Online ISSN: 2515-8260

Keywords : echocardiography


Echocardiographic Evaluation of Breast Cancer Patients on Chemotherapy

Dr. S. Murugarajan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 822-828

Background: Cardiovascular disease in patients with breast cancer undergoing chemotherapy is of major growing concern. The commonly  used  chemotherapeutic  regimen have cardiotoxic effects  including  doxorubicin, trastuzumab and  other agents .these  have  acute  effects  on  cardiac  function and  longterm effects  on cardiac  remodelling  and  function. There have been a few studies on this regard, Hence we  aimed  to investigate  the  early  effects  of chemotherapy  on cardiac  function  in addition to association  of N –terminal  pro-brain  natriuretic  peptide and  echocardiagraphic indices.
Methods: This is a prospective, single-center study including 100 patients who received a breast cancer diagnosis in the Government Royapettah Hospital between July 2021 and April 2022 before beginning chemotherapy. Before beginning chemotherapy (baseline -T1), the day following the conclusion of the second cycle (T2), and the day following the conclusion of the fourth cycle (T3), 2D echocardiography was performed on all patients enrolled.
Results: It showed that the mean age of the subjects was 44.2 ± 8.80 years. Out of all the subjects, 40% had breast cancer of right side and 60% had breast cancer of left side. Thirty percent subjects had diabetes and 40% had hypertension. Maximum subjects had undergone surgery (70%). The chemotherapy regimen followed in most of the subjects was ACP- regimen in 70% subjects, followed by 20% having CMF- regimen and 10% having TCH-regimen. It was seen that out of all the variables, only TAPSE, and S’–TV have significant difference at T1, T2 and T3. In our study 20 % had LV systolic dysfunction, 20% had LV diastolic dysfunction and 30% had RV systolic dysfunction which correlate with NT pro BNP values.
Conclusion: Tissue Doppler echocardiography is currently used and is sufficient for providing chemotherapy patients with effective cardiac care in places with limited resources. Our study also enlighten that Echo should performed at T1 and T3 stage for all chemotherapy patients with focus on RV function as it is the earlier marker for cardiotoxicity. Future molecular mechanisms will facilitate the use of medications that operate on certain molecular targets to treat cardiotoxicity

Study of cardiac co-morbidities in newly diagnosed type 2 diabetes mellitus patients with help of 2D echocardiography

Pranav Shamraj, Amitkumar Vishwasrao Bhalerao, Sagar Subhash Nanaware, Pankaj Narayan Baravkar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 874-880

Background: Diabetes mellitus is a metabolic disorder distinguished by chronic hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. Cardiovascular diseases (CVDs)-majorly coronary artery disease (CAD), heart failure (HF), and stroke are the major cause of death and disability in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to asses cardiac co-morbidities in newly diagnosed type 2 diabetes mellitus with the help of echocardiography at a tertiary hospital.
Material and Methods: Present study was single-center, cross-sectional, observational study conducted in newly diagnosed patients of type 2 diabetes mellites (diagnosed in last 3 months), clinically asymptomatic, blood pressure <130/80mmHg, with normal ECG, underwent, conventional 2 D echocardiography.
Results: In present study, 60 asymptomatic type 2 diabetes mellitus patients underwent 2-D echocardiography, majority were male (73.33 %) as compared to females (26.67 %). Most common age group was 41-50 years and 51-60 years (26.66 % each), followed by 31-40 years (21.67 %). On 2-D echocardiography, diastolic dysfunction was noted in 10 patients (16.67 %). Grade I, II and III diastolic dysfunction was noted in 10 %, 5 % and 1.67 % patients respectively. Reduced early mitral inflow velocity was noted in 7 cases (11.67 %) and mitral annular early diastolic velocity was noted in 11 cases (18.33 %). As HbA1c increases, severity of left ventricular diastolic dysfunction increases, difference was statistically significant. We noted a statistically significant difference in values of age (years), BMI (kg/m2), FBS (mg/dl), PPBS (mg/dl) and HbA1c (%) between patients with LVDD and patients without LVDD. Conclusion: 2D Echo is recommended for screening for cardiovascular abnormalities in newly diagnosed type 2 diabetes melites patients to prevent further progression to symptomatic cardiovascular abnormalities. 

