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Clinical Profile of Patients with Exaggerated Blood Pressure Response During Treadmill Stress Test and Its Correlation with Risk Factors for Coronary Artery Disease
Angelica Dela Cruz,
Dioscoro Bayani,
Arnolfo Tomas,
Elmer Jasper Llanes
Issue:
Volume 4, Issue 3, September 2020
Pages:
80-84
Received:
10 May 2020
Accepted:
28 May 2020
Published:
8 June 2020
Abstract: This study determined the prevalence and clinical profile of patients with Exaggerated Blood Pressure Response (EBPR) during Treadmill Exercise Test (TET) and its correlation with traditional risk factors of Coronary Artery Disease (CAD). Methodology: This is a cross-sectional study performed in Out Patient Department of Philippine General Hospital of patients 19 years old and above. Clinical profile was obtained and TET parameters including blood pressure at rest, during exercise and recovery period were determined. Results: There were 226 patients included in the study. The mean age is 52 and 121 (53.5%) were females. There were 108 (47.8%) with hypertension, 55 (24.3%) were smoker, 73 (32.3%) with dyslipidemia, 1 (0.4) with hyperuricemia, 31 (13.7) with diabetes, 51 (22.6%) with family history of CAD and 2 (3.9%) with history of supraventricular tachycardia (SVT). The prevalence of EBPR is 20.21%. Those with EBPR are usually female 31 (81.6%) and likely hypertensive 22 (57.9%). Female sex and abnormal BMI were the significant predictors of EBPR with p-value of 0.001 and 0.042 respectively. Conclusion: The prevalence of ESBR is 20.21%. The EBPR is strongly correlated with female sex and abnormal BMI. Further screening of these patient and aggressive management by adapting new HTN guidelines might help to reduce cardiovascular risk.
Abstract: This study determined the prevalence and clinical profile of patients with Exaggerated Blood Pressure Response (EBPR) during Treadmill Exercise Test (TET) and its correlation with traditional risk factors of Coronary Artery Disease (CAD). Methodology: This is a cross-sectional study performed in Out Patient Department of Philippine General Hospital...
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An Evaluation of the Frequency and Severity of Erectile Dysfunction in Hypertensive Married Men Compared with Normotensive Married Men
Kabirul Hasan Bin Rakib,
Afroja Alam,
Md. Atikur Rahman,
Nazim Al Azad,
Akm Habibullah Bahar,
Nazmul Hoque Munna,
Rabeya Bosri,
Shaheen Lipika Quayum,
Md. Abul Kalam Azad
Issue:
Volume 4, Issue 3, September 2020
Pages:
85-91
Received:
22 April 2020
Accepted:
21 May 2020
Published:
9 June 2020
Abstract: Background: Erectile dysfunction (ED) exerts a major burden on the quality of life of the patients and their sexual partners. It has been identified as an independent risk factor for cardiovascular disease. Hypertension is a well-established risk factor for ED. Both hypertension and erectile dysfunction has age dependent relationship. Objective: To evaluate the frequency and severity of erectile dysfunction in hypertensive married men compared with normotensive married men of similar demographic characteristics attending a tertiary care hospital of Bangladesh during the period from June 2017 to March, 2018. Methodology: This cross-sectional comparative study includes 75 hypertensive and 75 normotensive young and middle-aged married men (31–59 years) those visited our outpatient clinic. From them, 75 patients had hypertension and 75 were normotensive. Erectile dysfunction was evaluated with pre validated Bengali version of the International Index of Erectile Function (IIEF-5) questionnaire. Results: Erectile dysfunction (ED) was found in 61.3% of patients with hypertension compared with 37.3% of normotensive subjects. ED is more common and more severe among hypertensive patients than normotensive counterparts. Hypertension duration, hypertension severity and age were found positively correlated with erectile dysfunction. Taking regular medication and control of BP gave positive influence upon erectile status. No association was found between ED and smoking but a weak negative correlation of increased body mass index (BMI) and decreased ED was found in both hypertensive and normotensive group. Conclusion: Hypertensive patients present with erectile dysfunction more frequently than age matched normotensive individuals. As erectile dysfunction is a matter of embarrassment, doctors should be motivated to discuss such issue. Control of blood pressure seems to confer good influence upon the prevalence of erectile status. We need further studies to authenticate such observation and to unveil other risk factors of ED in our country and to go for appropriate management.
