Mahboob Ali

Association of Body Mass Index with Angiographic Severity of Coronary Artery Disease in Patients with Acute ST- Segment Elevation Myocardial Infarction

Background: This study evaluated the association of body mass index (BMI) and angiographic severity of coronary artery disease in patients with acute ST segment elevation myocardial infarction (STEMI). Methods: Data were analyzed from 100 acute STEMI patients who underwent coronary angiogram. The patients were grouped based on BMI; those with normal BMI, 18.5- 24.9 kg/m 2 (group I) and those with increased BMI, >25 kg/m 2 (group II). Each group contained 50 patients. Angiographic severity of the three groups was compared and the relation between BMI and angiographic severity was assessed. Results: The mean BMI of subjects with normal angiographic findings was 20.81 ± 1.03 kg/m2. The mean BMI of single, double and triple vessel disease were 23.85 ± 2.24, 24.25 ± 2.41 and 32.06 ± 7.86 kg/m 2 respectively. The number of vessel involvement increased in proportion with increased BMI and the differences were statistically significant (p=0.001). Conclusion: Increased BMI is associated with angiographic severity of coronary artery disease in patients with acute ST-segment elevation myocardial infarction. Cardiovasc. j. 2017; 10(1): 68-73

Value of ST- Segment Depression with T-Wave Inversion in Lateral Leads I, aVL, V4-V6 in Diagnosing the Left Main or Left Main Equivalent Coronary Artery Disease

Background: Critical stenosis in the proximal part of the left anterior descending, severe 3 vessel disease and left main stem stenosis have all been recognized as clinical conditions complicated by a high incidence of large infarction, pump failure, arrhythmias and sudden death in patients with acute coronary syndrome (ACS). As many effective treatment modes are available currently, early recognition of those circumstances is crucial for appropriate management. Methods: this observational study was carried out at the Department of Cardiology, National Institute of Cardiovascular Disease (NICVD), Dhaka. Patients (30 patients) with NSTEACS having ST-segment depression with T-wave inversion maximally in leads I,avL,V4-V6 were considered as cases (Group I) and those (30 patients) with ST-segment depression without T-wave inversion in lateral leads were controls (Group II). Coronary angiogram (CAG) was done during in-hospital stay. Results: In present study, it was evident that among group I patients, 43.3% had stenotic lesion in left main artery (LM) and 26.67% in LM equivalent coronary artery (LME CA), whereas had no stenotic lesion in LM and 3.33% had LME CA lesion in group II patients. Low cost, widely available ECG criteria is supposed to be useful predictor of left main or left main equivalent coronary artery obstruction (Sensitivity=95%, Specificity= 76%, Positive predictive value= 70.0% and Negative predictive value= 97.0%) and high ST–segment changes score (>18 mm (100%) &/or ³10mm (80%) was an additive predictor of LM or LMECA lesion. Conclusion: Maximum ST- segment depression with T-wave inversion in the lateral leads I, aVL, V4-V6 on admission ECG can predict the critical LM or LMECA obstruction in patients with NSTEACS. It can help to provide prompt and appropriate management earlier to reduce the mortality & morbidity. Cardiovasc. j. 2017; 9(2): 135-141

TCTAP A-182 Immediate In-Hospital Complications of Percutaneous Transvenous Mitral Commissurotomy in Patients with Mitral Stenosis

Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2: