Md. Toufiqur Rahman, RA Ahmed, Rumi Alam, M. A. Hossain, Md Sarowar Hossain, M. A. Hossain, Mohammad Nasimul Goni, Md Sajjadur Rahman, Mohammad Faridul Hoque, Manobendra Sarker
Background: Heart failure is a complex syndrome that arises from abnormalities in the structure and/or function of the heart, whether inherited or acquired. It impairs the ability of the left ventricle to fill or eject blood, leading to a growing number of hospitalizations, deaths, and healthcare costs worldwide. According to the Global Burden of Disease Study 2019, heart failure affected approximately 64 million people worldwide in 2019, and caused over 3 million deaths. The prevalence of heart failure has been increasing worldwide, with an estimated 26% increase in age-standardized prevalence and a 14% increase in age-standardized incidence between 1990 and 2019. This increase in prevalence and incidence is due to a variety of factors, including the aging of the population, improved survival rates from other cardiovascular diseases, and changes in lifestyle and risk factors such as obesity and diabetes. Heart failure patients have various presentations and different etiologies. This study aimed to describe the baseline characteristics, associated co-morbid conditions, presenting features, and causes of heart failure in a study population of 3650 patients admitted to Colonel Maleque Medical College, Manikganj. Methods: This study was done to see Clinical Presentation of Heart Failure Patients admitted in Colonel Maleque Medical College, Manikganj and Maikganj Sadar Hospital. A total of 3650 patients were enrolled in this study during the period of April 2018 to March 2023. Results: Most of the patients (60%) were of 51-70 years age group. 70 % (2555) patients were male. 99% patients presented with SOB, 95% patients had basal creps, 70% had orthopnoea, 49% had Paroxysmal Nocturnal Dyspoea (PND), 40% had leg edema and 25% had raised JVP. Average heart rate was 84 beats/min, average systolic B.P. was 128 mm Hg and average diastolic B.P. was 76 mm Hg. 49% population had hypertension, 39% patients had diabetes and 28% had concomitant respiratory illness. Average EF was 37 %. Ischemic Cardiomyopathy was the commonest (40%) cause of heart failure, acute coronary syndrome was the second leading (30%) cause, valvular heart disease and hypertension are the third common causes. Conclusion: This study highlights the significant burden of heart failure in a population of patients admitted to a tertiary care hospital in Bangladesh. The findings underscore the importance of early detection and management of risk factors for heart failure, such as hypertension and diabetes, to prevent the development and progression of this condition. The identification of the most common causes of heart failure may guide targeted prevention and management strategies in this population. Most common causes are ischemic cardiomyopathy, a sequel of ischemic insult of the heart. So, patients of acute or chronic ischemic heart diseases should be treated and followed up with care, considering their socioeconomic conditions also. Bangladesh Heart Journal 2023; 38(1): 63-69
{"title":"Assessment of Heart Failure Patients in a Tertiary Care Hospital: A Retrospective Study","authors":"Md. Toufiqur Rahman, RA Ahmed, Rumi Alam, M. A. Hossain, Md Sarowar Hossain, M. A. Hossain, Mohammad Nasimul Goni, Md Sajjadur Rahman, Mohammad Faridul Hoque, Manobendra Sarker","doi":"10.3329/bhj.v38i1.67220","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67220","url":null,"abstract":"Background: Heart failure is a complex syndrome that arises from abnormalities in the structure and/or function of the heart, whether inherited or acquired. It impairs the ability of the left ventricle to fill or eject blood, leading to a growing number of hospitalizations, deaths, and healthcare costs worldwide. According to the Global Burden of Disease Study 2019, heart failure affected approximately 64 million people worldwide in 2019, and caused over 3 million deaths. The prevalence of heart failure has been increasing worldwide, with an estimated 26% increase in age-standardized prevalence and a 14% increase in age-standardized incidence between 1990 and 2019. This increase in prevalence and incidence is due to a variety of factors, including the aging of the population, improved survival rates from other cardiovascular diseases, and changes in lifestyle and risk factors such as obesity and diabetes. Heart failure patients have various presentations and different etiologies. This study aimed to describe the baseline characteristics, associated co-morbid conditions, presenting features, and causes of heart failure in a study population of 3650 patients admitted to Colonel Maleque Medical College, Manikganj. \u0000Methods: This study was done to see Clinical Presentation of Heart Failure Patients admitted in Colonel Maleque Medical College, Manikganj and Maikganj Sadar Hospital. A total of 3650 patients were enrolled in this study during the period of April 2018 to March 2023. \u0000Results: Most of the patients (60%) were of 51-70 years age group. 