Abstract not available University Heart Journal Vol. 15, No. 2, Jul 2019; 60-62
《大学心脏杂志》2019年7月第15卷第2期;60 - 62
{"title":"A Comparative Study with Carvedilol and Ivabradine in Ischaemic Heart Disease Patients with Heart Failure","authors":"H. Hoque, Khurshed Ahmed, M. F. Kabir, N. Fatema","doi":"10.3329/UHJ.V15I2.42648","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42648","url":null,"abstract":"Abstract not available \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 60-62","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81355596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. S. Masum, Kazi Jannat Ara, Atia Saeed, Shakil Shams, Mohiuddin, M. Hannan, Shahidullah Sabuj, N. Fatema
Stroke is the third leading cause of death in adult population throughout the world and is the most common cause of severe adult physical disability. It is increasing at an alarming rate in Asia including Bangladesh. The assessment of the frequency of development of various types of complications of stroke is important for proper management after acute stroke and its primary and secondary prevention. The aims of the study were to observe the complications in patients with ischemic and hemorrhagic stroke.A cross sectional observational study was conducted from September 2015 to April 2017 in the department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka. All the patients of ischemic and hemorrhagic stroke confirmed by neuroimaging (CT scan of head/ MRI of brain), meeting the inclusion and exclusion criteria were included in the study.Our study was performed with eighty stroke patients. Among them sixty five were ischemic and fifteen were hemorrhagic stroke patients. Present study showed that maximum stroke patients were more than 50 years of age. Mean age of the study population was 59.28 ± 13.98 years and 60.07 ± 17.29 years in ischaemic stroke patients and haemorrhagic stroke patients respectively. Stroke incidence rate is 1.25 times greater in men than women. University Heart Journal Vol. 15, No. 2, Jul 2019; 42-46
{"title":"Comparison of Personal Profile and Risk Factors between Patients with Ischaemic and Haemorrhagic Stroke","authors":"A. S. Masum, Kazi Jannat Ara, Atia Saeed, Shakil Shams, Mohiuddin, M. Hannan, Shahidullah Sabuj, N. Fatema","doi":"10.3329/UHJ.V15I2.42645","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42645","url":null,"abstract":"Stroke is the third leading cause of death in adult population throughout the world and is the most common cause of severe adult physical disability. It is increasing at an alarming rate in Asia including Bangladesh. The assessment of the frequency of development of various types of complications of stroke is important for proper management after acute stroke and its primary and secondary prevention. The aims of the study were to observe the complications in patients with ischemic and hemorrhagic stroke.A cross sectional observational study was conducted from September 2015 to April 2017 in the department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka. All the patients of ischemic and hemorrhagic stroke confirmed by neuroimaging (CT scan of head/ MRI of brain), meeting the inclusion and exclusion criteria were included in the study.Our study was performed with eighty stroke patients. Among them sixty five were ischemic and fifteen were hemorrhagic stroke patients. Present study showed that maximum stroke patients were more than 50 years of age. Mean age of the study population was 59.28 ± 13.98 years and 60.07 ± 17.29 years in ischaemic stroke patients and haemorrhagic stroke patients respectively. Stroke incidence rate is 1.25 times greater in men than women. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 42-46","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82093756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bashiruddin, M. Chowdhury, B. Bhattacharjee, Abul Hossen Shahin, S. Ahsan, Mrm Mandal, S. Dhar, I. Mahmud, S. Hossain
Background: Clinical guidelines recommend that optimal management of acute coronary syndrome (ACS) should include patient risk stratification. Predicting the anatomical extension of coronary artery disease (CAD) is also potentially useful for clinical decision. Objective: The objective of our study was to determine whether the TIMI risk score correlates with the angiographic extent and severity of CAD in patients with NSTE- ACS. Materials and Methods: This was a cross-sectional observational study carried out in the Department of Cardiology, Chattogram Medical College Hospital (CMCH) from September 2017 to May 2018. A total of 200 patients diagnosed with NSTE- Acute Coronary Syndrome were included as sample by purposive sampling method. TIMI risk score for each patient was calculated and the patients were