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We assessed the Right Ventricular (RV) systolic function using two dimensional (2D) speckle tracking echocardiography (STE) in Mitral valve disease before and after intervention. 90 patients divided into 3 groups of Mitral stenosis [MS], Mitral regurgitation [MR] and MS with MR were the study subjects. All the patients were subjected to conventional echocardiography and measurement of Right ventricular global longitudinal strain (RVGLS). Prior to intervention, subjects who demonstrated normal RV function by conventional methods, it was found that RVGLS was impaired significantly in the MS and MS with MR groups but normal in the MR group. After intervention, the RVGLS improved significantly in the MS group but not in the other groups. Right ventricular systolic pressure (RVSP) had a significant negative correlation to RVGLS in all 3 groups.We studied awareness, treatment and control of hypertension and factors associated with hypertension prevalence in Barmer district, Rajasthan. A cross-sectional study was conducted among 300 adults aged ≥ 30 years. Data were collected using a modified World Health Organization STEPs tool. Bivariate and multivariate analyses were done to find the factors associated with hypertension prevalence. Hypertension and pre-hypertension prevalence were 22.0% and 50.7% respectively. A quarter (27%) was aware, 25% were on treatment and 9% achieved adequate control of hypertension. Hypertension prevalence was significantly higher among men, older adults, overweight adults and those reported higher income compared to their counterparts.
Accurate estimation of fluid status is paramount in patients with heart failure. Lurbinectedin price We hypothesized that bedside ultrasound assessment of the internal jugular vein (IJV) and subclavian vein (SCV) could reliably estimate right atrial pressure (RAP).
Prospectively enrolled patients were positioned supine. IJV was imaged at the apex of the right sternocleidomastoid muscle and SCV was imaged at the lateral third of the right clavicle. Using M-mode on a portable ultrasound machine, the maximum (D
) and minimum (D
) anteroposterior diameters were noted during normal breathing. Respiratory variation in diameter (RVD) was calculated as [(D
- D
)/D
] and expressed as percent. Collapsibility was assessed with sniff maneuver. Patients then underwent right heart catheterization and their findings were correlated with above.
Total of 72 patients were enrolled with mean age 61 years, mean BSA 1.9m
, and left ventricular ejection fraction 45±20%. Elevated RAP≥ 10mmHg was associated with dilated IJV D
(1.0 vs. 0.7cm, p=0.001), less RVD with resting respiration (14% vs. 40% for IJV, p=0.001 and 24% vs. 45% for SCV, p=0.001), and reduced likelihood of total collapsibility with sniff (16% vs. 66% patients for IJV, p=0.001 and 25% vs. 57% patients for SCV, p=0.01). For RAP ≥10mmHg, lack of IJV complete collapsibility with sniff had a sensitivity of 84% while IJV D
> 1cm and RVD <50% had a specificity of 80%.
The IJV and SCV diameters and their respiratory variation are reliable in estimating RA pressure.
The IJV and SCV diameters and their respiratory variation are reliable in estimating RA pressure.The prognostic value of atrial thrombi (AT) among elective patients with atrial fibrillation (AF) referred for a rhythm control strategy is unclear. In this study, clinical variables were correlated with the presence of AT and long term survival among 205 patients submitted to transesophageal echocardiography before elective AF cardioversion or ablation. Atrial thrombi were present in 7.8% of cases and were significantly associated with reduced survival. Obesity was the only independent clinical predictor of AT [OR 4.27 (1.15-15.79), p = 0.03]. In patients with AF, AT appear to be associated with adverse outcomes, possibly indicating more advanced atrial cardiomyopathy.The benefits of CRT in select subsets of systolic heart failure patients with LBBB are proven. We prospectively evaluated conventional and newer echocardiographic parameters of left ventricular dyssynchrony in 35 patients who underwent CRT and were followed up after 6 months. Of the 33 surviving patients, 21 were echocardiographic responders and 24 were clinical responders. The parameters in clinical responders and non-responders were compared. The anatomic M Mode parameters of delays improved, while the radial strain and the mitral valve velocity time integral (MVVTI) did not show any significant change after CRT.Radiation exposure during electrophysiology procedures has been a point of discussion. We measured the ionising radiation dosage during ablation procedures for supraventricular tachycardia. This was compared with coronary angiographies performed via the radial route to put it in perspective. We found that the radiation dosage during the ablation procedure was far lower, less than forty percent of that during coronary angiography (Air Kerma 249.1 mGy ± 266.95 mGy v/s 671.9 mGy ± 328.6 mGy; p less then 0.001).Links between periodontitis and atherosclerosis can be predicted based on inflammatory mechanisms initiated by bacteria associated with periodontal lesions, which then influence the initiation or propagation of the atherosclerotic lesion. This study aimed to detect the presence of three periodontal pathogens, in atheromatous plaques of patients with coronary artery disease. Subgingival and atherosclerotic plaque samples were obtained from 80 patients scheduled for CABG or angioplasty. A nested PCR was done for the detection of the pathogens in the plaque samples. Porphyromonas gingivalis, Tanarella forsythia, and Treponema denticola were detected in 10%, 12.5%, and 1.3% of the atherosclerotic plaque samples respectively. It was also observed that patients whose atherosclerotic plaques tested positive for one or more of the pathogens had chronic periodontitis.Increasing evidence suggests that apelin and ghrelin may participate in atherogenesis. We sought to investigate whether the serum levels of apelin and ghrelin are significantly different in patients with coronary artery disease (CAD) compared to patients with nonsignificant coronary stenosis and determine the correlation between these adipokines and the severity of coronary stenosis. The study population included 31 stable CAD patients, 38 unstable CAD patients, and 39 non-CAD subjects. Serum levels of apelin and ghrelin, fasting blood glucose, lipid parameters, hs-CRP and hematological indices were determined in all groups using routine standard laboratory procedures. Serum apelin levels were significantly lower in patient with unstable CAD (0.354 ± 0.063 ng/mL) compared to stable CAD patients (0.401 ± 0.045 ng/mL, p = 0.003) and non-CAD subjects (0.415 ± 0.055 ng/mL, p less then 0.001). In addition, serum apelin levels were inversely correlated with the severity of coronary stenosis in CAD patients (p less then 0.
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