Abstract:Background: Obesity is an independent cardiovascular risk factor. The most common anthropometric measurement used to quantify obesity is body mass index (BMI). Percutaneous coronary intervention (PCI) is associated with various types of complications. The relationship between BMI and in-hospital complications particularly left ventricular failure (LVF) after PCI has not been thoroughly investigated, especially in Bangladesh. Methods:This cross sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e" 23.0 kg/m2). In-hospital LVF after PCI were observed and recorded. Results:The mean BMI of study population was 23.9 ± 1.9 kg/m 2 . The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean duration of hospital stay after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse inhospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 -2.24 and 1.16 -1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with in-hospital outcomes after PCI (OR = 0.95; 95% CI = 0.91 -0.98; p = 0.007).Conclusion: BMI is inversely associated with in-hospital LVF after PCI. The underweight and normal weight people are at greater risk to experience in-hospital LVF than overweight and obese people following PCI.
Abstract:Background-Evaluation of different morphology of premature ventricular contraction (PVC) in 12-lead ECG might reflect the presence or absence of myocardial diseases and determine PVC foci. It is important for ablation procedure and it can help in pre-procedural planning and potentially may improve ablation outcome. Conclusion-12-lead ECG is a simple, inexpensive and noninvasive tool to detect PVCs and facilitate their localization. By evaluating morphology of PVC, we can also predict the structural and functional state of heart. Methods and Results
Libman-Sacks endocarditis (LSE) is one of the most characteristic cardiac lesions in systemic lupus erythematosus (SLE). Patients may remain asymptomatic, while symptomatic patients often suffer with systemic emboli. These commonly test positive for anti-phospholipid antibody (aPA). The association of LSE with an overlap of rheumatoid arthritis (RA) and lupus (also known as ‘rhupus’) is rare. We report such a patient, who had been diagnosed as having RA seven years before and had suffered an acute ischaemic stroke one year previously and had echocardiographic evidence of LSE found during routine evaluation. However, she tested negative for aPA.
Background: Ischemic heart disease (IHD) is one of the leading cause of morbidity and mortality worldwide. Ischemic cardiomyopathy (ICM) is a delayed complication of IHD that arises as dilated cardiomyopathy with depressed ventricular function, which cannot be attributed entirely to coronary artery obstruction or ischemic injury. Objectives: To evaluate the clinical, electrocardiographic and echocardiographic profile of patients presenting with ischemic cardiomyopathy. Methods: In this cross sectional observational study 100 patients of ischemic cardiomyopathy admitted in hospital or visited OPD in NICVD, Dhaka from March’15 to Sept’15 were studied. Enrollment of the patients were done after fulfilling the inclusion and exclusion criteria. Clinical, electrocardiographic and echocardiographic data were collected then data analysis was done. Results: Data analysis of 100 patients was showed age range was 40-80 years and mean age was 61.4±7.9 years. 79% subjects were male. Most common symptoms were dyspnea (93%), chest pain(73%), palpitation (39%) and edema (23%). Most patients were in NYHA functional class lV (43%). 64% cases had history of anterior myocardial infarction (MI), 22% had inferior MI, 25% had H/O PTCA and 7% had CABG. 71% subjects had tachycardia, 65% had lungs basal rales, 56% had systolic blood pressure below 100 mmhg and 25% had edema. ECG findings was as follows sinus rhythm (85%), Sinus tachycardia 71%, AF 15%, LBBB 34%, RBBB 12%, pathological Q in anterior surface 65% and inferior surface 21%, non specific ST-T changes 41% and PVCs was found in 17%.On echocardiography ,anterior wall hypokinesia was seen in 52% and global hypokinesia in 43%. Mean left ventricular ejection fraction (LVEF) was 31±5.9% and mean left ventricular internal diastolic diameter (LVIDd) was 6.5±0.4 cm. (59%) subjects had mitral regurgitation (MR) grade-l and 20% had MR grade-ll. Conclusion: The clinical presentation of ischemic cardiomyopathy varies from patient to patient. Severity of symptoms correlates with severity of left ventricular systolic dysfunction, left ventricular diameter and mitral regurgitation grade . Anterior Myocardial infarction has more chance to develop ischemic cardiomyopathy. Bangladesh Heart Journal 2020; 35(2) : 121-127
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