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Association of Preoperative HbA1c Level with Incidence of New-onset Atrial Fibrillation during Early Postoperative Period after Off-Pump Coronary Artery Bypass Grafting Surgery in Diabetic Patients 糖尿病患者非体外循环冠状动脉搭桥术术后早期HbA1c水平与新发房颤发生率的关系
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47988
Md Jilhaj Uddin, Akm Manzurul Alam, A. Rahim, Aym Shahidullah, A. Hossain, Manzil Ahmad
Background: Diabetes mellitus is an independent risk factor for coronary artery disease and it adversely affects the postoperative outcome after CABG surgery. Adequate control of diabetes for a longer period, which can be assessed by HbA1c, before OPCAB may reduce development of postoperative atrial fibrillation and thus improve outcome. Methods: This was an observational study included sixty diabetic patients purposively who underwent isolated off pump coronary artery bypass procedure in NICVD. Total sample contained 60 diabetic patients, which were divided in two equal groups. Grouping was Group I – 30 Diabetic patients with preoperative HbA1c <7% and Group II – 30 Diabetic patients with preoperative HbA1c ≥7% and all of whom underwent isolated OPCAB. Postoperative atrial fibrillation and other complications were recorded and compared in two groups of patients. Results: Most postoperative atrial fibrillation (AF) developed in higher age group 61-70 years (61.5%). Postoperative complications were higher in group II. Postoperative AF was significantly higher in diabetic patients having preoperative HbA1c ≥7% compare to diabetic patients with HbA1c <7% in early postoperative period after OPCAB. Age (61-70 years) (OR=1.872, p=0.018), preoperative HbA1c ≥7% (OR=19.029, p=0.002) and hypertension (OR=1.091, p=0.019) was found significantly associated with increased development of postoperative atrial fibrillation. Conclusion: Our study revealed that higher preoperative HbA1c level was associated with increased incidence of new onset atrial fibrillation after OPCAB. So, it can be used as a reliable indicator for adequate control of diabetes preoperatively among patients selected for isolated elective OPCAB in future. Cardiovasc. j. 2020; 12(2): 113-119
背景:糖尿病是冠状动脉疾病的独立危险因素,对冠状动脉搭桥术后预后有不利影响。在OPCAB前较长时间内充分控制糖尿病(可通过HbA1c评估)可能减少术后房颤的发生,从而改善预后。方法:这是一项观察性研究,包括60例糖尿病患者,他们在NICVD中接受了孤立的非体外循环冠状动脉搭桥手术。共60例糖尿病患者,分为两组。分组为I - 30组术前HbA1c <7%的糖尿病患者和II - 30组术前HbA1c≥7%的糖尿病患者,均行孤立性OPCAB。记录两组患者术后房颤及其他并发症并进行比较。结果:术后房颤(AF)发生在61 ~ 70岁年龄组(61.5%)。II组术后并发症发生率较高。术前HbA1c≥7%的糖尿病患者术后房颤发生率明显高于术后早期HbA1c <7%的糖尿病患者。年龄(61-70岁)(OR=1.872, p=0.018)、术前HbA1c≥7% (OR=19.029, p=0.002)和高血压(OR=1.091, p=0.019)与术后房颤发生增加显著相关。结论:我们的研究表明,术前较高的HbA1c水平与OPCAB后新发房颤的发生率增加有关。因此,它可以作为今后选择单独选择性OPCAB患者术前充分控制糖尿病的可靠指标。Cardiovasc。j。2020;12 (2): 113 - 119
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引用次数: 0
Surgical Extraction of a Huge Pacemaker Lead Vegetation Causing Infective Endocarditis 巨大起搏器引线植物的手术摘除引起感染性心内膜炎
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47997
Smazn Palash, M. D. Hossain, Tamjid Mohammad Najmus Sakib Khan, T. Meher, K. Hassan, Saiful Khan, N. Ahmed, Sohail Ahmed, Z. Haider
