Early outcome of concurrent mitral valve replacement and coronary artery bypass grafting

Concomitant coronary artery bypass surgery [CABG] in patients undergoing mitral valve replacement [MVR] has been shown to be an important risk factor for hospital mortality. We evaluated preoperative characteristics, postoperative complications, in-hospital mortality rate, and length of stay in hospital for patients undergoing concurrent CABG with MVR. Preoperative and postoperative clinical data from 175 patients undergoing concurrent CABG with MVR operation at Tehran Heart Center from 2002 through 2006 were collected and entered into a database. Information was obtained by clinical and case note review as well as detailed questionnaires to physicians and patients. Mean age of patients was 57.95 +/- 10.54 years and 51.4% were male. Mean New York Heart Association [NYHA] score was 2.46 +/- 0.84. Among studied patients, 18.3% and 2.9% underwent aortic and tricuspid valve replacement, respectively. In-hospital mortality was 6.9% and 96.0% of patients were hospitalized >/= 14 days. History of congestive heart failure [P = 0.027] and postoperative brain stroke [P = 0.004] were independent predictors for in-hospital mortality. Exact considering of congestive heart failure and postoperative brain stroke related to in-hospital mortality in concurrent CABG with MVR operation are necessary

Hypertriglyceridemia and low HDL-cholesterol are the major lipid abnormalities in normal Pakistani adults: are these contributing to the high rates of coronary artery disease in this population?

Objective: Lipid abnormalities are related to enhanced risk of developing cardiovascular disease. The objective of the study was to investigate variability in lipid profile in Pakistani normal adults [from the personnel of 4 tertiary care hospitals] by age, gender, body mass index [BMI] and smoking, and to determine the prevalence of hypertriglyceridemia, hypercholesterolemia, low HDL-cholesterol and isolated low HDL-cholesterol in this population

Method: Serum samples from 323 normal healthy subjects [236 males and 87 females, age 30-70 years] from the personnel of the Aga Khan University, Civil Hospital, Karachi, Armed Forces Institute of Cardiology and Military Hospital, Rawalpindi were analyzed for total cholesterol, HDL-cholesterol and triglycerides using kit methods. LDL-cholesterol was determined using the Friedewald formula

Results: Mean +/- SD concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were found to be 165+/-37 mg/dl, 37+/-11.5 mg/dl, 98+/-34 mg/dl and 155 +/- 88 mg/dl, respectively. Mean levels of total cholesterol were found to be significantly higher in hypertriglyceridemia [>200mg/dl] than normotriglyceridemia [181+/-30 mg/dl vs 160+/-38 mg/dl; p=0.001]. Mean concentration of HDL-cholesterol in the younger age group [50 years] group [39.6+/-11.7 mg/dl vs 33.4+/-9.7 mg/dl; p=0.001]. Similarly, mean concentration of HDL-cholesterol in females was significantly higher compared to males [44.3+/-14 mg/dl vs 34.9+/-9.1 mg/dl; p=0.001]. In hypertriglyceridemia [>200 mg/dl], mean HDL-concentration was significantly lower compared to normotriglyceridemia [33.4+/-8.3 mg/dl vs 38.9+/-12 mg/dl; p=0.001]. The combined effect of age, gender and triglyceridemia was found to be significantly associated with HDL-cholesterol concentration [p25], triglyceride levels were significantly higher compared to those with BMI<25 [180+/-107 mg/dl vs 144+/-71 mg/dl; p=0.001]. Levels of triglycerides were, therefore, significantly associated with gender and BMI [p<0.001; R2 =0.076]. LDL-cholesterol levels were not found to be significant by age, gender, smoking, BMI and triglyceridemia. Smoking had no significant effect on lipid levels of male healthy subjects. Frequencies of hypercholesterolemia, hypertriglyceridemia, low HDL-cholesterol and isolated low HDL-cholesterol were found to be 17.6%, 26.9%, 45.8% and 29.4%, respectively. High prevalence values of low HDL-cholesterol and isolated low HDL-cholesterol are reported for the first time in Pakistani normal adults and require further studies at the community level

Conclusion: High levels of triglycerides and low levels of HDL-cholesterol are the most prominent abnormalities in Pakistani adults working in tertiary health care centers

Non-invasive assessment of 100 normal males

Wide variety of techniques, both invasive and non-invasive, are used to asses the Cardiovascular functions. The invasive techniques, do cause some discomfort to the patients and to some extent some of them carry certain percentage of risk to life. The non invasive techniques have been in use for long and do not cause any discomfort to the patient and carry no risk. The objective of this study is to have cardiac cycle date available for our population

Non-invasive assessment of 42 cases of dilated cardiomyopathy [idiopathic]

Over the past thirty years the new techniques of biotechnology have touched most of the recalcitrant problems in the cardiac diagnosis. Non-invasive assessment of 42 cases of Idiopathic Dilated Cardiomyopathy by using ECG, PCG, ACG and Carotid pulse wave, are presented here. The diagnosis of Idiopathic dilated cardiomyopathy was done by exclusion. Endomycardial biopsies and Angio studies of these cases were not be done. The age varied from 3-50 yrs with mean of 24 +/- 14. 3 SD and male: female ratio was 3:1. STIs show incease in CMI [Mean-49 +/- 10 SD], QMl [Mean-91 +/- 10 SD] PEP/LVET ratio [Mean - 66 +/- 14 SD], C-Ml/M1-E% [Mean-159 +/- 55 SD]. STIs shows decrease in Ml-E [Mean 34 +/- 13 SD], LVET [Mean-197 +/- 38 SD], EF [Mean-36 +/- 13 SD] and Ml-A2 [Mean-231 +/- SD] with no change in Q-A2 interval. DTIs show increase in A2-MI [Mean-278 +/- 26 SD], OF/EO ratio% - [Mean 27 +/- 18 SD], CMl-OF [Mean 8 +/- 16 SD], OF/SFW% [Mean-133 +/- 46 SD] and a/EO% - [Mean-18 +/- 9 SD]. ACG shows early change of slope, prominent F-wave, sharp E-point, LSB and increase in 1/2 time RR%. Carotid pulse wave shows prominent dicrotic wave, normal 1/2 time RR% and lower normal rate of rise