University Heart Journal最新文献

{"title":"Rate of Cardiotoxicity in Childhood Acute Lymphoblastic Leukemia Treated with Daunorubicin Using Echocardiography and Troponin I","authors":"Tania Sultana, Tapas Chowdhury, Farzana Islam, Umme Nusrat Ara, Chowdhury Shamsul, Hoque Kibria, C. Jamal, A. T. M. A. Rahman, Anwarul Karim","doi":"10.3329/uhj.v19i1.69821","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69821","url":null,"abstract":"Background and Aim: Acute lymphoblastic leukemia (ALL) is the commonest malignancy in childhood. Childhood ALL Survivors have a lifelong increased risk for cardiovascular morbidity and mortality compared to the general population, mainly caused by chemotherapy with daunorubicin. The aim of the study is to detect the rate of daunorubicin induced cardiotoxicity in children with acute lymphoblastic leukemia during induction phase chemotherapy. Meterials & Methods : This prospective observational study was conducted in the department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU) on 40 newly diagnosed patients of ALL aged between 1 to17.9 years who got daunorubicin during induction. Complete blood count and echocardiography were done and troponin I was measured in all patients before and after completion of induction period. Result: Of the 40 patients, 8 patients (20%) had developed cardiotoxicity evidenced by reduction of left ventricular ejection fraction (LVEF) in echocardiography. Baseline LVEF was 68.80±5.98% which was then reduced to 65.32±7.07% after induction phase of chemotherapy (p=0.023). No significant alteration of troponin I was seen (P= 0.581) between baseline and after completion of induction. Total WBC count and hemoglobin had a significant difference (P<0.05) between baseline and after induction period. Male patients had a greater risk of developing cardiotoxicity than females but statistically was not significant (P=0.643). There was no significant association between age of the patients and cardiotoxicity (P=0.112).Cardiotoxicity was seen higher in patient with initial high WBC count (p=0.039). Echocardiography also reveled increased tendency of mitral regurgitation and left ventricular hypertrophy after induction phase chemotherapy. Conclusion: This study showed the rate of cardiotoxicity was 20% in ALL patients treated with daunorubicin. It also found that LVEF was decreased during therapy.Echocardiography can be used to detect early cardiotoxicity induced by daunorubicin. University Heart Journal 2023; 19(1): 20-25","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"206 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250372","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}

{"title":"The Link between Major Depressive Disorder & Chronic Coronary Syndrome - A Literature Review","authors":"Afm Azim Anwar, Sheikh Nashfiqur Rahaman, Sanjida Anjum Mumu, Md Fakhrul Islam Khaled, Khurshed Ahmed, Md. Harisul Hoque","doi":"10.3329/uhj.v19i1.69827","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69827","url":null,"abstract":"Depression is prevalent among patients with coronary artery disease and has significant consequences. Occurrence of depression after a new diagnosis of stable angina is common and affects nearly 1 in 5 individuals. There have been several biological mechanisms by which depression may be related to coronary artery disease. As compared with nondepressed patients, those with depression have increased catecholamine levels,elevated resting heart rate, and decreased heart rate variability. . Behavioral characteristics of patients with depression include poor medication adherence, lower exercise tolerance,physical inactivity, poor dietary habits,and tobacco use. Although depression and its impact have been well documented in post-MI patients, much less is known about its significance in patients with chronic coronary syndrome(CCS).Despite the fact that CCS is the most common manifestation of coronary artery disease,sothere is a huge gap in the field of knowledge correlating CCS and depression. University Heart Journal 2023; 19(1): 26-30","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"76 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248393","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}

