Transient SWMA can occur due to aneurysmal SAH itself and when associated with LV dysfunction, it had a higher mortality. (Echocardiography 2010;27:496-500).
Background Pregnancy is a physiologic condition which is unique in that it alters the physiology of each organ in the body. Cardiovascular changes during pregnancy are significant and start at 6 to 8 weeks of gestation. Physiologic cardiovascular changes during pregnancy suggest the chance of altered electrocardiographic (ECG) parameters during pregnancy. Study of variations in ECG in normal pregnant women serves as a basis to detect pathologic changes in pregnant women. Material and Methods This is a cross-sectional data of case series of pregnant women across all stages of gestation who attended antenatal clinic of our teaching hospital, on Women's Day (March 8, 2017). A 12-lead ECG was recorded in all the participants in supine position. The parameters noted from the ECG include heart rate, PR interval, QRS duration, QRS axis, corrected QT (QTc) interval, and ST-T changes. Results Total 151 pregnant women were studied. The average age was 23.38 ± 3.49 years. With respect to gestational age, 12 (7.94%), 48 (31.78%), and 91 (60.26%) women were in the first, second, and third trimesters of pregnancy, respectively. With respect to parity, 60 (39.7%) were primigravidae and 91 (60.26%) were multigravidae. The mean ECG heart rate was increased (100.15 ± 12.48 beats/min). The mean systolic blood pressure (109.67 ± 9.34 mm Hg) and the mean diastolic blood pressure (71.32 ± 6.89 mm Hg) were decreased. The mean of ECG intervals and durations (PR, QRS, QTc) were in normal range (0.14 ± 0.01, 0.08 ± 0.008, and 407.83 ± 11.98, respectively). There was no abnormal P-wave dispersion. Even though the QTc was in normal range in 63.56% of pregnant women, this parameter was in upper quadrant of the normal range. General linear regression demonstrated that systolic blood pressure and palpitations were the only variables to independently predict QTc in upper quadrant of normal range (p = 0.05, 0.03, respectively). Conclusion The cardiovascular hemodynamic adaptation to pregnancy is a well-established fact that is also seen in our study. There is shortening of PR interval and QRS duration. Even though QTc is with in normal range, in more than half (63.56%) of pregnant women, it is in the upper quadrant of the normal range.
Objective Outcomes of patients with deferred revascularization for intermediate stenosis coronary lesion based upon physiological assessment using fractional flow reserve ([FFR] >0.80). Methods Patients with chest pain with angiographic intermediate stenosis, (40–70% stenosis) without noninvasive test evidence of ischemia were selected and underwent an FFR assessment between January 1, 2015, and August 31, 2018. Patients with intermediate lesions of FFR > 0.80 were followed, and those patients with lesion with FFR < 0.8 were excluded from the study. The primary outcomes of the study were to know the composite of target lesion revascularization (TLR), myocardial infarction (MI), and other vascular complications (major adverse cardiovascular events [MACE]). Results In 102 patients who underwent deferred revascularization (FFR > 0.80), 104 FFR studies were done and followed over one year. Four patients needed target lesion revascularization (3.92%). Three patients underwent percutaneous coronary intervention (2.94%) within nine months of follow-up, and one patient underwent coronary artery bypass graft (CABG) (0.98%) at one year of follow-up. Two patients died with acute MI with sudden cardiac arrest (1.96%). Two patients developed right hemiparesis (2.94%) on one year of follow-up due to acute ischemic stroke of a middle cerebral artery, and one patient underwent permanent pacemaker implantation for complete heart block (CHB). The incidence of the total events was 8.82%, TLR was 3.92%, Coronary event rate was 5.88%, and MACE was 7.84%. Conclusions Our study shows that there was a significant increase in the incidence of coronary event rate (5.88%) and the MACE rate (7.84%) in patients of deferred coronary revascularization based on higher FFR values (>0.8).
Objective The aim of this study was to investigate the relationship between oxidative and antioxidative stress markers with presence of left ventricular dysfunction (LVD) and the severity of LVD with coronary artery disease (CAD) in patients who have undergone percutaneous coronary intervention (PCI). Further, the role of oxidative and anti-oxidative stress markers on gender was also investigated. Methods This was an observational prospective pilot study of patients diagnosed with CAD with LVD who underwent PCI at the center from June 2017 to December 2017. Based on the ejection function (EF), patients were categorized into three groups: mild (> 40–50%), moderate (> 35–40%), and severe (≤ 35%). The oxidative and antioxidative stress markers (malondialdehyde [MDA], glutathione [GSH], and nitric oxide [NO]) were studied and compared in these groups and in both genders as subanalysis. Results Total 33 patients were enrolled, of whom 23 were male (69.7%) and 10 were female (30.3%). Mean age of the study population was 58.8 ± 9.3 years. Significant elevation of MDA and NO was seen in 33 (100%) and 26 (78.8%), respectively, and decreased GSH was seen in 30 (90.9%). There was no significant difference with respect to oxidative and antioxidative stress markers and severity of LVD (MDA, p = 0.25; NO, p = 0.79; and GSH, p = 0.2) despite elevated MDA levels in all patients. The subanalysis was done to see the gender effect with oxidative and antioxidative stress markers (MDA, p = 0.29; NO, p = 0.10; and GSH, p = 0.50), and they all were insignificant. Conclusion In this study, there was no significant relationship of oxidative and anti-oxidative stress markers on the degree of LVD even though the elevated MDA levels suggestive of increased oxidative stress were seen in all patients. The further analysis of gender in relation to oxidative and antioxidative stress markers was also insignificant.
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