Pradeep Rongali, K. Jain, Srikanth Nakka, Achukatla Kumar
Patients with post-myocardial infarction (MI) are more likely to die later from heart failure (HF), arrhythmic events, or reinfarction. According to recent studies, mortality rates were noticeably higher in women, than in men. This has been linked to variations in age, comorbidities, symptom presentation, and pathophysiology of the underlying coronary artery disease. There is little information on how these typical gender disparities affect post- MI survival. Studies on individuals with coronary artery disease have primarily focused on men, with women typically being left out of most series. Despite the relatively high prevalence of ischemic heart disease in women, there is a lack of information regarding the clinical course of the condition, its management, and clinical outcomes in this particular population due to the underrepresentation of women in the medical literature in this field. The gender disparities in post-MI patients who present with HF will be briefly discussed in this article. A total of 50 patients that presented with HF and had a previous history of MI were included in this study after taking consent. After taking history and detailed physical examination, investigations that were sent were reviewed and the subjects followed up in the hospital stay to look for outcomes. The data are compiled and subjected to statistical analysis. It is observed that among the 50 subjects, 32% of them had recurrent HF (13 of the 30 females and three of the 20 males). p = 0.04 is statistically significant. Among the study subjects, the hospital outcomes observed showed that, out of 50 subjects, 47 subjects recovered and the other three died in hospital stay. All the three deaths are women. p = 0.15 is not statistically significant. This study concludes that women are more likely than males to require hospitalization for recurrent HF following a MI. This study also demonstrates that, despite the higher risk of recurrent HF, women do not have a higher mortality risk than males.
{"title":"Gender Differences in Heart Failure Hospitalization Post-Myocardial Infarction","authors":"Pradeep Rongali, K. Jain, Srikanth Nakka, Achukatla Kumar","doi":"10.25259/mm_ijcdw_471","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_471","url":null,"abstract":"\u0000\u0000Patients with post-myocardial infarction (MI) are more likely to die later from heart failure (HF), arrhythmic events, or reinfarction. According to recent studies, mortality rates were noticeably higher in women, than in men. This has been linked to variations in age, comorbidities, symptom presentation, and pathophysiology of the underlying coronary artery disease. There is little information on how these typical gender disparities affect post- MI survival. Studies on individuals with coronary artery disease have primarily focused on men, with women typically being left out of most series. Despite the relatively high prevalence of ischemic heart disease in women, there is a lack of information regarding the clinical course of the condition, its management, and clinical outcomes in this particular population due to the underrepresentation of women in the medical literature in this field. The gender disparities in post-MI patients who present with HF will be briefly discussed in this article.\u0000\u0000\u0000\u0000A total of 50 patients that presented with HF and had a previous history of MI were included in this study after taking consent. After taking history and detailed physical examination, investigations that were sent were reviewed and the subjects followed up in the hospital stay to look for outcomes. The data are compiled and subjected to statistical analysis.\u0000\u0000\u0000\u0000It is observed that among the 50 subjects, 32% of them had recurrent HF (13 of the 30 females and three of the 20 males). p = 0.04 is statistically significant. Among the study subjects, the hospital outcomes observed showed that, out of 50 subjects, 47 subjects recovered and the other three died in hospital stay. All the three deaths are women. p = 0.15 is not statistically significant.\u0000\u0000\u0000\u0000This study concludes that women are more likely than males to require hospitalization for recurrent HF following a MI. This study also demonstrates that, despite the higher risk of recurrent HF, women do not have a higher mortality risk than males.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84344226","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}
The objectives of this study were to compare levels of NT-proBNP in various grades of hypertension, correlate with electrocardiographic criteria of LVH and with diastolic function on echocardiography. This study was conducted on 100 patients attending the cardiology outpatient department of Nizam’s Institute of Medical Sciences, patients satisfying the inclusion criteria were enrolled in this study after taking informed consent. This study includes the patient population with a mean of 54.32 ± 6 years of age. ECG criteria of LVH are more common in patients with Grade 1 (60%) and Grade 2 (89%) hypertension. Patients with higher grades of hypertension have more LV mass which is corresponding to ECG criteria satisfying LVH and more diastolic dysfunction as well as higher NT pro-BNP values.
