Han Naung Tun
University of Zurich, Switzerland, Cardiology, Department Member
Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area... more
Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area pacing (LBAP). The most significant advantage of HB pacing is that it can provide a regular, narrow QRS; however, the disadvantages are challenging implantation and a high risk of re-intervention due to lead dislodgement and the development of high pacing threshold. LBAP provides optimum physiological activation of the left ventricle by engaging the left bundle/fascicular fibers. LBAP is more physiological than traditional RV apical pacing and could be an attractive alternative to conventional cardiac resynchronization therapy (CRT). The advantages of LBAP are a relatively more straightforward implantation technique than HBP, better lead stability and pacing thresholds. HBP and LBAP are more physiological than right ventricular pacing and may be used ...
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Hypertension is one of the most common disorders encountered, yet pharmacotherapy for resistant hypertension has limited effective options. Aprocitentan is postulated to be a novel anti-hypertensive. The main goal was to determine the... more
Hypertension is one of the most common disorders encountered, yet pharmacotherapy for resistant hypertension has limited effective options. Aprocitentan is postulated to be a novel anti-hypertensive. The main goal was to determine the effect of aprocitentan on blood pressure among patients with hypertension. A thorough search of five electronic databases, including PubMed Central, PubMed, EMBASE, Springer, and Google Scholar, was carried out. The study included nine articles with a total of 2024 participants. With doses exceeding 25 mg, plasma ET-1(endothelin-1) concentrations, which show ETB (Endothelin receptor type B) receptor antagonism, significantly rose. Aprocitentan significantly reduced systolic and diastolic blood pressure with both doses of 10mg and 25mg in patients with hypertension. Further research is warranted to evaluate the efficacy, safety, and long-term outcomes of aprocitentan and its synergistic effect with other anti-hypertensives
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Right ventricular function is one of the important predictors of survival in heart failure patients. In the past, there has been only limited knowledge regarding right-sided heart failure when compared to left-sided failure. However,... more
Right ventricular function is one of the important predictors of survival in heart failure patients. In the past, there has been only limited knowledge regarding right-sided heart failure when compared to left-sided failure. However, there are more emerging data in recent years, and several studies have emphasized the unique features of the right ventricle regarding its anatomy, pathophysiology, clinical consequences, diagnostic modalities, and treatment options. Despite that, management of acute right ventricular failure is still challenging. This article summarizes an overview of acute right heart failure including pathophysiology, causes, clinical features, and diagnostic work-up with emphasis on the role of echocardiography
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Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area... more
Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area pacing (LBAP). The most significant advantage of HB pacing is that it can provide a regular, narrow QRS; however, the disadvantages are challenging implantation and a high risk of re-intervention due to lead dislodgement and the development of high pacing threshold. LBAP provides optimum physiological activation of the left ventricle by engaging the left bundle/fascicular fibers. LBAP is more physiological than traditional RV apical pacing and could be an attractive alternative to conventional cardiac resynchronization therapy (CRT). The advantages of LBAP are a relatively more straightforward implantation technique than HBP, better lead stability and pacing thresholds. HBP and LBAP are more physiological than right ventricular pacing and may be used instead of conventional pacemakers. Both HBP and LBBP are being investigated as alternatives to conventional CRT
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Introduction: Myocardial bridging (MB) is an inborn abnormality of coronary vessel. It occurs when a segment of a coronary artery or its major branch travels through the myocardium instead of on th...
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Contrast echocardiography Second generation contrast agents allows improved visualisation of the endocardium, which is useful in the assessment of: • LV systolic function in patients with poor endocardial border delineation • LV... more
Contrast echocardiography Second generation contrast agents allows improved visualisation of the endocardium, which is useful in the assessment of: • LV systolic function in patients with poor endocardial border delineation • LV pseudoaneurysms • Intracardiac masses They may also be used to facilitate the diagnosis of aortic dissection. Despite some earlier safety concerns regarding the use of contrast agents, recently published data revealed no increase in mortality in patients who underwent contrast-enhanced echocardiography examinations, including critically ill patients. Agitated saline may be useful to: • Differentiate between intracardiac and intrapulmonary shunting • Confirm correct placement of the cannula/drain during echocardiographic-guided pericardiocentesis Click here for a review of the use of contrast echocardiography in the intensive care, and here for the EACVI recommendations on the use of contrast echocardiography. Focused echocardiography Several focused echo pro...
