Indian heart journal最新文献

{"title":"Reappraising the role of cardiac magnetic resonance in heart failure with preserved ejection fraction","authors":"Barbara Segulin, Nikolaos Miaris","doi":"10.1016/j.ihj.2026.04.009","DOIUrl":"10.1016/j.ihj.2026.04.009","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Page 221"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular ejection fraction and outcomes following PCI in STEMI and other acute coronary syndromes: ACC NCDR registry in India","authors":"Hemant Chaturvedi,&nbsp;Rajeev Gupta,&nbsp;Sanjeev K. Sharma,&nbsp;Jitender S. Makkar,&nbsp;Krishna Kumar Sharma,&nbsp;Vishnu Natani,&nbsp;Raghubir S. Khedar,&nbsp;Ajeet Bana,&nbsp;Samin Sharma","doi":"10.1016/j.ihj.2026.03.003","DOIUrl":"10.1016/j.ihj.2026.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To assess influence of echocardiographic left ventricular ejection fraction(LVEF) on outcomes following percutaneous coronary intervention(PCI) in ST-elevation myocardial infarction(STEMI) and other acute coronary syndromes(oACS).</div></div><div><h3>Methods</h3><div>Successive patients with ACS who underwent PCI from April’2019 to March’2022 were enrolled, while those who did not undergo PCI were excluded. In all patients, LVEF was obtained at hospital admission and classified into &lt;30.0%,30.0-39.9%,40.0-49.9% and ≥50.0%. Details of risk factors, coronary angiography, interventions, management, and in-hospital and 3-year outcomes were obtained. Multivariate Cox-proportionate hazard ratios(HR) and 95% confidence intervals(CI), adjusted for age, sex, risk factors, presentation, angiography, interventions, management, and hospitalisation, for major adverse cardiovascular events(MACE) and deaths were calculated.</div></div><div><h3>Results</h3><div>Data of 3789 patients (men 3011, women 778) with ACS (STEMI = 1601; oACS = 2188) were available at baseline and 3.0yr (IQR 2.1-4.0) median follow-up. STEMI patients were younger, with more men, smoking, hypercholesterolemia, impaired LVEF, vasopressor support, hospitalisation duration, and in-hospital deaths vs oACS (p &lt; 0.01). Important determinants of reduced LVEF were smoking, 3-vessel, left-main or left anterior descending CAD (p &lt; 0.01). In both groups, patients with lower LVEF(&lt;30.0%,30.0-39.9%) had more in-hospital deaths (p &lt; 0.05). At 3-year follow-up, compared to LVEF &gt;50.0%, multivariate-adjusted HR(95%CI) in LVEF&lt;30.0% for MACE [STEMI 8.55(3.04-24.03); oACS 2.71(1.39-5.29)] as well as CV deaths [STEMI 16.50(3.64-74.71); oACS 3.72(1.40-9.85)] were significant (p &lt; 0.001). For LVEF 30.0-39.9% group, HRs were of borderline significance [STEMI 2.26(0.86-5.89);oACS 1.34(0.76-2.36)] and not significant for LVEF 40.0-49.9% group. Outcomes were not significantly different in men and women.</div></div><div><h3>Conclusions</h3><div>STEMI and other ACS patients undergoing PCI with LVEF&lt;30% have significantly higher in-hospital and 3-year major adverse cardiovascular events and deaths.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 192-200"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary aldosteronism in premature coronary artery disease: A cross-sectional study from a tertiary center in India","authors":"Manish Thakur,&nbsp;Manasvini Bhatt,&nbsp;Alpesh Goyal,&nbsp;Sandeep Singh,&nbsp;Ambuj Roy,&nbsp;Sarah Alam,&nbsp;Rajesh Khadgawat","doi":"10.1016/j.ihj.2026.03.002","DOIUrl":"10.1016/j.ihj.2026.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Primary aldosteronism (PA) is the most prevalent cause of secondary hypertension and is associated with adverse cardiovascular outcomes. While its prevalence is well established among patients with resistant hypertension and hypokalemia, evidence regarding its occurrence in premature coronary artery disease (CAD) remains limited, particularly in South Asian populations with a high burden of early cardiovascular disease.</div></div><div><h3>Objective</h3><div>To determine the prevalence of PA in patients with premature CAD (≤45 years) and to describe their clinical and biochemical characteristics.