Abstract: Background: Erectile dysfunction (ED) exerts a major burden on the quality of life of the patients and their sexual partners. It has been identified as an independent risk factor for cardiovascular disease. Hypertension is a well-established risk factor for ED. Both hypertension and erectile dysfunction has age dependent relationship. Objective: To...
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Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy
Atul Kapur,
Goldaa Mahajan,
Aprajita Kapur
Issue:
Volume 4, Issue 3, September 2020
Pages:
92-98
Received:
30 April 2020
Accepted:
11 June 2020
Published:
28 June 2020
Abstract: OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of <35% were enrolled in the study. CMR was done using ECV and LGE protocol. All patients had normal renal functions. Viability (V) scores and Corrected Viability (CV) scores were calculated on LGE and ECV –LGE images. Segments with ECV>50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.
Abstract: OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy...
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Lipid Profile and Prevalence of Dyslipidemia in Hypertensive Patients at the Kara University Hospital Center (Togo)
Tchaa Tcherou,
Komlavi Yayehd,
Tchalla Yowdéma Abena,
Abalo Mario Bakai,
Koku Languede,
Soulemane Pessinaba,
Doguénsaga Borgatia Atta,
Machihude Pio,
Soodougoua Baragou,
Findibe Damorou
Issue:
Volume 4, Issue 3, September 2020
Pages:
99-103
Received:
27 May 2020
Accepted:
17 June 2020
Published:
4 July 2020
Abstract: Dyslipidemia, a primary or secondary pathological modification of serum lipids, is one of the major risk factors for cardiovascular disease. It is currently very common in the populations of the developing countries due to changing dietary and behavioral habits. The objective of this study was to determine the prevalence of dyslipidemia in hypertensive patients received in cardiology consultations at the Kara University Hospital Center. This is a descriptive and cross-sectional study. It included all hypertensive patients received during the study period (January to December 2019), who were able to perform a lipid assessment. The sample was taken on an empty stomach and assayed on a "SELECTRA ProS" automaton using "HELITech clinical system" reagents. The standards: Total cholesterol < 2g/l, HDL > 0.4 g/l (men and women), LDL < 1.3 g/l and triglycerides < 1.5 g/l. Dyslipidemia is defined by the disturbance of at least one of the lipid balance fractions (HDL, LDL and triglycerides). Data analysis was performed by Epi info 7. The prevalence of dyslipidemia was 55.2% with 28.4% of hypo HDL cholesterol, 29% of hyper LDL cholesterol and 21.9% of hypertriglyceridemia. This prevalence is higher in women (59%) than in men (48.5%). Advanced age, obesity and especially abdominal obesity are factors correlated with a high rate of dyslipidemia. Total hypercholesterolemia was found in 34.4% of cases. The prevalence of dyslipidemia is very high in hypertensive people in our environment. It is more frequent in women than in men.
Abstract: Dyslipidemia, a primary or secondary pathological modification of serum lipids, is one of the major risk factors for cardiovascular disease. It is currently very common in the populations of the developing countries due to changing dietary and behavioral habits. The objective of this study was to determine the prevalence of dyslipidemia in hyperten...
