Search results for: cardiac ischemia

Authors: Tsai-chun Lai, Szu-ju Fu, Tzu-lin Lee, Yuh-Lien Chen

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There is much evidence that exposure to fine particulate matter (PM) from air pollution increases the risk of cardiovascular morbidity and mortality. According to previous reports, PM in the air enters the respiratory tract, contacts the alveoli, and enters the blood circulation, leading to the progression of cardiovascular disease. PM pollution may also lead to cardiometabolic disturbances, increasing the risk of cardiovascular disease. The effects of PM on cardiac function and mitochondrial damage are currently unknown. We used mice and rat cardiomyocytes (H9c2) as animal and in vitro cell models, respectively, to simulate an air pollution environment using PM. These results indicate that the apoptosis-related factor PUMA, a regulator of apoptosis upregulated by p53, is increased in mice treated with PM. Apoptosis was aggravated in cardiomyocytes treated with PM, as measured by TUNEL assay and Annexin V/PI. Western blot results showed that CASPASE3 was significantly increased and BCL2 (B-cell lymphoid 2) was significantly decreased under PM treatment. Concurrent exposure to PM increases mitochondrial reactive oxygen species (ROS) production by MitoSOX Red staining. Furthermore, using Mitotracker staining, PM treatment significantly shortened mitochondrial length, indicating mitochondrial fission. The expression of mitochondrial fission-related proteins p-DRP1 (phosphodynamics-related protein 1) and FIS1 (mitochondrial fission 1 protein) was significantly increased. Based on these results, the exposure to PM worsens mitochondrial function and leads to cardiomyocyte apoptosis.

Keywords: particulate matter, cardiomyocyte, apoptosis, mitochondria

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Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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Authors: Tayyibah Shah Alam, Joe Thomas, Nayantara Shenoy

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Presenting a case that we would like to share, the answer is straight forward but the path taken to get to the diagnosis is where it gets interesting. A 31-year-old lady presented to the Rheumatology Outpatient department with left-sided chest pain associated with left-sided elbow joint pain intensifying over the last 2 days. She had been having a prolonged history of chest pain with minimal intensity since 2016. The pain is intermittent in nature. Aggravated while exerting, lifting heavy weights and lying down. Relieved while sitting. Her physical examination and laboratory tests were within normal limits. An electrocardiogram (ECG) showed normal sinus rhythm and a chest X-ray with no significant abnormality was noted. The primary suspicion was recurrent costochondritis. Cardiac blood inflammatory markers and Echo were normal, ruling out ACS. CT chest and MRI Thorax contrast showed small ill-defined STIR hyperintensity with thin peripheral enhancement in the anterior mediastinum in the left side posterior to the 5th costal cartilage and anterior to the pericardium suggestive of changes in the fat-focal panniculitis. Confirming the diagnosis as Epicardial fat necrosis. She was started on Colchicine and Nonsteroidal anti-inflammatory drugs for 2-3 weeks, following which a repeat CT showed resolution of the lesion and improvement in her. It is often under-recognized or misdiagnosed. CT scan was collectively used to establish the diagnosis. Making the correct diagnosis prospectively alleviates unnecessary testing in favor of conservative management.

Keywords: EFN, panniculitis, unknown etiology, recurrent chest pain

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Authors: Sheila R. Pai, Rekha D. Kini, Amrutha Mary

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Objective: To assess and compare the cardiac autonomic activity after mental stress among the wards of normal and hypertensive parents. Methods: The study included 67 subjects, 30 of them had a parental history of hypertension and rest 37 had normotensive parents. Subjects were divided into control group (wards of normotensive parents) and Study group (wards of hypertensive parents). The height, weight were noted, and Body Mass Index (BMI) was also calculated. The mental stress test was carried out. Blood pressure (BP) and electro cardiogram (ECG) was recorded during normal breathing and after mental stress test. Heart rate variability (HRV) analysis was done by time domain method HRV was recorded and analyzed by the time-domain method. Analysis of HRV in the time-domain was done using the software version 1.1 AIIMS, New Delhi. The data obtained was analyzed using student’s t-test followed by Mann-Whitney U-test and P < 0.05 was considered significant. Results: There was no significant difference in systolic blood pressure and diastolic blood pressure (DBP) between study group and control group following mental stress. In the time domain analysis, the mean value of pNN50 and RMSSD of the study group was not significantly different from the control group after the mental stress test. Conclusion: The study thus concluded that there was no significant difference in HRV between study group and control group following mental stress.

