Bangladesh Heart Journal最新文献

{"title":"Association of free Tri-iodothyronine Level with Cardiogenic Shock and Prognosis in Patients Hospitalized with Acute STelevation Myocardial Infarction Treated with Streptokinase Therapy","authors":"S. Huda, A. Choudhury, J. Jahan, Masuma Tabassum, Atikur Rahman, D. Debnath","doi":"10.3329/bhj.v38i1.67187","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67187","url":null,"abstract":"Background: Cardiogenic shock is the leading cause of death in patients with Acute ST-segment Elevation Myocardial Infarction (STEMI). Low free Tri-iodothyronine (FT3) levels are generally associated with poor prognosis in STEMI patients. This study was done to assess the association between FT3 levels and Cardiogenic shock in patients hospitalized with STEMI treated with streptokinase therapy. \u0000Methods: This was an observational study of 140 patients of STEMI treated with streptokinase therapy in the department of cardiology, NICVD, Dhaka, Bangladesh from October 2018 to September 2019. The patients were divided into low FT3 (FT3 <3.5pmol/L; n = 70) and normal FT3 (FT3 e” 3.5pmol/L; n = 70) groups according to FT3 levels measured within 24 hours after admission. \u0000Results: During the index hospitalization period, 30 patients developed cardiogenic shock, 23(32.9%) in low FT3 group and 7(10.0%) in normal FT3 group. There were 17 deaths with 18.6% in low FT3 group and 5.7% in normal FT3 group (p=0.01). MACE occurred 45.7% in low FT3 group and 18.6%in normal FT3 group (p=0.001). The mortality in patients with cardiogenic shock was 43.3% compared to 3.6% in patients without cardiogenic shock. Multivariate logistic regression analysis showed FT3 level was an important predictor for cardiogenic shock in patients hospitalized with STEMI (p=0.01). \u0000Conclusion: Low FT3 levels were strongly associated with cardiogenic shock in patients with STEMI. The FT3 level screening may be a simple and valuable way to predict Cardiogenic shock after STEMI. \u0000Bangladesh Heart Journal 2023; 38(1): 1-7","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117235477","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":"Effect of Open Heart Surgery on Lung Complications with their Incidence and Fate – a Single Center Study","authors":"Tawfiq Ahmed, A. Rahim, A. Hossain, M. Islam, Aym Shahidullah","doi":"10.3329/bhj.v38i1.67188","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67188","url":null,"abstract":"This prospective study was designed to determine the incidence of pulmonary complications after open cardiac surgery as well as to identity predisposing factors of these complications at NICVD, Dhaka, Bangladesh. The cumulative incidence of pulmonary complications after open heart surgery was 16.85% (15of 89) with a mortality rate of 33.33% (5 of 15) and the overall mortality among all patients was 5.62% (5 of 89). Pulmonary complications occurred in 15.9% of patients with coronary artery revascularization, 11.53% in patients with valvular replacement and 26.31% in patients with congenital heart disease. ARDS occurred in 2.25% of patients with a mortality rate of about 100%,, pneumonia in 5.62%, atelectasis in 2.25%, pleural effusion in 5.62% and pneumothorax in 3.37%. The most predisposing factors were massive blood transfusion, re-exploration for control of post-operative bleeding, cardiopulmonary resuscitation and prolonged length stay in the intensive care unit. \u0000Bangladesh Heart Journal 2023; 38(1): 8-12","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126458137","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 Left Atrial Volume Index and In-hospital Outcome in Patients with Acute ST Segment Elevation Myocardial Infarction and It’s Correlation with the Level of NT-proBNP","authors":"H. Iqbal, T. Haque, Ashok Dutta, S. Choudhury, Sayeedur Rahman Khan, Fazila-Tun Nesa Malik","doi":"10.3329/bhj.v38i1.67218","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67218","url":null,"abstract":"Background: ST segment elevation myocardial infarction (STEMI) is associated with ventricular dysfunction due to ischemic myocardial damage, decrease ventricular compliance and increase filling pressure resulting in left atrial stretching, dilatation, increase left atrial volume and subsequently increase secretion of atrial natriuretic peptides. This study is aimed to determine the association between increase left atrial volume index (LAVI) and in-hospital outcome and to explore the correlation between LAVI and NT-proBNP in patients suffered from acute ST segment elevation myocardial infarction (STEMI). \u0000Methods: This cross sectional analytic study include 92 patients with acute STEMI admitted for reperfusion therapy. 