Electrocardiographic Examination Research Articles

Normal M-mode, Pulsed Wave and Tissue Doppler Echocardiographic Studies in Healthy Working Police Dogs

Background: Physical activity alters the cardiovascular system of dogs depending on the exercise characteristics and the animal’s physical conditioning. Little is known about the cardiovascular changes in working police dogs. This study evaluated the cardiovascular responses of working Labradors to regular exercise and various workload. Methods: Twelve working Labradors of Tamil Nadu police department that were regularly trained and exercised 30 minutes morning and evening and twelve normal household pet Labradors brought for regular checkup to Madras Veterinary College Teaching hospital were taken for the study. All the animals were subjected to physical, clinical, hematobiochemical, electrocardiographic examinations and cardiac auscultation before performing echocardiography. Those animals which showed normal recordings in all the above tests were further subjected to M-mode, Pulsed wave and Tissue Doppler echocardiography. In this study, the resting heart rate values of working groups were lesser than that of normal pet dogs. Result: The results of echocardiography showed significant increase in Interventricular septal diameter during diastole, left atrial diameter, aortic artery diameter and the left atrium to aortic diameter ratio without impairing systolic and diastolic cardiac functions in working dogs. The present study indicated that there were few changes in the echocardiographic parameters which might be a response to physiological adaptation and regular exercise.

Role of Ferroptosis Regulation by Nrf2/NQO1 Pathway in Alcohol-Induced Cardiotoxicity In Vitro and In Vivo.

The aim of the present study was to evaluate the cardiotoxic effects of alcohol and its potential toxic mechanism on ferroptosis in mice and H9c2 cells. Mice were intragastrically treated with three different concentrations of alcohol, 7, 14, and 28%, each day for 14 days. Body weight and electrocardiography (ECG) were recorded over the 14 day period. Serum creatine kinase (CK), lactic dehydrogenase (LDH), MDA, tissue iron, and GSH levels were measured. Cardiac tissues were examined histologically, and ferroptosis was assessed. In H9c2 cardiomyocytes, cell viability, reactive oxygen species (ROS), labile iron pool (LIP), and mitochondrial membrane potential (MMP) were measured. The proteins of ferroptosis were evaluated by the western blot technique in vivo and in vitro. The results showed that serum CK, LDH, MDA, and tissue iron levels significantly increased in the alcohol treatment group in a dose-dependent manner. The content of GSH decreased after alcohol treatment. ECG and histological examinations showed that alcohol impaired cardiac function and structure. In addition, the levels of ROS and LIP increased, and MMP levels decreased after alcohol treatment. Ferrostatin-1 (Fer-1) protected cells from lipid peroxidation. Western blotting analysis showed that alcohol downregulated the expression of Nrf2, NQO1, HO-1, and GPX4. The expressions of P53 and TfR were upregulated in vivo and in vitro. Fer-1 significantly alleviated alcohol-induced ferroptosis. In conclusion, the study showed that Nrf2/NQO1-dependent ferroptosis played a vital role in the cardiotoxicity induced by alcohol.

Comparative analysis of classical artificial intelligence and deep learning models for atrial fibrillation detection in electrocardiograms

Abstract Background/Introduction Early diagnosis of atrial fibrillation (AF) presents a challenging yet critical task for appropriate interventions aimed at reducing disease-related burden. In this context, strategies employing classical artificial intelligence (CAI) and deep learning (DL) have emerged as promising approaches to optimize cardiac disorder screening and detection. Purpose This study aimed to compare a CAI model and a DL model for the detection of AF in patients undergoing electrocardiographic (ECG) examinations in tertiary healthcare centers. Methods Between December 2022 and November 2023, a total of 135,476 ECGs were performed, comprising 5,067 with AF and 130,409 without AF. The ECGs were analyzed using both artificial intelligence models. The obtained results were then compared to the gold standard (cardiologist's report). In the CAI model, signals were extracted from ECG images, analyzing five key parameters: cardiac rhythm, atrial depolarization, atrioventricular conduction, ventricular depolarization, and ventricular repolarization (figure 1A). These parameters were benchmarked against the standard values from the Brazilian Society of Cardiology guidelines for detecting cardiac anomalies. Conversely, the DL model utilized a one-dimensional ResNet-based Convolutional Neural Network (CNN). This model was trained using ADAM optimization and binary cross-entropy loss, enabling the learning of complex patterns in the data (figure 1B). Results The mean age was 54.6 years (71.9 years with AF and 53.9 without AF). In the AF population, 52.2% were male (46% were male in the overall sample). In the analysis conducted, the CAI model showed a sensitivity and specificity of 90% and 62%, respectively, while the DL model had 90% and 69%, respectively. ROC curves were generated for both models, demonstrating the superior performance of the DL model (figure 2A). Conclusions Although the sensitivity remained similar between the models, the DL model distinguished itself with higher specificity. These results suggest that artificial intelligence, particularly the deep learning approach, holds promise as a supportive resource in AF diagnosis. However, further studies are needed to evaluate the models more thoroughly and determine their clinical applicability in a broader context.Artificial intelligence modelsROC curves