{"title":"NT-proBNP Levels in Relation to Various Grades of Hypertension – An Observational Study","authors":"Archana Remala, K. Karthikeya","doi":"10.25259/mm_ijcdw_428","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_428","url":null,"abstract":"\u0000\u0000The objectives of this study were to compare levels of NT-proBNP in various grades of hypertension, correlate with electrocardiographic criteria of LVH and with diastolic function on echocardiography.\u0000\u0000\u0000\u0000This study was conducted on 100 patients attending the cardiology outpatient department of Nizam’s Institute of Medical Sciences, patients satisfying the inclusion criteria were enrolled in this study after taking informed consent.\u0000\u0000\u0000\u0000This study includes the patient population with a mean of 54.32 ± 6 years of age. ECG criteria of LVH are more common in patients with Grade 1 (60%) and Grade 2 (89%) hypertension.\u0000\u0000\u0000\u0000Patients with higher grades of hypertension have more LV mass which is corresponding to ECG criteria satisfying LVH and more diastolic dysfunction as well as higher NT pro-BNP values.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89034161","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}
Sarita Rao, Roshan Rao, S. Burgess, Achukatla Kumar
Complex coronary artery disease with severe coronary calcification can be challenging to treat, with a higher risk of procedural complications and major adverse cardiac events. Intravascular lithotripsy (IVL) is a pioneering technology for the treatment of critically calcified coronaries. IVL utilizing localized pulsatile sonic pressure waves at low pressure provides a novel approach for lesion preparation of severely calcified plaques. The deliverability and ease of use are also likely to increase access and use of IVL, and combination therapy with other devices shows promise.
{"title":"Shock Wave Intravascular Lithotripsy: Shock the Rock","authors":"Sarita Rao, Roshan Rao, S. Burgess, Achukatla Kumar","doi":"10.25259/ijcdw_16_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_16_2022","url":null,"abstract":"Complex coronary artery disease with severe coronary calcification can be challenging to treat, with a higher risk of procedural complications and major adverse cardiac events. Intravascular lithotripsy (IVL) is a pioneering technology for the treatment of critically calcified coronaries. IVL utilizing localized pulsatile sonic pressure waves at low pressure provides a novel approach for lesion preparation of severely calcified plaques. The deliverability and ease of use are also likely to increase access and use of IVL, and combination therapy with other devices shows promise.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72940126","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":"Is NT-proBNP a Valuable Marker for Risk Stratification in Hypertensive Patients?","authors":"Bhupinder Singh, Suraj Kumar","doi":"10.25259/ijcdw_9_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_9_2022","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77019095","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}
Chaitra Doddamadaiah, Veena Nanjappa, Hema Raveesh, D. Javaregowda, K. Sadananda, M. Nanjappa
Acute coronary syndrome (ACS) is the leading cause of death in women. There are limited studies exclusively in Indian women presenting with ACS. This is the first largest study in south Indian women. To assess Demographic, clinical and angiographic profile of women with ACS. We collected data regarding baseline clinical, demographics, laboratory investigations, electrocardiogram, echocardiographic assessment, coronary angiogram details, treatment data, and outcomes in women presenting with ACS. Majority were in the age group between 55 and 65 year (35.886%). Most common comorbidity seen in our study group is hypertension (59.90%), followed by Diabetes milletus (DM) (54.80%). ACS patients most frequently presented with ST-elevation myocardial infarction (STEMI)-AWMI in postmenopausal group, premenopausal women presented more commonly with non-STEMI. Though SVD is the most common presentation in our study, TVD is most commonly seen in premenopauasal (25.45%) compared to postmenopausal women (11.81%). Hypertension is the most common comorbidity seen in our study group, followed by DM. STEMI is the most common presentation. Higher mortality is seen in patients presenting late to the hospital and with higher Killip’s class. More studies are needed in women with ACS.
