University Heart Journal最新文献

{"title":"Role of serum β2m in predicting severity of Coronary artery disease","authors":"Zebun Nessa, S. Ferdoushi, F. I. Khaled, S. Islam, N. Jahan, D. Adhikary, Khaleda Kahnam, Mahejabeen, T. Sultana, D. Paul","doi":"10.3329/uhj.v16i1.44818","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44818","url":null,"abstract":"Background: Coronary artery disease is the principal cause of disability and mortality worldwide. Its prevalence is increasing around world. It is about 75% of deaths occurring in developing countries like Bangladesh. It is very important to know about the inflammatory risk factors of coronary artery disease for early assessment of coronary artery disease. Serumβ2-microglobulin (²2m) is a newly identified biomarker that has been found to increase in patients with coronary artery disease. Aims: To determine the role of â2m in predicting the severity of coronary artery disease. \u0000Methods: This cross-sectional study was carried out in Department of Cardiology and Laboratory Medicine, BSMMU, Shahbag, Dhaka during March 2017 to February 2018. Total seventy four patients who underwent coronary angiography as per criteria where included in this study. Serum β2-microglobulin (²2m)was done before angiography procedure by indirect ELISA method and severity of coronary artery disease was assessed by extent of diseased coronary vessels and SYNTAX score. \u0000Results: β2-microglobulin level was found higher (≥3/ml) in coronary artery disease patients which was statistically significant (p<0.001).β2-microglobulin was also correlated with number of diseased coronary vessels (r=0.562, p<0.001). Mean â2m level was found 4.48±0.95 μg/ml with range from 3-6.1 μg/ml and the mean SYNTAX score was found 16.27±08.99 with the range from 1 to 44. Pearson’s correlation coefficient was done between â2m level and SYNTAX score. Then the result is r=0.547 and p<0.001. Therefore, there was a positive correlation between â2m level and SYNTAX score. The area under the receiver-operator characteristic (ROC) curves ²2m cut off value of 3.6 with 81.4% sensitivity and 86.7% specificity as the value for identifying the coronary artery disease. \u0000Conclusion: Our study revealed that β2-microglobulin effectively correlates with the severity of coronary artery disease. So it may be used as a reliable marker for assessment of coronary artery disease severity. \u0000University Heart Journal Vol. 16, No. 1, Jan 2020; 22-27","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"111 1","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88060294","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":"Angiographic Severity of Coronary Artery Disease among Patients with Non-ST Elevated Acute Coronary Syndrome having Fragmented-QRS in ECG","authors":"Abu Raihan Ferdous, Mrm Mandal, F. Kabir, Rasul Amin, S. Ahsan, S. E. Mahbub, A. Bhuiyan, M. M. Rahman","doi":"10.3329/uhj.v16i1.44819","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44819","url":null,"abstract":"Fragmented QRS (f-QRS) complex in 12 lead ECG may develop in the background of acute coronary syndrome (ACS). This study was aimed to evaluate the angiographic severity of CAD among non-ST ACS patients having f-QRS in the ECG.This cross-sectional observational study was conducted in Cardiology department of BSMMU. Total 52 non-ST ACS patients who underwent invasive coronary angiography (CAG) were included in two groups according to presence or absence of f-QRS complex. 25 patients were included in f-QRS group and 27 in non-f-QRS group. After CAG, severity of CAD was assessed and compared by number of vessel involvement and degree of vessel stenosis. Patients’ demographic parameters were same in both groups. Depending on the number of vessel involvement, it was found that among f-QRS patient group, highest percentage had triple vessel (32%) followed by double vessel (28%) and single vessel (24%) disease and 16% patient had normal or non-critical epicardial coronary arteries. Among non-f QRS group, highest percentage had normal or non-critical lesions (40.7%) followed by double vessel (25.9%), single vessel (22.2%) and triple vessel disease (7.4%). In conclusion, this study revealed that presence of f-QRS in ECG is associated with more severe form of CAD and once the finding is observed, the particular patient should be targeted for aggressive management. University Heart Journal 2020; 16(1): 28-32 University Heart Journal Vol. 16, No. 1, January 2020 Received: 15 October, 2019 Accepted: 01 December, 2019","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"51 1","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91016380","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":"Blood Lipids: How much low is low enough?","authors":"M. Mahmood, H. Hoque","doi":"10.3329/uhj.v16i1.44814","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44814","url":null,"abstract":"Abstract not available \u0000University Heart Journal Vol. 16, No. 1, Jan 2020; 1-2","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"15 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82326521","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":"Echocardiographic Imaging of Intracardiac Thrombus and Evaluated its Underlying cause along Therapeutic Implications: A Review","authors":"Mostashirul