Myocardial blush grade: a determinant of left ventricular ejection fraction and adverse outcomes in STEMI.

BACKGROUND AND AIMS: Despite restoration of blood flow, subtle microvascular obstruction can occur. This obstruction can be graded using myocardial blush grade. We aimed to investigate the role of myocardial blush grade in ejection fraction and adverse outcomes, after percutaneous intervention. METHODS: A prospective, observational study was conducted at our institute with a calculated sample size. Variables such as age, gender, and ejection fraction were noted before the intervention. The patients were followed for 3 months to determine the outcomes. The data was analyzed using IBM SPSS software version 26.0. P-value of less than 0.05 was considered significant for the statistical tests. RESULTS: There were 74 male and 36 female participants in the study. The mean age was 52.20 ± 10.02 years. The most common adverse outcome was heart failure (18%). There was a significant Pearson's correlation between myocardial blush grade and improvement in ejection fraction (p < 0.05). Improvement in myocardial blush grade was significantly related to a decrease in adverse outcomes (p < 0.05). Regression analysis proved myocardial blush grade and diabetes status as independent predictors of percentage increase in ejection fraction (p < 0.05). CONCLUSION: High myocardial blush grade is one of the independent predictors of better outcomes in ST-elevation myocardial infarction.

Accidental left ventricular perforation during coronary angiogram.

Myocardial perforation (MP) is an uncommon entity which occurs most commonly in the setting of acute myocardial infarction. We report a case of accidental left ventricular perforation during a routine coronary angiogram. A 55-year-old male, known diabetic with moderate renal impairment, non-hypertensive, suffered an acute inferior wall myocardial infarction for which he was thrombolyzed with streptokinase. Coronary angiogram was done for postmyocardial infarction angina. Judkin right, 6F diagnostic catheter was used for left ventriculogram. After the ventriculogram the patient became hemodynamically unstable. A repeat left ventriculogram with a 6F pigtail catheter showed a perforation of the basal inferoposterior wall. Two pigtail catheters were inserted into the pericardial cavity to relieve the pericardial tamponade. Emergency surgical repair of a 1.5 cm rent in the inferior wall of the left ventricle was attempted. The friable and infarcted myocardium prevented a successful repair and the patient died after 24 hours.

Assurance of energy efficiency and data security for ECG transmission in BASNs.

With the technological advancement in body area sensor networks (BASNs), low cost high quality electrocardiographic (ECG) diagnosis systems have become important equipment for healthcare service providers. However, energy consumption and data security with ECG systems in BASNs are still two major challenges to tackle. In this study, we investigate the properties of compressed ECG data for energy saving as an effort to devise a selective encryption mechanism and a two-rate unequal error protection (UEP) scheme. The proposed selective encryption mechanism provides a simple and yet effective security solution for an ECG sensor-based communication platform, where only one percent of data is encrypted without compromising ECG data security. This part of the encrypted data is essential to ECG data quality due to its unequally important contribution to distortion reduction. The two-rate UEP scheme achieves a significant additional energy saving due to its unequal investment of communication energy to the outcomes of the selective encryption, and thus, it maintains a high ECG data transmission quality. Our results show the improvements in communication energy saving of about 40%, and demonstrate a higher transmission quality and security measured in terms of wavelet-based weighted percent root-mean-squared difference.

Wearable patient monitoring application (ECG) using wireless sensor networks.

In this paper, we discuss a design for a wearable electrocardiograph device constructed with small, low-powered "mote" sensors for use in wireless sensor networks. A wearable, wireless three-lead electrocardiograph sensor module is utilized and the initial tests are presented that illustrate the viability of this design. This device can be integrated into a suite of wearable wireless sensors used for patient monitoring and other applications.