Keywords: heart rate variability, time domain analysis, mental stress, hypertensive

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Authors: Chandra Mukherjee

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The prevalent knowledge of the biological systems is based on the standard scientific perception of natural equilibrium, determination and predictability. Recently, a rethinking of concepts was presented and a new scientific perspective emerged that involves complexity theory with deterministic chaos theory, nonlinear dynamics and theory of fractals. The unpredictability of the chaotic processes probably would change our understanding of diseases and their management. The mathematical definition of chaos is defined by deterministic behavior with irregular patterns that obey mathematical equations which are critically dependent on initial conditions. The chaos theory is the branch of sciences with an interest in nonlinear dynamics, fractals, bifurcations, periodic oscillations and complexity. Recently, the biomedical interest for this scientific field made these mathematical concepts available to medical researchers and practitioners. Any biological network system is considered to have a nominal state, which is recognized as a homeostatic state. In reality, the different physiological systems are not under normal conditions in a stable state of homeostatic balance, but they are in a dynamically stable state with a chaotic behavior and complexity. Biological systems like heart rhythm and brain electrical activity are dynamical systems that can be classified as chaotic systems with sensitive dependence on initial conditions. In biological systems, the state of a disease is characterized by a loss of the complexity and chaotic behavior, and by the presence of pathological periodicity and regulatory behavior. The failure or the collapse of nonlinear dynamics is an indication of disease rather than a characteristic of health.

Keywords: HRV, HRVI, LF, HF, DII

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

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Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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Authors: Feng Ji Mervin Goh, Edmund Chee Jian Pua, Stuart Alexander Cook

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Dilated cardiomyopathy (DCM) is a common cause of heart failure. Genetic mutations account for 50% of DCM cases with TTN mutations being the most common, accounting for up to 25% of DCM cases. However, the genetic architecture underlying Asian DCM patients is unknown. We evaluated 68 patients (female= 17) with DCM who underwent follow-up at the National Heart Centre, Singapore from 2013 through 2014. Clinical data were obtained and analyzed retrospectively. Genomic DNA was subjected to next-generation targeted sequencing. Nextera Rapid Capture Enrichment was used to capture the exons of a panel of 169 cardiac genes. DNA libraries were sequenced as paired-end 150-bp reads on Illumina MiSeq. Raw sequence reads were processed and analysed using standard bioinformatics techniques. The average age of onset of DCM was 46.1±10.21 years old. The average left ventricular ejection fraction (LVEF), left ventricular diastolic internal diameter (LVIDd), left ventricular systolic internal diameter (LVIDs) were 26.1±11.2%, 6.20±0.83cm, and 5.23±0.92cm respectively. The frequencies of mutations in major DCM-associated genes were as follows TTN (5.88% vs published frequency of 20%), LMNA (4.41% vs 6%), MYH7 (5.88% vs 4%), MYH6 (5.88% vs 4%), and SCN5a (4.41% vs 3%). The average callability at 10 times coverage of each major gene were: TTN (99.7%), LMNA (87.1%), MYH7 (94.8%), MYH6 (95.5%), and SCN5a (94.3%). In conclusion, TTN mutations are not common in Singaporean DCM patients. The frequencies of other major DCM-associated genes are comparable to frequencies published in the current literature.

Keywords: heart failure, dilated cardiomyopathy, genetics, next-generation sequencing

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Authors: Jarel Elgin Tolentino, Arby Denise Nera, Mary Rose Roco, Angela Vianca Aspa, Nikko Beltran, Else Dapat

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Drug resistance by cells has been the problem in the medical field for decades now. The use of medicinal plants as a source of creating powerful drugs has been nowadays recognized worldwide to treat such resistant diseases. In the present study, the potential for Diospyros philippinensis A. DC. to inhibit growth of both bacteria and cancer cell line was conducted. The leaf crude extracts were screened for the presence of phytochemicals and examined for potential bioactivities by employing several assays like Kirby-Bauer disc diffusion method, DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay for the antibacterial, antioxidant and cytotoxic activities of the extract, respectively. Phytochemical test results of the extracts revealed the presence of alkaloids, flavonoids, saponins, phenols, quinones, cardiac glycosides, phlobatannins, carbohydrate, cardenolides and proteins. The leaf extracts were found to exhibit antibacterial activity against gram-positive bacteria, high antioxidant activity (99.22% ± 0.005) but did not show any sign of cytotoxicity towards HCT116 (ATCC CCL-247). The study therefore concludes that D. philippinensis A. DC. leaf extract can be a source of antibacterial and chemopreventive agents. This claim may be used as basis for future investigation.

