{"title":"I look into the chest: History and evolution of stethoscope","authors":"Rony Vincent","doi":"10.4103/jpcs.jpcs_77_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_77_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816797","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}
Introduction: Cardiac resynchronization therapy (CRT) has revolutionized the treatment of cardiac dyssynchrony in chronic heart failure (HF), yet, complications and failures are reported in some patients. We aim to determine the predictors of response to CRT through clinical, electrocardiographic ECG, and echocardiographic assessment of patients following CRT and recommend the best practices to achieve optimum results for patients. Methodology: We analyzed the history, clinical examination, brain natriuretic peptide (BNP) levels, ECG, and echocardiography findings of 35 patients before CRT and on day 7 and day 180 following CRT. Observations: 71.4% of patients responded to CRT and 28.6% were nonresponders. The responders had fewer hospitalizations for HF. They showed a significant improvement in the New York Heart Association (NYHA) class, mean 6 min walk distance (6MWD), BNP level, QRS duration, and echocardiographic parameters on day 7 and day 180. The duration of HF ≤3 years, NYHA class III–IV symptoms, baseline 6MWD ≥240 m, QRS duration ≥150 ms, LVEF ≥25%, septal to posterior wall motion delay ≥130 ms, and mean pulmonary arterial pressure <50 mmHg were identified as the strong predictors of response to CRT. Recommendations: Patients with symptomatic HF should undergo early CRT to reduce recurrent hospitalizations and those with NYHA Class III–IV symptoms should be offered CRT before the duration of HF exceeds 3 years. BNP levels and echocardiography are invaluable tools to assess outcomes following therapy. A multiparametric, echocardiographic approach is helpful in selecting patients likely to undergo reverse remodeling after CRT and predicting outcomes.
心脏再同步化治疗(CRT)已经彻底改变了慢性心力衰竭(HF)中心脏非同步化的治疗，然而，一些患者出现了并发症和衰竭。我们的目的是通过临床、心电图、超声心动图评估患者对CRT的反应来确定预测因素，并推荐最佳做法，以达到患者的最佳效果。方法:我们分析了35例患者的病史、临床检查、脑钠肽(BNP)水平、心电图和超声心动图的结果，这些患者在CRT前、CRT后第7天和180天。观察:71.4%的患者对CRT有反应，28.6%的患者无反应。应答者较少因心衰住院。在第7天和第180天，他们在纽约心脏协会(NYHA)等级、平均6分钟步行距离(6MWD)、BNP水平、QRS持续时间和超声心动图参数方面均有显著改善。HF持续时间≤3年，NYHA III-IV级症状，基线6MWD≥240 m, QRS持续时间≥150 ms, LVEF≥25%，室间隔到后壁运动延迟≥130 ms，平均肺动脉压<50 mmHg被认为是对CRT反应的强预测因子。建议:有症状的心衰患者应尽早接受CRT治疗，以减少复发住院，有NYHA III-IV级症状的患者应在心衰持续时间超过3年之前接受CRT治疗。BNP水平和超声心动图是评估治疗后预后的宝贵工具。多参数超声心动图方法有助于选择可能在CRT后进行反向重构的患者并预测结果。
{"title":"Predictors of response to cardiac resynchronization therapy: A prospective observational study","authors":"Jignesh Parikh, R. Patil, Ajitkumar Jadhav","doi":"10.4103/jpcs.jpcs_2_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_2_22","url":null,"abstract":"Introduction: Cardiac resynchronization therapy (CRT) has revolutionized the treatment of cardiac dyssynchrony in chronic heart failure (HF), yet, complications and failures are reported in some patients. We aim to determine the predictors of response to CRT through clinical, electrocardiographic ECG, and echocardiographic assessment of patients following CRT and recommend the best practices to achieve optimum results for patients. Methodology: We analyzed the history, clinical examination, brain natriuretic peptide (BNP) levels, ECG, and echocardiography findings of 35 patients before CRT and on day 7 and day 180 following CRT. Observations: 71.4% of patients responded to CRT and 28.6% were nonresponders. The responders had fewer hospitalizations for HF. They showed a significant improvement in the New York Heart Association (NYHA) class, mean 6 min walk distance (6MWD), BNP level, QRS duration, and echocardiographic parameters on day 7 and day 180. The duration of HF ≤3 years, NYHA class III–IV symptoms, baseline 6MWD ≥240 m, QRS duration ≥150 ms, LVEF ≥25%, septal to posterior wall motion delay ≥130 ms, and mean pulmonary arterial pressure <50 mmHg were identified as the strong predictors of response to CRT. Recommendations: Patients with symptomatic HF should undergo early CRT to reduce recurrent hospitalizations and those with NYHA Class III–IV symptoms should be offered CRT before the duration of HF exceeds 3 years. BNP levels and echocardiography are invaluable tools to assess outcomes following therapy. A multiparametric, echocardiographic approach is helpful in selecting patients likely to undergo reverse remodeling after CRT and predicting outcomes.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"35 - 41"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48280777","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}
R. Sankaran, S. Sadhanandham, N. Senguttuvan, T. Muralidharan, V. Balakrishnan, Manokar Panchanatham, Dasarath Boppana, J. Balasubramaniyan
{"title":"Applying resting global longitudinal strain by two-dimensional speckle tracking as a noninvasive diagnostic tool in predicting coronary artery disease","authors":"R. Sankaran, S. Sadhanandham, N. Senguttuvan, T. Muralidharan, V. Balakrishnan, Manokar Panchanatham, Dasarath Boppana, J. Balasubramaniyan","doi":"10.4103/jpcs.jpcs_15_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_15_21","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814762","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}
I. Balouch, K. Khan, SajidAli Shaikh, S. Rasheed, M. Khalid, I. Ahmed, J. Sial, N. Qamar
{"title":"Echocardiographic assessment of left ventricular ejection fraction recovery after primary percutaneous coronary intervention in patients under 40 years of age","authors":"I. Balouch, K. Khan, SajidAli Shaikh, S. Rasheed, M. Khalid, I. Ahmed, J. Sial, N. Qamar","doi":"10.4103/jpcs.jpcs_10_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_10_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814954","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}
Debasish Das, A. Banerjee, Abhinav Kumar, S. Singh, Subhash R. Pramanik