ECHOCARDIOGRAPHY BASED APPROACH TO THE DIAGNOSIS OF CARDIOVASCULAR GENETIC DISEASES: CASE SERIES AND REVIEW OF LITERATURE

Rajesh Nandal, Kuldip Singh Laller, Ashwani Kumar, Saurabh Biswas, Meenakshi Lallar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 460-464

Cardiovascular genetic diseases include syndromic and non-syndromic congenital structural heart diseases and cardiomyopathies, arrhythmic disorders, vascular disorders in connective tissue diseases, lipid disorders such as familial hypercholesterolemia, storage disorders etc. We aim to discuss spectrum of genetic diseases seen in cardiology practise while performing routine echocardiography and also try to propose and highlight a simple approach to identify such patients to prioritise for genetic testing to aid further management. Out of total 930 patients seen in the OPD (from July 2021 to July 2022), 65 patients were suspected to be affected with genetic disease. Out of these 65, only 25 underwent genetic testing (38%). Amongst these 25 patients, a genetic diagnosis was possible in 11 patients (yield -44%). Authors concluded that lack of suspicion and training, or resources cardiac genetic disorders are often diagnosed late or sometimes never diagnosed and this leads to missed opportunities to treat and prevent recurrences in the same family, either through reproductive counseling or cascade screen of at-risk relatives. As seen, any genetic disorders ranging from chromosomal to single gene defects have characteristic cardiac lesion and a cardiologist doing echocardiography can play a pivotal role in diagnosis. A multidisciplinary approach and basic sensitization of cardiologist when to suspect and refer for genetic work up/testing becomes important for clinical management of all such patients and cascade screening in at-risk relatives.

Study of ECG and Echocardiographic Changes in Patient with Chronic Kidney Disease (CKD)

Dr. S. L. Annapoorna, Dr. B. Madhavilatha; Dr. K.D. Singh, Dr. D.K. Malviya, Dr. Anchal Upadhyay

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 552-559

Background and Objectives: Cardiovascular disease is the leading cause of morbidity and mortality in patients with Chronic Kidney Disease. This increased risk of Cardiovascular Disease may begin during early stage of Chronic Kidney Disease much before the onset of kidney failure. This high burden of cardiovascular disease mortality is well illustrated by comparing cardiovascular disease mortality in dialysis population to general population. Our study aim is to identify Electrocardiographic and Echocardiographic changes in patients with chronic kidney disease.

An Echocardiographic Study Of Atrial Septal Defect And Its Clinical Correlation

Miss Jyoti Pandey , Dr. Medha Das , Dr. Pranjal Pankaj

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 715-720

Background: Knowledge of the size, location and type of the atrial septal defect is very important guideline for clinicians to decide the type of intervention required .The objective of the study was to determine the same using transthoracic echocardiography.
Method: Total 42 patients diagnosed with atrial septal defect were studied using two-dimensional echocardiography. Examination was done by Siemens ultrasound echo machine using a P5-1MHz transducer.
Results: In our study we found 41 cases of   isolated Ostium secundum type of defect .Single case of Ostium Primum type were also found.
Conclusion: Atrial Septal Defect is one of the commonest congenital heart defects, which if detected early, can be corrected easily by surgical intervention. Echocardiography is an easily available, cost effective and non invasive screening method. This study further boosts its role as screening and evaluating tool in cases of Atrial Septal Defects.

Original research article: Study of Effect of exercise on left ventricle systolic function in person without any heart disease

Dr Ekta Khurana .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 540-544

Background: Regular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters
Objective: To determine the impact of measures of cardiac function assessed by echocardiography on exercise capacity and to determine if these associations are modified by sex or advancing age.
Methodology: The Study was conducted on 100 subjects at Haldiram and Moolchand Heart Centre, PBM Hospital, S.P. Medical College, Bikaner. First a resting echocardiography was performed to evaluate cardiovascular diastolic function. After echocardiography the subjects were underwent Bruce protocol treadmill test.
Result & Conclusion:: There was no correlation between exercise capacity and end systolic volume index (p=0.089), between exercise capacity and ejection fraction(p=0.459), between exercise capacity and fractional shortening(p=0.467), between exercise capacity and stroke volume index(p=0.361), between exercise capacity and  cardiac index(p=0.475).
 

