Indian heart journal最新文献

{"title":"Leveraging ECG Images for Predicting Ejection Fraction using Machine Learning Algorithms.","authors":"Abhyuday Kumara Swamy, Vivek Rajagopal, Deepak Krishnan, Paramita Auddya Ghorai, Anagha Choukhande, Santhosh Rathnam Palani, Deepak Padmanabhan, Emmanuel Rupert, Devi Prasad Shetty, Pradeep Narayan","doi":"10.1016/j.ihj.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.009","url":null,"abstract":"<p><strong>Introduction: </strong>The capability to accurately predict the ejection fraction (EF) from an electrocardiogram (ECG) holds significant and valuable clinical implications. Various algorithms based on ECG images are currently being evaluated, with most methods requiring raw signal data from ECG devices. In this study, our objective was to train and validate a neural network on a readily available ECG trace image graph to determine the presence or absence of left ventricular dysfunction (LVD).</p><p><strong>Methods: </strong>12-lead ECG trace images paired with their echocardiogram reports performed on the same day were selected. A DenseNet121 model, using ECG images as input, was trained to identify EF <50%. and then externally validated.</p><p><strong>Results: </strong>1,19,281 ECG-echocardiogram pairs were used for model development. The model demonstrated comparable performance in both the internal test data and external validation data. The area under receiver operating characteristic and precision-recall curves were 0.92 and 0.78, respectively, for the internal test data and 0.88 and 0.74, respectively, for the external validation data. The model accurately identified more than 85% of cases with EF <50% in both datasets.</p><p><strong>Conclusions: </strong>Actual images of ECGs with simple pre-processing and model architecture can be used as a reliable tool to screen for LVD. The use of images expands the reach of these algorithms to geographies with resource and technological limitations.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Long-Term Outcomes of Drug Coated Balloon in De Novo Lesions of Small Versus Large Coronary Vessels.","authors":"Hesham Refaat, Mohamed Arab","doi":"10.1016/j.ihj.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.015","url":null,"abstract":"<p><strong>Objective: </strong>Drug eluting stent (DES) could result in both in-stent restenosis and high bleeding risk due to long-term anti-platelet therapy. Drug-coated balloon (DCB) delivers anti-proliferative drugs without implanting metal into vascular wall. Our aim was to investigate its feasibility in large vessel coronary artery disease (LvCAD), compared to small vessel coronary artery disease (SvCAD).</p><p><strong>Methods: </strong>This study enrolled 237 patients with de novo coronary lesions treated with DCB-only strategy and categorized according to the reference vessel diameter of 3 mm into SvCAD and LvCAD groups. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints included composite major adverse cardiac events (MACE), cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and vessel thrombosis.</p><p><strong>Results: </strong>The immediate (3.06 ± 0.25 vs. 2.33 ± 0.21 mm, p=0.001) and follow up minimal lumen diameter (3.13 ± 0.25 vs. 2.41 ± 0.21 mm, p=0.001) and acute gain (1.92 ± 0.29 vs. 1.5 ± 0.26 mm, p=0.04) were significantly higher in LvCAD group. In-lesion LLL was negative without significant difference (- 0.07 ± 0.02 vs. - 0.06 ± 0.04 mm, p=0.69). The incidence of adverse clinical events was not statistically significant accounting for 6.5% vs. 10.5% for composite MACE (p=0.27), 0.8% vs. 0.9% for cardiac death (p=0.96), 4.9% vs.7% for non-fatal MI (p=0.49), 4.1% vs. 6.1% for TLR (p=0.47), 2.4% vs. 3.5% for TVR (p=0.63) and 1.6% vs. 2.6% for vessel thrombosis (p=0.59).