Indian heart journal最新文献

{"title":"Clinico-imaging Profile and Correlations of Global Longitudinal Strain Abnormalities in Indian Hypertrophic Cardiomyopathy patients.","authors":"Mohsin Raj Mantoo, Sandeep Seth, Nitish Naik, Priya Jagia, Satyavir Yadav, Rakesh Yadav","doi":"10.1016/j.ihj.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.06.008","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) is a prevalent genetic cardiac disorder with variable clinical expression. While global data are available, phenotypic characterization of Indian HCM patients remains limited. Speckle-tracking echocardiography (STE)-derived global longitudinal strain (GLS) may serve as a surrogate marker of myocardial fibrosis in settings with limited access to cardiac magnetic resonance (CMR).</p><p><strong>Objectives: </strong>To characterize the clinical and imaging features of Indian patients with HCM and evaluate the correlation of GLS with CMR-derived late gadolinium enhancement (LGE) and electrocardiographic abnormalities.</p><p><strong>Methods: </strong>This cross-sectional study enrolled 150 consecutive adult HCM patients at a tertiary care center in North India. All patients underwent detailed clinical evaluation, standard transthoracic echocardiography including STE-derived GLS, electrocardiography, and 24-hour Holter monitoring. CMR was performed in 74 patients based on physician discretion. GLS was quantified using vendor-specific semi-automated software. LGE was quantified as a percentage of total left ventricular mass. Correlations were assessed using Spearman's coefficient (ρ).</p><p><strong>Results: </strong>The mean age of the cohort was 46.7 ± 13.5 years, with 80% males. Asymmetric septal hypertrophy (76%) and obstructive HCM (53%) were the predominant phenotypes. GLS was reduced (<-20%) in 89% of patients (mean GLS: -12.1% ± 4.1%). CMR revealed LGE in 92% of patients, with ≥15% LGE in 40%. Peak GLS showed a strong positive correlation with percent LGE (ρ = 0.739). GLS was significantly lower in patients with CMR-detected perfusion deficits (p = 0.04), but not significantly associated with non-sustained ventricular tachycardia (p = 0.18). Modest inverse correlations were noted between GLS and tissue doppler indices (medial e': -0.55; lateral e': -0.60).</p><p><strong>Conclusion: </strong>Indian HCM patients exhibit a distinct clinical profile with high fibrosis burden. STE-derived GLS correlates strongly with myocardial fibrosis on CMR and may serve as a practical risk stratification tool in resource-limited settings. Further multicentric studies are needed to validate these findings.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527753","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 utility of the Glidesheath Slender for arterial access interventions in young infants.","authors":"Mani Ram Krishna, Usha Nandini Sennaiyan","doi":"10.1016/j.ihj.2025.06.005","DOIUrl":"10.1016/j.ihj.2025.06.005","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336492","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":"Exploring the Role of Left Atrial Fibrosis and Left Atrial Volume Index Through Cardiac Magnetic Resonance Imaging in Embolic Stroke of Undetermined Source: A Network Meta-Analysis.","authors":"Surya Sinaga Immanuel, Gabriel Tandecxi, Fransiskus Xaverius Rinaldi, Yeziel Sayogo, Alvin Sunjaya, Gredel Faustine, Andrew Eka Pramudita Sunardi, Ira Posangi, Victor Bandana","doi":"10.1016/j.ihj.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.06.006","url":null,"abstract":"<p><strong>Objectives: </strong>Left atrial fibrosis (LAF) and left atrial volume index (LAVI), assessed via cardiac magnetic resonance (CMR), are emerging biomarkers for atrial cardiomyopathy and stroke risk. Their roles in the embolic stroke of undetermined source (ESUS) remain unclear. This study evaluates LAF and LAVI in ESUS and explores whether age modifies these outcomes.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42024615479), we searched eight databases (inception-October 2024) for studies evaluating LAF or LAVI via CMR in ESUS, compared to atrial fibrillation (AF) without stroke, cardioembolic stroke (CES), non-cardioembolic stroke (NCE), and healthy controls. We performed a Bayesian network meta-analysis to estimate mean differences (MD) with 95% credible intervals (CrI). Node-splitting tested consistency, and a meta-regression examined the effect of age.</p><p><strong>Results: </strong>Ten observational studies with 1,285 patients (mean age 65.1 ± 12.1 years) were included, demonstrating a generally low risk of bias. ESUS patients had significantly higher LAF than healthy controls (MD 9.86%, 95% CrI 3.05%-16.62%). No significant LAF differences were found between ESUS and AF without stroke, CES, or NCE. LAVI did not differ significantly between ESUS and any comparator groups. Node-splitting indicated no inconsistencies. Age was not significantly associated with LAF or LAVI.</p><p><strong>Conclusion: </strong>ESUS patients show increased LAF compared to healthy individuals, suggesting a key role of LAF in ESUS pathogenesis. Nonetheless, the application of CMR-detected LAF as a prognostic biomarker requires prospective validation to confirm its clinical utility in predicting stroke recurrence.