Pub Date : 2022-10-10DOI: 10.3329/cardio.v15i1.61906
P. Bala, M. A. Ali, A. Reza, S. Talukder, S. Munwar, T. Ahmed, Kazi Atiqur Rahman, M. Khan, Nighat Islam, A. H. Bhuiyan, A. Islam, D. Afroz, Abeeda Tasnim Reza, Md Arifur Rahman, Aparajita Karim, Kanu Bala, M. Chaudhary
Background: Radiofrequency catheter ablation is a curative modality of treatment for paroxysmal supraventricular tachycardia. The aim of our study was to evaluate our experience of electrophysiology procedures and radiofrequency ablation in atrioventricular reciprocating tachycardia (AVRT). Methods: All patients undergoing cardiac electrophysiology and radiofrequency ablation procedures during the period from July, 2019 to July, 2021 at Department of Cardiology, Evercare Hospital, Dhaka were included in this study. The study analyzed 141 patients of among them 75(53.2%) patients were male and 66(46.8%) were female. Results: Patients who came with AVRT, 91 (65%) had concealed and 50 (35%) had manifested. The overall short term success rate was 99 %. There was no difference in the success rates between the younger and older patients. Complication rate is lower side of the spectrum, which is 1.4% (four patients). Conclusion: Radiofrequency ablation is a safe and successful treatment modality for patients with atrioventricular reciprocating tachycardia in this real - world study. Cardiovasc j 2022; 15(1): 20-25
{"title":"Outcome in Cardiac Electrophysiology and Radiofrequency Ablation of Atrioventricular Reciprocating Tachycardia - A Single Center Experience","authors":"P. Bala, M. A. Ali, A. Reza, S. Talukder, S. Munwar, T. Ahmed, Kazi Atiqur Rahman, M. Khan, Nighat Islam, A. H. Bhuiyan, A. Islam, D. Afroz, Abeeda Tasnim Reza, Md Arifur Rahman, Aparajita Karim, Kanu Bala, M. Chaudhary","doi":"10.3329/cardio.v15i1.61906","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61906","url":null,"abstract":"Background: Radiofrequency catheter ablation is a curative modality of treatment for paroxysmal supraventricular tachycardia. The aim of our study was to evaluate our experience of electrophysiology procedures and radiofrequency ablation in atrioventricular reciprocating tachycardia (AVRT).\u0000Methods: All patients undergoing cardiac electrophysiology and radiofrequency ablation procedures during the period from July, 2019 to July, 2021 at Department of Cardiology, Evercare Hospital, Dhaka were included in this study. The study analyzed 141 patients of among them 75(53.2%) patients were male and 66(46.8%) were female.\u0000Results: Patients who came with AVRT, 91 (65%) had concealed and 50 (35%) had manifested. The overall short term success rate was 99 %. There was no difference in the success rates between the younger and older patients. Complication rate is lower side of the spectrum, which is 1.4% (four patients).\u0000Conclusion: Radiofrequency ablation is a safe and successful treatment modality for patients with atrioventricular reciprocating tachycardia in this real - world study.\u0000Cardiovasc j 2022; 15(1): 20-25","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77880553","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61916
D. Roychoudhury, J. Koruth
Brugada syndrome is inherited in an autosomal dominant pattern which is associated with ventricular fibrillation and sudden cardiac death in a patient with structurally normal heart. The diagnosis is clinched on characteristic EKG pattern of >2 mm ST segment elevation followed by negative T wave in right precordial leads V1,2 either occurring spontaneously or with pharmacological provocation with a sodium channel blocker. Prevalence of this disease varies by geographic location and sex with highest preponderance in South East Asian countries and in males. Among South-East Asian countries, there has been only one case report so far from Bangladesh and that too in a male patient. We present a case of female patient from Bangladesh with Brugada syndrome. We also report an association of Autism with Brugada syndrome in patient’s only female child. Cardiovasc j 2022; 15(1): 86-87
{"title":"Brugada Syndrome in a Female Patient from Bangladesh: A Rare Occurrence","authors":"D. Roychoudhury, J. Koruth","doi":"10.3329/cardio.v15i1.61916","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61916","url":null,"abstract":"Brugada syndrome is inherited in an autosomal dominant pattern which is associated with ventricular fibrillation and sudden cardiac death in a patient with structurally normal heart. The diagnosis is clinched on characteristic EKG pattern of >2 mm ST segment elevation followed by negative T wave in right precordial leads V1,2 either occurring spontaneously or with pharmacological provocation with a sodium channel blocker. Prevalence of this disease varies by geographic location and sex with highest preponderance in South East Asian countries and in males. Among South-East Asian countries, there has been only one case report so far from Bangladesh and that too in a male patient. We present a case of female patient from Bangladesh with Brugada syndrome. We also report an association of Autism with Brugada syndrome in patient’s only female child.\u0000Cardiovasc j 2022; 15(1): 86-87","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84790644","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61904
