Pub Date : 2024-07-24DOI: 10.9734/ca/2024/v13i3428
Hager Ibrahem Allam, Asmaa Mostafa Badrawy, Ahmed Abd Elmoneum Mohamed, Mahmoud Shawky Abd Elmoneum
Background: The utilization of two-dimensional speckle-tracking echocardiography (2-D STE) serves as a precise measurable technique for conducting an assessment of both global and localized cardiac performance, exhibiting remarkable sensitivity. Its utility is particularly noteworthy in the early identification of cardiac impairments that are not clinically evident. This study’s objective was to investigate the effectiveness of STE in identifying latent left ventricular dysfunction among individuals who have recuperated from COVID-19. Methods: This study was conducted at a single center; this analytical cross-sectional analysis involved 100 individuals over the age of 18. The study comprised two cohorts: one with 50 post COVID-19 patients, confirmed through a positive PCR test within a month of diagnosis, and a control group of 50 healthy subjects be compatible for age, sex, and risk factors. Subsequently, the post COVID-19 patients were stratified based on high-sensitivity troponin levels into two subgroups: Group I included those exhibiting signs of myocardial damage, while Group II consisted of patients showing no evidence of myocardial injury. Results: Elderly individuals, a greater prevalence of hypertension (HTN), raised levels of D-dimer and, serum C-reactive protein (CRP) along with increased Left ventricular end-diastolic volume (LVEDV) and diminished Left ventricular global longitudinal strain (LVGLS) over a one-month observation period, were all significantly linked to myocardial injury, as indicated by a p-value < 0.05. The LVGLS was a reliable indicator of cardiac injuries in COVID-19 survivors, with an AUC of 0.947 and a CI ranging from 0.886 to 1.00 (P < 0.001), particularly at a threshold of ≤ -20%, where it achieved 87.2% sensitivity and 100% specificity. Approximately 35 patients exhibited an LVGLS below this threshold. Furthermore, D-dimer and CRP levels post COVID-19 were notably elevated in those with cardiac injuries in comparison with those not, a difference that was statistically significant (P < 0.05). Furthermore, during the follow-up after one month period, post COVID-19 CRP levels, LVEDV, and LVGLS remained significantly higher in patients with myocardial injury in comparison with those didn’t have myocardial injury (p < 0.05). Conclusions: LV GLS is acknowledged as a noteworthy, autonomous predictor of outcome for myocardial injury in individuals diagnosed with COVID-19. This metric offers preliminary insights into the infection’s severity, potentially aiding in the early intervention and management strategies for affected patients.
{"title":"Role of Speckle Tracking Echocardiography in the Assessment of Subclinical Left Ventricular Dysfunction in Post COVID-19 Patients","authors":"Hager Ibrahem Allam, Asmaa Mostafa Badrawy, Ahmed Abd Elmoneum Mohamed, Mahmoud Shawky Abd Elmoneum","doi":"10.9734/ca/2024/v13i3428","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3428","url":null,"abstract":"Background: The utilization of two-dimensional speckle-tracking echocardiography (2-D STE) serves as a precise measurable technique for conducting an assessment of both global and localized cardiac performance, exhibiting remarkable sensitivity. Its utility is particularly noteworthy in the early identification of cardiac impairments that are not clinically evident. This study’s objective was to investigate the effectiveness of STE in identifying latent left ventricular dysfunction among individuals who have recuperated from COVID-19.\u0000Methods: This study was conducted at a single center; this analytical cross-sectional analysis involved 100 individuals over the age of 18. The study comprised two cohorts: one with 50 post COVID-19 patients, confirmed through a positive PCR test within a month of diagnosis, and a control group of 50 healthy subjects be compatible for age, sex, and risk factors. Subsequently, the post COVID-19 patients were stratified based on high-sensitivity troponin levels into two subgroups: Group I included those exhibiting signs of myocardial damage, while Group II consisted of patients showing no evidence of myocardial injury.\u0000Results: Elderly individuals, a greater prevalence of hypertension (HTN), raised levels of D-dimer and, serum C-reactive protein (CRP) along with increased Left ventricular end-diastolic volume (LVEDV) and diminished Left ventricular global longitudinal strain (LVGLS) over a one-month observation period, were all significantly linked to myocardial injury, as indicated by a p-value < 0.05. The LVGLS was a reliable indicator of cardiac injuries in COVID-19 survivors, with an AUC of 0.947 and a CI ranging from 0.886 to 1.00 (P < 0.001), particularly at a threshold of ≤ -20%, where it achieved 87.2% sensitivity and 100% specificity. Approximately 35 patients exhibited an LVGLS below this threshold. Furthermore, D-dimer and CRP levels post COVID-19 were notably elevated in those with cardiac injuries in comparison with those not, a difference that was statistically significant (P < 0.05). Furthermore, during the follow-up after one month period, post COVID-19 CRP levels, LVEDV, and LVGLS remained significantly higher in patients with myocardial injury in comparison with those didn’t have myocardial injury (p < 0.05).\u0000Conclusions: LV GLS is acknowledged as a noteworthy, autonomous predictor of outcome for myocardial injury in individuals diagnosed with COVID-19. This metric offers preliminary insights into the infection’s severity, potentially aiding in the early intervention and management strategies for affected patients.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"61 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806842","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}
