Background and aim of the study: Sutureless aortic valves are used to reduce operation time. However, the stent implantation might cause postoperative ECG alterations and a higher risk of paravalvular leakage. In literature, some cases of thrombocytopenia are described after implantation. We investigated the Sorin Perceval S Sutureless Valve and the Edwards Intuity Sutureless Valve. Material and methods: Seventy-nine patients underwent aortic valve replacement using a sutureless valve in a single center between 2015 - 2018. Thirty-seven patients received Sorin Perceval S (Group A) and 42 Edwards Intuity (Group B). Simultaneous bypass surgery was performed in 23 patients in Group A and 22 patients in Group B. We compared the groups regarding postoperative TTE and paravalvular leakage, postoperative ECG alterations, need for pacemaker implantation, postoperative platelet count, and 30-day mortality Results: Only in Group B 2 patients had paravalvular leakage, and one was reoperated within the same hospital stay. In Group A, nine patients suffered from postoperative atrial fibrillation, and in Group B, 16 patients. Left bundle branch block (LBBB) was observed in 5 patients in Group A, and 13 patients in Group B. Two patients in Group A needed a definite pacemaker, and five patients in Group B. Tachy-Brady Syndrome and LBBB were observed more frequently in Group B as well as ECG alterations. One patient died within 30 days in Group A due to multiorgan failure. This patient was older and multimorbid compared to the average. Regarding platelet count, we saw a statistically significant decrease in both groups. There were no major bleeding complications or reoperations due to hemorrhage. Conclusion: Our data shows that sutureless aortic valve replacement is associated with new postoperative ECG alterations, which are self-limiting in most cases. Compared to the literature pacemaker implantation rate in Group B is higher.
{"title":"Single-center experience in sutureless aortic valve implantation using two aortic valve prostheses","authors":"Rings Laura, Ntinopoulos Vasileios, Dushaj Stak, Hoti Gojart, Dzemali Philine Fleckenstein Omer, Häussler Achim","doi":"10.29328/journal.jccm.1001134","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001134","url":null,"abstract":"Background and aim of the study: Sutureless aortic valves are used to reduce operation time. However, the stent implantation might cause postoperative ECG alterations and a higher risk of paravalvular leakage. In literature, some cases of thrombocytopenia are described after implantation. We investigated the Sorin Perceval S Sutureless Valve and the Edwards Intuity Sutureless Valve. Material and methods: Seventy-nine patients underwent aortic valve replacement using a sutureless valve in a single center between 2015 - 2018. Thirty-seven patients received Sorin Perceval S (Group A) and 42 Edwards Intuity (Group B). Simultaneous bypass surgery was performed in 23 patients in Group A and 22 patients in Group B. We compared the groups regarding postoperative TTE and paravalvular leakage, postoperative ECG alterations, need for pacemaker implantation, postoperative platelet count, and 30-day mortality Results: Only in Group B 2 patients had paravalvular leakage, and one was reoperated within the same hospital stay. In Group A, nine patients suffered from postoperative atrial fibrillation, and in Group B, 16 patients. Left bundle branch block (LBBB) was observed in 5 patients in Group A, and 13 patients in Group B. Two patients in Group A needed a definite pacemaker, and five patients in Group B. Tachy-Brady Syndrome and LBBB were observed more frequently in Group B as well as ECG alterations. One patient died within 30 days in Group A due to multiorgan failure. This patient was older and multimorbid compared to the average. Regarding platelet count, we saw a statistically significant decrease in both groups. There were no major bleeding complications or reoperations due to hemorrhage. Conclusion: Our data shows that sutureless aortic valve replacement is associated with new postoperative ECG alterations, which are self-limiting in most cases. Compared to the literature pacemaker implantation rate in Group B is higher.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48659542","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 : 2022-07-04DOI: 10.29328/journal.jccm.1001133
Mubarak Yasser
Background: Posterior pericardiotomy (PP) is helpful to prevent arrhythmia; especially atrial fibrillation (AF), and cardiac tamponade postoperative cardiac valve surgery. The incidence of postoperative AF is increased due to postoperative pericardial effusion (PE). This study aimed to investigate the early outcome of PP after heart valve surgery. Methods: In this prospective study, 120 patients underwent elective valve heart surgery at our center from January 2020 until April 2022. Patients were followed up for AF and pericardial effusion, and reopening due to tamponade. Results: The mean age of patients was 35.26 years, 70.2% were female and 29.8% were male. Surgery was elective and all were valve surgery. The incidence of postoperative AF was 2%, and pericardial effusion was seen in 1% of patients. Tamponade was not seen in any case. Left PE needed intervention tube drainage of 2%. Conclusion: Posterior pericardiotomy is a simple and safe procedure during valve heart surgery, and it is effective in reducing the incidence of atrial fibrillation, pericardial effusion, and tamponade.