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Introduction: There is alarming problem in increasing incidence of hypertension and its complications in Myanmar. The genetic background of hypertension is not known well in Myanmar population. The present study aimed to find out the... more
Introduction: There is alarming problem in increasing incidence of hypertension and its complications in Myanmar. The genetic background of hypertension is not known well in Myanmar population. The present study aimed to find out the association with angiotensinogen gene M235T polymorphism, plasma angiotensinogen level, BMI and essential hypertension in local area.
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Citation: Han Naung Tun. “Trends in Interventional Cardiology: What 2019 Left Promising Hopes in Interventional Cardiology Practice?”. EC Cardiology 7.3 (2020): 01-03. *Corresponding Author: Han Naung Tun, Council on Clinical Practice,... more
Citation: Han Naung Tun. “Trends in Interventional Cardiology: What 2019 Left Promising Hopes in Interventional Cardiology Practice?”. EC Cardiology 7.3 (2020): 01-03. *Corresponding Author: Han Naung Tun, Council on Clinical Practice, Clinical and Research Working Groups, European Society of Cardiology and National Representative of Heart Failure Specialist of Tomorrow for Myanmar in European Heart Failure Association, European Society of Cardiology, France.
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Ventricular septal rupture (VSR) definitive treatment, but it remains challenging and associated with high morbidity and mortality. We present a 58-year-old patient with AMI who developed VSR 72 h after primary revascularization, the... more
Ventricular septal rupture (VSR) definitive treatment, but it remains challenging and associated with high morbidity and mortality. We present a 58-year-old patient with AMI who developed VSR 72 h after primary revascularization, the patient was complicated by cardiogenic shock managed with mechanical circulatory support and an attempt at VSR closure was performed by percutaneous closure procedure under transoesophageal echocardiographic guidance. As the defect was extensive and large for percutaneous closure, the procedure failed and was aborted. The patient died of cardiogenic shock with severe acute pulmonary edema one week post PCI, while awaiting the surgical repair procedure.
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Background: No previous study has investigated the association between gamma glutamyltransferase (GGT) and vitamin D in patients with stable coronary artery disease (CAD). We investigated the cross-sectional associations between vitamin D... more
Background: No previous study has investigated the association between gamma glutamyltransferase (GGT) and vitamin D in patients with stable coronary artery disease (CAD). We investigated the cross-sectional associations between vitamin D status as assessed by serum 25(OH)D and GGT. Methods: 169 patients were enrolled. Study population was divided into three groups: 1: 25(OH)D < 10 ng/mL (n = 59); 2: 25(OH)D 10–20 ng/mL (n = 82), and 3: 25(OH)D > 20 ng/mL (n = 28). Based on a cut-off GGT value identified in ROC analysis, we also divided the study population to compare the following groups: GGT ≤19 (n = 66) and GGT >19 (n = 103). Results: GGT activity was the highest in vitamin D severely deficient patients and the lowest in vitamin D insufficient patients. GGT was inversely correlated with 25(OH)D concentrations (R = −0.23; p = 0.002). The receiver operating characteristics curve identified the discrimination threshold of GGT of >19 U/L in predicting vitamin D deficiency...
