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Occurrences of heart disease in apparently healthy cats in Klang Valley, Malaysia

Khor KH, Chin MX

J Adv Vet Anim Res, 2020 Sep;7(3):501-508.
PMID: 33005676 DOI: 10.5455/javar.2020.g446

Objective: Annual health screening inclusive of heart workup is recommended for the detection of heart diseases, especially in asymptomatic patients (no clinical signs). This study determined the occurrences of the common heart disease and the risk factors in apparently healthy cats.
Materials and methods: This prospective study that screened 59 healthy cats and the status of the heart were evaluated based on a combination of findings from physical examination, electrocardiography, blood pressure measurement, routine blood test, urinalysis, and total thyroid level.
Results: Approximately 40.7% (n = 24/59) of the apparently healthy cats were diagnosed with heart disease hypertrophic cardiomyopathy (62.5%) remains to be the most commonly diagnosed. The mean age was 4.9-year old (age range, 7-month-old to 19-year-old). The prevalence was higher in males (45.0%; n = 17/38) cats, especially the domestic shorthairs (46.0%; n = 11/24). Among the healthy cats with vertebral heart scale (VHS) > 8.0, only 52% (n = 12/23) of them were diagnosed with cardiomyopathy. However, 33% (n = 12/36) of the cats with normal VHS ≤ 7.9 were diagnosed with heart disease. Consistently, all healthy cats with abnormal heart sounds were diagnosed with heart disease. About 31.4% (n = 16/51) of these cats with typical heart sound had cardiomyopathy too.
Conclusion: The occurrence of cardiomyopathy in apparently healthy cats has no association with the patient's age, sex, and VHS, except for the heart sound. Echocardiography remains the best diagnostic tool, as normal heart size and normal heart sound do not exclude cardiomyopathy in this group of apparently healthy cats.

Matched MeSH terms: Heart; Heart Sounds
Acute ingestion of hydrogen-rich water does not improve incremental treadmill running performance in endurance-trained athletes

Ooi CH, Ng SK, Omar EA

Appl Physiol Nutr Metab, 2020 May;45(5):513-519.
PMID: 31675478 DOI: 10.1139/apnm-2019-0553

There is emerging evidence that hydrogen-rich water (H2-water) has beneficial effects on the physiological responses to exercise. However, few studies investigate its ergogenic potential. This randomized controlled trial examined the effects of H2-water ingestion on physiological responses and exercise performance during incremental treadmill running. In a double-blind crossover design, 14 endurance-trained male runners (age, 34 ± 4 years; body mass, 63.1 ± 7.2 kg; height, 1.72 ± 0.05 m) were randomly assigned to ingest 2 doses of 290-mL H2-water or placebo on each occasion. The first bolus was given before six 4-min submaximal running bouts, and the second bolus was consumed before the maximal incremental running test. Expired gas, heart rate (HR), and ratings of perceived exertion (RPE) were recorded; blood samples were collected at the end of each submaximal stage and post maximal running test. Cardiorespiratory responses, RPE, and blood gas indices were not significantly different at each submaximal running intensity (range: 34%-91% maximal oxygen uptake) between H2-water and placebo trials. No statistical difference was observed in running time to exhaustion (618 ± 126 vs. 619 ± 113 s), maximal oxygen uptake (56.9 ± 4.4 vs. 57.1 ± 4.7 mL·kg-1·min-1), maximal HR (184 ± 7 vs. 184 ± 7 beat·min-1), and RPE (19 ± 1 vs. 19 ± 1) in the runners between the trials. The results suggest that the ingestion of 290 mL of H2-water before submaximal treadmill running and an additional dose before the subsequent incremental running to exhaustion were not sufficiently ergogenic in endurance-trained athletes. Novelty Acute ingestion of H2-water does not seem to be ergogenic for endurance performance. A small dose of H2-water does not modulate buffering capacity during intense endurance exercise in athletes.

