Aims Soluble suppression of tumourigenicity 2 (sST2) and galectin-3 are involved in cardiac fibrosis, inflammation, and remodelling. However, the place of sST2 and galectin-3 in predicting the outcomes of electrical cardioversion of atrial fibrillation (AF) is uncertain. We evaluated whether these biomarkers could predict sinus rhythm (SR) maintenance after cardioversion of persistent AF in patients with normal left ventricular systolic function. Methods and results The study included 80 patients with persistent AF, who underwent cardioversion from February 2016 to August 2018. The blood concentrations of sST-2 and galectin-3 were measured with ELISA and the ASPECT-PLUS assays. Clinical and electrocardiographic follow-up was performed at months 1, 6, and 12. Patients who maintained SR at 12 months had significantly lower concentrations of sST2, measured by ELISA and ASPECT-PLUS assays, than the remaining patients (16.9 ± 9.8 vs. 28 ± 22.9 ng/mL; P < 0.001; 28.7 ± 13.4 vs. 40 ± 25.1 ng/mL; P = 0.003); the concentration of galectin-3 did not differ between these patients. Multivariable logistic regression showed that log-transformed sST2 ELISA was a significant predictor of SR maintenance at 12 months [odds ratio 0.14; 95% confidence interval (CI) 0.03–0.58; P = 0.006]. On receiver-operating characteristic curve analysis, the areas under the curve for the concentration of sST2 was 0.752 (95% CI 0.634–0.870; P < 0.001). The concentrations of sST2 measured with the two assays were strongly correlated (rho = 0.8; CI 95% 0.7–0.87; P = 0.001). Conclusion Soluble suppression of tumourigenicity 2, but not galectin-3, can be used to predict SR maintenance after cardioversion of AF in patients with normal left ventricular systolic function. The measurements of sST2 concentrations with the rapid lateral flow and enzyme-linked immunoassays were consistent.

PurposeCaseous calcification is a relatively uncommon variant of calcification of the mitral annulus. The purpose of the study was to assess characteristic radiological features of caseous calcification of the mitral annulus (CCMA) using computed tomography (CT) and compare the usefulness of CT and transthoracic echocardiogram (TTE) in a diagnosis of CCMA.Material and methodsSeventeen patients with CCMA, who underwent TTE and CT, were analysed. The following features of CCMA were evaluated: location, size, attenuation, enhancement after contrast administration, and margins.ResultsIn all cases TTE visualised an echo-dense structure with an irregular appearance involving the mitral valve annulus. In five cases the acoustic shadowing artefact was visible, and in four cases the mass contained central areas of echolucency. Eleven patients had valve disease.On CT CCMA appeared as a round mass in one case, in 10 cases as an oval mass, and in six patients it had a semilunar shape.In all cases on unenhanced CT, CCMA appeared as a hyperdense mass. On enhanced CT, CCMA in 10 cases (58.8%) had a hypodense centre, and in 7seven (41.2%) it had a hyperdense centre without enhancement after contrast administration. A hyperdense rim was observed in all cases except one patient.ConclusionsIn cases of the atypical appearance of CCMA on TTE, CT can lead to a definitive diagnosis. The combination of unenhanced CT and after IV contrast administration scans allows for recognition and distinction of CCMA from other pathologies, while TTE allows for assessment of additional valve dysfunction.

We describe the arterial supply of a human kidney harvested post-mortem from a 75-year-old female volunteer body donor. The kidney was analysed with contrast-enhanced computed tomography, and corrosion casting was used to reveal the kidney's angio-architecture. In the left kidney, we observed four renal arteries, each originating directly from the abdominal aorta. Three renal arteries, including the main renal artery, coursed through the renal hilum, and the fourth renal artery reached the lower kidney pole. The supply areas of each of the four renal arteries were analysed with a 3D reconstruction of computed tomography images and with corrosion casting. There were no clear boundaries between the areas supplied by the four renal arteries because their branches overlapped in most kidney segments.

A 73-year-old female patient was referred for coronary artery computed tomography angiography (CTA) due to dyslipidemia, hypertension, and mild ventricular arrhythmia. The study demonstrated a double left anterior descending artery (LAD) Type 1 variant (Fig. 1A) and significant atherosclerotic lesions in the coronary arteries. Conventional coronary angiography confirmed presence of an anomaly and significant atherosclerotic lesions within the second marginal branch (Mg 2) and the right coronary artery (RCA). The patient was treated with percutaneous coronary intervention (PCI) of Mg 2 and RCA with drug-eluting stenting (DES).A 63-year-old female smoker with hypertension, had a positive stress test with low exercise tolerance (5.9 METS) and significant ST depression in leads II, III, aVF, V5 and V6, with chest pain. The 24-h Holter electrocardiography monitoring demonstrated ventricular arrhythmia with nonsustained ventricular tachycardia (nsVT). The CTA revealed multifocal significant atherosclerotic lesions and dual LAD Type 1 (Fig. 1B). The patient did not consent to coronary angiography.Computed tomography angiography is the preferred imaging method in the assessment of coronary arteries anomalies. The main advantages