Keywords: bioassay, medicinal plants, plant crude extracts, phytochemical screening

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Authors: C. Bala Prashanth Reddy, B. Abhinay, C. Sreekar, D. V. Shobhana Priscilla

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The project aims in designing an emergency pacemaker which is capable of giving shocks to a human heart which has stopped working suddenly. A pacemaker is a machine commonly used by cardiologists. This machine is used in order to shock a human’s heart back into usage. The way the heart works is that there are small cells called pacemakers sending electrical pulses to cardiac muscles that tell the heart when to pump blood. When these electrical pulses stop, the heart stops beating. When this happens, a pacemaker is used to shock the heart muscles and the pacemakers back into action. The way this is achieved is by rubbing the two panels of the pacemaker together to create an adequate electrical current, and then the heart gets back to the normal state. The project aims in designing a system which is capable of continuously displaying the heart beat and blood pressure of a person on LCD. The concerned doctor gets the heart beat and also the blood pressure details continuously through the GSM Modem in the form of SMS alerts. In case of abnormal condition, the doctor sends message format regarding the amount of electric shock needed. Automatically the microcontroller gives the input to the pacemaker which in turn gives the shock to the patient. Heart beat monitor and display system is a portable and a best replacement for the old model stethoscope which is less efficient. The heart beat rate is calculated manually using stethoscope where the probability of error is high because the heart beat rate lies in the range of 70 to 90 per minute whose occurrence is less than 1 sec, so this device can be considered as a very good alternative instead of a stethoscope.

Keywords: missing R wave, PWM, demand pacemaker, heart

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Authors: Olga Blagova, Yuliya Osipova, Evgeniya Kogan, Alexander Nedostup

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Purpose: to quantify the value of various clinical, laboratory and instrumental signs in the diagnosis of myocarditis in comparison with morphological studies of the myocardium. Methods: in 100 patients (65 men, 44.7±12.5 years) with «idiopathic» arrhythmias (n = 20) and dilated cardiomyopathy (DCM, n = 80) were performed 71 endomyocardial biopsy (EMB), 13 intraoperative biopsy, 5 study of explanted hearts, 11 autopsy with virus investigation (real-time PCR) of the blood and myocardium. Anti-heart antibodies (AHA) were also measured as well as cardiac CT (n = 45), MRI (n = 25), coronary angiography (n = 47). The comparison group included of 50 patients (25 men, 53.7±11.7 years) with non-inflammatory heart diseases who underwent open heart surgery. Results. Active/borderline myocarditis was diagnosed in 76.0% of the study group and in 21.6% of patients of the comparison group (p < 0.001). The myocardial viral genome was observed more frequently in patients of comparison group than in study group (group (65.0% and 40.2%; p < 0.01. Evaluated the diagnostic value of noninvasive markers of myocarditis. The panel of anti-heart antibodies had the greatest importance to identify myocarditis: sensitivity was 81.5%, positive and negative predictive value was 75.0 and 60.5%. It is defined diagnostic value of non-invasive markers of myocarditis and diagnostic algorithm providing an individual assessment of the likelihood of myocarditis is developed. Conclusion. The greatest significance in the diagnosis of latent myocarditis in patients with 'idiopathic' arrhythmias and DCM have AHA. The use of complex of noninvasive criteria allows estimate the probability of myocarditis and determine the indications for EMB.

Keywords: myocarditis, "idiopathic" arrhythmias, dilated cardiomyopathy, endomyocardial biopsy, viral genome, anti-heart antibodies

Procedia PDF Downloads 173

Authors: Shalini Rankawat, Mansi Rankawat, Rahul Dubey, Mazad Zaveri

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Physiological signals such as electrocardiogram (ECG) and arterial blood pressure (ABP) in the intensive care unit (ICU) are often seriously corrupted by noise, artifacts, and missing data, which lead to errors in the estimation of heart rate (HR) and incidences of false alarm from ICU monitors. Clinical support in ICU requires most reliable heart rate estimation. Cardiac activity, because of its relatively high electrical energy, may introduce artifacts in Electroencephalogram (EEG), Electrooculogram (EOG), and Electromyogram (EMG) recordings. This paper presents a robust heart rate estimation method by detection of R-peaks of ECG artifacts in EEG, EMG & EOG signals, using energy-based function and a novel Signal Quality Index (SQI) assessment technique. SQIs of physiological signals (EEG, EMG, & EOG) were obtained by correlation of nonlinear energy operator (teager energy) of these signals with either ECG or ABP signal. HR is estimated from ECG, ABP, EEG, EMG, and EOG signals from separate Kalman filter based upon individual SQIs. Data fusion of each HR estimate was then performed by weighing each estimate by the Kalman filters’ SQI modified innovations. The fused signal HR estimate is more accurate and robust than any of the individual HR estimate. This method was evaluated on MIMIC II data base of PhysioNet from bedside monitors of ICU patients. The method provides an accurate HR estimate even in the presence of noise and artifacts.

