Background & objective: Involvement of the right coronary artery frequently occurs in acute infer... more Background & objective: Involvement of the right coronary artery frequently occurs in acute inferior myocardial infarction. Typical ECG changes in this condition involve ST-segment elevation in inferior leads. The present study was intended to predict the site of the lesion in the right coronary artery (RCA) in patients with acute inferior wall myocardial infarction using the height of ST-segment elevation as the predictor variable. Methods: The present cross-sectional study was carried out in the Department of Cardiology, National Institute Cardiovascular Diseases (NICVD), Dhaka, Bangladesh over a period of one year between July 2010 to June 2011. Patients with acute inferior myocardial infarction admitted to CCU of NICVD within 12 hours of the onset of chest pain and underwent coronary angiography within 4 weeks of acute myocardial infarction (AMI) were the study population. With the help of a 12-lead ECG, magnitudes of ST-segment elevation in leads II, III, and aVF were measured....
Background: The coronavirus disease (COVID-19) is a multisystem disease that sometimes affects th... more Background: The coronavirus disease (COVID-19) is a multisystem disease that sometimes affects the cardiovascular system (CVS) during acute illness and follows a protracted course in a proportion of patients causing ‘post-COVID syndrome’. Exercise tolerance test (ETT) can assess functional capacity and imaging modalities like echocardiography and cardiac magnetic resonance (CMR) can assess structural and functional status of cardiovascular system (CVS) efficiently. However, the pattern of cardiovascular involvement and its effect on functional capacity in COVID-19 survivors long after the index illness are inadequately known. This study was carried out to detect the functional status and imaging findings in COVID-19 recovered healthcare workers. Methods: This cohort study was carried out in the Department of Cardiology of the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from July 2021 to December 2021. Thirty male healthcare workers, previously not known ...
Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) functi... more Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this study was to predict the presence of coronary artery disease by longitudinal 2D strain analysis using speckle tracking echocardiography in patients with stable or unstable angina with no regional wall motion abnormality at rest. Objectives: Objective of this study is to predict the presence of significant CAD in a patient with no regional wall motion abnormality by longitudinal 2D strain analysis using speckle tracking echocardiography. Methods: This cross-sectional study included a total 66 patients (mean age, 51.92±8.9 years) with suspected CAD without RWMA on resting echocardiography who underwent coronary angiography. Longitudinal 2D strain analysis by STE was performed in all patients before coronary angiography. Global and segmental peak systolic longitudinal strain (PSLS) were recorded & computed by offline dedicated software semi-automatic...
Background: Intervention for bifurcation lesions is associated with increased risk of adverse eve... more Background: Intervention for bifurcation lesions is associated with increased risk of adverse events and includes acute side branch (SB) occlusion during main branch (MB) stenting. This acute occlusion of side branch can often be catastrophic for the patient. We here in describe our experience in National Institute of Cardiovascular Diseases and Hospital (NICVD), Dhaka, Bangladesh with a technique which can be incorporated into bifurcation stenting to reduce or almost eliminate the incidence of side branch occlusion or catastrophe. Methods: A prospective, observational, non-blinded study in patients from a single tertiary referral cardiac center National Institute of Cardiovascular Diseases & Hospital (NICVD), Dhaka, Bangladesh. Patients with an indication for percutaneous coronary intervention (PCI) of a denovo bifurcation lesion were screened. The study included 51 patients who underwent coronary angiogram in our institution and had bifurcation lesions suitable for single stent st...
