Md. Mahbubur Rahman, S. Ghafur, R. Barman, H. Sarkar, Abu Zahid Basunia, Md Hasanul Islam, A. Mahmud
Background: One of the ultimate grave consequences of rheumatic heart disease is mitral stenosis. Percutaneous trans-mitral commissurotomy (PTMC) has been practiced with good results in the world since Inoue introduced it in 1982. Objective: The aim of this study was to audit the procedural success, in- hospital outcome in patients undergoing PTMC in our set up. Study Design: Observational cross sectional study. Place and Duration: The study was conducted in northern division of Bangladesh with the collaboration of department of cardiology, Rangpur Medical College Hospital, Rangpur & Zia Heart Foundation, Dinazpur from February 2018 to November 2019. Materials and Methods: Total Thirty patients who fulfill the inclusion and exclusion criteria for PTMC was enrolled in this study. Among them the procedural success & immediate results were assessed. Results: Among 30 patients , 22(73.33%) were female and 8(26.66%) were male showing a female predominance. The mean age was 28.28±8.4.The procedure was successful in 29(96.66%) patients. In 1(3.3%) patient, we failed due to inability to puncture the septum for unfavourable anatomy. There was no mortality related to the procedure, no systemic embolization but one patient (3.33%) had significant MR(G II ). Pre PTMC mean MVA (cm2) was 0.801± 0.1325 and post PTMC it was 1.545± 0.292 cm2. Mean MVPG pre PTMC was 27.108±5.94 mmHg and post PTMC , 6.61±5.008 mmHg with significant p value 0.0001. Mean LA pressure before procedure was 28.65±8.456 mmHg and post PTMC, 11.27±6.34 and p value was 0.0001. Most of the patients 25(83.3%) before PTMC were in severe pulmonary hypertension and after PTMC most of the patients 21(70%) were in mild pulmonary hypertension.We successfully done 7 special cases like pregnancy, re do cases, H/O CVD etc. Conclusions: We conclude that PTMC is a safe procedure in experienced hand with good success rate and optimal results even in patients with special problems like pregnancy, previous CVA and redo cases. University Heart Journal Vol. 17, No. 1, Jan 2021; 47-54
{"title":"Percuteneous Trans-Mitral Commissurotomy (PTMC); Procedural Success and Immediate Results, an Experience from Tertiary Care Hospital in Northern Division of Bangladesh","authors":"Md. Mahbubur Rahman, S. Ghafur, R. Barman, H. Sarkar, Abu Zahid Basunia, Md Hasanul Islam, A. Mahmud","doi":"10.3329/uhj.v17i1.50881","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50881","url":null,"abstract":"Background: One of the ultimate grave consequences of rheumatic heart disease is mitral stenosis. Percutaneous trans-mitral commissurotomy (PTMC) has been practiced with good results in the world since Inoue introduced it in 1982. \u0000Objective: The aim of this study was to audit the procedural success, in- hospital outcome in patients undergoing PTMC in our set up. Study Design: Observational cross sectional study. Place and Duration: The study was conducted in northern division of Bangladesh with the collaboration of department of cardiology, Rangpur Medical College Hospital, Rangpur & Zia Heart Foundation, Dinazpur from February 2018 to November 2019. \u0000Materials and Methods: Total Thirty patients who fulfill the inclusion and exclusion criteria for PTMC was enrolled in this study. Among them the procedural success & immediate results were assessed. \u0000Results: Among 30 patients , 22(73.33%) were female and 8(26.66%) were male showing a female predominance. The mean age was 28.28±8.4.The procedure was successful in 29(96.66%) patients. In 1(3.3%) patient, we failed due to inability to puncture the septum for unfavourable anatomy. There was no mortality related to the procedure, no systemic embolization but one patient (3.33%) had significant MR(G II ). Pre PTMC mean MVA (cm2) was 0.801± 0.1325 and post PTMC it was 1.545± 0.292 cm2. Mean MVPG pre PTMC was 27.108±5.94 mmHg and post PTMC , 6.61±5.008 mmHg with significant p value 0.0001. Mean LA pressure before procedure was 28.65±8.456 mmHg and post PTMC, 11.27±6.34 and p value was 0.0001. Most of the patients 25(83.3%) before PTMC were in severe pulmonary hypertension and after PTMC most of the patients 21(70%) were in mild pulmonary hypertension.We successfully done 7 special cases like pregnancy, re do cases, H/O CVD etc. \u0000Conclusions: We conclude that PTMC is a safe procedure in experienced hand with good success rate and optimal results even in patients with special problems like pregnancy, previous CVA and redo cases. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 47-54","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"299 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88404185","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}