{"title":"Clinical and Angiographic Profile of Women with Acute Coronary Syndrome from a Large Tertiary Cardiac Care Center in South India – An Observational Study","authors":"Chaitra Doddamadaiah, Veena Nanjappa, Hema Raveesh, D. Javaregowda, K. Sadananda, M. Nanjappa","doi":"10.25259/mm_ijcdw_349","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_349","url":null,"abstract":"\u0000\u0000Acute coronary syndrome (ACS) is the leading cause of death in women. There are limited studies exclusively in Indian women presenting with ACS. This is the first largest study in south Indian women. To assess Demographic, clinical and angiographic profile of women with ACS.\u0000\u0000\u0000\u0000We collected data regarding baseline clinical, demographics, laboratory investigations, electrocardiogram, echocardiographic assessment, coronary angiogram details, treatment data, and outcomes in women presenting with ACS.\u0000\u0000\u0000\u0000Majority were in the age group between 55 and 65 year (35.886%). Most common comorbidity seen in our study group is hypertension (59.90%), followed by Diabetes milletus (DM) (54.80%). ACS patients most frequently presented with ST-elevation myocardial infarction (STEMI)-AWMI in postmenopausal group, premenopausal women presented more commonly with non-STEMI. Though SVD is the most common presentation in our study, TVD is most commonly seen in premenopauasal (25.45%) compared to postmenopausal women (11.81%).\u0000\u0000\u0000\u0000Hypertension is the most common comorbidity seen in our study group, followed by DM. STEMI is the most common presentation. Higher mortality is seen in patients presenting late to the hospital and with higher Killip’s class. More studies are needed in women with ACS.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79437473","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":"Do Gender Differences in Medicine Really Matter?","authors":"V. Gupta","doi":"10.25259/ijcdw_10_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_10_2022","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78823656","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}
Veena Nanjappa, Hema Raveesh, Ashwini Kuldeep, Sadanand K. S, M. C. N
Higher testosterone and lower Estrogen levels are associated with cardiovascular disease in women. However, studies on endogenous sex hormones and acute coronary syndrome (ACS) in pre-menopausal women are sparse. We studied 50 pre-menopausal women presenting with ACS and age-matched controls who consented to the study with Testosterone, Estradiol, and Sex hormone-binding globulin (SHBG) levels at baseline. They were clinically followed up for 6 months duration. The mean age was 37.42 ± 5.7 years. 48% patients were obese. The mean body mass index was 27.53 ± 5.41 kg/m2. Hypertension followed by Diabetes was the most common risk factor. 14% had family history of coronary artery disease (CAD). 24% had atypical chest pain at presentation. Anterior wall ST elevation myocardial infarction was the most common presentation. Single-vessel disease was seen in 38%; 24% had Non-Obstructive CAD. Ratios of Bioavailable Testosterone: Estradiol, Estradiol: Low-density Lipoprotein (LDL), Estradiol: High-density Lipoprotein, SHBG: LDL, and SHBG: HbA1c were analyzed in cases and controls and were not found to be significantly associated. Endogenous sex hormones were not found to be significantly associated with ACS in premenopausal women.