Matched MeSH terms: Heart Rate/physiology
Automated detection of diabetic subject using pre-trained 2D-CNN models with frequency spectrum images extracted from heart rate signals

Yildirim O, Talo M, Ay B, Baloglu UB, Aydin G, Acharya UR

Comput Biol Med, 2019 10;113:103387.
PMID: 31421276 DOI: 10.1016/j.compbiomed.2019.103387

In this study, a deep-transfer learning approach is proposed for the automated diagnosis of diabetes mellitus (DM), using heart rate (HR) signals obtained from electrocardiogram (ECG) data. Recent progress in deep learning has contributed significantly to improvement in the quality of healthcare. In order for deep learning models to perform well, large datasets are required for training. However, a difficulty in the biomedical field is the lack of clinical data with expert annotation. A recent, commonly implemented technique to train deep learning models using small datasets is to transfer the weighting, developed from a large dataset, to the current model. This deep learning transfer strategy is generally employed for two-dimensional signals. Herein, the weighting of models pre-trained using two-dimensional large image data was applied to one-dimensional HR signals. The one-dimensional HR signals were then converted into frequency spectrum images, which were utilized for application to well-known pre-trained models, specifically: AlexNet, VggNet, ResNet, and DenseNet. The DenseNet pre-trained model yielded the highest classification average accuracy of 97.62%, and sensitivity of 100%, to detect DM subjects via HR signal recordings. In the future, we intend to further test this developed model by utilizing additional data along with cloud-based storage to diagnose DM via heart signal analysis.

Matched MeSH terms: Heart Rate*
Effects of durian fruit on blood pressure of spontaneously hypertensive rats

Malina Jasamai, Nurul Hanis Samsudin, Norazrina Azmi, Endang Kumolosasi

Sains Malaysiana, 2018;47:1221-1226.

Durian or scientifically known as Durio zibethinus is one of the most well-known seasonal fruits in the Southeast Asia
region. However, its safe consumption in individuals with hypertension is still controversial. This study was conducted
to investigate the effect of durian on blood pressure of spontaneously hypertensive rat model. Four groups of rats (n=5)
were fed with either a low dose durian (26 g/kg), a high dose durian (52 g/kg), sugar solution (8 mL/kg) which has
similar sugar composition in the durian as placebo control, and distilled water as vehicle control (8 mL/kg) for 14 days.
The durian doses for rats were obtained by converting from human doses. Baseline reading of blood pressure and heart
rate were recorded before the first oral administration of durian. The blood pressure and heart rate were also measured
1 h after the durian oral administration on day 1, 3, 7 and 14 of the experiment. In conclusion, durian fruit possessed
an acute effect on the blood pressure of hypertensive rats but heart rate was unaffected. High dose administration of
durian led to significant elevation of blood pressure after 1 h of consumption. Meanwhile, low dose of durian (26 g/kg)
caused an insignificant reduction in systolic and diastolic blood pressure. Tolerance to the durian fruit was observed after
three to seven days of the oral administration and low dose consumption of durian fruit was safe in the hypertensive rat.

Matched MeSH terms: Heart; Heart Rate
Contrast echocardiogram in diagnosing rare type of persistent left superior vena cava

Koay HS, Anis M, Mokhtar SA

Med J Malaysia, 2018 12;73(6):413-414.
PMID: 30647217

We report a rare case of persistent left superior vena cava (PLSVC) with direct drainage into the left atrium in a 3-yearsold boy who had been electively admitted for hypospadias repair, when he was noticed to have finger clubbing and mild hypoxia but was otherwise asymptomatic. The diagnosis of PLSVC can be made without an invasive tool as direct drainage of PLSVC into the left atrium be visualised using transthoracic echocardiography (TTE) by injecting agitated saline into the left arm.

Matched MeSH terms: Heart Defects, Congenital/diagnosis
Flickering of cardiac state before the onset and termination of atrial fibrillation

Lan BL, Liew YW, Toda M, Kamsani SH

Chaos, 2020 May;30(5):053137.
PMID: 32491883 DOI: 10.1063/1.5130524

Complex dynamical systems can shift abruptly from a stable state to an alternative stable state at a tipping point. Before the critical transition, the system either slows down in its recovery rate or flickers between the basins of attraction of the alternative stable states. Whether the heart critically slows down or flickers before it transitions into and out of paroxysmal atrial fibrillation (PAF) is still an open question. To address this issue, we propose a novel definition of cardiac states based on beat-to-beat (RR) interval fluctuations derived from electrocardiogram data. Our results show the cardiac state flickers before PAF onset and termination. Prior to onset, flickering is due to a "tug-of-war" between the sinus node (the natural pacemaker) and atrial ectopic focus/foci (abnormal pacemakers), or the pacing by the latter interspersed among the pacing by the former. It may also be due to an abnormal autonomic modulation of the sinus node. This abnormal modulation may be the sole cause of flickering prior to termination since atrial ectopic beats are absent. Flickering of the cardiac state could potentially be used as part of an early warning or screening system for PAF and guide the development of new methods to prevent or terminate PAF. The method we have developed to define system states and use them to detect flickering can be adapted to study critical transition in other complex systems.