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Since the beginning of the COVID-19 pandemic, healthcare workers (HCWs) have been under immense physical and psychological stress as they face the pandemic sequelae of being the frontline workers. Unfortunately, mental health consequences... more
Since the beginning of the COVID-19 pandemic, healthcare workers (HCWs) have been under immense physical and psychological stress as they face the pandemic sequelae of being the frontline workers. Unfortunately, mental health consequences could affect HCWs during and even after the pandemic. Hence, we aimed through this survey to study the prevalence of anxiety among HCWs during the COVID-19 pandemic.
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THE European Society of Cardiology (ESC) Congress 2020 presented several promising clinical trials that may potentially change our practice in heart failure management. Among the trials and studies reported on, I am going to evaluate the... more
THE European Society of Cardiology (ESC) Congress 2020 presented several promising clinical trials that may potentially change our practice in heart failure management. Among the trials and studies reported on, I am going to evaluate the most important heart failure studies that may change our practice. What does the future look like for heart failure management?
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Bradycardia is commonly encountered in emergency department. Hyperkalemia may sometime cause bradycardia with block and also synergize with AV node blockers to cause bradycardia and hypoperfusion. We report a 53 years old male with... more
Bradycardia is commonly encountered in emergency department. Hyperkalemia may sometime cause bradycardia with block and also synergize with AV node blockers to cause bradycardia and hypoperfusion. We report a 53 years old male with history of hypertension, congestive heart failure and coronary artery disease was admitted to hospital for sudden onset of breathlessness. He underwent percutaneous coronary intervention (PCI) to left anterior descending (LAD) artery and left circumflex (LCx) artery one year ago and taking Aspilet 80 mg for daily, Clopidogrel 75 mg daily, Ramipril 5 mg daily, Atorvastatin 20 mg daily, Metoprolol 25 mg daily, Spironolactone 25 mg daily and Frusemide 40 mg daily. Significant physical examination was remarkable for a temperature 97.5'F, blood pressure of 110/70 mmHg, heart rate of 40 beats per minute, oxygen saturation was 99% on air and both lung were full with audible crepitation by auscultation. He was given atropine 0.6 mg bolus and transcutanaeous pacing with unimproved heart rate and then a transvenous pacing was immediately placed before the blood investigation results were returned. His relevant laboratory values were significant for a potassium of 7.99 mmol/L(ref range : 3.5-5.2 mmo/l) , creatinine of 458 micmol/L (ref range : 59-104 micmol/L) , Urea of 33.9 mmol/L (ref range : 2.7-8.0 mmol/l), random blood glucose of 233mg/dl , sodium 126.8 mmol/L (ref range 135-145 mmol/L) , anion gap of 13.5 mmol/? (ref range : 3.6-11.0 mmo/L) and bicarbonate of 15.6 mmil/L (ref range: 22-29 mmol/L). He was given calcium glucoronate , insulin with dextrose , kaexylate , nebulizer salbutamol with significant improvement in his potassium levels to 4.6 in 24 hours. In Cardiac intensive care unit his heart rate was improved and the transvenous pacemaker was turned off the next day.
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Background: Heart failure (HF) is one of the leading causes of hospitalization and readmission among older adults. Chronic heart failure (CHF) is the most common cause of readmission among patients in Pakistan and worldwide. Despite this... more
Background: Heart failure (HF) is one of the leading causes of hospitalization and readmission among older adults. Chronic heart failure (CHF) is the most common cause of readmission among patients in Pakistan and worldwide. Despite this recent attention to HF readmission, we know relatively little about its actual causes despite the fact that patients themselves can identify the underlying factors that contribute to their readmissions.