M. A. K. Akanda, Abeeda Tasnim Reza, Md Muhtasim Akanda, Md.Khyrul Kabir
Background: Diabetes Mellitus (DM) is an established independent predictor of adverse prognosis in patients undergoing percutaneous coronary intervention (PCI) even with improvements in diabetes treatment and interventional techniques. The aim of this study was to compare long term post PCI outcome between diabetic and non-diabetic patients with ischemic heart disease (IHD). Method: The data was derived from a prospective observational study to evaluate the outcome after PCI in DM patients for 2 years. A total of 305 patients with IHD & DM were randomly selected and enrolled who underwent PCI from 2010 to 2013 in an urban cardiac hospital of Bangladesh. The study population were divided into two groups with group 1 consisting of patients with DM (n=108) and group 2 of patients without DM (n=197). After the PCI, all patients were followed up for 2 years. The incidences of bleeding, stent thrombosis, myocardial infarction (MI), stroke and repeat revascularization were compared. Results: Diabetic patients had significant adverse outcomes having MI, stroke & MACCE respectively following 1 year (p= 0.018, 0.036 & 0.017) and MI following 2 years (p= 0.013) compared to non-diabetic patients. However, in multivariate analysis, diabetes mellitus was not found to be an independent predictor for 1-year & 2-year adverse events following PCI [OR 1.016 (0.317-3.259) & p 0.979, after 1 year and 1.554 (0.087 – 27.902) & p 0.765, after 2 years]. Conclusions: The outcome of PCI after 1 year and 2 years among diabetic and non-diabetic subjects with IHD differed significantly in respect of MI, stroke & MACCE. But this study failed to identify diabetes mellitus as an independent risk factor for 1-year and 2-year adverse outcomes. Cardiovasc j 2022; 15(1): 5-12
{"title":"Comparison of Long-term Outcome between Diabetic and Non-Diabetic Patients with Ischemic Heart Disease following Percutaneous Coronary Intervention: A Prospective Study","authors":"M. A. K. Akanda, Abeeda Tasnim Reza, Md Muhtasim Akanda, Md.Khyrul Kabir","doi":"10.3329/cardio.v15i1.61904","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61904","url":null,"abstract":"Background: Diabetes Mellitus (DM) is an established independent predictor of adverse prognosis in patients undergoing percutaneous coronary intervention (PCI) even with improvements in diabetes treatment and interventional techniques. The aim of this study was to compare long term post PCI outcome between diabetic and non-diabetic patients with ischemic heart disease (IHD).\u0000Method: The data was derived from a prospective observational study to evaluate the outcome after PCI in DM patients for 2 years. A total of 305 patients with IHD & DM were randomly selected and enrolled who underwent PCI from 2010 to 2013 in an urban cardiac hospital of Bangladesh. The study population were divided into two groups with group 1 consisting of patients with DM (n=108) and group 2 of patients without DM (n=197). After the PCI, all patients were followed up for 2 years. The incidences of bleeding, stent thrombosis, myocardial infarction (MI), stroke and repeat revascularization were compared.\u0000Results: Diabetic patients had significant adverse outcomes having MI, stroke & MACCE respectively following 1 year (p= 0.018, 0.036 & 0.017) and MI following 2 years (p= 0.013) compared to non-diabetic patients. However, in multivariate analysis, diabetes mellitus was not found to be an independent predictor for 1-year & 2-year adverse events following PCI [OR 1.016 (0.317-3.259) & p 0.979, after 1 year and 1.554 (0.087 – 27.902) & p 0.765, after 2 years].\u0000Conclusions: The outcome of PCI after 1 year and 2 years among diabetic and non-diabetic subjects with IHD differed significantly in respect of MI, stroke & MACCE. But this study failed to identify diabetes mellitus as an independent risk factor for 1-year and 2-year adverse outcomes.\u0000Cardiovasc j 2022; 15(1): 5-12","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88001424","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61911
Mohammad Mamoon Islam, Abdul Kader Akanda, M. Ullah, M. Alam, Md Gulam Mostofa, Md Zillur Rahman, Md Bonday Ali, Suchitra Basak