70 % (2555) patients were male. 99% patients presented with SOB, 95% patients had basal creps, 70% had orthopnoea, 49% had Paroxysmal Nocturnal Dyspoea (PND), 40% had leg edema and 25% had raised JVP. Average heart rate was 84 beats/min, average systolic B.P. was 128 mm Hg and average diastolic B.P. was 76 mm Hg. 49% population had hypertension, 39% patients had diabetes and 28% had concomitant respiratory illness. Average EF was 37 %. Ischemic Cardiomyopathy was the commonest (40%) cause of heart failure, acute coronary syndrome was the second leading (30%) cause, valvular heart disease and hypertension are the third common causes. \u0000Conclusion: This study highlights the significant burden of heart failure in a population of patients admitted to a tertiary care hospital in Bangladesh. The findings underscore the importance of early detection and management of risk factors for heart failure, such as hypertension and diabetes, to prevent the development and progression of this condition. The identification of the most common causes of heart failure may guide targeted prevention and management strategies in this population. Most common causes are ischemic cardiomyopathy, a sequel of ischemic insult of the heart. So, patients of acute or chronic ischemic heart diseases should be treated and followed up with care, considering their socioeconomic conditions also. \u0000Bangladesh Heart Journal 2023; 38(1): 63-69","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128210327","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}
Atrial septal defect (ASD) is a commonly encountered congenital lesion in paediatric and adult populations and accounts for 8-10 % of all congenital heart disease. Echocardiography is the most sensitive and specific imaging tool to diagnose this condition and also to determine management guidelines. Various modalities of echocardiography imaging can assess atrial septal defects completely with associated changes in cardiac chambers, haemodynamic status, relationship with neighboring structures, suitability for percutaneous closure or need for surgical intervention. Echocardiography can guide percutaneous device closure procedure as well. Bangladesh Heart Journal 2022; 37(2): 130-138
{"title":"Echocardiographic Evaluation of Atrial Septal Defects and Clinical Applications; A Focused Review","authors":"N. Fatema","doi":"10.3329/bhj.v37i2.63137","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63137","url":null,"abstract":"Atrial septal defect (ASD) is a commonly encountered congenital lesion in paediatric and adult populations and accounts for 8-10 % of all congenital heart disease. Echocardiography is the most sensitive and specific imaging tool to diagnose this condition and also to determine management guidelines. Various modalities of echocardiography imaging can assess atrial septal defects completely with associated changes in cardiac chambers, haemodynamic status, relationship with neighboring structures, suitability for percutaneous closure or need for surgical intervention. Echocardiography can guide percutaneous device closure procedure as well.\u0000Bangladesh Heart Journal 2022; 37(2): 130-138","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122102734","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 Zillur Rahman, S. Chowdhury, I. J. Shimu, P. Biswas, A. Towab, A. K. Das, Khurshadul Alam, A. Mahmud, Khondoker Al Monsur Helal
Introduction: As coronary artery disease (CAD) is a major cause of morbidity and mortality; timely diagnosis and appropriate therapy is of paramount importance to improve clinical outcomes. Though there are major risk factors for CAD but sometimes it does not correlate with ACS. So, search for new risk factor is necessary for better management of CAD specially STEMI. Aim: To see the association between ABO blood group and severity of CAD in patients with STEMI. Methods: This study was done during the period of January 2016 to June 2016 with STEMI at National Institute of Cardiovascular diseases, Dhaka, Bangladesh. 100 patients were grouped in I and II where group-I having 50 patients of non-O blood group and group-II having 50 patients of O blood group. After CAG all reports were analyzed by two experts and SYNTAX score were calculated and data were analyzed by SPSS. Results: Baseline characteristics (100 patients) were well matched between the groups. Low SYNTAX score (d”22) was 16% and 56%; intermediate score (23-32) was 40% and 36% and high score (>32) was 44% and 8% in group- I and group-II respectively. These indicate that patients of non-O blood group have high SYNTAX score that is more severe CAD. Univariate and multivariate regression analysis showed that non-O blood group is an independent risk factor for CAD. So easily available ABO blood grouping can be helpful to determine the severity of CAD in patients with STEMI. Bangladesh Heart Journal 2022; 37(2): 107-115
