Rakibul Hasan, Md. Saif Ullah Khan, Mainul Mahmud, Samaresh Chandra Saha, Sourav Bhowmick
Background: Chronic venous leg ulcer is one of the common medical conditions encounter by the vascular surgeons in Bangladesh. Many of these patients develop venous leg ulcer as a sequel of the disease. In advance chronic venous disease such as development of ulcer, single or multilayer dressings are usually used. Objective: To find out a compression therapy (single layer crepe/short stretch bandage and multilayer/four layer bandage) in patients with venous leg ulcer. Materiel & Methods: This study was conducted on 200 patients with in last two years, march 2017 to february 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of vascular surgery. In which 100 patients with venous leg ulcer where treated with four layer bandage and another 100 patients with same condition were treated with single layer crepe bandage. Before application of bandage, proper history of patient was taken and duplex scan was done. The primary outcome was measured by time duration of ulcer healing. Secondary outcome included incidence and number of adverse events in every patient. Results: Healing time of venous ulcers was accessed with periodic interval. The four layer bandage was associated with significantly shorter time of healing. P value reached from unpaired t-test. Primary outcome shows 68% of patients who received four layer bandages achieved healing within one month. On the other hand, 12% of patients who received single layer/crepe bandage did so. Conclusion: Four layer bandages heals venous leg ulcer more rapidly than the single layer crape bandage. These data suggest that the benefits observed the consistent despite prognosis is different. Patients with large ulcers have poor healing prognosis regardless of its treatment modalities. University Heart Journal Vol. 16, No. 2, Jul 2020; 78-85
{"title":"Healing Rates of Venous Leg Ulcer Using Four Layer Bandage and Short Stretch Bandage- A Comparative Study in Aspect of Bangladesh","authors":"Rakibul Hasan, Md. Saif Ullah Khan, Mainul Mahmud, Samaresh Chandra Saha, Sourav Bhowmick","doi":"10.3329/uhj.v16i2.49664","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49664","url":null,"abstract":"Background: Chronic venous leg ulcer is one of the common medical conditions encounter by the vascular surgeons in Bangladesh. Many of these patients develop venous leg ulcer as a sequel of the disease. In advance chronic venous disease such as development of ulcer, single or multilayer dressings are usually used. \u0000Objective: To find out a compression therapy (single layer crepe/short stretch bandage and multilayer/four layer bandage) in patients with venous leg ulcer. Materiel & Methods: This study was conducted on 200 patients with in last two years, march 2017 to february 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Department of vascular surgery. In which 100 patients with venous leg ulcer where treated with four layer bandage and another 100 patients with same condition were treated with single layer crepe bandage. Before application of bandage, proper history of patient was taken and duplex scan was done. The primary outcome was measured by time duration of ulcer healing. Secondary outcome included incidence and number of adverse events in every patient. Results: Healing time of venous ulcers was accessed with periodic interval. The four layer bandage was associated with significantly shorter time of healing. P value reached from unpaired t-test. Primary outcome shows 68% of patients who received four layer bandages achieved healing within one month. On the other hand, 12% of patients who received single layer/crepe bandage did so. \u0000Conclusion: Four layer bandages heals venous leg ulcer more rapidly than the single layer crape bandage. These data suggest that the benefits observed the consistent despite prognosis is different. Patients with large ulcers have poor healing prognosis regardless of its treatment modalities. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 78-85","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87558017","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, S. K. Banerjee, Md Faisal Ibne Kabir, N. Fatema