Background: Microalbuminuria may have an association with myocardial infarction in absence of traditional risk factors like diabetes. The present study was intended to find the association between microalbuminuria and angiographic severity of coronary artery disease in non-diabetic myocardial infarction patients. Methods: This cross sectional analytical study included 105 non-diabetic patients with myocardial infarction who underwent coronary angiography (CAG). The microalbuminuria was defined as urine albumin to creatinine ratio (ACR) of 30 -300 mg/g, while angiographic severity was measured by Gensini score with score e” 36 was taken as moderate to severe coronary artery disease (Group I) and score below 36 was termed as absent or mild coronary artery disease (Group II). Association of microalbuminuria with severity of coronary artery disease was determined. Results: Presence of microalbuminuria was found significantly higher (45%) in patients with moderate to severe coronary artery disease than that in patients with absent or mild CAD (4.6%). The Odds of having moderate to severe coronary artery disease in patients with microalbuminuria was observed to be 17 times (95% CI = 4.5 - 63) higher than that in patients without having this condition. Correlation between ACR and Gensini score was also found a significant positive relationship (r=0.702, p<0.001) with 70% of variation in Gensini score being explained by ACR. Conclusion: Microalbuminuria can be considered as a predictor of the severity of coronary artery disease in non-diabetic myocardial infarction patients. Cardiovasc j 2022; 15(1): 56-62
{"title":"Correlation between Microalbuminuria and Coronary Angiographic Severity in Non-diabetic Myocardial Infarction patients","authors":"Mohammad Mamoon Islam, Abdul Kader Akanda, M. Ullah, M. Alam, Md Gulam Mostofa, Md Zillur Rahman, Md Bonday Ali, Suchitra Basak","doi":"10.3329/cardio.v15i1.61911","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61911","url":null,"abstract":"Background: Microalbuminuria may have an association with myocardial infarction in absence of traditional risk factors like diabetes. The present study was intended to find the association between microalbuminuria and angiographic severity of coronary artery disease in non-diabetic myocardial infarction patients.\u0000Methods: This cross sectional analytical study included 105 non-diabetic patients with myocardial infarction who underwent coronary angiography (CAG). The microalbuminuria was defined as urine albumin to creatinine ratio (ACR) of 30 -300 mg/g, while angiographic severity was measured by Gensini score with score e” 36 was taken as moderate to severe coronary artery disease (Group I) and score below 36 was termed as absent or mild coronary artery disease (Group II). Association of microalbuminuria with severity of coronary artery disease was determined.\u0000Results: Presence of microalbuminuria was found significantly higher (45%) in patients with moderate to severe coronary artery disease than that in patients with absent or mild CAD (4.6%). The Odds of having moderate to severe coronary artery disease in patients with microalbuminuria was observed to be 17 times (95% CI = 4.5 - 63) higher than that in patients without having this condition. Correlation between ACR and Gensini score was also found a significant positive relationship (r=0.702, p<0.001) with 70% of variation in Gensini score being explained by ACR.\u0000Conclusion: Microalbuminuria can be considered as a predictor of the severity of coronary artery disease in non-diabetic myocardial infarction patients.\u0000Cardiovasc j 2022; 15(1): 56-62","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"141 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76183423","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61905
Suchitra Basak, M. A. K. Akanda, M. Ullah, Sushanta Barua, M. Hasan, Md Shazedur Rahman, Mohammad Mamoon Islam, Md Gulam Mostafa
Background: Early detection and appropriate management play a key role in reducing the morbidity and mortality of acute heart failure in patients with acute myocardial infarction. Many prognostic factors have been assessed till date. This study aimed to evaluate the prognostic effect of NLR on in-hospital outcomes in patients with acute heart failure due to acute anterior ST elevation myocardial infarction. Methods: The present study was carried out in the Department of cardiology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from January 2020 to December 2020. A total of 88 cases of acute heart failure due to acute anterior ST elevation Myocardial infarction patients are enrolled in this study. NLR was estimated and patients were divided into two groups based on the NLR (Group I NLR <6; Group II NLR ≥6). Then in-hospital outcome was observed and compared between two groups. Results: In-hospital mortality and length of hospital stay were higher among NLR ≥6 patients with statistical significance (11.6% vs. 40.9%, p<0.001). These patients also had high incidence of cardiogenic shock (25% vs. 43%, p>0.072), Arrhythmia (18% vs. 34%, p>0.089) but without statistically significant difference. Conclusion: In this study, we observed that in-hospital outcomes were worse in patients with acute heart failure due to acute anterior myocardial infarction with NLR ≥6. So NLR can be used as a predictor of outcome in acute heart failure patients. This association is independent of conventional cardiovascular risk factors. Cardiovasc j 2022; 15(1): 13-19
