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Register a new userStudy Of On The Walls Motion And Function Of Left Ventricular By Echo - Doppler With And Without Captopril In Myocardial Infarction
دراسة حركية جدر البطين الأيسر و وظيفته بعد احتشاء العضلة القلبية بالأمواج ما فوق الصوتية مع و دون الكابتوبريل
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أجريت الدراسة على ١٢١ مريضاً مصاباً باحتشاء عضلة قلبية و ذلك في مشافي جامعة دمشق , و قد قسم المرضى إلى مجموعتين : المجموعة الأولى : و شملت ٦٠ مريضاً عولجوا معالجة تقليدية دون استخدام حاصرات الخميرة القالبة للأنجيوتنسين (الكابتوبريل) . المجموعة الثانية : و شملت ٦١ مريضاً عولجوا بالإضافـة إلى المعالجـة التقليديـة بحاصرات الخميرة القالبة للأنجيوتنسين . تمت مراقبة هؤلاء المرضى بالأمواج فوق الصوتية في الفترة الحادة من الاحتشاء و بعد ستة أشهر منه , و ذلك لمعرفة تأثير حاصرات تلك الخميرة في حركية و وظيفة البطيـن الأيسر .
Study has been made on 121 patients affected by myocardial infarction ( MI ) in Damascus university hospitals whereas the patients were divided in tow groups : the first group contained 60 patients treated traditionally without captopril. the second group contained 61 patients treated traditionally and by captopril these patients were examined by Echo – Doppler during the acute phase and after six months of MI to realize the effect of captopril on contractility and function of left ventricular (LV) .
Artificial intelligence review:
Research summary
تبحث هذه الدراسة في تأثير استخدام الكابتوبريل على حركية ووظيفة البطين الأيسر بعد احتشاء العضلة القلبية. أجريت الدراسة على 121 مريضًا في مشافي جامعة دمشق، وقسموا إلى مجموعتين: الأولى تلقت علاجًا تقليديًا دون الكابتوبريل، والثانية تلقت العلاج التقليدي مع الكابتوبريل. تم تقييم المرضى باستخدام الأمواج فوق الصوتية في المرحلة الحادة من الاحتشاء وبعد ستة أشهر. أظهرت النتائج أن الكابتوبريل كان له تأثير إيجابي على حركية البطين الأيسر وحجمه، دون تأثير كبير على الوظيفة الانقباضية الكلية للبطين الأيسر في المرحلة الحادة. ومع ذلك، كانت تأثيراته أكثر إيجابية بعد مرور ستة أشهر، حيث ساهم في منع توسع البطين الأيسر، وتقليل الحمل القبلي والبعدي، وضبط التوازن الشاردي، وتقليل نسبة الوفيات والإمراضية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة في مجال طب القلب، حيث تسلط الضوء على دور الكابتوبريل في تحسين نتائج المرضى بعد احتشاء العضلة القلبية. ومع ذلك، يمكن أن تكون هناك بعض النقاط التي تحتاج إلى مزيد من التوضيح. أولاً، لم يتم توضيح ما إذا كانت هناك اختلافات كبيرة في الخصائص الديموغرافية بين المجموعتين، مما قد يؤثر على النتائج. ثانيًا، لم يتم مناقشة الآثار الجانبية المحتملة لاستخدام الكابتوبريل بشكل كافٍ. وأخيرًا، قد يكون من المفيد إجراء دراسات مستقبلية تشمل عددًا أكبر من المرضى وتقييم تأثيرات الكابتوبريل على مدى فترة زمنية أطول.
Questions related to the research
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ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي هو دراسة تأثير الكابتوبريل على حركية ووظيفة البطين الأيسر بعد احتشاء العضلة القلبية.
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كم عدد المرضى الذين شاركوا في الدراسة؟
شارك في الدراسة 121 مريضًا.
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ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟
أظهرت الدراسة أن الكابتوبريل له تأثير إيجابي على حركية البطين الأيسر وحجمه، دون تأثير كبير على الوظيفة الانقباضية الكلية في المرحلة الحادة، وكانت تأثيراته أكثر إيجابية بعد مرور ستة أشهر.
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ما هي التوصيات التي انتهت إليها الدراسة؟
أوصت الدراسة بأهمية استخدام الكابتوبريل في المرحلة الحادة من الاحتشاء، خاصة في حالات الاحتشاء الأمامي الواسع، لمنع توسع البطين الأيسر وتقليل نسبة الوفيات والإمراضية.
References used
SABBAH. H N and al Ventricular remodeling consequence and therapy J . 1993 , 14 Supple : 9 – 24
MANCIA C sympathetic activation in congestive heart failure , Eur heart J .1990, 11 supple A : 3 – 11
SHARPE N and al Prevention of left ventricular dysfunction after myocardial Infarction with angiotensin – converting enzyme inhibitors 1991 , 337 : 872 – 876
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Background: primary percutaneous coronary intervention PCI is the treatment of
choice in civilized countries for acute myocardial infarction, the aim of the treatment here
is the revascularization as soon as possible. Patients and methods: it is re
trospective study
of 133 patients of acute MI have been divided into two subgroups. The first subgroup has
been treated with streptokinase infusion, and the other subgroup has beet treated by PCI.
