Background: Definitive diagnosis of pulmonary artery hypertension (PH) requires an elevated mean pulmonary arterial pressure (MPAP) of 25 mmHg at rest measured by right heart catheterization (RHC). As it is invasive mode of investigation, it is declined by many patients, echocardiography was thought to be an acceptable substitute to assess pulmonary arterial pressures. Whether there is a correlation between these measurements is controversial. The aim of this study was to assess PH by echocardiography and its correlation with RHC.Methods: Twenty-six patients aged ≥18 years with pulmonary artery hypertension with or without tricuspid regurgitation (TR) were included in this cross-sectional study. All the patients underwent a transthoracic echocardiography evaluation and were taken for RHC study within an hour.Results: The correlation between pulmonary artery acceleration time (PAAT) and pulmonary artery systolic pressure (PASP) and PAAT and MPAP was significant in all degrees of PH. In contrast, correlation between TR jet maximum velocity (TR Vmax) derived estimated pulmonary artery systolic pressure (EPASP) and PASP was significant in moderate and severe PH, while it did not correlate in mild PH.Conclusions: PAAT is easily measurable parameter and strongly correlates with the values of PASP and the MPAP obtained by right heart catheterization. Implementation of a novel method of determining EPASP from PAAT shall increase significantly the number of patients in whom TTE can be used for the assessment of pulmonary hemodynamic non-invasively.
Background: Telengiectasias are defined as persistent dilatation of small capillaries in the superficial dermis Case: A 26-year-old woman presented with red lesions, epistaxis, joint pains, color changes of the hands, and breathlessness. On clinical examination and investigations, a final diagnosis of mixed connective tissue disease (MCTD), with interstitial lung disease (ILD), with telangiectasias, and epistaxis was made. Telangiectasias and epistaxis are rare presentations of MCTD.
Background: Cardiovascular diseases have become the fastest growing health issue in India and worldwide. Population with metabolic syndrome is known to be pre-disposed to several chronic disorders along with higher risk of experiencing cardiovascular events. The role of uric acid as a cardiovascular risk factor in metabolic syndrome was not well studied in the literature, which made us to undertake the present study.Methods: All the patients aged between 18 to 75 years (both gender) who approached Madhavbaug cardiac care clinics located in Maharashtra, India for assessing risk of heart disease from January 2015 to January 2017 were screened. Risk factors for metabolic syndrome have been evaluated among the study population and categorised into metabolic syndrome positive (³3 risk factors) and negative groups (<3 risk factors). Statistical analysis was done using SPSS software version: 21.0.Results: Our study includes 2294 subjects who met the inclusion and exclusion criteria. Males outnumbered the females and sex ratio was 2.89:1. Females had lower serum uric acid levels compared to males irrespective of metabolic component. Gender and serum uric acid levels (high and low) were used stratification of the subjects. Serum uric acid is an independent predictor of cardiovascular diseases with an Odds ratio of 1.13 (95% confidence interval).Conclusions: Serum uric acid level is one of the important predictor for cardiovascular risk in metabolic syndrome. Raised uric acid is not an innocent by-stander and one of the major contributors in development of cardiovascular diseases.
Background: Atrioventricular plane displacement (AVPD) reflects global left ventricular function despite left ventricular asymmetry as it is determined in four different regions of left ventricle. The limitations of agreement between left ventricular ejection fraction (LVEF) and AVPD are not close enough for these two measurements to be interchangeable. There is reason to question whether AVPD provides the same information as LVEF. Aim: The aim of this study was to assess relations of AVPD with LVEF and clinical findings in patients left ventricular failure (LVF). Materials and Methods: One hundred patients aged ≥18 years with coronary artery disease admitted with LVF were included in this cross sectional study. Echocardiographic examination was performed. Left ventricular AVPD was evaluated by M mode, in the four and two chamber views. Primary aim was to compare AVPD with LVEF by echocardiography. Secondary outcome measures were comparison of AVPD with traditional risk factors, clinical features, and pro-B-type natriuretic peptide (BNP) levels. Comparison of qualitative and quantitative variables was done by using Chi-square test/Fisher's exact test and unpaired t-test. Pearson's correlation was used to study correlation. Results: Mean AVPD was significantly lower in patients with severe LVEF as compared to mild, and moderate LVEF. Correlation of AVPD with LVEF, pro BNP, septum, anterior, lateral and posterior wall hypokinesia was 0.895. 0.841, 0.898, 0.911, 0.893 and 0.907 respectively. Conclusions: Mean AVPD was significantly lower in patients with severe LVEF. Mean AVPD positively correlated with LVEF, pro BNP, septum, anterior, lateral and posterior wall hypokinesia.
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