Journal of Cardio -Thoracic Medicine
Volume:8 Issue: 4, Autumn 2020

Chronic obstructive pulmonary disease (COPD) is a common multisystem disease mostly affecting the respiratory system. Despite the well-known pulmonary manifestations of COPD, the extrapulmonary complications are mainly demonstrated in clinical studies, and the exact mechanisms behind the relationship between COPD and some extrapulmonary manifestations are still unclear. Many case-control studies reported osteoporosis as a common complication of COPD. However, the possible causality between COPD and osteoporosis is not clearly understood, and a lack of follow-up studies on COPD patients is an important issue addressed in the literature. In the present review, we discussed the common molecular pathways in COPD and osteoporosis and summarized the follow-up studies on COPD patients evaluating the possible changes in bone mass density or the development of fractures in COPD patients.

Speckle tracking echocardiography (STE) based on frame-to-frame tracking of acoustic speckles is a novel angle-independent method, used for evaluating myocardial deformation and recently to assess left atrium (LA) function. To the best of our knowledge, there is no investigation evaluating the predictor role of LA strain parameters in detection of coronary artery stenosis in ischemic heart disease. In this study, we assessed this parameter for predicting the culprit artery in patients underwent selective coronary angiography (SCA) in Mashhad, Iran. This was a case-control study, which was performed in Imam Reza and Ghaem Hospitals in Mashhad, Iran between 2017 and 2018 in patients referred for SCA. Subjects with two or three- vessel diseases were  excluded .Sixty-five cases were included in the study and divided into four groups according to the vessel involved : Group (1): normal coronary artery subjects (n=36); group (2): patients with left anterior descending (LAD) artery stenosis (n=12); group (3): patients with left circumflex artery (LCX) stenosis (n= 7) and group 4: patients with right coronary artery (RCA) stenosis (n=10). Patients underwent routine TTE and Speckle Tracking Imaging. The mean age of participants was 56.72± 10.69 years old. The male/female ratio was 0.96. Mean absolute value of LA strain was 24.74% in normal subjects, while in groups with stenotic coronary artery disease, less values were defined as 18.63%, 16.03% and 19.05%, respectively (p value=0.05). The amounts of left ventricle end systolic volume (LVESV), LV global longitudinal strain (GLS) and Em of septal annulus were significantly different between normal group and those with LCX stenosis. Among different echocardiographic parameters, LA strain, LVESV and Em of septal annulus were defined as predictors of LCX occlusion with regression analysis. LA strain in subjects with coronary artery stenosis was lower than the strain in normal group and could predict isolated LCX occlusion.

Chronic obstructive pulmonary disease (COPD) is a disease of chronic diffuse irreversible airflow obstruction. Due to the relatively high prevalence of the disease, paying attention to the treatment of these patients helps a lot in controlling the disease and reducing its cost. This study aimed to investigate the presence of serum procalcitonin in patients with an acute attack of COPD.

Methods & Materials: 

This cross-sectional study was performed on 65 patients with an acute COPD attack in Imam Reza Hospital in 2019 by the convenience sampling method. Three ccs of blood samples were taken from patients to check serum procalcitonin levels from hospitalization to 24 hours after that. Patients with an acute COPD attack were selected based on American thoracic society criteria. Also, demographic information such as age, sex, hospitalization time, and duration of the disease was recorded. Patient complaints, disease exacerbation, and type of ventilation were recorded. Data were analyzed with SPSS software (version 16). Man-Whitney and Kruskal Wallis tests were used to analyze the data. The significance level was

According to data, 65 patients (36 men and 29 women) were examined and the mean age of the patients was 66.72 (±12.65) years. Dyspnea was the most common complaint in patients. Serum procalcitonin levels were higher in patients with invasive ventilation (P = 0.007). Also, serum procalcitonin levels were lower in patients with non-invasive ventilation (P = 0.008). Besides, serum procalcitonin levels increase with increasing disease exacerbation from mild to moderate (P <0.001). According to the results of the post hoc test, there was a significant difference between mild and severe (P <0.001) and moderate and severe groups (P <0.001). There is also a significant correlation between procalcitonin serum levels and Exacerbation (R=0.6, P <0.001) and age (R=0.2, P = 0.01). serum procalcitonin levels were higher in patients with the use of invasive ventilation