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 64 patients with premature CAD and 60 age-matched controls with CAD onset after 45 years were evaluated. Patients with a positive screening result—defined as plasma direct renin concentration (DRC) &lt; 12 μIU/mL together with plasma aldosterone concentration (PAC) &gt; 10 ng/dL—underwent a recumbent saline infusion test (SIT). A post-infusion PAC &gt;5 ng/dL was considered confirmatory for the diagnosis of primary aldosteronism. Clinical, biochemical and cardiovascular parameters were systematically assessed.</div></div><div><h3>Results</h3><div>Among 64 patients with premature CAD, 2 (3.1%) were diagnosed with PA, whereas no cases were identified in the control group. PA-positive patients exhibited significantly higher systolic (161 ± 15.6 mmHg) and diastolic (94.0 ± 5.7 mmHg) blood pressures, longer hypertension duration, and echocardiographic evidence of left ventricular hypertrophy compared with PA-negative patients.</div></div><div><h3>Conclusion</h3><div>PA may represent an underrecognized contributor to premature CAD in young adults. Larger multicenter studies are needed to validate these observations. Routine PA screening in young CAD patients could enable earlier diagnosis and targeted management, potentially reducing long-term cardiovascular morbidity.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 187-191"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter device closure of post–myocardial infarction ventricular septal rupture: A single-centre experience","authors":"Praveen Chandra,&nbsp;Nagendra Singh Chouhan,&nbsp;Seenu Prasanth Adimoulame,&nbsp;Siddarth Varshney,&nbsp;Deepti Yadav,&nbsp;Anushree Kumbhalkar","doi":"10.1016/j.ihj.2026.04.001","DOIUrl":"10.1016/j.ihj.2026.04.001","url":null,"abstract":"<div><div>Post–myocardial infarction ventricular septal rupture is a rare but fatal mechanical complication, frequently complicated by cardiogenic shock. We conducted a single-centre retrospective cohort study of seventeen surgically declined patients who underwent transcatheter device closure between 2014 and 2025. Cardiogenic shock was present in 15 of 17 patients (88.2%). Device implantation achieved high technical success; however, early mortality remained substantial, with only six patients (35.3%) surviving beyond 30 days. Deaths were mainly due to refractory shock and multiorgan failure. Survival was associated with lower SCAI shock stage, preserved lactate clearance, and higher arterial pH, underscoring the importance of physiological status.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 206-208"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and performance of the Hydra self-expanding THV: 6 months outcomes from the GENESIS-II study","authors":"Anmol Sonawane,&nbsp;Praveen Chandra,&nbsp;John Jose,&nbsp;Sandeep Bansal,&nbsp;Rahul Gupta,&nbsp;Krishnankutty Sudhir,&nbsp;Nagendra Boopathy Senguttuvan","doi":"10.1016/j.ihj.2026.03.004","DOIUrl":"10.1016/j.ihj.2026.03.004","url":null,"abstract":"<div><h3>Aim</h3><div>The Hydra THV incorporates an active release mechanism designed to facilitate the deployment of the supra-annular valve. The aim of the GENESIS-II study was to assess the safety and performance of Hydra THV at 6 months follow-up after treating severe aortic stenosis in patients at high surgical risk.</div></div><div><h3>Methods</h3><div>This prospective, multicenter, non-randomized, investigational study was conducted between November 2021 and November 2023. The study enrolled 40 patients with high surgical risk and symptomatic severe aortic stenosis from 19 sites across India. The primary safety endpoint of the study was cardiovascular mortality at 30 days, while the primary performance endpoint was device success, as defined by VARC-2.</div></div><div><h3>Results</h3><div>Among the 40 patients, the mean age was 74.4 ± 6.7 years, 65% were male, and the mean Society of Thoracic Surgeons (STS) risk score was 3.5 ± 1.6%. The device had a success rate of 95%. At 6 months, there was one cardiovascular death (2.5 %). All-cause death was observed in 5% patients. The incidence of new permanent pacemaker implantation was 7.9%. There was a progressive enhancement in effective orifice area, from 0.6 ± 0.2 cm² at baseline to 1.9 ± 0.4 cm² at 6 months (<em>p</em> &lt; 0.001). Similarly, the mean aortic valve gradient significantly improved from 53.1 ± 12.5 mm Hg at baseline to 8.7 ± 3.3 mmHg at 6 months (<em>p</em> &lt; 0.001) post-intervention.