Study of Effect of exercise on left ventricle diastolic function in normal subjects

Dr Ekta Khurana .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1520-1524

Background: Determining the factors affecting exercise capacity is extremely significant because it can improve the life span and the quality of life of subject as exercise capacity is related to prognosis in healthy people and in heart disease patients.
Objective: To determine the effectof cardiac diastolic function assessed by echocardiography on exercise capacity
Methodology: The Study was conducted on 100 subjects at Haldiram and Moolchand Heart Centre, PBM Hospital, S.P. Medical College, Bikaner. First a resting echocardiography was performed to evaluate cardiac diastolic function. After echocardiography the subjects were underwent Bruce protocol treadmill test.
Result & Conclusion:: There exists a strong association among VO2max and diastolic function as observed by E/A and A’s positive correlation with VO2max and negative correlation of diastolic function indices E,E/E’, LAVI with VO2max

The study of biochemical (CPK-MB) ,ECG, and Echocardiographic changes in patients of snake bite

Dr.Roopesh Singh Kirar, Dr.Ritesh Yadav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2055-2064

Background:Snake bite is an occupational hazard for farmers and farm laborers in the Indian
subcontinent. Every year approximately 15,000 people reportedly died due to snake venom
interaction in India alone. However, unreported deaths are estimated to be many times greater
than the reported cases in the subcontinent.
Materials & Methods:ThisCross Sectional Observational Study was carried on sample size of
75 patients of snake bite admitted in Ward/ICU, Department Of Medicine, NSCB Medical
College, and Jabalpur on patients of snake bite reporting from all over mahakaushal area of
central India from March 2017 to August 2018.
Results: CPK-MB analysis shown to have highest raised values in neurotoxic group that is
32.3±0.9 IU/L which was higher in cases where local signs were prominent, 34.0±1.1 IU/L and
in cases without local signs it was lower 30.7±1.6 IU/L. CPK-MB values were for vasculotoxic
bites was also raised 27.3±1.2 IU/L, while for non-poisonous snake bites it was below upper
limit, 21±2.1 IU/L. A total of 39.2% (n=33) patients shown to have positive ECG findings while
rest 60.7% (n=51) shown no abnormality in electrocardiogram. Analysis of 2D-ECHO findings
was done for pattern of positive findings and found that most common positive finding was
pericardial effusion with 9 (10.71%) patients followed by 6 (7.1%) patients showed diastolic
dysfunction, and 5 (5.9%) patients each shown to have systolic dysfunction and RWMA.
Conclusion: CPK-MBanalysis shown to have highest raised values in neurotoxic group which
was higher in cases where local signs were prominent, and in cases without local signs it was
lower. Abnormal ECG was significant predictor of mortality in vasculotoxic snake bites.
Echocardiography was a significant predictor of mortality in neurotoxic bites.

Assessment of Ventricular Function in Children with Bronchial Asthma

Dalia Soliman Abdullah,Eman Mahmoud EL- Moghazy, HebaAbouZeid

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3698-3705

Background:Bronchial asthma is a chronic inflammatory disease of airways in which many
cells and cellular elements play a role particularly mast cells, eosinophils, T lymphocytes,
macrophages, neutrophils and epithelial cells.Chronic bronchial asthma may cause pulmonary
arterial hypertension which causes RV hypertrophy and dilatation as well as systolic and
diastolic RV dysfunction. The level of right ventricular diastolic dysfunction depends on the
degree of right ventricular hypertrophy and pulmonary vascular resistance.
Aim of the study: The aim of this study wasto evaluatethe ventricular functions in patients with
bronchial asthma using Traditional Echocardiography and tissue Doppler imaging.
Patients and methods:This was a cross sectional study that included thirty-eight patients with
bronchial asthma. All patients were subjected to full history taking, clinical examination and
they underwent Echocardiography.
Results:Tricuspid and mitral E wave velocities were significantly lower among cases. Tricuspid
and mitral A wave Velocities were significantly higher among cases. No significant
differencewas found regarding any of the measured cardiac dimensions. No significant
statistical difference regarding fractional shortening was found.Right ventricular myocardial
performance (MPI) was higher in case group when compared to control group with no
significant statistical difference.
Conclusion:Early and late biventricular diastolic dysfunction was detectable in children with
bronchial asthma using conventionalDoppler echocardiography. The absolute value of right
ventricular tissue Doppler-derived MPI was increased in cases of bronchial asthma compared
with control subjects although the difference did not reach statistical significance.

