scholarly journals Failure of Stent Delivery in Lima PCI

2017 ◽  
Vol 02 (01) ◽  
pp. 026-029
Author(s):  
Rama Janapati ◽  
G Sneha ◽  
Indrani Garre
Keyword(s):  
Retrospective Analysis ◽  
Left Ventricular Dysfunction ◽  
Internal Mammary Artery ◽  
Ventricular Dysfunction ◽  
Tertiary Care ◽  
Chronic Stable Angina ◽  
Left Ventricular ◽  
Care Hospital ◽  
Significant Difference ◽  
Internal Mammary

AbstractBack Ground: The internal mammary artery was the most effective conduit for coronary artery bypass surgery and it was associated with significantly better long term patency, survival, and reintervention rates compared to other bypass conduits. The internal mammary artery (IMA) is not immune to atherosclerosis. IMA interventions constitute low percentage out of all coronary interventions. In addition to the tortuous course, the long length of IMA than native coronaries adds procedural difficulties to IMA PCI.Aim: To analyze the acute outcomes of Percutaneous intervention procedures to the internal mammary artery and to found any association with clinical and demographic parameters to the procedural success at a single tertiary care hospital from IndiaMaterials And Methods: This study was a retrospective analysis of post CABG patient who required and undergone the IMA intervention. We collected the clinical, demographic and procedural details of the IMA intervention. We defined as failure of the procedure when the stent could not be delivered to the lesion site through IMA.Results: Total 21 patients were included in this retrospective analysis. Mean age of the study population was 56.1± 9.98 years and 18 patients were male. Twelve (57.1%) patients presented with chronic stable angina and six (28.6%) had Left ventricular dysfunction (LVD) (mild LVD in 5 and one patient had severe LVD). Mean stent diameter was 2.75±0.442 mm and the mean stent length was 17.71 ±5.63 mm. Transient slow flow occurred in 5 patients, but the end result of PCI procedure was good in them. In 4 (19.1%) patients stent could not be delivered. No LIMA dissections were observed. On binary logistic regression, there was no significant difference between successful PCI to the failed PCI with respect to age (p=0.9, z=0.16, OR=0.99, 95%CI=0.83to1.17), male sex (p=0.7, Z=0.34, OR=1.68), type of presentation (p=0.7, Z=0.38, OR=1.60, 95%CI= 0.14 to 17.7), presence of Left ventricular dysfunction (p=0.7, z=0.38, OR=1.60, 95%CI= 0.14 to 16.97) and with pre-dilatation during PCI (p=0.9, z=-0.16, OR=0.99).Conclusion: PCI to the internal mammary artery was associated with 80.95% of success. Not able to deliver the stent to the target lesion was the major problem with LIMA PCI, in addition, to slow or no flow. The success or failure of PCI were not dependent on the age, sex, type of presentation or LV dysfunction.

Neopterin levels and left ventricular dysfunction in patients with chronic stable angina pectoris

2009 ◽  
Vol 207 (2) ◽  
pp. 514-518 ◽  
Author(s):  
Rodrigo Estévez-Loureiro ◽  
Alejandro Recio-Mayoral ◽  
Juan A. Sieira-Rodríguez-Moret ◽  
Ernesto Trallero-Araguás ◽  
Juan Carlos Kaski
Keyword(s):  
Angina Pectoris ◽  
Left Ventricular Dysfunction ◽  
Stable Angina ◽  
Ventricular Dysfunction ◽  
Chronic Stable Angina ◽  
Left Ventricular ◽  
Stable Angina Pectoris

scholarly journals An Echocardiographic Evaluation of Dilated Cardiomyopathy in a Tertiary Care Hospital

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Raj Kumar Thapa ◽  
Kanchan K.C ◽  
Rishi Khatri ◽  
Devendra Khatri ◽  
Rajeeb Kumar Deo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Care Hospital ◽  
Echocardiographic Evaluation ◽  
Significant Difference

Introduction: Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup.Methods: This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21.Results: Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091).Conclusions: Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition. Keywords: dilated cardiomyopathy; echocardiography; ejection fraction; left ventricle.

