Cardiovascular Diseases & Diagnosis

The dilated cardiomyopathy (DCM) is a myocardial disease characterized by a dilated left ventricle (LV) and an impaired systolic function of the left ventricle. Most common secondary DCM is ischemic, but severe uncorrected valvulopathies also can lead to the enlargement of LV due to volume or pressure overload. In almost half of DCM patients, the etiology remains unknown. The dilated cardiomyopathy will lead to a progressive, irreversible heart failure, despite the big progressions made in both medical treatment and heart assisting devices. Atrial fibrillation (AF) is a commonly seen arrhythmia in patients with dilated cardiomyopathy, due to the structural modifications of left atrial myocytes.

The objective of this study is to observe the impact of the association between dilated cardiomyopathy and atrial fibrillation on the severity of heart failure. For this purpose, 139 patients were taken into observation, from the moment of their emergency hospitalization for heart failure, and were followed for a year. At baseline, 64 patients (46.04%) had permanent atrial fibrillation, and the rest of 75 (53.96%) were in sinus rhythm. From all patients, 70.5% (98) were men, the incidence of DCM being greater in men than women. Patients with AF were older, required prolonged hospitalization, had Lower Left Ventricle Ejection Fraction (LVEF), greater New York Heart Association (NYHA) class and more frequently associated right ventricle disfunction (RV).

Background: This study aimed to examine the effect of prolonged fasting on symptoms and major adverse cardiac events (MACE) in patients with percutaneous coronary intervention (PCI) more than 1 year.

Methods: Patients with history of PCI more than 1 year were selected in this study. Patients were instructed how to divide their medication across two meals. We asked patients to immediately stop prospective cohort fasting and contact the clinic if they experienced any signs of cardiovascular disease, including shortness of breath, chest pain, or palpitations. At the end of Ramadan, patients were contacted by telephone and asked about their symptoms, and MACE.

Results: 405 patients were enrolled. There were no significant differences in baseline characteristics between the fasting and non-fasting group. No MACE was reported in either group. In the fasting group, 7 patients (3.4%) stopped fasting during Ramadan due to dyspnea, chest pain, or combined dyspnea and chest pain. In the non-fasting group, 5 patients (2.5%) reported dyspnea, chest pain, or combined dyspnea and chest pain (p=0.581). Patients in fasting group developed more changes in BP (increase or decrease), compare to no fasting group (P=0.04), but changes were not that significant to make patients seek any medical assistances.

Conclusion: In patients with a history of PCI more than 1 year, fasting was not associated with acute health risks. Patient education can play an important role in reducing the risks. (clinicaltrial.gov: NCT04772924, 26/02/2021)