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ObjectivesDetection of the echocardiographic predictors of post-operative atrial fibrillation in patients with rheumatic mitral valve disease undergoing mitral valve replacement.MethodsThe study included 50 patients with rheumatic mitral valve disease undergoing mitral valve replacement. Preoperative assessment included standard two-dimensional echocardiography to assess LA diameter, volume, and emptying fraction, LV volume and ejection fraction. TDI derived velocity, strain of the left atrium and speckle tracking to assess left ventricular function then postoperative follow up for 1 month for occurrence of atrial fibrillation.ResultsThe incidence of postoperative AF was 44%; these patients were significantly older (P = 0.001) and show higher prevalence of DM (P = 0.001) and HTN (P = 0.001). Also, LA diameters (antero-posterior, transverse and longitudinal) and LA volumes (maximal and minimal) were increased (P < 0.001), but no difference in LA emptying fraction (P > 0.05). Systolic LA strain and left ventricular global longitudinal strain were significantly reduced in those patients (P value <0.001). Echocardiographic predictors of AF were LA systolic strain (P value <0.001) and LV global longitudinal strain (P value = 0.003). Cutoff value for systolic LA strain ≤23 had sensitivity 90.91% and specificity 93.33% in predicting POAF. While, left ventricular global longitudinal strain ≤−14.9% had sensitivity 63.6% and specificity 100.0% in predicting AF.ConclusionLA systolic strain and LV global longitudinal strain were significant predictors of POAF. Echocardiographic parameters can identify patients at greater risk of developing POAF who can benefit from preventive measure and guide the selection of prosthesis.

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Intense coronary disorder (ACS) is a condition (set of signs and indications) because of diminished blood stream in the coronary courses with the end goal that piece of the heart muscle can't work appropriately or kicks the bucket. The point of study is to assess chemerin levels in patients with intense coronary disorder. The investigation included 100 subjects who were ordered into two gatherings; control bunch which included 20 subjects with typical coronary discoveries, and cases bunch which included 80 cases with ACS (counting STEMI, NSTEMI, and UA). All cases and controls were exposed to finish history taking, careful actual assessment, and routine lab examinations. Likewise, serum chemerin were estimated for all cases and controls. The mean age of the included subjects was 55.99 and 56.2 years for ACS and control bunches individually. Guys spoke to 55 and 52.5% of cases in the two gatherings individually, with no measurably huge distinction between the two gatherings (p=0.448). Serum chemerin level was fundamentally higher in the ACS gathering (268.8 ng/ml versus 115 ng/ml in controlsp < 0.001). On separating ACS cases into 3 subtypes, there was mellow huge distinction between STEMI, NSTEMI, and UA (p = 0.086). The best cutoff purpose of Chemerin to foresee the event of ACS was >249.5 ng/ml with 74.6% affectability, 82% particularity, 78% PPV, 72% NPV and precision of 72%. Chemerin was more touchy than troponin in distinguishing cases with ACS.