Prevalence of Left Ventricular Diastolic Dysfunction in Metabolic Syndrome as Assessed by Echocardiography

Introduction: Metabolic syndrome is a complex disorderwith high socio-economic cost that is considered aworldwide epidemic. It is very common condition Consistinghyperglycemia,central obesity, hypertension and dyslipidemia(low levels of high density lipoprotein cholesterol(HDL-C)and high levels of triglycerides). Current study was done toassess Left Ventricular Diastolic Dysfunction in patients ofMetabolic Syndrome by 2d- Echocardiography.Material and methods: In this study my aim is to find outthe prevalence of left ventricular diastolic dysfunction inmetabolic syndrome and to highlight the importance ofprimary prevention in metabolic syndrome. The Presentstudy is cross-sectional observational study carried out atCSS Hospital Subharti medical college Meerut UP, consistingof 50 patients having metabolic syndrome according to thecriteria of International Diabetic Federation and to look forthere LVDD via 2d- Echocardiography.Results: The left ventricular diastolic dysfunction grade isassociated with the number of characteristics of metabolicsyndrome. Waist circumference, FBS, E/A, IVRT, Decelerationtime, E/e’ showed a statistically significant association (p value<0.01) with the degree of diastolic dysfunction.Conclusion: The current study showed that, metabolicsyndrome group have an associated abnormal left ventriclediastolic performance So the patients with metabolic syndromeshould receive aggressive therapy to avoid occurrence of heartfailure in the future.

Study to determine serum vitamin D levels in patients with congestive heart failure

Background: It was to evaluate the association of serum levels of vitamin D in patients with congestive heart failure.Methods: The present study was conducted in the department of Medicine at Chattrapati Shivaji Subharti Hospital among 100 patients, aged 18 years and above diagnosed as congestive heart failure on the basis of clinical and echocardiographic evidence. Clinical manifestations looked for CHF were: Dyspnea, orthopnea, acute pulmonary edema, cerebral symptoms, cheyne-stokes respiration, cyanosis, sinus tachycardia, raised jugular venous pressure, congestive hepatomegaly and pedal edema. In the present study deficiency/ insufficiency of vitamin D was considered when the presence of levels of 25-hydroxyvitamin D was <30 ng/ml. Laboratory tests performed to diagnose congestive heart failure and serum vitamin D levels were complete blood count, KFT (urea, serum creatinine), serum electrolytes, ECG, chest X ray and echocardiogram. Data were tabulated and examined using the statistical package for Social Sciences Version 22.0.Results: When data was assessed for comparison in relation to NHYA grades and vitamin D levels, it was found to be statistically significant. The Mean±SD scores of serum urea (mg/dL) was found to be 44.7±56.4, 47.3±63.8 and 36.4± 18.3 in whole study sample, vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference. The Mean±SD scores of CPK MB (IU/L) was found to be 33.1±20.8 and 18.6±13.3 among the subjects having vitamin D levels <30 and vitamin D levels >30 respectively with statistically significant difference.Conclusions: The results of the present study suggest that low levels of vitamin D may adversely affect the cardiovascular system.

Alteration of cardiovascular autonomic activity in type 2 diabetes mellitus

Background: Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycaemia due to absolute or relative insulin deficiency. Cardiovascular autonomic neuropathy (CAN) invokes potentially life-threatening outcomes especially in poorly controlled diabetic patients. This study was to evaluate the prevalence of CAN in diabetic patients and its relationship with QTc interval.Methods: This observational study of two year duration was included total 123 patients of more than 30 (thirty) years and up to 60 (sixty) years of age who were presented with diabetic mellitus (DM) those were evaluated for CAN using four distinct clinical tests-Resting heart rate (RHR), test for orthostatic hypotension (OH), hand gripping test (HGT) and QTc interval on ECG. Data were analyzed with statistical package for social sciences (SPSS), version 23.Results: The mean age of all 103 studied patients was 48.94±8.69 years; Mostly patients belong to 50-60 years of age and the majority was males (69.0%). Out of 103 72.8% patients were reported with CAN (51 males and 24 females) and without CAN were 27.2.0% (20 males and 8 females), 36% of patients of Definite Parasympathetic neuropathy, 25% Normal and 20% of Sympathetic neuropathic patients. HbA1c level increases the danger of CAN also. QTc interval is a reliable indicator for the presence of CAN.Conclusions: Duration of diabetes is directly proportional to the prevalence of CAN. Various cardiac autonomic function tests detect CAN.

To Study the Prevalence of Thyroid Dysfunction in Patients of Type II Diabetes Mellitus

Introduction: Diabetes mellitus (DM) and thyroid dysfunction(TD) are the two most common endocrine disorders in clinicalpractice. The unrecognized TD may adversely affect themetabolic control and add more risk to an already predisposingscenario for cardiovascular diseases. TMaterial and methods: 100 patients with T2DM were selectedfrom the Outpatient department and admitted in Inpatientdepartment of Medicine in Subharti Medical College Meerut,participated in the study. Thyroid dysfunction was classifiedas Subclinical hypothyroidism (SCH) was defined as TSH- 4.5to 10 mIU/ml with normal FT4. Overt hypothyroidism-TSH>10 mIU/ml with low FT4. Hyperthyroidism- <0.45 mIU/ml TSH with raised FT4 Subclinical hyperthyroidism- <0.45mIU/ml TSH with normal FT4.Result: The prevalence of Thyroid Dysfunction in all diabeticpatients was 24%.function was 24% (16% had subclinicalhypothyroidism, 6% of patients had overthypothyroidism and only 2% of patients had overthyperthyroidismConclusion: Our study emphasizes the need to checkTSH levels in all type 2 diabetic patients, as subclinicalhypothyroidism was most prevalent thyroid dysfunction inpatients with diabetes.