Open Access Case Study

Extensive Type A Aortic Dissection; from Internal Carotid Artery to Iliac Artery: A Case Report and Review of the Literature

Yasemin Gunduz, Akif Ergüven, Kiyasettin Asil, Lacin Tatli Ayhan, Zeynep Ozozen

Cardiology and Angiology: An International Journal, Page 97-102
DOI: 10.9734/CA/2015/13272

Aortic dissection is defined as separation of the layers within the aortic wall. An acute aortic dissection is associated with high morbidity and mortality rates, indeed, many patients die before presentation to the emergency department (ED) or before diagnosis is made in the ED. The location, size and etiology of a dissection all impact on the clinical outcome. All arteries may be affected by the dissection, and clinical signs and symptoms such as neurologic, renal and extremity complications may vary depending on the involvement.

We reported the case of a 59-year-old woman who presented with sudden-onset pain, weakness and numbness of the right leg, with no chest or back pain. A combination of features on transcervical carotid Doppler and CT angiograhy demonstrated type A aortic dissection extending to the common iliac artery and involving the supra-aortic branches, with distal extension to the carotid vessels.


Open Access Original Research Article

Signal Processing Tools for Heart Sounds Analysis Based on Time-Frequency Domain

Ali Moukadem, Christian Brandt, Emmanuel Andrès, Samy Talha, Alain Dieterlen

Cardiology and Angiology: An International Journal, Page 103-113
DOI: 10.9734/CA/2015/13185

This paper present several signal processing tools for the analysis of heart sounds. Cardiac auscultation is noninvasive, low-cost and accurate to diagnose some heart diseases. A new module for the segmentation of heart sounds based on S-Transform is presented. The heart sound segmentation process divides the Phono Cardio Gram (PCG) signal into four parts: S1 (first heart sound), systole, S2 (second heart sound) and diastole. The segmentation can be considered one of the most important phases in the auto-analysis of PCG signals. A segmentation method based on the Shannon energy of the local spectrum calculated by the S-transform is proposed. Then, the energy concentration of the S-transform is optimized to accurately detect the boundaries of the localized sounds. New features based on the energy concentration of the S-transform are proposed to classify S1 and S2 and other features based on the complexity measure via Time-Frequency (TF) domain are proposed to detect systolic murmurs.


Open Access Original Research Article

Serum Zinc Levels do not Differ in Type 2 Diabetic Subjects with and without Coronary Artery Disease

Aggelos G. Ioannidis, Athanasia K. Papazafeiropoulou, Alexios Sotiropoulos, Athanasia Kokkinari, Ourania Apostolou, Maria Stefanidou, Stavroula A. Papadodima

Cardiology and Angiology: An International Journal, Page 114-121
DOI: 10.9734/CA/2015/13760

Aims: The scope of this study is to investigate zinc levels in type 2 diabetic subjects with and without coronary artery disease (CAD).

Place and Duration of Study: This study was performed in outpatient clinic of General Hospital of Nikaia between December 2009 and May 2010.

Methodology: A total of 100 type 2 diabetic subjects with CAD and 100 diabetic subjects without CAD were enrolled into the study.

Results: There was no difference of serum zinc levels between diabetic subjects with and without CAD (89.53±22.39 vs. 86.97±20.85 μg/dl, P= 0.40). Multivariate linear regression analysis showed significant independent associations between zinc and age (beta = -0.23, P= 0.01) and alcohol consumption (beta = 0.29, P=0.001) in diabetic subjects with CAD. Also, significant independent associations demonstrated between serum zinc and dietary vitamins intake (beta = 0.19, P= 0.03) and number of platelets (beta = 0.16, P= 0.05) in diabetic subjects without CAD.

Conclusion: Serum zinc levels were not different between diabetic subjects with and without CAD. Age and alcohol consumption were the only determinants of serum zinc levels in diabetic subjects with CAD. Dietary vitamins intake and number of platelets were the only determinants of serum zinc levels in diabetic subjects without CAD.


Open Access Original Research Article

Correlation of Left Atrial Septal Pouch with the Prevalence of Patent Foramen Ovale: A Retrospective Review

Silanath Terpenning, Loren H. Ketai, Stacy M. Rissing, Shawn D. Teague

Cardiology and Angiology: An International Journal, Page 122-129
DOI: 10.9734/CA/2015/13996

Purpose: To determine the prevalence of Left Atrial Septal Pouch (LASP) and assess the association with Patent Foramen Ovale (PFO).

Materials and Methods: We retrospectively reviewed 275 cardiac-gated CT examinations at Indiana University from January 2010 to June 2012, 160 cardiac CTs performed prior to pulmonary vein ablation, 115 for evaluation of coronary artery evaluation. Consensus readings were performed by two readers on a PACS workstation using the Multiplanar Reformat software to identify the presence or absence of LASP and PFO. PFO was diagnosed by the presence of a contrast jet extending from the left atrium to the right atrium.

Results: Overall prevalence of LASP was 24.7% (68 LASPs out of 275 patients). There was no significant difference regarding the gender and age between patients with and without LASP, p-values 0.054 and 0.63 respectively. The overall prevalence of PFO in both groups is low 2.2% (6 PFOs out of 275 patients). The prevalence of PFO in patients with LASP was 5.9% (4 out of 68 patients) and was 1.0% (2 PFOs out of 207 patients) in patients without LASP. There was a significant difference in prevalence of PFO between patients with and without LASP, p-value 0.035.

Conclusions: LASP is a common finding on cardiac CT, its prevalence not affected by age or gender. Patients with LASP have statistically greater prevalence of PFO than patients without LASP, but the prevalence remains low.


Open Access Review Article

Cardiac Computed Tomographic Angiography: Clinical Applications

Haliah Z. Al Shehri, Yahya S. Al Hebaishi, Abdulrahman M. Al Moghairi

Cardiology and Angiology: An International Journal, Page 78-96
DOI: 10.9734/CA/2015/13582

Cardiovascular disease is the lead­ing cause of morbidity and mor­tality worldwide. Cardiac imaging plays an important role in diagnosis and risk stratification of various cardiac diseases. Cardiac computed tomography added a major diagnostic value and led to reducing the need for invasive cardiac measures in many cardiac conditions. Cardiac computed tomography has emerged as an accurate anatomic method for detection of coronary artery disease. The negative predictive value to exclude significant coronary artery stenosis approaches 100%. Advances in multidetector computed tomography technology improved coronary arteries imaging during a single breath hold in a wide range of coronary pathologies. Appropriate patient preparation, image acquisition, and post processing techniques to detect coronary artery stenosis and plaque are prerequisites to achieving diagnostic image quality. Cardiac computed tomography applications also include assessment of cardiac structure and function, post myocardial infarction complications, electro anatomical mapping, and delineation of the pericardium.