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Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome
Ibrahim Mohammed Ibrahim,
Attia Morsy Shokr,
Mostafa Attia Al-Sawasany
Issue:
Volume 5, Issue 4, December 2021
Pages:
157-165
Received:
21 September 2021
Accepted:
18 October 2021
Published:
28 October 2021
Abstract: Metabolic syndrome (MetS) and visceral adiposity are crucial cardio metabolic risk factors. There is evidence of subclinical left ventricular myocardial dysfunction in individuals with metabolic syndrome (MetS). However, the effect of MetS on the right ventricle (RV) is yet unknown. By using 2D Speckle Tracking Echocardiography, we investigated the link between MetS and right ventricle function. This study was conducted on 50 MetS patients and 25 age and gender matched individuals (control group). The MetS is diagnosed when presence of ≥3 American Heart Association/National Heart, Lung, and Blood Institute criteria. All individuals had sufficient laboratory assays as well as a thorough 2D examination including tissue Doppler imaging (TDI) and R. V global longitudinal strain (GLS) during the period between November 2019 and December 2020. The metabolic group had a statistically significant lower RV- GLS (-18.27±2.16 in MetS subjects vs. - 26.64±3.05 in control subjects, P<0.001), a significantly lower E/A ratio (0.95±0.12 in MetS subjects vs. 1.14±0.15 in controls, P<0.001), and a statistically significant increase in the E/Em ratio (5.66±1.03 in MetS subjects vs. 4.24±0.46 in controls, P<0.001). Other echocardiographic or functional capacity tests revealed no significant differences between the two groups. We concluded that MetS was associated with preclinical right ventricle systolic dysfunction detected by 2D-STE observed with Normal RV by TAPSE and FAC and Normal left ventricular ejection fraction (LVEF) in addition to RV diastolic dysfunction.
Abstract: Metabolic syndrome (MetS) and visceral adiposity are crucial cardio metabolic risk factors. There is evidence of subclinical left ventricular myocardial dysfunction in individuals with metabolic syndrome (MetS). However, the effect of MetS on the right ventricle (RV) is yet unknown. By using 2D Speckle Tracking Echocardiography, we investigated the...
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Carotid Atherosclerosis in Asymptomatic Patients with at Least One Cardiovascular Risk Factor: A Cross-Sectional Study in Yaounde, Cameroon
Liliane Mfeukeu-Kuate,
Honoré Yemele Kemnang,
Christine Fahrida Ngalla,
Ahmadou Musa Jingi,
Eric Savom,
Jean Claude Mballa Amougou,
Ba Hamadou,
Bernadette Ngo Nonga,
Alain Patrick Menanga
Issue:
Volume 5, Issue 4, December 2021
Pages:
166-171
Received:
8 October 2021
Accepted:
29 October 2021
Published:
10 November 2021
Abstract: Introduction: Atherosclerosis is a leading cause of vascular disease worldwide. One of its main locations is in the carotid artery which is implicated in 20% of ischemic strokes. This study aimed to determine the frequency of carotid atherosclerosis in a group of asymptomatic patients with at least one cardiovascular risk factor. Methodology: This was a cross-sectional study from January to June 2021 (6 months). We included consenting adults followed up at the Yaoundé Central Hospital and the Yaoundé University Teaching Hospital, aged at least 50 years and having at least one cardiovascular risk factor such as hypertension, diabetes, dyslipidemia, smoking, or obesity. A Doppler ultrasound of the supra-aortic trunks was performed on each patient. Statistical analyses were performed using the chi-2 test for bivariate analysis and binary logistic regression for multivariate analyses. The threshold of significance was set at 0.05. Results: A total of 75 participants were included of which 26 were men and 49 women. The mean age (SD) was 62.96 (8.87) years. Hypertension was seen in 93.3% of the participants, dyslipidemia in 77.3%, obesity in 48%, type 2 diabetes in 34.7%, and 9.3% were smokers. High cardiovascular risk was seen in 22 (29.4%) participants. Twenty-seven participants (36%) had one or more carotid atheroma plaques, and 11 (14.7%) participants had a stenosis plaque. Hypercholesterolemia and high cardiovascular risk were associated with the presence of carotid atheroma plaque. Conclusion: The frequency of carotid atherosclerosis appears to be high in people over 50 years of age with at least one cardiovascular risk factor justifying the importance of control strategies against these factors.
