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Introduction: Minor defects in the mitochondrial ATP-generating system and post-cardioplegia oxidative phosphorylation can negatively impact cardiac function in immature hearts. This study aimed to examine the mitochondrial respiratory pathway using three different cardioplegic solutions (Custodiol HTK, St. Thomas, and Del Nido) during moderate (1 h) and long (3 h) ischemic periods., Methods: A total of 41 male Wistar albino rats were utilized in this study. Five experiments were conducted without the use of any cardioplegic solution (CP0 group). To assess both moderate and prolonged ischemic periods, six experiments were carried out in each of the following groups: CP1 group (St. Thomas solution), CP2 group (Custodiol HTK solution), and CP3 group (Del Nido solution)., Results: After 1 h, the highest mitochondrial respiration rate was observed in the CP3 group and the lowest in the CP1 group (p = 0.006). After adding ADP substrate, the highest mitochondrial ATP-production-coupled respiration was recorded in the CP3 group, which was similar to the control group CP0. After 3 h, while evaluating the ratio between mitochondrial respiration ATP-production coupled and basal respiration, significant differences were found between CP1 group and CP3 group (p = 0.035), as well as between the CP1 and CP0 groups (p = 0.045). Additionally, by assessing the condition of the outer mitochondrial membrane using the Cyt C effect (Cyt/Phos [ADP]), significant differences were observed between the CP1 and CP3 group (p = 0.004), as well as between CP1 and CP0 groups (p = 0.003)., Conclusion: Del Nido cardioplegic solution provided optimal mitochondrial protection under moderate and long myocardial ischemia conditions., Competing Interests: Declarations. Conflict of interests: The authors stated that they have no conflicts of interest regarding the research, writing, or publication of this article., (© 2024. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.)

Introduction: Left ventricular pseudoaneurysm is a rare but serious clinicopathologic entity., Materials and Results: This article describes a case report of 51-year-old man who experienced recurrence of chest pain and dyspnea 4 months later after anterior ST elevation myocardial infarction of first diagonal branch. Anterior basal left ventricular pseudoaneurysm was diagnosed and successful surgical treatment was performed. One year after operation, patient has no cardiovascular events and remains in NYHA class II., Conclusion: Cardiac magnetic resonance should be performed, if there is a suspicion of left ventricular pseudoaneurysm from transthoracic echocardiography. Surgery is the treatment of choice in case of left ventricular pseudoaneuryms because untreated lesions carry a significantly high risk of rupture., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Mediastinal neuroendocrine tumors are rare malignancies with aggressive behavior and a grim prognosis. These malignancies often go undetected until they are diagnosed at advanced stages., Case Report: We present the case of 74 -years old man who was hospitalized because of non-ST elevation myocardial infarction and in case of three vessels coronary artery disease, coronary bypass surgery was planned. During preoperative investigation, computer tomography revealed a huge tumor (20 cm × 11 cm × 21 cm in size) in the anterior mediastinum. Successful simultaneous operation coronary bypass surgery and removal of the mediastinal tumor was performed., Discussion: Surgery is the treatment of choice for neuroendocrine tumors but the relapse rate ranges between 5% and 30% and is higher (65%) in atypical neuroendocrine tumors and patients with mediastinal node involvement. Despite the poor prognosis of neuroendocrine tumors, the spread to the lymph nodes, the patient continues chemotherapy treatment 49 months after the operation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Objectives : The combination of aortic valve stenosis (AS) and ischemic heart disease (IHD) is quite common and is associated with myocardial fibrosis (MF). The purpose of this study was to evaluate the association between the histologically verified left ventricular (LV) MF and its geometry and function in isolated AS and AS within IHD groups. Materials and Methods : In a single-center, prospective trial, 116 patients underwent aortic valve replacement (AVR) with/without concomitant surgery. The study population was divided into groups of isolated AS with/without IHD. Echocardiography was used, and LV measurements and aortic valve parameters were obtained from all patients. Myocardial tissue was procured from all study patients undergoing elective surgery. Results : There were no statistical differences between isolated AS and AS+IHD groups in LV parameters or systolic and diastolic functions during the study periods. The collagen volume fraction was significantly different between the isolated AS and AS+IHD groups and was 7.3 ± 5.6 and 8.3 ± 6.4, respectively. Correlations between MF and left ventricular end-diastolic diameter (LVEDD) ( r = 0.59, p = < 0.001), left ventricular mass (LVM) ( r = 0.42, p = 0.011), left ventricular ejection fraction (LVEF) ( r = -0.67, p < 0.001) and an efficient orifice area (EOA) ( r = 0.371, p = 0.028) were detected in isolated AS during the preoperative period; the same was observed for LVEDD ( r = 0.45, p = 0.002), LVM ( r = 0.36, p = 0.026), LVEF ( r = -0.35, p = 0.026) and aortic annulus ( r = 0.43, p = 0.018) in the early postoperative period; and LVEDD ( r = 0.35, p ≤ 0.05), LVM ( r = 0.43, p = 0.007) and EOA ( r = 0.496, p = 0.003) in the follow-up period. In the group of AS and IHD, correlations were found only with LV posterior wall thickness ( r = 0.322, p = 0.022) in the follow-up period. Conclusions : Histological MF in AS was correlated with LVM and LVEDD in all study periods. No correlations between MF and LV parameters were found in aortic stenosis in the ischemic heart disease group across all study periods.

