Indian heart journal最新文献

{"title":"Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: A network meta-analysis of randomized trials","authors":"Manyata Srivastava ,&nbsp;Annu Gulia ,&nbsp;Kamalesh Kumar Patel ,&nbsp;Ashish Datt Upadhyay ,&nbsp;Deepti Vibha ,&nbsp;Pradeep Kumar","doi":"10.1016/j.ihj.2025.12.002","DOIUrl":"10.1016/j.ihj.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Direct oral anticoagulants (DOACs) are increasingly preferred over vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF), including valvular (VAF) and non-valvular (NVAF). This network meta-analysis aimed to evaluate and compare the efficacy and safety of different DOACs versus VKAs in patients with AF.</div></div><div><h3>Methods</h3><div>A Bayesian network meta-analysis was conducted to estimate odds ratios (ORs) with 95 % credible intervals (CrIs).</div></div><div><h3>Results</h3><div>43 RCTs were included (30 VAF, 13 NVAF). Dabigatran (OR 0.77, 95 % CrI 0.68–0.87) demonstrated the strongest reduction in ischemic stroke/systemic embolism, followed by apixaban (0.81, 0.73–0.91). All DOACs were associated with reduced risk of hemorrhagic stroke.</div></div><div><h3>Conclusion</h3><div>DOACs, particularly apixaban and dabigatran, showed superior efficacy and safety compared with VKAs, with apixaban emerging as the most favorable overall option. However, these findings are derived from indirect rather than direct head-to-head comparisons among DOACs and VKAs and should therefore be interpreted with caution.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 100-111"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742251","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":"Balloon-expandable transcatheter aortic valve implantation: Device evolution, technique, and post-operative care","authors":"Amit Kumar Chaurasia ,&nbsp;Satyavir Yadav ,&nbsp;Nitish Naik","doi":"10.1016/j.ihj.2025.09.009","DOIUrl":"10.1016/j.ihj.2025.09.009","url":null,"abstract":"<div><div>Transcatheter aortic valve implantation (TAVI) is the treatment of choice in elderly patients with severe symptomatic aortic stenosis. Though trials have shown positive results in low-risk patients, we should be cautious, as these trials were not all comer. Studies have also shown that early intervention helps in patients with asymptomatic severe aortic stenosis as well. The first device introduced was a balloon expandable (Edward Sapien), and a self-expanding (Medtronic CoreValve) device soon followed. Presently, multiple devices are available in both balloon expandable and self-expanding categories. This review provides a brief review of balloon expandable TAVI valves and stepwise approach for performing TAVI.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 47-54"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250968","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":"Impact of internal migration on cardiovascular disease risk factors: Insights from a large industrial cohort in Ludhiana","authors":"Bishav Mohan,&nbsp;Akash Batta,&nbsp;Sarit Sharma,&nbsp;Tarun Satija,&nbsp;Geeti Puri Arora,&nbsp;Sarvotham Ramanathan,&nbsp;Anusha Singhania,&nbsp;Sumeet Sharma,&nbsp;Navneet Kishore,&nbsp;R.K. Soni,&nbsp;Gautam Singal,&nbsp;Anshuman Gupta,&nbsp;Rohit Tandon,&nbsp;Abhishek Goyal,&nbsp;Shibba Takkar Chhabra,&nbsp;Naved Aslam,&nbsp;Roopa Shivashankar,&nbsp;Kavita Singh,&nbsp;Meenkashi Sharma,&nbsp;Gurpreet Singh Wander","doi":"10.1016/j.ihj.2026.01.001","DOIUrl":"10.1016/j.ihj.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Amongst the various risk factors for, cardiovascular diseases (CVDs), the impact of migration is often underappreciated and underexplored. The aim of the study was to look into the CVD profiles of migrant industrial workers and to explore the impact of duration migration on CVD risk-factors.</div></div><div><h3>Methods</h3><div>This was an observational, prospective and a multi-center study which recruited migrant industrial workers working across 23 industries from the organized sector in Ludhiana. Age-adjusted regression models were prepared to determine if duration of migration was an independent risk factor for adverse CV health.</div></div><div><h3>Results</h3><div>A total of 11,151 migrant workers (9,158, 82.1 % males) were included in the analysis. The mean age of the cohort was 35.00 ± 10.89 years, with the majority (40.6 %, <em>n</em> = 4528) belonging to the &lt;30 years age group. The prevalence of hypertension, diabetes and obesity in the cohort was 19.73 %,4.0 % and 25.9 % respectively. Duration since migration emerged as an independent risk factor for adverse CV health. Age-adjusted models revealed the independent risk of developing obesity, hypertension and diabetes beyond 3, 6 and 12 years since migration respectively [OR = 2.332, 1.401 &amp; 3.462 respectively; <em>p</em> &lt; 0.005 for all].