Abstract: Introduction: Atherosclerosis is a leading cause of vascular disease worldwide. One of its main locations is in the carotid artery which is implicated in 20% of ischemic strokes. This study aimed to determine the frequency of carotid atherosclerosis in a group of asymptomatic patients with at least one cardiovascular risk factor. Methodology: This ...
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Simulation of Altered Blood Flow in Bicuspid Aortic Valve Disease: A Proof of Concept Study
Lewis Holmes,
George Black,
Richmond Jeremy,
Rachael Cordina,
David Celermajer,
Srinivas Karkenahalli,
Rajesh Puranik
Issue:
Volume 5, Issue 4, December 2021
Pages:
172-175
Received:
18 September 2021
Accepted:
1 November 2021
Published:
17 November 2021
Abstract: Background: Bicuspid aortic valve (BAV) is a common congenital heart disease which is associated with aortic dilatation. There is controversy in the literature regarding the various measures of the biomechanical properties of the aorta in these patients and their relationship to aortic dilatation. The present study aimed to assess both conventional 2D Cardiac Magnetic Resonance Imaging (CMRI) measurements of aortic biomechanics (compliance and distensibility) and a computational fluid dynamics (CFD) approach in patients with BAV and either normal or dilated ascending aorta. Methods: 2D CMRI was performed in 18 patients (6 controls, 6 BAV with dilated ascending aorta and 6 BAV with normal ascending aorta i.e. <36mm diameter) and ascending aortic compliance and distensibility was calculated. CFD was performed with ANSYS Fluent software using 2D CMRI derived parameters to simulate the hemodynamic relationships between blood and the aortic wall. Results: The groups were similar in terms of demographics (mean age 38±13 years, 56% male, pulse pressure 56±15mmHg). There was a numerically lower but not significant difference in aortic compliance between dilated BAV and the other groups. Aortic distensibility was no different between groups. Using CFD, at the mid-ascending aorta pressure was significantly higher in patients with dilated BAV (147.6 ± 24.1 mmHg) than non-dilated BAV (118.6 ± 16.2 mmHg) and controls (124.5 ± 14.4 mmHg), p=0.04. Conclusions: We demonstrate that is possible to estimate regional aortic pressure from 2D CMRI derived parameters using a CFD approach. These novel parameters may add value to surveillance strategies in aortic disease.
Abstract: Background: Bicuspid aortic valve (BAV) is a common congenital heart disease which is associated with aortic dilatation. There is controversy in the literature regarding the various measures of the biomechanical properties of the aorta in these patients and their relationship to aortic dilatation. The present study aimed to assess both conventional...
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A Randomized Study Comparing Patency of Infarction Related Vessel at Time of Primary PCI in Patients Who Received Streptokinase and Who Did Not
Nura Ibrahim Maiyadi,
Mostafa Attia Al Sawasany,
Hatem Abdelateif Kholeif
Issue:
Volume 5, Issue 4, December 2021
Pages:
176-182
Received:
24 October 2021
Accepted:
9 November 2021
Published:
17 November 2021
Abstract: Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients presenting with STEMI diagnosis within less than 12 hours from diagnosis either at the centre or referred to the center after SK were screened. 200 patients were randomized into primary PCI (PPCI) or pharmacoinvasive PCI following SK (PhI-SK) administration 3-24 hours after SK. Failed SK patients underwent rescue PCI immediately. The outcome of IRA patency pre- and post PCI in both groups along with short term outcome of bleeding, re-infarction or cardiovascular death in 30 days were looked at. The end points were reached in 81 of 89 (91.0%) in the SK group and 21 of 98 (21.4%) in the PPCI group (p-value <0.001), while TIMI 3 flow was seen in 87 of 89 (98.7%) patients post PCI in the SK group and 69 of 98 (70.4%) patients of PPCI (p-value <0.001). The outcomes of bleeding, MI and death were not different among the groups. We concluded that Fibrinolysis with SK is a viable and safe reperfusion strategy in STEMI especially in low- and middle-income countries (LMICs), where PPCI is not commonly available within the guideline recommended time. It can reduce stress and risk of complications that can occur during PPCI. There is no any difference in the early outcomes of bleeding, MI and death between the two groups.
