Purpose: The autonomic nervous system serves as the final gateway by which music exerts a therapeutic effect on health and disease. The aim of the study is to find the effect of different instrumental music on heart rate variability (HRV) as a part of our pilot protocol for identifying suitable auditory stimuli for evaluating the autonomic functions by HRV analysis. Methodology: The effect of music on HRV was assessed by frequency domain parameters of HRV, i.e. total power (TP, variance of N-N intervals over temporal segment), low frequency (LF, power in LF range), high frequency (HF, power in HF range), LF/HF ratio, LF%, and HF% using fast Fourier transform technology. Results: Flute was found to increase LF and HF as well as TP. Tabla and violin were found to increase HF% but had no effect on TP. This makes flute, table, and violin tranquilizing music. Piano was found to lower LF% and increase TP. Sitar and guitar were found to decrease HF%, as well as increase LF/HF ratio. They also increase TP. Conclusion: Although the results were not statistically significant, music is a low-cost and safe adjuvant for intervention and therapy. Therefore, there is growing need for high-quality research on the effects of music on the heart in both healthy individuals and patients.
{"title":"Impact of instrumental music on heart rate variability in ardent music listeners","authors":"N. John, P. Dubey, J. John","doi":"10.4103/rcm.rcm_8_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_8_21","url":null,"abstract":"Purpose: The autonomic nervous system serves as the final gateway by which music exerts a therapeutic effect on health and disease. The aim of the study is to find the effect of different instrumental music on heart rate variability (HRV) as a part of our pilot protocol for identifying suitable auditory stimuli for evaluating the autonomic functions by HRV analysis. Methodology: The effect of music on HRV was assessed by frequency domain parameters of HRV, i.e. total power (TP, variance of N-N intervals over temporal segment), low frequency (LF, power in LF range), high frequency (HF, power in HF range), LF/HF ratio, LF%, and HF% using fast Fourier transform technology. Results: Flute was found to increase LF and HF as well as TP. Tabla and violin were found to increase HF% but had no effect on TP. This makes flute, table, and violin tranquilizing music. Piano was found to lower LF% and increase TP. Sitar and guitar were found to decrease HF%, as well as increase LF/HF ratio. They also increase TP. Conclusion: Although the results were not statistically significant, music is a low-cost and safe adjuvant for intervention and therapy. Therefore, there is growing need for high-quality research on the effects of music on the heart in both healthy individuals and patients.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44453151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hamed Fattahi, Mozhgan Parsaee, N. Rezaeian, A. Azarkeivan, S. Meimand, Khadije Mohammadi, B. Naghavi
Objective: We evaluated the accuracy of two-dimensional speckle-tracking echocardiography (2DSTE) and 3DSTE to identify early cardiac dysfunction in comparison with cardiac T2* magnetic resonance imaging (MRI) in patients with blood transfusion-dependent β-Thalassemia. Methods: A total of 48 consecutive patients (36 males) successfully underwent 2DSTE, 3DSTE, and MRI on the same day. We calculated left ventricular segmental global longitudinal strain (GLS) (%) and segmental global circumferential strain (GCS) (%) from strain curves. Cardiovascular MRI was performed with the relevant protocols to measure the T2*. Results: In this study, we found that the GLS and GCS derived from 3DSTE correlated with cardiac T2* (r = −0.50, r = −0.49, respectively), whereas no correlation was detected between 2DSTE parameters and cardiac T2*. We calculated the area under the receiver operating characteristic area under the curve to determine the capability of 3DSTE parameters including GLS (<−23.5%) and GCS (<−33.4%) to discriminate between patients with (cardiac magnetic resonance T2* <20 ms) and those without myocardial iron overload. Conclusion: The study will clarify GLS and GCS's superiority derived from 3DSTE over the 2DSTE parameters in the detection of myocardial iron overload in patients with blood transfusion-dependent β-Thalassemia.