Adnan Bashar, Md. Harisul Hoque, M. Chowdhury, A. Hasan, Khurshed Ahmed
Antiplatelet therapy is the cornerstone in the treatment of acute coronary syndrome. Aspirin is the most widely used antiplatelet agent followed by P2Y12 inhibitors. Glycoprotein (GP) IIb-IIIa antagonists are also gaining popularity as an antiplatelet agents during peri-PCI period. This review article summarizes the indications, duration of dual antiplatelet therapy (DAPT) in ACS setting. Antiplatelet therapy in special situations like atrial fibrillation and thrombocytopenia are discussed here. Issues like switching between P2Y12 inhibitors and genetic testing of antiplatelet agents are also mentioned in this article University Heart Journal Vol. 17, No. 1, Jan 2021; 66-70
{"title":"Antiplatelet Therapy in Patients with Acute Coronary Syndrome: An Update","authors":"Adnan Bashar, Md. Harisul Hoque, M. Chowdhury, A. Hasan, Khurshed Ahmed","doi":"10.3329/uhj.v17i1.50884","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50884","url":null,"abstract":"Antiplatelet therapy is the cornerstone in the treatment of acute coronary syndrome. Aspirin is the most widely used antiplatelet agent followed by P2Y12 inhibitors. Glycoprotein (GP) IIb-IIIa antagonists are also gaining popularity as an antiplatelet agents during peri-PCI period. This review article summarizes the indications, duration of dual antiplatelet therapy (DAPT) in ACS setting. Antiplatelet therapy in special situations like atrial fibrillation and thrombocytopenia are discussed here. Issues like switching between P2Y12 inhibitors and genetic testing of antiplatelet agents are also mentioned in this article \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 66-70","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77348401","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 Nizamul Hossain Sowdagar, Mushtaq Ahmad, Akm Musa Khan, Z. Jabbar, M. M. Rahman, Md. Ashraf Uddin Sultan
Background: Coronary heart disease is a global health problem and a major cause of death in both developed and developing countries. Clinical importance of hyponatremia in ST-elevated acute myocardial infarction (STEMI) is an important topic of study among present researchers. Objective: To assess the outcomes and prognostic implications of early development of hyponatremia inhospitalized acute ST-elevated myocardial infarction patients. Methods: This is a prospective observational study performed in the department of Cardiology, Combined Military Hospital (CMH), Dhaka from July 2018 to June 2019. A purposive sampling technique was used on 82 patients with ST-elevated acute myocardial infarction admitted in CCU and treated with thrombolysis. They were evaluated for serum sodium level at admission and at 48 hours after admission. Here sodium concentration <135 mmol/L is defined as Hyponartemia. Fourty one patients with hyponatremia were included in Group-I and 41 patients with normal sodium level were included in Group-II. Then the in-hospital outcome variables were analyzed. Results: Among the study population 86.58% were male and 13.42% were female. Age range was 25 years to 74 years. Considering risk factors highest percentage of study population in group- I had hypertension (60.97%) followed by dyslipidemia (51.21%), diabetes mellitus (51.21%), history of smoking (53.60%), and family history of Coronary Artery Disease (CAD) (31.14%). There were five outcome variables such as heart failure, cardiogenic shock, arrhythmia, duration of hospital stay and death. 10 patients died in Group-I and 2 patients died in Group-II. Among the outcome variables death, heart failure and hospital stay was more in Group-I and was statistically significant. hospital outcome of study population according to serum sodium level. Considering in hospital outcome heart failure occurred in 14 patients (p= .001), arrhythmia developed in 17 patients (p=0.108), cardiogenic shock occurred in 9 patients (p=0.354) and death occurred in 10 patients (p=0.002). P-Value of heart failure and death was statistically significant. Conclusion: Early developed hyponatremia in patients with ST-elevated acute myocardial infarction was an independent predictor of prognosis. It has been found that heart failure, duration of hospital stay and death was more in hyponatremic patients and prognosis worsen with increasing severity of hyponatremia. Plasma sodium level may serve as a simple marker to identify patients at high risk. University Heart Journal Vol. 17, No. 1, Jan 2021; 16-21