</div></div><div><h3>Conclusion</h3><div>The results of 6 months follow-up after implantation of the Hydra THV with an active release mechanism in the GENESIS-II study demonstrated a high device success rate with favorable safety and performance of the device.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 201-205"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Valsalva versus standard Valsalva manoeuvre in patients with paroxysmal supraventricular tachycardia in the emergency department: A randomised trial","authors":"Sheena Arora,&nbsp;Praveen Aggarwal,&nbsp;Akshay Kumar,&nbsp;Nayer Jamshed,&nbsp;Prakash Ranjan Mishra,&nbsp;Meera Ekka,&nbsp;Ankit Kumar Sahu","doi":"10.1016/j.ihj.2026.02.004","DOIUrl":"10.1016/j.ihj.2026.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Vagal manoeuvres, particularly the Valsalva manoeuvre (VM), are recommended as first-line therapy for paroxysmal supraventricular tachycardia (PSVT). We aimed to compare the efficacy and safety of a modified Valsalva manoeuvre with the standard technique in terminating PSVT in the emergency department.</div></div><div><h3>Methods</h3><div>This prospective, randomised, parallel-group trial was conducted in the emergency department of a tertiary care hospital. Adults with stable PSVT were randomised (1:1) to receive either a modified or standard Valsalva manoeuvre. The modified manoeuvre involved a 40-mmHg strain for 15 s in a semi-recumbent position followed by immediate supine repositioning with passive leg elevation, while the standard manoeuvre comprised a 40-mmHg strain for 15 s in the semi-recumbent position alone. The primary outcome was return to sinus rhythm at 1 min, confirmed by electrocardiography.</div></div><div><h3>Results</h3><div>A total of 75 participants were enrolled (37 in the standard group and 38 in the modified group) on an intention-to-treat basis. Sinus rhythm was restored in 10 of 38 patients (26.3%) in the modified Valsalva group compared with 6 of 37 patients (16.2%) in the standard group (odds ratio 0.54; 95% CI 0.17–1.68; <em>p</em> &gt; 0.05). No serious adverse events were observed in either group.</div></div><div><h3>Conclusions</h3><div>The modified Valsalva manoeuvre demonstrated a higher, though not statistically significant, cardioversion rate compared with the standard technique. Both manoeuvres were safe and well tolerated. Larger adequately powered studies are required to establish definitive efficacy.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 173-178"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor, “Reappraising the role of CMRI in HFpEF: A tiny step in the black and white world of HFpEF”","authors":"Sudipta Mondal,&nbsp;Swasthi S. Kumar,&nbsp;Garikapati Vrandha,&nbsp;Valaparambil Kumaran Ajit Kumar,&nbsp;Bijulal Sasidharan,&nbsp;Harikrishnan Sivadasanpillai,&nbsp;Ayyappan Anoop,&nbsp;Jayakrishnan Radhakrishnan,&nbsp;Suprakash Mandal","doi":"10.1016/j.ihj.2026.06.004","DOIUrl":"10.1016/j.ihj.2026.06.004","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 222-223"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracoronary thrombus in ST-segment elevation myocardial infarction: Practical management strategies for the interventional cardiologist","authors":"Debabrata Dash,&nbsp;Umanshi Dash,&nbsp;Rohit Mody","doi":"10.1016/j.ihj.2026.06.003","DOIUrl":"10.1016/j.ihj.2026.06.003","url":null,"abstract":"<div><div>Intracoronary thrombus is a hallmark of ST-segment elevation myocardial infarction (STEMI) and remains a major challenge during primary percutaneous coronary intervention (PPCI). Large thrombus burden is associated with distal embolization, microvascular obstruction, no-reflow, stent thrombosis, and adverse clinical outcomes. Optimal management requires an individualized approach integrating pharmacological and mechanical strategies. This review summarizes the pathophysiology, angiographic