University Heart Journal最新文献

{"title":"Familiar form of ASD with Mitral Stenosis – An Uncommon Presentation of Lutembacher’s Syndrome","authors":"Afm Azim Anwar, Sanjida Anjum Mumu, Md Noornabi Khondokar, Md Tafijul Islam, Md Azharul Islam, Manzoor Mahmood, Md. Fakhrul Islam Khaled","doi":"10.3329/uhj.v3i1.73755","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73755","url":null,"abstract":"Lutembacher’s syndrome refers to combination of congenital Atrial Septal Defect with acquired mitral stenosis. Lutembacher’s syndrome is a vety rare disease and in the past, it has been either over diagnosed or misdiagnosed. Here, we will discuss the case of a lady who presented with chief complaints of palpitation and dyspnea and after detailed examination and investigations; she was diagnosed as a case of “Lutembacher’s syndrome”. \u0000University Heart Journal 2023; 19(2): 66-70","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657519","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}

{"title":"Correlation between the GRACE Risk Score and the SYNTAX Score in Patients with Non-ST-Segment Elevation Myocardial Infarction","authors":"S. N. Huda, Mohammad Faisal, Ibn Kabir, MD. Tasnim MOSTASHIRUL HAQUE, Afm Azim Alam, Swadesh Kumar Anwar, SK SAHA, MD Nafis Kabir, MD. Fakrul H.N. ASHIQUR RAHMAN, Islam Khaled, Chaudhury TANJIMA PARVIN, MD. Rasul MESHKAT AHMED, Amin","doi":"10.3329/uhj.v3i1.73749","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73749","url":null,"abstract":"Background: The GRACE risk score is a valid clinical tool to risk stratify patients with non-ST-segment elevation myocardial infarction (NSTEMI). The SYNTAX score is a comprehensive angiographic grading tool to determine the anatomic complexity of coronary artery disease. Predicting the SYNTAX score before a coronary angiogram (CAG) can help with patient counseling, optimization of planning, and preparation for possible complex percutaneous procedures or CABG in patients with NSTEMI.\u0000Objective: The objective of this study is to determine the correlation between the GRACE risk score and the SYNTAX score in patients with NSTEMI.\u0000Materials and Methods: A total of 52 patients with NSTEMI undergoing coronary angiography were enrolled in this study. According to the calculated GRACE score on admission, patients were divided into a low-risk group (GRACE score ≤108), an intermediate-risk group (GRACE score = 109–140), and a high-risk group\u0000(GRACE score > 140). After coronary angiography, the SYNTAX score was calculated. The correlation between the scores was determined by Pearson’s correlation test.\u0000Results: The mean SYNTAX score in the low GRACE risk group was 9.5 ± 5.1, in the intermediate GRACE risk group it was 12.5 ± 7.6, and in the high GRACE risk group it was 18.5 ± 8.9, and the differences were significant (P value = 0.005). There was a significant positive correlation (r = 0.515, p = <0.001) between the GRACE risk score and the SYNTAX score in patients with NSTEMI.\u0000Conclusion: Our study demonstrates that in NSTEMI patients, the GRACE risk score has a significant positive correlation with the SYNTAX score.\u0000University Heart Journal 2023; 19(2): 49-54","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"124 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656835","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}

{"title":"Mitral annular Calcification and Cardiovascular mortality","authors":"Mohammad Ashraf Uddin Sultan, H. Hoque, Khurshed Ahmed, M. M. Rahman, Atm Iqbal Hasan, Md Abu Salim, Naveen Sheikh, C. M. Ahmed, N. Fatema","doi":"10.3329/uhj.v3i1.73754","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73754","url":null,"abstract":"Mitral annular calcification (MAC) is a degenerative change involving mitral valve annulus which has an increased cardiovascular mortality and morbidity. After first autoptic description, a diagnostic tool brought cardiac computed tomography (CT) scan to become the gold standard in MAC detection and classification. The Mitral annular calcifications has always represented an issue for cardiac surgeons, being it linked with an increased risk of atrioventricular groove rupture, circumflex artery injury, or embolism during Mitral valve surgery. As a consequence, different surgical techniques have been developed over time in order to reduce the incidence of these dreadful complications. Recently, transcatheter mitral valve replacement (TMVR) has emerged as a valid alternative to surgery in high-risk patients on the basis of TAVR. Both hybrid transatrial, transfemoral, or transapical approaches have been described to deliver balloon-expandable or self-expanding aortic transcatheter valves into the calcified annulus, with conflicting early and long-term results. Tendyne (Abbott Structural Heart, Santa Clara, CA, USA) is a promising transapical-delivered option. Early results have shown effectiveness and safety of this device in patients with MAC and severe mitral valve disease, with the lowest rate of embolization, mortality, and left ventricular outflow tract obstruction (LVOTO) reported so far.\u0000University Heart Journal 2023; 19(2): 61-65","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"33 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658793","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}