Pub Date : 2024-07-01DOI: 10.9734/ca/2024/v13i3427
Asu-Ma Kamal, Maliha Kamal, Sheam Ahmed, Auni Kamal, Iftequar Alam, Mahmood Hasan Khan, S. M. Z. Haque, Ruhul Amin, Mohamed Naser Thabet Ali
Introduction: Platelet Lymphocyte ratio (PLR) has been found to be a good predictor of future adverse cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Aim: Investigation was done in the aim to detect the role of Platelet Lymphocyte ratio (PLR) in predicting in-hospital adverse cardiac events in patients with STEMI thrombolysed with streptokinase in a tertiary care hospital. Methods: This cross sectional descriptive study carried out in the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh for fifteen-month duration from January, 2018 to March, 2019, in STEMI patients, who were thrombolysed with inj. Streptokinase (STK) had blood samples at admission, analyzed complete blood counts for PLR calculation. They were grouped into two, low and high PLR, taking 150 as cut-off. Chi square test was used to compare rate of adverse events and death in hospital stay. Logistic regression analysis was used to estimate predictive ability of PLR for in-hospital cardiac events. Results: A total of 79 patients among 217 patients had complications. Patients in high PLR group had higher rate of complications (63.6% vs. 21.4%, p <0.001) in hospital than those in low PLR group. Arrhythmias (13.0% vs. 5.0%, p <0.036), Heart failure (45.5% vs. 15.0%, p=0.001), Cardiogenic shock (10.4% vs.3.6%, p <0.001), Death (9.1% vs. 6.4%, p=0.473), occurred more in high PLR group. Mean PLR was significantly different between Group-I and Group-II (96.21±27.79 vs. 233.21±88.20, p<0.001). Multivariate regression analysis showed PLR an independent predictor of in-hospital adverse cardiac events (at 10% level of significance, p = 0.001). Conclusion: High admission PLR is an independent predictor for in-hospital adverse cardiac events in patients hospitalized for STEMI thrombolysed with streptokinase.
{"title":"The Association between Platelet Lymphocyte Ratio and In-Hospital Outcomes in Patients with First Attack of Acute ST-elevation Myocardial Infraction following Thrombolysis with Streptokinase in a Tertiary Care Hospital","authors":"Asu-Ma Kamal, Maliha Kamal, Sheam Ahmed, Auni Kamal, Iftequar Alam, Mahmood Hasan Khan, S. M. Z. Haque, Ruhul Amin, Mohamed Naser Thabet Ali","doi":"10.9734/ca/2024/v13i3427","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3427","url":null,"abstract":"Introduction: Platelet Lymphocyte ratio (PLR) has been found to be a good predictor of future adverse cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI). \u0000Aim: Investigation was done in the aim to detect the role of Platelet Lymphocyte ratio (PLR) in predicting in-hospital adverse cardiac events in patients with STEMI thrombolysed with streptokinase in a tertiary care hospital. \u0000Methods: This cross sectional descriptive study carried out in the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh for fifteen-month duration from January, 2018 to March, 2019, in STEMI patients, who were thrombolysed with inj. Streptokinase (STK) had blood samples at admission, analyzed complete blood counts for PLR calculation. They were grouped into two, low and high PLR, taking 150 as cut-off. Chi square test was used to compare rate of adverse events and death in hospital stay. Logistic regression analysis was used to estimate predictive ability of PLR for in-hospital cardiac events. \u0000Results: A total of 79 patients among 217 patients had complications. Patients in high PLR group had higher rate of complications (63.6% vs. 21.4%, p <0.001) in hospital than those in low PLR group. Arrhythmias (13.0% vs. 5.0%, p <0.036), Heart failure (45.5% vs. 15.0%, p=0.001), Cardiogenic shock (10.4% vs.3.6%, p <0.001), Death (9.1% vs. 6.4%, p=0.473), occurred more in high PLR group. Mean PLR was significantly different between Group-I and Group-II (96.21±27.79 vs. 233.21±88.20, p<0.001). Multivariate regression analysis showed PLR an independent predictor of in-hospital adverse cardiac events (at 10% level of significance, p = 0.001). \u0000Conclusion: High admission PLR is an independent predictor for in-hospital adverse cardiac events in patients hospitalized for STEMI thrombolysed with streptokinase.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"86 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697263","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}
Pub Date : 2024-06-13DOI: 10.9734/ca/2024/v13i3422
Udoka Charity Ken-Eze, Ozojide Kingsley Onyekachukwu, Eberechukwu G Anamazobi, O. Okobi, Adedoyin Olawoye, Ubogun Ogheneakpobor Efe
