Relationship of Off-Pump Coronary Artery Bypass Surgery with the Cardiac Enzyme Troponin T, LVEF, TAPSE and Post-Operative Recovery.

Cardiovascular diseases (CVD) are the leading cause of death globally including India. Ischemic heart disease is the most common cause of death. There is a sharp rise in Off Pump Coronary Artery Bypass Surgery (OPCAB), which increases cardiac enzymes like Troponin T, that is used as prognostic guide. In triple vessel disease 40 to 50% cases involve right ventricle, therefore along with left ventricular ejection fraction (LVEF), Tricuspid Annular Plane Systolic Excursion (TAPSE) can be used as a prognostic guide, which can be measured by noninvasive doppler echocardiography.METHODSPatients with specific criteria who underwent OPCAB surgery from January 2018 to March 2019 were studied. Both pre- and post-operative (14-16 hours) Troponin T (TropT) sensitivity tests were done and only preoperative Trop T negative patients were selected for the study. Postoperative patients were divided into 2 groups, TropT positive and negative. Echocardiography was done on the day before surgery, on postoperative day 5 (POD5) and postoperative day 30 (POD30). Results were compared between the two groups.RESULTSAmong 88 patients thus selected, 34 patients (38.63%) were Trop T positive, and 54 patients (61.37%) were Trop T negative. On post-operative day 5, increase in brain natriuretic peptide (BNP), decrease in TAPSE and decrease in haemoglobin were significant in Trop T positive group. Need for ventilation and postoperative hospital stay were significantly prolonged in positive groups. In POD30, decrease in albumin, decrease in LVEF and TAPSE all are significant in TropT positive group.CONCLUSIONSIt is important to determine the prognosis of OPCAB patients in early postoperative period. Troponin T has a significant prognostic value in OPCAB patients supported by LVEF and TAPSE.

Study of Angiography Findings in Diabetic and Non Diabetic Patients with Cardiac Symptoms

Introduction: Diabetes mellitus is a complex metabolicdisorder associated with an increased risk of microvascularand macrovascular disease. Type 2 diabetes mellitus is aprevalent metabolic disorder that often leads to cardiovasculardiseases and diabetic cardiomyopathy, which may lead tochronic pressure overload and myocardial infarction. Thepresent study aimed at studying the extent and complexity ofcardiovascular lesions among diabetic patients and comparesame with non-diabetic patients.Materials and methods: The present study was a CaseControl (Analytical and Interventional) Study conductedover 18 months (October 2016 to March 2018). Case groupconsisted of 250 Diabetic patients with cardiac symptoms,with or without ECG changes, who have undergone coronaryangiography. And Controls group consisted of 250 NonDiabetic patients with cardiac symptoms, with or withoutECG changes, have undergone coronary angiography.Results: In the present study, among diabetics, there were52.8% male patients and 47.2% female patients, similarlyamong non diabetic group, 57.2% were males and 42.8%cases were females. 12.4% people were found normal, 37.6%were suffering from Single vessel disease, 28.8% people withDouble vessel disease and 21.2% people with Triple vesseldisease.Conclusions: According to the present study, among coronaryangiography diagnosis, severe forms of coronary artery lesionswere found common among diabetic patients as compared tonon diabetic patients.

Analysis on the Correlation Between ECG Parameters and Cardiac Function in Severe Triple Coronary Vessel Disease Patients Without Myocardial Infarction / 中国循环杂志

Objectives:To analyze the correlation between systolic cardiac insufficiency and ECG parameters of patients with triple-vessel disease(left anterior descending artery, left circumflex artery and right coronary artery showed ≥ 70% of diameter stenosis), but without history of myocardial infarction. Methods: A total of 96 triple-vessel disease patients without prior myocardial infarction who underwent coronary angiography examination between 2017-03-01 and 2017-07-05 in Zhongshan hospital were recruited in this study. According to LVEF, patients were divided into the normal cardiac function group (78 patients with LVEF ≥ 50%) and the reduced LVEF group (18 patients with LVEF < 50%). The Receiver Operating Characteristic (ROC) curve was applied to test optimal cut-off value of the ECG parameters and logistics regression analysis was utilized to determine the correlation between ECG indices with cardiac insufficiency. Results: A small percentage (18.8%) triple-vessel disease patients without prior myocardial infarction developed cardiac insufficiency. QRS duration, QTc duration were all significantly increased in patients with cardiac dysfunction) compared with patients with normal cardiac function (P < 0.05). ROC curve indicated good predictive efficacy to systolic cardiac insufficiency with HR > 70.5 bpm (sensitivity 81.3%, specificity 58.9%), QRS > 97.5 ms(sensitivity 82.4%, specificity 67.5%), QTc > 425 ms (sensitivity 93.8%, specificity 41.1%). Logistic multivariate regression analysis showed that QRS >97.5 ms(OR=7.577, 95%CI:1.094~52.490,P =0.030) was significantly correlated with systolic cardiac insufficiency. Conclusions: For triple-vessel disease patients without prior myocardial infarction, wider QRS in the resting ECG may indicate cardiac insufficiency.

Association of CDKN2B-AS1 Polymorphisms with Premature Triple-vessel Coronary Disease and Their Sex Specificity in the Chinese Population / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study is to establish whether cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) gene polymorphisms are associated with premature triple-vessel disease (PTVD).@*METHODS@#Nine single-nucleotide polymorphisms (rs1063192, rs10757274, rs1333042, rs1333049, rs2285327, rs3217986, rs3217992, rs4977574, and rs9632884) were genotyped in 884 PTVD patients and 907 control subjects (males ⪕ 50 years old and females ⪕ 60 years old) using the improved multiplex ligase detection reaction method.@*RESULTS@#The allele frequencies of rs10757274 G, rs1333049 C, rs4977574 G (all P < 0.001), and rs3217986 G (P = 0.040) were significantly higher in the PTVD group than in the control group, but those of rs1063192 A, rs1333042 G, and rs9632884 C (all P < 0.001) were significantly lower in the former than in the latter. Logistic regression analysis revealed that homozygote AA of rs1333042 is associated with decreased risk for PTVD (OR = 0.42, 95% CI: 0.22-0.82, P = 0.011). In addition, the allele frequencies observed differed between genders. The G allele of rs3217986 was associated with increased risk for PTVD in male patients only (OR = 2.94, 95% CI: 1.27-6.80, P = 0.012) in the dominant model, and no positively mutated allele was found in female patients.@*CONCLUSION@#Polymorphisms of the CDKN2B-AS1 gene are associated with the incidence of PTVD in the Chinese population. Furthermore, the frequencies of mutated alleles differed between genders.

The Late Sequalae of Coronary Artery in A Grown Up Kawasaki Disease Patient

No available abstract