| Part1Objective:The aim our of study was to assess the role of ST depression in precordial leads with concomitant ST elevation in posterior chest leads (V7-V9) and to further investigate precordial ST depression in acute inferior MI with concomitant ST elevation in posterior chest leads were associated with larger myocardial damage.Background:The12ECG alone is neither sensitive nor specific for diagnosis of posterior wall infarction in acute setting.Methods:In our retrospective study,69(47male,22female) patients with acute inferior-posterior MI were included. They were divided into two groups according to the presence (Group A:mean age62.13±212.71) or absence (Group B:mean age58.25±11.49) of ST depression in precordial leads with concomitant ST elevation in posterior leads (V7-V9). Complete demographic data were recorded in all the subjects, CKMB and CPK were used to determine the infarct size, left ventricular ejection fraction was assessed by echo-cardiography and culprit lesion was evaluated by coronary angiography.Results:In our study,25.5%(n=69) patients had ST elevation in the posterior leads (V7-V9) where as74.4%(n=201) patients had no involvement of posterior wall of the left ventricle.65.21%(n=45) patients with inferior-posterior MI had ST depression in at least two consecutive anterior chest leads in V1-V3whereas34.78%(n=24) patients had no ST depression. Patients with ST depression in anterior chest leads were also associated with larger infarction as shown by high CK-MB levels (209.72±108.88VS156.21±93.6, p=0.039). Creatine kinase (CK) in Group A had a trend toward larger infarct size (mean peak CK,2300.09±248.52versus1568.72±251.36IU/L, p=NS) which did not reach statistical significance There was no difference in ejection fraction between the two groups.49%had evidence of mitral regurgitation (MR), which was moderate MR in10%of the patients. Conclusion:ST segment elevation in leads (V7-V9) with concomitant ST depression in leads (V1-V3) in acute inferior MI is associated with extensive infarct area involving the posterior-lateral walls. Such Patients might benefit from early reperfusion therapy. Part2Abstract-Endovascular catheter-based renal sympathetic denervation is a new promising technique in the treatment of resistant hypertension, when the use of conventional anti-hypertensive therapy has failed to control BP. We conducted a meta-analysis of randomized, controlled trials and case controlled trials to evaluate the effects of RSD on office BP, where Office Bp was reported as a primary/secondary endpoint in patients with resistant hypertension. Data were retrieved using English-language search of PubMed (2000to march2013), The Cochrane Database of Systemic Reviews, Ovid, Embase, Conference abstracts and original articles. Reference sections of the identified studies were also examined for additional search of studies. Data on sample size, participant’s characteristics, study design, intervention type, follow up duration and treatment results were assessed by2independent reviewers using standard protocol. Data from7trials with526participants were examined by random effects model. The pooled mean net change in systolic BP and diastolic BP at3and6months follow-up duration for those treated with RSD compared to control group were-21.2mmHg (95%CI:14.97-27.96);-4.9mmHg(95%CI:0.92-8.97) and-24.26mmHg(95%CI:17.63-30.88);-8.42(95%CI:5.52-11.39) respectively. Net Reductions in Blood pressure was statistically significant at both the time periods. These results indicate that RSD lowers blood pressure among those with Resistant Hypertension and may help prevent hypertension related adverse effects. |
PDF Full Text Request