{"title":"Changes in Echocardiographic profile of NSTEMI patients, before and after PCI in Diabetes vs. Non-Diabetes group","authors":"Afm Azim Anwar, Sanjida Anjum Mumu, Md Yousuf Ali, Srizon Roy Tirtho, Adib Siddik, M. Chowdhury, Md. Fakhrul Islam Khaled, Smg Saklayen, H. Hoque","doi":"10.3329/uhj.v3i1.73742","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73742","url":null,"abstract":"Background: Revascularization may improve outcomes of patients with LV dysfunction by improvement of EF. Though this is not so, in diabetic patients. Because diabetic ischemic etiology is consistently reported as a risk factor for lack of ejection fraction (EF) improvement after revascularization. The determinants of EF improvement havenot yet been investigated comprehensively among diabetic vs nondiabetic group. The goal of the study was to examine how diabetic and non-diabetic patients’ left ventricular systolic performance change from the beginning of the trial to three months following PCI. Methodology: This comparative clinical study, conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January to December 2018 with IRB clearance (Protocol No: BSMMU/2017/ 6624), adhered to Helsinki declaration principles. Patient selection based on inclusion/exclusion criteria involved comprehensive history-taking and clinical examinations. Transthoracic 2D echocardiography was performed pre-PCI, at discharge, and 3 months post-PCI using validated measurements. Left ventricular function parameters were assessed, and coronary angiography preceded percutaneous coronary intervention (PCI) with newer drug-eluting stents. Standard procedural techniques and anticoagulation were employed, maintaining medication consistency to minimize confounding variables. Results: In our study, diabetic patients significantly improved systolic function, after PCI, to the point where it was nearly comparable to non-diabetes. Most of these measures were poorer in diabetics than in nondiabetics at baseline. However, in this subgroup, our study also demonstrated excellent reversibility of these negative effects following PCI. After PCI, there was also a change in LVEF in non-diabetics. Both people with diabetes and people without diabetes showed improvement in WMA. However, the degree of improvement in these two groups varied. Discussion: This study compared coronary stenosis in diabetic and non-diabetic patients. Diabetics exhibited significantly higher LAD stenosis (60% vs. 40%), while RCA and LCx stenoses were similar. Baseline LVEF, LVESV, and LVIDs showed no significant differences between groups. Diabetics had more regional wall motion abnormalities. Three months post-PCI, both groups improved in LV parameters, with no significant inter-group differences. Diabetic patients showed improved LVEF, contrary to a study by Nabati et al. in non-diabetics. Regional wall motion abnormalities decreased more in non-diabetic patients Conclusion: Contrary to the common belief favoring CABG for diabetics, our study indicates that newer drug-eluting stents offer comparable benefits in clinical outcomes, survival rates, and LV systolic function improvements for both diabetic and non-diabetic patients. \u0000University Heart Journal 2023; 19(2): 45-48","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"107 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657207","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}

{"title":"Awareness on MINOCA","authors":"J. Arzu, C. M. Ahmed","doi":"10.3329/uhj.v3i1.73693","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73693","url":null,"abstract":"Abstract not available\u0000University Heart Journal 2023; 19(2): 35","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655920","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}