{"title":"Outcomes of Early Development of Hyponatremia in Acute ST-Elevated Myocardial Infarction Patients: A Study in a Tertiary Hospital","authors":"Mohammad Nizamul Hossain Sowdagar, Mushtaq Ahmad, Akm Musa Khan, Z. Jabbar, M. M. Rahman, Md. Ashraf Uddin Sultan","doi":"10.3329/uhj.v17i1.50875","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50875","url":null,"abstract":"Background: Coronary heart disease is a global health problem and a major cause of death in both developed and developing countries. Clinical importance of hyponatremia in ST-elevated acute myocardial infarction (STEMI) is an important topic of study among present researchers. \u0000Objective: To assess the outcomes and prognostic implications of early development of hyponatremia inhospitalized acute ST-elevated myocardial infarction patients. \u0000Methods: This is a prospective observational study performed in the department of Cardiology, Combined Military Hospital (CMH), Dhaka from July 2018 to June 2019. A purposive sampling technique was used on 82 patients with ST-elevated acute myocardial infarction admitted in CCU and treated with thrombolysis. They were evaluated for serum sodium level at admission and at 48 hours after admission. Here sodium concentration <135 mmol/L is defined as Hyponartemia. Fourty one patients with hyponatremia were included in Group-I and 41 patients with normal sodium level were included in Group-II. Then the in-hospital outcome variables were analyzed. \u0000Results: Among the study population 86.58% were male and 13.42% were female. Age range was 25 years to 74 years. Considering risk factors highest percentage of study population in group- I had hypertension (60.97%) followed by dyslipidemia (51.21%), diabetes mellitus (51.21%), history of smoking (53.60%), and family history of Coronary Artery Disease (CAD) (31.14%). There were five outcome variables such as heart failure, cardiogenic shock, arrhythmia, duration of hospital stay and death. 10 patients died in Group-I and 2 patients died in Group-II. Among the outcome variables death, heart failure and hospital stay was more in Group-I and was statistically significant. hospital outcome of study population according to serum sodium level. Considering in hospital outcome heart failure occurred in 14 patients (p= .001), arrhythmia developed in 17 patients (p=0.108), cardiogenic shock occurred in 9 patients (p=0.354) and death occurred in 10 patients (p=0.002). P-Value of heart failure and death was statistically significant. \u0000Conclusion: Early developed hyponatremia in patients with ST-elevated acute myocardial infarction was an independent predictor of prognosis. It has been found that heart failure, duration of hospital stay and death was more in hyponatremic patients and prognosis worsen with increasing severity of hyponatremia. Plasma sodium level may serve as a simple marker to identify patients at high risk. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 16-21","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83472551","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:Many patients with coronavirus disease 2019(COVID-19) have pre-existing heart disease or develop various cardiac complications during the disease. Understanding the relationship between heart disease and COVID-19 is necessary for optimum management of such condition. Methods: Literature search done by using Google search engines and PubMed. Results: Heart involvement occurs in approximately 8-12% of all patients. Acute cardiac injury, as evident by a significant cardiac troponin elevation is the commonest abnormality. Myocarditis, type II myocardial infarction, heart failure, arrhythmia are other cardiac menifestations that are less common. Pre-existing heart disease and/or involvement of the heart by COVID-19 carries worse prognosis. Conclusion: Most of the reports currently available describes cardiac menifestations briefly. Further study may reveal more clearly the various aspects of cardiac menifestations in COVID-19 patients. University Heart Journal Vol. 17, No. 1, Jan 2021; 60-65
{"title":"Heart disease and COVID-19","authors":"P. Das, F. Rahman","doi":"10.3329/uhj.v17i1.50883","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50883","url":null,"abstract":"Background:Many patients with coronavirus disease 2019(COVID-19) have pre-existing heart disease or develop various cardiac complications during the disease. Understanding the relationship between heart disease and COVID-19 is necessary for optimum management of such condition. \u0000Methods: Literature search done by using Google search engines and PubMed. \u0000Results: Heart involvement occurs in approximately 8-12% of all patients. Acute cardiac injury, as evident by a significant cardiac troponin elevation is the commonest abnormality. Myocarditis, type II myocardial infarction, heart failure, arrhythmia are other cardiac menifestations that are less common. Pre-existing heart disease and/or involvement of the heart by COVID-19 carries worse prognosis. \u0000Conclusion: Most of the reports currently available describes cardiac menifestations briefly. Further study may reveal more clearly the various aspects of cardiac menifestations in COVID-19 patients. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 60-65","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87686341","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}
