Cardiology and Angiology: An International Journal

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https://imsear.searo.who.int/handle/123456789/151218

ISSN: 2347-520X

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.sciencedomain.org/journal-home.php?id=26

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2D Echocardiographic Findings, NT-ProBNP Levels, and Outcomes in Dyspnoeic Patients: Results from the Pro-BNP Investigation of Dyspnoea in the Emergency Department- a Single Centre Experience
(Sciencedomain International, 2022-09) Balaraju, D; Kumar, V; Kumar, C; Setty, H. S. S. N; Sridhar, L. S; Kharge, J; Patil, R; Manjunath, C. N.
Background: Dyspnoeic in the emergency department with multiple co-morbidities is a diagnostic challenge. Approximately 15-20% of acute dyspneic in the Emergency Department due to ADHF (acute decompensated heart failure) are misdiagnosed. B-type peptide (BNP) and its amino-terminal fragment (NT-proBNP) accurately identify HF in dyspnoeic patients. In the general population with dyspnoea, plasma pro-BNP concentrations are increased in left ventricular dilatation, hypertrophy, systolic dysfunction, or diastolic dysfunction but are unaffected by pulmonary dysfunction. Aims and Objectives: To study the relation between NT pro-BNP & echocardiographic findings in acute dyspnoeic patients, and the relation between NT pro-BNP and In-hospital Mortality. Materials and Methods: Source of data- Patients admitted to the Emergency Room or cardiac intensive care unit with a history of acute dyspnea in a tertiary cardiac care center in south India, meeting inclusion & exclusion criteria, were studied. Results: The study population is predominantly constituted of the elderly population. The most common co-morbid condition was hypertension. The present study uses an NT pro BNP level of 900pg/ml as the cut-off level. 78 patients were positive for the test. Echocardiography showed that 58% had LV systolic dysfunction, 60% had diastolic dysfunction. 42 patients had EF >55%, 10 patients between 55-45%, 33 patients between 44-30% and 15 patients had EF < 30%. Mortality rate was 6% in the whole study population. However, Mortality was seen in only NT pro-BNP positive group it was not statistically significant (p=0.46). Conclusions: NT pro-BNP correlates well with the worsening of LV systolic function; as the EF decreases, NT pro-BNP increases. Increase in NT pro-BNP levels has to be interpreted in the clinical context, and it is not a substitute for echocardiography for assessing cardiac abnormalities and dysfunction.
AA Amyloidosis Secondary to Horton's Disease Complicated by Pulmonary Fibrosis: A Very Challenging Diagnosis and Therapy
(Sciencedomain International, 2023-07) Njie, M; Mulendelé, P. M; Mokni, O; Boutar, M. S; Haboub, M; Arous, S; Benouna, M. G; Drighil, A; Azzouzi, L; Habbal, R.
AA amyloidosis is a classic and serious complication of many chronic inflammatory processes, whether of infectious, autoimmune, or neoplastic origin. It is frequently complicated by kidney damage, often in the form of a nephrotic syndrome. Giant cell arteritis is a common inflammatory arteritis in the elderly; however, it rarely causes AA amyloidosis. We report a rare case of Horton disease causing AA amyloidosis in an elderly patient with history of myopericarditis and repeated episodes of congestive heart failure. Patient was treated initially with dual therapy based on corticosteroids and anti TNF therapy (Tocilizumab) associated with heart failure therapy recommended by the European society of cardiology (ESC 2021 guidelines on Heart Failure). The initial outcome was favorable but later complicated by the involvement of the lungs; pulmonary fibrosis, responsible for repeated episodes of pleural effusion non controlled in spite of high dose of loop diuretics and repeated pleural punction. Patient died shortly after her second hospitalization due to respiratory insufficiency.
Acute Aortic Dissection Masquerading a Rare Type of Congenital Bicuspid Aortic : A Case Report
(Sciencedomain International, 2022-12) Njie, M.; Tahir, A. Fadoul; Sidi, Boutar M.; Mulendele, P. M.; Haboub, M.; Arous, S.; Benouna, M. Ghali; Drighil, A.; Azouzi, L.; Habbal, R.