{"title":"ABO Blood Group and Severity of Coronary Artery Disease Assessed by Syntax Score in Patients with Acute Myocardial","authors":"Md Zillur Rahman, S. Chowdhury, I. J. Shimu, P. Biswas, A. Towab, A. K. Das, Khurshadul Alam, A. Mahmud, Khondoker Al Monsur Helal","doi":"10.3329/bhj.v37i2.63134","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63134","url":null,"abstract":"Introduction: As coronary artery disease (CAD) is a major cause of morbidity and mortality; timely diagnosis and appropriate therapy is of paramount importance to improve clinical outcomes. Though there are major risk factors for CAD but sometimes it does not correlate with ACS. So, search for new risk factor is necessary for better management of CAD specially STEMI. Aim: To see the association between ABO blood group and severity of CAD in patients with STEMI.\u0000Methods: This study was done during the period of January 2016 to June 2016 with STEMI at National Institute of Cardiovascular diseases, Dhaka, Bangladesh. 100 patients were grouped in I and II where group-I having 50 patients of non-O blood group and group-II having 50 patients of O blood group. After CAG all reports were analyzed by two experts and SYNTAX score were calculated and data were analyzed by SPSS.\u0000Results: Baseline characteristics (100 patients) were well matched between the groups. Low SYNTAX score (d”22) was 16% and 56%; intermediate score (23-32) was 40% and 36% and high score (>32) was 44% and 8% in group- I and group-II respectively. These indicate that patients of non-O blood group have high SYNTAX score that is more severe CAD. Univariate and multivariate regression analysis showed that non-O blood group is an independent risk factor for CAD. So easily available ABO blood grouping can be helpful to determine the severity of CAD in patients with STEMI.\u0000Bangladesh Heart Journal 2022; 37(2): 107-115","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130251163","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}
Khandaker Abu Rubaiyat, A. Chowdhury, Mohsin Ahmed, Md Gaffar Amin, Atm Mahfuzul Hoque, K. Islam, Chowdhury Md Kudrat E Khuda, Abm Imam Hosen, M. Haque
Objective: Vitamin D deficiency is emerging as a new risk factor for various cardiovascular events. Several studies have been done to find out association of vitamin D level with CAD with varying Results. Very few studies, however, have investigated the association between serum vitamin D levels and clinical outcomes in ACS patients thus far. The Objective of this study was to assess the association between serum vitamin D levels and in-hospital complications of AMI patients in Department of Cardiology, Dhaka Medical College Hospital (DMCH), Dhaka. Methods: This was a cross-sectional observational study. We measured serum vitamin D level in AMI (STEMI and NSTEMI) patients (n=198) admitted in Department of Cardiology, DMCH. Patients with normal vitamin D level (e”30 ng/ml) were considered as Group I and patients with low serum vitamin D level (<30 ng/ml) were considered as Group II; and in-hospital complications were evaluated. Results: The study showed that 51% of study subjects of AMI had in-hospital complications; 71.1% patients with low vitamin D level had adverse in-hospital outcome whereas 14.3% patients with normal vitamin D level had AMI complications which was statistically significant (p<0.001). Heart failure and arrhythmias were the most frequently observed complications. The Results of the study demonstrates that the association between low vitamin D level and in-hospital complications after AMI remains statistically significant (p<0.001). Conclusions: Low serum vitamin D level is independently associated with a higher frequency of several in-hospital adverse clinical events including mortality after acute myocardial infarction (STEMI and NSTEMI). Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated. Bangladesh Heart Journal 2022; 37(2): 89-98
{"title":"Association of Serum Vitamin D level with in-hospital Outcome in Patients with Acute Myocardial infarction","authors":"Khandaker Abu Rubaiyat, A. Chowdhury, Mohsin Ahmed, Md Gaffar Amin, Atm Mahfuzul Hoque, K. Islam, Chowdhury Md Kudrat E Khuda, Abm Imam Hosen, M. Haque","doi":"10.3329/bhj.v37i2.63132","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63132","url":null,"abstract":"Objective: Vitamin D deficiency is emerging as a new risk factor for various cardiovascular events. Several studies have been done to find out association of vitamin D level with CAD with varying Results. Very few studies, however, have investigated the association between serum vitamin D levels and clinical outcomes in ACS patients thus far. The Objective of this study was to assess the association between serum vitamin D levels and in-hospital complications of AMI patients in Department of Cardiology, Dhaka Medical College Hospital (DMCH), Dhaka.\u0000Methods: This was a cross-sectional observational study. We measured serum vitamin D level in AMI (STEMI and NSTEMI) patients (n=198) admitted in Department of Cardiology, DMCH. Patients with normal vitamin D level (e”30 ng/ml) were considered as Group I and patients with low serum vitamin D level (<30 ng/ml) were considered as Group II; and in-hospital complications were evaluated.