Keywords: ECG, ABP, EEG, EMG, EOG, ECG artifacts, Teager-Kaiser energy, heart rate, signal quality index, Kalman filter, data fusion

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Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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Authors: Viruska Jaichand, John Jason Mellem, Viresh Mohanlall

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Malnutrition is a global issue that affects both children and adults, irrespective of their socio-economic status. It is, therefore, important to find various means to tackle malnutrition. This is especially important as undernutrition and overnutrition can be linked to a variety of non-communicable diseases (NCDs). This study aimed to gather more insight into the nutritional and phytochemical quality of Momordica balsamina leaves and fruit (fruit pericarp, fruit flesh and seeds). Results showed that Momordica balsamina had a nutritional composition that would be advantageous to the human diet. The nutritional quality is verified by the presence of a high protein percentage across all samples (19.72%-29.08%), with the leaves containing the highest protein content (29.08%±0.77). There was also a low-fat content present across all samples, which ranged from 1.03% to 2.40%. The ash content indicated the presence of total minerals to be adequate (2.93%-21.16%), where the pericarp had the highest ash quantity (21.16%±0.09). The moisture levels were low (7.11%-13.40%). Momordica balsamina seeds had the highest carbohydrate content (67.84%±0.30). Rich in the major phytoconstituents, Momordica balsamina extracts were found to contain alkaloids, saponins, cardiac glycosides, steroids and triterpenoids. Based on these findings, it can thus be said that the incorporation of Momordica balsamina into an individual’s diet could prevent diseases associated with malnutrition, as well as it could be used to supplement the human diet in managing certain NCDs. Even though there were a number of bioactive compounds detected, further studies which would correlate the phytochemical constituents detected in Momordica balsamina and its effectiveness in treating various diseases are recommended.

Keywords: momordica balsamina, nutrients, proximate composition, bioactive compounds, phytoconstituents

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Authors: Sarah K. Hagi, Majdi Alnowaimi

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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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Authors: Edite Kulmane, Mara Pilmane, Romans Lacis

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Introduction: Acquired heart diseases remain one of the leading health care problems in the world. Changes in myocardium of the diseased hearts are complex and pathogenesis is still not fully clear. The aim of this study was to identify appearance and distribution of apoptosis, homeostasis regulating factors, and innervation and ischemia markers in right atrial tissue in different acquired heart diseases. Methods: During elective open heart surgery were taken right atrial tissue fragments from 12 patients. All patients were operated because of acquired heart diseases- aortic valve stenosis (5 patients), coronary heart disease (5 patients), coronary heart disease and secondary mitral insufficiency (1 patient) and mitral disease (1 patient). The mean age was (mean±SD) 70,2±7,0 years (range 58-83 years). The tissues were stained with haematoxylin and eosin methods for routine light-microscopical examination and for immunohistochemical detection of protein gene peptide 9.5 (PGP 9.5), human atrial natriuretic peptide (hANUP), vascular endothelial growth factor (VEGF), chromogranin A and endothelin. Apoptosis was detected by TUNEL method. Results: All specimens showed degeneration of cardiomyocytes with lysis of myofibrils, diffuse vacuolization especially in perinuclear region, different size of cells and their nuclei. The severe invasion of connective tissue was observed in main part of all fragments. The apoptotic index ranged from 24 to 91%. One specimen showed region of newly performed microvessels with cube shaped endotheliocytes that were positive for PGP 9.5, endothelin, chromogranin A and VEGF. From all fragments, taken from patients with coronary heart disease, there were observed numerous PGP 9.5-containing nerve fibres, except in patient with secondary mitral insufficiency, who showed just few PGP 9.5 positive nerves. In majority of specimens there were regions observed with cube shaped mixed -VEGF immunoreactive endocardial and epicardial cells. Only VEGF positive endothelial cells were observed just in few specimens. There was no significant difference of hANUP secreting cells among all specimens. All patients operated due to the coronary heart disease moderate to numerous number of chromogranin A positive cells were seen while in patients with aortic valve stenosis tissue demonstrated just few factor positive cells. Conclusions: Complex detection of different factors may indicate selectively disordered morphopathogenetical event of heart disease: decrease of PGP 9.5 nerves suggests the decreased innervation of organ; increased apoptosis indicates the cell death without ingrowth of connective tissue; persistent presence of hANUP proves the unchanged homeostasis of cardiomyocytes probably supported by expression of chromogranins. Finally, decrease of VEGF detects the regions of affected blood vessels in heart affected by acquired heart disease.