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Metabolic Syndrome in HIV/AIDS Patients at the Tiko Central Clinic and Cottage Hospital in Cameroon: Influence on Cardiovascular Risk and Predictors
Njeodo Njongang Vigny,
Jules Clement Nguedia Assob,
Achidi Eric Akum
Issue:
Volume 4, Issue 3, September 2020
Pages:
104-110
Received:
27 June 2020
Accepted:
7 July 2020
Published:
17 July 2020
Abstract: Highly active anti-retroviral therapy (HAART) use by HIV patients since the mid-1990’s has led to a significant drop in HIV mortality. However, HAART and HIV related metabolic syndrome (hypertriglyceridaemia, reduced HDL-c, abdominal obesity, hypertension, and insulin resistance) is associated with increased cardiovascular risk in aging HIV sero-positive patients. This study was aimed at investigating the predictors of metabolic syndrome and influence of metabolic syndrome on cardiovascular (CV) risk amongst persons living with HIV on HAART. This is a hospital-based case-control study. The cases were HIV sero-positive individuals on HAART for at least 6 months and controls were HIV sero-negative individuals. Out of 135 participants, 74 (54.8%) were females amongst which 53/75 (70.7%) were in the cases group and 21/60 (35%) were in the control group. The mean age of the participants was 42.04 (±9.61) years. HIV-infected participants at moderate CV risk based on the DAD risk calculator were more frequently diagnosed with metabolic syndrome based on the International Diabetes Federation (IDF) criteria with high statistical significance than those at low CV risk (5/19 – 26.3% vs. 12/55 – 21.8%, P=<0.001). Bivariate analysis of metabolic syndrome predictors in the study population revealed that gender is associated with increased odds of metabolic syndrome (OR: 5.376, 95% CI: 1.907-15.153; P=0.001). Gender was the only predictor associated with metabolic syndrome (OR: 6.958, CI: 2.317-20.896; P=0.001) following multivariate analysis of gender, vegetables or fruits intake, vigorous physical activity and family history of CVD and females were 7 times more likely to develop metabolic syndrome than males. More HAART-treated HIV patients at moderate CVD risk develop metabolic syndrome than those at low CVD risk. Female HIV patients on HAART have higher chances of developing metabolic syndrome compared to their male counterparts. HIV patients particularly females should be screened early for metabolic syndrome following HAART initiation.
Abstract: Highly active anti-retroviral therapy (HAART) use by HIV patients since the mid-1990’s has led to a significant drop in HIV mortality. However, HAART and HIV related metabolic syndrome (hypertriglyceridaemia, reduced HDL-c, abdominal obesity, hypertension, and insulin resistance) is associated with increased cardiovascular risk in aging HIV sero-po...
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Assessment of Right Atrial Function in Patients with First Inferior Myocardial Infarction with & Without Right Ventricular Involvement by 2D Speckle Tracking Echocardiography
Mohamed Fahmy El-Noamany,
Ghada Mahmoud Soltan,
Naglaa Fahim Ahmed,
Haitham Mohamed Omar El-Ahwal
Issue:
Volume 4, Issue 3, September 2020
Pages:
111-118
Received:
23 May 2020
Accepted:
18 June 2020
Published:
23 July 2020
Abstract: Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but RA affection is not fully elucidated in patients with myocardial infarction (MI) Objective: To assess RA function by 2-Dimensional speckle tracking echocardiography (2D-STE) imaging in patients with acute first left ventricular (LV) inferior wall MI with and without RV involvement. Patients & methods:-Sixty patients with acute first inferior MI were included in this study; 30 patients had ECG signs of inferior MI without RV infarction (group II) and 30 patients had ECG signs of inferior MI with RV involvement (group III). Twenty five age and sex -matched healthy volunteers were included as a control group (group I). Assessment of RA function was done in all subjects using (2D-STE) for measurements of RA septal and free walls longitudinal strain and strain rate (SR). Results:-RA septal wall & global systolic strain were significantly reduced in group III (22.5±14.8% and 40.4±24.5%) compared to group I (37.5±16.3% and 60.4±22.4%) and group II (35.7±17.4% and 54.9±25.73%), (P<0.001), (P=0.008) respectively. RA septal wall and global early diastolic strain rate were also significantly reduced in group III (- 0.77±0.46 s-1 and – 3.61±0.55 s-1) compared to group I (-1.38±0.74 s-1 and – 4.41±0.67 s-1) and group II (-1.07±0.76 s-1 and -3.73±0.76 s-1), (P=0.005), (P<0.001) respectively. Conclusion:-In patients with first LV inferior wall MI with RV involvement, RA functional parameters (RA septal and global strain and SR) were significantly impaired in comparison to healthy controls and patients with first LV inferior wall MI without RV affection. This result may illustrate the significant relation between RV & RA which is still under research.
Abstract: Background: The right atrium (RA), has received the least attention by researchers. Many reports demonstrated that, RA function may be impaired in the early stages of cardiac disease. The RA plays an important role in maintaining right ventricular (RV) output. RA functional changes have been evaluated in patients with coronary artery disease, but R...
