Association Of Heart Rate At Hospital Discharge And Rehospitalization Of Patients With Heart Failure And Reduced Ejection Fraction.

BACKGROUND: One of the major causes of cardiovascular morbidity and mortality is heart failure. The study aims to assess the effect of heart rate on the incidence of rehospitalization in patients with heart failure and reduced ejection fraction. METHODS: It is a cross-sectional, analytical research conducted over six months, from June to December 2022, at the cardiology department of a tertiary care hospital. Patients who satisfied the modified Framingham heart failure criteria at admission and were discharged with an initial diagnosis of heart failure and those readmitted within 6 months or less of their discharge were included in the study. Pregnant women, patients diagnosed with cognitive impairment, and patients who had contraindications for taking any of the beta-blockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker /angiotensin receptor -neprilysin inhibitor, Sodium-Glucose co-transport inhibitor, and mineralocorticoid inhibitors were excluded from the study. RESULTS: A total of 77 patients were included in the study. At discharge, approximately 71 patients had a heart rate of less than 70 beats/min and had no readmissions whereas, 6 patients had a heart rate of greater than 70 beats/min with 5 patients requiring readmission in the following 6 months. This relationship was statistically significant with a p-value of 0.000. CONCLUSIONS: According to the study, heart rate is a significant factor in the rehospitalization of individuals with heart failure and a low ejection fraction. At discharge, if the heart rate is not optimized then the rate of readmissions is increased.

To assess the co-relation between corrected qt interval prolongation and abnormal scan during vasodilator nuclear stress test.

In the detection of coronary heart diseases amongst the non-invasive techniques the role of myocardial perfusion imaging is indexed. The rationale of this study was to compare the different parameters and the association between the exercise MPI and vasodilator MPI in the detection of coronary artery disease (that is prolonged Qt interval with the size of perfusion defects). It was a cross-sectional prospective study with purposive non-probability sampling technique which was conducted in a tertiary care hospital from January 2020 to June 2020 for a period of 6 months. All patients regardless of gender were included in this study and age ranging from 30 to 80 years with comorbidities ranging from diabetes, hypertension and smokers were also included. A total of 100 patients were included in this study out of which 81% were male, 50% were diabetics, 69% were hypertensive, 39% had a history of coronary artery disease, 25% were smokers and 63% had hyperlipidemia. For statistical analysis SPSS 21 was applied and significant association was observed between DTS treadmill score and the perfusion defect in vasodilator MPI, corrected Qt interval and DTS tread mill score and between corrected Qt and size of the perfusion defect (P value < 0.001). It was thus seen that the different components of the noninvasive nuclear stress test tend to co-relate and thus aid in the detection of coronary artery disease increasing the accuracy of results.

Assessment of the co-relation between 1st set of Troponin I, age, duration of chest pain and LVEF in patients presenting with first stemi and treatment protocol followed.

Coronary heart disease is the cause of 17.1 million deaths per year throughout the world. The rationale of this study was to determine the importance of 1st set of Troponin I in relation to age, duration of chest pain and left ventricular ejection fraction (LVEF) in patients presenting with acute ST elevation myocardial infarction along with the treatment protocol followed in emergency. It was a cross sectional prospective observational study which was conducted at a tertiary care hospital, at the Cardiology department for a period of 12 months. All patients regardless of gender, aged between 30-80 years with co-morbidities were included presenting with acute STEMI. A total of 150 patients were included in this study with a mean age of 61.2±10.3 years out of which males were (71%). Around 61% of the people presented to emergency >12 hours after onset of chest pain. There was non-significant difference in the treatment protocol given to all patients. For statistical analysis SPSS 21 was applied and significant relationship was observed between age, duration of chest pain and LVEF (p value <0.05). It was seen in our population that people older than 50 years tend to present to emergency department late with chest pain symptoms which results in a linear rising relationship with Troponin I and with increasing Troponin I there was significant reduction seen in LVEF.