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The artery of Kugel is defined as a rare anatomical variant of the coronary arteries. It consists of an anastomotic connection between the branches of the right coronary artery (RCA) and the left circumflex artery (LCx). In patients with coronary artery occlusion, the presence of this connection bypassing the area of the occluded vessel may be a factor that prevents significant necrosis of a specific area of the myocardium. Most cases are detected by invasive coronary angiography. We present images from coronary computed tomography angiography (CCTA), which documented the existence of Kugel's artery in a 67-year-old patient with subtotal stenosis of the left main artery. The presented images clearly indicate that CCTA can visualize the existing rescue collateral circulation in patients with significant coronary artery disease. [ABSTRACT FROM AUTHOR]

Objectives: Arterial hypertension (AH) is one of the major risk factors for cardiovascular diseases. An association between untreated AH and arrhythmia is observed. Cardiac magnetic resonance (CMR) assesses myocardial fibrosis by detecting foci of late gadolinium enhancement (LGE). Clinical significance of LGE at the right ventricular insertion point (RVIP) is not fully established. This study aimed to assess the relationship between the presence of LGE at the RVIP determined by CMR and the incidence of arrhythmia in a group suffering from arterial hypertension. Methods: The study group consisted of 81 patients with AH (37 men and 44 women, age: 56.7 ± 7.1 years). All subjects underwent CMR and 24 h Holter ECG monitoring. Two subgroups were distinguished in the study group based on the criterion of the presence of LGE at the RVIP in CMR. The RVIP+ subgroup consisted of patients with LGE at the RVIP, while the RVIP− group consisted of patients without LGE at the RVIP. Results: The RVIP+ subgroup was characterized by higher maximum and minimum heart rates in 24 h Holter ECG recordings compared to the RVIP− subgroup (p < 0.05). The RVIP+ subgroup had a statistically significantly higher number of single premature supraventricular beats, supraventricular tachycardias, and single premature ventricular beats than the RVIP− subgroup (p < 0.05). Regression analysis documented that a longer duration of AH (counted from diagnosis) as well as the occurrence of LGE at the RVIP (assessed by CMR) are independent risk factors for arrhythmia (p < 0.05). Conclusions: Due to the possibility of detecting LGE at the RVIP, CMR may be a useful diagnostic method in estimating the risk of arrhythmias in the group of patients with AH. [ABSTRACT FROM AUTHOR]

The aim of this paper is to demonstrate the difference in usefulness of the coronary artery calcium score (CACS) and the full assessment of the severity of coronary artery disease in coronary computed tomography angiography (CCTA) studies. The difference between the population risk of coronary artery disease (CAD) assessed by the CACS and the severity of CAD was demonstrated in images from two CCTA studies. The first image is from a patient with a CACS of 0 and significant coronary artery stenosis. In the native phase of CCTA examination, no calcified changes were detected in the topography of the coronary arteries. In the middle section of the left descending artery (LAD), at the level of the second diagonal branch (Dg2), a large non-calcified atherosclerotic plaque was visible. Mid-LAD stenosis was estimated to be approximately 70%. The second image features a patient with a high CACS but no significant coronary artery stenosis. The calcium score of individual coronary arteries calculated using the Agatston method was as follows: left main (LM) 0, LAD 403, left circumflex (LCx) 207.7, right coronary artery (RCA) 12. CACS was 622.7, representing a significant population risk of significant CAD. In the proximal and middle sections of the LAD, numerous calcified and mixed atherosclerotic plaques with positive remodeling were visible, causing stenosis of 25–50%. Similarly, in the proximal and middle sections of the LCx, numerous calcified and mixed atherosclerotic plaques with positive remodeling were visualized, causing stenoses of 25–50%. Calcified atherosclerotic plaques were found in the RCA, causing stenosis <25%. The entire CCTA image met CAD-RADS 2 (coronary artery disease reporting and data system) criteria. In summary, CACS may be applicable in population-based studies to assess the risk of significant CAD. In the evaluation of individual patients, a comprehensive assessment of CAD severity based on the angiographic phase of the CCTA examination should be used. [ABSTRACT FROM AUTHOR]