Introduction: Isolated coronary ostial stenosis of both ostia is a rare, potentially life-threatening condition, occurring in 0.1%-0.2% of patients undergoing coronary angiography., Case Report: We present a case of a 69-year-old woman with a past medical history of breast cancer, who had been treated with radiotherapy, which most likely caused significant stenosis of both coronary ostia and likely accelerated aortic stenosis. Surgical angioplasty with autopericardium patch reconstruction of the left main coronary artery and right coronary arteries due to proximal stenotic disease was performed instead of venous or arterial bypasses with concomitant aortic valve replacement. The postoperative course was uneventful. There were no cardiovascular events 5 years after operation, and the patient remained free of any symptoms., Conclusions: Surgical coronary angioplasty offers an alternative to conventional coronary artery bypass grafting in isolated coronary ostial lesions and is advantageous in restoring more physiological myocardial perfusion, especially in those cases when conduits are suspected to be fibrotic, scarred or stenosed after radiation therapy or if there is the need to preserve conduits for future myocardial revascularisation in young patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Patient-prosthesis mismatch (PPM) has been associated with numerous short- and long-term adverse events. This study aimed to evaluate the effect of PPM on early postoperative results after aortic valve replacement (AVR) in daily practice., Methods: In this single-centre retrospective study, 150 non-consecutive patients from March 2019 to January 2020 with clinically indicated AVR with/without concomitant surgery were analysed. The study protocol included operative mortality, complication rate, and pre- and postoperative echocardiographic data. PPM was considered severe with indexed effective orifice area at <0.65 cm 2 /m 2 , moderate at 0.65-0.85 cm 2 /m 2 and none at >0.85 cm 2 /m 2 ., Results: Moderate PPM was observed in 16 patients (10.6%). No patient had severe PPM. PPM was not related to early mortality ( r  = 0.40, p = 0.630), intra- ( r  = -0.076, p = 0.352) and postoperative ( r  = -0.0134, p = 0.102) events., Conclusion: In this study, moderate PPM was a frequent finding after AVR, whereas severe PPM was not observed. PPM did not affect the early results after AVR. A long-term follow-up study in a large patient population is required to assess the actual influence of residual PPM.

Background and objectives : The aims of this study were to investigate changes in the hemodynamics associated with different types of aortic prostheses and to evaluate patient-prosthesis mismatch (PPM) at rest and after exercise. Materials and Methods : We retrospectively analyzed 150 patients who presented with indications for aortic valve replacement (AVR) with/without concomitant surgery from March 2019 to January 2020. The study population included 90 (60%) men and 60 (40%) women (mean age, 67.33 ± 10.22 years; range, 37-88 years). Echocardiography data such as peak and mean transprosthetic pressure gradients (Gmax, Gmean), velocity (V), effective orifice area (EOA), and indexed EOA (iEOA) were derived at rest and after exercise at baseline and before discharge. The study patients performed the six-minute walk test (6MWT) on the 5th-7th postoperative day. Results : Stented tissue valves showed excellent performance at rest and after exercise in comparison with mechanical valves, which showed favorable hemodynamics at rest only. At the time of discharge, moderate PPM was observed in 7/74 patients (9.5%) at rest and 5/98 (3.3%) patients after exercise. None of the patients showed severe PPM. EOA and iEOA were not significantly different between the groups. However, the stented group showed more pronounced changes in EOA and iEOA after exercise, whereas the changes in the mechanical valve group did not reach significance. Conclusions: In the early postoperative period, mechanical valves and stented valves showed favorable resting hemodynamics. The PPM rate measured after exercise was lower than that at rest.

Cardiac positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) are encouraging precise non-invasive imaging modalities that allow imaging of the cellular function of the heart, while other non-invasive cardiovascular imaging modalities are considered to be techniques for imaging the anatomy, morphology, structure, function and tissue characteristics. The role of cardiac PET has been growing rapidly and providing high diagnostic accuracy of coronary artery disease (CAD). Clinical cardiology has established PET as a criterion for the assessment of myocardial viability and is recommended for the proper management of reduced left ventricle (LV) function and ischemic cardiomyopathy. Hybrid PET/CT imaging has enabled simultaneous integration of the coronary anatomy with myocardial perfusion and metabolism and has improved characterization of dysfunctional areas in chronic CAD. Also, the availability of quantitative myocardial blood flow (MBF) evaluation with various PET perfusion tracers provides additional prognostic information and enhances the diagnostic performance of nuclear imaging.

