Abstract not available Bangladesh Heart Journal 2018; 33(2) : 78-79
孟加拉心脏杂志2018;33(2): 78-79
{"title":"Congenital and Structural Heart Diseases: We are in Progress","authors":"N. Fatema","doi":"10.3329/bhj.v33i2.39300","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39300","url":null,"abstract":"Abstract not available \u0000Bangladesh Heart Journal 2018; 33(2) : 78-79","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124438036","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}
Tufazzal Hossen, S. Ahsan, A. Salim, Khurshed Ahmed, Mukhlesur Rahman, D. Adhikary, Joarder Ai, F. I. Khaled, M. Paul, A. Jamil, Z. Abedin, Fazlul Karim
Background: The effect of late percutaneous coronary intervention on left ventricular function is incompletely understood. Objectives: To evaluate the effect of late Percutaneous Coronary Intervention on LV systolic function following coronary stenting after acute anterior myocardial infarction. Methods: A total of 60 patients, > 24 hours to 6 weeks after anterior AMI who attended in UCC, BSMMU between July 2014 to June 2015 were included in this study. They underwent coronary stenting. After coronary stenting all patients were in TIMI flow-3. Serial echocardiographic assessment of LV function before and after late intervention with modified Simpson’s rule in apical 4 chamber view as well as comparison between baseline result with that of after intervention were done. The patients were on standard medical therapy in post intervention period. Result: Mean age was 54.3±8.91 years with minimum 30 years and maximum 75 years. Most of the patients were male (67%). LVESV was 60.0±14.4 ml before PCI and 58.3±15.3 ml at discharge (p value 0.091) & 44.1±17.6 ml after 3 months (p value <0.001). LVEF was 40.2±3.1% before PCI, 40.2±3.3% at discharge (p value 0.509) & 47.6±5.9% after 3 months (p value <0.001). There was no significant improvement of LV function from baseline till discharge but significant improvement occurred after 3months. Conclusion: Using echocardiographic techniques, our results showed that left ventricular volume decreased and the left ventricular ejection fraction increased significantly after three months of late intervention. Bangladesh Heart Journal 2018; 33(2) : 90-93
背景:晚期经皮冠状动脉介入治疗对左心室功能的影响尚不完全清楚。目的:探讨经皮冠状动脉介入治疗对急性前壁心肌梗死冠状动脉支架植入术后左室收缩功能的影响。方法:选取2014年7月至2015年6月在UCC、BSMMU就诊的60例AMI前段24小时至6周的患者作为研究对象。他们接受了冠状动脉支架植入术。冠状动脉支架植入术后,所有患者的TIMI血流均为3。采用改良的心尖4室面Simpson规则连续超声心动图评价晚期干预前后左室功能,并与干预后基线结果进行比较。干预后患者接受标准药物治疗。结果:平均年龄54.3±8.91岁,最小30岁,最大75岁。患者以男性居多(67%)。PCI前LVESV为60.0±14.4 ml,出院时为58.3±15.3 ml (p值0.091),3个月后为44.1±17.6 ml (p值<0.001)。PCI前LVEF为40.2±3.1%,出院时为40.2±3.3% (p值0.509),3个月后为47.6±5.9% (p值<0.001)。从基线到出院,左室功能无明显改善,但3个月后有明显改善。结论:通过超声心动图技术,我们的结果显示,晚期干预3个月后,左心室容积减小,左心室射血分数明显升高。孟加拉国心脏杂志2018;33(2): 90-93
{"title":"Echocardiographic Evaluation of left Ventricular Function Following Late Percutaneous Coronary Intervention after Acute Anterior Myocardial Infarction with Left Ventricular Systolic Dysfunction","authors":"Tufazzal Hossen, S. Ahsan, A. Salim, Khurshed Ahmed, Mukhlesur Rahman, D. Adhikary, Joarder Ai, F. I. Khaled, M. Paul, A. Jamil, Z. Abedin, Fazlul Karim","doi":"10.3329/bhj.v33i2.39303","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39303","url":null,"abstract":"Background: The effect of late percutaneous coronary intervention on left ventricular function is incompletely understood. \u0000Objectives: To evaluate the effect of late Percutaneous Coronary Intervention on LV systolic function following coronary stenting after acute anterior myocardial infarction. \u0000Methods: A total of 60 patients, > 24 hours to 6 weeks after anterior AMI who attended in UCC, BSMMU between July 2014 to June 2015 were included in this study. They underwent coronary stenting. After coronary stenting all patients were in TIMI flow-3. Serial