Optical coherence tomography (OCT) has better resolution than that of intravascular ultrasound. OCT provides vital information during percutaneous coronary intervention (PCI) procedure and is associated with better procedural and inhospital outcomes along with improved survival rate. In the present article, we have investigated three special cases including anomalous separate origin of the left circumflex artery at our hospital. We have reported the feasibility and safety of OCT-guided PCI in these three cases.
{"title":"Feasibility and Safety of Optical Coherence Tomography-Guided Percutaneous Coronary Intervention in Technically Challenging Lesions: A Case Series","authors":"Rajesh Pandey","doi":"10.4103/jicc.jicc_67_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_67_21","url":null,"abstract":"Optical coherence tomography (OCT) has better resolution than that of intravascular ultrasound. OCT provides vital information during percutaneous coronary intervention (PCI) procedure and is associated with better procedural and inhospital outcomes along with improved survival rate. In the present article, we have investigated three special cases including anomalous separate origin of the left circumflex artery at our hospital. We have reported the feasibility and safety of OCT-guided PCI in these three cases.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649888","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":"Multistaged closure of bilateral multiple pulmonary arteriovenous fistula","authors":"M. Panja, M. Panja, A. Singhi","doi":"10.4103/jicc.jicc_57_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_57_21","url":null,"abstract":"","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"31 1","pages":"46 - 47"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90177909","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}
Background: Hypothyroidism is a common endocrine disorder in the general population. Most of the cardiovascular and neurological manifestations of hypothyroidism are due to autonomic dysfunction. The American Academy of Neurology has recommended simple bedside autonomic function tests for the diagnosis and follow-up of autonomic functions. Recognition of autonomic dysfunction and treatment of hypothyroidism may improve cardiovascular outcomes. This study aims to assess autonomic dysfunction in hypothyroidism and correlate it with serum thyroid-stimulating hormone (TSH) levels. Materials and Methods: This cross-sectional study was conducted on 60 patients diagnosed with hypothyroidism for 12 months at a tertiary care center in Southern India. Patients with a Zulewski clinical score over 5 and fulfilling the selection criteria were included in the study after obtaining written informed consent. Details of history, treatment, examination, and thyroid function tests data were collected and bedside tests for autonomic functions were performed. Results: Ninety percent of individuals were female, and the average age of the included study population was 40.38 ± 11.78 years. Based on TSH and FT4 values, the patients were subgrouped into currently euthyroid and overt hypothyroid individuals. The majority of the individuals (81.67%) included in the study had autonomic dysfunction. Based on the autonomic dysfunction score, there was a significantly higher proportion of overt hypothyroid individuals (n = 18) with severe autonomic dysfunction compared to euthyroid individuals (n = 4). About 75% of the study individuals had sympathetic dysfunction and 66.7% of individuals had parasympathetic dysfunction. There was no statistically significant association between autonomic dysfunction and the duration of hypothyroidism. Conclusion: Autonomic dysfunction in hypothyroidism is common; sympathetic dysfunction was observed more as compared to parasympathetic dysfunction.
