scholarly journals Ivabradine in the management of coronary artery disease with or without left ventricular dysfunction or heart failure

2015 ◽  
Vol 17 (suppl G) ◽  
pp. G24-G29 ◽  
Author(s):  
Roberto Ferrari
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Artery Disease

scholarly journals Impact of Renin-Angiotensin-Aldosterone System Gene Polymorphisms on Left Ventricular Dysfunction in Coronary Artery Disease Patients

2012 ◽  
Vol 32 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Avshesh Mishra ◽  
Anshika Srivastava ◽  
T. Mittal ◽  
N. Garg ◽  
B. Mittal
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Output ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
P Value ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Artery Disease

Background: Left ventricular dysfunction (LVD), followed by fall in cardiac output is one of the major complications in some coronary artery disease (CAD) patients. The decreased cardiac output over time leads to activation of the renin-angiotensin-aldosterone system which results in vasoconstriction by influencing salt-water homeostasis. Therefore, the purpose of the present study was to explore the association of single nucleotide polymorphisms (SNPs) in angiotensin I converting enzyme;ACE(rs4340), angiotensin II type1 receptor; AT1 (rs5186) and aldosterone synthase;CYP11B2(rs1799998) with LVD.Methods and results: The present study was carried out in two cohorts. The primary cohort included 308 consecutive patients with angiographically confirmed CAD and 234 healthy controls. Among CAD, 94 with compromised left ventricle ejection fraction (LVEF ≤ 45) were categorized as LVD. The ACE I/D, AT1 A1166C andCYP11B2T-344C polymorphisms were determined by PCR. Our results showed that ACE I/D was significantly associated with CAD but not with LVD. However, AT1 1166C variant was significantly associated with LVD (LVEF ≤ 45) (p value=0.013; OR=3.69), butCYP11B2(rs1799998) was not associated with either CAD or LVD. To validate our results, we performed a replication study in additional 200 cases with similar clinical characteristics and results again confirmed consistent findings (p value=0.020; OR=5.20).Conclusion: AT1 A1166C plays important role in conferring susceptibility of LVD.

scholarly journals Comparison of Early Outcome of Off-pump and Conventional Coronary Artery Bypass Graft Surgery in Patients with Multivessel Coronary Artery Disease and Left Ventricular Dysfunction

2020 ◽  
Vol 35 (1) ◽  
pp. 20-27
Author(s):  
Sanjay Kumar Raha ◽  
Md Sorower Hossain ◽  
Smriti Kana Biswas ◽  
Salahuddin Rahaman ◽  
Manzil Ahmad ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Multivessel Coronary Artery Disease ◽  
Off Pump ◽  
Opcab Group ◽  
Artery Disease

Introduction: Left ventricular dysfunction is an important predictor of in-hospital mortality. Due to the theoretical and practical advantages to avoid the harmful effects of cardiopulmonary bypass (CPB), many cardiac surgeons are using Off-pump Coronary Artery Bypass (OPCAB)as an effective alternative to conventional CABG (CCAB) even in patients with reduced left ventricular (LV)ejection fraction. Objectives: This study performed in the National Institute of Cardiovascular Diseases (NICVD) evaluated the early outcomes of OPCAB in terms of mortality and major post-operative morbidities and compared them with that of CCAB in patients with multivessel coronary artery diseases and reduced left ventricular (LV) function. Methods: Total 120 patients with multivessel coronary artery disease with reduced left ventricular ejection fraction (d”50%)were allocated into two groups: a) 60 patients who underwent OPCAB and b) another 60 patients who underwent conventional CABG between January 2013 and December 2015. Pre-operative, peroperative and early post-operative variables were recorded, compiled and compared. Results: All risk factors and co-morbidities were homogenously distributed between the two groups. Majority of the patients had triple vessel disease. Nearly three-quarter (73.3%) of patients in OPCAB group and 80% in CCAB group received 3 grafts (p=0.470). The mean total operative time (268.5 ± 33.5vs. 296.3 ± 34.8minutes, p < 0.001), intubation times(8.6±0.3 vs. 12.3±0.5 hours, p<0.001), blood losses (377.8378 ± 45 ml vs. 602 ± 60 ml, p < 0.001); requirements for blood and blood products (689.7±21.1 vs. 1199.3±34.5ml, p < 0.0010),intensive care unit stays (31.7±0.9 hours versus 41.6±1.5 hours; p<0.001) and hospital stays (8.2 ± 0.2days vs.10.3 ± 0.3days, p < 0.001)were all significantly lower in the OPCAB group. Conclusion: OPCAB is a safe and effective operative revascularization procedure for patients with multivessel coronary artery disease and left ventricular dysfunction and is associated with reduced morbidity. However, a larger and omized trial with long-term followup may show the real benefits of OPCAB. Bangladesh Heart Journal 2020; 35(1) : 20-27

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