{"title":"Correlation Between B line in Lung Ultrasound and Plasma NT-proBNP Level in Patients with Acute Heart Failure","authors":"Md Hasan Zaman, Md Imam Hosen, Farhana Moyaj, J. Arzu, D. Osmany, Sheikh Foyez Ahmed, Muhammad Mobarack Hossain, Muhammad Kamal Hossain, C. M. Ahmed","doi":"10.3329/uhj.v19i1.69820","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69820","url":null,"abstract":"Background: Acute heart failure (AHF) is a major cause of morbidity and mortality worldwide. Although this is a common cause of dyspnoea, its diagnosis still represents a challenge. Lung ultrasound (LUS) is an emerging point-of-care diagnostic tool. Objective: The aim of the study was to assess the Correlation between B line in lung ultrasound and plasma NT-proBNP level in patients with acute heart failure & thus to assess the predictive value of B line in patients with suspected acute heart failure. Materials and Method: Crosssectional observational study conducted in cardiology department of BSMMU from October 2020 to September 2021. Study procedure: 36 patients presenting with of shortness of breath or heart failure diagnosis were enrolled meeting inclusion and exclusion criteria. The number of B-lines by Lung Ultrasound was measured. Correlation between number of B-lines on lung ultrasonography and NT-proBNP level were analyzed. Results: There is a positive correlation between the number of B-lines and the NT-proBNP levels (r=0.55, p< 0.01) in acute heart failure patients. Conclusion: Patients presenting with acute shortness of breath with raised NTproBNP level, B line detection &quantification by lung ultrasound can be used as a tool for a faster diagnosis and decision-making on lung congestion in acute heart failure. University Heart Journal 2023; 19(1): 15-19","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247301","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}

{"title":"In Hospital Outcome of Pharmaco-invasive Therapy versus Primary PCI In ST-segment elevation Myocardial Infarction in Dhaka, Bangladesh","authors":"S. D. M. Taimur, S. Khan","doi":"10.3329/uhj.v19i1.69804","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69804","url":null,"abstract":"Background & Objectives: In many low middle income countries (LMIC), it is difficult to treat patients with ST-segment elevation Myocardial Infarction (STEMI) with timely PPCI. Thus, many undergo fibrinolysis. Whether early fibrinolysis followed by timely coronary angiography provides a clinical outcome similar to that of primary percutaneous coronary intervention (PPCI) after acute STEMI in LMIC settings remains a question. In this observational study we primarily aimed to compare in-hospital outcomes of primary PCI versus pharmaco-invasive strategy (immediate fibrinolysis followed by coronary angiography with possible PCI within 3-24 hours) for reperfusion in eligible patients with STEMI at a tertiary cardiac care center. Methods: This prospective observational study was done in Ibrahim Cardiac Hospital & Research Institute, Dhaka from April 2022 to July 2022 where consecutive patients presenting with STEMI were enrolled and divided into two groups: those who underwent primary PCI (Group-I) and those who underwent immediate fibrinolysis with subsequent coronary angiography with PCI within 3 to 24 hours (Group-II). The main outcomes analyzed were all-cause death, cardiogenic shock, acute left ventricular failure, life threating arrhythmia, acute stent thrombosis, CVD, Contrast induced nephropathy (CIN), re-infarction, target-vessel revascularization, and major bleeding up to 7 days. Results: A total 122 patients presented with acute STEMI, 61 in each group. One group underwent primary PCI and another group treated with fibrinolysis by tenecteplase. The mean age of the studied patients was 53.86±9.72 years (range 18-75 years). Eighteen percent of patients presented with Extensive Anterior MI,19.7% showed Anterior MI, 21.3% showed Antero-septal MI, 21.3% showed Inferior MI, 9.8% showed Inferior with posterior and 3.3% showed Lateral MI. 35.5% had Single vessel disease, 31.1% had double vessel disease,28.7% had triple vessel disease, LM with LAD was 0.8% and 0.8% had recanalized infarct related artery in both groups overall. In group-I 45.9% of PPCI were undertaken in LAD and 32.8% patient. of group-II was done PCI in LAD. There were no significant differences between two groups in primary outcome and mortality. Conclusion: Immediate fibrinolysis followed by coronary angiography within 3-24 hours resulted in similar short-term outcomes in patients with STEMI compared to PPCI. Our study suggests that, compared with PPCI, fibrinolysis performed in the hospital setting is associated with similar mortality rates, acute CVD, CIN and acute left ventricular failure in with PPCI than STEMI. University Heart Journal 2023; 19(1): 10-14","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248081","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}