{"title":"Autonomic functions in hypothyroidism","authors":"A. Jose, Roshan Maroli, P. George","doi":"10.4103/jicc.jicc_15_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_15_22","url":null,"abstract":"Background: Hypothyroidism is a common endocrine disorder in the general population. Most of the cardiovascular and neurological manifestations of hypothyroidism are due to autonomic dysfunction. The American Academy of Neurology has recommended simple bedside autonomic function tests for the diagnosis and follow-up of autonomic functions. Recognition of autonomic dysfunction and treatment of hypothyroidism may improve cardiovascular outcomes. This study aims to assess autonomic dysfunction in hypothyroidism and correlate it with serum thyroid-stimulating hormone (TSH) levels. Materials and Methods: This cross-sectional study was conducted on 60 patients diagnosed with hypothyroidism for 12 months at a tertiary care center in Southern India. Patients with a Zulewski clinical score over 5 and fulfilling the selection criteria were included in the study after obtaining written informed consent. Details of history, treatment, examination, and thyroid function tests data were collected and bedside tests for autonomic functions were performed. Results: Ninety percent of individuals were female, and the average age of the included study population was 40.38 ± 11.78 years. Based on TSH and FT4 values, the patients were subgrouped into currently euthyroid and overt hypothyroid individuals. The majority of the individuals (81.67%) included in the study had autonomic dysfunction. Based on the autonomic dysfunction score, there was a significantly higher proportion of overt hypothyroid individuals (n = 18) with severe autonomic dysfunction compared to euthyroid individuals (n = 4). About 75% of the study individuals had sympathetic dysfunction and 66.7% of individuals had parasympathetic dysfunction. There was no statistically significant association between autonomic dysfunction and the duration of hypothyroidism. Conclusion: Autonomic dysfunction in hypothyroidism is common; sympathetic dysfunction was observed more as compared to parasympathetic dysfunction.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"136 1","pages":"23 - 28"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86311544","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}
M. Al-Daydamony, M. El-Shaer, Hany Abdel‐Latif, Moataz El-Sanan
Background: Cardiac arrhythmias had a significant association with the increased mortality rate in COVID-19 patients in hospitals. The present study aimed to evaluate the frequency of supraventricular arrhythmias in COVID-19 patients and to assess the echocardiographic parameters and inflammatory biomarkers in COVID-19 patients who developed supraventricular arrhythmias. Methods: This cross-sectional study enrolled 196 patients, 33 of them developed supraventricular arrhythmias during hospitalization in Zagazig University isolation hospital. Results: There was a statistically significant association between the occurrence of atrial fibrillation (AF) and both oxygen saturation and lymphocyte percentage, which was significantly lower in those with AF. There was a statistically significant association between the occurrence of AF and CORADS, C-reactive protein (CRP), and interleukin-6, which were significantly higher in those with AF. Younger age and higher oxygen saturation decreased the risk of supraventricular tachycardia among the studied patients. Increasing oxygen saturation decreased the risk of AF among the studied patients, while higher CRP significantly increased risk by 1.045 folds. Conclusions: Atrial arrhythmias, especially with AF considered prevalent in cases with COVID-19. The atrial arrhythmias were correlated with higher cardiac injury and inflammatory markers and elevated severe COVID-19 clinical manifestations. Regarding mortality in-hospital, the association between COVID-19 and atrial arrhythmias was independent.
{"title":"Frequency of supraventricular arrhythmias in COVID-19 patients: A single-center study","authors":"M. Al-Daydamony, M. El-Shaer, Hany Abdel‐Latif, Moataz El-Sanan","doi":"10.4103/jicc.jicc_13_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_13_22","url":null,"abstract":"Background: Cardiac arrhythmias had a significant association with the increased mortality rate in COVID-19 patients in hospitals. The present study aimed to evaluate the frequency of supraventricular arrhythmias in COVID-19 patients and to assess the echocardiographic parameters and inflammatory biomarkers in COVID-19 patients who developed supraventricular arrhythmias. Methods: This cross-sectional study enrolled 196 patients, 33 of them developed supraventricular arrhythmias during hospitalization in Zagazig University isolation hospital. Results: There was a statistically significant association between the occurrence of atrial fibrillation (AF) and both oxygen saturation and lymphocyte