Background: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality among adults with diabetes. Understanding the prevalence and trends in hospitalizations for CVD complications in this population is crucial for informing healthcare strategies and interventions. Aim: This study aimed to analyze the prevalence and hospitalization rates of CVD complications among adults with diabetes using data from the USDSS database. Methods: This retrospective study analyzed USDSS database data from 2000 to 2020, exploring CVD complications' prevalence and hospitalization patterns in adults with diabetes.The study explored prevalence rates of major CVD complications, including heart disease and stroke, alongside demographic factors like age, gender, race/ethnicity, and education level. Hospitalization rates for ischemic heart disease, heart failure, and stroke were calculated. Temporal trends were analyzed graphically, and statistical tests (chi-square, ANOVA) with a significance level of p<0.05 were conducted. Results: The analysis revealed notable temporal trends in major heart disease prevalence and stroke rates among adults with diabetes. Over the study period, major heart disease incidence increased from 2.7 in 2000 to 4.9 in 2022, with an average of 4.22. Prevalence ranged from its lowest at 18.2% in 2014 to its highest at 23.7% in 2001, with the latest at 17.4% in 2022. Stroke cases rose steadily from 1.1 in 2000 to 2.1 in 2022, with the latest prevalence at 7.4%. Subgroup analysis revealed variations across gender, age, race, and education levels. Hospitalization rates for CVD declined from 78.6 per 1,000 in 2000 to 46 per 1,000 in 2020. Rates for ischemic heart disease decreased from 32.2 per 1,000 to 10.2 per 1,000, heart failure from 20.7 per 1,000 to 15 per 1,000, and stroke from 9.4 per 1,000 to 8.4 per 1,000. Conclusion: This study provides valuable insights into the prevalence and hospitalization trends of cardiovascular disease complications among adults with diabetes in the United States. The findings underscore the importance of targeted interventions to reduce the burden of CVD in this population.
{"title":"Prevalence and Hospitalizations of Cardiovascular Disease Complications in Adults with Diabetes: A Comprehensive USDDS Database Analysis","authors":"Udoka Charity Ken-Eze, Ozojide Kingsley Onyekachukwu, Eberechukwu G Anamazobi, O. Okobi, Adedoyin Olawoye, Ubogun Ogheneakpobor Efe","doi":"10.9734/ca/2024/v13i3422","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3422","url":null,"abstract":"Background: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality among adults with diabetes. Understanding the prevalence and trends in hospitalizations for CVD complications in this population is crucial for informing healthcare strategies and interventions. \u0000Aim: This study aimed to analyze the prevalence and hospitalization rates of CVD complications among adults with diabetes using data from the USDSS database. \u0000Methods: This retrospective study analyzed USDSS database data from 2000 to 2020, exploring CVD complications' prevalence and hospitalization patterns in adults with diabetes.The study explored prevalence rates of major CVD complications, including heart disease and stroke, alongside demographic factors like age, gender, race/ethnicity, and education level. Hospitalization rates for ischemic heart disease, heart failure, and stroke were calculated. Temporal trends were analyzed graphically, and statistical tests (chi-square, ANOVA) with a significance level of p<0.05 were conducted. \u0000Results: The analysis revealed notable temporal trends in major heart disease prevalence and stroke rates among adults with diabetes. Over the study period, major heart disease incidence increased from 2.7 in 2000 to 4.9 in 2022, with an average of 4.22. Prevalence ranged from its lowest at 18.2% in 2014 to its highest at 23.7% in 2001, with the latest at 17.4% in 2022. Stroke cases rose steadily from 1.1 in 2000 to 2.1 in 2022, with the latest prevalence at 7.4%. Subgroup analysis revealed variations across gender, age, race, and education levels. Hospitalization rates for CVD declined from 78.6 per 1,000 in 2000 to 46 per 1,000 in 2020. Rates for ischemic heart disease decreased from 32.2 per 1,000 to 10.2 per 1,000, heart failure from 20.7 per 1,000 to 15 per 1,000, and stroke from 9.4 per 1,000 to 8.4 per 1,000. \u0000Conclusion: This study provides valuable insights into the prevalence and hospitalization trends of cardiovascular disease complications among adults with diabetes in the United States. The findings underscore the importance of targeted interventions to reduce the burden of CVD in this population.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"55 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141345822","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}
Pub Date : 2024-06-12DOI: 10.9734/ca/2024/v13i3420
M. C. Bacharou, B. Ovaga, B. M. Sidi, P. M. Mulendelé, M. Njie, M. Haboub, L. Azzouzi, R. Habbal
Introduction: Rare cardiomyopathy left ventricle non-compaction (LVNC) or excess trabeculation is an unclassified heart disease related to the cessation of the normal process of myocardial development during the first trimester of pregnancy. Familial forms account for approximately half of the cases, and men are the most affected. The usual clinical presentation corresponds to the classic triad, which includes heart failure, arrhythmias, and thromboembolic manifestations. Case Presentation: Here, we describe the case of a 56-year-old man with no pathological history who consulted for dyspnea, and in whom transthoracic echocardiography and magnetic resonance imaging have made it possible to retain the diagnosis of an excess of trabeculations complicated by heart failure and an apical thrombus. Conclusion: LVNC is a rare cardiomyopathy that frequently affects men and is diagnosed using echocardiography and in borderline cases, supplemented by cardiac MRI.