2D Echocardiography was done and based on LAVI, study population were grouped as Group A:LAVI >34 ml/m2 (n=48) & Group B:LAVI d”34 ml/m2(n=44). \u0000Results: In-hospital outcome, plasma level of NT-proBNP and echcardiographic evaluation was done successfully. Mean NT-proBNP was significantly high in Group A than Group B (1234.6±738.77 vs 689.52±721.04). Statistically significant association was present between LAVI and adverse in-hospital outcome. Persistent chest pain, hypotension, acute LVF, arrhythmia, acute kidney injury were higher in Group A than Group B and acute LVF occurred significantly (p<0.05) more in Group A than Group B (38.3% vs. 9.1%). Statistically significant correlation was present between LAVI and NT-proBNP (r=0.453; p=0.001). According to receiver-operating characteristic curve (ROC) analysis, LAVI with a cut off value of 33.75 ml/m2 can predict adverse in-hospital outcome in patients of acute STEMI underwent reperfusion therapy with sensitivity 66.2% and specificity 75% and better than NT-proBNP with more sensitivity (66.2% vs 50.0%). \u0000Conclusion: Significant association present between increase LAVI and adverse in-hospital outcome and it can predict adverse in-hospital outcome better than NTproBNP. There is also positive correlation between LAVI and NT-proBNP in acute STEMI. \u0000Bangladesh Heart Journal 2023; 38(1): 46-57","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129443710","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":"Characteristics and Clinical Outcomes of Patients on Mechanical Ventilation in the Coronary Care Unit of a Tertiary Care Hospital in Bangladesh","authors":"Masuma Jannat Shafi, S. Nasrin, Md. Jabed Iqbal","doi":"10.3329/bhj.v38i1.67190","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67190","url":null,"abstract":"Background: This study was undertaken to evaluate clinical characteristics, indications, outcomes, and factors affecting outcomes in adult patients on mechanical ventilation admitted to CCU that will help planning of proper MV management programs. There are few studies in the coronary care unit (CCU) population and even fewer from developing countries. \u0000Methods: All adult patients received MV at Ibrahim cardiac hospital CCU between June 2019 and July 2020 were prospectively recruited. Different demographic, indications, type and characteristics of ventilation, concomitant complications and treatment, outcomes, clinical and laboratory variables were recorded at the initiation of mechanical ventilation and daily, all throughout the course of MV & thereafter. \u0000Results: Out of 1563 patients admitted to the CCU, 138 patients received IMV. Mean age was 64.2±12.1. Male were predominant (71.7% vs. 28.3%). DM was the most common (81.9%) risk factor. Reasons for intubation were as follows: type 1 respiratory failure (40%), type II respiratory failure (35%), and post cardiac arrest (25%). Mostly used mode of ventilation was A/C VCV (96.4%). Invasive MV was associated with high APACHE II score, low admission PH, Po2, and high Pco2. A higher in-coronary care unit death was observed in MV patients (65.2%) while that for MI (70.3%) than survivors (34.8%). CAG±PCI was (5.8%) keeping on MV or after extubation. The mean duration of MV, stay in CCU and hospital were (53.5±5.8, 80.5±7.6 and 128.8±12.0) hours respectively. The main factors independently associated with increased mortality were (i) pre-MV factors: age, APACHE II scores, acute left ventricular failure, and cardiogenic shock, sepsis (64.2±12.1, 39.1±19.2, 65.9%, 81.2%, and 70%). (ii) Patient management factors during ventilation: without positive end-expiratory pressure (65.6%) (iii) Factors occurring over the course of MV: PaO2/FiO2<100 (61.2±18.75) and development of renal failure (47.8%), VAP (40.6%), MODS (21.0%) & ARDS (8.7%) after initiation of MV. \u0000Conclusion: Outcome among mechanically ventilated patients depended on the factors (including patient’s demographics, nature of associated morbidity, characteristics