BackgroundExercise-based Cardiac rehabilitation (CR) plays a major role in reducing mortality and morbidity in patients with coronary artery disease (CAD). The standard protocol is usually of moderate intensity exercise. High-intensity interval training (HIIT) consists of alternating periods of intensive aerobic exercise with periods of passive or active moderate/mild intensity recovery.AimThis study aimed to assess HIIT program for ischemic patients attending CR after percutaneous coronary intervention (PCI) who have mild left ventricular dysfunction and to compare its effect on the functional capacity and quality of life with standard exercise CR program.Patients and methodsOur study included 40 patients with documented CAD, who participated in the outpatient CR program in Ain Shams University hospital (Al-Demerdash Hospital) divided into two equal groups, each included 20 patients. Group A included the patients who underwent standard cardiac rehabilitation program, while group B joined the high intensity interval training exercise protocol.ResultsGroups A and B showed significant improvement in all items of comparison; especially functional capacity, lipid profile and quality of life. Group B showed better improvements in the emotional well-being items of QOL parameters.ConclusionWe emphasize the positive effects of exercise-based CR program on patients with CAD and mild left ventricular dysfunction after PCI. The novel high intensity cardiac training proved to be safe and at least as beneficial as the standard moderate intensity cardiac training protocols, with better quality of life improvement.
Background: red cell distribution width is a marker associated with increased mortality and morbidity in cardiac patients, however it's relation with coronary artery calcium score (CACS) is not well studied yet. Aim of the work: this study aimed to assess the relation between red cell distribution width (RDW) and coronary artery calcium score (CACS) in the diabetic patients undergoing coronary CT angiography. Patients and methods: this study was conducted on 60 patients presented for assessment of coronary artery disease (CAD) by coronary CT angiography and they were categorized into 2 groups, group (A) diabetics(30 patients),group(B)non-diabetics (30 patients), All patients included in this study were subjected to: History Taking, complete physical examination, multi-slice CT coronary angiography (MSCT) including calcium score(CACS), laboratory investigations including complete blood count (CBC) including RDW(SD&CV), serum calcium level(total and ionized), erythrocyte sedimentation rate (ESR), lipid profile. Results: higher RDW(SD) was associated with the presence of greater coronary complexity of CAD and higher calcium score. In our study total serum calcium and RDW (SD) were found to be independent predictors of high Ca score more than 100, while ionized calcium and systolic blood pressure(SBP) were independent predictors of high Calcium score more than 400. Cut off value of RDW to predict high calcium score (more than 100) was RDW(CV) more than 13.45 & RDW(SD) more than44.45, while Cut off value of RDW to predict high calcium score (more than 400) was RDW(SD) more than 45.1. Conclusions: a greater baseline RDW(SD) value was independently associated with the presence of a greater coronary complexity of CAD and higher calcium score.
Background With the continuous improvement of the respiratory care of Duchenne muscular dystrophy patients, cardiac manifestations (heart failure and arrhythmias) become the leading causes of morbidity and mortality. Early identification of cardiac muscle affection is crucial to start anti-failure drugs that reverse remodeling and improve prognosis. This study aimed to detect subtle cardiac changes in Duchenne muscular dystrophy patients and carriers using electrocardiography and echocardiography. Results This study included genetically diagnosed Duchenne muscular dystrophy patients (28 males) and carriers (25 females) and compared them to healthy gender-matched control groups. All study participants underwent clinical assessment, 12-lead electrocardiography, and global longitudinal strain augmented echocardiography. In the current study, Duchenne muscular dystrophy patients had higher heart rates, smaller left ventricular internal diameters, left atrial diameter, lower ejection fraction, and worse left ventricular global longitudinal strain in comparison with the control group. The global longitudinal strain inversely correlated with the age of Duchenne muscular dystrophy patients. The number of exon mutations did not affect electrocardiography and echocardiographic findings. Exon mutations 45–47 and 51–54 were significantly associated with an ejection fraction less than 60%. Duchenne muscular dystrophy carriers had smaller left ventricular wall diameters, left ventricular end-diastolic diameter, left atrial diameter, and worse left ventricular global longitudinal strain in comparison with the control group. Conclusions Left ventricular global longitudinal strain could detect subtle left ventricular systolic dysfunction in Duchenne muscular dystrophy patients and carriers before the decline of left ventricular ejection fraction.