Infections of implantable intracardiac devices such as pacemakers are relatively rare but serious complications. In this paper we report removal of a huge vegetation in RV lead of permanent pacemaker though open surgical approach using extracorporeal circulation which was giving rise to lead endocarditis. A new epicardial lead was placed as the patient was pacemaker dependent. Though the culture of the extracted material didn’t reveal any organism but the patient was improved a lot after operation from both symptomatic (subsidence of fever) & hemodynamic point of view. In follow-up OPD visit she was found to be recovered well without any complication. In conclusion, explantation of the entire pacemaker system is necessary to cure lead endocarditis in addition to appropriate antibiotic therapy. (Cardiovasc. j. 2020; 12(2): 162-166)
心脏内植入式装置如起搏器感染相对罕见,但并发症严重。在本文中,我们报告了通过体外循环开放手术方法去除永久性起搏器右心室导联中的巨大植被,这是引起铅心内膜炎的原因。由于患者依赖起搏器,因此放置了新的心外膜导联。虽然提取物的培养未发现任何生物,但从症状(退烧)和血流动力学的角度来看,术后患者有了很大的改善。在后续的OPD访问中,发现她恢复良好,没有任何并发症。综上所述,除了适当的抗生素治疗外,整个起搏器系统的外植是治疗铅性心内膜炎的必要条件。(Cardiovasc。j。2020;12 (2): 162 - 166)
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引用次数: 0
Clarence Walton Lillehei: The Pioneer Open Heart Surgeon 克拉伦斯·沃尔顿·利勒黑:心脏直视外科先驱
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47994
Anisuzzaman, N. Hosain
Abstract not available Cardiovasc. j. 2020; 12(2): 145-148
摘要:心血管。j。2020;12 (2): 145 - 148
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引用次数: 1
Impact of Baseline Admission Serum Creatinine Level in ST Segment Elevated Myocardial Infarction (STEMI) Patient Undergoing Primary PCI: An Important Predictor of in-hospital and 12-month Survival Outcome ST段抬高型心肌梗死(STEMI)患者接受首次PCI治疗时入院基线血清肌酐水平的影响:住院和12个月生存结局的重要预测指标
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47991
A. Islam, S. Munwar, S. Talukder, A. Reza, A. H. Bhuiyan, T. Ahmed, Kazi Atiqur Rahman, M. A. Ali, Shamsul Alam, M. Hasan, Aparajita Karim
Background: Several studies has shown that impaired renal function might be an important predictor of adverse cardiovascular events in patient with ST elevated myocardial Infarction (STEMI) undergoing primary percutaneous intervention (pPCI). Exact data on clinical impact of baseline or admission serum creatinine level of STEMI patient undergoing pPCI in our patient population not well established. Therefore, we have carried out this non-randomized study to see the effects of S. creatinine level on major adverse cardiovascular outcomes among STEMI patient undergoing pPCI. Methods: Patients were enrolled in this observational non-randomized prospective cohort between November 2017-July 2019, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced of acute ST elevated myocardial infarction. Total 137 patient (F 12; Male 125) were enrolled in this study. Results: Out of 137 patients, female :12 (8.75%) vs Male: 125 (91.2%). Among, these patient females were more obese (BMI: Female 27.0 ± 2.2 vs male 25.4 ± 4.9) and developed CAD in advance age (Female 59.1 ± 14.5 vs Male 53.4 ± 10.5). Among the 137 patients, 89 (65%) were dyslipidemia, 72 (52.6%) were hypertensive, Diabetic 66(48%), Smoker 70 (51%) and FH positive for CAD were 31 (22.6%). According to the involvement of myocardium infarction, STEMI diagnosis of Anterior MI were 48.9% (n=67) and Inferior MI 51.1% (n=70). An elevated serum creatinine level was defined as creatinine >1.2mg/dl. Based on baseline serum creatinine level, patients were divided into group-A and Group-B. In Group-A. Total 68 patients have S. Creatinine level <1.2 