echocardiographic assessment of LV function before and after late intervention with modified Simpson’s rule in apical 4 chamber view as well as comparison between baseline result with that of after intervention were done. The patients were on standard medical therapy in post intervention period. \u0000Result: Mean age was 54.3±8.91 years with minimum 30 years and maximum 75 years. Most of the patients were male (67%). LVESV was 60.0±14.4 ml before PCI and 58.3±15.3 ml at discharge (p value 0.091) & 44.1±17.6 ml after 3 months (p value <0.001). LVEF was 40.2±3.1% before PCI, 40.2±3.3% at discharge (p value 0.509) & 47.6±5.9% after 3 months (p value <0.001). There was no significant improvement of LV function from baseline till discharge but significant improvement occurred after 3months. \u0000Conclusion: Using echocardiographic techniques, our results showed that left ventricular volume decreased and the left ventricular ejection fraction increased significantly after three months of late intervention. \u0000Bangladesh Heart Journal 2018; 33(2) : 90-93","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130902421","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. Hoque, S. Moinuddin, M. Hossain, A. B. Ahmed, Ashfaq Nazmi, Souda Sultana, M. Khan, Tanvir Hosaain
Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the leftright shunt with cardiac insufficiency. In this paper, we presented a case study of severe mitral stenosis with giant LA with LA thrombus in a 42 years old female patient. The patient underwent successful mitral valve replacement and removal of LA thrombus and discharged from the hospital with advice. Bangladesh Heart Journal 2018; 33(2) : 141-144
{"title":"Severe mitral stenosis with giant LA with LA thrombus - A case report","authors":"A. Hoque, S. Moinuddin, M. Hossain, A. B. Ahmed, Ashfaq Nazmi, Souda Sultana, M. Khan, Tanvir Hosaain","doi":"10.3329/bhj.v33i2.39312","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39312","url":null,"abstract":"Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the leftright shunt with cardiac insufficiency. In this paper, we presented a case study of severe mitral stenosis with giant LA with LA thrombus in a 42 years old female patient. The patient underwent successful mitral valve replacement and removal of LA thrombus and discharged from the hospital with advice. \u0000Bangladesh Heart Journal 2018; 33(2) : 141-144","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128058044","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. Azad, Naharuma Aive Hyder Chowdhury, A. Shamsuddin
A 2 years old boy presented to us with a history of repeated respiratory tract infections and bluish discoloration of tongue, lips and figure tips for last 18 months. Echocardiography and Computed tomography (CT) angiogram revealed total anomalous pulmonary venous connection (TAPVC) mixed type (supracardiac and cardiac);all pulmonary veins drain into a common chamber behind left atrium (LA) and left lower pulmonary vein (LUPV) drains to vertical vein and common chamber both.The patient underwent rerouting of pulmonary veins and vertical vein ligation above the drainage of LUPV. Bangladesh Heart Journal 2018; 33(2) : 138-140
{"title":"Atypical Mixed Total Anomalous Pulmonary Venous Connection: A Case Report","authors":"A. Azad, Naharuma Aive Hyder Chowdhury, A. Shamsuddin","doi":"10.3329/bhj.v33i2.39311","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39311","url":null,"abstract":"A 2 years old boy presented to us with a history of repeated respiratory tract infections and bluish discoloration of tongue, lips and figure tips for last 18 months. Echocardiography and Computed tomography (CT) angiogram revealed total anomalous pulmonary venous connection (TAPVC) mixed type (supracardiac and cardiac);all pulmonary veins drain into a common