Desaibradley3286

Right atrial volume/Left atrial volume (RAV/LAV) ratio is a good hemodynamic parameter in acute pulmonary thromboembolism (PTE), whose prognostic ability by 2D echocardiography is not studied to date. We conducted a 27 month, prospective observational study on 55 eligible acute PTE thrombolysed (29 Tenecteplase; 26 Streptokinase) patients. The primary endpoint was a composite of in-hospital death and poor right ventricular reverse remodelling at the time of discharge. The incidence of primary end-point and death were 40% and 7.2% respectively. On regression analysis, RAV/LAV ratio was the only predictor of the primary endpoint, with an optimal cut-off of 3.8 (accuracy 75%).Using radiofrequency energy for closure of the patent ductus arteriosus (PDA) has been reported by us previously. In this article we report the early and late outcome of the first group in whom patent ductus arteriosus has been occluded with radiofrequency. Six children with PDA were enrolled. The procedure was successful in five cases and transient hoarseness was observed in 2 cases as the only complication.We investigated the diagnostic utility and safety of intracoronary bolus administration of nicorandil compared with intravenous administration of adenosine for evaluating FFR in patients with intermediate (40-70%) coronary stenosis. The FFR values obtained with nicorandil and adenosine showed linear relationship. This correlation is statistically significant with regression coefficient of 0.932 (R2 = 0.834, p less then 0.001). The side effects such as bronchospasm, hypotension, and bradycardia were significantly higher after administration of adenosine compared to nicorandil (20% vs. 1.66%, p = 0.001). Intracoronary use of nicorandil seems to be promising in offering the advantages of lesser side effects, similar efficacy, and lesser cost as compared to adenosine.Few studies from various countries have reported decline in Acute Coronary Syndrome (ACS) admissions to hospital during COVID-19 pandemic. We studied the impact of COVID-19 strict lockdown on ACS admission in a tertiary referral hospital in India. This showed 43% decline in admissions (n = 104 vs mean n = 183) and even in those who got admitted, there was a delay in presentation compared to previous year, which was reflected in the outcome of patients. Government and health organizations should educate the public early-on during the pandemic about the consequences of ignoring other acute medical problems such as ACS.

Coronavirus disease 2019 (COVID-19) has led to a widespread morbidity and mortality. Limited data exists regarding the involvement of cardiovascular system in COVID-19 patients. We sought to evaluate the cardiovascular (CV) complications and its impact on outcomes in symptomatic COVID-19 patients.

This was a single center observational study among symptomatic COVID-19 patients. Data regarding clinical profile, laboratory investigations, CV complications, treatment and outcomes were collected. Cardiac biomarkers and 12 lead electrocardiograms were done in all while echocardiography was done in those with clinical indications for the same. Corrected QT-interval (QTc) at baseline and maximum value during hospitalization were computed.

Of the 108 patients, majority of them were males with a mean age of 51.2±17.7 years. Hypertension (38%) and diabetes (32.4%) were most prevalent co-morbidities. ECG findings included sinus tachycardia in 18 (16.9%), first degree AV block in 5 (4.6%), VT/VF in 2 (1.8%) and sinus bradycardia in one (0.9%). QTc prolongation was observed in 17.6% subjects. CV complications included acute cardiac injury in 25.9%, heart failure, cardiogenic shock and acute coronary syndrome in 3.7% each, "probable" myocarditis in 2.8% patients. Patients with acute cardiac injury had higher mortality than those without (16/28 [57.1%] vs 14/78 [17.5%]; P<0.0001). Multivariate logistic regression analysis showed that acute cardiac injury (OR 11.3), lymphopenia (OR 4.91), use of inotropic agents (OR 2.46) and neutrophil-lymphocyte ratio (OR1.1) were independent predictors of mortality.

CV complications such as acute cardiac injury is common in COVID-19 patients and is associated with worse prognosis.

CV complications such as acute cardiac injury is common in COVID-19 patients and is associated with worse prognosis.

To estimate the incidence of major adverse cardiovascular events (MACE) with genotype test-guided antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome.

Patients who had undergone PCI for acute coronary syndrome as well as stable coronary artery disease were recruited. Salivary samples were obtained from these patients and genotyped for CYP2C19∗2, CYP2C19∗3 variations by sequencing method (GAAP x method). Patients were categorized as normal (GG, GG) (29%), intermediate (AG) (52%) or poor metabolizes (homozygous variant AA) (19%). Dual antiplatelets were given based on the genotyping data. Poor metabolizes received newer agent (ticagrelor), intermediate metabolizes received double-dose of clopidogrel and normal metabolizes received therapeutic doses of clopidogrel. All subjects were followed-up for six months.

Based on the genotyping data of CYP2C19∗2 and CYP2C19∗3 variations, it was found that most patients were categorized as 'intermediate' (78, 51.65%), followed by 'normal' (43, 28.48%) and 'poor' metabolizes (30, 19.87%). Only 3 (1.5%) of 151 patients reported MACE at follow-up.

Genotyping for CYP2C19 variations to assess clopidogrel resistance in patients undergoing PCI and subsequent drug selection helps reduce MACE after coronary intervention.

Genotyping for CYP2C19 variations to assess clopidogrel resistance in patients undergoing PCI and subsequent drug selection helps reduce MACE after coronary intervention.