Acute aortic dissection on bicuspid aortic valve (BAV) type 0 is a rare especially in young masculine. Risk factors like smoking and intensive sport activities can hasten their apparition especially in non-diagnosed population. Trans thoracic echocardiography is very important in the diagnosis of BAV whereas Angio CT scan helps to confirm acute aortic dissection. Treatment is based on surgery for type A Stanford classification for acute aortic dissection. We report a rare case of acute aortic dissection masquerading a rare type of BAV, type 0 in a young sportive male with no history of heart disease who presented for the first-time with acute chest pain after lifting a heavy weight metal at the complex sport center. Patient was initially placed on medical treatment before surgery for heart valve and root replacement (Bentall procedure).
Acute Coronary Syndrome in Egyptian Women during their Reproductive Age Period
(Sciencedomain International, 2022-09) Essa, G. N; Ashmawy, M. M; Salama, M. M; El-Din, S. M. S; Khalel, S. S.
Background: Young women have low risk of acute coronary syndrome (ACS) during their reproductive period, mainly due to the physiologically protective effect of estrogen hormone on the coronary endothelium. The purpose of this study was to assess the risk factors of ACS in the Egyptian women patients during their reproductive age period, who admitted to Tanta University Cardiovascular department hospital. Results: Obesity, hypertension, diabetes mellitus, chronic kidney disease, systemic lupus erythematosus, myocardial bridge, cushion syndrome and radiotherapy for breast cancer were significantly independently ACS risk factors that correlated to the SYNTAX score. There is significance of coefficient of the independent variable in the risk factors (Group A, group B, group C separately and groups A, B, C together) on the severity and level of SYNTAX score in ACS. The regression analysis was significant in groups A and B of ACS risk factors separately. While the regression analysis was significant and there was a clear relationship between ACS risk factors- groups A, B, C. together and SYNTAX score. Conclusions: There was a positive relationship between the increase total number of ACS risk factors subgroups (Traditional, Nontraditional and Gynecological) and the severity of coronary artery stenosis that assessed by SYNTAX scorer.
Acute Limb Ischemia Due to Cardiac Thromboembolismin a Young Patient without Myocardial Infarction or Cardiomyopathy
(Science Domain International, 2018-04) Khalid, Muhammad; Murtaza, Ghulam; Albalbissi, Ahmad; Bochis, Melania; Paul, Timir K.
Acute limb ischemia secondary to systemic arterial embolism from left ventricular thrombus is a rare life threatening emergency. Peripheral arterial thrombosis superimposed on an atherosclerotic disease or thromboembolism from cardiac or aortic source are the two most common causes of acute limb ischemia. We present a case of a young healthy female who had recurrent admissions with acute lower extremity ischemia secondary to embolism from intra cardiac thrombus diagnosed by bedside doppler and computed angiogram, managed by surgical thromboembolectomy and discharge on anticoagulation.
Acute Myocardial Infarction (AMI) Diagnosis; Impact of Technology in Developing Highly Sensitive Biomarkers and Assays
(Sciencedomain International, 2022-06) Osafo, R; Olatunji, S. H; Nduka, C. L.
Acute myocardial infarction (AMI), a cardiovascular disease have been known to cause high morbidity and mortality rate in several countries. Hence, several serum biomarkers have evolved as a standard and bedrock for its diagnosis one of which is, cardiac troponin. This cardiac biomarker's accurate and rapid detection is critical in reducing the risk of heart attack-related complications. However, the delay experienced in the determination of a patient’s clinical state, coupled with the time of admitting them to the hospital depicts the need for improving diagnosing AMI by developing a highly sensitive biomarker. In this review we discuss, biomarkers and immunoassays employed in diagnosing acute myocardial infarction. Specifically, we reviewed and discussed cardiac troponin, a widely used biomarker. Subsequently, we discuss various methods used in assessing its performance and how technology has helped in developing more sensitive cardiac troponin to fast track its rate of diagnosis. At the end, we propose the integration of several disciplines from nanotechnology to biotechnology to develop a robust medical diagnostic system to facilitate disease diagnosis and help save lives.