Abstract: Coronary blood flow in an infarct related artery (IRA) in patients that had streptokinase (SK), as the fibrinolytic of choice before percutaneous intervention (PCI), in comparison to the blood flow in patients that underwent primary percutaneous intervention (PPCI) has not been well understood or considered for studies in recent times. All patients...
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Effect of Complete Revascularization vs. Staged PCI of Secondary Lesion on LV Systolic Function in Patient with STEMI
Mostafa Attia Al-Sawasany
Issue:
Volume 5, Issue 4, December 2021
Pages:
183-193
Received:
24 October 2021
Accepted:
11 November 2021
Published:
23 November 2021
Abstract: After a myocardial infarction, early restoration of normal coronary perfusion reduces infract size, preserves left ventricular function, and lowers mortality. Reperfusion therapy's major goal is to not only restore the culprit epicardial vessel's patency, but also to reperfuse tissue to preserve myocyte viability and hence LV function. The pathophysiology of myocardial infarction, on the other hand, is not limited to the culprit vessel. The treatment of non-culprit lesions in STEMI is a contentious issue. Previously published guidelines (the 2011 PCI and 2013 STEMI guidelines) recommended treating the culprit lesion only if the patient was in cardiogenic shock. These guidelines are based on expert opinions rather than randomized controlled trials, which take into account safety concerns such as complications from repeated intervention, a low technical success rate, a high incidence of coronary restenosis, and renal insufficiency after contrast agent use. The aim of this work is to Long-term outcomes Lt ventricular ejection fraction (6 months) between complete revascularization and culprit-only revascularization (followed by staged percutaneous coronary intervention of secondary lesions) in STEMI patients with multi vessel coronary disease undergoing primary angioplasty. This prospective analysis included 50 patients with acute ST elevation myocardial infarction who were amenable to primary coronary intervention and were admitted to the critical care unit. And was blindly randomized alternatively into 2 groups: Group A: Complete coronary revascularisation during primary percutaneous intervention. Group B: Culprit-only revascularization during primary PCI. This study enrolled 50 patients, 35 males (70%) and 15 females (30%); in G I, there were 18 males (72%) and 7 females (18%) while in G II there were 17 males (68%) and 8 females (32%). The age ranged from 34 yrs. to 82 yrs. with mean age: In G I was 61.6 (±8.9) In G II was 62.2 (±12.9) were enrolled in this study, pre-procedural EF% (Mean±St) there was no significant difference between both groups. In G I, patients had a mean EF% 49.9±10.1 Versus 48.0±11.3 seen in G II. (P=0.54) In G I, there was no a significant difference between pre- procedural versus post-procedural mean EF%. (P=0.53) In G II, there was no a significant difference between pre-procedural versus post-procedural mean EF%. (P=0.14) We concluded that There were no significant differences between infarct-related artery revascularization and multivessel revascularization in the rates of 6-month MACE, Also, there were no differences as regard in-hospital mortality, stroke, cardiogenic shock and reinfarction, ejection fraction.
Abstract: After a myocardial infarction, early restoration of normal coronary perfusion reduces infract size, preserves left ventricular function, and lowers mortality. Reperfusion therapy's major goal is to not only restore the culprit epicardial vessel's patency, but also to reperfuse tissue to preserve myocyte viability and hence LV function. The pathophy...
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Reducing the Incidence of Cardiovascular Disease in North China by Healthy Dieting
Zhao Xi Lin,
Ting Wen Xie,
Liang Li
Issue:
Volume 5, Issue 4, December 2021
Pages:
194-197
Received:
13 October 2021
Accepted:
30 October 2021
Published:
27 November 2021
Abstract: Cardiovascular disease (CVD) is one of the most deadly diseases globally. In recent years, the incidence rate and the fatality rate of CAD has ranked first in China. CAD not only seriously damage public’s health but also cause property losses to patients’ family and the society. Therefore, the factors that affect the incidence of CAD are considered. Based on a research, that different eating habits and the body mass index among different regions are closely related to its incidence is proposed. The knowledge of linear algebra is then used to establish three models to get a healthy diet which helps to prevent CVD. In the first nutrient model, the purpose is to solve for a combination of food that can meet the nutrition requirement. In the second replacement model, some replacement tricks are used not only to deal with no or negative solutions problems but also to replace food which is beneficial to prevent CVD. Finally, the last energy model is used to check if the recipe satisfies the daily energy intake requirement. Eventually, a recipe which is flexible and contains various types of food is put forward. It ensures that people not only take in all kinds of nutrients and required energy daily but also prevent CVD.