Aortic, mitral and tricuspid valvular dysplasia in a 7‐month‐old colt

SummaryA 7‐month‐old Warmblood cross colt was presented for the assessment of a laceration of the right hind pastern of 4‐days duration. At presentation, the colt was in poor body condition and had a rough, dull coat. Cardiac auscultation revealed a grade 5/6 pansystolic murmur on the left side and grade 4/6 continuous murmur on the left and right sides and a regular cardiac rhythm. Electrocardiographic examination confirmed sinus tachycardia. Echocardiographic examination showed malformation of the aortic and mitral valves, with associated regurgitation and evidence of left atrial and ventricular volume overload. Dysplasia of the mitral, tricuspid and aortic valves was confirmed by post‐mortem examination. Valvular dysplasia is a rare cause of cardiac failure in horses.

Atrial Fibrillation After Spontaneous Intracerebral Hemorrhage

Introduction: Cardiac arrhythmias often occur during the acute phase of a stroke and can cause hemodynamic instability and sudden cardiac death. Data regarding determinants and the course of arrhythmia onset in the acute phase of stroke are still rare, especially in hemorrhagic stroke. Case report: A male, 74 years old, came to the emergency department with a complaint of weakness in the left hand and leg that had occurred suddenly 5 hours previously. Weakness is described by the left arm and leg still being able to be lifted a few seconds later and falling again. This complaint was accompanied by lips that appear pursed and severe dysarthria. The patient was said to have had a history of uncontrolled hypertension for 10 years. A previous history of heart disease was denied. A CT scan of the head without contrast showed intracerebral hemorrhage in the basal ganglia and right external capsule with a volume of 5 cc. An electrocardiography (ECG) examination showed sinus rhythm without any indication of heart rhythm disturbances. Further ECG examination after the 4th day of hospitalization showed atrial fibrillation with rapid ventricular response (AFRVR). The patient eventually died one day after the heart rhythm changed. Discussion: The incidence of AF varies depending on the type of stroke that occurred, the monitoring device used, the interval between initial monitoring and stroke onset, and the duration of cardiac monitoring. AF in patients can occur as a result of a hemorrhagic stroke, but it is also possible because of the presence of previously undetected paroxysmal AF. High NIHSS correlates with system disturbances in autonomous cardiovascular systems. According to current NIHSS measurements, hospital admission is required as a parameter for heart rhythm monitoring for more than 24 hours. Conclusion: Newly detected AF after ICH greatly influences the clinical outcome of patients. Understanding the mechanism and pathophysiology of new AF after ICH will contribute to a better understanding of the management of the patient. Keywords: atrial fibrillation, cardiac arrhythmia, case report, stroke, intracerebral hemorrhage

Association between the early repolarization pattern and nocturnal suicide attempts.