</div></div><div><h3>Conclusions</h3><div>The overall age-adjusted prevalence of hypertension was higher amongst migrant workers compared to national average and state wise data for hypertension reflecting the aggravated risk in this cohort. Duration of migration emerged to be an independent predictor of CVD risk with a threshold effect for developing obesity emerging earliest at 3 years since migration.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 89-99"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998066","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":"Reply to the Letter to the Editor entitled: “Cardiology fellow training based on COCATS-4 framework: Limitation and future direction.”","authors":"Rajesh Vijayvergiya ,&nbsp;Atit A. Gawalkar ,&nbsp;Mahek Vijayvergiya","doi":"10.1016/j.ihj.2025.12.004","DOIUrl":"10.1016/j.ihj.2025.12.004","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Page 46"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800514","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":"Distributive shock in cardiac intensive care unit patients","authors":"Sarvesh Pal Singh","doi":"10.1016/j.ihj.2025.09.008","DOIUrl":"10.1016/j.ihj.2025.09.008","url":null,"abstract":"<div><div>Shock is a life-threatening condition of circulatory failure. Mixed shock is observed in approximately 24.5 % of patients with cardiogenic shock. In cases of out-of-hospital cardiac arrest, outcomes are worse when the predominant shock type is distributive rather than cardiogenic. Thus, distinguishing between cardiogenic and distributive phenotypes is crucial for appropriate management. A dysregulated immune response has been observed in both. This review article details the pathophysiology, diagnostic challenges, and management of distributive shock when encountered in a cardiac intensive care unit.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 40-44"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212524","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":"Validation of complete and shortened WHO Rose angina questionnaire to detect coronary heart disease in a tertiary care hospital","authors":"Soorampally Vijay,&nbsp;Bharat Raj Kidambi,&nbsp;Nitish Naik,&nbsp;Sandeep Singh,&nbsp;Gautam Sharma,&nbsp;Ramakrishnan S,&nbsp;Ambuj Roy","doi":"10.1016/j.ihj.2025.05.015","DOIUrl":"10.1016/j.ihj.2025.05.015","url":null,"abstract":"<div><h3>Objectives</h3><div>Validation of the complete and shortened RAQ to detect coronary heart disease (CHD) in a tertiary care hospital.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 239 patients aged 40–75 years with chest pain, referred for TMT from the cardiology OPD were subjected to RAQ and SRAQ, followed by a treadmill test (TMT). We used the treadmill test with the Bruce/modified Bruce protocol as the gold standard to assess RAQ and SRAQ.</div></div><div><h3>Results</h3><div>The RAQ had 44.3 % sensitivity, 72.6 % specificity, 59 % accuracy, 60 %, and 58.4 % positive and negative predictive values, 1.62, 0.77 positive and negative likelihood ratios, respectively. SRAQ had 87.8 % sensitivity, 27.4 % specificity, 56.5 % accuracy, 52.9 % and 70.8 % positive and negative predictive values, 1.21 and 0.44 positive, and negative likelihood ratios, respectively, to detect CHD. The sensitivity of RAQ and SRAQ was higher in women.</div></div><div><h3>Conclusion</h3><div>Both RAQ and SRAQ have poor accuracy in diagnosing CHD in the Indian population. Alternate tools are needed for determining the population burden of CHD in India.