{"title":"Association of Neutrophil to Lymphocyte Ratio with In- hospital Outcome of Acute Heart Failure due to Acute Anterior ST-elevation Myocardial Infarction","authors":"Suchitra Basak, M. A. K. Akanda, M. Ullah, Sushanta Barua, M. Hasan, Md Shazedur Rahman, Mohammad Mamoon Islam, Md Gulam Mostafa","doi":"10.3329/cardio.v15i1.61905","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61905","url":null,"abstract":"Background: Early detection and appropriate management play a key role in reducing the morbidity and mortality of acute heart failure in patients with acute myocardial infarction. Many prognostic factors have been assessed till date. This study aimed to evaluate the prognostic effect of NLR on in-hospital outcomes in patients with acute heart failure due to acute anterior ST elevation myocardial infarction.\u0000Methods: The present study was carried out in the Department of cardiology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from January 2020 to December 2020. A total of 88 cases of acute heart failure due to acute anterior ST elevation Myocardial infarction patients are enrolled in this study. NLR was estimated and patients were divided into two groups based on the NLR (Group I NLR <6; Group II NLR ≥6). Then in-hospital outcome was observed and compared between two groups.\u0000Results: In-hospital mortality and length of hospital stay were higher among NLR ≥6 patients with statistical significance (11.6% vs. 40.9%, p<0.001). These patients also had high incidence of cardiogenic shock (25% vs. 43%, p>0.072), Arrhythmia (18% vs. 34%, p>0.089) but without statistically significant difference.\u0000Conclusion: In this study, we observed that in-hospital outcomes were worse in patients with acute heart failure due to acute anterior myocardial infarction with NLR ≥6. So NLR can be used as a predictor of outcome in acute heart failure patients. This association is independent of conventional cardiovascular risk factors.\u0000Cardiovasc j 2022; 15(1): 13-19","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75904173","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61907
Md Gulam Mostofa, Abdul Kader Akanda, M. Ullah, Md Zillur Rahman, Mohammad Mamoon Islam, M. Alam, Md. Ahsanul Haque, Suchitra Basak
Background: Glycated hemoglobin (HbA1c) values reflect two to three months average endogenous exposure haemoglobin to glucose including postprandial spikes and have low intra-individual variability particularly in non-diabetic patients. Elevated HbA1c is regarded as an independent risk factor for coronary artery disease (CAD) in patients with or without diabetes mellitus (DM). The purpose of this study is to determine the correlation between the level of HbA1c and the severity of coronary artery disease in non-diabetic non ST elevation myocardial infarction (NSTEMI) patients. Methods: This observational study was carried out with total of 64 non-diabetic patients with a history of NSTEMI. Patients were divided into 2 groups based on HbA1c - one group having HbA1c ³5.7 – 6.4% (High risk group) and another group with HbA1c < 5.7% (Low risk group). Severity of CAD was assessed using Gensini score derived from coronary angiographic data. Gensini score < 36 points was regarded as mild coronary artery disease and Gensini score 36 points as moderate to severe coronary artery disease. Then patients with high and low risk HbA1C groups were correlated with severity of CAD. Results: Over 55.5% patients with HbA1c in high-risk group (5.7 – 6.4%) had severe CAD as opposed to 28.6% patients with HbA1c in low-Risk group (<5.7%). The individuals with high-risk group of HbA1c was 3.1 (95% of CI = 1.1 – 8.9) times more likely to have severe CAD than those with HbA1c < 5.7% (p = 0.031). Spearman correlation between HbA1c and Gensini score depicted that the two variables exhibit a linear relationship indicating that Gensini score rises parallel with the rise of HbA1c (r = 0.289, p = 0.021). Conclusion: The study concluded that over half of the non-diabetic, NSTEMI patients with high-risk range HbA1c are likely to have severe CAD than those with HBA1c within normal range. Cardiovasc j 2022; 15(1): 26-35