Pulmonary hypertension is a hemodynamic disorder defined by abnormally high pulmonary artery pressure that affects the arteries in your lungs and the right side of your heart. In this study, hepatic venous duplex will be done to diagnose and quantify the PH. So that Patients can avoid unnecessary invasive right heart catheterization. This practical demonstration is the key to enrich our experience and knowledge in the field of PH. Objectives of this study was to assess PH status by Hepatic venous Duplex (HVD) as well by right heart catheterization and to compare them. This study was conducted in the Department of Cardiology, BSMMU, Shahbagh, Dhaka extending from July 2018 to December 2019. Total 100 (One hundred) subjects were enrolled in this study. It was an Observational study and includes the subjects between 18 years to 45 years of age. Results of this study shows very close proximity to that of Right heart catheterization. Hemodynamic changes in Hepatic venous duplex study could be used as an alternative diagnostic tool for evaluating moderate to severe pulmonary hypertension. This method could counteract the weakness of the currently used diagnostic methods and improve the accuracy of assessing pulmonary hypertension when combined with other methods. University Heart Journal Vol. 16, No. 2, Jul 2020; 86-91
{"title":"Hepatic Venous Duplex as an Alternative Non- invasive Diagnostic Tool for Diagnosis of Pulmonary Hypertension","authors":"Md. Harisul Hoque, S. Zaman, Khurshid Ahmed, S. K. Banerjee, Md Faisal Ibne Kabir, N. Fatema","doi":"10.3329/uhj.v16i2.49665","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49665","url":null,"abstract":"Pulmonary hypertension is a hemodynamic disorder defined by abnormally high pulmonary artery pressure that affects the arteries in your lungs and the right side of your heart. In this study, hepatic venous duplex will be done to diagnose and quantify the PH. So that Patients can avoid unnecessary invasive right heart catheterization. This practical demonstration is the key to enrich our experience and knowledge in the field of PH. Objectives of this study was to assess PH status by Hepatic venous Duplex (HVD) as well by right heart catheterization and to compare them. This study was conducted in the Department of Cardiology, BSMMU, Shahbagh, Dhaka extending from July 2018 to December 2019. Total 100 (One hundred) subjects were enrolled in this study. It was an Observational study and includes the subjects between 18 years to 45 years of age. Results of this study shows very close proximity to that of Right heart catheterization. Hemodynamic changes in Hepatic venous duplex study could be used as an alternative diagnostic tool for evaluating moderate to severe pulmonary hypertension. This method could counteract the weakness of the currently used diagnostic methods and improve the accuracy of assessing pulmonary hypertension when combined with other methods. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 86-91","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88782816","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}
Assessment is a systematic procedure for measuring a trainee’s progress or level of achievement against defined criteria, in order to make a judgement about the trainee. It includes traditional exam-style questions, multiple choice questions (MCQs), viva voce examinations, assessments of performance carried out in real time. The purpose of assessment include diagnosing learning needs, motivating learners and to determine entry to a course or profession. Traditional examinations are often used to measure the candidates to recall previously learned knowledge, but may not correlate well with a person’s workplace based performance. Workplace based assessments (WBA) are much better suited to providing an indication of actual performance in the workplace. University Heart Journal Vol. 16, No. 2, Jul 2020; 106-110
{"title":"Assessment of Cardiology Trainees in the Workplace","authors":"M. Mahmood, H. Hoque, C. M. Ahmed, S. Banerjee","doi":"10.3329/uhj.v16i2.49668","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49668","url":null,"abstract":"Assessment is a systematic procedure for measuring a trainee’s progress or level of achievement against defined criteria, in order to make a judgement about the trainee. It includes traditional exam-style questions, multiple choice questions (MCQs), viva voce examinations, assessments of performance carried out in real time. The purpose of assessment include diagnosing learning needs, motivating learners and to determine entry to a course or profession. Traditional examinations are often used to measure the candidates to recall previously learned knowledge, but may not correlate well with a person’s workplace based performance. Workplace based assessments (WBA) are much better suited to providing an indication of actual performance in the workplace. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 106-110","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80430319","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 Noornabi Khondokar, Khurshed Ahmed, M. A. Hossain, R. Rashed, M. Siraj, Mohammad Walidur Rahman, S. Banerjee, S. Ahsan, F. Rahman, S. Zaman, Md. Harisul Hoque