percentage, which was significantly lower in those with AF. There was a statistically significant association between the occurrence of AF and CORADS, C-reactive protein (CRP), and interleukin-6, which were significantly higher in those with AF. Younger age and higher oxygen saturation decreased the risk of supraventricular tachycardia among the studied patients. Increasing oxygen saturation decreased the risk of AF among the studied patients, while higher CRP significantly increased risk by 1.045 folds. Conclusions: Atrial arrhythmias, especially with AF considered prevalent in cases with COVID-19. The atrial arrhythmias were correlated with higher cardiac injury and inflammatory markers and elevated severe COVID-19 clinical manifestations. Regarding mortality in-hospital, the association between COVID-19 and atrial arrhythmias was independent.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"25 11","pages":"16 - 22"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91437435","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}
Akhil Mehrotra, Ajay Sharma, M. Shadab, O. Prakash, Shubham Kacker
Background: Interrelationship of arterial stiffness with diastolic impairments of left ventricle (LV) in healthy population has been reported in several studies; however, to the best of our knowledge, no study till date has evaluated the relationship of aortic stiffness, with LV diastolic, systolic, and strain components, in healthy adults, by conventional, tissue Doppler imaging, and speckle-tracking echocardiography. Materials and Methods: Fifty-eight healthy participants were recruited (38 males and 20 females), and their mean age was 30.53 ± 12.22 years and 35.25 ± 10.61 years, respectively. A detailed assessment of aortic stiffness and elasticity, LV systolic, diastolic, and strain parameters was performed by the ingenious technology of four-dimensional XStrain echocardiography. Moreover, Pearson's correlation coefficient was employed to investigate the association of aortic stiffness with LV diastolic, systolic, and strain functions. Results: A significant relationship was documented between aortic stiffness and a number of parameters of LV diastolic and systolic functions. On the contrary, there was an insignificant trend of positive or negative correlation of aortic stiffness with LV strain. Conclusion: This is the first study to document the correlation between aortic stiffness and various LV functions in healthy adults.
{"title":"Four-dimensional XStrain echocardiography: Correlation of aortic stiffness with left ventricular diastolic, systolic, and strain parameters in healthy adults – A single-center Indian perspective","authors":"Akhil Mehrotra, Ajay Sharma, M. Shadab, O. Prakash, Shubham Kacker","doi":"10.4103/jicc.jicc_30_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_30_22","url":null,"abstract":"Background: Interrelationship of arterial stiffness with diastolic impairments of left ventricle (LV) in healthy population has been reported in several studies; however, to the best of our knowledge, no study till date has evaluated the relationship of aortic stiffness, with LV diastolic, systolic, and strain components, in healthy adults, by conventional, tissue Doppler imaging, and speckle-tracking echocardiography. Materials and Methods: Fifty-eight healthy participants were recruited (38 males and 20 females), and their mean age was 30.53 ± 12.22 years and 35.25 ± 10.61 years, respectively. A detailed assessment of aortic stiffness and elasticity, LV systolic, diastolic, and strain parameters was performed by the ingenious technology of four-dimensional XStrain echocardiography. Moreover, Pearson's correlation coefficient was employed to investigate the association of aortic stiffness with LV diastolic, systolic, and strain functions. Results: A significant relationship was documented between aortic stiffness and a number of parameters of LV diastolic and systolic functions. On the contrary, there was an insignificant trend of positive or negative correlation of aortic stiffness with LV strain. Conclusion: This is the first study to document the correlation between aortic stiffness and various LV functions in healthy adults.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"68 1","pages":"29 - 39"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83124609","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}
We did a retrospective analysis of 102 coronary angiograms for coronary dominance. Right-dominant circulation was seen in 62 (60.8%) patients, whereas left-dominant and codominant circulation was seen in 25 (24.5%) and 15 (14.7%) patients, respectively. Regarding gender variations, among males 71.42% had right-dominant circulation, where it was left dominant in 20.63% and codominant in 7.93%. For females, right-dominant circulation was present in 43.59% of patients, and left-dominant and codominant circulation was present in 30.77% and 25.64% of patients, respectively.