{"title":"Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients","authors":"Md Gulam Mostofa, Abdul Kader Akanda, M. Ullah, Md Zillur Rahman, Mohammad Mamoon Islam, M. Alam, Md. Ahsanul Haque, Suchitra Basak","doi":"10.3329/cardio.v15i1.61907","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61907","url":null,"abstract":"Background: Glycated hemoglobin (HbA1c) values reflect two to three months average endogenous exposure haemoglobin to glucose including postprandial spikes and have low intra-individual variability particularly in non-diabetic patients. Elevated HbA1c is regarded as an independent risk factor for coronary artery disease (CAD) in patients with or without diabetes mellitus (DM). The purpose of this study is to determine the correlation between the level of HbA1c and the severity of coronary artery disease in non-diabetic non ST elevation myocardial infarction (NSTEMI) patients.\u0000Methods: This observational study was carried out with total of 64 non-diabetic patients with a history of NSTEMI. Patients were divided into 2 groups based on HbA1c - one group having HbA1c ³5.7 – 6.4% (High risk group) and another group with HbA1c < 5.7% (Low risk group). Severity of CAD was assessed using Gensini score derived from coronary angiographic data. Gensini score < 36 points was regarded as mild coronary artery disease and Gensini score 36 points as moderate to severe coronary artery disease. Then patients with high and low risk HbA1C groups were correlated with severity of CAD.\u0000Results: Over 55.5% patients with HbA1c in high-risk group (5.7 – 6.4%) had severe CAD as opposed to 28.6% patients with HbA1c in low-Risk group (<5.7%). The individuals with high-risk group of HbA1c was 3.1 (95% of CI = 1.1 – 8.9) times more likely to have severe CAD than those with HbA1c < 5.7% (p = 0.031). Spearman correlation between HbA1c and Gensini score depicted that the two variables exhibit a linear relationship indicating that Gensini score rises parallel with the rise of HbA1c (r = 0.289, p = 0.021).\u0000Conclusion: The study concluded that over half of the non-diabetic, NSTEMI patients with high-risk range HbA1c are likely to have severe CAD than those with HBA1c within normal range.\u0000Cardiovasc j 2022; 15(1): 26-35","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77745572","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 : 2022-10-10DOI: 10.3329/cardio.v15i1.61908
M. Z. Rahman, Abdul Kader Akanda, M. Ullah, Md. Shariful Alam, Md Gulam Mostofa, Mohammad Mamoon Islam, Md. Iqbal Hossain, Md. Ahsanul Haque
Background: Early risk stratification of patients with myocardial infarction is critical to determine optimum treatment strategies and enhance outcomes. The present study was therefore undertaken to determine the relationship between QRS duration (QRSd) on admission ECG and left ventricular ejection fraction (LVEF) as a measure of left ventricular function in non-ST elevated myocardial infarction (NSTEMI) patients. Methods: This observational study was carried out from January to December 2020 with total of 120 patients with a history of NSTEMI. Based on the cut-off value of QRS duration 100 msec, the patients were divided into two groups – one group with QRS duration d” 100 msec (normal QRS) and another group with QRS duration > 100 msec (prolonged QRS). Left ventricular systolic function was considered preserved, if it was e” 52% and reduced if it was < 52%. The association and correlation between QRS duration and LVEF was then observed. Results: The prevalence of reduced LVEF in patients with prolonged QRS duration (> 100 msec) was double (38%) than that of preserved (19.5%). The risk of having LV dysfunction in patients with prolonged QRS duration was 2.5 (95% CI = 1.1 – 6.2) times higher than that in patients normal QRS duration (d” 100 msec) (p = 0.039). The QRS duration and LVEF bear a significantly inverse relationship (r = -0.341, p < 0.001). The sensitivity of prolonged QRS duration (> 100 msec) in correctly detecting LV dysfunction was inappreciably low (38%), although its specificity in excluding those who did not have LV dysfunction was optimum (80.5%) with overall diagnostic accuracy being 52.5%. Conclusion: Prolonged QRS duration on a standard 12-lead ECG is associated with reduced echocardiographic LVEF. However, QRS duration in predicting LV dysfunction is much less sensitive, although its specificity is optimum indicating that QRS duration is not a good predictor of LV dysfunction (reduced LVEF), but it can dependably predict those who do not have LV dysfunction (preserved LVEF). Cardiovasc j 2022; 15(1): 36-41
