21 research outputs found

    Cirrhotic Cardiomyopathy in Egyptian Patients

    No full text
    Abstract Background: Cirrhotic cardiomyopathy is the term used to describe a constellation of features indicative of abnormal heart structure and function in patients with liver cirrhosis. Aim of this study is to assess the pattern and the extent of cardiac affection in cirrhotic patients and its relation to the presence or absence of ascites. Patients and methods: This study included 70 patients with liver cirrhosis and 30 healthy controls. All persons were subjected to careful history taking, physical examination, laboratory investigations, abdominal ultrasonography, and echocardiography. Results: Left ventricle end diastolic diameter was significantly increased in cirrhotic patients with ascites (5.40±0.58) and without ascites (5.31±0.51), compared to the control group (4.52±0.58) (p<0.05), left ventricle end systolic diameter was increased in cirrhotic patients with ascites (3.57±2.2) and without ascites (3.46±3.1), compared to the control group (3.18±2.5) (p > 0.05).Left atrium diameter , right ventricular end diastolic diameter and pulmonary artery systolic pressure were significantly increased in cirrhotic patients compared to the control group (p<0.05).Conclusion: Liver cirrhosis was associated with significant enlarged cardiac chambers and. diastolic dysfunction compared to the control group especially in the presence of ascites

    B-type natriuretic peptide as an index of symptoms and severity of chronic rheumatic mitral regurgitation

    No full text
    Background: The most common causes of severe mitral regurgitation (MR) in developing countries are rheumatic heart disease. The plasma level of B-type natriuretic peptide (BNP) is known to increase with left ventricular (LV) dysfunction. Aim of the Work: To study BNP level as an index of symptoms and severity of chronic rheumatic MR. Patients and Methods: One hundred and forty patients with rheumatic MR and LV ejection fractions (EFs) of >55% underwent assessment of symptoms, transthoracic echocardiography, and measurement of BNP. Results: The level of BNP rose with increasing left atrium (LA) dimensions and volumes, LV dimensions and volumes, echocardiographic parameters of MR severity (width of the vena contracta, regurgitation jet area, effective regurgitation orifice area, and regurgitant volume), and E waves. Results: BNP was significantly higher in patients with severe MR compared with moderate and mild MR (P < 0.001), and using cutoff point of 61 pg/mL mm had 97% sensitivity and 89% specificity for predicting patients with severe MR (0.99, 95% confidence interval [CI] 0.9–1). BNP was significantly higher in patients with New York Heart Association (NYHA III) compared with NYHA II, I and asymptomatic patients (P < 0.001) and using cutoff point of 53 pg/mL had 97% sensitivity and 87% specificity for predicting symptomatic patients with symptomatic MR (0.81, 95% CI 0.70–0.92). Conclusions: BNP level increase with increasing severity of rheumatic MR and are higher in symptomatic compared to asymptomatic patients, even in the presence of normal EF%

    Relationship of endothelial nitric oxide synthase gene polymorphism with atherosclerotic coronary and carotid arterial disease in Egyptian population

    Get PDF
    Introduction: Atherosclerosis is partly a heritable disorder. Various genetic polymorphisms have been linked to the atherosclerotic process and its complications. Glu298Asp polymorphism of endothelial nitric oxide synthase gene is one such genetic marker for atherosclerosis. Aim of the work: To study the relationship between endothelial nitric oxide synthase gene polymorphism and atherosclerotic coronary and carotid arterial disease in Egyptian population. Patients and methods: Our study included 95 Egyptian patients with Egyptian father and mother, classified into two groups: Group 1; 63 patients with ischemic heart disease and Group 2; 32 control subjects and subjected to careful history taking, thorough clinical examination, standard twelve-lead surface electrocardiogram, routine laboratory investigations, echo Doppler study, carotid arterial duplex, invasive coronary angiography and analysis of the endothelial NOS3 gene polymorphism using PCR–RFLP for detection of different genotype variants (Glu/Glu (GG), Glu/Asp (GT) and Asp/Asp (TT) genotype). Conclusion: Glu298Asp polymorphism in the endothelial nitric oxide synthase gene did not increase the susceptibility to coronary and carotid arteries disease in the studied patients

    Role of two dimensional strain and strain rate imaging in assessment of left ventricular systolic function in patients with rheumatic mitral stenosis and normal ejection fraction

    Get PDF
    Introduction: Conventional echocardiographic parameters are not able to detect subclinical left ventricular (LV) systolic dysfunction in patients with mitral stenosis (MS). Two-dimensional (2D) longitudinal strain (S) and strain rate (Sr) imaging is a new technique which evaluates global LV systolic function with high reproducibility. The aim of the study was to assess LV systolic function, in patients with moderate–severe MS and normal ejection fraction (EF%), by 2D longitudinal systolic S and Sr imaging. Patients and method: The study included 50 patients with an established diagnosis of MS (mean age: 32 ± 8 years) and 30 age-matched healthy individuals (mean age 34 ± 7 years). The mitral valve area (MVA) was measured by planimetry and pressure half time (PHT) methods. 2D longitudinal systolic S and Sr imaging was performed for each participant from the apical long axis (LAX), 4 chamber (4C) and 2 chamber (2C) views. Global longitudinal systolic S and Sr were calculated by averaging the three apical views. Results: There were no significant differences in LV EF%, LV end-systolic and end-diastolic dimensions between the two groups. Patients with MS had significantly lower 2D longitudinal LV systolic S and Sr compared to the control group (<0.001 and <0.05 respectively). Conclusion: Patients with MS and preserved EF% had lower 2D longitudinal LV systolic S and Sr compared to the control group. 2D longitudinal LV systolic S and Sr imaging appears to be useful in the detection of subclinical LV systolic dysfunction in patients with MS and preserved EF%