Metabolic Syndrome (MetS) is a strong predictor of Coronary Heart Disease (CHD). Studies in urban India have found about one-third of Indians suffer from MetS. Less is known about the prevalence of MetS in rural areas, where 70% of the population reside. This study examined the prevalence of Metabolic Syndrome in a population of rural women in India.

Data were gathered in a community-based study of 500 rural and tribal women residing in the Mysore district, between the age of 30-59 years. The study used the WHO STEPS approach, in which information on demographics and behavioral risk factors were collected. Along with anthropometric measurements, blood pressure, blood glucose, lipids were measured. A harmonized definition of MetS recommended by International Diabetes Federation Task Force on Epidemiology and Prevention was used in this study.

Three out of five study participants were found to have MetS (47.1%, n=223). Of those, 56.5% met 3 of the 5 criteria, 32.2% met 4 criteria, and 11.2% metall 5 criteria. Among the entire sample, low HDL was the most prevalent criterion (88.4%), followed by elevated glucose (57.9%), elevated triglycerides (49.3%), elevated BP (41.5%), and increased waist circumference (15.3%). In this sample, women with METS were generally older (p<0.001), housewives (p=0.001), that consumed salty highly processed foods (p=0.020) and had low physical activity (p=0.015).

This study showed a high prevalence of MetS in rural women. There is a compelling need for interventions aimed at reducing CHD risk factors in this population.

This study showed a high prevalence of MetS in rural women. There is a compelling need for interventions aimed at reducing CHD risk factors in this population.There is sparse Indian data on whether fetal echocardiography among pregnant diabetics would be useful to predict adverse perinatal/neonatal outcome.

To study fetal cardiac changes in diabetic mothers and non-diabetic controls from 24 weeks gestation until the neonatal period; correlate them with maternal glycemic control; study their implications on adverse perinatal/neonatal outcome.

Prospective observational cohort study. Pregnant diabetics (17 overt, 66 gestational) recruited beyond 24 weeks, divided as well (39) and poorly (44) controlled, based on American Diabetes Association 2016 criteria. Controls were 102 healthy non-diabetic pregnancies. Fetal echocardiography performed at weeks 24-32, 32-36, >37, and between 4 and 7 days on neonates. The thickness of Interventricular septum (IVS), Right Ventricle (RV), and Left ventricle (LV) assessed with M mode. E/A ratio across Tricuspid/Mitral valves and Tei index determined. TDI(Tissue Doppler imaging) used to assess tissue annular velocities across IVSrdial hypertrophy and some of the adverse perinatal events including hypoglycemia. ARRY-575 mouse However these newborns were not found to have clinically relevant cardiac comorbidities even though there was significant septal hypertrophy in utero.

Our study shows a significant association between fetal myocardial hypertrophy and maternal glycemic control among GDM pregnancies. There also seems to be an association between fetal myocardial hypertrophy and some of the adverse perinatal events including hypoglycemia. However these newborns were not found to have clinically relevant cardiac comorbidities even though there was significant septal hypertrophy in utero.

To report mid-term follow-up result of transcatheter closure of perimembranous Ventricular septal defect (VSD) in children weighing less than 10kg using Amplatzer Duct Occlude-I (ADO-I) by left ventricular (LV) mid-cavity approach.

This is retrospective review of 35 children weighing less than 10kg with moderate to large perimembranous VSD who were selected for transcatheter closure of VSD using ADO-I in between October 2016 to September 2018. Mean age was 2.08±0.67 years (mean±SD) and mean weight was 7.2±1.2kg (mean±SD). Procedure was done by crossing the VSD from right ventricular side instead of using the standard approach by forming arterio-venous loop. Average fluoroscopic time was 9.2±2.9min (mean±SD) and mean procedure time was 34.1±13.1min (mean±SD). Mean follow-up period was 8.7 months (3-12 months) RESULT Device closure was successfully done in 32 patients. There was device induced aortic regurgitation (AR) in one case who was sent for surgery. One child was found to have complete heart block on first post-procedure day requiring permanent pace-maker implantation. During follow up none of them had any residual VSD, rhythm disturbance, AR and left or right ventricular outflow obstruction.

Device closure can be successfully done in moderate to large perimembranous VSD using left ventricular mid cavity approach in small children. LV mid-cavity approach has advantages in terms of lesser hemodynamic instability, lesser fluoroscopy and lesser chance of device induced AR than standard technique particularly in smaller children.

Device closure can be successfully done in moderate to large perimembranous VSD using left ventricular mid cavity approach in small children. LV mid-cavity approach has advantages in terms of lesser hemodynamic instability, lesser fluoroscopy and lesser chance of device induced AR than standard technique particularly in smaller children.

Ventricular tachycardia (VT) is a major cause of morbidity in patients with cardiomyopathy. Radiofrequency ablation has emerged as the mainstay of the management of recurrent sustained VT in these patients. We describe the clinical characteristics, procedural and medium term outcomes of patients undergoing ablation of scar VT in a tertiary care center in India.

This was a single-center descriptive cohort study. All patients who underwent ablation for scar related VT were included. Endpoints were immediate procedural success, procedural complications and recurrence during follow up.

A total of 72 patients with scar VT underwent ablation with electroanatomic mapping. Previous myocardial infarction (MI) was the commonest etiology (69.4%) with arrhythmogenic right ventricular cardiomyopathy (ARVC) being the next common (19.4%). Acute procedural success was achieved in 69.4% patients, partial success in 9.7% and failure in 1 patient (1.4%). Outcome was labeled indeterminate in 19.4% who did not undergo post ablation VT induction.