Matched MeSH terms: Heart Rate/physiology
Fulltext Traditional Jones criteria: limitation in the diagnosis of rheumatic fever in patients with mitral valve repair

Putri Yubbu, Johan Aref Jamaluddin, Lydia Chang Mun Yin, Geetha Kandavello, Mazeni Alwi, Hasri Samion, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):316-319.
MyJurnal

The present study aims to determine the limitations of traditional Jones criteria during the first episode of acute rheu- matic fever (ARF) at the initial referral hospital, in a cohort of patients below 18 years old who had undergone mitral valve repair in National Heart Institute (IJN) from 2011 to 2016. Carditis followed by fever and joint involvement were the most frequent manifestations at first diagnosis. Of the 50 patients, only seven (14%) fulfilled the traditional Jones criteria for the diagnosis of the first episode of ARF. When compulsory evidence of a previous group A Beta he- molytic streptococcus (GABHS) was disregarded, this figure rose to 54%. Therefore, strict adherence to Jones criteria with absolute documentation of GABHS will lead to underdiagnoses of ARF. The application of echocardiographic diagnostic criteria of rheumatic heart disease (RHD) needs to be emphasized to allow early diagnosis and adminis- tration of secondary prophylaxis to prevent progression to severe valvular disease.

Matched MeSH terms: Heart Valve Diseases; Rheumatic Heart Disease
Automated detection of sleep apnea using sparse residual entropy features with various dictionaries extracted from heart rate and EDR signals

Viswabhargav CSS, Tripathy RK, Acharya UR

Comput Biol Med, 2019 05;108:20-30.
PMID: 31003176 DOI: 10.1016/j.compbiomed.2019.03.016

Sleep is a prominent physiological activity in our daily life. Sleep apnea is the category of sleep disorder during which the breathing of the person diminishes causing the alternation in the upper airway resistance. The electrocardiogram derived respiration (EDR) and heart rate (RR-time-series) signals are normally used for the detection of sleep apnea as these two signals capture cardio-pulmonary activity information. Hence, the analysis of these two signals provides vital information about sleep apnea. In this paper, we propose the novel sparse residual entropy (SRE) features for the automated detection of sleep apnea using EDR and heart rate signals. The features required for the automated detection of sleep apnea are extracted in three steps: (i) atomic decomposition based residual estimation from both EDR and heart rate signals using orthogonal matching pursuit (OMP) with different dictionaries, (ii) estimation of probabilities from each sparse residual, and (iii) calculation of the entropy features. The proposed SRE features are fed to the combination of fuzzy K-means clustering and support vector machine (SVM) to pick the best performing classifier. The experimental results demonstrate that the proposed SRE features with radial basis function (RBF) kernel-based SVM classifier yielded higher performance with accuracy, sensitivity and specificity values of 78.07%, 78.01%, and 78.13%, respectively with Fourier dictionary and 10-fold cross-validation. For subject-specific or leave-one-out validation case, the SVM classifier has sensitivity and specificity of 85.43% and 92.60%, respectively using SRE features with Fourier dictionary (FD).