{"title":"Excessive Trabeculation of the Left Ventricle Revealed by de Novo Heart Failure in Adults: A Clinical Case with a Literature Review","authors":"M. C. Bacharou, B. Ovaga, B. M. Sidi, P. M. Mulendelé, M. Njie, M. Haboub, L. Azzouzi, R. Habbal","doi":"10.9734/ca/2024/v13i3420","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3420","url":null,"abstract":"Introduction: Rare cardiomyopathy left ventricle non-compaction (LVNC) or excess trabeculation is an unclassified heart disease related to the cessation of the normal process of myocardial development during the first trimester of pregnancy. Familial forms account for approximately half of the cases, and men are the most affected. The usual clinical presentation corresponds to the classic triad, which includes heart failure, arrhythmias, and thromboembolic manifestations. \u0000Case Presentation: Here, we describe the case of a 56-year-old man with no pathological history who consulted for dyspnea, and in whom transthoracic echocardiography and magnetic resonance imaging have made it possible to retain the diagnosis of an excess of trabeculations complicated by heart failure and an apical thrombus. \u0000Conclusion: LVNC is a rare cardiomyopathy that frequently affects men and is diagnosed using echocardiography and in borderline cases, supplemented by cardiac MRI.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"142 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350892","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}
Pub Date : 2024-06-12DOI: 10.9734/ca/2024/v13i3419
B. Ovaga, IS Alfakihi, H. Charif, B. M. Sidi, P. M. Mulendelé, M. Njie, M. C. Bacharou, J. Moyambi, M. Haboub, L. Azzouzi, A. Drighril, R. Habbal
Background: Stress cardiomyopathy or Tako-Tsubo syndrome is a heart disease which is most likely linked to an excessive discharge of catecholamines triggered by physical or emotional stress responsible for myocardial toxicity. Tako-tsubo constitutes the main differential diagnosis of an acute coronary syndrome. Women are most affected, but recently more and more men are described in the literature. We describe here the case of a 45-year-old smoking man, followed for a manic-depressive illness who consulted for chest pain typical of ACS and in whom coronary angiography, transthoracic echocardiography, ventriculography and imaging cardiac magnetic resonance led to the diagnosis of Tako-Tsubo syndrome.
