Cardiovascular Diseases & Diagnosis

ISSN: 2329-9517

Open Access

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    Research Article Pages: 1 - 8

    Valsalva Maneuver Impact on Both Ventricular Systolic and Diastolic Echocardiographic Parameters in Subjects with Normal Versus High Ventricular Filling Pressures: A Double Blinded Study

    Mohammad Bagher Sharif Kazemi, Esmaeil Mehdinejad and Mohammad Yasin Karami

    Introduction: Echocardiography is used as a useful and common method to assess Left Ventricular and Right Ventricular (LV and RV) systolic and diastolic functions. Valsalva Maneuver (VM) with the increase in the intra-thoracic and intra-abdominal pressure is often used as an uncomplicated, cost-effective and non-invasive technique for diagnosing clinical conditions such as heart murmurs. However, in terms of echocardiography, the use of VM has been limited to only a few parameters for many years. In contrast, blood level of N-Terminal Pro-BType Natriuretic Peptide (NT Pro-BNP) indirectly discriminates normal or high ventricular Filling Pressure (FP). This study aimed at providing a comprehensive review of the technique as well as comparing the VM effect in ACS patients; with and without elevated FP on either RV or LV diastolic and systolic echocardiographic parameters. Methods: Thirty-eight patients, who were diagnosed with possible ACS; unstable angina pectoris, NSTEMI and STEMI, underwent coronary angiography enrolled in this double-blinded clinical trial study. The mild Coronary Artery Disease (CAD) with normal NT Pro-BNP levels were included in study group one and cases with significant CAD and high level of NT Pro-BNP who underwent PCI were included in study group two. All the systolic and diastolic indicators of both ventricles, totaling twenty-four parameters which have been previously mentioned in the academic literature, have been evaluated; once before valsalva and once during second stage of the maneuver. Echocardiography is performed by an advanced echo machine and by an expert cardiologist-echocardiographer; the recorded images were reviewed by the second echocardiographer separately.Results: Between the two groups, LV parameter analysis showed significant difference in LV EF pre and post VM. However, there was a statistically insignificant difference regarding other systolic as well as diastolic parameters. Between the two groups, RV parameters analysis indicated no significant difference regarding systolic and diastolic parameters pre and post VM.Conclusion: This research for the first time assessed post VM changes in four chambers as well as mitral and tricuspid valves parameters in ACS patients with normal versus high level of FP. Previously, LV diastolic dysfunction and Doppler mitral inflow pattern correlation with VM were verified. In the present study, in addition to those known findings from before-except the LV Ejection Fraction (LVEF) that showed there was statistically significant difference in pre-and post-VM-other systolic parameters, as well as diastolic indicators in either RV and LV, were identical. Therefore, we do not recommend conducting valsalva maneuver on the rest of the other parameters to diagnose systolic and diastolic dysfunction in ACS patients with mild versus significant CAD who were assumed to have normal or elevated filling pressures.

      Review Article Pages: 1 - 5

      Underrepresentation Of Women In Cardiovascular Trials In Arab Middle East Region

      Hanan Albackr*, Abdulaziz Backer Albacker and Deema H. AlGhufaili

      Cardiovascular Disease (CVD) is the leading cause of death in women worldwide. The burden of CVD is rising among Arab Middle Eastern (ME) women. Information regarding the prevalence and incidence of CVD and its risk factors in women in Arab ME is scares and may be lacking in some countries. One of the reasons is low participation of Arab women in cardiovascular trials and research. The underlying reasons for the under-representation of women in clinical trials are complex and exploration of additional causes, such as socioeconomic and psychological factors is crucial to help us to address the gap in scientific evidence on women with cardiovascular disease in the Arab region.

        Research Article Pages: 1 - 6

        Diagnosis of Autism Spectrum Disorder through Complex Network Communications

        Elyas Irankhah*

        Modular associations are structures in complex networks that are defined based on the communication density between the network elements. The difference in these structures in a complex network of human brain signals (EEG) can be used as a factor in the diagnosis of diseases. In this study, with the focus on modular associations, attempts to achieve the differences between a complex two-group of network of Normal Case (NC) and Autistic of Spectrum Disorder (ASD). Eventually, using real EEG signals, the tested groups, with no use of the pre-processing signaling, have an accuracy of 88.37% in detecting Autism Spectrum Disorder (ASD).

          Mini Review Pages: 1 - 3

          Incident Cardiovascular Disease is more Commonly Associated with Remnant Cholesterol than with LDL Cholesterol

