This study aims to describe prevalence and clinical significance of latent Brugada syndrome (BrS) in a young population with atrial fibrillation (AF). Methods: Between September 2015 and November 2017, among 111 AF patients below 45 years of age, those without pre-existing pathologies and/or known risk factors were selected for the study. Based on baseline 12-lead−24-h Holter electrocardiogram (ECG), previous class 1C antiarrhythmic drug therapy, or ajmaline testing, patients were stratified as latent type 1 BrS or not. Results: Within the 78 enrolled patients, 13 (16.7%; group 1) revealed a type 1 BrS ECG pattern, while 65 (83.3%; group 2) did not. Mean age was 37 ± 8 vs. 35 ± 7 (p = 0.42), and males were 7 (54%) vs. 54 (83%) (p = 0.02) in the two groups, respectively. Family history of BrS was significantly more common within group 1 patients (2, 15% vs. 0; p = 0.03), and 4 (31%) patients experienced syncope in group 1 vs. 5 (8%) in group 2 (p = 0.02). After a mean follow-up of 42 ± 18 months from the index AF event, more than 80% of the patients, in both study groups, were in sinus rhythm. Conclusion: In young patients with AF without pre-existing pathologies and/or known risk factors, latent BrS should be suspected. Syncope and a family history of BrS emerge as easily identifiable factors related to BrS. Long-term sinus rhythm maintenance appears satisfactory, either in the presence or not of BrS.
Objectives:To identify coronary plaque morphology using grey scale and virtual histology intravascular ultrasound in patients with and without elevated glycated haemoglobin.Methods: The cross-sectional study was conducted at the Cardiology Department of Kafrelsheikh University, Egypt, from November 2019 to January 2022, and comprised adult patients of either gender suffering from acute coronary syndrome admitted for catheterisation. The patients were divided into three groups.Diabetic patients were in group A, prediabetic patients with elevated glycated haemoglobin in group B, and patients with normal glycated haemoglobin in group C. All patients were subjected to clinical examination, 12-lead electrocardiogram, coronary angiography and multimodality intravascular ultrasonography scan of proximal segments 3-6cmof non-culprit coronary arteries intra group differences were compared using the analysis of variance (ANOVA) test.Continue..
Objective: To evaluate plaque morphology in non-culprit coronary arteries using intravascular ultrasound in patients with acute coronary syndrome with and without elevated glycated haemoglobin and its assocaition with patient outcome.Methods: The cross-sectional study was conducted at the Cardiology Department of Kafrelsheikh University, Egypt, from November 2019 to January 2022, and comprised adult patients of either gender suffering from acute coronary syndrome. The patients were divided into three groups. Diabetic patients were in group A, prediabetic patients with elevated glycated haemoglobin in group B, and patients with normal glycated haemoglobin in group C. The patients were subjected to coronary angiography and percutaneous coronary intervention. Intravascular ultrasound scan wasdone after succcessful intervention. Lesions were classified according to ultrasound findings. Patients were followed up for one year to observe subsequent events to the morphology of the lesions detected at baseline. Data was analysed using SPSS 20.Results: Of the 52 patients, 18(34.7%) were females and 34(65.3%) were males. Group A had 18(34.6%)patients; 13(72%) males and 5(28%) females with mean age 57.9±6.9 years. Group B had 17(32.7%) patients; 11(64.7%) males and 6(35.3%) females with mean age 56.5±5.5 years. Group C had 17(32.7%) patients; 10(59%) males and 7(41%) females with mean age 59.5±5.1 years (p>0.05). Thin-capped fibro-atheroma was significantly higher in groups A and B compared to group C (p=0.045). Significant direct correlation between major adverse cardiac events and prevalence of thin-capped fibro-atheroma was found between groups A and C (p=0.033), and between groups B and C (p=0.047)regarding prevalence of necrotic plaque and subsequent myocardial infarction.Conclusion: Thin-capped fibro-atheroma was the more common plaque type in patients with raised glycated haemoglobin, and the subsequent rate of major adverse cardiac events was significantly higher in such patients compared to the non-diabetic population.Keywords: Plaque, Atherosclerotic, Angiography, Vessels, Percutaneous, Prediabetic.
Background:Early trans-mitral inflow velocity and mitral annular tissue Doppler imaging (E/Em ratio) is widely applied to noninvasively estimate left ventricular (LV) filling pressures. However, E/Em ratio has a significant gray zone among patients with severely impaired ejection fraction. Speckle tracking echocardiography (STE) was recently proposed as an alternative surrogate to estimate LV filling pressures. This study aimed at assessing performance of tissue Doppler parameters and left atrial global longitudinal strain as noninvasive surrogates for LV filling pressures and comparing accuracy of these two parameters across different striae of LVEF. Methods: A total of 96 patients with sinus rhythm and different ejection fraction who divided into four groups of 24 patients each according to their EF(>55%, 45-54%, 30-44%, and <30%), had an invasive measurement of the LV pressure. Both medial and lateral E/Em ratio were measured in all subjects by 2D Tissue Doppler, peak atrial longitudinal strain (PALS) and Peak atrial contraction strain (PACS) were obtained by averaging all segments measured in the 4-chamber. Results: Significant Correlation between global PALS and invasive LVEDP in all groups (r = 0.70 P < 0.000), While Lateral E/E' shows significant correlation only in two groups; preserved and mildly impaired EF (r=0.42 P=0.023, r=0.439 p-0.032; respectively) Conclusion:In patients with preserved or mildly reduced LV ejection fraction, global PALS and Lateral E/E' ratio presented good correlations with LVEDP. In patients with moderate or severe reduction of EF, E/E' ratio correlated poorly with invasively measured LV filling pressures. Global PALS provided an overall better estimation of LV filling pressures.
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