Abstract: Cardiovascular disease (CVD) is one of the most deadly diseases globally. In recent years, the incidence rate and the fatality rate of CAD has ranked first in China. CAD not only seriously damage public’s health but also cause property losses to patients’ family and the society. Therefore, the factors that affect the incidence of CAD are considered...
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Multicenter Long Term Experience with Management of TASC II C, D Femoropopliteal Occlusive Disease Drug Coated Versus Uncoated Ballon Angioplasty
Mohammad Alsagheer Alhewy,
Abdelaziz Ahmed Abdelhafez,
Ehab Abdelmoneim Ghazala
Issue:
Volume 5, Issue 4, December 2021
Pages:
198-203
Received:
4 November 2021
Accepted:
24 November 2021
Published:
2 December 2021
Abstract: Backgroud: The use of drug-coated balloons for the treatment of TransAtlantic Inter-Society Consensus TASC-II C, D femoro-popliteal lesions has become widespread in recent years. Drug-coated balloons promise to minimize the rates of restenosis by effective delivery of antiproliferative agent (paclitaxel) directly to vessel wall without the need for a permanent implant. Reinterventions with drug coated balloons are lower and easier to perform because we leave no stent behind. Objective: The aim of this retrospective study was to investigate the efficacy of drug‐coated balloon (DCB) and comparing it with conventional un-coated balloon (UCB) angioplasty for the treatment of femoropopliteal occlusive disease TASC II C, D in critical lower limb ischemia. Patients and Methods: Thirty patients were included and presented to vascular surgery department of Al-Azhar University hospitals and Sednawy hospitals in Cairo, Elaraby Specialized Hospital in Monofia and Albahah hospital in KSA with TASC II C, D femoro-popliteal lesions, distributed into two equal groups; Group I was treated with DCB for femoropopliteal lesions while group II was treated with UCB during the period from December 2017 to November 2020. Primary end point was wound healing, limb salvage or amputation. All patients were monitored with 0, 3, 6 and 12 months’ serial postoperative duplex scanning surveillance. Results: Twenty-five patients (83%) reached the end point of healing and limb salvage (14 patients with ‘DCB’ technique and 11 patients with ‘UCB’ technique), whereas 5 patients underwent major amputations (2 with ‘DCB’ technique and 3 with ‘UCB’ technique). The early patency rate at 1 and 3 months was 93.34% in the group with ‘DCB’, and 89.93% in the group with ‘UCB’. While the late patency rate at one year post-operatively was 88.86% in the ‘DCB’ group with, and 53.33% in the ‘UCB’ group. Conclusion: Both DCB and UCB were effective for treatment of femoro-popliteal occlusive disease TASC II C, D, and there was nearly no difference regarding wound healing and limb salvage while DCB appeared to be superior on UCB regarding high patency and low re-intervention rates.
Abstract: Backgroud: The use of drug-coated balloons for the treatment of TransAtlantic Inter-Society Consensus TASC-II C, D femoro-popliteal lesions has become widespread in recent years. Drug-coated balloons promise to minimize the rates of restenosis by effective delivery of antiproliferative agent (paclitaxel) directly to vessel wall without the need for...