Numerous recent reports have highlighted the association between mental disorders and electrocardiographic findings. The early repolarization pattern (ERP) on electrocardiogram has been linked with a history of suicide attempts and attention deficit hyperactivity disorder, and associations with impulsivity have also been reported. It is known that suicidal intent is more common at night. Patients who have a mental disorder and ERP may have a higher likelihood of impulsivity, potentially increasing the risk of suicide at night. The subjects were 43 patients with a history of suicide attempts who had undergone electrocardiographic examination at Jikei University School of Medicine Kashiwa Hospital and received intervention from our department. Due to the diurnal variation in electrocardiographic findings, only patients who underwent the examination during the daytime were included. Patients' clinical backgrounds were compared according to the presence or absence of ERP, and the association between nocturnal suicide attempts and ERP was examined using multivariate analysis. The frequency of nocturnal suicidal behavior was 76.2% in patients with ERP and 31.8% in those without ERP, but the difference was not significant after Bonferroni correction. In the multivariate analysis, there was a significant association of ERP with nocturnal suicide attempts (p = 0.018). The finding of an association between ERP and nocturnal suicide attempts indicates that ERP is a biological indicator that can predict nocturnal suicide attempts.

Differences in cardiac adaptation to exercise in male and female athletes assessed by noninvasive techniques: a state-of-the-art review.

Athlete's heart is generally regarded as a physiological adaptation to regular training, with specific morphological and functional alterations in the cardiovascular system. Development of the noninvasive imaging techniques over the past several years enabled better assessment of cardiac remodeling in athletes, which may eventually mimic certain pathological conditions with the potential for sudden cardiac death, or disease progression. The current literature provides a compelling overview of the available methods that target the interrelation of prolonged exercise with cardiac structure and function. However, this data stems from scientific studies that included mostly male athletes. Despite the growing participation of females in competitive sport meetings, little is known about the long-term cardiac effects of repetitive training in this population. There are several factors-biochemical, physiological and psychological, that determine sex-dependent cardiac response. Herein, the aim of this review was to compare cardiac adaptation to endurance exercise in male and female athletes with the use of electrocardiographic, echocardiographic, and biochemical examination, to determine the sex-specific phenotypes, and to improve the healthcare providers' awareness of cardiac remodeling in athletes. Finally, we discuss the possible exercise-induced alternations that should arouse suspicion of pathology and be further evaluated.

Could Tumor Necrosis Factor Serve as a Marker for Cardiovascular Risk Factors and Left Ventricular Hypertrophy in Patients with Early-Onset Coronary Artery Disease?

Introduction: Tumor necrosis factor (TNF), a pro-inflammatory cytokine, can be produced by cardiomyocytes, leading to metabolic disorders in the myocardium. The objective of this study was to assess the relationship between plasma levels of the TNF cytokine and the presence of known biochemical and clinical risk factors for cardiovascular disease, along with the parameters of cardiac morphology in patients diagnosed with coronary artery disease (CAD) at a young age. Materials and Methods: The study group included 75 men aged up to 50 years and 25 women aged up to 55 years. The plasma TNF concentration was measured by use of the ELISA assay. Echocardiography and electrocardiographic examinations were performed in all patients. Results: We observed positive correlations for TNF with the BMI ratio, weight, waist and hip circumference. We also found negative correlations for TNF with HDL levels and ApoA concentrations, and positive correlations with the ApoB/ApoA1 ratio, Apo B, IL6, LDL and TG concentrations. These results suggest an association between higher plasma TNF concentrations and components of metabolic syndrome, including dyslipidemia. TNF may be a potential risk factor for impaired diastolic function. Conclusions: While TNF may be useful for diagnosing certain risks in CAD patients, the TNF measurement cannot be used as a surrogate test for echocardiography.

Predictors of Higher Frequency of Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy.

