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Closure of the shunt resulted in normalization of the pulmonary artery pressures in 4/5 patients.

Congenital portosystemic malformations form an important and potentially treatable cause of pulmonary hypertension.

Congenital portosystemic malformations form an important and potentially treatable cause of pulmonary hypertension.

Coronavirus disease 2019 (COVID-19) has been reported to cause worse outcomes in patients with underlying cardiovascular disease, especially in patients with acute cardiac injury, which is determined by elevated levels of high-sensitivity troponin. There is a paucity of data on the impact of congestive heart failure (CHF) on outcomes in COVID-19 patients.

We conducted a literature search of PubMed/Medline, EMBASE, and Google Scholar databases from 11/1/2019 till 06/07/2020, and identified all relevant studies reporting cardiovascular comorbidities, cardiac biomarkers, disease severity, and survival. Pooled data from the selected studies was used for metanalysis to identify the impact of risk factors and cardiac biomarker elevation on disease severity and/or mortality.

We collected pooled data on 5967 COVID-19 patients from 20 individual studies. We found that both non-survivors and those with severe disease had an increased risk of acute cardiac injury and cardiac arrhythmias, our pooled relative risk (RR) was - 8.52 (95% CI 3.63-19.98) (p<0.001); and 3.61 (95% CI 2.03-6.43) (p=0.001), respectively. Mean difference in the levels of Troponin-I, CK-MB, and NT-proBNP was higher in deceased and severely infected patients. Cathepsin Inhibitor 1 The RR of in-hospital mortality was 2.35 (95% CI 1.18-4.70) (p=0.022) and 1.52 (95% CI 1.12-2.05) (p=0.008) among patients who had pre-existing CHF and hypertension, respectively.

Cardiac involvement in COVID-19 infection appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF, and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes.

Cardiac involvement in COVID-19 infection appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF, and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes.

Left atrial (LA) and left ventricular (LV) remodelling are the adaptive changes that occur in primary mitral regurgitation (MR) and are related to its clinical outcomes. Despite the pathophysiological differences in MR in rheumatic heart disease (RHD) and mitral valve prolapse (MVP), whether the pattern of LV and LA remodelling is different between the two conditions remains unknown. Hence, we compared the LA and LV strain pattern in MR due to RHD, the predominant etiology in developing countries topatients with MVP and age and sex-matched controls.

A total of 50 patients of severe MR which included 30 MVP MR and 20 RHD MR were assessed by strain imaging by speckle tracking echocardiography (STE) and were compared with age and sex-matched controls. 2D STE was used for LA and 3D STE was used for LV strain analysis. LA and LV strain parameters were compared between MVP MR and RHD MR groups.

30 patients with MVP and 20 with RHD were studied. 60% (n=30) were symptomatic. Mean GLS was-17.2±4.4% compared to-2 with large multicentric studies. The current strain parameters from MVP with the prognostic value may be applied to MR of RHD etiology, pending confirmation of our results by other groups.

Various studies have shown racial differences in adult cardiac chamber measurements by echocardiography. There is lack of any large scale data from India regarding the echocardiographic chamber measurements in cardiologically healthy individuals. In this study we present the normal reference values of echocardiographic chamber dimensions in young eastern Indian adults and compare it with the data in present guidelines and recent studies involving Indian subjects.

This study was performed on 1377 healthy adults aged 18-35 years. Standard transthoracic echocardiographies were performed to obtain basic measurements. All measurements were indexed to body surface area.

The mean maximal aortic valve cusp separation (ACS) and indexed ACS were significantly more in females (p=0.002, p=0.03). Mean left ventricular (LV) ejection fraction (LVEF) and LV fractional shortening were marginally higher in females. Upper normal reference limit of LV end diastolic dimension (LVEdD) is slightly more for males. Comparing to ASE data, LVEdD, LV end systolic dimension, LV end diastolic volume, indexed LV end systolic volume, left atrial anteroposterior dimension, aortic root dimension and right ventricle outflow diameter were significantly lower in study population while LVEF was significantly higher (p<0.0001).

The study reconfirms that Indian subjects have smaller cardiac chamber measurements compared to western population where as LVEF is higher in the Indian population and also demonstrates the wide variation of normal echocardiographic measurements within Indian subcontinent. No previous data from eastern India makes this research a singular experience.

The study reconfirms that Indian subjects have smaller cardiac chamber measurements compared to western population where as LVEF is higher in the Indian population and also demonstrates the wide variation of normal echocardiographic measurements within Indian subcontinent. No previous data from eastern India makes this research a singular experience.

HCQ is a commonly recommended drug for the prophylaxis of COVID-19. One of its rare side-effect includes QTc prolongation.

This was a prospective, cross sectional and observational study conducted on Hydroxychloroquine (HCQ) among Healthcare Workers (HCWs) at Max Super Speciality Hospital, Saket, New Delhi, India. A 3-lead ECG (only limb leads, it does not require chest leads) was performed. The QTc cut offs were pre decided, QTC<470ms for males and <480ms for females was considered within the normal limits and anything above this was regarded as QTc prolongation.

There were 274 HCWs enrolled into the study, including 175 males and 99 females. Majority of the HCWs were young and had a mean age of 32.19±9.29 years. Out of these, 218 were taking HCQ as per the Indian Council of Medical Research (ICMR) guidelines. The median cumulative dose being taken was 1600mg and the median QTc of these participants was 390ms in males and 391.5ms in females. Subsequently, 33 participants were followed-up and found to have a median QTc of 389ms and a cumulative dose of HCQ as 2000mg.

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