Echocardiographic Assessment Of Left Ventricular Function After COVID-19 Vaccination In Adults.

Objectives: To assess left ventricular function by conventional and speckle tracking echocardiography in subjects having received coronavirus disease-2019 vaccine. Method: The cohortstudy was conducted from April 2021 to April 2022 at the Department of Cardiology, Kafrelsheikh University Hospital, Egypt, and comprised adults of either gender who had received coronavirus disease-2019 vaccine. Detailed history was noted before clinical assessment, electrocardiogram and echocardiography, which were done at baseline and after two weeks of the last vaccine dose. Apical 4, apical 3 and apical 2 strains were obtained to get the global longitudinal strain. Data was analysed using SPSS 20. RESULTS: Of the 100 subjects, 50(50%) each were males and females. The overall mean age was 39.20±14.57 years. There were 16(16%) subjects with diabetes mellitus and 21(21%) with hypertension. Regarding vaccine distribution, 34(34%) had received AstraZeneca AZD1222, 31(31%) had BioNTech Pfizer vaccine BNT162B2 and 35(35%) had Sinopharm Beijing Institute of Biological Products BBIBP-CorV. The global longitudinal strain before and after vaccination did not show a significant difference (p<0.063). There was no significant variation in global longitudinal strain between the various vaccination types (p=0.584). CONCLUSIONS: The studied vaccines had similarly acceptable safety profiles regarding left ventricular functions.

Coronary Plaque Morphology And Characteristics In Patients With Raised Haemoglobin A1c: An Intravascular Ultrasound Study.

Objectives: To identify coronary plaque morphology using grey scale and virtual histology intravascular ultrasound in patients with and without elevated glycated haemoglobin. Method: The cross-sectional study was conducted at the Cardiology Department of Kafrelsheikh University, Egypt, from November 2019 to January 2022, and comprised adult patients of either gender suffering from acute coronary syndrome admitted for catheterisation. The patients were divided into three groups.Diabetic patients were in group A, prediabetic patients with elevated glycated haemoglobin in group B, and patients with normal glycated haemoglobin in group C. All patients were subjected to clinical examination, 12-lead electrocardiogram, coronary angiography and multimodality intravascular ultrasonography scan of proximal segments 3-6cmof non-culprit coronary arteries intra group differences were compared using the analysis of variance (ANOVA) test. RESULTS: Of the 52 patients, 18(34.7%) were females and 34(65.3%) were males. Group A had 18(34.6%)patients; 13(72%) males and 5(28%) females with mean age 57.9±6.9 years. Group B had 17(32.7%) patients;11(64.7%) males and 6(35.3%) females with mean age 56.5±5.5 years. Group C had 17(32.7%) patients; 10(59%) males and 7(41%) females with mean age 59.5±5.1 years(p>0.05). Thin-cap fibroatheroma wassignificantly higher in groups A and B compared to group C (p=0.045). CONCLUSIONS: Patients with raised glycated haemoglobin presenting with acute coronary syndrome were found to have more vulnerable plaque types than those with normal levels.

Clinical Presentation And Outcome In Acute Coronary Syndrome Patients In Relation To Plaque Morphology Identified By Intra Vascular Ultra Sound.

Objectives: To evaluate plaque morphology in non-culprit coronary arteries using intravascular ultrasound in patients with acute coronary syndrome with and without elevated glycated haemoglobin and its assocaition with patient outcome. Method: The cross-sectional study was conducted at the Cardiology Department of Kafrelsheikh University, Egypt, from November 2019 to January 2022, and comprised adult patients of either gender suffering from acute coronary syndrome. The patients were divided into three groups. Diabetic patients were in group A, prediabetic patients with elevated glycated haemoglobin in group B, and patients with normal glycated haemoglobin in group C. The patients were subjected to coronary angiography and percutaneous coronary intervention. Intravascular ultrasound scan was done after succcessful intervention. Lesions were classified according to ultrasound findings. Patients were followed up for one year to observe subsequent events to the morphology of the lesions detected at baseline. Data was analysed using SPSS 20. RESULTS: Of the 52 patients, 18(34.7%) were females and 34(65.3%) were males. Group A had 18(34.6%)patients; 13(72%) males and 5(28%) females with mean age 57.9±6.9 years. Group B had 17(32.7%) patients; 11(64.7%) males and 6(35.3%) females with mean age 56.5±5.5 years. Group C had 17(32.7%) patients; 10(59%) males and 7(41%) females with mean age 59.5±5.1 years(p>0.05). Thin-capped fibro-atheroma wassignificantly higher in groups A and B compared to group C (p=0.045). Significant direct correlation between major adverse cardiac events and prevalence of thin-capped fibro-atheroma wasfound between groups A and C (p=0.033), and between groups B and C (p=0.047) regarding prevalence of necrotic plaque and subsequent myocardial infarction. CONCLUSIONS: Thin-capped fibro-atheroma was the more common plaque type in patients with raised glycated haemoglobin, and the subsequent rate of major adverse cardiac events was significantly higher in such patients compared to the non-diabetic population.