Background and Objectives: Cardiac resynchronization therapy (CRT) is one of the effective therapeutic options in the treatment of systolic heart failure (HF) with persistent symptoms. This prospective study was designed to determine whether CRT with biventricular pacing would reduce the risk of development of atrial fibrillation (AF) and to identify predictors for AF occurrence. Materials and Methods: The study population consisted of 126 patients, with a mean age of 63.8 ± 9.1 years, who were eligible for CRT with biventricular pacing. Inclusion criteria were left ventricular ejection fraction (LVEF) ≤ 35%, QRS duration ≥ 130 msec, and persistent HF symptoms of New York Heart Association (NYHA) II or III, despite optimal drug therapy. Patients were followed for a period of 24 months and were evaluated through clinical, electrocardiographic, and echocardiographic examination at baseline (prior to CRT implantation), as well as at 6 and 24 months post-implantation. At the end of follow-up, patients were divided into clinical responders and non-responders based on the following criteria: decrease in NYHA class ≥ I, increase in LVEF ≥ 10%, and reduction in QRS duration ≥ 20 msec. Results: At follow-up, CRT was associated with a significant increase in LVEF (20.6 ± 6.9% pre-implantation, 32.9 ± 9.3% 24 months after implantation; p < 0.001), reduction in left ventricular end-diastolic and end-systolic diameters, and decrease in QRS duration (167.6 ± 14.3 msec pre-implantation, 131.7 ± 11.7 msec 24 months after implantation; p < 0.001), while left atrial (LA) diameter was slightly increased (p = 0.070). The frequency of AF occurrence increased after two years of follow-up (52.4% to 56.9%, p < 0.001). Significant predictors of AF occurrence in our study population were response to CRT-AF more frequent in non-responders (B = 8.134; p < 0.001), LA diameter-AF more frequent with larger LA diameter (B = 0.813; p < 0.001), and coronary sinus (CS) lead position-AF more frequent with posterolateral in comparison with lateral CS lead position (B = 5.159; p = 0.005). Conclusions: The results of our study provide new data on AF predictors in patients with HF subjected to CRT. There remains a permanent need for new predictors, which might help in patient selection and improvement in response rate.

P-wave characteristics as electrocardiographic markers of atrial abnormality in prediction of incident atrial fibrillation – The Malmö Preventive Project

BackgroundP-wave indices reflect atrial abnormalities contributing to atrial fibrillation (AF). We aimed to assess a comprehensive set of P-wave characteristics for prediction of incident AF in a population-based setting. MethodsMalmö Preventative Project (MPP) participants were reexamined in 2002–2006 with electrocardiographic (ECG) and echocardiographic examinations and followed for 5 years. AF-free subjects (n = 983, age 70 ± 5 years, 38% females) with sinus rhythm ECGs were included in the study. ECGs were digitally processed using the Glasgow algorithm. P-wave duration, axis, dispersion, P-terminal force in lead V1 and interatrial block (IAB) were evaluated. ECG risk score combining the morphology, voltage and length of P-wave (MVP score) was calculated. New-onset diagnoses of AF were obtained from nation-wide registers. ResultsDuring follow up, 66 patients (7%) developed AF. After adjustment for age and gender, the independent predictors of AF were abnormal P-wave axis > 75° (HR 1.63 CI95% 1.95–11.03) and MVP score 4 (HR 6.17 CI 95% 1.76–21.64), both correlated with LA area: Person r − 0.146, p < 0.001 and 0.192, p < 0.001 respectively. Advanced IAB (aIAB) with biphasic P-wave morphology in leads III and aVF was the most prevalent variant of aIAB and predicted AF in a univariate model (HR 2.59 CI 95% 1.02–6.58). ConclusionP-wave frontal axis and MVP score are ECG-based AF predictors in the population-based cohort. Our study provides estimates for prevalence and prognostic importance of different variants of aIAB, providing a support to use biphasic P-wave morphology in lead aVF as the basis for aIAB definition.

Assessing the Inter-observer Agreement of Electrocardiography Interpretation in the Elderly Surgical Patients: A Cross-Sectional Study

Background: Electrocardiography (ECG) is an essential objective diagnosis tool, specifically for the elderly who are about to undergo surgery. From the examination results, it is possible to determine the presence of a heart condition that could impair the surgical outcome. Furthermore, the examination is slightly influenced by the subjectivity of observers. Purpose: To evaluate the inter-observer agreement on the reader of a 12-lead ECG on elderly patients subjected to elective surgery. Method: A consequential ECG examination was conducted on elderly patients who underwent elective surgery at Dr. Kariadi Hospital Semarang between July and November 2021. Two junior internist observers were independently involved in reading the ECG results in different places. The inter-observer reliability analysis used kappa statistics to determine consistency between observers. Result: Analysis was carried out on 193 patients aged 60-87 years old, with a prevalence of abnormal ECG was 33.7%. Kappa Conformity Value was 0.864 (95 % CI: 0.790-0.938, p&lt;0.001). Conclusion: The value of agreement between junior internists in ECG interpretation among elderly surgical patients is good (kappa value &gt;0.8). Even though the observers are junior internist, the result of the interpretation with a high kappa is considered to have reliable validity.

