Background: Acute renal failure is linked to an increased risk of death and morbidity after cardiac surgery. Because there are no standard criteria for acute renal damage, there is a wide variation in the reports that have been published. The Acute Dialysis Quality Initiative Workgroup has developed new RIFLE criteria for acute renal dysfunction. The goal of current study was to appraise whether this definition of postoperative renal dysfunction after coronary artery bypass surgery (CABG) was accurate.Methods: Fifty patients with critical coronary artery disease & undergoing CABG were enrolled in the study. Out of 50 patients, 25 patients had CABG with cardiopulmonary bypass (CPB) and remaining 25 underwent off pump CABG (OPCAB). Patients were distributed into various groups (based on the severity of renal impairment) using the RIFLE classification: Risk, Injury, Failure, Loss, End-stage kidney disease) depending on either serum creatinine level/ estimated glomerular filtration rate (eGFR) or urine output. The variation with 30 days-mortality, ICU stay and renal replacement therapy after CABG were identified.Results: After CABG, 10% of patients experienced renal impairment, as per definitions of RIFLE classification. In this study, there is no significant difference in ARF (RIFLE classification-normal and risk) with or without use of CPB. However, incidence of RIFLE- injury and failure is higher in CPB group than no CPB group. The postoperative proportions of death and renal failure necessitating renal replacement therapy (RRT) were 2% (number of patients, 1 of 50) and 2% (1 of 50), respectively in RIFLE-failure. For the whole study cohort, the median duration of postoperative ICU stay was 4.0 days, with interquartile ranges of 3.0 to 7.0 days. All the patients of Rifle classification-injury and failure had prolonged ICU stay (5 or more days).Conclusions: The RIFLE criteria are a useful tool for determining renal impairment after CABG. Increased renal replacement treatment, longer ICU stays, and a higher death rate are all linked to the severity of RIFLE classification.Cardiovasc j 2022; 14(2): 150-156
{"title":"The RIFLE Classification: A Stratification Scheme for Patients of Acute Renal Failure after Coronary Artery Bypass Surgery","authors":"Rumman Idris, Musaid Khan, M. Kamruzzaman, Abdul Hannan, H. Kabir, N. Jahan","doi":"10.3329/cardio.v14i2.58780","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58780","url":null,"abstract":"Background: Acute renal failure is linked to an increased risk of death and morbidity after cardiac surgery. Because there are no standard criteria for acute renal damage, there is a wide variation in the reports that have been published. The Acute Dialysis Quality Initiative Workgroup has developed new RIFLE criteria for acute renal dysfunction. The goal of current study was to appraise whether this definition of postoperative renal dysfunction after coronary artery bypass surgery (CABG) was accurate.\u0000Methods: Fifty patients with critical coronary artery disease & undergoing CABG were enrolled in the study. Out of 50 patients, 25 patients had CABG with cardiopulmonary bypass (CPB) and remaining 25 underwent off pump CABG (OPCAB). Patients were distributed into various groups (based on the severity of renal impairment) using the RIFLE classification: Risk, Injury, Failure, Loss, End-stage kidney disease) depending on either serum creatinine level/ estimated glomerular filtration rate (eGFR) or urine output. The variation with 30 days-mortality, ICU stay and renal replacement therapy after CABG were identified.\u0000Results: After CABG, 10% of patients experienced renal impairment, as per definitions of RIFLE classification. In this study, there is no significant difference in ARF (RIFLE classification-normal and risk) with or without use of CPB. However, incidence of RIFLE- injury and failure is higher in CPB group than no CPB group. The postoperative proportions of death and renal failure necessitating renal replacement therapy (RRT) were 2% (number of patients, 1 of 50) and 2% (1 of 50), respectively in RIFLE-failure. For the whole study cohort, the median duration of postoperative ICU stay was 4.0 days, with interquartile ranges of 3.0 to 7.0 days. All the patients of Rifle classification-injury and failure had prolonged ICU stay (5 or more days).\u0000Conclusions: The RIFLE criteria are a useful tool for determining renal impairment after CABG. Increased renal replacement treatment, longer ICU stays, and a higher death rate are all linked to the severity of RIFLE classification.\u0000Cardiovasc j 2022; 14(2): 150-156","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89240494","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}
Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with high mortality and few treatment options. Pulmonary thromboendarterectomy (PTE) is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension (CTEPH). This is a challenging procedure in our perspective because of number of regions such as, late diagnosis, scarcity of appropriate instruments, lack of skilled surgeon as it is not familiar to them. Here we are presenting such a case that was also diagnosed incidentally. We successfully operated the patient with chronic pulmonary thromboembolism with severe pulmonary hypertension.Cardiovasc j 2022; 14(2): 176-179
{"title":"Bilateral Pulmonary Thromboendarterectomy for a Patient with Chronic Pulmonary Thromboembolism Developing Severe Pulmonary Hypertension – A Case Report","authors":"P. Biswas, Gafur-Akhunov Ma, Rahman H, S. Dasgupta, P. K. Chanda","doi":"10.3329/cardio.v14i2.58783","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58783","url":null,"abstract":"Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease with high mortality and few treatment options. Pulmonary thromboendarterectomy (PTE) is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension (CTEPH). This is a challenging procedure in our perspective because of number of regions such as, late diagnosis, scarcity of appropriate instruments, lack of skilled surgeon as it is not familiar to them. Here we are presenting such a case that was also diagnosed incidentally. We successfully operated the patient with chronic pulmonary thromboembolism with severe pulmonary hypertension.\u0000Cardiovasc j 2022; 14(2): 176-179","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88183541","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: In anterior ST-segment elevation myocardial infarction (STEMI), attention paid mainly to the left ventricle. The predictive significance of right ventricular (RV) dysfunction in patients with anterior STEMI has been frequently neglected. In this study, we evaluated the prognostic effect of RV dysfunction on in-hospital outcomes in patients with first anterior STEMI.Methods: Present study is based on the analysis of 77 patients admitted to Coronary care unit of the Sir Salimullah Medical College & Mitford Hospital, Dhaka during April, 2019 to March, 2020, with acute anterior wall myocardial infarction. 12 lead ECG with thorough physical examination was done along with echocardiographic assessment of RV and LV function within index hospitalization, preferably within 24 hours of admission. Patients were divided into two groups depending on right ventricular function assessment. Group I included anterior MI with right ventricular dysfunction and group II included anterior MI without right ventricular dysfunction. In hospital outcomes were observed and compared between two groups.Results: Patients with RV dysfunction had statistically significant higher incidence of cardiogenic shock (22.2 % vs. 2.4%, p < 0.05), acute heart failure (69.4% vs. 24.4%, p < 0.05), arrhythmia (11.1% vs. 0.0%, p < 0.05), increase length of hospital stay in patients of RV dysfunction group. In-hospital mortality was non significantly higher in RV dysfunction group (8.3% vs. 2.4%, p > 0.305).Conclusion: In this study, we observed that in-hospital outcomes were worse in patients with anterior STEMI with RV dysfunction and demands more intense invasive management. Thus, special care should be given for the assessment function of right ventricle in anterior STEMI.Cardiovasc j 2022; 14(2): 128-134
背景:在st段抬高型心肌梗死(STEMI)中,人们主要关注左心室。右心室功能障碍在STEMI前路患者中的预测意义经常被忽视。在这项研究中,我们评估了右心室功能障碍对首次前路STEMI患者住院预后的影响。方法:本研究基于2019年4月至2020年3月在达卡Sir Salimullah医学院& Mitford医院冠状动脉监护室收治的77例急性前壁心肌梗死患者的分析。12导联心电图伴全面体格检查,超声心动图评估左室和左室功能,最好在入院24小时内完成。根据右心室功能评分将患者分为两组。I组为前路心肌梗死伴右室功能不全组,II组为前路心肌梗死伴右室功能不全组。观察两组的住院情况并进行比较。结果:右心室功能障碍组心源性休克发生率(22.2% vs. 2.4%, p < 0.05)、急性心力衰竭发生率(69.4% vs. 24.4%, p < 0.05)、心律失常发生率(11.1% vs. 0.0%, p < 0.05)、住院时间延长均有统计学意义。右心室功能障碍组住院死亡率无显著性增高(8.3% vs. 2.4%, p < 0.05)。结论:在本研究中,我们观察到伴有左心室功能障碍的STEMI前路患者的住院预后更差,需要更强的侵入性治疗。因此,在评估STEMI前路右心室功能时应特别注意。心血管病杂志[j] 2022;14 (2): 128 - 134