Journal of the American College of Cardiology, 2019
prosthetic regurgitation after 72 months and 2 cases of severe stenosis after 26 and 89 months). ... more prosthetic regurgitation after 72 months and 2 cases of severe stenosis after 26 and 89 months). Seventeen events led to a new hospitalization for heart failure: in two cases endocarditis was diagnosed and the pathogen isolated, after 9 and 16 months, respectively. The first case has been treated by means of urgent surgical aortic valve replacement. The second was managed conservatively. In the remaining 15 cases, 8 were treated with a "Valve-in-Valve procedure", 2 underwent surgical aortic valve replacement and 5 were treated medically. Echocardiographic data, analyzed at last available follow-up and compared with discharge data, showed that the aortic valve area (from 1.61 AE 0.6 cm 2 to 1.66 AE 0.49 cm 2 , p ¼ 0.71), and mean aortic gradient (from 8.6 AE 4.9 mmHg to 8.7 AE 5.9 mmHg, P ¼ 0.6) remained substantially unchanged. The rates of the mild and moderate paravalvular leak (PVL) did not change from discharge (53.8% and 14.1%) to last available follow-up (51% and 16%), p ¼ 0.65. CONCLUSION While transcatheter aortic valves are questioned about long term performance and durability, the results of the present study provide reassuring and unprecedented evidence on the CoreValve long term performance. Whether these data apply to other transcatheter devices is unknown.
Journal of the American College of Cardiology, 2018
BACKGROUND Invasive procedure has been prerequisite for coronary physiology study. We investigate... more BACKGROUND Invasive procedure has been prerequisite for coronary physiology study. We investigated the implication of non-invasive physiological parameters including coronary blood flow (CBF), flow velocity, and microvascular resistance from coronary computed tomography angiography (CCTA). METHODS Vessel-specificCBF was derived from transluminal attenuation flow encoding (TAFE) and was tested by threes eparated datasets, computational simulation model, human perfusion CT study, and human CCTA study. TAFE-derived CBF showed a good correlation with vessel-specific myocardial blood flow or CBF assessed from these datasets. RESULTS CBF per myocardial mass decreased consistently according to the severity of stenosis, and was better than transluminal attenuation gradient (TAG) for detection of significant stenosis. Flow velocity and microvascular resistance could also be calculated from CBF and vessel anatomy. CONCLUSION The results of non-invasively acquired parameters according to the severity of stenosis were similar to those of known invasive physiologic study.Our study showed that non-invasive comprehensive coronary physiology parameters can be derived from CCTA without any pre-specified condition or heavy computational process, which would expand the clinical coverage of coronary physiology study.
Journal of the American College of Cardiology, 2018
BACKGROUND Emotional stimulation was reported to be related to coronary events, but, there is a l... more BACKGROUND Emotional stimulation was reported to be related to coronary events, but, there is a lack of direct mechanistic evidence between metabolic activity of the amygdala, a neural stress center, and coronary artery disease (CAD) including acute coronary syndrome. In this study, we aimed to evaluate whether brain amygdala activity validated by 1 ⁸F-FDG PET/CT could be associated with the occurrence of CAD and plaque vulnerability of the patients who underwent coronary artery evaluation; invasive coronary angiography (ICA) or coronary CT angiography (CCTA).
Journal of the American College of Cardiology, 2019
remains high and the prognostic factor has not been fully elucidated. In this study, we investiga... more remains high and the prognostic factor has not been fully elucidated. In this study, we investigated the potential predictors of 30-day inhospital mortality in the very elderly with ACS. METHODS Between September 2013 and May 2015, we retrospectively collected consecutive 45 patients (mean age, 84.1 AE 3.5 years; male, 51.1%) with ACS who admitted to our institution and underwent primary PCI on the day of admission. RESULTS The number of patients with ST-elevation myocardial infarction was 20, and that with non-ST-elevation myocardial infarction/unstable angina was 25. The overall 30-day in-hospital mortality was 15.5% (n ¼ 7). Pre-PCI creatinine level, current heart failure, history of heart failure, left ventricular ejection fraction < 50%, shock status, and usage of circulatory support were significantly associated with 30day mortality in the bivariate analysis, therefore enrolled in multivariate analysis. In Consequence, compared to patients without circulatory support, patients requiring circulatory support had significantly higher mortality rate (odds ratio 92.5; 95% CI 7.0-1220.0, p < 0.001). CONCLUSION Our results revealed that indispensable circulatory support seems to be a strong predictor of 30-day in-hospital mortality in the very elderly with ACS. The recognition of risk factors for poor short-term prognosis may contribute to treatment decision-making in daily clinical practice.
