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: Inflammation has been shown to play a role in atherosclerosis and acute coronary syndrome. This study was carried out to evaluate the relationship between baseline white blood cell (WBC) count and C-reactive protein (CRP) with angiographic severity of coronary artery disease in patients with acute coronary syndrome and to identify those subsets of patients with acute coronary syndrome who may need to undergo invasive or conservative strategies.Method: A total of 100 patients with acute coronary syndrome including unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to correlate angiographic findings, C-reactive protein and WBC count. Results: This study observed that either raised WBC count or raised CRP independently and combination of both WBC count and CRP elevation were significantly associated with more severe coronary artery disease. Either raised WBC count or raised CRP or combination of raised WBC    count and CRP were significant predictor of multivessel disease and high stenosis score. Conclusion: Elevation of WBC count and CRP in patients with acute coronary syndrome are associated with severe coronary disease. WBC count and CRP can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12209 Cardiovasc. j. 2012; 5(1): 23-29

Background: Fibrinogen has been identified as an independent risk factor for cardiovascular disease and associated with traditional cardiovascular risk factors. Few reports have so far investigated the relationship between fibrinogen levels and the extent of coronary artery disease (CAD) as evaluated by coronary angiography. Therefore the current study was carried out to evaluate the relationship between fibrinogen levels and the extent of CAD as evidenced by coronary angiography. Method: A total of 210 patients having ischemic heart disease including chronic stable angina, unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to find out the relationship between fibrinogen levels and the extent of CAD undergoing coronary angiography. Patients were divided in 3 groups according to fibrinogen levels: Group I = fibrinogen levels <400 mg/dl, Group II = fibrinogen levels (400-600) mg/dl, Group III = fibrinogen levels > 600 mg/dl. In this study, angiographic severity was assessed by vessel score, stenosis score and lesion morphology and tries to find out their relationship with angiographic severity and fibrinogen level. Result: Using a prospective analytic design we studied 210 patients who were divided into 3 groups : Vessel score in Group I, Group II & Group III were 1.14 ± 0.56, 2.24 ± 0.58, & 3.00 ± 0.65 respectively which was statistically significant (p < 0.01) and Stenosis score in group- I, group- II & group- III were 6.00 ± 4.19, 18.72 ± 4.94, & 32.41 ± 15.75 respectively which was statistically significant (p < 0.01). Regarding morphology of the lesions, complex lesions in group I, group II & group III were 21%, 32% & 39% respectively (statistically significant; p < 0.01). Conclusion: High fibrinogen level is independently and significantly associated with more severe coronary artery disease. Serum fibrinogen can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20784 Cardiovasc. j. 2014; 7(1): 4-10