Pakistan Heart Journal最新文献

{"title":"Frequency and Factors Associated with Early Repolarization Changes in ECG in Patients Presenting With Chest Pain","authors":"Anoshi Anoshi, Shakir Zada, K. Khan, Sumera Rajpoot, Poonam Bai, Paras Nazir, Sorath Sorath, Pashmina Kumari","doi":"10.47144/phj.v56i4.2668","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2668","url":null,"abstract":"Objectives: The “early repolarization (ER)” pattern, previously regarded as benign, has recently shown associations with adverse outcomes, including all-cause, arrhythmic and cardiac mortality. This study aimed to assess the prevalence and factors linked to ER changes in the ECG among chest pain patients at a tertiary cardiac center. Methodology: We enrolled 271 patients aged 18-80 with chest pain complaints. Baseline 12-lead ECGs were used to assess the ER pattern. Multivariable binary logistic regression was conducted, and “odds ratios (OR)” with 95% “confidence intervals (CI)” were reported. Results: Of the 271 patients, 162 (59.8%) were male, with a mean age of 55.3 ± 10 years, and 40 (14.8%) were ≤45 years old. The ER pattern was present in 92 (33.9%) patients. The ER pattern was associated with low “body mass index (BMI)” (OR=0.85 [95% CI: 0.77 - 0.94; p=0.002]), shorter T-wave duration (OR=0.99 [95% CI: 0.98 - 1.00; p=0.008]), and lower heart rate (OR=0.94 [95% CI: 0.90 - 0.98; p=0.007]). Additionally, the odds of ER pattern were lower in patients with “ST-elevation myocardial infarction (STEMI)” (OR=0.23 [95% CI: 0.07 - 0.72; p=0.012]) and non-STEMI (OR=0.21 [95% CI: 0.07 - 0.63; p=0.006]) compared to non-cardiac chest pain. Conclusion: Early repolarization is a common ECG pattern in one-third of chest pain patients. Associated factors include low BMI, shorter T-wave duration, and lower heart rate, and it is less frequent in patients with STEMI and non-STEMI.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":" 1069","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136582","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":"Association of Body Mass Index with Peripheral Vascular Resistance","authors":"Urooj Bhatti, Ramesh Kumar, Kavita Bai, K. Laghari, Bheem Soothar, Zoheb Rafique Memon","doi":"10.47144/phj.v56i4.2636","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2636","url":null,"abstract":"Objectives: To determine the relationship of body mass index (BMI) with peripheral circulation in healthy adults. Methodology: This cross-sectional study was carried out at Jamshoro's Liaquat University of Medical and Health Sciences' Physiology Department. The study lasted one year (January to December 2018). One hundred and eighty healthy persons under the age of forty were chosen, including males and females. After calculating the BMI, to determine the peripheral circulation, arterial blood pressure and heart rate (pulse rate) were recorded. Data was analyzed using IBM SPSS version 23.0. Results: A total of one hundred eighty (180) people took part in the study, 94 (52.2%) of whom were men and 86 (47.8%) of whom were women. Participants in the study had an average age of 21.83 5.88 years. The average person weighed 66.12 kg and was 2.85 m tall. Their average body mass index was 25.10±6.55. The pulse rate (beats/minute) in underweight, normal, overweight, and obese were 73.85±6.17, 73.56±6.04, 76.66±6.72, and 78.85±6.85, respectively (p<0.01). The mean arterial pressures in underweight, normal weight, overweight, and obese were 87.08±6.70, 85.72±8.15, 91.20±6.57 and 94.59±8.14mmHg respectively (p<0.01) Mean pulse pressure in BMI groups mentioned above were also statistically significant (p<0.01), i.e., 36.32±6.43, 39.12±8.12, 40.33±6.78 and 43.49±6.67mmHg respectively. Similarly, systolic BP (mmHg) in underweight, normal weight, overweight, and obese were 111.32±9.31, 113.17±10.41, 120.86±9.23 and 127.23±10.77 respectively (p<0.01). Conclusion: Peripheral vascular resistance varies in accordance with body mass index, but no variation is noted on the basis of gender. In the present study, mean systolic and diastolic BP were significantly different on the basis of difference in BMI.