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Coronaviruses are a group of related viruses, cause respiratory tract infections in human that can be mild as common cold and can be lethal, such as SARS, MERS, and COVID-19. Coronavirus disease 2019 (COVID-19) is caused by severe acute... more
Coronaviruses are a group of related viruses, cause respiratory
tract infections in human that can be mild as common cold and can
be lethal, such as SARS, MERS, and COVID-19. Coronavirus disease
2019 (COVID-19) is caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2). The disease was first identified in November 2019 in Wuhan, the capital of China's Hubei province, and
has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic Worldwide, total numbers of cases have reached up to 1,188,486with recovered cases 244,280 and deaths 64,091. To begin with China was having the most diagnosed cases but currently USA is
leading by 302,919 and Spain following by 124,736. This data has
been changing dramatically everyday
tract infections in human that can be mild as common cold and can
be lethal, such as SARS, MERS, and COVID-19. Coronavirus disease
2019 (COVID-19) is caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2). The disease was first identified in November 2019 in Wuhan, the capital of China's Hubei province, and
has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic Worldwide, total numbers of cases have reached up to 1,188,486with recovered cases 244,280 and deaths 64,091. To begin with China was having the most diagnosed cases but currently USA is
leading by 302,919 and Spain following by 124,736. This data has
been changing dramatically everyday
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Persistent left superior vena cava (PLSVC) is the most common variation of anomalous venous return to the heart and present in 0.1–0.5% of the general population. The left anterior cardinal veins typically obliterate during... more
Persistent left superior vena cava (PLSVC) is the most common variation of anomalous venous return to the heart and present in 0.1–0.5% of the general population. The left anterior cardinal veins typically obliterate during early cardiac development but failure of involution results in PLSVC. It is an asymptomatic congenital anomaly, usually discovered while performing interventions through the left subclavian vein or during cardiovascular imaging. PLSVC can be associated with cardiac arrhythmias and congenital heart disease. We present two cases of PLSVC: first, a 68-year-old male who presented with complete heart block, for which a temporary pacemaker was initially inserted followed by a permanent pacemaker; second, a 53-year-old female with a history of hypertension and ischemic cardiomyopathy with a left ventricular ejection fraction of 25%, and a survivor of sudden cardiac death, who underwent an implantable cardioverter-defibrillator (ICD) for secondary prevention.Both cases of PLSVC were detected incidentally during the transvenous approach to the heart. PLSVC was suspected by the unusually left medial position of the lead, while cineflouroscopy showed the venous trajectory toward the coronary sinus and drainage into the right atrium. It is technically difficult to cross the wire through the tricuspid valve when coming from the PLSVC and coronary sinus without making a loop in the right atrium, which is known as a wide loop technique.PLSVC is an uncommon anomalous anatomical variant and should be recognized appropriately by specialists who frequently carry out procedures through the left subclavian vein, such as implantation of permanent pacemaker, ICD and cardiac resynchronization therapy. It should also be recognized that wide loop formation of the right ventricular lead in the right atrium is helpful to cross the tricuspid valve and to affix the lead in the right ventricle
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In the end of last decade, 2019 left us with some promising trials that potentially may change our interventional practice. Among the numbers of trials and studies were published in 2019, I am going to cull some interesting clinical... more
In the end of last decade, 2019 left us with some promising trials that potentially may change our interventional practice. Among the numbers of trials and studies were published in 2019, I am going to cull some interesting clinical trials that may have changed our practice. What was ahead in 2019 for interventional cardiovascular medicine? They are modifying use of antiplatelet in acute coronary syndrome (ACS) and other conditions; new paradigms in the management of revascularization strategy; increased use of transcatheter aortic valve replacement (TAVR) and emerging of new generation stents and its effective outcomes. Revascularization in acute coronary syndrome (ACS) In patients with ST-segment elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI) of the culprit lesion reduces the risk of cardiovascular death or myocardial infarction. COMPLETE (Complete Revascularization with Multivessel PCI for Myo-cardial Infarction) Trial