Journal of the American College of Cardiology, 2019
Hb 8 g/dl to < 11 g/dl) and Severe (Hb < 8 g/dl). Anemia comparisons were performed on the entire... more Hb 8 g/dl to < 11 g/dl) and Severe (Hb < 8 g/dl). Anemia comparisons were performed on the entire study population and on subgroups stratified by Hemoglobin concentration. Univariate and multivariate analysis of factors associated with anemia for in-hospital mortality. Statistical analyses were done with SPSS version 21. RESULTS Of 736 patients with STEMI, 27.7% were female. Mean age was 61.08 AE 12.2 and prevalence of anemia was 30.6%. Mild, moderate and severe anemia was found in 148 (20.1%), 71 (9.6%) and 6 (0.8%) patients, respectively. Anemic patients were elderly and had a higher percentage of diabetic, previous stroke and chronic kidney disease compared with their nonanemic. In-hospital mortality was significantly higher in anemic patient (12% vs. 4.1%, p < 0.05). Lower hemoglobin levels were significantly associated with a higher prevalence of heart failure, cardiogenic shock, multi-vessels disease and in-hospital mortality (p < 0.05 for all). The absence of Primary PCI use as the reperfusion therapy was independently associated with in-hospital death in multivariate analysis (OR: 2.33, 95%
Journal of the American College of Cardiology, 2019
by the release of proteases. This phenomenon is known as KOUNIS type III syndrome. Conclusions. E... more by the release of proteases. This phenomenon is known as KOUNIS type III syndrome. Conclusions. Even rare now, stent thrombosis is a life-threatening situation. Several mechanisms have been identified, this could be mostly mechanical, like under expansion or malposition of the stent, biological like inefficient antithrombotic treatment... Another unknown and under recognized entity exists, the Kounis syndrome, an immunoallergic mechanism that must be kept in mind when the patient express atopy and allergic manifestations.
Background: In conventional coronary angiography (CAG) by transfemoral approach patients usually ... more Background: In conventional coronary angiography (CAG) by transfemoral approach patients usually need to stay at least one night in hospital. CAG by transradial approach gives the opportunity for same day hospital discharge. The objective of this study was to assess the safety and feasibly of day case CAG in Bangladesh. Methods: This is a single operator observational study where patients admitted for CAG through transradial (conventional and distal radial) approach were included. Patients were admitted at least 2 hours before the procedure. Hemostasis was done with manual compression followed by tight gauge-rolled bandage. Predischarge criteria had been set and applied to all patients. An emergency telephone number was given to the patient and they were contacted on the next day over telephone. Results: 30 (30%) female and 70 (70%) male were included with mean age 53±9SD years. Patients were discharged from the hospital on an average after 3.3±1.1 hours of the procedure. Only 4(4%)...
Background and purpose: Speckle-tracking imaging is a novel method for assessing left ventricular... more Background and purpose: Speckle-tracking imaging is a novel method for assessing left ventricular function and ischemic changes. The aim of this study was to predict the presence of coronary artery disease by longitudinal 2D strain analysis using speckle tracking echocardiography in patients with stable or unstable angina with no regional wall motion abnormality at rest. Methods: This cross-sectional study included a total 66 patients (mean age, 51.92±8.9 years) with suspected coronary aartery ddisease without RWMA on resting echocardiography who underwent coronary angiography. Longitudinal 2D strain analysis by STE was performed in all patients before coronary angiography. Global and segmental peak systolic longitudinal strain (PSLS) were recorded & computed by offline dedicated software semi-automatically on bull's-eye report. The patients were divided into two groups according to the coronary angiographic findings; group-I: significant CAD on coronary angiogram (n=35), group-II: normal coronaries on CAG (n=31). All the baseline characteristics and outcome were then compared between the two groups. Results: PSLSs of all left ventricular segments were obtained successfully in 66 patients. PSLS (both global and segmental) was significantly decreased in patients with significant CAD on CAG group. Receiver operating characteristic (ROC) curve analysis demonstrated that global PSLSs could effectively detect patients with CAD (area under ROC curve = 0.877, 95% CI=0.749-0.960). According to ROC curve analysis,-18.77% appeared to be a good cutoff value for predicting those with significant CAD (specificity 77.4% and sensitivity 82.9%). Conclusion: Global and segmental PSLS using speckle tracking echocardiography at rest was significantly lower in patients with CAD without RWMA, and might be useful for identifying patients with a significant CAD with good degree of sensitivity and specificity.