Percutaneous coronary intervention for chronic total occlusion of the left circumflex branch in mirror dextrocardia: a case report

BackgroundMirror dextrocardia (MDC) is a condition in which the heart is located in a mirror-image position on the right side of the chest compared to the normal position in individuals with physiological variations. Patients with MDC and chronic total occlusion (CTO) of the left circumflex branch (LCX) are extremely rare in clinical practice. The treatment of MDC-CTO-LCX differs significantly from patients without mirror dextrocardia and the same condition in terms of instrument selection and procedural techniques. In this article, we report a successful case of interventional treatment in a patient with MDC-CTO-LCX. We summarize the anatomical and electrocardiographic variations in patients with MDC-CTO-LCX, and discuss the selection of interventional instruments and techniques that can be useful for interventionists as well as the diagnostic and therapeutic considerations that can be helpful for clinical physicians.Case presentationA male Han Chinese patient, 51, was admitted, presenting recurrent chest pain for a year and recent onset of exertional fatigue over the past week.He reported episodes of chest pain following physical activities over the past year, lasting between 5 and 20 min.Despite these symptoms, the patient did not seek immediate medical attention, and the occurrence of his chest pain has progressively lessened within the year.A week prior, the patient developed exertional dyspnea after brief walks, though without any episodes of nocturnal paroxysmal dyspnea.Upon arrival at our hospital for evaluation, he was initially diagnosed with chronic coronary syndrome, previous inferior myocardial infarction, atrial arrhythmia, and classified under the New York Heart Association functional class III.Following his admission, a chest X-ray and coronary angiography were conducted.The results indicated mirror dextrocardia and total occlusion of the left circumflex branch. Percutaneous coronary intervention (PCI) was performed on the left circumflex branch. Subsequent angiography demonstrated optimal stent positioning without evidence of hematoma or dissection.Following the procedure, the patient's symptoms of chest pain and exertional dyspnea were resolved, which led to his subsequent discharge.A follow-up electrocardiogram, 10 months post-procedure, displayed a slow and regular atrial rhythm.ConclusionsThe incidence of dextrocardia is very low, and it may appear normal on an electrocardiogram; however, careful diagnosis is required when there is an abnormal direction of the P wave in limb leads. During the operation for chronic occlusive lesions of the right-sided coronary artery, the anomalous anatomical structure necessitates specific requirements for instrument selection and operative techniques. After revascularization of chronic occlusive vessels in dextrocardia, routine electrocardiographic examination may show false normalization, requiring caution in interpretation.

Left ventricular mechanical dispersion as a predictor of the need for pacemaker implantation after transcatheter aortic valve implantation: MeDiPace TAVI study.

Permanent pacemaker (PM) implantation is common after transcatheter aortic valve implantation (TAVI). Left ventricular mechanical dispersion (MeDi) by speckle tracking echocardiography is a marker of fibrosis that causes alterations in the conduction system. We hypothesized that MeDi can be a predictor of the need for PM implantation after TAVI. Consecutively, 200 TAVI patients were enrolled. Transthoracic echocardiography and electrocardiography examinations were recorded before TAVI to evaluate global longitudinal strain (GLS), MeDi, and conduction disturbances. PM implantation information was obtained 3 months after TAVI. Patients were stratified into PM or no PM group. Mean age was 80 + 7 years (44% women). Twenty-nine patients (16%) received PM. MeDi, QRS duration, existence of right bundle branch abnormality (RBBB), and first-degree atrioventricular (AV) block were significantly different between groups. MeDi was 57 ± 15 ms and 48 ± 12 ms in PM and no PM groups, respectively (P < 0.001). In multivariate analysis, MeDi predicted the need for PM after TAVI independently of GLS, QRS duration, RBBB, and first-degree AV block [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.22-2.45] with an area under the curve (AUC) of 0.68 in receiver operating characteristic (ROC) curves. Moreover, RBBB was an independent predictor of PM need after TAVI (OR: 8.98, 95% CI: 1.78-45.03). When added to RBBB, MeDi had an incremental predictive value with an AUC of 0.73 in ROC curves (P = 0.01). MeDi may be used as an echocardiographic functional predictor of the need for PM after TAVI.