of MV received, and conditions developing over the course of MV). These factors may be present before or develop after initiation of MV as well as on the development of complications and the management protocols in the CCU. \u0000Bangladesh Heart Journal 2023; 38(1): 22-31","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124619542","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":"Wave-Wise Comparison of Demographics, Clinical Characteristics & In-Hospital Outcome of COVID-19 Pandemic in Bangladesh: Single Centre Study","authors":"Fazila-Tun Nesa Malik, M. Kalimuddin, M. Ishraquzzaman, M. Al Mamun, Ashok Dutta, Md Habibur Rahman, Smita Kanungo, N. Laila, Md. Shamim Chowdhury, S. Choudhury","doi":"10.3329/bhj.v38i1.67189","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67189","url":null,"abstract":"Background: Most countries in the world faced two waves of Corona virus disease-19 (COVID-19). But there is a lack of data regarding the wave-wise comparison of epidemiological and clinical characteristics of the COVID-19 outbreak. This study aimed to compare the demographics, clinical characteristics, and in-hospital outcomes of two waves of the COVID-19 pandemic in Bangladesh. \u0000Methods: This prospective cross-sectional study was carried out at the National Heart Foundation Hospital & Research Institute. From April 3, 2020, to January 28, 2021, was considered the first wave, and from February 27, 2021, to September 25, 2021, was considered the second wave. COVID-positive patients and all admitted patients who became COVID-19 positive during these periods were included in this study for comparison. \u0000Results: The first wave included 727 patients, and the second wave included 858 patients. The mean age of the patients in the first wave was 48.11 15.75 years, and in the second wave it was 50.65 16.63 years. Males were predominant in both waves. Healthcare personnel were less affected during the second wave (11.9% vs. 30.7%; p=0.001). Hypertension, chronic kidney disease, and cardiovascular disease were more prevalent in the second wave (p 0.05), and dyslipidemia and obesity in the first wave (p<0.05). During the second wave, 80.5% of patients were unvaccinated. Asymptomatic patients were predominant in the second wave (26.9% vs. 17.5%; p=0.001). COVID-19-related symptoms (fever, body ache, headache, anosmia, sore throat, shortness of breath, and diarrhea) were less prominent during the second wave (p<0.05). Oxygen requirements and IV antibiotic use were higher during the second wave (p<0.05). Asymptomatic & severe disease form were prevalent in second wave (p<0.05). Mortality rate was more during second wave (5.1% vs 3.4%; p=0.1). Age > 50 years, severe left ventricular dysfunction, severe and critically ill patients were the independent predictor of mortality. \u0000Conclusion: In comparison to the first wave, during the second wave symptoms were less prominent, asymptomatic and severe disease forms were more prevalent & mortality rate was high. Unvaccinated persons are more prone to affected by COVID-19. \u0000Bangladesh Heart Journal 2023; 38(1): 13-21","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134211265","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":"Magnitude of ST-Segment Elevation in Acute Inferior Myocardial Infarction and the Proximity of Right Coronary Artery Lesion","authors":"Aks Zahid Mahmud Khan, Khondoker Al Monsur Helal, Lima Asrin Sayami, Farhana Ahmed, Md. Saqif Shahriar, A. Islam, M. Ahmed, Gourango Kumar, Mahbub Ali, Md Saiful Islam, Mst. Ismot Ara","doi":"10.3329/bhj.v38i1.67219","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67219","url":null,"abstract":"Background & objective: Involvement of the right coronary artery frequently occurs in acute inferior myocardial infarction. Typical ECG changes in this condition involve ST-segment elevation in inferior leads. The present study was intended to predict the site of the lesion in the right coronary artery (RCA) in patients with acute inferior wall myocardial infarction using the height of ST-segment elevation as the predictor variable. \u0000Methods: The present cross-sectional study was carried out in the Department of Cardiology, National Institute Cardiovascular Diseases (NICVD), Dhaka, Bangladesh over a period of one year between July 2010 to June 2011. Patients with acute