Impact of Educational Level on Anticoagulation Control in Patients Receiving Warfarin Therapy (original) (raw)
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Cardiovascular Journal Of Africa, 2015
In Turkey, a type of smokeless tobacco called Maras powder (MP) is widely used in the south-eastern region. Smokeless tobacco is found in preparations for chewing and for absorption by the nasal and oral mucosae. The purpose of this study was to investigate whether MP damages intra-and inter-atrial conduction delay and left atrial (LA) mechanical function as much as cigarette smoking. Method: A total of 150 chronic MP users (50 males, 32.5 ± 5.4 years), smokers (50 males, 32.1 ± 6.0 years) and controls (50 males, 30.1 ± 5.8 years) were included in the study. LA volumes were measured echocardiographically according to the biplane area-length method. Atrial electromechanical coupling was measured with tissue Doppler imaging and LA mechanical function parameters were calculated. Results: The LA passive emptying fraction was significantly decreased and LA active emptying volume (LAAEV) was significantly increased in the MP group (p = 0.012 and p = 0.024, respectively), and the LA active emptying fraction (LAAEF) was significantly increased in the smokers (p = 0.003). There was a positive correlation between the amount of MP used and smoking (pack years) with LAAEV and LAAEF (r = 0.26, p = 0.009 and r = 0.25, p = 0.013, respectively). Lateral atrial electromechanical intervals (PA) were significantly higher in MP users, and the septal mitral PA was statistically higher in the smokers (p = 0.05 and p = 0.04, respectively). Conclusion: We suggest that atrial electromechanical coupling intervals were prolonged and LA mechanical function was impaired in MP users and smokers, but there was no significant difference between the MP users and smokers. These findings may be markers of subclinical cardiac involvement and tendency to atrial fibrillation.
International Journal of Cardiology, 2012
Objective: In Turkey, a type of smokeless tobacco called Maras powder (MP) is widely used in the southeastern region. Smokeless tobacco is found in preparations for chewing and for absorption by the nasal and oral mucosae. The purpose of this study was to investigate whether MP damages intra-and inter-atrial conduction delay and left atrial (LA) mechanical function as much as cigarette smoking. Method: A total of 150 chronic MP users (50 males, 32.5 ± 5.4 years), smokers (50 males, 32.1 ± 6.0 years) and controls (50 males, 30.1 ± 5.8 years) were included in the study. LA volumes were measured echocardiographically according to the biplane area-length method. Atrial electromechanical coupling was measured with tissue Doppler imaging and LA mechanical function parameters were calculated. Results: The LA passive emptying fraction was significantly decreased and LA active emptying volume (LAAEV) was significantly increased in the MP group (p = 0.012 and p = 0.024, respectively), and the LA active emptying fraction (LAAEF) was significantly increased in the smokers (p = 0.003). There was a positive correlation between the amount of MP used and smoking (pack years) with LAAEV and LAAEF (r = 0.26, p = 0.009 and r = 0.25, p = 0.013, respectively). Lateral atrial electromechanical intervals (PA) were significantly higher in MP users, and the septal mitral PA was statistically higher in the smokers (p = 0.05 and p = 0.04, respectively). Conclusion: We suggest that atrial electromechanical coupling intervals were prolonged and LA mechanical function was impaired in MP users and smokers, but there was no significant difference between the MP users and smokers. These findings may be markers of subclinical cardiac involvement and tendency to atrial fibrillation.
Journal of Cardiovascular Electrophysiology, 2008
Smoking is a major risk factor for cardiovascular disease. The impact of smoking on the right and left atrial substrates is unknown. This study included 88 patients (age 50 +/- 13 years, M/F = 71/17) who underwent four pulmonary veins isolation (PVI) for paroxysmal atrial fibrillation (AF). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system, and were compared between the patients with and without a previous smoking history. The dose effect was evaluated by the smoking intensity-duration, defined as the number of packs per day plus how many years they had been smoking. The right atrial (RA) mean voltage was lower in the patients with a previous history of smoking than in those without a history of smoking (1.92 +/- 0.49 vs 2.17 +/- 0.56 mV, P < 0.05). The left atrial (LA) mean voltage was similar between the two groups (1.73 +/- 0.67 vs 1.82 +/- 0.48 mV, P = 0.488). Further, the total activation time of the RA was longer in the patients with a previous history of smoking than in those without a history of smoking, but not so for the LA. Furthermore, the voltage reduction in the RA was related to the smoking intensity-duration (Pearson's correlation, r = 0.650, P < 0.001). In patients with atrial fibrillation, the RA mean voltage and total activation time were significantly correlated to smoking and had a dose-dependent effect.