</p><p><strong>Conclusion: </strong>DCB-only strategy is effective in treating LvCAD with comparable outcomes to SvCAD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and One-year Follow-Up Analysis of Percutaneous ASD Closure at a Tertiary Care Hospital.","authors":"Naga Raghunandan Thota, Kamalakar Kosaraju, John Satish Rudrapogu, Krishna Prasad Nevali, Thirupathi Rao Kondaveeti","doi":"10.1016/j.ihj.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.011","url":null,"abstract":"<p><strong>Aim: </strong>This study was designed to evaluate the safety and effectiveness of the Cocoon Septal Occluder device (Vascular Innovations Co. Nonthaburi, Thailand) for transcatheter closure of isolated secundum type atrial septal defect (ASD) in Indian patients METHODS: This was a single-center, retrospective, observational study which included patients who underwent transcatheter closure of isolated secundum ASD using the Cocoon Septal Occluder between April 2014 and May 2023. Follow-up assessments up to one-year were conducted through review of hospital medical records, clinic visits, or via telephonic communication with primary care physicians.</p><p><strong>Results: </strong>A total of 400 patients were included in the study, consisting of 28 paediatric (aged ≤15 years, 8.14±4.41 years) and 372 adult patients (40.83±13.23 years). The mean defect diameter and device size were 16.75±5.85 mm and 20.43±6.24 mm for paediatric patients, and 21.62±6.87 mm and 24.94±7.28 mm for adult patients, respectively. The device was successfully implanted in all paediatric patients, achieving 100% closure of the defect with no complications, which persisted through one-year follow-up. In the adult cohort, complete ASD closure was achieved in 99.2% of patients, with two cases of device embolization and one case of device withdrawal. At one-year follow-up, adult patients experienced 0.3% late device embolization, 0.8% pericardial effusion/cardiac tamponade, 0.5% atrioventricular block, and 0.5% atrial flutter/fibrillation. No cases of endocarditis, haemolysis, nickel allergy, stroke/transient ischemic attack, or migraine were reported in either paediatric or adult patients.</p><p><strong>Conclusion: </strong>The results demonstrate that Cocoon Septal Occluder is safe and effective in closing isolated secundum ASD during one-year follow-up.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic testing of cardiomyopathies: Position statement of the Cardiological Society of India.","authors":"Ajay Bahl, Sandeep Seth, Perundurai S Dhandapany, Anupam Mittal, Priya Chockalingam, Hisham Ahamed, Muthiah Subramanian, Sheela Nampoothiri, Narayanan Namboodiri, Soumi Das, Vanya Vaidya, Rajaram Anantharaman, Madhu Khullar, Deepa Selvi Rani, Kumarasamy Thangaraj, Nitish Naik, Sridhar Sivasubbu, Debabrata Roy, Vijay Harikisan Bang, Partha Sarathi Banerjee, Pratap Chandra Rath, Dhurjati Prasad Sinha, Rakesh Yadav, Dipankar Ghosh Dastidar","doi":"10.1016/j.ihj.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.013","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of machine learning models versus TIMI score in ST-segment-elevation myocardial infarction patients.","authors":"Mohit D Gupta, Dixit Goyal, Shekhar Kunal, Manu Kumar Shetty, Girish Mp, Vishal Batra, Ankit Bansal, Prashant Mishra, Mansavi Shukla, Vanshika Kohli, Akul Chadha, Arisha Fatima, Subrat Muduli, Anubha Gupta, Jamal Yusuf","doi":"10.1016/j.ihj.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification is an integral component of ST-segment-elevation myocardial infarction (STEMI) management practices. This study aimed to derive a machine learning (ML) model for risk stratification and identification of factors associated with in-hospital and 30-day mortality in patients with STEMI and compare it with traditional TIMI score.</p><p><strong>Methods: </strong>This was a single center prospective study wherein subjects >18 years with STEMI (n=1700) were enrolled. Patients were divided into two groups: training (n=1360) and validation dataset (n=340). Six ML algorithms (Extra Tree, Random Forest, Multiple Perceptron, CatBoost, Logistic Regression and XGBoost) were used to train and tune the ML model and to determine the predictors of worse outcomes using feature selection. Additionally, the performance of ML models both for in-hospital and 30-day outcomes was compared to that of TIMI score.