Md. Abu Salim, Mohammad Walidur Rahman, D. Adhikary, J. Arzu, Md. Harisul Hoque, A. I. Joarder, M. Mahmood
Peripartum cardiomyopathy (PPCM) is a life threatening entity of peripartum period characterized by left ventricular systolic dysfunction and heart failure in absence of any known cardiac disease. Though its incidence is rising but there is still uncertainty regarding its incidence, pathogenesis, and optimum management protocol. Retrospective analysis of twenty cases of PPCM admitted, within July 20016 to June 2018 in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka is done here. Mean age of study population was 25 (6.3). Majority of the patients were multi-paras 12 (60%). 80% of the patients were diagnosed after delivery. Breathlessness was the most common symptom. Bibasal lung base crepitations was most frequent sign, which was found in 95% cases. Sinus tachycardia was most frequent electrocardiographic change which was found in 80% cases. Mean left ventricular ejection fraction (LVEF) was 35.2(2.8). All the patients had different extent of global hypokinesia of left ventricle (LV) at rest. The patients were treated with bed rest, water and salt restriction, loop diuretic, digitalis, selective Beta-blocker, vitamin B complex and an anticoagulant in relevant cases in antepartum period, Angiotensin converting enzyme inhibitor (ACEI) or Angiotensin receptor blocker (ARB) was added in postpartum period.70% patients were clinically improved and in 45% the left ventricular functional status returned to normal. 30% developed persistent cardiomyopathy beyond six months of presentation. Maternal mortality was 1 (5%). Among all live births three had intra uterine growth retardation. The pathophysiology, emerging investigations modalities, updated management protocol, and prognosis of PPCM are also discussed in this review. University Heart Journal Vol. 17, No. 1, Jan 2021; 71-75
{"title":"Peripartum Cardiomyopathy: A Case Series","authors":"Md. Abu Salim, Mohammad Walidur Rahman, D. Adhikary, J. Arzu, Md. Harisul Hoque, A. I. Joarder, M. Mahmood","doi":"10.3329/uhj.v17i1.50885","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50885","url":null,"abstract":"Peripartum cardiomyopathy (PPCM) is a life threatening entity of peripartum period characterized by left ventricular systolic dysfunction and heart failure in absence of any known cardiac disease. Though its incidence is rising but there is still uncertainty regarding its incidence, pathogenesis, and optimum management protocol. Retrospective analysis of twenty cases of PPCM admitted, within July 20016 to June 2018 in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka is done here. Mean age of study population was 25 (6.3). Majority of the patients were multi-paras 12 (60%). 80% of the patients were diagnosed after delivery. Breathlessness was the most common symptom. Bibasal lung base crepitations was most frequent sign, which was found in 95% cases. Sinus tachycardia was most frequent electrocardiographic change which was found in 80% cases. Mean left ventricular ejection fraction (LVEF) was 35.2(2.8). All the patients had different extent of global hypokinesia of left ventricle (LV) at rest. The patients were treated with bed rest, water and salt restriction, loop diuretic, digitalis, selective Beta-blocker, vitamin B complex and an anticoagulant in relevant cases in antepartum period, Angiotensin converting enzyme inhibitor (ACEI) or Angiotensin receptor blocker (ARB) was added in postpartum period.70% patients were clinically improved and in 45% the left ventricular functional status returned to normal. 30% developed persistent cardiomyopathy beyond six months of presentation. Maternal mortality was 1 (5%). Among all live births three had intra uterine growth retardation. The pathophysiology, emerging investigations modalities, updated management protocol, and prognosis of PPCM are also discussed in this review. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 71-75","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77378585","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}
