Background and Objective: Trans-radial approach of coronary catheterization has been increasingly used as an alternative to transfemoral approach due to less vascular complications, earlier ambulation and improved patient comfort. The aim of the study was to compare procedural and post procedural vascular complications in patients with percutaneous coronary intervention by trans-radial and transfemoral approach. Methods: This observational comparative study was conducted in the National Institute of Cardiovascular Diseases between June 2015 to May 2016. A total of 180 patients were categorized into two groups according to the approach of the percutaneous coronary intervention (PCI). Group I comprising 90 patients who underwent trans-radial PCI and group II consists of 90 patients who underwent transfemoral PCI. Patients with an abnormal Allen’s test, acute coronary syndrome, history of coronary artery bypass surgery, chronic renal insufficiency or older age (>75 years) were excluded. Results: Patient demographics were the same in both groups. The mean procedural time in min (37.44±5.13 vs 34.14±4.42, p=0.004) and fluoroscopy time in min (21.62±4.11 vs 17.55±2.78, p=0.02) were more in TR-PCI group but the mean haemostasis time in min (7.58±1.11 vs 15.59±3.33, p=0.005) and ambulation time in hour (0.00±0.00 vs 15.59±3.33, p=<0.001) were more in TF-PCI group. Significant arterial spasm following puncture (6.7% vs 0%, p=0.01) were found in trans-radial group but access site bleeding during procedure (2.2% vs 8.9%, p=0.04) were more in TF-PCI group. After the procedure major hematoma (0% vs 4.4%, p=0.04), minor hematoma (5.7% vs 14.4%, p=0.04) and ecchymosis (4.4% vs 13.3%) were significant in TF-PCI group but vessel occlusion (5.7% vs 0%, p=0.02) were significant in TR-PCI group. The mean hospital stays, day (1.64±0.42 vs 2.54±0.62) were more in TF-PCI group. Conclusion: TR-PCI is safe in respect of procedural and post procedural vascular complications. Trans-radial procedure leads to improved quality of life after the procedure and thus gives much comfort to the patient. It also shortened mean duration of hospital stay. So, trans-radial approach is an attractive alternative to conventional transfemoral approach. Bangladesh Heart Journal 2019; 34(2) : 86-91

The incidence rate and mortality of coronary artery disease is obviously higher in men than in women, which may be related to the influence of serum testosterone. This cross-sectional study was conducted at Department of Laboratory Medicine in collaboration with Department of Cardiology, BSMMU and National Institute of Cardiovascular Diseases (NICVD), Dhaka from March 2020 to February 2021 to investigate the association of serum testosterone with coronary artery disease in young adult males in Bangladesh. Total 110 subjects from inpatient Department of Cardiology were enrolled, 60 were CAD patients and 50 were Normal Coronaries according to coronary angiography report. In this study, 60 patients with coronary artery disease were compared with 50 normal coronary subjects. Mean age in CAD group and normal coronaries was 37.72±2.73 and 37.48±2.54 years respectively. Hypertension, diabetes mellitus and dyslipidemia were significantly higher in CAD group. Total testosterone levels of CAD were significantly lower than those of normal coronaries (2.11±0.81ng/ml vs 2.94±0.78ng/ml). Among 60 CAD patients, 10 patients had single vessel disease, 17 patients had double vessel disease and 33 patients had triple vessel disease. There was significant association between the level of total testosterone and the number of affected vessels within CAD group (p=0.1). This study also showed that total testosterone level was negatively correlated with Gensini score. Serum total testosterone was significantly lower in patients with CAD compared to normal coronaries. Patients with lower total testosterone levels had higher Gensini score. Low level of total testosterone may be related to the develop- ment of coronary artery disease. BSMMU J 2021; 14(3): 67-73