{"title":"An unusual case of isolated symmetric bilateral peripheral artery disease of the radial artery of the index finger in systemic sclerosis: A case report and literature review","authors":"Debasish Das, A. Banerjee, Abhinav Kumar, S. Singh, Subhash R. Pramanik","doi":"10.4103/jpcs.jpcs_20_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_20_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815193","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":"Emotional intelligence","authors":"L. Giray","doi":"10.4103/jpcs.jpcs_35_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_35_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815540","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":"Clinical evaluation of heart failure: A clinical case discussion of a patient with rheumatic heart disease","authors":"M. Mantoo, Vibhav Sharma, S. Chaudhary, S. Seth","doi":"10.4103/jpcs.jpcs_29_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_29_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815590","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}
S. Acharya, Sandeep Kamat, S. Shukla, Anamika Giri, S. Sushanth Kumar
{"title":"Ehlers–Danlos syndrome Type VI with mitral valve prolapse and regurgitation","authors":"S. Acharya, Sandeep Kamat, S. Shukla, Anamika Giri, S. Sushanth Kumar","doi":"10.4103/jpcs.jpcs_40_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_40_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815625","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 report an extremely rare association of left-sided inferior vena cava (IVC) in a 38-year-old female presenting with recurrent palpitation for the past 2 years with typical slow-fast atrioventricular reentrant tachycardia (AVNRT). We delineated the course of the left-sided IVC with pigtail injection and catheter course to the right atrium and successfully modified the slow pathway with conventional catheters with difficulty in ablation catheter maneuvering and his catheter stability was an issue. Our case is the first description of an unusual association of isolated left-sided IVC in a patient with typical AVNRT.
{"title":"An unusual association of left-sided inferior vena cava with slow-fast atrioventricular reentrant tachycardia","authors":"Debasish Das, Tutan Das, Subhash R. Pramanik","doi":"10.4103/jpcs.jpcs_46_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_46_21","url":null,"abstract":"We report an extremely rare association of left-sided inferior vena cava (IVC) in a 38-year-old female presenting with recurrent palpitation for the past 2 years with typical slow-fast atrioventricular reentrant tachycardia (AVNRT). We delineated the course of the left-sided IVC with pigtail injection and catheter course to the right atrium and successfully modified the slow pathway with conventional catheters with difficulty in ablation catheter maneuvering and his catheter stability was an issue. Our case is the first description of an unusual association of isolated left-sided IVC in a patient with typical AVNRT.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"51 - 54"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47532910","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}
Debasish Das, Tutan Das, S. Singh, J. Gupta, Subhash R. Pramanik
We report a rarely encountered case of premature and parallel posterior descending artery (PDA) and posterior left ventricular branch (PLVB) in a case of 22-year-old male with effort angina Class II for the last 6 months in whom treadmill test (TMT) was strongly positive for provocative coronary ischemia with structurally normal heart and good biventricular function. Interestingly, all the coronaries were normal without any obstructive coronary lesion. Paradoxically, those two prematurely separating branches were small making the distal right coronary artery (RCA) territory relatively ischemic attributing toward a strongly positive TMT. Small anomalous coronary is a well-known cause of demand ischemia, but our case is unique to describe small prematurely originating PDA and PLVB were the culprit behind coronary ischemia in a young male without conventional risk factors. Furthermore, much premature separation of PDA and PLVB is rarely encountered in routine clinical practice, and recognition of this anomaly is important as it should not be mistaken for duplicate RCA, dual RCA, or split RCA. Our case is also unique to illustrate the association of the premature and parallel PDA and PLVB with a conus crossing the right ventricular outflow tract without the presence of structural heart disease.
{"title":"A rare case of premature and parallel posterior descending artery and posterior left ventricular branch with conus crossing the right ventricular outflow tract causing provocative coronary ischemia","authors":"Debasish Das, Tutan Das, S. Singh, J. Gupta, Subhash R. Pramanik","doi":"10.4103/jpcs.jpcs_50_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_50_21","url":null,"abstract":"We report a rarely encountered case of premature and parallel posterior descending artery (PDA) and posterior left ventricular branch (PLVB) in a case of 22-year-old male with effort angina Class II for the last 6 months in whom treadmill test (TMT) was strongly positive for provocative coronary ischemia with structurally normal heart and good biventricular function. Interestingly, all the coronaries were normal without any obstructive coronary lesion. Paradoxically, those two prematurely separating branches were small making the distal right coronary artery (RCA) territory relatively ischemic attributing toward a strongly positive TMT. Small anomalous coronary is a well-known cause of demand ischemia, but our case is unique to describe small prematurely originating PDA and PLVB were the culprit behind coronary ischemia in a young male without conventional risk factors. Furthermore, much premature separation of PDA and PLVB is rarely encountered in routine clinical practice, and recognition of this anomaly is important as it should not be mistaken for duplicate RCA, dual RCA, or split RCA. Our case is also unique to illustrate the association of the premature and parallel PDA and PLVB with a conus crossing the right ventricular outflow tract without the presence of structural heart disease.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"45 - 47"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48315418","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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