\u0000Results: The study showed that 51% of study subjects of AMI had in-hospital complications; 71.1% patients with low vitamin D level had adverse in-hospital outcome whereas 14.3% patients with normal vitamin D level had AMI complications which was statistically significant (p<0.001). Heart failure and arrhythmias were the most frequently observed complications. The Results of the study demonstrates that the association between low vitamin D level and in-hospital complications after AMI remains statistically significant (p<0.001).\u0000Conclusions: Low serum vitamin D level is independently associated with a higher frequency of several in-hospital adverse clinical events including mortality after acute myocardial infarction (STEMI and NSTEMI). Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated.\u0000Bangladesh Heart Journal 2022; 37(2): 89-98","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"354 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134087462","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. Khanom, Md Akhtarul Islam Chowdhury, Md. Amir Hossain
Objective: The general Objective of this pilot study was to unveil the findings of blood pressure screening program at a Non-Government Tertiary Care Hospital in Bangladesh. The specific Objectives were to find out socio-demographic profile of the participants, to categorize the blood pressure readings according to the defined variables, to select among the participants who would require intervention and to encourage people in order to adopt healthy diet as well as lifestyle behaviors. Methods: It was a cross-sectional study conducted at outpatient department of Chattagarm International Medical College Hospital (CIMCH), Shamsherpara, Chattogram from 16.05.2022 to 19.05.2022. The study participants were volunteers of 18 years or older who wished to get the free blood pressure checkup on observation of world hypertension day at CIMCH outpatient premises. Results: Altogether 232 patients participated in the blood pressure screening program, 10.7% were pre-hypertensives and 11.2% had high blood pressure; none of them visited any physician previously for checking blood pressure. Pre-existing hypertensives constituted 16.4% of total participants; nearly half of them had good compliance to medication or life style modification. The maximum (26 out of 51) ‘pre-hypertensive’ and ‘high blood pressure’ were in the 30-49 years age group. Conclusion: Community based blood pressure screening and patient education covering a wider area can be an effective approach to reduce the burden of hypertension as well its conquences on the patient, family, society, nation, and the globe. The Results of the current pilot study might provide preliminary data and encourage for future prospective studies. Bangladesh Heart Journal 2022; 37(2): 84-88
{"title":"Blood Pressure Screening at a Non-Government Tertiary Care Hospital in Bangladesh: A Pilot Study","authors":"M. Khanom, Md Akhtarul Islam Chowdhury, Md. Amir Hossain","doi":"10.3329/bhj.v37i2.63131","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63131","url":null,"abstract":"Objective: The general Objective of this pilot study was to unveil the findings of blood pressure screening program at a Non-Government Tertiary Care Hospital in Bangladesh. The specific Objectives were to find out socio-demographic profile of the participants, to categorize the blood pressure readings according to the defined variables, to select among the participants who would require intervention and to encourage people in order to adopt healthy diet as well as lifestyle behaviors.\u0000Methods: It was a cross-sectional study conducted at outpatient department of Chattagarm International Medical College Hospital (CIMCH), Shamsherpara, Chattogram from 16.05.2022 to 19.05.2022. The study participants were volunteers of 18 years or older who wished to get the free blood pressure checkup on observation of world hypertension day at CIMCH outpatient premises.\u0000Results: Altogether 232 patients participated in the blood pressure screening program, 10.7% were pre-hypertensives and 11.2% had high blood pressure; none of them visited any physician previously for checking blood pressure. Pre-existing hypertensives constituted 16.4% of total participants; nearly half of them had good compliance to medication or life style modification. The maximum (26 out of 51) ‘pre-hypertensive’ and ‘high blood pressure’ were in the 30-49 years age group.\u0000Conclusion: Community based blood pressure screening and patient education covering a wider area can be an effective approach to reduce the burden of hypertension as well its conquences on the patient, family, society, nation, and the globe. The Results of the current pilot study might provide preliminary data and encourage for future prospective studies.\u0000Bangladesh Heart Journal 2022; 37(2): 84-88","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132067937","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}
P. Bala, A. Saxena, A. Jaswal, Amitesh Chakravarty, Ravikanth Telikicherla, Nighat Islam, M. Khan
