Background: Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality all around the world. Red cell distribution width (RDW) is an indicator for the variability and size of circulating erythrocytes, has recently been shown to be an independent predictor of prognosis in patients with cardiovascular disease. Objectives: to assess the relationship between RDW and severity of coronary artery disease (CAD) by SYNTAX score in patients with ST-elevation myocardial infarction (STEMI) undergoing coronary angiography. Patients and methods: Eighty consecutive patients, who underwent coronary angiography after diagnosis of STEMI, were enrolled in this study which was conducted at cardiology department of Qena university hospital and Qena general hospital at period from October 2018 to July 2019. Results: there was no statistical significant difference (p-value > 0.05) between normal RDW patients and Abnormal RDW patients as regard demographic data(age, sex, BMI, smoking, HTN, dyslipidemia) except for DM, there was statistical significant difference, also there was no statistical significant difference (p-value > 0.05) between normal RDW patients and Abnormal RDW patients as regard laboratory data (eGFR,WBCs, neutrophils, lymphocytes, N/L ratio). While there was statistically significant difference (p-value < 0.05) between normal RDW patients and Abnormal RDW patients as regard LVEF, SWMA, number of affected vessels and SYNTAX score. After adjusting for all correlates, patients was high syntax scores were 3.6 times more liable for having abnormal RDW class (AOR=3.6, 95% CI: 1.2-7.3, p-value =0.029). Conclusion:Red cell distribution width is positively correlated with number of diseased vessels and high syntax score and extent of coronary artery disease.

Background: Abnormality of left ventricular (LV) diastolic function is frequently the earliest indicator of LV dysfunction in many diseases, including coronary artery disease (CAD), and hypertension. Electrocardiography (ECG)-gated technetium (Tc)-99 m tetrofosmin singlephoton emission computed tomography (SPECT) has been reported to be a useful method for evaluation of LV function. Objectives: The purpose of this study was to assess the impact of hypertension on diastolic left ventricular function using ECG-gated Tc-99m tetrofosmin SPECT. Methods: Thirty consecutive patients with normal exercise myocardial perfusion and normal LV systolic function, were studied out of 233 patients underwent ECG-gated Tc-99m tetrofosmin SPECT at our institution between January 2012 and December 2013. Patients were divided into two groups according to the presence or absence of systemic hypertension (blood pressure P140/ 90 mm Hg on P3 measurements or treatment with antihypertensive medication). Parameters of diastolic LV function were assessed. Results: Of the studied 30 patients, 19/30 (63%) had hypertension. There was no difference with respect to age, gender, LV end-diastolic volume (EDV), LV end-systolic volume (ESV), and LV ejection fraction values obtained by quantitative gated SPECT between patients with and without hypertension. The first-third mean filling rate (1/3 MFR), peak filling rate (PFR) of patients with hypertension (1.22 ± 0.38, 2.83 ± 1.10 EDV/s) were lower than those of patients without This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). hypertension (1.54 ± 0.30, 2.90 ± 0.35 EDV/s), and the time to peak filling (TTPF) of patients with hypertension (199.42 ± 68.34 ms) was higher than TTPF of patients without hypertension (164.90 ± 36.39 ms). Conclusions: Quantitative ECG-gated Tc-99m tetrofosmin SPECT reveals that hypertensive patients with preserved global LV systolic function may have significant changes in diastolic LV function. Gated myocardial perfusion SPECT reports are always lacking in these changes in diastolic function. We recommend inclusion of such changes in diastolic function in gated myocardial perfusion SPECT reports that can help in proper management of hypertensive patients.

Background and aim Systemic hypertension (SH) causes a gradual increase in the mass of the left ventricle, resulting in left ventricular hypertrophy (LVH). Derangement of LV function is caused by morphologic changes in the left ventricular (LV) walls, which result in hypertrophy. According to a recent meta-analysis, LVH raises the risk of cardiovascular morbidity and mortality. The aim was to compare between hypertensive patients with LVH and hypertensive patients without LVH regarding LV function (by Simpson's method) and myocardial performance index (by Tissue Doppler echocardiography). Patients and methods The study included 40 selected hypertensive patients and 20 healthy participants undergoing echocardiographic assessment at the echocardiography unit. The patients were classified into two groups: group I included 20 normotensive healthy control, and group II included 40 hypertensive patients. Group II was further divided into two subgroups according to the absence or presence of echocardiographic signs of LVH: group IIa included 20 hypertensive patients without echocardiographic signs of LVH, and group IIb included 20 hypertensive patients with echocardiographic signs of LVH. Results Regarding systolic and diastolic blood pressures, there was an extremely statistically significant difference between the two groups. Regarding LV mass index, there was a highly statistically significant difference. However, LVMI in subgroup IIa was normal in comparison with subgroup IIb, with an extremely statistically significant difference. Regarding ejection fraction (EF%), there was an extremely statistically significant difference between the two groups. Regarding EF%, there was an extremely statistically significant difference between group I and group IIa. Regarding EF%, there was an extremely statistically significant difference between subgroup IIa and subgroup IIb. Regarding myocardial performance index, there was an extremely statistically significant difference between the two groups (0.36±3.2 in group I vs. 0.51±4.8 in group II). Conclusion First, SH causes a cascade of LV hemodynamic changes that can range from maladaptive hypertrophy to heart failure. Second, Tissue Doppler echocardiography appears to be able to differentiate between the many types and degrees of LV dysfunction in SH, as well as the various stages of the hypertensive disease process. Third, Myocyte apoptosis and collagen deposition in the interstitial space appear to be factors that favor the transition from LVH to heart failure.

Background:The management of ischemic mitral regurgitation (MR) represents a therapeutic challenge and is still controversial. The restoration of coronary blood flow reduces left ventricular remodeling and improves regional and global left ventricular function. The effect of revascularization by percutaneous coronary intervention (PCI) for coronary artery disease (CAD) on the severity of ischemic MR is still unclear. This strategy is expected to attenuate ischemic MR.Objective: To evaluate the role of PCI in the improvement of Ischemic MR in patients with CAD.Patients and methods: Fifty patients undergoing PCI were enrolled in the study with assessment of severity of MR by transthoracic echocardiography before and 4 weeks after PCI. This study was carried out at Cardiology Department, Sohag Cardiac Specialised center, from March 2018 to December 2019.Results: There was significant improvement of severity of ischemic MR in patients with CAD after PCI. Conclusion:PCI was useful in treatment of patients with ischemic MR due to its beneficial role in the improvement of the degree of ischemic MR as well as left ventricular (LV) systolic function.