stratified into 3 groups according to the TIMI risk score: low risk (0-2); intermediate risk (3-4); high risk (5-7). The severity of the CAD was assessed by Vessel score and Gensini score. Result: The mean ± SD of the age of study population was 53.7 ±10.8 years (range 37–77) and 142 (71%) were male. Regarding cardiovascular risk factors, 137 (68.5%) patients had diabetes mellitus, 83 (41.5%) had dyslipidaemia, 155 (77.5%) had hypertension, 136 (68%) were current smoker and 70 (35%) had a family history of CAD. The Gensini score was higher in patients at high risk TIMI group (p<0.001). Moreover, there was a signiûcant positive correlation between the TIMI and Gensini score (r=0.446,p<0.001). TIMI score can predict significant CAD moderately well (area under the curve 0.661, p=0.001). Patients with TIMI score > 4 were more likely to have significant three vessel CAD (65.9%) versus those with TIMI risk score 3-4 (17.9%) and TIMI risk score < 3 (2%) (p< 0.001). Conclusion: Study showed the TIMI score is significantly correlated with the extent of CAD as assessed by the Gensini score. It is accurate for predicting severe CAD among NSTE-ACS patients. University Heart Journal Vol. 15, No. 2, Jul 2019; 68-73
背景:临床指南建议急性冠脉综合征(ACS)的最佳管理应包括患者风险分层。预测冠状动脉疾病(CAD)的解剖扩展也可能对临床决策有用。目的:我们研究的目的是确定TIMI风险评分是否与NSTE- ACS患者冠心病的血管造影程度和严重程度相关。材料与方法:本研究是一项横断面观察性研究，于2017年9月至2018年5月在Chattogram Medical College Hospital (CMCH)心内科开展。采用目的抽样方法，选取200例诊断为NSTE-急性冠脉综合征的患者作为样本。计算每位患者的TIMI风险评分，并根据患者的TIMI风险评分将患者分为3组:低危(0-2);中度风险(3-4);高风险(5-7)。采用Vessel评分和Gensini评分评估冠心病的严重程度。结果:研究人群年龄均值±SD为53.7±10.8岁(37 ~ 77岁)，男性142例(71%)。在心血管危险因素方面，糖尿病患者137例(68.5%)，血脂异常患者83例(41.5%)，高血压患者155例(77.5%)，吸烟者136例(68%)，冠心病家族史患者70例(35%)。与TIMI风险评分为3-4分(17.9%)和TIMI风险评分< 3分(2%)的患者(p< 0.001)相比，高风险TIMI组患者Gensini评分更高(p = 4)，更有可能出现显著的三支血管CAD(65.9%)。结论:研究显示TIMI评分与Gensini评分评价的CAD程度有显著相关。预测NSTE-ACS患者严重CAD的准确性较高。《大学心脏杂志》2019年7月第15卷第2期;68 - 73
{"title":"Association of Thrombolysis in Myocardial Infarction (TIMI) Risk Score with Angiographic Severity of Coronary Artery Disease In Patients with Non-ST Elevation Acute Coronary Syndrome","authors":"A. Bashiruddin, M. Chowdhury, B. Bhattacharjee, Abul Hossen Shahin, S. Ahsan, Mrm Mandal, S. Dhar, I. Mahmud, S. Hossain","doi":"10.3329/UHJ.V15I2.42649","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42649","url":null,"abstract":"Background: Clinical guidelines recommend that optimal management of acute coronary syndrome (ACS) should include patient risk stratification. Predicting the anatomical extension of coronary artery disease (CAD) is also potentially useful for clinical decision. \u0000Objective: The objective of our study was to determine whether the TIMI risk score correlates with the angiographic extent and severity of CAD in patients with NSTE- ACS. \u0000Materials and Methods: This was a cross-sectional observational study carried out in the Department of Cardiology, Chattogram Medical College Hospital (CMCH) from September 2017 to May 2018. A total of 200 patients diagnosed with NSTE- Acute Coronary Syndrome were included as sample by purposive sampling method. TIMI risk score for each patient was calculated and the patients were stratified into 3 groups according to the TIMI risk score: low risk (0-2); intermediate risk (3-4); high risk (5-7). The severity of the CAD was assessed by Vessel score and Gensini score. \u0000Result: The mean ± SD of the age of study population was 53.7 ±10.8 years (range 37–77) and 142 (71%) were male. Regarding cardiovascular risk factors, 137 (68.5%) patients had diabetes mellitus, 83 (41.5%) had dyslipidaemia, 155 (77.5%) had hypertension, 136 (68%) were current smoker and 70 (35%) had a family history of CAD. The Gensini score was higher in patients at high risk TIMI group (p<0.001). Moreover, there was a signiûcant positive correlation between the TIMI and Gensini score (r=0.446,p<0.001). TIMI score can predict significant CAD moderately well (area under the curve 0.661, p=0.001). Patients with TIMI score > 4 were more likely to have significant three vessel CAD (65.9%) versus those with TIMI risk score 3-4 (17.9%) and TIMI risk score < 3 (2%) (p< 0.001). \u0000Conclusion: Study showed the TIMI score is significantly correlated with the extent of CAD as assessed by the Gensini score. It is accurate for predicting severe CAD among NSTE-ACS patients. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 68-73","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84467351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Talukder, M. Siraj, N. Khondokar, S. Habib, A. Salim, Mohammad Walidur Rahman, S. Banerjee, S. Ahsan, H. Hoque, F. Rahman