inferior myocardial infarction admitted to CCU of NICVD within 12 hours of the onset of chest pain and underwent coronary angiography within 4 weeks of acute myocardial infarction (AMI) were the study population. With the help of a 12-lead ECG, magnitudes of ST-segment elevation in leads II, III, and aVF were measured. The highest degree of stenosis along the RCA revealed by an angiogram was accepted as the culprit lesion. The right coronary artery was divided into proximal (from its ostium to the origin of the RV branch), mid (from the RV branch to the acute marginal branch), and distal (from the acute marginal branch onward) parts. The sum of ST-segment elevation was then computed and compared among the three groups of patients divided on the basis of the site of lesion in RCA. \u0000Result: The findings of the study showed that nearly half (48%) of the patients had lesions in the proximal, 38% in the mid, and the rest (14%) in the distal part of the right coronary artery (RCA). While patients with proximal lesions had the highest mean sum of the ST-segment elevation (12.1 ± 0.6 mm), those with distal lesions had the lowest mean sum of the ST-segment elevation (6.1 ± 0.2 mm). The three groups were significantly heterogeneous (p < 0.001). The magnitude of STsegment elevation in Lead II, III, and aVF and the sum of ST-segment elevation all were significantly higher in patients with proximal lesions than those in patients with mid and distal lesions (p < 0.001). \u0000Conclusion: The magnitude of ST-segment elevation can predict the site of lesion in RCA in inferior wall myocardial infarction. The greater the height of STsegment elevation, the higher the probability of lying the lesion in the proximal part of the RCA. \u0000Bangladesh Heart Journal 2023; 38(1): 58-62","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121631100","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":"Prediction of Short-Term Outcome after Primary Percutaneous Coronary Intervention by CADILLAC Risk Score","authors":"M. Kabir, M. Arefin, Md Shafiqul Islam, J. Jahan, B. Dutta, M Zahid Hasan, Md Imam Hosen, Tausif Amim Shadly, Md Nazmul Hoque Bhuiyan, M. Azam","doi":"10.3329/bhj.v38i1.67216","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67216","url":null,"abstract":"Introduction: The CADILLAC risk score (CRS) has been developed and validated in the context of primary PCI as a reperfusion strategy for accurate risk stratification. Patients with low CRS have better outcome than those with intermediate to high CRS. However, further studies are needed to validate this score in our population. \u0000Aim of the study: The present study was conducted to predict the short-term outcome after primary percutaneous coronary intervention (pPCI) by CRS. Method: This prospective observational study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from March, 2019 to August, 2020, on 62 patients with two equally divided groups based on CRS: Group I with score 0-2 and Group II with e” 3. The score was calculated by summation of points gathered from each component of the score. Bleeding events, vascular access site complication, heart failure, cardiogenic shock, significant arrhythmia, major adverse cardiovascular and cerebrovascular events (MACCE), were observed during hospital stay and at 30- day follow up. \u0000Result: Mean CRS of the groups were 0.45±0.85 and 4.71±1.74 respectively. Overall adverse outcome, both in-hospital and 30-day, were significantly higher in group II (12.9%vs.35%, p=0.003 and 0vs.22.6%, p=0.001 respectively). Heart failure (22.6%vs.6.5%, p=0.04; 19.4%vs.0, p=0.01) and MACCE (19.3%vs.3.2%, P=0.04; 16.1vs.0%, p=0.02) were significant during hospital stay and at 30-day follow up. Bleeding events (12.9%vs.0, p=0.03) and significant arrhythmia (6.5%vs.0, p=0.04) were significant during hospital stay. Length of hospital stay was also significantly shorter in group I (d”3days: 74.2%vs.35.5%; p= 0.01). The components of CRS except post-PCI TIMI (Thrombolysis in myocardial infarction) flow, intermediate to high CRS, male gender, diabetes mellitus, hypertension, were significant in univariate regression analysis. Moderate to high CRS (in-hospital and 30-day), left ventricular ejection fraction< 40% (inhospital), triple vessel disease (30-day) were significant in multivariate analysis. ROC curve analysis showed, area