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50% of CHD cases occurred in pregnancies not associate with any (fetal or maternal) risk factor. The sensitivity, and specificity for prenatal CHD detection were 91.7% and 100% respectively.

Our study indicates that a substantial proportion of CHD cases occur in women not having high risk of giving birth to children with CHD. FE is a highly sensitive and specific test with strong predictive values. We recommend that FE should be done in every pregnancy.

Our study indicates that a substantial proportion of CHD cases occur in women not having high risk of giving birth to children with CHD. FE is a highly sensitive and specific test with strong predictive values. We recommend that FE should be done in every pregnancy.

Low-flow, low-gradient severe aortic stenosis (LFLGAS) is a common clinical entity and is associated with poor prognosis. Increased left ventricular (LV) afterload is one of the mechanisms contributing to low LV stroke volume index (SVi) in these patients. Aortic stiffness is an important determinant of LV afterload, but no previous study has evaluated its relationship with LVSVi in patients with AS.

Fifty-seven patients (mean age 66±8 years, 71.9% men) with severe AS [aortic valve area (AVA)<1.0cm

] undergoing aortic valve replacement (AVR) were included in this study. Echocardiographic parameters of AS were correlated with carotid-femoral pulse wave velocity (cfPWV), a measure of aortic stiffness, derived using PeriScope® device.

Mean AVA was 0.63±0.17cm

with mean and peak transvalvular gradient 56.5±18.8mmHg and 83.2±25.2mmHg, respectively. Nearly half (26 of 57, 45.6%) of the subjects had SVi <35mL/m

, indicative of low-flow severe AS. selleck chemicals These subjects had lower AVA, lower aortic valve gradient, and LV ejection fraction. CfPWV was numerically lower in these subjects [median 1467 (interquartile range 978, 2259) vs 1588 (1106, 2167)] but the difference was not statistically significant (p=0.66). However, when analyzed as a continuous variable, cfPWV had significant positive correlation with SVi (Pearson's r 0.268, p=0.048) and mean aortic valve gradient (Pearson's r 0.274, p=0.043).

In patients with severe AS undergoing AVR, aortic stiffness measured using cfPWV is not a determinant of low-flow state. Instead, an increasing cfPWV tends to be associated with increasing transvalvular flow and gradient in these patients.

In patients with severe AS undergoing AVR, aortic stiffness measured using cfPWV is not a determinant of low-flow state. Instead, an increasing cfPWV tends to be associated with increasing transvalvular flow and gradient in these patients.

We investigated the prevalence, awareness, treatment, control of hypertension and the factors associated with hypertension prevalence and control among school teachers in Kerala, India.

We surveyed 2216 school teachers in Thiruvananthapuram district of Kerala as part of the control of hypertension among teachers in schools in Kerala (CHATS-K), India. We used World Health Organization STEPS tools for non-communicable diseases risk factor surveillance. Blood pressure, weight and height were measured using standard protocols. Hypertension was defined as systolic blood pressure (SBP)≥140mmHg and/or diastolic blood pressure (DBP)≥90mmHg, or self-reported current antihypertensive medication. Controlled hypertension was defined as SBP<140 and DBP<90mmHg. Separate multivariate analysis was done for finding the associated factors with prevalence and control of hypertension.

Age adjusted hypertension prevalence was 14.6%. Men, those with self-reported diabetes, having family history of hypertension and overopulation in the state.

We examined the level of awareness about Rheumatic Heart Disease (RHD) among school-aged children in a rural district of India and evaluated the effects of a questionnaire-based survey in improving the level of awareness.

The study involved 8,646 students aged 10-16 years from 20 schools in West Midnapore, India which was conducted in August 2017. We examined changes in the level of awareness of RHD using a 29-point scoring system in seven domains. The baseline questionnaire survey assessed students' knowledge and was followed by a multimedia presentation about RHD and a post-intervention survey using the same questionnaire. The questionnaire included 9 questions on different aspects of RHD including prevalence, nature of disease, symptoms, determinants, treatment options, impact of the disease and diagnosis.

The mean age of the study population was 13 years and 46% were boys. At baseline, the mean level of knowledge about RHD was 42% (12.2 out of 29 points). After the school-based presentation, the score improved to a mean of 55% (15.9 points on the 29-point scale), a 31% relative improvement. Improvement in students' knowledge was noted across all seven domains, individually and combined (p<0.001).

Awareness among children in rural India about RHD is modest. A school-based intervention could help in improving awareness about this chronic condition and may promote secondary prophylaxis to reduce the morbidity and mortality from RHD.

Awareness among children in rural India about RHD is modest. A school-based intervention could help in improving awareness about this chronic condition and may promote secondary prophylaxis to reduce the morbidity and mortality from RHD.

We aimed to measure the change in prevalence of Coronary Heart Disease (CHD) and Cardiovascular Diseases (CVDs) risk among those aged 35-64 years in urban and rural areas of National Capital Region (NCR) of Delhi, between 1991-1994 (survey 1) and 2010-2012 (survey 2).

Both surveys used similar sampling methodology and mean ages of participants were similar. A total of 3048 and 2052 subjects were studied in urban Delhi and 2487 and 1917 participants recruited from rural Ballabgarh in survey 1 and in survey 2 respectively. CHD was diagnosed based on a Minnesota coded ECG and Rose angina questionnaire. Data on behavioural, physical, clinical and biochemical parameters were collected using standard methods. CVD Risk of participants was calculated using the gender specific Framingham risk equation.

The age and sex standardised prevalence of CHD in urban Delhi increased from 10.3% (95% CI 9.2-11.4) to 14.1% (95% CI 12.6-15.6) between the two surveys as compared to an increase from 6.0% (95% CI 5.0-6.9) to 7.4% (95% CI 6.