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Correlation Between Coronary Calcium Scoring and Duke’s Treadmill Score in Patients with Normal Myocardial Perfusion Imaging SPECT
Abd Al Aziz Mohie Al Deen Abd Al Aziz,
Mohamed Abou Mandour Ali,
Ayman El Saeed Saddek,
Adel Hassan Allam
Issue:
Volume 5, Issue 4, December 2021
Pages:
204-210
Received:
9 November 2021
Accepted:
24 November 2021
Published:
2 December 2021
Abstract: Background: Stress myocardial perfusion imaging (MPI) is a highly valuable test in the evaluation and risk stratification of ischemic heart disease. However, negative stress MPI does not exclude coronary atherosclerosis. The Coronary artery calcium (CAC) score is a validated simple test in the evaluation of coronary atherosclerosis. Our goal was to investigate the correlation between CAC score and Duke’s treadmill score, as well as the prevalence of CAC in patients with negative MPI. Methods: A total of 926 consecutive Egyptian patients, aged 30 to 60 years without known CAD, underwent CAC score testing following normal MPI. Results: In the setting of normal MPI among Egyptian patients without known CAD, mean age 48±7 years, 325 (35%) patients had a positive CAC score, and 9% had high CAC>100. Out of CAC>0, 160 were low-risk DTS. Our study showed no correlation between CAC score and DTS (P value=0.5). Age (OR=1.119, P value=<.001 and 95% confidence interval (CI)=1.071 - 1.169), male gender (OR=2.795, P value=.001 and 95% (CI)=1.494 - 5.230), and statin therapy (OR=2.020, P value=.008 and 95% (CI)=1.199 - 3.404), were significant independent predictors of a high CAC score>100. Conclusion: In a large number of normal MPI Egyptian patients without known CAD, CAC prevalence was 35%, confirming the beneficial value of adding CAC score test to negative MPI for cardiovascular risk stratification and screening for subclinical CAD regardless of DTS. Higher CAC values and prevalence were associated with age and male gender.
Abstract: Background: Stress myocardial perfusion imaging (MPI) is a highly valuable test in the evaluation and risk stratification of ischemic heart disease. However, negative stress MPI does not exclude coronary atherosclerosis. The Coronary artery calcium (CAC) score is a validated simple test in the evaluation of coronary atherosclerosis. Our goal was to...
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Prevalence of Hypertension and Associated Factors Among Bank Workers in Harar Town, Eastern Ethiopia
Hailu Dagne,
Tilaye Gebru,
Yalew Mossie
Issue:
Volume 5, Issue 4, December 2021
Pages:
211-218
Received:
12 November 2021
Accepted:
30 November 2021
Published:
11 December 2021
Abstract: Background: Hypertension is one of the leading causes of the global burden of disease. It is being the root cause of many of the body system and organs failure remains to be a major public health challenge globally. Epidemiological studies have shown that sedentary lifestyles and stress are important risk factors for hypertension. The job of bank Workers is both sedentary and involves a high level of stress and thus making banking a potential occupational risk group for hypertension. Though the problem is huge in both developed and developing countries. Objective: To assess the prevalence of hypertension and associated factors among bank Workers in Harar town, Eastern Ethiopia, 2017. Methods: An Institutional based cross-sectional descriptive study design was used. The target population was conducted on Bank Workers of Harar town by taking a total sample size of 149 and physical measurement-based. Self-Administered questioners were disseminated and recollected from the selected respondents and the physical measurement part was filled by the data collector. Prevalence was computed with a 95% confidence interval. Data has been analyzed in a database using SPSS version 21.0 software. Descriptive statistics were used to determine prevalence. Then the data was transferred to multivariate analysis to control confounding factors and to identify determinant factors of the outcome variable. P-value less than or equal to 0.05 was considered as a level of statistical significance. Result: A total of 149 participants were approached with a response rate of 143 (96.4%). The prevalence of Hypertension in the study was 27.5%. Aging, Sedentary lifestyle, and BMI (Obesity) in this study were positively associated with higher odds of having hypertension. Conclusion and recommendation: Hypertension are one of the most important health-related problems among men worldwide. Therefore, a well-planned health education program should be implemented to address the observed knowledge gaps.
Abstract: Background: Hypertension is one of the leading causes of the global burden of disease. It is being the root cause of many of the body system and organs failure remains to be a major public health challenge globally. Epidemiological studies have shown that sedentary lifestyles and stress are important risk factors for hypertension. The job of bank W...
