Introduction: Atrial septal aneurysm (ASA) is often associated with other atrial septal abnormalities, particularly with atrial septal defect type ostium secundum or patent foramen ovale. ECG signs of incomplete or complete right bundle branch block are known to be associated with atrial septal defects, however such correlation with other atrial septal abnormalities is not documented.

Introduction:The coronary anatomic variation of the left circumflex artery (LCx) is considered as the most common anatomic variation with a separate ostium from the right sinus, and very unusual variation as a proximal branch of right coronary artery (RCA).Case report:We report two cases, the first case is a 64-year-old man with chest pain and with history of hypertension, obesity, dyslipidemia and current smoker, and the second case is a 67-year-old who presented to the emergency department with chest pain and with a past medical history of arterial hypertension and type 2 diabetes mellitus. In the coronarography of the first case is detected an ectopic left circumflex coronary artery from the right coronary sinus with stenotic changes in RCA and LCx. The second case in the coronary angiography revealed an ectopic left circumflex coronary artery from the proximal part of the right coronary artery with stenotic changes in LAD, RCA and LCx. Based on guidelines for revascularization our patients successfully underwent treatment procedures. We present two cases that because of the atherosclerotic coronary artery disease leads to the need of coronarography find out the presence of coronary artery anomalies.Conclusion:During the coronarography we should think about coronary artery anomaly or missing artery knowing that type of these anomalies, considering that may be a contributing factor in the development of the atherosclerosis determines the method of the treatment.

Background:Data on the lowering effects of statins in hypertensive patients have been mixed and highly controversial. Some studies shows reductions effects of statins in blood pressure, whereas others do not. The evidence in the literature on the effects of statins on blood pressure raises the possibility that statins may directly lower blood pressure in addition to reduce cholesterol levels–pleiotropic effects of statins.Aim of the study:The role of statins as additional treatment in patients with severe hypertension and advanced aortic atherosclerotic plaques. Methods. We enrolled 62 patients. Study has been approved by Committee of Ethics and patients signed a Term of Free Informed Consent. All patients were studied with transoesophageal echocardiography at baseline and 12 months after enrolment. Inclusion criteria were severe hypertension and presence of aortic atherosclerotic plaques. Patients have been divided into two groups; group A (treated with antihypertenives and statins) and group B (treated, just with antihypertensives).Results:Twenty patients, of totally 38, from group A (20/38 or 52.6%) had significantly plaque reduction. One patient of totally 24 (1/24 or 4.1% ) from group B had significantly atherosclerotic plaque reduction. Difference of plaques reduction between two groups was highly significant. Regarding blood pressure levels, statins users had significantly reduction on systolic and diastolic blood pressure compared to statins nonusers.Conclusion:Hypertensive patients with presence of AA plaques treated with antihypertensives and statins have more BP reduction compared will hypertensive patients treated with antihypertensives alone.

IntroductionAbnormal aortic function in hypertension is generally attributed to accelerated breakdown of elastin in the aorta, leading to dilatation of the lumen and stiffening of the wall as elastin is replaced with stiffer collagen. Aortic stiffness is an independent predictor of cardiovascular risk and all-cause and cardiovascular mortality. Vascular stiffening can activate endothelium which in turn may promote atherogenesis. Modulation of arterial stiffness has been shown to be successfully managed via changes in lifestyle and put under control of hypertension pharmacologically with antihypertensive drugs and statins.MethodsHundred and forty four patients have been enrolled in this study. They have been divided in two groups, with hypertension and group of control. Groups were with no age difference.ResultsGroup with hypertension were with reduced aortic strain, distensibility (compliance) and have higher stiffness than control group; GrHTA =9.3 compared to GC=5.4. After successful treatment of hypertension with antihypertensives and statins, for two years, these parameters showed improvement, but still remain out of normal range compared to control group; 7.6 vs. 5.38.ConclusionsHypertensive patients have reduced aortic elasticity and increased stiffness which can be stopped and improved after treatment with antihypertensive and statin.

Bedri faik zahiti, daut rashit gorani, fitim Bejtullah gashi, sami Bajram gjoka, lorita Bedri zahiti, Bekim sylë Haxhiu, lulzim selim kamberi university clinical centre of kosova, prishtina, kosovo corresponding author: daut rashit gorani, md. e-mail: daut_g@yahoo.com introductionAbnormalities in diastolic function are considered to be an early sign of diabetic cardiomyopathy, and are identified in type 2 diabetic patients without systolic ventricular dysfunction as assessed by conventional methods, and also by tissue Doppler imaging (TDI) (1,2,3,4,5,6,7,8). The close association of diabetes with high cardiovascular morbidity and mortality is primarily due to an increased rate of ischemic heart disease. Some authors have reported a direct effect of diabetes on the myocardium (diabetic cardiomyopathy) that can lead to congestive heart failure in the absence of coronary atherosclerosis (9, 10, 11). Prevalence of CVD especially of ischemic heart disease in diabetics is more increased when associated with: arterial hypertension, overweight, increased levels of serum lipoproteins etc. (12, 13). Therefore, tissue Doppler imaging, as a new echocardiography tool, based on measurement of wall motion velocities (1,14,15,16,17,18), seems better suited for evaluating diastolic function, and is expected to improve the identification of diabetic patients with diastolic dysfunction and early impairment of cardiac performance (1,19). Recent studies have reported that the addition of TDI to CE increases the ability to identify diastolic dysfunction among diabetic patients (6). In the early stage, diabetic cardiomyopathy is characterized by left ventricular diastolic dysfunction (LVDD), while left ventricular (LV) systolic function impairs later on in the clinical course of diabetes (20).The aim of the study was to evaluate whether TDI is able to detect abnormalities of diastolic function by using exercise stress test in type 2 diabetic subjects even in the presence of a normal cardiac function with CE and symptom free in rest. material and metHods subjectsThree hundred subjects of both genders were studied; the study population was selected from two groups of subjects: 150 non-obese, normotensive, uncomplicated type 2 diabetic patients of average age of 50,5±10, in five years duration of disease and the control group which consisted of 150 non-diabetic subjects, of average age of 47,50±8,5, recruited from healthy volunteers. From the study were excluded patients with HTA, obesity, acute ischemic disease, heart failure, heart defects and pulmonary obstructive disease. The diagnosis of original paper ABSTRACT the aim of the study was detection of diastolic dysfunction of myocardium with Tissue Doppler Imaging (TDI) in asymptomatic type 2 diabetic patients, in five years duration of disease, and normal cardiac function on conventional echocardiography (CE), according to the performance showed on exercise stress test. material and methods: We studied 300 patients, of them 150 patients with nonobese, normotensive, uncomplicated type ...