Arif Mohammad Sohan, M. Chowdhury, K. Mohammad Iqbal, Najnin Akhter, A. Hasan, C. M. Ahmed
Background: Extent of viable myocardial tissue has been recognized as a major determinant of recovery of left ventricular (LV) function after myocardial infarction. The present research was aimed at assessment of myocardial viability and prediction of left ventricular functional recovery in patients after acute anterior ST-elevated myocardial infarction using Tissue Doppler strain. Methods: In this prospective observational research, 47 patients admitted into the hospital with acute anterior ST-elevated myocardial infarction were included. All patients underwent two-dimensional and strain echocardiography within 48-72 hours of admission. Follow up two-dimensional echocardiography had performed at 6 months after baseline examination. Results: Total 47 patients (mean age, 57±5 years) underwent two-dimensional and strain echocardiography within 48-72 hours of admission. Significant relations were observed between baseline global systolic lengthening strain and wall motion score index (r=0.67), change in left ventricular ejection fraction (LVEF, r= -.844), Global Ses (r=.441) and on admission troponin I (r =0.397). At 6-months follow-up, LV ejection fraction was reassessed. Patients with absolute improvement in LV ejection fraction ≥5% at 6-months follow-up (n=24; 51%) had a higher (more negative) baseline global Ses strain (P<0.001) and lower global systolic lengthening (P<.001). A cutoff value for baseline global systolic lengthening strain of 7.6% yielded a sensitivity of 83% and a specificity of 87% to predict LV functional recovery at 6-months follow-up. Conclusions: Global Left ventricular strain (Ses and Systolic lengthening) early after acute anterior ST-elevated myocardial infarction reflects myocardial viability and predicts recovery of LV function at 6-monts follow-up. University Heart Journal Vol. 17, No. 1, Jan 2021; 22-30
{"title":"Echocardiographic Assessment of Myocardial Viability and Prediction of Left Ventricular Functional Recovery after Acute Myocardial Infarction Using Strain and Strain Rate","authors":"Arif Mohammad Sohan, M. Chowdhury, K. Mohammad Iqbal, Najnin Akhter, A. Hasan, C. M. Ahmed","doi":"10.3329/uhj.v17i1.50876","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50876","url":null,"abstract":"Background: Extent of viable myocardial tissue has been recognized as a major determinant of recovery of left ventricular (LV) function after myocardial infarction. The present research was aimed at assessment of myocardial viability and prediction of left ventricular functional recovery in patients after acute anterior ST-elevated myocardial infarction using Tissue Doppler strain. \u0000Methods: In this prospective observational research, 47 patients admitted into the hospital with acute anterior ST-elevated myocardial infarction were included. All patients underwent two-dimensional and strain echocardiography within 48-72 hours of admission. Follow up two-dimensional echocardiography had performed at 6 months after baseline examination. \u0000Results: Total 47 patients (mean age, 57±5 years) underwent two-dimensional and strain echocardiography within 48-72 hours of admission. Significant relations were observed between baseline global systolic lengthening strain and wall motion score index (r=0.67), change in left ventricular ejection fraction (LVEF, r= -.844), Global Ses (r=.441) and on admission troponin I (r =0.397). At 6-months follow-up, LV ejection fraction was reassessed. Patients with absolute improvement in LV ejection fraction ≥5% at 6-months follow-up (n=24; 51%) had a higher (more negative) baseline global Ses strain (P<0.001) and lower global systolic lengthening (P<.001). A cutoff value for baseline global systolic lengthening strain of 7.6% yielded a sensitivity of 83% and a specificity of 87% to predict LV functional recovery at 6-months follow-up. \u0000Conclusions: Global Left ventricular strain (Ses and Systolic lengthening) early after acute anterior ST-elevated myocardial infarction reflects myocardial viability and predicts recovery of LV function at 6-monts follow-up. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 22-30","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"126 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73199823","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}
Abstract not available University Heart Journal Vol. 17, No. 1, Jan 2021; 1-2
《大学心脏杂志》第17卷第1期，2021年1月;1 - 2