Background and Objective: Myocardial deformation indices are considered as sensitive markers of ischemia and may be useful in the quantification of hemodynamic significance of coronary artery disease (CAD). We sought to determine the diagnostic value of speckle-tracking echocardiography derived myocardial deformation parameters at rest and during stress to determine hemodynamically significance coronary artery stenosis in patients with moderate and high probability of CAD., Materials and Methods: In 81 patients (mean age, 64±8.6 years) with stable CAD inducible myocardial ischemia was evaluated by dobutamine stress echocardiography (DSE) and adenosine magnetic resonance imaging (AMRI). Based on AMRI patients were divided into two groups: nonpathologic (n=41) and pathologic (n=40). Strain and strain rate (SR) parameters and their changes from the rest (BASE) to low stress (MIN), peak stress (MAX), and recovery (REC) were analyzed using 2D speckle-tracking imaging (STI)., Results: In the nonpathologic group, systolic longitudinal and circumferential strain increased significantly from BASE to MIN, as well as systolic SR from BASE to MIN and from MIN to MAX in longitudinal plane. In contrast, in the pathologic group, insignificant longitudinal systolic SR increase and radial and circumferential systolic SR decrease from MIN to MAX was observed. Discriminant function analysis revealed that select STI derived parameters best classify patients into predefined AMRI groups (pathologic and nonpathologic) with the accuracy respectively 90.9% and 83.3%. According to ROC analysis these myocardial deformation parameters had the greatest predictive value of significant coronary artery stenoses: longitudinal strain at high dose (AUC 0.811, sensitivity 89.4%, specificity 64.7%), longitudinal strain rate at high dose (AUC 0.855, sensitivity 88.1%, specificity 71.0% at high doses). The sensitivity and specificity of inducible wall motion abnormalities were 74.0% and 85.0% (AUC 0.798) and was lower compared with the diagnostic value of longitudinal myocardial deformation parameters., Conclusions: Left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high risk for CAD., (Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Background and Objective: Low-T3 syndrome is common in patients with acute myocardial infarction (AMI). Recent experimental and clinical data have suggested a potential negative impact of low-T3 syndrome on myocardial function in patients with AMI. The aim of this study was to assess left ventricular (LV) myocardial function in patients with low-T3 syndrome and to investigate the association between hormonal profile and the severity of LV dysfunction using speckle-tracking echocardiography (STE)., Materials and Methods: In 130 patients with first-onset ST-segment elevation acute myocardial infarction (STEMI), conventional 2D and speckle-tracking echocardiography within 48-72h after the hospitalization was performed, and blood samples for TSH, fT4, fT3, and anti-TPO levels were obtained to investigate thyroid hormone production within 24h and on the fourth day after the onset of STEMI symptoms., Results: The patients were divided into two groups according to their serum level of fT3: group 1 with fT3 concentration below 3.2pmol/L (n=34) and group 2 with normal fT3 (>3.2pmol/L) level (n=96). LV ejection fraction (EF) tended to be lower in the low fT3 group. The systolic longitudinal strain did not differ between the groups, but the late diastolic longitudinal strain rate was lower in group 1 (P=0.011). The systolic basal LV rotation positively correlated with the level of fT3 (r=0.4; P<0.001), while a negative correlation was detected between myocardial rotational parameters - systolic apical rotation (r=-0.2; P<0.05), torsion (r=-0.3; P<0.001), and diastolic apical rotation rate (r=-0.3; P<0.01) - and fT3 levels., Conclusions: The late diastolic longitudinal LV strain rate and LV rotation evaluated by speckle-tracking echocardiography were impaired in patients with low-T3 syndrome after AMI., (Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Objective: The aim of the study was to investigate the relation between health-related quality of life (HRQoL) and left ventricular systolic and diastolic function parameters in stable coronary artery disease (CAD) patients with mild and moderate heart failure., Materials and Methods: This study included 758 CAD patients. Left ventricular ejection fraction (LVEF) and ratio of peak velocities of early (E) and late (A) diastolic mitral inflow, ratio E/A, deceleration time, isovolumic relaxation time were assessed. Patients completed the SF-36 questionnaire., Results: There were no strong and significant associations between echocardiographic measures and HRQoL in NYHA I-II class patients. In NYHA III class in univariate linear regression analyses significant associations were found between LVEF and physical functioning (β=0.230, P=0.009) and role limitations due to physical problems (β=0.230, P=0.009) and these associations remain significant after adjustment for age, gender, hypertension, angina pectoris class, nitrate, ACE inhibitors and diuretics use. E/A ratio was significantly associated only with mental health domain (β=0.188, P=0.048), and this association remains significant after all adjustments., Conclusions: In stable CAD patients with NYHA I-II functional class HRQoL was not strongly associated with left ventricular function; in NYHA III functional class patients' greater systolic function mainly was associated with better physical health and better diastolic function, with better mental health., (Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)