{"title":"Relationship between QRS duration on ECG and Left Ventricular Systolic Function by Echocardiography in patients with Non-ST elevated Myocardial Infarction","authors":"M. Z. Rahman, Abdul Kader Akanda, M. Ullah, Md. Shariful Alam, Md Gulam Mostofa, Mohammad Mamoon Islam, Md. Iqbal Hossain, Md. Ahsanul Haque","doi":"10.3329/cardio.v15i1.61908","DOIUrl":"https://doi.org/10.3329/cardio.v15i1.61908","url":null,"abstract":"Background: Early risk stratification of patients with myocardial infarction is critical to determine optimum treatment strategies and enhance outcomes. The present study was therefore undertaken to determine the relationship between QRS duration (QRSd) on admission ECG and left ventricular ejection fraction (LVEF) as a measure of left ventricular function in non-ST elevated myocardial infarction (NSTEMI) patients.\u0000Methods: This observational study was carried out from January to December 2020 with total of 120 patients with a history of NSTEMI. Based on the cut-off value of QRS duration 100 msec, the patients were divided into two groups – one group with QRS duration d” 100 msec (normal QRS) and another group with QRS duration > 100 msec (prolonged QRS). Left ventricular systolic function was considered preserved, if it was e” 52% and reduced if it was < 52%. The association and correlation between QRS duration and LVEF was then observed.\u0000Results: The prevalence of reduced LVEF in patients with prolonged QRS duration (> 100 msec) was double (38%) than that of preserved (19.5%). The risk of having LV dysfunction in patients with prolonged QRS duration was 2.5 (95% CI = 1.1 – 6.2) times higher than that in patients normal QRS duration (d” 100 msec) (p = 0.039). The QRS duration and LVEF bear a significantly inverse relationship (r = -0.341, p < 0.001). The sensitivity of prolonged QRS duration (> 100 msec) in correctly detecting LV dysfunction was inappreciably low (38%), although its specificity in excluding those who did not have LV dysfunction was optimum (80.5%) with overall diagnostic accuracy being 52.5%.\u0000Conclusion: Prolonged QRS duration on a standard 12-lead ECG is associated with reduced echocardiographic LVEF. However, QRS duration in predicting LV dysfunction is much less sensitive, although its specificity is optimum indicating that QRS duration is not a good predictor of LV dysfunction (reduced LVEF), but it can dependably predict those who do not have LV dysfunction (preserved LVEF).\u0000Cardiovasc j 2022; 15(1): 36-41","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82985809","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 : 2022-04-06DOI: 10.3329/cardio.v14i2.58774
M. Ahmed, Solaiman Hossain, M. S. Alam, Md. Shahimur Parvez, Debashish Debnath, Md Mahidur Rahman Khan
Background: Atherosclerotic coronary artery disease is rare in young adults aged 40 years or less. However, South Asia is among the top 3 of the countries with highest proportion of cases of first acute coronary syndrome events occurring at age 40 years or less. This study was to explore the extent and pattern of angiographic coronary artery disease among patients of ischemic heart disease aged 40 years or less. Methods: This cross-sectional retrospective descriptive study included 140 patients who had coronary angiography for ischemic heart disease at the Department of Cardiology of Enam Medical College between July 2012 and December 2020. Coronary angiography was analyzed with particular attention to the extent of involvement of major epicardial coronary arteries including significant branch involvement. Results: Of the 140 patients included in the study - aged 18-40 years (mean 35.90 and SD 4.05) and 59.28% in the 36-40 years age group – 85% were male. Coronary angiogram revealed Single Vessel Disease in 39.29%, Double Vessel Disease in 25.72%, Triple Vessel disease in 23.57%, normal Coronaries in 9.28%. Left Anterior descending territory was most involved - 94 (67.14%) patients having significant stenosis in the main trunk and/or one or more major branches. Overall, 23(16.43%) of the whole cohort of patients had multiple branch involvements in the three coronary artery territories. Conclusion: In patients aged up to 40 years with ischemic heart disease, significant coronary artery disease burden was seen, including a significant proportion with multi-vessel disease and a high level of branch involvement in all the principal epicardial coronary territories. This indicates a high burden of disease in a relatively young age group, with significant implications for long term management over and beyond reperfusion/revascularization efforts. Cardiovasc j 2022; 14(2): 103-110
