M - Mode and doppler tissue imaging analysis of mitral annulus for detecation of pseudonormal mitral inflow pattern

This study was designed to assess whether M-mode and/or Doppler tissue imaging of mitral annulus are accurate parameters for the diagnosis of pseudonormal left ventricular [LV] diastolic pattern and the relation of these parameters to LV diastolic pressure measured during cardiac catheterization. The study comprised 30 patients [age 49.0 +/- 8.3 years, 14 males and 16 females]. All of them performed echocardiography to record transmitral flow velocity including E and A velocities, deceleration time of early mitral filling and IVRT. Patients with pseudonormal pattern were included in this study. M- mode of lateral aspect of mitral annulus was done. The amplitude Em and Am as well as slope E and slope A of early and late diastolic motion were measured

Interstitial pneumonitis: is it a major hidden criteria of rheumatic fever

Rheumatic heart disease still a major cause of acquired heart disease in developing countries. Dyspnea and palpitation are two major symptoms that disabling cardiac patients. However, these symptoms could not be attributed to the severity of cardiac affection. So, the aim of this work was to study the effect of rheumatic fever disease on children regarding the cardiac chambers and valvular lesions as well as pulmonary functions. Also, to study the relation between symptoms, cardiac structural changes and pulmonary functions in diseased patients and control children. The study included three groups of children: group I comprised 24 patients with rheumatic valvular lesions. Group II comprised 15 patients with MVP and past history of rheumatic fever and group III included 15 patients with normal heart as control. All of them were subjected to clinical examination, ECG recording, pulmonary function tests and doppler echocardiographic study. Their age ranged from 7 to 16 years old in the three groups. There was no significant difference between the three groups regarding their age, gender, height, weight, blood pressure and heart rate. Echocardiographic study revealed significant increase of LVIDs, LVIDd and left atrial dimension in group I than both group II and control group [p < 0.01, 0.01 and 0.00001 respectively]. Doppler parameters revealed increase of mitral flow "E" and "A" velocities only in group I. The pulmonary function tests revealed small airway obstruction with significant decrease of FEF[25-75], FEF[50], FEF[75] in both group I and group II than the control group [P<0.0001, <0.002, P<0.0001 respectively]. These changes occurred without changes of pulmonary vein velocities during doppler study. The prime cause of abnormal pulmonary function tests is due to the rheumatic fever pathology affection of parenchymal connective tissue that is beyond the cardiac hemodynamic changes. This raises several questions including; is interstitial pneumonitis a major hidden criteria of rheumatic fever?. Rheumatic fever still requires to be studied again thoroughly

Serum neopterin level in childerin with acute rheumatic fever

Acute rheumatic fever [ARF] is a systemic inflammatory disease thought that immune activation may play an important role in the pathogenesis of the disease. The objective of. this study was to investigate serum concentration of marker of immune activation [Neopterin], in acute rheumatic fever patients. The study included 30, patients, 16 of them with acute rheumatic fever diagnosed according to updated J Jone's criteria and 14 childern of matched age, sex, socioeco-nomic st and er and didn't suffer sore-throat or other infection as control group. All studied childern subjected for detailed history analysis, clinical examination, ECG and echocardiography. Blood sambles were examined for CBC.CRP, Asot, and Neopterin level before and after treatment before discharge from the hospital.Analysis of the two groups data was performed using Student Test. Neopterin marker were analysed in both groups and the associated correlation between them and the laboratory data were evaluated. All the patients had elevated sedimentation rate [mean +/- SD: 76.3 +/- 27.2 mm/h.]. Increased ASOT [mean +/- SD: 345.8 +/- 137.6 Todd's]. Colour Echo- Doppler detected single mitral valve disease in 5 patients, mitral valve prolapse in one patient, mitral and aortic valve affection in 8 patients. Affection of mitral, aortic and tricuspid valves were detected in two patients Neoptrein was assessed in both patient and control group, the mean value was 11.5 +/- 8.8 nmol/1 during acute rheumatic fever and decreased to 7.5 +/- 2.3, nmol/1 during follow up before hospital -discharge. While it was 5.3 +1.8 nmol/1 in control group. Neopterin differ significantly than control group either during acute stage [P<.0001] or before hospital discharge [P <.05]. In conclusion serum neopterin is increased in acute rheumatic fever reflecting activation of the cellular immune system. Higher serum neopterin concentration are associated with development of combined aortic and mitral insufficiency. Neopterin may allow assessment of severity of cardiac involvement and may present markers by which immunosuppression can be judged.

protective role of flavonoids on the cardiac muscle during the development of myocardial infarction

In this study, three common natural flavonoids [sour orange, sweet orange and salvia] known to have positive cardiotonic effect were chosen and their ability to inhibit apoptotic death of cardiac muscles and the extent that they could protect them during evolving myocardial infarction were tested. The three flavonoids influenced the apoptotic cell death. The elevated creatine kinase isoenzymes [CK MB] and lactate dehydrogenase [LDH] levels were significantly decreased. Also, the decrease in QRS volts and the increase in the heart rate, which were observed in cardiac infarction, were significantly improved. Thus, it was concluded that the three flavonoids, with variable degrees, influenced the apoptotic cell death in the cardiac muscle and protected the heart during evolving MI by decreasing the degree of tissue necrosis. Also, they can improve the performance of the heart and decrease the incidence of ventricular fibrillation

Helicobacter pylori infection as a risk factor for coronary heart disease

The work included 17 coronary diseased patients and 10 controls, their mean ages were 56.4 +/- 12 years vs 46.3 +/- 15.2 years, respectively. Electrocardiography, echocardiography, cardiac enzymes levels in blood, lipid profile together with IgG and IgA to detect Helicobacter pylori infections were done to both coronary heart disease and control groups. The results showed that H. pylori infections were detected in 41% of CHD patients and control group, respectively, while recent infections was detected in 47% of CHD patients, it was doubtful in 24% with no recent infection in 29% of them as showed by IgA. For the control group, none had recent infections and 20% of them were doubtful. H. pylori seropositivity was inversely related to the level of HDL in both the CHD and the control patients