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"108 34","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139133815","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":"Obesity from Clinical Evaluation to Management Local Perspective","authors":"Tariq Ashraf, Rafat Sultana, Asif Nadeem, M. Lashari","doi":"10.47144/phj.v56i4.2704","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2704","url":null,"abstract":"For over two millennia, physicians have been aware of the morbidity and mortality linked to overweight and obesity. Various definitions of obesity, as outlined by the World Health Organization (WHO) and the Centers for Disease Control & Prevention (CDC), utilize the Body Mass Index (BMI) to characterize these conditions. Screening for high-risk patients is crucial for guiding lifestyle changes, treatment decisions, and risk reduction strategies.1,2 The assessment involves clinical and laboratory studies to categorize the type and severity of obesity, forming the foundation for effective management. Globally, the prevalence of obesity in 2015 exhibited a rising trend in females compared to males. Between 1980 and 2015, the prevalence surged from 11.1% to 38.3% for males aged 25 to 29 in low to middle-income countries.3 Pakistan ranks tenth among 188 countries, with half of its population classified as overweight or obese. Alarming projections from the World Obese Federation estimate that 5.4 million Pakistani school-aged children will grapple with obesity by 2030, emphasizing the dual challenges of overnutrition and poor nutrition.4,5 World Health Organization data indicates that 58.1% of Pakistanis are overweight, with 43.9% classified as obese. Asian cutoffs, though not globally recognized, suggest that 72.3% of Pakistanis are overweight, with obesity affecting 58.1% of the population. Research by Danielle H. Bodicoat et al. suggests an obesity threshold of 25 kg/m2 for South Asian individuals, coupled with a very high Waist Circumference (WC).6 A WC ≥ 31 inches (80cm) in Asian females and ≥ 35 inches (90cm) in Asian males is considered abnormal. The primary rationale for managing obesity is to mitigate morbidity, including conditions like diabetes, hypertension, dyslipidemia, heart disease, stroke, sleep apnea, and cancer, ultimately reducing mortality. The initial step in managing obesity involves screening to determine the degree of overweight using BMI and waist circumference measurements. However, studies reveal that only 6% of individuals receive ongoing care for weight management, such as prescriptions for obesity medication or referrals to dieticians.7,8 BMI classifications, primarily based on cardiovascular disease (CVD) risk, may underestimate risks for conditions like diabetes in the Asian population. Beyond BMI, measuring waist circumference is essential for identifying adults at increased risk for morbidity and mortality, especially in the BMI range of 25 to 35 kg/m2.9 In addition to physical examinations, measurements of fasting glucose (or glycated hemoglobin [A1C]), thyroid-stimulating hormone (TSH), liver enzymes, and fasting lipids should be conducted.10 Investigating the causes of obesity involves ruling out a sedentary lifestyle, increased caloric intake, and secondary factors. Medical history should include inquiries about medications that cause weight gain and smoking cessation. Weight loss interventions are recommended for","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"121 23","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139134775","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 Retrospective Chart Review of the Head-Up Tilt Table Test at a Tertiary Care University Hospital","authors":"Rizwan Zafar, Mohammad Asad Ali Saleem, A. Niazi, Arsalan Ahmad, Aamir Naseer, Danish Hassan Khan","doi":"10.47144/phj.v56i4.2606","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2606","url":null,"abstract":"Objectives: Syncope is a non-traumatic and self-limiting transient loss of consciousness (TLOC) caused by momentary cerebral hypo-perfusion. It can be classified into orthostatic, cardiac, and vasovagal etiologies, distinguished using the up-tilt table test (HUTT). Our objective was to determine the characteristics of patients undergoing HUTT for TLOC. Methodology: We conducted a single-center retrospective chart review of patients aged > 16 years who underwent HUTT from January 2010 to March 2020 at the cardiology and neurology departments of Shifa International Hospital, Islamabad, Pakistan. Charts were reviewed for basic demographic data and indications and outcomes of HUTT. Results: Our study included 496 patients with 72.2% males and a mean age of 51.1 ± 19.08 years. Vasovagal syncope was the most common etiology (79.8%, 158), followed by orthostatic syncope (11.6%, 23), autonomic syncope (6.1%, 12) and postural orthostatic tachycardia syndrome (2.5%, 5). Vasovagal syncope was divided into three subtypes, with the most common being mixed type (82.3%, 130), followed by pure vasodepressor (14.6%, 23) and cardio-inhibitory (3.2%, 5). The two most common prodromal symptoms were loss of consciousness (45.8%, 227) with or without preceding dizziness, followed by dizziness alone (34.5%, 171). Both symptoms had a statistical significance when compared to the diagnostic yield of HUTT testing (p<0.05). No significant correlation (p>0.05) was found between presenting symptoms, age, gender, and HUTT outcomes. Conclusion: The most common etiology of syncope is vasovagal, predominantly the mixed type. LOC and dizziness were significantly associated with the HUTT yield.