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   Table of Contents - Current issue
Coverpage
October-December 2022
Volume 8 | Issue 4
Page Nos. 89-114

Online since Tuesday, November 29, 2022

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REVIEW ARTICLE  

Risk of sudden cardiac death and preventive measures in athletes p. 89
Adel Khalifa Sultan Hamad
DOI:10.4103/ijca.ijca_17_22  
Arrhythmias, which are fatal in some patients, can be triggered by sports in vulnerable people. It is estimated that 1:40,000–1:250,000 athletes will suffer a sudden cardiac death (SCD). However, female athletes appear to have some level of cardiac protection, since suffering from SCD considerably less than male athletes during sports. Athletes with underlying coronary, valvular or myocardial disease, as well as channelopathies, may be particularly prone to SCD from exercise- and sports-related physical activity. There are three main causes of SCD in young athletes: Sudden Arrhythmic Death Syndrome (56%), congenital anomalous coronary arteries (7%–14%), and hypertrophic cardiomyopathy (36%–48%). In the context of exercise, acute ischemia, myocardial infarction, and stroke risk are increased by catecholamine surge and exercise-induced stress. In middle-aged athletes, excessive cardiovascular activity is associated with a higher risk of mortality related to cardiovascular disease. It is possible to detect at-risk athletes by conducting cardiac screening, which involves a family history, physical examination, and a resting electrocardiogram. Consequently, efforts have been made to better understand the causes of SCD in athletes and to develop appropriate prevention methods.
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ORIGINAL ARTICLES Top

Evaluation of electrocardiographic changes in patients under COVID-19 treatment regimes p. 96
Emre Ozdemir, Ugur Karagoz, Selin Ozdemir, Mustafa Ozan Gursoy, Sadik Volkan Emren, Banu Karaca, Nihan Kahya Eren, Mustafa Karaca
DOI:10.4103/ijca.ijca_14_22  
Background and Aim: Awareness of electrocardiographic (ECG) changes is crucial in patients who receive coronavirus disease 2019 (COVID-19) treatment. In this study, we aimed to evaluate ECG parameters in patients under COVID-19 therapy and their relationship with the severity of lung involvement and the disease on the basis of thoracic computerized tomography (TCT) findings and laboratory parameters. Materials and Methods: Of 350 patients hospitalized due to COVID-19 between March 2020 and June 2020, 300 patients with available data were retrospectively analyzed. Blood analysis, electrocardiographic, and clinical findings were evaluated. Six-month follow-up data were also recorded. Results: The patients were categorized into two groups: survivor (n = 206, 68.7%, Group 1) and nonsurvivor patients (n = 94, 31.3%, Group 2). The mean total follow-up period was 125.39 ± 73.09 days. The mean age was similar in both groups. In multivariate regression analysis that aimed to predict COVID-19 disease severity, it was found that besides increased C-reactive protein and D-dimer levels, and ≥50% lung involvement in TCT, which are well known as bad prognostic factors, the corrected QT interval duration (QTc) prolongation ≥60 miliseconds (msn) during hospitalization was associated with worse prognosis in COVID-19 patients during follow-up. Conclusion: Our study is the first study that demonstrated that the presence of ≥60 msn QTc prolongation during hospital stay was found to be the most valuable ECG parameter to predict the prognosis and had a significant association with ≥50% lung involvement in TCT in patients under anti-COVID therapy. Close monitoring of this ECG parameter is important both in terms of treatment planning and interpretation of disease progression.
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Outcomes of aortic balloon valvuloplasty in newborns: A single-centre experience p. 102
Meryem Beyazal, Utku Arman Orun, Vehbi Dogan, Dilek Dilli
DOI:10.4103/ijca.ijca_18_22  
Introduction: Critical or severe aortic stenosis in new-borns is a condition that requires rapid intervention. Aortic balloon valvuloplasty (ABV) is a method of choice that has been successfully performed since 1983. Aims: This study was conducted to explore the experiences of our centre. Study Design: The data of ABV performed on new-borns (n = 52) between 2007 and 2020 were retrospectively analysed to evaluate follow-up of the cases. Materials and Methods: Patients were divided into 4 groups according to procedural immediate results. Results: Left ventricular endocardial fibroelastosis and left ventricular systolic dysfunction were detected in 18 (34.6%) and 19 (36.5%) patients, respectively and there was a significant association between fibroelastosis and left ventricular dysfunction (P < 0.05). The preprocedural echocardiographic mean gradient was significantly lower in the unsuccessful group (P < 0.41). The mean hospital stay day was shorter in the group with optimal results without statistical significance (P = 0.055). Immediate inadequate results after the procedure were detected as a major risk for re-intervention. Re-intervention was required in one-fifth of the patients and the most common cause was aortic stenosis. The risk factors of mortality were found to be associated with the disease itself such as ventricular dysfunction, being critical aortic stenosis instead of procedural reasons. Conclusion: ABV is an effective method and as left ventricular dysfunction and critical aortic stenosis are risk factors of mortality, preprocedural evaluation, and quick intervention are essential.
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Effectiveness of statin treatment in reducing red cell distribution width and mean platelet volume in patients with stable coronary artery disease: A retrospective study p. 110
Ayse Colak, Yesim Akin
DOI:10.4103/ijca.ijca_21_22  
Objectives: Mean platelet volume (MPV) has been shown to be a predictor of platelet activation and plays a crucial role in the pathogenesis of atherosclerosis. Red cell distribution width (RDW) is a measure of the variability of erythrocyte volumes and might reflect underlying chronic inflammation. Both MPV and RDW are related to increased risk for cardiovascular disease. Since statins have pleiotropic effects, we aim to investigate the effect of statins on this possible hematologic markers of atherosclerotic risk in stable coronary artery disease (CAD). Materials and Methods: One hundred and twenty-one statin-naive patients who had undergone coronary angiography for stable CAD between June 2012 and June 2013 were retrospectively enrolled in this study. Patients were treated with atorvastatin or rosuvastatin. The lipid profile and hematological parameters were measured at baseline and after statin treatment. Results: One hundred and twenty-one patients were included in the study. The mean age was 60.5 ± 9 years and 38% of patients were women. Out of 121 patients, 106 (87.6%) patients received atorvastatin therapy and 15 (12.4%) patients received rosuvastatin therapy. After a median follow-up period of 36 days, statin treatment markedly reduced low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) levels (P = 0.0001, for all). For hematological parameters, only RDW significantly decreased after statin treatment (P = 0.0001). The Δ RDW were not associated with Δ LDL-C (r = 0.03; P = 0.72), ΔTG (r = 0.06; P = 0.49) and Δ TC levels (r = 0.05; P = 0.55). Statins had no effect on MPV levels (P = 0.32). Conclusions: Statin therapy significantly reduces the RDW levels in stable CAD irrespective of cholesterol levels, which might confirm the anti-inflammatory effect of statins. However, the association between decreased RDW levels and prognosis in stable CAD has to be established by multi-center, prospective studies in large populations.
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