{"title":"Comparison between two and three-dimensional speckle-tracking echocardiography and cardiac T2* magnetic resonance imaging in ß-thalassemia","authors":"Hamed Fattahi, Mozhgan Parsaee, N. Rezaeian, A. Azarkeivan, S. Meimand, Khadije Mohammadi, B. Naghavi","doi":"10.4103/rcm.rcm_15_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_15_21","url":null,"abstract":"Objective: We evaluated the accuracy of two-dimensional speckle-tracking echocardiography (2DSTE) and 3DSTE to identify early cardiac dysfunction in comparison with cardiac T2* magnetic resonance imaging (MRI) in patients with blood transfusion-dependent β-Thalassemia. Methods: A total of 48 consecutive patients (36 males) successfully underwent 2DSTE, 3DSTE, and MRI on the same day. We calculated left ventricular segmental global longitudinal strain (GLS) (%) and segmental global circumferential strain (GCS) (%) from strain curves. Cardiovascular MRI was performed with the relevant protocols to measure the T2*. Results: In this study, we found that the GLS and GCS derived from 3DSTE correlated with cardiac T2* (r = −0.50, r = −0.49, respectively), whereas no correlation was detected between 2DSTE parameters and cardiac T2*. We calculated the area under the receiver operating characteristic area under the curve to determine the capability of 3DSTE parameters including GLS (<−23.5%) and GCS (<−33.4%) to discriminate between patients with (cardiac magnetic resonance T2* <20 ms) and those without myocardial iron overload. Conclusion: The study will clarify GLS and GCS's superiority derived from 3DSTE over the 2DSTE parameters in the detection of myocardial iron overload in patients with blood transfusion-dependent β-Thalassemia.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49055417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Eskandarian, Z. Sani, M. Behjati, R. Alizadehsani, A. Shoeibi, Kourosh Kakhi, A. Khosravi, S. Nahavandi, S. S. Shariful Islam
A 65-year-old male was introduced with a history of percutaneous coronary intervention 2 years ago who received Aspirin and Plavix. He was referred for coronary angiography after receiving thrombolytic therapy for ST-elevation myocardial infarction in precordial leads. On admission, he had dyspnea with low oxygen saturation, leukocytosis, lymphopenia, elevated C-reactive protein, and cardiac troponin levels. Transthoracic echocardiography demonstrated left ventricular ejection fraction (LVEF) of 25% and pulmonary artery pressure of 45 mmHg. A small thrombus at the site of the previously deployed stent was noticeable at coronary angiography. The chest computed tomography depicted significant involvement of the lungs manifested by peripheral ground-glass opacifications. A positive polymerase chain reaction confirmed coronavirus infection. He was oxygen dependent for 1 week. Gradually, his respiratory distress improved and his LVEF reached to 30% after discharge.
{"title":"Late stent thrombosis and acute ST-elevation myocardial infarction in a case affected with COVID-19: A rare manifestation","authors":"R. Eskandarian, Z. Sani, M. Behjati, R. Alizadehsani, A. Shoeibi, Kourosh Kakhi, A. Khosravi, S. Nahavandi, S. S. Shariful Islam","doi":"10.4103/rcm.rcm_39_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_39_20","url":null,"abstract":"A 65-year-old male was introduced with a history of percutaneous coronary intervention 2 years ago who received Aspirin and Plavix. He was referred for coronary angiography after receiving thrombolytic therapy for ST-elevation myocardial infarction in precordial leads. On admission, he had dyspnea with low oxygen saturation, leukocytosis, lymphopenia, elevated C-reactive protein, and cardiac troponin levels. Transthoracic echocardiography demonstrated left ventricular ejection fraction (LVEF) of 25% and pulmonary artery pressure of 45 mmHg. A small thrombus at the site of the previously deployed stent was noticeable at coronary angiography. The chest computed tomography depicted significant involvement of the lungs manifested by peripheral ground-glass opacifications. A positive polymerase chain reaction confirmed coronavirus infection. He was oxygen dependent for 1 week. Gradually, his respiratory distress improved and his LVEF reached to 30% after discharge.