assessment, and clinical implications of intracoronary thrombus in STEMI. Contemporary pharmacological therapies, including dual antiplatelet therapy, anticoagulation, glycoprotein IIb/IIIa inhibitors, and intracoronary thrombolytics, are discussed alongside mechanical approaches such as aspiration thrombectomy, mechanical thrombectomy devices, direct stenting, and deferred stenting. Current evidence from major clinical trials and guideline recommendations is reviewed to clarify the selective role of these therapies in modern practice. A practical stepwise management algorithm is proposed to assist interventional cardiologists in tailoring therapy according to thrombus burden, coronary flow, and lesion characteristics. Emerging technologies and future directions aimed at improving thrombus management and microvascular reperfusion are also highlighted. This manuscript is a narrative review of intracoronary thrombus management in acute coronary syndrome, particularly STEMI during PPCI. A structured literature search was performed in PubMed and Embase, along with major guideline documents and cardiovascular society recommendations. Studies published from 2000 to 2026 were included using keywords such as “STEMI,” “intracoronary thrombus,” “thrombectomy,” and “no-reflow.” Eligible evidence included randomized controlled trials, observational studies, meta-analyses, and guidelines, while chronic coronary syndromes and chronic total occlusion-related thrombus were excluded. No formal quality assessment or statistical synthesis was performed, and findings were synthesized qualitatively for clinical relevance.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 213-220"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopmental outcomes after cardiac surgery for congenital heart disease in India: A narrative review","authors":"Shikhar Bakhshi,&nbsp;Nabeel V. Faisal,&nbsp;Maryam Y. Naim,&nbsp;Saurabh Kumar Gupta","doi":"10.1016/j.ihj.2026.04.012","DOIUrl":"10.1016/j.ihj.2026.04.012","url":null,"abstract":"<div><div>Neurodevelopmental outcomes among survivors post-surgery for congenital heart disease (CHD) in India remain insufficiently characterized. Structured searches in PubMed and Google Scholar for studies on neurodevelopmental outcomes published between January 2000 and December 2025 identified six studies from India: five single-centre and one multicentric cohort. Across studies, early motor delay was reported in 14–33% of children and mental or cognitive delay in 15–24%. Risk factors included syndromic association, prolonged postoperative illness, and socioeconomic disadvantage. Long-term, longitudinal, and regionally representative data remain sparse. Integration of structured neurodevelopmental follow-up into CHD care is needed.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 4","pages":"Pages 209-212"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Clinical profile and optical coherence tomography based morphological characteristics of coronary in-stent restenosis: A cross-sectional study\".","authors":"Faizan Ahmed, Malik Zubair Hussain, Asad Ali","doi":"10.1016/j.ihj.2026.06.007","DOIUrl":"10.1016/j.ihj.2026.06.007","url":null,"abstract":"<p><strong>Background: </strong>Sharma et al reported important findings regarding optical coherence tomography (OCT)-based morphological characteristics of coronary in-stent restenosis (ISR). However, several methodological considerations require further discussion.</p><p><strong>Main text: </strong>Key limitations include the cross-sectional design, absence of comparator groups, potential selection bias due to restrictive exclusion criteria, inadequate adjustment for confounding variables, and lack of standardized OCT interpretation with inter-observer variability assessment.</p><p><strong>Conclusion: </strong>Addressing these issues in future studies through longitudinal designs, broader inclusion criteria, standardized OCT protocols, and robust statistical analyses may improve the validity and clinical applicability of ISR research.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329095","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}