chamber behind left atrium (LA) and left lower pulmonary vein (LUPV) drains to vertical vein and common chamber both.The patient underwent rerouting of pulmonary veins and vertical vein ligation above the drainage of LUPV. \u0000Bangladesh Heart Journal 2018; 33(2) : 138-140","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126910380","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. Islam, Afzalur Rahman, A. Chowdhury, Sayed Nasir Uddin, N. Kar, K. K. Karmakar, Mohammad Ullah Firoze, Mohammad Arifur Rahman, Monir Hossen Khan, Nure Alam Ashrafi, Muhammad Ruhul Amin, M. Arefin, F. Cader
Background: Limited contemporary data exist regarding the impact of SYNTAX score on in-hospital outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients. Objectives: To evaluate the significance of the SYNTAX score for predicting in- hospital outcome after primary PCI in patient with acute STEMI. Methods: This cohort study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low SYNTAX score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. In-hospital outcome was observed in between two groups. Results: Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P<0.05). The high SYNTAX score group had lower TIMI 3 (76.47% vs 91.3%, p  0.03) compared to the low SYNTAX score group. But there were no significant difference in complications as arrhythmia (2.5% vs 0%), cardiogenic shock (2.5% vs 0%), heart failure (5% vs 2.5%) and mortality (5%vs 0%) between high and low SYNTAX score. Multivariate logistic regression analysis revealed SYNTAX score (OR = 5.95, p  0.001) was an independent predictor of in-hospital outcome in patients under going primary PCI. Performance test of SYNTEX score in the setting of Primary PCI outcome showed positive predictive value 83%. Conclusions: SYNTAX score was an independent variable that can predict in-hospital outcomes of patients with acute STEMI undergoing primary PCI. Bangladesh Heart Journal 2018; 33(2) : 121-125
背景:目前关于SYNTAX评分对急性STEMI患者接受初级经皮冠状动脉介入治疗(PCI)住院结果的影响的数据有限。目的:评价SYNTAX评分对急性STEMI患者首次PCI术后院内预后的预测意义。方法:本队列研究于2015年9月- 2016年9月在孟加拉国达卡国立心血管疾病研究所心内科进行。42例接受首次PCI治疗的急性STEMI患者被纳入研究。但2例患者因首次PCI失败而被排除在研究之外。将患者分为两组:1组(低SYNTAX评分d " 22)和2组(高SYNTAX评分> 22)。所有患者的句法评分是根据首次PCI前的初始冠状动脉造影计算的。观察两组患者的住院情况。结果:在传统心血管危险因素中,II组糖尿病患病率明显高于I组(82.4% vs 34.8%, p  0.003)。血管造影显示,ⅰ组LAD动脉罪魁祸首病变最大(69.6% vs 17.6%),ⅱ组RCA罪魁祸首病变最大(64.7% vs 21.7%),两组间差异有统计学意义(P<0.05)。SYNTAX高评分组的TIMI 3较低(76.47% vs 91.3%, p  0.03)。SYNTAX评分高低在心律失常(2.5% vs 0%)、心源性休克(2.5% vs 0%)、心力衰竭(5%vs 2.5%)和死亡率(5%vs 0%)等并发症方面无显著差异。多因素logistic回归分析显示SYNTAX评分(OR = 5.95, p  0.001)是初次PCI患者住院预后的独立预测因子。初步PCI预后设置中SYNTEX评分的性能测试阳性预测值为83%。结论:SYNTAX评分是一个独立变量,可以预测急性STEMI患者接受初级PCI治疗的住院结果。孟加拉国心脏杂志2018;33(2): 121-125
{"title":"Impact of SYNTAX Score on In-hospital Outcome after Primary Percutaneous Coronary Intervention","authors":"S. Islam, Afzalur Rahman, A. Chowdhury, Sayed Nasir Uddin, N. Kar, K. K. Karmakar, Mohammad Ullah Firoze, Mohammad Arifur Rahman, Monir Hossen Khan, Nure Alam Ashrafi, Muhammad Ruhul Amin, M. Arefin, F. Cader","doi":"10.3329/bhj.v33i2.39308","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39308","url":null,"abstract":"Background: Limited contemporary data exist regarding the impact of SYNTAX score on in-hospital outcomes undergoing primary percutaneous coronary intervention(PCI) in acute STEMI patients. \u0000Objectives: To evaluate the significance of the SYNTAX score for predicting in- hospital outcome after primary PCI in patient with acute STEMI. \u0000Methods: This cohort study was conducted in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from September, 2015 to September, 2016. 