{"title":"Posterior pericardiotomy in heart valve surgery; is it still performed or neglected?","authors":"Mubarak Yasser","doi":"10.29328/journal.jccm.1001133","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001133","url":null,"abstract":"Background: Posterior pericardiotomy (PP) is helpful to prevent arrhythmia; especially atrial fibrillation (AF), and cardiac tamponade postoperative cardiac valve surgery. The incidence of postoperative AF is increased due to postoperative pericardial effusion (PE). This study aimed to investigate the early outcome of PP after heart valve surgery. Methods: In this prospective study, 120 patients underwent elective valve heart surgery at our center from January 2020 until April 2022. Patients were followed up for AF and pericardial effusion, and reopening due to tamponade. Results: The mean age of patients was 35.26 years, 70.2% were female and 29.8% were male. Surgery was elective and all were valve surgery. The incidence of postoperative AF was 2%, and pericardial effusion was seen in 1% of patients. Tamponade was not seen in any case. Left PE needed intervention tube drainage of 2%. Conclusion: Posterior pericardiotomy is a simple and safe procedure during valve heart surgery, and it is effective in reducing the incidence of atrial fibrillation, pericardial effusion, and tamponade.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43103087","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 : 2022-05-05DOI: 10.29328/journal.jccm.1001131
Le Hoang P, Nguyen Binh G
Background: Arterial stiffness has been considered an independent predictor of cardiovascular disease in addition to the traditionally known cardiovascular risk factors. Objectives: This study aimed to investigate the associations between arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives. Methods: A descriptive cross-sectional study compared a control group in 210 study subjects (105 hypertensives and 105 normotensives). Measuring left ventricular mass index by echocardiography and carotid intima-media thickness by carotid doppler ultrasonography. Pulse wave velocity was measured using the Agedio B900 device and the Agedio K520 application. The manual method was measured by the ankle-brachial index. Results: There was a statistically significant positive correlation between pulse wave velocity and age (r = 0.922, p < 0.001). The ankle-brachial index had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.219 (p < 0.05) and 0.250 (p < 0,001), respectively. Pulse wave velocity also had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.188 (p < 0.05) and 0.289 (p < 0,001), respectively. Pulse wave velocity had a multivariable linear correlation with gender, pulse, mean blood pressure, and ankle-brachial index with statistical significance; and they were written in the form of the following equation: Pulse wave velocity (R2: 41.3%) = 0.641*(Gender) – 0.027*(Pulse) + 0.043*(Mean blood pressure) + 8.378*(Ankle-brachial index) – 3.254. Conclusion: Arterial stiffness was statistically correlated with left ventricular mass index and carotid intima-media thickness in the hypertensives. Through the above research results, we suggest that the hypertensives should be combined with the evaluation of hemodynamic parameters and arterial stiffness for contributing to the diagnosis and detection of cardiovascular complications, thereby improving the quality of monitoring and treatment in hypertensive patients.
