Background: Gestational hypertension represents a transient period of elevated blood pressure with special effects on the maternal left ventricle that is different from the effects observed in chronic essential hypertension; it affects a previously normal heart and lasts for a maximum of nine months associated with volume and pressure overload on the maternal heart. Tei index (also called myocardial performance index) was found to be a dependent combined index evaluating the systolic and diastolic function of the left ventricle and represents a sensitive indicator for many types of heart diseases.
Objective: to evaluate the effects of gestational hypertension on the maternal myocardial function during the third trimester by measuring the Tie index using transthoracic echocardiography.
Method: This study was performed in Baghdad teaching hospital in the time period from November 2015 to August 2016. The study included a total of 150 women; 100 women had gestational hypertension, in the third trimester of a singleton pregnancy and with a mean age (29.83 ± 5.33 year), gestational hypertension was identified as elevated systolic or diastolic blood pressure over 140/90 mmHg that emerges after the
20th week of gestation with proteinuria level lower than 300 mg/dl. Another 50 normotensive pregnant women with singleton pregnancy and mean age (28 ± 3.18 year) were used as controls. Left ventricular mass index (LVMI) and relative wall thickness (RWT) were measured to find the type of hypertrophy in gestational hypertension. Ejection fraction (EF) was measured with 2D directed M mode echocardiography,
and isovolumic relaxation time (IVRT), isovolumic contraction rime (ICT) and ejection time (ET) were measured for both groups using pulse wave Doppler echocardiography in order to calculate the myocardial performance index which is also called “Tei index” and equals the sum of IVRT and IVCT divided by the
ET (Tei index = IVRT+IVCT/ET).
Results: Left ventricular mass index and relative wall thickness were significantly higher in gestational hypertensive women, 41% of gestational hypertensive women had normal geometry and 59% had abnormal geometry (34% eccentric hypertrophy, 19% concentric hypertrophy and 6% concentric remodeling). IVRT and IVCT were significantly higher in gestational hypertensive women with p value of 0.0001 and P =0.003. ET showed a non-significant lower values (p= 0.34) in gestational hypertensive women. Tei index
was significantly higher in Gestational hypertension (P=0.011).
Conclusion: Women with gestational hypertension had altered myocardial function characterized by the
higher Tei index values associated with eccentric hypertrophy which can be explained by the fact that gestational hypertension poses higher afterload on the left ventricle instead the state of low peripheral resistance that is ysually expected during normotensive pregnancy.
Background: Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease. Its morphologically divided into asymmetrical septal hypertrophy, symmetrical concentric hypertrophy and apical hypertrophy,and physiologically divided into obstructive HCM and non obstructive HCM according to the left ventricular outflow tract (LVOT) gradient at rest or with provocation. Several factors that increase risk of sudden cardiac death (SCD), the more risk factors a patient has, the greater the chance that the patient is exposed to sudden death and sufficient to warrant consideration for interventional therapy.
Objective: The aims of the study are to evaluate the clinical presentations, risk strat
... Show MoreBackground: Ejection fraction have been used frequently
for assessment of the left ventricular function, but can be
associated with errors in which myocardial performance
index have been used as another parameter to measure the
left ventricular function.
Objective: selecting another echocardiography parameter
for the assessment of myocardial in function instead of the
ejection fraction.
Methods: 160 patients referred to the echocardiogram unit
from the period december 2007 to august 2008 requesting
assessment of left ventricular function. After clinical
examination, routine blood tests; chest x-ray and
electrocardiographic recording have been completed. All
patients informed to come for this unit af
advancing age. The risk of cardiovascular disease in adults is lowest with systolic BP <120 mm Hg and diastolic BP < 80 mm Hg and increases progressively with higher systolic and diastolic blood pressures. Acupuncture (from the Latin word acus, “needle”, and pungere, meaning “prick”) is a technique in which the practitioner inserts fine needles into specific points on the patient’s body. Accupuncture could be used as a nonpharmacological way of controlling high readings of blood pressure among cases with essential hypertension. This study aimed to investigate the effects of acupuncture on essential hypertension.
Patients and Methods: 51 hypertensive patients of both genders and 30 normotensive control subjects were inv
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: 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
The current study is designed to achieve the goal of early detection of heart disease because it is the main risk of death. Some biomarkers were measured as well as the percentage of the effect of certain risk factors in people with myocardial infarction and heart failure. The study included 40 serum samples from people with heart disease. The effectiveness of the creatine kinase (CK-MB), as well as its temporal and albumin effects, as well as sodium ions in people with myocardial infarction and heart failure, were compared with the control group. as shown below:
-The first group consisted of 25 blood samples from people with myocardial infarction and 15 serum samples from people with heart failure. Blood
... Show MoreBackground: Hypertension from smoking is a chronic medical condition that impacts human health. It has been proved that it could be a significant risk factor for different disorders like brain damage, the lung disease and has been related to the growth of oral diseases. However, there are few and conflicting research on its effect on salivary electrolytes concentrations.
Aim of the study: To assess the effect of hypertension with and without smoking on electrolyte concentrations in saliva and to identify its effect on normal oral balance.
Methods: A total number of 90 subjects included, which is comprised of (49) (54.4 %) males subjects and (41) (45.6 %) females subjects in
... Show MoreBackground: Preeclampsia (PE) is a major cause of maternal morbidity and mortality, complicating 3-14% of all pregnancies. Although the etiology remains unknown, placental hypoperfusion and diffuse endothelial cell injury are considered to be the central pathological process; many endocrinological changes have been linked to the etiology of preeclampsia including parathyroid hormone and calcium level.
Objective: to compare serum parathyroid hormone and total serum calcium levels in mild and severe preeclampsia versus normal pregnancy.
Patients and methods: Serum parathyroid hormone (PTH) level and total serum calcium level were measured in thirty normotensive pregnant wom
... Show MoreBackground: Atherosclerosis causes thickening of the artery walls. The intima-media thickness (IMT) of the common carotid artery (CCA) is widely used as an early indicator of the development of coronary artery disease, atherosclerosis, and independently cardiovascular disease (CVD). Diabetes increased the risk of cardiovascular disease, also accelerates the common IMT progression. The Sonographic measurement of carotid intima-media thickness is used as a valid simple and noninvasive method for the assessment of atherosclerosis disease.
Also the ankle brachial index (ABI) is considered as a strong predictor for future cardiovascular events, and a golden standard for the diagnosis of peripheral arterial disease (PA
... Show MoreBackground: Artifact waves in the ECG and Holter recording are not rare in clinical practice and can be mistaken for tachyarrhythmia.
Objective: To orient the practicing physicians to differentiate these artifacts from cardiac arrhythmias.
Patients and Methods: Thirteen patients with incorrectly diagnosed cardiac arrhythmias by ECG or Holter recording then distinguished to be ECG artifacts were included in this study. The patients were collected from the author’s private practice in the northern Iraqi governorate of Sulaimanya during the period from June 2015 to August 2020. The differentiation of the artifact waves from the arrhythmias were made by careful inspection o
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