Research in Cardiovascular Medicine

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A 65-year-old male was introduced with a history of percutaneous coronary intervention 2 years ago who received Aspirin and Plavix. He was referred for coronary angiography after receiving thrombolytic therapy for ST-elevation myocardial infarction in precordial leads. On admission, he had dyspnea with low oxygen saturation, leukocytosis, lymphopenia, elevated C-reactive protein, and cardiac troponin levels. Transthoracic echocardiography demonstrated left ventricular ejection fraction (LVEF) of 25% and pulmonary artery pressure of 45 mmHg. A small thrombus at the site of the previously deployed stent was noticeable at coronary angiography. The chest computed tomography depicted significant involvement of the lungs manifested by peripheral ground-glass opacifications. A positive polymerase chain reaction confirmed coronavirus infection. He was oxygen dependent for 1 week. Gradually, his respiratory distress improved and his LVEF reached to 30% after discharge.

Spontaneous coronary artery dissection (SCAD) is a well-documented cause of acute coronary syndrome and could have life-threatening consequences. We report the case of young female with a prior history of cardiac surgery due to congenital aortic stenosis presenting with multi-vessel SCAD. She was successfully managed with medical treatment.

Cardiac myxomas are the most common primary cardiac tumors, with an estimated incidence of 0.5 per million individuals annually. Although surgical resection is curative however, postoperative tumor recurrence has been reported, especially in familial and complex type of myxoma. Literature reviews reveal only a few cases of recurrence in sporadic cardiac myxoma. Herein we have reported a case of sporadic cardiac myxoma, with multiple recurrences after surgical resection. The possibility of repeated recurrence of cardiac myxomas demonstrates the importance of regular echocardiographic surveillance after surgical resection in order to detection of recurrence even in non-familial and non-syndromic cases. Further evaluations, including genetic analysis of patients with recurrent cardiac myxomas, are warranted to investigate the exact nature of these tumors.

Objective: We evaluated the accuracy of two-dimensional speckle-tracking echocardiography (2DSTE) and 3DSTE to identify early cardiac dysfunction in comparison with cardiac T2* magnetic resonance imaging (MRI) in patients with blood transfusion-dependent β-Thalassemia. Methods: A total of 48 consecutive patients (36 males) successfully underwent 2DSTE, 3DSTE, and MRI on the same day. We calculated left ventricular segmental global longitudinal strain (GLS) (%) and segmental global circumferential strain (GCS) (%) from strain curves. Cardiovascular MRI was performed with the relevant protocols to measure the T2*. Results: In this study, we found that the GLS and GCS derived from 3DSTE correlated with cardiac T2* (r = −0.50, r = −0.49, respectively), whereas no correlation was detected between 2DSTE parameters and cardiac T2*. We calculated the area under the receiver operating characteristic area under the curve to determine the capability of 3DSTE parameters including GLS (<−23.5%) and GCS (<−33.4%) to discriminate between patients with (cardiac magnetic resonance T2* <20 ms) and those without myocardial iron overload. Conclusion: The study will clarify GLS and GCS's superiority derived from 3DSTE over the 2DSTE parameters in the detection of myocardial iron overload in patients with blood transfusion-dependent β-Thalassemia.

Objective: The objective was to study the role of 12-lead electrocardiogram (ECG) changes in predicting the association of severe stenosis of other coronary arteries along with infarct-related artery in patients who presented with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: We studied the admission ECG, clinical records, and coronary angiography of 201 patients with STEMI who underwent primary PCI within the first 12 h of symptoms. Patients with first episode of STEMI and coronary angiogram showing coronary artery disease between January 2015 and July 2016 were included in this study. Results: Most of the patients in this study were males (82.1%). The mean age of the patients was 55.20 ± 11.79 years. Diabetic mellitus (37.8%), hypertension (37%), and smoking (49.7%) were the main risk factors. This study had 117 (58.2%) patients of anterior wall myocardial infarction (MI) (Group I) while inferior wall MI was present in 84 (41.8%) patients (Group II). In Group I, 83 (70.9%) patients had single-vessel disease (SVD) while 34 (29.1%) patients had multivessel disease (MVD). The presence of ST-segment depression ≥0.1 mV in leads I, aVL, and V6 significantly correlated with the presence of MVD (P = 0.001, 0.001, and 0.001, respectively). In Group II, 39 (51.3%) patients had SVD while 37 (48.7%) patients had MVD. The presence of ST-segment depression in leads aVL, V5, and V6 significantly correlated with the presence of MVD (P = 0.049, 0.001, and 0.001, respectively). Conclusion: The presence of ST-segment depression of ≥0.1 mv in leads I, aVL, and V6 on admission ECG in the setting of acute anterior wall STEMI and in leads aVL, V5, and V6 on admission ECG in the setting of acute inferior wall STEMI was associated with MVD.

Purpose: The autonomic nervous system serves as the final gateway by which music exerts a therapeutic effect on health and disease. The aim of the study is to find the effect of different instrumental music on heart rate variability (HRV) as a part of our pilot protocol for identifying suitable auditory stimuli for evaluating the autonomic functions by HRV analysis. Methodology: The effect of music on HRV was assessed by frequency domain parameters of HRV, i.e. total power (TP, variance of N-N intervals over temporal segment), low frequency (LF, power in LF range), high frequency (HF, power in HF range), LF/HF ratio, LF%, and HF% using fast Fourier transform technology. Results: Flute was found to increase LF and HF as well as TP. Tabla and violin were found to increase HF% but had no effect on TP. This makes flute, table, and violin tranquilizing music. Piano was found to lower LF% and increase TP. Sitar and guitar were found to decrease HF%, as well as increase LF/HF ratio. They also increase TP. Conclusion: Although the results were not statistically significant, music is a low-cost and safe adjuvant for intervention and therapy. Therefore, there is growing need for high-quality research on the effects of music on the heart in both healthy individuals and patients.

Online since 6^the October 2017.