{"title":"Viral Infections and the Heart","authors":"M. Mahmood, Md. Harisul Hoque","doi":"10.3329/uhj.v17i1.50872","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50872","url":null,"abstract":"Abstract not available \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 1-2","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83353290","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}
Md Hasanul Islam, S. Ghafur, R. Barman, H. Sarker, Abu Zahid Basunia, Mahbubur Rahman, A. Mahmud
Background: Coronary artery disease (CAD), one of the leading causes of death is increasing globally. The number of CAD is also increasing in Bangladesh. Rangpur Medical College & Hospital is also providing cardiovascular services to populations from urban, semiurban and rural population of northern region of the country. It started coronary angiography services from June 2011. This paper aims to analyze pattern of coronary artery occlusion in patients undergoing coronary angiography during January to October 2019. Methods: This was a retrospective observational study conducted in the cardiology department. There were a total of 308 cases of diagnostic angiography and coronary interventions done in Rangpur Medical College & Hospital from January to October 2019. Among them 308 cases of coronary angiography done for Acute Coronary Syndrome and Stable Angina, were analyzed using SPSS (Statistical Package for Social Science), version 17. Results: Males were higher in number than females and majority of the patients were at or above 50 years of age. Out of 308 cases 225 had Acute Coronary Syndrome (ACS) and 83 had Stable Angina. 54 out of 308 were found to have normal coronaries. 25 patient with ACS had normal coronary. Out of all the patients with coronary stenosis, 19 had left main disease, 59 had SVD, 62 has DVD, 71 patient had TVD. 9 patients had CTO. 159 patients had severe coronary stenosis. 117 out of 225 ACS patient had more than one coronary artery involved, which is significantly higher than the stable angina group ( p<0.01). Severe stenosis was found to be more common in ACS group (p<0.003) when compared to the stable angina group. Conclusion: There has been a change with regard to clinical presentation and onset of risk factors for CAD at young age, but the load of atherosclerotic burden and pattern of involvement of coronary arteries have not changed in Elder group. Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Coronary status is significantly different in ACS and stable angina. ACS has more chance of having multivessel stenosis whereas stable angina has single vessel, less severe or normal coronaries. Severity of stenosis is also high in ACS than in stable angina. University Heart Journal Vol. 17, No. 1, Jan 2021; 55-59
背景:冠状动脉疾病(CAD)是全球范围内死亡的主要原因之一。孟加拉国的CAD人数也在增加。Rangpur医学院和医院还为该国北部地区的城市、半城市和农村人口提供心血管服务。从2011年6月开始提供冠状动脉造影服务。本文旨在分析2019年1 - 10月冠状动脉造影患者冠状动脉闭塞模式。方法:在心内科进行回顾性观察性研究。2019年1月至10月，Rangpur医学院和医院共进行了308例诊断性血管造影和冠状动脉介入治疗。其中308例急性冠状动脉综合征和稳定型心绞痛的冠状动脉造影，采用SPSS (Statistical Package for Social Science)第17版进行分析。结果:男性多于女性，年龄≥50岁者居多。308例患者中225例为急性冠脉综合征，83例为稳定型心绞痛，54例冠脉正常。25例ACS患者冠脉正常。其中左主干病变19例，SVD 59例，DVD 62例，TVD 71例。9例患者有CTO。严重冠状动脉狭窄159例。225例ACS患者中有117例冠脉累及1条以上，明显高于稳定型心绞痛组(p<0.01)。与稳定型心绞痛组相比，ACS组严重狭窄发生率更高(p<0.003)。结论:冠心病的临床表现和发病危险因素在年轻时发生了变化，但老年组的动脉粥样硬化负荷和冠状动脉受累模式没有改变。冠状动脉造影是一种有用的CAD诊断和治疗工具。冠脉状态与稳定型心绞痛有显著性差异。ACS有更多的机会有多支血管狭窄，而稳定型心绞痛有单支血管，不太严重或正常的冠状动脉。ACS患者的狭窄程度也高于稳定型心绞痛患者。《大学心脏杂志》第17卷第1期，2021年1月;55-59
{"title":"Angiographic Studies of Coronary Artery Disease in Rangpur Medical College Hospital","authors":"Md Hasanul Islam, S. Ghafur, R. Barman, H. Sarker, Abu Zahid Basunia, Mahbubur Rahman, A. Mahmud","doi":"10.3329/uhj.v17i1.50882","DOIUrl":"https://doi.org/10.3329/uhj.v17i1.50882","url":null,"abstract":"Background: Coronary artery disease (CAD), one of the leading causes of death is increasing globally. The number of CAD is also increasing in Bangladesh. Rangpur Medical College & Hospital is also providing cardiovascular services to populations from urban, semiurban and rural population of northern region of the country. It started coronary angiography services from June 2011. This paper aims to analyze pattern of coronary artery occlusion in patients undergoing coronary angiography during January to October 2019. \u0000Methods: This was a retrospective observational study conducted in the cardiology department. There were a total of 308 cases of diagnostic angiography and coronary interventions done in Rangpur Medical College & Hospital from January to October 2019. Among them 308 cases of coronary angiography done for Acute Coronary Syndrome and Stable Angina, were analyzed using SPSS (Statistical Package for Social Science), version 17. \u0000Results: Males were higher in number than females and majority of the patients were at or above 50 years of age. Out of 308 cases 225 had Acute Coronary Syndrome (ACS) and 83 had Stable Angina. 