{"title":"Pattern and Extent of Coronary Artery Disease in Patients of Ischemic Heart Disease aged 40 Years or less","authors":"M. Ahmed, Solaiman Hossain, M. S. Alam, Md. Shahimur Parvez, Debashish Debnath, Md Mahidur Rahman Khan","doi":"10.3329/cardio.v14i2.58774","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58774","url":null,"abstract":"Background: Atherosclerotic coronary artery disease is rare in young adults aged 40 years or less. However, South Asia is among the top 3 of the countries with highest proportion of cases of first acute coronary syndrome events occurring at age 40 years or less. This study was to explore the extent and pattern of angiographic coronary artery disease among patients of ischemic heart disease aged 40 years or less.\u0000Methods: This cross-sectional retrospective descriptive study included 140 patients who had coronary angiography for ischemic heart disease at the Department of Cardiology of Enam Medical College between July 2012 and December 2020. Coronary angiography was analyzed with particular attention to the extent of involvement of major epicardial coronary arteries including significant branch involvement.\u0000Results: Of the 140 patients included in the study - aged 18-40 years (mean 35.90 and SD 4.05) and 59.28% in the 36-40 years age group – 85% were male. Coronary angiogram revealed Single Vessel Disease in 39.29%, Double Vessel Disease in 25.72%, Triple Vessel disease in 23.57%, normal Coronaries in 9.28%. Left Anterior descending territory was most involved - 94 (67.14%) patients having significant stenosis in the main trunk and/or one or more major branches. Overall, 23(16.43%) of the whole cohort of patients had multiple branch involvements in the three coronary artery territories.\u0000Conclusion: In patients aged up to 40 years with ischemic heart disease, significant coronary artery disease burden was seen, including a significant proportion with multi-vessel disease and a high level of branch involvement in all the principal epicardial coronary territories. This indicates a high burden of disease in a relatively young age group, with significant implications for long term management over and beyond reperfusion/revascularization efforts.\u0000Cardiovasc j 2022; 14(2): 103-110","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72652780","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 : 2022-04-06DOI: 10.3329/cardio.v13i2.52969
A. Islam, S. Munwar, S. Talukder, A. Reza, A. H. Bhuiyan, T. Ahmed, Kazi Atiqur Rahman, M. A. Ali, Shamsul Alam, Z. Rahman, I. Yusuf, Nighat Islam, M. Hasan, A. B. Siddique, P. Bala, M. Z. Haque, MS Alam, H. Tanvir
Background: Primary percutaneous coronary intervention (pPCI) is the preferred and established mode of treatment in ST elevated myocardial infarction (STEMI). Exact data on procedural outcome in patient undergoing primary PCI in our population is not well documented. Therefore, we have carried out this study to see the prognosis, in-hospital, and 12-month survival outcome of our patients. Methods: Patients were enrolled in the observational non-randomized prospective cohort between November 2017-Mar 2020, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced acute ST elevated myocardial infarction. Total 182 patient (F 14; Male 168) were enrolled in this study. Results: Out of 182 patients, female :14 (7.7%) vs. Male: 168 (92.3%). Among, these patient females were more obese (BMI: Female 27.1 ± 2.1 vs. male 25.8 ± 4.1) and developed CAD in advance age (Female 59.1 ± 13.5 vs. Male 53.7 ± 10.5). Anterior MI were 47.8% (n=87) and Inferior MI 50.5% (n=92) and Lateral MI 1.6% (n=3). At presentation 10.4% (n=19) patents were in cardiogenic shock with STEMI, 42.1%(n=8) patients with Ant MI, 57.9%(n=11) in Inf MI group. Total, 15 (8.2%) patients died; 93.3%(n=14) within 1 week of pPCI due shock and poor LV function and subsequent development of LVF with arrhythmia and 6.7%(n=1) patient died 6 months after pPCI due to other cause. Death was more in Ant Wall STEMI than Inferior wall STEMI, though Cardiogenic shock at presentation were more in Inf MI STEMI than Ant wall STEMI. Conclusion: We may conclude from our observational study on STEMI PCI that the territory wise involvement of myocardium, baseline serum Troponin-I level, infarcted vessel, time to presentation, duration of anginal chest pain and door to balloon time may be the key determinant of better in hospital outcome. Cardiovasc. j. 2021; 13(2): 154-163
{"title":"Primary Percutaneous Coronary Intervention of ST-segment Elevated Myocardial Infarction- Experiences in a Tertiary Care Hospital","authors":"A. Islam, S. Munwar, S. Talukder, A. Reza, A. H. Bhuiyan, T. Ahmed, Kazi Atiqur Rahman, M. A. Ali, Shamsul Alam, Z. Rahman, I. Yusuf, Nighat Islam, M. Hasan, A. B. Siddique, P. Bala, M. Z. Haque, MS Alam, H. Tanvir","doi":"10.3329/cardio.v13i2.52969","DOIUrl":"https://doi.org/10.3329/cardio.v13i2.52969","url":null,"abstract":"Background: Primary percutaneous coronary intervention (pPCI) is the preferred and established mode of treatment in ST elevated myocardial infarction (STEMI). Exact data on procedural outcome in patient undergoing primary PCI in our population is not well documented. Therefore, we have carried out this study to see the prognosis, in-hospital, and 12-month survival outcome of our patients. \u0000Methods: Patients were enrolled in the observational non-randomized prospective cohort between November 2017-Mar 2020, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced acute ST elevated myocardial infarction. Total 