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48550243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Despite the fact that the incidence of cardiovascular disease is more pronounced in women, there is a lack of evidence-based studies that investigate the characteristics of acute coronary syndrome (ACS) in Indian women. Aim: The study aimed to assess the clinical characteristics, angiographic profile, and hospital outcomes of ACS in women <55 years of age in a tertiary care hospital of Northern Kerala. Materials and Methods: This was an observational study. In total, 179 women with <55 years of age, who had experienced the first episode of ACS were included in the study. Baseline characteristics including demography, risk factor, clinical presentation, and therapeutic management were reported. Results: Out of 179 female patients, 102 (57%) patients were postmenopausal. The most common risk factors of ACS in our population were found to be dyslipidemia (64.80%), followed by diabetes mellitus (58.10%) and hypertension (41.34%). The most frequent clinical presentation of ACS was non-ST-elevation myocardial infarction (STEMI) (49.16%), followed by STEMI (26.26%) and unstable angina (24.58%). Regarding the severity of disease, single-vessel disease (32%) was more common, followed by double-vessel disease (28%) and triple-vessel disease (24%). Left anterior descending artery (116 patients) was the most frequently involved artery in female patients, followed by right coronary artery (72 patients). Postprocedure complications associated with the study were as follows: hematoma (two patients), pseudoaneurysm (one patient), and takotsubo cardiomyopathy (one patient). Deaths were reported in two patients. Conclusions: The epidemiological trend of ACS, especially in the postmenopausal women, has been continuously rising in developing countries including India. Hence, more emphasis should be given on the identification of risk factors, clinical presentation, and diagnosis in this vulnerable group, which is ultimately beneficial for therapeutic management as well as reduces mortality and morbidity.
{"title":"Clinical Characteristics, Angiographic Profile, and Hospital Outcomes of Acute Coronary Syndrome in Women Less than 55 Years of Age in a Tertiary Care Hospital of Northern Kerala","authors":"A. Manzil, P. Pramod","doi":"10.4103/rcm.rcm_36_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_36_20","url":null,"abstract":"Background: Despite the fact that the incidence of cardiovascular disease is more pronounced in women, there is a lack of evidence-based studies that investigate the characteristics of acute coronary syndrome (ACS) in Indian women. Aim: The study aimed to assess the clinical characteristics, angiographic profile, and hospital outcomes of ACS in women <55 years of age in a tertiary care hospital of Northern Kerala. Materials and Methods: This was an observational study. In total, 179 women with <55 years of age, who had experienced the first episode of ACS were included in the study. Baseline characteristics including demography, risk factor, clinical presentation, and therapeutic management were reported. Results: Out of 179 female patients, 102 (57%) patients were postmenopausal. The most common risk factors of ACS in our population were found to be dyslipidemia (64.80%), followed by diabetes mellitus (58.10%) and hypertension (41.34%). The most frequent clinical presentation of ACS was non-ST-elevation myocardial infarction (STEMI) (49.16%), followed by STEMI (26.26%) and unstable angina (24.58%). Regarding the severity of disease, single-vessel disease (32%) was more common, followed by double-vessel disease (28%) and triple-vessel disease (24%). Left anterior descending artery (116 patients) was the most frequently involved artery in female patients, followed by right coronary artery (72 patients). Postprocedure complications associated with the study were as follows: hematoma (two patients), pseudoaneurysm (one patient), and takotsubo cardiomyopathy (one patient). Deaths were reported in two patients. Conclusions: The epidemiological trend of ACS, especially in the postmenopausal women, has been continuously rising in developing countries including India. Hence, more emphasis should be given on the identification of risk factors, clinical presentation, and diagnosis in this vulnerable group, which is ultimately beneficial for therapeutic management as well as reduces mortality and morbidity.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41309451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bafna, Meenakshi Gajbiye, Kishore Deore, S. Shah, V. Bafna
The peak of the coronavirus disease 2019 (COVID-19) crisis has exposed a substantial number of patients presenting with manifestations of venous and arterial thrombosis. Here, described is an extremely rare case of subclavian arterial thrombosis in a COVID-19 patient. Moreover, the patient presented with normal D-dimer, antinuclear antibody, fibrinogen, and serum ferritin levels, prothrombin time and platelet count. To the best of our knowledge, this is the first such case reported till date.