Background: Heart Failure (HF) is a major public health burden worldwide. Approximately 5 million Americans, 0.4–2% of the general European population and over 23 million people worldwide are living with heart failure. Like few other chronic disease, low serum albumin is common in patients with heart failure (HF). However, very few studies evaluated the outcome of albumin infusion in different stages of HF. Therefore, the objective of this study is to assess the outcome of albumin infusion in heart failure patients. Methods: It was a cross-sectional study. A total of 50 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV with serum albumin level <2.5g/dl who were admitted in CCUwere selected by purposive sampling, from September 2017 to August 2018. 100ml of 20% albumin was infused and serum albumin was measured after 3 days. Then the patients were divided into two groups, Patients who failed to attain serum albumin of 3g/dl(Group A) or Patients who attained serum albumin of ≥3g/dl (Group B). Analysis and comparison for symptomatic improvement of heart failure by NHYA classification and LVEF was done at 10th day after infusion between group A and B. Result: Among the 50 patients, mean age of patients was 53.64 ± 13.44 years (age range: 26-84 years) with a male-female ratio of 3:2 (60%-male vs 40%- female). Majority patients were previously re-admitted at least two times (40%), 28% were re-admitted once, 16% were re-admitted three times and 4% were re-admitted for four times. Of all, 56% patients presented NYHA class IV and AHA stage D heart failure (56%) and 44% patients presented with NYHA class III and AHA stage C. At day 10 follow up following albumin infusion, overall frequency of following ten days of albumin therapy, in group B, 8 patients (72.7%) among Class III improved to Class I and 3 patients (27.3%) improved to class II. Also, 7 patients (50%), 5 patients (35.7%) and 2 patients (14.3%) among class IV improved to respectively class I, class II and class III. In group A, 3 patients (27.3%) among class III improve to class II and 8 patients (72.7%) remain in class III. Also, 2 patients (14.3%), 5 Patients (35.7%) and 7 patients (50%) among class IV improve to respectively class I, class II and class III. Moreover, statistically significant improvement was noted in ejection fraction of patents irrespective of initial class of heart failure (p<0.001) in group B patients compare to group A (p<0.09). Conclusion: In this study, the improvement of heart failure was more in patients who attained albumin level of ≥3g/dl.Therefore, in can be concluded that albumin infusion improves both subjective and objective improvement of patients with heart failure. University Heart Journal Vol. 15, No. 2, Jul 2019; 47-53
背景:心力衰竭(HF)是世界范围内主要的公共卫生负担。大约500万美国人、欧洲总人口的0.4% - 2%以及全球超过2300万人患有心力衰竭。像其他一些慢性疾病一样，低血清白蛋白在心力衰竭(HF)患者中很常见。然而，很少有研究评估白蛋白输注在心衰不同阶段的结果。因此，本研究的目的是评估白蛋白输注在心力衰竭患者中的效果。方法:采用横断面研究。选择2017年9月至2018年8月收治的50例慢性心力衰竭伴射血分数降低，NYHA III级或IV级，血清白蛋白水平<2.5g/dl。注射20%白蛋白100ml, 3天后测定血清白蛋白。患者分为两组,患者未能实现3 g / dl血清白蛋白(A组)或获得患者血清白蛋白≥3 g / dl (B组)。为改善心衰症状分析和比较NHYA分类和LVEF是在十天之后完成输液组A和B之间的结果:在50个患者,患者的平均年龄为53.64±13.44岁(年龄:26 - 84年),男女比例为3:2(60%的男性和40%的女性)。大多数患者既往至少两次(40%)再入院，28%再入院一次，16%再入院三次，4%再入院四次。其中，56%的患者表现为NYHA IV级和AHA D期心力衰竭(56%)，44%的患者表现为NYHA III级和AHA c期心力衰竭。在白蛋白输注后第10天随访，白蛋白治疗后10天的总频率，B组中，III级中有8例(72.7%)改善为I级，3例(27.3%)改善为II级。IV类患者中有7例(50%)、5例(35.7%)和2例(14.3%)分别改善为I类、II类和III类。在A组，3例(27.3%)III级患者改善为II级，8例(72.7%)患者仍处于III级。IV类患者分别有2例(14.3%)、5例(35.7%)和7例(50%)改善为I类、II类和III类。此外，与A组(p<0.09)相比，B组患者的射血分数与初始心力衰竭类型无关(p<0.001)，在统计学上有显著改善。结论:在本研究中，白蛋白水平≥3g/dl的患者心力衰竭的改善更明显。因此，可以得出结论，白蛋白输注对心力衰竭患者的主客观改善都有促进作用。《大学心脏杂志》2019年7月第15卷第2期;47-53
{"title":"Outcome of Albumin Infusion in Heart Failure Patients","authors":"A. Talukder, M. Siraj, N. Khondokar, S. Habib, A. Salim, Mohammad Walidur Rahman, S. Banerjee, S. Ahsan, H. Hoque, F. Rahman","doi":"10.3329/UHJ.V15I2.42646","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42646","url":null,"abstract":"Background: Heart Failure (HF) is a major public health burden worldwide. Approximately 5 million Americans, 0.4–2% of the general European population and over 23 million people worldwide are living with heart failure. Like few other chronic disease, low serum albumin is common in patients with heart failure (HF). However, very few studies evaluated the outcome of albumin infusion in different stages of HF. Therefore, the objective of this study is to assess the outcome of albumin infusion in heart failure patients. \u0000Methods: It was a cross-sectional study. A total of 50 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV with serum albumin level <2.5g/dl who were admitted in CCUwere selected by purposive sampling, from September 2017 to August 2018. 