and in Group-B, 69 patients have S. Creatinine level >1.2. Anterior MI were higher in group -B patient than Group-A; Ant MI as 35 (50.4%) vs 31(45.6%), Inf MIL: 34 (49.35) vs 34 (50%), Shock 11 (15.9%) vs 6 (8.8%0, CHB 4 (5.8%) vs 4 (5.9%), Death 12 (17.4%) vs 2 (2.9%) and LVF 5(7.2%) vs 1(1.5%) with 7 days in-hospital stay after primary PCI. Territory wise involvement of vessel in Group-B patient has more involvement of LAD 35 (50.7%) and Group-A has RCA 26(38.2%). Conclusion: In this present study, we found, that in acute STEMI patients, baseline higher serum creatinine level is associated with more AMI related complications and death than in lower serum creatinine level. Thus, we may conclude that baseline admission serum creatinine level may be an important predictor for both in-hospital and 12-month survival outcomes in STEMI patients undergoing pPCI. (Cardiovasc. j. 2020; 12(2): 135-142)
背景:几项研究表明,肾功能受损可能是ST段抬高型心肌梗死(STEMI)患者接受原发性经皮介入治疗(pPCI)时不良心血管事件的重要预测因素。在我们的患者群体中,接受pPCI的STEMI患者的基线或入院血清肌酐水平的临床影响的确切数据尚未得到很好的确定。因此,我们进行了这项非随机研究,以观察S.肌酐水平对STEMI患者接受pPCI的主要不良心血管结局的影响。方法:2017年11月至2019年7月期间,患者被纳入该观察性非随机前瞻性队列,这些患者因急性发作的严重胸痛或心绞痛而就诊于急诊科,心电图显示为急性ST段升高的心肌梗死。137例患者(f12;共纳入125名男性。结果:137例患者中,女性12例(8.75%),男性125例(91.2%)。其中,女性肥胖者较多(BMI:女性27.0±2.2 vs男性25.4±4.9),且出现冠心病的年龄较早(女性59.1±14.5 vs男性53.4±10.5)。137例患者中,血脂异常89例(65%),高血压72例(52.6%),糖尿病66例(48%),吸烟者70例(51%),FH阳性冠心病31例(22.6%)。根据心肌梗死的累及程度,STEMI诊断前路心肌梗死占48.9% (n=67),下路心肌梗死占51.1% (n=70)。血清肌酐水平升高定义为肌酐bb0 1.2mg/dl。根据基线血清肌酐水平将患者分为a组和b组。在赛区。68例患者S.肌酐水平为1.2。b组前路心肌梗死发生率高于a组;首次PCI术后住院7天,Ant MI为35 (50.4%)vs 31(45.6%), Inf MIL: 34 (49.35) vs 34 (50%), Shock 11 (15.9%) vs 6 (8.8%), CHB 4 (5.8%) vs 4 (5.9%), Death 12 (17.4%) vs 2 (2.9%), LVF 5(7.2%) vs 1(1.5%)。b组患者的血管占位有LAD 35 (50.7%), a组有RCA 26(38.2%)。结论:在本研究中,我们发现,在急性STEMI患者中,基线较高的血清肌酐水平与较低的血清肌酐水平相关的AMI相关并发症和死亡更多。因此,我们可以得出结论,入院时基线血清肌酐水平可能是接受pPCI的STEMI患者住院和12个月生存结果的重要预测因子。(Cardiovasc。j。2020;12 (2): 135 - 142)
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引用次数: 2
Life sketch of Prof. Emeritus M. Nabi Alam Khan 名誉教授纳比·阿拉姆·汗的生平素描
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47992
N. Ahsan
Abstract not available Cardiovasc. j. 2020; 12(2): 143
摘要:心血管。j。2020;12 (2): 143
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引用次数: 0
The Challenging Dream of Rene Favaloro and Genesis of Saphenous Venous Grafts Rene Favaloro的挑战之梦与隐静脉移植物的起源
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47995
Anisuzzaman, N. Hosain
Rene Geronimo Favaloro was a noble personality in the history of heart surgery. Though Known mostly in the surgeons’ circles for the Favaloro sternal retractor named after him, his contribution in introducing saphenous venous coronary grafts have saved millions of lives over last six decades. By his admirable integrity, honesty, commitment to the patients, selflessness and compassion, Dr Favaloro has set an example that every surgeon should emulate.1 But this famous and talented surgeon ultimately had a very unfortunate and tragic end of his colorful life. Rene G Favaloro was born in 1923 and raised in La Plata, Argentina. After graduating from high school, he was admitted to the School of Medicine at the National University of La Plata. During his third year, he began his medical residency at the Hospital Policlinico San Martin, a medical centre that received the most complicated cases from much of Buenos Aires province. In that residency program, he attended procedures carried out by Professors Jose Maria Mainetti and Federico E. B. Christmann, from whom he learned simplicity and standardization that he would later apply to his great contributions to cardiovascular operating techniques. Favaloro graduated with a medical degree in 1949.2,3