{"title":"Coronary Dominance Pattern: An Angiography-based Preliminary Report from Eastern India","authors":"Avishek Bagchi","doi":"10.4103/jicc.jicc_14_23","DOIUrl":"https://doi.org/10.4103/jicc.jicc_14_23","url":null,"abstract":"We did a retrospective analysis of 102 coronary angiograms for coronary dominance. Right-dominant circulation was seen in 62 (60.8%) patients, whereas left-dominant and codominant circulation was seen in 25 (24.5%) and 15 (14.7%) patients, respectively. Regarding gender variations, among males 71.42% had right-dominant circulation, where it was left dominant in 20.63% and codominant in 7.93%. For females, right-dominant circulation was present in 43.59% of patients, and left-dominant and codominant circulation was present in 30.77% and 25.64% of patients, respectively.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649883","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}
GanthalaPaul Kiran, T. Santosh, Grace John, MSrinivasa Rao
Background: Right ventricular (RV) dysfunction is a potent predictor of mortality and morbidity after acute myocardial infarction (MI). Even though elective percutaneous coronary intervention (PCI) has significantly decreased myocardial damage of the left ventricle; in literature, there has been a lack of information regarding the effect of PCI on RV function. Objective: The objective of this study is to examine the effect of the right coronary artery (RCA) revascularization on systolic and diastolic functions of the right ventricle following acute inferior wall MI (IWMI). Subjects and Methods: Fifty-nine patients diagnosed with acute IWMI following RCA revascularization were prospectively investigated between April 2018 and January 2020. Patients were subjected to two-dimensional echocardiography. RV systolic and diastolic functions were reported before and after the PCI procedure and compared using different echocardiographic RV systolic and diastolic parameters. Results: After PCI, echocardiographic RV systolic and diastolic functions were significantly improved in proximal and mid RCA in terms of tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and early RV filling velocity/late RV filling velocity (E/A). Significant improvement was found in mid RCA in terms of peak systolic (S') velocity (P = 0.008) and proximal RCA in terms of early RV filling velocity/early diastolic tricuspid annulus velocity (E/e') (P = 0.021). Overall echocardiographic systolic and diastolic parameters in patients with RV dysfunction following PCI were improved (TAPSE [37.29% vs. 81.82%], S' velocity [37.29% vs. 68.18%], RVFAC [33.90% vs. 90.00%], and E/A [33.90% vs. 75.00%]). Conclusions: Patients with RV dysfunction were remarkably improved after RCA revascularization. Hence, RCA revascularization can become an appropriate treatment alternative for the recovery of patients who suffer from RV dysfunction.
背景:右心室功能障碍是急性心肌梗死(MI)后死亡率和发病率的有效预测因子。尽管选择性经皮冠状动脉介入治疗(PCI)显著降低了左心室的心肌损伤;在文献中，缺乏关于PCI对RV功能影响的信息。目的:探讨急性下壁心肌梗死(IWMI)后右冠状动脉(RCA)血运重建术对右心室收缩和舒张功能的影响。对象和方法:在2018年4月至2020年1月期间，对59例经RCA血运重建术诊断为急性IWMI的患者进行前瞻性调查。患者接受二维超声心动图检查。报告PCI手术前后左室收缩和舒张功能，并使用不同的超声心动图右室收缩和舒张参数进行比较。结果:PCI术后，超声心动图右心室收缩和舒张功能在三尖瓣环面收缩偏移(TAPSE)、右心室分数面积改变(RVFAC)和早期右心室充盈速度/晚期右心室充盈速度(E/A)方面均显著改善。中期RCA在峰值收缩速度(S')方面有显著改善(P = 0.008)，近端RCA在早期RV充盈速度/舒张早期三尖瓣环速度(E/ E ')方面有显著改善(P = 0.021)。左室功能障碍患者PCI术后超声心动图收缩期和舒张期总参数均有改善(TAPSE [37.29% vs. 81.82%]， S' velocity [37.29% vs. 68.18%]， RVFAC [33.90% vs. 90.00%]， E/A [33.90% vs. 75.00%])。结论:RCA血运重建术后右心室功能障碍患者有明显改善。因此，RCA血运重建术可以成为右心室功能障碍患者康复的一种合适的治疗选择。