42 patients with acute STEMI who underwent primary PCI were considered for the study. But 2 patients were excluded from the study due to failure of primary PCI. The patients were divided into two groups: Group I (low SYNTAX score d”22) and Group II (high Syntax score > 22). The Syntax score of all patients were calculated from an initial coronary angiogram before primary PCI. In-hospital outcome was observed in between two groups. \u0000Results: Among traditional cardiovascular risk factors diabetes was significantly more prevalent in the Group II than Group I ( 82.4% vs 34.8%, p  0.003). Angiographic profile revealed maximum (69.6% vs 17.6%) culprit lesion in LAD artery in Group I and maximum culprit lesion (64.7% vs 21.7%) in RCA in Group II, these were the statistically significant between Group I and Group II (P<0.05). The high SYNTAX score group had lower TIMI 3 (76.47% vs 91.3%, p  0.03) compared to the low SYNTAX score group. But there were no significant difference in complications as arrhythmia (2.5% vs 0%), cardiogenic shock (2.5% vs 0%), heart failure (5% vs 2.5%) and mortality (5%vs 0%) between high and low SYNTAX score. Multivariate logistic regression analysis revealed SYNTAX score (OR = 5.95, p  0.001) was an independent predictor of in-hospital outcome in patients under going primary PCI. Performance test of SYNTEX score in the setting of Primary PCI outcome showed positive predictive value 83%. \u0000Conclusions: SYNTAX score was an independent variable that can predict in-hospital outcomes of patients with acute STEMI undergoing primary PCI. \u0000Bangladesh Heart Journal 2018; 33(2) : 121-125","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131895722","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}
Syed Dawood Md Taimur, S. Nasrin, M. M. Haq, M. Rashid, Hemanta I Gomes, F. Islam
Background : Diabetes mellitus is one of the important risk factors for coronary artery disease. The hemoglobin A1c is used for evaluating glycemic control in diabetic patients. Here, we conducted the study to evaluate the relationship between HbA1c level and severity of coronary artery disease among the hospitalized patients with ACS. Materials & Methods : This cross sectional study was conducted in the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from September 2015 to December 2015. Total of one hundred patients were studied and they were grouped on the basis of their glycaemic status. One hundred patients with acute coronary syndrome were enrolled in this study. Out of them fifty were diabetic (HbA1c>6.5%) and rest of were nondiabetics (HbA1c<6.5%) ( group-A and B). Results: Out of one hundred patients fifty eight were male and fourty two were female. Mean age of patients in group-A was 58.54±10.22 years and mean age of patients in group-B was 54.52±13.69 years. Mean age of male and female was 57.72±11.48 years and 54.0±13.08 years respectively. Mean HbA1c of patients in group-A was 11.43±1.43% and group-B was 6.34±0.915%. 38% of group-A and 22% of group-B had triple vessel disease, 26% of group-A and 20% of group- B had double vessel disease and 28% of group-A and 18% of group-B had single vessel disease, and 8% of group-A and 40% of group-B had normal coronary arteries. 48% patients of age group 46-50 in group-A had more incidence in coronary artery disease than other age group which was statistically significant ( p=0.035). 61-75 years age group in group-B patients had coronary artery disease than other age groups which was statistically not significant(p=0.084). Patients of group-A was significantly relation with coronary artery disease (p>.001) and six times greater coronary artery disease than patients of group-B (OR= 6.15, 95% CI for OR =2.074 -18.289). Conclusions: In this way the importance of appropriate glycaemic control has been emphasized in diabetic patients. This study showed the relation between HbA1c levels and the severity of CAD in patient with type-II diabetes mellitus .Our findings demonstrate that elevated HbA1c level was risk factor for severity of coronary artery disease in ACS patients. Bangladesh Heart Journal 2018; 33(2) : 80-84