The Adverse Effects of Wealth on Cardiovascular Health: A Scientific Statement of the International College of Cardiology.
(2013-01) Singh, R B; Hristova, K; Muthusamy, V V; Rastogi, S S; Basu, T K; Toda, E; Takahashi, T; Fedacko, J; Pella, D; Meester, F De; Wilson, D W; Mondal, R N; Ishaq, M; Mohideen, M R
Background and Aims: Increase in economic status may be associated with increased consumption of Western type of foods and sedentary behaviour. In the present review, we discuss that increase in wealth may be associated with adverse effects on health behaviour Study Design and Methods: Internet search and discussion with colleagues. Results: Review of studies indicate that with increase in wealth, there is increased consumption of high fat, ready prepared foods and decrease in physical activity in most of the countries resulting in obesity and metabolic syndrome, leading to cardiovascular diseases (CVDs) and other chronic conditions. Many experts during the United Nations High Level Meeting in Sept 2011, misinterpreted the WHO estimates and proposed that, of total deaths, 22·4 million arise in the poorest countries, and 13.7 million in high-income and upper-middle-income countries and therefore poverty may be the major cause of deaths due to non-communicable diseases (NCDs). A recent study shows that 57.0 % of deaths in adults (aged 25-64 years) were due to CVDs and other chronic diseases, 25.5% due to communicable diseases and 15.9% due to injury and accidents. The deaths due to NCDs were highly prevalent among higher social classes compared to lower social classes who had greater deaths due to communicable diseases. It is interesting to know from new data from United States, that there is ‘Wealth’ without cardiovascular health in America. The whole world is likely to have the same scenario in the near future. Conclusions: Increase in wealth may be associated with altered health behaviour; greater consumption of unhealthy foods, tobacco consumption, mental load and sedentary behaviour resulting in increased risk of deaths due to CVDs and other chronic diseases which may change with knowledge about health education. Wealth may cause extension in life by buying of expensive drug therapy, intervention and surgery which are known to add income and employment in the west.
Age Related Hemodynamic Blood Pressure Changes for Cardiovascular Disease and Stroke: A Mini-review.
(2013-01) Chrysant, Steven G; Chrysant, George S
The blood pressure (BP) changes with the advancement of age from the predominant diastolic BP (DBP) in the young to the predominant systolic BP (SBP) in the older person. This shift is due to the stiffening of the large arteries as a result of the ageing process and the replacement of the elastic fibers with collagen fibers resulting in the loss of compliance and the elastic recoil of these vessels. The end result is augmentation in pulse wave velocity (PWV) and widening of pulse pressure (PP). The SBP rises linearly with the advancement of age whereas, the DBP rises up to the age 50 years and begins to decline after the age of 60 years leading to a progressive increase in PP. These hemodynamic changes of BP are frequently associated with an increased incidence in cardiovascular disease (CVD) and strokes. Several studies have shown an inverse relationship between DBP and CVD, whereas no such a relationship has been demonstrated for stroke. However, recently, an inverse relationship has been reported between DBP and stroke for subjects 50 years of age or older. The implications of BP changes with age as they are related to CVD and strokes will be discussed in this mini review. It appears from these recent findings that in treating the hypertension in the elderly to reduce CVD and stroke, care should be taken not to allow the DBP to drop below 55-80 mmHg, since below this DBP level the incidence of CVD and strokes increase.
Alteration of Pulmonary Venous Flow Doppler Post Transcatheter Closure of Atrial Septal Defect
(Sciencedomain International, 2022-10) Gobran, S. M. A; El-Saied, A. M; El-Shedoudy, S. A. A; Maria, D. A.