{"title":"Study of Acute Coronary Syndrome in Premenopausal Women in Correlation with Sex Hormones","authors":"Veena Nanjappa, Hema Raveesh, Ashwini Kuldeep, Sadanand K. S, M. C. N","doi":"10.25259/mm_ijcdw_485","DOIUrl":"https://doi.org/10.25259/mm_ijcdw_485","url":null,"abstract":"\u0000\u0000Higher testosterone and lower Estrogen levels are associated with cardiovascular disease in women. However, studies on endogenous sex hormones and acute coronary syndrome (ACS) in pre-menopausal women are sparse.\u0000\u0000\u0000\u0000We studied 50 pre-menopausal women presenting with ACS and age-matched controls who consented to the study with Testosterone, Estradiol, and Sex hormone-binding globulin (SHBG) levels at baseline. They were clinically followed up for 6 months duration.\u0000\u0000\u0000\u0000The mean age was 37.42 ± 5.7 years. 48% patients were obese. The mean body mass index was 27.53 ± 5.41 kg/m2. Hypertension followed by Diabetes was the most common risk factor. 14% had family history of coronary artery disease (CAD). 24% had atypical chest pain at presentation. Anterior wall ST elevation myocardial infarction was the most common presentation. Single-vessel disease was seen in 38%; 24% had Non-Obstructive CAD. Ratios of Bioavailable Testosterone: Estradiol, Estradiol: Low-density Lipoprotein (LDL), Estradiol: High-density Lipoprotein, SHBG: LDL, and SHBG: HbA1c were analyzed in cases and controls and were not found to be significantly associated.\u0000\u0000\u0000\u0000Endogenous sex hormones were not found to be significantly associated with ACS in premenopausal women.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81499601","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":"Pregnancy with Mechanical Heart Valves – A Complete Interplay of Dose and Anticoagulation","authors":"Rajivkumar Gupta","doi":"10.25259/ijcdw_14_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_14_2022","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83805734","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":"Women In Cardiology And Related Sciences","authors":"","doi":"10.25259/ijcdw_7_4_228","DOIUrl":"https://doi.org/10.25259/ijcdw_7_4_228","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80802772","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}
Sudden cardiac arrest (SCA) and its consequence sudden cardiac death (SCD) are the common cardiac pathway for death. Often, the cause is not found and the inability to delineate the underlying process presents a major public health challenge. Although CAD represents the most common cause of SCD, arrhythmias are an important cause of the same as these patients present with fewer premonitory symptoms and often go undetected. Inherited arrhythmia syndromes represent a challenge due to limited availability of widespread genetic testing and known pathogenic genetic mutations. One such gene is ABCC9 gene, which encodes the SUR2 subunit of the ATP sensitive potassium channel or KATP channel. Mutations in KATP channel are associated with wide range of inherited diseases. Gain-of-function mutations are associated with Cantu syndrome characterized by hypertrichosis and acromegaloid facial features. Loss-of-function mutations are associated with Brugada syndrome and dilated cardiomyopathy. Here, we report a patient with a likely pathogenic mutation in the ABCC9 gene, identified by whole exome sequencing. The male proband came with multiple episodes of syncopal events and palpitations found to have advanced atrioventricular block. This case highlights the consequences of KATP channel dysfunction in the cardiovascular system.
{"title":"ABCC9 Associated Symptomatic Advanced Atrioventricular Block in a Patient with Significant Family History of Sudden Cardiac Death: A Case Report","authors":"J. Maddury, Aditya Sharma, S. Imran","doi":"10.25259/ijcdw_2_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_2_2022","url":null,"abstract":"Sudden cardiac arrest (SCA) and its consequence sudden cardiac death (SCD) are the common cardiac pathway for death. Often, the cause is not found and the inability to delineate the underlying process presents a major public health challenge. Although CAD represents the most common cause of SCD, arrhythmias are an important cause of the same as these patients present with fewer premonitory symptoms and often go undetected. Inherited arrhythmia syndromes represent a challenge due to limited availability of widespread genetic testing and known pathogenic genetic mutations. One such gene is ABCC9 gene, which encodes the SUR2 subunit of the ATP sensitive potassium channel or KATP channel. Mutations in KATP channel are associated with wide range of inherited diseases. Gain-of-function mutations are associated with Cantu syndrome characterized by hypertrichosis and acromegaloid facial features. Loss-of-function mutations are associated with Brugada syndrome and dilated cardiomyopathy. Here, we report a patient with a likely pathogenic mutation in the ABCC9 gene, identified by whole exome sequencing. The male proband came with multiple episodes of syncopal events and palpitations found to have advanced atrioventricular block. This case highlights the consequences of KATP channel dysfunction in the cardiovascular system.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75100585","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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