{"title":"In-hospital Outcome of Acute Anterior Myocardial Infarction with Right Ventricular Dysfunction","authors":"Md. Iqbal Hossain, Mohammad Ullah, M. Rahman, Md Bonday Ali, M. A. K. Akanda","doi":"10.3329/cardio.v14i2.58777","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58777","url":null,"abstract":"Background: In anterior ST-segment elevation myocardial infarction (STEMI), attention paid mainly to the left ventricle. The predictive significance of right ventricular (RV) dysfunction in patients with anterior STEMI has been frequently neglected. In this study, we evaluated the prognostic effect of RV dysfunction on in-hospital outcomes in patients with first anterior STEMI.\u0000Methods: Present study is based on the analysis of 77 patients admitted to Coronary care unit of the Sir Salimullah Medical College & Mitford Hospital, Dhaka during April, 2019 to March, 2020, with acute anterior wall myocardial infarction. 12 lead ECG with thorough physical examination was done along with echocardiographic assessment of RV and LV function within index hospitalization, preferably within 24 hours of admission. Patients were divided into two groups depending on right ventricular function assessment. Group I included anterior MI with right ventricular dysfunction and group II included anterior MI without right ventricular dysfunction. In hospital outcomes were observed and compared between two groups.\u0000Results: Patients with RV dysfunction had statistically significant higher incidence of cardiogenic shock (22.2 % vs. 2.4%, p < 0.05), acute heart failure (69.4% vs. 24.4%, p < 0.05), arrhythmia (11.1% vs. 0.0%, p < 0.05), increase length of hospital stay in patients of RV dysfunction group. In-hospital mortality was non significantly higher in RV dysfunction group (8.3% vs. 2.4%, p > 0.305).\u0000Conclusion: In this study, we observed that in-hospital outcomes were worse in patients with anterior STEMI with RV dysfunction and demands more intense invasive management. Thus, special care should be given for the assessment function of right ventricle in anterior STEMI.\u0000Cardiovasc j 2022; 14(2): 128-134","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88236087","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: In recent year ‘s considerable progress has been made in the early diagnosis and treatment of congenital heart disease (CHD) and a significant number of children are expected to survive into adulthood after completion of treatment. This has created a scope of a substantial population of patients with adult congenital heart disease. In Bangladesh, milder or simple from of congenital heart diseases are prevalent among populations but palliated and treated cases of CHD are gradually increasing the load of work for adult congenital heart disease (ACHD) professionals. Many of these cases can be treated by transcatheter intervention with excellent outcome.Methods: This is a retrospective study conducted in a tertiary level cardiac hospitals of Bangladesh from January 2015 to December 2020. All cases aging 18 years and above were included who had undergone cardiac catheterization or percutaneous interventions. Data were collected from Echocardiography department, Catheterization Laboratory and indoor department. Follow up data were collected from echocardiography and outpatient department.Results: Total Two hundred Ninety-four cases were enrolled for cardiac catheterization. Two hundred eighteen cases had various types of intervention. Most of the cases were in 18-25 years age group. Among shunt lesions, 165 cases (56.12%) had atrial septal defect (ASD), 48(22.02%) had ventricular septal defect (VSD), 32 (14.67%) had patent ductus arteriosus (PDA), and 4(1.83%) had patent foramen ovale (PFO). Device closure was performed in 120(55.04%) cases of ASD, 13(5.96%) cases of VSD, 30 (13.76%) cases of PDA and in 4(1.83%) cases of PFO. Nineteen (8.72%) had valvuloplasty for pulmonary stenosis (PS), 2 (0.68%) had valvuloplasty for aortic stenosis (AS), 2(0.068%) had coarctoplasty for coarctation of the aorta (CoA), 4 (1.83%) had percutaneous pulmonary valve implantation (PPVI). Seventeen (7.79%) cases had double intervention of ASD device closure and pulmonary stenosis, 5 (2,29%) cases had ASD and PDA device closure and 2 (0.92%) cases had PDA device closure and balloon coarctoplasty. ASD device was embolized in 4 cases. There were no other complications.Conclusion: Outcome of intervention in ACHD was found safe and effective and no significant short or long-term complications were noticed.Cardiovasc j 2022; 14(2): 121-127