Background: The aim of this study was to evaluate the immediate impact of Percutaneous Transvenous Mitral Commissurotomy (PTMC) on RV function in patients with mitral stenosis (MS).Methods: This study was conducted in the National Institute Cardiovascular Diseases, Dhaka for a period of one year starting from October 2008 to September 2009. A total of 50 consecutive patients (Case group) with mitral stenosis were selected after considering inclusion and exclusion criteria that subsequently undergone PTMC. The control group (n=50) consisted of age and sex matched healthy individual (having no ECG or echocardiographic evidence of structural or functional cardiovascular disease). Healthy control group was taken because there was no data about RV function in our population. Control group used to compare with baseline characteristics of case group.Results: Immediately after PTMC (24 to 48 hours) mitral valve area increased from 0.8± 0.1 to 2.0 ± 0.2 (p <0.001) and RV outflow tract fractional shortening (RVOTfs % ) increased from 54.9 ± 4.6 to 74.9 ± 4.8% (p <0.001). There was a significant decrease in systolic pulmonary artery pressure from 47.7 ± 7.9mmHg to 28.2 ± 5.9 mmHg (p <0.001), in the RV Tei index from 0.5 ± 0.1 to 0.3 ± 0.1 (p <0.001 ), in myocardial acceleration during isovolumic contraction (IVA) at the lateral tricuspid annulus from 0.4 ± 0.1 m/s² to 0.3 ± 0.0 m/s² (p <0.001). The RVEF (%) did not exhibit any significant change from pre-PTMC figure (p = 0.538).Conclusion: After successful PTMC the parameters of infundibular and global RV function as assessed by RVOTfs and Tei index showed significant improvement and significant decrease in RV contractility as assessed by IVA was observed. Further work using larger numbers of patients is needed to confirm our findings and to assess their utility in patient follow-up and management. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12205 Cardiovasc. j. 2012; 5(1): 3-11

Background: Risk stratification is extremely important in ACS patients especially acute STEMI. We studied in-hospital outcomes of acute STEMI according to their NT-proBNP level as a new prognostic marker.Methods: This observational prospective study was conducted to evaluate the significance of raised plasma NT-proBNP level on in-hospital outcomes in patients with STEMI, without clinical manifestation of heart failure. A total 88 patients of STEMI were included in the study. Among them 10 Patients have normal levels of NT-proBNP (<110 pg/ml) and were included in Group-A (n = 10). Patients with increased proBNP level (e”110 pg/ml) were included in Group-B (n = 78). Patients were followed to see worse in-hospital outcomes (Heart failure, cardiogenic shock, significant arrhythmia and death) during index hospitalization period.Results: Plasma NT-proBNP level was observed to be significantly higher among patients who developed heart failure, cardiogenic shock and death than the patients who did not developed these outcome (p < 0.001). The binary logistic regression analysis of Odds Ratios for characteristics of the patients likely to cause worse in-hospital outcome shows that NT-ProBNP and smoking habit were found to be the independent predictors of worse in-hospital outcome with ORs being 5.0 and 4.7 respectively.Conclusion: On admission plasma NT-pro BNP level in patients with STEMI is a strong independent predictor of adverse in-hospital outcome.Cardiovasc. j. 2017; 10(1): 8-12

Background: Spontaneous echocardiographic contrast (SEC) is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. The present study was conducted to evaluate the association between left atrial spontaneous echocardiographic contrast with inflammatory markers in mitral stenosis patients. Methods: This observational analytical study was undertaken in the department of Cardiology, National Institute of Cardiovascular diseases (NICVD), Dhaka. A total of 70 patients with mitral stenosis were categorized into two groups: group I with left atrial SEC and group II without left atrial SEC. All patients underwent transthoracic as well as transoesophageal echocardiography. Complete blood count with ESR was done and neutrophil lymphocyte ratio was calculated. The high sensitive C-reactive protein (hs-CRP) was assayed. Results: The hs-CRP levels were significantly greater in the SEC-positive group (5.6±2.1vs 1.5±0.7, p=0.001). The mean ESR level was significantly greater in the SEC-positive group (32.6±15.5 mmvs15.8±4.7 mm).The neutrophil levels ((76.1±1.9 vs 63.7±3.3) were significantly greater in the SEC-positive group, and the lymphocyte levels (33.3±3.0 vs 21.5±1.3) were significantly greater in the SEC-negative group (p=0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.4±0.4 vs2.1±0.6, p=0.001).On multivariate analysis hs-CRP, neutrophil/lymphocyte ratio, raised ESR, mitral valve area and left atrial diameter were independent risk factors for SEC in patients with mitral stenosis. Conclusion: From this study it may be concluded that left atrial SEC is associated with raised inflammatory markers in majority of patients with mitral stenosis. So, SEC may be considered as a reflection of ongoing inflammatory process in patients with mitral stenosis. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20797 Cardiovasc. j. 2014; 7(1): 24-30