Background:Chronic heart failure (CHF) is the most common and prognostically unfavorable outcome of many diseases of the cardiovascular system. Clinical trials have demonstrated mortality and morbidity benefits of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure. These studies have used either eplerenone or spironolactone as the MRA. Eplerenone is a selective aldosterone antagonist expected to have a lower incidence of hormonal side effects than spironolactone. The present study is designed to compare these two drugs in chronic heart failure patients as no head to head trial between these two drugs is found regarding improvement of systolic function, tolerability and safety. The aim of this study is to compare the effects of eplerenone and spironolactone on LV systolic function in patients with chronic heart failure in a single center. Methods:It was a randomized clinical trial single blind study. A total of 224 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV were selected by random sampling, from July 2017 to June 2018. Each patient was randomly allocated into either of the two arms, and was continued receiving treatment with either spironolactone (Arm-I) or eplerenone(Arm-II). Each patient was evaluated clinically, biochemically and echocardiographically at the beginning of treatment (baseline) at 1 month and at the end of 6th month. Echocardiography was performed to find out change in left ventricular systolic function. Result: After 6 months of treatment, ejection fraction was found higher in the eplerenonearm (40.3 ± 6.5 versus 38.3 ± 4.6%; P < 0.05). Ejection fraction (EF) changes were 6.2% in eplerenone group and 4.1% in spironolactonearm. A significant reduction in left ventricular end-systolic volume (21.9±2.5 in group I versus 14.9±5.7 in group II; P < 0.05) and left ventricular systolic diameter (48.7±4.0 in arm I versus 45.2±4.9 in arm II; P<0.05) occurred after 6 months of treatment. But no significant differences were observed in left ventricular end-diastolic volume (187.8±37.4 versus 184.5±33.9; P=0.101) and left ventricular diastolic diameter (60.1±4.5 versus 61.0±4.9; P=0.0818) between arms. Assessment of blood pressure six months after treatment shows, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were improved in both arms but difference between two arms were statistically non-significant (p>0.05). Conclusion: In this study, the improvement in systolic function was more in eplerenone arm, which also had fewer adverse side effects when compared to spironolactone arm. So, it can be concluded that eplerenone can be advised in patient with chronic heart failure in addition to other drugs that are used to treat heart failure. University Heart Journal Vol. 16, No. 2, Jul 2020; 65-70
背景:慢性心力衰竭(CHF)是许多心血管系统疾病中最常见和预后不利的结果。临床试验已经证明矿皮质激素受体拮抗剂(MRAs)对心力衰竭患者的死亡率和发病率都有好处。这些研究使用依普利酮或螺内酯作为MRA。依普利酮是一种选择性醛固酮拮抗剂，预期其激素副作用发生率低于螺内酯。本研究旨在比较这两种药物在慢性心力衰竭患者中的疗效，因为没有发现这两种药物在改善收缩功能、耐受性和安全性方面的正面试验。本研究的目的是在单中心比较依普利酮和螺内酯对慢性心力衰竭患者左室收缩功能的影响。方法:采用随机临床试验、单盲研究。随机抽取2017年7月至2018年6月慢性心力衰竭伴射血分数降低、NYHA III或IV级患者224例。每位患者被随机分配到两组中的任何一组，并继续接受螺内酯(1组)或依普利酮(2组)的治疗。在治疗开始(基线)1个月和6个月结束时，对每位患者进行临床、生化和超声心动图评估。超声心动图观察左室收缩功能的变化。结果:治疗6个月后，大网膜射血分数升高(40.3±6.5 vs 38.3±4.6%);P < 0.05)。埃普利酮组的射血分数(EF)变化为6.2%，螺内酯组为4.1%。左心室收缩末期容积显著降低(I组21.9±2.5 vs II组14.9±5.7);P < 0.05)和左心室收缩直径(组1 48.7±4.0 vs组2 45.2±4.9);P0.05)。结论:本研究中，与螺内酯组相比，依普利酮组的收缩功能改善更多，不良反应也更少。因此，可以得出结论，在其他治疗心力衰竭的药物之外，依普利酮可以被建议用于慢性心力衰竭患者。《大学心脏杂志》第16卷第2期，2020年7月;65 - 70
{"title":"Comparison between Spironolactone and Eplerenone on LV Systolic Function in Patients with Chronic Heart Failure","authors":"Md Noornabi Khondokar, Khurshed Ahmed, M. A. Hossain, R. Rashed, M. Siraj, Mohammad Walidur Rahman, S. Banerjee, S. Ahsan, F. Rahman, S. Zaman, Md. Harisul Hoque","doi":"10.3329/uhj.v16i2.49649","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49649","url":null,"abstract":"Background:Chronic heart failure (CHF) is the most common and prognostically unfavorable outcome of many diseases of the cardiovascular system. Clinical trials have demonstrated mortality and morbidity benefits of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure. These studies have used either eplerenone or spironolactone as the MRA. Eplerenone is a selective aldosterone antagonist expected to have a lower incidence of hormonal side effects than spironolactone. The present study is designed to