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05). However, there was no significant difference in ghrelin levels among the 3 groups. This data may suggest that the presence of unstable CAD may be associated with lower serum apelin which may indicate the potential role of this peptide in the progression and destabilization of coronary plaques.The goal of this study is to portray an initial experience with the efficacy, safety, and, acceptance of ARNI in ambulatory cardiology practices in India. The research is a retrospective review of single-centre data who began therapy with ARNI in HFrEF between 2019 and 2020. The analysis included data for 454 symptomatic patients, aged 57 ± 20.8 years in NYHA class II-III. During follow-up, patients experienced significant improvement in HF symptoms determined by using Kansas City Cardiomyopathy Questionnaire (KCCQ) and a considerable reduction in NT-proBNP levels. ARNI is associated with substantial clinical benefit in an outpatient setting in HFrEF.

Sacubitril/Valsartan (ARNI) has now class 1 recommendation for treatment of heart failure with reduced ejection fraction (HFrEF). It has been shown to reduce cardiovascular morbidity & mortality in Heart failure with reduced ejection fraction (HFrEF) and significant improvement in all echocardiographic parameters besides TEI index. Tei index is a marker of inflammation, myocardial cell metabolism and its contractile function has not been evaluated as a distinctive entity so we took up this study to evaluate the effects of ARNI on the LV functions using two dimensional (2D)ECHO parameters in Indian population and to assess TEI index for myocardial function.

256 patients with class II, III or IV HF and EF<40% were enrolled. 171(66.8%) were males and 85(33.2%) were females. selleck Patients were evaluated at baseline, 6 and 12 months for LVEF, LV mass &,LVMPI. Drug was discontinued in 2 patients due to angioedema, in 5 patients due to acute kidney injury and in 2 patients due to hypotension. LV mass measurement done by linear echocardiographic method and Flow Doppler method used for TEI index calculation.

Baseline parameters in 247 patients were mean EF=26.33±6.28%, mean LV mass=270.84±68.94gm, mean Tei Index=0.852±0.22. ARNI use was associated with an average gradual increase in EF, from a mean baseline of 26.33±6.28% to 33.88±7.73%(p=0.000001) after 1 year of treatment. There was a significant progressive reduction of 57.97g/m2 in mean LV mass index after 1 year of treatment (p=0.000001).TEI index showed significant reduction from baseline mean 0.85±0.22 to 0.70±0.12(p=0.000001)after 1 year of treatment.

Use of ARNI as additive adjunct to standard care of treatment resulted in significant progressive decline in LV mass and increase in TEI index.

Use of ARNI as additive adjunct to standard care of treatment resulted in significant progressive decline in LV mass and increase in TEI index.

Potts shunt has been suggested as an effective palliative therapy for patients with pulmonary artery hypertension (PAH) not associated with congenital heart disease.

This is a prospective single-center study performed to assess outcomes of Potts shunt in patients with PAH who are in functional class III or IV.

52 patients in functional class III/IV with pulmonary arterial hypertension without significant intra or extracardiac shunt on maximal medical therapy were evaluated and counseled for undergoing Potts shunt/patent ductus arteriosus (PDA) stenting. 16/52 patients (13 females) consented for the procedure; 14 patients underwent surgical creation of Potts, and 2 underwent transcatheter stenting of PDA, which physiologically acted like a Potts shunt. Standard medical therapy was continued in patients who did not consent for the procedure. 12/16 patients survived the procedure. Patients who did not survive the procedure were older, with severe right ventricular systolic dysfunction, and functional class intra or extracardiac shunts. It can be done safely with an acceptable success rate. Patient selection, preoperative stabilization, and meticulous postoperative management are essential. It should be performed at the earliest sign of clinical, echocardiographic, or laboratory deterioation for optimal outcomes. Long-term follow-up is required to see a sustained improvement in functional class and the need for a lung transplant in the future.

In patients with ACS, risk assessment at hospital discharge has not received much consideration in prior risk scoring systems. Hence, there is a need for a reliable and simple tool to identify patients with high mortality risk at discharge form the hospital.

In a 1-year observational, prospective study, 1012 patients admitted with ACS were followed up for 6 months after discharge. From 26 potential variables, a new risk score to predict 6-month mortality was developed.

A multi-variant Cox regression analysis with forward stepwise variable selection was performed and 10 highly significant independent predictors of 6-month mortality were identified. These include previous history of ACS, higher Killip class at admission, NYHA class at discharge, recurrent ischemia during hospital stay, heart failure, requiring ionotropic supports, requiring hemodialysis, presence of arrhythmia, left ventricular dysfunction detected on echocardiography and elevated admission blood glucose levels. Points were given to each variable and a total score was calculated. A risk score of 0-4 (low risk) predicted a mortality of 3.7%,a risk score of 5-15 (Intermediate risk) predicted a mortality of 16.4% and a risk score of 11-15 predicted a mortality of 32.0% over a 6-month period. The new risk score was noninferior to GRACE risk score in its predictive accuracy of 6-month mortality in the same cohort of patients (p<0.05).

The risk score developed in our study can be easily calculated at the bedside and is aimed at identifying high risk patients who require more intense follow up after discharge.

The risk score developed in our study can be easily calculated at the bedside and is aimed at identifying high risk patients who require more intense follow up after discharge.