ABSTRACT
Objective: In India, the commonest cardiovascular ailment encountered in hospitals is rheumatic heart disease, mitral valve being most commonly affected. Rheumatic mitral valve disease affects left-ventricular performance as a result of myocardial and functional factors. This study is aims to review the use of Tissue Doppler Echocardiography over conventional echocardiography in assessment of ventricular functions in patients having rheumatic heart disease. Material and Methods: This is a cross sectional study carried out at Shree Sayajirao General Hospital and Medical College Baroda. Total of 35 patients with an established diagnosis of rheumatic MS, and 30 age-matched healthy individuals were included in this study. Echocardiography equipped with TDE function was performed on each participant. The mitral valve area, gradient across mitral valve, Left atrial size, ejection fraction, isovolumic contraction time of ventricles, myocardial velocity of ventricular walls were measured. Discussion: The average age of study population was 33 years with 57% females patients and 43% males patients. There was maximum correlation between Systolic myocardial velocity and ejection fraction calculated by Simpson’s Four Chamber method . Regional distribution of systolic dysfunction occur in rheumatic mitral valve disease with maximum maximum affection of posterior and lateral wall and minimal affection of interventricular septum. LV systolic and diastolic dysfunction can occur in pure mitral stenosis independent of severity of mitral stenosis & Tissue Doppler echocardiography appears to be feasible in the prediction of subclinical LV dysfunction.
ABSTRACT
Objective: Use of ART in HIV infected individuals’ results in reduced mortality and morbidity associated with AIDS. Long term complications of HIV & ART including dyslipidemia & dysglycemia have raise concern regarding accelerated cardiovascular risk in these patients. Aim of study is to determine prevalence of dyslipidemia & dysglycemia in HIV infected patients and its relation to CD 4 count. Material and Methods: A cross sectional two arm comparison study carried out at Shree Sayajirao General Hospital and Medical College Baroda. The treatment arm, ON ART arm, constituted 30 patients already on ART defined as a combination of at least three classes of antiretroviral drugs, namely PIs, NNRTIs and NRTIs, one of which was a PI or an NNRTI ,or a triple combination of NRTIs. Comparator arm, ART naïve arm constituted 30 HIV-positive patients, eligible for, but not yet receiving ART. Dyslipidemia & dysglycemia were defined as high total or LDL cholesterol, high triglycerides, or low HDL cholesterol according to the adult treatment panel III (ATP III) guidelines and as the presence of diabetes , impaired fasting blood sugar(FBS) , impaired post prandial blood sugar(PP2BS) or impaired glucose tolerance according to ADA (American diabetes association)criteria ,respectively. Discussion: Dysglycemia was present in 30% of study population and dyslipidemia was present in 73.33% of study population. Difference in elevation of serum Cholesterol level and serum LDL level in patients on ART arm was statistically significant. Dysglycemia and dyslipidemia was associated with low CD 4 count compare to patients with normal blood glucose level and normal lipid profile level.