{"title":"Left Subclavian Arterial Thrombosis Presenting as Acute Limb Ischemia in a Coronavirus Disease 2019 Patient – An Extreme Rarity","authors":"A. Bafna, Meenakshi Gajbiye, Kishore Deore, S. Shah, V. Bafna","doi":"10.4103/rcm.rcm_24_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_24_20","url":null,"abstract":"The peak of the coronavirus disease 2019 (COVID-19) crisis has exposed a substantial number of patients presenting with manifestations of venous and arterial thrombosis. Here, described is an extremely rare case of subclavian arterial thrombosis in a COVID-19 patient. Moreover, the patient presented with normal D-dimer, antinuclear antibody, fibrinogen, and serum ferritin levels, prothrombin time and platelet count. To the best of our knowledge, this is the first such case reported till date.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47159781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Homocysteine is a sulfhydryl containing amino acid implicated in the pathogenesis of cardiovascular disease in multiple epidemiologic studies. However, elevated homocysteine in isolation is not known to lead to severe coronary artery disease requiring emergency intervention. We report a previously asymptomatic 55-year-old gentleman who presented with an acute myocardial infarction with bradycardia and was found to have triple-vessel coronary artery disease on angiography. After stabilization, he underwent a coronary artery bypass grafting in view of the severity of disease. A thorough evaluation revealed the absence of all traditional risk factors except elevated serum homocysteine. The evaluation of family members also revealed elevated homocysteine levels in both his sons and wife. Mutation testing of the methylenetetrahydrofolate reductase (MTHFR) gene showed homozygous Q429A mutation in the patient and heterozygous A222V and Q429A mutation in both his sons. The patient was discharged successfully and is well after 9 months of follow-up. Homocysteine has been implicated in the pathogenesis of cardiovascular disease in synergy with other traditional risk factors. This is a rare presentation of familial hyperhomocysteinemia presenting with severe coronary artery disease and elevated homocysteine levels in all family members. Elevated homocysteine levels in isolation may lead to significant cardiovascular disease and should be checked if no other risk factors are present. It may be useful to screen the patient and family members for underlying MTHFR mutations. In the absence of prospective evidence, there appears to be little harm in providing multivitamins to attempt to reduce homocysteine levels.
{"title":"Triple-Vessel Coronary Artery Disease Associated with Familial Hyperhomocysteinemia","authors":"Suvir Singh, B. Mohan","doi":"10.4103/rcm.rcm_34_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_34_20","url":null,"abstract":"Homocysteine is a sulfhydryl containing amino acid implicated in the pathogenesis of cardiovascular disease in multiple epidemiologic studies. However, elevated homocysteine in isolation is not known to lead to severe coronary artery disease requiring emergency intervention. We report a previously asymptomatic 55-year-old gentleman who presented with an acute myocardial infarction with bradycardia and was found to have triple-vessel coronary artery disease on angiography. After stabilization, he underwent a coronary artery bypass grafting in view of the severity of disease. A thorough evaluation revealed the absence of all traditional risk factors except elevated serum homocysteine. The evaluation of family members also revealed elevated homocysteine levels in both his sons and wife. Mutation testing of the methylenetetrahydrofolate reductase (MTHFR) gene showed homozygous Q429A mutation in the patient and heterozygous A222V and Q429A mutation in both his sons. The patient was discharged successfully and is well after 9 months of follow-up. Homocysteine has been implicated in the pathogenesis of cardiovascular disease in synergy with other traditional risk factors. This is a rare presentation of familial hyperhomocysteinemia presenting with severe coronary artery disease and elevated homocysteine levels in all family members. Elevated homocysteine levels in isolation may lead to significant cardiovascular disease and should be checked if no other risk factors are present. It may be useful to screen the patient and family members for underlying MTHFR mutations. In the absence of prospective evidence, there appears to be little harm in providing multivitamins to attempt to reduce homocysteine levels.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46807013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahin Rahimi, A. Firouzi, Iman Harirforoosh, M. Zangenehfar, Z. Khajali