{"title":"Associations of arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives","authors":"Le Hoang P, Nguyen Binh G","doi":"10.29328/journal.jccm.1001131","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001131","url":null,"abstract":"Background: Arterial stiffness has been considered an independent predictor of cardiovascular disease in addition to the traditionally known cardiovascular risk factors. Objectives: This study aimed to investigate the associations between arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives. Methods: A descriptive cross-sectional study compared a control group in 210 study subjects (105 hypertensives and 105 normotensives). Measuring left ventricular mass index by echocardiography and carotid intima-media thickness by carotid doppler ultrasonography. Pulse wave velocity was measured using the Agedio B900 device and the Agedio K520 application. The manual method was measured by the ankle-brachial index. Results: There was a statistically significant positive correlation between pulse wave velocity and age (r = 0.922, p < 0.001). The ankle-brachial index had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.219 (p < 0.05) and 0.250 (p < 0,001), respectively. Pulse wave velocity also had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.188 (p < 0.05) and 0.289 (p < 0,001), respectively. Pulse wave velocity had a multivariable linear correlation with gender, pulse, mean blood pressure, and ankle-brachial index with statistical significance; and they were written in the form of the following equation: Pulse wave velocity (R2: 41.3%) = 0.641*(Gender) – 0.027*(Pulse) + 0.043*(Mean blood pressure) + 8.378*(Ankle-brachial index) – 3.254. Conclusion: Arterial stiffness was statistically correlated with left ventricular mass index and carotid intima-media thickness in the hypertensives. Through the above research results, we suggest that the hypertensives should be combined with the evaluation of hemodynamic parameters and arterial stiffness for contributing to the diagnosis and detection of cardiovascular complications, thereby improving the quality of monitoring and treatment in hypertensive patients.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45789779","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 : 2022-04-26DOI: 10.29328/journal.jccm.1001130
Monsalve Tatiana Moreno, Frutos-Esteban Laura, Navarro-Fernández Jose Luis, Contreras-Gutierrez Jose Fulgencio
Cardiac angiosarcomas are rare malignant neoplasms with an aggressive clinical course. These are characterized by the absence of specific clinical findings, rapid growth with frequent metastasis at the time of diagnosis, correlated with poor prognosis, and reduced response to treatment. But with early diagnosis, more possibilities for treatment and survival can be provided. We report the case of a young woman diagnosed with right atrial angiosarcoma locally advanced with bone metastases detected by 18F-FDG PET/CT, which revealed distant disease extent at diagnosis, consequently, chemotherapy was started.
{"title":"FDG PET/CT of uncommon cardiac angiosarcoma with bone metastases: a case report","authors":"Monsalve Tatiana Moreno, Frutos-Esteban Laura, Navarro-Fernández Jose Luis, Contreras-Gutierrez Jose Fulgencio","doi":"10.29328/journal.jccm.1001130","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001130","url":null,"abstract":"Cardiac angiosarcomas are rare malignant neoplasms with an aggressive clinical course. These are characterized by the absence of specific clinical findings, rapid growth with frequent metastasis at the time of diagnosis, correlated with poor prognosis, and reduced response to treatment. But with early diagnosis, more possibilities for treatment and survival can be provided. We report the case of a young woman diagnosed with right atrial angiosarcoma locally advanced with bone metastases detected by 18F-FDG PET/CT, which revealed distant disease extent at diagnosis, consequently, chemotherapy was started.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41674764","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 : 2022-04-11DOI: 10.29328/journal.jccm.1001129
Susan Ujuanbi Amenawon, Chiemerie Onyeka Adaeze
Background: Down syndrome (DS), or Trisomy 21, is the most common genetic disorder in the world and congenital heart disease (CHD) contributes significantly to morbidity and mortality in this population. Early diagnosis and prompt cardiac intervention improve their quality of life. This study was done to determine the prevalence and pattern of congenital heart disease among children with Down syndrome seen at the Paediatric Cardiology Unit of Federal Medical Centre (FMC), Bayelsa State. Method: A prospective study of children with Down syndrome referred for cardiac evaluation and echocardiography at the Paediatric Cardiology Unit of FMC, Bayelsa State over four years from 1st January 2016 to 30th December 2019. Data on socio-demographic information, echocardiographic diagnosis, and outcome were retrieved from the study proforma and analyzed. Results: A total of 24 children with Down syndrome were seen over the study period. Their age ranged from 0 to 16years. The majority, 20 (83.3%) of the children with Down syndrome were aged 5 years and below. There were 13 males and 11 females with a male to female ratio of 1.2:1. A total of 23 (95.8%) of the children with Down syndrome had CHD. The most common CHD was AVSD (including complete, partial, isolated, or in association with other defects) in 66.6% followed by TOF in 8.3%. Multiple CHDs were seen in 43.5% of the children. Only one child (4.2%) had a structurally normal heart on echocardiography. All the children with Down syndrome had pericardial effusion of varying severity while 33% had pulmonary artery hypertension (PAH). The fatality rate among the children seen with Down syndrome over the study period was 34.8% and only one child (4.2%) had open-heart surgery with the total repair of cardiac defect during the study period. Conclusion: Morbidity and mortality are high among children with Down syndrome due to the high prevalence of CHD. Early referral, diagnosis, and prompt intervention are encouraged.