{"title":"The outcome of Autogenous Venous Graft Vs Prosthetic Graft in Peripheral Arterial Disease- Study in Bangladesh","authors":"Mainul Mahmud, Nur A Al Amin, Kamal Hossain, Uzzal Ahmed, Ashik Rahman Rifat, Rakibul Hasan, Md Saif Ullah Khan","doi":"10.3329/uhj.v3i1.73744","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73744","url":null,"abstract":"Graft insertion is a surgical intervention employed to address advanced stages of peripheral artery disease (PAD) or peripheral vascular disease (PVD). Peripheral artery disease (PAD) or peripheral vascular disease (PVD) refers to the narrowing or blockage of blood vessels, typically in the lower extremities resulting from the accumulation of fatty deposits (atherosclerosis). This condition leads to diminished blood flow to the affected regions. These symptoms may include leg pain, cramping, numbness, and, in severe instances, tissue damage and gangrene. Objective: This study aims to evaluate the surgical outcome of autogenous venous grafts and prosthetic grafts in peripheral arterial disease. Method: The cross-sectional study was conducted at Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University & Enam Medical College Hospital, Savar, Dhaka - over two year from January 2021 to December 2022. This study represented patients who received surgical treatment for peripheral artery disorders using grafts, which could be either autogenous (vein) or prosthetic in nature. Results: Smoking, hypertension, and dyslipidemia were the main risk factors for PAD. The main indications of revascularization in our investigation were gangrene, critical limb ischemia, and limb salvage. In the case of a prosthetic graft, post-operative infection was higher. The other postoperative problems were thrombosisrelated occlusion and hemorrhage. Conclusion: Autogenous venous and prosthetic grafts can provide a bypass or supply blood flow to the damaged area during peripheral arterial disease (PAD) revascularization. The surgeon’s preference and the patient’s condition determine which graft type is used. In this study, prosthetic and autogenous venous grafts in PAD are compared. \u0000University Heart Journal 2023; 19(2): 55-60","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"129 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656457","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}

{"title":"Association of Cardiac Troponin I Levels with the Severity of Coronary Artery Disease in Non-ST Elevation Myocardial Infarction","authors":"K. Mahmood, M. Arefin, M. M. Rahman, A. Jafar, Nishat Ahmed, Md Shafiqul Islam, M. Ahsan, Neena Islam, Forhad Karim Mojumder, M. Azam","doi":"10.3329/uhj.v3i1.73695","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73695","url":null,"abstract":"Background : Among the acute coronary syndromes (ACS), Non-ST-elevation myocardial infarction (NSTEMI) is the most common presentation and a leading cause of hospital admissions. Prognosis of patients with ACS are related to the magnitude of cardiac biomarker release. Hence it is essential to see the relationship of increase in troponin levels in the setting of NSTEMI with the severity of CAD. Objective: This study was conducted to determine the association of cardiac troponin I (cTnI) with the severity of coronary artery disease in NSTEMI. Method : A cross-sectional analytical study was conducted on 120 NSTEMI patients admitted in National Institute of Cardiovascular Diseases, Dhaka between August 2016 to March 2017. cTnI was measured using IMMULITE 1000 (Siemens, USA) which is a three-step assay, based on the immunochemistry technology. All patients underwent coronary angiography in the index hospitalization. Stenosis > 70% in any of the three major epicardial vessels was considered significant CAD. Extent of CAD was defined as significant single, two or three vessel CAD. Chi-square test was applied to test the association between cTnI levels and CAD extent. Severity of coronary artery disease was also analysed by Vessel score and Gensini score. Spearmen’s Rank correlation test & Pearson’s correlation test were applied to test the association of cTnI with Vessel score and Gensini score respectively. Results: In the study, out of 120 patients, in 58 patients with cTnI levels < 10 folds upper limit of normal(ULN) (Group-I), (14) 24.1 % of the patients had single vessel, (18)31% had two vessel and (15)25.9 % had three vessel significant CAD, while among patients with cTnI levels > 10 folds ULN (Group-II) ,(11) 17.7 % of the patients had single vessel, (16)25.8% had two vessel and (29) 48.6% had three vessel significant CAD.There was an insignificant association between the cTnI levels and single vessel, two vessel CAD extent (p= 0.38, p= 0.52 respectively), however there was a statistically significant association between the cTnI levels and three vessel CAD (p=0.03) and also cTnI levels and multivessel disease (combined double vessel and triple vessel disease) (p=0.04). Mean vessel score was higher in group II than group I (2.101.02 vs. 1.641.07) with statistical significant difference (p=0.02). Mean Gensini Score was significantly higher in group II compared to group I (61.5±37.6 vs. 39.6±27.4, p<.001).There is a positive correlation between cTnI and coronary artery disease severity in terms of Gensini score (r=0.40, p=0.01).there is also a positive correlation between cTnI and coronary artery disease severity in terms of vessel score (r=0.28,p=0.01). Conclusion: Higher cTnI levels in NSTEMI are associated with severe CAD in the form of multi-vessel involvement with higher vessel score and Gensini score . Early coronary angiography should be considered especially in these patients & earlier revascularization would improve their clinical outcomes","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"75 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655330","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}

