Asian Journal of Cardiology Research <p style="text-align: justify;"><strong>Asian Journal of Cardiology Research</strong>&nbsp;aims to publish&nbsp;high-quality&nbsp;papers (<a href="/index.php/AJCR/general-guideline-for-authors">Click here for Types of paper</a>) in all areas of&nbsp;‘Cardiology research’. This journal facilitates the research and wishes to publish papers as long as they are technically correct, scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer-reviewed, open access INTERNATIONAL journal.</p> en-US (Asian Journal of Cardiology Research) (Asian Journal of Cardiology Research) Mon, 17 Jun 2019 11:08:05 +0000 OJS 60 MRI Scan Early after Implantation of an MRI Conditional Implantable Cardioverter-Defibrillator: Case Report <p><strong>Introduction: </strong>MRI scans are not recommended for the first four weeks after device implantation. However, conditions like hypoxic-ischaemic encephalopathy can only be evaluated by MRI. A case where MRI brain was done in a patient with HIE four days after ICD implantation has been reported.</p> <p><strong>Case History: </strong>A 54 year old male with old anterior wall myocardial infarction presented with recurrent monomorphic, pulseless ventricular tachycardia. Anti-arrhythmic treatment resulted in severe junctional bradycardia for which temporary pacemaker was inserted. After 48 hours of stability, Medtronic Evera MRI XT DR SureScanTM Series DDMB2D1 implantable cardiovertor-defibrillator was implanted. During implantation, patient had ventricular fibrillation requiring prolonged (Comprehensive Cardiac Rehabilitation) CCR for 45 minutes.</p> <p>Post-procedure, he remained comatose for more than 48 hours. Bedside EEG showed mild to moderate generalised encephalopathy which did not match the clinical picture. Therefore, MRI brain was done on fourth day after implant taking risk consent from the patient’s wife. The MRI scan was done safely using SureScan mode. It showed mild changes of hypoxic encephalopathy suggesting a decent prognosis. The ICD lead positions and parameters were rechecked and found to be optimum.</p> <p>The patient slowly recovered over three weeks. He needed dialysis for acute kidney injury, antibiotics for ventilator associated pneumonia, tracheostomy for ventilation and percutaneous endoscopic gastrostomy for feeding. He was discharged with percutaneous endoscopic gastrostomy (PEG) in-situ and improving neurological status.</p> <p><strong>Conclusion: </strong>While a single case cannot make a recommendation, this case demonstrates that it not impossible to do an MRI scan safely in a patient very shortly after an ICD implant if the clinical situation warrants it.</p> S. Chitnis Nishad ##submission.copyrightStatement## Mon, 17 Jun 2019 00:00:00 +0000 Gas Flaring and Crude Oil Contaminants as Modifiers of Blood Pressure in Delta State <p>Several toxic effects of crude oil have been reported on human reproductive, respiratory, cardiovascular, and nervous systems. An instance is seen in the negative effect on fertility resulting from prolonged exposure to fumes from the exhausts of vehicles. This study, therefore, investigated gender-specific changes in selected cardiovascular variables of residents of gas flaring and crude oil contaminated communities of Delta State, southern Nigeria. Two Hundred and Forty (240) subjects exposed to gas flaring and crude oil contamination (Experimental group) were ethically sourced from Agbarho [Ughelli North Local government Area (LGA)] and Bomadi (Bomadi LGA); both gas flaring communities in Delta State. One hundred and twenty (120) non-exposed individuals were also recruited (control group) from Abraka, a non-gas flaring community in Ethiope East LGA of the same state. Subjects were matched by gender and duration of stay (exposure) in the target communities. The cardiovascular variables [systolic blood pressure (SBP), diastolic blood pressure (DBP)] of all the subjects were measured, while pulse and mean arterial pressures (PP and MAP respectively) were calculated. Following statistical analysis (using the student t-test), results showed (at p &lt; 0.05) a statistically significant increase in SBP and MAP of the experimental group. The study also found a significant increase in DBP and PP for experimental than the control group; it also reflected a durational-dependent exposure of subjects to increased SBP and DBP. Exposed males showed an increase in average values of PP, MAP, SBP and DBP than their female counterparts. Also, oil contamination caused a greater negative percentage impact on the MAP than gas flaring. This Study, therefore, ascertained the veracity of previous findings; confirming gas flaring and crude oil contamination as potent elicitors of hypertension. Hence, we recommend periodic epidemiological assessment of environmental pollutants as a factor of hypertensive individuals.&nbsp;</p> D. O. Ogbeide, R. N. Ativie, A. O. Naiho, J. C. Igweh, O. M. Odigie ##submission.copyrightStatement## Tue, 03 Sep 2019 00:00:00 +0000 Cardiovascular Recovery and Adiposity Indices among Sedentary Young Adults Following a Structured Physical Activity <p><strong>Background:</strong> Physical activity has been shown to have positive impact on health and in the long term results in improved physical fitness and quick recovery in cardiovascular parameters after sub-maximal exertion. Clinical evaluation of cardiovascular recovery as a prognostic tool for cardiovascular diseases has been subject of interest and many factors has been established to influence recovery.