compare these two drugs in chronic heart failure patients as no head to head trial between these two drugs is found regarding improvement of systolic function, tolerability and safety. The aim of this study is to compare the effects of eplerenone and spironolactone on LV systolic function in patients with chronic heart failure in a single center. \u0000Methods:It was a randomized clinical trial single blind study. A total of 224 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV were selected by random sampling, from July 2017 to June 2018. Each patient was randomly allocated into either of the two arms, and was continued receiving treatment with either spironolactone (Arm-I) or eplerenone(Arm-II). Each patient was evaluated clinically, biochemically and echocardiographically at the beginning of treatment (baseline) at 1 month and at the end of 6th month. Echocardiography was performed to find out change in left ventricular systolic function. \u0000Result: After 6 months of treatment, ejection fraction was found higher in the eplerenonearm (40.3 ± 6.5 versus 38.3 ± 4.6%; P < 0.05). Ejection fraction (EF) changes were 6.2% in eplerenone group and 4.1% in spironolactonearm. A significant reduction in left ventricular end-systolic volume (21.9±2.5 in group I versus 14.9±5.7 in group II; P < 0.05) and left ventricular systolic diameter (48.7±4.0 in arm I versus 45.2±4.9 in arm II; P<0.05) occurred after 6 months of treatment. But no significant differences were observed in left ventricular end-diastolic volume (187.8±37.4 versus 184.5±33.9; P=0.101) and left ventricular diastolic diameter (60.1±4.5 versus 61.0±4.9; P=0.0818) between arms. Assessment of blood pressure six months after treatment shows, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were improved in both arms but difference between two arms were statistically non-significant (p>0.05). \u0000Conclusion: In this study, the improvement in systolic function was more in eplerenone arm, which also had fewer adverse side effects when compared to spironolactone arm. So, it can be concluded that eplerenone can be advised in patient with chronic heart failure in addition to other drugs that are used to treat heart failure. \u0000University Heart Journal Vol. 16, No. 2, Jul 2020; 65-70","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74550605","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}
Joarder Ai, A. I. Akand, Sharmina Ahmed, Azharul Islam, S. Mahabub, D. Adhikary, Mostashirul Haque, Mohammed Rayhan Masum Mandal, F. I. Khaled, S. Hossain, H. Hoque
The SARS-CoV 2 causing COVID-19 has reached pandemic levels since March 2020. In the absence of vaccines or curative medical treatment, COVID-19 exerts an unprecedented global impact on public health and health care delivery. Owing to the unexpected need for large capacities of intensive care unit (ICU) beds with the ability to provide respiratory support and mechanical ventilation, temporary redistribution and reorganization of resources within hospitals have become necessary with relevant consequences for all medical specialties. In addition, protective measures against SARS-CoV 2 gain particular significance for health care personnel (HCP) in direct contact with patients suffering from COVID-19 as well as for ambulatory and hospitalized patients without infection. In view of finite health care resources, health care providers are confronted with ethical considerations on how to prioritize access to care for individual patients as well as providing care for COVID-19 while not neglecting other life-threatening emergencies. Of note, assays to detect the virus in asymptomatic and symptomatic patients have important limitations in terms of sensitivity and specificity and will be complemented by tests for antibodies to identify those that already have been infected previously.
{"title":"Lifestyle Modification in Cardiac Patient in COVID 19 Pandemic Time","authors":"Joarder Ai, A. I. Akand, Sharmina Ahmed, Azharul Islam, S. Mahabub, D. Adhikary, Mostashirul Haque, Mohammed Rayhan Masum Mandal, F. I. Khaled, S. Hossain, H. Hoque","doi":"10.3329/uhj.v16i2.49669","DOIUrl":"https://doi.org/10.3329/uhj.v16i2.49669","url":null,"abstract":"The SARS-CoV 2 causing COVID-19 has reached pandemic levels since March 2020. In the absence of vaccines or curative medical treatment, COVID-19 exerts an unprecedented global impact on public health and health care delivery. Owing to the unexpected need for large capacities of intensive care unit (ICU) beds with the ability to provide respiratory support and mechanical ventilation, temporary redistribution and