[Comparative study of echocardiographic right ventricular systolic function before and after angioplasty on right coronary artery]

Background: In patients who undergoing PCI, association between right ventricular function and outcome of the procedure remained unclear

The present study aimed to determine association between echocardiography findings of systolic right ventricular function and functional status of patients following PCI

Methods: In a cross-sectional study conducted at Imam Ali hospital and heart center in Kermanshah, Iran in 2013, 40 patients with history of inferior wall myocardial infarction [Inf MI] according to previous electrocardiography [ECG] in past hospitalization for MI who were candidate for percutaneous coronary intervention [PCI] on right coronary artery [RCA] and had left ventricle ejection fraction [LVEF] less than 40% were included

The subjects underwent echocardiography on admission to assess echocardiography indices of systolic right ventricular function including tricuspid annular plane systolic excursion [TAPSE], tricuspid annular systolic velocity [TASV], Tei-index [Myocardial performance index), and RV fractional area [RVFA] change that was repeated one month later. Baseline functional status was assessed based on the New York Heart Association functional classification score [NYHA score] that divided to 4 grades

Results: NYHA score improved following PCI procedure [from 2.20+/-0.46 to 1.10+/-0.30, P<0.001]. The mean score of TAPSE significantly increased from 18.68+/-2.12 to 20.40+/-2.11 [P<0.001]

The mean of TASV also increased from 13.28 +/- 1.52 to 14.85+/-1.90 [P<0.001]

Also, Tei-index was improved from 0.52+/-0.05 to 0.47+/-0.03 [P<0.001]

Moreover, RVFA was significantly increased after PCI [from 35.02+/-2.40 to 38.25+/-2.57, P<0.001]

There was no significant relationship between the changes in NYHA score and each of right ventricular systolic function indices

Conclusion: Although right ventricular systolic function considerably improved following PCI procedure, but the changes in this improvement is not associated with the improvement of function class after the procedure

Echocardiographic findings in power athletes abusing anabolic androgenic steroids

Anabolic androgenic steroids [AAS] abuse for improving physical appearance and performance in body builders is common and has been considered responsible for serious cardiovascular effects. Due to disagreement about cardiovascular side effects of these drugs in published articles, this case control study was designed to evaluate the echocardiographic findings in body builder athletes who are current and chronic abusers of these drugs. Body builder athletes with continuous practice for the preceding two years and were training at least twice weekly were selected and divided into AAS abuser and non user and compared with age and BMI matched non athletic healthy volunteers [15 cases in each group]. There was no significant difference in left ventricular size or function either systolic or diastolic in comparison to cases and control groups. The only difference was in diastolic size of septum and free wall but observed differences were only significant [P = 0.05] between first [athletic with AAS abuser] and third group [non athletic and nonuser]. The difference between the above-mentioned indexes were not significant between two groups of athletes. Observed differences in diastolic size of septum and free wall is in favor of that long term abuse of anabolic steroid results in accentuation of physiologic hypertrophy due to long term sport most probably due to higher rate pressure product. Furthermore long term abuse and supra pharmacologic doses do not have significant effect in size and left ventricular function

Coronary arteries bypass grafting surgery in elderly patients

The incidence of coronary artery bypass grafting surgery [CABG] in elderly patients has been increasing. There are contradictory reports on the early outcome of elderly coronary artery patients as compared with their young counterparts. We designed this retrospective study to address this issue. We retrospectively analyzed the results of 1489 on-pump CABG cases performed at our hospital during a 4.5-year period. Perioperative data such as demographic, medical, clinical, operative, and postoperative variables were collected and compared between patients 70 years old or younger [Group A, n = 1164] and patients above 70 years of age [Group B, n = 325]. Statistical analysis was performed using the t-test for the continuous and the X[2] tests for the categorical variables. Significant variables according to the univariate analysis [X[2] and t-test] were further analyzed using multivariate logistic regression analysis. The variables of weight [P value < 0.001], preoperative PO[2] [P value = 0.005], ejection fraction > 30% [P value = 0.001], body surface area [P value = 0.003], and hypercholesterolemia [P value = 0.007] were higher in Group A, whereas preoperative myocardial infarction [P value < 0.001], postoperative low cardiac output syndrome [P value = 0.019], emergent surgery [P value = 0.003], inotropic drug use [P value < 0.001], preoperative heparin use [P value < 0.001], re-exploration for bleeding [P value = 0.015], hospital stay [P value < 0.001], low ejection fraction [ 1.5 mg/dl [P value < 0.001], chronic obstructive pulmonary disease [P value < 0.001], intra-aortic balloon pump use [P value < 0.001], infection [P value < 0.001], pulmonary complications [P value < 0.001], atrial fibrillation [P value < 0.001], postoperative renal complications [P value < 0.001], and death [P value = 0.012] were more frequent in Group B. CABG in the elderly patients had certain surgical risks such as chronic obstructive pulmonary disease, preoperative myocardial infarction, emergent surgery, and death. Also, postoperative complications such as pulmonary complications, inotropic drug use, intra-aortic balloon pump use, and infection were more frequent in the elderly than in the younger patients