{"title":"Minimally Invasive Ascending Aortic Replacement with Concomitant Aortic Valve Replacement, A Case Report","authors":"S. Gupta, Ali Haider, P. K. Chanda, D. K. Adhikary","doi":"10.3329/uhj.v3i1.73756","DOIUrl":"https://doi.org/10.3329/uhj.v3i1.73756","url":null,"abstract":"Aortic valve stenosis or aortic stenosis is a type of heart valve disease (valvular heart disease). The valve between the lower left heart chamber and the body’s main artery (aorta) is narrowed and doesn’t open fully. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body. Here we will discuss the care of a young male who presented with exertional dyspnea with palpitation and after detailed examination and investigation he was diagnosed as a care of severe aortic stenosis with moderate aortic regurgitation with bicuspid aortic valve and ascending aortic dilatation. \u0000University Heart Journal 2023; 19(2): 71-73","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"141 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655979","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}

{"title":"A Case of Infective Endocarditis Caused by Rapidly Growing Non-tuberculous Mycobacterium after Cardiac Catheterization","authors":"SM Nurul Huda, Mohammad Faisal Ibn Kabir, Md Fakhrul Islam Khaled, Afm Azim Anwar, Md Rasul Amin","doi":"10.3329/uhj.v19i1.69828","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69828","url":null,"abstract":"Endocarditis caused by non-tuberculous mycobacterium is rare and often missed without appropriate blood cultures. It does not respond to standard antitubercular treatment and is also resistant to many other antibiotics. The course of the disease may be indolent and often results in a fatal outcome. Here we report a case of Nontuberculous mycobacterial endocarditis of the native aortic valve in an immunocompetent patient following coronary angiography. The case highlights an unfortunate intervention – related nosocomial infection and the difficulties in chemotherapeutic options for this organism, particularly in the presence of marrow suppression and acute interstitial nephritis. University Heart Journal 2023; 19(1): 31-34","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249773","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}

{"title":"Coronary Angiographic Findings between Diabetic and nondiabetic Patients in Coronary Artery Disease: A Comparative Study","authors":"Syed Mahabub Ebna Al Baker, Mohammad Nizamul Hossain Showdagor, Mukhlesur Rahman, Manzoor Mahmood, Ahsan Habib, Fazlur Rahman, Syed Ali Ahsan","doi":"10.3329/uhj.v19i1.69782","DOIUrl":"https://doi.org/10.3329/uhj.v19i1.69782","url":null,"abstract":"Background & Objectives: Coronary artery disease (CAD) accounts for the major risk factor of mortality in diabetes. Coronary angiography is the “gold-standard” technique for diagnosing and evaluating CAD. Material and Methods: The present study was undertaken at Border Guard hospital, Dhaka between the periods of November - 2017 to December 2021. Percutaneous coronary angiography (CAG) was performed in 204 consecutive patients with suggestive of ischaemic chest pain. The population consisted of 88 cases which are diabetic and 116 cases nondiabetic Results: We observed angiographic lesion among both groups comparing site & number of vessel(s) involvement and also average percentage of stenosis. The presence of coronary risk factors was not significantly different between the two populations. Total positive angiographic lesion was (61.5%) in both groups. Among the Diabetes mellitus patients positive CAG finding (69.3%). The recognized lesions were single vessel disease (SVD) 23 (26.1%), double vessel disease (DVD) 14 (15.9%), triple vessel disease (TVD) 24 (27.3%) percentage of vessel stenosis 82.63%. On the other hand, total positive angiographic lesion was 70 (53.4%) in non-diabetic group; among them single vessel disease (SVD) 30 (25.9%), double vessel disease (DVD) 15(12.9%), triple vessel disease (TVD) 17 (14.7%). No diffuse lesions was found and average vessel stenosis was 78.03%. The results of the angiographic finding suggest that diabetic patients have a higher incidence of coronary heart disease (CHD), DVD, TVD, diffuse lesion & marked stenosis of coronary vessel than non-diabetic patient. Conclusion: CAD in diabetics had considerably higher percent of severe and unpredictable presentation. This increased frequency of complex lesion morphology is more difficult to treat by definitive intervention like percutaneous transluminal coronary angioplasty (PCI) & coronary artery bypass graft (CABG). Diabetics have a higher risk factor profile and poor clinical outcome. Early diagnosis and appropriate management will reduce the risk of complication after the onset of disease. University Heart Journal 2023; 19(1): 5-9","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"54 4-5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139248007","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}