European Journal of Cardiovascular Medicine

Background: There is still a lack of knowledge about the clinical relevance of electrocardiographic findings in patients following out-of-hospital cardiac arrest (OHCA). Methods: All victims of OHCA who were admitted to our hospital between January 1st 2008 and December 31st 2013 were identified and their QRS complexes were analyzed according to QRS duration and QRS morphology measured with the simplified Selvester Score. Results: A total of 147 out of 204 OHCA patients were included in our study, of which 76 received coronary angiography. The first 12-lead ECG showed a mean QRS duration of 108.0 ± 22.1 ms and 4.3 ± 3.5 points for the simplified Selvester Score. QRS complexes in patients following OHCA due to an initial shockable rhythm were significantly wider in patients who were discharged alive (114.0 ± 23.8 ms) than in patients who died in-hospital (98.9 ± 18.1 ms) (p=0.016), and patients who survived until the follow-up examination showed a significant reduction in the QRS duration (p=0.001), whereas the simplified Selvester Score showed no such changes. Subgroup analyses revealed that this reduction in QRS duration was most pronounced in patients with coronary artery disease (CAD) who received percutaneous coronary intervention (PCI). Conclusion: Neither QRS duration nor QRS morphology can reliably predict the prognosis of all patients following OHCA. However, as QRS durations decrease, especially in patients with CAD who receive PCI, it is possible that standardized QRS monitoring in patients following OHCA could be a useful tool in the monitoring of the hemodynamics of patients following OHCA.

Context: Central obesity, increased neck circumference are strong established risk factors of OSA. Familial aggregation is less explored potential risk factors. Aims: To compare sleep, metabolic parameters and risk of OSA in subjects with and without history of loud snoring in first degree blood relatives. Settings and Design: Cross-sectional tertiary hospital- based study Methods and Material: Overweight subjects (body mass index >25 kg/m2 aged 18-65 yrs were selected using systematic random sampling from attendants of patients attending Pulmonary Medicine OPD .On the basis of inclusion and exclusion criteria,380 subjects were enrolled, inquired about “Loud Snoring” in their first degree blood relatives and full night study, fasting serum lipid profile, plasma glucose level estimation was carried out after taking informed/written consent. Statistical analysis used: Statistical analysis was performed using SPSS 20. Student t test was applied for comparing mean values of various variables between two groups. Fisher test was applied for estimation of odd ratio (OR). Results: Neck circumference (p value .01), AHI value (p value .01) and fasting plasma glucose levels (p value .04) were found significantly higher in subjects with positive history of loud snoring in any first degree blood relative . Increased but insignificant risk (P value 0.15) of OSA (defined as AHI<5 ); OR 1.7 (range .8-3.6 with 95% CI) was observed in these subjects when compared on the basis of presence or absence of history of loud snoring in any first degree blood relative . Conclusion: This study gives us a new direction for determining potential role of family history in near relatives in progression and occurrence of OSA in an individual.