reorganization of resources within hospitals have become necessary with relevant consequences for all medical specialties. In addition, protective measures against SARS-CoV 2 gain particular significance for health care personnel (HCP) in direct contact with patients suffering from COVID-19 as well as for ambulatory and hospitalized patients without infection. In view of finite health care resources, health care providers are confronted with ethical considerations on how to prioritize access to care for individual patients as well as providing care for COVID-19 while not neglecting other life-threatening emergencies. Of note, assays to detect the virus in asymptomatic and symptomatic patients have important limitations in terms of sensitivity and specificity and will be complemented by tests for antibodies to identify those that already have been infected previously.","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"31 1","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2020-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74401602","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}
Shafiqul Islam, S. Mondal, J. Jahan, M. Arefin, N. Ahmed, Pinaki Das, Mehedi Azam
Background:‘Coronary heart disease (CHD) is now the leading cause of death worldwide; it is on the rise and has become a true pandemic that respects no borders. For the diagnosis of coronary artery disease, the 12 leads electrocardiogram (ECG) is the most readily available non invasive test by which, in addition of diagnosis, localizing and estimating the size of myocardial ischemia can be determined. Abnormally high QT dispersion has been correlated with risk of arrhythmic death in various cardiac diseases including CAD. An increase in QTd is reported to predict the occurrence of life-threatening ventricular tachyarrhythmias and sudden cardiac death in patients with ischemic heart disease. Materials and Methods: This Cross sectional analytical study was conducted in Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka from January 2013 to December 2013. A total of 100 consecutive patients with angina based on predefined enrollment criteria were included in the study. .All patients were evaluated by history, clinical examination, biochemical analysis, and coronary angiogram (CAG) which was performed during index hospital admission. PCI was done only if the vessel was significantly stenosed.i,e. for LMCA e”50%, for LAD, LCX and RCA it was e”70% as significant stenosis. Severity of stenosis of the involved vessels were categorized as severe( e”90%) and moderate(<90%). Results: Among the study population 76 (76%) patients were male and 24 (24%) patients were female. The left anterior descending artery (LAD) group comprised 37 patients and there were significant differences between before and after PCI QTc dispersion (90.5±38.9 vs 70.4±39.6 ms, p=0.001). The left circumflex artery (LCX) group was comprised of 6 patients and there were significant differences between before and after PCI QTc dispersion (62.2±41.9 vs 50.2±37.2 ms, p=0.001). The right coronary artery (RCA) group consisted of 18 patients, there being significant differences between before and after PCI QTc dispersion (84.9±40.7 vs 69.1±41.5 ms, p=0.001) Conclusion: PCI reduces QTc dispersion significantly among patients with angina. This QTc dispersion change is not influenced by sex, smoking, beta-blockers, hypertension, diabetes, renal impairment, stable or unstable angina but it depends upon the severity of coronary artery stenosis, involvement of coronary vessel and number of vessels.Reduction of QTc dispersion is a good sign of successful PCI that indicates successful reperfusion which carries an excellent prognostic value of revascularization.Further long term follow up will establish it.
背景:冠心病(CHD)目前是世界范围内死亡的主要原因;它正在上升，并已成为一种真正不分国界的大流行病。对于冠状动脉疾病的诊断，12导联心电图(ECG)是最容易获得的无创检查，除了诊断外，还可以确定心肌缺血的定位和估计大小。在包括冠心病在内的各种心脏疾病中，异常高的QT离散度与心律失常死亡的风险相关。据报道，QTd的增加可预测缺血性心脏病患者发生危及生命的室性心动过速和心源性猝死。材料与方法:本横断面分析研究于2013年1月至2013年12月在达卡国立心血管疾病研究所心内科进行。根据预先设定的入组标准，共纳入100例连续的心绞痛患者，所有患者均通过病史、临床检查、生化分析和在入院时进行的冠状动脉造影(CAG)进行评估。只有当血管明显狭窄时才行PCI。LMCA为50%，LAD、LCX和RCA为70%。受累血管狭窄的严重程度分为严重(90%)和中度(<90%)。结果:研究人群中男性76例(76%)，女性24例(24%)。左前降支(LAD)组37例患者，PCI前后QTc离散度(90.5±38.9 ms vs 70.4±39.6 ms, p=0.001)差异有统计学意义。左旋动脉组6例患者，PCI前后QTc离散度差异有统计学意义(62.2±41.9 vs 50.2±37.2 ms, p=0.001)。右冠状动脉(RCA)组18例患者，PCI前后QTc离散度差异有统计学意义(84.9±40.7 ms vs 69.1±41.5 ms, p=0.001)。结论:PCI可显著降低心绞痛患者QTc离散度。这种QTc弥散度变化不受性别、吸烟、受体阻滞剂、高血压、糖尿病、肾功能损害、稳定型或不稳定型心绞痛的影响，但取决于冠状动脉狭窄的严重程度、冠状动脉受累程度和血管数量。QTc弥散度降低是PCI成功的良好标志，表明再灌注成功，具有良好的血运重建预后价值。进一步的长期跟进将确定这一点。