Atypical atrial flutter has become amenable to catheter ablation with remarkable improvement in the acute and long-term efficacy of this therapy for this macro reentrant atrial arrhythmia. Here it was described a case of atypical atrial flutter which arises from left atrium and demonstrates the importance of a systematic approach to mapping and ablating atypical atrial flutter to prevent a recurrence of symptomatic arrhythmia. We also highlighted importance of 3D mapping which is a key tool for analysis and successful ablation. Bangladesh Heart Journal 2022; 37(2): 139-142
{"title":"3D Mapping and Ablation of Left Sided Atypical Atrial Flutter","authors":"P. Bala, A. Saxena, A. Jaswal, Amitesh Chakravarty, Ravikanth Telikicherla, Nighat Islam, M. Khan","doi":"10.3329/bhj.v37i2.63138","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63138","url":null,"abstract":"Atypical atrial flutter has become amenable to catheter ablation with remarkable improvement in the acute and long-term efficacy of this therapy for this macro reentrant atrial arrhythmia. Here it was described a case of atypical atrial flutter which arises from left atrium and demonstrates the importance of a systematic approach to mapping and ablating atypical atrial flutter to prevent a recurrence of symptomatic arrhythmia. We also highlighted importance of 3D mapping which is a key tool for analysis and successful ablation.\u0000Bangladesh Heart Journal 2022; 37(2): 139-142","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123938911","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}
Sultan Sarwar Parvez, S. Gupta, Reazul Haque, J. Uddin
Lutembacher’s syndrome is a rare clinical condition presenting with a combination of congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Lutembacher’s syndrome is more prevalent in developing countries and its prevalence depends on the prevalence of rheumatic fever in that geographical area. The syndrome can present at any age but is usually more commonly observed in young female adults. Echocardiography remains the gold standard for diagnosis and evaluation of Lutembacher’s syndrome (LS). Now a days many treatment options are available for LS – either percutaneous intervention or surgical correction. But pericardial patch closure of atrial septal defect and prosthetic mitral valve replacement is the treatment of choice for Lutembacher’s syndrome. Bangladesh Heart Journal 2022; 37(2): 143-147
{"title":"Lutembacher’s Syndrome in a young female treated Surgically: A Case Report","authors":"Sultan Sarwar Parvez, S. Gupta, Reazul Haque, J. Uddin","doi":"10.3329/bhj.v37i2.63139","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63139","url":null,"abstract":"Lutembacher’s syndrome is a rare clinical condition presenting with a combination of congenital atrial septal defect (ASD) and acquired mitral stenosis (MS). Lutembacher’s syndrome is more prevalent in developing countries and its prevalence depends on the prevalence of rheumatic fever in that geographical area. The syndrome can present at any age but is usually more commonly observed in young female adults. Echocardiography remains the gold standard for diagnosis and evaluation of Lutembacher’s syndrome (LS). Now a days many treatment options are available for LS – either percutaneous intervention or surgical correction. But pericardial patch closure of atrial septal defect and prosthetic mitral valve replacement is the treatment of choice for Lutembacher’s syndrome.\u0000Bangladesh Heart Journal 2022; 37(2): 143-147","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122169659","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. Shahadat Hossain, A. Jamil, A. Sarker, S. Haque, M. Ahsan, MD Ali, I. Alam
Background: This cross sectional observational study was carried out with an aim to find out in-hospital outcome in patients with ST-T changes in non-STsegment elevation myocardial infarction (NSTEMI). Methods: This cross sectional observational study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2014 to December 2014. A total of 120 patients with NSTEMI were the study population. Patients were divided into two groups on the basis of ST-T changes, 60 patients with ST-T changes were in group I and 60 patients without ST-T changes were in group II. Result: In this study, the mean age was 54.2 ±14.2 years. Male female ratio was 2.75:1 among the study population. There was no statistically significant difference in mean BMI among the two groups. Smoking was the most common risk factor present (47.5%). Smoking was found significantly more in Group I than patients of group II (p=0.02). Serum troponin I was found significantly raised in group I (42.8±5.5 vs 10.5±8.3, p=0.002). The mean left ventricular ejection fraction (LVEF) of patients in group I was significantly lower than group II (52.1±9.1% vs 61.7±6.9%. p=0.001). Adverse in-hospital outcome was significantly more in group I than group II (48.3% vs 26.7%, p=0.01). Recurrent angina pectoris, STEMI, significant arrhythmia, acute LVF and cardiogenic shock were also more in group I than in group II. In-hospital mortality was noted in group I patients with both ST segment depression and T wave inversion (6.7%). Emergency revascularization was done more commonly in patients of group I (6.7%). The mean duration of hospital stay was statistically significant between the groups (6.24±2.58 vs 4.44±1.71 days. p<0.05)). Multivariate logistic regression analysis revealed that ST-T changes are an independent predictor for developing adverse inhospital outcome in patients with non-ST-segment elevation myocardial infarction. Conclusion: The ST-segment depression and T-wave inversion on admission ECG are important predictors of outcome in patients with NSTEMI. The ST-segment depression on admission ECG of patients with NSTEMI is associated with higher adverse in hospital outcome and mortality. Bangladesh Heart Journal 2022; 37(2): 99-106