100ml of 20% albumin was infused and serum albumin was measured after 3 days. Then the patients were divided into two groups, Patients who failed to attain serum albumin of 3g/dl(Group A) or Patients who attained serum albumin of ≥3g/dl (Group B). Analysis and comparison for symptomatic improvement of heart failure by NHYA classification and LVEF was done at 10th day after infusion between group A and B. \u0000Result: Among the 50 patients, mean age of patients was 53.64 ± 13.44 years (age range: 26-84 years) with a male-female ratio of 3:2 (60%-male vs 40%- female). Majority patients were previously re-admitted at least two times (40%), 28% were re-admitted once, 16% were re-admitted three times and 4% were re-admitted for four times. Of all, 56% patients presented NYHA class IV and AHA stage D heart failure (56%) and 44% patients presented with NYHA class III and AHA stage C. At day 10 follow up following albumin infusion, overall frequency of following ten days of albumin therapy, in group B, 8 patients (72.7%) among Class III improved to Class I and 3 patients (27.3%) improved to class II. Also, 7 patients (50%), 5 patients (35.7%) and 2 patients (14.3%) among class IV improved to respectively class I, class II and class III. In group A, 3 patients (27.3%) among class III improve to class II and 8 patients (72.7%) remain in class III. Also, 2 patients (14.3%), 5 Patients (35.7%) and 7 patients (50%) among class IV improve to respectively class I, class II and class III. Moreover, statistically significant improvement was noted in ejection fraction of patents irrespective of initial class of heart failure (p<0.001) in group B patients compare to group A (p<0.09). \u0000Conclusion: In this study, the improvement of heart failure was more in patients who attained albumin level of ≥3g/dl.Therefore, in can be concluded that albumin infusion improves both subjective and objective improvement of patients with heart failure. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 47-53","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80092352","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}
B. Hossain, M. Chowdhury, Z. Islam, R. C. Debnath, S. Banerjee, M. Bari
Background: Acute STEMI patients constitute a large proportion of admissions in coronary care unit and their management and prognostic implification is of immense importance. Prolonged QRS duration on electrocardiogram (ECG) has been associated with cardiac structural and functional abnormalitiesVery few studies were performed correlating QRS duration and LV systolic function in acute STEMI patients in our country. This study assessed whether QRS duration on ECG is correlated with LV systolic function measured in patients with acute STEMI. Aim of the Study: The aim of the study is to evaluate the relationship between QRS duration on ECG with left ventricular systolic function by echocardiography in patients with acute ST elevation myocardial infarction. Methods: A cross sectional observational study was conducted in the department of Cardiology in Mymensingh Medical College Hospital from November, 2016 to February, 2018 among purposively selected 235 patients with STEMI following inclusion & exclusion criteria. After detailed history, physical examination and investigations the selected patients underwent transthoracic Echocardiography to asses left ventricular systolic function applying Teichholz method. Results: Mean age of the patients 51.84±11.74 years. 135(57.45%) patients had acute anterior MI, while 98(41.70%) had Inferior MI and only 2(0.85%) had lateral MI. Mean QRS duration was 93.3 ±10.18 ms, with maximum value 125ms and minimum value 66ms. Mean left ventricular ejection fraction was 49.71%±9.87%, with maximum value 74% and minimum value 23%. QRS duration and left ventricular ejection fraction were moderate negative correlation with r= -0.611,
{"title":"Relationship Between QRS Duration on ECG and LV Systolic Function by Echocardiography in Patients with STEMI","authors":"B. Hossain, M. Chowdhury, Z. Islam, R. C. Debnath, S. Banerjee, M. Bari","doi":"10.3329/UHJ.V15I2.42647","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42647","url":null,"abstract":"Background: Acute STEMI patients constitute a large proportion of admissions in coronary care unit and their management and prognostic implification is of immense importance. Prolonged QRS duration on electrocardiogram (ECG) has been associated with cardiac structural and functional abnormalitiesVery few studies were performed correlating QRS duration and LV systolic function in acute STEMI patients in our country. This study assessed whether QRS duration on ECG is correlated with LV systolic function measured in patients with acute STEMI. \u0000Aim of the Study: The aim of the study is to evaluate the relationship between QRS duration on ECG with left ventricular systolic function by echocardiography in patients with acute ST elevation myocardial infarction. Methods: A cross sectional observational study was conducted in the department of Cardiology in Mymensingh Medical College Hospital from November, 2016 to February, 2018 among purposively selected 235 patients with STEMI following inclusion & exclusion criteria. After detailed history, physical examination and investigations the selected patients underwent transthoracic Echocardiography to asses left ventricular systolic function applying Teichholz method. \u0000Results: Mean age of the patients 51.84±11.74 years. 