Cytotoxin associated gene A [CAG A] antigen carrying strains of helicobacter pylori and increased risk of acute myocardial infarction

The aim of work: is to study the possible association between Helicobacter pylori infection and increased risk of acute myocardial infarction. Subjects and Fifty patients were included in this study with acute myocardial infarction "AMI" admitted to the intensive care unit at cardiology department Tanta university hospital. All patients were subjected to clinical assessment, electro cardiography [E.C.G]. Echo cardiographic examination, and quantification of IgG antibodies to cytotoxin associated gene-A [Cag-A] in plasma samples using ELISA. H. pylori infection was significantly higher in patients with acute myocardial infarction [80.4%] than in controls [20%]. Also, infection with CagA bearing strains of H. pylori was significantly higher in AMI patients [64.7%] than in controls [10.0%]. H. pylori seropositive AMI patients showed positive CagA strains were significantly higher [64.7%] compared to infection with CagA negative strains [15.7%]. Helicobacter pylori, particularly CagA positive strains, significantly increase the risk of coronary heart disease, and is independent from the classical risk factors

Impact of percutaneous balloon mitral valvuloplasty on right and left ventricular functions assessed by tissue Doppler imaging

Pure mitral stenosis affect left ventricular performance as a result of myocardial and mechanical factors. It has been found that, with increase in pulmonary artery pressure, the right ventricle may hypertrophy and dilate, and right ventricular ejection fraction decreases. Pulsed TDI has been used for the evaluation of impaired systolic or diastolic function. Percutaneous mitral valvotomy has proven to be effective technique for the relief of obstruction in patients with mitral stenosis. However, the results of the studies about the effect of percutaneous mitral balloon valvuloplasty [PMBV] on ventricular functions are controversial. Of this study was to assess right and left ventricular functions using Doppler tissue imaging [DTI] before and after percutaneous mitral valvuloplasty two days after and at 3 months follow up. We studied 30 selected thirty patients with symptomatic mitral stenosis of rheumatic etiology, who were admitted for percutaneous mitral valvuloplasty and another twenty normal disease free subjects, as proved by electrocardiography ECG and Doppler-echocardiography, thirteen were females and seven were males. All patients were subjected to history analysis, clinical examination, ECG analysis, transthoracic echo Doppler study to asses mitral valve area and trans mitral diastolic gradient, transoesophageal echo study to exclude left atrial cavity or appendage thrombi and lastly pulsed TDI to asses right and left ventricular functions one day before and two days after percutaneous mitral valvuloplasty and then repeat at 3 months follow up. Significant increase in mitral valve area, drop of transmitral pressure gradient and increase of left and right venticular ejection fraction two days and 3 months after the procedure [p <0.05]. By TDI all the myocardial velocities significantly increased after PMV but still below the normal values of the control group [p < 0.05]. PMV results in significant improvement of systolic myocardial velocities of right and left ventricles two after and at follow up, but these velocities are still below the normal values