Role of telemedicine network provided by pharmacies to detect electrocardiographic changes deserving cardiological evaluation in young patients

Abstract Background cardiac arrhythmias affecting adolescents and young subjects are a wide-ranging problem. Often-such conditions, in addition to being highly varied and sometimes hard to diagnose, are largely silent and onset variably and suddenly, sometimes resulting in sudden cardiac death. Such individuals, being asymptomatics, usually do not undergo cardiological evaluation, as their condition may be misrecognized or not suspected until it manifests clinically. Thus, there is a need to develop cheap and easily accessible screening systems for patients that allow early identification of electrocardiographic (EKG) findings deserving evaluation by the cardiologist. Recently, pharmacies have proposed EKG screening programs for cardiac arrhythmias using a telematics network, enabling referral to the cardiology specialist and identification of patients worthy of further diagnostic investigations. Aim of the Study to assess validity, feasibility and usefulness of an electrocardiographic screening program for the prevention of cardiac sudden death in subjects &amp;lt; 18 years old with the support of a telemedicine service available in local pharmacies. Materials and Method we analyzed 12-lead electrocardiograms (ECGs) recorded by 4,500 country pharmacies in subjects with &amp;lt; 18 years old, evaluated and stored in one telemedicine platform provided by Health Telematic Network (HTN), in cooperation with a cardiology department hospital and a university. Results from April 2010 to January 2023, 266.381 subjects with &amp;lt; 18 years old underwent electrocardiographic examination in territorial pharmacies. Of them, 142.924 (53.65%) were men. In 440 subjects (0.16%) a first or a second-degree atrio-ventricular block were found. Moreover, in 94 (0.03%) of them a delta-wave in QRS complex was found, suggesting the presence of a Wolff-Parkinson-White syndrome. In 59 (0.022%), a ST segment with Brugada-like pattern was identified, whereas in 118 (0.04%) a long QT was detected. All subjects in which an electrocardiographic alteration was found were referred to outpatient cardiological visit for further diagnostic evaluations. Conclusion These data suggest the potential validity, feasibility and usefulness of an electrocardiographic screening program for the prevention of cardiac sudden death in subjects &amp;lt; 18 years old performed in territorial pharmacies. This could be a valuable strategy to noninvasively and easily identify those subjects who need further diagnostic investigations and to rule out conditions that, especially in a young and otherwise healthy population, could manifest dramatically and suddenly, often without the possibility of intervention.

Functional state of the cardiovascular system in children after COVID-19

Introduction. The new coronavirus infection (COVID-19) in children often occurs in a mild, moderate, or asymptomatic. After experiencing COVID-19, some children, as well as adults, had persistent symptoms over more than 12 weeks and could not be explained by alternative diagnoses. These changes are called Post-acute COVID-19 Syndrome (PACS, post-COVID-19 syndrome or post-covid syndrome). Clinical manifestations of post-covid syndrome in children are very diverse, there are combinations of autonomic, psycho-emotional, cognitive and somatic disorders, including disorders of the cardiovascular system. &#x0D; Aim: analysis of changes in the functional state of the cardiovascular system in children in the post-covid period.&#x0D; Materials and methods. The study included one hundred thirty one child aged of 5 to 17 years 11 months 29 days (mean age 12 years [9.5; 15]). The observed children were divided into 2 groups: group 1 (main) — children who had a mild new coronavirus infection (n = 76). The comparison group consisted of children who did not have COVID-19, suffered from acute respiratory viral infections of unspecified etiology of a mild course (n = 55). All children were analyzed for medical history, underwent clinical examination, electrocardiographic examination (ECG), echocardiographic examination (ECHO-KG), 24-hour Holter ECG monitoring and 24-hour blood pressure (BP) monitoring.&#x0D; Results. Children who have had COVID-19 are significantly more often showed sinus tachycardia (p = 0.025), extrasystole (supraventricular, ventricular) (p = 0.046), atrioventricular blockade of the 2nd degree (p = 0.027) compared with children with ARVI. After undergoing COVID-19, in 19.7% of children an increase in blood pressure was detected, in 15.8% of children there was a significant decrease in blood pressure at night (p = 0.008). In 38.2% of children after COVID-19, there was a decrease in the activity of the parasympathetic division of the nervous system.&#x0D; Conclusion. Children who have had a new mild coronavirus infection were shown to undergo a clinical examination with a mandatory assessment of blood pressure, heart rate and an ECG 3 and 6 months after the illness.