funded by the Canadian Institutes of Health Research has given interesting results that may change our practice in revascularization of coronary arteries. The COMPLETE trial was presented at European Society of Cardiology (ESC) Congress 2019 and studied patients presented with STEMI and multivessel disease. The study was concluded that among patients with STEMI and multives-sel coronary artery disease, complete revascularization was superior to culprit-lesion-only PCI in reducing the risk of cardiovascular death or myocardial infarction, as well as the risk of cardiovascular death, myocardial infarction, or ischemia-driven revascularization [1]. Antiplatelet therapy Another interesting trial that was conducted in Acute Coronary Syndrome (ACS) is ISAR-REACT 5 (The Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 5) trial. German Center for Cardiovascular Research and Deutsches Herzzentrum München supported this phase 4, multicenter, randomized, open-label trial was conducted in patients who presented with acute coronary syndromes with or without ST-segment elevation. The trial has given hope for patients who presented with acute coronary syndromes with or without ST-segment elevation, the incidence of death, myocardial infarction, or stroke was significantly lower among those who received prasugrel than among those who received ticagrelor and the incidence of major bleeding was not significantly different between the two groups [2]. When it comes to dual antiplatelet therapy (DAPT), Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention (TWILIGHT) study was one of the biggest highlights. In this double-blind trial, the trialists examined the effect of ticagrelor alone as compared with ticagrelor plus aspirin with regard to clinically relevant bleeding among patients who were at high risk for bleeding
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Temporary cardiac pacing via trans-venous approach is a treatment technique of choice in case of life threatening arrhythmias. This approach is used to re-establish the hemodynamics that are acutely compromised by a fast or slow heart... more
Temporary cardiac pacing via trans-venous approach is a treatment technique of choice in case of life threatening arrhythmias. This approach is used to re-establish the hemodynamics that are acutely compromised by a fast or slow heart rate. Inadvertent lead placement into abnormal locations is an uncommon but serious complication of temporary cardiac pacing in emergency departments. These can easily be detected and managed, even in emergencies, with the help of readily available modalities including 12-lead ECG and chest x-rays, as well as transthoracic echocardiography. Here, we report 2 cases of mal-placement of temporary pacing lead and their timely management to highlight the significance of simple yet necessary post procedure investigation techniques.
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Introduction: An abnormal ankle-brachial index (ABI) is associated with higher risk for future cardio-vascular (CV) events; however, it is unknown whether this association is true in patients with associated diabetes mellitus (DM).
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Background: Acute Coronary Syndrome describes a spectrum of disease ranging from unstable angina through non-ST-Elevation Myocardial Infarction (NSTEMI) to ST-Elevation Myocardial Infarction (STEMI). Early death in NSTEMI is usually due... more
Background: Acute Coronary Syndrome describes a spectrum of disease ranging from unstable angina through non-ST-Elevation Myocardial Infarction (NSTEMI) to ST-Elevation Myocardial Infarction (STEMI). Early death in NSTEMI is usually due to an arrhythmia. Patients should be admitted immediately to hospital, preferably to a cardiac care unit because there is a significant risk of death.
Objective: To compare the diagnostic accuracy of TIMI versus GRACE for prediction of death in patients presenting with Acute Non-ST elevation Myocardial Infarction.
Material & Methods: This present cross sectional study was conducted at Department of Cardiology, CPEIC, Multan. All patients assessed according to given scores in the two scoring system i.e. TIMI risk score and GRACE score. Then patients were labeled as high or low risk for death. Data was collected by using pre-designed proforma. 2x2 tables were generated to measure the sensitivity, specificity, positive predictive value, negative Predictive value and diagnostic accuracy of TMI Risk score and GRACE Score for prediction of death in NSTEMI patients.
Results: In our study the mean age of the patients was 55.73±9.78 years. The male to female ratio of the patients was 1.6:1. The diabetes as risk factor was found in 145(39%) patients, smoking as risk factor was found in 53(14.2%) patients and hypertension as risk factor was found in 174(46.8%) patients. the sensitivity of TIMI risk was 97.7% with specificity of 92.93% and the diagnostic accuracy was 95.16%, similarly the sensitivity of GRACE risk was 100% with specificity of 95.96% and the diagnostic accuracy was 97.85%.