    Iatrogenic Left Main Coronary Artery Stenosis Following Aortic and Mitral Valve Replacement

    No full text
    Iatrogenic coronary artery disease following prosthetic valve implantation is a rare complication. This may result from mechanical injury in the intraoperative period. The use of balloon tip perfusion catheter presumably provides the initial insult with local vessel wall hypoxia. Once the diagnosis of coronary ostial stenosis is established, the procedure of choice is coronary artery bypass surgery. We report a case of a young lady who underwent aortic and mitral valves replacement for infective endocarditis. She was then diagnosed with ostial left main stem coronary stenosis after presenting with atypical symptoms. The patient eventually underwent coronary artery bypass surgery

    Detection of subclinical right ventricular systolic dysfunction in patients with mitral stenosis by two dimensional strain and strain rate imaging

    Get PDF
    Introduction: Right ventricular (RV) systolic dysfunction occurs early before clinical systemic congestion in patients with mitral stenosis (MS). Conventional echocardiographic techniques have some limitations in the assessment of RV function. Aim of the work: To evaluate the role of two dimensional (2D) longitudinal systolic strain and strain rate imaging in detection of subclinical RV systolic dysfunction in patients with moderate-severe MS. Patients and methods: Fifty patients with isolated MS (moderate-severe) and 30 healthy control subjects constituted the study population. Conventional echocardiography, pulsed wave tissue Doppler imaging (TDI) of the tricuspid annulus and 2D longitudinal segmental and global RV systolic strain (RV-GLS) and strain rate (RV-GLSr) measurements were obtained. Results: Patients with MS had significantly lower RV-GLS and RV-GLSr compared to control subjects (−19.67 ± 6.23 vs. −24.19 ± 3.25, P < 0.001, and −1.49 ± 0.87 vs. −1.91 ± 0.56, P = 0.02, respectively). Conclusion: Patients with MS had significantly lower 2D RV-GLS and RV-GLSr compared to control group. 2D RV-GLS and RV-GLSr imaging appear to be useful in detection of subclinical RV systolic dysfunction in patients with MS

    Impact of gender difference on PCI outcome in Egyptian diabetic patients: Prospective two center registry study

    Get PDF
    Introduction: Diabetes mellitus is a chronic condition with devastating cardiovascular complications. Earlier studies have reported a gender-based difference in major adverse cardiac events (MACEs) after index PCI procedures. In the drug eluting stent era, more recent studies have failed to show any differences in post-PCI outcomes between both genders. However, this finding has never been verified in Egyptian patients with diabetes. The aim of the study: The aim of the study was to compare the impact of female gender on short- and long-term outcomes after elective PCI using drug-eluting stents (DES) in Egyptian diabetic patients. Patients and method: The study included 100 diabetic males and 100 diabetic females, all of whom had DES deployed during elective PCI and followed up for 12 months. The clinical endpoints were death, myocardial infarction (MI), target vessel revascularization (TVR), or target lesion revascularization (TLR) at any time during 12 month follow-up period. Results: Both diabetic females and males have a low and nearly equal incidence of adverse events following PCI using DES. Conclusion: When all patients had DES implanted and after adjustment of demographic and risk factor/co morbidity profiles, there were no significant differences in the short- or long-term PCI outcomes of diabetic females treated with DES when compared to diabetic males

    CIRRHOTIC CARDIOMYOPATHY IN EGYPTIAN PATIENTS

    Get PDF
    Background: Liver  cirrhosis is   a health care problem in  Egypt  caused  by the high prevalence of  hepatitis C virus (HCV)  infection that affects 15-20 % of the population  . Cirrhotic cardiomyopathy is the term used to describe a constellation of features indicative of abnormal heart structure and function in patients with cirrhosis. Aim of this study is to assess the pattern and the extent of cardiac affection in cirrhotic patients and its relation to the presence or absence of ascites. Materials  and methods: This study was carried out on 70 patients with liver cirrhosis and 30 healthy controls. All persons were subjected to careful history &amp; physical examination, laboratory investigations, abdominal ultrasonography ,and echocardiography. Results:   left ventricle end diastolic diameter was significantly  increased in cirrhotic patients with  ascites (5.40±0.58)  and without ascites ((5.31±0.51), compared to the control group (4.52±0.58) (p&lt;0.05), . left ventricle end systolic diameter was      increased in cirrhotic patients with  ascites (3.57±2.2)  and without ascites (3.46±3.1), without ascites (3.18±2.5)but the difference was statistically non significant    (p &gt; 0.05).   Left atrium diameter &amp; Right ventricular end diastolic diameter were significantly increased in cirrhotic patients compared to the control group (p&lt;0.05  The  pulmonary artery pressure  was elevated in cirrhotic patients compared to the control group .. Conclusion:  In the present study ptient with Liver cirrhosis were  associated with significant enlargement of cardiac chambers and diastolic dysfunction compared to the control group specially   in  the presence of ascites.Â
    corecore