BMC Cardiovascular Disorders最新文献

Background: Ischaemic heart disease remains the leading global cause of death, and is strongly linked to hypertension. However, recent data on hypertension and cardiovascular risk in Sri Lanka are limited. This study aimed to determine the prevalence of hypertension, its associations with demographic characteristics, and the cardiovascular risk profile of the population in the Western Province of Sri Lanka.

Methods: A descriptive cross-sectional epidemiological study was conducted in 2018-2020 in Western province. A total of 1800 non-institutionalized adults aged over 20 years were recruited using a multi-stage stratified random cluster sampling method. Data collection was made through interviewer administered questionnaire, physical measurements, and laboratory investigations of biochemical analysis. Hypertension was diagnosed based on the 2017 guidelines of the American College of Cardiologists/American Heart Association. Cardiovascular risk was assessed using the WHO Cardiovascular Disease Risk Laboratory-Based Chart for the South-East Asia region and the Framingham Risk Score (FRS). Prevalence estimates are presented with 95% confidence interval.

Results: Data from 1,333 participants (response rate 78.2%) were analyzed; 62.3% were females, 36.4% lived in urban areas, and the mean age was 49.8 years (± 9.1) (males- 49.7 ± 8.93, females-49.8 ± 8.99). Age- and sex-standardized prevalence of hypertension among all adults was 47.2% (95% CI:44.5-49.9). Crude prevalence was 56.3% (95% CI: 52.1-60.5), undiagnosed prevalence was 32.9% (95% CI:28.4-37.4) and already diagnosed was 23.4% (95% CI:20.2-26.6). Hypertension prevalence was highest among adults aged 60-69 years (75.5%, 95%CI:68.8-82.2), those with primary education (62.6%, 95% CI:52.7-72.5), in Gampaha district (57.3%, 95% CI:53.0-61.6), rural setting (57.2%, 95% CI:53.6-60.8) and with lowest monthly income of USD < 200 (59.8%, 95% CI:52.7-66.9). Among adults aged 40 years and older, the prevalence of high cardiovascular risk (> 20%) was 19.3% (95% CI:16.1-22.5) based on the FRS and 5.4% (95% CI:3.5-7.3) according to the WHO Risk Score.

Conclusions: Over half of adults in Western Province, Sri Lanka have hypertension, with one-third undiagnosed. Nearly one-fifth of midlife adults face high cardiovascular risk. Socioeconomic disparities highlight the need for targeted workplace screenings and tailored health education for lower-income communities.

Purpose: We aimed to evaluate left atrial appendage functions (LAA) derived by speckle tracking echocardiography in patients with mild to severe mitral regurgitation (MR) and assess the relation between MR severity and LAA's anatomical, structural, and physiological functions.

Methods: Ninety-seven patients with mild, moderate, or severe MR admitted to our department for transesophageal echocardiography were included. In addition to conventional echocardiographic measurements, LAA functions were assessed by speckle tracking echocardiography. Patients were divided into three groups according to MR grades: mild MR, moderate MR, and severe MR.

Results: The LAA reservoir, conduit, and contractile phase strain were lower in patients with moderate and severe MR than in those with mild MR. (10.0 ± 3.7 vs. 8.2 ± 3.5 vs. 16.7 ± 6.7, p < 0.001; 6.4 ± 3.0 vs. 4.9 ± 3.0 vs. 10.6 ± 4.9, p < 0.001; 3.6 ± 2.8 vs. 3.3 ± 2.1 vs. 6.1 ± 3, p < 0.001, respectively). Also, the LAA volume and area were significantly higher in the severe MR group. Spontaneous echo contrast was another factor associated with lower LAA strain parameters.

Conclusion: Hemodynamically important MR was associated with reduced LAA functions detected by speckle-tracking echocardiography. LAA strain may be used to predict the unfavorable effects of MR on LAA.

Background: Iatrogenic left main coronary artery (LMCA) dissection and stent dislodgement are rare but potentially life-threatening complications of coronary angiography and percutaneous coronary intervention. Their simultaneous occurrence is extremely uncommon and poses significant technical challenges.

Case presentation: A 62-year-old man with a history of hypertension developed LMCA dissection accompanied by chest pain during coronary angiography performed via the right radial approach, caused by non-coaxial catheter engagement. To stabilize the dissection, an additional femoral access was obtained. A drug-eluting stent implanted from the circumflex artery to the LMCA adhered to the balloon and migrated retrogradely, becoming lodged at the tip of the guiding catheter. Because retrieval attempts were unsuccessful, the dislodged stent was intentionally implanted into the right brachial artery to prevent distal embolization. The patient remained hemodynamically stable throughout the procedure and was discharged without complications.

Conclusions: This case represents the first reported instance of simultaneous LMCA dissection and complete retrograde stent dislodgement successfully managed percutaneously without the need for surgical intervention. Prompt recognition, access modification, and careful device manipulation were essential for achieving a favorable outcome.