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Association of Major Cardiovascular Risk Factors and the Severity of Coronary Artery Disease with Vitamin D Level
Ahmed Hussein,
Sherif Abdelaziz Sayed,
Mohammad Shafiq Awad
Issue:
Volume 4, Issue 3, September 2020
Pages:
119-126
Received:
25 July 2020
Accepted:
5 August 2020
Published:
13 August 2020
Abstract: Objectives: We aimed to investigate the association of major cardiovascular risk factors and the severity of coronary artery disease (CAD) with vitamin D level. Background: Numerous efforts have been made to reduce cardiovascular morbidity and mortality, especially in acute coronary syndrome (ACS). However, results are still not optimal. Much consideration is set on the revelation of new, conceivably modifiable cardiovascular risk factors. Vitamin D deficiency is proposed to be one such factor, and it might be related to an increased risk of cardiovascular diseases. Methods: We conducted a cross-section study on 475 patients undergoing elective coronary angiography, the participants were subjected to assessment of vitamin D level and major cardiovascular risk factors. The severity of CAD was assessed using the gensini score. Results: There were 352 (74.11%) patients, had a significant CAD. We found that vitamin D level had a significant negative correlation with the gensini score while diabetes and dyslipidemia had a significant positive correlation. The multivariate regression analysis showed that, vitamin D deficiency, diabetes, dyslipidemia, higher BMI, and ACS (p-value <0.05), were statistically significant predictors of a significant CAD. There were 184 (38.74%) patients, had vitamin D deficiency. Also, we found that diabetes and dyslipidemia had a significant negative correlation with vitamin D level. The multivariate regression analysis showed that diabetes and dyslipidemia were statistically significantly associated with low vitamin D levels (p-value 0.005 and 0.024 respectively). Conclusions: Vitamin D deficiency, diabetes, dyslipidemia, higher BMI, and ACS were statistically significant associated with severe CAD. Also, diabetes and dyslipidemia were statistically significant associated with vitamin D deficiency.
Abstract: Objectives: We aimed to investigate the association of major cardiovascular risk factors and the severity of coronary artery disease (CAD) with vitamin D level. Background: Numerous efforts have been made to reduce cardiovascular morbidity and mortality, especially in acute coronary syndrome (ACS). However, results are still not optimal. Much consi...
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Advances in the Value of Cardiac Troponin and ST Segment Depression in Predicting Coronary Artery Disease in Patients with Paroxysmal Supraventricular Tachycardia
Issue:
Volume 4, Issue 3, September 2020
Pages:
127-130
Received:
2 August 2020
Accepted:
11 August 2020
Published:
13 August 2020
Abstract: Paroxysmal supraventricular tachycardia (PSVT) is similar to coronary artery disease (CAD) in that it is often accompanied by chest pain, ST segment depression or elevated cardiac troponin in the electrocardiogram (ECG). Studies have shown that only 20%-40% of these patients are diagnosed with CAD by coronary angiography and even lower in foreign countries. Therefore, a noninvasive and simple method is urgently needed in practice to determine the high-risk population of PSVT patients with CAD, so as to avoid excessive examination and waste of medical resources. Cardiac troponin and ECG are favored in clinic because of their simple, economical and non-invasive detection methods. By analyzing the mechanism, it is concluded that elevated troponin and ST segment depression are of low predictive value for CAD diagnosis in PSVT patients, and it is necessary to further evaluate the risk factors for cardiovascular disease in these patients to determine whether coronary angiography is required. However, it is worth noting that ST segment depression in PSVT patients may be associated with coronary microcirculation lesions. Future research should also start from the pathogenesis, symptoms and characteristics of coronary microcirculation lesions to find more similarities and differences with PSVT combined with ST segment depression. This paper may contribute to a better understanding of troponin elevation and ST segment depression in PSVT patients.
Abstract: Paroxysmal supraventricular tachycardia (PSVT) is similar to coronary artery disease (CAD) in that it is often accompanied by chest pain, ST segment depression or elevated cardiac troponin in the electrocardiogram (ECG). Studies have shown that only 20%-40% of these patients are diagnosed with CAD by coronary angiography and even lower in foreign c...