135(57.45%) patients had acute anterior MI, while 98(41.70%) had Inferior MI and only 2(0.85%) had lateral MI. Mean QRS duration was 93.3 ±10.18 ms, with maximum value 125ms and minimum value 66ms. Mean left ventricular ejection fraction was 49.71%±9.87%, with maximum value 74% and minimum value 23%. QRS duration and left ventricular ejection fraction were moderate negative correlation with r= -0.611, <P = 0.001. \u0000Conclusion: The study concluded that QRS duration is negatively correlated with Left ventricular systolic function in patients with acute ST elevation myocardial infarction. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 54-59","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80859107","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. Masum, Rayhan Shahrear, Z. A. Yesmin, L. Nishat, L. Banu
Background:Hypertrophic cardiomyopathy (HCM) is the most frequent type of cardiomyopathy. HCM is a disease of changing cardiac morphology that causes various form of cardiac dysfunction. HCM patients may remain asymptomatic and undiagnosed for a long time. If they become symptomatic, they commonly present with breathlessness, chest discomfort, and exertion. It is also responsible for the sudden cardiac death.Proper assessment of the functional status of the heart is required for proper management strategies of HCM. Objective: The objective of the study was to assess the IVS, PWT and LVEF in different cardiac phenotypes as well as to draw correlation among them. Materials and method:A descriptive cross-sectional study was undertaken on thirty-four adult Bangladeshi hypertrophic cardiomyopathy patients (thirty-one male, three female). The study was carried out in the Department of Anatomy, BSMMU. Diagnoses adult HCM patients were selected as study patients. Transthoracic echocardiography was done to assess the interventricular septal thickness (IVS), left ventricular posterior wall thickness (PWT) and left ventricular ejection fraction (LVEF). Result: The changes in the value of the left ventricular ejection fraction shows significant correlation with left ventricular posterior wall thickness,rather than the interventricular septal thickness. Conclusion:Though significant correlation between left ventricular ejection fraction and left ventricular posterior wall thickness was found, a large cohort study could be done to see the long term outcome of such correlation. University Heart Journal Vol. 15, No. 1, Jan 2019; 12-15
{"title":"Evaluation of LVEF with Changing left Ventricular Morphology in Hypertrophic Cardiomyopathy","authors":"M. Masum, Rayhan Shahrear, Z. A. Yesmin, L. Nishat, L. Banu","doi":"10.3329/UHJ.V15I1.41440","DOIUrl":"https://doi.org/10.3329/UHJ.V15I1.41440","url":null,"abstract":"Background:Hypertrophic cardiomyopathy (HCM) is the most frequent type of cardiomyopathy. HCM is a disease of changing cardiac morphology that causes various form of cardiac dysfunction. HCM patients may remain asymptomatic and undiagnosed for a long time. If they become symptomatic, they commonly present with breathlessness, chest discomfort, and exertion. It is also responsible for the sudden cardiac death.Proper assessment of the functional status of the heart is required for proper management strategies of HCM. Objective: The objective of the study was to assess the IVS, PWT and LVEF in different cardiac phenotypes as well as to draw correlation among them. Materials and method:A descriptive cross-sectional study was undertaken on thirty-four adult Bangladeshi hypertrophic cardiomyopathy patients (thirty-one male, three female). The study was carried out in the Department of Anatomy, BSMMU. Diagnoses adult HCM patients were selected as study patients. Transthoracic echocardiography was done to assess the interventricular septal thickness (IVS), left ventricular posterior wall thickness (PWT) and left ventricular ejection fraction (LVEF). Result: The changes in the value of the left ventricular ejection fraction shows significant correlation with left ventricular posterior wall thickness,rather than the interventricular septal thickness. Conclusion:Though significant correlation between left ventricular ejection fraction and left ventricular posterior wall thickness was found, a large cohort study could be done to see the long term outcome of such correlation. \u0000University Heart Journal Vol. 15, No. 1, Jan 2019; 12-15","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"175 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90050256","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}