雷内·杰罗尼莫·法瓦洛罗是心脏外科历史上一位崇高的人物。尽管法瓦洛罗以他的名字命名的胸骨牵开器在外科医学界广为人知,但他在引入冠状动脉隐静脉移植方面的贡献在过去的60年里挽救了数百万人的生命。法瓦洛罗医生以其令人钦佩的正直、诚实、对病人的承诺、无私和同情心,为每个外科医生树立了一个应该效仿的榜样但这位著名而有才华的外科医生最终以非常不幸和悲惨的方式结束了他丰富多彩的一生。Rene G Favaloro出生于1923年,在阿根廷的拉普拉塔长大。高中毕业后,他被拉普拉塔国立大学医学院录取。第三年,他开始在圣马丁医院(Hospital Policlinico San Martin)实习,这是一家接收布宜诺斯艾利斯省大部分地区最复杂病例的医疗中心。在住院医师项目中,他参加了Jose Maria Mainetti和Federico E. B. Christmann教授的手术,从他们那里他学会了简单和标准化,后来他将这些应用到心血管手术技术中。法瓦洛罗于1949年毕业,获得医学学位
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引用次数: 0
Study on Seasonal Variation of Acute Myocardial Infarction Hospitalization 急性心肌梗死住院的季节变化研究
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47990
Md Sajjadur Rahman, A. Chowdhury, Khandker Md Nurus Sabah, Md Gaffar Amin, Sudhakar Sarker, Md Shuaib Ahmed, Mohammad Harun Ur Rashid Khan, Md Anisul Goni Khan
Background: Coronary artery disease is an important medical and public health issue as it is common and leading cause of mortality and morbidity in Bangladesh as it is throughout the world. This study was carried out to determine the existence of seasonal rhythms in hospital admissions due to acute myocardial infarction (AMI) in Dhaka Medical College Hospital. Methods: This cross-sectional observational study was conducted during the period of April 2015 to March 2016 among the patients with AMI admitted at the Cardiology Department of DMCH. 882 patients were enrolled. Results: The highest number of patients were admitted during winter (n=285, 32.3%) followed by post monsoon (n=213, 24.1%) and monsoon (n=194, 22.0%). The lowest number of patients were admitted during summer (n=190, 21.5%). The hospital admission was significantly higher in winter compared to other seasons (p-value versus summer, monsoon and post monsoon was 0.008, 0.011 and 0.042 respectively). Conclusion: A seasonal variation in the hospital admission due to AMI with a peak in winter was clearly demonstrated in the study. Persons admitted to hospital with AMI tend to be all age groups and both sexes present a stronger seasonal variation peak admission in winter. (Cardiovasc. j. 2020; 12(2): 126-134)
背景:冠状动脉疾病是一个重要的医疗和公共卫生问题,因为它是孟加拉国和世界各地死亡和发病的常见和主要原因。本研究旨在确定达卡医学院医院急性心肌梗死(AMI)住院患者是否存在季节性节律。方法:对2015年4月至2016年3月在大连医科大学附属医院心内科住院的AMI患者进行横断面观察研究。882名患者入组。结果:冬季住院患者最多(285例,占32.3%),其次为季风后(213例,占24.1%)和季风后(194例,占22.0%)。夏季入院患者最少(190例,21.5%)。冬季住院率显著高于其他季节(p值分别为0.008、0.011和0.042)。结论:本研究明确了AMI住院人数的季节性变化,冬季为高峰。AMI住院患者多为各年龄组,男女均有较大的季节差异,冬季为住院高峰。(Cardiovasc。j。2020;12 (2): 126 - 134)
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引用次数: 0
Cholesterol Granuloma of Chest Wall – A very Rare Benign Tumour 胸壁胆固醇肉芽肿-一种非常罕见的良性肿瘤
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47996
S. Z. Nine, Z. Haider, Sohail Ahmed, N. Ahmed, Saiful Khan, M. D. Hossain, Nazmus Sakib Khan, Tahera Mehar, Kamrul Hasan