Matched MeSH terms: Heart Rate*
Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management

Krishnasamy S, Sivalingam S, Dillon J, Mokhtar RAR, Yakub A, Singh R

Braz J Cardiovasc Surg, 2021 Feb 01.
PMID: 33577258 DOI: 10.21470/1678-9741-2020-0207

INTRODUCTION: The presence of aortic regurgitation (AR) in the setting of ventricular septal defect (VSD) has always been a management challenge.
METHODS: This is a retrospective study looking at patients who underwent VSD closure with or without aortic valve intervention between January 1st, 1992 and December 31st, 2014 at the Institute Jantung Negara. This study looked at all cases of VSD and AR, where AR was classified as mild, moderate, and severe, the intervention done in each of this grade, and the durability of that intervention. The interventions were classified as no intervention (NI), aortic valve repair (AVr), and aortic valve replacement (AVR).
RESULTS: A total of 261 patients were recruited into this study. Based on the various grades of AR, 105 patients had intervention to their aortic valve during VSD closure. The rest 156 had NI. All patients were followed up for a mean time of 13.9±3.5 years. Overall freedom from reoperation at 15 years was 82.6% for AVr. Various factors were investigated to decide on intervening on the aortic valve during VSD closure. Among those that were statistically significant were the grade of AR, size of VSD, age at intervention, and number of cusp prolapse.
CONCLUSION: We can conclude from our study that all moderate and severe AR with small VSD in older patients with more than one cusp prolapse will need intervention to their aortic valve during the closure of VSD.

Matched MeSH terms: Heart Septal Defects, Ventricular; Heart Valve Prosthesis
Fulltext Challenges for Adolescents With Congenital Heart Defects/Chronic Rheumatic Heart Disease and What They Need: Perspectives From Patients, Parents and Health Care Providers at the Institut Jantung Negara (National Heart Institute), Malaysia

Tye SK, Kandavello G, Wan Ahmadul Badwi SA, Abdul Majid HS

Front Psychol, 2020;11:481176.
PMID: 33584393 DOI: 10.3389/fpsyg.2020.481176

Objectives: This study aimed to describe the experiences and challenges faced by adolescents with moderate and severe congenital heart defects (CHD) or Chronic Rheumatic Heart Disease (CRHD) and to determine their needs in order to develop an Adolescent Transition Psychoeducational Program.
Methods: The study involved seven adolescents with moderate to severe CHD/CRHD, six parents, and four health care providers in Institute Jantung Negara (National Heart Institute). Participants were invited for a semi-structured interview. Qualitative data were analyzed through the Atlas.ti 7 program using triangulation methods.
Results/conclusions: We identified five themes concerning the experience and challenges of adolescents relating to: (1) emotional/psychological issues; (2) the progress of the illness; (3) relationship issues; (4) future preparation; and, (5) school and community. These themes were identified together with eleven subcategories. The staff expressed support for the development of the Adolescent Transition Psychoeducational Program and adolescents with CHD/CRHD and their parents were willing to participate in the program if their schedule allowed. Their suggestions to improve the program were classified into six categories, with two main themes, (1) the self-management of illness in life and the future; and, (2) social support. In conclusion, the findings from the situation analysis act as a basis for a conceptual framework that will contribute to the development of an Adolescent Transition Psychoeducational Program that aims to empower adolescents with CHD/CRHD, enabling them to manage challenges during the transition phase between childhood and adulthood.

Matched MeSH terms: Heart Defects, Congenital; Rheumatic Heart Disease
Fulltext Anomalous right pulmonary artery from aorta, surgical approach case report and literature review

Alhawri K, Alakhfash A, Alqwaee A, HassabElnabi M, Ahmed F, Alhawri M, et al.

J Card Surg, 2021 Aug;36(8):2890-2900.
PMID: 34047395 DOI: 10.1111/jocs.15618

BACKGROUND: Anomalous origin of one pulmonary artery from the aorta is a rare congenital anomaly affecting the right pulmonary artery more than the left. These patients are at risk for the early development of significant pulmonary hypertension. Early surgical treatment has been proven safe with excellent results. The surgical approach and technique is challenging and should be decided ahead before the patient to surgery. Different techniques were described including direct reimplantation, conduit interposition, aortic ring flap.
AIM: We present a neonate with anomalous origin of the right pulmonary artery from the aorta and discuss the surgical technique and complications in the literature.

Matched MeSH terms: Heart Defects, Congenital*
Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry

Lam CS, Teng TK, Tay WT, Anand I, Zhang S, Shimizu W, et al.

Eur Heart J, 2016 11 01;37(41):3141-3153.
PMID: 27502121 DOI: 10.1093/eurheartj/ehw331

AIMS: To characterize regional and ethnic differences in heart failure (HF) across Asia.

