A BSTRACT Objectives: The objective of this study was to evaluate if the diastolic reserve is different in prediabetes versus control during exercise. Materials and Methods: During the resting stage and graded supine bicycling exertion (25 W, 3 min increment), the mitral inflow and septal mitral annular velocities were determined in 50 patients with prediabetes (21 females, mean age 48 ± 16 years) and 50 gender- and age-matched controls. None demonstrated rest or inducible cardiac ischemia on echocardiography. Results: Between the two study groups, the velocities of the mitral inflow (E) and septal mitral annulus (E′) at rest are not significantly different. E′ during exercise, on the other hand, was significantly lower in individuals with prediabetes than in controls (8.57 ± 2.46 vs. 9.82 ± 2.42 cm/s at 25 W, P = 0.012; 9.42 ± 1.93 vs. 11.15±2.97 cm/s at 50 W, P = 0.001). E/E′ behaves oppositely during exercise with a value that is significantly higher in patients with prediabetes. Conclusion: The diastolic reserve of the left ventricle, as determined by the change in E′ and E/E′ throughout exercise, is abnormal in individuals with prediabetes who do not have overt cardiac disease. Using exercise stress echocardiography may be helpful for the early recognition of subclinical diastolic dysfunction in prediabetics which may have clinical repercussions in the future.

Acute aortic dissection (Stanford Type A) is a life-threatening medical emergency associated with a high rate of early mortality (57 percent) without surgical intervention. During coronary catheterization, it occurs at a rate of 0.02 percent to 0.06 percent. There are no clear guidelines regarding the optimal management of this fatal condition. The critical importance of preventing dissection propagation by stenting the dissection's entrance in the coronary artery had been emphasized in prior review articles. Iatrogenic aortic dissections that do not involve the coronary arteries can be managed conservatively and closely followed-up with repeated imaging.