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 20-24"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421579","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":"Contemporary issues in implantable cardioverter-defibrillators: Personalising device therapy","authors":"Christopher Monkhouse ,&nbsp;Syed Ahsan ,&nbsp;Pier D. Lambiase","doi":"10.1016/j.ihj.2025.10.003","DOIUrl":"10.1016/j.ihj.2025.10.003","url":null,"abstract":"<div><div>Implantable Cardioverter Defibrillators (ICDs) have undergone substantial evolution since the 1980s, with the aim of decreasing sudden cardiac death, whilst minimising device related complications. Traditional transvenous ICDs (TV-ICDs), though comprehensive and effective, are associated with risks with having leads inside the veins and heart. The emergence of the subcutaneous ICD (S-ICD) offered a solution for patients without a pacing indication, significantly reducing the risks of complications acutely and long term. The absence of pacing and need for specific ECG requirements limit its usability for all ICD patients. The extravascular ICD (EV-ICD) has attempted to provide a solution using a substernal lead position and warrants further investigation into its usability. Recent innovations of modular ICD therapy, combining the S-ICD with a leadless pacemaker, that communicate to deliver painless anti-tachycardia pacing and single chamber pacing could be the comprehensive solution.</div><div>This review examines the strengths and limitations of these ICD technologies, drawing on current available data in 2025. We critically appraise the literature and discuss perspectives on recent evidence in ICD studies.</div><div>As technology advances, the selection of the type of ICD should be guided by the risk and benefit, particularly with the perceived lower benefit from more modern medical management and programming. Patients should be fully informed of the risks and benefits of devices that they are being offered, guided by evidence. With the expanding capabilities of modern ICDs and remote monitoring, the future of ICD therapy maybe increasingly customisable and tailored for the individual.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 1-8"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329213","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":"Cardinal aspects of treatment to control hypertension in India-2022 (CATCH 22): A survey on arterial hypertension management in young Indian adults: A report from cardiology society of India","authors":"Debabrata Roy ,&nbsp;Nitish Naik ,&nbsp;Dilip Kumar ,&nbsp;Mohsin Raj Mantoo ,&nbsp;P.S. Banerjee ,&nbsp;Punit Srivastava ,&nbsp;Vijay Harikisan Bang ,&nbsp;Pratap Chandra Rath ,&nbsp;Rakesh Yadav ,&nbsp;P.K. Asokan ,&nbsp;D.P. Sinha","doi":"10.1016/j.ihj.2025.11.001","DOIUrl":"10.1016/j.ihj.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>India has a high burden of premature cardiovascular disease, with early-onset hypertension being a key driver. However, real-world data on hypertension management in young Indian adults remain limited.</div></div><div><h3>Objectives</h3><div>To evaluate physician practices in diagnosing and treating hypertension among Indian adults aged 18–45 years, with a focus on guideline concordance, lifestyle interventions, and comorbidity-specific treatment choices.</div></div><div><h3>Methods</h3><div>A nationwide, web-based survey of 3,289 physicians was conducted from December 2022 to August 2023 using a 22-point questionnaire. An additional module collected anonymized data on 8,195 hypertensive patients. Analyses included descriptive statistics and logistic regression to assess factors associated with BP control (&lt;130/80 mmHg).</div></div><div><h3>Results</h3><div>Most physicians (66 %) managed over five young hypertensive patients monthly. While lifestyle advice was commonly given (&gt;80 %), no structured programs or adherence tracking were used. Monotherapy was initiated in 49 % of cases, with β-blockers prescribed in 32 %, despite guidelines favoring dual therapy with ARBs, ACE inhibitors, or CCBs. Only 27 % of physicians reported BP control in &gt;50 % of their patients. Among patients, 65 % achieved target BP; 34.6 % had target organ damage. Positive predictors of BP control included male gender, private-sector care, and fruit/vegetable intake, while longer disease duration and target organ damage were associated with poorer control.</div></div><div><h3>Conclusions</h3><div>Hypertension management in young Indian adults shows substantial deviations from global guidelines. Overuse of monotherapy, β-blockers, and lack of structured lifestyle support underscore the need for practice transformation to improve long-term cardiovascular outcomes.