Conclusion: Our study results concluded that both the TIMI risk and GRACE risk are good predictor of death in patients presenting with Acute Non-ST elevation Myocardial Infarction with higher sensitivity and diagnostic accuracy. However the GRACE risk showed more accurate results as compared to TIMI risk.
Objective: To compare the diagnostic accuracy of TIMI versus GRACE for prediction of death in patients presenting with Acute Non-ST elevation Myocardial Infarction.
Material & Methods: This present cross sectional study was conducted at Department of Cardiology, CPEIC, Multan. All patients assessed according to given scores in the two scoring system i.e. TIMI risk score and GRACE score. Then patients were labeled as high or low risk for death. Data was collected by using pre-designed proforma. 2x2 tables were generated to measure the sensitivity, specificity, positive predictive value, negative Predictive value and diagnostic accuracy of TMI Risk score and GRACE Score for prediction of death in NSTEMI patients.
Results: In our study the mean age of the patients was 55.73±9.78 years. The male to female ratio of the patients was 1.6:1. The diabetes as risk factor was found in 145(39%) patients, smoking as risk factor was found in 53(14.2%) patients and hypertension as risk factor was found in 174(46.8%) patients. the sensitivity of TIMI risk was 97.7% with specificity of 92.93% and the diagnostic accuracy was 95.16%, similarly the sensitivity of GRACE risk was 100% with specificity of 95.96% and the diagnostic accuracy was 97.85%.
Conclusion: Our study results concluded that both the TIMI risk and GRACE risk are good predictor of death in patients presenting with Acute Non-ST elevation Myocardial Infarction with higher sensitivity and diagnostic accuracy. However the GRACE risk showed more accurate results as compared to TIMI risk.
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Infective endocarditis is the most common cause of heart infections. The epidemiology, pathophysiology, clinical presentation, diagnosis, management and prevention have evolved in the past several years due to the increasingly-recognized... more
Infective endocarditis is the most common cause of heart infections. The epidemiology, pathophysiology, clinical presentation, diagnosis, management and prevention have evolved in the past several years due to the increasingly-recognized healthcare associated infective endocarditis and advancements in cardiac devices. Prevention of infective endocarditis has been an important issue for the cardiovascular societies across the world, leading to updates in the guidelines of infective endocarditis prevention. The effective use of antibiotics prophylaxis in IE is still been a challenge as there is a threat of antibiotic resistance by widespread use of antibiotics , an important issue today, as well as needlessly exposing patients to antibiotic side effects. In this article, we are discussing the medical literature on infective endocarditis, mainly addressing its burden, the evolving causative microorganisms and endocarditis prevention guidelines.
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Cardiovascular disease (CVD) is one of the most global threatened diseases; particularly coronary artery disease (CAD) is a major deadly attack around the world. Diabetes mellitus (DM) is associated with a 2 to 4-fold increased mortality... more
Cardiovascular disease (CVD) is one of the most global threatened diseases; particularly coronary artery disease (CAD) is a major deadly attack around the world. Diabetes mellitus (DM) is associated with a 2 to 4-fold increased mortality risk from heart disease. Diabetes related microvascular complication is seemed to be a hazardous factor for cardiovascular system and likely to cause coronary arteries disease, hypertension, peripheral arteries, and carotid vessels, especially seen in the type 2 DM populations. The severity of cardiovascular complications are related to prolong hyperglycemia and the control of dysglycemia. Thus, effective glycemic control is one of the imperative aspects of the management for the prevention of CVD in diabetes. In addition, different kinds of antidiabetes agents have different mechanism of actions that has impacted to cardiovascular outcome. The benefi t and risk of current anti-diabetic agents are needed to defi ne clearly and that is needed to promote effective clinical care between cardiology and diabetology. There are multiple complications and sequelae of diabetes that requires the involvement of cardiologic expertise in the diabetes care setting in heart disease population. Therefore, the close cooperation between the cardiologist and the diabetologist is new perceptive way of care to defeat diabetes related cardiovascular complications.