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Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels
Mohammed Fahmy El-Noamany,
Ashraf Abd ElRaouf Dawood,
Waleed Abdou Ibrahim Hamed,
Nowrus Emad Amer
Issue:
Volume 4, Issue 3, September 2020
Pages:
131-145
Received:
24 July 2020
Accepted:
10 August 2020
Published:
18 August 2020
Abstract: Background: Hypertension and diabetes are major contributors to structural changes including myocardial fibrosis and progressive alteration of LV systolic and diastolic functions. Two-dimensional speckle tracking echocardiography is a reliable imaging modality that overcomes the limitations of Tissue Doppler imaging and allows a more accurate assessment of myocardial deformation at the global and regional levels. Objectives: The investigation aims to assess Left Ventricular functions in patients with hypertension and/or diabetes who have apparently preserved LV systolic function; using speckle tracking echocardiography, and correlate the findings with plasma Brain Natriuretic Peptide levels. Methods: Twenty healthy subjects were enrolled as a control group. Sixty patients with hypertension and/or diabetes were recruited and assembled as three equal groups, hypertensives, diabetics, and hypertensive-diabetics. 2D-STE was performed to assess LV longitudinal strain and strain rate. Plasma BNP levels were measured for all subjects. Results: Global systolic longitudinal strain was significantly reduced in patients compared to controls (P=0.001). It was more reduced in group 4. Global systolic SR was reduced in patients compared to controls, being more significantly reduced in groups 2 and 4 (P=0.001). Global early diastolic SR was reduced in patients compared to controls (P=0.001). Meanwhile, Global late diastolic SR values were higher among patients, especially groups 2 and 4 (P=0.001). BNP levels were significantly higher in group 4 compared to group 1 (P=0.000), group 2 (P=0.000), and group 3 (P=0.000). BNP levels and global systolic strain in group 4 were significantly correlated. Conclusion: LV systolic dysfunction was found among all patients groups, confirmed by the significant reduction in LV global longitudinal systolic SR. Hypertensive-diabetics exhibited lower global strain than patients with hypertension only and patients with diabetes only, even though their EF showed no apparent difference. Elevated BNP levels, being the highest among group 4, indicate the presence of ventricular dysfunction, even before chamber failure occurs.
Abstract: Background: Hypertension and diabetes are major contributors to structural changes including myocardial fibrosis and progressive alteration of LV systolic and diastolic functions. Two-dimensional speckle tracking echocardiography is a reliable imaging modality that overcomes the limitations of Tissue Doppler imaging and allows a more accurate asses...
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Role of the Ghanaian Clinical Pharmacist in Providing Evidence-based Pharmacotherapy for Heart Failure Patients: The Way Forward
Martin Mumuni Danaah Malick,
Botah Baafi Adomako,
Kwame Agyepong
Issue:
Volume 4, Issue 3, September 2020
Pages:
146-151
Received:
21 June 2020
Accepted:
23 July 2020
Published:
20 August 2020
Abstract: Background: Heart failure is extensively characterized as a disorder arising from a complex interaction between impaired ventricular performance and neurohormonal activation. In order to achieve optimal therapeutic outcomes, all heart failure patients must be managed by a multidisciplinary team of healthcare providers, using evidence-based Pharmacotherapy. Purpose: The aim of this article is to assess the clinical role of the Ghanaian Pharmacists in optimizing Pharmacotherapy for heart failure patients based on internationally established clinical roles of Pharmacists. Methods: A literature search was conducted via google scholar using the “search engine” terms: Pharmacist, Clinical Role, Heart failure to look for all studies published in English. The search revealed a total of 98 studies. Only the studies that discussed the role of the clinical Pharmacists specific to heart failure or generally for patients with cardiovascular diseases were included; All other studies were excluded. A Total of 54 studies were used for data analysis. Clinical Pharmacists who are somehow involved in the management of heart failure patients were interviewed to ascertain their roles as members of a multidisciplinary team and their responses documented. Conclusions: A Multidisciplinary team approach including a Clinical Pharmacists with expertise in cardiovascular therapeutics, is required in the management of heart failure patients in order to improve therapeutic outcomes. The current clinical role of the Ghanaian Pharmacist in the management of heart failure patients is substandard.
Abstract: Background: Heart failure is extensively characterized as a disorder arising from a complex interaction between impaired ventricular performance and neurohormonal activation. In order to achieve optimal therapeutic outcomes, all heart failure patients must be managed by a multidisciplinary team of healthcare providers, using evidence-based Pharmaco...