背景:本横断面观察研究旨在了解ST-T改变的非st段抬高型心肌梗死(NSTEMI)患者的住院预后。方法:本横断面观察研究于2014年1月- 2014年12月在孟加拉国达卡国立心血管疾病研究所心内科进行。共有120名NSTEMI患者作为研究人群。根据ST-T改变情况将患者分为两组，有ST-T改变的患者60例为I组，无ST-T改变的患者60例为II组。结果:本组患者平均年龄54.2±14.2岁。研究人群的男女比例为2.75:1。两组患者的平均BMI差异无统计学意义。吸烟是最常见的危险因素(47.5%)。I组吸烟明显多于II组(p=0.02)。I组血清肌钙蛋白I显著升高(42.8±5.5 vs 10.5±8.3,p=0.002)。I组患者平均左室射血分数(LVEF)明显低于II组(52.1±9.1% vs 61.7±6.9%)。p = 0.001)。不良住院结局I组明显多于II组(48.3% vs 26.7%， p=0.01)。复发性心绞痛、STEMI、明显心律失常、急性LVF和心源性休克发生率均高于II组。第一组ST段下陷和T波倒置患者的住院死亡率为6.7%。急诊血运重建术在I组患者中更为常见(6.7%)。两组患者平均住院时间(6.24±2.58天和4.44±1.71天)差异有统计学意义。p < 0.05)。多因素logistic回归分析显示ST-T变化是非st段抬高型心肌梗死患者发生不良住院预后的独立预测因子。结论:入院心电图st段下降和t波反转是预测非stemi患者预后的重要指标。非stemi患者入院心电图st段压低与较高的不良住院预后和死亡率相关。孟加拉国心脏杂志2022;37 (2): 99 - 106
{"title":"In-Hospital Outcome of Patients with ST - T Changes in Non ST Segment Elevation Myocardial Infarction","authors":"Md. Shahadat Hossain, A. Jamil, A. Sarker, S. Haque, M. Ahsan, MD Ali, I. Alam","doi":"10.3329/bhj.v37i2.63133","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63133","url":null,"abstract":"Background: This cross sectional observational study was carried out with an aim to find out in-hospital outcome in patients with ST-T changes in non-STsegment elevation myocardial infarction (NSTEMI).\u0000Methods: This cross sectional observational study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2014 to December 2014. A total of 120 patients with NSTEMI were the study population. Patients were divided into two groups on the basis of ST-T changes, 60 patients with ST-T changes were in group I and 60 patients without ST-T changes were in group II.\u0000Result: In this study, the mean age was 54.2 ±14.2 years. Male female ratio was 2.75:1 among the study population. There was no statistically significant difference in mean BMI among the two groups. Smoking was the most common risk factor present (47.5%). Smoking was found significantly more in Group I than patients of group II (p=0.02). Serum troponin I was found significantly raised in group I (42.8±5.5 vs 10.5±8.3, p=0.002). The mean left ventricular ejection fraction (LVEF) of patients in group I was significantly lower than group II (52.1±9.1% vs 61.7±6.9%. p=0.001). Adverse in-hospital outcome was significantly more in group I than group II (48.3% vs 26.7%, p=0.01). Recurrent angina pectoris, STEMI, significant arrhythmia, acute LVF and cardiogenic shock were also more in group I than in group II. In-hospital mortality was noted in group I patients with both ST segment depression and T wave inversion (6.7%). Emergency revascularization was done more commonly in patients of group I (6.7%). The mean duration of hospital stay was statistically significant between the groups (6.24±2.58 vs 4.44±1.71 days. p<0.05)). Multivariate logistic regression analysis revealed that ST-T changes are an independent predictor for developing adverse inhospital outcome in patients with non-ST-segment elevation myocardial infarction.\u0000Conclusion: The ST-segment depression and T-wave inversion on admission ECG are important predictors of outcome in patients with NSTEMI. The ST-segment depression on admission ECG of patients with NSTEMI is associated with higher adverse in hospital outcome and mortality.\u0000Bangladesh Heart Journal 2022; 37(2): 99-106","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122987062","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. Haque, M. Rashid, Md. Zulfikar Ali, Iftekhar Alam, Md Sukur Ahmed, A. Mamun, T. C. Shil, Golam Rahman Mallick, M. Khan, T. Ghosh, Zahidul Islam Khan, Shahriar Azad, D. Halder, P. Biswas, A. Nobi
Background: Obesity is a proven independent risk factor for coronary artery disease. There are different Methods for evaluation of obesity. The aim of this study is to evaluate the association between waist hip ratio and the severity of CAD in non-ST-segment elevation myocardial infarction patients. Methods: This cross-sectional observational study was done at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total of 100 patients with NSTEMI who underwent coronary angiogram during the indexed hospitalization period were included in this study. On the basis of WHR, study patients were divided into two groups 50 patients of NSTEMI with normal WHR (Male <0.90, Female <0.80) were assigned as group I and 50 patients of NSTEMI with increased WHR (Male ³0.90, Female ³0.80) were assigned as group II. Results: The mean age of patients was 49.6±7.9 years and 52.3±8.7 years in Group I and Group II respectively with a male predominance in both the groups. No significant difference was found