背景:糖尿病是冠心病的重要危险因素之一。糖化血红蛋白用于评估糖尿病患者的血糖控制。本研究旨在评价ACS住院患者HbA1c水平与冠状动脉疾病严重程度的关系。材料与方法:本横断面研究于2015年9月至2015年12月在孟加拉国达卡易卜拉欣心脏医院及研究所心内科进行。共研究了100例患者,并根据他们的血糖状况进行了分组。100名急性冠状动脉综合征患者参加了这项研究。其中50例为糖尿病(HbA1c>6.5%),其余为非糖尿病(HbA1c.001),冠状动脉疾病比b组患者高6倍(OR= 6.15, 95% CI OR= 2.074 -18.289)。结论:通过这种方式强调了糖尿病患者适当控制血糖的重要性。本研究显示了HbA1c水平与2型糖尿病患者冠心病严重程度的关系。我们的研究结果表明,HbA1c水平升高是ACS患者冠状动脉疾病严重程度的危险因素。孟加拉国心脏杂志2018;33(2): 80-84
{"title":"Relationship between Hemoglobin A1c Level and Severity of Coronary Artery Disease Among The Hospitalized Patients with Acute Coronary Syndrome","authors":"Syed Dawood Md Taimur, S. Nasrin, M. M. Haq, M. Rashid, Hemanta I Gomes, F. Islam","doi":"10.3329/bhj.v33i2.39301","DOIUrl":"https://doi.org/10.3329/bhj.v33i2.39301","url":null,"abstract":"Background : Diabetes mellitus is one of the important risk factors for coronary artery disease. The hemoglobin A1c is used for evaluating glycemic control in diabetic patients. Here, we conducted the study to evaluate the relationship between HbA1c level and severity of coronary artery disease among the hospitalized patients with ACS. \u0000Materials & Methods : This cross sectional study was conducted in the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from September 2015 to December 2015. Total of one hundred patients were studied and they were grouped on the basis of their glycaemic status. One hundred patients with acute coronary syndrome were enrolled in this study. Out of them fifty were diabetic (HbA1c>6.5%) and rest of were nondiabetics (HbA1c<6.5%) ( group-A and B). \u0000Results: Out of one hundred patients fifty eight were male and fourty two were female. Mean age of patients in group-A was 58.54±10.22 years and mean age of patients in group-B was 54.52±13.69 years. Mean age of male and female was 57.72±11.48 years and 54.0±13.08 years respectively. Mean HbA1c of patients in group-A was 11.43±1.43% and group-B was 6.34±0.915%. 38% of group-A and 22% of group-B had triple vessel disease, 26% of group-A and 20% of group- B had double vessel disease and 28% of group-A and 18% of group-B had single vessel disease, and 8% of group-A and 40% of group-B had normal coronary arteries. 48% patients of age group 46-50 in group-A had more incidence in coronary artery disease than other age group which was statistically significant ( p=0.035). 61-75 years age group in group-B patients had coronary artery disease than other age groups which was statistically not significant(p=0.084). Patients of group-A was significantly relation with coronary artery disease (p>.001) and six times greater coronary artery disease than patients of group-B (OR= 6.15, 95% CI for OR =2.074 -18.289). \u0000Conclusions: In this way the importance of appropriate glycaemic control has been emphasized in diabetic patients. This study showed the relation between HbA1c levels and the severity of CAD in patient with type-II diabetes mellitus .Our findings demonstrate that elevated HbA1c level was risk factor for severity of coronary artery disease in ACS patients. \u0000Bangladesh Heart Journal 2018; 33(2) : 80-84","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126386179","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}
Akm Manzurul Alam, Istiaq Ahmed, M. Ahmad, Abdullah Al Mamun Hossain, M. Reza, Mizanur Rahman, Muzibur Rahman Rony, S. Ahmed