{"title":"Tako-Tsubo Mimicking a Myocardial Infarction in a Young Man: A Clinical Case with Review of the Literature","authors":"B. Ovaga, IS Alfakihi, H. Charif, B. M. Sidi, P. M. Mulendelé, M. Njie, M. C. Bacharou, J. Moyambi, M. Haboub, L. Azzouzi, A. Drighril, R. Habbal","doi":"10.9734/ca/2024/v13i3419","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3419","url":null,"abstract":"Background: Stress cardiomyopathy or Tako-Tsubo syndrome is a heart disease which is most likely linked to an excessive discharge of catecholamines triggered by physical or emotional stress responsible for myocardial toxicity. Tako-tsubo constitutes the main differential diagnosis of an acute coronary syndrome. Women are most affected, but recently more and more men are described in the literature. \u0000We describe here the case of a 45-year-old smoking man, followed for a manic-depressive illness who consulted for chest pain typical of ACS and in whom coronary angiography, transthoracic echocardiography, ventriculography and imaging cardiac magnetic resonance led to the diagnosis of Tako-Tsubo syndrome.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"136 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141351276","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}
Pub Date : 2024-06-12DOI: 10.9734/ca/2024/v13i3421
Kamal Haless, Eljazouli Ali, Haboub Meriem, Abdenasser Drighil, Habbal Rachida
Background: Our study aimed to evaluate the predictive ability of resting strain to determine the severity of CAD in the absence of impaired LVEF in patients with NSTEMI and unstable angina. Additionally, the study sought to predict culprit and infracted related artery (IRA) using regional strain (SLR). Methods: The study was conducted between January 2023 and May 2023 at the cardiology department of Ibn Rochd Hospital, Morocco. We conducted a comparative analysis involving 30 patients, comprising 23 individuals with NSTEMI and 7 with unstable angina. In all cases, we assessed both GLS and RLS before proceeding to coronary angiography. Subsequently, we categorized the patients into two groups: one consisted of 18 individuals with severe coronary lesions, including left main trunk (LM) and three vessels lesions, while the other group, comprising 12 patients, served as the control group and had non-severe coronary lesions Results: At resting GLS threshold below -16,3 %, despite its subnormal nature, should raise suspicion and suggest severe coronary artery disease. RLS in the "Single-vessel" group was significantly lower in the culprit artery territories, suggesting that RLS may be a better marker for identifying the culprit artery. Both GLS and the visual analysis of segmental kinetics by WMSI (Wall Motion Score Index) at rest, were statistically significant for detecting severe coronary lesions. Conclusion: GLR and SLR are sensitive markers for early detection of myocardial ischemia and predicting its severity. A resting GLR threshold of less than -16.13% could indicate severe CAD with severe tri-truncular or LMT damage, especially when combined with abnormal WMSI scores. These 2D strain parameter changes precede subjective abnormalities in segmental kinetics, which are often considered normal at rest.
{"title":"The Value of 2D Global Longitudinal Strain in Predicting the Severity of Coronary Artery Disease in Patients with NSTEMI and Unstable Angina and Regional Strain Value for Predicting the Culprit Artery","authors":"Kamal Haless, Eljazouli Ali, Haboub Meriem, Abdenasser Drighil, Habbal Rachida","doi":"10.9734/ca/2024/v13i3421","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3421","url":null,"abstract":"Background: Our study aimed to evaluate the predictive ability of resting strain to determine the severity of CAD in the absence of impaired LVEF in patients with NSTEMI and unstable angina. Additionally, the study sought to predict culprit and infracted related artery (IRA) using regional strain (SLR). \u0000Methods: The study was conducted between January 2023 and May 2023 at the cardiology department of Ibn Rochd Hospital, Morocco. We conducted a comparative analysis involving 30 patients, comprising 23 individuals with NSTEMI and 7 with unstable angina. In all cases, we assessed both GLS and RLS before proceeding to coronary angiography. Subsequently, we categorized the patients into two groups: one consisted of 18 individuals with severe coronary lesions, including left main trunk (LM) and three vessels lesions, while the other group, comprising 12 patients, served as the control group and had non-severe coronary lesions \u0000Results: At resting GLS threshold below -16,3 %, despite its subnormal nature, should raise suspicion and suggest severe coronary artery disease. RLS in the \"Single-vessel\" group was significantly lower in the culprit artery territories, suggesting that RLS may be a better marker for identifying the culprit artery. Both GLS and the visual analysis of segmental kinetics by WMSI (Wall Motion Score Index) at rest, were statistically significant for detecting severe coronary lesions. \u0000Conclusion: GLR and SLR are sensitive markers for early detection of myocardial ischemia and predicting its severity. A resting GLR threshold of less than -16.13% could indicate severe CAD with severe tri-truncular or LMT damage, especially when combined with abnormal WMSI scores. These 2D strain parameter changes precede subjective abnormalities in segmental kinetics, which are often considered normal at rest.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"138 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141351020","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}
Pub Date : 2024-06-11DOI: 10.9734/ca/2024/v13i3418
Mina Boutgourine, Assala Cherki, Kawtar Bennajma, Joumana El Massrioui, M. E. Jamili, S. Karimi, M. Hattaoui
Introduction: Infective endocarditis (IE) remains a major health problem with significant morbidity and mortality rates. Despite its serious implications, data on prognostic factors remain scarce. Aim: We aim to determine predictive factors of mortality during infective endocarditis. Methods: We performed a retrospective study including patients admitted to university hospital Mohammed 6 of Marrakech between September 2019 and January 2024 for a confirmed IE based on Dukes modified criteria. Results: Of 43 patients included, 30 were males (69%) and 13 were females (30%). The mean age was 47.4 for men and 49.30 for women. 44.1% of our patients were admitted in heart failure, and 37% presented themselves late to our facility for management. Only 25.58% suffered from kidney failure and 55.8% presented an LV dysfunction. Complications were noted at a rate of 48%. Male’s group had less complication rate with 10% vs 38% in females’ group (p=0.042). And an overall mortality rate was at 34% and there were no significant sex related differences in terms of mortality between the two groups (33% in males vs 38% in females, p = 0.742). The analytical study concluded that heart failure at admission(p<0.001), neurological complications(p=0.024), anemia (p=0.049), kidney failure (p=0.002), prolonged antibiotics (p=0.016), LV dysfunction (p=0.027) and an emergency surgery (p<0.001) were independent risk factors for mortality. Conclusion: Our study underscores the urgent need to identify predictive factors of mortality in infective endocarditis (IE), and to adopt a multidisciplinary approach to enhance the care and management of patients, ultimately aiming to improve their survival rates.