According to the results, serum procalcitonin levels are associated with acute COPD attacks. Measurement of procalcitonin levels in patients with acute COPD attacks can help diagnose and perform timely care.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death. Restless Legs Syndrome (RLS) is associated with many systemic diseases. RLS is found in many patients with COPD. There is paucity of data on this topic from India. The aim is to find the prevalence of RLS in COPD patients and its distribution in study population with respect to various demographic and clinical characteristics. Correlation between severity of RLS and COPD severity was also aimed to be evaluated. Prospective, observational study conducted in a tertiary care institute over a period of 12 months. After fulfilling the inclusion criteria the patients were categorized according to the severity of COPD using the GOLD guidelines. Diagnosis and severity of RLS was evaluated using IRLSSG criteria. Prevalence and association of RLS with COPD and its demographic and clinical characteristics was evaluated. A total of 294 patients were taken which included 229 (77.9%) males and 65 females (22.1%). Mean age was 62.05 ± 10.32 years. Smoking was a more common risk factor among the patients (85.7%). 110 patients were diagnosed with RLS. A statistical significant association was found between duration of COPD and RLS (p value =0.001) and also between severity of COPD and RLS (p value=0.001). A significant positive correlation (r=0.395, p value= 0.001) between severity of COPD and RLS. Forty two (87.5%) patients with definite RLS had stage D COPD. Degree of obstruction of airways showed a statistical significant association with prevalence of RLS (p value=0.001).   RLS showed increased prevalence in COPD patients making it crucial to screen all the COPD patients for symptoms of RLS and if required to treat the symptoms, thus improving the quality of life.

Coronavirus disease (COVID-19) causes acute respiratory syndrome, it became widespread in China at first in December 2019, and then was spread in other countries. Pregnant women are considered to be more susceptible to the coronavirus disease (COVID-19) complications. We report a case of a neonate born with COVID-19, believed to be due to a vertical transmission from mother to her baby. The case also reports a preterm labour which may be related to COVID-19 infection during pregnancy.

Primary Burkitt lymphomas of the chest wall are relatively rare in occurrence. The authors describe a first case report in Malagasy child. It presents as an isolated soft-tissue mass on the chest wall with a sudden installation of paraplegia in an 8-year-old girl. Our patient was treated with aggressive chemotherapy regimen with complete remission on 2 years of follow-up.

Clinical presentation of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) usually is nonspecific in young, representing a challenge diagnostic. We present an 11-year-old male patient, with a syncope event and normal ECG in the first medical assessment. Eight months later, presented a new syncope event, but now with 1st degree block that evolved to complete AV block in 24 hrs in ECG. In Tertiary Medical Care Hospital showed sinus arrhythmia with nodal rescues. The echocardiographic assessment showed dilatation and global hypokinesia in the Right Ventricle.  The MR showed in apex and lateral wall late Gadolinium enhancement indicating fibrosis greater than 20%. The electrophysiologic assessment showed a low-voltage zone in the RVOT, normal stimulation between sinus and AV nodes. Was implanted ICD which identified events of ventricular tachycardia (185 bpm), giving discharges between 21 to 41 Jules, which were not perceived for the patient. Currently continues under cardiology surveillance to eventually receive a heart transplant as definitive treatment

Today surgical repair of the atrial septal defect (ASD) is considered as relatively a simple and safe procedure with minor to no morbidity and mortality. When a complication occurs after ASD repair, is associated with considerable morbidity and mortality, which is much higher than primary surgical procedure. We report two patients that underwent ASD repair with caval inflow occlusion without CPB with late presentations of iatrogenic diversion of IVC to LA and subsequent complications of right to left shunting.