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Atrial Deformation Correlated with Functional Capacity in Mitral Stenosis Patients
Monir Osman Amin,
Mohamed Saad Al Gammal,
Mohamed Said Ewais Mohamed
Issue:
Volume 4, Issue 3, September 2020
Pages:
152-163
Received:
8 July 2020
Accepted:
3 August 2020
Published:
25 August 2020
Abstract: Background: Mitral stenosis (MS) is the most common valve disease seen as a sequel of rheumatic fever and usually presents with exertional dyspnea, right sided heart failure and pulmonary arterial hypertension. Aim: To determine the functional class of dyspnea in patients with MS and to investigate the relationship between Left Atrial (LA) deformation as measured by two-dimensional Speckle Tracking Echocardiography (STE)-derived LA strain and heart failure symptoms. Patients and methods: This was a prospective study carried out on 25 patients referred for evaluation of MS using echocardiography and 25 control subjects, who were evaluated using 2D and color Doppler echocardiography, including STE-derived LA strain (LAS) and peak positive filling strain rate (LASRr) during the LA reservoir phase. Those results were then correlated with New York Heart Association (NYHA) functional class. Results: There was a statistically significant difference between the patients and the control groups in the LAS in the apical 4 chamber view (LAS A4) (64.240±15.271, 40.360±21.785, respectively; p=0.001), LASRr A4 (2.504±0.358, 1.740±0.716, respectively; p=0.001) and LASRc A4 (-2.796±0.226, -1.820±0.928, respectively; p=0.001). also, there was a highly significant relation between NYHA class and LAS A4, LASRr A4 and Peak Negative Conduit Strain Rate (LASRc A4), with P<0.001 with all data. Conclusion: This study showed that all left atrial (LA) reservoir, conduit and contractile functions showed prominent impairment in mitral stenosis patients. Speckle tracking strain and strain rate were useful in pointing out the different effects of MS on left atrial functions. The assessment of LA dimension and function can provide further insights in patients with MS, LA dimension and volume in patients with MS had a positive significant correlation with NYHA classes (heart failure symptoms). In stable patients (NYHA classes I & II) with MS, NYHA functional class independently correlated with LAS and LASRr as LAS and LASRr values of stable patients and control aspects were normal. While LA deformation (LAS and LASRr) was significantly correlated with heart failure symptoms (NYHA Classes III & IV) in patients with MS.
Abstract: Background: Mitral stenosis (MS) is the most common valve disease seen as a sequel of rheumatic fever and usually presents with exertional dyspnea, right sided heart failure and pulmonary arterial hypertension. Aim: To determine the functional class of dyspnea in patients with MS and to investigate the relationship between Left Atrial (LA) deformat...
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Dobutamine Stress Echocardiography in Chronic Kidney Disease Patients Candidates for Renal Transplantation
Abdel Mohsen Mostafa Aboualia
Issue:
Volume 4, Issue 3, September 2020
Pages:
164-168
Received:
5 September 2020
Accepted:
17 September 2020
Published:
23 September 2020
Abstract: Background: Dobutamine stress echocardiography (DSE) is used for induction of ischemia in different population. One of those is chronic kidney disease patients before renal transplantation for pre-operative risk assessment. Aim of the work: to evaluate the difference in dobutamine stress echocardiography between those with chronic kidney disease (CKD) on regular dialysis and patient with no known history of chronic renal impairment. Methods: From February 2016 to January 2017, twenty consecutive chronic kidney disease patients prepared for renal transplantation without history suggestive of ischemic heart disease and 40 consecutive patients with without history of renal impairment. Their heart rate, dobutamine dose, atropine dose and adverse side effects were compared between the two groups. Results: Both groups were matched in age and risk factors. Peak heart rate (HR) (133.7±16.99 vs. 144.08±10.99 b/m, P=0.012), time to target heart rate was (17.75±3.29 vs. 13.05±2.95 min, p=0.001) and dobutamine and atropine doses were higher in chronic kidney disease group than other group. Adverse reactions present in both groups but more incidence in CKD group. Conclusion: Chronic kidney disease patients response to dobutamine when underwent dobutamine stress echocardiography showed delayed effect of it with more dobutamine and atropine doses needed and more adverse reactions including Bezold-Jarisch reflex.
Abstract: Background: Dobutamine stress echocardiography (DSE) is used for induction of ischemia in different population. One of those is chronic kidney disease patients before renal transplantation for pre-operative risk assessment. Aim of the work: to evaluate the difference in dobutamine stress echocardiography between those with chronic kidney disease (C...
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