Objectives: this study aims to evaluate the prevalence of various arrhythmias and other electrocardiographic patterns within the group of individuals with overweight and obesity. Methods: One hundred eighty-one adults (90 females and 91 males) were qualified for inclusion in the experimental group. All participants had a body mass index (BMI) exceeding 25 kg/m2 (98 patients with obesity and 83 with overweight). The mean BMI in the obesity group was 33.6 kg/m2, and all participants had class 1 obesity. The control group comprised 69 individuals (56 females and 13 males) with normal BMI. The basic measurements were performed, and the participants filled out questionnaires describing their health conditions and lifestyles. Each participant underwent an electrocardiographic (ECG) examination and a 24 h Holter ECG examination. Results: In patients with class 1 obesity compared to the control patients, the average numbers of premature ventricular beats (PVBs) and premature supraventricular beats (SPBs) were statistically significantly higher (p = 0.030 and p = 0.042). There was a positive correlation between body weight and PVB (p = 0.028) and between body weight and SPB (p = 0.028). Moreover, BMI and waist circumference were correlated with SPB (p = 0.043 and p = 0.031). In the backward stepwise multivariate regression model considering 24 h Holter ECG monitoring, concerning SPB as the dependent variable, it was observed that BMI (especially obesity class 1), type 2 diabetes, and thyroid disease exhibited the highest regression coefficients. Conclusions: obesity, even in class 1, might be a factor in a more frequent occurrence of abnormalities in electrocardiographic tests. [ABSTRACT FROM AUTHOR]

The intracavitary coronary arteries (ICCA) course is a rare phenomenon, where the segments of the coronary artery go through the atria or ventricles of the heart. In the past, these changes were incidentally detected during invasive diagnostic procedures for other reasons, as well as during postmortem examinations. As the use of multidetector computed tomography angiography (CTA) becomes more widespread, it has emerged that the incidence of ICCA has been underestimated. We present images from two coronary computed tomography angiography cases, which document the existence of ICCA in patients with non-specific chest pain. In the first case, in a 66-year-old woman, in addition to confirming coronary artery disease without significant stenosis (CAD-RADS 2-category 2 in the coronary-artery-disease-reporting and data system), the course of the middle section of the right coronary artery (RCA) in the lumen of the right atrium was demonstrated. In the second case, in a 47-year-old man in whom the presence of atherosclerotic lesions in the coronary arteries was excluded (CAD-RADS 0), the course of the distal segment of the left anterior descending (LAD) was found in the lumen of the apical layers of the right ventricle. To sum up, it should be stated that coronary CTA is a non-invasive diagnostic method that allows for visualization of the ICCA. In coronary CTA performed for indications consistent with the guidelines of scientific societies, attention should also be paid to the possible intracavitary course of the coronary arteries. The identification of such a course of the coronary arteries may be useful when preparing the patient for potential future invasive procedures involving the cardiac cavities. [ABSTRACT FROM AUTHOR]

In this narrative review, we investigate the essential role played by the computed tomography Aortic Valve Calcium Score (AVCS) in the cardiovascular diagnostic landscape, with a special focus on its implications for clinical practice and scientific research. Calcific aortic valve stenosis is the most prevalent type of aortic stenosis (AS) in industrialized countries, and due to the aging population, its prevalence is increasing. While transthoracic echocardiography (TTE) remains the gold standard, AVCS stands out as an essential complementary tool in evaluating patients with AS. The advantage of AVCS is its independence from flow; this allows for a more precise evaluation of patients with discordant findings in TTE. Further clinical applications of AVCS include in the assessment of patients before transcatheter aortic valve replacement (TAVR), as it helps in predicting outcomes and provides prognostic information post-TAVR. Additionally, we describe different AVCS thresholds regarding gender and the anatomical variations of the aortic valve. Finally, we discuss various scientific studies where AVCS was applied. As AVCS has some limitations, due to the pathophysiologies of AS extending beyond calcification and gender differences, scientists strive to validate contrast-enhanced AVCS. Furthermore, research on developing radiation-free methods of measuring calcium content is ongoing. [ABSTRACT FROM AUTHOR]