54 out of 308 were found to have normal coronaries. 25 patient with ACS had normal coronary. Out of all the patients with coronary stenosis, 19 had left main disease, 59 had SVD, 62 has DVD, 71 patient had TVD. 9 patients had CTO. 159 patients had severe coronary stenosis. 117 out of 225 ACS patient had more than one coronary artery involved, which is significantly higher than the stable angina group ( p<0.01). Severe stenosis was found to be more common in ACS group (p<0.003) when compared to the stable angina group. \u0000Conclusion: There has been a change with regard to clinical presentation and onset of risk factors for CAD at young age, but the load of atherosclerotic burden and pattern of involvement of coronary arteries have not changed in Elder group. Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Coronary status is significantly different in ACS and stable angina. ACS has more chance of having multivessel stenosis whereas stable angina has single vessel, less severe or normal coronaries. Severity of stenosis is also high in ACS than in stable angina. \u0000University Heart Journal Vol. 17, No. 1, Jan 2021; 55-59","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81829389","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. Mollika, S. Begum, Md. Harisul Hoque, Khandaker Nadia Afreen, Elora Sharmin, Sheik Foyez Ahmed
Background: Chronic heart failure (CHF) causes multiple lung complications and lung functions are reduced in CHF patients. Objective: To observe FVC, FEV1, FEV1/FVC% and their relationship with EF% in patients with chronic heart failure. Methods: This cross sectional study was conducted in the Department of Physiology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, during 2016. For this, 60 diagnosed stable male, aged 35-65 years CHF patients were randomly selected from the Cardiology Department of BSMMU, Dhaka. On the basis of staging of the disease (Stage C) and New York Heart Association (NYHA) functional classification, the study subjects were divided into two groups, 30 patients of NYHA Class- I and 30 patients of NYHA class –II. Thirty (30) apparently healthy Age, Sex and BMI matched subjects were taken as control. To assess the ventilatory function, Forced vital capacity (FVC), Forced expiratory volume in 1st second (FEV1), Forced expiratory ratio (FEV1/FVC%) of all subjects were measured by a portable Digital Spirometer. Again, Ejection fraction (EF%) ranged (≥35% to ≤50%) were measured by Echocardiogram to observe left ventricular function of the heart. For statistical analysis, Independent sample‘t’ test and Pearson’s correlation co-efficient test was performed by using SPSS for windows version-16 & p≤0.05 was accepted as level of significance. Results: The mean percentage of predicted values of FVC and FEV1 were significantly lower but FEV1/FVC% was significantly higher in CHF patients comparison to the healthy control. All the study variables were significantly lower in patients of NYHA class–II as compared to patients of NYHA class–I. 73.33% CHF patients had restrictive, 10.00% small airway obstruction and 16.67% combined restrictive and small airway obstruction feature. In addition, FVC and FEV1 (p<0.05) was positively and FEV1/FVC% (p<0.05) negatively correlated with EF% in chronic heart failure patients. Conclusion: Left ventricular dysfunction may be silently associated with decrease ventilatory function mainly restrictive type of pulmonary disorder. University Heart Journal Vol. 16, No. 2, Jul 2020; 59-64
{"title":"FVC, FEV1, FEV1/FVC % and their Relationship with EF% in Patients with Chronic Heart Failure","authors":"R. Mollika, S. Begum, Md. Harisul Hoque, Khandaker Nadia Afreen, Elora Sharmin, Sheik Foyez Ahmed","doi":"10.3329/uhj.v16i2.49648","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49648","url":null,"abstract":"Background: Chronic heart failure (CHF) causes multiple lung complications and lung functions are reduced in CHF patients. \u0000Objective: To observe FVC, FEV1, FEV1/FVC% and their relationship with EF% in patients with chronic heart failure. \u0000Methods: This cross sectional study was conducted in the Department of Physiology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, during 2016. For this, 60 diagnosed stable male, aged 35-65 years CHF patients were randomly selected from the Cardiology Department of BSMMU, Dhaka. On the basis of staging of the disease (Stage C) and New York Heart Association (NYHA) functional classification, the study subjects were divided into two groups, 30 patients of NYHA Class- I and 30 patients of NYHA class –II. Thirty (30) apparently healthy