{"title":"Adult Congenital Heart Disease and Percutaneous Interventions : Analysis of Cases over five years in a Bangladeshi Center","authors":"N. Fatema","doi":"10.3329/cardio.v14i2.58776","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58776","url":null,"abstract":"Background: In recent year ‘s considerable progress has been made in the early diagnosis and treatment of congenital heart disease (CHD) and a significant number of children are expected to survive into adulthood after completion of treatment. This has created a scope of a substantial population of patients with adult congenital heart disease. In Bangladesh, milder or simple from of congenital heart diseases are prevalent among populations but palliated and treated cases of CHD are gradually increasing the load of work for adult congenital heart disease (ACHD) professionals. Many of these cases can be treated by transcatheter intervention with excellent outcome.\u0000Methods: This is a retrospective study conducted in a tertiary level cardiac hospitals of Bangladesh from January 2015 to December 2020. All cases aging 18 years and above were included who had undergone cardiac catheterization or percutaneous interventions. Data were collected from Echocardiography department, Catheterization Laboratory and indoor department. Follow up data were collected from echocardiography and outpatient department.\u0000Results: Total Two hundred Ninety-four cases were enrolled for cardiac catheterization. Two hundred eighteen cases had various types of intervention. Most of the cases were in 18-25 years age group. Among shunt lesions, 165 cases (56.12%) had atrial septal defect (ASD), 48(22.02%) had ventricular septal defect (VSD), 32 (14.67%) had patent ductus arteriosus (PDA), and 4(1.83%) had patent foramen ovale (PFO). Device closure was performed in 120(55.04%) cases of ASD, 13(5.96%) cases of VSD, 30 (13.76%) cases of PDA and in 4(1.83%) cases of PFO. Nineteen (8.72%) had valvuloplasty for pulmonary stenosis (PS), 2 (0.68%) had valvuloplasty for aortic stenosis (AS), 2(0.068%) had coarctoplasty for coarctation of the aorta (CoA), 4 (1.83%) had percutaneous pulmonary valve implantation (PPVI). Seventeen (7.79%) cases had double intervention of ASD device closure and pulmonary stenosis, 5 (2,29%) cases had ASD and PDA device closure and 2 (0.92%) cases had PDA device closure and balloon coarctoplasty. ASD device was embolized in 4 cases. There were no other complications.\u0000Conclusion: Outcome of intervention in ACHD was found safe and effective and no significant short or long-term complications were noticed.\u0000Cardiovasc j 2022; 14(2): 121-127","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74957128","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: With consideration of differing cardiac characteristics between women and men, such as coronary vessel sizes, this study was constructed to investigate if sex-based differences are present following drug-eluting stent implantation.Methods: Using PubMed and MeSH search tags, published data analyzing the potential sex differences in clinical outcomes following drug-eluting stent implantation was collected.Results: As compared to male patients, women had similar incidences of major adverse cardiac events and stent thrombosis at long-term follow-up despite being found to consistently have smaller vessels, higher incidences of advanced age, diabetes mellitus, and hypertension at hospital admission. At short-term follow-up, however, women had an increase of major adverse cardiac events as compared to men with complex lesions. Furthermore, height may play a role in clinical outcomes following treatment with a drug-eluting stent. Additionally, women may have superior healing responses with lower neointimal obstruction and lower maximum cross-sectional narrowing following drugeluting stent implantation.Conclusions: When differing baseline characteristics were corrected for with multivariate analysis, drug-eluting stents demonstrate similar clinical outcomes in women and men at long-term follow-up.Cardiovasc j 2022; 14(2): 157-167