Background: Coronary artery disease (CAD) is the most common cause of mortality & morbidity in al... more Background: Coronary artery disease (CAD) is the most common cause of mortality & morbidity in all over the world. Reperfusion therapy is the cornerstone for treating acute ST-segment elevation myocardial infarction. Effective reperfusion in STEMI can be achieved by either fibrinolysis or primary percutaneous coronary intervention (PPCI). PPCI generally produces better outcomes than fibrinolysis but is not widely available. ST-segment abnormalities play a fundamental role in assessment and decision making for patients with STEMI. Methods: This quasi-experimental study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute. Group I underwent primary PCI and group II received fibrinolytic therapy as reperfusion therapy for acute STEMI.Results: The mean ST-segment resolutions were significantly more in group I than group II at 60 minutes (63.54±20.98 vs 33.97±15.88%, p<0.001) and at 90 minutes (73.15±18.76 vs 60.06±23.33%, p<0.015...
The study was carried out in two intensive potato growing areas (Rangpur and Munshigonj) to estim... more The study was carried out in two intensive potato growing areas (Rangpur and Munshigonj) to estimate the technical efficiency of potato producers and to describe the level of variation in potato productivity due to differences in input use. Data were collected from 60 farmers (30 farmers from each district) using simple random sampling technique. Average technical efficiency was 86% implying that on average 14% inefficiency remained at producers level. The application of human labour, MoP, and weedicides would increase potato yield significantly. On the other hand, the coefficient of urea and pesticide cost was found negative and significant which advarsely effect the yield of potato. Moreover, the coefficient of operated land and extension linkage were found negative and significant implying that with further increase in operated land and extension linkage, technical efficiency would increase. Munshigonj was found to be more suitable area for potato production. The performance of ...
Background: Vitamin D plays several vital roles in the body and its impact on cardiovascular outc... more Background: Vitamin D plays several vital roles in the body and its impact on cardiovascular outcome is of great concern to cardiac specialists. This study investigated the influences of Vitamin D levels on coronary artery stenosis (CAS). Subjects and Method: A case study involving 248 patients (74% ,184 males); mean age of 57±13 years in which serum levels of vitamin D were measured in Saudi patients admitted to King Saud Medical Hospital with acute coronary syndrome. Coronary arteries were classified angiographically as normal, non-obstructive or obstructive coronary stenosis when there is more than 70% luminal stenosis. The relationship between vitamin D levels and coronary stenosis was assessed using SPSS software. Results: The findings show that the mean (standard deviation; SD) levels of vitamin-D was (14.3 7.3 ng/ml. Most of the patients (205 [82.7%]) were found to have low serum vitamin-D level. Of 248 patients recruited for this study, 70 (28%) of them had unstable angina, 85 (34.5%) had ST-segment elevation myocardial infarction and 93 (37.5%) had non-ST-segment elevation myocardial infarction. Likewise, 58 patients (23.4%) had three vessel disease, 75 (30.2%) had two vessel disease, 76 (30.4%) had one vessel disease, 29 (12%) had a non-obstructive coronary artery stenosis and 10 (4%) had visually normal coronary arteries. Vitamin-D level was not a significant predictor of the degree of coronary luminal stenosis (p=0.15).However, a low vitamin-D level in individuals older than 55 years was a significant predictor of non-obstructive coronary artery stenosis [odds ratio (OD) =2.63, 95% confidence interval (CI):1.21-5.55, p=0.015]. Conclusions: It is concluded that low vitamin-D level does not correlate with the severity of coronary stenosis, but normal level in patients older than 55 years is associated with decreased severity of coronary stenosis.