{"title":"Prevalence and pattern of congenital heart disease among children with Down syndrome seen in a Federal Medical Centre in the Niger Delta Region, Nigeria","authors":"Susan Ujuanbi Amenawon, Chiemerie Onyeka Adaeze","doi":"10.29328/journal.jccm.1001129","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001129","url":null,"abstract":"Background: Down syndrome (DS), or Trisomy 21, is the most common genetic disorder in the world and congenital heart disease (CHD) contributes significantly to morbidity and mortality in this population. Early diagnosis and prompt cardiac intervention improve their quality of life. This study was done to determine the prevalence and pattern of congenital heart disease among children with Down syndrome seen at the Paediatric Cardiology Unit of Federal Medical Centre (FMC), Bayelsa State. Method: A prospective study of children with Down syndrome referred for cardiac evaluation and echocardiography at the Paediatric Cardiology Unit of FMC, Bayelsa State over four years from 1st January 2016 to 30th December 2019. Data on socio-demographic information, echocardiographic diagnosis, and outcome were retrieved from the study proforma and analyzed. Results: A total of 24 children with Down syndrome were seen over the study period. Their age ranged from 0 to 16years. The majority, 20 (83.3%) of the children with Down syndrome were aged 5 years and below. There were 13 males and 11 females with a male to female ratio of 1.2:1. A total of 23 (95.8%) of the children with Down syndrome had CHD. The most common CHD was AVSD (including complete, partial, isolated, or in association with other defects) in 66.6% followed by TOF in 8.3%. Multiple CHDs were seen in 43.5% of the children. Only one child (4.2%) had a structurally normal heart on echocardiography. All the children with Down syndrome had pericardial effusion of varying severity while 33% had pulmonary artery hypertension (PAH). The fatality rate among the children seen with Down syndrome over the study period was 34.8% and only one child (4.2%) had open-heart surgery with the total repair of cardiac defect during the study period. Conclusion: Morbidity and mortality are high among children with Down syndrome due to the high prevalence of CHD. Early referral, diagnosis, and prompt intervention are encouraged.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47579101","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 : 2022-04-07DOI: 10.29328/journal.jccm.1001128
Chaddad Rima, R. Hussein, Awada Batoul, Hmadeh Malek
Coronary artery disease is the leading cause of death worldwide. Percutaneous coronary intervention (PCI) is one of the most widely performed medical procedures used to save lives, currently over 3 million annually worldwide. The femoral artery has been the preferred vascular access site. However, radial access is gaining extensive popularity due to the benefits of earlier ambulation, fewer access site complications, and decreased rates of bleeding. Improvements in technology and understanding of the anatomic features of the vascular system have led to new insights into coronary angiography procedures. Distal radial access, which was first used in 2017, shows a higher success rate and fewer complications than previous sites; therefore, it might be the future for cardiovascular intervention. For this purpose, we conducted this prospective study at Beirut Cardiac Institute (BCI) comparing the two arms: radial vs. distal radial artery techniques through the anatomical snuffbox, in terms of patient’s length of stay, complication rate, and success rate of each procedure.
