Oteh Maskon

Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Contrast-Induced Nephropathy After Coronary Angiography

We investigated whether serum neutrophil gelatinase-associated lipocalin (NGAL) was an early predictive biomarker of contrast-induced nephropathy (CIN) in patients with chronic kidney disease (n = 100) undergoing coronary catheterization. Serum creatinine (SCr) levels were measured at baseline, 24 hours, and 48 hours post procedure. Serum NGAL was measured preprocedure, 4 hours, and 24 hours post procedure. The frequency of CIN was 11%. In patients with CIN, SCr achieved significance only at 48 hours (P = .006), whereas serum NGAL increased ≥25% from baseline at 24 hours in 7 of 11 patients with CIN (P = .04) but did not change in the other 4. However, serum NGAL also rose ≥25% in 12 of 89 non-CIN patients. This subgroup could have had “incipient CIN.” Serum NGAL delta value at baseline, 24 hours was superior to SCr for early diagnosis of CIN. In conclusion, serum NGAL is an early predictive biomarker for CIN.

Serum neutrophil gelatinase-associated lipocalin and cystatin C are early biomarkers of contrast-induced nephropathy after coronary angiography in patients with chronic kidney disease

We had previously reported on serum neutrophil gelatinase-associated lipocalin (NGAL) as an earlier biomarker of contrast-induced nephropathy (CIN) than serum creatinine (SCr) in 100 patients with chronic kidney disease undergoing coronary angiography.1 We then compared serum NGAL to serum cystatin C (CysC) in the same group of patients. The SCr, estimated glomerular filtration rate, serum NGAL, and serum CysC were measured at baseline and various time points as appropriate postprocedure. The frequency of CIN was 11% (n = 11). Serum NGAL increased ≥25% from baseline at 24 hours in 7 patients with CIN (P = .04). Serum CysC increased ≥25% from baseline at 24 hours in 4 patients with CIN (P = .008). Changes in serum NGAL and serum CysC from baseline at 24 hours (▵ values) could diagnose CIN 24 hours earlier than SCr with serum NGAL showing a superior performance.

Effects of Swedish Massage Therapy on Blood Pressure, Heart Rate, and Inflammatory Markers in Hypertensive Women

Swedish Massage Therapy (SMT) is known for its therapeutic relaxation effects. Hypertension is associated with stress and elevated endothelial inflammatory markers. This randomized control trial measured the effects of whole body SMT (massage group) or resting (control group) an hour weekly for four weeks on hypertensive women. Blood pressure (BP) and heart rate (HR) were measured before and after each intervention and endothelial inflammatory markers: vascular endothelial adhesion molecules 1 (VCAM-1) and intracellular adhesion molecules 1 (ICAM-1) were measured at baseline and after the last intervention. Massage group (n=8) showed significant systolic BP (SBP) reduction of 12 mmHg (P=0.01) and diastolic BP (DBP) reduction of 5 mmHg (P=0.01) after four sessions with no significant difference between groups. Reductions in HR were also seen in massage group after sessions 1, 3, and 4 with significant difference between groups. VCAM-1 showed significant reduction after four sessions: the massage group showed reduction of 998.05 ng/mL (P=0.03) and the control group of 375.70 ng/mL (P=0.01) with no significant differences between groups. There were no changes in ICAM-1. In conclusion, SMT or resting an hour weekly has effects on reducing BP, HR, and VCAM-1 in hypertensive women.

Atrial fibrillation as a complication of dengue hemorrhagic fever: non-self-limiting manifestation

While electrocardiogram (ECG) changes are common during viral dengue infection, atrial fibrillation (AF) is a very rare manifestation. It has previously been highlighted that cardiac complications during dengue infection are invariably transient and will spontaneously resolve following recovery from the illness. We present the case of a young patient with IgM- and IgG-positive dengue hemorrhagic fever complicated by AF. ECG revealed a structurally normal heart. The patient remained in AF despite resolution of the illness. Reversion to normal sinus rhythm was achieved after loading of oral amiodarone.

