Inorganic arsenic (iAs) exposure has been reported to have an impact on cardiovascular diseases (CVD). However, there is not much known about the cardiac tissue injury of CVD patients in relation to iAs exposure and potential role of single nucleotide polymorphisms (SNPs) of genes related to iAs metabolism, oxidative stress, endothelial dysfunction and inflammation which may play important roles in such CVD cases. In this dual center cross-sectional study, based on the exclusion and inclusion criteria, we have recruited 50 patients out of 270, who came from known arsenic-affected and- unaffected areas of mainly Chittagong, Dhaka and Rajshahi divisions of Bangladesh and underwent open-heart surgery at the selected centers during July 2017 to June 2018. We found that the patients from arsenic affected areas contained significantly higher average iAs concentrations in their urine (6.72 ± 0.54 ppb, P = 0.028), nail (529.29 ± 38.76 ppb, P < 0.05) and cardiac tissue (4.83 ± 0.50 ppb, P < 0.05) samples. Patients’ age, sex, BMI, hypertension and diabetes status adjusted analysis showed that patients from arsenic-affected areas had significantly higher iAs concentration in cardiac tissue (2.854, 95%CI 1.017–8.012, P = 0.046) reflecting higher cardiac tissue injury among them (1.831, 95%CI 1.032–3.249, P = 0.039), which in turn allowed the analysis to assume that the iAs exposure have played a vital role in patients’ disease condition. Adjusted analysis showed significant association between urinary iAs concentration with AA (P = 0.012) and AG (P = 0.034) genotypes and cardiac iAs concentration with AA (P = 0.017) genotype of AS3MT rs10748835. The AG genotype of AS3MT rs10748835 (13.333 95%CI 1.280–138.845, P = 0.013), AA genotype of NOS3 rs3918181 (25.333 95%CI 2.065–310.757, P = 0.002), GG genotype of ICAM1 rs281432 (12.000 95%CI 1.325–108.674, P = 0.010) and AA genotype of SOD2 rs2758331 (13.333 95%CI 1.280–138.845, P = 0.013) were found significantly associated with CVD patients from arsenic-affected areas. Again, adjusted analysis showed significant association of AA genotype of AS3MT rs10748835 with CVD patients from arsenic affected areas. In comparison to the reference genotypes of the selected SNPs, AA of AS3MT 10748835, AG of NOS3 rs3918181 and AC of rs3918188, GG of ICAM1 rs281432, TT of VCAM1 rs3176867, AA of SOD2 rs2758331 and GT of APOE rs405509 significantly increased odds of cardiac tissue injury of CVD patients from arsenic affected areas. The results showed that the selected SNPs played a susceptibility role towards cardiac tissue iAs concentration and injury among CVD patients from iAs affected areas.

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Background: Bronchodilators, by dilatation of bronchial tree through relaxation of bronchial smooth muscle increases the vital capacity, tidal volume and total lung capacity and reduces gas trapping. This study was conducted to assess the pulmonary function after off-pump coronary artery bypass graft (CABG) surgery between patients with impaired pulmonary function treated with or without preoperative bronchodilator. We also compared duration of mechanical ventilation and days spent in the surgical intensive care unit (ICU) after CABG in both group of patients. Methods: This prospective cohort study was carried out in the department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2009 to April 2011. This study included 50 patients (25 patients in each group) with multi-vessels coronary artery disease with impaired pulmonary function who underwent off-pump CABG. Results: Spirometry was done in both groups of patients after admission, day before operation and on 7th post-operative day. The difference in Forced vital capacity (FVC) and Forced expiratory volume in 1st second (FEV1 ) between two groups were not statistically significant after admission (P>0.05). On the day before surgery the values of FVC and FEV1 were increased (more in Group-I who were treated with bronchodilator) and 7th postoperative day the values were decreased (more in Group-II who were not treated with bronchodilator). The results were found statistically significant in between groups (P<0.05). Conclusion: Bronchodilator should be considered pre-operatively in all patients having impaired pulmonary function undergoing off-pump CABG for better preservation of postoperative pulmonary function. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22260 Cardiovasc. j. 2015; 7(2): 123-127

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Peripheral arterial disease affects with loss of limb if untreated. For decades, arterial bypass has been regarded as one of the trustworthy and effective methods for treatment of atherosclerosis in lower limbs. A 65 year old male patient was treated for a worsening short distance intermittent claudication in left calf muscle. Clinical examinations identified occlusion of the superficial femoral artery. Peripheral Angiogram (PAG) revealed popliteal artery had good calibre with distal run off. Left superficial femoral artery to popliteal artery bypass was performed on the patient with autologous reversed great saphenous venous conduit. Post operative course was uneventful. The pulses of the dorsalis pedis and posterir tibial arteries in left leg regained and remain strong. The Ankle Brachial Index (ABI) increased from 0.60 to 1.09. As far as arterial bypass in lower limb is concerned, the efficacy is usually not so desireable because of lack of vascular substitutes, insufficient availability of autologous vessels and also the scarcity of skilled vascular surgeon. Therefore, it becomes our long-lasting desire to find out a safe and endurable graft conduit and also to establish vascular surgery in a city where this type of surgery was absent previously. We have recently succeeded in performing femoro-popliteal bypass surgery in Chittagong Medical College Hospital (CMCH). Probably this was the first successful femoro-popliteal bypass surgery with autologous great saphenous venous conduit for chronic arterial occlusive disease of lower limb in this hospital. JCMCTA 2015 ; 26 (1) : 46-51