{"title":"Save the radial: go distally","authors":"Chaddad Rima, R. Hussein, Awada Batoul, Hmadeh Malek","doi":"10.29328/journal.jccm.1001128","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001128","url":null,"abstract":"Coronary artery disease is the leading cause of death worldwide. Percutaneous coronary intervention (PCI) is one of the most widely performed medical procedures used to save lives, currently over 3 million annually worldwide. The femoral artery has been the preferred vascular access site. However, radial access is gaining extensive popularity due to the benefits of earlier ambulation, fewer access site complications, and decreased rates of bleeding. Improvements in technology and understanding of the anatomic features of the vascular system have led to new insights into coronary angiography procedures. Distal radial access, which was first used in 2017, shows a higher success rate and fewer complications than previous sites; therefore, it might be the future for cardiovascular intervention. For this purpose, we conducted this prospective study at Beirut Cardiac Institute (BCI) comparing the two arms: radial vs. distal radial artery techniques through the anatomical snuffbox, in terms of patient’s length of stay, complication rate, and success rate of each procedure.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44692466","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 : 2022-03-30DOI: 10.29328/journal.jccm.1001127
Puppo Antonio M, Caro Manuel Fernández, Sastre Sara Martín, Gómez Francisco T, Sánchez Jose Mariá López
Fibromuscular dysplasia is a rare, non-atherosclerotic, non-inflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Aortic dissection is rare. We present the clinical case of a patient with fibromuscular dysplasia with type B aortic dissection.
{"title":"Fibromuscular dysplasia and aortic dissection","authors":"Puppo Antonio M, Caro Manuel Fernández, Sastre Sara Martín, Gómez Francisco T, Sánchez Jose Mariá López","doi":"10.29328/journal.jccm.1001127","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001127","url":null,"abstract":"Fibromuscular dysplasia is a rare, non-atherosclerotic, non-inflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Aortic dissection is rare. We present the clinical case of a patient with fibromuscular dysplasia with type B aortic dissection.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45203221","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}
Background: An association between Atrial Fibrillation (AF) and Metabolic Syndrome (MS) a constellation of abnormalities (high blood pressure, hyperglycemia, dyslipidemia, and abdominal obesity), has been demonstrated. There have been many studies that have shown that elevated blood pressure (BP), was significantly associated with an increased risk of AF. It is uncertain whether maintaining the optimal BP levels can prevent AF in the patients with MS categorized as ‘high-risk’ patients. Objective: The aim of this study was to evaluate the influence of control of BP on the occurrence of new-onset atrial fibrillation in patients with Metabolic Syndrome. Methods: Into this observational study, was enrolled 435 consecutive patients (210 males and 225 females) aged 45-79 years who fulfilled criteria for MS. Participants were selected among primary and secondary care patients, who were receiving ongoing care for arterial hypertension in the period from November 2018 till November 2021. The study was conducted at outpatients in 5 Health Care Clinics (3 Secondary Health Care Clinics and 2 Primary Health Clinics). Patient were categorized according to their BP levels as Group 1-patients with controlled BP, {(patients aged < 65 years Systolic Blood Pressure (SBP) of 120 - 130 mmHg, patients aged ≥ 65 years SBP of 130 - 139 mmHg)} and Diastolic Blood Pressure (DBP), {(patients aged < 65 years of < 80 mmHg. but not < 70 mmHg; patients aged ≥ 65 years of 85 - 89 mmHg)}, or Group 2-patients with uncontrolled BP(> 130/80 mmHg),and in patients aged ≥ 65 years BP (≥ 140/90 mmHg ). Results: New-onset of AF, was more frequent in participants with uncontrolled BP, respectively (34.7% vs. 19.5%, p = 0.009).Patients with uncontrolled BP have more frequent persistent AF (15.2% vs. 0.04%) and permanent AF (0.08% vs. 0.02%), whereas there was not significant changes between groups in relation to frequency of paroxysmal AF, respectively (12.8% vs. 10.9%, p = 0.29). There was observed significant association of uncontrolled BP with: increased frequency of AF (OR = 2.193; 95% CI 1.390 - 3.439), persistent AF (OR = 3.931; 95% CI 1.771 - 8.084), permanent AF (OR = 4.138; 95% CI 1.383-12.381), LA. Dimension ≥ 2.2 cm/m2 (OR = 2.089, 95% CI 1.330 - 3.252), BMI (OR = 5.226, 95% CI 3.155 - 8.659) and 5-risk factors for MS, respectively (OR = 2.998, 95% CI 1.833 - 4.901). Conclusion: Optimal BP levels, can reduce the frequency of new-onset AF in patients with MS categorized as ‘high-risk’ patients. Uncontrolled BP was associated with an increased risk of both subtypes of AF (persistent and permanent) in the patients with MS categorized as ‘high-risk’ patients.