{"title":"Effect of PCI on QTC Dispersion in Patients with Angina","authors":"Shafiqul Islam, S. Mondal, J. Jahan, M. Arefin, N. Ahmed, Pinaki Das, Mehedi Azam","doi":"10.3329/uhj.v16i1.44820","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44820","url":null,"abstract":"Background:‘Coronary heart disease (CHD) is now the leading cause of death worldwide; it is on the rise and has become a true pandemic that respects no borders. For the diagnosis of coronary artery disease, the 12 leads electrocardiogram (ECG) is the most readily available non invasive test by which, in addition of diagnosis, localizing and estimating the size of myocardial ischemia can be determined. Abnormally high QT dispersion has been correlated with risk of arrhythmic death in various cardiac diseases including CAD. An increase in QTd is reported to predict the occurrence of life-threatening ventricular tachyarrhythmias and sudden cardiac death in patients with ischemic heart disease. Materials and Methods: This Cross sectional analytical study was conducted in Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka from January 2013 to December 2013. A total of 100 consecutive patients with angina based on predefined enrollment criteria were included in the study. .All patients were evaluated by history, clinical examination, biochemical analysis, and coronary angiogram (CAG) which was performed during index hospital admission. PCI was done only if the vessel was significantly stenosed.i,e. for LMCA e”50%, for LAD, LCX and RCA it was e”70% as significant stenosis. Severity of stenosis of the involved vessels were categorized as severe( e”90%) and moderate(<90%). Results: Among the study population 76 (76%) patients were male and 24 (24%) patients were female. The left anterior descending artery (LAD) group comprised 37 patients and there were significant differences between before and after PCI QTc dispersion (90.5±38.9 vs 70.4±39.6 ms, p=0.001). The left circumflex artery (LCX) group was comprised of 6 patients and there were significant differences between before and after PCI QTc dispersion (62.2±41.9 vs 50.2±37.2 ms, p=0.001). The right coronary artery (RCA) group consisted of 18 patients, there being significant differences between before and after PCI QTc dispersion (84.9±40.7 vs 69.1±41.5 ms, p=0.001) Conclusion: PCI reduces QTc dispersion significantly among patients with angina. This QTc dispersion change is not influenced by sex, smoking, beta-blockers, hypertension, diabetes, renal impairment, stable or unstable angina but it depends upon the severity of coronary artery stenosis, involvement of coronary vessel and number of vessels.Reduction of QTc dispersion is a good sign of successful PCI that indicates successful reperfusion which carries an excellent prognostic value of revascularization.Further long term follow up will establish it.","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"1 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82368115","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 Rayhan Masum Mandal, S. Ahsan, H. Hoque, M. F. Kabir, Khurshed Ahmed, Fakrul Islam Khaled, S. E. Mahbub, N. Fatema
Introduction: Myocardial hypokinesia is assessed by Echocardiography which is a non-invasive method.1,2 This technique, based on two-dimensional visual evaluation of endocardial wall thickening, is subjective. Inter-observer variability is more as it is dependent on operator experience. 3,4 and may not identify small but clinically significant changes in myocardial function that are below the threshold of visual resolution.5 Tissue Doppler imaging provides a more objective assessment of myocardial contractility but is subject to the confounding effects of cardiac translational motion and passive pathological tethering.6 These limitations may be overcome by the measurement of local myocardial deformation parameters with strain and strain rate echocardiography. Strain rate is defined as the rate of deformation in response to an applied force and is determined from the spatial gradient of local myocardial tissue velocities between two points which is calculated from the time integral of strain rate and reflects the magnitude of deformation.7,8 These parameters are potentially more accurate and specific measures of local myocardial function and may offer an opportunity to improve the detection of regional abnormalities.8,9 This study was designed to determine the role of Global longitudinal strain (GLS) in the detection functional ischaemic zone and assessed myocardial contractility following successful thrombolysis and primary percutaneous coronary intervention (PCI) and compare in between two groups.