</p><p><strong>Results: </strong>Of the 1700 patients, 168 (9.88%) had in-hospital mortality while 30-day mortality was reported in 210 (12.35%) subjects. In terms of in-hospital mortality, Random Forest ML model (sensitivity: 80%; specificity: 74%; AUC: 80.83%) outperformed the TIMI score (sensitivity: 70%; specificity: 64%; AUC:70.7%). Similarly, Random Forest ML model (sensitivity: 81.63%; specificity: 78.35%; AUC: 78.29%) had better performance as compared to TIMI score (sensitivity: 63.26%; specificity: 63.91%; AUC: 63.59%) for 30-day mortality. Key predictors for worse outcomes at 30-days included mitral regurgitation on presentation, smoking, cardiogenic shock, diabetes, ventricular septal rupture, Killip class, age, female gender, low blood pressure and low ejection fraction.</p><p><strong>Conclusions: </strong>ML model outperformed the traditional regression based TIMI score as a risk stratification tool in patients with STEMI.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac evaluation in patients awaiting kidney transplant-position statement of the Cardiological Society of India and Indian Society of Nephrology.","authors":"Ajay Bahl, Narayan Prasad, Dhurjati Prasad Sinha, Kajal Ganguly, Sandipta Roy, Debabrata Roy, Sumit Rakshit, Dilip Kumar, Saurav Das, Dinkar Bhasin, Sree Bhushan Raju, Mayuri Trivedi, Manish Rathi, Sanjeev Gulati, Sourabh Agstam, Vinant Bhargava, Anil Kumar Bhalla, Shyam Bihari Bansal, Santosh Varughese, Manas Ranjan Patel, Rakesh Yadav, Nitish Naik, Vijay Harikisan Bang, Dipankar Ghosh Dastidar, Partha Sarathi Banerjee","doi":"10.1016/j.ihj.2025.03.012","DOIUrl":"10.1016/j.ihj.2025.03.012","url":null,"abstract":"<p><p>Cardiovascular diseases are a major cause of death after kidney transplantation. This statement addresses preoperative cardiac decision-making and management with the aim of assessing and reducing the risk of the kidney transplant surgery. Important issues from a clinician's perspective include the basic cardiovascular workup of these patients, coronary evaluation and management of coronary artery disease, valvular heart disease and left ventricular systolic dysfunction. Recovery left ventricular function after kidney transplant is discussed. In addition, the use of cardiovascular drugs in patients with special emphasis on antiplatelets and anticoagulants in patients planned for kidney transplant is also discussed.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear imaging studies in patients with an indeterminate diagnosis of infective endocarditis: A retrospective analysis of a case series.","authors":"Ísis da Capela Pinheiro, Alysson Selton Santiago, Vitor Deriquehem de Araújo Silva, Lucas Ferreira de Oliveira, Rebeca Maria Gomes Guimarães Alves, Ana Glória Bucar, João Mansur Filho, Lúcia Helena Alvares Salis, Nelson Albuquerque de Souza E Silva, Roberto Muniz Ferreira","doi":"10.1016/j.ihj.2025.03.008","DOIUrl":"10.1016/j.ihj.2025.03.008","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the role of nuclear imaging (NI) in evaluating inconclusive cases with suspicion of infective endocarditis (IE).</p><p><strong>Methods: </strong>Consecutive patients with an indeterminate diagnosis of IE who underwent labelled leucocyte scintigraphy (LS) or ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) between 2018 and 2021 at 2 reference hospitals in Rio de Janeiro were retrospectively analysed. Subsequent confirmed or rejected diagnoses of IE were evaluated, in addition to clinical and imaging data. Kappa coefficient was used to compared the diagnostic agreement between echocardiographic and NI findings, with a p-value <0.05 considered statistically significant.