scholarly journals The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

2017 ◽  
Vol 55 (2) ◽  
pp. 75-81
Author(s):  
Morteza Safi ◽  
Fariba Bayat ◽  
Zahra Ahmadi ◽  
Masood Shekarchizadeh ◽  
Isa Khaheshi ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Pressure Gradient ◽  
Mitral Stenosis ◽  
Normal Sinus Rhythm ◽  
Left Atrial Volume ◽  
Normal Sinus ◽  
Mean Pressure ◽  
Percutaneous Transvenous Mitral Commissurotomy ◽  
Pulmonary Arterial ◽  
The Mean

Abstract Background. The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters. Methods. Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram. Results. It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia. Conclusion. PTMC procedure leads to reduce the level of NT-pro-BNP. The change in NT-pro-BNP is an indicator for change in MS severity indicated by decreasing MPG parameter. Lower change in PAP as well as higher change in NT-pro-BNP is predicted following PTMC in the group with AF compared to those with normal sinus rhythm.

Atrial contribution to ventricular filling in mitral stenosis and normal sinus rhythm

1993 ◽  
Vol 1 (1) ◽  
pp. 63
Author(s):  
Jae Phil Kim ◽  
Yang Soo Kim ◽  
Heung Sun Kang ◽  
Chung Whee Choue ◽  
Kwon Sam Kim ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Ventricular Filling ◽  
Atrial Contribution

scholarly journals A study of spontaneous echo contrast in patients with rheumatic mitral stenosis and normal sinus rhythm: an Indian perspective.

Heart ◽  
1995 ◽  
Vol 74 (3) ◽  
pp. 296-299 ◽  
Author(s):  
R. R. Kasliwal ◽  
S. Mittal ◽  
A. Kanojia ◽  
R. P. Singh ◽  
O. Prakash ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Normal Sinus Rhythm ◽  
Spontaneous Echo Contrast ◽  
Rheumatic Mitral Stenosis ◽  
Normal Sinus ◽  
Indian Perspective

scholarly journals PAROXYSMAL ATRIAL FIBRILLATION OBSERVED ON 48 HOURS HOLTER MONITORING IN PATIENTS WITH SINUS RHYTHM ON ELECTROCARDIOGRAM

2021 ◽  
Vol 54 (2) ◽  
pp. 148-152
Author(s):  
Syed Haseeb Raza ◽  
Muhammad Sohail Saleemi ◽  
Ammar Akhtar ◽  
Kashif Ali Hashmi ◽  
Muhammad Zubair Zaffar
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Holter Monitoring ◽  
Cross Sectional Study ◽  
Male Dominance ◽  
Cross Sectional ◽  
Normal Sinus ◽  
The Mean ◽  
Written Informed Consent

Objectives: To find out the prevalence of undiagnosed atrial fibrillation and the risk factors associated with atrial fibrillation in patients with complaints of palpitations having normal sinus rhythm on electrocardiogram. Methodology: The descriptive cross-sectional study was carried out from 1st of January 2017 to 31st of December 2020 at Department of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan. All the patients presented with the complaints of palpitations for six months with normal sinus rhythm on standard 12 lead electrocardiogram were included in the study. After written informed consent, a Holter monitor was applied for 48 h. Data regarding gender, age, diabetes mellitus, hypertension, smoking, obesity, stable ischemic heart disease, valvular or nonvalvular structural heart defect and hyperthyroidism was collected on a preformed Performa for each patient. Presence of atrial fibrillation was noted on Holter monitoring. Results: Total 1891 patients were studied over the period of 4 years. The mean age of the studied population was 55.99 ±16.28 years. There was male dominance with 70.3% (n=1329) males and 29.7% (n=562) females. 12.50% (n=236) patients had been diagnosed with atrial fibrillation on Holter monitoring. Age group of patients with age more than 75 years has high burden of atrial fibrillation (31.34%). Conclusion: A large number of studied population has been diagnosed with atrial fibrillation on Holter monitoring who presented with palpitation and have normal sinus rhythm on electrocardiogram.

Correlates of spontaneous echo contrast in patients with mitral stenosis and normal sinus rhythm

1994 ◽  
Vol 128 (2) ◽  
pp. 287-292 ◽  
Author(s):  
Neil E. Bernstein ◽  
Laura A. Demopoulos ◽  
Paul A. Tunick ◽  
Barry P. Rosenzweig ◽  
Itzhak Kronzon
Keyword(s):  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Normal Sinus Rhythm ◽  
Spontaneous Echo Contrast ◽  
Normal Sinus

Abstract 217: Are Discharge Rate Control Medications Adequate for Future Atrial Fibrillation Needs?

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Katherine E White ◽  
William H Carter ◽  
Shabnam Tiwari ◽  
Elaine Davis ◽  
Suzanne Kemper ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Rate Control ◽  
Normal Sinus Rhythm ◽  
Symptom Control ◽  
Rapid Rate ◽  
Single Center ◽  
Normal Sinus ◽  
The Mean ◽  
One Year

Background: Rate control medications (RCM) for atrial fibrillation (AF) usually prescribed are diltiazem (DTZ) and beta blockers. Patients entering the Emergency Department (ED) with AF often convert to a normal sinus rhythm (NSR) by means of spontaneous conversion to normal sinus rhythm (SCNSR), electrical cardioversion, or medications. However, recurrent AF often leads to repeat ED visits and frequent hospitalizations within one year. Goals: To evaluate admission and discharge metoprolol (MTP) and DTZ doses for patients presenting to the ED with rapid AF. Methods: Retrospective, single center chart review of MTP and DTZ doses on admission and discharge for patients admitted with a primary diagnosis of AF. Patients who received new or an increase of other RCMs, or antiarrhythmic medications with RCM properties were excluded. Results: Of 402 patients, 310 (77%) had a heart rate ≥110 bpm on admission. Of those with a rapid rate, 235 (76%) converted to NSR after admission predominantly due to SCNSR. The mean daily dose of MTP was 61mg on admission and 65mg at discharge. The mean DTZ dose on admission was 188mg and 157mg at discharge. Discussion: The discharge doses of 65mg of MTP and 157mg of DTZ were well below the recommended doses of RCMs for AF. The RATAF trial demonstrated adequate rate and symptom control with MTP 100mg/day and DTZ up to 360mg/day. The current study demonstrated significant under dosing of RCMs to manage future rapid ventricular rate. It is possible patients with rapid ventricular rates who convert to NSR, which by itself, results in rate control, would not have attention by the provider focused on the rapid admission rate. Most patients who convert to NSR do not have the substrate leading to AF corrected. Thus, it is not surprising recurrence of AF, regardless of the method of cardioversion, occurs in approximately 70% of patients within one year. It is likely when AF recurs it will have the same rapid rate unless RCMs are increased before discharge from the first initial admission dose. It is possible at discharge an order set may lead to a more logical assessment of targeted RCMs. Lack of long term follow-up to address outcome of apparent under dosing of RCM is a limitation. Conclusion: This single center study found no significant increases in MTP and DTZ dosing at the time of discharge for patients with rapid AF who reverted to NSR after admission. It is possible that modification of RCMs before hospital discharge may decrease future ED admission for symptomatic AF.

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