EFFECT OF EECP (ENHANCED EXTERNAL COUNTER PULSATION) ON LEFT VENTRICULAR FUNCTION AS MEASURED BY ECHOCARDIOGRAPHY USING STRAIN.

2021 ◽  
pp. 50-53
Author(s):  
Sama Akber ◽  
M . Chokkalingam ◽  
G. Ashok ◽  
Durga Devi
Keyword(s):  
Coronary Revascularization ◽  
Left Ventricular ◽  
Epidemiological Transition ◽  
Common Symptom ◽  
Age Group ◽  
Elderly Age ◽  
Coronary Anatomy ◽  
The World ◽  
Artery Disease ◽  
Repeated Revascularization

India stands as one of the fastest developing countries in the world. It has entered quickly into an epidemiological transition leading to a 1 phenomenal increase in non-communicable diseases . Of them leading the way is coronary artery disease. 0 It has been estimated that 4 lakh 2 deaths a year are attributable to cardiovascular disease. The most common symptom in CAD is angina pectoris. The treatment for angina includes medical therapy and coronary revascularization by PTCA or CABG. However, a large number of these patients are not suitable to the usual procedures due to unfavorable coronary anatomy, repeated revascularization attempts, elderly age group, associated comorbidities and patient's preference.

Myocardial revascularization: symptomatic and prognostic indications

ESC CardioMed ◽  
2018 ◽  
pp. 1393-1395
Author(s):  
Jean-Claude Tardif ◽  
Philippe L. L’Allier ◽  
Fabien Picard
Keyword(s):  
Coronary Artery ◽  
Medical Therapy ◽  
Coronary Revascularization ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Optimal Medical Therapy ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Large Area ◽  
Artery Disease

The primary goal of therapy in patients with chronic ischaemic heart disease is to relieve symptoms, delay or prevent progression of coronary artery disease, and decrease the risk of major adverse cardiovascular events. This is primarily achieved with optimal medical therapy. When coronary revascularization is considered, symptomatic and prognostic indications must be differentiated. For symptomatic indications, revascularization is justified if there is a large area of inducible ischaemia or if there is persistent limiting angina despite optimal medical therapy. The key prognostic indications for revascularization are left main disease with stenosis greater than 50%, any proximal left anterior descending artery stenosis greater than 50%, two-vessel or three-vessel disease with stenosis greater than 50% with impaired left ventricular function (left ventricular ejection fraction <40%), a large area of ischaemia (>10% of the left ventricle), or a single remaining patent coronary artery with stenosis greater than 50%.

scholarly journals Clinical profile and outcome of organ dysfunction in sepsis

2018 ◽  
Vol 6 (6) ◽  
pp. 1927
Author(s):  
Laxmikanta Dash ◽  
Lagendra Kumar Singh ◽  
Malati Murmu ◽  
Susruth Krishnadas P. ◽  
Amita Kerketta ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Clinical Profile ◽  
Apache Ii Score ◽  
Common Symptom ◽  
Age Group ◽  
Elderly Age ◽  
Female Ratio ◽  
Common System ◽  
Source Of Infection ◽  
Life Threatening

Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%. 

scholarly journals Prognostic implications of left ventricular mass-geometry in patients with no or nonobstructive coronary artery disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
You-Jung Choi ◽  
Jun-Bean Park ◽  
Chan Soon Park ◽  
Inchang Hwang ◽  
Yeonyee E. Yoon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Survival Rates ◽  
Left Ventricular ◽  
Nonobstructive Coronary Artery Disease ◽  
Luminal Narrowing ◽  
All Cause Mortality ◽  
Prognostic Implications ◽  
Artery Disease

Abstract Background Coronary computed tomography angiography (CCTA) is widely used as a first-line noninvasive modality that frequently exhibits no or nonobstructive coronary artery disease (CAD) in clinical practice, along with abnormal left ventricular (LV) geometry on echocardiography. However, the combined prognostic value of these findings has not been well elucidated. Therefore, we aimed to evaluate the prognostic implications of abnormal LV geometry in individuals with no or nonobstructive CAD. Methods A total of 5806 subjects with no CAD or nonobstructive CAD (luminal narrowing < 50%) on CCTA were included in the study. The major exclusion criteria were structural heart disease and a history of myocardial infarction or coronary revascularization. Abnormal LV geometry on echocardiography was defined as LV mass index > 95 g/m2 in women and > 115 g/m2 in men, and/or relative wall thickness > 0.42. The primary outcome was all-cause mortality. Results A total of 5803 subjects without significant obstructive CAD (age, 56.6 ± 8.87 years; men, 3884 [66.9%]). Of them, 4045 (69.7%) subjects had normal LV geometry and 1758 (30.3%) had abnormal LV geometry respectively. During a mean follow-up of 6.2 ± 1.48 years, 84 (1.44%) subjects died in the study population. Of these, 56 subjects were from the normal LV geometry group (1.24%) and 28 were from the abnormal LV geometry group (2.32%). Subjects with abnormal LV geometry had significantly worse survival rates (log-rank, p < 0.001). After adjustment for confounding factors, abnormal LV geometry was an independent predictor of all-cause mortality (adjusted hazard ratio, 1.64; 95% confidence interval, 1.04–2.58; p = 0.034). Moreover, abnormal LV geometry was significantly worse in survival when classified as those with no CAD (log-rank, p = 0.024) and nonobstructive CAD (Log-rank, p < 0.001). Conclusions Abnormal LV geometry portends a worse prognosis in subjects with no or nonobstructive CAD. These findings suggest that LV geometry assessment can help improve the stratification of individuals with these CCTA findings.

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