T. A. Khan, Saiful Ahmed, Mostashirul Haque, Rasul Amin, A. Hasan, J. Arzu, Aparna Rahman, A. Zahid
Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in the 12 lead electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less. This study was intended to assess regional wall motion abnormality (RWMA) in acute anteroseptal STEMI patients. 90 patients with AS-STEMI admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient’s ECG data.The mean (± SD) age of the patients was 51.57 (± 12.02) years with mean (± SD) age of the patients was 52.58 (± 12.02) years with a range of 23 - 80 years. There were 91.1% male and 8.9% female. The mean (± SD) EF% was 38.80 %( ± 5.78). All the segments of left ventricle, except basal and mid inferolateral segments, were affected in anteroseptal STEMI. So, the term AS-STEMI may be a misnomer, as it implies that only the anteroseptal segments of the left ventricle are involved. This study shows that regional dysfunction in patients with AS-STEMI extends beyond the anteroseptal region and may be it is as much extensive as extensive anterior myocardial infarction. So, any patients with anterior wall involvement should be treated with utmost importance. University Heart Journal Vol. 15, No. 1, Jan 2019; 28-33
{"title":"Assessment of Regional Wall Motion Abnormality in Patients with Acute Anteroseptal ST Segment Elevation Myocardial Infarction","authors":"T. A. Khan, Saiful Ahmed, Mostashirul Haque, Rasul Amin, A. Hasan, J. Arzu, Aparna Rahman, A. Zahid","doi":"10.3329/UHJ.V15I1.41443","DOIUrl":"https://doi.org/10.3329/UHJ.V15I1.41443","url":null,"abstract":"Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in the 12 lead electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less. This study was intended to assess regional wall motion abnormality (RWMA) in acute anteroseptal STEMI patients. 90 patients with AS-STEMI admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient’s ECG data.The mean (± SD) age of the patients was 51.57 (± 12.02) years with mean (± SD) age of the patients was 52.58 (± 12.02) years with a range of 23 - 80 years. There were 91.1% male and 8.9% female. The mean (± SD) EF% was 38.80 %( ± 5.78). All the segments of left ventricle, except basal and mid inferolateral segments, were affected in anteroseptal STEMI. So, the term AS-STEMI may be a misnomer, as it implies that only the anteroseptal segments of the left ventricle are involved. This study shows that regional dysfunction in patients with AS-STEMI extends beyond the anteroseptal region and may be it is as much extensive as extensive anterior myocardial infarction. So, any patients with anterior wall involvement should be treated with utmost importance. \u0000University Heart Journal Vol. 15, No. 1, Jan 2019; 28-33","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"247 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79330231","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. 15, No. 1, Jan 2019; 1-2
《大学心脏学报》2019年1月第15卷第1期;1 - 2
{"title":"Management of Heart Failure","authors":"Mohammad Safiuddin, H. Hoque","doi":"10.3329/UHJ.V15I1.41437","DOIUrl":"https://doi.org/10.3329/UHJ.V15I1.41437","url":null,"abstract":"Abstract not available \u0000University Heart Journal Vol. 15, No. 1, Jan 2019; 1-2","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90579571","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}
K. M. Iqbal, S. Ahsan, M. M. Rahman, M. Chowdhury, Khurshed Ahmed, T. Parvin, A. Jamil, F. I. Khaled, S. Malla, Pritam Kumar Gachchhadar, Mrm Mandal
Background: ST-elevation myocardial infarction (STEMI) is a major cause of mortality worldwide. PCI remain gold standard management of STEMI. An Angiographic Perfusion Score (APS) is a combination of TIMI Flow Grades (TFG) and myocardial perfusion (TMPG) grades before and after PCI. So it can accurately measure both epicardailand myocardial perfusion and predict major adverse cardiac events (MACE). The aim of the study is to evaluate the association of APS for determining the short term clinical outcomes after PCI in ST-segment elevation myocardial infarction without thrombolytic therapy. Methodology: This cross sectional observational study carried out among adult patients presenting STsegment elevation myocardial infarction without thrombolytic pretreatment to the cardiology department of BSMMU who underwent Percutaneous Coronary Intervention and met inclusion and exclusion criteria. This study was conducted from April 2017 to March 2018. After informed written consent