{"title":"Predictors of Mortality in Infective Endocarditis: A Retrospective Study","authors":"Mina Boutgourine, Assala Cherki, Kawtar Bennajma, Joumana El Massrioui, M. E. Jamili, S. Karimi, M. Hattaoui","doi":"10.9734/ca/2024/v13i3418","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3418","url":null,"abstract":"Introduction: Infective endocarditis (IE) remains a major health problem with significant morbidity and mortality rates. Despite its serious implications, data on prognostic factors remain scarce. \u0000Aim: We aim to determine predictive factors of mortality during infective endocarditis. \u0000Methods: We performed a retrospective study including patients admitted to university hospital Mohammed 6 of Marrakech between September 2019 and January 2024 for a confirmed IE based on Dukes modified criteria. \u0000Results: Of 43 patients included, 30 were males (69%) and 13 were females (30%). The mean age was 47.4 for men and 49.30 for women. 44.1% of our patients were admitted in heart failure, and 37% presented themselves late to our facility for management. Only 25.58% suffered from kidney failure and 55.8% presented an LV dysfunction. Complications were noted at a rate of 48%. Male’s group had less complication rate with 10% vs 38% in females’ group (p=0.042). And an overall mortality rate was at 34% and there were no significant sex related differences in terms of mortality between the two groups (33% in males vs 38% in females, p = 0.742). \u0000The analytical study concluded that heart failure at admission(p<0.001), neurological complications(p=0.024), anemia (p=0.049), kidney failure (p=0.002), prolonged antibiotics (p=0.016), LV dysfunction (p=0.027) and an emergency surgery (p<0.001) were independent risk factors for mortality. \u0000Conclusion: Our study underscores the urgent need to identify predictive factors of mortality in infective endocarditis (IE), and to adopt a multidisciplinary approach to enhance the care and management of patients, ultimately aiming to improve their survival rates.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"74 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141357906","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}
Pub Date : 2024-06-03DOI: 10.9734/ca/2024/v13i3417
Kamal Haless, Eljazouli Ali, Amina Arous, Abdenasser Drighil, R. Habbal
Introduction: Acute myocardial infraction typically associated with atherosclerosis and coronary lesions, can occur without significant stenosis, implicating microcirculatory obstruction. Case Presentation: We present a case of a 60-year-old woman with hypertension and atrial fibrillation who was admitted with chest pain. Initially diagnosis of high-risk NSTEMI, but coronary angiography showed no significant lesions. Cardiac MRI revealed myocardial necrosis, indicating myocardial infraction with non-obstructive coronary arteries (MINOCA). Further investigation identified polycythemia vera as the cause. The patient was transferred to the hematology department and discharged with DAPT, atorvastatin, and bisoprolol. Conclusion: The case presented illustrates the importance of recognizing polycythemia vera as an important cause of thrombosis, not only of MI with significant coronary lesion, but also of MI with non-obstructive coronary arteries.