Shone syndrome or complex is defined by sequential left-sided heart stenosis, including supravalvular mitral membrane, valvular mitral stenosis (MS) by a parachute mitral valve, subaortic stenosis, and aortic coarctation. It is a rare entity which occurs most frequently in its incomplete form, a 31-year-old man who referred to our adult congenital clinic with a chief complaint of recent chest discomfort. He had a history of hypertension since last year. Echocardiography revealed congenital severe MS (parachute-like mitral valve), two papillary muscles with decreased space between them and underdeveloped lateral papillary muscle. Other findings of echocardiography were bicuspid aortic valve (fusion of the right coronary cusp [RCC] and left coronary cusp) with moderate-to-severe aortic stenosis (AS) and moderate eccentric aortic insufficiency. Deformed aortic arch (gothic arch) and aortic coarctation were also reported in transthoracic echocardiography. We also found an abnormal vessel like density in 5-chamber view that suggested bleb sign and retroaortic course of the left circumflex (LCX). The patient was scheduled for coronary angiography and intervention for coarctation of the aorta, which revealed an abnormally originated LCX from RCC, significant coarctation of the aorta, and significant AS. Aortic coarctoplasty with CP STENT 8 × 39 mounted on balloon Altosa-XL-Gemini 26 × 40 was done in this session. Shone complex is a rare anomaly that may need multiple procedures for correction. Echocardiography is a specially important modality in these patients for diagnosis and evaluation of severity. By this modality, even we can diagnose some coronary artery origin abnormality.
{"title":"A Case Report of the Shone Syndrome in Association with Coronary Abnormality","authors":"Shahin Rahimi, A. Firouzi, Iman Harirforoosh, M. Zangenehfar, Z. Khajali","doi":"10.4103/rcm.rcm_33_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_33_20","url":null,"abstract":"Shone syndrome or complex is defined by sequential left-sided heart stenosis, including supravalvular mitral membrane, valvular mitral stenosis (MS) by a parachute mitral valve, subaortic stenosis, and aortic coarctation. It is a rare entity which occurs most frequently in its incomplete form, a 31-year-old man who referred to our adult congenital clinic with a chief complaint of recent chest discomfort. He had a history of hypertension since last year. Echocardiography revealed congenital severe MS (parachute-like mitral valve), two papillary muscles with decreased space between them and underdeveloped lateral papillary muscle. Other findings of echocardiography were bicuspid aortic valve (fusion of the right coronary cusp [RCC] and left coronary cusp) with moderate-to-severe aortic stenosis (AS) and moderate eccentric aortic insufficiency. Deformed aortic arch (gothic arch) and aortic coarctation were also reported in transthoracic echocardiography. We also found an abnormal vessel like density in 5-chamber view that suggested bleb sign and retroaortic course of the left circumflex (LCX). The patient was scheduled for coronary angiography and intervention for coarctation of the aorta, which revealed an abnormally originated LCX from RCC, significant coarctation of the aorta, and significant AS. Aortic coarctoplasty with CP STENT 8 × 39 mounted on balloon Altosa-XL-Gemini 26 × 40 was done in this session. Shone complex is a rare anomaly that may need multiple procedures for correction. Echocardiography is a specially important modality in these patients for diagnosis and evaluation of severity. By this modality, even we can diagnose some coronary artery origin abnormality.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42950906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Khani, M. Hamidzad, Fariba Bayat, M. Esfahani, Fatemeh Saffarian, H. Bakhshande, Seyed Talebzade
Aim: To investigate the relation between the postoperative RV dysfunction and cardiopulmonary bypass time (CPB time) and aortic cross clamp time by comparing new echocardiographic parameter (2D speckel tracking). Methods and Results: We included 38 patients who underwent CABG between March 2019 and November 20019 in the Academic Medical Centre in Tehran. Before and one week after CABG, patients had TEE,71% were male. There was statistically significant decrease in RVGLS from (-19 to -11) after CABG. There w ere significant correlation between Pre op TAPES and FAC (P value=0.002), pre op FAC and Sv (P value=0.001), Pre op TAPES and GLS (P value=0.011) and Pre op Sv and GLS (P value=0.013) And there was significant correlation between post op TAPES and FAC (P value=0.045) and Post op Sv and GLS (P value=0.04), Conclusion: There is not significant correlation between decline in RV function parameter (TAPES, GLS, FAC, Sv) and cardiopulmonary bypass time and aortic cross clamp time.