data collection was carried out by using a data sheet. Calculated sample size of the study was 205. Angiogram was done by SIEMENS AXOM ARTIS machine, CD Analysis to see TFG & TMPG for calculation of APS was done by two specialist observer (Professor, Associate or Assistant Professor) MACE was observed within 30 days. Chi square test was done to see the association of APS with MACE by Statistical Package for Social Science program 20 version of computer on the basis of different variables. Results: MACE distribution of the study patients revealed that only 7.8% of the patients had MACE whereas 92.2% of the patients had no MACE among 205 patient APS score with MACE distribution of the study patients revealed that 9.3% patient of partial perfusion group and 44.4% patient of failed perfusion group had MACE but there were no major adverse cardiac event in full perfusion group of patient. The difference were statistically highly significant (p<0.05) among three groups but there were no differences in the baseline characteristics of those who had full, partial or failed perfusion of APS. Conclusion: APS which combines TFG with TMPG before and after PCI is a better discriminator of 30 day MACE than TMPG or TFG alone taken only after PCI. It can identify high risk patients who need implementation of early invasive strategies. We conclude that APS is a better predictor of MACE to take care of patient more accurately. University Heart Journal Vol. 15, No. 1, Jan 2019; 16-21
{"title":"Prediction of MACE by Angiographic Perfusion Score (APS) in Risk Stratification following Percutaneous Coronary Stenting in STEMI without Thrombolytic Therapy","authors":"K. M. Iqbal, S. Ahsan, M. M. Rahman, M. Chowdhury, Khurshed Ahmed, T. Parvin, A. Jamil, F. I. Khaled, S. Malla, Pritam Kumar Gachchhadar, Mrm Mandal","doi":"10.3329/UHJ.V15I1.41441","DOIUrl":"https://doi.org/10.3329/UHJ.V15I1.41441","url":null,"abstract":"Background: ST-elevation myocardial infarction (STEMI) is a major cause of mortality worldwide. PCI remain gold standard management of STEMI. An Angiographic Perfusion Score (APS) is a combination of TIMI Flow Grades (TFG) and myocardial perfusion (TMPG) grades before and after PCI. So it can accurately measure both epicardailand myocardial perfusion and predict major adverse cardiac events (MACE). The aim of the study is to evaluate the association of APS for determining the short term clinical outcomes after PCI in ST-segment elevation myocardial infarction without thrombolytic therapy. Methodology: This cross sectional observational study carried out among adult patients presenting STsegment elevation myocardial infarction without thrombolytic pretreatment to the cardiology department of BSMMU who underwent Percutaneous Coronary Intervention and met inclusion and exclusion criteria. This study was conducted from April 2017 to March 2018. After informed written consent data collection was carried out by using a data sheet. Calculated sample size of the study was 205. Angiogram was done by SIEMENS AXOM ARTIS machine, CD Analysis to see TFG & TMPG for calculation of APS was done by two specialist observer (Professor, Associate or Assistant Professor) MACE was observed within 30 days. Chi square test was done to see the association of APS with MACE by Statistical Package for Social Science program 20 version of computer on the basis of different variables. Results: MACE distribution of the study patients revealed that only 7.8% of the patients had MACE whereas 92.2% of the patients had no MACE among 205 patient APS score with MACE distribution of the study patients revealed that 9.3% patient of partial perfusion group and 44.4% patient of failed perfusion group had MACE but there were no major adverse cardiac event in full perfusion group of patient. The difference were statistically highly significant (p<0.05) among three groups but there were no differences in the baseline characteristics of those who had full, partial or failed perfusion of APS. Conclusion: APS which combines TFG with TMPG before and after PCI is a better discriminator of 30 day MACE than TMPG or TFG alone taken only after PCI. It can identify high risk patients who need implementation of early invasive strategies. We conclude that APS is a better predictor of MACE to take care of patient more accurately. \u0000University Heart Journal Vol. 15, No. 1, Jan 2019; 16-21","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90893266","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}
S. Malla, Mostashirul Haque, D. Osmany, T. Parvin, Mohammad Safiuddin, S. Banerjee, S. Ahsan, C. M. Ahmed, K. M. Iqbal