背景:心房颤动(AF)与代谢综合征(MS)之间的关联已被证实，代谢综合征是一系列异常(高血压、高血糖、血脂异常和腹部肥胖)。有许多研究表明，血压升高与房颤风险增加显著相关。对于被归类为“高风险”的MS患者，维持最佳血压水平是否能预防房颤尚不确定。目的:探讨控制血压对代谢综合征患者新发房颤发生的影响。方法:在这项观察性研究中，纳入了435名符合ms标准的连续患者(210名男性和225名女性)，年龄在45-79岁之间，参与者选择于2018年11月至2021年11月期间接受动脉高血压持续治疗的初级和二级护理患者。这项研究是在5个保健诊所(3个二级保健诊所和2个初级保健诊所)的门诊病人中进行的。根据患者的血压水平分为血压控制组，{(< 65岁患者收缩压(SBP) 120 ~ 130 mmHg，≥65岁患者收缩压130 ~ 139 mmHg)}和舒张压(DBP)，{(< 65岁患者< 80 mmHg。但不能低于70 mmHg;≥65岁患者(85 - 89 mmHg)，或2组患者血压未控制(bbb130 /80 mmHg)，以及≥65岁患者血压(≥140/90 mmHg)。结果:新发房颤在血压未控制的受试者中更为常见(34.7% vs. 19.5%， p = 0.009)。血压不受控制的患者有更频繁的持续性房颤(15.2%比0.04%)和永久性房颤(0.08%比0.02%)，而两组之间阵发性房颤的频率没有显著变化(12.8%比10.9%，p = 0.29)。未控制的血压与房颤频率升高有显著相关性(OR = 2.193;95% CI 1.390 - 3.439)，持续性房颤(OR = 3.931;95% CI 1.771 - 8.084)，永久性房颤(OR = 4.138;95% ci 1.383-12.381)。尺寸≥2.2 cm/m2 (OR = 2.089, 95% CI 1.330 - 3.252)、BMI (OR = 5.226, 95% CI 3.155 - 8.659)和5个危险因素分别为MS (OR = 2.998, 95% CI 1.833 - 4.901)。结论:最佳血压水平，可降低MS“高危”患者新发房颤的发生频率。在被归类为“高风险”的MS患者中，不受控制的血压与AF两种亚型(持续性和永久性)的风险增加相关。
{"title":"Control of arterial hypertension and risk of new-onset of atrial fibrillation in patients with metabolic syndrome","authors":"Jani Ylber, Haxhirexha Kastriot, Haxhirexha Ferizat, Pocesta Bekim, Rexhepi Atila, Ferati Fatmir, Kamberi Ahmet, Zeqiri Agim, Xhunga Sotiraq, Serani Artur, Zylbeari Lutfi","doi":"10.29328/journal.jccm.1001126","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001126","url":null,"abstract":"Background: An association between Atrial Fibrillation (AF) and Metabolic Syndrome (MS) a constellation of abnormalities (high blood pressure, hyperglycemia, dyslipidemia, and abdominal obesity), has been demonstrated. There have been many studies that have shown that elevated blood pressure (BP), was significantly associated with an increased risk of AF. It is uncertain whether maintaining the optimal BP levels can prevent AF in the patients with MS categorized as ‘high-risk’ patients. Objective: The aim of this study was to evaluate the influence of control of BP on the occurrence of new-onset atrial fibrillation in patients with Metabolic Syndrome. Methods: Into this observational study, was enrolled 435 consecutive patients (210 males and 225 females) aged 45-79 years who fulfilled criteria for MS. Participants were selected among primary and secondary care patients, who were receiving ongoing care for arterial hypertension in the period from November 2018 till November 2021. The study was conducted at outpatients in 5 Health Care Clinics (3 Secondary Health Care Clinics and 2 Primary Health Clinics). Patient were categorized according to their BP levels as Group 1-patients with controlled BP, {(patients