Background: Atrial septal defect is a common congenital heart anomaly results in hemodynamically significant right ventriclular volume overload and an increase in the pulmonary venous flow. Aim: Evaluate changes of pulmonary venous flow parameters after transcatheter closure of secundum atrial septal defect. Patients and Methods: 50 patients with atrial septal defect aged from 3.5 to 31 years were included in the study. Pulmonary venous flow Doppler and right ventricular function were evaluated before and after successful transcatheter closure by transthoracic and transesophageal echocardiography. Results: The defect size ranged from 15 to 37mm with a mean (24.96 ±7.52), Normal systolic and diastolic waves of pulmonary venous flow Doppler were replaced by a continuous antegrade wave (mean 60±13.6 cm/s) in all atrial septal defect patients. Post-closure, the normal pulmonary venous flow pattern was regained, two separate waves, with a significant decrease in mean peak Systolic wave velocity (44.54±8.12 cm/sec vs 69.61±12.37, P=0.000), the mean peak Diastolic Wave velocity (55.85±9.81 cm/sec vs 72.65±10.38, P=0.000) and a significant increase in the mean peak atrial reversal wave velocity (28.75±4.63cm/sec vs 21.18±3.64, P=0.000). In multivariate regression analysis, significant predictors of haemodynamic significant ASD were ASD size,(odds ratio 1.508, P=0.007, 95% CI 1.153,2.671) and ASD/IAS ratio (odds ratio 2.313, P=0.001, 95% CI 1.064,3.104). Conclusions: Atrial septal defect patients have characteristic pulmonary venous flow pattern: continuous antegrade wave with systolic predominance and decrease in atrial reversal wave, which return to normal after closure. These changes could be helpful echocardiographic tool in prediction of successful closure of the defect.
Analysis of Association of Brain Natriuretic Peptide Levels and Blood Pressure Variability
(Sciencedomain International, 2023-05) Nachid, M; Benhar, I; Mounaouir, K; El-Jazouli, A; Ghali, B; Salim, A; Drighil, A; Habbal, R.
Objective: The present study aimed to investigate the relationship between brain natriuretic peptide (BNP) levels and blood pressure variability among hypertensive patients aged over 40 years. Methods: The study recruited 120 patients from a cardiology outpatient clinic who had been diagnosed with hypertension and taking antihypertensive medication for at least 6 months. Demographic and clinical information, blood pressure measurements, and blood samples were collected to measure BNP levels. The standard deviation of the mean arterial pressure over 24 hours was calculated as a measure of blood pressure variability. Linear regression was used to examine the association between BNP levels and blood pressure variability while controlling for age, sex, BMI, and medication history. Results: The study found a significant positive association between BNP levels and blood pressure variability (?=0.31, p=0.002), even after controlling for other variables. The linear regression model explained 20% of the variance in blood pressure variability (R2=0.20, F=9.52, p<0.001). Conclusion: The findings suggest that higher BNP levels are associated with increased blood pressure variability among hypertensive patients. Further studies are needed to explore the underlying mechanisms and the potential implications of this association.
Analysis of Novel Anticoagulants for Atrial Fibrillation – Pharmacokinetics and Pharmacological Considerations.
(2014-10) Colquitt, Charlie; Jones, Jocelyn D; Jackson, Sylvia H
Atrial Fibrillation (AF) is the most common arrhythmia. AF is a major risk factor for stoke. Warfarin has been available for more than 60 years and until recently it was the only oral anticoagulant used for the prevention of stroke. Despite the extensive studies and proven efficacy, its utility is limited by multiple factors. Warfarin interacts with a multitude of drugs and foods, has a delayed onset of action, has a narrow therapeutic range, requires routine lab monitoring and exhibits variable responses in patients. The novel agents dabigatran, rivaroxaban and apixaban have the potential to have some of the limitations of warfarin. This article will discuss the pharmacokinetic and pharmacological considerations and different characteristics of the novel anticoagulants when used for the prevention of AF.
Angiotensin 1-7: A Second Window of Protection in Hypertensive Patients
(Science Domain International, 2019-04) Mohamed, Mazin Salaheldin Abdalla; Ibrahim, Muntaser; Abdelwhab, Muhanad S.