{"title":"The Relationship/Association of Triglyceride and Severity of Coronary Artery Disease: Is Triglyceride Really a Risk Factor for Coronary Artery Disease?","authors":"K. K. Karmoker, Khandaker Aisha Siddika, Mohammad Walidur Rahman, Bijoy Datta, M. B. Rashid, Golam Rahman Mallick, Niranjan Kumar Sana","doi":"10.3329/uhj.v18i2.62732","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62732","url":null,"abstract":"Worldwide, the major cause of mortality and morbidity is coronary artery disease (CAD). In the pathogenesis and progression of atherosclerosis, lipid and its metabolites play an important role. The aim of the study was to find out the association of triglyceride (TG) level on the severity of coronary artery disease (CAD) in patients with ischemic heart disease (IHD). In this cross-sectional study, 431 patients with ischemic heart disease were enrolled after taking informed written consent. TG level were categorized into normal (< 150 mg/dl), borderline (150-199 mg/dl) and high (³200 mg/dl). Patients with ischemic heart disease (IHD) were stratified according to TG level. Severity of CAD was assessed by the Gensini score. Most of the patients (33.4%) belonged to the age group 51–60 years. The mean age was 51.31±10.30 years. The majority (74.5%) of patients were male. Among risk factors, 205 (47.6%) patients were smokers, followed by hypertension 190 (44.1%) and diabetes mellitus 175 (40.5%). The association of TG with the whole spectrum of IHD was found statistically significant (p < 0.05). Moderate to severe CAD was found to be higher in the high TG level group compared with the other groups and was statistically significant. \u0000University Heart Journal 2022; 18(2): 101-105","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82946318","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}

{"title":"Long term Cardiovascular Manifestations of COVID - 19","authors":"Khurshed Ahmed, Sudhir Sah, Md Fakhrul Islam Khaled, Afm Azim Anwar, Md. Harisul Hoque","doi":"10.3329/uhj.v18i2.62734","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62734","url":null,"abstract":"Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well known for causing an acute respiratory disease, a number of patients after they get recovered from acute infection, subsequently experience a constellation of symptoms and events that lasts for more than 3 months. Adequate clinical data are now accumulating on the subacute and long-term effects of Covid-19 and can involve multiple organ systems. This spectrum of symptoms and late manifestations are thought to have a possible link with the covid-19 and this condition is named LONG COVID or POST-COVID. Some of the patients may show the ongoing evidence of cardiovascular damage on long term without having symptoms which may be picked up by different imaging modalities like CMR. There has been an increase in the number of COVID-19 patients in an exponential fashion so as to cause a collapse in the healthcare system in many countries across the world, with an effect not only on public health, but also on social and economic activities. \u0000University Heart Journal 2022; 18(2): 118-124","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89749490","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}

{"title":"Complete Heart Block in a Case of Rheumatoid Arthritis: Uncommon Presentation of a Common Disease","authors":"C. Singha, S. Zaman, Rasul Amin, F. I. Khaled, E. Biswas, Afm Azim Anwar, Sanjida Anjum Mumu","doi":"10.3329/uhj.v18i2.62739","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62739","url":null,"abstract":"We report a case of complete heart block (CHB) in a patient with rheumatoid arthritis (RA) because of its atypical presentation, negative Anti CCP and one of the uncommon causes of CHB. It occurs mainly in patients with established erosive nodular RA. It is usually sudden and permanent. It has several mechanisms, but the most common cause is infiltration in or near the AV node or bundle of His. If CHB develop the best option of treatment is the insertion of a permanent pacemaker. The prognosis is usually good provided no other cardiac lesions exist. \u0000University Heart Journal 2022; 18(2): 132-134","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84721809","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}