{"title":"2D Speckel Tracking of RV Function after CABG and CPB Time","authors":"M. Khani, M. Hamidzad, Fariba Bayat, M. Esfahani, Fatemeh Saffarian, H. Bakhshande, Seyed Talebzade","doi":"10.4103/rcm.rcm_26_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_26_20","url":null,"abstract":"Aim: To investigate the relation between the postoperative RV dysfunction and cardiopulmonary bypass time (CPB time) and aortic cross clamp time by comparing new echocardiographic parameter (2D speckel tracking). Methods and Results: We included 38 patients who underwent CABG between March 2019 and November 20019 in the Academic Medical Centre in Tehran. Before and one week after CABG, patients had TEE,71% were male. There was statistically significant decrease in RVGLS from (-19 to -11) after CABG. There w ere significant correlation between Pre op TAPES and FAC (P value=0.002), pre op FAC and Sv (P value=0.001), Pre op TAPES and GLS (P value=0.011) and Pre op Sv and GLS (P value=0.013) And there was significant correlation between post op TAPES and FAC (P value=0.045) and Post op Sv and GLS (P value=0.04), Conclusion: There is not significant correlation between decline in RV function parameter (TAPES, GLS, FAC, Sv) and cardiopulmonary bypass time and aortic cross clamp time.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49481026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The aim of this study was to assess the validity of using early cardiac troponin (cTn) levels for the identification of postoperative myocardial infarction (MI) in patients undergoing off-pump coronary artery bypass (OPCAB) graft surgery, identify influencing factors, and determine optimal cut-off values for early identification. Materials and Methods: Patients undergoing OPCAB by a single surgical unit from January 2018 to January 2020 were included in this prospective study. Their preoperative and intraoperative characteristics were noted. The cTn was collected at 12 h and the in-hospital outcome was studied. Results: A total of 370 patients were included in the study. Eleven patients had MI determined by other criteria (2.9%), but 220 patients (60%) were identified using cTn consensus cut-off value, as per the universal definition of MI. This indicated significant mislabelling of coronary artery bypass graft-related MI and need for the recalculation to have a realistic cut-off value. The optimal cut-off levels at for identifying postoperative MI was found to be 1.8 ng/ml at 12 h, with a higher negative predictive value to exclude mislabeling. Using a cTn range, rather than a single cut-off value, would be more helpful. The factors causing significant mislabeled elevation of postoperative cTn were found to be preoperative high levels and intraoperative findings of iatrogenic hematoma secondary to suction stabilizer, surgical maneuvers for intramyocardial target vessels. Conclusion: The cTn levels were affected by the various patient and operative factors and measurements using higher cut-offs were needed to rule out MI. Certain factors peculiar to OPCAB were found to be significantly responsible. It will help identify patients needing earlier invasive re-intervention or focused intensive care.