Background: Atrial Fibrillation (AF) is common in early recovery period after cardio-thoracic surgery. There have been several pharmacological and nonpharmacological strategies suggested for prevention against AF after coronary artery bypass grafting. The purpose of this study was to evaluate the effect of oral amiodarone in the prevention of atrial fibrillation in patients who underwent off pump coronary artery bypass graft (OPCAB).Methods: This interventional study was conducted from February 2017 to January 2018 in the department of cardiac surgery, National Institute of Cardiovascular Disease (NICVD) Dhaka, Bangladesh. By purposive sampling a total of 100 patients having sinus rhythm who will undergo OPCAB were selected for the study. Among them 50 patients (Group-A) got amiodarone (600mg/day started 3 days prior to surgery) and 50 patients (Group-B) did not get amiodarone. Two (2) patients of group-A were excluded from the study due to conversion to on pump from off pump during operation. So, finally group A had 48 patients and group- B had 50 patients. Preoperative electrocardiography (ECG), serum electrolytes (e.g. potassium & magnesium), thyroid function test, liver function test and echocardiogram were done in all patients under study. Per-operative occurrence of AF was assessed on operation theatre monitor. Each patient was evaluated by continuous ECG up to 5th post-operative day (POD). Serum potassium & magnesium were measured in every alternative day up to 5th POD. ECG with long lead tracing was done for all patients on the day of hospital discharge & was recorded. Data were analyzed by SPSS 24.0 (Statistical Package for the Social Sciences) and tested by student T-test and Chi-square test. P < 0.05 was considered significant.Results: Pre-operative baseline characteristics were similar in both groups. Per-operative and postoperative AF occurred more frequently in group B than group A. Those were 10(20.83%) and 32(64.0%) peroperative, 9(18.75%) and 31(36.0%) immediate postoperative period respectively in group A and group B. The result was statistically significant (P value<.05). Post-operative amiodarone used in all patients who developed AF irrespective of groups. This also decreased AF significantly. There were statistically no significant difference found in postoperative serum electrolytes and use of inotropes, anti-arrhythmic drugs. All patients recovered well.Conclusion: This study concluded that preoperative oral administration of amiodarone can prevent the occurrence of atrial fibrillation in patients undergone Off Pump Coronary Artery Bypass (OPCAB).Bangladesh Heart Journal 2018; 33(1) : 67-73
背景:房颤(AF)常见于心胸外科术后恢复期。有几种药物和非药物策略建议预防冠状动脉搭桥术后房颤。本研究的目的是评估口服胺碘酮在非体外循环冠状动脉旁路移植术(OPCAB)患者房颤预防中的作用。方法:本介入研究于2017年2月至2018年1月在孟加拉国达卡国家心血管疾病研究所(NICVD)心脏外科进行。通过有目的的抽样,共选择100例将接受OPCAB的窦性心律患者进行研究。其中50例患者(a组)在手术前3天开始使用胺碘酮(600mg/天),50例患者(b组)未使用胺碘酮。a组2例患者因术中由停泵转为开泵而被排除在研究之外。最后,A组有48名患者B组有50名患者。对所有患者进行术前心电图、血清电解质(如钾、镁)、甲状腺功能检查、肝功能检查和超声心动图检查。术中监测房颤发生情况。每例患者术后5天(POD)连续心电图评估。每隔一天测定血清钾、镁含量,直至第5 POD。所有患者出院当天均行长导联示踪心电图并记录。采用SPSS 24.0 (Statistical Package for Social Sciences)软件对数据进行分析,采用学生t检验和卡方检验。P < 0.05为差异有统计学意义。结果:两组术前基线特征相似。B组术中、术后房颤发生率均高于A组,A组术中、术后即刻期房颤发生率分别为10例(20.83%)、32例(64.0%)、9例(18.75%)、31例(36.0%),差异有统计学意义(P值< 0.05)。术后胺碘酮应用于所有发生房颤的患者,不论分组。这也显著降低了AF。术后血清电解质及抗心律失常药物的使用差异无统计学意义。所有患者均恢复良好。结论:本研究认为术前口服胺碘酮可预防非体外循环冠状动脉搭桥术(OPCAB)患者房颤的发生。孟加拉国心脏杂志2018;33(1): 67-73
{"title":"Effect of Pre-operative Amiodarone on Atrial Fibrillation after Off-Pump Coronary Artery Bypass Surgery","authors":"Akm Manzurul Alam, Istiaq Ahmed, M. Ahmad, Abdullah Al Mamun Hossain, M. Reza, Mizanur Rahman, Muzibur Rahman Rony, S. Ahmed","doi":"10.3329/BHJ.V33I1.37028","DOIUrl":"https://doi.org/10.3329/BHJ.V33I1.37028","url":null,"abstract":"Background: Atrial Fibrillation (AF) is common in early recovery period after cardio-thoracic surgery. There have been several pharmacological and nonpharmacological strategies suggested for prevention against AF after coronary artery bypass grafting. The purpose of this study was to evaluate the effect of oral amiodarone in the prevention of atrial fibrillation in patients who underwent off pump coronary artery bypass graft (OPCAB).Methods: This interventional study was conducted from February 2017 to January 2018 in the