Background & objective: Involvement of the right coronary artery frequently occurs in acute infer... more Background & objective: Involvement of the right coronary artery frequently occurs in acute inferior myocardial infarction. Typical ECG changes in this condition involve ST-segment elevation in inferior leads. The present study was intended to predict the site of the lesion in the right coronary artery (RCA) in patients with acute inferior wall myocardial infarction using the height of ST-segment elevation as the predictor variable. Methods: The present cross-sectional study was carried out in the Department of Cardiology, National Institute Cardiovascular Diseases (NICVD), Dhaka, Bangladesh over a period of one year between July 2010 to June 2011. Patients with acute inferior myocardial infarction admitted to CCU of NICVD within 12 hours of the onset of chest pain and underwent coronary angiography within 4 weeks of acute myocardial infarction (AMI) were the study population. With the help of a 12-lead ECG, magnitudes of ST-segment elevation in leads II, III, and aVF were measured....
Background: The coronavirus disease (COVID-19) is a multisystem disease that sometimes affects th... more Background: The coronavirus disease (COVID-19) is a multisystem disease that sometimes affects the cardiovascular system (CVS) during acute illness and follows a protracted course in a proportion of patients causing ‘post-COVID syndrome’. Exercise tolerance test (ETT) can assess functional capacity and imaging modalities like echocardiography and cardiac magnetic resonance (CMR) can assess structural and functional status of cardiovascular system (CVS) efficiently. However, the pattern of cardiovascular involvement and its effect on functional capacity in COVID-19 survivors long after the index illness are inadequately known. This study was carried out to detect the functional status and imaging findings in COVID-19 recovered healthcare workers. Methods: This cohort study was carried out in the Department of Cardiology of the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from July 2021 to December 2021. Thirty male healthcare workers, previously not known ...
Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) functi... more Background: Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this study was to predict the presence of coronary artery disease by longitudinal 2D strain analysis using speckle tracking echocardiography in patients with stable or unstable angina with no regional wall motion abnormality at rest. Objectives: Objective of this study is to predict the presence of significant CAD in a patient with no regional wall motion abnormality by longitudinal 2D strain analysis using speckle tracking echocardiography. Methods: This cross-sectional study included a total 66 patients (mean age, 51.92±8.9 years) with suspected CAD without RWMA on resting echocardiography who underwent coronary angiography. Longitudinal 2D strain analysis by STE was performed in all patients before coronary angiography. Global and segmental peak systolic longitudinal strain (PSLS) were recorded & computed by offline dedicated software semi-automatic...
Background: Intervention for bifurcation lesions is associated with increased risk of adverse eve... more Background: Intervention for bifurcation lesions is associated with increased risk of adverse events and includes acute side branch (SB) occlusion during main branch (MB) stenting. This acute occlusion of side branch can often be catastrophic for the patient. We here in describe our experience in National Institute of Cardiovascular Diseases and Hospital (NICVD), Dhaka, Bangladesh with a technique which can be incorporated into bifurcation stenting to reduce or almost eliminate the incidence of side branch occlusion or catastrophe. Methods: A prospective, observational, non-blinded study in patients from a single tertiary referral cardiac center National Institute of Cardiovascular Diseases & Hospital (NICVD), Dhaka, Bangladesh. Patients with an indication for percutaneous coronary intervention (PCI) of a denovo bifurcation lesion were screened. The study included 51 patients who underwent coronary angiogram in our institution and had bifurcation lesions suitable for single stent st...