Assessment of different indices of RV functions by Echocardiography in acute Inferior wall Myocardial Infarction and its coronary angiographic correlation

Shilpi Lahoty; Ravindra Jain; C. Sridevi; Rajendra Patil; Pranav Shende

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7117-7124

Background:Cardiovascular diseases (CVD) are the top most cause of death in the world. As per world health organization (WHO), greater number of people die of CVDs than any other cause.Out of the CVDs predominant mortality is attributed to coronary artery disease(CAD) which includes stable CAD and unstable CAD (which can manifest as unstable angina, NSTEMI or STEMI) . Hence the present study was undertaken at our tertiary care centre to assess different indices of RV function by Echocardiography within 48 hours of onset of symptoms in 1st episode of acute IWMI and to correlate it with the site of lesion in CAG.

Clinical and hemodynamic efficacy of prehospital thrombolysis in acute coronary syndrome with ST elevation

Kenjaev S.R

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2327-2331

According to the World Health Organization (WHO), cardiovascular disease (CVD) is the leading cause of death and disability in countries around the world, with ST segment elevated myocardial infarction (STEMI) leading the way. Despite advances such as the widespread introduction of many effective drugs, angioplasty and surgical treatments into clinical practice, CVD kills 17.3 million people annually, accounting for 30% of all deaths worldwide. This figure is projected to increase to 23.6 million by 2030. In the world, including in Uzbekistan, over the past two decades there has been an increase in morbidity and mortality from cardiovascular pathology.

THE ROLE OF CLINICAL AND INSTRUMENTAL METHODS IN EARLY DIAGNOSIS AND PROGNOSIS OF CARDIOMYOPATHY IN CHILDREN

D.I. Akhmedova .; N.R. Akhmedova .; D.M. Ruzmatova .; S.B. Akhmedova .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2747-2755

Cardiomyopathy is a severe pathology, which requires careful
study of clinical parameters and data of functional diagnostics methods (ECG,
ECHO) for early detection. The study aimed to study the role of clinical and
instrumental, biochemical, and immunological investigation methods for early
detection and prognosis of cardiomyopathy course in children. Materials and
methods of study: 85 children with cardiomyopathy under 18 years of age were
examined, including 60 children with dilated cardiomyopathy (DCMP), 16
children with hypertrophic cardiomyopathy (HCMP) and 9 children with
restriction cardiomyopathy (RCMP) who were hospitalized in the
cardioreumatology department of the Republican Specialized Scientific-
Practical Medical Center of Pediatrics of the Ministry of Health of the Republic
of Uzbekistan. The control group consisted of 30 practically healthy children.

CORRELATION DEPENDENCE OF PARAMETERS OF N-TERMINAL BRAIN NATRIURETIC PEPTIDE (N-proBNP) AND ECHO-CARDIOGRAPHIC INDICATORS IN CHILDREN WITH CONGENITAL HEART DISEASES

Mamura Rakhmatillaeva; Dilnoza Abdurakhmanova; Oydin Ubaydullaeva

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1010-1017

Correlation dependence of the parameters of N - terminal cerebral natriuretic (NT-ProBNP) peptide and echocardiographic parameters for the diagnosis of pulmonary hypertension in children with CHD. For the study, 81 children aged 1 to 34 months were examined. The first group of CHD children without pulmonary hypertension, the second group - 56 CHD children with pulmonary hypertension. The results of our study show a statistically significant relationship between NT-ProBNP levels and structural features and pancreatic function during the development of PH with CHD.