aged < 65 years Systolic Blood Pressure (SBP) of 120 - 130 mmHg, patients aged ≥ 65 years SBP of 130 - 139 mmHg)} and Diastolic Blood Pressure (DBP), {(patients aged < 65 years of < 80 mmHg. but not < 70 mmHg; patients aged ≥ 65 years of 85 - 89 mmHg)}, or Group 2-patients with uncontrolled BP(> 130/80 mmHg),and in patients aged ≥ 65 years BP (≥ 140/90 mmHg ). Results: New-onset of AF, was more frequent in participants with uncontrolled BP, respectively (34.7% vs. 19.5%, p = 0.009).Patients with uncontrolled BP have more frequent persistent AF (15.2% vs. 0.04%) and permanent AF (0.08% vs. 0.02%), whereas there was not significant changes between groups in relation to frequency of paroxysmal AF, respectively (12.8% vs. 10.9%, p = 0.29). There was observed significant association of uncontrolled BP with: increased frequency of AF (OR = 2.193; 95% CI 1.390 - 3.439), persistent AF (OR = 3.931; 95% CI 1.771 - 8.084), permanent AF (OR = 4.138; 95% CI 1.383-12.381), LA. Dimension ≥ 2.2 cm/m2 (OR = 2.089, 95% CI 1.330 - 3.252), BMI (OR = 5.226, 95% CI 3.155 - 8.659) and 5-risk factors for MS, respectively (OR = 2.998, 95% CI 1.833 - 4.901). Conclusion: Optimal BP levels, can reduce the frequency of new-onset AF in patients with MS categorized as ‘high-risk’ patients. Uncontrolled BP was associated with an increased risk of both subtypes of AF (persistent and permanent) in the patients with MS categorized as ‘high-risk’ patients.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47354685","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 : 2022-02-18DOI: 10.29328/journal.jccm.1001125
Alshwikh Haifa Elhadi, Hander Faiza
Aim: To examine the relationship between the levels of HbA1c and hospital admission rates. Methods: We recorded HbA1c levels of all diabetic patients in Tripoli University Hospital over one year. Results: The mean HbA1c was 8.03%, with no difference between males and females. Over half of patients (56.5%) were admitted through their diabetes was well-controlled. Over half of the patients with type 1 diabetes (57/102, 55.9%) had a high HbA1c at admission compared to 42.1% of patients with type 2, who were mainly admitted with HbA1c level within the acceptable range set for this study. The HbA1c level was positively and significantly correlated with the length of hospital stay (R = 0.93, p = 0.000), and was significantly associated with hyperglycemia, diabetic ketoacidosis, coronary artery disease, limb ischemia, cataract, osteomyelitis, and non-alcoholic steatohepatitis. Conclusion: HbA1c is correlated significantly with hospitalization in type 1 diabetes but not in type 2.