</p><p><strong>Results: </strong>A total of 85 NI scans (28 FDG-PET/CT, 57 LS) from 76 patients were evaluated, of whom 48 (63.2 %) underwent only LS, 19 (25 %) only FDG-PET/CT, and 9 (11.8 %) both studies. Average age was 63.8 years (SD ± 18.5) and 51.3 % were women. Prosthetic valves were present in 15.8 % of cases, and intracardiac devices in 10.5 %. Among the 76 patients, 18 (23.7 %) had NI findings suggestive of IE. A total of 28 patients (36.8 %) were ultimately diagnosed with IE, 28.6 % of whom had confirmed infections by NI scans. Echocardiographic results had a low level of agreement with NI findings in those diagnosed with IE (kappa = -0.44).</p><p><strong>Conclusions: </strong>Nuclear imaging contributed to the diagnosis of IE in approximately 30 % of subsequently confirmed cases, which were initially classified as inconclusive by echocardiography. The low level of agreement between these methods underscores their complementary role in the diagnosis of IE, particularly in indeterminate cases.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic of intrinsic valvular inflammation in rheumatic heart disease.","authors":"Ertan Yetkin","doi":"10.1016/j.ihj.2025.03.005","DOIUrl":"10.1016/j.ihj.2025.03.005","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ¹⁸F-FDG PET/CT and Cardiac MRI in Early Cardiac Sarcoidosis.","authors":"Muthiah Subramanian, Bharat Narasimhan, Radhika Korabathina, Suneetha Batchu, Vishnu Vardhan Ravilla, Mohan Roop, Sachin Yalagudri, Daljeet Kaur Saggu, Calambur Narasimhan","doi":"10.1016/j.ihj.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.03.007","url":null,"abstract":"<p><strong>Background and aims: </strong>Although ¹⁸F-FDG-PET/CT and CMR are commonly used to diagnose cardiac sarcoidosis(CS), their clinical utility in early- vs. late-stage disease is unclear. The objective of this study was to compare the diagnostic utility of 18-fluorodeoxyglucose positron emission tomography/computed tomography(¹⁸F-FDG-PET/CT) and cardiac magnetic resonance imaging(CMR) in patients with early- and late-stage CS.</p><p><strong>Methods: </strong>Data of 110 consecutive patients with biopsy-proven CS from the Granulomatous Myocarditis Registry were analyzed. All patients underwent ¹⁸F-FDG0PET/CT and CMR within 2 weeks of initial clinical presentation. Patients were divided into early-(<6 months) and late-stage groups based on the time since their first cardiac presentation. Myocardial uptake and late gadolinium enhancement(LGE) were qualitatively and quantitatively assessed. Complete clinical,echocardiographic, and radiological responses were assessed after 4-6 months of immunosuppressive therapy(IST).</p><p><strong>Results: </strong>Among the 102 patients in the final analysis(44.1±10.3 years;LV ejection fraction[LVEF], 43.1±9.5%),54.9% and 45.6% received early and late diagnosis, respectively. Abnormal myocardial uptake on ¹⁸F-FDG-PET/CT 100%) was observed in all patients with early CS, while only 73.2% showed LGE on CMR(p<0.001). The diagnostic yield of ⁸F-FDG-PET/CT and CMR was similar in late CS(91.3%vs.97.8%,p=0.498). Patients with early CS had a higher myocardial SUV_max and more extensive LV involvement than those with late CS. Complete response to IST was more common in patients with early CS than in those with late CS(62.5%vs.47.8%,p=0.019). In the early CS cohort, patients without LGE had a higher rate of complete response following IST than those with LGE (86.7%vs.53.7%,p=0.025).</p><p><strong>Conclusion: </strong>In patients with early CS,¹⁸F-FDG-PET/CT appears to be more sensitive and useful than CMR for diagnosis and assessment of response to IST.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiac cycle and diastolic duration in healthy adults: Verifying Golden Ratio?","authors":"Ertan Yetkin","doi":"10.1016/j.ihj.2025.03.006","DOIUrl":"10.1016/j.ihj.2025.03.006","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}