{"title":"Comparison of pre and post Global longitudinal Strain imaging in thrombolytic and primary percutaneous coronary intervention in acute ST elevation Anterior Myocardial infarction","authors":"Mohammad Rayhan Masum Mandal, S. Ahsan, H. Hoque, M. F. Kabir, Khurshed Ahmed, Fakrul Islam Khaled, S. E. Mahbub, N. Fatema","doi":"10.3329/uhj.v16i1.44816","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44816","url":null,"abstract":"Introduction: Myocardial hypokinesia is assessed by Echocardiography which is a non-invasive method.1,2 This technique, based on two-dimensional visual evaluation of endocardial wall thickening, is subjective. Inter-observer variability is more as it is dependent on operator experience. 3,4 and may not identify small but clinically significant changes in myocardial function that are below the threshold of visual resolution.5 Tissue Doppler imaging provides a more objective assessment of myocardial contractility but is subject to the confounding effects of cardiac translational motion and passive pathological tethering.6 These limitations may be overcome by the measurement of local myocardial deformation parameters with strain and strain rate echocardiography. Strain rate is defined as the rate of deformation in response to an applied force and is determined from the spatial gradient of local myocardial tissue velocities between two points which is calculated from the time integral of strain rate and reflects the magnitude of deformation.7,8 These parameters are potentially more accurate and specific measures of local myocardial function and may offer an opportunity to improve the detection of regional abnormalities.8,9 This study was designed to determine the role of Global longitudinal strain (GLS) in the detection functional ischaemic zone and assessed myocardial contractility following successful thrombolysis and primary percutaneous coronary intervention (PCI) and compare in between two groups.","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"6 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87261783","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. Alam, M. Mahmood, D. Adhikary, F. I. Khaled, M. Chowdhury, Amanat Hasan, S. Islam, A. Sultan, S. Banerjee
Background: Acute myocardial infarction (AMI) is a major cause of death worldwide with arrhythmia being the most common determinant in the post-infarction period. Identification and management of arrhythmias at an early period of acute MI has both short term and long term significance.Objective: The aim of the study is to evaluate the pattern of arrhythmias in acute STEMI in the first 48 hours of hospitalization and their inhospital outcome. Methods: A total of 50 patients with acute STEMI were included in the study after considering the inclusion and exclusion criteria. The patients were observed for the first 48 hours of hospitalization for detection of arrhythmia with baseline ECG at admission and continuous cardiac monitoring in the CCU. The pattern of the arrhythmias during this period & their in-hospital outcome were recorded in predesigned structured data collection sheet.Result: The mean age was 53.38 ± 10.22 years ranging from 29 to 70 years. Most of the patients were male 42(84%). Majority of the patients had anterior wall ( anterior, antero-septal & extensive anterior) myocardial infarction (54%). Sinus tachycardia in isolation was the most common arrhythmia observed in 36.8% of patients followed by sinus bradycardia (22.8%), ventricular tachycardia (19.3%), ventricular ectopic (12.3%),first degree AV block (5.3%), complete heart block and atrial ectopic 1.7% each. Tachyarrhythmias were more common in anterior wall myocardial infarction, whereas bradyarrhythmias were more common in inferior wall myocardial infarction. Among studied patients, 72% had favourable outcome , followed by acute left ventricular failure 10%, cardiogenic shock & lengthening of hospital stay 8% each and death 2%.Conclusion: The commonest arrhythmias encountered were sinus tachycardia followed by sinus bradycardia, ventricular tachycardia, ventricular ectopic, AV block and atrial ectopic. The incidence of mortality was 2%.
{"title":"The Pattern of Cardiac Arrhythmias in Acute ST Elevated Myocardial Infarction and their in-hospital Outcome","authors":"M. Alam, M. Mahmood, D. Adhikary, F. I. Khaled, M. Chowdhury, Amanat Hasan, S. Islam, A. Sultan, S. Banerjee","doi":"10.3329/uhj.v16i1.44817","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44817","url":null,"abstract":"Background: Acute myocardial infarction (AMI) is a major cause of death worldwide with arrhythmia being the most common determinant in the post-infarction period. Identification and management of arrhythmias at an early period of acute MI has both short term and long term significance.Objective: The aim of the study is to evaluate the pattern of arrhythmias in acute STEMI in the first 48 hours of hospitalization and their inhospital outcome. Methods: A total of 50 patients with acute STEMI were included in the study after considering the inclusion and exclusion criteria. The patients were observed for the first 48 hours of hospitalization for detection of arrhythmia with baseline ECG at admission and continuous cardiac monitoring in the CCU. The pattern of the arrhythmias during this period & their in-hospital outcome were recorded in predesigned structured data collection sheet.Result: The mean age was 53.38 ± 10.22 years ranging from 29 to 70 years. Most of the patients were male 42(84%). Majority of the patients had anterior wall ( anterior, antero-septal & extensive anterior) myocardial infarction (54%). Sinus tachycardia in isolation was the most common arrhythmia observed in 36.8% of patients followed by sinus bradycardia (22.8%), ventricular tachycardia (19.3%), ventricular ectopic (12.3%),first degree AV block (5.3%), complete heart block and atrial ectopic 1.7% each. Tachyarrhythmias were more common in anterior wall myocardial infarction, whereas bradyarrhythmias were more common in inferior wall myocardial infarction. Among studied patients, 72% had favourable outcome , followed by acute left ventricular failure 10%, cardiogenic shock & lengthening of hospital stay 8% each and death 2%.Conclusion: The commonest arrhythmias encountered were sinus tachycardia followed by sinus bradycardia, ventricular tachycardia, ventricular ectopic, AV block and atrial ectopic. The incidence of mortality was 2%.","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"94 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83872653","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}