{"title":"Relevance of Cardiac Troponin in Predicting Postoperative Myocardial Infarction","authors":"Manish Pangi, Satish Govindaiah, Vivekananda Siddaiah, Jedidaiah Samraaj","doi":"10.4103/rcm.rcm_37_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_37_20","url":null,"abstract":"Introduction: The aim of this study was to assess the validity of using early cardiac troponin (cTn) levels for the identification of postoperative myocardial infarction (MI) in patients undergoing off-pump coronary artery bypass (OPCAB) graft surgery, identify influencing factors, and determine optimal cut-off values for early identification. Materials and Methods: Patients undergoing OPCAB by a single surgical unit from January 2018 to January 2020 were included in this prospective study. Their preoperative and intraoperative characteristics were noted. The cTn was collected at 12 h and the in-hospital outcome was studied. Results: A total of 370 patients were included in the study. Eleven patients had MI determined by other criteria (2.9%), but 220 patients (60%) were identified using cTn consensus cut-off value, as per the universal definition of MI. This indicated significant mislabelling of coronary artery bypass graft-related MI and need for the recalculation to have a realistic cut-off value. The optimal cut-off levels at for identifying postoperative MI was found to be 1.8 ng/ml at 12 h, with a higher negative predictive value to exclude mislabeling. Using a cTn range, rather than a single cut-off value, would be more helpful. The factors causing significant mislabeled elevation of postoperative cTn were found to be preoperative high levels and intraoperative findings of iatrogenic hematoma secondary to suction stabilizer, surgical maneuvers for intramyocardial target vessels. Conclusion: The cTn levels were affected by the various patient and operative factors and measurements using higher cut-offs were needed to rule out MI. Certain factors peculiar to OPCAB were found to be significantly responsible. It will help identify patients needing earlier invasive re-intervention or focused intensive care.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42736614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Alemzade-Ansari, F. Nouhi, M. Maleki, M. Kiavar, H. Basiri, E. Khalilipur, M. Peighambari, A. Firouzi, B. Mohebbi, Parham Sadeghipour, Mohsen Madaani, A. Zahedmehr, Farshad Shakerian, R. Kiani, Zahra Hosseini, A. Rashidinejad, H. Bakhshandeh
Introduction: Most fatal presentation of coronary artery disease (CAD) has been related to acute coronary syndrome (ACS), and we as a referral center in the country decide to launch a registry of patients with ACS to monitor the way they are managed and the way they are treated. Materials and Methods: Rajaie Cardiovascular, Medical and Research Center ACS registry (RHC-ACS registry) launched on December 2015 with enrolling all ACS patients referred or presented to the center. All patients' demographic variables, presenting symptoms, known risk factors, past medical history, past CAD records, serial ischemic electrocardiogram (ECG) changes, presenting echocardiographic data (such as left ventricular ejection fraction [LVEF], valvular abnormality, and mechanical complication of myocardial infarction [MI]), laboratory assessment (biochemistry, complete blood count, cardiac markers, and inflammatory indicators), and their angiographic and angioplasty data were recorded. Results: Recordings showed in the RHC-ACS registry, most patients were men (73.2%), with mean age of 59.16 ± 11.64 years, hypertension were the most known cardiac risk factor. Most patients were non-ST elevation MI patients (43.2%), 32.8% were in premature CAD group, and typical retrosternal chest pain were complained in 83.5% of our registry population. Most patients had no new ECG changes (51.7%) and from whom with new ECG changes, anterior territory ECG changes were the most common pattern (28.2%). LVEF was reported 30% or less in 171 (16.6%) of patients. Angiographic findings revealed femoral access was most common access (63.9%), most involved vessel was left anterior descending with 49.3% of the patients, percutaneous coronary intervention was performed in 48% of patients with drug-eluting stent implantation in 99.3% of these patients, dissection was the most angiographic-related complication in our registry (1%), and in-hospital death was reported in six patients (0.5%). Conclusion: RHC-ACS registry as a real-world middle-east running ACS registry would help cardiologists justify their revascularization strategy in ACS patients and would have a promising impact in future multi-center studies.