{"title":"Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) Revealing Polycythemia Vera: A Case Report","authors":"Kamal Haless, Eljazouli Ali, Amina Arous, Abdenasser Drighil, R. Habbal","doi":"10.9734/ca/2024/v13i3417","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i3417","url":null,"abstract":"Introduction: Acute myocardial infraction typically associated with atherosclerosis and coronary lesions, can occur without significant stenosis, implicating microcirculatory obstruction. \u0000Case Presentation: We present a case of a 60-year-old woman with hypertension and atrial fibrillation who was admitted with chest pain. Initially diagnosis of high-risk NSTEMI, but coronary angiography showed no significant lesions. Cardiac MRI revealed myocardial necrosis, indicating myocardial infraction with non-obstructive coronary arteries (MINOCA). Further investigation identified polycythemia vera as the cause. The patient was transferred to the hematology department and discharged with DAPT, atorvastatin, and bisoprolol. \u0000Conclusion: The case presented illustrates the importance of recognizing polycythemia vera as an important cause of thrombosis, not only of MI with significant coronary lesion, but also of MI with non-obstructive coronary arteries.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"50 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141269724","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}
Pub Date : 2024-05-16DOI: 10.9734/ca/2024/v13i2411
B. Mohamed Ghoulame, H. Siyam, P. M. Mulendele, S.M. Obeidat, M. Bouziane, M. Haboub, S. Arous, G. Bennouna, A. Drighil, R. Habbal
Arrhythmogenic right ventricular cardiomyopathy is a genetic disease that affects young people. As its name indicates, it carries a risk of ventricular rhythm disturbances and sudden death, particularly during sporting efforts emphasizing the need for early diagnosis of the disease. The most frequently observed symptoms are palpitations, syncope, clinical signs of right heart failure and cardiac arrest. These clinical manifestations, as well as the progression and prognosis of the disease have been well studied and described in the literature in adult population unlike in children where it has not been well elucidated. Its diagnosis is based on the morphological characteristics of the right ventricle during cardiac ultrasound and especially on cardiac MRI. The extent of morphological abnormalities and the frequency of occurrence of rhythm disorders make it possible to stratify the disease risk. High-risk patients should benefit from implantable cardioverter defibrillator implantation. Treatment is based on moderate physical exercise, beta blockers medical therapy and an implantable cardioverter defibrillator in certain cases. We report a case of a 15-year-old child, with a history of first-degree consanguinity and undocumented heart disease in the father who consulted for chest pain over 8 days. The clinical presentation, electrical signs, cardiac ultrasound and imaging made it possible to make the diagnosis of ARVC.
{"title":"Supraventricular Tachy-arrhythmia Revealing an Arrhythmogenic Right Ventricle Cardiomyopathy in An Adolescent: Case Report","authors":"B. Mohamed Ghoulame, H. Siyam, P. M. Mulendele, S.M. Obeidat, M. Bouziane, M. Haboub, S. Arous, G. Bennouna, A. Drighil, R. Habbal","doi":"10.9734/ca/2024/v13i2411","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i2411","url":null,"abstract":"Arrhythmogenic right ventricular cardiomyopathy is a genetic disease that affects young people. As its name indicates, it carries a risk of ventricular rhythm disturbances and sudden death, particularly during sporting efforts emphasizing the need for early diagnosis of the disease. The most frequently observed symptoms are palpitations, syncope, clinical signs of right heart failure and cardiac arrest. These clinical manifestations, as well as the progression and prognosis of the disease have been well studied and described in the literature in adult population unlike in children where it has not been well elucidated. Its diagnosis is based on the morphological characteristics of the right ventricle during cardiac ultrasound and especially on cardiac MRI. The extent of morphological abnormalities and the frequency of occurrence of rhythm disorders make it possible to stratify the disease risk. High-risk patients should benefit from implantable cardioverter defibrillator implantation. Treatment is based on moderate physical exercise, beta blockers medical therapy and an implantable cardioverter defibrillator in certain cases. \u0000We report a case of a 15-year-old child, with a history of first-degree consanguinity and undocumented heart disease in the father who consulted for chest pain over 8 days. The clinical presentation, electrical signs, cardiac ultrasound and imaging made it possible to make the diagnosis of ARVC.","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"3 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969972","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}
Pub Date : 2024-05-13DOI: 10.9734/ca/2024/v13i2410
Haritha Bandi, Sampada Nandala, Shalini Gudepu, Syed Umar Farooq