182 patient (F 14; Male 168) were enrolled in this study. \u0000Results: Out of 182 patients, female :14 (7.7%) vs. Male: 168 (92.3%). Among, these patient females were more obese (BMI: Female 27.1 ± 2.1 vs. male 25.8 ± 4.1) and developed CAD in advance age (Female 59.1 ± 13.5 vs. Male 53.7 ± 10.5). Anterior MI were 47.8% (n=87) and Inferior MI 50.5% (n=92) and Lateral MI 1.6% (n=3). At presentation 10.4% (n=19) patents were in cardiogenic shock with STEMI, 42.1%(n=8) patients with Ant MI, 57.9%(n=11) in Inf MI group. Total, 15 (8.2%) patients died; 93.3%(n=14) within 1 week of pPCI due shock and poor LV function and subsequent development of LVF with arrhythmia and 6.7%(n=1) patient died 6 months after pPCI due to other cause. Death was more in Ant Wall STEMI than Inferior wall STEMI, though Cardiogenic shock at presentation were more in Inf MI STEMI than Ant wall STEMI. \u0000Conclusion: We may conclude from our observational study on STEMI PCI that the territory wise involvement of myocardium, baseline serum Troponin-I level, infarcted vessel, time to presentation, duration of anginal chest pain and door to balloon time may be the key determinant of better in hospital outcome. \u0000Cardiovasc. j. 2021; 13(2): 154-163","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87941880","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 : 2022-04-06DOI: 10.3329/cardio.v14i2.58782
A. Islam, S. Talukder, S. Munwar, A. Reza, T. Ahmed, K. Rahman
Bifurcation lesion whether it is left main (LM) stem disease with left main to left anterior descending artery (LM-LAD) or left main to left circumflex (LM-LCX), LAD-Diagonal or LCX-Obtuse marginal or right coronary artery- posterior descending artery (RCA-PDA); are not uncommon lesion type that needs to be revascularized either by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) to establish the coronary flow and relieved patient anginal symptoms. Even though, many of the literature maintained non-inferiority of bifurcation lesion PCI over CABG and is Class IIb indication for PCI by coronary stent. In literature, bifurcation lesions commonly encountered in PCI and are regarded as most technically challenging lesions to treat, in up to 20% of PCI cases. With the advent of interventional procedures and the availability of cardiac catheterization laboratory facilities, skilled interventionist, many of the Bangladeshi patients are being treated for coronary artery diseases (CAD). With the advent of drug eluting stents, availability of IVUS (Intravascular Ultrasound), FFR (Fractional Flow Reserve) and individual expertise, treating bifurcation lesion may not be difficult task. Interventionist must be expert enough in doing PCI, before to proceed for bifurcation lesion PCI. We need to work together to develop common consensus in developing updated skill in treating bifurcation lesion which will prove bifurcation PCI in our population. Cardiovasc j 2022; 14(2): 168-175
{"title":"Percutaneous Coronary Intervention of Bifurcation Lesion","authors":"A. Islam, S. Talukder, S. Munwar, A. Reza, T. Ahmed, K. Rahman","doi":"10.3329/cardio.v14i2.58782","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58782","url":null,"abstract":"Bifurcation lesion whether it is left main (LM) stem disease with left main to left anterior descending artery (LM-LAD) or left main to left circumflex (LM-LCX), LAD-Diagonal or LCX-Obtuse marginal or right coronary artery- posterior descending artery (RCA-PDA); are not uncommon lesion type that needs to be revascularized either by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) to establish the coronary flow and relieved patient anginal symptoms. Even though, many of the literature maintained non-inferiority of bifurcation lesion PCI over CABG and is Class IIb indication for PCI by coronary stent. In literature, bifurcation lesions commonly encountered in PCI and are regarded as most technically challenging lesions to treat, in up to 20% of PCI cases. With the advent of interventional procedures and the availability of cardiac catheterization laboratory facilities, skilled interventionist, many of the Bangladeshi patients are being treated for coronary artery diseases (CAD). With the advent of drug eluting stents, availability of IVUS (Intravascular Ultrasound), FFR (Fractional Flow Reserve) and individual expertise, treating bifurcation lesion may not be difficult task. Interventionist must be expert enough in doing PCI, before to proceed for bifurcation lesion PCI. We need to work together to develop common consensus in developing updated skill in treating bifurcation lesion which will prove bifurcation PCI in our population.\u0000Cardiovasc j 2022; 14(2): 168-175","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"236 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73888467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：