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484114","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":"Diastolic duration and golden ratio-stretch of imagination.","authors":"Soorampally Vijay, Neeta Bachani, Aniruddha Vyas, Gopikrishna Panicker, Yash Lokhandwala","doi":"10.1016/j.ihj.2025.06.002","DOIUrl":"10.1016/j.ihj.2025.06.002","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293688","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":"Prevalence of stage B heart failure in patients undergoing echocardiography during regular clinical practice.","authors":"Rakesh Gupta, Tamoghna Das, Malvika K Suchak, Smita Suraj Kudalkar, Prasenjit Pandey, Sameer Shrivastava, Manish Bansal, M K Das","doi":"10.1016/j.ihj.2025.06.003","DOIUrl":"10.1016/j.ihj.2025.06.003","url":null,"abstract":"<p><p>Recognizing individuals with stage B heart failure (HF) is important to prevent or delay its progression to symptomatic HF. Unfortunately, no study at present describes the prevalence of stage B HF in Indian patients. This study involved 227 consecutive patients (mean age 56.3 ± 12.1 years, 60 % were men) undergoing echocardiography at a referral center in North India. Overall, 13 % of patients had increased left atrial volume index, 7 % had elevated ratio of early diastolic mitral inflow to mitral annular velocity, and 47 % had reduced left ventricular global longitudinal strain. Based on these findings, stage B HF was diagnosed in 119 (52.4 %) subjects. The patients with stage B HF had significantly lower left atrial reservoir strain. In conclusion, this study shows a high prevalence of stage B HF in a general clinical setting in India. Further, larger studies are needed to overcome the current study limitations and better define stage B HF's prevalence and clinical implications in Indian patients.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283792","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":"Dobutamine stress echocardiography in end-stage liver disease: Insights from pre-transplant cardiac assessment - A cross-sectional prospective study from a tertiary cardiac centre in South India.","authors":"Doddi Neusha, Manoj Kumar Agarwala, Manish C Varma, Sana Firdouse, Rufus Demel","doi":"10.1016/j.ihj.2025.06.004","DOIUrl":"10.1016/j.ihj.2025.06.004","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular complications are a significant cause of morbidity and mortality in patients with end-stage liver disease (ESLD) undergoing liver transplantation (LT). Dobutamine stress echocardiography (DSE) is a commonly used tool for cardiac risk stratification, but its predictive utility in this population remains controversial.</p><p><strong>Objective: </strong>To evaluate the role of DSE in predicting 30-day cardiac morbidity and mortality in ESLD patients undergoing LT.</p><p><strong>Methods: </strong>This was a prospective observational study conducted at a tertiary care centre from June 2020 to November 2021. Ninety-four patients aged ≥40 years with ≥2 cardiovascular risk factors underwent DSE as part of their pre-LT evaluation. Patients were categorized based on DSE results as ischemic, non-ischemic, or indeterminate. Outcomes measured included 30-day mortality, major adverse cardiac events (MACE), ICU stay, and inotrope requirement.</p><p><strong>Results: </strong>The study included 94 patients (mean age 53.4 ± 7.8 years; 81 males). DSE results were non-ischemic in 83 (88.3 %), indeterminate in 9 (9.6 %), and ischemic in 2 (2.1 %) patients. Both ischemic and indeterminate cases had non-significant coronary disease. There were 10 deaths (10.6 %) in 30 days, one attributed to cardiac cause. Two MACES were recorded in DSE-negative patients (ACS, HF). Sensitivity of DSE for mortality prediction was 0 %, specificity 97.4 %, and NPV 89.2 %.</p><p><strong>Conclusion: </strong>DSE demonstrated high specificity but limited sensitivity in predicting short-term cardiac events in ESLD patients undergoing LT. The utility of DSE as a sole screening in this population appears limited.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274765","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":"Unilateral access versus bilateral access in transfemoral transcatheter aortic valve replacement: A systematic review and meta-analysis.","authors":"Hritvik Jain, Mariam Shahabi, Aimen Shafiq, Siddharth P Agrawal, Marwan S Saad, Barry L Sharaf, Paul C Gordon, J Dawn Abbott, Saraschandra Vallabhajosyula","doi":"10.1016/j.ihj.2025.06.001","DOIUrl":"10.1016/j.ihj.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) procedures frequently require a second arterial access to perform aortic root angiography. In recent times, there has been an increase in the use of unilateral access, however, the outcomes data are conflicting.</p><p><strong>Methods: </strong>A systematic database search was conducted to retrieve studies comparing unilateral to bilateral access in TAVR. Risk ratios (RR) with 95 % confidence intervals (CI) were pooled using the Mantel-Haenszel random-effects model. Outcomes of interest included minor vascular complications, major vascular complications, 30-day stroke, and 30-day all-cause mortality.</p><p><strong>Results: </strong>Three studies with a total of 2,181 patients undergoing TAVR (unilateral 368, bilateral 1813) were included in this meta-analysis. Unilateral access was comparable to bilateral access for minor vascular complications (RR: 0.88; 95 % CI: 0.48-1.62), major vascular complications (RR: 0.61, 95 % CI: 0.14-2.75), stroke (RR: 0.95; 95 % CI: 0.42, 2.17) and all-cause mortality (RR: 0.52; 95 % CI: 0.04, 6.93).</p><p><strong>Conclusion: </strong>Unilateral access for TAVR was associated with similar short-term outcomes and safety profiles compared to bilateral access for TAVR.