Journal of Clinical and Preventive Cardiology

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Background: Hypertension is known to impact significant changes on the heart causing left ventricle diastolic dysfunction which precedes a sequel of anatomical and functional changes in the left atrium. Since hypertension remains the leading cause of diastolic dysfunction in the heart, it is expedient to determine how changes in the blood pressure of patients relate to measures of left atrial (LA) indices. Aims and Objectives: to determine how changes in blood pressure parameters relate to measures in LA indices. Materials and Methods: The study was a descriptive cross-sectional appraisal of 200 hypertensive patients and 100 normotensive controls (matched for age and sex in a 2:1 ratio) using electrocardiography and echocardiography. Participants were recruited from the cardiology clinics in Delta State University Teaching Hospital (DELSUTH), Oghara. Results: The mean age of the study population was 58.7 ± 13.96 (58.42 ± 13.29 for hypertensives and 59.26 ± 15.27 for controls) years, while the median age was 59 years. The female-to-male ratio was 1.06 among cases and 1.27 among the controls. The LA size (volumes and linear diameter) was significantly larger in the hypertensive group compared to the control arm. LA maximum volume correlated significantly with average systolic blood pressure, pulse pressure, and mean arterial pressure. LA pre A wave volume and LA minimum volume correlated significantly with average systolic blood pressure and pulse pressures. Conclusion: Hypertensive patients have larger LA volumes than normotensive controls. The size of the left atrium relates positively with blood pressure variables.

Background: Autonomic dysfunction has a prognostic significance in various cardiovascular (CV) disorders, particularly atherosclerotic coronary artery disease (CAD). Previous studies are few, regarding the association of parasympathetic dysfunction with increased complications in patients with the acute coronary syndrome, a subset of CAD. We aimed to study the correlation of trends in the serum cholinesterase (sChE) levels, the marker of parasympathetic activity, with the occurrence of major adverse cardiovascular events (MACEs) in ST-segment elevation myocardial infarction (STEMI) patients. Methodology: We prospectively observed the levels of sChE in patients with STEMI on the day of admission, day 3, and day 5 along with routine biochemical profile, electrocardiogram, echocardiography, and coronary angiography. The patients were monitored during the hospital stay and were followed up at 1 month for the occurrence of any MACE. The MACE monitored was cardiac death, complete heart block, arrhythmias, and heart failure. The sChE levels are laboratory dependent and a value between 4000 and 14000 IU/L was considered normal in our laboratory. A value <4000 IU/L is noted as a low sChE level. The receiver operating characteristic curve was plotted for the cut off value of the sChE levels to predict the outcomes of patients. Results: Of the 100 STEMI patients studied, the sChE levels were persistently lower in patients who had MACE compared to those without MACE during the hospital stay and at month follow-up, which was statistically significant. A sChE <3745 IU/l on day 5 predicted an increased MACE with a sensitivity of 93.55% and specificity of 92.11%. Conclusion: A persistently low sChE levels from the day of admission can predict MACE in STEMI patients. Larger studies with prolonged follow-up are required for the causal association in the future.

Cardiac surgery-associated acute kidney injury (CS-AKI) is a very serious and common complication after heart surgery. Standard knowledge of the etiology, treatment, and prognosis is a prerequisite for effective therapy. The etiology includes a set of predisposing pre-, intra-, and postoperative factors with varying incidence and severity. Although not specified yet, the treatment involves standard and modern modalities based on medication, nutrition, and dialysis as well as on alleviative measures. CS-AKI enhances the incidence of infections and hospitalization leading to increased morbidity and overall mortality. Early diagnosis and treatment reduce the risk of transition to a more severe stage of AKI or chronic kidney disease.

Although drug-induced liver injury (DILI) is an uncommon diagnosis, it is an important cause of morbidity and mortality in hepatology practice. A timely diagnosis of DILI is important to stop causative drugs and keeping a high index of suspicion is important. There is no gold standard single test to diagnosed DILI, causality scores help in establishing a diagnosis. DILI presenting as acute liver failure is associated with poor prognosis in natural course. The association of nonalcoholic fatty liver disease with cardiac disease makes it more important to think of DILI in a patient with liver dysfunction. We discuss various aspects of DILI in cardiology context in the current review.

Online since 11^th May,2016