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome.

Several studies conducted on humans demonstrate the increase in cardiac troponins and the onset of arrhythmias in the course of systemic inflammatory response syndrome (SIRS). The aim of the current study was to assess the blood concentration of cardiac troponin I (cTnI) and electrocardiographic findings in SIRS-affected cats. Seventeen shorthair cats hospitalized with SIRS were enrolled (Group 1). SIRS diagnosis was performed based on the detection of at least two of the four criteria such as abnormal body temperature, abnormal heart rate (i.e., tachycardia or bradycardia), abnormal respiratory rate (i.e., tachypnea or bradypnea), and alterations of white blood cell number (i.e., leukocytes or band neutrophils). Ten cats screened for elective surgery such as neutering or dental procedures were evaluated as a control population (Group 2). They were considered healthy based on history, physical examination, hematological and biochemical profile, urinalysis, coprological exam, thyroxine assay, blood pressure measurement, and echocardiography. A physical examination, complete blood cell count, biochemistry test (including an electrolyte panel), electrocardiographic examination, and cTnI assay were carried out in each cat enrolled. Traumatic events, gastrointestinal, neoplastic, respiratory, and neurological disorders were identified as causes of SIRS in Group 1. In Group 1, a significantly higher concentration of cTnI than that in Group 2 was recorded (p = 0.004). In 37.5% of cats with SIRS, ventricular premature complexes occurring in couplets with multiform configuration were detected. Similarly, to humans, data herein reported would indicate possible cardiac damage present in cats with SIRS diagnosis.

Association between long-term exposure to PM2.5 constituents and electrocardiographic abnormality: A nationwide longitudinal study in China

BackgroundElectrocardiogram (ECG) abnormalities are known to have prognostic value for heart conditions, while evidence on the relationship between long-term exposure to PM2.5 constituents and electrocardiographic (ECG) abnormalities is limited. This study aimed to quantify the association between long-term exposure to PM2.5 constituents and changes in ECG diagnoses. MethodsWe designed a longitudinal study among participants with repeated records of ECG examination based on the China National Stroke Screening Survey 2013–2018. Logistic regressions with multiple adjustment, estimated by the generalized estimating equation to incorporate repeated measurements, were used to assess the associations between the occurrence of any physician-diagnosed ECG abnormalities and long-term exposure to PM2.5 constituents. ResultsWe included 61,094 participants with 132,249 visits. All five constituents (sulfate, nitrate, ammonium, organic matter, and black carbon) were significantly associated with an increased risk of ECG abnormalities. The excess risk of ECG abnormalities per interquartile-range increase in exposure was the highest for sulfate (26%, 95% confidence interval [CI] 23–29%), followed by ammonium (22%, 19–26%), nitrate (21%, 17–24%), black carbon (16%, 13–10%) and organic matter (9%,6%-11%). We also found that atrial fibrillation patients might be susceptible to the adverse effects of PM2.5 constituents on ECG. ConclusionDifferential associations between various constituents of PM2.5 and ECG abnormalities were found. The unequal toxicities for different chemical constituents of ambient particles on cardiovascular electrophysiological endpoints should be taken into consideration when considering the biological pathways linking PM2.5 and cardiovascular conditions.

THE STUDY OF THE RELATIONSHIP BETWEEN FGB GENE POLYMORPHISM AND PLATELET PARAMETERS IN PATIENTS WITH CORONARY HEART DISEASE, TYPE 2 DIABETES MELLITUS, AND ARTERIAL HYPERTENSION

