Background: 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 evaluation and management. The ABI for each leg was calculated by dividing the lowest value of the ankle systolic blood pressure (SBP) (over both dorsalis pedis and posterior tibial arteries) by the highest value of either brachial SBP by using a Doppler ultrasound. The lower of the two values was used to define the patient ABI. The ejection fraction (EF) % and fractional shortening (FS) % were determined by using trans-thoracic echocardiography. Participants were divided into two groups according to ABI results: Group І: 29 patients with abnormal low ABI (ABI ≤ 0.90) with ABI mean of 0.79±0.12 and Group ІІ: 38 patients with normal ABI (0.9< ABI ≤1.30) with ABI mean of 1.03±0.10 as a control group.
Results: There were no statistically significant differences in statistics between the two groups regarding risk factors for atherosclerosis. EF% was significantly lower in group I than those in group II in such a way that the mean values of EF% was 53.41±14.72 for group I vs. 63.11±8.93 for group II with the p value = 0.003. Also ABI is correlated with the severity of left ventricular systolic dysfunction.
Conclusion: ABI is a useful bedside clinical test that predicts and assess left ventricular systolic dysfunction in patients with coronary artery disease.
Background: 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: Endothelial dysfunction is thought to be a key event in the development of atherosclerosis. It is a systemic process that simultaneously affects different vascular territories including coronary arteries. It is recommended that noninvasive approaches assessing endothelial function in peripheral vessels like flow mediated dilatation are indirectly representative of coronary vascular function.
Objectives: This study is aimed to assess endothelial dysfunction by using flow mediated dilatation in patients with coronary artery disease
Patients and methods: 82 patients of either sex with an age range of 40-65years are involved in this study. Each patient was subjected to two tests; first test was the flow mediated dilatation
Background: revascularization therapy for patients with left main (LM) and/or three vessel coronary disease is a matter of argument for long a time whether bypercutaneous coronary angiography orcoronary artery bypass grafting. SYNTAX trial was designed to assess the optimal revascularization strategy between percutaneous coronary intervention and coronary artery bypass grafting, for patients with left main stem coronary artery disease and/or 3-vessel coronary disease.
Aim: To estimate the complexity of coronary artery disease in patients referred to a tertiary Iraqi cardiac center and its effect on mode of revascularization.
Patients and Method: Ninety nine patients who w
... 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: 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: Coronary artery bypass graft is routinely performed on an arrested heart using cardiopulmonary bypass with aortic cross clamping and Cardioplegia. Off-pump coronary artery bypass graft (OPCABG) is being increasingly used in selected cases as an attempt to decrease morbidity and mortality.
Objective: The main objective of this study is to clarify those patients who are indicated for OPCABG despite it is surgically demanding technique and to evaluate the mortality and morbidity associated with such procedures.
Patients and methods: It is a retrospective study of 28 patients with coronary artery disease, in need for coronary artery bypass graft admitted and surgically treated at the Iraqi Centre fo
Background: 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: Acute phase proteins which include C-reactive protein (CRP) and haptoglobin (Hp) are associated with inflammatory diseases such as injury, infection or malignancy, cardiovascular disease and obesity. Atherogenic index of plasma (AIP) evaluated as the atherogenicity index is correlated with different diseases.
Objective : The study was to investigate hs-CRP and Hp concentration in Iraqi patients with coronary artery disease (CAD) and calculate AIP which predicts this disease.
Subject and Method: The study included 64 subjects (39 patients with CAD and 25 healthy subjects as a control group). The markers of inflammatory hs-CRP and Hp levels were measured. Lipid profile (Total cholesterol TC,
Background : Left main coronary artery (LMCA) disease represents important and serious portion of coronary artery disease(CAD).
Aim: The aim of this study is to estimate the incidence of LMCA disease among patients with CAD undergoing coronary artery angiography and to evaluate clinical characteristics of patients with LMCA disease.
Methods: The study involved review of clinical notes and coronary angiography of 1020 patients with CAD in Ibin Al Bitar hospital for cardiac surgery between April and September 2004.This review included evaluation of electrocardiogram (ECG), echocardiogram(ECHO), ECG exercise test (EET) and coronary angiography.
Results: Among 56 patients proved to have left main corona