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  • ISSN: 2333-6676
    Volume 2, Issue 4
    Case Report
    Yadav D1*, Garg L1, Narwal P1, Ladkany R1 and Franey L1
    Abstract: Takotsubo cardiomyopathy is a clinical entity characterized by ventricular dysfunction in the absence of obstructive coronary artery disease. Posterior reversible encephalopathy syndrome is another rare clinical syndrome characterized by reversible neurological symptoms. Concomitant occurrence is being increasingly reported leading to credence to hypothesis of "heart brain connection". We present a case of 60 year old female admitted for neurological symptoms that developed Takotsubo cardiomyopathy within 24 hours of admission.
    Research Article
    Valmore Bermúdez3*, Joselyn Rojas3, Juan Salazar3, Robys González3, María Sofía Martínez3, Carmen Chávez3, Marcos Palacio1,2, Edward Rojas3 and José López Miranda3
    Abstract: Introduction: Type 2 Diabetes Mellitus (T2DM) is an independent risk factor for coronary artery disease. Nevertheless, the coronary risk rendered by pre-diabetes states such as Impaired Fasting Glucose (IFG) has not been thoroughly explored. The purpose of this study was to evaluate the influence of glycemic status on coronary risk estimated by the recalibrated Framingham-Wilson equation in our population. Materials and Methods: A total 1,378 of subjects were selected from the Maracaibo City Metabolic Syndrome Prevalence Study. A complete medical history was taken, along with laboratory workup and anthropometric measurement. All subjects were classified according to glycemic status in Normal Fasting Glucose (NG), Impaired Fasting Glucose (IFG), and T2DM. Coronary risk estimation was calculated using the Framingham-Wilson equation recalibrated for our population.
    Results: An increase in coronary risk was observed in IFG (p=3.78x10-6) and DM (p=4.34x10-13) when compared to NG; pattern also observed within genders: men (p=1.57x10-4) and women (p=2.37x10-4). Coronary risk also increased according to age in all categories of glycemic status. Within the IFG group, occupational status (p=0.004), smoking (p=2.29x10-5) and alcohol consumption (p=0.013) were associated with higher coronary risk. Finally, subjects with IFG exhibited greater probability for allocation in high coronary risk categories [OR: 1.46 (1.06 - 2.14); p=0.05].
    Conclusion: Coronary risk scores from the recalibrated Framingham-Wilson equation were significantly higher in subjects with IFG. In our population, this increase may be influenced by sociodemographic and psychobiological traits, such as marital and occupational status, smoking and alcohol consumption.
    Fariba Bayat, Elham Farahani* and Habibollah Saadat
    Abstract: Introduction: Coronary Artery Disease (CAD) is the most common cause for left ventricular dysfunction. Unfortunately, the treatment strategies of regional myocardial diastolic dysfunction in patients with CAD have not been well characterized and benefit of Percutaneous Coronary Intervention (PCI) as a treatment strategy is not clear. So the present study aimed to assess the effects of PCI on isolated left ventricular diastolic dysfunction in patients with CAD by using Strain Rate (SR) imaging.
    Methods: Thirty adult patients with coronary artery disease candidate for PCI on left anterior descending artery were enrolled to our study. Echocardiographic finding and early diastolic SR was measured before and 48 hours after PCI.
    Results: Mean age of the patients was 59.9±8.3 years. All of the left ventricular diastolic parameters showed significant difference before and after elective PCI; while pulmonary vein flow before and after PCI did not show any significant differences by using McNemar exact test. Also before PCI, mean (SD) SR in ischemic region (1.89±0.22) was smaller than of non ischemic region (2.53±0.26) while after PCI this parameter was became similar in ischemic region (2.55±0.27) and non-ischemic region (2.55±0.26).
    Discussion: Left ventricular diastolic parameters improved after PCI in CAD patients. Also regional myocardial relaxation as measured by peak early diastolic SR (ESR) in the ischemic segments improved significantly compared with that in non-ischemic segments.
    Behzad B Pavri1*, Kar-Lai Wong2, Reginald T Ho1 and Dusan Z Kocovic2
    Abstract:
    Objective: This study was designed to study the role of autonomic function in hemodynamic stability during Ventricular Tachycardia (VT).
    Background: Sustained VT may be hemodynamically tolerated or may result in syncope. Autonomic modulation may play an important role in the hemodynamic consequences of VT.
    Methods: The study was performed in two parts: (1) A retrospective review of electrophysiology studies with induced VT with ventriculo-atrial dissociation; and (2) Prospective performance of three standardized tests of autonomic function (isometric handgrip, Valsalva maneuver, deep breath test) in 45 patients with inducible VT. Sinus Cycle Length (SCL) was measured for the first 20 seconds during VT from the high right atrial electrogram, and compared in patients with stable and unstable VT with ventriculo-atrial dissociation.
    Results: SCL shortened in patients with stable VT (from 778 ms at VT onset to 664 ms at 20 s, p<0.001), whereas SCL did not change in patients with unstable VT (803 ms to 790 ms, p=0.8). Stable VT patients were more likely to have normal results on standardized autonomic tests as compared to patients with unstable VT. Both groups had comparable LV function and medication use, although VT rate was faster in the unstable group.
    Conclusion: Sinus acceleration during VT, preserved autonomic function, and slower VT rate were associated with hemodynamic stability. Standardized autonomic test results correlated with hemodynamic behavior during VT. Based upon these data, we conclude that in addition to VT rate, the ability of the autonomic nervous system to respond to abrupt-onset tachycardia may influence hemodynamic stability during VT.
    Clinical Image
    Panneerselvam Arun Kumar* and Gopalan Rajendiran
    A 37-year-old male presented with acute ST-elevation anterior wall myocardial infarction with window period of 3 hours and he opted for fibrinolytic therapy for the same.
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