Effect of Acute Cigarette Smoking on Atrial Impulse Propagation
Kosuyolu Heart Journal
Introduction: Acute cigarette smoking has been associated with sympathetic hyperactivity. We therefore sought to determine whether acute cigarette smoking alters atrial impulse propagation. Materials and Methods: Twenty healthy smokers with a history of active smoking were included to the study. The 12-leads surface ECG recorded at a pepper speed of 50 mm/s was obtained from all participants before and average 15 minutes after smoking one cigarette. Results: The change in maximum and minimum P wave duration was measured manually and difference between two values was defined as P wave dispersion (PWD). Both maximum P wave duration and PWD remained unchanged while heart rate significantly increased after smoking one cigarette (104 ± 10 vs. 105 ± 7 ms, p> 0.05; 38 ± 10 vs. 42 ± 8 ms, p> 0.05, and 66 ± 5 vs. 72 ± 8 beat/min, p< 0.05, respectively). Conclusion: We found that acute cigarette smoking alone did not alter atrial impulse propagation in chronic smokers.
Electrocardiographic changes in smokers
Background: In India, tobacco kills 8–10 lakh people each year and majority of these deaths occur in young age. An estimate says that an average of five-and-a-half minutes of life is lost for each cigarette smoked. A 12-lead electrocardiogram (ECG) is aroutine, inexpensive tool for assessment of cardiovascular disease in both clinical and research setting and ECG changes powerfully predicts future CVD events Hence the present study is carried out to demonstrate the effects of smoking on electrocardiogram and thereby creating awareness and the potential benefits of primordial prevention in such population. Materials and methods: This study was carried out in the department of Physiology, Sri Venkateswara medical college, Tirupati, Andhra Pradesh, India. Informed consent was obtained from all the participants. The study group comprised of 45 males with age range between 40 and 55years and 45 age matched males as controls. The smokers in this study were that smoking 11-20 cigarette/day for last 15 years. Questionnaires were administered to provide the details about their smoking habits. Results: In the present study of 90 subjects, 45 non-smokers and 45 smokers, who smoke 11-25 cigarettes per day for the past 15 years. In this case-control study, it was found that abnormalities in ECG parameters were more likely to be prevalent in smokers as compared to non-smokers. QTc-interval increased with increase in pack years of smoking. P-wave duration, PR-interval, Conclusion: This study clearly showed the importance of ECG evaluation in young healthy smokers. These ECG abnormalities indicate cardiovascular risk in term of cardiac arrhythmia, pulmonary arterial hypertension, heart blocks etc in such subjects.
Chronic effect of smoking on the electrocardiogram
Japanese Heart Journal, 1989
The electrocardiograms (ECG) of 232 male non-smokers and 224 male smokers, aged 20-60 years, devoid of cardiovascular diseases, were studied. Among these subjects 5.2% of non-smokers and 6.7% of smokers had pathological ECGs. Non-pathological ECGs of 220 nonsmokers and 209 smokers were analyzed for R, S and T-wave amplitudes, P and QRS axes and P-R, QRS and Q-Tc intervals. The 2 groups did not differ significantly from each other for R and T-wave amplitudes in any of the age groups except for 40-60 years, in which R-amplitude obtained from standard limb leads was significantly lower in smokers. Samplitude recorded from standard limb leads was significantly lower in smokers of all ages combined. The reverse phenomenon was noted for S-amplitude obtained from precordial leads. R, S and T-amplitudes decreased with the advancement of age at a relatively higher rate in smokers. These waves had significant negative correlation with pack years of smoking habit. QRS and P axes differed significantly between smokers and non-smokers. The rate of shifting of these axes to the left with increasing age was relatively higher in non-smokers. Lung function did not show any relation to electrocardiogram in normal healthy subjects. These results indicate that aging affects electrocardiographic wave patterns and that this aging effect is modified by long term smoking.
The anatolian journal of cardiology, 2015
The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peerreview principles. The journal's publication language is English however titles of articles, abstracts and Keywords are also published in Turkish on the journal's web site. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal's scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
Objectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 AE 10.2 ms vs. 102.2 AE 7.5 ms, p = 0.02; 40.6 AE 7.6 ms vs. 33.6 AE 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 AE 7.8 ms vs.11.2 AE 4.4 ms, p < 0.001; 9.0 AE 7.3 ms vs. 6.0 AE 3.8 ms, p = 0.002, and 7.4 AE 5.2 ms vs. 5.1 AE 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428, p < 0.001).
A Comparative Study of Electrocardiographic Changes between Non smokers and Smokers
2012
cardiovascular diseases were on the constant rise in developing countries. Cigarette smoking is a major risk factor for cardiovascular disease. In this study changes in ECG were evaluated in healthy adult male smokers and non smokers to identify the possible high risk factor for cardiovascular diseases. ECG was recorded in smokers and non smokers. Subjects age ranged from 22 to 30 years were selected. After taking consent and a detailed history from subjects, electrocardiogram was recorded during resting supine position. The ECG results are evaluated for different parameters like heart rate, P-wave, P-R interval, QRS complex, QT interval, and T-wave. Probability (p) values of 0.05 are less (p < 0.05) was considered for statistical significance. There is statistically significant increase in the heart rate and decrease in QRS complex and T-P interval in smokers compared to non-smokers. P-wave, P-R interval, QT interval, QRS complex, ST segment and T-wave does not show statisticall...