardiac structure and function, plasma biomarkers, or quality of life. Conclusion: In patients with HCM, a 16‐week treatment with sacubitril/valsartan was well tolerated but had no effect on exercise capacity, cardiac structure, or function. [ABSTRACT FROM AUTHOR]

Background and Aims: An increasing number of patients referred for coronary artery bypass grafting (CABG) have had prior percutaneous coronary intervention (PCI). We sought to determine whether a relationship exists between increased postoperative mortality and morbidity following CABG procedure in patients with prior PCI., Methods: Over an 18-month period, 950 patients having first-time isolated CABG were divided into two groups based on absence (Group A, 819 patients--86.21%) or presence of a prior PCI (Group B, 131 patients--13.79%)., Results: In the prior PCI population, 74 patients (56.4%) had only one stent, and only 6.8% had multiple admissions for PCI. The overall incidence of three vessel disease in the entire patient population was only 65% and the average ejection fraction was 52%. Multivariate analysis demonstrated age (OR 1.080; 95% CI: 1.020 to 1.145; p = 0.009), left ventricular ejection fraction (OR 0.939; 95% CI: 0.901 to 0.978; p = 0.002), and emergency surgery (OR 0.138; 95% CI: 0.0.045 to 0.424; p = 0.001) as risk factors for 30-day mortality, while age (OR 1.059; 95% CI: 1.016 to 1.104; p = 0.007) and emergency surgery (OR 0.205; 95% CI: 0.078 to 0.537; p = 0.001) predicted major adverse cardiac events (MACE). Prior PCI did not influence mortality or MACE at 30 days., Conclusion: In this study involving low risk patients, a PCI prior to CABG did not increase morbidity or mortality., (© 2013 Wiley Periodicals, Inc.)

Coronary arteriovenous fistulae present rare clinical finding with the incidence of about 0.002% in the general population. Usually they are asymptomatic, but sometimes they can mimic other cardiac diseases, most commonly heart failure, myocardial ischemia, and endocarditis. Coronary arteriovenous fistulae have been reported to arise more commonly from the right coronary artery. Most of these fistulae are congenital, and only a small fraction acquired. In this report we present successful surgical treatment of coronary artery to pulmonary artery fistula combined with myocardial revascularization.