in between two groups in terms of demographic characteristics and traditional risk factors for CAD. Different parameters of angiographic severity of CAD were significantly higher in patients with increased WHR. Patients with non critical CAD (14% vs 0%, P = 0.02) and single vessel disease (58% vs 24%, P = 0.005) were more frequent in Group I, on the contrary double vessel disease (24% vs. 56%, P = 0.001) and triple vessel disease (4% vs. 20%, P = 0.03) were significantly more frequent in patients of Group II. Patients with moderate to severe CAD (Gensini score ³36) were found more in Group II than that of in Group I (24% vs. 76%, P <0.001) and there was statistically significant higher Gensini score was found in Group II (21.96±19.72 vs. 44.18±28.91, P <0.001). Significant positive correlation was found in between WHR and coronary artery disease severity measured by vessel score (r = 0.41, P < 0.001) and Gensini score (r = 0.31, P< 0.001). Multivariate regression analysis yielded that the risk of having significant CAD are 3.45 times more in patients with increased WHR than those of normal WHR (95% CI: 1.229-12.979, P = 0.01). Conclusion: Abdominal obesity, as evidenced by increased WHR, may be considered as a predictor of the severity of CAD in patients with acute NSTEMI. Bangladesh Heart Journal 2022; 37(2): 122-129
{"title":"Association of Waist and Hip Ratio with the Angiographic Severity of Coronary Artery Disease in Patients with Non ST Segment Elevation Myocardial Infarction","authors":"M. Haque, M. Rashid, Md. Zulfikar Ali, Iftekhar Alam, Md Sukur Ahmed, A. Mamun, T. C. Shil, Golam Rahman Mallick, M. Khan, T. Ghosh, Zahidul Islam Khan, Shahriar Azad, D. Halder, P. Biswas, A. Nobi","doi":"10.3329/bhj.v37i2.63136","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63136","url":null,"abstract":"Background: Obesity is a proven independent risk factor for coronary artery disease. There are different Methods for evaluation of obesity. The aim of this study is to evaluate the association between waist hip ratio and the severity of CAD in non-ST-segment elevation myocardial infarction patients.\u0000Methods: This cross-sectional observational study was done at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total of 100 patients with NSTEMI who underwent coronary angiogram during the indexed hospitalization period were included in this study. On the basis of WHR, study patients were divided into two groups 50 patients of NSTEMI with normal WHR (Male <0.90, Female <0.80) were assigned as group I and 50 patients of NSTEMI with increased WHR (Male ³0.90, Female ³0.80) were assigned as group II.\u0000Results: The mean age of patients was 49.6±7.9 years and 52.3±8.7 years in Group I and Group II respectively with a male predominance in both the groups. No significant difference was found in between two groups in terms of demographic characteristics and traditional risk factors for CAD. Different parameters of angiographic severity of CAD were significantly higher in patients with increased WHR. Patients with non critical CAD (14% vs 0%, P = 0.02) and single vessel disease (58% vs 24%, P = 0.005) were more frequent in Group I, on the contrary double vessel disease (24% vs. 56%, P = 0.001) and triple vessel disease (4% vs. 20%, P = 0.03) were significantly more frequent in patients of Group II. Patients with moderate to severe CAD (Gensini score ³36) were found more in Group II than that of in Group I (24% vs. 76%, P <0.001) and there was statistically significant higher Gensini score was found in Group II (21.96±19.72 vs. 44.18±28.91, P <0.001). Significant positive correlation was found in between WHR and coronary artery disease severity measured by vessel score (r = 0.41, P < 0.001) and Gensini score (r = 0.31, P< 0.001). Multivariate regression analysis yielded that the risk of having significant CAD are 3.45 times more in patients with increased WHR than those of normal WHR (95% CI: 1.229-12.979, P = 0.01).\u0000Conclusion: Abdominal obesity, as evidenced by increased WHR, may be considered as a predictor of the severity of CAD in patients with acute NSTEMI.\u0000Bangladesh Heart Journal 2022; 37(2): 122-129","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133331744","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. Badiuzzaman, Afk Ahmed, Mohammad Refatul Islam, Md Durul Hoda, Abdur Rashid, F. Ahmed, Iftekhar Alam