under the curve for CRS was 0.745 (95% CI: 0.616- 0.874; p=0.001). CRSe”3 predicted in-hospital outcome after pPCI with sensitivity and specificity of 35.5% and 87%, respectively. \u0000Conclusion: In the setting of pPCI, low CRS is associated with better in-hospital outcome in comparison to intermediate to high CRS. Also, in comparison to intermediate to high CRS, low CRS is associated with better 30-day outcome after pPCI, However, for prediction of adverse short-term outcome after pPCI, CRS has got relatively low sensitivity and high specificity. \u0000Bangladesh Heart Journal 2023; 38(1): 32-37","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"2000 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125726967","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 Risk Factors with Socio Demographic Profile in Young Stroke Patients in a Tertiary Care Hospital in Bangladesh. An Observation Study of 100 Patients.","authors":"Sami Nazrul Islam, F. Zaman, Nazia Siddiqui, -. Atiquzzaman, Marufa Yasmin, Mushrefa Chowdhury, Sayeedur Rahman Khan","doi":"10.3329/bhj.v38i1.67222","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67222","url":null,"abstract":"Background: Young people who avoid strokes live longer and have more productive lives than their senior counterparts. The prevalence of the main vascular risk factors in atherosclerosis patients rises with age, starting in early middle age, and declines beyond 70–80 years. The majority of studies on young people are small and single-center, which makes generalization challenging. Stroke risk factors differ between men and women, and vascular risk factors are more prevalent in older age groups of young adult stroke patients. \u0000Objective: The aim of the study is to find out the association of cardiac risk factors in young patients. Methods: This hospital-based cross-sectional study was carried out in the indoor patients in the Shaheed Suhrawardy Medical College Hospital, Dhaka, from April 2015 to October 2015. Young stroke patients (15-45 years old) admitted to the hospital were used as the study’s sample size. \u0000Results: According to this study, the majority of patients (36.0%) were between the ages of 41 and 45. The percentages of patients in the 26–30–year–old, 31–35– year–old, and 36–40–year–old age groups were fairly close to one another (18.0%, 20.0%, and 22.0%, respectively). Just 4.0% of the population was under 25. The majority of the patients (64.0%) suffered from valvular heart disease. In addition, 10.0% had ischemic heart disorders, 16.0% had myocardial infarction, and 8.0% had atrial fibrillation. More over 75.0% of stroke patients also had some type of heart illness, according to the Framingham Heart study risk calculation. \u0000Conclusion: Young adults from Bangladesh who suffered an ischemic stroke exhibited a high incidence of known cardiac risk factors, significant sex disparities, and alarmingly rising trends with age in both sexes. Regardless of where a person lives in the nation, preventive actions must be more aggressive and customized to each individual’s specific risk profile. \u0000Bangladesh Heart Journal 2023; 38(1): 81-87","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122257738","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":"Relationship between Left Atrial Volume Index and Atrial Fibrillation after Mitral Valve Replacement in Patients with Mitral Valve Disease","authors":"Md. Akram Hossain, Md Anwar Hossain, Mobarak Hossain, Kazi Jamil, Sayeedur Rahman Khan, Rampada Sarker","doi":"10.3329/bhj.v38i1.67217","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67217","url":null,"abstract":"Background: Mitral valve replacement (MVR) is a surgical procedure that is often performed in patients with severe mitral valve disease, to replace the damaged valve with a new artificial valve. Left Atrial Volume Index (LAVI) is a measurement of the size of the left atrium of the heart, normalized to the body surface area which is often used as an indicator of left atrial enlargement, which is a common finding in patients with mitral valve disease. There is a significant relationship between LAVI and Atrial Fibrillation (AF) after MVR in patients with mitral valve disease. \u0000Aim of the study: The aim of this study was to evaluate the relationship between LAVI and the occurrence of atrial fibrillation