Keywords: heart, apoptosis, protein-gene peptide 9.5, atrial natriuretic peptide, vascular endothelial growth factor, chromogranin A, endothelin

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Authors: Chika C. Ogueke, Ijeoma M. Agunwah

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The antimicrobial activities and preservative potentials of crude extracts of Alstonia boonei stem bark and Euphorbia hirta leaves were studied. Soxhlet extraction and cold ethanol extraction methods were used for the extraction of the dried and ground plant samples. Well in agar diffusion method was used for the antimicrobial screening at different concentrations of 25mg/ml, 50mg/ml, 100mg/ml and 200mg/ml on E.coli and B.subtilis. The preservative effects of the extracts at 0.1%, 0.2% and 0.3% singly and in combination were determined in minced meat using E. coli and B. subtilis as test isolates. Phytochemical analysis was also conducted on the extracts using standard analytical methods. E.hirta cold and A.boonei cold extracts gave the highest zone of growth inhibition on E. coli and B.substilis with 20mm zone diameter at 200mg/ml concentration. Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, saponins and cardiac glycosides. A.boonei at 0.1, 0.2 and 0.3% produced a log cycle reduction on the growth of E.coli. Mixture of A. boonei and E. hirta extracts (1:1) at 0.1% and 0.2% also produced a log cycle reduction on the growth of E.coli and B. subtilis, however the A. boonei extracts had more significant effect on the isolates. The observed antimicrobial activities are attributed to the phytochemicals identified in the extracts. The results reveal the potentials of plant extracts as natural antimicrobial preservatives in minced meat. Thus the crude extracts can act as inhibitors of bacteria in a food system. Upon further purification better results may be obtained.

Keywords: antimicrobial preservative, crude extracts, minced meat, test isolates

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Authors: Nicole Selvi Hill, Archchana Radhakrishnan

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Introduction: Traumatic brain injury (TBI) is a leading cause of mortality among trauma patients. In the management of TBI, the main principle is avoiding cerebral ischemia, as this is a strong determiner of neurological outcomes. The use of vasoactive drugs, such as vasopressin, has an important role in maintaining cerebral perfusion pressure to prevent secondary brain injury. Current guidelines do not suggest a preferred vasoactive drug to administer in the management of TBI, and there is a paucity of information on the therapeutic potential of vasopressin following TBI. Vasopressin is also an endogenous anti-diuretic hormone (AVP), and pathways mediated by AVP play a large role in the underlying pathological processes of TBI. This creates an overlap of discussion regarding the therapeutic potential of vasopressin following TBI. Currently, its popularity lies in vasodilatory and cardiogenic shock in the intensive care setting, with increasing support for its use in haemorrhagic and septic shock. Methodology: This is a review article based on a literature review. An electronic search was conducted via PubMed, Cochrane, EMBASE, and Google Scholar. The aim was to identify clinical studies looking at the therapeutic administration of vasopressin in severe traumatic brain injury. The primary aim was to look at the neurological outcome of patients. The secondary aim was to look at surrogate markers of cerebral perfusion measurements, such as cerebral perfusion pressure, cerebral oxygenation, and cerebral blood flow. Results: Eight papers were included in the final number. Three were animal studies; five were human studies, comprised of three case reports, one retrospective review of data, and one randomised control trial. All animal studies demonstrated the benefits of vasopressors in TBI management. One animal study showed the superiority of vasopressin in reducing intracranial pressure and increasing cerebral oxygenation over a catecholaminergic vasopressor, phenylephrine. All three human case reports were supportive of vasopressin as a rescue therapy in catecholaminergic-resistant hypotension. The retrospective review found vasopressin did not increase cerebral oedema in TBI patients compared to catecholaminergic vasopressors; and demonstrated a significant reduction in the requirements of hyperosmolar therapy in patients that received vasopressin. The randomised control trial results showed no significant differences in primary and secondary outcomes between TBI patients receiving vasopressin versus those receiving catecholaminergic vasopressors. Apart from the randomised control trial, the studies included are of low-level evidence. Conclusion: Studies favour vasopressin within certain parameters of cerebral function compared to control groups. However, the neurological outcomes of patient groups are not known, and animal study results are difficult to extrapolate to humans. It cannot be said with certainty whether vasopressin’s benefits stand above usage of other vasoactive drugs due to the weaknesses of the evidence. Further randomised control trials, which are larger, standardised, and rigorous, are required to improve knowledge in this field.

