Siddharth Raut, Chandan Saurav Mohapatra, Abdul Wasay, Nooruddin Owaisi, Aleem Ahmed Khan*
BNP is a peptide consisting of 2 aminoacids produced by the myocytes as a prohormone .it is released as a response to ventricular dilatation and pressure overload in its active form after peptidases degradation, into the cardiovascular system. BNP levels are increased after myocardial infarction and high levels are related to increased risk of adverse events. Acute coronary syndromes without ST elevation encompass a wide range of events and have different prognostic values in relation to the type of plaque lesions and diffusion of coronary atherosclerosis. The risk assessment, based on clinical history and examination, ECG changes and markers of myocardial damage, still remains relatively inaccurate. So this study was planned to better assess the role of NT pro BNP in assessing severity of CAD in real world practice in a prospective manner with well defined patient inclusion and exclusion among a spectrum of NSTEACS
Background: Diabetes mellitus (DM) is a major risk factor for the occurrence of heart failure even in patients with preserved left ventricular ejection fraction (LVEF) ,we aimed to assess the usefulness of mitral annular plane systolic excursion (MAPSE)to predict subclinical left ventricular systolic dysfunction in patient with type II diabetes mellitus in comparison to global longitudinal strain(GLS) derived from speckle tracking echocardiography(STE).
Patients and methods: The study included 80 asymptomatic patients with type II DM , all of them had preserved LVEF>50%, and 30 healthy subjects as a control group, echocardiography was performed to all patients and control group with measurement of the following parameters, MAPSE was measured using M-mode imaging in the apical four chamber view, GLS was measured using 2 dimensional STE , the ECG-gated images were obtained in apical long-axis, four- and two- chamber views
Results: The study included 80 patients, 42 of them were males, their mean age is 47.55 ± 5.54years, MAPSE were significantly lower in patients (14.51 ± 2.13mm) compared to control group (16.60 ± 1.67mm) p<0.001, the GlS was significantly lower in patients (-15.85 ± 2.79%)compared to control (-21.95 ± 2.84),p value <0.001. MAPSE was linearly and strongly correlated to the GLS, and MAPSE value of 16.4mm had( a sensitivity of 100% but its specificity is 73.2,AUC=0.887, PPP=48,NPP=100,Pvalue <0.001) when compared to the GLS in prediction of subclinical dysfunction.
Conclusions: MAPSE is a simple and rapid diagnostic tool in prediction of left ventricular subclinical systolic dysfunction in asymptomatic type II diabetic patients , and its strongly correlated to the gold standard STE derived global longitudinal strain .
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