Haque, M. F. Kabir, Rasul Amin, F. I. Khaled, Rayhan Masum Mandal, S. Zaman, H. Hoque, F. Rahman, Cm Ahmed","doi":"10.3329/uhj.v16i1.44842","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44842","url":null,"abstract":"Introduction: Transesophageal echocardiography(TEE) is considered to be superior to the transthoracic echocardiography(TTE) for detecting cardiovascular sources of embolism because of lack of intervening lungs and bone, and the use of higher-frequency imaging transducers provide enhanced spatial resolution and improved detection of intra-cardiac thrombi and spontaneous left atrial echo contrast, a marker of blood stasis.1 Clinical detection of ventricular thrombi is generally performed by TTE and evaluation of atrial thrombi is generally performed by TEE.2","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"8 1","pages":"40-42"},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87865568","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 Microvascular Dysfunction: An Update","authors":"S. Zaman, H. Hoque, Khurshed Ahmed, Mukhlesur Rahman, M. Chowdhury, A. Jamil, F. I. Khaled","doi":"10.3329/uhj.v16i1.44843","DOIUrl":"https://doi.org/10.3329/uhj.v16i1.44843","url":null,"abstract":"Structural and functional abnormalities of the microcirculation can impair myocardial perfusion which is called coronary microvascular dysfunction and the resulting ischemia is known as microvascular ischaemia. Most of the researches have focused on the epicardial coronary arteries while addressing angina pectoris. Although the importance of the coronary microcirculation in maintaining appropriate myocardial perfusion has been recognized for several decades, the substantial morbidity of coronary microvascular dysfunction (CMD) has not been appreciated until recently. It is not possible to diagnose of microvascular angina clinically with the current knowledge. Resting or exercise electrocardiogram is nondiagnostic. Imaging with speckle tracking in echocardiography may reveal focal diastolic and/or systolic dysfunction. Other noninvasive investigations includes, Contrast stress echocardiography, 99Tc-sestamibi imaging, cardiovascular magnetic resonance (CMR),Nuclear magnetic resonance spectroscopy may show some degree of abnormality. Invasive methods like intracoronary adenosine and acetylecholine test may guide us to diagnose CMD. No guideline directed medical therapy is still available for the CMD. Risk factors modification like smoking cessation and weight-loss may improve endothelial dysfunction and CMD. Beta blockers, calcium channel blockers, Angiotensin converting enzyme inhibitors and statin are now used in different clinical condition related to microvascular angina. After these medical treatment patient with microvascular angina have higher risk of MACE compared with people without angina. So, physicians must be aware of this potentially fatal but under recognized clinical entity. \u0000University Heart Journal Vol. 16, No. 1, Jan 2020; 43-49","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83255842","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":"Validation of Pharmacogenetic Testing Before Initiation of Warfarin Therapy","authors":"M. Chowdhury, F. I. Khaled, S. Sultana, Mohammad Walidur Rahman, Mrm Mandal, Khurshed Ahmed, H. Hoque","doi":"10.3329/UHJ.V15I2.42665","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42665","url":null,"abstract":"Warfarin is an oral anticoagulant used to prevent or treat clotting disorders associated with venous thrombosis, pulmonary embolism, atrial fibrilation, cardiac valve replacement, stroke and acute myocardial infarction. It is a vitamin K antagonist composed of S- and R- isomers. The more potent S-warfarin is metabolized by cytochrome 450 isoenzyme 2C9 (CYP2C9), encoded by CYP2C9 gene. Warfarin exerts its anticoagulants effect by inhibitingits target enzyme vitamin K epoxide reductase (VKOR), encoded by vitamin K epoxide reductase subunit 1 (VKOR1) gene. Genetic variation in the CYP2C9 and VKOR1 gene can affect warfarin efficacy and dose required to achieve stable International Normalization Ratio (INR). Specifically two variants in the CYP2CP gene (CYP2C9*2 and CYP2C9*3) result in an enzyme with reduced activity, leading to increased active warfarin levels. A variant in the VKORC1 gene (VKORC1-1639 G>A) can lead to reduced gene expression resulting in decresed level of VKOR. Together these three variants can account for 40-70% of the variability of warfarin dose. Carriers of variant alleles are at higher risk for bleeding complications, particularly at the induction of warfarin therapy. So, genotype-guided dosing algorithms would be better approximate for maintenance of warfarin dose than fixed-dose algorithms. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 74-78","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76777168","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":"Factors Influencing Pre-Hospital Delay In Patients with Acute Myocardial Infarction","authors":"Md Fakhrul Islam Khaled, S. Banerjee, D. Adhikary, M. Chowdhury, M. Mahmood, M. M. Rahman, Khurshed Ahmed, M. F. Kabir, Sanjida Ansari","doi":"10.3329/UHJ.V15I2.42666","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42666","url":null,"abstract":"Acute coronary syndrome is a lethal condition. Treatment modality and success mostly depend on time yielded since onset of symptoms. It is known for more than 30 years that delay between symptom onset and treatment of less than 60 min are desirable, but pre hospital delays remain unacceptably long worldwide including Bangladesh. A greater understanding of the contributing factors may help to reduce delays. A number of sociodemographic, clinical, social and proximal factors have been associated with pre hospital delay. The total pre hospital delay period consists of two component: time taken by patients to recognize that their symptoms are serious and to contact medical help (decision time) and the time taken from requesting help to admission where emergency coronary care is available (time to hospital delay). Different factors may affect these two components. In hospital delay also known as door-to-treatment, is defined as time from arriving to hospital to initiation of reperfusion therapy. Regardless of how to shorten in hospital delay, if the pre hospital delay is not reduced, then reperfusion therapy cannot achieve the best results. We set out to discover what factors are specifically associated with three components: decision time, home to hospital delay and First Medical Contact (FMC) to revascularization delay. This review may help the National health management system to identify the factors associated with treatment delay in ACS and thus reduces ACS related morbidity and mortality. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 79-85","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73561722","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 Patent Ductus Arteriosus with Aortic Stenosis","authors":"Khurshed Ahmed, H. Hoque, S. Zaman, F. I. Khaled, A. Sultan, N. Fatema, M. Chowdhury, Adnan Bashar","doi":"10.3329/UHJ.V15I2.42667","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42667","url":null,"abstract":"Patent ductus arteriosus(PDA) is a congenital cardiac disorder which is not so uncommon but it becomes rare when associated with aortic stenosis. In our case clinical finding was consistent with PDA and aortic stenosis. Echocardiographic finding showed that patient also has moderate aortic regurgitation which makes this case one of the rarest. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 86-88","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83571347","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":"Frequency and Clinical Characteristics of Heart Failure with Preserved Ejection Fraction Patients in a Tertiary Level Hospital","authors":"Mohammad Walidur Rahman, M. Mahmood, D. Adhikary, S. Ahsan, C. M. Ahmed, H. Hoque, T. Parvin, F. I. Khaled, Mrm Mandal, A. Salim, S. Sharmin, A. Talukder, K. Iqbal, M. Siraj, M. Chowdhury, S. Banerjee","doi":"10.3329/UHJ.V15I2.42650","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42650","url":null,"abstract":"Background: Heart failure with preserved ejection fraction (HFpEF) has already emerged as the predominant form of heart failure in the western world. We aimed to estimate the frequency and clinical characteristics of HFpEF cohort in Bangladesh as limited data are available about this extremely heterogeneous syndrome. \u0000Methods: This cross sectional study was conducted at the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka from December, 2017 to December, 2018. A total of 124 heart failure patients were enrolled in the study for the estimation of frequency of HFpEF. Comorbidities and presentation of 30 HFpEF patients were assessed. HFpEF diagnosis was made according to the 2016 European Society of Cardiology (ESC) Guidelines. \u0000Results: The frequency of HFpEF was 30 (24.1%) (95% confidence interval 16.6% to 31.7%). The mean (SD) age of was 65.0 (10.1) years. Majority of the patients (73.3 %) were between 60 to 79 years of age. Majority of the patients (60%) were male. Most of the patients had multiple comorbidities and risk factors. Hypertension was the most prevalent risk factor which was present in 80% cases. Dyslipidemia was found in 63.3% cases, DM in 53.3% cases. 36.6% patients had coronary artery disease (CAD). CKD was found in 30% cases. 26.6% patients had atrial fibrillation, which was the most common arrhythmia. 62.0% were overweight to obese. Anemia was found in 55.1% cases. 73.3% patients presented in a decompensated stage of NYHA IV. Breathlessness was the most common (100%) complaint, whereas bilateral lung base crepitations was the most frequent sign (96%). \u0000Conclusions: This study findings has paved the way for characterization of HFPEF in Bangladeshi population but more large scale epidemiological studies are needed. \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 63-67","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79370422","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":"Third and Fourth Heart Sounds: Clinical and Haemodynamic Significance","authors":"M. Mahmood, H. Hoque","doi":"10.3329/UHJ.V15I2.42644","DOIUrl":"https://doi.org/10.3329/UHJ.V15I2.42644","url":null,"abstract":"Abstract not available \u0000University Heart Journal Vol. 15, No. 2, Jul 2019; 40","PeriodicalId":23424,"journal":{"name":"University Heart Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79881167","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}