{"title":"Impact of percutaneous coronary intervention in the right coronary artery on right ventricular function in patients with acute myocardial infarction","authors":"GanthalaPaul Kiran, T. Santosh, Grace John, MSrinivasa Rao","doi":"10.4103/jicc.jicc_16_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_16_22","url":null,"abstract":"Background: Right ventricular (RV) dysfunction is a potent predictor of mortality and morbidity after acute myocardial infarction (MI). Even though elective percutaneous coronary intervention (PCI) has significantly decreased myocardial damage of the left ventricle; in literature, there has been a lack of information regarding the effect of PCI on RV function. Objective: The objective of this study is to examine the effect of the right coronary artery (RCA) revascularization on systolic and diastolic functions of the right ventricle following acute inferior wall MI (IWMI). Subjects and Methods: Fifty-nine patients diagnosed with acute IWMI following RCA revascularization were prospectively investigated between April 2018 and January 2020. Patients were subjected to two-dimensional echocardiography. RV systolic and diastolic functions were reported before and after the PCI procedure and compared using different echocardiographic RV systolic and diastolic parameters. Results: After PCI, echocardiographic RV systolic and diastolic functions were significantly improved in proximal and mid RCA in terms of tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and early RV filling velocity/late RV filling velocity (E/A). Significant improvement was found in mid RCA in terms of peak systolic (S') velocity (P = 0.008) and proximal RCA in terms of early RV filling velocity/early diastolic tricuspid annulus velocity (E/e') (P = 0.021). Overall echocardiographic systolic and diastolic parameters in patients with RV dysfunction following PCI were improved (TAPSE [37.29% vs. 81.82%], S' velocity [37.29% vs. 68.18%], RVFAC [33.90% vs. 90.00%], and E/A [33.90% vs. 75.00%]). Conclusions: Patients with RV dysfunction were remarkably improved after RCA revascularization. Hence, RCA revascularization can become an appropriate treatment alternative for the recovery of patients who suffer from RV dysfunction.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"29 1","pages":"11 - 15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74389827","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}
Background: There is a constant search across the globe for optimal healthcare solutions with affordability, accessibility, availability, and quality of healthcare services being the burning issue for mankind. The pandemic has further necessitated the need of use of the Telemedicine platform to address healthcare issues which are also non Covid related. Though Telemedicine has been in use for over two decades in India, there have been various challenges and adoption issues which have not yet made the technology an effective solution to address the current healthcare issues. There has been phenomenal growth in the Information and Communication Technology (ICT) over the last decade and its utilization in the healthcare field. Methods: Internet research on the various adoption strategies by healthcare providers coupled with our own experience for using this technology along with guidelines provided by the information and communication technology providers. The Telemedicine Guidelines of 2020 released by the Ministry of Health and Family welfare, India, provides a framework for the implementation of healthcare delivery through this technology. Results: This paper mentions our telemedicine experience in governmental and private institutes and highlights the implementation challenges of this technology and some solutions that made a difference in the execution. However, we discuss to a larger extent the possible challenges and barriers in the implementation of this technology in India. Conclusion: Despite successful work in the field of telemedicine, it is yet to become an integral part of healthcare system because challenges related to adaptability of healthcare users and lack of proper training to fast growing technologies. The future is going to compel the usage of this kind of technology and it is essential for setting up infrastructure and having trained personnel to man these departments to encash the full potential of the telemedicine technology.