Background: One of the limitations of the right radial access approach is complex vessel anatomy, such as subclavian tortuosity. Several clinical predictors have been proposed for tortuosities, such as older age, female sex and hypertension. In this study, we hypothesised that chest radiography would add predictive value to the traditional predictors. Methods: This prospective blinded study included patients who underwent transradial access coronary angiography. They were classified into four groups according to difficulty: Group I, Group II, Group III and Group IV. Different groups were compared according to clinical and radiographic characteristics. Results: The study included 108 patients (54, 27, 17 and 10 patients in Groups I, II, III and IV, respectively). The rate of crossover to transfemoral access was 9.26%. Age, hypertension and female sex were associated with a greater difficulty and failure rates. Regarding radiographic parameters, a higher failure rate was associated with a higher diameter of the aortic knuckle (Group IV, 4.09 ± 1.32 cm versus Groups I, II and III combined, 3.26 ± 0.98 cm; p=0.015) and the width of the mediastinum (Group IV, 8.96 ± 2.88 cm versus Groups I, II and III combined, 7.28 ± 1.78 cm; p=0.009). The cut-off value for prominent aortic knuckle was 3.55 cm (sensitivity 70% and specificity 67.35%) and the width of mediastinum was 6.59 cm (sensitivity 90% and specificity 42.86%). Conclusion: Radiographic prominent aortic knuckle and wide mediastinum are valuable clinical parameters and useful predictors for transradial access failure caused by tortuosity of the right subclavian/brachiocephalic arteries or aorta.
Background Recent studies have suggested that fat disposition in epicardial tissue may be a predictor of the severity of coronary artery disease (CAD). Epicardial adipose tissue (EAT) is defined as the adipose tissue located between the outer wall of the myocardium and the visceral layer of pericardium, surrounding the heart and the coronary vessels. EAT is closely related to the adventitia of the coronary arteries without a barrier that may directly influence the development and progression of atherosclerosis and CAD through pro-inflammatory mediators. Objective The aim of the work is to investigate the relation between epicardial fat volume (EFV) [assessed by multidetector computed tomography (MDCT)] and severity of CAD. Methods This cross sectional study was conducted on 40 patients referred for MDCT coronary angiography to assess their complaint. EFV was quantified during non-contrast phase and severity of CAD was assessed by segment involvement score (SIS) and segment stenosis score (SSS) during contrast phase at Nasr City Police Hospital in the period between August 2018 and April 2019. Results The 40 consecutive subjects consisted of 30 males (75%) and 10 females (25%) with mean age 56 ±10.27 years. Risk factors of atherosclerosis were analyzed among the studied population as followed; the BMI ranged between 24 and 30.9 kg/m2, hypertensive patients were 77.5%, diabetic patients were 55% and smokers were 67.5%. The laboratory finding of the studied group revealed that the serum LDL.C ranged between 70 and 218 mg/dl (Mean±SD =163.88±43.37, Median= 183.5). The serum HDL.C ranged between 30 and 62 mg/dl (Mean±SD = 41.45±9.87, Median= 37). The serum total cholesterol ranged between 136 and 280 mg/dl (Mean±SD = 214.35± 35.51, Median= 224). The serum triglycerides ranged between 110 and 215 mg/dl (Mean±SD = 164.13±27.38, Median= 173).The serum creatinine ranged between 0.8 and 1.8 mg/dl (Mean±SD = 1.12±0.19, Median= 1.1). 17.5% of the studied patients had normal coronaries while 37.5% had single vessel disease and 45% had multi-vessel disease. There was a significant relationship between EFV and CAC score (p = 0.011, r = 0.397), a highly significant relationship between EFV and SSS score (p = 0.001, r = 0.518) and significant relationship between EFV & SIS score (P = 0.003, r = 0.459). Patients with normal coronary arteries were noted to have a lower EFV value than those with coronary lesions (highly significant relationship, p = 0.004) either single vessel disease or multi-vessel disease. There is no significant difference between the effects of EFV on number of diseased coronaries either single vessel disease or multi-vessel disease. Conclusion EFV increased in patients with both significant coronary artery stenosis or coronary calcification. EFV is considered an independent risk factor for CAD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.