department of cardiac surgery, National Institute of Cardiovascular Disease (NICVD) Dhaka, Bangladesh. By purposive sampling a total of 100 patients having sinus rhythm who will undergo OPCAB were selected for the study. Among them 50 patients (Group-A) got amiodarone (600mg/day started 3 days prior to surgery) and 50 patients (Group-B) did not get amiodarone. Two (2) patients of group-A were excluded from the study due to conversion to on pump from off pump during operation. So, finally group A had 48 patients and group- B had 50 patients. Preoperative electrocardiography (ECG), serum electrolytes (e.g. potassium & magnesium), thyroid function test, liver function test and echocardiogram were done in all patients under study. Per-operative occurrence of AF was assessed on operation theatre monitor. Each patient was evaluated by continuous ECG up to 5th post-operative day (POD). Serum potassium & magnesium were measured in every alternative day up to 5th POD. ECG with long lead tracing was done for all patients on the day of hospital discharge & was recorded. Data were analyzed by SPSS 24.0 (Statistical Package for the Social Sciences) and tested by student T-test and Chi-square test. P < 0.05 was considered significant.Results: Pre-operative baseline characteristics were similar in both groups. Per-operative and postoperative AF occurred more frequently in group B than group A. Those were 10(20.83%) and 32(64.0%) peroperative, 9(18.75%) and 31(36.0%) immediate postoperative period respectively in group A and group B. The result was statistically significant (P value<.05). Post-operative amiodarone used in all patients who developed AF irrespective of groups. This also decreased AF significantly. There were statistically no significant difference found in postoperative serum electrolytes and use of inotropes, anti-arrhythmic drugs. All patients recovered well.Conclusion: This study concluded that preoperative oral administration of amiodarone can prevent the occurrence of atrial fibrillation in patients undergone Off Pump Coronary Artery Bypass (OPCAB).Bangladesh Heart Journal 2018; 33(1) : 67-73","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115442521","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}
Rezaul Karim, Tawfiq Ahmed, R. Khurshid, S. Moinuddin, K. Hasan
Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery.Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study.Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB.Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.Bangladesh Heart Journal 2018; 33(1) : 16-21
{"title":"Preoperative Aspirin Use and Outcomes in Off-pump Coronary Artery Bypass Grafting Surgery","authors":"Rezaul Karim, Tawfiq Ahmed, R. Khurshid, S. Moinuddin, K. Hasan","doi":"10.3329/BHJ.V33I1.37019","DOIUrl":"https://doi.org/10.3329/BHJ.V33I1.37019","url":null,"abstract":"Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery.Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study.Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB.Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.Bangladesh Heart Journal 2018; 33(1) : 16-21","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125904752","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}
Z. Alam, S. Hoque, Jubaidul Islam, Mohammad S Hossain, Aparna Rahman, A. Mohibullah
