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Cardiovascular Diseases & Diagnosis

ISSN: 2329-9517

Open Access

Article in Press

Volume 8, Issue 6 (2020)

    Research Article Pages: 1 - 4

    ADAMTS13 Deficiency with Left Atrial Dilatation can Predict Left Atrial Thrombosis in Patients with Atrial Fibrillation

    Nadia El-Menshawy, Tarek Selim, Shahir George, Mena Mikhaeiln, Mohamed Eissa

    DOI: 10.37421/jcdd.2020.8.420

    Atrial fibrillation (AF) represents the most common sustained cardiac arrhythmia. The thrombo-embolic complication is a frequent and serious event with high morbidity and mortality in patients with atrial fibrillation. This study aimed to assess plasma levels of ADAMTS13 as a risk factor for left atrial thrombosis in patients with atrial fibrillation and correlate it with spontaneous echocardiographic parameters. This study was conducted on 60 atrial fibrillation patients. The patients were diagnosed clinically and confirmed by ECG and transthoracic M-mode, two-dimensional echocardiography, and Doppler. They were classified according to transesophageal echocardiography into 31 AF without spontaneous echocardiography contrast (SEC) and 29 AF with SEC. Plasma ADAMTS13 was measured in addition to measurement von Willebrand Factor (vWF) antigen and activity. The results showed a significant decrease in the ADAMTS13 level in AF cases when compared to control subjects. In addition to significantly lowered ADAMTS levels were observed in AF patients with SEC when compared to AF patients without SEC and a significant negative correlation between ADAMTS13 level and left atrial diameter in AF cases. ADAMTS13 deficiency is a potential risk factor of left atrial thrombosis in patients with atrial fibrillation (AF). ADAMTS13 could be implemented in laboratory workup of AF patients with left atrial dilatation for predicting left atrial thrombosis.

    Research Article Pages: 1 - 7

    Echocardiography Evaluation of the Effects of Midazolam on Passive Leg Raising Test in Critically ill Patients in the Intensive Care Unit, Diagnosed with Sepsis, determined to be Hypovolemic and responding to Fluid Treatment

    Abdulkadir Yektas

    DOI: 10.37421/jcdd.2020.8.421

    Background: In this study, we aimed to investigate the effects of midazolam sedation on intravascular volume in intubated patients diagnosed with sepsis and treated with invasive mechanical ventilation in continuous positive airway pressure mode using echocardiography (ECHO) parameters. Methods and Results: One hundred fifty-two intensive care unit patients aged 30-50 years with spontaneous breathing who were intubated, ventilated in continuous positive airway pressure mode via invasive mechanical ventilation, were determined to have fluid deficit. Cardiac index, cardiac out-put and velocity time integral measurements were performed by passive leg rising test before and after midazolam sedation in hypovolemic patients that were determined to respond to fluid treatment and changes in passive leg rising test before and after midazolam were compared. >15% cardiac out-put, >10% cardiac index, and >15% velocity time integral increase in passive leg rising test before midazolam administration showed that patients were hypovolemic and responded to fluid therapy. <15% cardiac out-put, <10% cardiac index, and <15% velocity time integral increase in passive leg rising test after midazolam administration showed that patients were not hypovolemic. Conclusion: We recommend that passive leg raising test, which is performed to determine the intravascular volume status of critically ill intensive care unit patients determined to be hypovolemic and responding to fluid therapy, should be performed before midazolam sedation.

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