{"title":"A Case of Type 2 MI with Normal Coronary Arteries: Case Report & Literature Review","authors":"Afm Azim Anwar, Sanjida Anjum Mumu, Azharul Islam, Md Fakhrul Islam Khaled, Khurshed Ahmed, Md. Harisul Hoque","doi":"10.3329/uhj.v18i2.62738","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62738","url":null,"abstract":"Clinicians have long recognized that acute myocardial infarction (MI) can occur in the absence of atherothrombosis . The Universal Definition of MI Global Taskforce introduced a classification system in 2007 (and reaffirmed in 2012) that defined type 2 MI (following standard diagnostic criteria) as MI occurring due to an imbalance in myocardial oxygen supply and/or demand not caused by atherosclerotic plaque disruption. Nevertheless, ambiguity remains regarding how to diagnose type 2 MI and how to distinguish it from both type 1 MI and myocardial injury. Here we report a case of a 23 year old young woman attended to emergency department, with typical chest pain and shortness of breath for 6 hours, Diarrhoea for 2 days, and single time loss of consciousness for 5 minutes, 6 hours before attending to hospital. Cardiac enzymes were rising titres in subsequent samples, Serum Creatinine was also high. Echocardiography performed 36 hour later, showed no regional wall motion abnormality, coronary angiogram showed normal coronary arteries. So, a diagnosis of Myocardial Infarction (Type 2 MI) with Non Obstructive Coronary Artery (MINOCA) was made, and MINOCA was attributed to hypovolemic shock (resulting from Dirrrahoea), manifested as MI, Syncope and AKI. \u0000University Heart Journal 2022; 18(2): 128-131","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83973885","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}

{"title":"Association between Retinal Microvascular Changes and Severity of Coronary Heart Disease in Hypertensive Patients","authors":"A. Jamil, K. Iqbal, M. A. Hossain, Khan daker Harun Rashid, Md Tufazzal Hossen, A. Sarker, M. Hossain, M. Das, S. Ahsan","doi":"10.3329/uhj.v18i2.62688","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62688","url":null,"abstract":"Background : The prevalence of coronary artery disease is increasing day by day. In many cases it is undiagnosed. Hypertension is one of the risk factors of coronary artery disease. Hypertension also causes some changes in retina which is easy to diagnose in clinical practice. So the aim of this study is to predict coronary artery disease by seeing hypertensive retinal changes. \u0000Methods: A total of 100 patients with hypertension presenting to the emergency department with ischemic chest pain who underwent coronary angiography were studied. Presence or absence of coronary artery disease was determined. Optic fundi were assessed for hypertensive retinopathy which were photographed. \u0000Results: Mean ± SD age of the study population was 56.23±10.76 years. There were 75 men (75%) and 25 women (25%). Prevalence of coronary artery disease and hypertensive retinopathy were 84% and 44% respectively. There was association between coronary artery disease and retinopathy (P< 0.017). Age (P= 0.019), smoking (P=0.011) and dyslipidaemia (0.039) were identified as risk factors for coronary artery disease. \u0000Conclusion: Important observations from this study are that hypertensive retinopathy has an association with coronary artery disease. Retinal change can be used in predicting coronary artery disease in patients with hypertension which can be used as screening tool for diagnosing coronary artery disease in resource poor settings. \u0000University Heart Journal 2022; 18(2): 93- 97","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73488545","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}

{"title":"Detection of Viable Myocardium in Patients with Myocardial Infarction (MI) with Dobutamine Stress Echocardiography (DSE) Comparing with Single Photon Emission Computed Tomography (SPECT-MPI)","authors":"M. Azam, N. Ahmed, S. Banerjee, C. M. Ahmed, F. Rahman, M. M. Rahman, M. Mahmood, Rabin F, Minhazul Arefin, Md Mahmudul Karim","doi":"10.3329/uhj.v18i2.62731","DOIUrl":"https://doi.org/10.3329/uhj.v18i2.62731","url":null,"abstract":"Aims and objectives: To evaluate the role of Dobutamine Stress Echocardiography (DSE) in detecting viable myocardium in patients with myocardial infarction comparing with Single Photon Emission Computed Tomography (SPECT-MPI). \u0000Methodology: It was a prospective study, conducted over sixty one patients of MI in Bangabondhu SK Mujib Medical University (BSMMU). Serial DSE, SPECT-MPI and CAG were done and compared. \u0000Result: With DSE viable myocardium was found in 71.1% of territory supplied by LAD, 58.3% of territory supplied by LCX and 65.9% of territory supplied by RCA. With SPECT-MPI viable myocardium was found in 68.2% of territory supplied by LAD, 66.7% of territory supplied by LCX and 65.1% of territory supplied by RCA. Comparing two methods there was no significant difference between DSE and SPECT-MPI in determining viable myocardium (p>0.05). \u0000Conclusion: DSE is effective in detecting viable myocardium in patients with MI, which is comparable to SPECT-MPI. \u0000University Heart Journal 2022; 18(2): 98-100 \u0000 ","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77666591","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}