METHODS AND RESULTS: We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions.

CONCLUSIONS: These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics.

CLINICALTRIALSGOV IDENTIFIER: NCT01633398.

Matched MeSH terms: Heart Failure*
Fulltext Doppler echocardiography guided cardiac resynchronization therapy in heart failure

Oemar, Hamed, Abdulgani, Hafil Budianto

Medical Health Reviews, 2008;2008(1):17-28.
MyJurnal

Heart failure (HF) is a major burden in almost all countries. The prevalence of symptomatic HF is still high. Despite our best understanding of its pathophysiologic mechanisms and the recent advances in pharmacologic therapy, it remains a highmortality and morbidity disease. About 30-50% of patients with HF have concurrent electrical delay in the electrocardiogram (ECG), mainly in the form of LBBB.1 This kind of conduction delay commonly occurs in patients with idiopathic dilated cardiomyopathy and ischemic cardiomyopathy as well. The abnormality of left ventricle (LV) conduction will lead to a change in LV contraction pattern resulting dyssynchronized with right ventricle) contraction. Thus, a dyssynchronous LV contractile pattern usually manifested by late activation of the LV lateral wall which in turn impairs LV systolic function, reduces cardiac output, raises filling pressure and worsens mitral regurgitation2. Cardiac resynchronization therapy (CRT) improves cardiac function and exercise capacity leading to an improved survival in patients with advanced heart failure and ventricular conduction delay.3 The underlying mechanisms of these beneficial effects are not fully understood, but they appear to be related to a restored coordination of the left (LV) and right ventricular (RV) contraction and relaxation.4 These effects may directly lead to augmented contractility and reduction of LV filling pressures.5 Echocardiography has been widely used to identify patients who are candidates for CRT and to monitor the response in LV function at follow-up after device implantation. This review addresses the applications of CRT in patients with moderate– severe heart failure and the role of echocardiography in optimizing CRT including patient selection, risk and benefit of CRT and appropriate measures.

Matched MeSH terms: Heart Failure; Heart Ventricles
The significance of atrial fibrillation in rheumatic mitral stenosis: an echocardiographic study

Singham KT, Ariffin M

Med J Malaysia, 1979 Dec;34(2):136-9.
PMID: 548714
Matched MeSH terms: Rheumatic Heart Disease/diagnosis*
Ischaemic heart disease

HARRIS CH

Med J Malaya, 1962 Sep;17:55-61.
PMID: 13952910
Matched MeSH terms: Heart Failure*
Echocardiography in the evaluation of mitral valve disorders

Singham KT

Med J Malaysia, 1979 Jun;33(4):307-10.
PMID: 522741
Matched MeSH terms: Rheumatic Heart Disease/diagnosis*
Epidemiology and short-term outcome of kawasaki disease in Malaysian children

Hung, Liang Choo

Malaysian Journal of Paediatrics and Child Health, 2007;15(1):28-32.
MyJurnal

Background: Kawasaki Disease (KD) and acute rheumatic fever are the two leading causes of acquired heart disease in children in the developing countries. Objectives: To determine the epidemiology of KD and its short-term outcome in Malaysian children. Materials & Methods: A retrospective study of patients with a diagnosis of KD at the Kuala Lumpur Hospital from January 1999 to December 2003. Results: 84 patients with KD were seen over the 5 year period. Of these, 52 (61.90%) were male and 32 (38.10%) female. Malays comprised 51 (60.71%), Chinese 30 (35.71%) and Indian 3 (3.57%). Their ages ranged from 2 months to 11 years 1 month old. There were 25 (29.76%) patients less than one year old, 50 (59.52%) aged 1-4 years, 4 (4.76%) aged 5-7 years and 5 (5.95%) were more than 7 years old. Echocardiographic examination during the acute phase showed that 24 patients (28.57%) had coronary artery dilatation; 23 had mild dilatation and one had giant aneurysm involving both coronary arteries. Echocardiographic examination at 8 weeks showed that 5 (21.74%) of the 23 patients with mildly dilated coronary arteries had resolved; the bilateral giant coronary aneurysms remained the same. There was no death due to KD over the 5 year period. Conclusion: KD occurred most commonly in children aged 1-4 years old with a peak at 17 months. There was male preponderance with a male to female ratio of 1.6:1. Despite immunoglobulin therapy, 29% of patients had coronary artery involvementduring the acute phase; 22% of those with mild coronary artery dilatation resolved at 8 weeks after disease onset.