简介:冠状动脉疾病(CAD)的大多数致命表现都与急性冠状动脉综合征(ACS)有关，我们作为国内的转诊中心决定启动ACS患者登记，以监测他们的管理和治疗方式。材料和方法:Rajaie Cardiovascular, Medical and Research Center ACS registry (RHC-ACS registry)于2015年12月启动，纳入了所有转诊或提交给该中心的ACS患者。记录所有患者的人口统计学变量、表现症状、已知危险因素、既往病史、既往CAD记录、缺血性心电图(ECG)系列变化、超声心动图(如左室射血分数[LVEF]、瓣膜异常、心肌梗死机械并发症[MI])、实验室评估(生物化学、全血细胞计数、心脏标志物、炎症指标)以及血管造影和血管成形术数据。结果:记录显示，RHC-ACS患者以男性居多(73.2%)，平均年龄59.16±11.64岁，高血压是已知的心脏危险因素。大多数患者为非st段抬高型心肌梗死患者(43.2%)，32.8%为早期冠心病组，83.5%的登记人群主诉典型胸骨后胸痛。大多数患者无新的心电图改变(51.7%)，有新的心电图改变的患者中，前领地心电图改变最常见(28.2%)。171例(16.6%)患者报告LVEF为30%或更低。血管造影结果显示，股骨通路是最常见的通路(63.9%)，49.3%的患者最累及的血管是左前降支，48%的患者接受了经皮冠状动脉介入治疗，99.3%的患者接受了药物洗脱支架植入，夹层是我们登记的血管造影相关并发症中最多的(1%)，6例患者(0.5%)报告了住院死亡。结论:RHC-ACS注册表作为一个真实的中东运行的ACS注册表将帮助心脏病专家证明他们对ACS患者的血运重建策略，并将在未来的多中心研究中产生有希望的影响。
{"title":"Acute Clinical and Procedural Outcome of Rajaie Cardiovascular Medical and Research Center Acute Coronary Syndrome Registry","authors":"Mohammad Alemzade-Ansari, F. Nouhi, M. Maleki, M. Kiavar, H. Basiri, E. Khalilipur, M. Peighambari, A. Firouzi, B. Mohebbi, Parham Sadeghipour, Mohsen Madaani, A. Zahedmehr, Farshad Shakerian, R. Kiani, Zahra Hosseini, A. Rashidinejad, H. Bakhshandeh","doi":"10.4103/rcm.rcm_27_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_27_20","url":null,"abstract":"Introduction: Most fatal presentation of coronary artery disease (CAD) has been related to acute coronary syndrome (ACS), and we as a referral center in the country decide to launch a registry of patients with ACS to monitor the way they are managed and the way they are treated. Materials and Methods: Rajaie Cardiovascular, Medical and Research Center ACS registry (RHC-ACS registry) launched on December 2015 with enrolling all ACS patients referred or presented to the center. All patients' demographic variables, presenting symptoms, known risk factors, past medical history, past CAD records, serial ischemic electrocardiogram (ECG) changes, presenting echocardiographic data (such as left ventricular ejection fraction [LVEF], valvular abnormality, and mechanical complication of myocardial infarction [MI]), laboratory assessment (biochemistry, complete blood count, cardiac markers, and inflammatory indicators), and their angiographic and angioplasty data were recorded. Results: Recordings showed in the RHC-ACS registry, most patients were men (73.2%), with mean age of 59.16 ± 11.64 years, hypertension were the most known cardiac risk factor. Most patients were non-ST elevation MI patients (43.2%), 32.8% were in premature CAD group, and typical retrosternal chest pain were complained in 83.5% of our registry population. Most patients had no new ECG changes (51.7%) and from whom with new ECG changes, anterior territory ECG changes were the most common pattern (28.2%). LVEF was reported 30% or less in 171 (16.6%) of patients. Angiographic findings revealed femoral access was most common access (63.9%), most involved vessel was left anterior descending with 49.3% of the patients, percutaneous coronary intervention was performed in 48% of patients with drug-eluting stent implantation in 99.3% of these patients, dissection was the most angiographic-related complication in our registry (1%), and in-hospital death was reported in six patients (0.5%). Conclusion: RHC-ACS registry as a real-world middle-east running ACS registry would help cardiologists justify their revascularization strategy in ACS patients and would have a promising impact in future multi-center studies.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47511152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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