{"title":"Role of Sex on the Clinical Outcomes of Coronary Artery Diseases Treated with Drug-Eluting Stents","authors":"Prabjot K. Batth, Mohammed Alsabri","doi":"10.3329/cardio.v14i2.58781","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58781","url":null,"abstract":"Background: With consideration of differing cardiac characteristics between women and men, such as coronary vessel sizes, this study was constructed to investigate if sex-based differences are present following drug-eluting stent implantation.\u0000Methods: Using PubMed and MeSH search tags, published data analyzing the potential sex differences in clinical outcomes following drug-eluting stent implantation was collected.\u0000Results: As compared to male patients, women had similar incidences of major adverse cardiac events and stent thrombosis at long-term follow-up despite being found to consistently have smaller vessels, higher incidences of advanced age, diabetes mellitus, and hypertension at hospital admission. At short-term follow-up, however, women had an increase of major adverse cardiac events as compared to men with complex lesions. Furthermore, height may play a role in clinical outcomes following treatment with a drug-eluting stent. Additionally, women may have superior healing responses with lower neointimal obstruction and lower maximum cross-sectional narrowing following drugeluting stent implantation.\u0000Conclusions: When differing baseline characteristics were corrected for with multivariate analysis, drug-eluting stents demonstrate similar clinical outcomes in women and men at long-term follow-up.\u0000Cardiovasc j 2022; 14(2): 157-167","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88905291","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: Serum creatinine and blood urea nitrogen (BUN) are the common markers of renal function and also one of the known predictors of adverse outcomes of acute coronary syndrome (ACS). The aim of this study is to assess the impact of elevated BUN on in-hospital outcome of ACS patients and superiority of BUN over creatinine for the assessment of in-hospital outcome in our setting. Methods: This prospective observational study with purposive sampling of a total of 184 patients was conducted from October, 2009 to September, 2010. Based on normal cut off values (BUN and serum creatinine was <20 mg/dl and <1.4 mg/dl respectively) all the patients were divided into four groups; group I- both BUN and serum creatinine are normal, group-II- normal BUN and high serum creatinine, group-III- high BUN and normal serum creatinine, group-IV- - both BUN and serum creatinine are high. In-hospital data like hemodynamic conditions, heart failure, arrhythmias, conduction abnormalities, death etc. were noted. Assessment of in-hospital outcome of ACS patients and comparison to elevated serum creatinine and elevated BUN was done. Results: ACS patients with only raised BUN level had more occurrence of cardiogenic shock (p=0.008), left ventricular failure (p=0.020), ventricular Tachycardia (p=0.022), ventricular fibrillation (P=0.037) and complete AV block (p=0.022) than those with only raised serum creatinine. In hospital mortality and hospital stay was also increased in ACS patients with elevated BUN than elevated serum creatinine (p value is 0.022 and 0.007 respectively). Conclusion: Incidence of in-hospital death, cardiogenic shock, left ventricular failure, arrhythmia and duration of hospital stay were significantly (p<0.05) higher in patients who had raised BUN than raised serum creatinine. It is observed that elevated BUN is a better predictor of in-hospital outcome of ACS patients than elevated creatinine. Cardiovasc j 2022; 14(2): 135-142