We monitored the patients within hospitalization , reinfarction, mortality, cardiogenic
shock, heart failure, also we recorded the time needed to apply the method of treatment and
Timi score by diagnostic cardiac catheterization after applying the treatment.
Aim of study: to compare between streptokinase and PCI in our hospitals to know
which way is better in which we can give the best medical care for this critical patients.
Results: 63 patients undergo to pci and 70 patients undergo to streptokinase therapy.
Streptokinase group had higher rates in mortality for noncardiac reasons 100%,
cardiogenic shock 60% , reinfarction 81%, mortality for cardiac reasons 80%, while it was
faster in applying the treatment and equal to pci in timi score. While pci group has higher
rated in hospitalization for cardiac reasons 70% and in cases that has new congestive heart
failure 63%, and nearly equal to streptokinase group in timi score.
Conclusion: pci was better in mortality and cardiogenic shock and reinfarction than
streptokinase but it was worse in hospitalization for cardiac reasons and congestive heart
failure cases . pci was too late than streptokinase in applying the treatment . we notice that
the two methods of treatment was nearly equal in timi score.
This research tries to the rate of arrhythmia manifested during the first (48) hours of heart infarction and define its nature as well as its relationship with heart infarction in regard to patients subjected to anti-coagulation (streptokinase) ther
apy and patients who were not subjected to it. Moreover, it also aims to detect the relationship between arrhythmia and the death rates of the patients during their stay in the Heart Intensive Care Unit.
The study started in October 2012 and lasted twelve months, up to October 2013.
The sample of study here consisted of (187) patients hospitalized in the Heart Intensive Care Unit having acute myocardial infarction. The sample included (142) males (76 % of the sample) and (45) females (24%). The research reached the following findings:
A hundred and seven of the patients monitored in the study were smokers; and smoking was the most important risk factor causing myocardial infarction.
Ventricular extra systole were the most common symptoms of acute myocardiac infarction arrhythmia during the first (48) hours of hospitalization reaching (79%). The second was increased auto ventricular rhythms rating (43 %).
High rates of dangerous arrhythmia like (VT) and (VF) rating (9%) in patients who were not subjected to streptokinase (anti-coagulation) compared with those subjected to it (4. 5%), and (3.8) respectively.
Decreased (EF) increased the possibility of life-threatening ventricular arrhythmia like (VT).
Diabetes did not increase the dangers of arrhythmia monitored in this research
The study was performed in 64 children aged 6 months to 5 years had
ventricuLar septal defect. Systolic pressure in the right ventricle and
Pulmonary Hypertension were determined by two ways.
1- From arteriovenous shunt via ventricular septal defe
ct the
correlation ratio of doppler echo cardiographic catheterization
values was %76.
2- From systolic regurgitation via the tricuspid valve the correlation
was %97.
Background: longitudinal and radial systolic function are weakened by cardiac diseases and
longitudinal one is weakened first. Assessment of left ventricular LV systolic function is important
in management and prognosis of cardiac diseases. Mitral
annular displacement MAD is used to
assess LV longitudinal and global systolic function.
Objectives: To validate the accuracy of MAD assessed by Doppler tissue imaging DTI and
m-mode echocardiography MME as a surrogate for determination of LV systolic function in
pationts with ischemic heart disease and/or heart failure, and maybe easy and fast way instead of
conventional echocardiography assessment of LV function. This way permits to study the function
of LV longitudinal cardiac fibers function while the conventional ways of echocardiography
assesses the circumferential shortening.
Patients and methods: We studied a series of 96 patients (men and women) with (ischemic
heart diseases,heart failure) divided into three age groups and compared with another 59 healthy
age matched volunteers as a control group. We selected subjects from AL ASSAD hospital
/LATAKIA over the year 2014. A medical history, whole medical examination, ECG, conventional
echocardiography were made to each subject. Ejection fraction EF of LV, Doppler recording of the
mitral inflow, MME and pulse wave Doppler tissue imaging PW DTI data (from each four sites of
mitral annulus, anterior, septal, lateral and inferior) were obtained. Mean peak systolic velocity (S
wave), mean annular early diastolic velocity (e') by PW DTI and mean mitral annular displacement
(MAD) by MME were calculated by averaging of values measured at each annular site.
Results: MAD correlate well with LV EF, mean MAD < 11.275 mm determined by MME
has 85% sensitivity and 87.8% specificity and 85.8% accuracy for detection of LV EF < 50%, Mad
was low in patients with infarctions and lower in pationts with heart failure.
Conclusion: Mean MAD connect with a positive relationship with LV EF and can detect the
abnormal systolic motion on the long axis. That means the ability to detect the ischemia in early
stages.
We studied 67 cases of left ventricular aneurysm following a myocardial
infarction through 1993 to 2002.
22 Patients had only aneurysmectomy
45 Patients had aneurysmectomy + CABG + Mitral surgery.
Death percentage in the first year after surgery
was 8.9 %.
The good clinical and haemodynamical results are due to the clear
indication of surgery on patients who had more than 25% of the LVDV
involved by aneurysm.
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