International Journal of Cardiovascular Practice

Review Article

Assessment of the Left Ventricular Deformable Indices (Strain Components) in Different Echocardiography Systems

Mersedeh Karvandi

International Journal of Cardiovascular Practice, Vol. 3 No. 4 (2018), 11 November 2018, Page 65-69

This Article provides simplified, easy-to-understand descriptions of the echocardiographic software used in conjunction with different echocardiography machines, such as those from Toshiba, Philips, GE, and Siemens, and explains how these sophisticated systems can best be used to exploit fully their ability to deliver more precise diagnoses and assist in treatment choice and follow-up. A variety of applications are covered, with presentation of algorithms and highlighting of tips and tricks. It will be of value for cardiologists, other interested clinicians, those pursuing fellowships in echocardiography, and sonographers; it will also be highly relevant for biomedical engineers, bio-mathematicians, computer scientists, and researchers in medical physics. There would be enormous clinical benefits of any non-invasive technique to estimate the true level of wall abnormal motions. Strain and strain rate are deformation measures. If different components of an object have different velocities, the object shape may be changed. In this article, we mentioned the left ventricular 2- dimensional strain in normal hearts for each different type of strain methods from 5 echocardiography machines and we have also introduced MATLAB software as an echocardiography desk.

Original Articles

Thrombocytopenia as a Marker of Patient Outcome in Medical Intensive Care Unit

Abbas Fadae, Seyed Mojtaba Heidari, Maryam Alizadeh Chamkhaleh, Mohammad Amin Abbasi

International Journal of Cardiovascular Practice, Vol. 3 No. 4 (2018), 11 November 2018, Page 70-73

Introduction: Thrombocytopenia is a common hematologic disorder observed in many pathological conditions in critically ill patients. The current study aimed at investigating the prevalence of thrombocytopenia and its relationship with the length of stay and mortality among intensive care unit (ICU) patients.
Methods: The current prospective cohort study enrolled 150 patients consecutively admitted to the medical ICU during a nine-month period. Patients’ baseline characteristics and underlying diseases were recorded. Laboratory findings and admission mean platelets and platelet counts on the 3rd day of admission were obtained. Patients were divided into thrombocytopenic (platelet count of less than 150×109/L or decrease of platelet to more than 50%) and non-thrombocytopenic groups according to the 3rd day platelet count.
Results: Thrombocytopenia was detected in 53(35%) patients while 13 patients (8.6%) had severe thrombocytopenia (platelets count < 50 × 109/L). ICU stay and mortality were significantly higher in patients with thrombocytopenia compared with non-thrombocytopenic patients (16 ± 2.7 vs 12 ± 2.4 days, P = 0.01) and (45.5% vs 37.3%, P = 00.1) respectively.
Conclusions: Platelet might be considered as a prognosis monitor in ICU settings. Severe thrombocytopenia could be mentioned as a poor prognostic factor for increased mortality and prolonged hospitalization period in ICU patients.

Predictors of the extent and severity of coronary artery disease for prognosis of patients with non-ST-segment elevation acute coronary syndromes

Chirag Patel, Jayesh Prajapati, Iva V Patel, Roopesh Singhal, Ashish Mishra, Gaurav Singh

International Journal of Cardiovascular Practice, Vol. 3 No. 4 (2018), 11 November 2018, Page 74-79

Introduction: The proportion of patients visiting emergency department with chest pain indicative of non‐ST‐segment elevation acute coronary syndrome (NSTE-ACS) is increasing. The current risk assessment of patients with NSTE-ACS may calculate patients risk for recurrent events but may fail to identify patients with severe coronary artery disease (CAD). The present study aimed to identify predictors of the extent and severity of CAD for prognosis of NSTE-ACS patients undergoing early angiography.
Methods: A total of 215 patients with NSTE-ACS were enrolled randomly and followed up between April-2015 and February-2017 at a tertiary healthcare center. The coronary angiography was performed. Patients were divided into two groups: high-risk coronary anatomy (HRCA) and low-risk coronary anatomy (LRCA). Patients were analyzed for baseline, demographic, clinical characteristics, and cardiovascular risk factors, during hospitalization and 30 days post discharge.
Results: Among 215 enrolled patients, 90 (mean age: 52.22 ± 10.24 year) and 125 (mean age: 57.78 ± 8.83 year) patients were in the LRCA and HRCA group, respectively. The presence of previous heart failure [Odds Ratio (OR): 3.95, 95% confidence interval (CI): 1.11-14.10; P = 0.03], chronic renal failure [OR: 5.11, 95% CI: 1.12-23.22; P = 0.03] and peripheral vascular disease [OR: 3.38, 95% CI: 1.09-10.42; P = 0.03] were significant independent predictors of HRCA. Additionally, Grace score >140 was the significant predictor of 30 days mortality [OR: 5.85; P = 0.02] and major adverse cardiac and cerebral events [MACCE; OR: 6.23, 95% CI: 2.22-17.50; P = 0.001].
Conclusions: The extent and severity of CAD in NSTE-ACS patients can be predicted by assessing HRCA through clinical parameters. However, the correlation of HRCA with 30 days MACCE and mortality was modest

Case report

Suspected Short Peripheral Venous Catheter Intravascular Embolization: Identification and Management

Limael Esteban Rodriguez, Francisco Steven Rodriguez, Francisco Javier Rodriguez-Pedrogo

International Journal of Cardiovascular Practice, Vol. 3 No. 4 (2018), 11 November 2018, Page 80-82

Embolization of a standard short peripheral venous catheters (S-PVC) related to catheter fracture is an extremely rare complication. Early identification and management is essential to avoid potential complications (i.e. central embolization, arrhythmias, cardiorespiratory failure, etc.). In this report, we describe a case of suspected short-PVC fracture in a pediatric patient. The goal is to review available literature and provide insight on what to do in the setting of suspected PVC fracture.

ECG and EPS for students and associated professionals

Bradycardia-Induced Recurrent Torsade de Pointes: When Serenity Turns into Chaosity

Laksmi Senja Agusta, Harnanik P. Riswati, Rizal R. Akbar, Ardian Rizal

International Journal of Cardiovascular Practice, Vol. 3 No. 4 (2018), 11 November 2018, Page 83-86

Torsade De Pointes is typical form of polymorphic ventricular tachycardia. It was in the setting of bradycardia when first described. We present a case of patient coming to emergency room with torsade de pointes development who was found to have bradycardia on basal electrocardiography record. In fact, bradycardia has been shown as a cause of acquired long QT syndrome that can lead to torsade de pointes. The inverse relationship between heart rate and repolarization time primarily accounts for QT prolongation. Finally, proper treatment considering electrophysiology mechanism is essential to prevent mortality.