The effects of the renin-angiotensin-aldosterone system on the human body are so diverse and our knowledge about them is ever growing. Angiotensin 1-7 has been proven to play protective roles in patients with cardiovascular disorders including but not limited to hypertension. As is the case with Africa, the prevalence of hypertension in Sudan is rising, and its complications could be delayed by pharmacologically manipulating the levels of renin-angiotensin system metabolites. The aim of this review is to compare the advantageous and deleterious effects of Angiotensin 2 in contrast to those of Angiotensin 1-7 and to assert the well-established protective effects of Angiotensin 1-7 (systemically and locally) in hypertensive patients
Antioxidant and Radical Scavenging Properties of β-Carotene on Cisplatin Induced Cardiotoxicity.
(2015) Kiran, B Uday; Sushma, M; Prasad, K V S R G; Rao, V Uma Maheshwara; Bai, D Jhansi Laxmi; Nisheetha, V
Objective: To investigate the protective role of β-Carotene against cisplatin induced cardiotoxicity in male albino rats. Methods: Various biochemical parameters such as Creatine kinase-MB, Lactate dehydrogenase (LDH), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Triglycerides (TG) and Total cholesterol (TC) are being assessed. Also the levels of the in vivo antioxidants such as Reduced glutathione (GSH), Catalase (CAT), and Malondialdehyde (MDA) in the post mitochondrial supernatant of heart were measured. In addition, the histopathological studies were performed to study the protective activity of β-carotene. Results: Cisplatin administration has shown the elevated levels of the cardiac markers and diminished the endogenous antioxidant levels when compared with the normal rats. β-carotene treatment showed the inhibitory effect on the free radicals showing decreased levels of the cardiac markers like CK-MB, LDH, AST, ALT and ALP. The β-carotene treated rats showed significant (p<0.001) decrease in lipid peroxidation in both prophylactic and curative groups when compared to the cisplatin group. Also showed a significant (p<0.05, p<0.001) increase in the levels of GSH in prophylactic and curative group respectively when compared with the cisplatin group. Both prophylactic and curative groups have shown a significant (p<0.001) increase in the levels of CAT. Further, the histopathological studies confirm the protective effect of β-carotene. Conclusion: These findings justify the biological and traditional uses of β-carotene as confirmed by its promising radical scavenging activity against cisplatin induced cardiotoxicity.
Aortic Pathologies and Pregnancy: A Special Focus on Connective Tissue Disorders.
(2014-07) Bara, Petrit; Gjyli, Lidra; Gega, Marsela; Belshi, Xhina; Vyshka, Gentian
Pregnancy represents a physiological status which, due to clear and typical hormonal and hemodynamic changes, is frequently accompanied by a high morbidity of aortic structures, in all of its segments. Such morbidity might become patent when a pregestational situation exists, especially with the mother suffering from connective tissue disorders. Nevertheless, morbid occurrences that will be met only during pregnancy are well known, with particular pathophysiological and etiological theories, as well as a diversity of treatments proposed in such an unusual setting. The authors discuss the main pathologies of aorta that are seen during pregnancy, from a theoretical point of view, and from a historical perspective as well. A special focus is made to the connective tissue disorders, and the theoretical considerations are illustrated with images of dissecting aneurysms of aorta.
Aorto-right Ventricular Fistula: A Rare and Severe Complication in a Young Patient with Double Localization of Infective Endocarditis
(Sciencedomain International, 2023-03) Ibara-Onguema , J. R; Othende , F. B. E; Camara , T; El Jamili , M; Karimi , S. E; Hattaoui , M. E.
Aorto-right ventricular fistulas are defects of the aortic wall in the area above the right coronary cusp, where it separates aorta and right ventricular outflow tract. This entity is rare and exceptional. Often, these defects are due to trauma or infective endocarditis. We report an occasional finding of such a fistula with dramatic issue, in young patient without past medical history which admitted for rupture of cerebral mycotic aneurysm secondary to infective endocarditis with double localization (aortic and pulmonary valve).
Approaching Long Term Cardiac Rhythm Monitoring Using Advanced Arm Worn Sensors and ECG Recovery Techniques.
