BACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The study was performed in Baghdad Teaching Hospital during the period between 2/2/2013 and 5/3/2014. History was taken from all patients and recoded using a specially prepared questionnaire paper. Left ventricular internal dimensions at end diastole (LVIDd) and end systole (LVIDs) were measured using M-mode echocardiography to asses left ventricular systolic function (ejection fraction). Pulse Doppler tracing of the transmitral flow velocities and tissue Doppler image (TDI) mitral annular velocities were obtained from the apical four-chamber view to assess left ventricular diastolic function. Doppler-derived dP/dt was determined from mitral regurgitation (MR) spectral flow RESULTS: The study included 50 patients (31 males and 19 females, mean age of 65.26 ± 5 years). Low dP/dt values were found in 42 patients (84%). Low dP/dt values were found more in the age group (51-60 yrs) (p value < 0.05). The mean age of patients with low dP/dt (<1000) was (65.62 ± 5yrs) and that of patients with normal dP/dt (≥ 1000) was (63.38 ± 5 yrs) with no significant difference (p value > 0.05). Low dP/dt value was significantly associated with smoking and positive family history and not significantly associated with male sex, hypertension, and diabetes mellitus. No significant association was found between low dP/dt value and type of presentation of acute coronary syndrome (p value > 0.05) or ejection fraction (p value > 0.05). It was significantly associated with LV diastolic dysfunction, left atrial size, left atrial pressure, and left ventricular size (p value < 0.05). CONCLUSION: The use of dP/dt is useful for evaluating left ventricular function in patients with acute coronary syndrome.
Background: Obesity is a public health concern worldwide associated with significant health risks and comorbid conditions. Obesity might be a strong factor that can induce left ventricular systolic dysfunction and eventually cause heart failure independent to coronary artery disease or other morbidities. In uncomplicated obese subjects, diastolic dysfunction is caused by hemodynamic and metabolic factors.
Objectives: To assess the left ventricular (systolic and diastolic) function in a sample of overweight and obese subjects using different Echocardiographic tools and exploring the percentage and type of diastolic dysfunction in those people.
Subjects and methods: one hundred seven (107) normal adult males subjects with a mean age
Background: Normal Left Ventricular systolic function is present in nearly 50% of patients with congestive heart failure, the majority of such patients have systemic hypertension. Recent studies have demonstrated Left Ventricular dyssynchrony among patients with heart failure and normal systolic function. The co-existence between Left Ventricular dyssynchrony and hypertension with normal systolic function (with no clinical evidence of heart failure) is less well understood.
Objective:
To assess the Left Ventricular dyssynchrony among hypertensive patients with normal systolic function by using Tissue doppler imaging.To find out the associations between the LV dyssynchrony and other global
... Show MoreBackground: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –Brachial Pressure Index (ABI) is a simple index related to the extent of atherosclerosis in coronary and noncoronary arterial beds, reflecting generalized atherosclerosis.
Objectives: the aim of this study is to evaluate the relation of ABI to left ventricular systolic function using echocardiography in patients with coronary artery disease (CAD).
Patients and Methods: Sixty seven patients (67) with CAD of either sex (70% males) with mean age 58± 6 years enrolled in this study, from December 2013 till May 2014; all were referred to the Iraqi Centre for Heart Disease (I.C.H.D.) for further evalua
Background: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
... Show MoreBackground : The contribution of diastolic dysfunction in patients with preserved left ventricular (LV) systolic function to impaired functional status and cardiac mortality in myocardial infarction (MI) is unknown.
Materials and Methods : Assessment of LV diastolic function was performed by Doppler analysis of the mitral and pulmonary venous flow and the propagation velocity of early mitral flow by color M-mode Doppler echocardiography in 150 consecutive patients at day 5-7 following their first acute MI.
Results : Patients were classified into four groups: group A: preserved LV systolic and diastolic function (n=59); group B: LV systolic dysfunction with preserved diastolic function (n=8); group C: LV diastolic dysfunction with
Background: Acute coronary syndrome refers to any group of clinical symptoms compatible with acute myocardial ischemia including unstable angina (UA), Non-ST-segment elevation myocardial infarction (NSTEMI) & ST-segment elevation myocardial infarction (STEMI).
Apelin is a novel endogenous peptide with inotropic and vasodilatory properties, it was recently reported that serum measurements of apelin were similar to its immunohistochemical data in vessels and heart tissues.
Objectives: This study aims to evaluate serum levels of apelin in patients with Acute Coronary Syndrome related to severity of presentation.
Patients and Methods: The present study was conducted during the period from September 2014 until March 2015. Fifty-n
Background: women with acute coronary syndrome have increased in-hospital morbidity & mortality as compared with men following percutaneous coronary intervention (PCI). It remains unclear if this difference secondary to the sex or other confounding variables.
Patients and Methods: We sought to examine the characteristics and outcomes of 71 consecutive women (49.2%) and men (50.7) undergoing PCI at The Iraqi Center of Heart Diseases from October 2005 to March 2006.
Results: There were significant differences in the baseline characteristics between both sexes. Women more frequently had SVD(single vessel desiease) (25.7% vs. 16.6%) and 2VD (37.1% vs. 16.6%) while Men wer
... Show MoreBackground: Assessment of function of the right side of the heart in cases of left ventricular dysfunction has been widely studied but the sensitive and specific echocardiographic parameter to be tested is still a matter of controversy. Right ventricular function is related to left ventricular function by ventricular independence so function of both should be assessed carefully. The objective of this study was to evaluate the effects of left ventricular systolic dysfunction on right ventricular systolic and diastolic functions and pulmonary pressure using conventional and tissue Doppler echocardiography. Patients and Methods: Sixty patients (39 males and 21 females) with heart failure due to left ventricular systolic dysfunction
... Show MoreBackground: Diabetes mellitus is a major risk factor for coronary artery disease, with a higher incidence of myocardial infarction and sudden death. Left ventricular dysfunction is difficult to diagnose and to differentiate into diastolic and systolic dysfunction on the basis of medical history, physical examination, electrocardiography (ECC) and chest radiography. Two-dimensional, M-mode, and Doppler echocardiography are excellent for diagnosing left ventricular dysfunction. M-mode echocardiography was used for diagnosing left ventricular systolic dysfunction, while Doppler echocardiography has become well accepted as a reliable, reproducible and practical noninvasive method for the diagnosis of left v
... Show MoreBackground:
Inflammation has been shown to play a role in atherosclerosis and acute coronary syndromes. An elevated total WBC count has been associated with increased cardiovascular
risk, but which leukocyte subtypes carry this risk. is uncertain. This study was designed to determine the effect of WBC count and other inflammatory markers on severity and
outcome of patients with UA/NSTEMI.
Patients and Methods:
Seventy (70) patients with UA / NSTEMI admitted to CCU at the Iraqi Center for Heart Diseases were subjected to thorough history and physical examination and WBC indices to
find their relation to clinical severity and outcome for both in-hospital and/month after discharge. The results were comp