High sensitive C-reactive protein as a predictor of acute heart failure in acute myocardial infarction

The development of heart failure in the setting of acute myocardial infarction [AMI] results in significant risk far above that of AMI. lndependently CRP level in the early phase of MI might be a simple marker for the magnitude of the inflammatory response to myocardial necrosis, potentially providing prognostic information regarding he risk of death and HF. However, it is not known whether inflammation plays a role in the time-course of heart failure [HF] in this clinical setting. Our aim was to study the relationship between high CRP levels and HF progression during the first week of hospitalization for AMI. This study included 59 patients admitted with acute myocardial infarction to the coronary care unit of the Suez Canal University hospital. CRP was assessed on the third and seventh day after admission. 42% of the study population developed heart failure. Among the patients with AMI, CRP was significantly higher in patients with HF than in patients without HF at .admission, after 48 hours and after 7 days of admission p=0.0001 and p=0.000 and p=0.001 respectively]. Prevalence :HF was significantly higher on admission in patients with isitia1 CRP serum level

Non-invasive predictors of functional capacity in patients with systolic heart failure

Heart failure [HF] is a major health problem facing the population and development all over the world. Selection of patients with heart failure that are at higher risk and in need for more aggressive and interventional modalities in treatment is needed to improve the outcome of HF patients. The functional capacity of HF patients is a good indicator of the patients' clinical status and response to therapy. Therefore, non-invasive predictors of the functional capacity in patients with HF will be useful in determining patients with low functional capacity, worse clinical status and thus at higher risk. 51 patients of either sex, aged 18 years or above attending Suez Canal University Hospital Cardiology outpatient clinic known to have depressed left ventricular [LV] systolic function "Ejection fraction [EF]

Assessment of autonomic activity in patients with rheumatic mitral stenosis

Mitral stenosis [MS] may increase sympathetic nervous activity by increasing left atrial pressure and decreasing cardiac output. Consequently, increased sympathetic nervous activity may be a risk factor for the development of clinical manifestations and complications of mitral stenosis. Thus, we aimed in this study to assess the sympathetic nervous activity in patients with rheumatic mitral stenosis using heart rate variability analysis and to define factors affecting autonomic function in those patients. The study was conducted upon thirty-one consecutive patients with rheumatic mitral stenosis in sinus rhythm attending cardiology outpatient clinics and another thirty-one normal controls matched for age and gender, and continued from April-2005 until April-2006. Heart rate variability [HRV] analysis was performed in both groups; with full clinical and echocardiographic assessment performed in mitral stenosis patients. Mean N-N interval [Mean NN], standard deviation of all N-N intervals [SDNN], number of N-N intervals that differ by more than 50 milliseconds from adjacent interval divided by the total number of all N-N intervals [PNN50], and high frequency power [HF] were lower; and low frequency power [LF] and low frequency-to-high frequency ratio [LF/HF ratio] were higher in patients with mitral stenosis as compared to their normal counterparts. HRV parameters favoring sympathetic overactivity were found to be significantly correlated to a tighter mitral valve area, higher mean trans-mitral gradient, wider left atrial diameter, higher systolic pulmonary arterial pressure, increased severity of dyspnea and overall duration of patients' symptoms. Thus, sympathetic nervous activity is increased in patients with mitral stenosis and sympathetic overactivity worsens their symptoms. Most significant factors that affect autonomic function in those patients are mitral valve area, mean transmitral gradient, left atrial diameter, and systolic pulmonary arterial pressure