Background and objectives: Cardiovascular disease is the most common cause of death worldwide and Coronary Care Unit (CCU) plays a central role in reducing this mortality. Currently the data on mortality in CCU is very limited in our country. Our purpose of this study to provide data on mortality so that we can focus and improve the factors determining deaths in CCU. Methodology: The data of all death cases admitted in the CCU of a tertiary level hospital between 1 January 2016 and 31 December 2017 were included for assessing the data on demography, diagnosis, and comorbidities at the time of death.Results: Among 802 cases admitted in CCU in two years, 40 patients died (5%). Male was 55% and female was 45%. Most of the death occurred in their 6th decade of life, due to Non-ST-Elevation Myocardial Infarction (NSTEMI) and sepsis, within 24-hour of CCU admission.Common associated co-morbidities were DM (75%), hypertension (42.5%), CKD (27.5%), and hypokalemia (12.5%).Conclusions: The death rate is much lower in our CCU in comparison to global rate. The common cause of death is still NSTEMI. The common co-morbidities we found are DM, hypertension and CKD. Most of the deathsoccurred within 24-hour of admission.Bangladesh Heart Journal 2018; 33(1) : 28-31
{"title":"Mortality in Coronary Care Unit of a Tertiary Level Hospital of Bangladesh","authors":"Z. Alam, S. Hoque, Jubaidul Islam, Mohammad S Hossain, Aparna Rahman, A. Mohibullah","doi":"10.3329/bhj.v33i1.37021","DOIUrl":"https://doi.org/10.3329/bhj.v33i1.37021","url":null,"abstract":"Background and objectives: Cardiovascular disease is the most common cause of death worldwide and Coronary Care Unit (CCU) plays a central role in reducing this mortality. Currently the data on mortality in CCU is very limited in our country. Our purpose of this study to provide data on mortality so that we can focus and improve the factors determining deaths in CCU. Methodology: The data of all death cases admitted in the CCU of a tertiary level hospital between 1 January 2016 and 31 December 2017 were included for assessing the data on demography, diagnosis, and comorbidities at the time of death.Results: Among 802 cases admitted in CCU in two years, 40 patients died (5%). Male was 55% and female was 45%. Most of the death occurred in their 6th decade of life, due to Non-ST-Elevation Myocardial Infarction (NSTEMI) and sepsis, within 24-hour of CCU admission.Common associated co-morbidities were DM (75%), hypertension (42.5%), CKD (27.5%), and hypokalemia (12.5%).Conclusions: The death rate is much lower in our CCU in comparison to global rate. The common cause of death is still NSTEMI. The common co-morbidities we found are DM, hypertension and CKD. Most of the deathsoccurred within 24-hour of admission.Bangladesh Heart Journal 2018; 33(1) : 28-31","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130621042","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. Islam, Tanveer Ahmed, I. J. Shimu, S. Nahar, Mohammad Arifur Rahman, Afzalur Rahman
Idiopathic thrombocytopenic purpura (ITP) and myocardial infarction (MI) in an individual patient is a rare combination. MI mandates thrombolytic and antiplatelet therapy which increases the risk of bleeding in ITP. So far, no guideline deals with management protocol for ischaemic heart disease (IHD) in ITP patients. Here, we describe 2 cases of IHD who developed ITP while on antiplatelet therapy.Bangladesh Heart Journal 2018; 33(1) : 74-77
{"title":"Idiopathic Thrombocytopenic Purpura in Patients with Ischaemic Heart Disease - A Therapeutic Challenge","authors":"A. Islam, Tanveer Ahmed, I. J. Shimu, S. Nahar, Mohammad Arifur Rahman, Afzalur Rahman","doi":"10.3329/BHJ.V33I1.37029","DOIUrl":"https://doi.org/10.3329/BHJ.V33I1.37029","url":null,"abstract":"Idiopathic thrombocytopenic purpura (ITP) and myocardial infarction (MI) in an individual patient is a rare combination. MI mandates thrombolytic and antiplatelet therapy which increases the risk of bleeding in ITP. So far, no guideline deals with management protocol for ischaemic heart disease (IHD) in ITP patients. Here, we describe 2 cases of IHD who developed ITP while on antiplatelet therapy.Bangladesh Heart Journal 2018; 33(1) : 74-77","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121395295","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}