effect of heavy cigarette smoking on exercise performance of young apparently healthy sedentary Egyptian male volunteers

To study the effect of cigarette smoking on the treadmill exercise performance, 15 apparently healthy, sedentary, heavy smokers, Egyptian volunteer-men, at their 4th decade of life were examined before and during treadmill exercise test [TET] using USAFASM protocol [group I] and another 15 non smoker men [group II] who were closely matched to group I as regards their age, BMI, physical activity level and the absence of other coronary artery disease risk factors. Aerobic impairment [AI] was defined as inability to achieve 85% of the age predicted exercise capacity in METs. Chronotropic incompetence [CI] was defined as failure to achieve 90% of their age-predicted maximum heart rate. Results indicated that [AI] was present in 80% of smokers and 0% of nonsmokers P <0.001, CI was present in 46% of smokers and 13% of nonsmokers, P= 0.25. Compared to nonsmokers, smokers had exercise capacity of 5.5 METs less. Furthermore, the ratio of peak exercise systolic blood pressure [SBP] to the SBP during the 1st, 2nd and 3rd minute post-exercise was higher in smokers [0.97, 0.93, 0.89, respectively] than in nonsmokers [0.88, 0.83, 0.73, respectively]. On the other h and, the use of Duke Activity Scale Index [DASI] questionnaire before TET, could identify 92% of those smokers who had had Al at peak TET

Non-invasive assessment of pulmonary artery pressure in patients with isolated ventricular septal defect

Quantification of pulmonary artery pressure in patients with ventricular septal defect [VSD] is essential in clinical or surgical management. Systolic pulmonary artery pressure [SPAP] was estimated by 3 methods: Estimation of the pressure drop [DP] across VSD using continuous wave Doppler [CWD] guided by color flow mapping [CFM], pulmonary flow velocity curve, right ventricular isovolumic relaxation time [RVIT] using phonocardiography and tricuspid diastolic flow, then predicted SPAP is derived from Burstin's monogram. 35 patients aged 2-24 years [mean +/- SD 8.3 +/- 5.2] with VSD were studied by 2D echo-CWD/CFM within 72 hours of cardiac catheterization [CC]. The use of RVIT proved to be the best method to predict SPAP in the absence of severe TR. The other methods are effective when tricuspid regurgitation is severe

Assessment of the severity of mitral stenosis by using dobutamine stress echocardiography

The aim of this work was to analyze the hemodynamic response to dobutamine infusion in patients with pure mitral stenosis. The study included 20 patients [17 females, 3 males]. Their age ranged between 16 and 48 years [mean +/- SD 29.4 +/- 10.4 years]. The patients were classified according to their stroke volume response to dobutamine infusion into two groups: group 1 [8 patients] with increase more than 14% of stroke volume; group 2 [12 patients] with less than 14% or no change of stroke volume than resting value. Group 1 displayed significant increase in calculated MVA [P <0.05], with less mitral echo-score and sub-valvular affection, increase in the maximum and mean diastolic pressure gradients [85% increase] with less increase in calculated systolic pulmonary artery pressure [58% increase] and more increase of cardiac output [135%]. Group 2, their hemodynamic data revealed no significant change in their calculated MVA, more mitral echo-score and sub-valvular affection, less increase in the maximum and mean diastolic pressure gradients [56% and 55% increase, respectively], marked increase of systolic pulmonary artery pressure [94% increase] and less increase of cardiac output [33%]. In conclusion, the evaluation of rheumatic mitral stenosis depending on objective and real stress situations can be achieved easily with informative hemodynamic consequences by using dobutamine stress echocardiography. That offers great help for decision making concerning medical or surgical intervention

Echocardiographic study of left ventricular diastolic function in patients with chronic right ventricular enlargements

To determine whether abnormalities in left ventricular geometry due to right ventricular enlargement result in abnormalities in left ventricular diastolic filling pattern, the pulsed Doppler transmitral recording was obtained from 13 patients with right ventricular dilatation and right ventricular systolic pressure estimated to be <40 mmHg [group I], 22 patients with right ventricular dilatation and right ventricular systolic pressure >/40 mmHg [group II] and 8 normal subjects served as control group. Results were discussed in detail

Cardiac involvement in rheumatoid arthritis: doppler echocardiographic study

This study was carried out to evaluate and to explain the discrepancy between the low incidence of cardiac affection as reported before and the common patients' symptoms. 15 rheumatoid arthritis [RA] patients whose mean age was 33.8 +/- 13 years and 15 normal subjects with mean age 32.8 +/- 8 years were examined clinically, by ECG and Doppler study. RA patients revealed significant increase of their LVIDs than control. Mitral regurgitation was found in 50% of the patients, mild pericardial effusion in 20%, and one case presented by tricuspid regurgitation. Doppler study of LV diastolic function revealed impairment of its function in 80%. Half of these patients showed typical restrictive filling pattern, i.e. shortened IVRT, increased E velocity and shortened deceleration time. The remaining half revealed normal IVRT, normal or decreased E velocity, increased A velocity, A integral and A fraction. Cardiac involvement in rheumatoid arthritis as revealed by echo Doppler examination is common and requires close supervision. More attention should be directed to therapy regimen that may avoid these complications and their unfavorable outcome

Evaluation of tricuspid valve replacement by round prosthetic valve designed for mitral position

616.126-089.84 A retrospective study was carried out for evaluation of cardiac performance after tricuspid valve replacement with fixed round prosthetic valve designed for mitral position. Tricuspid valve replacement was done for 15 patients from 1990 to 1994 in the National Heart Institute. 8 patients had history of previous cardiac surgery. All patients presented with severe right sided congestive heart failure. They were preoperatively prepared for surgery with intensive medical therapy: Massive diuretics, correction of A/G ratio and blood picture. 2 patients died 5 and 12 months postoperatively from intractable congestive heart failure and prosthetic endocarditis. One patient was lost from follow-up. The remaining 12 patients were followed-up for a mean period of 23.6 months. Echocardiography was done 6 months after surgery. There was functional tricuspid stenosis with reduction of ejection fraction of the right ventricle in all cases. No thromboembolic manifestations were noted in this series in either mechanical or biological prosthesis

Study of coronary risk factor profile of the northern Cairo court's judges and estimation of their risk probability for coronary events during the next 10 years

The purpose of this work is to study the CAD risk profile of judges, and to calculate the percent probability of judge's risk for coronary events during the next 10 years using coronary risk assessor. The study population of this work consisted of 20 judges randomly selected working at Cairo Northern Court [group I] and 10 nonjudges employees working at the same court who were closely matched to group I by age, sex and BMI