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247685","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":"Cardiometabolic risk factors among adults in rural, urban, and urban slum population in eight states of India.","authors":"I I Meshram, P V Sunu, K Sreeramakrishna, G Neeraja, G L Stephen, D Narasimhulu, Shantanu Sengupta, Anura Kurpad, Rajiva Raman, Chittaranjan Yajnik, Harshpal Singh Sachdev, A Laxmaiah, G Chandak","doi":"10.1016/j.ihj.2025.05.014","DOIUrl":"10.1016/j.ihj.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>Lifestyle and epidemiological transition have resulted in increasing burden of diet-related chronic diseases among the population, which are contributing to increasing morbidity and mortality.</p><p><strong>Objective: </strong>To assess the prevalence of overweight and obesity, hypertension, diabetes, and dyslipidemia and their associated risk factors among the adults.</p><p><strong>Method: </strong>A Multistage random sampling procedure was adopted for this community-based cross-sectional study carried out in eight states in urban, urban slum, and rural adult (≥18 years) populations of India. Household socioeconomic and demographic particulars, anthropometric, blood pressure measurements, and blood collection were done from all the selected subjects. Data analysis was done using SPSS version 23.</p><p><strong>Results: </strong>The prevalence of overweight and obesity was 23.5 % (CI = 22.1-25) and 6.7 % (CI = 5.8-7.6) respectively, and was higher among women (25.8 %; CI = 23.7-27.9) and among urban (28.6 %; CI = 26-31.3) adults. The prevalence of hypertension and diabetes was 44 % (CI = 42.3-45.7) and 21 % (CI = 19.8-22.6) respectively; and was higher among the elderly (62 % and 29.7 %) and among urban (46.7 % and 25 %) population. Hypertriglyceridemia and high LDL was observed among 15 % (M: 15.5 %; F: 14.5 %) and 43 % (M: 40 %; F: 46.8 %) of subjects, and was higher in urban compared to rural areas. The odds of hypertension and diabetes were higher among men, among the elderly, among the overweight and obese individuals, with abdominal and truncal obesity, and among increased CRP levels.</p><p><strong>Conclusions: </strong>The burden of cardiometabolic risk factors is substantial among adults in the eight states evaluated. The risk factors are greater among men, the elderly and in urban areas.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208445","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":"India cardiology training curriculum- a critical reappraisal: Is it the time to rethink?","authors":"Aditya Kapoor, Rishi Sethi, Rakesh Yadav","doi":"10.1016/j.ihj.2025.05.012","DOIUrl":"10.1016/j.ihj.2025.05.012","url":null,"abstract":"<p><p>The challenges and rigors of the modern-day health care systems demand a critical reappraisal of our training paradigms in cardiology. Today, modern day DM and DNB Cardiology training needs to seamlessly amalgamate traditional teaching methodologies with the rapidly evolving technology based educational tools now available to us for personalized and adaptive learning. The contemporary cardiology curricula need to incorporate ALL components of clinical competency including cognitive, psychomotor and affective skills to enable the next generation of cardiologists to provide truly holistic care to their patients. In addition, a greater focus on impactful cardiology research with an intent to publish it while in training, is likely to encourage at least some of the young trainees to pursue careers in academia. Most importantly, the exit examination patterns need to be restructured. We need to decide whether we need cardiologists who simply follow textbooks and are trained in procedures -or we need those who have the ability to themselves write the next chapters in cardiology, have the precision of thought, the depth of empathy, and the courage to question.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198965","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":"A comprehensive review on myocardial infarction with non-obstructive coronary arteries (MINOCA): One size does not fit all.","authors":"Babu Ezhumalai, Ranjan Modi, Sundar Chidambaram","doi":"10.1016/j.ihj.2025.05.013","DOIUrl":"10.1016/j.ihj.2025.05.013","url":null,"abstract":"<p><p>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is defined as clinical evidence of myocardial infarction (MI) without significant obstruction (<50 % stenosis) in coronary angiography, making it a clinically distinct and heterogeneous disorder. Unlike MI associated with obstructive coronary artery disease (MICAD), MINOCA is more common in younger women and often involves microvascular dysfunction or vasospastic conditions. Despite recent advancements in understanding MINOCA, its prognosis and predictors remain uncertain, necessitating further research into its pathogenesis. The diverse underlying causes of MINOCA mean that traditional treatment of the \"one-size-fits-all\" approach used for MICAD may not be appropriate, emphasizing the need for individualized treatment strategies based on accurate diagnosis. There is an urgent need to raise awareness among healthcare providers, implement standardized diagnostic protocols, and conduct targeted research to improve patient outcomes. Multi-centered studies and clinical trials are essential to establish evidence-based therapies and optimize management strategies for MINOCA, ensuring better long-term outcomes.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191726","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}