after mitral valve replacement in patients with mitral valve diseases. Methods: This prospective observational study was conducted in the department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka from March, 2018 to February, 2019. Total 60 patients were divided into two groups, out of them 30 patients had LAVI e”39 ml/m² (Group-A) and 30 patients had LAVI d” 39ml/m² (Group-B). \u0000Result: In patients with post-operative AF after MVR, was evaluated by ECG in the presence or absence of pwave and irregular R-R interval and measurement of LAVI more or less than cutoff value 39 ml/m². On postoperative day 3, 7 (23.33%) patients in Group A and 02(6.66%) patients in Group B developed post-operative AF. In Group A there was reduction in the LAVI but not below the cutoff value whereas in Group B, the LAVI was reduced below the cutoff value (< 39 ml/m2). On overall evaluation, after mitral valve replacement increased LAVI is significantly associated with post-operative AF occurrence and is a better predictor than LA diameters. From univariate analysis in our cohort, high inotropes support, MVT, ACT, CPB time and postoperative LAVI were significantly associated with occurrence of AF. But multiple logistic regression analysis revealed postoperative LAVI to be only significant predictor of occurrence of AF after Mitral valve replacement. \u0000Conclusion: Our study shows that postoperative LAVI measured by 2-D echocardiography is positively and independently associated with the occurrence of postoperative AF following MVR. Moreover, clinical risk factors are fairly good predictors of the occurrence of AF after MVR, but postoperative LAVI was the most significant independent predictor of postoperative AF in our study. \u0000Bangladesh Heart Journal 2023; 38(1): 38-45","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116497073","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":"Any Target Value of LDL-cholesterol before Elective PCI? A study at NICVD on Association of LDL-Cholesterol levels with Myocardial Injury during Elective PCI","authors":"M. Hasan, S. Hashem, Mohsin Ahmed, M. Haque, J. Jahan, M. Kabir, Md Imam Hosen, Tausif Amim Shadly","doi":"10.3329/bhj.v38i1.67221","DOIUrl":"https://doi.org/10.3329/bhj.v38i1.67221","url":null,"abstract":"Background: Raised LDL cholesterol has already been established as a strong risk factor the for pathogenesis of atherosclerotic plaque leading to coronary heart disease. During PCI procedure, many patients develop peri-procedural myocardial injury due to mainly atherosclerotic plaque disruption, side branch occlusion and distal small vessel embolization which subsequently affects the mortality and morbidity of patients. \u0000Objectives: To find out the association of preprocedural LDL cholesterol levels with myocardial injury in elective PCI patients. \u0000Methods: This Cross-sectional observational study was conducted at National Institute of Cardiovascular Diseases (NICVD), Dhaka from July 2020 to June 2021. The sample size was 170. LDL cholesterol and troponin-I were measured before the procedure and troponin I was measured 6 hours after PCI procedure. On the basis of pre-procedural cholesterol level, the study population were categorized into two groups: Group I: patients with normal LDL-C level (£70mg/dl) and Group II :patients with raised LDL-C (>70mg/dl). \u0000Results: Total 54(31.8%) patients developed peri-procedural myocardial injury, among them 15(19.7%) were in normal LDL-C group and 39(41.5%) were in raised LDL-C group. Elevation of troponin I after PCI was higher in group II than group I patients with statistically significant difference (p<0.001). Multivariate logistic regression analyses showed that raised LDL-C was an independent predictor of PMI (OR 4.71; 95% CI, 2.072- 10.658; p<0.001). There was positive correlation found between pre-procedural LDL-C and myocardial injury (r=0.44, p<0.001) by Pearson’s correlation coefficient test. \u0000Conclusion: Pre-procedural raised LDL-C level was positively and independently associated with myocardial injury after elective percutaneous coronary intervention (PCI). \u0000Bangladesh Heart Journal 2023; 38(1): 70-80","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"284 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116574464","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}