Matched MeSH terms: Heart; Heart Diseases
Fulltext Maternal death and isolated left ventricular non-compaction cardiomyopathy

Razuin, R., Shahidan, M.N., Thanikasalam K.

International Medical Journal Malaysia, 2017;16(2):125-127.
MyJurnal

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy, which is
characterized by hypertrabeculations and deep recesses of the left ventricle. A patient could be
asymptomatic or presented with common manifestations, including reduced systolic function, arrhythmia,
thromboembolic events and heart failure. The rarity of the condition as well as lack of proper assessment
has probably led to this condition to be largely underdiagnosed or unrecognized. A 23-year-old lady had
collapsed at home thirty one days after delivering her first child. She had a history of goitre diagnosed a
year ago and noted to be fairly well throughout the pregnancy. Post mortem findings showed increased
trabeculations of the left ventricle. Further history was obtained after the procedure, revealing symptoms
such as syncopal attacks and bilateral lower limb weakness dated back as far as five years prior to her
sudden demise. These features were in keeping with hypotension hypoperfusion effects resulted from
reduced systolic function and decreased ejection fraction, as a result of left ventricular dysfunction. While
LVNC remains a rare type of disease, we would like to highlight the importance of a good anamnesis. It may
help to uncover some uncommon pathology such as this heart disease, thus warranting an appropriate
cardiac imaging to be engaged to clinch the primary diagnosis.

Matched MeSH terms: Heart Failure; Heart Ventricles
Fetal heart rate monitoring device using condenser microphone sensor: Validation and comparison to standard devices

Ahmad HAB, El-Badawy IM, Singh OP, Hisham RB, Malarvili MB

Technol Health Care, 2018;26(4):573-579.
PMID: 29758955 DOI: 10.3233/THC-171067

BACKGROUND: Fetal heart rate (FHR) monitoring device is highly demanded to assess the fetus health condition in home environments. Conventional standard devices such as ultrasonography and cardiotocography are expensive, bulky and uncomfortable and consequently not suitable for long-term monitoring. Herein, we report a device that can be used to measure fetal heart rate in clinical and home environments.
METHODS: The proposed device measures and displays the FHR on a screen liquid crystal display (LCD). The device consists of hardware that comprises condenser microphone sensor, signal conditioning, microcontroller and LCD, and software that involves the algorithm used for processing the conditioned fetal heart signal prior to FHR display. The device's performance is validated based on analysis of variance (ANOVA) test.
RESULTS: FHR data was recorded from 22 pregnant women during the 17th to 37th week of gestation using the developed device and two standard devices; AngelSounds and Electronic Stethoscope. The results show that F-value (1.5) is less than F𝑐𝑟𝑖𝑡, (3.1) and p-value (p> 0.05). Accordingly, there is no significant difference between the mean readings of the developed and existing devices. Hence, the developed device can be used for monitoring FHR in clinical and home environments.

Matched MeSH terms: Heart Rate, Fetal/physiology*
Stenting of Lesions in Patent Ductus Arteriosus with Duct-Dependent Pulmonary Blood Flow: Focus on Case Selection, Techniques and Outcome

Alwi M, Mood MC

Interv Cardiol Clin, 2013 Jan;2(1):93-113.
PMID: 28581990 DOI: 10.1016/j.iccl.2012.09.011

Stenting of patent ductus arteriosus (PDA) is an attractive alternative to the surgical aortopulmonary shunt in the palliation of cyanotic congenital heart disease. However, the diverse morphology of PDA in this setting limits its role, as stenting an overly tortuous duct may not be feasible, and in a significant number of patients, ductus-related pulmonary artery stenosis contraindicates this procedure. The major acute complications are stent migration, thrombosis, and cardiac failure. Early failure of palliation caused by in-stent stenosis is another limitation of this procedure.

Study site: Institut Jantung Negara (IJN), Kuala Lumpur, Malaysia

Matched MeSH terms: Heart Defects, Congenital; Heart Failure

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