Indian heart journal最新文献

{"title":"Current status of cardiology fellow training based on COCATS-4 framework: A cross-sectional study from three tertiary care institutes across India","authors":"Atit A. Gawalkar ,&nbsp;Ganesh Paramasivam ,&nbsp;Krishna Prasad Akkineni ,&nbsp;Mahek Vijayvergiya ,&nbsp;Pragya Karki ,&nbsp;Nirmal Ghati ,&nbsp;R. Padmakumar ,&nbsp;Rajiv Narang ,&nbsp;Rajesh Vijayvergiya","doi":"10.1016/j.ihj.2025.05.010","DOIUrl":"10.1016/j.ihj.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>The Core Cardiology Training Symposium (COCATS) guidelines, endorsed by the American College of Cardiology (ACC) emphasize competency-based training and establish milestones to be met during cardiology training. However, India lacks such guidelines for training cardiology fellows.</div></div><div><h3>Objectives</h3><div>The study aimed to evaluate the self-declared competencies of cardiology fellows across multiple preselected domains as per the COCATS-4 recommendations.</div></div><div><h3>Methods</h3><div>The study was conducted at three premier institutions across India between June 2022 and December 2024. A total of 52 cardiology fellows who had recently completed their 3-year core cardiology training course were included in the study. These candidates completed a questionnaire that included a checklist assessing different levels of competency in various preselected aspects of cardiovascular medicine. Candidates were also asked about their awareness of COCATS-4 standards and cardiology training in India.</div></div><div><h3>Results</h3><div>While all trainees reported Level 1 competency in cardiac catheterization, heart failure, and adult congenital heart disease, a significantly lower percentage of trainees achieved Level 1 competency in nuclear medicine (1.9 %), cardiac MRI (3.8 %), and cardiac CT (17.3 %). At Level 2, cardiac catheterization (73.1 %) and echocardiography (63.5 %) had the highest self-declared competencies, whereas nuclear medicine (3.8 %), cardiac MRI (0 %), and cardiac CT (0 %) had the lowest. Only 23.1 % of trainees were aware of COCATS-4, and 82.7 % believed that standardized guidelines would improve cardiology training in India.</div></div><div><h3>Conclusions</h3><div>The results emphasize the wide variability in self-reported competencies of cardiology trainees across India and highlight the deficiencies in certain core areas like cardiovascular imaging.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 286-289"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127502","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,&nbsp;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":"77 4","pages":"Page 326"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","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":"Clopidogrel therapy in acute coronary syndrome: Contemporary issues","authors":"Satyavir Yadav,&nbsp;Rakesh Yadav","doi":"10.1016/j.ihj.2025.02.002","DOIUrl":"10.1016/j.ihj.2025.02.002","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 311-317"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373821","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 ,&nbsp;Bharat Narasimhan ,&nbsp;Radhika Korabathina ,&nbsp;Suneetha Batchu ,&nbsp;Vishnu Vardhan Ravilla ,&nbsp;Mohan Roop ,&nbsp;Sachin Yalagudri ,&nbsp;Daljeet Kaur Saggu ,&nbsp;Calambur Narasimhan","doi":"10.1016/j.ihj.2025.03.007","DOIUrl":"10.1016/j.ihj.2025.03.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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-(&lt;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).</div></div><div><h3>Results</h3><div>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(<em>p</em> &lt; 0.001). The diagnostic yield of ⁸F-FDG-PET/CT and CMR was similar in late CS(91.3 %vs.97.8 %,<em>p</em> = 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 %,<em>p</em> = 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 %,<em>p</em> = 0.025).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 253-257"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","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":"Long term outcomes of drug-coated balloons versus drug-eluting stents in patients with small vessel coronary artery disease","authors":"Hesham Refaat,&nbsp;Mohamed Arab","doi":"10.1016/j.ihj.2025.05.004","DOIUrl":"10.1016/j.ihj.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Drug-eluting stents (DES) are a normative care of coronary stenosis. However, their efficacy was limited by stent thrombosis and in-stent restenosis especially in small vessel coronary artery disease (SvCAD). The aim of this study was to assess angiographic efficacy and clinical outcomes of drug coated balloons (DCB) as compared with DES in SvCAD setting.</div></div><div><h3>Methods</h3><div>A total of 100 SvCAD patients with percutaeous angioplasty of culprit coronary arteries &lt;3 mm diameter and &gt;70 % stenosis were enrolled in this study. The patients were categorized into DES arm and DCB arm. One year clinical outcomes were assessed. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints were vessel thrombosis, major bleeding, all-cause death and major adverse cardiac events (MACEs).</div></div><div><h3>Results</h3><div>One year clinical follow-up revealed that in-lesion LLL was significantly lower in DCB arm as compared with DES arm (<em>p</em> = 0.004). Composite MACE was significantly higher in DES group compared to DCB group (<em>p</em> &lt; 0.001). Non-fatal myocardial infarction (MI), target lesion revascularization (TLR), and major bleeding in DES group were significantly higher than DCB group (<em>p</em> = 0.04 &amp; <em>p</em> &lt; 0.001 &amp; <em>p</em> = 0.03, respectively). However, there was a numerically; but not significantly, higher incidence of cardiac death (<em>p</em> = 0.65), and vessel thrombosis (<em>p</em> = 0.18) in DES arm compared to DES arm.</div></div><div><h3>Conclusion</h3><div>In SvCAD setting, DCB has favourable angiographic and clinical outcomes; as evidenced by lower LLL and composite MACE at one year follow up, compared to DES.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 267-274"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984852","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":"Very early discharge of LOw-Risk ST elevation myocardial infarction patients after successful primary percutaneous coronary intervention (VEDLOR-STEMI) study","authors":"Refai Showkathali ,&nbsp;Radhapriya Yalamanchi ,&nbsp;Aishwarya Mahesh Kumar ,&nbsp;Sengottuvelu Gunasekaran ,&nbsp;Abraham Oomman","doi":"10.1016/j.ihj.2025.04.002","DOIUrl":"10.1016/j.ihj.2025.04.002","url":null,"abstract":"<div><div>This VEDLOR-STEMI study assessed the safety and efficacy of very-early discharge (VED- ≤ 48 h) after primary percutaneous coronary intervention (PPCI) for patients with ST elevation myocardial infarction who are considered low risk and compared their outcome with low-risk patients who had standard discharge protocol. No major adverse cardiac events (MACCE) occurred within 6 months. Minor complications, like access site pain were managed without readmission. High patient satisfaction (97.3 %) was noted, with 48 % actively utilizing a hotline for queries. VED post-PPCI appears feasible and safe with appropriate discharge protocols and follow-up.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 308-310"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994535","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":"Early outcomes of aortic valve neocuspidization (the Ozaki procedure): Initial experience of a single centre","authors":"Ranajit Naik ,&nbsp;Abhishek Prabhu ,&nbsp;Mohan Gan ,&nbsp;Richard Saldanha","doi":"10.1016/j.ihj.2025.05.008","DOIUrl":"10.1016/j.ihj.2025.05.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortic valve neocuspidization (AVNeo) using fixed autologous pericardium, also known as the Ozaki technique, is an effective therapy for treating aortic valvulopathies. It serves as an alternative to complex aortic valve repair, offering better hemodynamics compared to biological or mechanical valve replacement, without the need for lifelong anticoagulation.</div></div><div><h3>Objectives</h3><div>To evaluate the immediate and early outcomes of our initial experience with the AVNeo procedure in a spectrum of aortic valve diseases.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, seventeen AVNeo procedures were performed between March 2023 and October 2023 at our center. All patients completed one year of follow-up. Outcomes were assessed by echocardiographic evaluation postoperatively and at one year, including complications and mortality.</div></div><div><h3>Results</h3><div>Patient age ranged from 7 to 77 years (mean 35.2 ± 22.4 years), with 3 females among the 17 patients. Aortic valve morphology was bicuspid in 6 (35.3 %) and tricuspid in 11 (64.7 %) patients. Twelve patients had aortic stenosis as the primary pathology, and five had moderate to severe aortic regurgitation. In aortic stenosis patients, the preoperative mean peak gradient was 82.3 ± 20.3 mmHg, and mean gradient was 48.9 ± 18.5 mmHg. Postoperatively, mean peak gradient reduced to 9 ± 5.3 mmHg, and mean gradient to 16.7 ± 9.1 mmHg. Two patients required conversion to prosthetic valve replacement for progressive aortic regurgitation. There was no mortality at one year, though one patient developed severe aortic regurgitation.</div></div><div><h3>Conclusion</h3><div>AVNeo is a feasible, reproducible procedure with favorable early outcomes, low pressure gradients, and mild regurgitation at one year. It is a cost-effective option, particularly in resource-limited settings like India.