Genetic factors are an important contributor to the risk of ischemic heart disease (IHD), and great progress has been made in this area over the past decade. The problem of studying the genetic mechanisms of IHD is quite complex and is associated with the development of adequate approaches and methods of analysis, which is noted by many authors. One of the effective approaches to studying the role of genetic mechanisms in the development of IHD is associated with the identification of a group of genes with a potentially greatest contribution to the pathogenesis of the disease. Purpose. Study of FGB gene polymorphisms and its relationship with platelet indexes in Azerbaijani patients with ischemic heart disease, arterial hypertension, and type 2 diabetes mellitus. Material and methods. 100 patient participated in the study. Anthropometric parameters, total blood count, lipid profile, fasting blood sugar and/or HbA1C, fibrinogen gene, and electrocardiographic and echocardiographic examination were performed in each patient. Results. A statistically significant prevalence of the homozygous G/G genotype of the FGB G (-455) A fibrinogen gene was noted in the studied groups. A statistically significant difference in the frequency of the GA polymorphism of the FGB G (-455) A fibrinogen gene was found between all groups. In addition, an increase in thrombocyte indexes was observed in homozygous allele A genotype carriers, which may be an indicator of thrombosis tendency in these genotype carriers.

Correlation of QRS/T angle with clinical, echocardiographic, and hemodynamic variables in chronic thromboembolic pulmonary hypertension patients

Objectives: In this study, we aimed to examine the relationships between frontal QRS-T (fQRS-T) angle prognostic risk factors outlined in the current pulmonary hypertension (PH) guidelines and to demonstrate whether the fQRS-T could detect patients with unfavorable echocardiographic and hemodynamic data. Patients and methods: Between July 2009 and February 2023, a total of 33 patients (8 males, 25 females; median age: 61 years; range, 55 to 70 years) with chronic thromboembolic pulmonary hypertension (CTEPH) who underwent electrocardiographic (ECG) examination were retrospectively analyzed. The fQRS-T angle was calculated from surface ECGs. Functional class, 6-min walk distance, and brain natriuretic peptide values were recorded. Two-dimensional echocardiographic data including comprehensive right ventricular (RV) functions, right atrial area (RAA), tricuspid annular systolic plane excursion (TAPSE), systolic pulmonary artery pressure (sPAP), and TAPSE/sPAP ratio were noted. Among invasive hemodynamic variables, sPAP, mean PAP (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) were obtained. The correlations between clinical, echocardiographic, and hemodynamic variables were analyzed. Results: There was no significant correlation between clinical variables and fQRS-T angle. The TAPSE and TAPSE/sPAP ratio were negatively correlated with fQRS/T angle (r=-0.37, p=0.02, r=-0.35, and p=0.03, respectively), whereas RV Tei index and RAA were positively correlated with the fQRS-T angle (r=0.53, p=0.014, r=0.47, and p=0.007, respectively). The hemodynamic data including sPAP, mPAP, and PVR were positively correlated with the fQRS-T angle (r=0.32, p=0.048, r=0.34, p=0.034, r=0.35, and p=0.02, respectively) and CI was negatively correlated with the fQRS-T angle (r=-0.30, p=0.048). Conclusion: Our study results suggest that the fQRS/T angle is correlated with poor prognostic echocardiographic and hemodynamic variables in CTEPH patients.

Outcomes of preoperative fragmented QRS detection on operative and postoperative events in patients undergoing elective coronary artery bypass grafting

Objectives: This study aims to investigate the preoperative electrocardiographic data of patients who were candidates for elective coronary artery bypass grafting (CABG) in terms of fragmented QRS (fQRS) presence and to evaluate short-term outcomes of fQRS on operative and postoperative courses. Patients and methods: Between January 2019 and April 2022, a total of 178 patients (137 males, 41 females; mean age: 61.4±9.3 years; range, 39 to 85 years) who underwent elective CABG were retrospectively analyzed. Preoperative electrocardiographic examinations were performed to detect fQRS. The patients were divided into two groups according to presence of fQRS as the fQRS+ (n=35) and fQRS– (n=143) group. Demographic, clinical, laboratory, operative, and postoperative data of both groups were evaluated. Results: The mean duration of cardiopulmonary bypass (p=0.017) and number of CABG (p=0.026) in the fQRS group were found to be significantly higher, while the mean preoperative left ventricular ejection fraction values were lower in this group (p&lt;0.001). There was a significant increase in the left ventricular ejection fraction values at the postoperative third month in the fQRS+ group (p&lt;0.001). Mortality encountered in 5.7% in the fQRS+ group, while this rate was 2.7% in the fQRS– group (p=0.336). Conclusion: Preoperative detection of QRS fragmentations on admission electrocardiograms may have an additional value in predicting postoperative cardiac status and short-term prognosis in patients undergoing CABG.