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Introduction: the right coronary artery (RCA) normally emerges from the right aortic sinus, travels through the coronary sulcus and curves towards the crux cordis of the heart, where it usually branches into the posterior interventricular artery (PIA), that irrigates the posterior part of the interventricular septum and the apex of the heart and determines the coronary arterial dominance. Purpose: to analyze the coronary arterial dominance and RCA and PIA morphometry in hearts of Northeast Brazil. Methods: 50 human hearts from the Anatomy Laboratory of the Federal University of Ceará were analyzed. The hearts were categorized according to coronary arterial dominance. The diameters of the beginning and end of the RCA were measured. PIA was divided in three parts and its diameters in the beginning and middle were measured, such as its full length. The results were statistically analyzed by Student t-test and one-way analysis of variance (ANOVA), significance p<0.05. Results: the mean diameters of RCA were 3.80±0.71 mm in the beginning and 3.12±0.49 mm in the end, just before it branches into PIA. The diameter of the RCA is bigger in its origin than in its end (p<0.001). The mean length of the PIA was found to be 54.52±5.18 mm. The mean diameters of the PIA were 2.46±0.69 mm in the origin, 2.27±0.66 mm in the first third, 2.06±0.59 mm in the second third, and 1.84±0.56 mm in the last third. The diameters of PIA were bigger in the first and in the second thirds compared to the third one (p=0.007 and p<0.001, respectively). In addition, 95.7% of the analyzed hearts were right dominants. Conclusion: there is a major right dominance with largest diameter in the initial slice of RCA and PIA compared to the final segment. This knowledge contributes to the management of coronary diseases in these vessels. [ABSTRACT FROM AUTHOR]

Objective: To establish reference range for the left ventricle (LV), right ventricle (RV) and interventricular septum (IVS) peak myocardial tissue Doppler velocities (MTD) using spectral tissue Doppler between 20 and 36 + 6 weeks of gestation in a Brazilian population. Methods: We performed a cross-sectional study evaluating 253 low risk singleton pregnancies with body mass index (BMI) between 18.5 and 29.9 kg/m2, and gestational age between 20 and 36+6 weeks. MTD during systole (S'), early (E') and late diastole (A') were performed with the sample volume placed at the basal segment of the LV side wall, the IVS and the RV free wall. Polynomial regression was used to obtain the best-fit using MPI measurements and gestational age (GA) with adjustments using determination coefficient (R2). Mod-MPI percentiles 5th, 50th and 95th were determined for each gestational age. Results: All myocardial tissue Doppler velocities (cm/sec) showed a progressive increased with gestational age (p<0.0001). The mean LV MTD ranged from: S' (4.25 to 6.81), E' (3.51 to 7.19) and A' (6.76 to 9.16). The mean RV MTD ranged from: S' (4.89 to 7.93), E' (4.40 to 9.04) and A' (8.39 to 11.43). The mean IVS MTD ranged from: S' (3.92 to 5.84), E' (3.41 to 5.81) and A' (5.99 to 8.07). Conclusions: Reference values for the fetal LV, RV and IVS MTD measurements between 20 and 36+6 weeks of gestation in a Brazilian population were established. [ABSTRACT FROM AUTHOR]

Objective: To establish reference range for the tricuspid, mitral and septal annular peak systolic excursion (TAPSE, MAPSE & SAPSE) between 20 and 36 + 6 weeks of gestation in a Brazilian population. Methods: We performed a cross-sectional study evaluating 253 low risk singleton pregnancies with body mass index (BMI) between 18.5 and 29.9 kg/m2, and gestational age between 20 and 36+6 weeks. M-mode measured the tricuspid, mitral and septal annular peak systolic excursion (TAPSE, MAPSE & SAPSE). Polynomial regression was used to obtain the best-fit using MPI measurements and gestational age (GA) with adjustments using determination coefficient (R2). Mod-MPI percentiles 5th, 50th and 95th were determined for each gestational age. Results: TAPSE, MAPSE & SAPSE (mm) showed a progressive increased with gestational age. The mean of TAPSE ranged from 3.98 to 8.14 mm (R2=0.68; p<0.0001). The mean of MAPSE ranged from 3.01 to 5.73 mm (R2=0.48; p<0.0001). The mean of SAPSE ranged from 3.92 to 5.84 mm (R2=0.36; p<0.0001). Conclusions: Reference values for the fetal TAPSE, MAPSE & SAPSE measurements between 20 and 36+6 weeks of gestation in a Brazilian population were established. [ABSTRACT FROM AUTHOR]

Objective: To analyze the efficacy of percutaneous transluminal septal alcoholization in the treatment of refractory obstructive hypertrophic cardiomyopathy (HOC)., Methods: The patients were referred for alcoholization after Doppler echocardiography. Before and after alcoholization, the intraventricular pressure gradient was recorded. Alcoholization was performed with a 3mL injection of absolute alcohol through a coronary angioplasty balloon catheter. The procedure was concluded after a significant reduction or abolition of the pressure gradient., Results: Of 22 patients, 18 (81.8%) successfully concluded the procedure with a reduction in intraventricular pressure gradient at baseline (from 67.6+/-24.2 mmHg to 3.8+/-1.9 mmHg, p<0.005) and after extrasystole (from 110.4+/-24.2 mmHg to 9.6+/-2.6 mm Hg, p<0.005). A significant reduction in mean interventricular septal thickness (from 2+/-0.3 mm to 1.7+/-0.2 mm, p<0.005) and in peak pressure gradient (from 90.7+/-23.5 mmHg to 6.1+/-1.4 mmHg, p<0.005) was observed on Doppler echocardiography after 6 months, when all patients were in functional class I. The most frequent acute complication, present in 11% of the patients, was the need for definitive pacing implantation. Relapse of the symptoms and reappearance of the pressure gradient occurred in 16.6% of the patients. One patient (5.5%) died probably due to a diffuse coronary spasm prior to the procedure, and another died suddenly on late follow-up., Conclusion: Percutaneous transluminal septal alcoholization is effective and safe in the treatment of HOC.