scholarly journals ASSESSMENT OF LEFT ATRIAL FUNCTION IN PATIENTS WITHMITRAL VALVE DISEASES

2016 ◽  
Vol 9 (6) ◽  
pp. 334
Author(s):  
Karthikrao N
Keyword(s):  
Mitral Valve ◽  
Left Atrial ◽  
Contractile Function ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Care Hospital ◽  
Set Inclusion ◽  
Cardiology Department ◽  
Significant Difference ◽  
Valve Diseases

ABSTRACTObjective:To observe and assess left atrial (LA) function by observing the differences in conventional Doppler echo parameters of left ventricular inflow, Left atrial appendage, among patients with mitral valve disease.Methods: Forty three mitral valve disease subjects appearing consecutively for echocardiogram (ECHO) test at the cardiology department in a tertiary care hospital were recruited into the study as per the pre-set inclusion and exclusion criteria. The data from the ECHO was pooled using Microsoft excel and analyzed using SPSS software by application of appropriate statistical tests.Results:Of the 43 objects, 39 had MS, 3 had MR and 2 of them were found to have both MS and MR. The major presenting symptom as observed in 33 subjects, was dyspnea. LA maximum volume was found to be 91±59 ml and minimum was 66±51 ml. Left atrial expansion index was 128±91. Left atrial active emptying fraction was 29±13 and passive emptying fraction was 31±15. No significant change in LA global strain among groups with MR and without MR was observed. Further, no significant difference was observed in left atrial indices like left atrial emptying fraction, left atrial passive emptying fraction, atrial fraction, Left atrial expansion index among   groups having MR and no MR.Conclusion:LA contractile, reservoir and conduit function was significantly reduced in mitral valve diseases due to increased hemodynamic load. No significant difference was noted in global LA strain irrespective of MS or MR.Key Words: Valvular disease; Left atria; Strain; Contractile function

scholarly journals Oxidative and Antioxidative Stress Markers in Relation to Left Ventricular Dysfunction and Gender

2018 ◽  
Vol 03 (01) ◽  
pp. 006-011
Author(s):  
Indrani Garre ◽  
Raju Nallagasu ◽  
Malleshwar Rao Dangati ◽  
Indumathi Bobbala ◽  
Ravikiran Muddada
Keyword(s):  
Oxidative Stress ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Oxidative Stress Markers ◽  
Stress Markers ◽  
Significant Difference ◽  
Antioxidative Stress ◽  
And Gender

Abstract Objective The aim of this study was to investigate the relationship between oxidative and antioxidative stress markers with presence of left ventricular dysfunction (LVD) and the severity of LVD with coronary artery disease (CAD) in patients who have undergone percutaneous coronary intervention (PCI). Further, the role of oxidative and anti-oxidative stress markers on gender was also investigated. Methods This was an observational prospective pilot study of patients diagnosed with CAD with LVD who underwent PCI at the center from June 2017 to December 2017. Based on the ejection function (EF), patients were categorized into three groups: mild (> 40–50%), moderate (> 35–40%), and severe (≤ 35%). The oxidative and antioxidative stress markers (malondialdehyde [MDA], glutathione [GSH], and nitric oxide [NO]) were studied and compared in these groups and in both genders as subanalysis. Results Total 33 patients were enrolled, of whom 23 were male (69.7%) and 10 were female (30.3%). Mean age of the study population was 58.8 ± 9.3 years. Significant elevation of MDA and NO was seen in 33 (100%) and 26 (78.8%), respectively, and decreased GSH was seen in 30 (90.9%). There was no significant difference with respect to oxidative and antioxidative stress markers and severity of LVD (MDA, p = 0.25; NO, p = 0.79; and GSH, p = 0.2) despite elevated MDA levels in all patients. The subanalysis was done to see the gender effect with oxidative and antioxidative stress markers (MDA, p = 0.29; NO, p = 0.10; and GSH, p = 0.50), and they all were insignificant. Conclusion In this study, there was no significant relationship of oxidative and anti-oxidative stress markers on the degree of LVD even though the elevated MDA levels suggestive of increased oxidative stress were seen in all patients. The further analysis of gender in relation to oxidative and antioxidative stress markers was also insignificant.