Globally, cardiovascular diseases are still the leading cause of death. Numerous methods are used to diagnose cardiovascular pathologies; there is still a place for straightforward and noninvasive techniques, such as electrocardiogram (ECG). Depolarization and repolarization parameters, including QT interval and its derivatives, are well studied. However, the Tpeak‐Tend interval is a novel and promising ECG marker with growing evidence for its potential role in predicting malignant arrhythmias. In this review, we discuss the association between the Tpeak‐Tend interval and several cardiovascular diseases, including long QT syndrome, cardiomyopathies, heart failure, myocardial infarction, and obesity, which constitutes one of the risk factors for cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are important risk factors in the development of cardiovascular diseases. New repolarization markers, such as the Tpeak-Tend interval and JTpeak intervals, have not yet been profoundly studied in obese patients. The study aims to analyze whether, in patients with obesity and overweight, repolarization markers, including the Tpeak-Tend interval, are prolonged and simultaneously check the frequency of other ECG pathologies in a 12-lead ECG in this group of patients. Methods: A study group consisted of 181 adults (90 females and 91 males) with overweight and first-class obesity. The participants completed a questionnaire, and the ECG was performed and analyzed. Results: When analyzing the classic markers, only QT dispersion was significantly higher in obese people. The Tpeak-Tend parameter (97.08 ms ± 23.38 vs. 89.74 ms ± 12.88, respectively), its dispersion, and JTpeak-JTend parameters were statistically significantly longer in the obese group than in the controls. There were also substantial differences in P-wave, QRS duration, and P-wave dispersion, which were the highest in obese people. Tpeak-Tend was positively correlated with body mass and waist circumference, while JTpeak was with BMI, hip circumference, and WHR. Tpeak/JT was positively correlated with WHR and BMI. In backward stepwise multiple regression analysis for JTpeak-WHR, type 2 diabetes and smoking had the highest statistical significance. Conclusions: Only selected repolarization markers are significantly prolonged in patients with class 1 obesity and, additionally, in this group, we identified more pathologies of P wave as well as prolonged QRS duration, [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the importance of T1-mapping sequences in the diagnosis of hypertrophic cardiomyopathy (HCM) in patients without foci of non-ischemic myocardial injury in classic cardiac magnetic resonance (CMR) sequences. Methods: Two groups were compared: 28 patients with HCM, without any foci of myocardial injury in the late gadolinium enhancement (LGE) sequence (HCM group), and 28 patients without cardiomyopathy (CON group). Classic CMR sequences and T1-mapping sequences were performed. The following parameters were assessed: T1 time of the whole left ventricular myocardium, T1 time of myocardium in the basal, middle and apical layers of the left ventricle, and T1 time in individual segments of the left ventricular myocardium. Myocardial extracellular volume (ECV) was assessed similarly. Results: ECV was significantly higher in the HCM group than in the CON group, for the whole left ventricular myocardium, for the basal and apical layers of the left ventricle, and for segments 1–3, 8, and 13–16 of the left ventricle. Regression analysis showed that a higher left-ventricular mass index (LVMI), a higher body mass index and older age are factors independently associated with a higher ECV of the whole myocardium but only in the group with LVMI ≥ 131.84 g/m2. Conclusion: In patients with HCM without foci of non-ischemic myocardial injury, higher ECV values of the left ventricular myocardium are observed. [ABSTRACT FROM AUTHOR]

Maintaining an active lifestyle is crucial for good health. Markers of health risk include tissue components. This study aimed to indicate which body composition elements create the strongest correlations with physical activity performed in young students of medical faculties. The study group consisted of 75 students (33 men and 42 women) from Wroclaw Medical University. Each student underwent accelerometer and anthropometric measurements and body composition analysis. Both men and women had similar physical activity levels. The study found that the amount of vigorous physical activity correlated significantly with the basal metabolic rate (BMR), fat, water and muscle content, fat-free mass (FFM), bone mass, extracellular to intracellular water ratio (ECW/ICW), and phase angle (PA), with r~ ± (0.2–0.4). The amount of moderate physical activity correlated with body mass, body mass index (BMI), BMR, FFM, and bone mass, with r~0.3–0.5. There are dimorphic differences in the strength of correlations between physical activity and elements of body composition. A greater amount of moderate and vigorous physical activity is associated with greater FFM and bone mass in men, which causes BMI to increase as well (in this case, higher BMI is not a sign of being overweight). For women, the beneficial effect of higher amounts of vigorous physical activity on reducing fat content and increasing muscle mass is more pronounced. In both men and women, an improvement in hydration is evident with increased vigorous physical activity volume. [ABSTRACT FROM AUTHOR]

Purpose. The aim of the study was to assess the importance of the measurements of thickness and volume of epicardial adipose tissue (EAT) in coronary computed tomography angiography (CCTA) as a predictive factor of increased stiffness and impaired elasticity of aorta. Methods and materials. The study involved a group of 97 patients (63.48 ± 8.50 years). In accordance with the medians of epicardial adipose tissue (EAT) parameters, aortic elasticity and stiffness parameters, patients were divided into subgroups: EAT thickness median 9.40 mm, EAT volume median 61.95 mL, EAT thickness index 5.08 mm/m2 and EAT volume index 34.33 mL/m2. Results. The mean coronary artery calcium score was 162.24 (±317.69). The mean aortic stiffness index was 4.18 (±0.81). The assessed mean aortic elasticity parameters were 3.29% (±2.37) and 0.12 cm2/dyn (±0.09) for strain and distensibility, respectively. A positive linear correlation was observed between EAT parameters and aortic stiffness (0.21), volume (0.51), thickness index (0.24), volume index (0.55) and, for aorta elasticity, a negative linear correlation between the following EAT parameters was observed: thickness (−0.32 and −0.30), volume (−0.49 and −0.48), thickness index (−0.34 and −0.31), volume index (−0.51 and −0.49) and aortic elasticity parameters (aorta strain and aorta distensibility, respectively). Conclusion. The study showed that CCTA illustrates a relationship between the parameters of EAT and an increased stiffness of the aorta, while the most predictive factor of stiffness was the volume index. [ABSTRACT FROM AUTHOR]