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Heart failure (HF) is a complex clinical syndrome and it is one of the common cardiovascular complication seen in diabetes mellitus (DM). The coexistence of heart failure and diabetes is not rare and affects vice versa between severity... more
Heart failure (HF) is a complex clinical syndrome and it is one of the common cardiovascular complication seen in diabetes mellitus (DM). The coexistence of heart failure and diabetes is not rare and affects vice versa between severity of Diabetes and Heart Failure in complex pathophysiology. The management of diabetes in heart failure patients is carefully tackled in clinical setting due to different adverse reaction of oral hypoglycemic agents that may affect and worsen the condition of heart failure. So, the selection of the use of effective oral hypoglycemic agents in heart failure especially in patients with heart failure reduced ejection fraction (HFrEF) is very important to control the cardio-endocrinological benefit. Metformin is a biguanide class of antidiabetic medications, was first described in the scientific literature in 1922, as a product in the synthesis of N,N-dimethyl guanidine. Generally, the suppressive action of metformin on liver glucose production (hepatic gluconeogenesis) decreases blood glucose level. Recent multicenter observational studies show metformin is associated with lower mortality rate and reduced the hospitalization in heart failure. This article focuses the metabolic disturbances of Type 2 DM in heart failure and the safely usefulness metformin of in Type 2 diabetes with heart failure.
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Cardiovascular disease is the number one killer of death around the world. Most of the cardiovascular diseases are caused by sedentary life style, bad eating habit, tobacco smoking, high alcohol intake, dyslipidemia and genetic factors... more
Cardiovascular disease is the number one killer of death around the world. Most of the cardiovascular diseases are caused by sedentary life style, bad eating habit, tobacco smoking, high alcohol intake, dyslipidemia and genetic factors .Recently the idea of human microbiome science has emerged in diseases pathogenesis .The human gut is a house of trillions of microbial fl oral. Since a couple of decades ago, there has been interesting insights into the human gut microbiota and have highlighted its increasingly association to cardiovascular (CV) and metabolic diseases. Trimethylamine N-oxide (TMAO), which is a metabolic product from gut microbiota plays a central role in cardiovascular disease pathogenesis. Nature of microbial inhabitants within the host has been noticed by the numbers of scientists and researchers to understand more about the hidden mechanism of diseases pathogenesis including cardiovascular disease, metabolic and autoimmune diseases and it has become a good hope to develop new drug designs to prevent metabolic and cardiovascular disease in near future.
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Citation: Han Naung Tun. " Severe Hypokalemia with Premature Ventricular Contraction ". EC Cardiology 5.4 (2018): 224-228. Abstract Electrolytes imbalance caused by potassium disorders are commonly seen in many clinical conditions due to... more
Citation: Han Naung Tun. " Severe Hypokalemia with Premature Ventricular Contraction ". EC Cardiology 5.4 (2018): 224-228. Abstract Electrolytes imbalance caused by potassium disorders are commonly seen in many clinical conditions due to alterations in potassium intake, changes in excretion or transcellular shifts. Hypokalemia is a common electrolyte disorder in clinical practice and that can lead to serious arrhythmias. Most of the arrhythmias caused by electrolytes imbalance can be usually noticed by electrocardio-gram changes. Despite the underlying causes of arrhythmia can be predicted by history taking from patients and ECG changes, sometime it can be missed to provide optimal care and effective medication in time. Thus, physicians and health care providers should be familiar with ECG changes and of electrocardiogram manifestations about electrolyte imbalance in clinical care. Typically, the first ECG manifestation of hypokalemia is decreased T-wave amplitude but arrhythmias associated with hypokalemia include sinus brady-cardia, premature ventricular contractions, ventricular tachycardia, or fibrillation, and torsade de pointes can lead to life threatening condition. The present case report article shows the association between the premature ventricular contraction and severe hypoka-lemia caused by electrolyte imbalance due to chronic diarrhea.