Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the cause of many different forms of heart disease worldwide and yet few cardiologists are aware of it as an etiology of heart disease, or its treatment. The burden of HBV and HCV derived heart diseases are global, with a higher prevalence in Asia, Africa, and low- and middle-income countries. The study showed that in more than 10% of Japanese patients, their cardiomyopathies are associated with HCV infection. More recently, it is found in the USA that up to 15% of patients with heart failure with myocarditis have been associated HCV infection. In contrast, in China 79% of patients with hepatocellular cancer and 37% of hepatitis C patients have heart disease, as detected by measuring a proven and sensitive biomarker of heart disease, NT-proBNP. In Pakistan, 17% of hepatitis C patients have heart diseases, as measured by this metric (NT-proBNP). Based on these data, 3% of 6.6 billion (198 million) persons worldwide are infected with HCV and 1737% (3473 million) persons are suffering from HCV-derived heart diseases. These figures may be comparable to the number of patients with hepatitis C. HCV infection causes only hepatitis in some patients, only heart diseases in some patients, and both hepatitis and heart diseases in other patients. A global network is required to establish methods to detect heart diseases caused by infectious agents. Other goals for the network are the expansion of preventive and therapeutic programs in under privileged countries. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16084 University Heart Journal Vol. 8, No. 2, July 2012
HCM is a relatively common genetic mediated primary cardiac disease which may cause sudden death in the young including competative athlets.PTSMA is an alternative therapeutic option for surgical septal myomectomy who are high risk for surgery and presented with severe disabling symptoms due to marked LV outflow obstruction. PTSMA is performed by injection of 1 to 4 ml of 96% to 98% ethanol into the target artery in 0.5 to 1.0 ml aliquots at 1 ml/min. Selection of patients for PTSMA includes those with severe symptoms refractory to maximum medical management associated with LV outflow gradient > 50 mm Hg and basal septal thickness > 18 mm. Successful outcome following septal ablation by LV outflow gradient often reduced to < 20 mm of Hg and improved from symptomatic standpoint. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16083 University Heart Journal Vol. 8, No. 2, July 2012
Percutaneous coronary catheterization and revascularization are commonly performed all over the world. Among various access sites for coronary interventions, most cardiologists favour the femoral approach, while the procedure via the radial artery is only performed by a limited number of operators. In this study, we aimed to assess the procedural outcome of the trans-radial coronary angiography (CAG) among the patients in a tertiary care hospital in Bangladesh. This prospective observational study was carried out among 40 patients underwent trans-radial coronary angiography. The study was conducted for a period of one year. Indication of CAG including chronic stable angina, unstable angina, non ST elevated myocardial infarction (MI) and ST elevated MI were observed. Procedural attempt, success rate and outcome with or without complications were mentioned. Out of 40 patients, 70% were male and 30% were female (M: F=2.3:1). Among the patients undergoing trans-radial CAG, 50% had dyslipidemia and HTN, 55% had family history of IHD, 52.5% were smoker and 20% had DM. Most of the patients underwent trans-radial CAG due to unstable angina (52.5%) and this was followed by ST elevated MI (30%), non ST elevated MI (10%) and chronic stable angina (7.5%).The mean procedural time was 19.85±1.3 minutes. The fluoroscopy time was 9.60±.9 minutes. The mean hemostasis time was 9.00±7.0 minutes. All patients were ready for discharge within 24 hours. Only 7.5% patients experienced spasm of radial artery during CAG. No other complications were detected. Trans-radial approach is an attractive alternative to conventional trans-femoral approach, in suitable patients at the hand of experienced operator, with appropriate hardwire and should be ready to cross over, to the femoral approach when needed.
Decompensated heart failure is one of the major causes of morbidity and mortality in worldwide. Some of these patients suffer repeatedly after taking optimum medical therapy (OPT). Cardiac resynchronization therapy (CRT) has been shown to be an effective therapy for patients with heart failure and dyssynchrony.
Electronic cardiac pacemakers are the definitive treatment of sinoatrial node (SAN) dysfunction and high degree atrioventricular block. But they have limitations like limited battery life, need for lead implantation into heart and lack of response to autonomic and physiologic demands on the heart. Genetically engineered biological pacemakers could be a possible alternative to electronic pacemakers. The strategies include upregulation of β-1 adrenergic receptors, conversion of cardiomyocyte into pacemaker cells and stem cell therapy. Investigators created biological pacemakers in animal models by gene therapy targeting If current (HCN) and inward rectifier current (IkI) (Kir 2.1). They delivered pacemaker current gene into animal heart by using viral vectors and human mesenchymal stem cells (hMSC). The limitations noted are longevity and stability of pacemaker genes and the chance of migration and tumour formation after stem cells therapy. Key words: Sinoatrial node (SAN); HCN-2 gene; If current; inward rectifier current (Ikl); human embryonic stem cells. DOI: 10.3329/uhj.v6i1.7189University Heart Journal Vol.6(1) 2010 pp.35-36
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