(2015) Lynn, William D; Escalona, Omar J; McEneaney, David J
According to recent British Heart Foundation statistics, one in six men and more than one in ten women die from coronary heart disease (CHD) in the UK. This equates to almost 74,000 deaths per annum from CHD alone. More worryingly, every week, 12 apparently fit and healthy young people aged 35 and under, die from undiagnosed cardiac conditions. In both circumstances, monitoring is preformed only when triggered by an event. Unfortunately, this may be too late in the large majority of cases. For instance, there is evidence suggesting that most indiscernible cardiac abnormalities are made detectable by ECG through the act of suddenly standing upright. This infers that the condition would be detectable during the course of everyday ambulatory activity and highlights the need for a long term monitoring device. Current diagnostic equipment consists of the Holter monitor for extended periods up to 36 hours and the implantable loop recorder (ILR) for monitoring up to 3 years. The diagnostic yield of the ECG monitoring strategy is greatly increased as the monitoring period increases. Therefore, for subjects that exhibit symptoms of cardiac involvement that are transient in nature, the ILR offers the best opportunity for diagnosis. However, the ILR is inserted under the surface of the skin in the upper chest area and requires a surgical procedure, with associated risks, which makes ILR’s a costly and inconvenient option in many cases. The need for a non-invasive long term monitoring device, which is comfortable to wear along the arm and able to provide reliable ECG monitoring, has been addressed by many, in several lines of approach to a solution. This review details the current state of the art and any pending limitations. It then presents key multidisciplinary solutions on the different aspects of the problem, which will still require integration in order to realise such a device.
Are Biodegradable Third Generation Drug Eluting Stents the Answer to Instent Restenosis.
(2014-01) Amritphale, Amod; Amritphale, Nupur; Ahsan, Chowdhury H
The third generation biodegradable Drug Eluting Stent (DES) are being evaluated and being introduced in clinical practice. They have been DESigned to overcome limitations associated with durable polymer and a persistent metallic stent scaffold which could be related to late target lesion revascularization (TLR) and very late stent thrombosis (VLST). Although a recent pooled data analysis found that biodegradable polymer stents were superior for TLR and VLST compared with first generation Sirolimus Eluting Stent (SES), superiority has not been demonstrated against second generation Everolimus eluting stents (EES) and is yet to be conclusively proven in randomized trials. This paper reviews the key features, recent trial data, and future directions of the third generation of DES technology including stents with fully biodegradable scaffolds, stents with biodegradable polymer, and polymer free stents.
Assessment of a Cardiac Rehabilitation Program Based on the Borg RPE Scale by Six-minute Walk Test: A Pilot Study.
(2014-04) Jelinek, Herbert F; Collins, Thomas; Smith, Megan; Kiat, Hosen
Aims: The ability of cardiac rehabilitation to reduce mortality in those with cardiovascular disease is well established. Despite its widespread use in the clinical setting, the Borg Rating of Perceived Exertion (RPE) scale is yet to be validated for its ability to lead to improvements in functional capacity. Study Design: A closed cohort pilot study. Place and Duration of Study: Department of Physiotherapy, Albury Base Hospital and School of Community Health, between November 2008 and November 2009. Methodology: Fifteen participants were assessed prior to and following completion of a cardiac rehabilitation program. Exercise was prescribed according to the Borg RPE scale. Pre and post Six-Minute Walk Test (6MWT) scores were obtained to determine the impact of the cardiac rehabilitation program. Results: Fifteen cardiac rehabilitation participants completed all requirements of the study after an initial enrolment of 22 patients. Wilcoxon signed-ranks test showed statistically significant improvements in 6MWT scores following participation in the cardiac rehabilitation program (p=.033) from a median value of 412 metres to 475 metres. Conclusion: In this pilot study, cardiac rehabilitation programs based on the Borg RPE scale may improvefunctional capacity measured by 6MWT during a 6-week period.
