BackgroundA full understanding of the geometry of the nonplanar saddle-shaped mitral annulus can provide valuable information regarding the pathophysiology of mitral regurgitation (MR).Aim of the workTo investigate mitral annular geometric deformities using three-dimensional echocardiography among patients with ischemic coronary illness with and without mitral regurgitation.MethodsThree-dimensional transesophageal echocardiographic data were acquired intraoperatively from patients with ischemic heart disease with or without associated mitral regurgitation who experienced coronary artery bypass grafting and normal control subjects. The mitral annulus was analyzed for differences in geometry using QLAB software.ResultsLeft ventricular ejection fraction was reduced in patients with ischemic heart disease and MR (n = 21; Group 1) and without MR (n = 7; Group 2) compared with that in normal subjects (n = 14; Group 3) (43.4% ± 11.8% and 35.9% ± 13.6% vs. 52.6% ± 9.3%, respectively; p = 0.015). Mitral annular height and mitral annular saddle-shaped nonplanarity were significantly lower in Group 1 compared to Group 2 and Group 3 (6.00 ± 1.07 mm, 7.96 ± 0.93 mm and 8.31 ± 1.12 mm; p < 0.0001) and (0.19 ± 0.04, 0.26 ± 0.04 and 0.26 ± 0.03; p < 0.0001) respectively while mitral annular ellipsicity and Mitral valve tenting volume were significantly higher in the same group (1) (114.82% ± 22.47%, 100.21% ± 9.87% and 97.29% ± 14.37%; p = 0.0421) and (2.73 ± 1.11, 2.20 ± 1.39 and 0.87 ± 0.67) respectively. Vena contracta diameter was inversely correlated with the mitral annular height (r = −0.82; p < 0.0001) and saddle-shaped nonplanarity of the annulus (r = −0.68; p < 0.0001).ConclusionAmong patients with ischemic heart disease, there are significant increases in mitral valve tenting volume and height, and those with mitral regurgitation exhibited a reduced mitral annular height, a shallower saddle shape annulus and losses of ellipsicity of the annulus.
Background and study aims: Acid regurgitation and/or heartburn are symptoms of Gastrointestinal Reflux Disease (GERD), which is the most frequent gastrointestinal diagnosis. Noncardiac chest pain is well documented to be linked to gastroesophageal reflux illness. We aimed to assess the link between GERD and cardiac arrhythmia.Methods: A total of 50 GERD patients were chosen from the Gastroenterology Unit of the Internal Medicine Department at Assiut university hospitals for this cross-sectional study. Patients had their medical histories taken, physical examinations performed, biochemical tests performed, and a full heart examination performed. Results:The SDDN (R-R interval) was determined to be 100.1±18.8 on average. Patients with S-T depression made up half of the sample, with an average S-T depression score of 0.92±0.20. Furthermore, around two-thirds of the individuals developed arrhythmia. There was a favorable connection between the occurrence of GERD and cardiac arrhythmia when all correlates were adjusted. The intercept (constant) in the final model after controlling for all correlates was 15.81, and four correlates, positive diabetes history, smokers, and patients with S-T segment depression/arrhythmia, were found as independent predictors of reflux episode number. Conclusion:The presence of GERD enhanced the likelihood of cardiac arrhythmia, according to this study. There was a link between having GERD and having cardiac arrhythmia .
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