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"63 8","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139131045","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":"Left Ventricular Apical Pseudoaneurysm: A Case Report Incidental Diagnosis and Management","authors":"Shakeela Naz, Mariam Naz, Parveen Akhter, Sabha Bhatti","doi":"10.47144/phj.v56i4.2649","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2649","url":null,"abstract":"Left ventricular pseudoaneurysm (LVPA) is a rare and life-threatening condition characterized by “an outpouching resulting from a rupture in the ventricular free wall.” We present a case with a history of myocardial infarction and left ventricular (LV) apical thrombus who presented with worsening dyspnea. Echocardiography revealed LVPA with bidirectional flow, confirmed by cardiac CT. He underwent successful surgical repair of LVPA and coronary artery bypass grafting. LVPA is associated with significant morbidity and mortality, so early diagnosis is crucial. This case report highlights the successful management of LVPA, underscoring the importance of prompt diagnosis and multidisciplinary care.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":" 3","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136303","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":"Improving Quality Health Care Services by Implementing DMAIC Approach in Paediatric Cardiology Department of Public Hospital of Sindh, Pakistan: A Case Study","authors":"Faheem Shaikh, Abdul Sattar Shaikh, Muhammad Mutasim Billah Tufail, Hussain Bux, Veena Kumari","doi":"10.47144/phj.v56i4.2504","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2504","url":null,"abstract":"Objectives: The hospital industry has changed its dimension from diagnosis to complete total patient satisfaction. This study aims to identify the critical variables that can enhance overall patient satisfaction in the hospital industry. The study identified three critical factors for any hospital to provide quality service. Methodology: The study adopted the lean Six Sigma process improvement methodology to identify the critical service factors in hospitals. Lean Six Sigma is a flexible problem-solving tool that comprehensively solves any problem. DMAIC process improvement methodology is used to define, measure, analyze, improve, and control the overall experience in the hospital. CTQ (critical to quality) was defined and represented by Kano methodology. After filtration through cause and effect analysis, three core dimensions and 25 sub-dimensions of critical quality were identified. The impacts of these 25 sub-dimensions were evaluated and prioritized using the Kano Model of patient satisfaction. This identifies the most critical service requirement. This study is an initiative for service quality improvement in the hospital industry. In the future, this technique can be modified and adopted by different public and private hospitals to enhance the practical implementation. Results: Findings indicate that healthcare organizations demonstrate enhanced system-wide capabilities, optimizing resource utilization. Understanding patient needs propels satisfaction and delight. Three overarching factors, with 25 sub-factors, significantly impact patient satisfaction, predominantly yielding positive effects across the categories. Conclusion: This research concludes that providing quality service is critical in the hospital industry. Quality service is pivotal in the evolving hospital industry, transitioning from a focus on diagnosis to holistic patient satisfaction. This study aims to identify critical variables essential for enhancing overall patient satisfaction, pinpointing key factors crucial for delivering quality service in any hospital.