Background: Abnormalities in thyroid function are frequent in patients with heart failure and are associated with increased mortality. However, the relation between thyroid hormone levels and echocardiographic parameters has not been investigated sufficiently. Aim: The aims of this study were to investigate the correlations of thyroid hormone levels with echocardiographic parameters and to evaluate their associations with subsequent mortality in a group of patients with dilated cardiomyopathy (DCMP). Methods: Serum levels of thyroid hormones were measured in 111 consecutive patients with DCMP (35 female, 76 male, mean age: 62 F 12 years). All patients underwent echocardiographic examination and were followed-up for a period of 12 F 8 months. Results: Twenty-three patients (21%) had abnormalities in thyroid function tests. Free triiodothyronine (fT3)/free thyroxine (fT4) ratio was significantly correlated with most of echocardiographic parameters, such as chamber diameters and ejection fraction. Sixteen patients (14%) died during the follow-up period; their fT3/fT4 ratio was significantly lower than the patients who survived (1.31 F 0.37 vs. 2.01 F 0.72, p < 0.001). A fT3/fT4 ratio of V 1.7 was associated with an increased risk of mortality ( p < 0.001), independent of other prognostic markers. Sensitivity, specificity, positive and negative predictivity of fT3/fT4 ratio V 1.7 for cardiac mortality were 100%, 71%, 36% and 100%, respectively. Conclusion: Determination of FT3/FT4 ratio may be a valuable and simple predictor for identification of patients with DCMP who are at high risk of subsequent mortality.

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Gated SPECT and two-dimensional echocardiography correlate well for the assessment of left ventricular function and volumes. Gated SPECT has the advantage of providing information about left ventricular function, dimensions and perfusion.

Purpose: The aim of this study was to investigate the long-term prognosis of non-interventionally followed patients with myocardial bridge and angiographic milking of the left anterior descending (LAD) coronary artery. Methods: All of the coronary angiography records from May 2000 to November 2007 were reevaluated and patients who had more than 70% narrowing during systole on LAD were eligible for the present study. Follow-up was carried out by physical examination, echocardiography, and treadmill exercise testing. The clinical situations of the patients, medical treatment at the time of follow-up, and experienced events (death, myocardial infarction, or revascularization) were recorded. Results: There were 59 eligible patients (44 male, 74.6%). The mean age of the patients was 54 ± 11 years. The bridges were located in the proximal, mid, and distal portion of the LAD in 17 (28.8%), 20 (33.9%), and 22 (37.3%) patients, respectively. Distributions of the narrowing degree were as follows: between 70% to 89% in 33 (56%) patients and 90% to 100% in 26 (44%) patients. Mean follow-up duration of the group was 37 ± 13 months (range 15-65 mo). The clinical presentation during follow-up was stable angina in 9 (15.3%) cases, atypical angina in 12 (20.3%), atypical chest pain in 13 (22%), dyspnea in 3 (5.1%), and syncope in 3 (5.1%) cases. There were no experienced events and/or hospitalizations related to cardiac disease. Echocardiographic examination revealed normal systolic ventricular function. Only 17 (28.8%) patients continued to use medication. Most of them were on β-blocker therapy. Conclusion: Patients with myocardial bridges and angiographic milking of the LAD coronary artery have a good long-term prognosis. IntroductionMyocardial bridging is anatomically defined as the muscle overlying the intramural segment of a major epicardial coronary artery. A myocardial bridge is the most common congenital coronary anomaly, with an incidence of between 1.5% and 16% as assessed on coronary angiography and up to 80% as assessed at necroscopy. 1 -3 It is usually considered an innocent anomaly. 4 -6 Although it is rare, myocardial infarction, left ventricular dysfunction, paroxysmal atrioventricular block, as well as exercise-induced ventricular tachycardia and sudden cardiac death are accused sequela of this pathology. 4 -12 The aim of this study was to investigate the prognosis of non-interventionally followed patients with myocardial bridge and angiographic milking of the left anterior descending (LAD) coronary artery.

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