Effect Of Left Ventricular Hypertrophy On The Outcome Of Coronary Artery Bypass Grafting.

Objectives: To evaluate the relationship between left ventricular hypertrophy (LVH) and coronary artery bypass grafting (CABG) procedure especially on the early outcome during the first 6 months following surgical intervention. Method: This prospective cohort study included 82 patients with coronary artery disease indicating CABG. These patients were admitted, operated and followed -up in cardiothoracic surgery departmentsin the faculty of medicine, Kafrelsheikh university hospitals in the period from April 2019 till November 2021.The patients included in this study were divided into two groups according to presence or absence of left ventricular hypertrophy, Group I had 38 (46.34%) patients with LVH and Group 2 had 44 (53 .65%). patients without LVH. RESULTS: The time to regain mechanical activity waslonger (5.76±1.82) minutesin LVH patients(p <0.001). LVH group had a significantly longer period of mechanical ventilation 16.50±4.25 hours (p <0.001) compared to non LVH group which was 9.61±3.78 hours. Also, the mean duration of ICU stays in the LVH group compared to the non LVH group was 3.81±1.20 days versus 2.56±0.81 daysrespectively. The ICU follow up showed a statistically significant relationship of arrhythmias with LVH (p =0.022), infections (p =0.005) and wound infections (p<0.001). CONCLUSIONS: In patients undergoing CABG surgery, LVH has been associated with increased morbidity and poor outcome.

Evaluation Of Left Ventricular Function After Sofosbuvir And Daclatasvir Regimen For Chronic Hepatitis C.

Objectives: To assess left ventricular functions by echocardiography after 12 weeks of sofosbuvir-daclatasvir combination therapy. Method: The prospective cohort study was conducted from December 2019 to December 2021 at Kafrelsheikh University Hospital, Egypt, and comprised adult patients of either gender who had been referred to the Cardiovascular Department for cardiac evaluation and were found to be eligible forsofosbuvir-daclatasvir combination therapy. The patients were classified into five groups according to cardiovascular risk factors. Group 1 had no risk factors; Group 2 had many risk factors; Group 3 had only hypertension; Group 4 had diabetes only; and Group 5 had smoking as the only risk. All patients were assessed at baseline and at the end of the 12-week of antiviral combination therapy sofosbuvir 400 mg once daily dose and daclatasvir 60 mg once daily dose. Parameters checked were left ventricular ejection fraction, global longitudinalstrain, wall motion abnormalities and diastolic function. Data was analysed using SPSS 23. RESULTS: Of the 200 patients, 104(52%) were females and 96(48%) were males. The age range was 34-81 years, and 18(9%) patients were aged >70 years. There were 78(39%) patientsin Group 1, 60(30%) in Group 2, 25(12.5%) in Group 3, Group 4 had 13(6.5%) and Group 5 had 24(12%) patients. There were no significant changes in mean ejection fraction, global longitudinal strain and wall motion abnormalities (p>0.05). Diastolic function had some significant parameters in each of the 5 groups (p<0.05). CONCLUSIONS: Sofosbuvir-daclatasvir combination therapy did not affect or impair left ventricular systolic or diastolic functions.

Cardiovascular Risk Assessment After Sofosbuvir And Daclatasvir Regimen For Chronic Hepatitis C Virus Infection.

Objectives: To assess cardiovascular risk after sofosbuvir and daclatasvir antiviral combination therapy in chronic hepatitis C virus patients. Method: The prospective cohortstudy was conducted at the Kafrelsheikh University Hospital, Egypt, from December 2019 to December 2021, and comprised adult patients of either gender with chronic hepatitis C virus and with minimum ejection fraction 40%. They were classified into groups according to their cardiovascular risk. Group 1 had individuals with no risk factors, Group 2 had patients with many risk factors, Group 3 had patients with only hypertension, Group 4 had those with diabetes alone, and Group 5 comprised smokers. All the patients were evaluated for the risk of major cardiovascular events at baseline and at the end of 12-week of antiviral combination therapy of sofosbuvir 400 mg once daily dose and daclatasvir 60 mg once daily dose. Data was analysed with SPSS version 23. RESULTS: Of the 200 patients, there were 96(48%) males and 104(52%) females. The age ranged 34-81 years. There were 78(39%) patients in Group 1; 20(25.6%) males and 58(74.4%) females with mean age 54.4±10.45 years. Group 2 had 60(30%) patients; 40(66.6%) males and 20(33.3%) females with mean age 59.57±9.1 years. Group 3 had 25(12.5%) patients; 3(12%) males and 22(88%) females with mean age 61.4±7.8 years. Group 4 had 13(6.5%) patients; 10(77%) males and 3(23%) females with mean age 55.4±10.4 years. Group 5 had 24(12%) patients who were all (100%) males with mean age 60.7±5.7 years. There were non-significant changes in the incidence of angina, arrhythmias or progression of dyspnoea (p>0.05). Echocardiography follow-up results showed non-significant changes in mean ejection fraction, global longitudinal strain and pulmonary artery pressure (p>0.05). CONCLUSIONS: Sofosbuvir and daclatasvir combination therapy wasfound to be safe in chronic hepatitis C virus patients regarding cardiac risks.