Keywords: catecholamines, cerebral perfusion pressure, traumatic brain injury, vasopressin, vasopressors

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Authors: Medet K. Khamitov, Marat M. Ospanov, Vasiliy M. Lozovoy, Zhenis N. Sakuov, Dastan Z. Rustemov

Abstract:

With a high rectosigmoid transitional zone in children with Hirschsprung’s disease, the upper rectal, sigmoid, left colon arteries are ligated during the pull-through of the descending part of the colon. As a result, the inferior mesenteric artery ceases to participate in the blood supply to the descending part of the colon. As a result, the reduced colon is supplied with blood only by the middle colon artery, which originates from the superior mesenteric artery. Insufficiency of blood supply to the reduced colon is the cause of the development of chronic hypoxia of the intestinal wall or necrosis of the reduced descending colon. Some surgeons prefer to preserve the left colon artery. However, it is possible to stretch the mesentery, which can lead to bowel retraction to anastomotic leaks and stenosis. Chronic hypoxia of the reduced colon, in turn, is the cause of acquired (secondary) aganglionosis. The highest frequency of anastomotic leaks is observed in children older than five years. The purpose is to reduce the risk of complications in the pull-through procedure of the descending part of the colon in patients with Hirschsprung’s disease by ensuring its sufficient mobility and maintaining blood supply to the lower mesenteric artery. Methodology and events. Two children aged 5 and 7 years with Hirschsprung’s disease were operated under the conditions of the hospital in Nur-Sultan. The diagnosis was made using x-ray contrast enema and histological examination. Operational technique. After revision of the left part of the colon and assessment of the architectonics of its blood vessels, parietal mobilization of the affected sigmoid and rectum was performed on laparotomy access, while maintaining the arterial and venous terminal arcades of the sigmoid vessels. Then, the descending branch of the left colon artery was crossed (if there is an insufficient length of the reduced intestine, the left colonic artery itself may also be crossed). This manipulation provides additional mobility of the pull-through descending part of the colon. The resulting "windows" in the mesentery of the reduced intestine were sutured to prevent the development of an internal hernia. Formed a full-blooded, sufficiently long transplant from the transverse loops of the splenic angle and the descending parts of the colon with blood supply from the upper and lower mesenteric artery, freely, without tension, is reduced to the rectal zone with the coloanal anastomosis 1.5 cm above the dentate line. Results. The postoperative period was uneventful. Patients were discharged on the 7th day. The observation was carried out for six months. In no case, there was a bowel retraction, anastomotic leak, anastomotic stenosis, or other complications. Conclusion. The presented technique of mobilization of the colon for the pull-through procedure in a high transitional rectosigmoid zone of Hirschsprung’s disease allows to maintain normal blood supply to the distal part of the colon and to avoid the tension of the colon. The technique allows reducing the risk of anastomotic leak, bowel necrosis, chronic ischemia, to exclude colon retraction and anastomotic stenosis.

Keywords: blood supply, children, colon mobilization, Hirschsprung's disease, pull-through

Procedia PDF Downloads 147

Authors: Yasuyuki Takahashi, Hirotaka Shimada, Takao Kanzaki

Abstract:

A Dual-detector SPECT system is widely by use of myocardial SPECT studies. With 180-degree (180°) acquisition, reconstructed images are distorted in the posterior wall of myocardium due to the lack of sufficient data of posterior projection. We hypothesized that quality of myocardial SPECT images can be improved by the addition of data acquisition of only a few posterior projections to ordinary 180° acquisition. The proposed acquisition method (180° plus acquisition methods) uses the dual-detector SPECT system with a pair of detector arranged in 90° perpendicular. Sampling angle was 5°, and the acquisition range was 180° from 45° right anterior oblique to 45° left posterior oblique. After the acquisition of 180°, the detector moved to additional acquisition position of reverse side once for 2 projections, twice for 4 projections, or 3 times for 6 projections. Since these acquisition methods cannot be done in the present system, actual data acquisition was done by 360° with a sampling angle of 5°, and projection data corresponding to above acquisition position were extracted for reconstruction. We underwent the phantom studies and a clinical study. SPECT images were compared by profile curve analysis and also quantitatively by contrast ratio. The distortion was improved by 180° plus method. Profile curve analysis showed increased of cardiac cavity. Analysis with contrast ratio revealed that SPECT images of the phantoms and the clinical study were improved from 180° acquisition by the present methods. The difference in the contrast was not clearly recognized between 180° plus 2 projections, 180° plus 4 projections, and 180° plus 6 projections. 180° plus 2 projections method may be feasible for myocardial SPECT because distortion of the image and the contrast were improved.