Journal of the American College of Cardiology, 2019
prosthetic regurgitation after 72 months and 2 cases of severe stenosis after 26 and 89 months). ... more prosthetic regurgitation after 72 months and 2 cases of severe stenosis after 26 and 89 months). Seventeen events led to a new hospitalization for heart failure: in two cases endocarditis was diagnosed and the pathogen isolated, after 9 and 16 months, respectively. The first case has been treated by means of urgent surgical aortic valve replacement. The second was managed conservatively. In the remaining 15 cases, 8 were treated with a "Valve-in-Valve procedure", 2 underwent surgical aortic valve replacement and 5 were treated medically. Echocardiographic data, analyzed at last available follow-up and compared with discharge data, showed that the aortic valve area (from 1.61 AE 0.6 cm 2 to 1.66 AE 0.49 cm 2 , p ¼ 0.71), and mean aortic gradient (from 8.6 AE 4.9 mmHg to 8.7 AE 5.9 mmHg, P ¼ 0.6) remained substantially unchanged. The rates of the mild and moderate paravalvular leak (PVL) did not change from discharge (53.8% and 14.1%) to last available follow-up (51% and 16%), p ¼ 0.65. CONCLUSION While transcatheter aortic valves are questioned about long term performance and durability, the results of the present study provide reassuring and unprecedented evidence on the CoreValve long term performance. Whether these data apply to other transcatheter devices is unknown.
Journal of the American College of Cardiology, 2018
BACKGROUND Invasive procedure has been prerequisite for coronary physiology study. We investigate... more BACKGROUND Invasive procedure has been prerequisite for coronary physiology study. We investigated the implication of non-invasive physiological parameters including coronary blood flow (CBF), flow velocity, and microvascular resistance from coronary computed tomography angiography (CCTA). METHODS Vessel-specificCBF was derived from transluminal attenuation flow encoding (TAFE) and was tested by threes eparated datasets, computational simulation model, human perfusion CT study, and human CCTA study. TAFE-derived CBF showed a good correlation with vessel-specific myocardial blood flow or CBF assessed from these datasets. RESULTS CBF per myocardial mass decreased consistently according to the severity of stenosis, and was better than transluminal attenuation gradient (TAG) for detection of significant stenosis. Flow velocity and microvascular resistance could also be calculated from CBF and vessel anatomy. CONCLUSION The results of non-invasively acquired parameters according to the severity of stenosis were similar to those of known invasive physiologic study.Our study showed that non-invasive comprehensive coronary physiology parameters can be derived from CCTA without any pre-specified condition or heavy computational process, which would expand the clinical coverage of coronary physiology study.
Journal of the American College of Cardiology, 2018
BACKGROUND Emotional stimulation was reported to be related to coronary events, but, there is a l... more BACKGROUND Emotional stimulation was reported to be related to coronary events, but, there is a lack of direct mechanistic evidence between metabolic activity of the amygdala, a neural stress center, and coronary artery disease (CAD) including acute coronary syndrome. In this study, we aimed to evaluate whether brain amygdala activity validated by 1 ⁸F-FDG PET/CT could be associated with the occurrence of CAD and plaque vulnerability of the patients who underwent coronary artery evaluation; invasive coronary angiography (ICA) or coronary CT angiography (CCTA).
Journal of the American College of Cardiology, 2019
remains high and the prognostic factor has not been fully elucidated. In this study, we investiga... more remains high and the prognostic factor has not been fully elucidated. In this study, we investigated the potential predictors of 30-day inhospital mortality in the very elderly with ACS. METHODS Between September 2013 and May 2015, we retrospectively collected consecutive 45 patients (mean age, 84.1 AE 3.5 years; male, 51.1%) with ACS who admitted to our institution and underwent primary PCI on the day of admission. RESULTS The number of patients with ST-elevation myocardial infarction was 20, and that with non-ST-elevation myocardial infarction/unstable angina was 25. The overall 30-day in-hospital mortality was 15.5% (n ¼ 7). Pre-PCI creatinine level, current heart failure, history of heart failure, left ventricular ejection fraction < 50%, shock status, and usage of circulatory support were significantly associated with 30day mortality in the bivariate analysis, therefore enrolled in multivariate analysis. In Consequence, compared to patients without circulatory support, patients requiring circulatory support had significantly higher mortality rate (odds ratio 92.5; 95% CI 7.0-1220.0, p < 0.001). CONCLUSION Our results revealed that indispensable circulatory support seems to be a strong predictor of 30-day in-hospital mortality in the very elderly with ACS. The recognition of risk factors for poor short-term prognosis may contribute to treatment decision-making in daily clinical practice.
