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  • ISSN: 2333-6676
    Volume 8, Issue 1
    Research Article
    Torgeir Sand Aas*, Jan Pal Loennechen, Øyvind Salvesen, and Rune Midgard
    Objectives: The main purpose of the present study was to compare left atrium fibrosis measured with integrated backscatter in atrial fibrillation patients with and without prior thromboembolism defined as cerebral infarction, transient ischemic attack or peripheral embolism.
    Method: We performed a cross-sectional study implementing a case-control design. The enrolled patients were allocated to two main categories; Stroke or Non Stroke. Clinical characteristics, standard echocardiographic parameters and integrated backscatter measurements from posterior wall in left atrium were obtained. Integrated backscatter measurements from left atrium posterior wall were calibrated to integrated backscatter measurements in the pericardium.
    Results: Of the 90 patients included, 66% were men, and mean age was 71.8 ± 10.3 years. A history of thromboembolic disease was documented in 21 (23%) patients. Mean calibrated integrated backscatter was measured to -10.9 ± 6.3 dB in the Stroke group and -10.1 ± 5.6 dB in the Non Stroke group, with no significant difference between groups (p = 0.57). Calibrated integrated backscatter was significant higher in permanent atrial fibrillation vs persistent atrial fibrillation (p = 0.01) and borderline significantly higher in permanent AF vs recurrent AF (p = 0.05). There was no significant difference between paroxysmal and persistent AF or between paroxysmal and permanent AF. Calibrated integrated backscatter tended to increase with time since AF diagnosis.
    Conclusion: Calibrated integrated backscatter did not differ between AF-patients with and without prior stroke.
    Moustafa Kamal Eldin Ibrahim*, Khalid A El-khashab, and Tamer M Ragab
    Background: Adverse left ventricular remodelling (LVR), defined as progressive ventricular dilatation, distortion of chamber shape, myocardial hypertrophy and deteriorating function, begins in some patients who suffered from acute myocardial infarction (AMI), sometimes even after successful Percutaneous Coronary Intervention (PCI). If uninterrupted, it could lead to congestive heart failure (CHF) and a poor clinical outcome.
    Aim: This study aims at evaluating the value of speckle tracking echocardiography in predicting LVR after successful PCI in AMI patients.
    Materials and Methods: Eighty-four AMI patients had a complete echocardiographic study, including speckle tracking, performed two days after PCI and then two months afterwards. The patients were then divided into two groups based on the presence of remodelling; R+ (remodelling) group and R- (non-remodelling) group.
    Results: At the baseline study, group R+ showed significantly lower strain parameters than group R-.These included global longitudinal strain (GLS) (-11.14±0.5 VS -16.78±0.4, p±0.0001), longitudinal strain rate (-1.01±0.05 VS -1.07±0.04, p±0.0001), culprit longitudinal strain (CulLS) (-9.74±0.59 VS -15.68±0.49, P±0.0001), and culprit longitudinal strain rate (-0.95±0.05 VS -1.02±0.04, P±0.0001). In the follow up study, all of the strain parameters studied was again significantly lower in the R+ than the R-group. The most sensitive and specific parameters were the GLS and CulLS (sensitivities of 91.7% and 95.8%, respectively and specificities of 95% and 96.7%, respectively).
    Conclusion: Our findings show that impaired indices of LV deformation detected two days after successful PCI for AMI may provide a predictive value in early detection of LV remodelling.
    Vivek Tewarson, Sarvesh Kumar, Mohammad Zeeshan Hakim, Shobhit Kumar, and Sushil K Singh*
    Introduction: While secondary cardiac tumors are more frequent, primary cardiac tumors are considered rare entities, with low prevalence. These tumors tend to affect females more frequently and are located mostly in the left atrium. Hemodynamic derangements, systemic embolization and constitutional symptoms are the common presentations and surgical treatment provides good results.
    Materials & methods: Data from 30 consecutive patients with cardiac myxomas who underwent surgery in our institution over a period of 10 years (June 2010 to June 2019) was collected from patient records and analyzed retrospectively. The pre-operative patient characteristics, intra-operative and post-operative data were collected to study the presentation, symptomatology, operative approaches, complications, and outcomes in these patients.
    Results: Out of the 30 cases that were included in this study all patients were evaluated pre-operatively with trans-thoracic echocardiography. Left sided masses were approached through the left atrium while right sided ones were dealt with via the right atrium. All patients had cardiac myxoma as confirmed by histopathological diagnosis. Patients were followed up for 60 months and two patients demonstrated tumor recurrence.
    Conclusion: Clinical outcomes of myxoma resection are acceptable. With proper surgical technique, good resection margin and timely excision, recovery from symptoms is good and recurrence rates can be lower than 5%.
    Opinion
    Omar Al-assaf* and Abdulla AlHawai
    Chloroquine, hydroxychloroquine and azithromycin are medications used in the pandemic of COVID-19 as a treatment for confirmed and suspected cases of COVID 19 infection. QTc prolongation a side effect of these medication scan result intorsade’s de pointes leading to cardiac arrest [1].
    Case Report
    Piyush Kalantri*, Aniruddha Kaushik, Rahul Singla, Arun bade, and Narendra Omprakash Bansal
    Percutaneous coronary intervention is associated with much complication and stent thrombosis is most feared amongst them. Common etiology of stent thrombosis includes high angiographic thrombus burden, inadequate antiplatelet dosing, total stent length, diabetes, and renal disease. Rarely can it be associated with thrombocytosis. We are reporting a rare case of stent thrombosis associated with reactive thrombocytosis. Although acute coronary events have been documented due to essential thrombocytosis but very few cases of reactive thrombocytosis leading to acute Coronary syndrome (ACS) are reported. Thrombocytosis as a possible etiology is suspected when other risk factors including antiplatelet resistance is ruled out .In these cases adequate treatment of both stent thrombosis and thrombocytosis need to be administered simultaneously and possible etiology of thrombocytosis sorted out and treated.
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