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"106 17","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139133609","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 Effects of Xanthine Oxidase Inhibitors on the Management of Cardiovascular Diseases","authors":"K. Ashiq, Sana Ashiq, Khaled Alsubari","doi":"10.47144/phj.v56i4.2633","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2633","url":null,"abstract":"Cardiovascular diseases (CVDs) are the fastest-growing cause of death around the world, and atherosclerosis plays a major role in the etiology of CVDs. The most recent figures show that the total number of CVD patients worldwide surged from 271 million in 1990 to 523 million in 2019. Furthermore, globally, the number of fatalities caused by coronary artery disease (CAD) went up from 1.2 million in 1990 to 18.6 million in 2019.1 The morbidity and mortality rates for patients with heart failure (HF) are still too high, despite being given the therapy according to the recommended guidelines.2 HF strains the public health system, so better treatment options are required. According to different studies, in HF, the manifestation of ventricular and vascular remodeling, as well as the progression of the illness, may be influenced by elevated oxidative stress.3,4 The most prevalent form of inflammatory arthritis in the world, gout, correlates with CVDs and is a standalone predictor of all-cause death.5,6 An important therapeutic target and potential contributor to oxidative stress is the enzyme xanthine oxidase (XO). Oxidative stress is a state in which there is excessive production of reactive oxygen species (ROS). The key generators of ROS are oxidant-producing enzymes, which are increased in various disease conditions.7 Superoxide and uric acid (UA) are produced due to increased XO activity during purine metabolism. In addition to being the primary cause of gout, elevated xanthine oxidase is also to blame for several clinical illnesses linked to hyperuricemia, such as cardiovascular disorders, diabetes, chronic wounds, and Alzheimer's disease. Numerous studies have shown a direct connection between high urate levels and CVDs. The generation of urate crystals is a complicated process. Since the same enzyme that makes urate also causes the creation of ROS. According to some research, the urate molecule can scavenge in vitro free radicals and acute urate infusions help at-risk population restore their endothelial function.8,9 More and more evidence suggests that XO activity plays a significant role in target organ damage and tissue destruction rather than UA itself. The formation of UA requires the xanthine oxidoreductase (XOR) enzyme, and XOR is composed of XO and xanthine dehydrogenase (XDH). By posttranslational modification, XDH is transformed into XO, which catalyzes the final two steps of the processes that change hypoxanthine into xanthine and xanthine into UA. During this process, superoxide and hydrogen peroxide are produced. As a result, ROS can be produced when XO is activated, which might cause tissue damage. Nitric oxide (NO) and circulating XO can directly interact when the latter binds to vascular cells, causing NO levels to drop and peroxynitrite levels to rise. On the other hand, uric acid transporters (UATs) have been identified to mediate the effects of serum UA on vascular endothelial cells or smooth muscle cells, as URAT1 is only expr","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"1 18","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139135716","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":"Novel Oral Anticoagulants in Cardiovascular Practice","authors":"Syed Haseeb, Raza Naqvi, H. N. Tun, F. A. Cader, Jolanda Sabatino, Madiha Fatima","doi":"10.47144/phj.v56i4.2618","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2618","url":null,"abstract":"In the recent era of medicine, Novel Oral Anticoagulants (Apixaban, Dabigatran, Edoxaban, and Rivaroxaban) have become the preferred drugs for long-term anticoagulation therapy in the majority of cardiovascular conditions, along with non-cardiac co-morbid conditions with few necessary exceptions. This preference is based on their easy availability, therapeutic efficacy, all-cost effectiveness, safety profile, and more convenient usage for both patients and clinicians. Novel Oral Anticoagulants (NOACs) have different pharmacokinetics and pharmacodynamics than oral vitamin K antagonists. This article highlights the basic pharmacology, common complications, available antidotes, and the utility of NOACs in different common cardiovascular diseases requiring long-term oral anticoagulation, including stroke prevention in valvular and non-valvular atrial fibrillation, coronary artery disease, myocardial infarction, left ventricular thrombus and cerebrovascular attacks. NOACs are still underutilized in cardiovascular practice because the concomitant co-morbid conditions hinder a clinician from prescribing these drugs confidently. This manuscript will provide a brief critical overview to help clinicians prescribe NOACs more conveniently.