Carotid plaque and increased carotid IMT are associated with the presence and severity of coronary calcification and disease on CTA in ambulatory subjects.

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Background Early diagnosis and treatment of myocardial affection in patients with systemic lupus erythematosus (SLE) are crucial. Objectives To evaluate the ventricular systolic function in juvenile-onset systemic lupus erythematosus (j-SLE) patients by 3-D speckle tracking echocardiography (3D-STE) and to determine the predictors of left ventricular (LV) dysfunction if present. Methods Twenty-six SLE patients without heart failure and 21 healthy controls were studied by standard echocardiogram and 3D-STE. Conventional parameters included LV ejection fraction (EF), fractional shortening (FS), and mitral annular plane systolic excursion (MAPSE). Global LV strain (GLS) and global area strain (GAS) were obtained by 3D-STE. Medical records, including diagnosis criteria, duration of disease, and SLE disease activity index (SLEDAI) were evaluated. Results The mean age was similar in patients and controls 11.42 vs 11.48 years p  =  0.93. The mean duration of the disease was 1.87 ± 1.02 years and SLEDAI ranged from 0 to 9. By conventional and tissue Doppler imaging echocardiography, only MAPSE was significantly lower in SLE patients compared to controls (14.56 vs 18.46 mm, p < 0.001). By 3D speckle tracking echocardiography, GLS and GAS were significantly reduced in SLE patients compared to controls (−15.07 vs −19.9.4%, −34.6% vs −39.7%, respectively, p < 0.001). Multiple linear regression and ROC analyses indicated that the SLEDAI score was the only predictive factor for the left ventricular remodeling. Conclusions These results indicate that early subclinical LV dysfunction occur in jSLE patients even with normal EF and SLE disease activity might be a potential driver for LV deformation.

Right atrial thrombus is a rare entity frequently encountered in patients with pulmonary embolism. Although the existing guidelines do not offer a clear statement for the management of right atrial thrombus and pulmonary embolism, this condition is associated with worse outcomes. We present a case of a 79-year-old patient presenting with signs suggestive of massive pulmonary embolism who was found to have a right atrial thrombus on transthoracic echocardiogram and was successfully treated with systemic thrombolysis. Despite the lack of data from randomized studies, right atrial thombi in transit should be considered a severe form of thromboembolic disease often requiring aggressive treatment, particularly in patients with severe right ventricular dysfunction.

4 L PEG plus menthol has better palatability and acceptability than 2 L ascorbic acid- PEG and is associated with a higher rate of excellent preparations; Clinicaltrial.gov identifier: NCT01788709.