{"title":"Overview of glycemic control among admitted patients with diabetes in Tripoli University Hospital","authors":"Alshwikh Haifa Elhadi, Hander Faiza","doi":"10.29328/journal.jccm.1001125","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001125","url":null,"abstract":"Aim: To examine the relationship between the levels of HbA1c and hospital admission rates. Methods: We recorded HbA1c levels of all diabetic patients in Tripoli University Hospital over one year. Results: The mean HbA1c was 8.03%, with no difference between males and females. Over half of patients (56.5%) were admitted through their diabetes was well-controlled. Over half of the patients with type 1 diabetes (57/102, 55.9%) had a high HbA1c at admission compared to 42.1% of patients with type 2, who were mainly admitted with HbA1c level within the acceptable range set for this study. The HbA1c level was positively and significantly correlated with the length of hospital stay (R = 0.93, p = 0.000), and was significantly associated with hyperglycemia, diabetic ketoacidosis, coronary artery disease, limb ischemia, cataract, osteomyelitis, and non-alcoholic steatohepatitis. Conclusion: HbA1c is correlated significantly with hospitalization in type 1 diabetes but not in type 2.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43175594","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 : 2022-01-24DOI: 10.17352/2455-2976.000176
Al-Aqeedi Rafid Fayadh, Mauuf Goma, Nabi Eiman
Electrical storm most often occurs in patients with coronary artery disease and left ventricular dysfunction. We report a case of recurrent ventricular Tachycardia (VT) in a 49-year-old male patient previously known to have an inferior myocardial infarction and hypertension, presented with ischemic chest pain accompanied by dizziness, hypotension, and tachycardia. An electrocardiogram showed monomorphic VT. A prompt synchronized electrical cardioversion under sedation has reverted the rhythm to the sinus. An echocardiogram showed left ventricular segmental wall motion abnormalities and ejection fraction of 37%. Then the condition complicated by recurrent VT necessitates multiple electrical cardioversions and defibrillation given for recurrent ventricular Fibrillation (VF) and short cardiopulmonary resuscitations that revived the patient from cardiac arrests. The patient had received a total of 103 electrical shocks over 15 days during which, he developed circulatory and respiratory compromise that required mechanical ventilation on twice occasions. Meticulous care including central monitoring and inotrope for hypotensive episodes was provided. A coronary angiogram showed normal left anterior descending and circumflex coronary arteries and a totally occluded right coronary artery which was failed to be revascularized in an attempt of angioplasty. The patient was successfully weaned off the ventilator and run a quiet course afterward. An implantable cardioverter-defibrillator was placed while maintained on oral amiodarone, mexiletine, metoprolol, and omega-3-acid ethyl esters, then discharged asymptomatic without recorded dysrhythmias. This case report underscores the challenges encountered throughout the management of such particular life-threatening ventricular arrhythmias and their impact on patient safety.
{"title":"Refractory electrical storm in coronary artery disease patient, challenges of dying heart","authors":"Al-Aqeedi Rafid Fayadh, Mauuf Goma, Nabi Eiman","doi":"10.17352/2455-2976.000176","DOIUrl":"https://doi.org/10.17352/2455-2976.000176","url":null,"abstract":"Electrical storm most often occurs in patients with coronary artery disease and left ventricular dysfunction. We report a case of recurrent ventricular Tachycardia (VT) in a 49-year-old male patient previously known to have an inferior myocardial infarction and hypertension, presented with ischemic chest pain accompanied by dizziness, hypotension, and tachycardia. An electrocardiogram showed monomorphic VT. A prompt synchronized electrical cardioversion under sedation has reverted the rhythm to the sinus. An echocardiogram showed left ventricular segmental wall motion abnormalities and ejection fraction of 37%. Then the condition complicated by recurrent VT necessitates multiple electrical cardioversions and defibrillation given for recurrent ventricular Fibrillation (VF) and short cardiopulmonary resuscitations that revived the patient from cardiac arrests. The patient had received a total of 103 electrical shocks over 15 days during which, he developed circulatory and respiratory compromise that required mechanical ventilation on twice occasions. Meticulous care including central monitoring and inotrope for hypotensive episodes was provided. A coronary angiogram showed normal left anterior descending and circumflex coronary arteries and a totally occluded right coronary artery which was failed to be revascularized in an attempt of angioplasty. The patient was successfully weaned off the ventilator and run a quiet course afterward. An implantable cardioverter-defibrillator was placed while maintained on oral amiodarone, mexiletine, metoprolol, and omega-3-acid ethyl esters, then discharged asymptomatic without recorded dysrhythmias. This case report underscores the challenges encountered throughout the management of such particular life-threatening ventricular arrhythmias and their impact on patient safety.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76956949","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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