Background: Transthoracic Doppler Echocardiography (TTDE) has made a breakthrough in noninvasive evaluation of coronary artery flow, especially in the distal left anterior descending coronary artery (LAD). The present study was intended to test the hypothesis whether TTDE can differentiate coronary perfusion with Thrombolysis in Myocardial Infarction (TIMI) grade 3 from TIMI grade ≤2 in patients with anterior myocardial infarction (AMI). Methods: A total of 30 consecutive patients suggestive of anterior MI including those who received thrombolysis with the potential need for Percutaneus Coronary Intervention (PCI) were enrolled in the study. The coronary perfusion was evaluated by antegrade flow visualization in distal LAD by Colour TTDE and antegrade flow velocity measured by pulsed TTDE followed by coronary angiogram for TIMI grade flow in culprit artery. The sensitivity, specificity and diagnostic accuracy were determined by comparing TTDE parameters with angiographic TIMI flow grade. Results: The antegrade distal LAD flow visualization by Color TTDE enabled differentiation of TIMI 3 from TIMI ≤2 with a sensitivity, specificity, PPV, NPV and diagnostic accuracy of 100%, 62.5%, 40%, 100% and 70% respectively. The Receiver Operating Characteristic (ROC) curve constructed to find the cut-off value for antegrade flow velocity in distal LAD in differentiating TIMI 3 from TIMI 0-2 was found to be 30.5 cm/ s with an area under the curve being 0.893, p =0.011. The antegrade flow velocity in distal LAD e” 30.5 cm/s by pulsed TTDE had a fair sensitivity (66.7%) , but had high specificity (100%) and overall diagnostic accuracy (86.7%). Conclusion: The study concluded that antegrade distal LAD flow visualization by Color TTDE can fairly differentiate TIMI 3 from TIMI ≤2 with high sensitivity, and moderate specificity and diagnostic accuracy. Additionally, the antegrade flow velocity in distal LAD by pulsed TTDE has a moderate sensitivity and high specificity to predict the angiographic TIMI flow grade. Thus, TTDE enables noninvasive differentiation of coronary perfusion in patients with anterior MI before coronary intervention. University Heart Journal Vol. 15, No. 1, Jan 2019; 22-27
{"title":"Noninvasive Evaluation of Coronary Perfusion by Transthoracic Doppler Echocardiography in Patients with Anterior Myocardial Infarction before Coronary Intervention","authors":"S. Malla, Mostashirul Haque, D. Osmany, T. Parvin, Mohammad Safiuddin, S. Banerjee, S. Ahsan, C. M. Ahmed, K. M. Iqbal","doi":"10.3329/UHJ.V15I1.41442","DOIUrl":"https://doi.org/10.3329/UHJ.V15I1.41442","url":null,"abstract":"Background: Transthoracic Doppler Echocardiography (TTDE) has made a breakthrough in noninvasive evaluation of coronary artery flow, especially in the distal left anterior descending coronary artery (LAD). The present study was intended to test the hypothesis whether TTDE can differentiate coronary perfusion with Thrombolysis in Myocardial Infarction (TIMI) grade 3 from TIMI grade ≤2 in patients with anterior myocardial infarction (AMI). Methods: A total of 30 consecutive patients suggestive of anterior MI including those who received thrombolysis with the potential need for Percutaneus Coronary Intervention (PCI) were enrolled in the study. The coronary perfusion was evaluated by antegrade flow visualization in distal LAD by Colour TTDE and antegrade flow velocity measured by pulsed TTDE followed by coronary angiogram for TIMI grade flow in culprit artery. The sensitivity, specificity and diagnostic accuracy were determined by comparing TTDE parameters with angiographic TIMI flow grade. Results: The antegrade distal LAD flow visualization by Color TTDE enabled differentiation of TIMI 3 from TIMI ≤2 with a sensitivity, specificity, PPV, NPV and diagnostic accuracy of 100%, 62.5%, 40%, 100% and 70% respectively. The Receiver Operating Characteristic (ROC) curve constructed to find the cut-off value for antegrade flow velocity in distal LAD in differentiating TIMI 3 from TIMI 0-2 was found to be 30.5 cm/ s with an area under the curve being 0.893, p =0.011. The antegrade flow velocity in distal LAD e” 30.5 cm/s by pulsed TTDE had a fair sensitivity (66.7%) , but had high specificity (100%) and overall diagnostic accuracy (86.7%). Conclusion: The study concluded that antegrade distal LAD flow visualization by Color TTDE can fairly differentiate TIMI 3 from TIMI ≤2 with high sensitivity, and moderate specificity and diagnostic accuracy. Additionally, the antegrade flow velocity in distal LAD by pulsed TTDE has a moderate sensitivity and high specificity to predict the angiographic TIMI flow grade. Thus, TTDE enables noninvasive differentiation of coronary perfusion in patients with anterior MI before coronary intervention. \u0000University Heart Journal Vol. 15, No. 1, Jan 2019; 22-27","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73713437","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：