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 281-285"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150366","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":"Quantification of residual pulmonary congestion defined by B-line findings on lung ultrasound to predict cardiovascular events in acute heart failure: A systematic review and meta analysis","authors":"Kevin Fernando Suhardi ,&nbsp;Agung Prasetyo ,&nbsp;Rahadian Malik ,&nbsp;Pauliana ,&nbsp;Aqsha Tiara Viazelda","doi":"10.1016/j.ihj.2025.05.003","DOIUrl":"10.1016/j.ihj.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary congestion detected by lung ultrasound (LUS) has emerged as a valuable prognostic marker in acute heart failure (AHF). This systematic review and meta-analysis aimed to evaluate the prognostic significance of residual B-lines identified by LUS before hospital discharge.</div></div><div><h3>Methods</h3><div>A comprehensive literature search of PubMed, Cochrane Library, ScienceDirect, and ClinicalTrials.gov was conducted up to October 4, 2024. Studies assessing the association between residual B-lines and adverse clinical outcomes in hospitalized AHF patients were included, while studies involving ambulatory assessments were excluded. The primary outcome was a composite of all-cause mortality and heart failure (HF) rehospitalization. Secondary outcomes included all-cause mortality and HF rehospitalization individually. Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated.</div></div><div><h3>Results</h3><div>Fifteen studies were included. Residual B-lines were significantly associated with an increased risk of composite outcomes (HR: 2.32; 95 % CI: 1.91–2.82), all-cause mortality (HR: 3.01; 95 % CI: 1.91–4.73), and HF readmission or cardiovascular events (HR: 4.01; 95 % CI: 2.22–7.24). Risk increased with greater B-line burden. Prognostic impact was stronger in short-term follow-up (&lt;6 months; HR: 3.57) than in longer-term follow-up (≥6 months; HR: 1.96).</div></div><div><h3>Conclusions</h3><div>Residual pulmonary congestion assessed by LUS at discharge is a strong independent predictor of adverse outcomes and may guide therapy decisions in AHF management.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 258-266"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998815","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":"Determination of Induction Time in Adult Patients with Valvular Heart Disease","authors":"Tanya Mital ,&nbsp;Suruchi Hasija ,&nbsp;Sambhunath Das ,&nbsp;Sandeep Chauhan ,&nbsp;Maroof A. Khan","doi":"10.1016/j.ihj.2025.05.007","DOIUrl":"10.1016/j.ihj.2025.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>Intravenous anaesthetics induce loss of consciousness in one arm-brain circulation time. As the circulatory transit time in patients with mitral stenosis (MS) and aortic stenosis (AS) is increased, the delivery of anaesthetics to the brain may be prolonged and consequently the onset of hypnosis. This study aimed to compare the induction time in patients with and without valvular heart disease (VHD).</div></div><div><h3>Design</h3><div>Prospective, single-center, open-label analytical study.</div></div><div><h3>Setting</h3><div>It was conducted in adult patients undergoing elective cardiac surgery.</div></div><div><h3>Participants</h3><div>The patients (<em>n</em> = 144) were segregated into three groups; Group 1 - Stenotic VHD (MS, AS), Group 2 - Regurgitant VHD (Mitral Regurgitation, Aortic Regurgitation), and Group 3 – Control (coronary artery disease).</div></div><div><h3>Method</h3><div>General anaesthesia was induced with intravenous thiopental 4mg kg⁻¹ bolus over 20s. The time to induction was noted as loss of eyelash reflex. Bispectral Index (BIS) values were recorded over 2 min. Statistical analysis was performed using SPSS software version 25.0. A <em>p</em> value &lt; 0.05 was considered significant.</div></div><div><h3>Main results</h3><div>Patients in Group 1 (<em>n</em> = 48) had significantly prolonged induction time (99.6 ± 12.9s; <em>p</em> &lt; 0.001) compared to the other two groups (<em>n</em> = 48 each) (68.5 ± 9.6s in Group 2 and 70.4 ± 11.8s in Group 3). Time required for BIS to fall below 60 was significantly longer in Group 1 (139.4 ± 24.6s; <em>p</em> &lt; 0.001) compared to Group 2 (90.4 ± 6.3s) and Group 3 (92.1 ± 12s).</div></div><div><h3>Conclusion</h3><div>The induction time was prolonged in patients with stenotic VHD compared to patients with regurgitant VHD or those without VHD.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 275-280"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020180","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 ,&nbsp;Ranjan Modi ,&nbsp;Sundar Chidambaram","doi":"10.1016/j.ihj.2025.05.013","DOIUrl":"10.1016/j.ihj.2025.05.013","url":null,"abstract":"<div><div>Myocardial infarction with non-obstructive coronary arteries (MINOCA) is defined as clinical evidence of myocardial infarction (MI) without significant obstruction (&lt;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.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 4","pages":"Pages 318-325"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","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}