Subclinical Diastolic Dysfunction in Diabetic Population

2016 ◽  
Vol 70 (3) ◽  
pp. 140-144
Author(s):  
Slavica Mitrovska
Keyword(s):  
Diastolic Dysfunction ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Diabetic Population ◽  
And Control

Abstract Introduction. Left ventricular dysfunction is very frequent in asymptomatic diabetic population. Tissue Doppler Imaging (TDI) is a new echocardiographic technique, able to record early changes of left ventricular dysfunction and to identify asymptomatic diabetic patients at high risk of developing heart failure. Aim. To assess the role of TDI in early detection of diastolic dysfunction in asymptomatic diabetic patients. Methods. Cross-sectional study that involved a total number of 48 subjects. The target group consisted of 25 asymptomatic diabetic patients and control group was composed of 23 subjects without diabetes. All subjects underwent echocardiography (conventional 2D and Pulsed-Wave Doppler and contemporary-TDI) to analyze left ventricular function. We compared the results from both echo-techniques and analyzed the relation of echo-cardiographic parameters with risk factors. Results. We found statistically significant difference between TDI and PW Doppler (E/E'vs E/A) in target (Z=−3.17, p<0.001) and control group (Z=−2.4, p<0.003). There was no significant difference in E/A between the groups (Z=0.0, p<1.0). TDI identified significantly lower E' (Z= 2.03, p<0.04) and higher E/E' (Z= −2.12, p<0.03) in target vs control group. LVDD strongly correlated with duration of DM (p<0.00001), age (p<0.00001), female gender (p<0.0001) and obesity indices (BMI, BSA) (p<0.00001, p<0.00001) in both groups. Conclusion. TDI unmasks the presence of subclinical LV dysfunction in asymptomatic diabetic patients and has a valuable prognostic importance.

scholarly journals Amiodarone-induced thyrotoxicosis: left ventricular dysfunction is associated with increased mortality

2006 ◽  
Vol 154 (4) ◽  
pp. 533-536 ◽  
Author(s):  
Anthony J O’Sullivan ◽  
Mridula Lewis ◽  
Terrance Diamond
Keyword(s):  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Treated Group ◽  
Left Ventricular ◽  
Graves Disease ◽  
Management Problem ◽  
Free Triiodothyronine ◽  
Free T4 ◽  
Severe Left Ventricular Dysfunction ◽  
Significant Difference

Objective: Amiodarone-induced thyrotoxicosis (AIT) is a challenging management problem, since patients treated with amiodarone invariably have underlying heart disease. Consequently, thyrotoxicosis can significantly contribute to increased morbidity and mortality. The aim of this study was to compare the clinical outcome and hormone profiles of patients with AIT (n = 60) with those with Graves’ thyrotoxicosis (n = 49) and toxic multinodular goitre (MNG, n = 40). Design: A retrospective study of patients with AIT in a single institution was conducted. Methods: Data from patients with AIT over 12 years were collected. Results: Mean TSH levels were significantly suppressed in all three groups. However, there was no intergroup significant difference. Free thyroxine (T4) levels were significantly higher in AIT (45.6 ± 3.5 pmol/l) and Graves’ disease (44.6 ± 4.0 pmol/l) compared with toxic MNG (31.5 ± 5.1 pmol/l, P < 0.05). In contrast, free triiodothyronine (T3) levels were only significantly higher in Graves’ disease (14.7 ± 1.5 pmol/l, P = 0.002) compared with AIT (8.6 ± 0.7 pmol/l) and toxic MNG (7.4 ± 0.5 pmol/l). Six deaths occurred in the patients with AIT (10.0%, P < 0.01) and no deaths occurred in the other groups. Amiodarone treatment (P = 0.002) was the most significant predictor of death, whereas free T4, free T3 and age did not affect outcome. Within the amiodarone-treated group severe left ventricular dysfunction (P = 0.0001) was significantly associated with death. Conclusions: (i) AIT differs from other forms of thyrotoxicosis, and (ii) severe left ventricular dysfunction is associated with increased mortality in AIT.

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