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"119 47","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139135136","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":"Comparison of Cardiovascular Disease-Related Mortality and Morbidity in Urban and Rural Residential Areas in Jatinangor Subdistrict, West Java, Indonesia: An Epidemiological Community Study","authors":"B. Tiksnadi, Kurnia Wahyudi, Rien Afrianti, Yulia Sofiatin, F. Y. Fihaya, Maulana Ibrahim, N. F. Tarsidin, Lisda Amalia, Rully MA Roesli, Rizki Akbar","doi":"10.47144/phj.v56i4.2582","DOIUrl":"https://doi.org/10.47144/phj.v56i4.2582","url":null,"abstract":"Objectives: Residential areas are considered part of the sociocultural aspect for determining health but are rarely studied in a cardiovascular disease-community study in developing countries. Jatinangor, considered a university area, has unique characteristics surrounded by urban and rural villages. We aim to investigate the association of residential areas in Jatinangor with cardiovascular morbidity and mortality. Methodology: A cross-sectional study from July to November 2018 was done in appointed rural and urban areas in Jatinangor district, West Java, Indonesia. Cardiovascular disease is defined using a self-reported questionnaire. Cardiovascular death was identified through a verbal autopsy performed by a general practitioner as an interviewer. The morbidity data were obtained from September to October 2018, while the mortality data were obtained from July to November 2018. Poisson regression was done to determine the association of residential areas to cardiovascular disease morbidity. Results: Data were obtained from 1469 respondents; 58.7% were from rural areas. The prevalence of cardiovascular disease morbidity is higher in urban than rural areas (5.6% vs. 2.5%, p=0.004). There were 42 cases of death reported during the study period, with 33 deaths considered caused by cardiovascular disease. The urban-rural differences in cardiovascular mortality showed no significant differences (p=0.388). The unadjusted model of the association of the urban-rural residential area with cardiovascular disease morbidity was (PR 2.253 (95% CI 1.262, 4.024)) while the adjusted model was (PR 2.264 (95% CI 1.257, 4.078, p = 0.007)). Conclusion: Urban area is associated with two times higher cardiovascular disease morbidity but not with mortality than those who live in rural areas.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"117 27","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139135438","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 Comparative Study of Sub-Specialty Selection Among Adult Cardiology Fellows: Does Gender Play a Role?","authors":"Reema Qayoom, Z. Mumtaz, Faisal Qadir, Abdul Mueed, Ghulam Kubra, Muhammad Mohsin","doi":"10.47144/phj.v56isupplement_2.2680","DOIUrl":"https://doi.org/10.47144/phj.v56isupplement_2.2680","url":null,"abstract":"Objectives: This study is aimed to determine the factors that influence the selection of sub-specialty training among adult cardiology FITs and whether this differs by gender. Methodology: A multiple-choice online survey was conducted on 198 cardiology Fellows-in-training (FITs) in Pakistan from January-May 2023 to assess the determinants of their career paths in clinical cardiac electrophysiology, interventional cardiology, cardiac imaging, and critical care. The survey tool was used for data collection. Results: A total of 198 FITs completed the survey; 36% anticipated specializing in interventional cardiology (IC), 28% in Electrophysiology (EP), 12% in critical care (CC), 15% in cardiac imaging (CI) and 9% were unsure. Among IC and CC group, there was male FIT dominance (70% and 54% respectively) and likelihood of getting employment after completing training was most important factor in both sub-specialties (P <0.001) . Among EP and CI group, there was predominance of women FIT (76% and 56% respectively). The most important factor that influenced FITs to pursue EP was a strong interest in the field and female role model (P <0.001), while for CI minimal radiation exposure and flexibility in job were important factors (all P<0.001). Conclusion: Female FITs are less inclined to choose interventional cardiology as future career path because of increased radiation exposure and old-boys club. Conversely there is growing trend for female FITS inclination towards choosing Electrophysiology, this is in contrast to similar study conducted internationally.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":"19 3","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139267682","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}