Journal of the American College of Cardiology, 2019
Hb 8 g/dl to < 11 g/dl) and Severe (Hb < 8 g/dl). Anemia comparisons were performed on the entire... more Hb 8 g/dl to < 11 g/dl) and Severe (Hb < 8 g/dl). Anemia comparisons were performed on the entire study population and on subgroups stratified by Hemoglobin concentration. Univariate and multivariate analysis of factors associated with anemia for in-hospital mortality. Statistical analyses were done with SPSS version 21. RESULTS Of 736 patients with STEMI, 27.7% were female. Mean age was 61.08 AE 12.2 and prevalence of anemia was 30.6%. Mild, moderate and severe anemia was found in 148 (20.1%), 71 (9.6%) and 6 (0.8%) patients, respectively. Anemic patients were elderly and had a higher percentage of diabetic, previous stroke and chronic kidney disease compared with their nonanemic. In-hospital mortality was significantly higher in anemic patient (12% vs. 4.1%, p < 0.05). Lower hemoglobin levels were significantly associated with a higher prevalence of heart failure, cardiogenic shock, multi-vessels disease and in-hospital mortality (p < 0.05 for all). The absence of Primary PCI use as the reperfusion therapy was independently associated with in-hospital death in multivariate analysis (OR: 2.33, 95%
Journal of the American College of Cardiology, 2019
by the release of proteases. This phenomenon is known as KOUNIS type III syndrome. Conclusions. E... more by the release of proteases. This phenomenon is known as KOUNIS type III syndrome. Conclusions. Even rare now, stent thrombosis is a life-threatening situation. Several mechanisms have been identified, this could be mostly mechanical, like under expansion or malposition of the stent, biological like inefficient antithrombotic treatment... Another unknown and under recognized entity exists, the Kounis syndrome, an immunoallergic mechanism that must be kept in mind when the patient express atopy and allergic manifestations.
Background: In conventional coronary angiography (CAG) by transfemoral approach patients usually ... more Background: In conventional coronary angiography (CAG) by transfemoral approach patients usually need to stay at least one night in hospital. CAG by transradial approach gives the opportunity for same day hospital discharge. The objective of this study was to assess the safety and feasibly of day case CAG in Bangladesh. Methods: This is a single operator observational study where patients admitted for CAG through transradial (conventional and distal radial) approach were included. Patients were admitted at least 2 hours before the procedure. Hemostasis was done with manual compression followed by tight gauge-rolled bandage. Predischarge criteria had been set and applied to all patients. An emergency telephone number was given to the patient and they were contacted on the next day over telephone. Results: 30 (30%) female and 70 (70%) male were included with mean age 53±9SD years. Patients were discharged from the hospital on an average after 3.3±1.1 hours of the procedure. Only 4(4%)...
Background and purpose: Speckle-tracking imaging is a novel method for assessing left ventricular... more Background and purpose: Speckle-tracking imaging is a novel method for assessing left ventricular function and ischemic changes. The aim of this study was to predict the presence of coronary artery disease by longitudinal 2D strain analysis using speckle tracking echocardiography in patients with stable or unstable angina with no regional wall motion abnormality at rest. Methods: This cross-sectional study included a total 66 patients (mean age, 51.92±8.9 years) with suspected coronary aartery ddisease without RWMA on resting echocardiography who underwent coronary angiography. Longitudinal 2D strain analysis by STE was performed in all patients before coronary angiography. Global and segmental peak systolic longitudinal strain (PSLS) were recorded & computed by offline dedicated software semi-automatically on bull's-eye report. The patients were divided into two groups according to the coronary angiographic findings; group-I: significant CAD on coronary angiogram (n=35), group-II: normal coronaries on CAG (n=31). All the baseline characteristics and outcome were then compared between the two groups. Results: PSLSs of all left ventricular segments were obtained successfully in 66 patients. PSLS (both global and segmental) was significantly decreased in patients with significant CAD on CAG group. Receiver operating characteristic (ROC) curve analysis demonstrated that global PSLSs could effectively detect patients with CAD (area under ROC curve = 0.877, 95% CI=0.749-0.960). According to ROC curve analysis,-18.77% appeared to be a good cutoff value for predicting those with significant CAD (specificity 77.4% and sensitivity 82.9%). Conclusion: Global and segmental PSLS using speckle tracking echocardiography at rest was significantly lower in patients with CAD without RWMA, and might be useful for identifying patients with a significant CAD with good degree of sensitivity and specificity.