Background: Inferior wall acute myocardial infarction accounts for 40 to 50% of all acute STEMI. Patients of acute inferior myocardial infarction with ST depression in lateral leads often have greater incidence of triple vessel disease and proximal RCA lesion but in case of patients of acute inferior myocardial infarction with ST depression in precordial leads (leads V1 to V4), is a subject of determination whether it is associated with more sever coronary artery disease. The aim of this study is to determine the association of sum of ST depression in precordial leads with the probability of concomitant severity of coronary artery disease in patients with acute inferior STEMI. Methods: this cross sectional observational study was done at National institute of cardiovascular diseases (NICVD), Dhaka, Bangladesh. Total 90 patients of acute inferior myocardial infarction with precordial lead ST depression admitted at CCU within 12 hours of onset of chest pain were the study population. They were divided in two groups on the basis of sum of ST depression in precordial leads (Sum of ST depression d”4mm and >4mm), 36 patients in group I and 54 patients in group II. Coronary angiography was performed during the index hospitalization period. Gensini score and Reardon score were measured. Results: Overwhelming majority of the patients was male (83.3% and 90.7%) with mean age of 51.0±9.7 and 51.0±9.9 years in group I and II respectively. Smoking, hypertension and diabetes mellitus were the most frequent risk factors in both groups. Serum troponin level was significantly high in group II (6.2±2.2 vs. 13.6±17.7, p <0.05). Sum of ST depression in precordial leads was 2.84±0.66 and 7.53±3.51 in group I and group II respectively, and was statistically significant. Consideration of mean of ST depression in individual leads shows significantly higher mean in leads V2, V3 and V4 among group II patients. SVD was more frequent in group I but group II patients had higher statistically significant incidence of DVD and TVD. Gensini score (20.26±13.0 vs. 36.98±16.9) and Reardon score (4.63±2.2 vs. 6.83±2.2) was high in group II patients. Positive correlation had been depicted between summation value of ST segment depression with that of Gensini score & Reardon score (Gensini score r=0.61 and Reardon score r= 0.52). Conclusion: Involvement Triple vessel and double vessel disease was remarkably higher with increasing sum of ST segment depression in precordial leads. The severity of ST segment depression in terms of summation of ST depression in leads V1 to V4 is directly proportional to the extent and severity of coronary artery disease. Bangladesh Heart Journal 2022; 37(2): 116-121
{"title":"Correlation of Sum of ST Segment Depression in Leads V1 to V4 in Acute Inferior Myocardial Infarction with Angiographic Severity of Coronary Artery Disease","authors":"M. Badiuzzaman, Afk Ahmed, Mohammad Refatul Islam, Md Durul Hoda, Abdur Rashid, F. Ahmed, Iftekhar Alam","doi":"10.3329/bhj.v37i2.63135","DOIUrl":"https://doi.org/10.3329/bhj.v37i2.63135","url":null,"abstract":"Background: Inferior wall acute myocardial infarction accounts for 40 to 50% of all acute STEMI. Patients of acute inferior myocardial infarction with ST depression in lateral leads often have greater incidence of triple vessel disease and proximal RCA lesion but in case of patients of acute inferior myocardial infarction with ST depression in precordial leads (leads V1 to V4), is a subject of determination whether it is associated with more sever coronary artery disease. The aim of this study is to determine the association of sum of ST depression in precordial leads with the probability of concomitant severity of coronary artery disease in patients with acute inferior STEMI.\u0000Methods: this cross sectional observational study was done at National institute of cardiovascular diseases (NICVD), Dhaka, Bangladesh. Total 90 patients of acute inferior myocardial infarction with precordial lead ST depression admitted at CCU within 12 hours of onset of chest pain were the study population. They were divided in two groups on the basis of sum of ST depression in precordial leads (Sum of ST depression d”4mm and >4mm), 36 patients in group I and 54 patients in group II. Coronary angiography was performed during the index hospitalization period. Gensini score and Reardon score were measured.\u0000Results: Overwhelming majority of the patients was male (83.3% and 90.7%) with mean age of 51.0±9.7 and 51.0±9.9 years in group I and II respectively. Smoking, hypertension and diabetes mellitus were the most frequent risk factors in both groups. Serum troponin level was significantly high in group II (6.2±2.2 vs. 13.6±17.7, p <0.05). Sum of ST depression in precordial leads was 2.84±0.66 and 7.53±3.51 in group I and group II respectively, and was statistically significant. Consideration of mean of ST depression in individual leads shows significantly higher mean in leads V2, V3 and V4 among group II patients. SVD was more frequent in group I but group II patients had higher statistically significant incidence of DVD and TVD. Gensini score (20.26±13.0 vs. 36.98±16.9) and Reardon score (4.63±2.2 vs. 6.83±2.2) was high in group II patients. Positive correlation had been depicted between summation value of ST segment depression with that of Gensini score & Reardon score (Gensini score r=0.61 and Reardon score r= 0.52).\u0000Conclusion: Involvement Triple vessel and double vessel disease was remarkably higher with increasing sum of ST segment depression in precordial leads. The severity of ST segment depression in terms of summation of ST depression in leads V1 to V4 is directly proportional to the extent and severity of coronary artery disease.\u0000Bangladesh Heart Journal 2022; 37(2): 116-121","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128508663","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：