{"title":"Superiority of Admission Blood Urea Nitrogen over Serum Creatinine in Predicting In-Hospital Outcome of Patients with Acute Coronary Syndrome","authors":"Md Saiful Islam, Mst. Ismot Ara, Md HN Ashiqur Rahman, M. Ullah, Md. Mostafizur Rahman, Md Sarwar Alam, Mamunur Rashid Shikder, Mohammad Abrar Kaiser, Md Aks Zahid Mahmud Khan, Md. Mojibur Rahman","doi":"10.3329/cardio.v14i2.58778","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58778","url":null,"abstract":"Background: Serum creatinine and blood urea nitrogen (BUN) are the common markers of renal function and also one of the known predictors of adverse outcomes of acute coronary syndrome (ACS). The aim of this study is to assess the impact of elevated BUN on in-hospital outcome of ACS patients and superiority of BUN over creatinine for the assessment of in-hospital outcome in our setting. Methods: This prospective observational study with purposive sampling of a total of 184 patients was conducted from October, 2009 to September, 2010. Based on normal cut off values (BUN and serum creatinine was <20 mg/dl and <1.4 mg/dl respectively) all the patients were divided into four groups; group I- both BUN and serum creatinine are normal, group-II- normal BUN and high serum creatinine, group-III- high BUN and normal serum creatinine, group-IV- - both BUN and serum creatinine are high. In-hospital data like hemodynamic conditions, heart failure, arrhythmias, conduction abnormalities, death etc. were noted. Assessment of in-hospital outcome of ACS patients and comparison to elevated serum creatinine and elevated BUN was done. Results: ACS patients with only raised BUN level had more occurrence of cardiogenic shock (p=0.008), left ventricular failure (p=0.020), ventricular Tachycardia (p=0.022), ventricular fibrillation (P=0.037) and complete AV block (p=0.022) than those with only raised serum creatinine. In hospital mortality and hospital stay was also increased in ACS patients with elevated BUN than elevated serum creatinine (p value is 0.022 and 0.007 respectively). Conclusion: Incidence of in-hospital death, cardiogenic shock, left ventricular failure, arrhythmia and duration of hospital stay were significantly (p<0.05) higher in patients who had raised BUN than raised serum creatinine. It is observed that elevated BUN is a better predictor of in-hospital outcome of ACS patients than elevated creatinine. Cardiovasc j 2022; 14(2): 135-142","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84847826","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: Early risk stratification of patients with myocardial infarction is critical to determine optimum treatment strategies and improve outcomes. This study was designed to determine the relation between QRS duration on admission ECG and severity of coronary artery disease (CAD) in patients with acute anterior myocardial infarction (AMI).Methods: This observational study was carried out from November 2019 to October 2020 with total of 100 patients with first attack of anterior MI who were treated with thrombolytic therapy. Based on the cut-off value of QRS duration 100, the patients were divided into two groups – one group with QRS duration £100 msec (normal QRS) and another group with QRS duration > 100 msec (prolonged QRS). 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 ³36 points as moderate to severe coronary artery disease. Then patients with prolonged and normal QRS durations were compared with severity of CAD to find their association.Results: Acute AMI patients with prolonged QRS duration (> 100 msec) more often tend to be associated with severe CAD. Risk of having severe CAD in patients with prolonged QRS duration were almost 8 (95% of CI = 3.2– 19.3) times higher than those with normal QRS duration (£100 msec) (p < 0.001).Conclusion: The study concluded that three out of four patients of acute anterior MI with prolonged QRS duration are likely to have severe CAD. QRS duration more than 100 msec can be used as a cheap, easily available prognostic factor in patients with acute anterior MI.Cardiovasc j 2022; 14(2): 143-149
{"title":"Relationship between QRS duration on Admission ECG and Angiographic Severity of Coronary Artery Disease in Patients with Acute Anterior Myocardial Infarction","authors":"M. Rahman, M. Ullah, Md. Iqbal Hossain, Md Bonday Ali, Md Abdul Kader Akanda","doi":"10.3329/cardio.v14i2.58779","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58779","url":null,"abstract":"Background: Early risk stratification of patients with myocardial infarction is critical to determine optimum treatment strategies and improve outcomes. This study was designed to determine the relation between QRS duration on admission ECG and severity of coronary artery disease (CAD) in patients with acute anterior myocardial infarction (AMI).