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 25-31"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523241","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":"Prediction of incident heart failure and/or re-hospitalization using different risk predictor models in Indian patients","authors":"Anupam Kumar ,&nbsp;Aditya Kapoor ,&nbsp;S. Harikrishnan ,&nbsp;Arpita Katheria ,&nbsp;Harshit Khare ,&nbsp;Arshad Nazir ,&nbsp;Ankit Kumar Sahu ,&nbsp;Roopali Khanna ,&nbsp;Sudeep Kumar ,&nbsp;Naveen Garg ,&nbsp;Satyendra Tewari","doi":"10.1016/j.ihj.2025.09.005","DOIUrl":"10.1016/j.ihj.2025.09.005","url":null,"abstract":"<div><h3>Background and aims</h3><div>Accurate prediction of incident heart failure (HF), risk of recurrent HF or hospitalization are essential for optimizing patient outcomes. Seeing the rising trends of HF in Indians, the present study assessed the applicability of 5 different HF risk scores in these patients.</div></div><div><h3>Methods and results</h3><div>Of the 280 patients recruited, 159 (55.7 %) had HF Stage A, B while 121 (44.3 %) had asymptomatic or symptomatic HF (HF Stage C, D). At 30 ± 7.5 months, new onset HF occurred in 32.07 % and in Stage C/D HF patients, rehospitalization was noted in 37.1 % and 8.9 % died. The incidence of new-onset HF increased incrementally with higher Health ABC scores (13.7, 31.4 and 52.9 % in score 5–10 %, 10–20 %, &gt;20 % respectively). Amongst diabetic patients, TRS-HFDM score strongly predicted new-onset HF (16.7, 30 and 43.3 % in score 1,2 and ≥ 3 respectively). LACE index also accurately predicted events in those with Stage C/D HF: rehospitalization for recurrent HF was 6.6, 44.5 and 48.9 % while mortality was 4, 36 and 60 % in those with LACE index 0–4, 5–9, &gt;9 respectively. Patients without any events had a lower MAGGIC score (19.25 ± 9.56) vs those who died (29.33 ± 8.32). H2FPEF score also performed well: re-hospitalization for HF was 22.2 vs 57.7 % and mortality was 20 vs 72 % in score &lt;2 vs score &gt;2.</div></div><div><h3>Conclusion</h3><div>These easily available risk scores can accurately predict events in Indian patients with HF and should be part of clinical workflow.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 14-19"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174901","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":"Presence of myocardial fibrosis on cardiac MRI and its impact on short-term outcomes in an Asian cohort of heart failure with preserved ejection fraction (HFpEF)","authors":"Sudipta Mondal MD, DM ,&nbsp;Swasthi S. Kumar MD, DM ,&nbsp;Garikapati Vrandha MD, DM ,&nbsp;Ajit Kumar Valaparambil Kumaran MD, DM ,&nbsp;Bijulal Sasidharan MD, DM ,&nbsp;Harikrishnan Sivadasanpillai MD, DM ,&nbsp;Anoop Ayyappan MD ,&nbsp;Jayakrishnan Radhakrishnan MD, DM ,&nbsp;Suprakash Mandal MD","doi":"10.1016/j.ihj.2025.09.003","DOIUrl":"10.1016/j.ihj.2025.09.003","url":null,"abstract":"<div><h3>Backgrounds and objectives</h3><div>This study aims to evaluate the presence and prognostic significance of myocardial fibrosis in subjects with and without HFpEF, using Cardiac MRI.</div></div><div><h3>Methods</h3><div>This was an ambidirectional observational study [mean follow-up: 25 months], selecting HFpEF patients and comparing them with an age and sex-matched control arm without HF. Late gadolinium-enhanced (LGE) imaging and T1 mapping were used to assess fibrosis.</div></div><div><h3>Results</h3><div>LGE (27 % vs 0 %, <em>p = 0.005</em>) and mid-segment (1062 ± 64 ms vs 1020±8 ms, p &lt; 0.001) or total average (1057 ± 70 ms vs 1020±4 ms, p = 0.006) T1 values were significantly higher in HFpEF group (N = 30) compared to the control group. However, there was no significant difference in T2 values (p = 0.657).</div><div>53.3 % of our patients with HFpEF had a clinical event (HF hospitalization, stroke or all-cause mortality) during the follow-up. It was found that average mid-segment (1099 ± 67 ms vs 1019 ± 17 ms, <em>p&lt;0.001</em>) and total average (1101 ± 70 ms vs 1007 ± 15 ms, <em>p&lt;0.001</em>) T1 values were significantly higher in the event group compared to the no-event group. There were no differences in LGE prevalence between event and no-event groups. However, LGE negative cases had significantly increased T1 values in all segments compared to the healthy control group (<em>p&lt;0.</em>001).</div></div><div><h3>Conclusions</h3><div>Higher T1 values but not T2 values , were associated with the HFpEF group compared to the age and sex-matched control group. Focal fibrosis, as evident by LGE, was significantly more in HFpEF. Among HFpEF patients, high T1 myocardial values were associated with a higher rate of all-cause death, stroke, and HF hospitalization in short-term follow-up.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 1","pages":"Pages 32-39"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148787","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}