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Adherence to Antihypertensive Treatment and Associated Factors in Semi-urban Area in North Togo
Tchaa Tcherou,
Komlavi Yayehd,
Machihuede Pio,
Doguensaga Borgatia Atta,
Mario Abalo Bakai,
Tchalla Yowdema Abena,
Findibe Damorou
Issue:
Volume 5, Issue 4, December 2021
Pages:
219-224
Received:
1 November 2021
Accepted:
6 December 2021
Published:
24 December 2021
Abstract: Background. The purpose of this study was to determine the rate of non-adherence to antihypertensive therapy and to investigate factors that may explain this non-adherence. Methods. This is a cross-sectional study conducted from March to December 2017 in two public hospitals in the city of Kara. It included hypertensive patients known to have been on treatment for at least six months, and who were able to provide information to the Girerd self-questionnaire. A survey form was used to collect sociodemographic, clinical and therapeutic data. Results. Of the 216 received patients, 35.2% had good adherence and 64.8% had difficulties in adhering to their treatment (16.7% had minor adherence problems and 48.1% had poor adherence). The low level of education (OR=1.87; 95% CI=1.01-3.44; p=0.04), the short duration of progression (<5 years) of hypertension (OR=2.90; 95% CI=1.62-5.17; p=0.001), lack of financial resources (OR=2.78; 95% CI=1.37-5.64; p=0.04), non-staff status (OR=2.89; 95% CI 1.60-5.20, p<0.001) and the high number of tablets to be taken per day (OR=3.32; 95% CI 1.80-6.10; p≤ 0.001) were predictive factors for treatment non-compliance. Conclusion. Adherence to antihypertensive therapy was low in a hypertensive population in Northern Togo. Low education level, a duration of hypertension evolution of less than five years, lack of financial means, non-civil servant status and high number of tablets were the factors associated with nonadherence to treatment.
Abstract: Background. The purpose of this study was to determine the rate of non-adherence to antihypertensive therapy and to investigate factors that may explain this non-adherence. Methods. This is a cross-sectional study conducted from March to December 2017 in two public hospitals in the city of Kara. It included hypertensive patients known to have been ...
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Global Cardiovscular Risk and Vascular Age in Patients with Ischemic Cardiopatia at the Kara University Hospital (Kara-U H)
Machihude Pio,
Tchaa Tcherou,
Doguénsaga Borgotia Atta,
Lihanimpo Djalogue,
Abalo Mario Bakai,
Bénédicte Souho,
Yaovi Mignazonzon Afassinou,
Soulemane Pessinaba,
Wiyaou Dieu-Donné Kaziga
Issue:
Volume 5, Issue 4, December 2021
Pages:
225-229
Received:
17 November 2021
Accepted:
16 December 2021
Published:
29 December 2021
Abstract: Introduction: Ischemic heart disease, which used to be infrequent in African countries, has become a leading cause of cardiovascular morbidity. Objectives: To determine the frequency of cardiovascular risk factors, to calculate the level of cardiovascular risk in patients with ischemic heart disease, and to compare the calendar age and vascular age of these patients. Patients and methods: This is a descriptive and analytical study conducted from July 2017 to May 2021 in the cardiology department of Kara University Hospital and included records of patients hospitalized for ischemic heart disease. The different cardiovascular risk factors were analyzed allowing to determine the vascular age and the global cardiovascular risk of these patients before their stroke. Results: The hospital incidence of ischemic heart disease was 3.2%. There was a discrete female predominance (men/women=45/51). High blood pressure (65.6%) was the most associated risk factor, followed by metabolic syndrome (42.7%), dyslipidemia (36.5%) and diabetes (28.1%). The mean vascular age was 69.2±13.1 years compared with 59.8±12.3 years of vital age, corresponding to a difference of 9.4 years. This mean difference was higher in the younger age group under 60 years (13.1 years) and in women (11.1 years). Before their stroke, the overall high cardiovascular risk (≥20%) of having a cardiovascular event at 10 years in these patients was 26.1% for the WHO abacus versus 53.1% for the Framingham score. Conclusion: The overall high cardiovascular risk of patients with ischemic heart disease was very high before their stroke. Similarly, the difference between the vascular age and the vital statistics age is significant, reflecting the early arterial aging of these patients.
Abstract: Introduction: Ischemic heart disease, which used to be infrequent in African countries, has become a leading cause of cardiovascular morbidity. Objectives: To determine the frequency of cardiovascular risk factors, to calculate the level of cardiovascular risk in patients with ischemic heart disease, and to compare the calendar age and vascular age...
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