Keywords: 180° plus acquisition method, a few posterior projections, dual-detector SPECT system, myocardial SPECT

Procedia PDF Downloads 295

Authors: Abeer Rababa'h, Ragad Bsoul, Mohammad Alkhatatbeh, Karem Alzoubi

Abstract:

Introduction: Tobacco use is one of the main risk factors to cardiovascular diseases (CVD) and atherosclerosis in particular. WPS contains several toxic materials such as: nicotine, carcinogens, tar, carbon monoxide and heavy metals. Thus, WPS is considered to be as one of the toxic environmental factors that should be investigated intensively. Therefore, the aim of this study is to investigate the effect of WPS on several cardiovascular biological markers that may cause atherosclerosis in mice. The study also conducted to study the temporal effects of WPS on the atherosclerotic biomarkers upon short (2 weeks) and long-term (8 weeks) exposures. Methods: mice were exposed to WPS and heart homogenates were analyzed to elucidate the effects of WPS on matrix metalloproteinase (MMPs), endothelin-1 (ET-1) and, myeloperoxidase (MPO). Following protein estimation, enzyme-linked immunosorbent assays were done to measure the levels of MMPs (isoforms 1, 3, and 9), MPO, and ET-1 protein expressions. Results: our data showed that acute exposure to WPS significantly enhances the levels of MMP-3, MMP- 9, and MPO expressions (p < 0.05) compared to their corresponding control. However, the body was capable to normalize the level of expressions for such parameters following continuous exposure for 8 weeks (p > 0.05). Additionally, we showed that the level of ET-1 expression was significantly higher upon chronic exposure to WPS compared to both control and acute exposure groups (p < 0.05). Conclusion: Waterpipe exposure has a significant negative effect on atherosclerosis and the enhancement of the atherosclerotic biomarkers expression (MMP-3 and 9, MPO, and ET-1) might represent an early scavenger of compensatory efforts to maintain cardiac function after WP exposure.

Keywords: atherosclerotic biomarkers, cardiovascular disease, matrix metalloproteinase, waterpipe

Procedia PDF Downloads 352

Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG; MACCEs; quality of life; total arterial revascularisation

Procedia PDF Downloads 217

Authors: Pornrut Rabintossaporn, Suphaket Saenthaweesuk, Amornnat Thuppia, Nuntiya Somparn

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Several dietary and herbal plants have been shown to possess cytoprotective and antioxidant effects with various mechanisms of action. The aim of this study was to determine the antioxidant effects and its mechanism of aqueous leaves extract of Ocimum americanum (OA), commonly known as American basil or 'hoary basil', in rat. The extract was screened for its phytochemical contents and antioxidant activity in vitro. Moreover, the extract was studied in rats to evaluate its effects in vivo. Rats were orally administered with the extract at the dose of 100, 200 and 400 mg/kg for 28 days. Phytochemical screening of plant extracts revealed the presence of alkaloid, cardiac glycosides, tannin and steroid compounds. The extract contained phenolic compounds 36.91 ± 0.66 mg of gallic acid equivalents per gram OA extract. The free radical scavenging activity assessed by DPPH assay gave IC50 of 41.27 ± 1.86 µg/mL, which is relatively lower than that of BHT with IC50 of 12.34 ± 1.14µg/mL. In the animals, the extract was well tolerated by the animals throughout the 28 days of study as shown by normal serum levels AST, ALP, ALT, BUN and Cr as well as normal histology of liver and pancreatic and kidney tissue. The protein expression of antioxidant enzymes, γ-glutamylcysteine ligase (γ-GCL) in liver was significantly increased compared with normal control. Consistent with the induction of γ-GCL protein expression significantly reduction of serum oxidative stress marker malondialdehyde (MDA) was found in rat treated with OA extract compared with control. Taken together, this study provides evidence that Ocimum americanum exhibits direct antioxidant properties and can induce cytoprotective enzyme in vivo.

Keywords: antioxidant, γ-glutamylcysteine ligase, MDA, Ocimum americanum

Procedia PDF Downloads 245

Authors: Oseni Margaret Oladunni, Ogundele Joan Olayinka, Olusanya Olalekan Samuel, Akinniyi Modupe Olakintan