Assessment of Functional Mitral Regurgitation Severity by Proximal Isovelocity Surface Area via 3D Transthoracic Echocardiography
(Sciencedomain International, 2022-02) Balbaa, Ahmed A. M.; Atia, Wael M.; Khalaf, Hani Abdelshafook
Background: Accurate quantitative evaluation of MR severity remains challenging because limited scan plane orientation of 2D echocardiography does not provide direct measurement of the regurgitant lesion. Three-dimensional echocardiography, which has become a clinically established technique, has been shown to provide useful information for flow quantification and so has the potential to address the major drawbacks of 2D-based approaches. Objectives: To assess the reliability of PISA measurement using real-time 3D color trans-thoracic echocardiographic imaging in clinical practice and to compare its derived EROA, regurgitant volume (Rvol) and regurgitant fraction with that obtained by 2D trans thoracic PISA. Patients and Methods: This cross-sectional study, included 30 patients with at least moderate functional MR came for evaluation on clinical basis indications at Al-Hussein and Bab El-Shaareya University Hospitals during the period from November 2020 to July 2021. Two- and three-dimensional echocardiography was done to asses MR and calculate vena contract width, 2D PISA and derived EORA and regurgitant volume. Also, calculation of 3D EROA using PISA method by 3D probe. Results: There was a significant positive correlation between 2D EPISA and 3D EROA using PISA method and EROA, p value was 0.0001. With higher values for 3D EROA using PISA method when compared with 2D PISA in different degrees of MR as summarized in “the mean value of EROA by 2D PISA in moderate MR was 0.25 ±0.042 cm2, while it was 0.32±0.059 cm2 by 3D EROA using PISA method. While the mean value of EROA by 2D PISA in severe MR was 0.58 ±0.14 cm2, and it was 0.47 ±0.049 cm2 by 3D EROA”. Also showed significant difference in different direction of MR jets especially in eccentric jet as shown by the mean value of EROA by 2D PISA in central MR was 0.41±0.19 cm2, while it was 0.41±0.87 cm2 by 3D method. While the mean value of EROA by 2D PISA in eccentric MR was 0.53 ±0.21 cm2, and it was 0.44 ±0.096 cm2 by 3D EROA using PISA method. Conclusion: The use of 3D EROA using PISA method and simple calculation of a mean systolic regurgitation orifice area proved to be superior to 2D measures (VC, 2D-PISA) for distinguishing moderate from severe MR, evaluation, classification and grading of MR in a routine clinical cardiology setting. 3D EROA reduces assumptions and seemingly improves diagnostic value as compared with 2D-PISA
Assessment of Left Ventricular Diastolic Dysfunction in Cases with Liver Cirrhosis
(Sciencedomain International, 2023-02) El-Mashad, M. E.-R; El-Masry, M. M; Al-Hefnawy, S. B; Elsheikh, A. A.
Background: Cirrhosis is a long-term inflammatory process of hepatic tissue condition that mainly affects people aged 50 to 60. This study aims to assess Left ventricular diastolic dysfunction (LVDD) in cases with cirrhotic liver by conventional, tissue Doppler and two-dimensional speckle tracking echocardiography to clarify the correlation between the severity of cirrhotic liver and LVDD. Methods: A prospective case-control research involved 100 adult cases with confirmed HCV and HBV. Cases were divided into 4 equal group: Group A: Child A cases, group B: Child B cases, group C: Child C cases and group D (Controls): healthy non-hepatic subjects of the same age and sex who have normal blood pressure, nonsmoking participants with no further concomitant problems. Results: Number of cases with LVDD had a statistical noticeable increase in Child A, B, and C (p =0.004, <0.001, and <0.001 respectively. LAVi had a statistical noticeable increase in Child C / B (p =0.013 and p =0.014). Conclusion: Left atrial volume index (LAVi) had a statistical noticeable increase in Child C / B in comparison to the controls but E m, E l were statistical noticeable lower in Child C / B. /E had a statistical noticeable increase in Child C group, LVSRe had a statistical noticeable decrease in Child C group but it was insignificantly different across Child A / B/ C and controls and across Child B / C and controls.

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