Part Of Cardiovascular Assessment Research Articles

Subclinical atherosclerotic vascular disease in chronic obstructive pulmonary disease: Prospective hospital-based case control study.

Introduction:Chronic obstructive pulmonary disease (COPD) is an important non-communicable disease worldwide with a rising global incidence. COPD is associated with multiple co-morbidities. Patients with COPD are at increased risk of atherosclerosis and other cardiovascular events. Cardiovascular diseases are an important cause of morbidity and mortality in COPD. The present case-control study was designed to assess the relationship between sub-clinical atherosclerotic vascular diseases with COPD.Methods:It was a prospective case-control blinded observational study. There were 142 COPD patients and 124 age-and sex-matched controls without COPD and cardiovascular diseases. Frequency of sub-clinical atherosclerosis was assessed by the carotid B-mode duplex ultrasonography assessment of carotid wall intima medial thickness (IMT). Plaque was defined as IMT of more than 1.2 mm.Results:Prevalence of carotid plaqing was significantly higher amongst patients of COPD (38.7%) compared to controls (13.7%, odds ratio 3.9, P < 0.0001). Multinomial logistic regression analysis revealed COPD as an independent predictor of carotid plaqing (r = 0.85, P < 0.023).Conclusion:The frequency of carotid plaqing is high in COPD patients. Carotid plaqing may be due to shared risk factors or the presence of low-grade systemic inflammation. Presence of increased CIMT and carotid plaqing in COPD patients identifies early atherosclerotic changes and future cardiovascular risk. Hence screening of CIMT should be a part of cardiovascular assessment in patients with COPD.

Inter-arm asymmetry in systolic and diastolic blood pressure measurements among normotensive primigravidae

Introduction: The detection of elevated BP during pregnancy is one of the major aspects of optimal antenatal care,and thus accurate measurement of BP is essential. Methods: To evaluate whether there is a significant difference in inter-arm blood pressure (BP) measurements among normotensive low-risk primigravidae as an observational study was conducted at Yediur Municipal Maternity Corporation Hospital, Bangalore. A total of 100 low-risk women at 6-14 weeks of gestation attending antenatal clinic was selected by purposive sampling technique. Bilateral BP was measured by a calibrated Normal mercury Sphygmomanometer during the initial antenatal visit and the subsequent 2 months visits. Mean Inter-arm systolic blood pressure (SBP) and diastolic blood pressure (DBP) differences were computed for each visit and the three pairs of readings were averaged to obtain a mean SBP and DBP for each arm to derive the mean inter-arm difference. Results: The results revealed a significant difference in the mean SBP in right (115.71 ± 0.827 standard deviation [SD]) versus left arm (105.23 ± 1.110 SD) and the mean DBP in right (73.10 ± 0.370 SD) versus left arm (69.43 ± 2.288) at P n = 21) primigravidae had clinically important differences >10 mmHg in SBP and DBP between their arms. None of the maternal characteristics were a significant predictor of inter-arm SBP and DBP differences at P > 0.001. Conclusion: Assessment of bilateral BP should become a routine part of cardiovascular assessment of pregnant women in primary care to determine whether the risk to the pathological condition is present.

Cross-Sectional and Longitudinal Assessment of Aortic Root Dilation and Valvular Anomalies in Hypermobile and Classic Ehlers-Danlos Syndrome

To delineate the prevalence of cardiac findings in hypermobile and classic Ehlers-Danlos syndrome and provide longitudinal analysis of aortic root growth. A retrospective chart review was conducted, and data were analyzed for cross-sectional prevalence of aortic dilation and valvular anomalies. The clinical implications of aortic root growth were determined by assessment of progression of aortic root measurements over time and clinical symptoms. Patients whose first echocardiogram was obtained in late childhood or adulthood were less likely to have aortic dilation (P < .002) than those whose first echocardiogram was obtained in early childhood. Longitudinally, seven individuals had dilated aortas before age 14, and only one individual continued to show dilation after age 14 (P = .0143). No patient with a normal aortic root in childhood had development of dilation in adulthood. Fifteen of the 252 patients (6.0%) had mitral valve prolapse (MVP), although only one patient (0.4%) had MVP that was mild to moderate. Although aortic root size and MVP are increased in patients with these types of Ehlers-Danlos syndrome, they tend to be of little clinical consequence. Echocardiography may still be warranted as part of cardiovascular assessment, but decreased frequency of screening is recommended especially in symptom-free adults.