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The world's growing population is pushing humans to look for alternative food sources among underutilised or wild plants. One of these food sources has been identified as Canavalia enisiformis, or jack beans. The only issue with using jack beans is that they contain anti-nutrient chemicals, which must be removed or diminished in order for them to be fit for human consumption. The objective of this study is to determine the nutritional and industrial utility of Canavalia enisiformis by analysing the anti-nutrient, phytochemical, and antioxidant composition of raw whole seed and soaking dehusked seeds using established procedures. Phytate (23.48±0.24, 15.24±0.41 and 14.83±0.00), oxalate (4.32±0.09, 3.96±0.09 and 2.88±0.09), tannins (22.77±0.73, 18.68±0.03 and 17.50±0.46), and lectins (6.67±0.04, 6.20±0.01 and 6.42±0.07) exhibited the highest anti-nutrient values in raw whole seed and, at the very least, in dehusked, soaked seeds. The samples were subjected to phytochemical screening, which detected the presence of cardiac glycosides as well as anthraquinones, alkaloids, tannins, saponins, steroids, flavonoids, terpenoids, phlobatannins, and flavonoids. Due to the reduction in phytochemical contents quantified as a result of dehusking and soaking, phenolbatannins and anthraquinones were not found in the samples. The research findings also demonstrated elevated concentrations of several plausible phytochemical components with potential medical value, with the raw whole seed exhibiting the greatest capacity to scavenge free radicals. Accordingly, the study's findings validate the seed's therapeutic applications and imply that it might be an inexpensive source of antioxidants for humans and animals alike.

Keywords: dehusking, soaking, anti-nutrients, antioxidants, jack bean

Procedia PDF Downloads 48

Authors: Pratima Tatke, Archana Avhad, Bhanu Duggal, Meeta Rajivlochan, Sujata Saunik, Pradip Vyas, Nidhi Pandey, Aditee Dalvi, Jyothi Subramanian

Abstract:

Background: Smoking is well established risk factor for the development and progression of coronary artery disease. It is strongly related to morbidity and mortality from cardiovascular causes. The aim of this study is to observe effect of smoking status on percutaneous coronary intervention(PCI) after 1 year. Methods: 2527 patients who underwent PCI at different hospital of Maharashtra(India) from 2012 to 2015 under the health insurance scheme which is launched by Health department, Government of Maharashtra for below poverty line(BPL) families which covers cardiology. Informed consent of patients was taken .They were followed by telephonic survey after 6months to 1year of PCI . Outcomes of interest included myocardial infarction, restenosis, cardiac rehospitalization, death, and a composite of events after PCI. Made group of two non smokers-1861 and smokers (including patients who quit at time of PCI )-659. Results: Statistical Analysis using Pearson’s chi square test revealed that there was trend seen of increasing incidence of death, Myocardial infarction and Restenosis in smokers than non smokers .Smokers had a greater death risk compared to nonsmoker; 5.7% and 5.1% respectively p=0.518. Also Repeat procedures (2.1% vs. 1.5% p=0.222), breathlessness (17.8% vs. 18.20% p=0.1) and Myocardial Infarction (7.3% vs. 10%) high in smoker than non smokers. Conclusion: Major adverse cardiovascular events (MACE) were observed even after successful PCI in smokers. Patients undergoing percutaneous coronary intervention should be encouraged to stop smoking.

Keywords: coronary artery diseases, major adverse cardiovascular events, percutaneous coronary intervention, smoking

Procedia PDF Downloads 210

Authors: M. Sirajul Islam Molla

Abstract:

Noise pollution has been a continuous and an increasing threat to human health in urban population all over the world. The situation in Bangladesh particularly in major cities has been dangerously aggravating. Despite the government of Bangladesh have laws in its hand to curb the noise pollution the authority’s reluctance in enforcing it, is making the situation worse. We do not see any difference in some other major cities of the South Asian Regional Countries like Delhi and Kathmandu, both of the cities are facing the same situation like Dhaka. With the expansion of technology-based township all over the world, the noise pollution has been an emerging threat to urban health. The information for this review has been derived from websites of GOs, NGOs, peer-reviewed papers, seminars and symposia. The worse situation of noise pollution results in people’s irritation and protest, but in many cases, the protesters are facing the wrath of the polluters. Two such consequences in Bangladesh have resulted in killing the protesters by the polluters – one happened in Dhaka city and the other in a rural town. The law-enforcing agencies proactively do not attempt to impose the law. Noise pollution has been increasing so rapidly that it has become a burden on human health in urban populations. Prolonged exposure to higher noise causes mental stress, sleeplessness, high blood pressure, cardiac failure, respiratory disorder, miscarriage and breaks attention of students to their studies and also irritates their behavior. The noise pollution-caused mortality has also been increasing all over the world. Recommendations from the international conferences such as ICUH should be forwarded to the United Nations. The UN then should pass it on to the concerned countries. The UN should also keenly monitor if the countries have appropriate plan to curb noise pollution to meet the sustainable development goals.

Keywords: decibel, environment, noise, pollution

Procedia PDF Downloads 244

Authors: Omar bin Mihat

Abstract:

The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.

Keywords: potassium, maximal heart rate, exercise dosage, fitness level

Procedia PDF Downloads 66

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

Procedia PDF Downloads 148

Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

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Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

Procedia PDF Downloads 164