Age, Sex and BMI matched subjects were taken as control. To assess the ventilatory function, Forced vital capacity (FVC), Forced expiratory volume in 1st second (FEV1), Forced expiratory ratio (FEV1/FVC%) of all subjects were measured by a portable Digital Spirometer. Again, Ejection fraction (EF%) ranged (≥35% to ≤50%) were measured by Echocardiogram to observe left ventricular function of the heart. For statistical analysis, Independent sample‘t’ test and Pearson’s correlation co-efficient test was performed by using SPSS for windows version-16 & p≤0.05 was accepted as level of significance. \u0000Results: The mean percentage of predicted values of FVC and FEV1 were significantly lower but FEV1/FVC% was significantly higher in CHF patients comparison to the healthy control. All the study variables were significantly lower in patients of NYHA class–II as compared to patients of NYHA class–I. 73.33% CHF patients had restrictive, 10.00% small airway obstruction and 16.67% combined restrictive and small airway obstruction feature. In addition, FVC and FEV1 (p<0.05) was positively and FEV1/FVC% (p<0.05) negatively correlated with EF% in chronic heart failure patients. \u0000Conclusion: Left ventricular dysfunction may be silently associated with decrease ventilatory function mainly restrictive type of pulmonary disorder. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 59-64","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"23 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72562382","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}
Md. Harisul Hoque, S. Zaman, Khurshid Ahmed, Md Faisal Ibne Kabir, N. Fatema
Acute coronary syndrome (ACS) is the public health issue as it is the single most common cause of death in the world. Role of vitamin D in cardiovascular health is of much interest at present. Experimental, as well as, some observational studies suggest that vitamin D and its metabolites are integrally related to blood pressure and the rennin-angiotensin system. Vitamin D insufficiency affects almost 50% of the population worldwide. Few studies have been carried out to determine the prevalence of hypovitaminosis D in Bangladesh . 30 Patient with ACS were included in this study who had admitted in the department of Cardiology of Bangabandhu Sheikh Mujib Medical University (BSMMU) patient with in first 48 hours of the onset of chest pain. This study was conducted from 1st July’18 to 30th June’19 (One year) by Purposive sampling. Data analysis was carried out by using the statistical package for Social Science (SPSS) version 20.0 windows software. Baseline characteristics have been compared using the independent sample student t-test test where appropriate. The student t-test was used to assess the correlation between PTH levels. p-value <0.05 was taken as significant. We found an association between elevated PTH levels and ACS. University Heart Journal Vol. 16, No. 2, Jul 2020; 71-77
{"title":"A Pilot Study of Serum Parathyroid Hormone in Acute Coronary Syndrome","authors":"Md. Harisul Hoque, S. Zaman, Khurshid Ahmed, Md Faisal Ibne Kabir, N. Fatema","doi":"10.3329/uhj.v16i2.49650","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49650","url":null,"abstract":"Acute coronary syndrome (ACS) is the public health issue as it is the single most common cause of death in the world. Role of vitamin D in cardiovascular health is of much interest at present. Experimental, as well as, some observational studies suggest that vitamin D and its metabolites are integrally related to blood pressure and the rennin-angiotensin system. Vitamin D insufficiency affects almost 50% of the population worldwide. Few studies have been carried out to determine the prevalence of hypovitaminosis D in Bangladesh . 30 Patient with ACS were included in this study who had admitted in the department of Cardiology of Bangabandhu Sheikh Mujib Medical University (BSMMU) patient with in first 48 hours of the onset of chest pain. This study was conducted from 1st July’18 to 30th June’19 (One year) by Purposive sampling. Data analysis was carried out by using the statistical package for Social Science (SPSS) version 20.0 windows software. Baseline characteristics have been compared using the independent sample student t-test test where appropriate. The student t-test was used to assess the correlation between PTH levels. p-value <0.05 was taken as significant. We found an association between elevated PTH levels and ACS. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 71-77","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81809020","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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