{"title":"Challenges in the implementation of telemedicine","authors":"P. Raju, Prasad Sistla","doi":"10.4103/jicc.jicc_22_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_22_21","url":null,"abstract":"Background: There is a constant search across the globe for optimal healthcare solutions with affordability, accessibility, availability, and quality of healthcare services being the burning issue for mankind. The pandemic has further necessitated the need of use of the Telemedicine platform to address healthcare issues which are also non Covid related. Though Telemedicine has been in use for over two decades in India, there have been various challenges and adoption issues which have not yet made the technology an effective solution to address the current healthcare issues. There has been phenomenal growth in the Information and Communication Technology (ICT) over the last decade and its utilization in the healthcare field. Methods: Internet research on the various adoption strategies by healthcare providers coupled with our own experience for using this technology along with guidelines provided by the information and communication technology providers. The Telemedicine Guidelines of 2020 released by the Ministry of Health and Family welfare, India, provides a framework for the implementation of healthcare delivery through this technology. Results: This paper mentions our telemedicine experience in governmental and private institutes and highlights the implementation challenges of this technology and some solutions that made a difference in the execution. However, we discuss to a larger extent the possible challenges and barriers in the implementation of this technology in India. Conclusion: Despite successful work in the field of telemedicine, it is yet to become an integral part of healthcare system because challenges related to adaptability of healthcare users and lack of proper training to fast growing technologies. The future is going to compel the usage of this kind of technology and it is essential for setting up infrastructure and having trained personnel to man these departments to encash the full potential of the telemedicine technology.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"9 1","pages":"178 - 183"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86568909","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}
Objective: The objective of the study is to evaluate the prevalence of metabolic syndrome (MS) and its clinical and angiographic profile in patients with naive acute coronary syndrome (ACS). Furthermore, this study tried to evaluate the severity of coronary artery disease in patients with and without MS. Methods: This was a single-center, cross-sectional study which prospectively enrolled 500 patients with naive ACS during the period from January 2017 to December 2018 at a tertiary care center in India. They were divided into two groups according to the presence and absence of MS based on revised NCEP ATP III guidelines. The ACS was defined based on the Joint Committee of the American College of Cardiology. After clinical evaluation and investigations, the prevalence of MS in ACS patients was calculated. Results: Prevalence of MS in this study was 46.2% and was more frequent in males (81%) compared to females (19%). Maximum number of patients with MS were between the age group of 40–59 years (55%). Prevalence of diabetes (56.7%), hypertension (58.0%), and smoking (45.88%) were significantly higher in patients with MS (P < 0.001). Most prevalent components of MS were low high-density lipoprotein (HDL) levels, increased blood pressure, fasting blood sugar, and triglyceride levels (P < 0.001). Conclusion: Prevalence of MS was high in patients with ACS and was more often after the age of 40 years and most commonly seen in males. Low HDL levels, increased blood pressure, and blood sugar were most prevalent components in the criteria for MS. Patients with MS tend to have more complex coronary lesions.
目的:本研究的目的是评估代谢综合征(MS)的患病率及其在初发急性冠脉综合征(ACS)患者中的临床和血管造影特征。此外，本研究试图评估患有和不患有ms的患者冠状动脉疾病的严重程度。方法:这是一项单中心横断面研究，在2017年1月至2018年12月期间，在印度的一家三级医疗中心前瞻性地招募了500名原发性ACS患者。根据修订后的NCEP ATP III指南，根据是否存在MS分为两组。ACS是根据美国心脏病学会联合委员会定义的。经临床评估和调查，计算ACS患者中MS的患病率。结果:本研究中多发性硬化症的患病率为46.2%，男性(81%)高于女性(19%)。MS患者的最大数量在40-59岁之间(55%)。糖尿病患病率(56.7%)、高血压患病率(58.0%)、吸烟患病率(45.88%)在多发性硬化症患者中显著升高(P < 0.001)。MS最常见的成分是低高密度脂蛋白(HDL)水平、血压升高、空腹血糖和甘油三酯水平(P < 0.001)。结论:MS在ACS患者中患病率较高，以40岁以后多见，以男性多见。低HDL水平、血压升高和血糖是MS标准中最普遍的组成部分，MS患者往往有更复杂的冠状动脉病变。