Cholesterol granuloma is a rare benign tumour and is described as inflammatory granulation that occurs in response to the deposition of cholesterol crystals. It is found most commonly in the paranasal sinuses or temporal bones, but there are also rare reports of their occurrence in the peritoneum, parotid gland, lymph nodes, thyroglossal duct, kidney, liver, and spleen. Involvement of the ribs has rarely been described previously. We report a case of cholesterol granuloma involving chest wall in second intercostals space of a 74-year-old male who presented with a slowly growing lesion of the anterior aspect of right side of the chest. (Cardiovasc. j. 2020; 12(2): 158-161)
胆固醇肉芽肿是一种罕见的良性肿瘤,被描述为炎性肉芽肿,发生在胆固醇晶体沉积的反应。它最常见于鼻窦或颞骨,但在腹膜、腮腺、淋巴结、甲状舌管、肾脏、肝脏和脾脏也有罕见的报道。累及肋骨以前很少有报道。我们报告一例胆固醇肉芽肿累及第二肋间隙胸壁的74岁男性,其表现为右胸部前部缓慢生长的病变。(Cardiovasc。j。2020;12 (2): 158 - 161)
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引用次数: 0
Life sketch of Prof. Sirajur Rahman Khan 西拉居尔·拉赫曼·汗教授的生平素描
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47993
N. Ahmed
Abstract not available Cardiovasc. j. 2020; 12(2): 144
摘要:心血管。j。2020;12 (2): 144
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引用次数: 0
Blood Lactate Level as Predictor of Early Outcome after Off-Pump Coronary Artery Bypass Grafting 血乳酸水平作为非体外循环冠状动脉搭桥术早期预后的预测因子
Pub Date : 2020-07-03 DOI: 10.3329/cardio.v12i2.47989
N. Aktar, A. Rahim, Aym Shahidullah, A. Hossain, F. Ahmed
Background: Identification of predictors of morbidity and mortality is an important issue for the management of cardiac surgical patients. Elevated lactate concentrations in the immediate postoperative period reflect unmet metabolic demand and may be associated with outcome. Methods: A prospective observational study was carried out in the department of cardiac surgery, at National Heart Foundation Hospital& Research Institute(NHFH&RI), Dhaka. commencing from July 2016 to March 2018. In all Adult patients irrespective of sex undergoing elective off-pump coronary artery bypass grafting (OPCABG). Purposive sampling was applied with patient with blood lactate level < 3 mmol/L 6hours after shifting from OT to ICU in Group-A and blood lactate level ≥3mmol/l, 6hours after shifting to the ICU in Group-B.Postoperative early adverse outcomes were analyzed in both the patient groups. Results: Blood lactate level 6 hours after ICU transfer is an independent predictor for prolonged mechanical ventilation time, (OR 2.540, 95% CI 1.781-3.621, p= <0.001).prolonged ICU stay, .(OR 1.767, 95% CI 1.348-2.315, p=< 0.001) pulmonary complication (OR 1.503, 95% CI 1.104-2.046, p= 0.010).and renal dysfunction(OR 1.460, 95% CI 1.156-1.843, p= 0.001). following off-pump coronary artery bypass grafting. Other risk factors for adverse outcome including, low LVEF, diabetes mellitus, blood transfusion and inotropic support were also found to be predictors of major complications in
背景:确定发病率和死亡率的预测因素是心脏手术患者管理的一个重要问题。术后即刻乳酸浓度升高反映了未满足的代谢需求,并可能与预后相关。方法:在达卡国立心脏基金会医院和研究所(NHFH&RI)心脏外科进行前瞻性观察研究。由2016年7月起至2018年3月。所有接受非体外循环冠状动脉旁路移植术(OPCABG)的成人患者不分性别。a组患者从OT转ICU后6小时血乳酸水平< 3mmol/ L, b组患者转ICU后6小时血乳酸水平≥3mmol/ L,采用目的采样。分析两组患者术后早期不良结局。结果:转ICU后6小时血乳酸水平是机械通气时间延长的独立预测因子(OR 2.540, 95% CI 1.781-3.621, p= <0.001)。肺部并发症(OR 1.503, 95% CI 1.104 ~ 2.046, p= 0.010)。肾功能不全(OR 1.460, 95% CI 1.156 ~ 1.843, p= 0.001)。非体外循环冠状动脉旁路移植术后。其他不良结果的危险因素包括低LVEF、糖尿病、输血和肌力支持也被发现是主要并发症的预测因素
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引用次数: 1
期刊
Cardiovascular Journal
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