Sajjad Safi, M. Chowdhury, T. Parvin, Khurshed Ahmed, Ashrafi Sultana, S. Banerjee
Background: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. ACS patients with renal impairment during hospitalization are associated with adverse in-hospital outcomes in the form of heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare the in-hospital adverse outcomesof patients with ACS with or without AKI.Materials and Methods: This prospective comparative study was conducted in the Department of Cardiology, BSMMU, Dhaka, during the period of August 2017 to July 2018. A total of 70 eligible patients were included in this study of which 35 patients were included in group A (ACS with AKI) and 35 patients were included in group B (ACS without AKI). AKI was diagnosed, on the basis of increased serum creatinine level 0.3mg/dL from baseline within 48 hours after hospitalization. They were subjected to electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, 2-D echocardiography along with serum troponin, CK MB and electrolytes. Results: It was observed that mean age was 58.0±8.5 years in group A and 55.6±12.3 years in group B. Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively) and arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). 7(20%) patients of group A required dialysis. The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Multiple logistic regression analysis revealed that heart failure, cardiogenic shock, duration of hospital stay were found to be the independently significant predictors of outcome of the patients with AKI with odds ratio being 5.53 (p=0.001), 4.353 (p=0.001) and 6.92 (p=0.001) Conclusion: This study shows that, heart failure, cardiogenic shock, arrhythmia, dialysis requirement, were more common in the patients with AKI (group A) than in the patients without AKI (group B). The duration of hospital stays were longer in patients with AKI (group A) than in the patients without AKI (group B). Therefore, an important research target is the identification of high-risk patients with ACS experiencing AKI, thereby appropriate medication and follow-up should be implemented. Keys words: ACS with or without AKI; heart failure; cardiogenic shock; arrhythmia; Hospital stay. University Heart Journal 2020; 16(1): 3-10 ORIGINAL ARTICLES Received: 03 October, 2019 Accepted: 01 December, 2019 University Heart Journal Vol. 16, No. 1, January 2020
{"title":"Comparison of In-Hospital Outcomes Between Patients With or Without Acute Kidney Injury Developed After Hospitalization Following Acute Coronary Syndrome","authors":"Sajjad Safi, M. Chowdhury, T. Parvin, Khurshed Ahmed, Ashrafi Sultana, S. Banerjee","doi":"10.3329/uhj.v16i1.44815","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44815","url":null,"abstract":"Background: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. ACS patients with renal impairment during hospitalization are associated with adverse in-hospital outcomes in the form of heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare the in-hospital adverse outcomesof patients with ACS with or without AKI.Materials and Methods: This prospective comparative study was conducted in the Department of Cardiology, BSMMU, Dhaka, during the period of August 2017 to July 2018. A total of 70 eligible patients were included in this study of which 35 patients were included in group A (ACS with AKI) and 35 patients were included in group B (ACS without AKI). AKI was diagnosed, on the basis of increased serum creatinine level 0.3mg/dL from baseline within 48 hours after hospitalization. They were subjected to electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, 2-D echocardiography along with serum troponin, CK MB and electrolytes. Results: It was observed that mean age was 58.0±8.5 years in group A and 55.6±12.3 years in group B. Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively) and arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). 7(20%) patients of group A required dialysis. The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Multiple logistic regression analysis revealed that heart failure, cardiogenic shock, duration of hospital stay were found to be the independently significant predictors of outcome of the patients with AKI with odds ratio being 5.53 (p=0.001), 4.353 (p=0.001) and 6.92 (p=0.001) Conclusion: This study shows that, heart failure, cardiogenic shock, arrhythmia, dialysis requirement, were more common in the patients with AKI (group A) than in the patients without AKI (group B). The duration of hospital stays were longer in patients with AKI (group A) than in the patients without AKI (group B). Therefore, an important research target is the identification of high-risk patients with ACS experiencing AKI, thereby appropriate medication and follow-up should be implemented. Keys words: ACS with or without AKI; heart failure; cardiogenic shock; arrhythmia; Hospital stay. University Heart Journal 2020; 16(1): 3-10 ORIGINAL ARTICLES Received: 03 October, 2019 Accepted: 01 December, 2019 University Heart Journal Vol. 16, No. 1, January 2020","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"17 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80465866","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：