Background: Hypertension is the most common disease in India where 1 in 4 people suffering with it. In order to achieve the intended therapeutic outcomes, medication adherence is essential. Patients with hypertension must adhere to their disease by taking their prescriptions on time, following their diet, and making other lifestyle modifications. This study aims to assess medication adherence in Warangal population among hypertensive patients with comorbidities, social habits, medication use etc. Aims: The aim of the study is to assess the level of medication adherence and to investigate predictors of medication adherence and controlled hypertension in patients and to identify the factors enhancing medication adherence. The secondary aim is to describe the extent and type of medication used in patient population in Warangal. Study Design: An Observational, retrospective and cross - sectional study was employed to assess the predictors and level of medication adherence in hypertensive patients. Place and Duration of Study: Department of Cardiology, Sri Sri Cardiac Centre and Bhageerath Cardiac Care Centre, Hanamkonda, Warangal. The study was conducted from October 2022 to April 2023 for about a duration of 7 months. Methodology: This study includes 300 Hypertensive patients (Male - 169, Female 131) of age range between 20-90 years with various comorbidities like diabetes mellitus, coronary artery disease, hypothyroidism, dyslipidemia, COPD. We also included various sociodemographic factors like Gender, Age, Literacy, Income status, Alcohol consumption, Smoking status, Marital status, Controlled and Uncontrolled hypertension, usage of various drugs and Duration of hypertension. We observed Medication Adherence by using MMAS 8 scale. Results: Low levels of medication adherence among female patients (41%), educated patients (58%) compared to other groups because of awareness about their condition. Low adherence is noted in patients with low-income status ( 9.6% ), High adherence in nonsmokers (73.3%) and non-alcoholic (60.6%) compared to smokers (10.6%) and alcoholics (12.6%) and high adherence is reported in married (85%) category as compared to unmarried (2.6%), Patients with low comorbidities reported high adherence compared to patients with low comorbidities. High medication adherence is reported in uncontrolled blood pressure (50.3%) and in patients with (le) year (24.6%) and 2-6 years (28%) of duration of hypertension. High adherence is noted with 2 combination therapy (23.6%), most of the participants are adherent to Telmisartan+ Metoprolol (25.2%) followed by Telmisartan+ hydrochlorothiazide (19.3%). According to MMAS-8 scale most of the patients reported (Q1) and (Q6), 91.3% of our study population were adherent to their medication, 7% were moderately adherent and 1.6% were low adherent to their medication. Conclusion: 91.3% of Medication adherence is noted in hypertensive patients in Warangal population. 8.6% of Medication Non-Adherence
{"title":"Assessment of Medication Adherence in Hypertensive Patients among Warangal Population","authors":"Haritha Bandi, Sampada Nandala, Shalini Gudepu, Syed Umar Farooq","doi":"10.9734/ca/2024/v13i2410","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i2410","url":null,"abstract":"Background: Hypertension is the most common disease in India where 1 in 4 people suffering with it. In order to achieve the intended therapeutic outcomes, medication adherence is essential. Patients with hypertension must adhere to their disease by taking their prescriptions on time, following their diet, and making other lifestyle modifications. This study aims to assess medication adherence in Warangal population among hypertensive patients with comorbidities, social habits, medication use etc.\u0000Aims: The aim of the study is to assess the level of medication adherence and to investigate predictors of medication adherence and controlled hypertension in patients and to identify the factors enhancing medication adherence. The secondary aim is to describe the extent and type of medication used in patient population in Warangal.\u0000Study Design: An Observational, retrospective and cross - sectional study was employed to assess the predictors and level of medication adherence in hypertensive patients.\u0000Place and Duration of Study: Department of Cardiology, Sri Sri Cardiac Centre and Bhageerath Cardiac Care Centre, Hanamkonda, Warangal. The study was conducted from October 2022 to April 2023 for about a duration of 7 months.\u0000Methodology: This study includes 300 Hypertensive patients (Male - 169, Female 131) of age range between 20-90 years with various comorbidities like diabetes mellitus, coronary artery disease, hypothyroidism, dyslipidemia, COPD. We also included various sociodemographic factors like Gender, Age, Literacy, Income status, Alcohol consumption, Smoking status, Marital status, Controlled and Uncontrolled hypertension, usage of various drugs and Duration of hypertension. We observed Medication Adherence by using MMAS 8 scale.\u0000Results: Low levels of medication adherence among female patients (41%), educated patients (58%) compared to other groups because of awareness about their condition. Low adherence is noted in patients with low-income status ( 9.6% ), High adherence in nonsmokers (73.3%) and non-alcoholic (60.6%) compared to smokers (10.6%) and alcoholics (12.6%) and high adherence is reported in married (85%) category as compared to unmarried (2.6%), Patients with low comorbidities reported high adherence compared to patients with low comorbidities. High medication adherence is reported in uncontrolled blood pressure (50.3%) and in patients with (le) year (24.6%) and 2-6 years (28%) of duration of hypertension. High adherence is noted with 2 combination therapy (23.6%), most of the participants are adherent to Telmisartan+ Metoprolol (25.2%) followed by Telmisartan+ hydrochlorothiazide (19.3%). According to MMAS-8 scale most of the patients reported (Q1) and (Q6), 91.3% of our study population were adherent to their medication, 7% were moderately adherent and 1.6% were low adherent to their medication.\u0000Conclusion: 91.3% of Medication adherence is noted in hypertensive patients in Warangal population. 8.6% of Medication Non-Adherence","PeriodicalId":505403,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"21 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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