Transcatheter PFO closure reduces the recurrence of stroke compared with medical therapy alone, with no significant safety concerns. Close follow-up of patients after PFO closure is recommended to detect new-onset atrial arrhythmias.
ObjectivesTo determine the value of Myocardial Performance Index (MPI) as an echocardiographic predictor of early in-hospital heart failure (HF) during first acute anterior ST-Elevation Myocardial Infarction (STEMI).BackgroundMyocardial infarction induces variable degrees of impairment in left ventricular (LV) systolic and diastolic functions. The ejection fraction (EF) and transmitral flow, the most frequently used methods for evaluation of systolic and diastolic functions respectively, both have considerable limitations. The MPI is a single parameter, capable of estimating combined systolic and diastolic performance and lacks such limitations.MethodsWe enrolled 60 patients presented with a first acute anterior STEMI who have undergone primary PCI. Echocardiography was done within 24 h of chest pain with measurement of MPI. The LV MPI was calculated as (isovolumic contraction time “ICT” + relaxation time “IRT”)/Ejection time “ET”. Besides, clinical and echocardiographic variables were analyzed and CHF was defined as Killip class ≥ II.ResultsEarly in-hospital HF occurred in 23 of patients (38%). Ejection fraction was found to have a highly significant negative correlation with the development of in-hospital HF (p = .0001), while MPI was found to have a highly significant positive correlation (p = .0001). A cut-off point of MPI > 0.73 showed a very high specificity (94.6%) and sensitivity (78.3%) for identifying patients with HF. On the other hand, a cut-off point of EF ≤ 33% has shown 94.6% specificity and 56.5% sensitivity for HF prediction.ConclusionsThe MPI might be a strong predictor of in-hospital HF after first acute anterior STEMI.
Background: Sick sinus syndrome (SSS) is a common disease and causes increased risk of death and cardiovascular disease in patients. When patients with SSS refuse pacemaker therapy because of contraindications or financial or personal reasons, drug treatment is needed, especially in developing countries.
Objective:The study assessed the therapeutic effects of calcium dibutyryladenosine cyclophosphate (CDC) on patients with SSS.
Method:We studied 65 inpatients with SSS who were without permanent pacemaker implantation and were treated with or without CDC at random. The patients who received intravenous injection with CDC in addition to conventional treatment were considered as treatment group. The patients who only received conventional treatment were considered as control group. After 12 days administration, manifestations, 12-lead electrocardiographic and 24-hour Holter monitor were compared respectively.Result: After the treatment with CDC, 91.2% of the patients reported a significant overall improvement of symptoms, while patients recovered clearly compared with the control group (P<0.01). CDC markedly improved heart rate measured by 24-hour Holter monitor in patients with SSS compared with the control group (P<0.01).
Conclusion:CDC showed significant therapeutic effects on patients with SSS and could be an affordable and expected alternative therapy.
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