{"title":"Prevalence of metabolic syndrome and its clinical and angiographic profile in patients with naive acute coronary syndrome","authors":"Anil Kumar, P. Surhonne, R. Reddy, M. Nanjappa","doi":"10.4103/jicc.jicc_64_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_64_21","url":null,"abstract":"Objective: The objective of the study is to evaluate the prevalence of metabolic syndrome (MS) and its clinical and angiographic profile in patients with naive acute coronary syndrome (ACS). Furthermore, this study tried to evaluate the severity of coronary artery disease in patients with and without MS. Methods: This was a single-center, cross-sectional study which prospectively enrolled 500 patients with naive ACS during the period from January 2017 to December 2018 at a tertiary care center in India. They were divided into two groups according to the presence and absence of MS based on revised NCEP ATP III guidelines. The ACS was defined based on the Joint Committee of the American College of Cardiology. After clinical evaluation and investigations, the prevalence of MS in ACS patients was calculated. Results: Prevalence of MS in this study was 46.2% and was more frequent in males (81%) compared to females (19%). Maximum number of patients with MS were between the age group of 40–59 years (55%). Prevalence of diabetes (56.7%), hypertension (58.0%), and smoking (45.88%) were significantly higher in patients with MS (P < 0.001). Most prevalent components of MS were low high-density lipoprotein (HDL) levels, increased blood pressure, fasting blood sugar, and triglyceride levels (P < 0.001). Conclusion: Prevalence of MS was high in patients with ACS and was more often after the age of 40 years and most commonly seen in males. Low HDL levels, increased blood pressure, and blood sugar were most prevalent components in the criteria for MS. Patients with MS tend to have more complex coronary lesions.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"1 1","pages":"162 - 167"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86458525","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}
Background: The incidence of coronary artery disease in the young is constantly rising. Understanding the outcomes of percutaneous coronary intervention (PCI) in young adults is necessary. This study aims to assess the procedural outcomes, inhospital and 1 year clinical outcomes of PCI in the young (<40-year-old). Methods: This is a prospective, observational study carried out in the Department of Cardiology at Nizam's Institute of Medical Sciences. The study included all subjects ≤40 years of age and has undergone PCI from January 1, 2019 to December 31, 2019 in our institute. Results: The study included 207 patients with a mean age of 36.01 ± 3.72 years and 72.46% males. Acute coronary syndrome was seen in 79.2% patients with ST elevation myocardial infarction (STEMI) being the most common. The median time interval of presentation in STEMI was 12–48 h (73%). Major adverse cardiac events (MACE) over 1-year were seen in 3.8% patients. Severe left ventricular (LV) dysfunction at presentation was an independent factor for acute (P = 0.04) and 1-year mortality (P = 0.0058). It was also associated with angina and chronic heart failure (CHF). Slow flow was significantly associated with mortality (P = 0.0254) and adverse 1 year outcomes. It was significantly associated with persistent LV dysfunction and recurrent CHF. Conclusion: Success rate after PCI is high in the young. 1 year outcome is very good with low mortality and MACE events. Severe LV dysfunction and slow flow are independent predictors of poor prognosis at 1 year.
{"title":"Outcomes of Percutaneous Coronary Intervention in the Young","authors":"Satya Lakshmi Vanaparty, Lalita Nemani, Jahangir Sheik","doi":"10.4103/jicc.jicc_8_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_8_22","url":null,"abstract":"Background: The incidence of coronary artery disease in the young is constantly rising. Understanding the outcomes of percutaneous coronary intervention (PCI) in young adults is necessary. This study aims to assess the procedural outcomes, inhospital and 1 year clinical outcomes of PCI in the young (<40-year-old). Methods: This is a prospective, observational study carried out in the Department of Cardiology at Nizam's Institute of Medical Sciences. The study included all subjects ≤40 years of age and has undergone PCI from January 1, 2019 to December 31, 2019 in our institute. Results: The study included 207 patients with a mean age of 36.01 ± 3.72 years and 72.46% males. Acute coronary syndrome was seen in 79.2% patients with ST elevation myocardial infarction (STEMI) being the most common. The median time interval of presentation in STEMI was 12–48 h (73%). Major adverse cardiac events (MACE) over 1-year were seen in 3.8% patients. Severe left ventricular (LV) dysfunction at presentation was an independent factor for acute (P = 0.04) and 1-year mortality (P = 0.0058). It was also associated with angina and chronic heart failure (CHF). Slow flow was significantly associated with mortality (P = 0.0254) and adverse 1 year outcomes. It was significantly associated with persistent LV dysfunction and recurrent CHF. Conclusion: Success rate after PCI is high in the young. 1 year outcome is very good with low mortality and MACE events. Severe LV dysfunction and slow flow are independent predictors of poor prognosis at 1 year.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"29 1","pages":"173 - 177"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73899578","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}
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