Background: Coronary artery disease (CAD) is the most common cause of mortality & morbidity in al... more Background: Coronary artery disease (CAD) is the most common cause of mortality & morbidity in all over the world. Reperfusion therapy is the cornerstone for treating acute ST-segment elevation myocardial infarction. Effective reperfusion in STEMI can be achieved by either fibrinolysis or primary percutaneous coronary intervention (PPCI). PPCI generally produces better outcomes than fibrinolysis but is not widely available. ST-segment abnormalities play a fundamental role in assessment and decision making for patients with STEMI. Methods: This quasi-experimental study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute. Group I underwent primary PCI and group II received fibrinolytic therapy as reperfusion therapy for acute STEMI.Results: The mean ST-segment resolutions were significantly more in group I than group II at 60 minutes (63.54±20.98 vs 33.97±15.88%, p<0.001) and at 90 minutes (73.15±18.76 vs 60.06±23.33%, p<0.015...
The study was carried out in two intensive potato growing areas (Rangpur and Munshigonj) to estim... more The study was carried out in two intensive potato growing areas (Rangpur and Munshigonj) to estimate the technical efficiency of potato producers and to describe the level of variation in potato productivity due to differences in input use. Data were collected from 60 farmers (30 farmers from each district) using simple random sampling technique. Average technical efficiency was 86% implying that on average 14% inefficiency remained at producers level. The application of human labour, MoP, and weedicides would increase potato yield significantly. On the other hand, the coefficient of urea and pesticide cost was found negative and significant which advarsely effect the yield of potato. Moreover, the coefficient of operated land and extension linkage were found negative and significant implying that with further increase in operated land and extension linkage, technical efficiency would increase. Munshigonj was found to be more suitable area for potato production. The performance of ...
Background: Vitamin D plays several vital roles in the body and its impact on cardiovascular outc... more Background: Vitamin D plays several vital roles in the body and its impact on cardiovascular outcome is of great concern to cardiac specialists. This study investigated the influences of Vitamin D levels on coronary artery stenosis (CAS). Subjects and Method: A case study involving 248 patients (74% ,184 males); mean age of 57±13 years in which serum levels of vitamin D were measured in Saudi patients admitted to King Saud Medical Hospital with acute coronary syndrome. Coronary arteries were classified angiographically as normal, non-obstructive or obstructive coronary stenosis when there is more than 70% luminal stenosis. The relationship between vitamin D levels and coronary stenosis was assessed using SPSS software. Results: The findings show that the mean (standard deviation; SD) levels of vitamin-D was (14.3 7.3 ng/ml. Most of the patients (205 [82.7%]) were found to have low serum vitamin-D level. Of 248 patients recruited for this study, 70 (28%) of them had unstable angina, 85 (34.5%) had ST-segment elevation myocardial infarction and 93 (37.5%) had non-ST-segment elevation myocardial infarction. Likewise, 58 patients (23.4%) had three vessel disease, 75 (30.2%) had two vessel disease, 76 (30.4%) had one vessel disease, 29 (12%) had a non-obstructive coronary artery stenosis and 10 (4%) had visually normal coronary arteries. Vitamin-D level was not a significant predictor of the degree of coronary luminal stenosis (p=0.15).However, a low vitamin-D level in individuals older than 55 years was a significant predictor of non-obstructive coronary artery stenosis [odds ratio (OD) =2.63, 95% confidence interval (CI):1.21-5.55, p=0.015]. Conclusions: It is concluded that low vitamin-D level does not correlate with the severity of coronary stenosis, but normal level in patients older than 55 years is associated with decreased severity of coronary stenosis.
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Papers by Saqif Shahriar