</p> <p><strong>Objective:</strong> This study sought to investigate the relationship between adiposity indices and cardiovascular recovery indices in sedentary young adults following a structured physical activity.</p> <p><strong>Materials and Methods:</strong> A total of two hundred and eleven (211) young adults (127 males and 84 females) participated in this study. Subjects performed a sub-maximal exercise on a cycle ergometer until they attain 60-70% of their age predicted maximum heart rate following which the heart rate and blood pressure recovery was measured after 1 minute, 3 minutes and 5 minutes. Prior to the exercise, participants’ anthropometric parameters were measured and adiposity indices recorded.&nbsp;</p> <p><strong>Results:</strong> Results showed a significant positive correlation between waist-hip ratio and heart rate recovery, a significant negative correlation between percentage body fat and heart rate recovery, a significant positive weak correlation between body mass index and systolic blood pressure recovery. There was no significant relationship between any of the adiposity indices and diastolic blood pressure recovery. Some levels of differences exist between body adiposity and recovery indices.</p> <p><strong>Conclusion:</strong> Body adiposity should be taken into consideration in preventing the risk of cardiovascular diseases occasioned by slow recovery after physical activity.</p> Uduonu Ekezie Mmanwanne, Ezeukwu Antoninus Obinna, Uchenwoke Chigozie Ikenna, Ezugwu Uchechukwu Anthonia ##submission.copyrightStatement## Fri, 18 Oct 2019 00:00:00 +0000 Drugs Used in Thromboembolic Disorders: An Insight into Their Mechanisms <p>In the United States alone, more than 6 million patients receive long-term anti-platelet and anticoagulation therapy. The hemostatic system must maintain a balance between fibrin formation (coagulation) and fibrin dissolution (fibrinolysis). Thrombin and Factor Xa are two of the most important components of the coagulation cascade. Any disruption in this cascade can lead to either thrombosis, hemorrhage or both. The clotting process is a dynamic, highly interwoven array of multiple processes. There are four different phases involved in the response of activated platelets: Adhesion, aggregation, secretion and the procoagulant activity. The coagulation cascade is a coordinated sequence of linked enzymatic reactions in which each reaction product converts the subsequent inactive zymogen into an active serine protease that are responsible for the conversion of soluble plasma fibrinogen into insoluble fibrin. Several antithrombotic factors regulate coagulation and limit the production of thrombin to prevent the perpetuation of coagulation and thrombus formation; these include protein C/protein S, antithrombin, heparin cofactor and tissue factor pathway inhibitor. Antiplatelet agents play a major role in the management of cerebrovascular, peripheral vascular and cardiovascular diseases. Aspirin is a non-steroidal anti-inflammatory drug that works by irreversibly inhibiting cyclo-oxygenase 1 and 2 by covalent acetylation. Cilostazol, a specific and strong inhibitor of PDE3 in platelets and smooth muscle cells was approved in the USA in 1999 for the treatment of intermittent claudication. Dipyridamole affects platelet function by inhibiting the reuptake of adenosine by red blood cells, in this way enhancing plasma levels of this vasodilator and platelet inhibitory nucleoside; it acts as an inhibitor of PDE5 and PDE3, thus increasing intraplatelet cAMP and/or cGMP; and it also acts as an antioxidant by scavenging free radicals that inactivate cyclo-oxygenase, thus enhancing PGI2 biosynthesis. Vorapaxar, a first in its class, is an orally available PAR-1 antagonist approved for patients with prior myocardial infarction or peripheral arterial disease with no previous history of stroke or TIA, and is added to standard therapy for long‐term secondary prevention of thrombotic CV events. Abciximab, eptifibatide, tirofiban all bind the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation. Warfarin is a Vitamin K antagonist that interferes with γ-carboxylation of vitamin K–dependent clotting factors II, VII, IX, and X, and proteins C and S. Dabigatran is a potent, competitive inhibitor of thrombin, while Apixaban, edoxaban and rivaroxaban all selectively inhibit factor Xa. Heparins, acts indirectly by binding to anti-thrombin (AT) rather than acting directly on the coagulation factors. This interaction converts AT to a rapid inactivator of factor IIa and factor Xa. Unfractionated heparin, LMW heparin (enoxaparin, dalteparin) and fondaparinux all inactivate factor Xa, but unfractionated heparin is a much more efficient inactivator of thrombin. Drugs such as anti-platelet therapy and anti-coagulants are frequently used in clinical settings. It is imperative that the physicians have a thorough understanding of these agents. An insight into the mechanism of how these medications act serves as a prelude to understanding the pharmacology of these drugs.</p> Abbas M. Hassan, V. N. Prasad, N. Fidelis ##submission.copyrightStatement## Sat, 20 Jul 2019 00:00:00 +0000