\u0000Methods: This observational study was carried out from November 2019 to October 2020 with total of 100 patients with first attack of anterior MI who were treated with thrombolytic therapy. Based on the cut-off value of QRS duration 100, the patients were divided into two groups – one group with QRS duration £100 msec (normal QRS) and another group with QRS duration > 100 msec (prolonged QRS). 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 ³36 points as moderate to severe coronary artery disease. Then patients with prolonged and normal QRS durations were compared with severity of CAD to find their association.\u0000Results: Acute AMI patients with prolonged QRS duration (> 100 msec) more often tend to be associated with severe CAD. Risk of having severe CAD in patients with prolonged QRS duration were almost 8 (95% of CI = 3.2– 19.3) times higher than those with normal QRS duration (£100 msec) (p < 0.001).\u0000Conclusion: The study concluded that three out of four patients of acute anterior MI with prolonged QRS duration are likely to have severe CAD. QRS duration more than 100 msec can be used as a cheap, easily available prognostic factor in patients with acute anterior MI.\u0000Cardiovasc j 2022; 14(2): 143-149","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85761815","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}
A 22 years old lady presented to emergency department of a private hospital with weakness and inability to move right side of the body along with aphasia, dizziness and headache since early morning. During process of evaluation and investigation she recovered spontaneously within few hours after conservative management. Magnetic resonance imaging of brain pre and post contrast along with MR angiography showed acute left parietal infarct. ECG excludes atrial fibrillation. Echocardiography later revealed tunnel shaped patent foramen ovale (PFO) with atrial septal aneurysm(ASA). Percutaneous closure of PFO was planned to prevent recurrence of stroke in this young lady.Cardiovasc j 2022; 14(2): 180-184
{"title":"Patent Foramen Ovale and Cryptogenic Stroke : A Case Report","authors":"N. Fatema, A. Khan","doi":"10.3329/cardio.v14i2.58784","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58784","url":null,"abstract":"A 22 years old lady presented to emergency department of a private hospital with weakness and inability to move right side of the body along with aphasia, dizziness and headache since early morning. During process of evaluation and investigation she recovered spontaneously within few hours after conservative management. Magnetic resonance imaging of brain pre and post contrast along with MR angiography showed acute left parietal infarct. ECG excludes atrial fibrillation. Echocardiography later revealed tunnel shaped patent foramen ovale (PFO) with atrial septal aneurysm(ASA). Percutaneous closure of PFO was planned to prevent recurrence of stroke in this young lady.\u0000Cardiovasc j 2022; 14(2): 180-184","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88199334","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}
Valve-sparing aortic root replacement (VSRR) is an established treatment method for aortic root dilatation and aortic valve insufficiency (AI). It was developed to restore the aortic valve functions in patients of aortic root aneurysms with morphologically normal aortic valve. We hereby present a case of 67 years, male, with aortic root aneurysm and severe aortic regurgitation who was treated successfully by David’s procedure for valve sparing aortic root replacement technique.Cardiovasc j 2022; 14(2): 185-190
{"title":"David Procedure for Valve-Sparing Aortic Root Replacement in a Marfan Syndrome Patient","authors":"S. Gupta, Sharif Hasan, Sarmistha Biswas, Tanvir Ahmed, Mozibul Haque, P. Chanda","doi":"10.3329/cardio.v14i2.58785","DOIUrl":"https://doi.org/10.3329/cardio.v14i2.58785","url":null,"abstract":"Valve-sparing aortic root replacement (VSRR) is an established treatment method for aortic root dilatation and aortic valve insufficiency (AI). It was developed to restore the aortic valve functions in patients of aortic root aneurysms with morphologically normal aortic valve. We hereby present a case of 67 years, male, with aortic root aneurysm and severe aortic regurgitation who was treated successfully by David’s procedure for valve sparing aortic root replacement technique.\u0000Cardiovasc j 2022; 14(2): 185-190","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86379340","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}