          Young Park*

          DOI: 10.37421/2329-9517.2023.11.554

          Hereditary, observational and clinical mediation studies demonstrate that coursing levels of fatty oils and cholesterol moved in fatty substance rich lipoproteins (remainder cholesterol) can foresee cardiovascular occasions. This study looked at the relationship between major cardiovascular events and a group of older people with high cardiovascular risk's triglycerides and residual cholesterol (remnant-C). This study searched the high risk primary prevention PREDIMED trial population for Major Adverse Cardiovascular Events (MACEs) and determined the baseline lipid profile. The mean age of the participants was: 67 years; index of mass in kg: 30 kg/m2; 43% men; 48% with diabetes) after a middle development of 4.8 years. The association between incident MACEs and lipid concentrations (either as continuous or categorical variables) was evaluated using both unadjusted and adjusted Cox proportional hazard models (N=6,901; n cases=263). Triglycerides' HR (hazard ratio) in multivariable adjusted analyses was as follows: 1.04; 95 percent confidence interval: 1.02 to 1.06 or 0.11 mmol/l, per 10 mg/dl; HDL-C (HR: p 0.001), non-high density lipoprotein cholesterol 1.05; 95% CI: 1.01 to 1.10 or 0.26 mmol/l, per 10 mg/dl; p=0.026) and remainder C (HR: 1.21; 95% CI: 1.10 to 1.33 or 0.26 mmol/l, per 10 mg/dl; MACEs were not associated with HDL-C or low density lipoprotein cholesterol (p=0.001), however. MACEs were also associated with atherogenic dyslipidemia (triglycerides>150 mg/dl (1.69 mmol/l) and HDL-C 40 mg/dl (1.03 mmol/l) in men or 50 mg/dl (1.29 mmol/l) in women) (HR: 1.44; 95% CI: 1.04 to 2.00; p=0.030). Regardless of whether LDL-C levels were on target at 100 mg/dl (2.59 mmol/l), subjects with residual C concentrations below 30 mg/dl (0.78 mmol/l) were more likely to experience MACEs. Triglyceride and remnant-C levels, but not LDL-C, were associated with cardiovascular outcomes in overweight or obese individuals at high cardiovascular risk, independent of other risk factors.

          Mini Review Pages: 1 - 3

          Compared to LDL Cholesterol, Incident Cardiovascular Disease is More Frequently Linked to Residual Cholesterol

          Nancy Babio*

          DOI: 10.37421/2329-9517.2023.11.555

          Hereditary, observational and clinical intercession studies demonstrate that coursing levels of Remainder Cholesterol (RC) are related with cardiovascular sicknesses. However, it is still unclear how well RC can predict cardiovascular mortality in the general population. The 19,650 adults in the United States who participated in our study were drawn from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. The Sampson formula was used to divide non-High-Density Lipoprotein Cholesterol (non-HDL-C) by Low-Density Lipoprotein Cholesterol (LDL-C) to arrive at RC. Subgroup analysis, restricted cubic spline analysis and multivariate Cox regression were used to investigate the connection between RC and cardiovascular mortality. Independent of conventional risk factors, elevated RC levels was linked to cardiovascular mortality.

          Review Article Pages: 1 - 7

          Comparison of Various Transcatheter Aortic Valves for Aortic Stenosis a Network Meta-analysis of Randomized Controlled Trials

          Ankur Sethi*, Emily Hiltner, Monarch Shah, Derek Schwabe-Warf, Bruce Haik, Abdul Hakeem and Mark Russo

          DOI: 10.37421/2329-9517.2023.10.556

          Objectives: Our aim was to compare available Transcatheter Aortic Valve Replacement (TAVR) valves using direct and indirect evidence from Randomized Controlled Trials (RCT).

          Background: TAVR is now an established treatment for majority of patients with severe aortic stenosis. However, there is limited data comparing various valves.

          Methods: We performed a systematic search of electronic databases for RCT comparing a TAVR valve to a valve or surgery. A Bayesian network meta-analysis was performed to compile evidence from both direct and indirect comparisons at 30 days and at one year.

          Results: Twelve studies with 10,307 patients eligible for TAVR met the criteria and were included. Self-expanding Valve Core valve type (SEV_C) is associated with higher risk of pacemaker implantation and use of >1 valve, SEV Accurate type (SEV_A) is associated with higher risk of ≥ moderate Aortic Regurgitation (AR) and death, and Mechanically Expandable Valve (MEV) is associated with lower risk of ≥ moderate AR but higher risk of pacemaker at 30 days, SEV_C and MEV were associated with higher pacemaker rates compared balloon expandable valve (BEV) at 1 year. There is no difference among the valves in stroke at 30 days and 1 year.

          Conclusions: At 30 days, BEV was superior on one or more outcomes of mortality, pacemaker implantation, >1 valve implantation and ≥ moderate AR compared to other valves except the higher rate ≥ moderate AR compared to MEV. At one year, BEV was associated with lower odds of pacemaker implantation compared to SEV_C and MEV but not different on other end points.

          Case Report Pages: 1 - 3

          Persistent Intraoperative Hypoxemia: a case report.

          Hong Xu*

          DOI: 10.37421/2329-9517.2023.11.557

          Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

          Research Article Pages: 1 - 5

          Influence of meteorological factors on the incidence of acute Type A aortic dissections in Northern Europe

          Simon Junghans1#, Peter Donndorf2*# ,Thore Scherff3, Christoph Lutter4, Anja Pueschel2 and Justus Groß1

          Background: Acute Type A Aortic Dissection (TAAD) is a life-threatening disease. Apart from the well- known atherosclerotic risk factor, circadian, seasonal and climate-related patterns are also factors with a significantly higher risk in winter, on the first day of the working week, and in the morning hours (between 6 a.m. and 12 p.m.). Acute TAAD can also be triggered by higher mean arterial blood pressure with corresponding blood pressure peaks, and changes in atmospheric pressure. The aim of this study is to analyze climatic parameters in the catchment area of Kiel in northern Germany which can influence the occurrence of acute TAAD. Methods: All acute TAAD repairs from January 1st, 2012 to November 24th, 2017 in the University of Hospital Schleswig-Holstein Campus (UKSH) were evaluated. Traumatic aortic dissections were excluded. Statistics were performed regarding to R&R commander programs using Wilcoxon rank sum test for data correlation analyzes.

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