Automatic border detection of cardiac cavity images using boundary and triangle equation

In this paper, an automatic border detection of cardiac cavity in two-dimensional short axis echocardiography image is proposed. The method uses boundary and triangle equation to detect and reconstruct the border. The first step is determining the initial centers boundary. The second step is applying morphological and thresholding operations to eliminate noise and convert it into binary image. The last step is using boundary and triangle equation to detect and reconstruct the imprecise border. This technique can detect centers of boundary and border very precisely.

Thin strut bare metal stents in patients with atrial fibrillation: Is there still a need for BMS?

This observational study assessed the 9‐month clinical outcomes in an « all comers » population with a focus on patients with atrial fibrillation (AF) after thin strut bare metal stenting.

On the Use of Collinear and Triangle Equation for Automatic Segmentation and Boundary Detection of Cardiac Cavity Images

In this chapter, the computational biology of cardiac cavity images is proposed. The method uses collinear and triangle equation algorithms to detect and reconstruct the boundary of the cardiac cavity. The first step involves high boost filter to enhance the high frequency component without affecting the low frequency component. Second, the morphological and thresholding operators are applied to the image to eliminate noise and convert the image into a binary image. Next, the edge detection is performed using the negative Laplacian filter and followed by region filtering. Finally, the collinear and triangle equations are used to detect and reconstruct the more precise cavity boundary. Results obtained have proved that this technique is able to perform better segmentation and detection of the boundary of cardiac cavity from echocardiographic images.

Left atrial volume index is an independent predictor of major adverse cardiovascular events in acute coronary syndrome.

BACKGROUND Left atrial volume index (LAVI) is well proven to be a reliable method of determining left atrial size, which has prognostic implications in cardiovascular diseases. Studies demonstrate that increased LAVI is a predictor of mortality in myocardial infarction, but its association with other major adverse cardiovascular events (MACEs) among patients post acute coronary syndrome (ACS) has not been adequately evaluated. METHODS We calculated the baseline LAVI for all patients who were admitted with ACS between December 2010 and August 2011. The patients were stratified into 2 arms: normal LAVI and increased LAVI, with a cutoff value of 28 mL/m(2). All patients were prospectively followed up during 6 months for development of MACEs. RESULTS Of the 75 patients who completed the study, 32 had increased LAVI, and 43 had normal LAVI. More than half (55%) of the patients were diagnosed with unstable angina. During the follow-up period of 6 months, 30 patients (93.8%) in the increased-LAVI arm and 23 patients (53.5%) in the normal-LAVI arm developed at least a single MACE. Patients with increased LAVI had significantly more MACEs (P = 0.021). The occurrence of MACE remained significantly higher in the increased-LAVI group even when atrial fibrillation was excluded (P = 0.016). After adjusting for confounding variables by multivariate analysis, LAVI was found to have a significant association with MACEs (P = 0.030, odds ratio = 1.229 (95% confidence interval, 1.020-1.481). CONCLUSION LAVI is a useful tool for prognostication and an independent predictor of MACEs post ACS.

Immediate postpartum cardiorespiratory collapse:a management quandary

A 35-year-old multiparous woman was found unresponsive, tachypnoeic, hypoxic and in shock 4 h postpartum. The ECG revealed S1 Q3 T3, a right bundle branch block pattern and right-axis deviation. The computed tomography of her pulmonary arteries revealed bilateral pulmonary artery thrombosis with dilated right ventricle. She was fibrinolyzed with intravenous Tenecteplase 30 mg bolus. Her saturation and tachypnoea improved and her ECG reverted to sinus rhythm subsequently. We discuss our use of off-label Tenecteplase in postpartum pulmonary embolism and review the literature.

Photoplethysmography analysis of artery properties in patients presenting with established erectile dysfunction

This study examines the variation of photoplethysmogram (PPG) morphology based on a sample by recording PPG finger tips from erectile dysfunction (ED) patients. Nine PPG indexes are calculated along with carotid intima-media thickness (CIMT) for all patients. The measured parameters are statistically analyzed and their association is shown in results section. These results show that PPG can be used to analyze cardiovascular disorders and supplement existing methods of analyzing arterial conditions.